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August 4, 1900


JAMA. 1900;XXXV(5):301-302. doi:10.1001/jama.1900.02460310035006

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In the "Festschrift" in honor of Jacobi is an important article on this subject by William H. Welch. He first describes an instance in a girl of 17 years, with chronic mitral and aortic endocarditis following acute articular rheumatism, and giving rise to regurgitation and eventually to cardiac insufficiency. During the last days of life a painful edema of the left arm made its appearance. Post-mortem, in addition to the cardiac lesions and their usual secondary effects, an infectious —streptococcus—thrombus was found filling the innominate, subclavian, axillary, and lower parts of the jugular vein. He then gives the clinical history of three other, more or similar cases from Dr. Osler's wards, but without post-mortem examination. In one case, a case of mitral stenosis, thrombus of the left jugular, axillary, subclavian, and innominate veins gave rise to a hard, painful edema, lasting for nearly three months before gradually disappearance set in.

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