The signs of internal disease, with a brief consideration of the principal symptoms thereof . Yet another murmur is heard in the mitral or:apical area, but is less common than the systolic bruit. This secondjnurrtiur is known from its describer as the Flint murmur. Its qualityIS rumbling, its area limited and its time presystolic or it is due to the inflowing blood from the left auricle, or tothe reflux current from the aorta producing: vibration of the mitralleaflets, is uncertain. Flint believed that the dilatation of the ven-tricle prevented the mitral leaflets from foldin
The signs of internal disease, with a brief consideration of the principal symptoms thereof . Yet another murmur is heard in the mitral or:apical area, but is less common than the systolic bruit. This secondjnurrtiur is known from its describer as the Flint murmur. Its qualityIS rumbling, its area limited and its time presystolic or it is due to the inflowing blood from the left auricle, or tothe reflux current from the aorta producing: vibration of the mitralleaflets, is uncertain. Flint believed that the dilatation of the ven-tricle prevented the mitral leaflets from folding completely backwardsagainst the chamber walls and, thus acting as an impediment, producedthe bruit. The pulse is described elsewhere. The delayed radial pulse whichfollows the apex beat after a distinct interval is characteristic, and the DISEASES OF THE HEABt 213 length of the interval increases with the increase of the the carotids, especially the right, the systolic murmur may be quiteas apparent as at the cartilage, and the second aortic sound may be u (>^>w ^. Fig- 57—Enlargement of the heart in aortic regurgitation (Patton). A Areaof greatest intensity of murmur, somewhat depressed. B Direction oftransmission of murmur. perfectly distinct here, even when absent ovefthe valve. Broadbentconsiders this a favorable sign, indicating that the amount of regurgi-tation is small. 214 DISEASES OP THE HEABT 0titer Symptoms. Cardiac palpitation, distress and faintness onsudden exertion or rising, are very early features, due to arterialanfemia. Pain and even angina are frequent. Headaches, dizzinessand attacks of syncope from disturbed cerebral circulation are notuncommon and likewise may be early manifestations. Nocturnal dyspncsa and oedema of the ankles and under the eyesindicate failing compensation. The patient sleeps at first with thehead elevated, then in a chair, lastly at a table. The sleep is fitfuland disturbed by a sense of impending suffocation.
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectdiagnos, bookyear1906
