Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine.
- Babcock, Robert H. (Robert Hall), 1851-1930
- Date:
- 1910
Licence: Public Domain Mark
Credit: Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. 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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![left auricle upon the artery, but explains other cases as due to a displacement upward of the pulmonary artery and a change in its axis and that of the right ventricle, in consequence of which its normal curve is increased and it is flattened somewhat against the wall of the chest. Bramwell attributes the murmur to the sudden discharge of a large wave of blood of abnormal composi- tion into the probably dilated artery. Sansom thinks that in a condition of right-ventricle weakness toiling to overcome increased resistance in the pulmonic system fibrillar tremors can be initi- ated at the overstrained portion of the right ventricle—i. e., the conns just below the valves—and in this way the murmur in ques- tion can be induced. Gibson holds that auricular or cardiac dila- tation cannot be assumed in these eases because the murmur oc- curs long before such dilatation takes place; also that the experi- ments on which Foxwell's view is based were faulty; also that if Sansom's theory is correct, then the murmur ought to exist more often than it does, and therefore advocates the view that it is the murmur of tricuspid insufficiency propagated into the pulmonary area. Quincke, cited by Balfour, concluded, as a result of obser- vations in 6 cases of healthy hearts and arteries, but with retrac- tion of the lung-borders, that a systolic basic murmur can be pro- duced by pressure by the heart of the pulmonary artery against the chest-wall. Vierordt agrees with Sahli that in many cases venous mur- murs are transmitted from the great intrathoracic veins to the heart. Potain urges the cardio-pulmonary origin of accidental murmurs, maintaining they are generated by the impulse of the heart's apex against the lung, an hypothesis that appears sup- ported by an observation of Fran(;ois-Franck's, Avho, during an operation upon a dog, detected a systolic mnrnnir in the region of the apex which disappeared so soon as the processus lingualis was lifted away from contact with the heart, and returned when this portion of pulmonary tissue was allowed to again rest against the surface of the organ. Such cardio-pulmonary origin is especially claimed for the murmurs of ana'uiia. Winckler, on the other hand, believes he has discovered the origin of accidental apex- bruits in a defective action of the p;i])illarv muscles or a faulty insertion of the valve-muscles, which |)ermits of regurgitation. Finally, it has been urged that these murmurs may have a](https://iiif.wellcomecollection.org/image/b21229533_0052.jp2/full/800%2C/0/default.jpg)
