Hints for clinical clerks in medical cases / Westminster Hospital.

  • Westminster Hospital
Date:
[1863?]
Catalogue details

Licence: Public Domain Mark

Credit: Hints for clinical clerks in medical cases / Westminster Hospital. Source: Wellcome Collection.

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    on a reduced scale from the folio work of Professor Luschka, of Tubingen, on “Die Brust-organe des Menschen in ihrer Lage (Tubingen, 1857). The right side of the heart and the great vessels containing black blood are of a darker shade than the edge of the left side of the heart (which edge is alone visible in a front view like this) and the large vessels contain¬ ing red blood. The areas over which valvular bruits are propagated, are marked out by Dr. Gairdner by means of dotted lines, the character of the dots being different in each of the four areas. Each area is also marked by a capital letter, viz. : A. The circle of mitral murmur, corresponding with the left apex. This murmur is often heard over a very limited space in front of the chest; it is mostly inaudible at the base of the heart; but, on the other hand, it is frequently heard with great distinct¬ ness at the back of the chest about the lower angle of the left scapula, and also in left axilla. B. The irregular space indicating the ordinary limits of diffusion of aortic murmurs, corresponding mainly with the whole sternum, and extendiug into the neck along the course of the arteries, and sometimes even to great distances along the spine, or even along the bones of the extremities. C. The broad and somewhat diffused area (roughly triangular in most cases) occupied by tricuspid mur¬ murs, and corresponding generally with the right ventricle, where it is least covered by lung. 1). The circumscribed circular area over which pulmonic mur¬ murs are commonly heard loudest, when not interfered with by overlapping lung. “ In many cases it is an inch, or even more, lower down, corresponding not so mucli with the actual seat of the valves, as with the conus arteriosus of the right ventricle, where it touches the thoracic wall. The seat of greatest dis¬ tinctness of pulmonic murmur is very much influenced by inspiration and expiration, and should be examined chiefly in the latter state.'’