Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine / by Robert H. Babcock ... with three coloured plates and one hundred and thirty-nine illustrations.

  • Babcock, Robert H. (Robert Hall), 1851-1930.
Date:
1903
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine / by Robert H. Babcock ... with three coloured plates and one hundred and thirty-nine illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    147/898 (page 115)
    inch to the right of the sternum to fully midway between the left nipple and the anterior axillary line (Fig. 23). There were no murmurs, but the iirst sound at the apex was weak and the second at the base reduplicated, the pulmonic second being accentuated. Iso signs of adherent pericarditis were noticed. The lower hepatic border was palpable at the level of the umbilicus, and was thin and hard. The spleen was not enlarged, and there was no ascites. The case was considered one of general cardiac dilata- tion supervening upon a previ- ous hypertrophy of the left ventricle and upon the in- creased pulmonary blood-pres- sure occasioned by the fluid in the right pleural cavity. How much of the increase in heart's dulness to the left was attributable to dilatation, and how much to transposi- tion of the organ from pres- sure by the intrapleural fluid, was left an 0})en question. In the absence of a definite his- tory of pleurisy and of other signs of dropsy, the nature of the liquid in the pleural cavity, whether an exudate or transudate, was a matter of doubt. The liver was evidently cirrhotic. Exam- ination of the urine was negative. In spite of physical rest, digitalis, diuretics, and cathartics, the amount of intrapleural fluid remained stationary for the next three weeks. Paracentesis was then performed, and the fluid rap- idly reaccumulating, ;:he operation was repeated within a week. After the second aspiration the fluid mounted to the upper level of the third rib and symptoms of pressure increased. It was then decided to try the efficacy of baths (Bad Xauheim). These were endured so badly, however, that they were discontinued after four days. By February 6th the actual embarrassment had become so pronounced that this fact, together with the failure of paracen- tesis to permanently reduce the amount of pleural effusion, led the Fig. 23.—Showing Ape .x-beat, Cardiac PULNESS, AND LiVEE BORDER IN CaSE (p. 114).