An introduction to the study of clinical medicine : being a guide to the investigation of disease for the use of students / by Octavius Sturges.

Sturges, Octavius, 1833-1894.

Date:: 1873

Credit: An introduction to the study of clinical medicine : being a guide to the investigation of disease for the use of students / by Octavius Sturges. 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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$apprehended for the heart than for the Iwng^^^^^^ ^v.^ goes for something that the beating of th^he'Si^fc is often both seen and felt^ that its sou distinct and obvious to the unpractised eS^/,#;id that no act on the part of the patient can su^enef]^^ J v^;. -. or modify them.* ,. The natural cardiac rhythm is best caught, I Jio^ of^the' think, by comparing the heart's action at various [he heart,'of . . , its two ages from infancy onwards. It is tlius seen that sounds, and ° of the pauses the ticking, equal sounds of the infant's heart gra- ^^j^^ ^^^^^ dually give place, as life advances, to two distinct and dissimilar sounds, differing in duration, and succeeded by pauses of unequal length. So soon as \hQ ear has once caught the well-marked cadence which arises from the recurrence of these separate sounds, and their pauses in the same order and within the same period of time, any d-eviation from * The heart's rhythm is easily recognized and remembered, and in a number of healthy persons of the same age and sex there is a close jesemblance in the general character of its action. It is quite different with the lungs : ordinary respiration is hardly suggestive of noise or movement, and is, in fact, sometimes per- formed with very little of either. Within the limit of health there is every degree of loudness or feebleness in the respiratory sounds, while the voluntary efforts of the patient, no less than the fact that he is breathing consciously, tend to embarrass the listener and to conceal the natural modulation of respiration. Commencing with the heart, the listener is at once satisfied as to the existence of sounds within the chest, and soon learns to discriminate their intimate characters. Commencing with the lungs, the ear very often fails to catch any sound whatever, and the task of discovering disease by such means seems hopeless. G$