THERAPEUTICS

Therapeutics

Josefa, aged thirty-six, married, had an affection of the chest, which she referred to the heart, as she had difficult breathing on ascending stairs, however slowly ; when she hastened in ascending she tired at once, and had violent palpitation of the heart, which obliged her to halt to recover her breath ; a deep inspiration or raising the left arm suddenly, caused a stabbing pain, acute, momentary, in the middle anterior portion of the fourth intercostal space on the same side. Auscultation revealed heart beats slightly accelerated, isochronos with the pulse, without any unnatural sounds ; all of which seemed to indicate a purely nervous affection. Bell, gave no relief.

The fact was brought out that some time previous she was wet for several hours in the river, and exposed at the same time to the sun.

What remedy do I prescribe?