Investigations into some morbid cardiac conditions : including the Cartwright prize essay on the heart in debility / by William Russell.

  • Russell, William, 1852-1940.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Investigations into some morbid cardiac conditions : including the Cartwright prize essay on the heart in debility / by William Russell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    regular, and small. Cough was always worse when she lay down. The area of cardiac dulness is seen in the preceding diagram. It commenced at the third left rib, and extended on that rib for 2£ inches from midsternum ; in the fourth space it was 3f inches from the same line; and in the sixth space, inches; while to the right it was only 1 inch from midsternum. There was pulsation over the large veins in the neck. There was also pulsa- tion in the fifth left space, and in the epigastrium, as marked X in the diagram. There was a systolic murmur in the fifth left space, loudest over the maximum pulsation in that space, but audible along that space to the sternum, over a small portion of which it was also audible. It was also audible in the adjoining epigastrium, and slightly in the fourth and sixth spaces, and was also propagated slightly to the left. In this case the murmur was low in situation because the heart was; but the murmur was heard over what would have been found to be the right side of the heart had the opportunity been afforded of examining it. The relation of the area of murmur to the area of dulness, coupled with the signs of venous disten- sion, leave no doubt in my mind that this murmur was a tricuspid regurgitant one. Case XVII.—Owen C, set. 66, also illustrates how the heart, by its displacement outwards and downwards, affects the area of audition of the tricuspid murmur. He complained of palpitation and weakness. The pulse was 88, regular, but rather small and weak. The vessels were hard. There was a trace of albumen in the urine, and there was a history of nocturnal calls to micturate. The thorax was barrel-shaped. It rose and fell during respiration, but expanded only slightly. The cardiac dulness is outlined in the annexed diagram. Such an