Certain clinical features of cardiac disease / by G. A. Gibson.

  • Gibson George Alexander, 1854-1913.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Certain clinical features of cardiac disease / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ory plays me false, it was, on admission, about 200 millimeters [362] of mercury. During the paroxysms of the pain it appeared to be even higher, but for obvious reasons it was not specially measured at such times. When Dr. Stewart was engaged one day taking some tracings with the sphygmograph, an attack appeared, and the curve, which had shown the ordinary fea- tures of a somewhat high-pressure pulse, at once became much smaller in amplitude with its tidal wave higher up on the descending limb; in other words, it was a tracing of a pulse of higher pressure than before. The administration of nitrite of amyl promptly relieved the patient (as it always did during an attack), and brought about a return of the pulse to lower pressure. The heart was slightly enlarged, and the aortic second sound was considerably increased in intensity, but there were no other objective evidences of cardiac disease. The ocular phenomena can be clearly seen in the pictures thrown on the screen, while the sensory disturbances which were traced upon the surface of the patient (who was after- wards photographed), have also been shown along with photo- graphs of the pulse tracings. It is satisfactory to be able to state that by means of the 1363] nitrites and iodides the patient made an excellent recovery. For some slight ailment he presented himself in my ward during the present summer, and we were able to assure our- selves of this fact. Disturbances of the rate and rhythm of the heart have dur- I 'ing the last few years furnished a fertile field for discussion. It is obviously too large to enter upon fully on the present occasion, but there are some aspects of the subject to which you will, perhaps, allow me to direct your attention. Before entering upon any discussion of the clinical bearings of such disturbances it is necessary to turn briefiy to the mechanism involved. The researches of Gaskell upon the connections of the auricle and ventricle, in which he was followed by a num- ber of observers, showed the existence of the now well-known auriculo-ventricular bundle. The entire course and distribu- tion of this interesting connecting link were unfolded by the jnndefatigable researches of Tawara, demonstrating that after (passing down from the inter-auricular to the inter-ventricular