Licence: Public Domain Mark
Credit: Outlines of human pathology / by Herbert Mayo. 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.
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![must labour doubly; in its systole it has to force the blood through a rigid and narrow passage, in its diastole it has no protection against the systole of the ventricle. The auricle being distended with blood, and acting forcibly, the pulmo- nary vessels must become gorged ; hence oppressed breath- ing, spitting of blood, pulmonary apoplexy, serous effusion into the lungs. The vessels of the lungs being loaded^, the right ventricle must exert unusual force to drive its blood into the pulmonary artery; hence it will become dilated, and at the same time probably hypertrophied : the ventricle dilating, its auricular opening will gradually yield, and the blood be forced backward into the auricle at the ventricular systole; from the right auricle of course the refluent pressure tells upon the systemic veins, and a systolic pulse is thus produced in the veins of the neck : at the same time oedema may be produced; or, to follow the retarded column of blood along the inferior cava, hepatic congestion and ascites, venous obstruction and oedema in the lower extremities may ensue. The heart at the same time, overwrought and irritable, is the seat of pain and palpitation alternating with syncope. This instance may serve to illustrate the use of pathological knowledge: a few principles justly laid down, the expla- nation of an immense assemblage of complicated pheno- mena is naturally and easily deduced from them. The inner membrane of the heart, where it is reflected over the muscular structure, is often the seat of inflammation, which leaves patches slightly thickened or covered with adherent vegetations. The same part of the membrane sometimes gives attachment or origin to pendulous tumours, which, if of gradual formation, and not of considerable magnitude, only produce symptoms when they happen to be so placed as to interfere with the action of the valves. \t. 55.] is a tumour as large as a walnut, firm, and in a section resembling a clot of blood, growing from the left side of the septum of the heart, and projecting into the left au- ricle. It probably interfered with the closure of the mitral valve, towards which it projected : and I am assured, that, during life, the first sound of the heart was wanting, and the diastolic attended with a murmur. The tumour was](https://iiif.wellcomecollection.org/image/b21066735_0508.jp2/full/800%2C/0/default.jpg)
