. A practical treatise on medical diagnosis for students and physicians . hich is produced at orifices when theyshould be closed is known as the murmur of regurgitation, as the valvepermits the blood to flow backward. A murmur that occurs when theblood should in health be passing through an orifice is known as a mur-mur of obstruction, as the flow of blood is obstructed. We have todetermine whether the murmur at an orifice is due to regurgitation or toobstruction. This is ascertained by the time of the murmur. The time of the murmur is determined by comparing it with the heart-sounds, the apex
. A practical treatise on medical diagnosis for students and physicians . hich is produced at orifices when theyshould be closed is known as the murmur of regurgitation, as the valvepermits the blood to flow backward. A murmur that occurs when theblood should in health be passing through an orifice is known as a mur-mur of obstruction, as the flow of blood is obstructed. We have todetermine whether the murmur at an orifice is due to regurgitation or toobstruction. This is ascertained by the time of the murmur. The time of the murmur is determined by comparing it with the heart-sounds, the apex-beat, or the carotid pulse. Murmurs with the Systole. 1. In the Mitral Area. In health during systole the auriculoven-tricular valve is closed. The murmur indicates that there is such disease MURMURS WITH THE SYSTOLE. 445 as to permit of a backward flow of blood or of regurgitation into theauricle. It is the murmur of mitral regurgitation. It may be due todisease of the valves (organic incompetency) or to relative incompetency.(See Fig. 123, and Plate XXXII., Fig. 1.). Maximum intensity of murmur of tricuspid regurgitation: systolic. 2. In the Tricuspid Area. As on the left side, the murmur in thisarea is due to valvular disease, organic incompetency or relative incom-petency, which permits of regurgitation, tricuspid regurgitation. (SeeFig. 124, and Plate XXXIII., Fig. 1.)
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