The annual oration : the rapid heart, a clinical study / by Arthur Ernest Sansom.

  • Arthur Ernest Sansom
Date:
[1890?]
Catalogue details

Licence: Public Domain Mark

Credit: The annual oration : the rapid heart, a clinical study / by Arthur Ernest Sansom. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    witli the rapid heart was a throbbing in the great arteries of the neck. I thought I might be justified in regarding these as inter- mediate cases—on the borderland of the more developed disorder. I will first take two cases which I consider particularly interest- ing as types:— Case 1.—The first seems specially instructive, as showing an acute de- termining cause of the grave symptoms in a shock to the nervous system, as indicating that such may lead up to organic disease of the heart with its commonly associated symptoms, and as pointing to the conclusion that protracted treatment may result in very satisfactory, if not complete, recoveiy. In September, 1882, I saw in consultation with Mr. Blackstone, of Regent's-park, a lady, aged 44, the subject of raj^id heart. A week previously she had been in the country with her husband, and walked with him to the railway station to take the train for their return to London. Just before reaching the station they observed that the train was already waiting at the platform ; they hurried on, and the husband entered a carriage intending to assist his wife to step in. Unfortunately the train started, leaving the lady on the platform. She immediately experienced a violent attack of palpitation of the heart, and was assisted to the waiting-room. The husband returned by a subsequent down train, but foimd her too ill to undertake any journey. She remained a week in the country town where the shock occui'red, and them came to London, Mr. Blackstone and myself seeing her shortly after her return. Her pulse was about 160 ; there was little or no dyspnoea, but extreme feeble- ness. There was no exophthalmos, but distinct enlargement of the thyroid. It was probable that this existed in some degree previously, but increased after the attack. We kept the patient as quiet as possi- ble, advised a course of digitalis in small doses, and the application of the continuous galvanic current to the situation of the great nerves of the neck and the prsecordium twice a day. Three months afterwards, general anasarca supervened, for which the usual remedies, with free puncturing the skin of the legs, were resorted to. A systolic murmur had become developed at the apex. The treatment by the continuous galvanic current was patiently persisted in for fifteen months. The signs of dropsy entirely passed away, the systolic murmur was no longer audible, and a very fair recovery ensued. The lady is now—nearly eight years after the onset—able to fulfil all ordinary social duties, though incapable of much exertion. The pulse is still rapid (100 to 125), and there have been occa- sional bronchial attacks, but no serious symptoms have been complained of. Case 2.—My second case in this category illustrates recovery from a condition of extreme danger. I was called in June, 1888, by Dr. Leeson, of Twickenham, to see a lady, aged 49, m consultation wiith him. The patient appeared to be in extremis. She was lying in bed, unconscious, manifesting short and shallow respirations. The pulse at the wrist was uncountable, but the heart beats by auscultation were estimated as 200 per minute. No murmurs were heard over the prsecordium. Five years previously the patient had complained of shortness of breath on exertion as well as of general irritability. At this period she had some muscular tremor and occasionally dropped a tea-cup from her hand. Three years
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