Clinical lectures on diseases of the heart delivered at the Mater Misericordiæ Hospital / by Thomas Hayden.

  • Hayden, Thomas.
Date:
1866
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Licence: Public Domain Mark

Credit: Clinical lectures on diseases of the heart delivered at the Mater Misericordiæ Hospital / by Thomas Hayden. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    My cases are also seven in number, with three deaths and three dissections; in six out of the seven the diagnosis was made; in the seventh it was not made for reasons already given, although post-mortem evidence showed that mitral constriction was considerable. In the two remaining cases in which a post-mortem examination was made it was confirmatory of the diagnosis. The prognosis in these cases is of the most unfavourable character. I cannot altogether agree with Dr. Gairdner in the opinion that mitral regurgitation on the average of cases is a much more immediately dangerous form of disease than mitral obstruction; it may be more imme- diately, but is not ■ more certainly fatal than mitral obstruction. In regard to treatment very little need be said. The tendency to death is by asthenia and vascular engorge- ment of the lungs ; the former due to failure of the systemic circulation by defect of supply, and the latter to obstruction on the left side of the heart. The object of treatment should therefore be to sustain the failing circu- lation by increasing the contractile force of the heart, which probably has itself suffered some impairment by defective coronary circulation. This is best accomplished by the administration of ethereal and alcoholic stimulants, and by nutritious diet frequently given, and in a concentrated form. Congestion of the lungs should at the same time be kept in check by means of dry cupping and counter-irri- tation, and the volume of the blood kept at a low standard by mild hydragogue aperients and diuretics. I have found much benefit in the treatment of these cases from the use of tincture of the sesquichloride of iron and chloric ether, of each three drachms, in seven ounces of infusion of quassia; a tablespoonf ul to be taken three times daily. I have now done, and for the length to which my ob- servations have been extended, the interesting nature of the subject, its novelty amongst us, and my desire to put you in possession of the clinical history and distinctive