On rheumatic carditis / by Thomas B. Peacock.

  • Peacock, Thomas B. (Thomas Bevill), 1812-1882.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On rheumatic carditis / by Thomas B. Peacock. 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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    cardiac symptoms have become fully established before the patient comes under treatment. Thus, of 12 uncomplicated cases of recent carditis, in which the signs were present when the patients were admitted into the hospital, in 7 they entirely disappeared, and in 5 they remained at the time of discharge; while in 12 cases in which the cardiac affection came on while the patients were under treatment, in 8 they entirely disappeared, and in 2 were very nearly gone when the patients left the hospital. The form and seat of the disease also influence the result. Peri- carditis is certainly more readily and completely curable than endocarditis. In 7 cases of recent pericarditis the signs entirely disappeared in all but one, and in that case they were nearly gone; while in the same number of cases of pericarditis and endo- carditis combined, they entirely disappeared in only two. The time during which the signs of pericarditis continue is also generally less than that in Avhich endocarditic murmurs are heard. The ready curability of pericarditis is to be ascribed to the comparative state of rest of the inflamed membrane, and to the more purely local character of the disease. Indeed, it probably only becomes dangerous when the accumulation of fluid in the sac is very large. When, however, the valves are inflamed, their constant movement must interfere with recovery. The aortic valves also are liable to become disorganized and to break down from the pressure which they have to sustain; and deposits of fibrine readily take place on the inflamed surfaces, which may produce thrombosis of the orifice, or being separated and con- veyed by the current of blood, may cause embolism of the smaller vessels. The mitral valves, though less apt to be immediately disorganized, may equally be the seat of fibrinous deposits causing thrombosis and embolism, and the cordse tendinese may give way. In valvular affections resulting from endocarditis, the danger varies according to the nature of the disease and the particu- lar valves affected. Incompetency of the valves is a more serious defect than simple obstruction It is also especially dangerous when the aortic valves are aflfected ; whereas obstruction is pro- bably of more importance when seated at the left auriculo-ven- tricular aperture. Pericarditic adhesions must necessarily in all cases interfere with the free movement of the heart, and doubtless sooner or later give rise to hypertrophy; yet it is evident that many