PREFACE. 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 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. . Cases of disease of the heart Absence of aneurism in cases observed Tabular Arrangement of 51 Cases presenting Subclavian Murmur Subclavian murmur rare in females Relative frequency in certain diseases Murmur observed mostly in connexion with manual labour re- quiring exercise of arms Its origin arterial Proofs in support of this theory Dr. Thorburn's theory-respiratory sound modified by the heart Subclavian murmur an arterial sound modified by respiration Cause of vibration external to artery Explanation given by Drs. Kirkes and Sibson Diagnosis of Subclavian Murmur, Differential and Absolute Murmur may be confounded with four physical signs of disease Diagnosis from aneurism of the arch of the aorta, of the innominate Absolute diagnosis of subclavian murmur Relationship of Subclavian to common Anamic Murmur Subclavian murmur may coexist with anæmia and be intensified by Generally unaccompanied by murmur in other parts of arterial Bearings of Subclavian Murmur on Practice |