Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine.
- Babcock, Robert H. (Robert Hall), 1851-1930
- Date:
- 1910
Licence: Public Domain Mark
Credit: Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![tendency to subsequent adhesive inflammation of other serous membranes and to the spreading of the adhesive process within the mediastinum furnishes an exceedingly grave outlook for the future. When ascites, anasarca, and other symptoms of the final breakdown appear there is small prospect of a restoration of compensation. Under such conditions the duration of life is likely to be bounded by a few months or even a few weeks. Although, as in the cases narrated, the struggle may be extended over a number of years, the patient is a chronic invalid at the best, and can only with great difficulty postpone the fatal event. The absence of all subjective and objective symptoms furnishes presumptive evi- dence that the adhesions are not extensive. If, on the contrary, symptoms of engorgement within the lesser and greater circula- tion are never wholly absent, they aflPord the basis for unfavourable prognosis. The greater the secondary cardiac hypertrophy and dilatation, particularly in children, in whom chest capacity is small, the slighter the prospect of the long retention of adequate compensation. When the last stage of the journey is reached it is likely to be a short one. The prognosis of chronic pericardial effusion depends upon its etiology and the length of time during which it has existed. It also depends upon its association or not with some other disease, as chronic nephritis, and upon its amenability to treatment. Treatment.—It goes without saying that we possess no means of breaking up the pericardial adhesions; at the most we can only strive to lessen their ill effects and to prevent.an exten- sion of the process. In our endeavour to accom]>lish the latter, any rlieumatic attack or acute illness, no matter how trifling, should be promptly and energetically combated by appropriate means. The patient should be at once confined to the house, and if possi- ble to the bed, in order to relieve the heart of any unnecessary work, and tlicreby if possible pi-event fresh pericardial inflamma- tion or restrain the activity of the process, sliouhl the pericardium again become attacked. Salicyhites, counter-irritants, or other mild antiphlogistic measures are in order. The chief aim of management should be to preserve compen- satory hypertrophy, and so far as possible to minimize the ill ef- fects produced by the; cai'diac disorder. In my opinion, the first essential is that the patient be not left in absolute ignorance of](https://iiif.wellcomecollection.org/image/b21229533_0148.jp2/full/800%2C/0/default.jpg)
