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Diphtheria Treated with Serum: The First 300 Cases of Diphtheria Treated with Serum, Compared with the Last 300 Cases Treated without it, at the Diphtheria Branch of the Sydney Children's Hospital

C. P. B. Clubbe
1897 BMJ (Clinical Research Edition)  
a of deciding whether a current at any period sets in the reverse direction, from right to left. A fair-sized, smooth-walled opening existed between the ventricles, large enough to permit a stron jet to be thrown through it in systole, as proved by the thriil; round this opening and close above it were masses of friable vegetation, actually throwing off emboli and producing pulmonary infarcts. Yet no extension of disease to the left side of the heart occurred, nor did emboli find their way into
more » ... find their way into the systemic circulation. One can scarcely escape the conclusion that no current of any importance, at any period of the cardiac cycle, set from right to left. 2. The Dif7culty of Diagno8i8.-In dealing with infective endocarditis, the textbooks lay stress very rightly on the importance of the evidence afforded by embolism in various parts of the systemic circulation. But though they allude to pulmonary embolism, the distinction is not drawn, I venture to think, quite so clearly as it might be between the symptoms of right-sided and left-sided disease. In those cases where murmurs are absent, or doubtfully recent, the difficulty of diagnosing infective endocarditis is decidedly increased if the left side of the heart is not implicated. 3. The Assistance rendered in thig Casge by Change8 in the Area
doi:10.1136/bmj.2.1921.1177 fatcat:khqd6hujprgznlcrfsgvx4t4ge