22 Guy's Hospital Reports, vol. vii. p. 421.
23 "Gulstonian Lectures," London Med. Gazette, 1844, pp. 755, 756.
24 Diseases of the Heart.
25 Diseases of the Heart and Aorta.
26 Ziemssen's Cyclopædia, vol. vi. p. 634.
It is strongly held by some that hypertrophy is occasioned more by the valvular disease that may coexist than it is by adherent pericardium. Sibson27 tells us that "when pericardial adhesions are associated with valvular disease the heart is always enlarged. It was so in twenty-five out of twenty-six cases, and in the remaining instance, a case of mitral constriction, the heart was rather large." Undoubtedly, this combination is not unusual, but there may be the most marked hypertrophy with adherent pericardium without valve affections. I have met with several such instances, and Blache28 has recorded three of striking character.
27 A System of Medicine, by Reynolds, London, 1877, vol. iv. p. 440.
28 Maladies du Coeur chez les Enfants, Thèse de Paris, 1869.
Adherent pericardium may occur at any age. It has been found by Behier as the result of chronic pericarditis in an infant of eleven months.29
29 Constantin Paul, Maladies du Coeur, Paris, 1883.