On stethometry : being an account of a new and more exact method of measuring & examining the chest, with some of its results in physiology and practical medicine also an appendix on the chemical and microscopical examination of respired air / by Arthur Ransome.

Arthur Ransome

Date:: 1876

Credit: On stethometry : being an account of a new and more exact method of measuring & examining the chest, with some of its results in physiology and practical medicine also an appendix on the chemical and microscopical examination of respired air / by Arthur Ransome. Source: Wellcome Collection.

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$11.] ' tions due to changes in posture, will be at once conceded— and it might fairly be anticipated that observations under- taken with these objects might well lead to . interesting collateral results. It is therefore somewhat surprising to find how few have been the observations on the subject. It is true that anatomists have stated in general terms the usual impulse-site, but no variations are recorded. In Quain and Sharpey's Anatomy it is stated that the heart's apex strikes the walls of the chest in the space between the cartilages of the fifth and six ribs, a little below the left mamilla. Dr. Sibson gives the point between the fourth and fifth or the fifth and sixth ribs, and Dr. Walshe, in more exact terms, states that it beats in the fifth interspace and somewhat against the sixth rib, about mid-way between the vertical line of the nipple and the left border of the sternum {Dis. of Heart, 4th ed., p. 18). Piorry on the other hand remarks that in some individuals in health, the heart-beat is raised three, four, or five centimetres higher than in others, that in some, it may be found three centimetres to the right of the sternum, in others three or four centimetres to the left of its ordinary state, and though he gives no proof of his statement, he believes it varies with age, sex, build, consti- tution, proportion of blood in the organism, and a crowd of other circumstances. Plessimetrisme,'^. 379. Still fewer records can be found of the degree of mobility of the impulse in different positions of the body. Dr. Quain (p. 1102) simply says that the heart comes more exten- sively into contact with the anterior walls of the chest when the body is in the prone posture, or lying on the left side, — and Dr. Walshe that changes of posture elevate, depres.s, throw it upwards or backwards,—or again, the heart falls downwards somewhat (if its substance be weighty the fall may equal an inch) in the erect attitude and comes more C$