ON TflE USE OF NITEITE OF AMYL IN 

 ANGINA PECTORIS. 



(Eeprinted from The Lancet for July 27th, 18G7.) 



Few things are more distressing to a physician than to siand 

 beside a suffering patient who is anxiously looking to him for 

 that relief from pain which he feels himself utterly unable to 

 afford. His sympathy for the sufferer, and the regret he feels 

 for tlie impotence of his art, engrave tlie picture indelibly on 

 his mind, and serve as a constant and urgent stimulus in his 

 search after the causes of the pain, and the means by which it 

 may be alleviated. 



Perhaps there is no class of cases in which such occurrences 

 as this take place so frequently as in some kinds of cardiac 

 disease, in which angina pectoris forms at once the most promi- 

 nent and the most painful and distressing symptom. This 

 painful affection is defined by Dr. A¥alshe as a paroxysmal 

 neurosis, in which tlie heart is essentially concerned, and the 

 cases included in this definition may be divided into two 

 classes. 



In the first and most typical, there is severe pain in the pre- 

 cordial region, often shooting up the neck and down the arms,, 

 accompanied by dyspnoea, and a most distressing sense of im- 

 pending dissolution. The occurrence and departure of the 

 attack are both equally sudden, and its duration is only a few 

 minutes. 



In the second class, which, from its greater frequency, is 

 probably the more important, though the pain and dyspnoea 

 may both be very great, the occurrence of the attack is some- 

 times gradual, and its departure generally so ; its duration is 

 from a few minutes to an hour and a half or more, and the 

 sense of impending dissolution is less marked or altogether 

 absent. 



Brandy, ether, chloroform, ammonia, nnd other stimulants 



