The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1898-01-02
SOME CAUSES OF SUDDEN DEATH.
One-HaIf of the Total Number Due
to Heart Disease.
London Lancet.

London Lancet.
Roughly speaking, about one-half of the
total number of cases of sudden death from
due to heart disease, which has existed for
some time and in which no further change
IS in progress at the time of death-such as
Valvular disease, angina, fatty heart and
sclerosis of the cardiac muscle from chronic
myocarditis. In many cases concurrent lung
or kidney disease complexities the statistics,
such cases frequently being tabulated as
deaths solely due to heart disease. Spon-
taneous rupture Of the heart, mostly in
men, may exceptionally occur; the left VEN
tricle. often toward the front, is almost in
Variably the seat of the rupture. 1t is to
be remembered that in traumic rupture of
the heart the right side, usually the auricle,
suffers more frequently than the left, in the
proportion of about as seventy to fifty-fOur.
ApopleXy and other cognate brain LESSONS
rank second as natural causes OF sudden
death. 1t is to be noted that military aneu-
risms of the vessels of the brain, although
most common in persons past middle life.
occasionally occur in young people, even in
children, and by bursting cause death from
apopleXy. Chronic alcoholism, a potent fac
tor among the causes of sudden death, is
frequently associated with rapidly terminal
ing heart and brain disease.
ASphyXia, not Unfrequent cause, may be
due to oedema of the CLOTHS, membranous
deposits in the trachea, pressure of neo-
pasm on the trachea, spasm of the vocal
chords, pulmonary emboliSm, air embollSm,
rupture of a vessel or of an aneuriSm into
the air passages, asthma, whooping cough,
pneumonia and haemo thorax, pleurluc et-
trio or of an intestinal ulcer, OF an aneurlsm,
of a VaricoSe vein, of the surroundings or
an ectopic CESSATION, the formation OF a
peri-uterine haemotocele may severally
prove quickly fatal. Nephritis turaemia and
apOpleXy), diabetes, eXophthalmlc goltre ana
Addison's disease may also terminate with
unexpected rapidity. Hemorrhage into the
pancreaS occasionally causes sudden death,
apparently from the impression produced or
the contiguous nerve centerS. 1t is most
common in males over forty years of age,
who may up to the occurrence of the hemor-
no
health. Obesity, the habitual use of alcohol
and the presence of heart disease appear IN
many of the cases TO be predlsposing causes.
KOetschau. however, observed hemorrhaSe
into the pancreas in Il woman-an alcoholic
in her twenty-fourth year. Occasionally 1t
occurs in spare people who are Tree from
obvious disease and who are abstemious as
regards alcohol. The sufferer may die with
in half hour after the occurrence OF the
hemorrhage or he may survive for twenty
four or even thirty-SiX hours. Draper re-
cords five cases between the ages OF twenty
five and thirty-five years, OF whlcn tnree
were men and two women. Fitz tabulated
sixteen cases. of which eleven were males
between thirty-one and seventy years or
age. and five were females between twenty
six and fOrty-seven years.
Sudden death has in instances followed
spontaneous rupture of an enlarged Spleen
the result of tropical maldrial influences,
the Individual Immediately BEFORE rupture,
being to all intents and purposes quite Well.
Pelereaux gives the history Oh t 1dai, en-
five the rupture was spontaneous, and In
the remainder it was due 10 apparently IN
adequate causes, such as a simple ran IN
the street. 1t is to be borne In mind that
when the spleen is thus enlarged mere pat
with the palm of the hand may determine
rupture and consequent speedy death, Wmcn,
in the absence of knowledge of the expert
ence of others, might readily be assumed
to be the result OF criminal violence. -,
IL is 10 be remembered that some or the
abOve-named diseases may exist without
giving rise to any symptoms until the hnai
moment arrives: this applies with special
force TO diseases which have prolonged
course, during which, as rlEe, symptoms
Such y disease IS gastric ulcer. have seen
more than one case in which, until the fataI
rupture occurred. absolutely no symptoms
We're experienced, not even such as might
have been attributed to simple dyspepsia;
In one such instance second ulcer WAS
present in the walls of the stomach in addi-
ton to the one that ruptured and causRd
DEATH and yet until perforation occurred
the patient never felt any abnormal sensa-
ton whatever.