A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 4).

  • Copland, James, 1791-1870.
Date:
1834-59
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 4). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    er if the signs occur in connexion with acute rheumatism. Most cases of the disease termi- nate in recovery, although it often lays the foundation of organic changes of the valves, which may ultimately produce the most serious consequences.] ii. Inflammation of the Pericardium.—Syn. Carditis externa, Author ; Pericarditis, Auct. var. ; Exocarditis, Barbier ; Carditis, Sauva- ges, Vogel, &c. ; Inflammatio Cordis et Peri- cardii, Senac; Hertzbeutelenzungdung, Germ.; Piricardite, Fr. ; Inflammation del Pericardio, Ital. ; External Carditis; Inflammation of the Envelope of the Heart. 83. Charact.—Pain under the sternum, in- clining to the left side and to the epigastrium, with tenderness on firm pressure in the latter sit- uations ; dyspnoea; anxiety, oppression, constric- tion, or tightness at the pracordia; great rapid- ity and irregularity of the heart's action, and of the pulse ; inflammatory fever; and morbid sounds detected by percussion and auscultation. 84. A. History, &c.—Pericarditis was first mentioned by Avenzoar, who was himself at- tacked by it, and was cured by blood-letting ; but, excepting the cursory notice taken of it by Rondelet, Salius Diversus, and Forestus, little attention was directed to it until Bonet, Hildanus, Berger, Morgagni, and others re- corded cases illustrative of its morbid rela- tions. Still more recently, our knowledge of its nature and treatment has been much ad- vanced by the writings of Corvisart, Burns, Kreysig, Laennec, Testa, Bertin, Elliot- son, Stokes, and others ; and by numerous memoirs which have appeared in the transac- tions of medical societies and in periodical works, and to many of which references are subjoined. 85. B. Structural Lesions.—a. In the acute stage of pericarditis.—a. The earliest change is redness of the pericardium, from capillary in- jection. In some cases, particularly when death has taken place rapidly, the redness is not remarkable, probably owing to the reces- sion of the blood from the capillaries after death. The increased vascularity is principally seated in the subjacent or connecting cellular tissue ; and the redness is sometimes increased by the infiltration of minute quantities of blood into this tissue, or into the serous membrane itself, so as to give rise to ecchymoses, or red points, spots or patches, or streaks. The thick- ness, transparency, and consistence of the per- icardium seldom undergo great changes at an early period of the disease, yet this membrane is often thicker and more opaque than in the healthy state. It is generally detached with greater ease from the surface of the heart, and its removal shows the injection and redness, or infiltration of the connecting cellular tissue. The natural exhalation from the surface of the pericardium is either increased in quantity or remarkably altered in kind, or both ; the accu- mulated effusion which thus results constituting a principal part of the changes produced by the disease. 86. /3. The effusion into the pericardium pre- sents various states, and undergoes changes of much importance as respects the subsequent course of the disease : 1st. The effused fluid usually coagulates or separates into a turbid or flocculent serum and a concrete or fibrinous false membrane, which is organizable. and commonly covers the free surface of the car- diac envelope. In some instances the coagu. lation is more irregular, or presents a curdled appearance, without being disposed in a mem- branous form over the external surface of the organ The more fluid part of the effusion is generally serous, but it is sometimes san- guineous or tinged by the escape of a portion of the colouring substance of the blood. Oc- casionally the effused matter consists chiefly of coagulable lymph disposed in the form of false membrane ; but more frequently the membranous depositions are accompanied by a quantity of fluid varying from a few oun- ces to several pounds. M. Louis adduces a case in which it amounted to four pounds; and Corvisart another, in which the pericardium contained a still larger quantity of a sero-puri- form fluid. 2d. In some cases of pericarditis, the effused matter consists of a homogeneous, inodorous, and well-digested pus of the con- sistence of cream, and of a grayish, yellowish, or greenish-white hue. The quantity of this matter varies as much as that of the former, or sero-pseudo-membraneous effusion. Cases of pericarditis, giving rise to a purulent effu- sion, have been recorded by P. Frank, Hasen- oehrl, Monro, Stoerck, Stoll, Lieutaud, Senac, Baillie, Corvisart, Louis, Bouillaud, and several recent writers. Instances in which the present fluid presents a sero-puriform char- acter are frequent. 87. y. The coagulated or fibrinous lymph form- ed in acute pericarditis is sometimes found in amorphous masses; but it is most frequently disposed in a membranous form, covering the greater part, or even the whole, of the free sur- face of the pericardium, especially of that part reflected over the heart. This false membrane varies in thickness from a fraction of a line to several lines. The appearance of the free sur- face of this membranous exudation is gen- erally peculiar. Corvisart compared it to the internal surface of the second stomach of a calf. Sometimes it resembles the surface of a pineapple. Dr. Hope remarks that, when the layer is thin, its free surface is often pitted with small depressions at regular intervals, presenting the aspect of a fine reticulation; and that, when it is thick, the surface is divi- ded into more spacious cells, often as large as a pea, and separated by coarser partitions. In most of the cases which I have examined the surface either was shaggy, or hanging in nu- merous short shreds—the Cor hirsulum, vil- losum, ^me^Gsum'' of the older writers ; or presented an appearance similar to that pro- duced by pressing soft grease between two smooth plates and by forcibly separating them. In some preparations of my late colleague Dr. Sweatman, these appearances are beautifully preserved, the membranous exudation in these having surrounded the whole of the heart. M. Cruveilhier and Dr. Hope have delineated these changes in their pathological works. In some instances the effused lymph is arranged in transverse undulations, or it presents an in- dented or wrinkled form. It occasionally ac- quires a deeper hue the older it becomes, or presents a deep brown or reddish-brown col- our, most probably derived from the colouring matter of the blood which the effused fluid coo-