The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . urs.—As a matter of fact, the organic pulmo- ofUtUeinnary murmurs and that of tricuspid stenosis are so rare in adults t^ to be practically out of the insurance examiners field, andhe has to consider only mitral, tricuspid, and aortic regurgitation # and mitral and aortic stenosis. Roughly speaking, a systolic murmur Is due, nine times out often, to mitral regurgitation or aortic stenosis, and as one is heardbest at the apex and tr
The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . urs.—As a matter of fact, the organic pulmo- ofUtUeinnary murmurs and that of tricuspid stenosis are so rare in adults t^ to be practically out of the insurance examiners field, andhe has to consider only mitral, tricuspid, and aortic regurgitation # and mitral and aortic stenosis. Roughly speaking, a systolic murmur Is due, nine times out often, to mitral regurgitation or aortic stenosis, and as one is heardbest at the apex and transmitted to the axilla and hack, and theother is best heard at the aortic cartilage and transmitted upward,no confusion need occur. A purely diastolic murmur is almostcertainly due to aortic regurgitation, and its pit uliar transmisand the associated signs make it quite unmistakable. The chief Source of error lies in a failure to take the tim<every murmur by the carotid 1- Associated Murmurs. Any combination of murmurs mayhe encountered, though in most instant eatly reduces tin- i numlnr sometir] Fig. 53.—Aneurysm of the Fig. 54.—Aortic Aneurysm (Ascending Portion of Arch).Unusual percussion area. +? Only point of pulsation. Had taken out insurance within two years. I III I \ VMINATION Ol I ill in i Differentiation of Murmurs. The chief means of differen-tiation of coexisting murmurs are the following: Determination of Difference in Quality. < me maj be rolling, etc. Di erences in Pitch. A most valuable means of distinguishingmurmurs of the same time and quality. Shape of the Cardiai Area. Ioniis of Maximum Intensity. As shown in foregoing des< rip tion. Transmission. Analysis of Associated Signs. ANEURYSM. Very tew cases of aneurysm are detected by medical exami Qers, and the reason is no doubt to be found in the fact that toolittle attention is paid to the region of the aortic arch. It should he remembered that men are seldo
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