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PREFACE.

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In the Asclepiad it is my intention to bring out in occasional volumes, after the manner of the volume now presented, a series of essays on subjects relating to medical science in its various departments. I cannot promise in this series any distinct regularity of publication, inasmuch as time, labour, and thought are not altogether at my disposal; but I hope that the volumes will, on an average, be issued half-yearly, or, at least, annually.

While it will be my object in this series always to consult, as far as in me lies, the requirements of practical medicine, I shall endeavour to weave into the subjects discussed such matters bearing on the current theories of medicine as shall tend to open the way to new and more comprehensive views, and to a sounder and more rational practice.

I wish it to be understood that if, in progress of time, any expression or opinion which may be

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advanced should prove on reasonable evidence to be incorrect, I shall not fail to make the correction. Nor shall I fear the charge that one volume is not strictly in accord with its predecessor; for, as Emerson aptly remarks, “ unyielding consistency is the hobgoblin of weak minds ;” and, as in medicine many things are still very obscure, and all things admit of being re-learned and re-taught by the light of advancing knowledge, so it is not for the student to dogmatise and to refuse to re-construct because he has previously constructed.

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CONTENTS.

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Introductory Note
Observed Facts and Analyses
Illustrative case.

Murmur observed in 51 cases out of 2000

Preponderance in males

Diseases in which the murmur was heard

Cases of bronchitis

Cases of phthisis

Case of mixed bronchial disease and phthisis

Cases of anæmia

Cases of dyspepsia

Cases of disease of the heart

Absence of aneurism in cases observed
Tabular Arrangement of 51 Cases presenting Subclavian Murmur
Laws regulating occurrence of subclavian murmur
Absence of subclavian murmur in children
Subclavian murmur rare in females
Relative frequency in certain diseases
Murmur observed mostly in connexion with manual labour re-

quiring exercise of arms

Cause and Causation of Subclavian Murmur

Its origin arterial

Dr. Thorburn's theory-respiratory sound modified by the heart

and large vessels .

Subclavian murmur an arterial sound modified by respiration
Proofs in support of this theory .
Cause of vibration external to artery
Explanation given by Drs. Kirkes and Sibson.

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