18 Damaschino, Thèse de Paris.
There are other general conditions in which there is a marked tendency to the formation of cardiac coagula. In the puerperal state, according to Simpson, it is occasioned by the resorption of many new elements which vitiate its composition and thus occasion this result. In the poisoning following upon glanders or pyohæmia intra-cardiac thrombi are often found. Lancereaux has found in this latter disease fibrinous deposits in the right ventricle and pulmonary artery around small masses composed of pus-cells. In the different cachectic states, such as those caused by chronic Bright's disease,19 advanced phthisis, and cancer, although we have a diminution in the proportion of red globules, there is present at the same time a relative increase of fibrin; and the consequence is that concretions are often formed in the heart. In fact, it is in these cachexiæ that we often encounter those fibrinous cysts which will be described under the title of [Morbid Anatomy].
19 Here the retention of the excreta is an important factor in the formation of cardiac thrombosis (Bristowe).
Many well-known authors have declared that diphtheria was very powerful in producing fibrinous concretions in the right heart some time previous to death. Among those who have written specially on this subject we would mention Winkler,20 Richardson,21 Meigs22 and Robinson.23 According to the latter writer, elastic fibrinous clots twisted in the valves and adherent to the cardiac walls are developed frequently in children at a period quite removed from that of the agony, and at a time when they are not as yet in a condition of extreme weakness. Except in exceptional instances this influence of diphtheria to produce cardiac coagula is doubted by Parrot.24 He admits its power, particularly when it is complicated with membranous croup, and in these examples he believes the precocious formation of coagula is determined probably by the asphyxic condition. Whilst denying the influence of diphtheria, Parrot freely acknowledges that measles, especially when complicated with broncho-pneumonia, tends to produce cardiac concretions. The same tendency is recognized by Harley in the early stage of scarlet fever where there is high pyrexia.25
20 Die Bluthlumpen dann der Häutiger Bräune, Wien, 1852.
21 Med. Times, vol. i. p. 23, 1860.
22 Am. Journ. Med. Sci., April, 1864.
23 De la Thrombose cardiaque dans la Diphthérie, Paris, 1872.
24 Dict. Encycl. des Sci. méd., vol. xviii. p. 484.
25 Medico-Chirurg. Trans., vol. lv.