Medical ArticlesSore Nipples
This affection of nursing women frequently comes on before th...
Emetic, followed by white of egg. Keep very warm. ...
Decannulation after tracheotomy done for papillomata should ...
Contraindications To Direct Laryngoscopy
There are no absolute contraindications to direct laryngosco...
A cold is often easily overcome. At other times it "sits down,...
Anatomy Of Larynx Trachea Bronchi And Esophagus Endoscopically Considered
The larynx is a cartilaginous box, triangular in cross-sectio...
This trouble appears in two opposite characters. In the one it...
Resume Of After-care Of A Tracheotomic Case
1. Always bear in mind that tracheotomy is not an ultimate ...
Memory Loss Of
A more or less complete suspension of this faculty is a not un...
Where biliousness prevails, without any symptom of real liver ...
On The Treatment By Eschar And Poultice
In many cases in which it is impossible to adopt either the m...
It is difficult to determine the presence of _worms_ in child...
The spatular end of the laryngoscope is introduced in the ri...
Tricuspid Stenosis Tricuspid Obstruction
This is rare and probably always congenital, and is supposed ...
Functional Hiatal Stenosis Hiatal Esophagismus Phrenospasm Diaphragmatic Pinchcock Stenosis
There is no sphincteric muscular arrangement at the cardiac o...
Few vital processes are more remarkable than that by which foo...
When soft, friable substances, such as a bolus of meat, beco...
The Surgical Dissection Of The Subclavian And Carotid Regions The Relative Anatomy Of Their Contents
A perfect knowledge of the relative anatomy of any of the s...
What is commonly called a "cough and spit" is sometimes due to...
Auricular Fibrillation Pathology
Schoenberg [Footnote: Schoenberg: Frankfurt. Ztschr. f. Patho...
Malignant Endocarditis Ulcerative Endocarditis
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
Previous: Prognosis And Convalescence