Image from page 120 of “Studies in cardiac pathology” (1911)
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Title: Studies in cardiac pathology
Year: 1911 (1910s)
Authors: Norris, George William, 1875-1965
Subjects: Cardiovascular System
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons
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Text Appearing Before Image:
ide, etc. Cloudy swelling of heart, liver, kidneys,etc. Heart: Is of usual size, weighs 330 gm. It is covered with a thick, boggy, shaggy, yellow,fibrinous exudate. The pericardial cavity contains 600 c.o. of yellow fluid, turbid with fibrin-ous shreds and flecks. The right auricle is of normal size, its tips free from thrombi. Tri-cuspid normal; also the pulmonary. The anterior leaflet of the mitral valve has quite a thickfibrous edge, but the chordos are not much thickened or shortened. Papillary muscles are pale andthickened. Ventricular wall IS to SO mm. and very cloudy. There are a few yellow plaques onthe arterial wall about the aortic valves. Microscopic Examination: The exudate covering the pericardium contains a moderatenumber of polynuclear cells. The muscle-cells are much swollen and have a waxy appearance(parenchymatous degeneration). Bacteriologic Examination: From both lungs and from the pericardial exudate smallcocci were obtained, occurring in pairs, and Gram-positive.
Text Appearing After Image:
108 STUDIES IN CARDIAC PATHOLOGY that these vessels drain into the glands which lie in the areolar tissue between thepleura and pericardium. The lymphatics in the visceral layer are much richerand intercommunicate. Nystrom considers the question debatable as to whetherthe lymphatics of the pericardial cavity communicate with those of the externallayer. It would have to be assumed, therefore, that when the pericardium isinfected from the bronchial glands the micro-organisms travel in a directionopposite to the lymphatic current, as may occur in carcinoma metastases. Pathogenesis.—Pericarditis occurs chietij in infectious dis-eases—rheumatic fever, pneumococcic, gonococcic, streptococcicsepticemias, also in tuberculosis, syphilis, and scarlatina. Itoccurs as a terminal infection in dyscrasic states, such as chronicnephritis, diabetes, leukemia, etc. More rarely it follows fromthe direct extension of an empyema, a subdiaphragmatic, medias-tinal abscess, or from penetrating wounds or
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