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

  • Duncan, Andrew, Jun., 1773-1832.
Date:
1816
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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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    the peculiarity of appearance of the efflorescence in the heart, that is, its being rounded into little masses, might be accounted for, by the peculiarity of the surface upon which it was exuded, viz. a reticulated muscular surface, in a constant state of alternate con- traction and dilatation. Concretions formed in the third manner are generally mas- sive, long, and fibrous; in short, more like a polypus. Still these concretions may have arisen in this way, if we suppose, that, in consequence of its becoming less fibrous, the heart did not contract so readily, and did not empty itself at each systole, it would only propel the blood in the direct current of circula- tion, while that at the sides, lying among the musculi pectinati, might become stagnant, and have time to coagulate into gru- mous masses, which would soon acquire the appearance we saw in Baxter. But, in whatever way they were formed, although I think the aetiology of such appearances always useful in leading us to fur- ther investigation and more accurate observation, the disco- very of a means of removing, alter they are formed, would be much more desirable- This is a degree of progress in the heal- ing art which we can scarcely hope to attain; and, therefore, any means which presents the slightest chance of success, although apparently strange, deserves attention ; and so I am disposed to consider M. Sherwen’s proposal of scorbuticizing the system, first suggested in the Gentleman’s Magazine for 1798, and after- wards renewed in this Journal for January 1814. The last part of this man’s dissection which I shall notice, was the great mass of disease found in the abdomen, and of it I shall say very little, as it has been sufficiently described by Dr Gordon. There were traces of inflammation, adhesion, forma- tion of albuminous tumour, and a most extensive affection of all the mesenteric glands; and in the liver one of those tubercles so well described and depicted by Dr Farre, * under the ti- tle of Tubera diffusa. These appearances sufficiently ac- count for the sensations of this patient; the pains in his belly, the feeling of a ball moving about, &c.; and all tend to shew the extensive manner in which the system was diseased, and the incurable nature of his complaint. * Morbid Anatomy of the Liver. By J. F. Farre, M. D. 4to, London. Part I. J 812. Part II. 1815. I have referred this to the Tubera diffusa, as si- milar tubercles were found dispersed in various structures of the body; but from its determinate figure, and existing singly in the liver, it more resembled the Tubera circumscripta.
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