A Treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them, comprising the author's view of the physiology of the heart's action / by J. Hope.

  • Hope, James, 1801-1841.
Date:
1846
Catalogue details

Licence: Public Domain Mark

Credit: A Treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them, comprising the author's view of the physiology of the heart's action / by J. Hope. Source: Wellcome Collection.

Provider: This material has been provided by the Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.

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    tionary measures both the one effect and the other may in general be prevented. In acute rheumatism, there is no more common and formidable source of danger than inflammation of the heart and its investing membranes. Should it be overlooked when existing in a severe form, (and even in that form it is, to those unacquainted with aus- cultation, one of the most obscure and insidious of maladies,) the patient almost invariably dies from the immediate effects of the attack, or becomes a short-lived martyr to an incurable organic disease of the heart. There is scarcely a disease of the heart, accompanied with ob- struction of the circulation for any considerable period, which is not productive of enlargement of the liver, and, sooner or later, of its ordinary consequence, abdominal dropsy. Yet there are few common facts in medical science less generally known than this intimate connection between the heart and the liver. The dropsy is ascribed to the latter; the treatment extends not beyond this organ; the unknown cause continues to reproduce its effect, and the patient, if he obtain relief at all, only obtains it to undergo a speedy relapse.* Individuals affected with disease of the heart are peculiarly liable to inflammation of the lungs; and such inflammation, as I have endeavoured strongly to inculcate throughout this volume, is sin- gularly rapid and destructive. Yet if, from ignorance of the state of the heart, free depletion be practised on the ordinary principles, the patient may sink suddenly after the first or second abstraction of blood. I have more than once witnessed this catastrophe, and few practitioners of experience have not seen the same. In fever and inflammation in general, disease of the heart may impart to the pulse, dangerously deceptive characters of hardness, fulness, weakness, or irregularity, and the patient may be bled too much, from the prevalence of the former characters, or too little, from the presence of the latter.f Thus it is seen that the practical improvements to be derived * Similar remarks often apply to enlargement of the spleen, to hemor- rhage from the stomach connected with congestion either of the liver or the spleen, to bleeding piles dependent on engorgement of the portal system, and occasionally even to uterine hemorrhage. [The triple lesion of organic change of the heart, liver, and kidneys, is presented in a majority of the cases of diseases of the central organ of the cir cul atio n.—P. ] f I have offered, at the termination of the work a complete table of the pulses of disease of the heart—the first, I believe, that has ever been at- tempted. They imitate all the pulses of ordinary disease: consequently, unless the practitioner can make allowance for disease of the heart, the pulse is a fallacious criterion of other affections. This appears to me to be the main reason why there has been, from time immemorial, so much disagreement amongst authors respecting the indications of the pulse and its value as a sio-n of disease.