In the examination of men in the army for cardiovascular diseases, one is continually impressed with the frequent occurrence of certain adventitious sounds and murmurs of the heart in men of apparently robust physique. The problem of determining whether certain sounds or murmurs other than the conventional "lub-dupp" of the heartsounds should be considered significant of heart disease or as merely accidental phenomena belonging to normal hearts is often perplexing. It is a much more simple task for most of us to classify properly a mixed group of organic cardiac lesions, probably because physical diagnosis is taught in medical schools largely from the study of pathologic conditions, and also because it is seldom possible to study normal hearts in large enough numbers to allow us to clarify our ideas as to which deviations from the usual should be considered normal and which pathological.
It is often advised that the diagnosis
KING JT. AUSCULTATORY PHENOMENA OF THE HEART IN NORMAL MEN AND IN SOLDIERS WITH IRRITABLE HEART. Arch Intern Med (Chic). 1919;24(1):89–97. doi:10.1001/archinte.1919.00090240092007
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