mi i OP Til 



THE m:\> i BOI v 



I )iirn ' .1111 |)l if lli.' 



Call I"' li' ;u >\ li\ ;i|>|il 



.ii the beginning of \ ■ 

 opex heat ; tl ' the heginti 



t lit till 



\ third Hound much 

 horl i line after i he second I ■ ■ tudy tho < 

 t he Bounds i he \ ibi at ion - w hieh tin 

 alongside cardiac i i mem 



oh ■ ' 



Can < "i Bound 



I : li.i . lm 11 round t hai i in' | 



one high pitched nnd 1 1 i hei of a dull < I 



■lir\ .-.I to I"- 1 1" i eault of \ ibral ioi up in th< 



nli»\ nil riculiir vnlvi I i hei in I he I • I • •« •« 1 in tin 



Niiddeii in systolic pressure The • 1 1 1 1 1 clement on th< 



is undoubtedly of museulnr 01 igin 'I 

 as follows I Win n the nuriculovcntriculnr valv< 

 closing properly either bj di or bj pusl loop o 



h pitched quality disappears, and not I 

 ■ound accompanies tho <lnll bruit produced ' 

 In a heart that lias b< [loss bj an ii 



api n in ai '-I but Btill bcatini <lwll i 



tho ound still continues to be heard for a bIio 



lusclo prodix ound i 



•II I ! 



\\ fii Mini 1 111 ■ inn' |" -i in 



I 



■•.in readily bo shov n to b< >\ U\ I 



of the semilunar \ ah i i"|i thi 



them, and tl 



till IIS1HII IS fill 



immediately «lisa|>i f tho ' 



tho apex, and il 

 vented from <•!•. 



