Your important communication to our society, which is about to be
published, will lay before the American public much more knowledge
respecting the diseases of the heart, and large vessels, than has
hitherto been presented to them. A case has lately fallen under my
observation, having so much similarity to those of organic diseases of
the heart, which have occurred to you, as to mark its affinity, yet
with some differences, which characterize it as a variety. If the
statement of it will add any value to your collection of cases, you
are at liberty to publish it.
A. S. twenty-eight years of age, and of middle stature, was attacked,
after a debauch, with pain in the region of the heart, which subsided,
but returned a year after on a similar occasion. He then became
affected with palpitations of the heart for six months, great
difficulty of breathing, which was augmented by ascending an eminence,
severe cough, dizziness, and violent head-ache, attended by a
disposition to bend the body forward, and sudden startings from sleep.
His pulse was always regular, and never remarkably hard. His
countenance, till within a few weeks of death, presented the
appearance of blooming health. His feet and legs did not swell at any
period of the disease. He suffered exceedingly from flatulence, to
which he was disposed to attribute all his complaints. This symptom
might have been aggravated by his habits of free living, and
occasional intoxication, which he acknowledged, and to which he traced
the origin of his disease.
After death, water was discovered in the thorax; but the lungs had not
that appearance of accumulation of blood, in particular spots, which
is commonly observed in cases of organic disease of the heart. The
only very remarkable morbid appearance about the heart was in the
aorta, and its valves. The valves had lost their transparency, and
were considerably thickened in various spots. The inner surface of
the aorta, for about an inch from its commencement, was elevated and
thickened, and the external surface singularly roughened and
verrucated. This appearance was so peculiar, that no words will give a
competent idea of it, and perhaps it would be sufficient for me to
call it a chronic inflammation[10].
I am, my dear sir,
Your friend and obedient servant,
JAMES JACKSON.
[Footnote 10: See plate second.]