The relative importance of valvular and muscular lesions in diseases of the heart / Solomon Solis-Cohen.

  • Solis-Cohen, Solomon, 1857-1948.
Date:
[1901]
Catalogue details

Licence: In copyright

Credit: The relative importance of valvular and muscular lesions in diseases of the heart / Solomon Solis-Cohen. 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.

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    eration in the muscular fibers and with varying quanti- ties and distribution of interstitial or substitutional fibrous tissue. Huchard, among the French observers, has made a number of refinements in the nomenclature of these conditions and has described special symptoms observed during life as associated with special forms of myocardial degeneration and interstitial alteration dis- covered post-mortem. Much of this, however, seems to be premature. It is well that histological studiep of the dead heart should be made as systematically as pos- sible. and the utmost information concerning the char- acter of the structural changes gathered: but it is only after a large number of cases shall have been carefully traced in their clinical histories over several years, and the intimate nature of the lesions found after death in such cases carefully collated and compared, that we shall be enabled to analyze the data and establish the signs and symptoms which, observed during life, shall warrant a diagnosis of some special affection of the myocardium. Even the term “myocarditis” as a generic designation seems to be going too far, unless we are pre- pared to assert that every alteration of the cardiac muscle and every form of increase of connective tissue indicates an inflammation. The French observers terra, “myopathy,” or, if we prefer to Anglicize it, “muscle dis- ease,” is better, and represents the full extent of pres- ent accurate knowledge applicable during life, to the diagnosis of the vast majority of the chronic cases which have not followed acute infectious diseases. CAUSATION. Among the principal causes of disease of the cardiac mui-cle in American men is the long-continued, even moderate, use of alcohol, and especially when this has been associated with the use of tobacco. I .have not ob- served the same degree of impairment in those who have used alcohol alone or those who have used tobacco alone as in those, and these, of course, form the ma- jority, who have used both. What constitutes temper- ate use of alcohol or tobacco varies very much with the individual. In some patients disturbance of the cardiac rhythm and irritable and weak over-action of the heart begin soon after the smoking habit has been established. In others it occurs only toward the involution period