The physical signs of cardiac disease, for the use of clinical students . diagnosis, namely. Inspection^ Palpation,Percussion, and Auscultation. Mensuration may be admitted as INTRODUCTORY REMARKS. V iSi fifth. Each method rightly applied yields its own specialinformation, and no clinical examination of the circulatoryapparatus can be considered complete, which omits to make useof the data afforded by any one of them. If we regard ourdiagnosis as a standpoint which we take up and have to defend,we may also regard the facts ascertained by each of thesemethods as lines of defence with which to a
The physical signs of cardiac disease, for the use of clinical students . diagnosis, namely. Inspection^ Palpation,Percussion, and Auscultation. Mensuration may be admitted as INTRODUCTORY REMARKS. V iSi fifth. Each method rightly applied yields its own specialinformation, and no clinical examination of the circulatoryapparatus can be considered complete, which omits to make useof the data afforded by any one of them. If we regard ourdiagnosis as a standpoint which we take up and have to defend,we may also regard the facts ascertained by each of thesemethods as lines of defence with which to accomplish ourobject. Every line, however, is defective at some part, and ifstanding alone, would offer a passage to the attack of anassailant. The greatest amount of security, therefore, for ourdiagnosis will depend upon our having availed ourselves of thehelp of all the defensive power at our command, , of thefacts afforded us by all four physical methods of diagnosis. Ofcourse symptomatology must not be neglected, but here wehave to do only Avith physical Fig. V| INSPECTION. It is taken for granted that we have the patient stripped beforeus, and usually in the recumbent position. The various pointsto be attended to in Inspection may be arranged according to thefollowing table:— A. 1. Bulging of the whole cardiac region. 2. Bulging of the intercostal spaces in the cardiac region. B.—Impulses of the Ventricles. 1. The apex-beat or impulse of the left ventricle. a. Extrinsic displacements of the apex-beat (due topericardial or peritoneal effusions, shrinking of theupper portion of the left lung, &c.) h. Intrinsic displacements of the apex-beat from en-largement of the left ventricle. 2. Epigastric impulse or impulse of the right ventricle. C.—Cardiac visible impulse other than that of the ventricles. 1. Pulsation over dilated left auricle (?). 2. Pulsation over dilated right auricle (?). 3. Pulsation over cardiac surface, which does not correspondto the impulse
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