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There the respiration ! Ordinarily breathe tiroes per minute or thereabouts. There are about residual air in the thorax, and the act respiration takes place normally about times per minute. By such tidal air the residual air kept fairly pure.
But when the ihoratic space encroached upon either by a air in emphysema connective tissue in cirrhosis diminution the calibre the air tubes from thickening the bronchial lining membrane engorgement the bloodvesscb in mitral disease then the respiration must more frequent in order keep the residual air fairly pure.
The stimulus respiration the effect venous blood, laden with carbonic acid, upon the respiratory centre in the medulla. When there an excess carbonic acid in the blood circulating in this centre, then the respiratory efforts are increased in vigour until the excess of carbonic acid got rid.
Now, when the right ventricle embarrassed, not usually enough give digitalis increase the energy the contractions the right ventricle.
Though, course, all medical men much experience have met with striking illustrations the almost magical effects digitalis in the pulmonary engorgement mitral disease many can also tell where digitalis failed afford relief under these circumstances, or even increased the respiratory embarrassment.
Now, rule for sometime past has been under these circumstances mitral lesion, no matter what form with embarrassed respiration, give strychnia, a well recognized respiratory stimulant Here, the effect digitalis upon the right ventricle, and that the strychnia upon the respiratory centre, work together for good with the most satisfac tory results.
The good effects this combination are conclusively demonstrated in those cases where digitalis given alone, fails good but where the addition strychnia at once makes a striking alteration.
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