In the fourth edition of this outstanding resource emphasis is placed on the physical examination, rather than physical diagnosis. The author s objective is to describe the physical signs and how they are elicited.

Sophisticated laboratory methods provide contemporary physicians with unprecedented diagnostic information, but in so doing, risk de-emphasizing the physical examination upon which previous generations were much more dependent and therefore much more adept. No organ system lends itself better to a close association between signs, structure and function than the heart and circulation.

The purpose of the book is to provide the reader with the results of the author s extensive experience in employing ordinary bedside methods that beautifully supplement the remarkable laboratory techniques that have done so much to reveal the meanings and increase the diagnostic value of cardiovascular physical signs. The cardiovascular physical examination is dealt with from birth to senescence, and includes physical appearance, the arterial pulse, the jugular venous pulse, the peripheral veins, percussion, palpation and observation of the precordium, cardiac auscultation, the thorax, lungs and abdomen.

This basic text liberally draws from these early descriptions which not only excite admiration for our predecessors, but also serve to make the book richer by bringing the reader closer to a distinguished past. All chapters have been substantially revised. Old figures have been digitized to look like new, especially the irreplaceable phonocardiograms.