North Carolina Medical Journal. Vol. 3. No. 4. April, 1879 — John Shaqi
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879Various
Science
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879
Various
Medicine -- North Carolina -- Periodicals; Medicine -- Periodicals
Despite the gravity of the symptoms, I felt only a slight degree of
alarm, when I considered the improbability of so small a dose of morphia
proving fatal. Being compelled to leave, I merely directed the
attendants to keep up circulation, by friction of the extremities. At 3
P. M., the condition of patient was unchanged, except that the
extremities were more difficult to keep warm. Temperature in the axilla
was 97.4°. The breathing was not at all better, and insensibility was,
if possible, even more profound than at my previous visit. I injected
1–20th grain sulph. of atropia under the skin of the forearm, and during
the next hour I made frequent applications of a moderately strong
galvano-faradic current, one pole being placed in the epigastrium and
moved along the insertion of the diaphragm, while the other was pressed
upon the middle of the neck just behind the sterno-mastoid muscle. The
heart’s beat was temporarily strengthened, and respiration slightly
increased in depth and frequency by each application. At 4 P. M., I
injected 1–12th grain of atropia, continuing the use of electricity. At
5 P. M., the circulation appeared to be failing, the pulse being
decidedly weaker and the extremities cold. Respiration was about 15 per
minute, irregular and shallow. The pupils were still obstinately
contracted. I now injected 1–6th grain of atropia and placed a bottle of
hot water under each arm, and a large jug to the feet, still employing
electricity at intervals. At 6 P. M., the change in my patient was
evidently for the worse. To be sure the body was warm (100° F.), but the
pulse at the wrist could only irregularly be felt. The heart contracted
feebly but regularly 115 times per minute. Respiration was more shallow,
although now 18 to 20 per minute. The pupils were unchanged, and there
was absolute insensibility of the conjunctiva. I now injected ¼ grain of
atropia. In twenty minutes the effect of this dose was perceptible. The
pupils were widely dilated, and respiration increased to 30 per minute;
but alas, the heart, although it contracted 130 to 140 times per minute,
failed to convey even the slightest impulse to the wrist. Cyanosis had
disappeared but the insensibility continued.
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