Three cases of inflammation of the heart, with the appearances on dissection / by Andrew Duncan.

  • Duncan, Andrew, Jun., 1773-1832.
Date:
1816
Catalogue details

Licence: Public Domain Mark

Credit: Three cases of inflammation of the heart, with the appearances on dissection / by Andrew Duncan. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    of hysteria in men have been seen by Dr Trotter and others. Hypochondriasis certainly oftener affects females. The difference between them depends much on temperament. Hysteria is peculiar to the sanguine, and hypochondriasis to the melancholic temperament. In hysteria, the affections of the mind are characterized by fickleness and mobility; in hypo- chondriasis, by the obstinacy with which the mind broods over a single subject. In hysteria, the patient is violently affected by every circumstance external to herself, and is agitated by every sudden impression ; but the paroxysm is no sooner over, than she laughs at her own lolly, thinks no more of it, and re- sumes her wonted spirits. In hypochondriasis, on the contrary, external circumstances make little impression on the patient; and if a sudden and violent impression rouse him for a mo- ment, he speedily returns to brood over his loss of health, or finds in what has just passed fresh cause for despondency. The symptom in Baxter giving rise to the idea that his disease was hysteria, was the accurate description he gave of the globus hystericus. But after he came under our care the symptom did not recur. I was then led to consider his complaint as hypochondriasis, from the pain of stomach, increased on taking food ; the irregu- lar state of his urine; the costive belly ; flatulence; interrupt- ed sleep ; bad appetite; foul tongue, and bad taste in his mouth ; and still more by his constant complaints. I therefore left him a day or two to observe the symptoms. On the 23d it is reported that the pulsation of his heart is distinctly felt, even when lying on or towards therightside; and it is remarkable, that, except the weakness of the pulse, and its oc- casional frequency, this is the only symptom connected with the state of the circulation noticed in the reports. It indicated a labouring action of the heart; but I did not perceive any irre- gularity in its action ; and as it is a common symptom in hypo- chondriasis, from sympathy with the state of the stomach and bowels, it did not farther attract my attention. Another symptom was noticed the same day, that he had repeatedly fallen from his chair when sitting by the fire. This might either proceed front syncope, or a nervous parox- ysm, or from falling asleep ; and 1 was positively assured that it proceeded from the last cause, which, in his debilitated state, was very probable. This day his complaints first appeared to me to be serious, and I resolved to try with him Kaempf’s method of treating hypo- chondriac affections. I therefore ordered him to get two of his