NITRITE OF AMYL IN ANGINA PECTOEIS. 



(Reprinted from the Clinical Society^ s Reports, vol. iii, 1870.) 



\yiLLiAM H — , set. 26 ; formerly a blacksmith, now a toll- 

 keeper, admitted to Ward I, Eoyal Infirmary, Edinburgh, 

 December 7th, 1866. 



Antecedent History. — Patient was strong and healthy till his 

 tenth year, when he was confined to bed for six months by a 

 severe attack of rheumatism. During the next twelve years he 

 had four other less severe attacks, and after recovering from the 

 last of these his feet began to swell during the day. 



In April, 1866, he had a seventh attack, whicli lasted for a 

 month, and six weeks after it was over he noticed an unusual 

 palpitation of his heart, for which he entered the infirmary, and 

 remained there three weeks, but left unrelieved. The palpita- 

 tion gradually increased till he felt it along the line of the 

 carotids as high up as the ears ; and in November last he began 

 to feel besides a dull heavy pain about the left nipple. At first 

 this came on every three days, usually during the night, and 

 lasted half an hour. During tlie day he felt little inconvenience 

 from the palpitation unless he exerted himself. 



On admission, the pain was no longer confined to the region 

 of the left nipple, but was worst along the right border of the 

 sternum, and extended up to the right arm. This pain was 

 more severe if he walked about much, otherwise he felt well. 

 Professor ^laclagan had charge of the clinical wards at this 

 time, and the patient was treated for six weeks with tincture oi 

 aconite, and then with tincture of digitalis ; but under these 

 remedies the pulse became intermittent, and the pain was not 

 relieved by either, and rather aggravated by digitalis. They 

 were therefore discontinued, the digitalis being stopped on 

 January 31st. During their employment wet cupping over the 

 cardiac region to the extent of ^iv temporarily relieved the 

 pain. 



