Practice of medicine : a manual for students and practitioners . x-beat is slightly displaced. In thepresence of perforation of the septum, some of the blood es-capes to the left side of the heart, causing more or less hyper-trophy of the left ventricle. Since the condition occurs inearly life, there maybe a distinct bulging of the chest, A 316 DISEASES OF THE ORGANS OF CIRCULATION. murmur, synchronous with the first sound of the heart, maybe heard in the second left intercostal space. Congenitalcases show cyanosis and usually arrested development of thebody. Pulmonary stenosis predisposes the
Practice of medicine : a manual for students and practitioners . x-beat is slightly displaced. In thepresence of perforation of the septum, some of the blood es-capes to the left side of the heart, causing more or less hyper-trophy of the left ventricle. Since the condition occurs inearly life, there maybe a distinct bulging of the chest, A 316 DISEASES OF THE ORGANS OF CIRCULATION. murmur, synchronous with the first sound of the heart, maybe heard in the second left intercostal space. Congenitalcases show cyanosis and usually arrested development of thebody. Pulmonary stenosis predisposes the individual totuberculosis, probably through imperfect development of thelungs more than through the defective blood-supply. Combined Valve-lesions. The following are the more frequent combinations: Insuf-ficiency and stenosis of the mitral valve ; insufficiency andstenosis of the aortic valve ; stenosis of the mitral valve withinsufficiency of the aortic valve; stenosis of the aortic valvewith insufficiency of the mitral valves; insufficiency of both Fig. 1, 2, S, 4, location of valves; I, II, III, IV, points where murmurs are heard ingreatest intensity ; arrows indicate direction in which murmurs are propagated. mitral and aortic valves; stenosis of both mitral and aorticvalves; tricuspid insufficiency with lesions of the mitralvalve ; tricuspid insufficiency with insufficiency of the aorticvalves; tricuspid stenosis with other valve-lesions. Diagnosis of valve-lesions: Accidental murmurs belong usu-ally to anaemia or cachexia. During compensation there is no VALVULAR DISEASE. 317 evidence of stasis or a failing of the circulation, notwith-standing the lesion in the heart. The breaking of compensa-tion is indicated by general degradation of health, loss ofenergy, inability to concentrate the mind, insomnia, headache,hebetude, sometimes vertigo, and symptoms on the part of thelungs. The pulse is increased in frequency and becomesweak. The surface of the body shows a lower
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Keywords: ., boo, bookcentury1800, bookdecade1890, booksubjectclinicalmedicine
