In disease, the pulse may become slower or more rapid than in health. Slowing of the pulse may be caused by old age, great exhaustion, or excessive cold. It may be due to depression of the central nervous system, as in dumminess, or be the result of the administration of drugs, such as digitalis or strophantus. A rapid pulse is almost always found in fever, and the more severe the infection and the weaker the heart the more rapid is the pulse. Under these conditions, the beats may rise to 80, 90, or even 120 per minute. When the pulse is above 100 per minute the outlook for recovery is not promising, and especially if this symptom accompanies high temperature or occurs late in an infectious disease. In nearly all of the diseases of the heart and in anemia the pulse becomes rapid. The pulse is irregular in diseases of the heart, and especially where the valves are affected. The irregularity may consist in varying intervals between the beats or the dropping of one or more beats at regular or irregular intervals. The latter condition sometimes occurs in chronic diseases of the brain. The pulse is said to be weak, or soft, when the beats are indistinct, because little blood is forced through the artery by each contraction of the heart. This condition occurs when there is a constriction of the vessels leading from the heart and it occurs in certain infectious and febrile diseases, and is an indication of heart weakness. In examining the heart itself it is necessary to recall that it lies in the anterior portion of the chest slightly to the left of the median line and that it extends from the third to the sixth rib. It extends almost to the breastbone, and a little more than half of the distance between the breastbone and the backbone. In contracting, it rotates slightly on its axis, so that the point of the heart, which lies below, is pressed against the left chest wall at a place immediately above the point of the elbow. The heart has in it four chambers--two in the left and two in the right side. The upper chamber of the left side (left auricle) receives the blood as it comes from the lungs, passes it to the lower chamber of the left side (left ventricle), and from here it is sent with great force (for this chamber has very strong, thick walls) through the aorta and its branches (the arteries) to all parts of the body. The blood returns through the veins to the upper chamber of the right side (right auricle), passes then to the lower chamber of the right side (right ventricle), and from this chamber is forced into the lungs to be oxidized. The openings between the chambers of each side and into the aorta are guarded by valves.