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Such cases must be watched before one can say that true valvular insufficiency is not present.

An examination at this stage may reveal valvular insufficiency, cardiac hypertrophy, or pulmonary engorgement.

In valvular disease or valvular insufficiency hypertrophy frequently results as a consequence of increased demand for propelling power.

In valvular insufficiency, which is caused by deposits upon the valves of the heart, the symptoms of which are principally difficulty of respiration, not much pain, but a feeling of uneasiness in the heart region, and a peculiar sound termed "the murmer," to be detected by the stethoscope, the use of the "Cascade" will sometimes effect wonders.