54 ON DIGITALIS, WITH SOME OBSERVATIONS ON THE UKINE 



riglit half was dilated, while the lower or left half was con- 

 tracted, and sometimes the auricles did not contract simul- 

 taneously. Finally, when the ventricle completely stopped, 

 one or more palpitating points could still be observed in it. 

 (2.) The second form, which was especially notable in poison- 

 ing by digitaline and green hellebore, consisted in a notable 

 diminution of the number of beats, the heart contracting regu- 

 larly, but very slowly, just as under galvanisation of the vagi. 

 This sometimes happened before peristaltic movements occurred, 

 or even after their appearance. Fagge and Stevenson* found 

 that the beats are not necessarily diminished, and sometimes 

 the ventricle contracted only once for two pulsations of the 

 auricles, and often one part, generally the apex, continued 

 white, and contracted while the rest dilated regularly. They 

 also observed palpitating points such as Dybkowsky and 

 Pelikan had described, and liken them to little crimson pouches 

 on the white contracted ventricle. All these observers found 

 that the ventricle stopped always in a state of firm con- 

 traction. 



(3) Impulse. — The cardiac impulse seems almost invariably 

 to be increased both in the lower animals and man, and becomes 

 abrupt and hammering. 



(4) Sounds. — When digitalis is given in poisonous doses, after 

 the pulse becomes intermittent, a change is noticed in the 

 <5ardiac sounds, there being first a vibratory thrill, and then a 

 l)lowing murmur with the first sound. The first I have not 

 observed ; but Dr. Gamgee felt it in a dog on which I was 

 •experimenting. The blowing murmur with the first sound I 

 have noticed several times. It occurs in horses, dogs, and the 

 human subject, and probably in all mammalia. It is probably 

 due to mitral or tricuspid regurgitation from irregular contraction 

 of the musculi papillares. I noticed it in one dog after section 

 of the vagi and before digitaline was injected; but unfortu- 

 nately, not having listened before dividing them, I cannot say 

 whether or not it was due to their section. 



On the Arterial Tension. — In small doses, digitalis, injected 

 into the veins, causes no cliange, either in the mean 'tension- or 



* ^Proceed. Roy. Soc, vol. xiv, 270. 



