Two remarkable cases of encephaloid disease of the heart; with observations / [Prescott Gardiner Hewett].

  • Hewett, Prescott (Prescott Gardiner), Sir, 1812 or 1813-1891.
Date:
1846]
Catalogue details

Licence: Public Domain Mark

Credit: Two remarkable cases of encephaloid disease of the heart; with observations / [Prescott Gardiner Hewett]. Source: Wellcome Collection.

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    being implicated in the disease, which had apparently begun in the os calcis. For the first two days after the operation, the patient ap¬ peared to be doing very well; but on the third day there was slight irritative fever, and the stump had put on an un¬ healthy appearance: on the following day he was in a very low state, with an intermittent pulse, and complained of pain in the right hypo chon drium. These symptoms went on in¬ creasing; jaundice, profuse perspirations and severe pleuritic pain of the left side, made their appearance on the 30th, and the patient died on the 31st. The body was examined thirteen hours after death. Marks of extensive recent inflammation, of a low character, were found in the left pleura, and in the pericardium. Slight emphysema existed at the anterior part of the lungs, and, at the posterior part, these organs were congested, but they did not present any other morbid appearance. The heart, much increased in size, presented dilatation of the right cavities, with hyper¬ trophy of the muscular structure of the left ventricle. In the right auricle was a large growth, which, proceeding from the appendix, occupied the greater part of the cavity of the auricle, and, passing through the auriculo-ventricular open¬ ing, projected into the ventricle, reaching nearly to the bases of the columnse carnese of the valve. The shape of this growth was conical, with its basis towards the auricle ; it distended the cavity of the appendix, in which it appeared to have originated, and it was also connected writh that part of the auricle in the immediate neighbourhood of the appendix, but it was impossible to decide which of the tissues of this organ had been the primary seat of the disease. The surface of the tumour was irregular, and its tissue firm, except at the lower part, where it was somewhat flocculent: when cut into, it presented a highly vascular appearance, and in structure resembled exactly the encephaloid disease of the foot, for which the patient's leg had been removed. The valves of the heart were healthy in structure, and all the cavities of this organ contained coagula of blood, for the