Clinical medicine : observations recorded at the bedside with commentaries / by W.T. Gairdner.

  • William Tennant Gairdner
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Clinical medicine : observations recorded at the bedside with commentaries / by W.T. Gairdner. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    proved fatal, and one of them went out, after a short residence, much improved. The other patient, a very ansemic and enfeebled woman (Barbara C.), is still under treatment, and suffers exceedingly from palpitation and haemoptysis. There is also considerable anasarca, and the kidney is affected with advanced Bright’s disease. The patient has been accustomed to take large quanti- ties of opium, and finds it necessary at present to have from one to three ounces of solution of morphia daily to procure rest from her distressing symptoms. [Barbara C. died very shortly after this report was drawn up. The heart weighed 16 ounces. The mitral orifice was contracted and rough with vegetations, which pre- vented its closure. It is difficult to be sure whether the obstruction-murmur existed in tins case ; ordinarily it was lost in the regurgitation-murmur, which was loud and obtrusive. Possibly there may also have been tricuspid regurgitation, but it was not distinctly indi- cated. (Similar cases at p. 605.)] In two cases there was a murmur chiefly referrible to the right side of the heart (tricuspid regurgitation), but complicated in one, probably in both, with mitral regurgitant disease. [One or two instances of indistinct or temporary murmurs of this kind were not included in this report.] In both these cases there was copious pulmonary hemorrhage. In one of them there was ex- treme cyanosis, with moderate venous pulsation ; in the other, the cyanosis was moderate, but the venous pulsation intense. Both cases ended fatally: one of them, how- ever, only after repeated partial recoveries under diuretics