On insufficiency of the aortic valves in connection with sudden death, with notes historical and critical.

  • Cockle, John, 1814-1901.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: On insufficiency of the aortic valves in connection with sudden death, with notes historical and critical. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    conformation of body, and of a good stature, having been long troubled with a difficulty of breathing, was relieved by blood bursting forth, every now and then, from the nostrils. But, after he had begun to be deficient in this discharge, he happened to take a long journey from Trent to Padua, which he performed, partly on foot and partly on horseback, within the space of two days. Immediately after coming off his journey, and while he was stooping to his portmanteau, which was laid on the ground, he fell down dead. The thorax being cut into on the day following, the ves- sels of the head and the neck were previously observed to be very turgid with blood. But when the cavity was opened there appeared to be no extravasation in it, nor were the lungs seen to adhere, anywhere, to the pleura. Both the lobes of this viscus, however, were livid, from the blood stagnating in them; and they were small besides, from the vast magnitude of the heart, which (when the pericardium was cut into, where there was no small quantity of reddish serum) appeared to be even bigger than that of a bullock. And, indeed, the auricles, and the right ventricle, were bigger than usual; yet, the greatest bigness was ob- served to be in the left ventricle. Nor, was this owing to the parietes, which were not thicker than usual; but to the cavity of the ventricle being dilated to such a degree that nothing could be conceived as being more so, and not only filled with a quantity of black blood (that had not formed itself into polypus concretions, though it was somewhat col- lected into grumous coagula), like the other cavities of the heart, but also distended therewith. Besides these appear- ances, the semilunar valves, which lie at the orifice of it, were not bony, indeed, but hard; and what immediately occurred to the eyes, very small, for they were contracted and corrugated. But the great artery, although it was not larger than it naturally is, yet in proportion as it receded from the heart, so much the thinner than usual were its coats. Nor was its internal surface entirely free from longi- tudinal furrows, notwithstanding they were somewhat obscure. However, in the heart and the whole thorax, there was nothing besides that was not natural “ 14. You will, perhaps, ask why, as all the four cavities of the heart were dilated in the young man in question, the dilatation of the left ventricle was, nevertheless, the greatest. Without doubt, because the dilatation of this ventricle had given rise to the dilatation of the other ventricle and the two auricles ; that is, by admitting a less quantity of blood