. A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism . murmurs are very easily understood, as regardspoints involved in their differentiation from each student is, therefore, advised first to become ac-quainted with the blood-currents in health and in dis-ease. Directing the attention to the left side of theheart, there are two normal blood-currents, namely, thecurrent from the left auricle to the left ventricle, andthe current from the left ventricle into the aorta. Thesemay be distinguished as the
. A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism . murmurs are very easily understood, as regardspoints involved in their differentiation from each student is, therefore, advised first to become ac-quainted with the blood-currents in health and in dis-ease. Directing the attention to the left side of theheart, there are two normal blood-currents, namely, thecurrent from the left auricle to the left ventricle, andthe current from the left ventricle into the aorta. Thesemay be distinguished as the direct currents. The firstis the mitral direct current, and the second is the aorticdirect current. Two abnormal currents may occur in CARDIAC MURMURS 219 the left side of the heart. These currents can only takeplace when the valves are rendered incompetent bylesions. The incompetency of the valves allows ofregurgitation, and these abnormal currents may be dis-tinguished as the regurgitant currents. One of these isa current backward from the left ventricle into the leftauricle, owing to incompetency of the mitral valve ; this Fig. 11. Diagram representing the Abnormal Blood-currents. Plain arrows represent currents in right side of heart. Dotted arrows represent currents in left side of heart. is the mitral regurgitant current. The other is a cur-rent backward from the aorta into the left ventricle,arising from incompetency of the aortic valve; this isthe aortic regurgitant current. (Figs. 11 and 12.) What are the relations of the four currents in the leftside of the heart with the heart-sounds? The mitraldirect current takes place when the auricles contraction of the auricles precedes the ventricular 220 THE HEART systole. The ventricular systole is synchronous withthe systolic sounds of the heart. The mitral direct cur-rent, therefore, takes place just before these sounds. Itbegins after the diastolic sounds, and continues until it issuddenly and completely arres
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