140 ON THE USE OF NITRITE OF AMYL IN ANGINA PECTOIIIS. 



the pain increases in severity. During the attack the breathing 

 is quick, the pulse small and rapid, and the arterial tension 

 liigh, owing, I believe, to contraction of the systemic capillaries. 

 As the nitrite is inhaled the pulse becomes slower and fuller, 

 the tension diminished, and the breathing less hurried. On 

 those occasions when the pain returned after an interval of a 

 few minutes, the pulse, though showing small tension, remained 

 small in volume, and not till the volume as well as tension of 

 the pulse became normal did I feel sure that the pain would not 

 return. 



As patients who suffer from angina are apt to become 

 plethoric, and greater relaxation of the vessels is then required 

 before the tension is sufficiently lowered, I think it is advisable 

 to take away a few ounces of blood every four weeks. When 

 the remedy is used for a long time, the dose requires to be 

 increased before the effect is produced. A less quantity is 

 sufficient wdien it is used with a •cone of blotting-paper, as 

 recommended by Dr. Eichardson, than when it is poured on a 

 large cloth. Ywin its power of paralysing both nerves and 

 muscles. Dr. Eichardson thinks it may prove useful in tetanus ; 

 and I believe that, by relaxing the spasm of the bronchial tubes, 

 it might be very beneficial in spasmodic asthma. I have tried 

 it in a case of epilepsy, but the duration of the fit seemed little 

 affected by it. It produces relief in some kinds of headache 

 and in one of neuralgia of the scalp it relieved the severe 

 shooting pain, though an aching feeling still remained. 



While cholera was present in Edinburgh during last autumn, 

 Dr. Gamgee proposed it as a remedy during the stage of 

 collapse, a condition in which there are good grounds for 

 supposing that the small arteries, both systemic and pulmonic, 

 are in a state of great contraction. No well-marked case after- 

 wards occurring in the town, he was deprived of an opp(>rtunity 

 of putting it to the test ; but it is a medicine well worthy of a 

 trial, and, should anotlier epidemic unhappily occur, it may 

 prove our most valuable remedy. 



