Some account of cardiac aneurysms : being the Bradshawe lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg.

  • John Wickham Legg
Date:
1884
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Licence: Public Domain Mark

Credit: Some account of cardiac aneurysms : being the Bradshawe lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg. Source: Wellcome Collection.

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    commonly attends aneurysm might be the cause rather than the effect; a speculation which I do not think would now find favour with many. Of the cause of fibrous myocarditis, it must be owned, we have as yet no clear knowledge; but I incline myself to the opinion that it will be found some day to be closely akin to those causes which make endocarditis and so many other pathological processes choose as their seat the left ventricle and its lining membrane rather than the other chambers of the heart. There seems to be no great connexion between the processes of endocarditis, and of those of fibrous myo¬ carditis in which aneurysms are formed. In my own collection of cases, I could ouly find 7 in which there were distinct evidences of endocarditis ; in 16 there was evidence of atheroma in thickening, calcification, or change of colour; in 20 the valves are expressly said to be natural; and of the remainder no opinion is either expressed or can be formed. It has been said that from the days of Cruveilhier and Thurnam, morbid anatomists have looked upon fibrous myocarditis as the chief cause of aneurysm. Dr. Hilton Fagge,1 in the admirable paper on fibrous myocarditis which must be known to every Fellow of this College and to which I am myself much indebted, expresses the opinion that “ cardiac aneurysm probably never occurs except as an accident in the course of that diseased* Let us then examine this proposition a little more closely. Let us first acknowledge, however, that as time goes on, the number of cases which are set down to any other cause than fibrous degeneration of the heart, hardly increases at all. Fatty degeneration, however, certainly deserves attention. Dr. Fletcher's case, which is some¬ times quoted, seems to have been one of fatty heart only, without an aneurysm, and in Mr. Meade's case there was rupture of the apex and a bulging at the place of rapture 1 Alas, that we should now have to lament liis early departure from among us ! (November, 1883.)
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