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Pedunculated malignant growths are readily removed with snar...
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Tricuspid insufficiency, except as rarely found in the fetus,...
This is a matter of great importance to the sick. Nor is anyth...
Mind In Disease
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Mild Reaction Erethic
If the poison is not virulent, and the body of the patient in...
JOHANN BAPTIST VAN HELMONT, a celebrated Belgian physician, s...
Why We Cook our Food. While some of all classes of food may...
Temperature Of The Sick-room
The _temperature of the sick-room_ should not be much above 6...
Symptoms And Signs Of Cardiac Disturbance
It is now recognized that any infection can cause weakness an...
Muscular Action Weak
The heart is the most important of all muscles. Sometimes the ...
Treatment Of Acute And Subacute Inflammation And Ulceration Of The Esophagus
Bismuth subnitrate in doses of about one gramme, given dry o...
Practice On The Dog
Having mastered the technic of introduction on the cadaver a...
Prognosis And Convalescence
The duration of acute endocarditis varies greatly; it may be ...
Inflammation Of The Eyes - Ophthalmia
For common Ophthalmia, in the early stages, while there is mo...
Wounds Bleeding Of
After sending for a surgeon the first thing to be looked at in...
The Nerves In The Skin
How We Tell Things from Touch, and Feel Heat and Cold and Pai...
While disease of the coronary arteries may occur without ge...
A few of the anatomical details must be kept especially in mi...
Mitral Insufficiency: Mitral Regurgitation
Source: Disturbances Of The Heart
This is the most frequent form of valvular disease of the heart, and
is due to a shortening or thickening of the valves, or to some
adhesion which does not permit the valve, to close properly, and the
blood consequently regurgitates from the left ventricle into the
left auricle during the contraction of the ventricle. Such
regurgitation may occur without valvular disease if for any reason
the left ventricle becomes dilated sufficiently to cause the valve
to be insufficient. Such a dilatation can generally be cured by rest
and treatment. As with mitral stenosis, the most frequent causes are
rheumatism and chorea, with the occasional other causes as
The characteristic murmur of this lesion is a systolic blow,
accentuated at the apex, transmitted to the left of the thorax,
generally heard in the back, near the lower end of the scapula, and
transmitted upward over the precordia.
Of all cardiac lesions, this is the safest one to have. Sudden death
is unusual, the compensation of the heart seems to be most readily
maintained, and the patient is not so greatly dangered by
overexertion or by inflammations in the lungs. As in mitral
stenosis, any increase in blood pressure--whether the normal
increase after the age of 40, any continued earlier high tension, or
increase from occupation or exercise--is serious as causing the left
ventricle to act more strenuously, so that more blood is forced back
into the left auricle, the lungs become congested, and the right
ventricle, sooner or later, becomes incompetent.
When compensation fails with these patients, the first sign is
pendent edema of the feet, ankles and legs; subsequently, if there
is progressive failure of compensation, the usual symptoms occur.
The treatment is principally rest and digitalis, and the recovery of
compensation is often almost phenomenal. Patients with this lesion
are likely to be children and young adults, and the heart muscle
readily responds as a rule to the treatment inaugurated. Later, in
these patients, or if the lesion occurs in older patients, the
return to compensation does not occur so readily. If the condition
is developed from a myocarditis or from fatty degeneration of the
heart, it may be impossible to cause the left ventricle to improve
so much as to overcome this relative dilatation or relative
insufficiency of the valve. If the dilatation of the left ventricle
is due to some poisoning such as nicotin, with proper treatment--
stopping the use of tobacco, administration of digitalis, and rest--
the heart muscle will generally recover and the valve again properly
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