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

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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$Valvular Defects.—Chronic valvular disease seems undoubt- edly to predispose to pericardial inflammation; tins is said to be particularly the case with aortic insufficiency. Why valvular le- sions should thus tend to the production of pericarditis is a mat- ter for conjecture. By the advocates of the doctrine of the infec- tious origin of all inflammations, it would probably be explained as an instance of secondary or mixed infection, in consequence of the very close anatomical and physiological connection existing between the endocardium and pericardium. Trauma.—Finally, acute pericarditis is sometimes the result of direct injury, as gunshot or stab wounds, blows' upon the chest- wall and laceration by fractured ribs. Under such circumstances micro-organisms are usually introduced into the pericardium, and there set up an acute inflammatory process which, if the cocci be pyogenic, will prove to be suppurative. DRY PERICARDITIS SvN.: Fibrinous, Plastic, Adhesive Pericarditis The pathology and etiology of this form have already been consi(l(n-(Ml, and therefore I shall pass at once to Symptoms.—This disease usually arises during the course of some already existing infectious process, and therefore its inva- sion, and even its subsequent progress, are likely to be masked for a time by the clinical phenomena of the primary affection. In- deed, some authors go so far as to state that there are so few subjective symptoms attending dry pericarditis that it may be said to be a latent afi^ection. In many instances this is probably correct, but I believe the existence or absence of subjective phe- nomena is determined by the degree of intensity and extent of the pericardiiil inflammation. If in the course of acute articular rheumatism there is a sud- den elevation of temperature which cannot ])e explained by the fresh involvement of other joints, or if (Icliriiiin or pronounced disturbance of the nervous system suddenly takes place, especially in children, it is suspicious of some of the lieart-structures having become invaded by the inflannnatory ])rocess. This organ, there- fore, should at once be carefully examined, and if necessary re- peatedly examined, for, according to the fig\ires already quoted$