Notice of a case of cyanosis, of the blue disease. connected with mutual adhesion of the semilunar valves of the pulmonary artery / by David Craigie.

  • Craigie, David.
Date:
[©1843?]
Catalogue details

Licence: Public Domain Mark

Credit: Notice of a case of cyanosis, of the blue disease. connected with mutual adhesion of the semilunar valves of the pulmonary artery / by David Craigie. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the conjunctiva were of a dark blue; the oedema of the feet and ankles continued. The'anterior part of the chest was very prominent, the sternum arched,*and the shoulders much elevated. Respiration was twen- ty-eight in the minute performed by the accessory muscles, and with much labour. The sound of respiration was bronchial, blow- ing and limited, in some parts approaching to cavernous, with some dry sonorous and sibilous wheezing, but no moist rattles. The cardiac region emitted, on percussion, a preternaturally dull sound ; but above the third rib, on the left side, and on the right side of the sternum, the sound emitted vvas clear, and in some parts tympanitic. The cardiac beats were from 92 to 96 in the minute, performed with rather strong impulse, between the fourth and seventh ribs. The cardiac beats were heard also in the epigastric region, and on the right side of the sternum ; and the first beat was performed with a rough, rasping, or sawing murmur, considerably prolonged. At this time the diagnosis given was, communication between the right and left chambers of the heart, probably by the foramen ovale, hypertrophy of the right ventricle, and probable contraction of the pulmonary artery. The only treatment consisted in the administration of some laxative medicine, in the observance of perfect rest, and the sub- sequent limited use of anodynes and antispasmodics. In the course of four days the breathle&sness was greatly abated, and the cough was less frequent and urgent; the colour of the face, lips, and hands was ratlicr less deeply violet than at admis- sion ; but the vessels of the conjunctiva were still dark-coloured, and the nails had a deep blue tint. 'J'hc cedema of the feet was diminished ; the urine was increased; and the pulse was reduced to about 88, but still rose at intervals to 02 and 96. There was no return of hemorrhage. At this time, when the beats of the heart were again examined, the pulsations were still heard most distinctly on the right side of the sternum ; the first beat was still performed with the rough, rasping murmur, which was also heard most distinctly and forcibly on the right side of the sternum, immediately below the third and fourth rib, and obscuring there the sounds of respiration. The cardiac beats were also heard in the back, but much less forcibly. From this time he continued much in the same state ; except that when he attempted to rise and move about, the breathlcssness was aggravated, and the cheeks and lips became unusually livid. On the 10th of May, about four weeks after admission, he was attacked in the evening with rigors, followed by discharge of blood from the lungs. This soon stopped, and next day the expectora- tion only vpas streaked with blood. The impulse at the heart was strong and labouring, beats 96 in the minute, with the same rasp-