The diagnostic signs of incompetence of the pulmonary valve / by G. A. Gibson.
- Gibson George Alexander, 1854-1913.
- Date:
- 1894
Licence: Public Domain Mark
Credit: The diagnostic signs of incompetence of the pulmonary valve / by G. A. Gibson. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![is pale. The superficial cortex shows irregular areas, and is diminished in places. There is a cyst about the size of a pea hi it. The capsule strips off badly. There is some superficial cirrhosis and some slight waxy change. Eight weighs 6^ oz. It resembles its fellow. Stomach.—The stomach contams some brownish fluid, and shows a chronic catarrh, but is otherwise healthy. The result of the post-mortem examination in this case shows that it is possible to be too cautious in the diagnosis of rare lesions. Another patient presenting many features similar to those just described was in the hospital about the same time. Esther C., 03t. 46, housewife; was admitted to Ward 25 of the Eoyal Infirmary on 3rd July 1893, suffering from dropsy and dyspnoea. The patient was so ill that it was not possible to disturb her by any prolonged examination, but it was ascertained that she had suffered more than once from acute rheumatism, and tliat four years before admission she had been attacked by liemi])legia of the right side. The patient was deeply cyanosed, and could only breathe wlien sitting upright in bed. The fingers and toes were most distinctly clubbed, and there was much arching of the nails. The right side of the face was rather vacant in expression, and its muscles were weak, while the right arm and leg were almost powerless. The feet, legs, and thighs were very oedematous, and there was some ascites. The pulse was irregular, and did not give any definite indications, altliough the pulse wave was of brief duration. The cardiac impulse was feeble, but the apex beat was felt in the sixth intercostal space. No thrill could be discovered. On account of the patient’s condition, it was not considered right to trouble her by percussing the prtecordia, and the size of the heart was not therefore ascertamed. For the same reason, it was not possible to study the auscultatory pheno- mena so fully as we could have wished, but the following facts were definitely established. At the apex of the heart there was a rough first sound, accompanied by a blowing systolic](https://iiif.wellcomecollection.org/image/b21713388_0012.jp2/full/800%2C/0/default.jpg)
