Clinical pocket-book : an aid to the study of clinical medicine for the use of students of the Manchester Royal Infirmary.

  • Manchester Royal Infirmary.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Clinical pocket-book : an aid to the study of clinical medicine for the use of students of the Manchester Royal Infirmary. Source: Wellcome Collection.

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    heart, and about two inches from above down¬ wards ; but as measured by percussion on the living body, it is usually only about two inches in length, and about an inch and half in depth. The apex of the heart is generally seen and felt to beat in the fifth interspace, from half an inch to an inch within the nipple line. The lower border of the heart cannot be di¬ rectly defined by percussion, because it lies on the left lobe of the liver—only separated there¬ from by the diaphragm. The position of this border is indirectly determined by drawing a line along the level of the lower border of the right lung in front and producing it to the apex of the heart. Livek.—The boundaries of the liver are in¬ dicated by the yellow lines in Plates III. and IV. The upper margin is overlapped by lung to the depth of about an inch in the infra-mammary region.* The upper limit of liver-dulness coincides with the lower margin of the right lung, and this, in the nipple line, lies at the level of the sixth rib ; and in the mid-axillary line, at the level of the eighth rib. The upper border of the liver is very constant in its situation in healthy persons. The lower border, on the contrary, is very in- * The real upper margin of the liver is therefore higher by about the breadth of an interspace than is represented in the diagram.