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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    described sometimes presents a truly cartilaginous hardness, and sometimes the consistence of fibro-cartilage, or only that of fibrous tissue. When divided, the aspect of the section varies according as the disease is cartilaginous, fibro-cartilaginous, or fibrous. In a more advanced degree, cartilaginous induration is trans- formed into imperfect bone. It seldom happens, however, that more than a very small proportion of the cartilaginous mass is ossi- fied, and the change takes place sometimes at its surface, and some- times deep in its substance. The bone produced does not exhibit the fibrous structure and peculiar arrangement of natural bone ; though, as it contains a large proportion of cartilage, it may be pre- sumed to possess more or less vascularity and vitality. There is another species of osseous induration of the valves, which is essentially different from the above, inasmuch as it con- sists of calcareous matter in great predominance, and, like vesical calculi, has no vitality. It presents itself under the form of small, polished, and semi-transparent scales ; or of minute, yellowisb, opake granules, the agglomeration of which forms concretions of various dimensions, from a mere point to the size of a horse-bean. The deposition commences underneath the lining membrane, and generally in a small patch of indurated, cheese-like steatomatosis matter ; the surrounding parts being healthy. The scales lie flat and superficial under the membrane, while the granules penetrate more or less deeply into the subjacent tissues. When either the scales or the granules enlarge, and their surfaces become rugged or acuminated, they cause absorption of the internal membrane, and come in immediate contact with the blood. Some authors believe that ossifications of this description are natural to old people, because they occur in a majority of those who have attained the age of sixty. Whatever be the character of the ossification, whether it be mixed with cartilage or purely cal- careous, to me it appears to be a morbid production. The circum- stance of its occurring in the majority of persons above the age of sixty, does not militate against this View : for, as the elasticity of the arterial, as of all the other tissties, is diminished by age, the valves of the heart and the coats of the arteries are, in the aged, less capable of resisting the distending force of the blood, and are therefore more liable to disease. Nor does the circumstance of the ossification being more calcareous and less cartilaginous in the old than in the young prove that, in the former, it is a natural change. It confirms, indeed, what is proved by every part of the bony tissue; viz. that in age the ossific tendency is greater ; but it does not, for this reason, follow that the tendency is natural when it dis- plays itself in an Uhnatural situation, as in the heart and arte- ries. I find this opinion expressed in almost the same words by Andral. The process of ossification naturally increases in extent as the individual advances in life : but, notwithstanding the general physiological nature of this process, it may constitute a true patho- logical condition, by interfering with the due accomplishment of 44