On malformations of the human heart, etc : With original cases and illustrations / by Thomas B. Peacock.

  • Thomas Bevill Peacock
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On malformations of the human heart, etc : With original cases and illustrations / by Thomas B. Peacock. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    93/304 page 37
    seat of the constriction, varies greatly in different cases. It may admit the point of one of the fingers, or a lead pencil, or common quill; or it may only allow of the passage of a probe or crow-quill. M. Louis has recorded a case in which, in a man. twenty-five years of age, it measured only two and a half lines in diameter (56 millimetres, *]33 English inches) ; and M. Bertin found the aperture of the same size in a female of fifty-seven. I have myself measured the capacity of the orifice in two males, fifteen and tAventy years, and in a female nineteen years of age, and found the cir- cumference thirteen (2925 mm. 1'154 e. in.), twelve (27' mm. 1*065 E. in.), and eight (18 mm. 'Tl e. in.) French lines respectively:—the average size in adults being about thirty- six French lines (81' mm. 3'19 e. in.). In four children, nine, seven, six and a half, and two and a half years of age, the cir- cumference of the orifice was fifteen (33'75 mm. I332 e. in.), six and a half (14*62mm.*577 e. in.), six (13*5 mm, '532 E.in.), and five (11*25 mm. 'd^M e. in.) French lines in circum- ference. Whatever be the source of obstruction at the exit of the ventricle, the trunk of the pulmonary artery is most generally smaller than natural, and its coats thin and transparent, more resembling those of veins. Usually, however, the trunk of the vessel is much larger than would be expected from the small size of the aperture; and this, though the ductus arteriosus is obliterated, and there is no other means by which the blood could enter the artery. In some cases, the arterial coats are, as before said, thickened and indurated, the obstruction being situated in the vessel itself, or the artery may be involved in disea&e which may have been primarily seated in the valves. In speaking of imperfection in the inter-ventricular septum, it has been mentioned that the defect may exist in very different degrees. The extent to which the septum may be misplaced may also vary greatly. In some cases, only a small portion of the aortic orifice, as one-third or one-fourth of its circumference, is in connexion with the right ventricle. In others, the aorta is placed immediately
    digitised image 1
    digitised image 2
    digitised image 3