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Intermittent Fever, Ague or Chill Fever. This comes on wit...

Acute Myocarditis

Probably most acute infections cause more or less myocarditis...


It should be understood that especially in acute conditions...


A MAN once grasped a very hot poker with his hand, an...

Eyes Accidents To

Three distinct classes of these are to be considered. They req...

Favorable Symptoms

are the following: Absence of internal inflammation; a bright...

Blood Pressure

The study of the blood pressure has become a subject of gre...

Trismus Lockjaw

For traumatic trismus, use the B D current, of vigorous force...

Nerves Shaken

By this we mean, not the nerve trouble which follows a sudden ...

Eyes Healthy

Cheap, ill-printed literature is responsible for much eye trou...

The Temperature Of The Room However Should Be A Few Degrees

higher than in scarlatina, as none of these other eruptive dise...

Foreign Bodies In The Stomach

Gastroscopy is indicated in cases of a foreign body that ref...

Noise And Disease

Perhaps nothing shows more the lack of human feeling in many p...

Flannel Bands

See Band, Flannel. ...

Nervous Strain In Pain And Sickness

THERE is no way in which superfluous and dangerous te...

The Surgical Dissection Of The First Second Third And Fourth Layers Of The Inguinal Region In Connexion With Those Of The Thigh

The common integument or first layer of the inguino-femoral r...


Sources of Starch. The starches are valuable and wholesome fo...

The Relative Position Of The Cranial Nasal Oral And Pharyngeal Cavities

On making a section (vertically through the median line) of t...

Rules For Endoscopic Foreign Body Extraction

1. Never endoscope a foreign body case unprepared, with the...


The cause of an irregularly acting heart in an adult may be o...

Malignant Endocarditis Ulcerative Endocarditis

Category: Uncategorized
Source: Disturbances Of The Heart

Since we have learned that bacteria are probably at the bottom of
almost any endocarditis, the terms suggested under the
classification of endocarditis as "mild" and "malignant" really
represent a better understanding of this disease. They are not
separate entities, and a mild endocarditis may become an ulcerative
endocarditis with malignant symptoms. On the other hand, malignant
endocarditis may apparently develop de novo. Still, if the cause is
carefully sought there will generally be found a source of
infection, a septic process somewhere, possibly a gonorrhea, a
septic tonsil or even a pyorrhea alveolaris. Septic uterine
disturbances have long been known to be a source of this disease.
Meningitis, pneumonia, diphtheria, typhoid fever and rarely
rheumatism may all cause this severe form of endocarditis.

Ulcerative endocarditis was first described by Kirkes in 1851, was
later shown to be a distinctive type of endocarditis by Charcot and
Virchow, and finally was thoroughly described by Osler in 1885.

Ulcerative endocarditis was for a long time believed to be
inevitably fatal; it is now known that a small proportion of
patients with this disease recover. Children occasionally suffer
from it, but it is generally a disease of middle adult life. Chorea
may bear an apparent causal relation to it in rare instances.

Ulcerative endocarditis may develop on a mild endocarditis, with
disintegration of tissue and deep points of erosion, and there may
be little pockets of pus or little abscesses in the muscle tissue.
If such a process advances far, of course the prognosis is
absolutely dire. If the ulcerations, though formed, soon begin to
heal, especially in rheumatism, the prognosis may be good, as far as
the immediate future is concerned. If the process becomes septic, or
if there is a serious septic reason for the endocarditis, the
outlook is hopeless. This form of endocarditis is generally
accompanied by a bacteremia, and the causative germs may be
recovered from the blood. One of the most frequent is the
Streptococcus viridans.

Next: Diagnosis

Previous: Prognosis And Convalescence

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