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 Sec. 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,
quae 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.
Some of the French physicians have devoted much attention to
this subject; especially M. Corvisart, professor in the
hospital of La Charite, at Paris, from whose clinical
lectures is derived the most important information.]