Congenital affections of the heart / by George Carpenter.

  • Carpenter, George, 1859-1910.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Congenital affections of the heart / by George Carpenter. Source: Wellcome Collection.

    93/112 (page 89)
    under either clavicle or over the right base. The apex is free from murmur. Not heard in the neck. No thrill. Lungs.—A few rales and rhonchi. Chest bulged in front and broadly guttered on either side. Case XVII.—William C, aged 3^ years, seen Oct. 4. A healthy child until four months back, when drowsiness, dyspnoea, and duskiness of the cheeks ap- peared. For the last fourteen days orthopncea, oedema of the legs, puffmess of the face, and passage of small quantities of urine. Mother and one sister suffered from rheumatic fever. On examination.—A well nourished but much cyanosed child. Lungs.—Nothing abnormal detected. Heart.— Impulse displaced outwards ; dulnessto right of sternum. Sounds.—Loud systolic bruit at apex, conducted to axilla and angle of the scapula. Heard all over the cardiac area and chest, but loudest at the apex and better to- wards the left clavicle than the right. Slight epigastric pulsation. Liver.—Two fingers' breadth below the costal margin; slight pulsation. Albumen a trace. Pulse 120, respirations 28, and temperature normal. The following day his temperature rose to 101.80 F. Passed rather more urine (5 oz.). Albumen i. Not quite so blue. On the 6th blood in the urine; albumen ^th. On 7th both bases dull and deficient entry of air; dyspnoea very great, pulselessness and collapse. I aspirated him and withdrew 13^ oz. from the right chest and n oz. from the left. Both fluids coagulated. No distinct improvement after the operation, and he died the follow- ing day. The temperature went up to io2°F. Post-mortem.—Much fluid both bases; a little lymph on the pleurae. Abdomen.—Some ascites; no lymph. Pericardium.—A little fluid. Heart.—Both, ventricles hy-