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Application of the Bio-Assay of Digitalis by the Cat Method To veins have supplied the compensatory circulation necessary for Current Medical Literature the functioning of the heart muscle. Reciprocal Beating of Heart.—The clinical and electro- AMERICAN cardiographic aspects of four cases of reciprocal beating of the heart are recorded The Association library lends periodicals to Fellows of the Association by Blumgart and Gargill and the nature of and to individual subscribers to The Journal in continental United the abnormal mechanism is discussed. In one case the distur¬ States and Canada for a period of three days. Issues of periodicals are bance was sufficiently prolonged to permit extensive pharma¬ kept on file for a period of five years only. Requests for issues of earlier cologie study. This indicated that date cannot be filled. Requests should be accompanied by stamps to study reciprocal beating was cover postage (6 cents if one and 12 cents if two periodicals are requested). influenced mainly by vagai hypertonicity. Periodicals published by the American Medical Association are not avail¬ Circulatory Mechanism in Arterial able for but be order. as Hypertension.—A lending, may supplied on purchase Reprints a is rule are the property of authors and can be obtained for permanent posses¬ study presented by Weiss and Ellis of the circulatory mecha¬ sion only from them. nism in thirty patients with hypertension. Although the aver¬ Titles marked with an asterisk (*) are abstracted below. age resistance of the arteriolar system of the greater circulation was twice as American Heart St. Louis great in the patients as in the normal control Journal, subjects, the circulating blood the cardiac 5: 401-544 (April) 1930 volume, output per minute, the arm to face velocity of the blood and the of Differences in Potency of in Clinical Practice. flow, •Importance Digitalis mean the were J. Wyckofï, H. Gold and J. G. Travell, New York.—p. 401. velocity of circulation either normal or slightly •Complete Occlusion of Both Coronary Orillees: Two Cases. T. Leary below normal. Although the peripheral resistance was increased and J. T. Wearn, Boston.—p. 412. to twice normal, the estimated work of the left ventricle of •Reciprocal Beating of Heart: Electrocardiographic and Pharmacologie the heart in hypertension was only 41 per cent greater than Study. H. L. Blumgart and S. L. Gargill, Boston.—p. 424. in normal Mechanism of Transitions from Auriculoventricular Dissociation to S-A subjects. A satisfactory explanation of the dynamics Rhythm: Relation to Theory of Parasystole. II. L. Blumgart and of the circulation in the patients with hypertension studied is S. L. Gargill, Boston.—p. 437. that, because of the abnormally accentuated arteriolar resis¬ •Quantitative and Dynamics of Mechanism in Arterial Aspects Circulatory tance, a arterial and arteriolar is essential to Hypertension. S. Weiss and L. B. Ellis, Boston.—p. 448. high pressure Disappearance of Intraventricular Heart Block Occurring in Uremia reestablish the normal capillary blood flow and pressure in the Following Intravenous Injection of Hypertonie Dextrose Solution. vital organs. The measurements and observations do not bear N. Moore and H. S. J. Stewart, New York.—p. 469. out the hypothesis that loss of the elasticity of the great •Paroxysmal Tachycardia with Myocardial Lesions: Case. R. H. Major increased and H. R. Wahl, Kansas City, Kan.—p. 477. arteries, cardiac output, increased circulating blood •So-Called Interpolation of Extrasystoles During Idioventricular Rhythm. volume or hypoventilation and decreased blood content of the C. C. Wolferth, Philadelphia.—p. 482. lungs is responsible for the presence of hypertension. The Complete Heart Block Associated with Rapid Ventricular Rate: Two between cardiac arterial B. Bloom and S. Perlow, 486. relationship output, pressure, peripheral Cases. Chicago.—p. resistance •Standstill of Heart of Vagai Origin. A. M. Wedd, Clifton Springs, and capillary circulation determines the nature of N. Y., and D. C. Wilson, Charlottesville, Va.—p. 493. the therapeutic procedures applicable in hypertension. in •Electrocardiographic Changes Quiescent Rheumatic Disease in Chil¬ with dren and Young Adults. M. J. Shapiro, Minneapolis.—p. 504. Paroxysmal Tachycardia Myocardial Lesions.— Al a or Density of Surface Capillary Bed of Forearm in Health, in Arterial j and Wahl have had the opportunity of studying a Hypertension, and in Arteriosclerosis. S. Weiss and W. R. Frazier, patient suffering from paroxysmal tachycardia of auricular Boston.—p. 511. origin, who died during the attack and on whom a Localized Swearing: Sympathetic Reflex Phenomenon in Angina Pectoris. necropsy R. S. Palmer, Boston.—p. 519. was obtained. This patient showed at autopsy an acute and Localized Sweating Replacing Cardiac Pain. E. Holt, New York.— chronic myocarditis. The myocarditis was obviously infectious, p. 522. and the patient's infected tonsils, which were removed approxi¬ Permanent Bradycardia Following Diphtheria: Case. W. D. Reid, Boston.—p. 524. mately one year before the onset of this attack, may have been the portal of entry for the infection. It is interesting that of Differences in Importance Potency of Digitalis in this patient's attacks at first had a sudden onset and a sudden Clinical Practice.—An analysis of the factors involved in the termination and clinically belonged definitely in the group of application the bio-assay of digitalis by the cat method to described by Bouveret, who insisted on this criterion for diag¬ clinical practice is made by Wyckoff et al. Evidence is pre¬ nosis. In this last attack, however, the tachycardia did not sented showing that body weight is a factor in digitalis dosage cease suddenly but gradually, the patient's pulse coming down and that it is essential to take into account differences in the to normal over a period of four days. The duration of this potency of digitalis as determined by bio-assay. It is pointed attack was unusually long, the patient having had the condi¬ out that when small doses of digitalis are used, the value of tion two weeks before admission and being under observation both factors (body weight and differences in potency) may ten days in the hospital—twenty-four days in all. escape detection. An analysis is made of the experience of So-Called Interpolation of Extrasystoles During Idio- of the committee for the study digitalis in pneumonia at Belle¬ ventricular Rhythm.—An electrocardiogram obtained from a vue Hospital with a well known commercial preparation of patient with complete heart block and what might be regarded digitalis, the potency of which was later proved to have been as interpolated extrasystoles is presented by Wolferth. It is incorrectly labeled by the manufacturer. This analysis shows, concluded that, thus far, there has been no proof of the occur¬ in the first place, that a specimen of digitalis which was found rence of interpolated beats during idioventricular rhythm. to be about twice as active as for man anticipated proved to Standstill of Heart of Vagai Origin.—A case is described be also twice as active by the cat method of assay ; and sec¬ by Wedd and Wilson which exhibited permanent nodal rhythm, ondly, the dangers arising from the use of digitalis, especially with periods of standstill of the whole heart and of high grade in large doses, when the exact potency is not known. Evidence bradycardia. The disappearance of these unusual disturbances is presented showing the confusion that arises from the use of rhythm following exercise and atropine is proof of vagai term "standardized a of the digitalis" without statement of the origin. From a consideration of the mental and emotional exact potency, because of the different standards used by make-up of the patient and of the circumstances associated the various manufacturers. The relative merits of so-called with increased vagai tone, it seems certain that the and weaker of primary stronger preparations digitalis are discussed. factor was a psychic one. Complete Occlusion of Both Coronary Orifices.—Two Electrocardiographic Changes in Quiescent Rheumatic cases of essential closure of both coronary orifices are reported Disease in Children and Young Adults. Electrocardio¬ and Wearn. — by Leary The lesions indicated a slowly progres¬ graphic tracings were made by Shapiro in 119 children which had giving sive process probably taken months at least to reach a history of rheumatic disease who were able to attend' school the point of essentially complete closure. No evidences of regularly ; tracings were also made in fifty normal children fatty change, myocarditis or repair were found in the heart who were used as controls. Many of the tracings taken from The muscle. only adequate explanation of the ability of these the children in the so-called quiescent group showed changes patients to live and work rests on a belief that the thebesian similar to those found in acute rheumatic fever, but the changes Downloaded From: http://jama.jamanetwork.com/ by a University of Arizona Health Sciences Library User on 05/29/2015 were found less frequently. tracings taken from chil¬ Better Protection in Vertical Fluoroscopy. J. Belot, Paris, France.— Repeated 859. dren in the showed variations similar to those p. quiescent group Improved Uterine Radium Applicator. H. Swanberg, Quincy, 111. found in the acute group. In the control group the tracings —p. 862. did not vary. The most common and most persistent finding Importance of Urography in Interpretation of Abdominal Symptoms. C. W. Moots and A. H. in this quiescent group was the lack of iso-electric period J. Magoun, Toledo, Ohio.—p. 866. Inflammation of Appendix. E. Hönck, Hamburg, Germany.—p. 872. between the R or S wave and the wave and the marked variability of the R-T or S-T interval from time to time. Cuticular Suture. Tomaiuoli makes a mattress suture, each loop on the surface— passing through a piece of rubber American Journal of Ophthalmology, Chicago tubing one-fourth inch long. It is said to be of special advan¬ 13: 379-472 (May) 1930 tage wherever the scar may show and in the flabby, pendulous New Eye and Hand Method of Training Squints.
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