Studies in Japanese "kakké" or beriberi / by Wallace Taylor.

  • Taylor, Wallace W.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Studies in Japanese "kakké" or beriberi / by Wallace Taylor. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    14/54 (page 8)
    and soft, but imparts to the finger a sense as if the blood flowed along the artery by floods, to be completely emptied during the cardiac diastole. Elevating the arm above the head does not affect the pulse. The aortic valve sound is less distinct than the pulmonary. The apex sound is forcible, somewhat water-ham- mer like. The chest does not heave. Trac. 2. ( ) These tracings were taken with the patient sitting by a table. Pressure, 2 oz. After tak- ing the upper tracing the patient walked back and forth across the room two or three times, when the lower tracing was taken. Seven days later tracings were again taken. In the mean time the patient had been taking digitalis and folt much more comfortable after slitfht exercise. He does not now suffer from palpitation. Trac. 3. ( ) These tracings were taken under the same conditions that the previous tracings were. Pressure of the upper tracing, 1 oz.; of the lower, 2 oz. Tracings 2 show very sudden systole, with condition in diastolic period irregular. Slight exercise brings out more forcibly the irregular action of the heart. Tracings 3 show hut little improvement, while the condition of the patient was very much more comfortable after slight exercise. The muscles of the legs were thrown into a violent quiver on slight exertion, and the patient was suffering somewhat from general nervous prostration, but the cardiac muscles were less affected than those of the lower ex- tremities. Case 3. /.—Om. Female* aet. 34. The patient is of good constitution, she has now been ill 20 days. This is a case compli- cated with pneumonia; the pneumonia com- mencing first, and kakke set in afterwards. She cannot rise up nor stand, she can, how- ever, suioari] with difficulty. She can imper- fectly flex and extend the legs, feet and toes. TAG grasi) of the hand is very weak. She can raise her arms up but cannot extend the fingers. Pulse 6U, and if an effort to rise up is made the pulse at once runs up to 85. She suffers much froin distress in the chest, and palpita- tion of tiie heart; and if an effort is made these are very much increased. The pulse feels * See Addenda.—Sex. t Sumari, to sit in the Japanese position. strong and full with a hammer-like stroke. The heart sounds are normal. Condition of blood, Table II.—No. 4. Trac. 4. ( ) These tracings were taken with the patient lying down. Pressure of the upper tracing 1 oz. and of the lower 4 oz. These tracings show a favorable condition of the heart and good tension of the circulation. With this woman's distress in the chest, marked dyspnoea, and extensive muscular pa- ralysis, I felt apprehensive for the result, but the sphygmographic tracings assured me there was no immediate danger. She soon began to improve, and in a short time was up and around. Case 4. M.—Male, aet. 44. This patient is of strong constitution, and has now been ill with kakke about 50 days. This is the ninth successive* year he has had kakke. He can walk a short distance without inconvenience, but if he attempts to walk any distance or to walk fast he suffers from dysp- noea, palpitation of the heart, distress in the chest, and is compelled to rest. If quiet he suffers no inconvenience. The upper extrem- ities are not affected. The pulse and heart sounds are normal. Trac. 5. ( ) This tracing was taken with the patient sitting at a table. Pulse 70, pressure 4 oz. The systolic upstroke shows a somewhat sud- den percussion. This is characteristic in kak- ke where the heart is but slightly affected. The tension of the circulation is good, however. I encouraged the man to keep on Avith his work (he was a doctor), but not to attempt to walk. The year before when this man had kakke, the muscular paralysis was mild, but the heart was exceedingly weak. He could not walk more than a few steps without suffering such distress in the chest, dyspnoea and palpitation of the heart, that he was compelled at once to lie down. The chest would palpitate and quiver under the violent and irregular action of the heart. He could not even rise up to svwari or stand mthout distressing disturbance of the heart. I kept him lying quiet in bed for over two months. But not having an instrument at my command at the time, I was unable to take a tracing. * See Addenda,—Recurrence.