Clinical observation of a sudden death following the intravenous use of strophanthin, as well as the very prompt therapeutic effects noted in favorable cases from minute doses of it and of camphor, seem to me to indicate that the primary effect of these drugs on the heart must be on some highly sensitive governing mechanism of a nervous character rather than on the cardiac muscle itself. The carefully balanced chemical and mechanical relations between the blood and the blood-vessel wall hold for the endocardium as well, and they must depend on and affect, to some extent at least, the nervous supply to that portion of the lining coming in most direct contact with the blood. Consequently, it is possible for chemical substances in the blood to exert a direct effect on nerve-endings of the endocardium, and there is some reason to suppose that this might be, because of the amount
WILBUR RL. SOME RELATIONS OF THE NERVOUS MECHANISM OF THE HEART TO DRUG EFFECTS, AS INDICATED BY EXPERIMENTS ON THE TERRAPIN. JAMA. 1911;LVII(26):2037–2043. doi:10.1001/jama.1911.04260120227001
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