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Cases of Organic Diseases of the Heart   By: (1778-1856)

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CASES OF ORGANIC DISEASES OF THE HEART.

WITH DISSECTIONS AND SOME REMARKS INTENDED TO POINT OUT THE DISTINCTIVE SYMPTOMS OF THESE DISEASES.

READ BEFORE THE COUNSELLORS OF THE MASSACHUSETTS MEDICAL SOCIETY.

BY JOHN C. WARREN, M. D.

BOSTON: PRINTED BY THOMAS R. WAIT AND COMPANY. COURT STREET. 1809.

PLATE I.

Appearance of the valves of the aorta in Case 3d, Article 10.

a a The two valves thickened.

b b Bony projections, one of which extends across the cavity of the valve.

c The orifices of the coronary arteries.

d d Fleshlike thickening of the aorta.

PLATE II.

Is a representation of the fleshlike thickening of the aorta in case 7th. The valves are smaller than usual, and their form is in some degree changed. A round spot, thickened, is seen at a little distance from the seat of the principal disease.

[Illustration]

[Illustration]

CASES OF ORGANIC DISEASES OF THE HEART, WITH DISSECTIONS.

Morbid changes in the organization of the heart are so frequent, as to have attracted the observation of those, who have devoted any attention to the study of morbid anatomy. Derangements of the primary organ of the circulation cannot exist without producing so great disorder of the functions of that and of other parts, as to be sufficiently conspicuous by external signs; but, as these somewhat resemble the symptoms of different complaints, especially of asthma, phthisis pulmonalis, and water in the thorax, it has happened, that each of these has been sometimes confounded with the former[1]. The object of the following statement of cases is to shew, that, whatever resemblance there may be in the symptoms of the first, when taken separately, to those of the latter diseases, the mode of connection and degree of those symptoms at least is quite dissimilar; and that there are also symptoms, peculiar to organic diseases of the heart, sufficiently characteristic to distinguish them from other complaints.

[Footnote 1: A careful examination of the works of some of the most eminent English practical writers does not afford evidence of any clear distinction of these diseases of the heart. Dr. Cullen, whose authority is of the highest estimation, evidently enumerates symptoms of them in his definition and description of the hydrothorax. In § 1702 Th. and Pr. he places much confidence on a particular sign of water in the chest, and remarks, that the same sign is not produced by the presence of pus. Now, there is no sufficient reason, why this symptom should not arise from the presence of pus, as well as from that of water; but it probably can depend on neither of those alone. See Morgagni de causis et sedibus morborum, Epist. 16. art. 11. The experienced Heberden says in the chapter "De palpitatione cordis," "Hic affectus manifesta cognitione conjunctus est cum istis morbis, qui existimantur nervorum proprii esse , quique sanguinis missione augentur ; hoc igitur remedium plerumque omittendum est." "Ubi remediis locus est, ex sunt adhibenda, quæ conveniunt affectibus hypochondriacis ."

Dr. Baillie's knowledge of morbid anatomy has enabled him to make nearer approaches to truth; yet it will probably be found, when this subject shall be fully understood, that his descriptions of the symptoms of diseases of the heart and of hydrothorax are not quite accurate, and, that with respect to the former, they are very imperfect... Continue reading book >>




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