Pneumonia, malignant endocarditis of tricuspid valve / by F.G. Finley.

  • Finley, Frederick Gault, 1861-1940.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Pneumonia, malignant endocarditis of tricuspid valve / by F.G. Finley. 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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    stools. At .S.oo this afternoon she 'md a ri^njr, tlie temperature rising to 1044°, lasting for five minutes, and followed by profuse sweating. March 80. There was a slight rigor at midnight, severe headache, and followed by profuse sweating, the tem]ierature ro.se to 104^°, and the pulse to 144 at 4 a.im ; ten minute.s^ later the temperature fell to 102. She slept badly, had a dry cough, and the diarrluna continues, being .somewhat controlled by starch and opium enemata. A pleuritic to and fro friction is present at the right base ; otherwise the phy.si- cal signs in the chest are unchanged, d'he splenic tininess reaches the costal l)oixler, but the organ is not yailpable. April 2. Two rigors occurred yesterday, the rectal temperatures reaching lOof to 106^°. Following and preceding the rigors the temperature fell to normal. During the high temperature, the pulse became very weak and rapid, 160 to 168, and the respiration very laVjored, increasing from 24 to 28 up to 40 or 44. The lungs as before, a!ul the heart, which has been carefully ex- amined daily, presents no murmur. April 8. Dr. Oanlner examined the fundi and reports them normal. A culture from the blood shows diplococci and staphylococci. Pros- tration is very marked, the 2nd sound is feeble, the first accentuated. The pulse varies with the temperature from 104 to 170, and once fell to 80. The temperature is remitting, rising from 103^° to 106° in the latter part of the day. and falling as low as 99^ in the morning. The last rigor, there being five altogether, took place on the 3rd. A dry cough without expectoration continues, and there are from three to four stools daily. April 8. Lies propped up in bed owing to dyspneea. Complains of severe pain at back of left knee ; nothing made out objectively. April 18. Breath extremely offensive for some days. Examination by Dr. Birkett shows atrophic catarrh and ozaina. April 16. Pro.stration during last few days has become extreme. Temperature 105° to 106° in the afternoon without rigors, the mini- mum temperatures being 102° to 103°. Yesterday and to-day tempera- ture 105° to 106°. The pulse rapid, 124 to 170, and weak. The mind has been clear throughout. The lungs when examined yesterday still showed the .same evidence of consolidation. The heart, which has been daily examined, has been normal. Diarrhft?a, 3 or 4 stools daily. Death took place at 2 a.ni. on the 17th April, the temperature rising before death to 108°. Autopsy by Dr. Wyatt Johnston, showed a very unusual condition of the heart, there being acute endocarditis confined to the tricuspid valve. This valve was covered with polypoid vegetations as large