The Practitioner . my hand upon my breast I found that as the distress diminishedthe epigastric pulsation disappeared, and I could again feel theapex beat in its normal situation. It is evident from this obser-vation that during the extra exertion the right side of my hearthad been unable to send on the blood through the lungs asquickly as it was received from the veins, and that consequentlythe right ventricle had become dilated (r/. Fig. 4, p. 747). Thisexperience has led me to think that the sensation of dyspnoea isprobably of cardiac rather than pulmonary origin, and I think itis only when
The Practitioner . my hand upon my breast I found that as the distress diminishedthe epigastric pulsation disappeared, and I could again feel theapex beat in its normal situation. It is evident from this obser-vation that during the extra exertion the right side of my hearthad been unable to send on the blood through the lungs asquickly as it was received from the veins, and that consequentlythe right ventricle had become dilated (r/. Fig. 4, p. 747). Thisexperience has led me to think that the sensation of dyspnoea isprobably of cardiac rather than pulmonary origin, and I think itis only when the right heart begins to fail to empty itself thatthe feeling of dyspnoea comes on. The forced respirations bywhich one tries to relieve it are I think beneficial, not merelyby bringing more air into the lungs, but by a kind ot mechanicalmassage to the heart, as was shown years ago by my friendProfessor Hugo Kronecker, and illustrated in the accompanyingdiagrams (Figs, i and 2). It is quite extraordinary how many. Fig. I. Diagram of a transverse section of the thorax duringinspiration and cardiac systole. It shows the tendency to theformation of a vacuum in the pleural and pericardial cavities intowhich lymph flows. Air is also drawn into the lungs, and blood issucked into the auricles from the abdominal veins. instances are on record of men and animals having fallen dead,not during the period of violent exertion, but just when it was Kronecker and Heinricius : Abkandlungcn der KSnigl. Sachsischtn Gcsell. , 1888, Bd. XIV., p. 427 740 THE PRACTITIONER. over. A short time ago I was at Fribourg, in Switzerland, andsaw a huge linden tree, which is said to have grown from thetwig which the messenger held in his hand when he brought tohis fellow citizens the news of tlieir victorv over Charles the
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