Failure of the heart in valvular disease / by J. Mitchell Bruce.

  • Bruce, J. Mitchell (John Mitchell), 1846-1929.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Failure of the heart in valvular disease / by J. Mitchell Bruce. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    THE JANUARY, 1888. (injgtnal Cflmmunuaiions. FAILUKE OF THE HEART IN VALVULAR DISEASE. BY J. MITCHELL BKUCE, M.D., F.R.C.P. LOND. It is only within the last few years that we have come to ap- preciate fully the significance of enlargement of the heart. Every thoughtful practitioner is now convinced, as the result of personal observation confirmed by high authority, that the subjects of valvular disease of the heart with enlargement may remain perfectly free from distress of every kind; that there are no symptoms attending perfect compemation of valvular lesions. We now understand that hypertrophy, whilst it is an indication of some disability or disease in connexion with the heart or vessels, is an indication also that the disability has been successfully removed, the disease prac- tically cured by a process of natural recovery. We search anxiously for hypertrophy, we welcome its oncome, we work to establish and maintain it. On the same principle the appear- ance in such a case of symptoms of cardiac distress—of palpita- tion, dyspnoea, and dropsy—is now regarded as evidence of the occurrence of failure of the heart. We say that the compen- sation has become imperfect, that the hypertrophy has broken down. What were formerly described as the symptoms of valvular disease of the heart are now regarded as the symptoms of failure of the cardiac wall. By careful treatment we can