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.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    has not occurred oftener among the cases which we have collected. I have not been able to find a single symptom in any of these cases, if we except the ninth case, to indicate thrombosis or embolism of the pulmonary artery. Yet the conditions under consideration are very many of them such as one would have expected to be accompanied by throm- bosis of the latter vessel, if the accident were as common a probability as some authors believe. I have serious doubts, however, respecting the accuracy of the views urged on that subject, and am far from being convinced that the appear- ance of a phlegmasia dolens some days after or coincident with symptoms of embolism, or, if you like, thrombosis of the pulmonary artery, proves that they were due to a common cause acting at once on the pulmonary artery and in the veins of the limb affected. I am much more inclined to believe that in an obscure pelvic phlebitis a common origin for both conditions would usually be found. At any rate, we have so many possible sources of plugging of the pulmonary artery, such as the existence of a dilated right auricular appendage, or the presence of a clot in a varicose vein in some part of the body, that I am loth to accept the probability of spontaneous coagulation of blood in the pulmonary artery even in hsemorrhagic cases, except on irrefragable post-mortem evidence. The only case among those that I have recorded in which death might probably have arisen from embolism of the pulmonary artery is the seventh one, which I extracted from Ramsbotham's Midwifery. It is, however, to be noticed that though it is to be presumed the lungs were examined with great care, as the condition of the heart, which does not seem to have been suspected before death, is noted with considerable accuracy, there is no mention made of any plugging or of any large clot in connection with the pulmonary organs. It is merely stated that