This section is from the book "Hartmann's Theory Acute Diseases And Their Homoeopathic Treatment", by Charles J. Hempel. Also available from Amazon: Theory of acute diseases, and their homoeopathic treatment.
§ 145. Pericarditis, carditis.
It is difficult to distinguish these two kinds of inflammation from each other; a post-mortem examination is the only safe means to obtain certainty in regard to either. These inflammations generally run a rapid course, which renders them very dangerous. They are likewise dangerous in this respect, that the symptoms are not always sufficiently violent to denote imminent danger. In most cases, these inflammations are characterized by the following symptoms: violent, more burning than cutting, pain behind the lower half of the sternum, near the xyphoid process, rather towards the left side, in the praecordial region, whence the pain spreads in different directions; considerable dyspnoea, which may be inferred from the expression of the features, and does not depend upon an affection of the lungs, or pleura, since no such affection is revealed, either by percussion or auscultation. The respiration is quick and short, panting, without mucous rattle. Cough is frequently present,though not in every instance, frequently without expectoration, or with slimy, purulent sputa. The beats of the heart are violent, frequently irregular, and increase to the most violent cardiogmus; the pulse is small, frequent, vibrating, frequently intermittent. The patient prefers lying on his back and with his head raised; lying on his side increases the pain. The distress is likewise aggravated by motion. The disease is accompanied with all sorts of sympathetic affections: delirium, frightful anguish, starting from sleep as if in affright, hiccough, difficulty of swallowing, vomiting, swelling of the joints, frequent fainting, want of agreement between the pulse and beats of the heart, etc.
The praecordial region, particularly in young subjects, is fuller, and the costal cartilages in the region of the heart are more prominent. When considerable exudation is present, the percussion-sound over the whole region of the heart is dull; the stethoscope reveals friction-sounds, together with the abnormal beats of the heart.
§ 146. Exciting causes are: cold drinking when the body is heated, etc.; inflammation of the pleura by metastasis to the pericardium. Females at the age of pubescence are most liable to that disease. Other causes, are: penetrating wounds in the chest, blows on the region of the heart. It is most generally a sequel of acute rheumatism, particularly of the knees. It likewise occurs by metastasis in the course of acute exanthemata, small-pox, scarlatina, measles, erysipelas, miliaria, etc. Emotions, such as anguish, fright, fear, may likewise lead to inflammation of the heart.