The spirometer, the stethoscope, & scale-balance : their use in discriminating diseases of the chest, and their value in life offices; with remarks on the selection of lives for life assurance companies / by John Hutchinson.
- Date:
- 1852
Licence: Public Domain Mark
Credit: The spirometer, the stethoscope, & scale-balance : their use in discriminating diseases of the chest, and their value in life offices; with remarks on the selection of lives for life assurance companies / by John Hutchinson. 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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![yet be healthy? From our experience we place this limit at 16 per cent, below the mean. A difference of only 5 or 10 cubic inches relative to the first column is of no consequence; but, if instead of breathing 230 cubic inches, 193 cubic inches be exhaled, then the case must be carefully examined, for some preternatural cause must exist to produce this efiect. Knowing the mean and minimum of the healthy volume of air, we can detennine the amount of disease in the lungs by the degree of difference from this. ] 3. As the volume of expired air is relative to the measurement of the walls of the chest, we may, in the absence of the Spirometer, roughly measure tliis mobihty by the common tape measure; thus, we may pass the tape measure round the chest (standing in front of the patient) over the nipples, and then request the patient to inspire deeply, and note the number of inches on the measure, this the maxinaimi circumference; then without moving the tape, we should reqiiest him to expire to his utmost, here again noting the minimum circumference, and the diflFerence will be the mobility of the chest; for instance, if the maximum circumference be 36 inches and the minimum 33 inches, the difference is 3 inches, and 3 inches is the mobility of the chest. 14. Without the tape measure, the hand can become so educated in measuring the chest mobility, that tolerably accurate information can be obtained by it alone, if the patient breathes his proper quan- tity, or if his lungs are healthy. To do this, we should stand behind tlae patient and gi-asp the top of the shoiJder, the thumbs resting upon the supra-spinous fossa of the scapulae and tl>e fingers extending in front down over the clavicle: in this way we command a good grip of the apex of the chest; if healthy, the apex in inspiration will swell up under our hands, and a little practice soon teaches us tlie healthy expansion, for if the lungs expand at the apex they are healthy everywhere else. The mobihty of the chest is sometimes non- symmetrical in its movements; the hands in the same position as just mentioned likewise detect this. An instrument termed Stethometer has been constructed by Dr. Kichabd Quain for expressing the non-symmetrical movement in figures. It is a small instmment, not larger than a watch, with a graduated dial and points. It is](https://iiif.wellcomecollection.org/image/b21977033_0009.jp2/full/800%2C/0/default.jpg)
