Contributions to practical medicine / by James Sawyer.

  • Sawyer, James, Sir, 1844-1920.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical medicine / by James Sawyer. Source: Wellcome Collection.

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    increased tension in the blood cniTent in that vessel. In that it is this, it is a trustworthy sign, which a little consideration will enable yon to understand, of a grave pathological condition ; it is an nnmistabable physical accompaniinent of a portentous change in an area of the blood-circula- tion which is vital, and which is removed beyond the reach of those tactile and metric methods of exploration which are applicable in variations of tension in the systemic arteries. In health, the aortic portion of the second sound of the heart predominates over that })ro- duced at the valves of the pulmonary artery. That is, the second sound is louder in the “ aortic” than it is in the “ pulmonary ” area. By this statement I mean that the second sound is louder close to the right edge of the sternum, over the lower portion of the second right costal interspace, than it is close to the left edge of the sternum over the upper portion of the second left interspace. The blood tension may be raised in pathological states ; either in the systemic circulation, of which the aorta is at the commencement, or in the lesser circulation, which passes from the right to the left sides of the heart, through the lungs, and at the commencement of which is the pulmonary artery. Whatever raises the l)lood-tension in the aorta intensilies the aortic second sound; whatever