Observations on the mortality of the Scottish Widows' Fund and Life Assurance Society, from 1815 to 1845 / by James Begbie.

Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the mortality of the Scottish Widows' Fund and Life Assurance Society, from 1815 to 1845 / by James Begbie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    to rheumatism. Two had previously been affected by it. In all these, early blood-letting was employed with advantage; and under the use of calomel and opium, complete recovery took place in the most severe case in eight days, and in the remaining two in three weeks. In none of these was there any indication at any time of cardiac complication. The sufferers under the slighter form of disease were two females and one male, from 15 to 20. years of age, of strumous habit and delicate appearance, but neither chlorotic nor anemic. The first of these, the male, early i in the disease manifested the signs of pericarditis, in the anxious ] countenance and uneasy breathing, with tenderness in the epigas- I trium, excessive impulse, and friction sound of the heart. These, ] with the articular pain and swelling, yielded to local blood-letting and other usual means, and the patient recovered in three weeks. ] The second, and sister of the former, was seized in the third week of rheumatism with the well-marked signs of endocarditis, pain in the • praecordial region, excessive impulse, and the distinctive murmur of impaired aortic valves. The more urgent symptoms subsided under local bleeding and repeated blistering, and the free use of calomel and opium. Life has been saved, and health apparently ; restored; but the continued endocardial murmur and excessive | impulse, declare that the heart still remains unsound. The last ■ and only fatal case was in character the mildest of all, but it was not amenable to treatment; it was long protracted, and tedious; and late in the disease, by slow and insidious steps, the symptoms of pericarditis, and subsequently of endocarditis, developed them- selves, and resisted the frequent application of leeches and blisters, and the long-continued use of mercury and other means employed in such cases. The patient sunk in six months from the period of attack, with tumultuous action of the heart, breathless, and drop- sical. I have recently seen, along with Dr Taylor, a stout young man of 28, labouring under acute rheumatism, but not of the most violent kind, in whom a slight diastolic murmur was observed for the first time about eight weeks from the commencement of the attack, the murmur has increased in distinctness, and is now accompanied with excessive impulse. The rheumatic pains have disappeared. But the heart is not the only vital organ liable to suffer inflam- mation during acute rheumatism; the pleura and lungs frequently participate. Chomel states that the pleura is as often inflamed as the pericardium, and Professor Hasse affirms that rheumatism is unquestionably the most ordinary source of pleurisy. Other ob- servers have not, however, corroborated these opinions. Among Dr Latham’s 136 patients, we find the lungs or their membranes inflamed in 24, or 1 in 5j. Of the 46 cases in which there was no heart complication, the lungs were inflamed in 5; but of the 90 ■, cases in which the heart was affected, the lungs were also inflamed ; in 19. These 24 cases were made up of 2 of pleurisy, 4 of bron- chitis, and 18 of pneumonia.