Investigations into some morbid cardiac conditions : including the Cartwright prize essay on the heart in debility / by William Russell.

  • Russell, William, 1852-1940.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Investigations into some morbid cardiac conditions : including the Cartwright prize essay on the heart in debility / by William Russell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    regarded as a concomitant of the anseniia, but the temper- ature could not be so regarded. In such a case, however, the diagnosis can only be made by carefully weighing the various factors comprising it; and the importance of accu- racy is forcibly brought out by the result of the case. Had we allowed the patient go about, instead of keeping her in bed, we should have blamed ourselves. Another and a common phase is to be seen in the con- valescent from acute rheumatism. The pains have pro- bably disappeared, tending only to return slightly in one or other joint, and are readily checked by salicine or a salicyl salt. The pulse, however, continues accelerated, the temperature more or less elevated at some period of the twenty-four hours, and there are probably perspirations. There is probably endocardial murmur, which was noted early in the attack. In such a case, the problem before the physician is, What are the conditions leading to the phenomena ? Are they to be regarded as the outcome of the rheumatic state, and simply as an expression of the presence of the rheumatic poison ; or is their cause to be found in an anatomical instead of a chemical condition ? I believe the phenomena are to be explained by the morbid changes taking place in the endocardium. The presence of albumen in the urine is probably to be explained in many cases by the molecular debris from the broken endocardium finding a lodgment in the kidney; for the only case in which albumen was not present was in Case XXIV., and in it the endocardium had not given way over the vegetations. The delirium also may—at least, sometimes—be accounted for in this way, the debris becom- ing arrested in cerebral capillaries. Murchison .{Lancet, 3rd May, 1879) has pointed out that there maybe endo- carditis with pyrexia, in which no emboli areifound; but