On acute dilatation of the heart as a cause of death in scarlatinal dropsy / by James F. Goodhart.

  • Sir James Goodhart, 1st Baronet
Date:
[1880?]
Catalogue details

Licence: Public Domain Mark

Credit: On acute dilatation of the heart as a cause of death in scarlatinal dropsy / by James F. Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    and syncope ? It was impossible to explain it to them, and had it been possible it would not have been wise, for it carried with it an exaggeratedly unpleasant reflection for an unprofessional mind, that it was an end from which apparent health gave no immunity, and that any one else, the most hale looking amongst them, might drop suddenly in the same way. That, indeed, is partly the wonder of the doctor, not that such cases occur, but that they do not present themselves more often. The case finished, so far as I was concerned, in a very sug- gestive way, for happening to meet the son of this gentleman some time afterwards, I did attempt to explain to him in some measure this dependence of syncope on high tension, and he closed the conversation with this remark : “ But that is very strange, for my father always had such a remarkably strong pulse.” “ A remarkably strong pulse,” methinks, would hardly obtain so favorable a verdict in a court with the sphyg- mograph as the presiding judge. The case was at the time more especially interesting to me as illustrating the difficulty that there is sometimes, and not very infrequently either, of putting one’s finger upon the precise cause of death. If the interpretation of this case is the right one, here is a cause of sudden death which may leave very little evidence behind it. P.S.—I have two omissions to record1st. My colleague, Mr. Howse, tells me that some years ago Sir William Gull was in the habit of giving special prominence to the fact that acute pericarditis in rheu- matic fever is liable to give rise to rapid dilatation of the heart, which is often mistaken for pericardial effusion. Sir W. Gull also taught that dilatation is succeeded, not preceded, by hypertrophy in some of these cases, and Mr. Howse has used this as an illustration in discussing the conditions associated with varices.1 I am very glad to be able to mention this, not only because it is a weighty confirmation of some of the remarks made in this paper from another point of view; but also because it has hitherto been unrecorded. And yet as an observation of one whose clinical experience is of the widest, upon a still disputed point in cardiac pathology, it is exactly the kind of record which is wanted. 2nd. Concerning the rate at which the heart hypertrophies, I have accidentally omitted to refer to Dr. Peacock’s original observations which were published in the ‘Edinburgh Monthly Journal,’ vol. vii, p. 405, and are again alluded to in his ‘ Croonian Lectures ’ for 1865, 1 ‘Guy’s Hospital Reports,’ 1877, vol. xxii, p. 481.
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