Blood Pressure From the Clinical Standpoint

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63. — Female. Aged seventy-three. Chronic uremia and myocar- ditis. Observations from (A) to {B) were made in the course of routine ex- amination, following a slight injury. It was noted that the patient's mental condition was becoming clouded and her reflexes were exaggerated, she complained of being smothered and dizzy with persistent ringing in the ears. The observation at (C) was made during a mild attack of uremic coma with- out convulsions, which was relieved by the usual eliminative trea...tment. At (D) the kidney excretion was reduced to under 15 ounces in twenty-four hours and was highly albuminous. This state gradually responded to digitalis medication. At (F) the uremic condition had largely disappeared and was replaced by dilated and incompetent heart. The blood-pressure and an examination of the circulation at this time showed a rather character- istic evidence of heart muscle weakness, in that it was easy to distinguish CARDIAC DISEASE 321 Fatty degeneration of the heart is due in most cases to the same conditions which cause atheroma of the aorta and disturbance in the coronary circulation.

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