Lectures on angina pectoris and allied states / by William Osler.

  • Osler, William, Sir, 1849-1919.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on angina pectoris and allied states / by William Osler. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    paralysis. Death followed an attack. Post mortem, the heart was found to be excessively fatty. There was no note about the coronary arteries. R. W. Smith * also noted the condition of very slow pulse with fatty heart, and Stokes de- scribed it more fully, f and suggested the name false or pseudo- apoplexy. He laid stress on the syncopal character of the at- tacks, their frequency, the absence of paralysis, and the good effect of a stimulant rather than a depleting plan of treat- ment. The first case which he gives is very remarkable, and is worthy of a brief abstract, as recent Anglo-American au- thors have not dwelt specially upon his symptom-group: A man, aged sixty-eight years, was suddenly seized with a faint- ing fit, which recurred several times in the day. For the three years before he was admitted to the Meath Hospital he had never been free from the attacks for any length of time, and had had at least fifty such seizures. A sudden exer- tion or a distended stomach was most apt to cause an attack. He had no convulsions, nor was there ever anything like pa- ralysis. He was perfectly insensible for four or five minutes. The pulse was 28 per minute, and the arteries were in a state of permanent distention, the temporal arteries ramify- ing under the scalp, just as they are seen in a well-injected subject. There was a soft hruit with the first sound. The threatenings of attacks he could recognize, and he had often warded off a seizure by turning on his hands and knees and keeping the head low. In passing I may remark that you will find in this paper Stokes's original description of the Cheyne-Stokes breathing, which, though fuller, is not a whit better than Cheyne's ac- count published thirty years before. * Dublin Journal^ ix. f Observations on some Cases of Permanently Slow Pulse. Dublin Quarterly Journal, 1846, p. 73.