On some of the principal effects resulting from the detachment of fibrinous deposits from the interior of the heart, and their mixture with the circulating blood / by William Senhouse Kirkes.

  • Kirkes, William Senhouse, 1823-1864.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: On some of the principal effects resulting from the detachment of fibrinous deposits from the interior of the heart, and their mixture with the circulating blood / by William Senhouse Kirkes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    38/46 (page 36)
    oppression came on, and proved so rapidly fatal. The lad’s depressed languid aspect, with an abundant petechial eruption, seemed to indicate, in the absence of a clear history, the ex- istence of low fever, and the restless, delirious manner in which he passed his first night in the Hospital, favoured this view, and justified the employment of wine and simple salines; yet the fatal coma which rapidly supervened two days after ad- mission, was quite unintelligible on this supposition, and could only be understood by an examination after death. Then the whole mystery seemed to be cleared up; and the most reasonable interpretation which can be offered of the phenomena observed during life and the appearances presented after death seems to be this :—The pain in the right groin with which the attack set in was rheumatic; then ensued rheumatic inflammation of the mitral and aortic valves, with ulceration of the latter, and deposition of fibri- nous vegetations on both. From these fibrinous deposits, many of which were loose and easily detached after death, portions had probably separated during life, and, being mingled with the blood, were transmitted with it to all parts of the body; then, arrested in the capillary networks and smaller arteries, they produced the vai’ious petechial- looking spots in the skin and most of the serous and mucous surfaces of the body, the buff-coloured blotches and streaks, and the solid fibrinous masses in the kidneys and spleen, while they probably caused the fatal issue of the case by the pressure resulting from the extreme engorge- ment of the minute vessels of the pia mater and the substance of the brain. Viewed by itself alone, this case is of extreme interest; but taken in conjunction with others it seems to possess features of great pathological value, as illustrating the serious effects which may result from direct poisoning of the blood, by the products of rheumatic inflammation of the valves of the heart being mingled with it. In the typhoid symptoms noticed during life, and the secondary deposits found after death, the case presents features almost exactly parallel with those ensuing in phlebitis after wounds. In both cases, indeed, the exciting cause of the morbid phenomena seems to be