Clinical essays.

  • Benjamin Ward Richardson
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Clinical essays. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    CLINICAL ESSAYS. pulsation. In one instance, where this thrill was in- tense, I could see the vibration when the finger was removed; and not only so, but on applying the ear near to the artery, without actual contact with the skin, I could hear the murmur. Lastly, it is not difficult, in applying the stetho- scope over the subclavian, to catch the murmur by a light pressure, and to remove it by a firm pressure, of the mouth of the tube. In such cases, the stetho- scope, by arresting the current of blood through the artery when the pressure is made considerable, re- moves the sound by stopping the circulation. Under such pressure, the radial pulse is also felt to be deficient or absent. The cause of the vibration of the artery is never- theless primarily external; that is to say, the sound is in the artery, but is not due to disease of the vessel. I imagined at one time that in some cases, where the murmur was very intense, there might be deposit on the inner surface of the artery; but this idea was soon dispelled by the observation, that in every case the murmur could be removed by some simple change in the position of the arms of the patient, or in the force of respiration. The view advanced by Dr. Kirkes as to the cause of the murmur was to the effect that the artery, at the moment when the sound was produced, was sub- jected to pressure upwards and forwards by a portion of solidified lung raised during inspiration. This ex- planation, which is the one also given by Dr. Sibson, in so far as it assigns to external pressure upon the
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