Harry Taube

Cardiovascular Dynamics, Blood Volumes, Renal Functions and Electrolyte Excretions in the Same Patients during Congestive Heart Failure and after Recovery of Cardiac Compensation

Largely on the basis of acute observations in cardiac patients during congestive heart failure and in noncardiac control subjects, two assumptions have been made: (a) that congestive heart failure develops as cardiovascular and renal functions change from the type found in the control subjects to the type found in decompensated cardiac patients, and (b) that a return to, or toward, the normal occurs in these functions as cardiac compensation is regained. That these assumptions are not necessarily valid is indicated by the herein reported simultaneous measurements of cardiovascular dynamics, renal functions, blood volumes and electrolyte excretions in eight patients during cardiac decompensation and after recovery of compensation.

A comparison of the actions of four cardiac glycosides on a patient with congestive heart failure

Abstract 1. 1. In a case of auricular fibrillation and congestive heart failure the circulation compensated promptly, but temporarily, after each intravenous administration of lanatoside C, digoxin, digitaline Nativelle, and ouabain. The drugs were given successively and in equal gram-molecular amounts. 2. 2. When compared molecule for molecule, ouabain initiated effects most rapidly, and digitaline Nativelle most slowly. Between the two, but resembling ouabain more closely, were digoxin and lanatoside C; the former was slightly more rapid in its action. 3. 3. When the cardiac glycosides were administered intravenously they produced abrupt changes in several circulatory functions without alterations in others: 3.1. a. Elevated venous pressure fell quickly to normal. 3.2. b. Rapid ventricular rate slowed promptly. 3.3. c. Diminished arterial pulse pressure increased as a result of elevation of the systolic pressure. 3.4. d. Volume of the blood flow to the calf and hand remained unaltered. 3.5. e. Cheyne-Stokes respiration speedily disappeared. 3.6. f. Cardiac size and shape did not change. 3.7. g. Electrocardiograms showed only a slowing of the ventricular rate.

The effect of intravenously administered digoxin and ouabain on the systemic venous pressure of patients with congestive heart failure

Abstract 1. 1. When administered intravenously in single therapeutic doses, digoxin and ouabain induced rapid improvement in the circulatory dynamics of patients with congestive heart failure. 2. 2. A rapid fall of the elevated venous pressure was the most striking and constant effect produced. It had the following characteristics: 2.1. a. Onset of effect: ouabain, 3 to 11 minutes, digoxin, 5 to 22 minutes. 2.2. b. Major effect: ouabain, 35 to 56 minutes, digoxin, 45 minutes to 3 hours. 2.3. c. It was associated with, but not dependent on, slowing of the ventricular rate when the cardiac mechanism was auricular fibrillation. 2.4. d. It was unaccompanied by a change in ventricular rate when the cardiac mechanism was normal. 2.5. e. It preceded the onset of diuresis, which at times was rapidly initiated. 2.6. f. Its pattern did not depend on the initial level of venous pressure or the degree of congestive heart failure. 2.7. g. It bore no relationship to changes in the electrocardiogram. 2.8. h. Its duration was relatively short, except in those patients whose cardiac reserve was sufficient to maintain circulatory compensation once it was re-established. 3. 3. Compared molecule for molecule, ouabain induced effects more rapidly than digoxin. 4. 4. Large doses of these two glycosides at times induced toxic complications. The intermediate doses were free of these effects and therapeutically just as effective.

Action of vitamin A on the skin following intracutaneous injection.

Summary It has been found that a single intracutaneous injection of vit. A in the rabbit causes an increase in thickness of the epidermis (excluding corneum) which is due to an increase in both number and size of the cells in the germinative and granular layers. The corneum becomes thinner and denser. The occurrence of large, young appearing nuclei in the absence of an increase in mitotic rate indicates that the maturation process is slowed.

A Comparative Study of the Local Toxic Action of Mercurial Diuretics

Summary and Conclusions Three mercurial diuretics, Thiomerin, Mercuzanthin and Mer-cuhydrin have been compared with respect to the tissue reaction which they produce. Thiom-erin was tolerated by mice on subcutaneous injection without exhibiting gross pathology while Mercuzanthin and Mercuhydrin gave rise to necrosis of the skin under the same conditions. After intramuscular injection in rats all three drugs gave an early inflammatory response characterized by the appearance of a polymorphonuclear exudate. In the case of Thiomerin this exudate was entirely resorbed without evidence of residual damage. After injection of Mercuzanthin, or Mercuhydrin, however, the irreversible nature of the response was indicated by marked fibroblastic proliferation. These results would seem to furnish an adequate experimental basis for the clinical use of Thiomerin by subcutaneous injection. The authors wish to thank the Misses Florence Katine and Josephine Brosseau for able technical assistance.