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Updated: June 25, 2025
The right auricle alone now received the venous blood from the body, while the left auricle received the venous blood that flowed from the lungs and gills to the heart. Thus the double circulation of the higher vertebrates was evolved from the simple circulation of the true fishes, and, in accordance with the laws of correlation, this advance led to others in the structure of other organs.
The right ventricle, in its turn being overworked, becomes dilated, and as a result of the inability of the right ventricle to evacuate its contents perfectly, the right auricle is unable to force its venous blood into the right ventricle, and there is then a damming back and sluggish circulation in the superior and inferior venae cavae.
The heart, therefore, ceases to pulsate sooner than the auricles, so that the auricles have been said to outlive it, the left ventricle ceasing to pulsate first of all; then its auricle, next the right ventricle; and, finally, all the other parts being at rest and dead, as Galen long since observed, the right auricle still continues to beat; life, therefore, appears to linger longest in the right auricle.
The stimulus must regularly begin in the auricle, must be perfectly transmitted through the bundle of His to the ventricles, the ventricles must normally contract with the normal and regular force, the valves must close normally and at the proper time, the blood pressure in the aorta must be normally constant to insure the perfect transmission of the blood to the peripheral arteries and to insure the normal circulation through the coronary arteries, and the arterioles must be normally elastic.
Various explanations of the heart pang have been suggested, such as a spasm or cramp of the heart muscle, sudden interference with the heart's action, as adherent pericarditis, a sudden dilatation of the heart, an interference with the usual stimuli from auricle to ventricle and therefore a very irregular contraction, a sudden obstruction to the blood flow through a coronary artery, or a sudden spasm from irritation associated with some of the intercostal or more external chest muscles causing besides the pang a sense of constriction.
Next in frequency to mitral insufficiency is aortic insufficiency, which occurs most frequently in men. The cavity of the heart that is most affected by this lesion is the left ventricle, which receives blood both from the left auricle, and regurgitantly from the aorta.
Name the divisions of the lungs. Trace air from the outside atmosphere into the alveoli. Trace the blood from the right ventricle to the alveoli and back again to the left auricle. How are the air passages kept clean and open? Describe the pleura. Into what divisions does it separate the thoracic cavity? Describe and name uses of the diaphragm.
And now returning to my immediate subject, I go on with what yet remains for demonstration, viz., that in the more perfect and warmer adult animals, and man, the blood passes from the right ventricle of the heart by the pulmonary artery, into the lungs, and thence by the pulmonary veins into the left auricle, and from there into the left ventricle of the heart.
The signs of lack of compensation are generally cardiac distress, rapid heart, insufficiency of the systolic force of the left ventricle, and therefore impaired peripheral circulation, a sluggish return circulation, pendent edemas, and soon, with the left auricle finding the left ventricle. insufficiently emptied, the damming back of the blood is in broken compensation with the mitral lesions.
One mode of treatment recommended by French surgeons consists in introducing the pipe of a catheter through the wound, if in the right jugular vein or if not, through an opening made for the purpose in that vein and the withdrawal of the air from the right auricle of the heart by suction. "Doctor Kline favored this treatment, but I knew that it would be fatal.
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