Remarks on failure of the heart from overstrain : being the opening of a discussion in the Section of Pathology at the Annual Meeting of the British Medical Association, held in Glasgow, August, 1888 / by Prof. Roy and J.G. Adami.

  • Roy, Charles Smart, 1854-1897.
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on failure of the heart from overstrain : being the opening of a discussion in the Section of Pathology at the Annual Meeting of the British Medical Association, held in Glasgow, August, 1888 / by Prof. Roy and J.G. Adami. 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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    [ seldom, in cases due to a primary muscular fault, and to conse- quent failure of the mitral valve by stretching, do we find the con- dition of the mitral one of simple dilation of the orifice. The chordae tendineae and the edges of the valves are usually thickened. There appears to be no stenosis in thsoe cases where the failure is due to senile weakness of the muscle, or to degeneration. “ Take, next,” he remarks, “ another fact less well known than it ought to be, namely, that in a large number of cases of chronic renal disease there is a notable, and sometimes extreme, thickening of the mitral flaps.” “ Of 192 consecutive cases of chronic renal disease, 72, or more than one-third, had some thickening either of the 6 ] mitral or the aortic valves, or both. In 49 of these the mitral was either thickened or actually contracted. The mitral was con- tracted, and therefore very thick, in 9 cases, and all 9 were from cases of granular contracting kidney; 97 of the 192 cases were granular, and of these 45 had more or less thickening of the valves.” Goodhart states as his opinion that much of the mitral stenosis, where there is no history of rheumatism, and which is so com- mon in women compared with men, is the outcome of the chlorotic, mitral regurgitation which is so commonly met with in girls and young women. With Goodhart’s views on this subject we entirely coincide.