A treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them : comprising the author's view of the physiology of the heart's action and sounds, as demonstrated by his experiments on the motions and sounds in 1830, and on the sounds in 1834-5 / by J. Hope.

  • Hope, James, 1801-1841.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the heart and great vessels : and on the affections which may be mistaken for them : comprising the author's view of the physiology of the heart's action and sounds, as demonstrated by his experiments on the motions and sounds in 1830, and on the sounds in 1834-5 / by J. Hope. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    partial, and confined even to a very limited portion of the mem- brane; but he adds that such cases are rare, scarcely amounting to one in ten, unless white spots, presently to be noticed, be ad- mitted as falling under the head of partial pericarditis, which will greatly augment the proportion. Partial pericarditis, he pursues, almost always terminates in recovery and transformation of the false membrane into long serous bands (De PAuscult. torn. ii. p. 655). Without denying that pericarditis can be partial, I doubt whether this can be proved; since the signs, both general and physical, do not differ, except in degree, from those of universal pericarditis, and since adhesions may be partial though the inflammation have been universal, provided the layers of lymph happen to have been only partially deposited. I lately, for instance, examined a heart presenting several detached patches of recent lymph, yet the redness, and probably therefore the in- flammation, was universal. Pericarditis sometimes leaves no other vestiges than opake white or milky spots, which are a well-known appearance on the surface of the heart. It is possible that they may be results of partial pericarditis, as supposed by Laennec, but there is no reason to suppose that they may not also be occasioned in some instances by universal pericarditis, as in the case referred to in the preceding paragraph. The spots vary in extent from a few lines to two or three inches in diameter; their thickness is about that of the nail: they commonly consist of a layer of false mem- brane, which has assumed the character of condensed cellular tissue, and, with a little care, they may generally be detached without injury to the pericardium beneath, which is commonly somewhat injected, though not thickened. But, though this is the ordinary cause of white spots, I have sometimes found them to be occasioned by hypertrophy of the sub-serous cellular tissue, and even of the fibrous layer of the pericardium itself; but I have never seen the serous layer so thickened and opake as to present this appearance. In concluding this account of the changes undergone by false membrane, it may be added that, in conformity with the laws of embryogony and of the scale of animals, false membrane, like cellular membrane in general, is subject to analogous trans- formations that is, a change from the state of cellular tissue to