Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . ooting up several degrees, but running so milda course as to scarcely merit the appellation of pyrexia. In others, again, the elevation of temperature is of irregulartype, or there are diurnal fluctuations, to possibly ° or ° F. The feature that mainly attracts attention in suchcases is the progressive anaemia, and the trifling changes discov-ered in the heart are commensurate with those of anaemia. The last of July, 1900, I wa
Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . ooting up several degrees, but running so milda course as to scarcely merit the appellation of pyrexia. In others, again, the elevation of temperature is of irregulartype, or there are diurnal fluctuations, to possibly ° or ° F. The feature that mainly attracts attention in suchcases is the progressive anaemia, and the trifling changes discov-ered in the heart are commensurate with those of anaemia. The last of July, 1900, I was consulted by a German, agedfifty-eight, who was a merchant in the interior of Indiana. Hisfamily history was unimportant, and his personal anamnesis wasmeagre. He had always considered himself well until about ayear previously, when he had suffered from bronchitis, for whichhe had received medical treatment, at which time a heart-murmurwas discovered. In March, 1900, he had been troubled withnight-sweats that had resisted treatment by belladonna. Since ACUTE ENDOCARDITIS 105 been losni around that time lie li had declined from ISO to 137 pounds. Fig. - Apex-beat and Relative CardiacDulness (p. 164). and altogether his weightlie gave a vague accountof some gastro-intestina] dis-order in the spring, but couldnot recall any attack of painthat might have been an at-tack of appendicitis, hepaticor renal colic. Neither couldhe remember any injury orlocal suppurating process,and he had never had rheu-matism, pneumonia, gonor-rhoea, or other infection. The patient was tall, ema-ciated, pale, and of a slightyellow hue, and his conjunc-tiva? were faintly icteric. Theradial arteries were thick-ened, and the pulse, of onlymoderate tension, was regular and equal, 100 to the minute. Afeeble cardiac impulse was diffused from epigastrium to the apex-beat, which, weak and accompanied by soft thrill, wras situatedin the sixth interspace, 10 cen-timetres to left of medianline. Relative c
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