Further observations on the diagnosis of fatty heart, and on smoking, etc., as causes of the disease / by Henry Kennedy.

  • Kennedy, Henry (Physician)
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Further observations on the diagnosis of fatty heart, and on smoking, etc., as causes of the disease / by Henry Kennedy. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    readily thrown off our guard, and this point is'Very strongly borne out by the fatal cases from the use of chloroform detailed in Snow's book and other places, where it is expressly stated that the pulse kept good till the very instant death occurred. In fact, as is well known, the death is apt to be very sudden, whether chloroform be used or not, and this is due on the one side to the morbid change which has occurred in the muscular texture of the organ, and on the other to the absence of valvular disease; and thus it is the radial pulse goes on to the very last, affording a marked contrast to what occurs when valvular disease exists, for then there is nothing more common tb^n for the pulse at the wrist to have ceased days before deat^u, as I am sure all present have witnessed. But when valvular disease does exist with fatty heart, there are two points worthy of note: the first, that it is the aortic valves which are very generally involved, leaving the mitral free ; and secondly, that the kind of morbid change is peculiar. The valves are commonly thickened and leathery, being fatty as contrasted with ossified valves. Now this state of the parts is, in many instances at least, quite capable of preventing regurgitation, for the valves will not allow water poured from above to pass, as I have repeatedly tested, whilst it very curiously, I must say, confirms the diagnosis of fatty heart as derived from physical signs, and which Dr. Stokes gives in his able work, but does not enter into the explanation of, nor in- deed does any other writer. That gentleman, in fact, from clinical research, arrived at conclusions, the truth of which are now fully confirmed by what has been added by myself from the study of the morbid anatomy cf the disease. Of these physical signs, however, it is not my