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Updated: June 9, 2025
The symptoms are those of loss of compensation as described under other valvular lesions. There may be jugular pulsation, especially evident in the external jugular on the left side. The liver enlarges and may pulsate. There are edemas, dropsies, ascites and perhaps hemorrhages. The heart is enlarged and there is a soft systolic blow heard at the lower end of the sternum.
In the median line, corresponding to the absence of sternum, was a longitudinal groove bounded on either side by a continuous hard ridge which articulated with the costal cartilages. The skin passed naturally over the chest from one side to another, but was raised at one part of the groove by a pulsatile swelling which occupied the position of the right auricle.
Arnold's marvellous nerve was breaking down. He clutched my hand fiercely; his eyes danced; his mind was weakening. Almost in a moment the flesh had been cut away to the bones, which were now exposed, two ribs and the sternum. A few quick cuts cleared the weapon between the guard and the ribs. "To work, Hippolyte be quick!" The machinist had evidently been coached before he came.
The ribs connect with the spinal column behind, and all but the two lowest ones connect with the sternum in front, and, by so doing, inclose the thoracic cavity. The ribs are so arranged that the volume of the thorax is increased by elevating them and diminished by depressing them, enabling the air to be forced into and out of the lungs.
Some acquire this faculty, while with others it is due to a natural resonance, formed, according to Dupont, in the space between the third and fourth ribs and their cartilaginous union and the middle of the first portion of the sternum. Examination of many of these cases proves that the vibration is greatest here. It is certain that ventriloquists have existed for many centuries.
The whole is secured to the head of the patient by a single chin-strap, and connection established with an ordinary galvanic battery by means of an appropriate clamp and insulated cord. The indifferent pole is applied over the sternum or other convenient point. Care should be taken not to employ too strong currents, as otherwise vertigo and other unpleasant symptoms may be produced.
The diameter of the body from front to back, taken from the sternum; this, with five centimeters added to it, gives the proper distance from the reading-desk to the back of the seat. The length of the femur, two-thirds of which represent the depth of the seat. Finally, the height of the epigastric cavity above the seat, augmented by a few centimeters, indicates the height of the reading-desk.
A distinctive murmur of this insufficiency would be diastolic and accentuated in the second intercostal space on the left of the sternum. It should be remembered that aortic murmurs are often more plainly heard at the left of the sternum. Sooner or later, if this lesion is actually present, the right ventricle dilates and cyanosis and dyspnea occur. Digitalis would therefore be indicated.
This span measure is called "chang'-an" or "i'-sa chang'-an," "chu'-wa chang'-an," etc. Chi-pa' is the measure between the tips of the two middle fingers when the arms are extended full length in opposite directions. Chi-wan' si chi-pa' is half the above measure, or from the tip of the middle finger of one hand, arm extended from side of body, to the sternum.
At this time they had diseased and atheromatous arteries, and Chang, who was quite intemperate, had marked spinal curvature, and shortly afterward became hemiplegic. They were both partially blind in their two anterior eyes, possibly from looking outward and obliquely. The point of junction was about the sterno-siphoid angle, a cartilaginous band extending from sternum to sternum.
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