An inaugural dissertation on the congenital malformations of the heart ... / [John Paget].

  • Paget, John, 1808-1892.
Date:
[1831]
Catalogue details

Licence: Public Domain Mark

Credit: An inaugural dissertation on the congenital malformations of the heart ... / [John Paget]. Source: Wellcome Collection.

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    this state depends on a want of pure air in the lungs, and this effort is made to contract the cavity of the chest, and expel as much as possible of the impure air. When this is as far as possible accomplished, continues the same author, the sigh or yawn, by which the recovery is preceded, again fills the lungs, and the patient finds himself suddenly relieved. But it is not in the lungs the disturbance first commences, and though first manifested by this organ, it is probably only from sympathy with the brain it is affected. The causes usually exciting the paroxysm, are such as increase the rapidity of the venous circu¬ lation, and consequently overload the right side of the heart with blood ; which in these malformed hearts is immediately trans¬ mitted unchanged to the left side, through the anormal com¬ munication. Hence, the blood passes forward to the brain, and produces complete or partial asphyxia ; till at last the circula¬ tion again becomes equalized, and a sufficient quantity of oxy¬ genized blood gains the left side, (for some portion still conti¬ nues to pass through the lungs,) when the organs again receiving their proper stimulus, again resume their natural functions. The peculiar posture is chosen probably, as the upright in or¬ dinary cases of dyspnoea, to allow the more easy passage of the blood from the lungs to the left side of the heart, whereby the former organ is relieved; while the fits have been put off* or mi¬ tigated by lying on the belly or side, merely, as we believe, be¬ cause in that position the body is most completely at rest, and the circulation becomes soonest tranquillized. From the imperfect manner in which the blood is oxygenat¬ ed, or rather from the small quantity of it submitted to the action of the lungs, two other effects arise,—the cyania, cyanose, morbus cceruleus, or blue jaundice, (for by all these names has it been called,)-—and an unnaturally low temperature of the sur¬ face. M. Caillot, in an essay on this subject, was the first who traced the connection, which exists between certain malformations of vation, that when the fit was coming upon him he could escape it altogether, or at least take considerably from its violence or duration, by instantly lying down upon the carpet on his left side, and remaining immovably in that position for about ten minutes. I saw the experiment made with success.”—Dr Hunter in Med. Observ. and Enquiries, Vol. vi. p. SOI.