Home >> Volume-02-nutritive-disorders >> Obesity Plethoric Form to Symptomatology Of Gout >> Rheumatism Case_7

Rheumatism Case

attack and surface

RHEUMATISM CASE XV.A girl, aged 20, who had previously enjoyed good health, suffered from an attack of acute rheumatism in March, 1872. The attack was an ordinary one of medium severity, presenting no unusual feature, but complicated by a slight attack of endocarditis which gave rise to no subjective symptom, and the only sign of whose existence was a soft and short systolic blow at the apex. She was treated with acetate of potassium, ten grains every three hours (the case occurred before the clays of the salicyl treatment). The endo cardial blow persisted, but the rheumatic symptoms had diminished in severity by the end of the second week. On the seventeenth day of her illness she got up of her own accord. Her sister, who was in the room, stated that her feet had scarcely touched the floor, when she fell back on her bed, and lay there motionless. She never moved or gave any sign of life. I saw her twenty minutes later, quite dead.

A few minutes before making the effort she expressed herself- as feel ing very well, and free from pain.

On post-mortem examination the mitral valve wasfound to be somewhat thickened, and on its auricular surface was a line of lymphy deposit. The heart's substance, especially that of the left ventricu lar walls, was rather dark in color, and softer than natural. On firm pressure it broke clown under the finger. On microscopic examina tion the normal shim were wanting in distinctness, and the fibres had a granular aspect. There was a little effusion into the pericar dium. There was no ulceration of the endocardial surface, no ap pearance of embolism ; nothing to explain the fatal result, except the altered condition of the ventricular walls. The cranial and abdom inal contents were normal.