CASE I.
Mrs. M——. Orthopnea, pain, and excessive oppression at the bottom of the sternum. Pulse irregular, with frequent intermissions. Appetite very much impaired. Legs anasarcous.
Empl. vesicator. pectori dolent.
Infus. Digital. e ʒiii. ad. aq. &c. ℥viii. cochl. j. o. h. donec nausea excitetur vel diuresis satis copiosa proveniat.
I ordered it of the above strength, and to be repeated often, on account of the great emergency of the case, but the nausea excited by the first dose prevented its being given at such short intervals. A 3d dose I found had been given, which was followed by vomitings. All her complaints gradually abated, but in about a fortnight recurred, notwithstanding the use of infus. amar. &c.
Dec. 2. Infus. Digit. e. ʒiss ad aq. &c. ℥viii. cochl. ii. horis &c. u. a.
Complaints gradually abated, swellings of the legs nearly gone down.
About a month afterwards you was desired to visit this patient.[9]
On the examination of the body I noticed, among others, the following appearances.
About ¾ oz. of bloody water flowed out, on elevating the upper half of the scull, and a small quantity also was found at the base.
Brain. Blood-vessels turgid with blood, and many of those of considerable size distended with air.
A very slight watery effusion between the Pia Mater and Tunica arachnoidea. About ¾ oz. of watery fluid in the lateral ventricles.
Thorax. In the left cavity about 4 oz. of bloody serum; in the right but little. Lungs, the hinder parts loaded with blood. Adhesions of each lobe to the pleura. Pericardium containing but a very small quantity of fluid. Heart containing no coagula of blood. Valves of the Aorta of a cartilaginous texture, as if beginning to ossify.
Abdominal Viscera natural, and a profusion of Fat under the integuments of the abdomen and thorax, in the former to the thickness of an inch and upwards, and in very considerable quantity on the mesentery, omentum, kidneys, &c.
Obs. The intermitting pulse should seem to have been owing to effusions of water in some of the cavities of the breast, as it disappeared on the removal of the waters.