lo8 THE FARM DOCTOR. 



Of these the jerking, intermittent, unequal, and irregular 

 pulses are especially indicative of heart-disease. The jerking 

 pulse is associated with disease of the valves at the commence- 

 ment of the great aorta which carries blood from the left side 

 of the heart, and is accompanied by a hissing or sighing noise 

 with the second heart sound. The intermittent pulse implies 

 functional derangement of the heart, but not necessarily disease 

 of structure. The unequal and irregular pulse is met in cases 

 of fatty degeneration, disease of the valves on the left side, 

 cardiac dilatation, etc. A retarded pulse, in which the beat of 

 heart and pulse follow each other with a perceptible interval, 

 implies imperfect closure of the valves at the commencement of 

 the aorta, or an aneurism on the aorta. A venom pulse, seen in 

 the jugular veins in the furrow near the lower border of the neck, 

 attends imperfect valves between the auricle and ventricle on the 

 right side of the heart, or congested lungs, but may exist in health. 



Palpitation. — The application of the hand over the chest 

 behind the left elbow will detect any violent and tumultuous 

 beating, irregularity in the force of successive beats, etc. 



Auscultation. — ^The ear applied to the same part will detect 

 a slight rubbing sound with each heart-beat in the early stages 

 of pericarditis. It will also detect any modification of the heart 

 sounds. In health each beat of the heart is characterised by 

 two distinct successive sounds, the first somewhat dull and 

 prolonged, the second short, sharp, and abrupt. The first 

 sound is simultaneous with the contraction and emptying of 

 the ventricles, the closure of the valves between the ventricles 

 and auricles and the flow of blood into the arteries. The 

 second corresponds to the completion of these acts, the recoil 

 of blood in the arteries, and the closure of the valves between 

 them and the heart. The following table will show the signifi- 

 cance of the various superadded sounds (blowing, sighing, purr- 

 ing, or hissing murmurs), to any one who will acquaint himselt 

 with the course of blood through the heart : — 



