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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![going like a veritable neuralgia. In others again it assumes a paroxysmal character. The countenance generally betrays suffer- ing by an expression of pain or distress, and the patient not infre- quently keeps his hand upon his heart. Although this symptom, pain, is doubtless due, in large part at least, to the friction pro- duced by the rubbing together of the inflamed pericardial sur- faces, still its intensity depends also upon the sensitiveness of the patient, it being well known that some persons never feel pain so acutely as do others of a less phlegmatic temperament. The pain of pericarditis persists so long as the inflamed surfaces continue to rub against each other, and hence when these become separated by effused fluid this symptom abates or disappears. Therefore, if pain suddenly ceases while the continuance of pyrexia points to continuance of the active inflammation, it may be taken to indi- cate beginning effusion into the sac. Cough may or may not be present, but when present is usually dry and frequent, and when conjoined with pain may give rise to the suspicion of pleurisy. In a fourteen-year-old girl seen not long ago and in whom the inflamed pericardium had led to great car- diac dilatation, with consequent pressure on the left lung, the attending physician at first mistook the case for one of pneu- monia. This case is so instructive that I will briefly rej^ort its salient features. On a certain Friday this girl complained of slight pain and stiffness of one of her legs, but was not prevented there])y from going to school as usual. The following Monday she felt several slight chills, which were attributed to the coldness of the room in which she was at the time. For several days follow- ing she showed signs of malaise, and in other respects did not seem well, yet did not give up and go to bed. Friday night, a whole week from her initial rheumatic attack^ she spent at a friend's house, but when the next morning came was unmistakably ill, and the family doctor was sent for. He found her with a dry cough, hurried respirations, rapid pulse, considerable fever, and a sharp pain in the left side above the heart. Examining tlie lungs, and discovering some dulness and bronchial breathing at the left posterior base, lie pronounced the case ])neumonia—an error that could have been avoided by a proper examination of the heart. Three days later another physician saw the patient, and at once recognised the true character of the disease. When on the ensu-](https://iiif.wellcomecollection.org/image/b21229533_0074.jp2/full/800%2C/0/default.jpg)
