Diseases of the Heart; Their Diagnosis and Treatment
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Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER VIII. ADDENDUM. The Heart Eeflex. Three years ago attention was directed to an heretofore undescribed clinical phenomenon which I called the heart reflex. It is practically a myocar- dial contraction consequent on irritation of the skin of the precordia by vigorous rubbing with the finger or better still by a spray of ether and is manifest by the Roentgen rays and the fluoro- scope. It can be most easily provoked in children. The contraction of the myocardium is of sudden and momentary duration and, like other reflex acts, soon becomes exhausted. My assistant, Dr. Louis Gross, and myself saw both ventricles recede fully 1 inches on either side after directing a spray of ether on the precordia in an emaciated girl of 14 years. Of course the anatomic heart in the adult measures only 3 inches in breadth, but we are here concerned with the physiologic heart. To properly appreciate the phenomenon of the heart reflex for therapeutic and diagnostic purposes, attention must be directed to the lung reflex. If the skin of the thorax is irritated, arti- New York Medical Journal, Jan. 13, 1900. ficial lung dilatation ensues. The degree of dilatation varies with the severity and extent of cutaneous irritation. Vigorous rubbing of the skin of the precordia is sufficient to obliterate the area of superficial cardiac dullness, if irritation is made over the lower lung border, percussion will show in the axillary line a descent of the lower lung border fully 6 cm., a degree of dislocation even exceeding that obtained by forced inspiration. Aside from its percussional recognition, the appearance of the reflex by means of the Eoentgen rays is distinctive. Coincident with the discharge of the reflex, the lung area implicated shows increased brightness lasting from a few se...
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