The physical signs of cardiac disease, for the use of clinical students . ^ ultimately be lost and the murmur becomeaudible at the back. Diastolic Murmurs.—Like the systolic, the diastolic is amurmur owning a diiferent mechanism according as it is pro-duced at the aortic or mitral orifices. In the former case it is amurmur of regurgitation, in the latter a murmur of the significance of a systolic murmur is so far exactly tlie £ 50 AUSCULTATION. reverse (, produced by blood currents flowing in oppositedirections), according as it is apical or basic in origin, so alsothe signi
The physical signs of cardiac disease, for the use of clinical students . ^ ultimately be lost and the murmur becomeaudible at the back. Diastolic Murmurs.—Like the systolic, the diastolic is amurmur owning a diiferent mechanism according as it is pro-duced at the aortic or mitral orifices. In the former case it is amurmur of regurgitation, in the latter a murmur of the significance of a systolic murmur is so far exactly tlie £ 50 AUSCULTATION. reverse (, produced by blood currents flowing in oppositedirections), according as it is apical or basic in origin, so alsothe significance of the diastolic murmur at base and apex isreversed (vide Fig. X.). The diastolic murmur due to aortic. AT APEX. Fig. X.—The arrows represent the direction of the current generating systolic anddiastolic murmurs, according as these are formed at the base or apex of the a systolic murmur at the base is of obstruction mechanism, at the apex ofregurgitation mechanism. A diastolic murmur at the base,again, is of regurgitationat the apex of obstruction mechanism. The long vertical lines represent the firstsound, the short the second sound, as in the preceding figure. incompetence is much the more common, and, as a rule, it ispreceded by a systolic mumiur, or at all events, a murmurishfirst sound, seldom by a perfectly healthy first sound. Fre-quently the second sound is audible as well as the murmur,indicating a less degree of damage to the valve. This occursmost remarkably where there is dilatation of the first part ofthe aorta, and we have a relative obstruction mumiur,systolic in time, succeeded by an accentuated second sound,immediately followed by a blowing murmur. The aort
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