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March 14, 1936


JAMA. 1936;106(11):892-895. doi:10.1001/jama.1936.02770110008003

For many years it has been taught that in infectious fevers, when the pulse becomes rapid and tends to be thready and the heart sounds become muffled, the heart is failing. Heart stimulants are indicated, for one must support by all means the failing heart. When one turns to textbooks on medicine in the sections on treatment of the various infections one finds it stated that when the heart fails cardiac stimulants should be administered, the chief of which is digitalis in some form. Others, such as caffeine with sodium benzoate, camphor and epinephrine, are mentioned. This idea has been taught for so many years that it has become almost axiomatic. Physiologists have known that this is not true and as long ago as 1899 Romberg and Paessler1 showed in animal experiments that the heart does not fail even in fatal infections with the diphtheria bacillus, pneumococcus and streptococcus.