On a systolic murmur in the pulmonary artery, and its application to the diagnosis of functional and organic murmurs / [Edward Latham Ormerod].

  • Ormerod, Edward Latham, 1819-1873.
Date:
[1846]
Catalogue details

Licence: Public Domain Mark

Credit: On a systolic murmur in the pulmonary artery, and its application to the diagnosis of functional and organic murmurs / [Edward Latham Ormerod]. Source: Wellcome Collection.

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    // ON A SYSTOLIC MURMUR IN THE PULMONARY ARTERY, AND ITS APPLICATION TO T1IE DIAGNOSIS OF FUNCTIONAL AND ORGANIC MURMURS. By Edward Latham Ormerod, M. B., Cambridge, Member of the Roval College of Physicians, Demonstrator of Morbid Anatomy at St Bartholomew’s Hospital. (From the Edin. Med. and Surg. Journal, No. 1G6.) A murmur heard at the base of the heart may generally be fol¬ lowed for some distance along the ascending aorta, and if loud is prolonged into the innominata and carotid arteries. In some cases, however, a murmur is heard loud at the base, and yet not traceable along the aorta, but clearly audible in a line from the third left intercostal space at the edge of the sternum, towards the middle of the left clavicle for the distance of two to two and a half inches. Or a murmur may be audible in this direction at the same time that it is traceable along1 the aorta. The frequent recurrence of a murmur in this situation, at the same time that it attracted my attention, gave the means of solv¬ ing the questions that arose as to the diagnostic value of such a sign, in what vessel was the murmur situated, and what state of things did it denote P The first question can only be settled by an examination of the phenomena displayed in individual cases ; the second by the termination of a number of cases in which these phenomena had been observed. The line above described corresponds nearly to the course of the pulmonary artery, which forms the arc to this chord, the pul¬ monary valves lying behind the third left costal cartilage at its junction with the sternum, and the bifurcation of the left branch of the pulmonary artery corresponding, at some depth, to the point at which the above line cuts the lower edge of the second left rib. So that anatomy inclines us to believe (and, as it is established that slow feeble currents vibrate more readily than ra¬ pid streams in tense vessels, physiology has nothing to object,) that a murmur in this direction is really situated in the pulmonary artery. Disease of the pulmonary sigmoid valvesisso extremely rare, that we have not the opportunity of verifying our diagnosis in a simple case before the heart is much enlarged, (the patient dying of some other disease,) as can so frequently be done for the aortic sigmoid