. Medical diagnosis for the student and practitioner. by the curious sub-jective manifestations of precordial, bumping, thumping, and turningover, of the heart, but the curious inward conviction of impending deathsometimes experienced even in miniature replicas of angina pectoris is seldompresent. IRREGULARITY AND INTERMITTENCY.—These conditions are de-scribed fully under the arrhythmias. Irregularity includes variation involume and strength as well as in wave intervals, though the former arebetter described by the term unequal By intermittency is meant the apparent or actual omission of beats
. Medical diagnosis for the student and practitioner. by the curious sub-jective manifestations of precordial, bumping, thumping, and turningover, of the heart, but the curious inward conviction of impending deathsometimes experienced even in miniature replicas of angina pectoris is seldompresent. IRREGULARITY AND INTERMITTENCY.—These conditions are de-scribed fully under the arrhythmias. Irregularity includes variation involume and strength as well as in wave intervals, though the former arebetter described by the term unequal By intermittency is meant the apparent or actual omission of stethoscope and more fully the polygraph or electrocardiograph showthat intermittency may be due either to premature and inefficient extra-systoles or the dropped, systoles of partial heart block ( pulsus deficiens). True pulse intermittency therefore, would apply only to the phases ofrecurrence of inefficient or dropped beats, which result in the transient,persistent or irregularly recurrent actual elimination of pulse waves in Fig. i 86.—Pulsus Irregularis Perpetuus. Two radial tracings taken during auricularfibrillation. Note extreme irregularity in time and force alike. (Drawn from the originaltracing of Parsons-Smith.) If an extrasystole is of sufficient vigor to cause a lesser beat in the arteriesthere is established during the period of recurrence what might be termed aregular irregularity and inequality with respect to the phases in which itoccurs. For the usual type of extrasystolic irregularity, as it is reflected inthe pulse, the term interrupted pulse would apply more aptly. The fundamental cause (extrasystoles of the heart) may therefore beexpressed by either an intermittent or irregular radial pulse. In the absence of definite clinical findings their significance is far moreserious in middle-aged, or elderly people than in the young and both varia-tions admit of subdivisions. (See pp. 546 and 549.) Pulsus deficiens. Pulsus intermittens. Sign
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
