Buffalo medical and surgical journal (1893) (14760538556)

Identifier: buffalomedicalsu3318unse (find matches)

Title: Buffalo medical and surgical journal

Year: 1894 (1890s)

Authors:

Subjects: Medicine General Surgery

Publisher: Buffalo : Joseph Warren & Co., Printers

Contributing Library: The College of Physicians of Philadelphia Historical Medical Library

Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

Text Appearing Before Image:

exami-nation and operation. Posture changes the site of the impulse of the normal heart,yet the text-books scarcely make reference to it. Paul says that the patient may sit, stand upright, or reclinefor examination of the heart, as is most convenient. Guttman alleges that the cardiac sounds are the loudest in theupright posture. Dr. Azoulay, of Paris, claims that he has devised a means ofintensifyingthe cardiac sounds by placing his patient upon the back,elevating the arms, flexing the lower extremities, and rising the 1. Copyrighted. 86 DAGGETT : CONCERNING POSTURE. head, which reinforces the heart sounds and slows its action. Drs.Azoulay and Jules Simon have employed this method in the Child-rens Hospital, in Paris, and state that they have been able tolocalize extra- and intra-cardiac bruits, as the slowing of the heartsaction and the augmentation of its sounds aided in clearing uptheir vagueness and complicated character. It is said that dyspnea and arythmia without slowing of the

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pulse, in the recumbent posture, and which do not occur in theupright, afflicting a person supposed to be in good health, indicatea lesion of the myocardium, and a fatal issue from asytole maybe predicted at an early date, according to the degree of thedisease. If this be true, applicants for life insurance should be postured DAGGETT I CONCERNING POSTURE. 87 for examination ; indeed, in all obscure cases diagnosticians couldprofitably utilize natural attitudes and assumed postures when con-ducting physical examinations. Sims discovered and demonstrated the advantages of the sideposture ; still, with all that has been said and written, a compara-tively small number of physicians employ it. Many specialists use the side position for ocular examination,and treatment; the dorsal recumbent posture for executing biman-ual examinations, and perineal operations. The vagina, in its usual desolate condition, is a collapsed sack,preserved in its closed condition by pressure of the superincum-ben

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1893

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