A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism / by Austin Flint.

  • Flint, Austin, 1812-1886.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism / by Austin Flint. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    prolonged in proportion as the heart is enlarged by hypertrophy. There are exceptions to this state- ment, which are to be explained by the altered form of the apex; when it loses its pointed form it does not so readily come into contact with the walls of the chest in an intercostal space, and, hence, the beat may be weak although the ventricular systole be abnormally strong. On the other hand, the apex- beat is weakened by dilatation, and it may be want- ing as a result of diminished strength of the systole of the ventricles. The apex-beat is also abnormally weak in fatty degeneration and softening of the heart, as well as in functional debility of the organ incident to other diseases than those of the heart. If there be considerable or great enlargement, the heart being in contact with the walls of the chest over a larger area than in health, impulses other than the apex-beat are generally apparent to the eye and touch. Not infrequently impulses are appre- ciable in each intercostal space between the situation of the apex and the base of the heart. These ab- normal impulses are felt to be strong in proportion as the enlargement is due to hypertrophy, and weak in proportion as dilatation predominates. Enlarge- ment seated in the right ventricle causes an impulse in the epigastrium which is strong or weak in pro- portion as hypertrophy or dilatation predominates. Cardiac impulses are felt and seen in abnormal situ- ations when the heart is removed from its normal situation by the pressure of an aneurism, or other tumor, by pleuritic effusion, hydroperitoneum, etc. The error of mistaking for a cardiac impulse the pulsation of an aneurismal tumor is to be avoided.