Acute Inflammation of the Lining of the Heart.
THE heart is one of the citadels of life. Disease attacks it on all sides. In this complaint, it has entered the fort and taken possession. The inflammation is on the lining membrane.
Physical Signs. The impulse is violent, abrupt and regular, as long as the circulation through the heart is free, but when this is impeded, it is at first a confused tumult (which generally happens when a fort is first taken), and gradually sinks to a feeble flutter.
The dull sound upon percussion covers a space of from three to seven square inches.
The beats of the heart are generally accompanied or marked by a bellows murmur, the loudness of which depends on the strength of the heart's action.
General Symptoms. Inflammatory fever. The action of the heart being generally violent and abrupt, the pulse corresponds with it, and is strong, full and hard.
Explanation. The bellows sound is supposed to depend on the inflamed and swollen condition of the valves.
The dullness on percussion will be slight when the circulation through the heart is free; more distinct and marked when it is obstructed.
Dr. Hope says the disease may be anticipated, if a person be suddenly attacked with these three signs: namely, fever, violent action of the heart, and a murmur which did not exist before.
This disease, like inflammation of the heart case, is often produced by, and is intimately connected with, acute rheumatism, and is then to be treated on same principles as rheumatic disorders.
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