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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    duction of the musical note, as it diminished when the heart became calm, and vice versa. The five following cases present instances of disease, with murmurs, in the pulmonary artery, and they completely exempliry the physical signs of these rare affections. Great dilatation of the pulmonary artery. Hypertrophy and dilata- Hon of the heart.— Sarah Wetherty, set. 36, of yellowish complexion, was admitted into St. George's hospital under Dr. Seymour, January 20th, 1830, with dyspnoea; pain at the scrobiculus cordis; ascites, oedema pedum; pulse 70, large, full, and rather lense; tongue clean; urine scanty; catamenia suppressed for five months. Short-winded for ten years, in consequence of striking her breast against a post. Eight months ago the catamenia were checked by cold, from which time she dates her■ complaint; but the oedema did not supervene until three months afterwards, when the menstrual flux became totally suppressed. Auscultation.—Resonance of the precordial region is extensively dull; prominence, pulsation, and purring tremor between the carti- lages of the second and third left ribs. Impulse, much more extensive, and considerably stronger than natural, particularly in the left pre- cordial region. The pulsation is felt in epigastric Sounds.—The first, is an extremely loud, harsh, and swper/idaZ sawing-murmur. It is extensively audible, but most so on the prominence between the second and third ribs. Diagnosis.—Hypertrophy and still more dilatation of the heart, greatest on the left side. Dilatation of the origin of the aorta, pro- bably forming an aneurismal pouch towards the left. V. S. ad 5 x.— ft calomel, gr. iij. hac nocte.—R haust. sennas cum tart potassae 3iij eras mane.—R haust. salin. efferv. ter die. Died a month after admission. Autopsy.—Heart encroached much, by its size, on the left side of the chest. It was hypertiophous and dilated; most on the left side. Pulmonary artery remarkably dilated. Its internal circumference near the valves was four inches and a half; and midway between this and the bifurcation, it was five inches. The enlargement did not extend beyond the bifurcation. The sigmoid valves appeared to be put on the stretch, and too small to close the orifice, yet this could not have been the case, as there was no murmur from regurgitation. Aorta rather contracted. Mitral valve slightly thickened. Abdo- men contained three or four quarts of straw-coloured fluid. Liver rather enlarged and hardened, and its peritoneum thickened by old inflammation. Remarks-.—Part of the diagnosis, in this case, was inaccurate.^ but as dilatation of the pulmonary artery is one of the rarest affections incident to the human frame, and as its signs had not previously been described by any author; whilst aneurism of the ascending aorta is an ordinary disease with well-known signs, the former could not, on any certain grounds, have been- diagnosticated in preference to the latter. On reviewing the signs of the former, however, they appear to me so