Volume 2

Glasgow hospital reports / edited for the committee by George S. Middleton [and others].

Date:
1898-1901
Catalogue details

Licence: In copyright

Credit: Glasgow hospital reports / edited for the committee by George S. Middleton [and others]. Source: Wellcome Collection.

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

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    comfort on unusual exertion, for the greater part of that time. No dropsy, until less than a week before admission. No local pain, or other definite subjective sensations of cardiac distress. No haemoptysis (this negative fact continued so to the end). Almost no orthopnoea. “ Previous history of syphilis, ten years ago or more. No rheumatism. No probable history of strain. Family history unimportant. “ Cardiac murmurs of complicated character, at first inter- preted as being at least partly aortic (V.S. and V.D.), with pulse more or less characteristic of aortic regurgitation. “ Well-marked hypertrophy, probably of both, certainly of the right ventricle, with heaving impulse and thrill to the hand; but no palpitation complained of. Dulness to percussion (of heart) 7J inches transverse. Epigastric pulsation. “ Question raised of aneurysm or other lesion, involving the right side of the heart as well as the aortic valves; but no positive evidence of this obtained. “ Enlargement of liver, with induration, but no marked irregularities. Other abdominal organs not apparently altered. Urine more or less albuminous throughout.” It will be observed from the above concise statement of the actual facts observed, that there was very little in the history to guide the mind to a conclusion as to the cardiac character of the case, still less as to aneurysm, or internal rupture, at least up to the time of the occurrence of general dropsy. And this peculiar insusceptibility, on the part of the patient, to impressions of cardiac suffering, was main- tained throughout the treatment, almost up to the fatal issue. Again and again it fell to be remarked that even in the presence of severe and dangerous objective symptoms—in- cluding a degree of general dropsy which required repeated puncturing of the limbs and scrotum, till it was for a time marvellously relieved under diuretin—the mental condition of the patient was one of apparently complacent optimism, which would hardly allow of the existence, according to his own reckoning, of any gravity in the symptoms at all. Along with this very remarkable euphoria there was, it is