The Wilmingtonian., 1888-06-30

n
! little unusual exeitiol sends an extr
amount of blood 10 TIE thin ,ed and weak
ened heart, which becomes suddenly para
lyzed and sudden death results.
DISEASE OF THE GREAT VESSELS,
But sudden deaths In diseases of the hear
aie usually due TO something different from
the valvllar diseases just noticed. In MD
die and advance lifs the heart and arteri,s q
are suij cited to a condition of degeneration
A which the valves shrink and the blond
tubes became gid, while thele ia deposit
Of chalky material which makes them yery
brittle. The valves between the left ven.
tricle Of the heart and the entrance of the
aofta-the first and greatest atery-are
especially apt To become shrunkeu and un-
able to Keep the blooI i'll tho arteiy after it
has been sent there by the contraction of the
heart. Hence, more or less Of it drops back
| int) tho heart as soou Ar he latter rclaxes
after its contraction. Tho blood. instead of
going to the head tn nouI;sh tho brti ;, falls
backward amt leaves the brain bio ,dlss,--
anamic--in the condition Of au individual
who fain,s.
When this h"ppens to an old pefsea who
is unable to help himself and place bimself
in a proper position to avail himself of the
forco of gravity to restore the blood to the
head, the results may be extremely grave.
Large numbers of cases of sudden death
are thus brought about and referred to hear.
diseases without any clear UNDERESTIMATE
to how they were produced or mig =. r.,
been prevented. 1t is for the
iDdioated-the suddenly q .,,,.,
it is entr .raely dangerous for
this class OF patient ,,,,a,n,u.o
.efn the reclining position,
~ "a patients should not be entirely
~ any time.
ia In this same class that are to be seen
those cases Of so.called augina-ceo is,
which suddenly removes its victims in the
midst of great agony. There is undoubted-
ly more than one variety OF this formidable
affliction. Que seems to be due to the sud.
den shutting off of blood from the muscular
walls of the heart, due to closure Of the
entrances of the two coronary arteries which
supply it. The sudden starvation seems to
cause the intense neuralgia pain.
ANURIsMAL DANGERS.
But the heart is not tie only organ that
suffers from the degeneration just referred
to. The large and medium sized arteries
also become softened first, then hardened
and brittle. In the softeued condition {fatty
degeneration or atheromsQ, the great vessels
are prone to dilate and form tumors con-
tanning blood, which go on enlarging as long
as there is room for them to increase in size,
finally bursting and causing death by hem
orrhage. Should the blood. .humor or aneur-
ism burst into one Of the great ca tiles Of
the bcdy, as that which contains the heart,
one of the lungs, or into the surface OF tie
abdomen, or upon the surface, the amount
of blood that can be discharge almost at
once is enormous, and death results almost
iustantaneousiy. This ia the way many
cases of remarkable sudden death are
brought about. These are all called ''deaths
from heart disease" Of course. 1t is true
that the aneuIism may be located SO as to
involve the heart itself, but this is unusual
The great artery, the aerta, is the most fire.
quent seat of the trouble, and it is not very
uncommon one.
When aneu~isms occur in the chest or ab-
domen they frequently attain large size,
because of the density of the structures in
yolved and the size of the arteries which
give them origin. In the smaller vessels, as
in those at the base of the brain, they never
attain large size, but this does not prevent
them from being of the very greatest i'm
portance. Not only may they cause hope.
less disablement when they do not kill, but
they may lead to death, which may come on
as suddenly as II it were brought about by
the lightning's stroke. Under the influence
of fatty or calcareous degeneration, the
coats of the arteries gradually give way in
places, permitting them to form small,
couch-like dilatations upon them, varying
in size from that of pea to a millet seed,
or smaller--many of them not being visible
to the unaided eye. These are points of very
little resistance, and when the circulation is
excited by strong exertion or powerful
emotion, these little sacs are likely to give
way. If a number of them burst they pro-
duce hemorrhage whose presence produces
pressure upon the brain, and when in sut-
ficient amount is capable of bringing all
mental operations to standstIll. This is
the usual mechanism of apoplexy or cere-
brai henorhage. OF course, appoplexy of
this variety does not always kill. But if the
bleeding takes place into the important
structures at the base of the brain, where
the centres that control the movements of
the heart and lungs are located, the effect
must be fatal almost without exception,
and not delayed long at that. If the bleed