Diseases of the Heart and Organs of Circulation. 299 



ciated with any further sign of heart disease does not then possess 

 the significance generally attributed to it, but a careful examina- 

 tion of the heart should invaribly be made when this functional 

 disorder is observed. It exists or may be brought about by slight 

 excitement in the great majority of heart diseases. 



In case of intermittent pulse it is useful to ascertain whether 

 there is also an intermission of the heart's beat, since in softening 

 of the heart, that organ may beat without being able to transmit 

 the impulse along the artery. 



A pulse at once unequal and irregular is a much more serious 

 indication than a merely intermittent pulse. It is observed espec- 

 ially in fatty degeneration of the muscular substance, and with 

 imperfection of the valves on the left side of the organ, though it 

 may be present in other cardiac diseases independent of the exist- 

 tence of those lesions. 



In hypertrophy of the left ventricle, the pulse is full and strong 

 and the impulse appears prolonged, because of the greater length 

 of time taken up by the ventricle in the act of contraction. When 

 dilatation coexists with hypertrophy the impulse is still full and 

 strong, more blood being transmitted through the vessel ; but when 

 dilatation is combined with attenuation of the ventricular walls 

 the impulse is soft and weak by reason of the feebleness of the 

 contractions. 



The pulse at the radial artery should be about synchronous with 

 the beat of the heart. If retarded it may be held to indicate the 

 existence on the anterior aorta or its primary divisions of an aneu- 

 rism with elastic walls or more probably an imperfection of the 

 aortic valves, which allows a regurgitation of the blood into the 

 heart. 



Venous pulse. A venous pulse seen in the lower end of the 

 jugular veins is common in the domestic animals. In the ox it is 

 quite compatible with health and is only to be judged by its am- 

 plitude and force. In other animals it often coexists with conges- 

 tion of the lungs which impedes the circulation through the right 

 side of the heart and leads to engorgement of the venous system. 

 In the absence of this condition it frequently indicates an imper- 

 fection of the auriculo-ventricular valves in the right heart and a 

 reflux of blood from the contracting ventricle which checks the 

 descending current in the veins. 



