Notice of a case of cyanosis, of the blue disease. connected with mutual adhesion of the semilunar valves of the pulmonary artery / by David Craigie.

  • Craigie, David.
Date:
[©1843?]
Catalogue details

Licence: Public Domain Mark

Credit: Notice of a case of cyanosis, of the blue disease. connected with mutual adhesion of the semilunar valves of the pulmonary artery / by David Craigie. 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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    ing murmur, heard on the right side of the sternum, and with a very small pulse at the wrist. The face and lips were again livid ; the surface was cold ; and the patient was so feeble that it was impossible to examine the chest fully. On the 14th the coldness of the surface was complained of by the patient himself, the face and extremities were livid, arid the breathing became hurried, and progressively increased till the morning of the 15th May, when death took place. Inspection of the body on the 17th May disclosed the following appearances in the internal organs. Slight old adhesions were found connecting both pleurae to the pulmonic pleurae, mostly cellular, but increasing in firmness to- wards the convex and posterior part of the chest. Two ounces of transparent straw-coloured serum were contained in the cavity of the pericardium. The heart presented no traces of inflammation on its surface or in its substance, but was very much enlarged, especially in its right ventricle and auricle. The right auricle was a good deal larger than usual; and the membrane forming the fenestra ovalis was thin and reticulated, presenting many minute holes; and at its lower limbus, close to the tricuspid valve, was a circular or rather elliptical hole, of the diameter of one-third of an inch, communicating directly with the left auricle. The right ventricle, when cut open, was large in its capacity, and its Avails were very much thickened, and considerably firmer than natural. At the apex of the ventricle was found a deposit partly of fibrinous blood, partly of decolorized fibrine, between the walls of the heart and the column<je carnecB. The latter, viz. the fleshy pillars, were much larger and firmer than they usually are in the right ventricle. The tricuspid valve was rather whiter and more opaque on its ventricular side than usual, but the aperture formed by it was not contracted. The pulmonary artery was in its diameter much smaller than usual at its origin and connection with the basis of the right ven- tricle. Its origin was provided not with three distinct semilunar valves, as usual, but with a firm opaque membrane, concave to- wards the ventricle, convex towards the artery, so elevated into the interior of the artery as to form a truncated cone, with a small aperture in its centre and apex, not larger than to admit a com- mon probe. This aperture was furnished round its margin with an elevated fringe, similar to the warty prominences usually found in diseased valves in general. Upon examining the convex or arterial side of this membrane, three small membranous slips were observed passing between the membrane and the walls of the artery,—indicating the position of