The student's guide to medical diagnosis / by Samuel Fenwick.

  • Fenwick, Samuel, 1821-1902.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to medical diagnosis / by Samuel Fenwick. Source: Wellcome Collection.

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    and is unwilling to make the slightest exertion. The attacks are liable to recur, are very dangerous, and chiefly affect those who are suffering from diseases of the valves, fatty degeneration of the heart or ossifica- tion of the coronary arteries, but they also occur in persons who are free from cardiac disease. 53. Angina Pectoris may be confounded with spasm of the stomach or the passage of a gall stone. Gastric spasm usually occurs in young females, angina pectoris in males of middle or advanced age; in the former the suffering is less severe and more confined to the chest or epigastrium, the heart's action is less depressed, and there is not the same disinclination to movement as. in the latter • there is also usually a history of dyspepsia, palpitation, and of hysterical symptoms, and the physical signs of heart disease are absent. In biliary colic the pain is usually situated in the epigas- trium or near the navel, and when it affects the chest, it seldom extends to the arms, vomiting is apt to occur, the pulse is less feeble, there is less disinclina- tion to movement than in angina pectoris, and there is often a history of previous attacks followed by jaundice, or by the passage of a bihary calculus. SECTION III. Aneurism of the Aorta. 54. You will often find morbid changes in the aorta after death, even in persons who have manifested no symptoms of disease of the heart or arteries. The most important of these is atheroma. It commences as a thickened patch in the internal coat (the intima) -It is generally of a cartilaginous consistence, and is slightly raised above the level of the surrounding membrane. Microscopically, the lamellse of the in- tima are separated from each other by a collection of '-oils, intermixed with thin layers of newly formed connective tissue. These little masses of cells may