In endocarditis complicating Bright's disease the rapid elimination of the urea must be established. The severe pain over the præcordial space may be relieved in many subjects by the application of a few leeches to the region.
Experience proved that the employment of mercury (internally) and blue ointment (externally) to lessen the plasticity of the blood, and the internal use of iodide of potassium (for the absorption of fibrinous exudation), were harmful, before it was demonstrated that the theory on which their use was based had no foundation.
Cardiac Murmurs, and their Relations to Valvular Diseases of the Heart.
DEFINITION.—A cardiac murmur is an adventitious or abnormal sound produced within the heart or blood-vessels, either by obstruction to the blood-current, an abnormal direction of the blood-current, or by a change in the blood-constituents.
HISTORY.—The systematic study of cardiac murmurs and valvular diseases dates from the discovery of auscultation by Laennec. Previous to his discovery there are a few recorded cases where observers during the seventeenth and eighteenth centuries described forms of valvular diseases. One of the first to describe a valvular lesion of the heart was Vieussens in 1716. At the close of the seventeenth century Willis and Riverius published cases of valvular disease. In all these instances it was the aortic valves that were diseased, and the discovery of their condition was undoubtedly due to the peculiarity of the radial pulse which is so marked and striking in aortic disease.
In Friedreich's article in Virchow's Handbuch, "Krankheiten des Herzens," Meckel's essay of 1756 is given as the first paper on endocardial disease.
John Hunter2 in 1794 gives a lengthened account of a most interesting case of aortic valvular disease. Senac3 gives an account of disease of the auriculo-ventricular valves; and Allan Burns, whose work was published in 1809, describes aortic regurgitation and obstruction, and supposes that "a reflux current can produce a hissing noise, something like what is described as audible palpitation in some diseases of the heart."4
2 Treatise on the Blood, etc.
3 Treatise on the Heart, 1783.
4 Obs. on some of the most Frequent and Important Dis. of the Heart, Allan Burns, Edinburgh, 1809.