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Clinical features of heart disease
Book CLINIC!AL
&ATURES
OF
HEART
Review I)ISEAS:E.---BY
Ileroy
Crummer,
M.D.,
Professor of Medicine, University of Nebraska. Pp. 353. Paul B. Hoeber, Inc., New York. The author of this volume, like many others, found in the examination of candidates for the army a unique opportunity to increase his knowledge of heart conditions and to observe \vith accuracy many slight deviations from the normal. The subject, matter of the book is based on “Circular 21” which was issued by the War I>epartment for the instruction of medical officers in examining the heart and blood vessels of army recruits. This necrssarilv limits the scope of the book and, as might be expected, the clinical features of all types of heart diseases are by no means covered. Gut the book presents in admirably clear and concise form the clinical alltl diagnostic features of the more important types of cardiac disease. Careful history taking and the accurate observation of l)hysical signs are stressed in a may that is refreshing in these days when so often x-ray plates, polygrams and elect,rocardiograms seem to have absorbed the interest of many practitioners to the exclusion of the less spectacular but more important methods of physical examination. Doctor Crummer presents a number of unusual observations and offers suggestions for their interpretation which do not always conHis origina. views need not perhaps alform to accepted opinions. ways be accepted as entirely so~md, but they are evidently advanced only after painstaking observations and with a sincerity which must challenge the respectful consideration of the reader. The antagonism which some of his statements arouse is st,imulat,ing and in this is to be found one of the .chief virtues of the book. Examples of his unusual points of view may be found in his discussion of the “first sound right” and the “first sound left” (chapter LV) and in his “block” method for the Rchllinistration of digitalis to fibrillators (pp. 121, 259, 261). More than once he takes a fling at dogmatism; even Osler and Mackenzie do not escape (p. 46). One who does this has all the greater need for caution as to his own statements; for example in heart (1). 39), when one finds a tumor of the chest pulsating rhythm, is a diagnosis of aneurysm “ permanent,ly established ” until (Or (p. 62) is a diastolic a localized empyema has been excluded1 decrescendo murmur heard in second right, interspace invariably diagnostic of aortic insufficiency f Evidently the a,uthor is an expert not only in the study of physical signs but also in the psychology of the patient. Internal evidence indicates that he has taken care of many patients outside institutional walls, from whom he has learned much that the purely hospital and laboratory man has had little opportunity to acquire. His book has many helpful hints and suggestions as to the best methods of handling patients who have or think they have defective hearts. 'I'. S. H. 2%
&ATURES
OF
HEART
Review I)ISEAS:E.---BY
Ileroy
Crummer,
M.D.,
Professor of Medicine, University of Nebraska. Pp. 353. Paul B. Hoeber, Inc., New York. The author of this volume, like many others, found in the examination of candidates for the army a unique opportunity to increase his knowledge of heart conditions and to observe \vith accuracy many slight deviations from the normal. The subject, matter of the book is based on “Circular 21” which was issued by the War I>epartment for the instruction of medical officers in examining the heart and blood vessels of army recruits. This necrssarilv limits the scope of the book and, as might be expected, the clinical features of all types of heart diseases are by no means covered. Gut the book presents in admirably clear and concise form the clinical alltl diagnostic features of the more important types of cardiac disease. Careful history taking and the accurate observation of l)hysical signs are stressed in a may that is refreshing in these days when so often x-ray plates, polygrams and elect,rocardiograms seem to have absorbed the interest of many practitioners to the exclusion of the less spectacular but more important methods of physical examination. Doctor Crummer presents a number of unusual observations and offers suggestions for their interpretation which do not always conHis origina. views need not perhaps alform to accepted opinions. ways be accepted as entirely so~md, but they are evidently advanced only after painstaking observations and with a sincerity which must challenge the respectful consideration of the reader. The antagonism which some of his statements arouse is st,imulat,ing and in this is to be found one of the .chief virtues of the book. Examples of his unusual points of view may be found in his discussion of the “first sound right” and the “first sound left” (chapter LV) and in his “block” method for the Rchllinistration of digitalis to fibrillators (pp. 121, 259, 261). More than once he takes a fling at dogmatism; even Osler and Mackenzie do not escape (p. 46). One who does this has all the greater need for caution as to his own statements; for example in heart (1). 39), when one finds a tumor of the chest pulsating rhythm, is a diagnosis of aneurysm “ permanent,ly established ” until (Or (p. 62) is a diastolic a localized empyema has been excluded1 decrescendo murmur heard in second right, interspace invariably diagnostic of aortic insufficiency f Evidently the a,uthor is an expert not only in the study of physical signs but also in the psychology of the patient. Internal evidence indicates that he has taken care of many patients outside institutional walls, from whom he has learned much that the purely hospital and laboratory man has had little opportunity to acquire. His book has many helpful hints and suggestions as to the best methods of handling patients who have or think they have defective hearts. 'I'. S. H. 2%