Case of sudden death from rupture of the superficial fibres of the heart / by David MacLagan.

  • Maclagan, David, 1785-1865.
Date:
[1845?]
Catalogue details

Licence: Public Domain Mark

Credit: Case of sudden death from rupture of the superficial fibres of the heart / by David MacLagan. Source: Wellcome Collection.

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

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    but not its exact limits, and though on applying my ear I thought I heard and felt a slight impulse of the heart, it was so obscure as not to be depended on. Though watching with much interest the symptoms of the case, and strongly impressed with its probable affinity to that of our la- mented friend, Dr Abercrombie, I need hardly apologize for the scantiness and imperfection of my observations. The Society can appreciate the circumstances in which a medical practitioner is placed, in the midst of an anxious family, constant in inquiry, watching his every movement and expression, and hoping even against hope, that something may be done to save the object of their affections. This lady had throughout life enjoyed a remarkable share of good health, was active to the last in the discharge of domestic duties, and in taking regular exercise in the open air. With the exception of occasional derangement of the digestive functions, which de- manded only the mildest remedies, she had rarely required medical aid. She had never complained of difficulty of breathing or inabi- lity for exertion, except that limitation of power and of facility in ascending heights or steeps common even to healthy persons of a less advanced age, particularly where, as in her case, increased cor- pulence accompanies it. The body was examined forty-six hours after death, by my son, Dr Douglas Maclagan, in my presence, and that of one of his pu- pils. The general appearance was that of a healthy person sud- denly deprived of life, and of an apparently less advanced age than that which the individual had actually attained. Previously to opening the cavities of the chest and abdomen, it was ascertained, that precordial dulness extended from the centre of the sternum to the left mamma, as far upwards as the fourth rib, and as low as the xyphoid cartilage. On opening the cavities of the chest and abdomen, the tegumen- tary coverings were found loaded with fat. The contained vis- cera exhibited a very healthy appearance. On exposing the peri- cardium,—the state of which, and of the contained heart, was the first and main object of inquiry,—the pericardium was immediately seen and felt to be much distended, and that apparently with fluid; on opening it, about eight ounces of fluid blood, and four of coagu- lated, were removed. On further examination, the source of the blood was found to be two small lacerations of the substance of the heart itself. One of these was about four lines in length, in a direction nearly corres- ponding with the greatest length of the organ. It was situated on the anterior aspect of the left ventricle, close to the septum cordis, and about an inch and a half above the apex of the heart. The smaller laceration was situated a little higher up on the heart,—was very shallow, and seemed little more than a rent or fissure of the invest- ing serous membrane. Close to the septum there were also one or