Observations on some points in dextral valvular disease of the heart / by Alexander Morison.

Date:
[1880?]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some points in dextral valvular disease of the heart / by Alexander Morison. 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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    ]iarticularly felt at tlie tip of the right little finger. He had also frequently experienced pain of a most acute and continuous character about the lower end of the sternum, which lasted on different occasions from half an hour to four or five hours, and was not influenced by food or drink. In bed he was most free from uneasiness when lying on the right side, with the head bent for- ward, and should he when asleep have lain on his left side, the heart pain awakened him. When lying on the back the head was usually turned to one side or the other. He thought that, on the whole, he was less embarrassed when sitting up than when lying down. He had also experienced a feeling of irritation about the nostrils, with a choking sensation, and during the last two or three months of life had occasionally slight attacks of epistaxis. For a year his feet were sometimes swollen across the instep to- wards night, but no trace of such remained next morning. He suffered much from general weakness, and occasionally had what he called fainting fits. When five or six years old the patient suffered from scarlatina, which was said not to have been severe, and to have left no perceptibly evil results. As a child he had frequent attacks of croup (rheumatic ?) but there is no definite information regarding any other disease of childhood. When eight years of age he was examined by a medical man for admission to an educational charity, and was found to have heart disease, though such a condition was quite unsuspected before examination. At the age of twelve he ran a race, fainted, and became cold all over. Animation was with difficulty restored, but next morning he did not appear much the worse of the accident. Except on this occasion he betrayed no sign of delicacy, and, but that his relatives were aware of his having heart disease, he was considered healthy till the age of fourteen, when he left home and entered into business. Though frequently overworked and exposed to cold, he continued in fair health for four years, having, however, on two or three occasions had severe pain in the side, for which a doctor attended him. When eighteen years of age a medical man gave him permission to play cricket, and to this exercise he and his relatives ascribed his gradual decline in health. Increasing dyspnoea and loss of strength forced him to abandon work about a year before death, since which his previous symptoms have progressively become more serious. He had never suffered from acute rheumatism. The patient's father died insane, and his mother of consumption. Two paternal uncles and a paternal aunt died of heart disease between the ages of thirty-two and sixty. A paternal first cousin, who, with four or five brothers and sisters, has had rheumatic fever, suffers from heart disease. One maternal uncle died of heart disease, having had rheumatic fever, and another has had pneumonia. He has a brother and sister who have not had any serious illness. The patient himself was fairly grown, but emaciated; with gray- blue eyes, light brown hair, a pale, somewhat livid countenance.