File:Diseases of the heart and thoracic aorta (1884) (14804705213).jpg

Identifier: diseasesofheart00bram (find matches)
Title: Diseases of the heart and thoracic aorta
Year: 1884 (1880s)
Authors: Bramwell, Byrom, Sir, 1847-1931
Subjects: Heart Diseases Aortic Diseases Heart Aorta Aorta, Thoracic
Publisher: Edinburgh, Pentland
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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extremely important to remember that thereturn current of blood through the cardiac veins is alsoobstructed ; the venous radicles and capillaries throughoutthe heart become engorged ; their contents tend to escapeinto the lymphatic spaces between the muscular fibres ; andthe nutrition of the muscular fibres is interfered with. Afterdeath the cardiac walls are usually found to be tougher andharder than natural. In those cases in which the muscularfibres are fatty, the cardiac wall may be soft and pale. In figure 184 I have attempted to represent in a diagram-matic manner the effects which are produced in the peri-pheral organs by the congestion of the venous system. Alterations in the Composition of the Blood.—In advancedstages of mitral disease the composition of the blood isprofoundly altered, and, in consequence of this alteration, thenutrition of the tissues and organs, including, of course, theheart itself, is very imperfectly carried out. The altered 436 Diseases of the Heart.
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Fig. 1S4. Clinical History of Mitral Incoinpctence. 437 composition of the blood is due to the following condi-tions :— I. Imperfect formation and elaboration.—The appetite isimpaired, the amount of food ingested is less than normal.The functional activity of the stomach and other organs,concerned in the manufacture of the blood, is seriouslydamaged in consequence of the deficient supply of healthyarterial blood, and of the venous congestion and its results,which have been already described. The impaired functionalactivity of the nerve centres reacts, of course, upon the stomachand other chylopoietic viscera, and adds further difficultiesto the digestive process ; 2. Impeifect elimination of wasteproducts.—The functional activity of the liver, kidneys, in-testines, and skin is, as we have already seen, seriously inter-fered with and the blood becomes loaded with effete products ;3. Imperfect aeration.—In consequence of the imperfect aera-tion of the blood in the lungs, which i

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