CYANOSIS, definition of, 169; causes of, 169-71; physical signs and general symptoms of, 171; prognosis of, 172; treatment of, 172.
DEATH, modes of, from thoracic aneu- rism, 216.
DELIRIUM in connection with pericarditis,
77-83, and endocarditis, 106-7. DIASTOLIC impulse, where perceived, 9-10; how produced, 9-10, and 12. DIGITALIS, action of, in regulating the heart, 144-5.
DILATATION of the heart, varieties of, 135; how produced, 136-7; physical signs of, 138-9; symptoms of, 139; diagnosis of, 140; prognosis of, 141-2; treat- ment of, 142-5.
of the aorta, see "Aorta, dilata- tion of."
of the pulmonary artery, 238-9. DISSECTING aneurism, see 66 Aneurism, dissecting." DIURETICS, value of, in cardiac dropsy, 123-4.
DROPSY, cardiac, where first observed, 123; mechanism of, 116, and 131; con- ditions of heart productive of, 117, 131, and 143; treatment of, 121-5, and 143-5.
DYSPEPSIA in connection with heart dis- ease, 140-1.
DYSPHAGIA caused by aneurism, its cha- racter, 207-9.
DYSPNEA, caused by aneurism, its dis- tinctive features, 204-5.
peculiarities of cardiac, 140-1.
EMBOLISM, 106-7, and 174-8, and 199. ENDOCARDIAL murmur, see "Murmur, endocardial."
ENDOCARDITIS, chronic, see "Valves, chronic disease of."
acute, pathology of, 95-9; physical signs of, 100-5; general symptoms of, 106; prognosis of, 107-8. ENDO-PERICARDITIS, statistics of, 109; physical signs and treatment of, 109.
FATTY degeneration, of the heart, see
"Heart, softening of;" of the cornea'
FIBRE, cardiac, in hypertrophy, 125; in dilatation, 137-8; in softening, 152. FORAMEN Ovale, patulous, its influence in the production of cyanosis, 169. FREMITUS friction, see "Friction fremi- tus."
FRICTION fremitus or thrill, cardiac, how produced, 14-15; pericardial, its cause, 74; diagnosis of pleuritic and pericar- dial, 57-8.
HÆMATEMESIS caused by aneurism, 195, and 211.
HÆMOPTYSIS caused by aneurism, 194. and 211.
HEAD symptoms, see "Brain, affection of," and "Cerebral disturbance." HEART, position of, in relation to chest walls, 1; position of, subject to vari- ation, 2; displacements of apex of, 7-9; rhythm of, 9-10; alterations in rhythm of, 13, and 15; alteration in rhythm of, due to functional causes, 185; impulse of, character of, and where perceived, 4-5; impulse of, how modified, 5, and 11; diminished impulse of, how produced, 11; in- creased impulse of, how produced, 11- 12; alterations in character and rhythm of impulse of, 12-13; normal sounds of, 24-39; adventitious sounds in, 42, see "Murmurs;" abnormal pulsa- tion of left auricle of, in connection with phthisis, 9; measurements of a healthy, 138.
sounds of rhythm of, 24; character of, 25; causes of, 34; theories as to causes of, 26-34; causes which modify the intensity and character of, 35-7; causes which modify the rhythm of, 38-40; reduplication of, 39-40.
valvular disease of, acute, patho- logy of, 95-9; physical signs of, 100; diagnosis of murmurs produced by, 101-6; general symptoms of, 106-7; prognosis of, 107-8; treatment of, 107.
HEART, valvular disease of, chronic, 110- 25; cause of, 100; murmurs produced by, 112; symptoms caused by, 113-6; diagnosis of murmurs caused by, 117- 20; prognosis of, 118-19; treatment of, 120-5.
thickness of walls of a healthy, 127; weight of a healthy, 127.
hypertrophy of, 125; varieties of, 125; causes of, 125-6; physical signs of, 127-9; general symptoms of, 128; how connected with apoplexy, 129-30; how related to enlargement of the thyroid gland and dilatation of the in- fra-thyroid arteries, 132; prognosis of, 133; treatment of, 134-5.
dilatation of, 135-44; varieties of, 135; causes of, 136-7; physical signs of, 138; symptoms of, 140-1; diagnosis of, 141-2; prognosis of, 142-3; treat- ment of, 143-6.
atrophy of, 146; structure of, 146; causes of, 147; physical signs and general symptoms of, 147.
induration of, 148; cause of, 148; morbid anatomy of, 148; physical signs, general symptoms, and treat- ment of, 149.
softening of, 150-7; causes of, 150; class of persons in whom it occurs, 151; microscopical appearance of, 152; physical signs and general symptoms of, 153-4; arcus senilis in connection with, 155; diagnosis of, 155-6; pro- gnosis of, 156; treatment of, 156-7.
rupture of, 157-61; causes of, 157; statistics of, 158; mode of death in, 158; signs of, 159; treatment of,
aneurism of, 162; seat of its occur- rence, 162; symptoms and physical signs of, 162.
fatty degeneration of, connected with angina pectoris, 164-6.
conditions of, productive of dropsy, 117, 131, and 143; malforma- tions of, 170; malposition of, 172-4.
malposition and displacements of, congenital, 172; as result of disease,
173; causes of, 173-4; physical signs and symptoms of, 174. HEART, fibrinous concretions in, varieties of, 174-8; physical signs and general symptoms produced by, 175-6; progno- sis of, 175, and 177; treatment of, 177.
functional derangement of, varieties of, 178-9; physical signs of, 179-80; general symptoms of, 181-2; diagnosis of, 182-3; treatment of, 183-5; pro- gnosis of, 185; alterations of rhythm connected with, 185-7.
HOARSENESS, caused by aneurism, its dis- tinctive features, 183. HYDROPERICARDIUM, its cause, 123, and
LUMBAR abscess, diagnosis between, and abdominal aneurism, 229-30.
MALPOSITION of the heart, 172-4. MANIACAL delirium, in connection with pericarditis, 77-83.
MEASUREMENT of a healthy heart, 138; of the thickness of the walls of a healthy heart, 127.
MEDIASTINAL tumours, see "Intratho- racic tumours, diagnosis of, from aneu- rism," 208, and 215-16.
MENINGITIS, simulated in pericarditis, 77. MITRAL murmur, systolic or regurgitant, auscultatory signs of, 52; other phy- sical signs and general symptoms of, 115; diastolic or obstructive, ausculta- tory signs of, 55; other physical signs and general symptoms of, 113. MURMURS, arterial, cause of organic, 16; and functional, 45-7.
cardiac, 42; mechanism of, 42. endocardial, seat of, 42; mechanism of, 42; character of, 42-3; causes of organic, 44-5; causes of functional, 45-50; causes which modify the cha- racter of, 42, and 48; diagnosis be- tween organic and functional, 48-9, and 55; systolic aortic, auscultatory signs of, 52; physical signs and general symp- toms of, 113; systolic pulmonary, aus- cultatory signs of, 52; physical signs and general symptoms of, 114; systolic tricuspid, auscultatory signs of, 53; physical signs and general symptoms of, 116; diastolic aortic, auscultatory signs of, 54; physical signs and gene- ral symptoms of, 114; diastolic mitral, auscultatory signs of, 55; physical signs and general symptoms of, 113; diastolic pulmonary, auscultatory signs of, 55; physical signs and general symptoms of, 115; diastolic tricuspid, auscultatory signs of, 56; physical signs and general symptoms of, 114; diagnosis of seat of, 101-3, and 117-18; diagnosis between recent and old-stand-
ing, 105; difficulties in the diagnosis of, 117-18; prognosis of, 118-19; treat- ment of disease connected with, 120- 25.
MURMURS, table exhibiting the seat and cause of the different, 51.
intensity of, not a reliable guide in diagnosis, 48.
exocardial or pericardial mechan- ism of, 56; character of, 56-7; diagno- sis between exocardial and endocardial murmurs, 58; and between peri- cardial and pleuritic friction sounds, 59-60.
- venous character of, 60-1; fre- quency of, 61; cause of, 62-3. MUSCULAR Contraction, sound of, under what circumstances heard during the action of the heart, 29, and 40.
NERVOUS influence, perversion of, its in- fluence on the action of the heart, 178; its probable influence in the causation of murmur, 101.
OBSTRUCTION or obliteration of the arch of the aorta, 232-5. EDEMA of lower extremities in connection with cardiac disease, see "Anasarca."
of the face, neck, and upper ex- tremities, in connection with thoracic aneurism, 194-5.
ESOPHAGUS, ulceration of, in connection with aneurism, 195, and 209. ORIFICES of the heart, chronic disease of, 110-25.
ORTHOPNOEA, in connection with hyper-
trophy of the heart, 131; in dilata- tion of the heart, 141.
PAIN in the back and chest caused by aneurism, character of, 209. PALPATION, indications derivable from it, 10-16.
PALPITATION, see "Aorta, functional pul- sation of."
PAPILLARY muscles, irregular action of, productive of endocardial murmur, 47.
PARACENTESIS thoracis in chronic peri-
PERCUSSION, Sound of, in region of heart, 18.
PERICARDIAL effusion, signs of, 71-5; diagnosis of, from hypertrophy and dilatation of the heart, 21. PERICARDITIS, chronic, paracentesis tho- racis in, 93.
acute, 64-94; constitutional origin of, 65-6; its frequent connection with acute rheumatism, 65-6; other diseases with which it is associated, 66; differences between rheumatic and non-rheumatic, 67; pathological effects of, 68-70; physical signs of, 71-5; general symptoms of, 76-82; prognosis of, 83-4; treatment of, 84-90; diagnosis of adhesions resulting from, 91-2.
POSTURE in hypertrophy of the heart, 131; in dilatation of the heart, 141; in aneurism of the arch of the aorta, 205; in ventral aneurism, 227; in con- traction of the pulmonary artery, 240. PRÆCORDIAL region, boundaries of, 2; form and position of, 2; how af- fected by respiration and by pos- ture, 2; percussion sound in, 18; causes which influence the percussion sound in, 18-24.
PRESSURE, effect of, on pericardial friction sound, 58; in, causing venous murmurs, 61-2. PULMONARY, artery, position of, in rela- tion to chest walls, 3; functional murmur in, 49; impulse produced on chest walls by, in certain cases of phthisis, 9.
inflammation of, 238; dilatation of, 238-9; aneurism of, 239-40; con- traction and obstruction of, 240.
murmur, systolic or obstructive, auscultatory signs of, 52; other physical signs and general symptoms of, 114; diastolic or regurgitant, aus- cultatory signs of, 55; other phy- sical signs and general symptoms of, 115.
PULSE, radial, in aortic obstruction, 113; ditto, regurgitation, 114-15; in mitral obstruction, 114; ditto, regurgitation, 115; in pulmonary obstruction, 114; ditto, regurgitation, 115-16; in tricuspid regurgitation, 116; in hypertrophy of the heart, 130; in dilatation of the heart, 140; in atrophy of the heart, 147; in softening of the heart, 153; in fatty heart, 153; in functional pal- pitation, 179; in aneurism of the arch, 210; infrequency of, produced by pulse- less systoles of the heart, 41, and 155.
PUPILS, state of, in thoracic aneurism, 195.
REDUPLICATION of sounds of the heart, 39-40.
RETICULATION of the valves, cause of, 111.
RHYTHM of the heart, 9-10; alterations in, 13; of sounds of heart, 24. RUPTURE of aortic aneurism, 216; of the heart, 157-61; of a chorda ten- dinea, 160-1; of a valve of the heart, 160-1.
SIGHING, a frequent symptom in dila- tation of the heart, 140; in softening of heart, 153; in fatty degeneration of heart, 153.
SOUNDS of heart, see "Heart, sounds of;" reduplication of, 39-40.
SPANÆMIA, provocative of cardiac and aneurismal thrill, 16; bearing of, on production of endocardial murmurs, 46-8.
SPUTA in thoracic aneurism, 204. STERNO-CLAVICULAR ligaments, section of, in thoracic aneurism, 223. SUBCLAVIAN artery, the left, its position in relation to the chest walls, 3.
which take place at different periods of the heart's action, 25.
the seat and cause of endocardial murmurs, 51.
the causes which assist in determin- ing the date at which valvular disease of the heart will prove fatal, 129-30.
the diagnostic differences between dilatation and hypertrophy of the heart, 142.
the thickness of the walls of a healthy heart, 127.
the admeasurement of a healthy heart, 138.
THRILL, arterial, 15-16; cardiac, 14-
15; valvular, 14; aneurismal, 198; venous, 16; pericardial friction, 74. THYROID gland, pulsation of, in connec- tion with disease of the heart, 132-3. TOPOGRAPHY, clinical, of the heart and great vessels, 1-4.
TRACHEOTOMY in thoracic aneurism, 222-3.
TRICUSPID murmur, systolic or obstruc- tive, auscultatory signs of, 53; physical signs and general symptoms of, 116; diastolic or regurgitant, auscultatory signs of, 56; physical signs and general symptoms of, 114.
TUBERCLE, connection of, with aneurism, 217.
TUMOURS, intrathoracic, diagnosis of, from aneurism, 208, and 215-16.
At page 24, line 5, for "contractile" read " conducting." At page 136, line 24, for " depressed" read "depraved."
J. E. ADLARD, PRINTER, BARTHOLOMEW CLOSE, E.C.
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