Henry Moore

Paroxysmal ventricular tachycardia

SummaryA case of paroxysmal tachycardia is described; the tachycardia we interpret as ventricular in origin. It was possible to terminate the longer attacks by the administration of quinidine by mouth, but it is not clear whether the oral routine administration of quinine in daily doses of 0.4 to 1.2 gram rendered the occurrence of the paroxysms less frequent. It is now more than 56 months since the patient was first studied; the attacks have become less frequent and of shorter duration, although no special treatment was undertaken for more than the last 9 months.

A clinical study of achlorhydria

Summary and ConclusionAchlorhydria, besides being found in a certain proportion of apparently healthy persons, in many cases of gastro-intestinal disease and in odd cases suffering from miscellaneous disorders, is a frequent finding in diabetes mellitus and a still more frequent occurrence in hyperthyroidism and in the non-megalocytic, “hypochromic” anæmia above described; in the latter disease it seems to have causal relationship, either direct or indirect, but in the light of recent work on pernicious anæmia even this surmised causal relationship may not be the complete explanation. At any rate, this non-megalocytic form of anæmia is of frequent occurrence, and its adequate treatment with iron in the ferrous form by mouth gives satisfactory results.It gives me great pleasure to acknowledge in this study the cordial co-operation of Dr. W. R. O’Farrell, Pathologist to the Hospital, and of Doctors L. K. Malley and M. A. Moriarty, while they were my House Physicians.

A study of four cases of auricular flutter

ConclusionsDigitalis alone, in a case of auricular flutter, caused a degree of auriculo-ventricular block sufficient to permit of the circulation being efficiently carried on; after several months of digitalis treatment flutter was replaced by sinus rhythm with no ill effects to, but rather improvement of, the patient’s condition.It is suggested that, in certain eases of auricular fiutter, this condition may be successfully treated by full digitalisation with the object of inducing the appearance of auricular fibrillation, and that the latter may in its turn be treated by small doses of quinidine, with resulting and rapid restoration of sinus rhythm. The above procedure was successful six times in two cases of auricular flutter, causing flutter to be replaced by auricular fibrillation and the latter, in its turn, to be replaced by sinus rhythm.A case of auricular flutter with 1:1 ventricular response is described.

The treatment of diabetes mellitus with a single daily dose of protamine zinc insulin

ConclusionProtamine zinc insulin in a single daily dose adequately controlled 48.5 per cent. of 35 cases of diabetes mellitus who were tinder treatment with soluble insulin for a considerable time previously, 82.8 per cent. of 35 cases recently admitted, and 65.7 per cent. of the 70 cases comprising both series.In the minority of cases, when a single daily dose of protamine zinc insulin is inadequate, more perfect results can probably be obtained by two daily doses, or by one dose of protamine zinc insulin and an additional dose of soluble insulin given daily and separately at appropriate times, or by one daily dose of the mixed insulins. It would appear that the single daily dose of protamine zinc insulin is likely to be unsuitable for the control of very severe diabetes; if adequate in size it will probably be successful in the majority of cases of diabetes of average intensity, particularly if the diabetes has not existed for too long a period of time before treatment is begun, and provided that the time of administration and the diet are properly adjusted. In judging of final success, however, one must not forget the desirability of avoiding any considerable degree of hypoglycæmia, even if the latter is not symptomologically manifested.