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Updated: May 18, 2025
The greater the amount of myocarditis, the more doubtful is the heart strength in the near future. The greater the amount of endocarditis, the greater the doubt of freedom from future permanent valvular lesions. This inflammation of the endocardium is generally confined to the region of the valves, and the valves most frequently so inflamed are the mitral and aortic.
This condition of auricular fibrillation occurs occasionally in valvular disease, and perhaps most frequently in mitral stenosis; but it can occur without valvular lesions, and with any valvular lesion. If it occurs in younger patients, valvular disease is apt to be a cause; if in older patients, sclerosis or myocardial degeneration is generally present.
He had smiled and bowed before lovely women of various and bewitching types of beauty, had his abstract speculative ideal of feminine perfection, and had been feted, flattered, coaxed, baited, and welcomed to many shrines, whereon grace, wit, and wealth had lavished their choicest charms; but the carefully watched and well-regulated valvular machine he was pleased to designate his heart, had never as yet experienced a warmer sensation than that of mere critical admiration for classic contours, symmetrical figures, or voluptuous Paul Veronese colouring.
CARDIAC TONICS.-Digitalis: There is no drug that can take the place of digitalis in loss of compensation in chronic valvular disease. It acts specifically for good, and it has its greatest success in the valvular lesions that cause enlargement of the left ventricle, on which it acts the most intensely. It also acts for good on the right ventricle. It has but little action on the auricles.
Where organic heart diseases are surely present, it seems that hypnotism can sometimes act beneficially if the heart trouble is accompanied by anæmia and general debility; of course a developed valvular disease cannot be removed. In the same way it seems that in Bright's disease, certain painful symptoms may be suppressed, but the kidneys certainly cannot be influenced.
By a peculiar arrangement of the fibers of the heart, a wound transverse to one layer of fibers is in the direction of another layer, and to a certain extent, therefore, valvular in function; it is probably from this fact that punctured wounds of the heart are often attended with little or no bleeding. Among the older writers, several instances of nonfatal injuries to the heart are recorded.
At the termination of the ileum the 'caecum' makes its appearance, with a kind of valvular opening into it, of such a nature that everything that passes along it having reached the blind or closed end, must return in order to escape; or rather the office of the caecum is to permit certain alimentary matters and all fluids to pass from the ileum, but to oppose their return.
The reserve strength of the heart muscle, as has been previously stated, is much less in valvular compensation than that of the normal heart, and this reserve force is easily overcome by the pregnancy, and loss of compensation occurs with all of its usual symptoms. The most serious lesion a woman may have, as far as pregnancy is concerned, is mitral stenosis.
Chestnut was summoned again when the condition of the woman became critical, after twenty-five days of fasting, but she became rapidly weaker with violent convulsions and vomiting, and was beyond medical aid. "She had never been treated for cancer of the stomach, which Ritter says he thinks she may have had, although she had a valvular affection of the heart which had existed for some time.
Thornton paused in his narrative, and at that moment one of the stewards of the club came and whispered something in his ear. He rose. "I'm sorry," he said, with a grave face. "I'm called away; a very old client of mine. Valvular trouble of the worst kind. I doubt if I can do anything, but I must at least go. Please don't let me break up your evening, however." With a courtly bow he left us.
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