A case of tricuspid and mitral stenosis in which physical signs of pulmonary arterial reflux were present / by Sir Dyce Duckworth.
- Duckworth Dyce, Sir, 1840-1928.
- Date:
- [1888]
Licence: Public Domain Mark
Credit: A case of tricuspid and mitral stenosis in which physical signs of pulmonary arterial reflux were present / by Sir Dyce Duckworth. 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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![epHnted from Vol. XXI of the * Clinical Societys Transactions.'] Case of Tricuspid mid Mitral Stenosis in which physical signs of Pulmonary Arterial Reflux ivere present. By Sir Dyoe Duckwoeth, M.D. Head January 27, 1888. MARY S., ast. 23, a fancy box-maker, married three years, without family, was admitted to Elizabeth Ward in St. Bartholomew's Hospital under my care on May 31, 1887, suf- fering from general dropsy and dyspnoea. She had had scarlet fever at the age of five years, but never rheumatism or chorea. She remembered suffering from short breath on exertion when fourteen years old. For twelve months past she had been particularly subject to dyspnoea, palpitation, and sickness. Three months previously she caught cold and had been worse since. Dropsy began in the legs, and was next noticed in the face, then in the belly. On admission, the face was very dusky and bloated. Ex- tremities cold. No clubbing of nose or finger-ends. Jugular veins slightly full. Tongue furred. Pulse barely perceptible, irregular, 128 per minute. The heart's impulse was diffused, maximum distinctness of apex-beat in left fifth space in nipple-line, but impulse felt indistinctly an inch outside this point. Well-marked praesystolic thrill over left ventricle. Prsecordial dulness began at fourth rib and extended to right beyond middle line of sternum. At the apex a prsesystolic murmur was heard, followed by a systolic one not traceable into axilla. Over the tricuspid area a systolic murmur was also heard. The pulmonary second sound was accentuated. Hepatic dulness began at fourth right interspace, and the lower edge of the liver was felt indistinctly about 2 inches above umbilicus. Spleen not palpable. Over the lungs was some impairment of resonance at the base, with feeble respi- ratory murmur and crepitation. The' urine was of sp. gr. 1025, deposited urates, and contained one fourth of albumen. The temperature was 98'2°. The legs were cold, very oede- matous and dusky, with scattered purpuric spots. She was ordered light diet, with 2 oz. of brandy; tincture of cannabis indica and spirit of chloroform, and compound jalap powder were given as medicines. After four days tine-](https://iiif.wellcomecollection.org/image/b21696640_0003.jp2/full/800%2C/0/default.jpg)
