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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    (pulmonary area) in wliicli its diagnosis is possible, has gained the soubriqiid of the region of romance.” The possible sacrifice or shortening of an occasional life, from imperfect knowledge of this kind of disease, is treated by some in their writings with con¬ temptuous indifference, when the rarity of such cases is considered a valid preliminary to ignoring their discussion; others, who treat the subject with more consideration, confess a want of clinical experience, satisfactorily verified by post-mortem examination ; and by none, so far as I know, has the matter been thoroughly investigated with a view to discover whether the physiological and clinical considerations differ sufficiently from analogous con¬ ditions in the arterial half of the organ, to necessitate a difference in the treatment of disease specially affecting the valves of the right heart. The title of this essay indicates its scope. While avoiding any attempt at an exhaustive treatise, which is precluded by our com¬ paratively limited knowledge, I have endeavoured to point out some “ considerations,” not usually discussed, which appear to have an influence upon the scientific treatment of such disease. The circumstance which has prompted my investigation of this somewhat uncultivated field of inquiry, has been my study of a remarkable instance of disease affecting the pulmonary and tricuspid valves, and should I be enabled, in the opinion of my compeers, to cast any light upon the therapeutics of these rare maladies, and thus mayhap contribute to the relief of one sufferer in a thousand, I shall (to borrow a stereotyped phrase from many a preface) consider myself amply rewarded. The case I have referred to was communicated to the Patho¬ logical Society of London on the 7th of December 1875, and my paper, together with the report of the Morbid Growths Committee of that Society, confirming the accuracy of my description of the specimen exhibited, and agreeing with me in the general conclusions of my paper, are published in vol. xxvii. of the Transactions of the Society. So much of that paper as bears upon the argument of this thesis I shall transcribe from the above publication. I shall then consider some physiological and pathological conditions calculated to elucidate valvular disease of the right heart generally ; and, finally, discuss the therapeutic conclusions derivable from the context. OBSTRUCTIVE AND REGURGITANT DISEASE OF THE PULMONARY VALVES; OBSTRUCTION OF THE RIGHT AURICULO-VENTRICULAR ORIFICE; DISEASE OF THE TRICUSPID VALVES ALLOWING REGURGITATION, ETC., ETC. Mr E. W. G. M., aged 20 years and 9 months, a bank-clerk, single, and of temperate habits, came under my care on 20th May 1875, complaining of breathlessness both when active and when in bed, with occasional attacks of severe pain over the heart, passing up to the right shoulder and down the right arm, being