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January 5, 1907


JAMA. 1907;XLVIII(1):56. doi:10.1001/jama.1907.02520270062012

Inasmuch as the nitrites are classified with the cardiac stimulants the average practitioner is apt to overlook the fact that their effect on the heart is only a secondary one, or, at any rate, mainly so. At first sight it would seem homicidal to order a cardiac stimulant to a patient with pulmonary hemorrhage, and this indeed would be the case if amyl nitrite were a direct cardiac stimulant. We know, however, that the action of most importance is the dilatation of the superficial capillaries, and that the effect on the heart is mainly due to the fact that this capillary dilatation reduces the work of the ventricles by decreasing the peripheral resistance. Even if this be the case, the action of the drug in controlling pulmonary hemorrhage is not explained, for it has generally been assumed that the pulmonary capillaries also are dilated. The recent researches of Pic and

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