A Treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them, comprising the author's view of the physiology of the heart's action / by J. Hope.

  • Hope, James, 1801-1841.
Date:
1846
Catalogue details

Licence: Public Domain Mark

Credit: A Treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them, comprising the author's view of the physiology of the heart's action / by J. Hope. Source: Wellcome Collection.

Provider: This material has been provided by the Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.

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    death varied from an inch to an inch and a half, on a transverse section made at a distance from the apex of one-third of its length, and the cavity was not large enough to hold the second phalanx of the thumb, and was almost filled by the carnese columns. This heart, in its open state, was put to macerate ; no force, was applied to extend it. At the end of some days, on. being folded up, it was found to have dilated very considerably) so that the left ventricle could not then be said to be smaller than natural. Dr. Budd argues against the existence of the diminished cavity from the fact that of eight cases collected by him, no one afforded signs, either during life or after death, of any obstacle to the circulation through the heart. There were no irregularity of pulse, no dropsy during life, no dilatation of the right cavities after death, phenomena which, it may be said, must of necessity be present if there be an obstacle to the circulation in the heart. It is impossible, as he states, to con- ceive that a left ventricle, which could scarcely hold an almond, should offer no obstacle to the circulation through the heart. Yet Laennec has recorded a case in which the parietes of the left ven- tricle had acquired the thickness of from an inch to an inch and a half, and the cavity seemed capable at most of containing an almond stripped of its shell. Yet the day before the patient's death his pulse was natural, the breathing perfectly free, 'nothing,' says La- ennec, ' led me to suppose that this man had a disease of his heart.' (See Cycopled. of Anat. and Physic. Abnormal Conditions of the Heart, by Dr. R. B. Todd, p. 12.) CHAPTER IT. DILATATION OF THE HEART. SECTION I.—Anatomical Characters, with classification and nomenclature of Dilatation. The disease commonly termed dilatation of the heart, consists in am amplification of one or more of its cavities. Although I have seen the muscular substance healthy in every form and degree of this affection, in general it is not so. For, when the dilatation is great, and the parietes are feeble in proportion to the quantity of blood which they have to propel, the muscle is usually more or less flaccid, and even softened, and in some cases of a deeper red, in others paler or more fawn-coloured than natural (Gillan, Anderson, Mrs. —1—n.). The deep red dye is attributable to venous engorgement of the muscular substance, resulting from stagnation of the blood within the heart. The paleness is often connected with general muscular paleness. The softening is some- times so great that the substance readily breaks up under the pres- sure of the fingers. Dilatation occurs with three different states of the ventricular