Minor maladies and their treatment / by Leonard Williams.
- Williams, Leonard (Leonard Llewelyn Bulkeley), 1861-1939.
- Date:
- 1906
Licence: In copyright
Credit: Minor maladies and their treatment / by Leonard Williams. 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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![gauge its degree. It is tlius at once a simple and accurate means of arriving at a correct estimate of the state of the arterial tension, and he who would make an early diagnosis of the conditions which lead to arterio-sclerosis will do well to remind himself that the two positions are as important in examining the pulse as they admittedly are in searching for murmurs in the cardiac area. So much, then, for the pulse. When we come to examine the heart, as we should do, to determine the exact site of the apex-beat, and map out the area of relative dulness (the amount of absolute dulness affords no information of any value), if we are seeing the case in the very early stage, we shall probably discover nothing abnormal. For it is, as a rule, not until the later stages, where definite arterio-sclerosis is already in full swing, that the heart breaks down and dilatation ensues. When the stethoscope is used—[never trust the man who commences an examination of the heart by listening]—there will probably be no murmur; the sounds may have a muffled quality, but the second sound at the aortic cartilage will be unduly loud. Under normal conditions, it is the pulmonary second sound which is the louder; but where arterial tension is unduly high the aortic second sound becomes much more pronounced, and this accentuation is very properly regarded as one of the most important signs of the condition. The degree of accentuation will vary, of course, with the amount of increased tension, but the](https://iiif.wellcomecollection.org/image/b21535899_0212.jp2/full/800%2C/0/default.jpg)
