. Medical diagnosis for the student and practitioner. Fig. 424.—General dilatation and insufficiency. This may resemble pericardial effu-sion yet more closely in certain universal dilatations of the drop heart occasionally en-countered in acute prostrating infections. (Schwartz, modified.) (See Fig. 358.) ing constitutional effect of such toxemias doubtless invites infection from themany obscure but potent sources now known to exist in a considerable pro-portion of individuals. The same statement applies to pericarditis associatedwith pulmonary tuberculosis in some instances, many of these bei
. Medical diagnosis for the student and practitioner. Fig. 424.—General dilatation and insufficiency. This may resemble pericardial effu-sion yet more closely in certain universal dilatations of the drop heart occasionally en-countered in acute prostrating infections. (Schwartz, modified.) (See Fig. 358.) ing constitutional effect of such toxemias doubtless invites infection from themany obscure but potent sources now known to exist in a considerable pro-portion of individuals. The same statement applies to pericarditis associatedwith pulmonary tuberculosis in some instances, many of these being non- PERICARDITIS 783 tubercular and probably due to the same conjunction of predisposition andpotent pathogenic Fig. 425.—Pericardial effusion, typical and decided but not extreme. (Dorso-ventralaspect.) The limitation of the ascent of the liquid by the attachment of the pericardiallayers to the great vessels and the resulting stubby neck of the flask or decanterprofile is indicated quite clearly. Dulness decided to right as well as left of sternum, trueapex-beat absent, heart sounds lost or extremely faint at apex. (Repetition of figureshown under Roentgenography.) {Dr. Frank S. Bissell.) In all cases of endocardial and myocardial disease the possibility of a peri- complication must be held in mind and, in children especially, involve-ment of the entire structure of the heart (pancarditis) is extremely common. Age, Sex.—By far the greater number of cases occur in children and youngadults and according to most statistics there is decided male predominance. 784 MEDICAL DIAGNOSIS Dry vs. Wet Cases.—Cases of fibrinous pericarditis and those of theexudative form occur in a
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