Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.

  • Pierre Charles Alexandre Louis
Date:
1844
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Licence: Public Domain Mark

Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    the heai't—a fatty condition of this organ, observed in four phthi- sical subjects, all of them females.^ In these four cases the lower half of the anterior wall of the right ventricle had undergone the fatty transformation; and, close to the columnse carnese, small discolom-ed fibres, surrounded with fat, appearing to spring di- rectly from the adipose tissue, and uninterruptedly continuous with the muscular fibres of the columnse, presented themselves. The heart was surrounded with a considerable mass of adipose substance, although all subcutaneous fat had disappeared. In all these cases the liver was fatty. I found the pericardium adherent to the heart in two cases. In a thii'd, both laminae of the serous sac were invested with a false membrane about one line [2 millimeters] thick, moderately firm, and containing a small quantity of transparent serosity in its substance. The individual exhibiting this example of pericarditis had sufi'ered greatly from palpitation, and during the twenty- three days he remained under my notice, his pulse was ex- tremely irregular. In my 'Essay on Pericarditis,^ I have related a case in which some semi-transparent gray granulations, seated under the serous lamina of the pericardium, acted in all probability as the exciting cause of the pericarditis under which the patient laboured. When simple, I have always seen this affection terminate favorably; but it is readily conceivable that it must often prove fatal, when arising under the influence of gray semi-transparent granulations,—even in subjects in whom the lungs contain but few tubercles. In one tenth of my cases there was serous effusion in the pericardium to the amount of from about 4f to 9|- ounces [150 to 300 grammes]. The state of the heart was very much the same in other chronic diseases as in phthisis. Of eighty subjects dying from some chronic affection of non-tuberculous nature, five pre- sented some enlargement of the organ. In nine cases it was flaccid and soft; in eight the left ventricle was hypertrophous, in seven attenuated; whereas hypertrophy and attenuation of the right ventricle existed in only a single instance. Lastly, the heart was considerably smaller than natural in thirty sub-