. Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . rds, some of the conditionscausing a murmur to have a musical quality are said to be vibra-tions imparted to the thin, stiffened edge of a cusp or fenestra-tion, or to a delicate atheromatous plaque by the blood-streamas it passes over them. In a case of aortic stenosis with a loudsystolic musical murmur reported by Mayne, two fibrous bandswere found stretched across the cavity of the ventricle just belowthe greatly narrowed orifice. In an
. Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . rds, some of the conditionscausing a murmur to have a musical quality are said to be vibra-tions imparted to the thin, stiffened edge of a cusp or fenestra-tion, or to a delicate atheromatous plaque by the blood-streamas it passes over them. In a case of aortic stenosis with a loudsystolic musical murmur reported by Mayne, two fibrous bandswere found stretched across the cavity of the ventricle just belowthe greatly narrowed orifice. In another case of mitral insuffi-ciency, which during life had exhibited a musical murmur at thebase and a systolic murmur at the apex, Potain discovered postmortem a cord which passed to the wall of the ventricle from the INTRODUCTORY 31 edec of the anterior mitral val vaive pi s1 below the aortic orifice. Demange reported a case of tricuspid regurgitation in which themusical murmur was evidently due to a fibrous hand stretchedacross the interior of the ventricle close to the tricuspid has suggested that a musical murmur may be generated. Fig. 11.—Interior of Left fibrous band connecting aortic cusps and responsible for musical murmur. by the vibration of a tendinous cord swinging free in the ventricle,or by one that, as a result of endocarditis, had been ruptured andsubsequently attached in an abnormal situation. It is needlessto remark that the musical quality of these murmurs possessesa pathological interest, but scarcely a diagnostic the most we cannot do more than conjecture their mode of 32 DISEASES OP THE HEART causation during life until the true condition is revealed by theautopsy. Accidental musical murmurs are rare, and yet that they dooccur is attested by the following case: Miss V. was referred tome by Dr. Charles True, of Kankakee, in the spring of 1897, be-cause of attacks of intense nervousness and agitation accom
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