Observations on some points in dextral valvular disease of the heart / by Alexander Morison.

  • Morison, Alexander (Alexander Blackhall), 1850-1927.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some points in dextral valvular disease of the heart / by Alexander Morison. Source: Wellcome Collection.

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    as many a hospital, while the division of labour would utilize time to the utmost. If, in the following pages, I should appear to have gone too minutely into the details of the cases recorded, I must plead a conviction that such minuteness is as desirable in the physician as in the physicist or physiologist, while for any deficiencies, such as the non-employment of the sphygmograph, which might have rendered valuable aid in the inquiry, I would urge the limited amount of time at the command of “ the busy practitioner,” as he at present exists. In the pathological, physiological, and therapeutic portions of the essay alike, I may be pardoned for thinking that prominence has been given to some topics not hitherto specially discussed (so far as I know), such as the com¬ parison instituted between the circulation of a quadruped and a biped, the use of digitalis in organic valvidar disease of the venous heart, etc. Finally, the illustrations, with the exception of the sketch of the heart of E. W. G. M., which I made shortly after the necropsy, are, I need scarcely say, wholly or half diagrammatic. Part I. “ There is no class of diseases which submits so difficultly to the trammels of nosological arrangement as the chronic affections of the heart. Their characters are so ill defined, so difficult is it to distinguish the idiopathic affections of this organ from those cases in which its functions are sympathetically disturbed, so impossible to anticipate with certainty, by the symptoms, the presence of structural disease there—in fine, so intimately are the functional disorders of the heart connected with those of the brain, that an attempt to arrange systematically this class of diseases may be considered as almost hopeless.” ^ So wrote Dr George Gregory of chronic affections of the heart in general, fifty-three years ago. Happily for suffering humanity, the lugubrious prospect entertained by him has not been justified by the scientific progress of the last half century, and failure to diagnose the vast majority of cases of diseased heart, which an accomplished physician at one time regarded as inevitable, would probably, at the present day, refer a tyro to his studies till he had learned to overcome a difficulty which is scarcely acknowledged to exist. While the comparative frequency of valvular disease of the left chambers of the heart, and its careful investigation by physical processes, has resulted in a knowledge of the diagnosis of such diseases which is well-nigh perfect, the rarity of similar disease affecting the valves of the right side of the heart has naturally retarded our progress in the diagnosis and treat¬ ment of the latter—so much so, indeed, that one of the sites ^ Elements of the Theory and Practice of Physic, by George Gregory, M.D., 1825, p. 445.