. Medical diagnosis for the student and practitioner. of certain chronic endocarditic valvular lesionsso rare an achievement (mitral stenosis, aortic stenosis;. For the patient, early detection of his heart lesion is quite as desirable and necessary- asthe early detection of pulmonary tuberculosis. Most of the tuberculous undergo a spon-taneous recovery- and the same is true of, and the same favorable issue attends, a host ofinstances of myocardial involvement during acute illness, yet in the case of both, earlyrecognition and proper regimen, wise counsel and judiciously timed treatment are in
. Medical diagnosis for the student and practitioner. of certain chronic endocarditic valvular lesionsso rare an achievement (mitral stenosis, aortic stenosis;. For the patient, early detection of his heart lesion is quite as desirable and necessary- asthe early detection of pulmonary tuberculosis. Most of the tuberculous undergo a spon-taneous recovery- and the same is true of, and the same favorable issue attends, a host ofinstances of myocardial involvement during acute illness, yet in the case of both, earlyrecognition and proper regimen, wise counsel and judiciously timed treatment are invalu-able, for in either disease the cases recognized and treated only when gross and obtrusivesigns are present, represent almost hopeless conditions, though, in each, life may be greatlyprolonged. 662 MEDICAL DIAGNOSIS Careful percussion by modern methods, having in mind the peculiarly smallhearts of patients bearing the asthenic stigmata and the narroned normal limitsrepresented by the table of Cohn* reveals the relative frequency of minor dila-. Fig. 356.—Ready dilatability of the drop heart. This figure represents an exposuremade during a period of continuing overstrain and shows a heart diameter of This patient has passed through three attacks of acute dilatation, two of whichthreatened his life and were slowly recovered from. The third produced effects lastingacutely only a few hours although the dilatation was pronounced. The two attacks ofmassive dilatation were associated with major surgical operations; the third with simplephysical overstrain. Compare this exposure with that shown in Fig. 357. tations following acute infections. The promptness of amelioration or dis-appearance of symptoms, and sometimes of gross border recession, under restand full therapeutic test doses of digitalis is oftentimes astonishing. *See opening pa ges of heart section in this volume. MYOCARDIAL OVERSTRAIN 663 The Split Second Sound.—As previously stated, the author during seve
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
