474 MATER i A MEDIC A AND THERAPEUTICS. 



sion; they lengthen the time of filling the heart, that is, of 

 emptying the veins, thus favouring the venous flow ; they 

 'afford rest to the heart; and they also increase the arterial 

 pressure, not only by filling the aorta tetter, but by stimulating 

 the vaso-motor nerves. They are therefore indicated in that 

 backward dilatation of chamber after chamber, ending in dropsy 

 and visceral congestion, which we have discussed, and as a matter 

 of fact they prove of the very greatest value in practice. 



Removal of effects: Treatment of symptoms. Cardiac pain, 

 oppression, anxiety, and other forms of distress, can be relieved 

 by cardiac sedatives, such as local heat or cold, Opium, 

 Chloral and Belladonna. Of these, Opium is the most powerful, 

 and of the greatest value. We must never forget, however, 

 that in Opium we are administering a dangerous cardiac depres- 

 sant, which paralyses in large doses every part of the circulatory 

 apparatus ; and the same remark applies to Chloral. The per- 

 fection of the therapeutic art is to use these remedies with 

 judgment. The hypodermic injection of Morphia sometimes 

 gives complete relief. Belladonna is a cardiac anodyne much 

 more easily employed, because less depressant ; but is much less 

 efficacious. It is frequently applied locally to the praecqrdium 

 as the Emplastrum. A rubefacient or even slight vesicant 

 effect on the surface of the chest quickly relieves cardiac pain. 

 Pulmonary distress from congestion of the bronchi and alveoli 

 may be specially relieved by stimulant expectorants, such as 

 Ammonia and Scilla, which increase and remove the bronchial 

 flux ; but here again the value of rational treatment is seen in 

 the disappearance of dyspnoea, haemoptysis, cough, and the. 

 physical signs of pulmonary engorgement, under the influence 

 of purely cardiac remedies, such as Digitalis and Alcohol. 

 Dropsy may be immediately relieved by puncture of the part, 

 but like other symptoms disappears rapidly by the veins when 

 the cardiac strength is restored. The same remarks apply ot 

 the visceral congestions and their temporary relief by purga- 

 tives. Diuretics are of great sendee in cardiac dropsy, acting 

 partly by relieving the renal veins (salines), but chiefly by 

 raising the arterial pressure (Digitalis and Scilla), as is fully 

 discussed under the head of The Kidney in chapter xii. 



Haemorrhage Haemostatics. External haemorrhage is 

 readily arrested by surgical means. If the lesion be internal, 

 as in the stomach or lungs, we must trust chiefly to medicinal 

 remedies which are known as haemostatics. 



(a) So far the cardiac depression caused by the haemorrhage 

 may be cautiously encouraged. In every case it is desirable to 

 employ all available means of reducing the force, not the power 

 of the heart, especially bodily and mental rest ; and for this 



