Angina pectoris / by G. A. Gibson.

  • Gibson George Alexander, 1854-1913.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Angina pectoris / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    reason can be adduced for the comparative immunity of your fellow countrymen from angina pectoris. My remarks upon this interesting subject will be mostly clinical, and will be especially directed, in accordance with the request which has been made to me, to some symptoms which have recently attracted my attention for the first time. It is inevitable that some reference must be made to the aetiology and pathology of the conditions underlying the complex of symptoms we have to consider, but this will be done as briefly as possible. The great fact in angina pectoris is the existence of pain, or some analogous subjective result of sensory disturbance ; around this predominant symptom the attendant phenomena H are variously grouped. The uneasy sensation has its principal seat in the prascordia, and usually, but not invariably, extends thence in different directions. Most typically it radiates ''‘I towards one or both of the shoulders and arms—to the left, '^1 when the cardiac disturbance is mostly connected with the left ^®|’side of the heart; to the opposite side when the right heart i^|:is chiefly involved ; to both sides if the heart is bilaterally affected. Very frequently the discomfort affects the region of the angle of the scapula, where indeed it sometimes seems i^|[to attain its greatest intensity. The pain often reaches the fingers, affecting especially the ring and little fingers of the eft hand. Sometimes but not nearly so often, it extends up Ihe neck to the back of the head, and occasionally it may ass down to the trunk and even reach the toes of one or other f the lower extremities. We shall afterwards see the reason or such facts of distribution, but let me in this place mention, passing, that the pain of biliary colic and renal colic, and iven of pulmonary congestion or hepatic congestion, has the ame tendency to radiate. The character of the uneasiness and the intensity of the uffering vary enormously. Time would fail me to give you iletails of the different varieties which are presented; suffice to say in a single word that there is a complete gradation vague uneasiness to intolerable anguish. As regards the occurrence of the chief symptom, one of its ^predominant characteristics is the paroxysmal mode of onset, first attack has undoubtedly often proved fatal, but it is lio Vd- P 5087.-1. it