Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell.

Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    outer end of the clavicle, so the auscultation of these regions ought never to be neglected. When the crepitations are abundant and present during both inspiration and expira- tion, the type of the breathing maj^ be quite obscured, and when this is so it ought to be mentioned. In the more advanced stages, when the changes in the lung and pleura are of a very varied kind, the physical signs vary greatly. There are marked diminution in expansion, considerable flattening, and dulness on percussion, or if a large cavity be present at the apex, the cracked-pot sound may be elicited. Yocal fremitus is usually increased. The breath sounds are bronchial, cavernous, or amphoric. The accompaniments are coarse crepitations, often gurgling. Fig. 63.—Showing phthisis at various stages in one lung, the physical signs depending on the stage. metallic, or tinkling in character, and along with this often wheezing and squeaking sounds which belong to the type of rhonchi. The vocal resonance is bronchojjhonic, pectori- loquous, or amphoric.