The Practitioner Volume 80

The Practitioner Volume 80

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1908 edition. Excerpt: ...1904. is necessary; rest in bed, skilled nursing, and a visit of the doctor twice a day are essential. I. The Right Heart.--It is the right heart which fails in pneumonia--rarely the left. The left heart may be dilated, if there is a concurrent infection by influenza, diphtheria, typhoid, or rheumatism, or if the heart or arteries have been previously diseased. But, in an ordinary pneumonia in a previously healthy person, careful percussion shows that the left border of the cardiac dulness is only slightly displaced to the left, not more than the distension of the right side will account for. But a dilatation of the right auricle may often be detected on the third day of a pneumonia--sometimes even on the second day. This observation is not diflicult if careful light percussion is practised in the innermost part of the fourth right interspace. In the normal heart, the right auricle yields a dulness at this spot which measures about a finger-breadth (2 centimetres). In pneumonia, this often increases to two finger-breadths, and then there will be one finger-breadth in the third space also. A rapid dilatation of the right heart always gives rise to acute dyspnoea, and with the dyspnoea are associated a dusky pallor, a small pulse, a sense of cardiac oppression, restlessness, and inability to sleep: symptoms which may be summed up as right-heart misery. Immediate relief may be given by a few leeches, applied between the right nipple and the costal margin, but, in neglected cases, venesection may be necessary. The relief will usually last for 48 hours, but it may then be found that the auricle is again dilated, and that the urgent symptoms have returned. The leeches or venesection should then be repeated. Two small bleedings, often only one, more

Product details

  • Paperback | 324 pages
  • 189 x 246 x 17mm | 581g
  • United States
  • English
  • black & white illustrations
  • 1236899628
  • 9781236899620