. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. ese and butter, of course, were to be allowed, to-gether with all kinds of cereals, vegetables, fruits, nuts, and several weeks his urine was sent to me for analysis, and wasalways loaded with indican and oxalic acid, but in other respectswas normal. Nearly four months later the patient reappearedAvith a perfectly regular pulse of 26, and was entirely free from hisvertigo, which he stated had left so soon as he began the prescribe
. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. ese and butter, of course, were to be allowed, to-gether with all kinds of cereals, vegetables, fruits, nuts, and several weeks his urine was sent to me for analysis, and wasalways loaded with indican and oxalic acid, but in other respectswas normal. Nearly four months later the patient reappearedAvith a perfectly regular pulse of 26, and was entirely free from hisvertigo, which he stated had left so soon as he began the prescribeddiet and had not once recurred. Examination of the heart showed the condition unchanged ex-cepting regularly interposed between every two vigorous cardiacsystoles were two feeble contractions that produced palpable andvisible small pulsations in the right common carotid, as well asweak heart-sounds, but no perceptible radial pulse. The actualheart-rate was therefore 78. The sul)joined sphygmographic tra- AORTIC STENOSIS 329 cing (Fig. 65) was taken by Dr. Edward F. Welles, and is by him,a competent judge, considered entirely normal except in Fig. 65.—Sphygmogram fkom Case of Aortic Stenosis (p. , 25 per minute. The conclusions to which I am forced by this case are the fol-lowing: 1. That this singular cardiac action is normal to this in-dividual, and that it is only its irregularity that occasions symp-toms of any kind. 2. That this irregularity was of an auto-infec-tious origin, due either to the production of leucomaines or to theinfluence of constipation on the vagus or heart-muscle cells, for onthis new dietary he has had two or more bowel movements That the lesion is a mild aortic stenosis together with a mitraldefect, of the exact nature of which I am not certain. But asI feel sure that at my last examination I detected a very shortpresystolic thrill and murmur as well as an apex-systolic murmur,I am inclined to the opinion that there is
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