Clinical essays.

  • Richardson, Benjamin Ward, 1828-1896.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Clinical essays. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    CLINICAL ESSAYS. sound, expresses what is, I believe, a general feeling. 1 shall endeavour in the succeeding observations to clear up the obscurities of the phenomenon, and to exhibit it in its true and simple light. The import- ance of the labour, in a diagnostic sense, I cannot better explain than by stating the fact that, within the last three years, four cases have been referred to me as cases of aneurism in the thorax, which have proved on further examination to be nothing more than well marked examples of subclavian murmur; cases, as we shall hereafter see, very innocent in their nature when compared with aneurismal disease. I will follow out the description of subclavian murmur from its history, as it is written in the natural facts. OBSERVED FACTS AND ANALYSES, In 1856, a young man came before me at the Royal Infirmary for Diseases of the Chest, complaining of great lassitude, thirst, flatulency, depression of spirits, and palpitation of the heart. He was a tall, thin, anaemic man, by trade a cabinet-maker, and evidently of an irritable and what is popularly called nervous temperament. On examining his chest, I was sur- prised to hear under each clavicle a sharp loud mur- mur, synchronous with the systole of the heart, and resembling closely an aneurismal hruit. Tracing the murmur downwards towards the heart, I found it becoming reduced; whilst over the heart it was ab- sent altogether. Each cardiac sound was clear, well defined, and natural. I followed out the courses of