A textbook of medical treatment, diseases and symptoms / by Nestor Tirard.

  • Tirard, Nestor Isidore Charles, Sir.
Date:
1900
Catalogue details

Licence: In copyright

Credit: A textbook of medical treatment, diseases and symptoms / by Nestor Tirard. Source: Wellcome Collection.

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

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    but, on the other hand, the usual indications of cardiac failure—oedema, hydro-thorax, or hydro-pericardium—do not appear to add to the risks of the treatment. The most suitable cases are those of enfeebled heart, with or without marked dilatation, and with or without organic valvular lesion. Fatty Degeneration. — Fatty degeneration frequently occurs as a sequel of many prolonged fevers which are ordinarily marked by wasting; thus it is common after typhus and typhoid fever, and it occurs, in addition, in con- nection with phosphorus poisoning. When resulting from such causes it is not likely to have any serious sequelae, nor does it require any special line of treatment. The indica- tions which are ordinarily followed during convalescence are those which are applicable to this condition. Thus it is advisable to encourage moderate but gradually increasing exercise, and to employ iron and other tonics to improve the general condition of the health. The patient’s dietary should also be rendered nourishing and digestible. A more serious form of fatty degeneration is that which ensues after the prolonged existence of various cardiac lesions; thus in the advanced stages of aortic disease, more particularly among the poorer classes, the hypertrophied muscle almost invariably undergoes fatty degeneration, and the treatment of such cases necessarily resolves itself into the treatment of uncompensated disease of the aortic valves. Fatty degeneration also occurs with some frequency as a result of impaired nutrition, owing to atheromatous changes in the coronary arteries ; and in such cases the prominent symptoms are dyspnoea, even on slight exertion, and a sense of weight upon the chest, from which the patient endeavours to free himself by taking deep breaths from time to time, so that the respiration is often of a sighing nature. Frequently under these conditions the patients suffer from sleeplessness at night, while they tend to doze off at odd times during the day, drowsiness being more particularly marked after meals. In addition, these patients are subject to true attacks of angina pectoris, the attacks being perhaps rather more common at night. As with other cases of angina, these symptoms are frequently conjoined with those of impaired digestion ; in c >1
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