A hand-book on the diseases of the heart and their homoeopathic treatment.
- Armstrong, W. P.
- Date:
- 1882
Licence: Public Domain Mark
Credit: A hand-book on the diseases of the heart and their homoeopathic treatment. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![or without atresia of that vessel. It is no doubt, in most cases at least, the result of endocardial in flam ] mation. The stenosis may be effected by contraction of the tissues surrounding' the orifice, by the edges of the valves adhering together, or by both of these pro- cesses combined. Perhaps most of those cases in which the valves are said to be deficient in number may be best explained in this way; two or more of the seg- ments having been thus united into one. All other things being equal, it may be said that the earlier the stenosis occurs, the smaller and more delicate will be the pulmonary artery. When that vessel is nearly or quite normal, the only obstruction to the pulmonary circulation being at the constricted orifice, a murmur is likely to be heard in the left sec- ond intercostal space, close to the sternum. It is sys- tolic in time and not transmitted. Blood passing through the septa from one auricle or ventricle to the other, seldom if ever gives rise to any murmur. Another congenital defect not so frequently met with, is stenosis of the conus arteriosus. This may be continuous with pulmonary stenosis, in which case the entire eonus may be converted into a more or less rigid tube, or the constriction may be confined to a single portion at some distance from the pulmonary opening, and the part so affected be converted into a narrow neck, thus cutting off the conus from the main body of the ventricle, with which it communicates by a narrow opening. In this case, the part so separated is by some considered as an additional ventricle.](https://iiif.wellcomecollection.org/image/b2103557x_0254.jp2/full/800%2C/0/default.jpg)
