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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    case of the former, as might be expected from the comparatively- small bronchial secretion in pleurisy. Some physicians have lately fancied that they have met with eegophony in cases of simple peripneumony without any pleuritic effusion ; but I have no doubt they mistook bronchophony for it. It must be admitted that the two phenomena are likely to be confounded ; I shall, therefore, in this place, compare them with each other, as well as with pectoriloquy. 1. Pectoriloquy being, in the great majority of cases, owing to the presence of tubercu- lous excavations, is almost always met with in the upper lobes. In whatsoever part, however it may exist, it will always be readily distinguished by the accompanying cavernous rhonchus, respiration and cough. In certain rare instances, namely, where the excavation is of a flattened shape with rather solid walls, pectoriloquy may assume something of the vibratory character of ccgophony; but it will almost always be distinguished from it, by the exact circumscription of the sound to a small space, by its situation, and by the consideration of the accompanying pheno- mena. 2. Bronchophony being caused by the simple induration of the substance of the lungs, does not yield the clear transmis- sion of the voice through the tube, except at the roots of the lungs. The sphere of this phenomenon is always over a certain extent, and no one small point can be said to be its exclusive site. The same is true of the respiration and cough; the former is frequently found to be bronchial, and the latter to give the mucous rhonchus, but they are diffused over a certain space, and not, like those which are observed in cases of pectoriloquy, con- fined within a circumscribed spot. Bronchphony is less readily suspended than pectoriloquy, but more frequently than segophony, for obvious reasons depending on the relative condition of the bronchial secretion in the diseases in which each especially occurs. Finally, the tone or key of the speaking trumpet completes the list of the distinctive characters of bronchophony. 3. True and simple cegophony is characterised by the harsh tremulous silvery tones of the voice, which is commonly more acute than the na- tural voice of the patient, and seems to be quite superficial, and to float, as it were, on the surface of the lungs, instead of coming from the interior, like pectoriloquy and bronchophony. It geems, moreover, to be rather the echo of the voice, repeating the words or their final syllables, in a small sharp and tremulous key, than the voice itself. This character of segophony is especially marked when it exists in the anterior and lateral* parts of the chest; since between the scapulae and at their lower edge (to which situation, by the way, it is most commonly restricted) it is almost always conjoined with the natural bronchophony, ren- dered stronger by the compression of the lungs in that part. And it is here, in the space between the inner edge of the scapula and the spine, and in this part only, that we occasionally 12 '