File:Medical diagnosis for the student and practitioner (1922) (14597932998).jpg

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

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cle is enlarged,left also probably. To what extent the almost universally present roentgenographic signs ofobsolete, latent or, more rarely, active tuberculous infection, affects the devel-opment of this type of heart is a question of interest. Such infections almostwholly, no doubt, date from childhood; for the asthenic tissues afford afavorable locus for the tubercle bacillus. Misleading Bruits.—Murmurs when present over these hearts are systolicand may be maximal in the mitral, tricuspid or pulmonic auscultation areas. THE DROP-HEART 603 The last are usually ascribed to anemia alone, but in such cases they may andoften do occur in its absence or tend to persist or recur after any existing initialanemia is relieved. (See Anemic and Accidental ^lurmurs.) Therapeutic Test.—In such cases the administration of full test doses ofdigitalis with, or oftentimes without, enforced rest, usually causes distinct amel-ioration or disappearance of some or even all subjective symptoms and, not
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Fig. 309.—Drop heart. It will be noted that the right border is hidden by the sternum-Ml. in this case is 5 cm. infrequently, a more or less decided but demonstrable shrinkage in the cardiacarea of what may have seemed originally to be a heart of normal dimensions, butwhich proves to have been a dilated drop. As previously stated, a normal transverse diameter, as usually defined, The cardinalrepresents in the heart of the congenital asthenic an enlargement, or, in 604 MEDICAL DIAGNOSIS Deceptivemeasurements. Such heartsQf ten adequate. other words, the heart that is normal for the congenital asthenic isabnormally narrow for the individual of good physique. The undilated and non-hypertrophied asthenic heart may measure nomore than 7.5 cm. in total transverse diameter in thin subjects and 9.5 to10.5 cm. constitute the usual normal.

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