Diseases of the heart and circulation in infancy and adolescence / by John M. Keating and William A. Edwards.

  • Keating, John M. (John Marie), 1852-1893.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the heart and circulation in infancy and adolescence / by John M. Keating and William A. Edwards. 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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    smelling pus were removed, and the child improved for a short time, when symptoms indicative of the reformation of purulent matter demanded better drainage, which was secured by an incision and the introduction of a tube. The liver and spleen were enlarged. A diarrhoea set in, which was totally uncontrollable, to which the child succumbed six weeks after we first saw her. Post-mortem.—Examination was made a few hours after death, and as we report the case solely for the condition of the pericardium, suffice it to say that the left pleural cavity con- tained several ounces of pus, and presented the usual appear- ances in such cases. Heart and pericardium.—The former much enlarged, and the latter adherent to the adjacent structures. The parietal pericardium was much thickened and covered by a pyogenic membrane; the visceral layer was thickened and covered by pus; the layers were adherent over left ventricle. The following case, recorded by Broxholm,* is of extreme interest on account of the fact that the child complained of no pain, and, although effusion was present in marked degree, did not present either dyspnoea or orthopncea. The child, a boy aged five, expired suddenly before medical aid could reach him. He had, however enjoyed seemingly good health. Sectio cadaveris twenty-four hours after death. Child was rickety. Meninges were vascular and congested, no effusion ; brain was very vascular. Nc ventricular effusion, none at base of brain. The lungs were adherent by lymph-deposits, some old, some recent. Tubercles infiltrated throughout lungs. Pericardium. — Much distended, contained one pint of straw-colored effusion, wTith numerous flakes of greenish-col- ored lymph : the interior of pericardium, all over its surface, presented deposits of fibro-plastic matter, rendering its sur- face exceedingly rough and granular. Heart-muscle hyper- trophied. and presented over the centre of the ventricles twr patches of a light-brown color, feeling very firm and hard, thinner than the surrounding tissue, and cutting like cartilage. * Lancet, London, vol. i., 1850, p. 343.