The cephalic murmur of anaemia / by G.A. Gibson.

  • Gibson George Alexander, 1854-1913.
Date:
[1882?]
Catalogue details

Licence: Public Domain Mark

Credit: The cephalic murmur of anaemia / by G.A. Gibson. Source: Wellcome Collection.

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

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    [Reprinted for the Author from the British Medical Journal, Jan. 21st, 1882.] THE CEPHALIC MURMUR OF ANAEMIA. By G. A. GIBSON, M.D., D.Sc., F.R.S.E., Fellow of the Royal College of Physicians of Edinburgh, and Lecturer on Medical Anatomy and Physical Diagnosis in the Edinburgh School of Medicine. In the early part of last year M. Tripier, of Lyons, published an inte- resting memoir* upon an important phenomenon which he observed in many cases, more especially in conditions of anaemia. By means of an abstract in the London Medical Record,\ I brought his investigations before the notice of the profession in this country soon after the appearance of his paper. In anaemia, and certain associated states, Tripier found that a murmur could be determined by auscultation over the cranium. He described it as always systolic in rhythm, never continuous, not modified by change of posture, but altered by pressure on the carotid arteries, and varying with the general condition of the patient. In a subsequent contribution!'he has re- considered the conclusions at which he previously arrived. He finds most of his statements fully supported by the evidence which he has accumulated, but sees reason to modify his former conclusion regarding the position of the maximum intensity of the murmur. In his first paper, he described it as being most distinct over the temporal region, especially of the right side. But it had not then oc- curred to him to investigate the state of the orbit; and, since writing that memoir, he has discovered that on auscultation of the eyeball the murmur can be heard more clearly in that position, than in any other part of the cranium. He points out that the murmur is clearly of local origin, as it not unfrequently exists apart from any cardiac murmur, and cannot, therefore, be transmitted from the heart. It gradually gains intensity as the anaemic state becomes more profound, and when the patient improves it steadily diminishes. The murmur over the orbit is heard at an earlier period than that in the temporal or other region of the head, and, as health is regained, it is longer in disappearing than that heard elsewhere. Tripier regards this murmur as arising in the terminal portions of the internal carotid artery, and thinks that its maximum intensity over the orbital region is a strong argument in favour of such an hypothesis. * Recherches Cliniques sur le Souffle Cdphalique chez l'Adultc (Revue de Mldecinc, vol. 1, Nos. 2 and 3, February and March 1881). t London Medical Record, April 1881. t Note sur le Souffle Cephalic]uede l’Adulte consider^ au niveau des Regions Orbi- taires (Revue de Mldecinc, vol. i, No. 10, October 1881).