Volume 6

A system of medicine / by many writers ; edited by Thomas Clifford Allbutt.

Date:
1896-1899
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / by many writers ; edited by Thomas Clifford Allbutt. Source: Wellcome Collection.

    20/974 (page 4)
    The stream, regurgitant through an aperture in the ventricular septum, or through a patent ductus arteriosus, tends to damage the endo- thelium of the wall on which it impinges, and thus gives rise to vegeta- FiG. 1.—A pulmonary artery with a mass of ])endulous vegetations attached to the right antejior cusps, wliile the greater portion of the posterior valve has completely ulcerated away, and what remained of the right anterior valve has been perforated by the pressure of the infective vegetations. From a man aged 19, who had gonorrhoea four mouths before death, and was admitted with pyrexia, dyspnoea, and a double basic bruit. At the inspection there were also found advanced tubal nephritis, with apoplexies in the lung, and a small patch of inieumonia. tions. This formation of vegetations opposite the aperture, and on the pulmonary valves, is well shown in several museum specimens. Fig 2 —A i)ulmonary artery stretched over an aortic aneurysm ; two cusps have adhered to the wall of the vessel and the aperture, which is apparent immediately below the juncture of two valves, leads into a saccular aneurysm of the aorta, an inch across, immediately above the aortic valves which had remained competent. The margin of the aperture is smooth, not much thickened, and is free from lymph. tj i j v From a man aged 39, who gave no history either of rheumatism or of syphilis. He had been short of breath for some years, but was only ill for three weeks. It is remarkable how very rarely a diastolic bruit has been noticed in cases of congenital pulmonary stenosis, even when the cusps are fused into a rigid cone, which, it would appear, must have allowed some regurgitation. Probably the blood does not regurgitate vigorously enough