190 NITRITE OF AMYL IN ANGINA PECTORIS. 



In these tracings, like the others, the patient's position was 

 unchanged, and neither the band nor pressure screw of sphyg- 

 mograph was touched. 



18th. — Pain came three times last night, and was very severe. 

 He has had it during the day three times. The purpuric spots 

 on the legs are much paler. To recommence iodide of 

 potassium. 



2 1 St. — The purpuric spots have reappeared on both legs. To 

 stop the Pot. lod. He had pain last night, but none during the 

 daj'-. 



24th. — Bled to ^iv on account of general uneasiness and 

 powerful pulsations of the heart. The bleeding was immediately 

 followed by a sense of relief. 



28th. — The pain has only been absent one night since the 

 bleeding, but it has been much less severe than before it. The 

 sphygmograph was fixed to his arm to-night in order to take a 

 normal tracing for comparison with one to be taken during the 

 attack. This had scarcely been done when the pain unex- 

 pectedly came on. The tracing (fig. 121, p. 195), though 

 unfortunately very imperfect, shows the diminished volume and 

 increased tension of the pulse. In 2 (fig. 122) the pain was 

 severe, and 3 (fig. 123) was taken after inhalation of ainjl. 



June 1st. — Condition remains the same, spasmodic pain in 

 the cardiac region occurring every night, but not severe, and 

 easily relieved by a few inhalations of nitrite of amyl. Patient 

 wished to resume his former occupation of toll- keeper, and was 

 to-day discharged at his own request. Eecommended to have 

 occasional small bleedings. 



Remarks. — In this case of Dr. Bennett's, which by his kind 

 permission I now publish, we have a history of numerous 

 attacks of rheumatic fever, followed by cardiac lesion, which 

 was accompanied by palpitation of the heart, throbbing in the 

 carotids extending as high as the ears, and a spasmodic pain in 

 the chest. This pain was sometimes most severe near the left 

 nipple, and sometimes at the right border of the sternum, but 

 extended over the whole cardiac region, and shot up to the right 

 ear and down the right arm. It used to come on suddenly 



