The Science of Therapeutics - Classical Homeopathy Online

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 303 of 65323854 Diseases of the Heart.lowing pnenomena : The intercostal spaces on the left side becomeeffaced or even bulge, the shock of the heart cannot be felt, butits stead we sometimes notice an undulating motion. Percussionreturns a larger extent of dulness within a triangular space, witits base downwards. On auscultation, the sounds of the heart ina recumbent posture are only feebly audible, whereas if the patiestoops forvv'ard, they are frequently heard very distinctly, at.rate much more distinctly than in the former position. At thecommencement of the disease, a feeble systolic blowing murmur isoften noticed in the region of the mitral valve, likewise in theregion of the aorta, or a double aortic murmur. Occasional throbbing of the veins of the neck. If the left lung is compressed byprofuse exudation, a tympanitic resonnance or even dulness resultThe first consequence of a decrease of inflammation is that the dness becomes less in extent ; after which the friction-murmurs agbecome audible, and may yet continue for some time. An importaut diagnostic sign of pericarditis is that while the area of cadulness increases in size, the sounds of the heart become less auble, and the impulse of the heart diminishes in force.The physical diagnosis of endocarditis is much more difficultthan that of pericarditis. Since the sounds of the heart constituthe most important criterium by which the presence of endocarditican be determined, it is of the utmost importance that the anatomand functions of the normal heart should be correctly known,otherwise valvular defects that had already been existing for a ltime, might be mistaken for consequences of the recent endocarditOn this account we should guard against a hasty diagnosis, andexplore the chest once a day or at least as often as may be convenient.As long as the valvular apparatus has not been invaded by theendocardiac inflammation, the disease may remain completely obscured. Although a bad case of endocarditis, with formation ofabscess, metastatic phenomena, etc., may exist without any valvular disease, yet a physical exploration does not reveal the exisof such inflammation by any positive sign. At the outset, the irapulse of the heart is generally stronger and felt over a larger eit is likewise more tumultuous, yet the pulse is not unfrequentlystrikingly small. Endocarditis attacking almost exclusively theleft ventricle, the first changes are noticed in the region of thfices, one of the first changes being an increased ringing or tinof the first sound. With the increase of the pathological processCarditis. S55with the softening or partial disorganization of the valves, or iconsequence of their incapacity from any other cause to close theorifices, a murmur is heard, most distinctly at the apex of theheart, side hy side with, or in the place of, the systolic murmurFriedreich calls attention to the fact that the diagnosis can oftbe more securely established by the circumstance that this murmurhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt