The practice of pediatrics . ng inflammation in which the entire thickness ofthe valve or pericardium is implicated, and the connective tissue through-out them is swollen and infiltrated with leukocytes. This process is 698 DISEASES OF THE HEART BLOODVESSELS very slow, but, eventually, there is great damage to the connectivetissue, and the contraction which results is extreme. It is well ex-emplified by the true mitral stenosis. The other deviation from theordinary type is a far more virulent process, in which the balancebetween the disease and resistance, far from being equal, is greatly
The practice of pediatrics . ng inflammation in which the entire thickness ofthe valve or pericardium is implicated, and the connective tissue through-out them is swollen and infiltrated with leukocytes. This process is 698 DISEASES OF THE HEART BLOODVESSELS very slow, but, eventually, there is great damage to the connectivetissue, and the contraction which results is extreme. It is well ex-emplified by the true mitral stenosis. The other deviation from theordinary type is a far more virulent process, in which the balancebetween the disease and resistance, far from being equal, is greatly infavor of the disease, and the bacteria multiply in the local lesions withgreat rapidity. It is well exemplified by the rheumatic form of malignantendocarditis. The result is a remarkable one. Large vegetations formupon the valve, and the micro-organisms are scattered by the bloodstream in every direction. Here, again, it must be pointed out thatmany will not accept this interpretation, but maintain that all cases Fig. 146. Diplococci. Rheumatic endocarditis, showing diplococci. of malignant endocarditis are the result of mixed infections with septicmicro-organisms. (See Plate XX., Figs. 145, 14(>, 147 and 148.) Endocarditis. The cardiac valves are damaged in this order offrequency: (1) the mitral, (2) the aortic, (3) the tricuspid, and, veryrarely, (4) the pulmonary. I am convinced that the statement thatrheumatism only affects the left side of the heart, because the bloodthere is arterial, is one of those ideas which appeals rather to theimagination than to the reason. The mitral and aortic valves areaffected simultaneously or in rapid sequence with considerable fre-quency, but any severe affection of the tricuspid valve is very rare. The local lesions in the mitral valve take the form of small, pinheadvegetations ranged along the lines of contact of the segments, and theyare usually situated upon the auricular surfaces of the mitral and PLATE XX. _ _• c ?
Size: 1615px × 1548px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectchildren, bookyear190
