Sb CLINICAL DIAGNOSTICS. 



In insufficienc}- the bruit occurs at the 

 moment at which the valves should close. In 

 consequence of their inability to close a regurgitation of the 

 blood takes place, which produces a renewed vibration of the 

 valves, and gives a bruit. If the insufficiency involves the 

 auriculo-ventricular valves, the bruit occurs at systole; if the 

 semilunar valves are insufficient the bruit appears at diastole: 



The character of the bruits is varied, they can be biia- 

 singj blozi'ing, purring, hissing, Jinmming, sazcing, rattling, 

 long or short tones. Insufficiency bruits are generally softer 

 than those due to stenosis. Heart bruits are made more 

 pronounced by an acceleration of the heart's action, therefore 

 the patient should be exercised before examination. 



Gmelin recommends digitalinum vernui subcutaneously to 

 bring out more distinctly heart sounds or casual bruits. The 

 dose for the horse and ox is 0.025 — 0.05 ; for the dog 0.002 

 0.009. The digitalin is first dissolved in 5ccm of 50% alcohol 

 and then diluted with SOccm of water. 



Systolic bruits I^N^^/N- I are characteristic of: 



I Insufficiency 



I of an auric- 



I ulo- ventric- 



\ ular valve. 



I Stenosis of 



I an arterial 



[ opening. 



Diastolic bruits] — v^n^ [ are characteristic of : 



Stenosis of 

 an auricu- 

 lo-ventricu- 

 lar opening. 

 Insufficiency 

 of a semi- 

 lunar valve. 



