Medical diagnosis for the student and practitioner (1922) (14597997069)

Identifier: medicaldiagnosi00gree (find matches)

Title: Medical diagnosis for the student and practitioner

Year: 1922 (1920s)

Authors: Greene, Charles Lyman, 1862-

Subjects: Diagnosis

Publisher: Philadelphia, Blakiston

Contributing Library: The Library of Congress

Digitizing Sponsor: The Library of Congress

Text Appearing Before Image:

Percussion.—This is of slight value relatively but one should always testthe note over the manubrium, third right interspace and third rib and thesecond right interspace for the dulness en casque of Potain, and inspectand palpate carefully for expansile pulsation. Auscultation.—The character of the second sound as heard over thethird left interspace may be of the utmost value before any considerable Dulnessen casque. The split second. 758 MEDICAL DIAGNOSIS degree of aortic leakage is established. It may be blurred and murmur-ish, or remarkably and suggestively clear and intense, and one of the mostimportant variants in the authors experience has been the split second sound,often heard over the third left interspace near the edge of the sternum, or

Text Appearing After Image:

Fig. 412—.One type of luetic diffuse dilatation of the aortic arch (2d and 3dportion). Strong resemblance to actual aneurysm as in Fig. 409. Correct diagnosis1 shown in Fig. 412 in which the oblique method was employed. First exposures severalmonths before showed no arterial change though the same enlargement of the heart existedtogether with the fatty tail at the left cardiodiaphragmatic angle, indicating fattyovergrowth. Patient highly neurasthenic at this time and showing some subjectivesigns of limitation of myocardial reserve. See Fig. 411. over its corresponding left half at the same level, as described by him severalyears ago. This may be present persistently or intermittently long beforethe true murmur appears and may later alternate with the short imperfectdiastolic bruit even during a single clinical seance. CARDIOVASCULAR SYPHILIS An importantsign. Much importance is to be ascribed to a clanging*1 second tone, for al-though it can hardly be regarded as in any sense pathog

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1922

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