The bearings of chronic disease of the heart upon pregnancy, parturition, and childbed : with papers on puerperal pluero-pneumonia and eclampsia / by Angus MacDonald.

  • Macdonald, Angus, 1836-1886.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: The bearings of chronic disease of the heart upon pregnancy, parturition, and childbed : with papers on puerperal pluero-pneumonia and eclampsia / by Angus MacDonald. Source: Wellcome Collection.

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    . both conditions when coexistent, tend to unduly exalt vas- cular tension; and if this produce rupture of minute vessels in the cerebral tissues, we may have as a result eclampsia. According to this view, the cerebral apoplexies that cause the convulsions are due to the vessels yielding to the extra tension under which the circulation is maintained, when diseased kidneys, an hypertrophied heart, and possibly also pregnancy, coincide in maintaining a specially high pressure in the blood vascular system. It is in cases of chronic renal disease in which Dr. Mahomed has found these minute apoplexies which he is inclined to regard as one cause of eclampsia. We of course would natu- rally expect to meet with these extravasations more readily in chronic cases of renal disease, in which we usually find general vascular degeneration associated with cardiac hyper- trophy. But the influences, whatever they be or however they are evolved, that tend to the development of these cerebral extravasations are manifestly very efficient in con- nection with eclampsia. Otherwise they could not have led to rupture in our case, in which the vessels were in a per- fectly healthy condition. Whether these minute apoplexies could of themselves be the efficient cause of eclampsia, as suggested by Dr. Mahomed, seems to me extremely doubtful. I certainly am more inclined to believe that they are rather a result of the main lesion which causes the fits, than themselves the cause of the convulsions. Certainly the minute apoplecti- form patch revealed by the sectio in my case could never by any imaginary arrangement have been the cause of these terrible convulsions. In connection with this question, I am constrained to refer, in closing, to an interesting case published by me in the Edinburgh Medical Journal for June 1875, where the exciting cause of the convulsions, which, however, assumed a tetanic S