Antall József szerk.: Orvostörténeti közlemények 115-116. (Budapest, 19869

KISEBB KÖZLEMÉNYEK — ELŐADÁSOK - Ringelhann, Béla: A digitalis 200 éve az orvostörténetben (angol nyelven)

the drug. Erdmann observed that in 1984 German patients took 6 to 8 times more then they did in France, England and the USA. This data is particularly remarkable, because in Germany the consumption of antibiotics, psychopharmacons and antidiabetics is only twice as much as it is in these other countries. In Erdmann's acute medical department the patients get catecholamin derivatives, Dopamin and Dobutamid. In left heart failure cases sublingual nitrates were prescribed. On the other hand in cases of atrium fibrillation and flattern prescribing Digitalis had good results. In the case of 56 of 200 patients treated with digitalis they stopped the therapy with this drug and they did not suffer any relapse. [36] Overviewing the history of Digitalis treatment we see the ups and downs of the method. For a thousand years nobody thought seriously of treating chardiac patients. Hundred years of meticulous observation of heart function and therapy were necessary to work out the treatment methods for the ailments of the heart by the end of the 20th century. Laube's words have a deep meaning: ' 7 would not like to be a physician without the Digitalis. ' ' How far we have gotten since the treatment procedure suggested by Laube! The well-known sayings: "once Digitalis — always Digitalis ", or ' 'experimental Digitalis therapy ' ' have lost their meaning. The foxglove will always bring good results in the treatment of patients suffering from heart diseases if the rules of the use of the drug are kept in mind. APPENDIX Firm indications for heart glucoside Tachyarrhythmia absolute (atrium flimmern and flattern) Paroxysmal atrium flimmern and flattern Clear left heart insufficiency (III and IV, NYHA)* No firm indications for heart glucoside Loading insufficiency (II, NYHA)* Giving preoperatively (beware of fast big doses!) Cardiomyopathy (inclusive restriction) No indication for heart glucoside Sinus tachycardia Coronary disease without heart insufficiency Hypertony without heart insufficiency Prophylactic therapy Contraindications for heart glucoside Atrio-ventricular block Sick sinus syndrome (without pacemaker) WPW syndrome Chamber tachycardy Aortic aneurysm Obstetric cardiomyopathy Carotis sinus syndrome Erdmann, E.: Stellenwert der Herzglykoside in der Therapie der chronischen Herzinsuffizienz. Klin. Wschr. 62, 507, 1984.