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June 7, 1924


JAMA. 1924;82(23):1882. doi:10.1001/jama.1924.02650490056031

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To the Editor:  —Muscle murmurs seem to present to the student some little difficulty in differentiation. They are confused with fine râles, not infrequently, while one student stated that what he heard as muscle murmur he had been accustomed to regard as "cog-wheel" respiration. Other students have told me that the murmur often so dominated the field that they were unable to determine the character of the sounds that they were hearing. This whole confused subject may be cleared up by the simple means of instructing the student to auscultate over other than chest muscles. Listening over the deltoid or the biceps will give a pure muscle murmur, when the arm is flexed against resistance, or, in the case of the deltoid, raised, against resistance.

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