Diseases of the Heart. 



201 



Blowing murmur 

 before the first 

 sound. 



^ 



BLOWING. HEAKT SOUNDS. 



Narrowing of the 

 auriculo - ventricular 

 orifice. Clots or 

 growths on tlie 

 valves. 



Strongest toward thj lase of r Narrowing of the 

 the heart. Heard along the < opening of the aorta, 

 large arteries. v 



Blowing murmur 

 trith the first sound. 



Narrowing of the 



Strongest toward the left of pulmonary artery, or 



the heart. Not heard over the ■> imperfect action of 



great arteries. the auriculo-ventric- 



ular valves. 



Blowing murmur i Double rushing sound heard r Imperfect action 

 with the second •; over the great arteries at each^; of the valves at the 

 sound. V. heart beat. I opening of the aorta. 



Blowing murmur r Double rushing sound in the r Aneurism (dilata- 

 after the second •; arteries with each beat of the i tion) of the aorta, 

 sound. I heart. V. 



Besides these the second sound may be doubled in hy- 

 pertrophy of one ventricle of the heart. 



The sounds are like whispered wJio, awe, ss, or r, very 

 low but exceedingly characteristic. 



Otlier Symptoms. Besides the feyer attendant on in- 

 flammatory affections there are characteristic phenomena 

 present in the chronic form of heart-disease. These are 

 shown at rest or only deyeloped under exercise. There are 

 habitually cold extremities, dropsies in the limbs, and be- 

 neath and within the chest and abdomen, difficult breath- 

 ing especially during exertion, unsteady gait when hurried, 

 vertigo, partial paralysis or cramps of the limbs. In most 

 cases there is sluggishness, dullness and a tendency to lay 

 on fat. Patients may be lively when at rest, but flag at 

 work and are liable to sudden fainting or death. 



PAIiPITATION. THUMPS. 



This is sudden violent convulsive beating of the heart 

 not connected with structural disease. Palpitations also 

 accompany most acute diseases of the heart. The func- 

 tional disorder comes on very abruptly, usually under 



