. A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism . y is at, or a little within, a vertical line passingthrough the nipple, the linea mammillaris, and the rightlateral boundary is represented by a vertical line situatedabout a fingers breadth to the right of the right mar-gin of the sternum. As the volume of the heart varies,within certain limits, in different healthy persons, theboundaries of the prsecordia are, of course, not alwaysexactly the same. The foregoing statements are suffi-ciently accurate for
. A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism . y is at, or a little within, a vertical line passingthrough the nipple, the linea mammillaris, and the rightlateral boundary is represented by a vertical line situatedabout a fingers breadth to the right of the right mar-gin of the sternum. As the volume of the heart varies,within certain limits, in different healthy persons, theboundaries of the prsecordia are, of course, not alwaysexactly the same. The foregoing statements are suffi-ciently accurate for practical purposes. The horizontal line representing the lower boundaryof the pra3cordia touches the point where the apex-beatof the heart is felt. The normal situation of the apex-beat must be recollected. In most healthy persons theapex-beat is felt in the fifth intercostal space, a littlewithin the linea mammillaris. This is assuming the 196 THE HEART persons to be sitting or standing; in recumbency on thehack the beat sometimes rises to the fourth intercostalspace, and it is sometimes found in the fourth space in Fig. 9. v»., ... \ I—. ,- / the sitting or standing position of the body. The dis-tance from the linea mammillaris varies in differenthealthy persons; it is sufficiently accurate to say it is alittle within that line. (Fig. 9.) The force of theapex-beat varies much in different healthy persons,owing to other causes than the power of the heartsaction, such as the amount of muscular substance andfat in that situation, the width of the intercostal space,the convexity of the chest, the relation to the left lung, CONDITIONS OF HEART IN HEALTH. 197 etc. Allowance is to be made for these variations indetermining the abnormal modifications of the force ofthe beat, which constitute physical signs of disease. Within a portion of the praecordia the heart is un-covered of lung, and in the remaining portion lungintervenes between the heart and the walls of the form
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Keywords: ., bookauthorflintaus, bookcentury1800, bookdecade1890, bookyear1890
