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ON

DISEASES OF THE HEART

AND

GREAT VESSELS:

THEIR

PATHOLOGY, PHYSICAL DIAGNOSIS, SYMPTOMS,

AND TREATMENT.

BY

HENRY WILLIAM FULLER, M.D. CANTAB.,

ANTAL

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PRINTED BY J. E. ADLARD, BARTHOLOMEW CLOSE, LONDON.

BOSTON MEDICAL LIBRARY

IN THE
FRANCIS A. COUNTWAY

LIBRARY OF MEDICINE

PREFACE.

Some of my professional friends, for whose judgment I entertain the highest regard, have urged me to publish in a separate form those portions of my work on diseases of the chest which relate to diseases of the heart and great vessels. Encouraged by their advice, I have determined to do so, in the hope that the present volume may be acceptable to many who have no occasion to refer. to much of the matter contained in the larger and more comprehensive treatise.

Little need be stated respecting the scope of the work itself. My object has been to make it embrace all that is known at present respecting the subjects on which it treats, and to present that information in a clear and intelligible form. In those chapters which relate especially to diagnosis I have endeavoured to explain every auscultatory sign by reference to the morbid condition and consequent altered mechanism in which each takes its origin. My wish has been to inculcate the necessity for regarding each physical sign, not as indicative of a certain disease, but rather as the natural consequence of a certain physical alteration of the tissues, the source and true interpretation of which must be determined by concomitant circumstances.

Further, my aim has been to simplify the subject as much as possible, to point out the conclusions which are to be drawn from recent experiments and pathological research, and to give a concise description of the various signs on which the diagnosis, prognosis, and treatment of cardiac affections must be based.

I have purposely avoided encumbering my pages with the discussion of remedies and modes of treatment which experience has • proved to be undeserving of confidence, and have contented myself with discussing the particular methods of treatment which have appeared to me most generally successful, and based upon the soundest physiological grounds.

The views which I entertain respecting the action of digitalis do not accord with those which are generally received, and as this remedy is, beyond comparison, the most important we possess in many forms of cardiac disease, I have endeavoured to point out the nature of the influence it exerts, and the precise forms of disease in which its operation is most signally beneficial.

Throughout the work I have availed myself of the labours of my predecessors, and have profited largely by their investigations. Whenever I have seen reason to dissent from their conclusions, I have not hesitated to avow it, and have stated the grounds of my opinion. In no other way is it possible to obtain a full discussion of the principles on which our science is founded, or to arrive at a satisfactory conclusion respecting their merits.

I need scarcely say how gratifying it would be to me to learn that the views which I have propounded have received the approval of my professional brethren; but as my sole object is to elicit the truth, I trust that those gentlemen who meet with facts which in any way elucidate the questions at issue will kindly favour me with the result of their experience.

13, MANCHESTER SQUARE, LONDON, W.;

January, 1863.

CONTENTS.

PAGE

PART II.-ON DISEASES OF THE HEART AND GREAT VESSELS, THEIR

PATHOLOGY, SYMPTOMS, DIAGNOSIS, AND TREATMENT.

CHAPTER 1.
PERICARDITIS : its Constitutional Origin-Its Causes-Its frequent connection

with Acute Rheumatism and with Bright's Disease of the Kidneys—Statis-
tics relating to it-Its Pathological Effects--The Symptoms, Diagnosis, and
Treatment of the Acute Disease_Treatment of the Chronic Stage of the
Disorder—The Diagnosis of Old Adhesions of the Pericardium , 64-94

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