A bedside manual of physical diagnosis : ... with an appendix, containing a plan for the registration of cases in hospital and private pratice : also an abstract of Mr. Farr's statistical nosology / by Charles Cowan.

  • Cowan Charles, 1806-1868.
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: A bedside manual of physical diagnosis : ... with an appendix, containing a plan for the registration of cases in hospital and private pratice : also an abstract of Mr. Farr's statistical nosology / by Charles Cowan. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    101/128 (page 77)
    June 9, 1836.) Occasionally it intermits, and when absent, it may sometimes be discovered by auscultating the sacral and lumbar regions. Pulsations of the foetal heart. From the four- teenth to the twentieth week the double pulsatory tic-tac of the foetal heart, generally beating from 120 to 150 in the minute, may be detected by an attentive ear. In the earlier periods it is gene- rally best heard over a surface of three or four- square inches in the hypogastric region. In more advanced pregnancy its most usual site is round the umbilicus, or midway between that point and one of the anterior spines of the ilea; but we must diligently explore the whole surface of the uterus. The sound is always weak and dis- tant, particularly in the earlier periods, variable in intensity, and requires a practised ear; but, as pregnancy advances, it becomes stronger and more diffused. It alone is a certain indication of a living foetus, and its cessation, after being dis- tinctly recognised, would announce its death. An imaginary line, dividing horizontally the uterus into two equal halves, enables us to register amongst the presentations of the pelvic extremity all cases, where the pulsations of the heart are recognized with their maximum intensity above that line ; and to classify under the presentation of the head all those much more numerous cases, ii 2