. Physical diagnosis . rifice is the result of achronic endocarditis which gradually glues together the two flaps ofthe valve until only a funnel-shaped opening or a slit like a button-hole is left (see Figs. 149 and 150). As we examine post-mortem thetiny slit which may be all that is left of the mitral orifice in a case oflong standing, it is difficult to conceive how sufficient blood to carry onthe needs of the circulation could be forced through such an insig-nificant opening. Usually a slow and gradually developed lesion, mitral stenosis 1 It must be remembered that in chlorosis, a diseas
. Physical diagnosis . rifice is the result of achronic endocarditis which gradually glues together the two flaps ofthe valve until only a funnel-shaped opening or a slit like a button-hole is left (see Figs. 149 and 150). As we examine post-mortem thetiny slit which may be all that is left of the mitral orifice in a case oflong standing, it is difficult to conceive how sufficient blood to carry onthe needs of the circulation could be forced through such an insig-nificant opening. Usually a slow and gradually developed lesion, mitral stenosis 1 It must be remembered that in chlorosis, a disease in which functional murmursare especially prone to occur, the pulmonic second sound is often surprisingly loud, owingto a retraction of the left lung, which uncovers the root of the pulmonic 210 PHYSICAL DIAGNOSIS often represents the later stages of a process which in its earlierphases produced pure mitral regurgitation. By some observers theadvent of stenosis is regarded as representing an attempt at com-. ?J/e&ar/g/ie/i Fig. 149.—Diagram to Represent the Position of the Valves in the Normal Heartduring Diastole, the Open Mitral Allowing the Blood to Flow from the Left Auricle,the Aortic Closed.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
