Experiments and observations on the sounds of the heart / by Robert Spittal.

  • Spittal Robert.
Date:
[1836?]
Catalogue details

Licence: Public Domain Mark

Credit: Experiments and observations on the sounds of the heart / by Robert Spittal. 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.

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    the 1st, synchronous with the impulse of the apex of the heart against the thorax ; the 2d, with the separation of that portion of the organ from the chest ; the 3d, with the dilatation of the ventricles in such cases as give an appreciable impulsion against the thorax; and the 4th, with the separation of the walls of the ventricles from the chest, immediately after their dilatation. But as two of these may occur at nearly the very same instant of time, especially during quick action of the organ, so there might only be three or two sounds, as usually heard, in consequence of the union of two into one. And m ordinary cases, with perfect integrity of the semilunar valves, one at least of the above would, according to the theory which has been adopted as most probably the chief cause of the second, be com- pletely lost in the valvular sound. These remarks are merely- thrown out as points for the consideration of those engaged in this inquiry, should they be deemed the least worthy of their re- gard.* I have several times endeavoured to test the views support- ed in this communication, and, at the same time the valvular theory of the second sound here adopted, in the following man- ner, but as yet without success, viz. by rapidly passing a liga- ture around the aorta and puknonary artery, through a small incision in the pericardium, insinuating the ligature behind these vessels, by the natural opening, and tying them close to the semilunar valves. In every instance, however, the action of the heart, though vigorous before, became immediately so enfeebled, after the operation, as to afford no useful result. • In two instances I have heard thr^e distinct sounds during one revolution of the heart; one of them, pointed out to me by my friend Dr Henderson, since writ- ing the above, in a boy in the Royal Infirmary labouring under dropsy alter Scarla- tina, and in whom all the sounds were much alike, and more resembling the character of the second than that of the first, with a short pause after the third, thus, Hc-iic- tac tlc-lic-tac. On examination after death, a small quantity of serous fluid was found in the pericardium, and the ventricles were somewhat dilated, especially the right. EDINBUKGH : I'llINTED BY JOHN STARK, or.n ASSEMHLY CLOSE.