Henry Baird Favill, AB, MD, LL.D., 1860-1916, a ... - University Library

The
172 HENRY BAIRD FAVILL
improvement in venous and capillary stasis, but no material
improvement of pulse and with no considerable response
to a repeated venesection or to other treatment. Patient
died after a period of two days.
This case serves to mark the contrast between two individuals
whose essential difference was the condition of
heart muscle : one who died, relatively young, exceptionally
strong, plethoric, and far less obviously embarrassed;
the one who survived, old, relatively far less strong,
and not plethoric, and, at the time of treatment, with dissolution
impending. It seems to me plain that, from the
mechanical side, the condition of the heart muscle rather
than the intensity of the provoking cause will determine
the issue.
With regard to exciting factors in these conditions, one
can know but little. "Taking cold" is an obvious enough
fact, but quite inexplicable. That it is a mixed result of
toxic influence and neurotic response seems likely,
and its
varieties will show the preponderance of the neurotic factor
at one time and the toxic or infectious factor at another.
This view is illustrated by cases which occur under circumstances
which do not seem to be causally adequate.
Case 3. A woman, thirty-eight years of age, was
brought into the hospital giving a history of several days'
sickness. Her condition on entrance was that of exaggerated
dyspnoea, pronounced cyanosis, and the following
physical findings: Respiration audible over the whole of
both lungs, showing no signs of consolidation, but with the
most extreme development of moist rales which I have ever
heard. Expectoration reasonably free, watery, but not
bloody. Pulse 130, with considerable volume, but irregular.
Area of heart dullness decidedly increased to the right,
but heart tones not appreciably altered.
The patient, being in terrible distress and with increasing
cyanosis, was bled 600 c.c, she being rather a delicate type
of woman. The symptomatic relief was immediate, the