Diseases of the heart and aorta / by Thomas E. Satterthwaite.

  • Satterthwaite, Thomas E. (Thomas Edward), 1843-1934
Date:
[1905]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the heart and aorta / by Thomas E. Satterthwaite. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    to the right. In aortic obstruction tlic obstructive unirniur is beard'. best over the right 3d costo-sternal junction, or at the junction of the second right interspace \vith the sternum, or even as far over as the correspon(Hng space on tlie left side; while the aortic regurgitant may be well heard along a broad area spreading like a fan from the aortic area to the ai)ex, or even to the cnsiform appendix. As the point of maximum intensity for the tricuspid is located at the junction of the left fifth interspace with the sternum,, it is not far from the mitral area, ami its munuurs may be conveyed to that area : hence it may be difficult to make a diagnosis between these two lesions, rulmonar} lesions are so rare that they are curi- osities ; most of them are due to congenital malformations of the heart. In general, the murmurs indicative of the greatest danger are the diastolic. Percussion is at first negative, but, as endocarditis progresses, the contour of the heart gets larger and more ovoid. This enlarge- ment is the most important sign of organic heart disease, because it is unequivocal. The heart swings like a pendulum in the cavity of the chest, sus- pended by its great vessels; so that the apex is carried well outside the nipple in some cases, especially in lateral curvature, where the spinal concavity is generally to the left. It may also be displaced to the right by fluid in the chest, and by lying on the right side. Still, as we only examine in the upright or recumbent positions, it is relatively fixed, and we find the apex in the fifth space, the left border of the heart the breadth of a rib inside the nipjile, and about twice that distance below it. The right auricle is al)0ut the only part of the heart outside the right border of the sternum. Two- fifths of the heart lies to the left of the median line. -Ingina pectoris is not uncommon in endo-cardio]:)athies. Both forms, which are best classified as the mild and the severe, are usu- ally brought on by mental or moral excitement, indigestion, over- exertion, and a number of minor causes, especially those that in- fluence the special senses. They are always, in my experience, capable of being controlled by suitable remedies, though drugs may prove ineffectual when rest, massage, electricity, baths or a change of scene will succeed. Endocarditis gives rise to various symptoms in other organs, for there may be hypersemia of the lungs, embarrassed respiration, engorgement of the kidney and chylopoetic tract, and even general' dropsy.
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