The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . lts .—(Sa nsom.) Shaded area represents field of maxi-mum intensity. Fig. 44.—Pulmonary Stenosis. Maximum point and direction oftransmission. so if a patent foramen ovale coexist with the pulmonary victims usually die young of pulmonary tuberculosis, and theinsurance examiner is not likely to meet with it. THE CHARACTERISTIC SYMPTOMS OF THE DIAS-TOLIC VALVULAR MURMURS. The diastolic valvular murmurs are, theoretically, mitral
The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . lts .—(Sa nsom.) Shaded area represents field of maxi-mum intensity. Fig. 44.—Pulmonary Stenosis. Maximum point and direction oftransmission. so if a patent foramen ovale coexist with the pulmonary victims usually die young of pulmonary tuberculosis, and theinsurance examiner is not likely to meet with it. THE CHARACTERISTIC SYMPTOMS OF THE DIAS-TOLIC VALVULAR MURMURS. The diastolic valvular murmurs are, theoretically, mitralstenosis, aortic regurgitation, tricuspid stenosis, and pulmonaryregurgitation. An exception must be made in the case of stenosis of the mitralor of the tricuspid orifice. Such murmurs are rarely diastolic, 1111 EXAMINATION O] MM CHI I blj because the flow of blood from auri< le to ventrii le duringdiastole is nol sufficiently forcible to produce a murmur untiljust before systole, when the ventricular suction is reinforcedby auricular contraction. For this reason the rhythm of mitralor tricuspid murmurs due to stenosis is presystole or auriculc. Diagrammatic Representatk I ra With sphygn .it moment of aurii ular contra* ti>n immediately mitral obstruction evident; ; and pulmonary vah freely ,,: rly empty; right venti Parti;Results. Presystolic <<r diastolic murmur, dilatation of lefl lungs, nlargemenl of right I \i v. valv< I valve. LA I < ?• R \ Right ; • Ri^ht venti P. Vn. Pulmonary •?• ins. P \ P 24S THE MEDICAL EXAMINATION FOR LIFE INSURANCE. tolic—;. en beginning late in the diastolic period, they are heardjust before and cease abruptly at the first sound. MITRAL STENOSIS. Quality.—Harsh, vibratory, or blubbering murmur terminatingabruptly in marked crescendo. Time.—Presystolic. Increasing in intensity as it runs into asharply accentuated first sound. Rarely diastolic. Still morerarely divided. 2dSd. PSd.
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