Contributions to practical medicine / by James Begbie.

  • James Begbie
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical medicine / by James Begbie. Source: Wellcome Collection.

    24/334 page 14
    cal conditions of the inner lining of the different cavities, and of the vegetations and wrinkled induration of the valves, which still baffle the speculations of the anatomist. Lobstein traces most of these morbid conditions of the endocardium to gout as their real source, and Hasse has acknowledged that the evidence he adduces is, in many instances, most convincing. I have long entertained the notion that the extreme fre- quency of pericarditis and of endocarditis, as demonstrated in these morbid alterations of the heart's structure found after death, is to be traced to the prevalence of the gouty diathesis. We know how slight and transient is the pain in the small joints of the fingers, which is occasioned by the gouty inflam- mation and the gouty deposit there, and how many are the years that elapse before these indications of diseased action re- veal themselves to our senses by thickening and stiffness, and swelling. May not the transient pangs in the cardiac region which so constantly affect the victims of the gouty habit, ori- ginate in the specific inflammation when it is in the act of depositing lymph which is, by slow yet sure degrees, to form the milky patches and the small adhesions, and the puckered valves and slender vegetations which we find so often after death, and which teach the lesson that there is no structure of the body more liable to inflammation than the investing and lining membranes of the heart, though the evidence of diseased action has neither been detected nor perhaps been detectable during life? There are few, or perhaps none, of the subjects of gout we have seen, who have not sooner or later given evidence of organic disease of the heart or arteries, progressive in its nature, yet often so slow and insidious that its existence has only been discovered when some accidental illness or other circumstance has called for an examination; and all must acknowledge that the fatal diseases of the gouty are those con-
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