Some points about the temperature and course of infective endocarditis / by Herbert French.

  • French, Herbert Stanley, 1875-1951.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Some points about the temperature and course of infective endocarditis / by Herbert French. 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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    October and November. The patient's condition continued almost unchanged. He was never able to leave his bed, but developed neither backward pressure signs nor emboli. He was always short of breath, but not acutely dyspnoeic, and not very anaemic. December 1. The patient suddenly got very much weaker, and there was increasing cyanosis, but no corresponding increase in the precordial distress or in backward pressure- signs. December 3. The patient became almost black from cyanosis, and died during the night. At the autopsy both mitral and aortic valves were fibrous and sclerosed, and there were large fungating masses on the mitral. The spleen was not very large. There were infarcts, old and recent, in both kidneys and spleen ; and there was cerebral softening secondary to an embolism in the right middle cerebral artery. The above cases, all occurring in the same hospital in the same year, and all but one of them under the same physician, serve to illustrate certain points which it is the object of this short paper to lay stress upon. These points are not new, but they do not seem to be strongly enough insisted upon in some text-book descriptions of the disease. Briefly they are as follows:— (1.) That, in addition to the pvsemic and the typhoid types of infective endocarditis, there is a third and important one, the cardiac type. (2.) That in this type the duration may be comparatively long—months rather than weeks. (3.) That it is often difficult to decide whether the cardiac symptoms are entirely due to old fibrosis of the valves, or whether there are fungating masses on the valves as well. Probably the additional symptoms most suggestive of the latter are — Some pyrexia. Multiple emboli. Splenic enlargement. Progressive anaemia. (4.) That there is no sharp line of demarcation between simple and infective endocarditis ; so that whereas some cases P 528.—i.
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