Les signes de la maladie interne, avec un bref examen des principaux symptômes de celle-ci . veryrapid l'action devient, à l'auditeur le premier son semble suivre la deuxième soundssince l'intervalle entre le second et le premier périodique ?lllllllll très Hapid Coeur. Le ?Illlllll Kapid modérément. Le ?Illlllll Ralentissement du pouls. IIII JE nul très lent. Fig. 40-Schéma illustrant la relation dans le temps de la première et secondheart sons dans différents rythmes. Le son est désormais plus longue que l'intervalle entre le premier son et le second ; un état d'aifairs ce qui peut être gênant pour thestu

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The signs of internal disease, with a brief consideration of the principal symptoms thereof . the action becomes veryrapid, to the listener the first sound seems to follow the second soundssince the interval betwen the second sound and the recurrent first ?lllllllll Very Hapid Heart. ?Illlllll Moderately Kapid. ?Illlllll Slow Heart. IIII nil I Very Slow. Fig. 40—Diagram illustrating the relationship in time of the first and secondheart sounds in different rhythms. sound is now longer than the interval between the first sound andthe second; a state of aifairs which may be embarrassing to thestudent. In the slowly-acting heart the distinction is easy, since it is onlynecessary to remember that the long silence follows the second sound, but in cases of rapid, irregular action accompanied by a change inthe qualities of the two sounds which makes them resemble each other, or when only the first sound is audible at the base and the second onlyaudible at the apex, the difficulty of separation is considerable. The accompanying diagram may aid in comprehending the rela-tionship.. PLATE IX. The cardinal points of tiie valve areas. Points at which valvesounds are best isolated? THE HEART 173 POSITION OF THE VALVES OF THE HEART. The valves are all located within such a narrow radius that a.silver quarter may be so placed as to cover a jJtortion of each. Indeed, the aortic and the pulmonary semi-lunar valves are separated fromeach other only by the thickness of the aortic wall. The two auriculo-ventricular valves and th|e aortic valve are in one plane, which formsa diagonal of the thorax. As described in the various text-books, much variation in the location of these valveswill be found to exist.Most recent anatomical research as to their ejcact topographical posi-tion locates them as follows: The pulmonary valve lies beneath thethird left costal cartilage, but close to its junction with the sternvim, and is the most superficial as well as the highest up of all the valves. Were the

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• bookcentury1900
• bookdecade1900
• booksubjectdiagnos
• bookyear1906