Congenital affections of the heart / by George Carpenter.

  • Carpenter, George, 1859-1910.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Congenital affections of the heart / by George Carpenter. Source: Wellcome Collection.

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    Lungs.—A few moist sounds. Liver, percusses two inches below the costal margin. During her attendance in the year 1893 she suffered from attacks of cyanosis and palpitation, but she was able to skip. In December of that year her lips were appreciably darker, the eyes slightly suffused, she be- came cyanosed on crying, and the fingers and toes showed signs of clubbing. Heart.—Thrill over the pul- monary area. Exaggerated epigastric impulse. Over the right base second valvular sound, over the left base this is absent. The bruit was much as before. The points of greatest intensity were as follows. (1) Over the pulmonary area ; (2) over the fifth left costal cartilage ; (3) over the apex. Pulse, small and regular. Lungs, resonant, breath sounds vesicular. Case XXII.—Emma R., aged 6 years, was brought for ulcerative stomatitis. It was said she had suffered from heart disease since birth, and always had a cough. Occasional haemoptysis. Pulse 126, respirations 42, tem- perature 97° F. Heart.—Impulse, sixth space outside nipple, epigastric pulsation. Dulness, to right sternal margin. Sounds.—A rough blowing systolic murmur loudest at the junction of the third costal cartilage and the sternum. Heard all over the chest, back and front, and in the neck vessels. The apical murmur is very similar to the basic. Over a small area round the apex there is a double murmur, and over a small space between the apex and left base, there is a position when the systolic murmur is not so loud as at the apex and base. No abnormalities detected in the organs. Chest, bulged over the heart, and a rickety Rosary.