A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ... ; translated from the latest French edition, with copious notes and a sketch of the author's life, by John Forbes ... ; from the fourth London edition, considerably enlarged and improved, with many additional notes and an extensive bibliography of the different diseases ; with plates.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ... ; translated from the latest French edition, with copious notes and a sketch of the author's life, by John Forbes ... ; from the fourth London edition, considerably enlarged and improved, with many additional notes and an extensive bibliography of the different diseases ; with plates. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    also to the completeness of the phenomenon : it is most distinct when this is somewhat considerable : it is however often com- plete when the cavity is very small. On the other hand, pecto- riloquy is sometimes very indistinct where the excavations are very large, the size of the fist, for instance, and when they com- municate with the bronchi by small openings.* It has several times been manifest to me, that when the number of fistulous openings, by which a very large excavation communicates with the bronchia, increases, pectoriloquy becomes less evident, or ceases altogether. It disappears also in the two following cases: viz. when an excavation opens into the pleura, particularly if the opening is large and direct; and when its contents make their way through the walls of the chest into the cellular membrane outside. Pectoriloquy may likewise be sometimes suspended for several hours, and even days, by the temporary obstruction of the communication of the cavity with the bronchi, by the matter contained in it. We shall hereafter point out the method of obtaining pectoriloquy, or other equivalent signs, in cases of this kind.f JEgophomy. The phenomenon to which I have applied this name, is, of all those furnished by auscultation, that which seems to me most complex in its causes. It may readily be con- founded, by the inexperienced, with pectoriloquy ; and still more so with bronchophony. I was myself long guilty of this mis- take ; and although the distinction is easy when the respective characters of each are strongly marked, there occur cases in which this is hardly practicable. My uncertainty as to the na- ture of asgophony was of longer duration, because it does not exist in every case of pleurisy ; because the analogous phenome- non of bronchophony is still more frequently wanting in perip- neumony; because these two diseases and consequently the two phenomena in question are frequently combined ; and, finally, because the number of fatal cases of these diseases, more parti- cularly of acute pleurisy, is too inconsiderable to afford many op- portunities of verifying, by examination after death, the accuracy of the diagnosis derived from ausculation.J Simple aegophony consists in a peculiar sound of the voice which accompanies or follows the articulation of words ; it seems * This fact may be explained on the principles of acoustics, and by a reference to certain musical instruments.—Author. f Pectoriloquy may be observed on any part of the thorax, as morbid excavations may occur in any part of the lungs ; but as these excavations are most commonly produced by the evacuation of the matter of tubercles, and as tubercles are princi- pally developed in the upper lobes, it is below the clavicles and in the axilla that we ought to expect to meet with it most frequently.—(M. L.) I This assertion may seem strange to the practitioners who employ only bleeding and blisters in those diseases, but will be confirmed by the young physicians and students who have attended my Clinique since I have been in the habit of using Tartar Emetic in large doses.—Author.