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November 17, 1951

Pharmacology of the Failing Human Heart

JAMA. 1951;147(12):1183. doi:10.1001/jama.1951.03670290091046

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John McMichael, professor of medicine in the University of London at the Post-Graduate School of London and a pioneer in cardiac catheterization, in this small monograph summarizes recent studies, by cardiac catheterization, on heart failure and its treatment. The assembled data are unchallenged, but their interpretations are still the subject of debate.

In the chapter on "General Ideas on Heart Failure," he discusses the differences in adaptation existing in the various types of chronic heart failure, especially in terms of cardiac output.

"The Behavior of the Failing Heart" is an account of Starling's Law of the Heart as interpreted in man from McMichael's own work. Effects of transfusion and venesection are discussed.

Chapters 3 and 4 deal with the mechanism of action and the therapeutic uses of aminophylline (theophylline ethylenediamine), digitalis, and strophanthus, based chiefly on the author's experiences with intracardiac catheterization.

In the final chapter, a summary of suggested

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