The Bradshaw lecture on the causation of functional heart murmurs : delivered before the Royal College of Physicians, London, on November 2, 1899 / by Arthur Foxwell.

  • Foxwell, William Arthur.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: The Bradshaw lecture on the causation of functional heart murmurs : delivered before the Royal College of Physicians, London, on November 2, 1899 / by Arthur Foxwell. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    was doubled. It was noted that as the pulmonary pressure approached that in the aorta the systolic murmur was better conducted to this vessel. On removing the pericardium from the aorta the audibility of the systolic murmur over this vessel was lessened. On removing it from the pulmonary artery and conus the systolic murmur became louder and was well heard all along the pulmonary artery, but it was less well heard in the aorta, especially if the difference of pressures was maintained. With the pericardium entirely off the systolic murmur was as when the pericardium was intact, except that it was better heard along the pulmonary artery. Experiment 2/.—The patient, a man, aged 31 years, died from acute anaemia of four weeks' duration. The liver and spleen were enlarged. The apex beat was at the fifth rib and the left vertical nipple line. There was vertical dulness at the upper border of the third cartilage and right dulness a little to the right of the left edge of the sternum. Systolic murmurs were heard over the apex and pulmonary area and a soft systolic murmur, probably conducted from the left, in the second right space. After death the heart was flabby but not much dilated. The tricuspid valve measured inches, the aortic valve 3-5 inches, and the pulmonary valve 3! inches in circumference. Scattered throughout the aorta and reaching up into the innominate and left carotid were remarkable bosses, almost ulcerated in places, of acute inflammation (hsemorrhagic aortitis). Pericardium intact: systolic murmur was heard; this was usually well heard in the aorta, sometimes so well heard there that it was doubtful in which vessel it arose [cf. condition of aorta and murmur of aortic degeneration]. Pericardium removed from conus and pulmonary artery : the murmur was much increased, but more over the pulmonary artery and conus than over the aorta. Pericardium entirely removed: murmur very feebly heard. Pressure on the pulmonary artery much more easily induced a murmur than similar pressure on the aorta even when the tension in both vessels was the same. I trust that I have convinced you of two things : first, that in
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