Medical diagnosis for the student and practitioner (1922) (14782229464)

Identifier: medicaldiagnosi00gree (find matches)

Title: Medical diagnosis for the student and practitioner

Year: 1922 (1920s)

Authors: Greene, Charles Lyman, 1862-

Subjects: Diagnosis

Publisher: Philadelphia, Blakiston

Contributing Library: The Library of Congress

Digitizing Sponsor: The Library of Congress

Text Appearing Before Image:

Fig. 318.—Same heart as shown i-n Fig. 317 showing shrinkage of outline undertreatment and the approach to the original drop heart outline, which has been obscuredby the dilatation existing over a long period of time. Many years ago the author pointed out that, with rare exceptions, in fluoro-scopic examinations one might make an immediate diagnosis of drop-heartin examining the abdomen and finding a gastroptosis or decidedly movablekidney. So on the other hand, finding the heart of congenital asthenia, onecould accurately affirm the presence of a ptotic stomach. THE DROP HEART 615 One must not understand that all cases of so-called effort syndrome,or soldiers heart are congenital asthenics. The symptoms characteristicof this syndrome are merely those of profound myocardial exhaustion.extreme narrowing of reserve, and may be produced most readily in theseindividuals congenitally unfit or potentially so.

Text Appearing After Image:

Fig. 319.—(E 86). Soldiers heart in civilian male. Type of individual who in theArmy broke down under the severer stress and strain of actual campaigning. This manhad lead an active out-of-door life as a ranchman but following severe overstrain com-plained of syncopal attacks, precordial pain on or following exertion, marked fatigability,recurrent edema of ankles and feet, and intervals of arrhythmia apparently due to recurrentfibrillation. Note that total transverse diameter of heart at this time was but 11.7 cm. The gastro-ptosis present in this case is shown in Fig. 320. (See also Fig. 321.) On the other hand any and every cause operating upon any heart andadequate to produce a marked diminution of tonus may produce exactly the 6i6 MEDICAL DIAGNOSIS same symptoms, for these are identical with those shown by individuals carryingnormal hearts but subjected to intense exhausting myocardial overstrain. Indeed, the recognition of the soldiers heart rested largely uponthe ease with whi

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1922

Library of Congress

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