138 ON THE USE OF NITRITE OF AMYL IN ANGINA PECTORIS. 



have hitherto been chiefly relied upon for the relief of angina 

 pectoris ; but the alleviation which they produce is but slight, 

 and the duration of the attack is but little affected by them. 



In now publishing a statement of the results which I have 

 obtained in the treatment of angina pectoris by nitrite of amyl, 

 I have to observe that the cases in which I employed this 

 remarkable substance belonged rather to the second than the 

 first of the classes above described. 



Nitrite of amyl was discovered by Balard ; and further 

 investigated by Guthrie,* who noticed its property of causing 

 flushing in the face, throbbing of the carotids, and acceleration 

 of the heart's action, and proposed it as a resuscitative in 

 drowning, suffocation, and protracted fainting. 



Little attention, however, was paid to it for some years, till 

 it was again taken up by Dr. B. W. Eichardson, who found that 

 it caused parahsis of the nerves from the periphery inwards, 

 diminished, the contractility of tlie muscles, and caused dilata- 

 tion of the capillaries, as seen in the web of the frog's foot. 



Dr. Arthur Gamgee, in an unpublished series of experiments, 

 both with the sphygmograph and haemadynamometer has found 

 that it greatly lessens the arterial tension both in animals and 

 man ; and it was these experiments — some of which I was 

 fortunate enough to witness — which led me to try it in angina 

 pectoris. 



. During the past winter there has been in the clinical wards 

 one case in which the anginal pain was very severe, lasting 

 from an hour to an hour and a half, and recurring every night, 

 generally between 2 and 4 a.m. ; besides several others in whom 

 the affection, though present, was less frequent and less severe. 

 Digitalis, aconite, and lobelia inflata were given in the intervals, 

 without producing any benefit ; and brandy and other diffusible 

 .stimulants during the fit produced little or no relief. When 

 chloroform was given, so as to produce partial stupefaction, it 

 relieved the pain for the time ; but whenever the senses again 

 became clear, the pain was as bad as before. Small bleedings, 

 of three or, four ounces, whether by cupping or venesection, 

 were, however, always beneficial ; the pain being completely 



* Journal of the Chemical Scciefy, 1859. 



