. 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. rdiacdulness may be due to an associated or antecedent cardiac or pul-monary affection. Vesicular emphysema, chronic pleuritic effu-sion or hydrothorax, and cirrhosis of the right lung, may renderunavailing any attempt to determine by percussion the accuratesize of the right heart. In vesicular emphysema the borders ofthe lungs are distended, pushing the heart away from the chest-wall and occasioning such a?degree of hyperresonance thatthe l
. 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. rdiacdulness may be due to an associated or antecedent cardiac or pul-monary affection. Vesicular emphysema, chronic pleuritic effu-sion or hydrothorax, and cirrhosis of the right lung, may renderunavailing any attempt to determine by percussion the accuratesize of the right heart. In vesicular emphysema the borders ofthe lungs are distended, pushing the heart away from the chest-wall and occasioning such a?degree of hyperresonance thatthe limits of deep-seated car-diac dulness become inappre-ciable. When fluid exists inthe right pleural cavity^ orthere is solidification of theright lung, the dulness thusoccasioned blends indistin-guishably with that of thebeart. Under favourable con-ditions, however, cardiac dul-ness is found increased to theright and downward, the ex-tent of this increase being de-termined by the degree of thedilatation of the right ventri-cle. In cases of primary or independent tricuspid insufficiencydue to endocarditis, the right ventricle is found less enlarged. Fig. to.—Relative Dulness in a Case ofPrimary Tricuspid Eegurgitation. 352 DISEASES OF THE HEART
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