Physiological principles in treatment / by W. Langdon-Brown.

  • Walter Langdon-Brown
Date:
1914
Catalogue details

Licence: Public Domain Mark

Credit: Physiological principles in treatment / by W. Langdon-Brown. Source: Wellcome Collection.

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    right heart. The most probable sequence of events is this: The left heart is already loaded to its full capacity; the proverbial last straw is too much for it, and it breaks down, while the right heart goes on beating still, forcing blood into the lungs until they become engorged, since they are unable to shut off any of the blood-supply by vaso-constriction. An out¬ pouring of serum occurs into the alveoli in such quantities that the patient is drowned in his own secre¬ tion. Two facts support this view: the commonest cardiac lesion in these cases is aortic regurgitation, which is known to terminate not infrequently in sudden stoppage of the heart; and venesection (10 to 12 ounces), according to French authorities, is the only effective treatment, and this would relieve the overloaded right heart and the stagnant pulmonary circulation. Heart.—It is not difficult to understand the absence of vaso-constrictors to the coronary arteries. If a rise of general blood-pressure is produced by vaso¬ constriction, the heart is given more work to do, so that a better blood-supply must be given to its muscle. If vaso - constriction took place in the coronaries, their blood-supply would be diminished, but in its absence the rise of pressure automatically forces more blood into them. If the heart has less work to do, the pressure falls and the coronaries receive less blood. In this way the supply to the heart muscle is made proportional to its require¬ ments. The power of compensation is extraordinary so long as the coronary arteries remain supple, but if
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