The American journal of the medical sciences (1827)
[Thorofare, N.J., etc.] Charles B. Slack [etc.] · leaf 81
to be sustained, and life is to go on, there must, in some cases, be such resistance in the auricle that no reflux of any moment into it can take place, however incompetent the valves may be. We need not, perhaps, therefore concern ourselves either with the diagnosis or prognosis of mitral… … a. first stage, at and near the apex, will be heard a double murmur, presys- tolic and systolic, the former vibratory or rumbling, and leading up to a
Medicine
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