The annual oration : the rapid heart, a clinical study / by Arthur Ernest Sansom.

  • Sansom, Arthur Ernest, 1839-1907.
Date:
[1890?]
Catalogue details

Licence: Public Domain Mark

Credit: The annual oration : the rapid heart, a clinical study / by Arthur Ernest Sansom. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    pei-iphercal irritation, as the presence of undigested food in the alimentary tract and the sometimes pronounced effects of intestinal ■worms. Furthermore, I exclude cases in which the acceleration is solely paroxysmal. So I do not deal with all those interesting cases which have been described as instances of paroxysmal hurry of the heart, though some of these, as I shall presently show, will be legitimately grouped with my own. Lastly, I exclude cases of palpitation when such symptom occurs in the case of a heart manifesting, at the times when such palpitation is absent, a normal rate of action. Palpitation is defined in * Quain's Dictionary' as abnormal movement of the heart, whereby the force of the systolic contractions is increased to such a degree as to give rise to a sensation of discomfort or distress on the part of the patient. This definition I entirely accept. In the cases which I shall ask you to consider there is of necessity no sense of distress or discomfort on the part of the patients when the heart is beating at a rate far above the normal, but these may be, and often are, the subjects of palpitation with its painful concomitants. I take, therefore, only those cases in which there is good reason to believe that the rate of the heart's cycles is unduly quickened for considerable, and in some instances for very protracted, periods. The cardiac action is, as it were, set for an abnormally rapid rate. For brevity, I have denoted these as cases of rapid heart. It is obvious that we have to think of a disturbance which has been termed functional. I share with our excellent librarian, Dr. Allchin, his objection to this term, and adopt his reasoning.* You will no doubt remember that a German professor long ago defined amaurosis as a disease in which the patient saw nothing, nor yet the physician. Perhaps I may be permitted to paraphrase in some sort this definition, and say that a functional disorder of the chief organ of the circulation is a disturbance which involves the heart of the patient and the mind of the doctor. The vision of the ophthalmic surgeon has been, in the case of amaurosis, greatly aided by instruments for precise observation. The disturbed mind of the physician can only be calmed by the appreciation of truth and this through the enlightenment which comes from the con- vergence of many facts. I shall here attempt no peering into the mysteries of intimate pathology, nor invoke the use of the imagina- * Functional Disease, by Dr. Allchin, 'Westminster Hosp. Kcp.,' vol. ii. h 2