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June 15, 1889


JAMA. 1889;XII(24):840-842. doi:10.1001/jama.1889.02401010012003

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On the Prognosis of Heart Disease.  Leyden reverts once more to the question how long the period of complete compensation of a cardiac lesion can last. Supposing, for instance, that in a patient with cardiac lesion the compensation is altered. This alteration admits of three phases:

  1. It is slight and manifests itself only by inability to work.

  2. The trouble of compensation is complicated by dropsy.

  3. Dropsy is accompanied by visceral congestions, asystole, etc.

This latter phase is beyond the physician's skill; only the first and second are susceptible to therapeutic measures.The first question to be asked is regarding the cause of the break in the compensation; whether it is the result of a progress of the cardiac lesion or of an accidental cause: fatigue, excess, overfeeding, additional disease, gravidity, etc. A conclusion of the utmost importance for prognosis may be drawn from the effect of the cardiac medicines, from

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