Volume 2

The Clinique médicale, or, Reports of medical cases / by G. Andral ... Condensed and tr., with observations extracted from the writings of the most distinguished medical authors: by D. Spillan.

  • Andral, G. (Gabriel), 1797-1876.
Date:
1836
Catalogue details

Licence: Public Domain Mark

Credit: The Clinique médicale, or, Reports of medical cases / by G. Andral ... Condensed and tr., with observations extracted from the writings of the most distinguished medical authors: by D. Spillan. 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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    plethoric state, though the continuance of the latter, by prolonging the excess of the heart’s action, may ultimately produce its hypertrophy, in the same way as a muscle increases in thickness under the influence of violent exercise; thirdly, these symptoms may again be occasioned by a vitiated disposition of the nervous influence, which may cause the heart to beat with force or irregularity ; just as it produces vomiting, or just as it excites the most disorderly' movements in the muscles of relative life. The palpitations called nervous may manifest themselves in conditions of the system differing most widely from each other. Thus they are one of the symptoms of the hysterical affection ; they occasionally appear on a sudden in consequence of some strong mental emotion ; we have seen the cases of three individuals, who had never presented the least sign of disease of the heart, up to the moment when some strong impression happened to act on them : from this moment they were seized with very painful palpitations, which no longer ceased,] and at the end of a certain time we discovered in these persons the existence of hypertrophy of the heart. Thus, in this case, the entire disease consisted at first in a disturbance of the nervous system, and this lesion of the innervation was gradually changed into a lesion of nutrition. Again, palpitations are often observed in chlorotic girls ; and that is even one of the cases in which these palpitations may most easily impose on one for the symptom of an organic affection of the heart. The patients have an extra- ordinary dyspnoea, which increases the moment they ascend a height; under the influence of the least exertion their hearts beat with violence, and by means of auscultation the pulsations of this organ are heard to a great extent; sometimes, even, it repels the ear rather forcibly, and each of its beats is accompanied by a well-marked bruit de soufllet. The diagnosis is then so much the more diflicult as the countenance of the patient presents that paleness and pufling, which mark,, at their commencement, many organic affections of the heart. However, after these symptoms have lasted a longer or shorter time, they are observed to dis- appear, and some patients, who were considered as doomed to die of aneurism of the heart, have been restored to perfect health. The preparations of iron, and particularly the subcarbonate of iron, in large doses, succeed very well in such cases, and by successfully combating chlorosis, this mode of treatment has removed the beating of the heart, and the dyspnoea, which are but some of its symptoms. I CHAPTER II. LESIONS OF ORGANS, OR OF FUNCTIONS RESULTING FROM THE DISTURBANCE WHICH THE ARTERIAL CIRCULATION UNDERGOES IN CASES OF DISEASE OF THE HEART. *' 15. These lesions may exist, 1st, in the large arteries, whence result divers modifications of the pulse ; 2nd, in the arterial capillaries, whence may result simple active sanguineous congestions, or even hemorrhages. The pulse presents so many varieties in. diseases of the heart, that only a secondary importance can be attached to it for the diagnosis of these diseases. There are, first, a great many cases in which the heart being seriously affected, the pulse does not deviate in any respect from its normal state. This is what almost always happens when the right cavities of the heart alone are attected,