A research upon combined mitral and aortic disease of rheumatic origin : a contribution to the study of rheumatic malignant endocarditis / by F.J. Poynton and Alexander Paine.

  • Frederic John Poynton
Date:
1912
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Licence: In copyright

Credit: A research upon combined mitral and aortic disease of rheumatic origin : a contribution to the study of rheumatic malignant endocarditis / by F.J. Poynton and Alexander Paine. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Among the most remarkable must be placed that one which suggests that rheumatism is a mysterious and unknown disease akin to simple scarlet fever, upon which all the manifestations are to be grafted as secondary infections. When we can imagine on the one band a scarlet fever which is not infectious and is without a rash save in exceptional cases, and on the other a rheumatism which is infectious and which possesses no manifestations except possibly a sore throat and an occasional rash, we may be able to appreciate the likeness between these two diseases. For us an infectious disease such as scarlet fever, whether complicated by secondary infections or not, possesses a peculiarity of its own, viz. its infectivity. Whereas acute rheumatism, deprived of its manifestations, is a disease still to be discovered, as also would be in our opinion a tuberculosis or pneumococcal infection without its manifestations. Group No. IV. Chronic Heart Disease due to previous Rheumatic Endocarditis. A. Cases showing chiefly aortic symptoms. No. 1. Male, aged 63. History of acute rheumatism: 3 attacks; heart disease at 13 years. Main symptoms of final illness: 2 days’ illness. Sadden death, aortic type, mitral and aortic disease. Approximate duration: 2 days. Result: Death. Cal- cified valves. No. 2. Male, aged 42. History of much rheumatism. Main symptoms of final illness : Angina pectoris—dyspnoea, aortic and mitral disease. Approximate duration : Many weeks. Result: Death. Thickened valves and aortic atheroma. Ho. 3. Male, aged 40. History of acute rheumatism at 27. Main symptoms of final illness: Mitral and aortic disease, angina pectoris. Approximate duration: 4 weeks. Result: Relieved. No. 4. Male, aged 40. History of acute rheumatism: Repeated attacks. Main symptoms of final illness : Mitral and aortic disease with angina. Approximate duration : 6 weeks. Result: Relieved. No. 5. Female, aged 14. History of acute rheumatism : Slight. Main symptoms of final illness : Mitral and aortic disease, pallor, pain in chest. Approximate duration : 9 days. Result: Relieved. No. 6. Male, aged 28. History of acute rheumatism at 18 years and since. Main symptoms of final illness : Mitral and aortic disease, dyspnoea. Approximate duration : 7 days. Result: Left at his own request. No. 7. Male, aged 48. History of acute rheumatism at 35 and 39 years. Main symptoms of final illness: Mitral and aortic disease, angina. Approximate duration : 3 weeks. Result: Relieved. B. Cases showing chiefly mitral symptoms. No. 1. Male, aged 38. History of acute rheumatism : Several attacks. Main symp- toms of final illness: Alcoholism. Mitral and aortic disease, jaundice, dropsy, dyspnoea. Approximate duration : 11 weeks. Result: Death. Sclerosis of aortic and mitral valves. No. 2. Male, aged 50. History of acute rheumatism at 8, 25, 36, and 49 years. Main symptoms of final illness : Mitral and aortic. Oedema, dyspnoea, &c. ; asystole. Approximate duration : Many weeks. Result: Death. Calcified aortic and mitral valves ; shortening of chordae tendineae. No. 3. Male, aged 72. History of acute rheumatism at 17 years. Main symptoms of [Q J- M., July, 1912.] M m