The diseases of the chest : including the principal affections of the pleurae, lungs, pericardium, heart, and aorta / by Vincent D. Harris.

  • Harris, Vincent Dormer.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of the chest : including the principal affections of the pleurae, lungs, pericardium, heart, and aorta / by Vincent D. Harris. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    present, with shortness of breath and a tendency to blueness of the lips and possibly dropsy, but these symptoms can hardly be said to be due immediately to the condition of which we are treating. As with symptoms, so with physical signs, al- though several are mentioned as possible, yet not one is certain—indeed, if the pericardium is adhe- rent to the heart only, we know of no physical sign whatever which would indicate the condition. If, however, the pericardium is adherent not only to the heart, but also to the chest wall in front or behind or to both, there may be these signs : i. A depression of the intercostal spaces at the position of the apex-beat, during the cardiac systole, and its cessation during diastole. This may happen,* so it is said, even although there be no adhesion of the pericardium to the chest wall anteriorly, but how, it is difficult to imagine. If there be no pleuro-pericardial adhesion the sign is absent. ii. If there are pleuro-pericardial adhesions, the area of cardiac dulness and the position of the apex-beat are unaffected by a deep inspiration. iii. There is systolic recession of the epigastrium. iv. The jugular veins are distended during systole and collapsed during diastole. III. Hydropericardium [hydrops pericardii] [An abnormal collection of fluid within the peri- cardium of non-inflammatory origin.] Causes.—It must be recollected that an apparent increase in the amount of fluid noted in the peri- cardial sac after death does not of necessity indicate anything but a serous transudation a few hours, it may be, before death has occurred. In other cases i. A collection of serous fluid in the pericardium is nearly always a part of a general dropsy, e. g. that arising in chronic kidney or lung disease. * See Niemeyer, vol. i, p. 390. 20
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