. Medical diagnosis for the student and practitioner. Fig. 171.—Murmur limited to {supra)aortic area in anemic cases. (Eleven percent, of cases, according to Sansom.) Fig. 172.—Coexisting pulmonary andapex murmurs in anemia. The apex ele-ment must be viewed with suspicion in allsuch cases of assumed hemic origin. Sansomheld such to be true mitral regurgitations. They call for rest, reassurance, the administration of test doses of such drugs asdigitalis and the bromides and always for repeated examinations. Postural Modifications.—All patients should be examined, if possible,both when recumbent
. Medical diagnosis for the student and practitioner. Fig. 171.—Murmur limited to {supra)aortic area in anemic cases. (Eleven percent, of cases, according to Sansom.) Fig. 172.—Coexisting pulmonary andapex murmurs in anemia. The apex ele-ment must be viewed with suspicion in allsuch cases of assumed hemic origin. Sansomheld such to be true mitral regurgitations. They call for rest, reassurance, the administration of test doses of such drugs asdigitalis and the bromides and always for repeated examinations. Postural Modifications.—All patients should be examined, if possible,both when recumbent and when erect, after a rest period, and, if their conditionpermits, after some brief brisk exercise. THE EXAMINATION OF THE HEART 451 The murmurs of valvular leakage are usually best heard in the recum-bent position, those of narrowing (obstruction) in the erect posture; whilesometimes, as in the case of mitral or tricuspid stenosis, a typical presystolicmurmur may appear only at the moment when the patient reaches theupright position and then rapidly subside. The diastolic murmur of aorticleakage often may be increased by raising the arms above the head or mayrequire brisk exercise to make it audible. The Intensity of the Murmur.—The stronger the heart and the narrowerthe affected opening, the louder and higher pitched is the murmur, and, speaking j Loud vs. and broadly, it may be said that the louder the endocarditic murmur the better is the prognosis, inasmuch as it oftenindicates an hypertrophy of the chambermost affected and most vital to general rule previously stated is,of course, a rough one subject to manyexceptions, nor would it cover certainexcessively loud or even musical
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
