Cases of Organic Diseases of the Heart

WITH DISSECTIONS AND SOME REMARKS INTENDED TO POINT OUT THE DISTINCTIVE SYMPTOMS OF THESE DISEASES.
READ BEFORE THE COUNSELLORS OF THE MASSACHUSETTS MEDICAL SOCIETY.
BY JOHN C. WARREN, M. D.
BOSTON: PRINTED BY THOMAS R. WAIT AND COMPANY. COURT-STREET. 1809.
PLATE I.
PLATE II.
The symptoms of organic disease of the heart are marked with extraordinary clearness in the following case. The opportunity for observing them was very favourable; and there was every incitement to close observation, which could arise from the important and interesting character of the patient. These advantages will justify an uncommon minuteness in the detail of the case; especially, as the most accurate knowledge of a complaint is obtained from a successive view of its stages.
The late Governour of this commonwealth was endowed with most vigorous powers of mind and body. At the age of sixteen he was attacked with fits of epilepsy, which first arose from a sudden fright, received on awaking from sleep in a field, and beholding a large snake erecting its head over him. As he advanced in life they became more frequent, and were excited by derangement of the functions of the stomach, often by affections of the mind, by dreams, and even by the sight of the reptile which first produced the convulsions.
At the commencement of the American revolution he became deeply engaged in public affairs; and from that time devoted himself to intense application to business, with which the preservation of his health was never allowed to interfere. In the expedition against Rhode Island, an attack of inflammation of the lungs had nearly proved fatal to him.
In the beginning of the year 1807, he suffered severely from the epidemic catarrh; and a remarkable irregularity of the pulse was then perceived to be permanent, though there is some reason to believe, that this irregularity had previously existed, during the fits of epilepsy, and for a few days after them. In the summer, while he was apparently in good health, the circulation in the right arm was suddenly and totally suspended; yet, without loss of motion or sensation. This affection lasted from noon till midnight, when it as suddenly ceased, and the circulation was restored. In the autumn he was again seized with the influenza, which continued about three weeks, leaving a troublesome cough of two or three months’ duration, and a slight occasional difficulty of breathing, which at that time was not thought worth attention. Soon after, in November, he had one or two singular attacks of catarrhal affection of the mucous membrane of the lungs, which commenced with a sense of suffocation, succeeded by cough and an expectoration of cream coloured mucus, to the quantity of a quart in an hour, with coldness of the extremities, lividity of the countenance, and a deathlike moisture over the whole body. These attacks lasted six or eight hours, were relieved by emetics, and disappeared, without leaving a trace behind.