A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1827
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    71/782 (page 37)
    BRONCHOPHONISM. 3/ Tenders them very unfit for its production ; while tlie smallness of their caliber must render whatever soinid is produced more acute and weaker in them than in the larger trunks. But if any one of these adverse cond't'ons is removed, and yet more, if several of them are so at the same time, the sound of the voice may become perceptible in the smaller bronchial tubes. Accordingly it is found that an attack of peripneumony, an extensive hemoptysical induration, or the accumulation of a great number of tubercles in the same point, by condensing the texture of the lungs, give occasion to a sound analogous to pectoriloquism. Tliis phenomenon, which I denominate accidental hronchophonism^ is, as might be expected, most marked when the pulmonary induration has place near the roots of the lungs. This sign is one of those which serve best to measure the progress of a recent peripneumony. The dilatation of the bronchia gives rise to the same pheno- menon, and the more readily, 'because the susbstance of the lungs in the neighbourhood of tlie dilated branches, is often Jiaore compact than in the natural state. Sometimes two of the causes mentioned conspire to produce it, for instance, the cause just mentioned, and the accumulation of tubercles. Bronchophonism is rarely so like pectoriloquism as to de- ceive a person even of moderate expeiience. In the former, the voice rarely traverses the cylinder; its tone is somewhat iike that of a speaking trumpet 5 and the sound is more dif- fused in its seat than pectoriloquism. Where any doubt ex- ists, this is removed by the cough and the character of the res- piration in the same point: neither of these have the cavern- ous eharacter : we feel assured that the v,'hole phenomena have for their site a series of extensive tubes, and not a circum- scribed space. Pectoriloquism, This phenomenon may be produced under very different circumstances : 1. by the softening of tubercles (by far the most common cause); 2. by the decomposition of a gangrenous eschar; 3. by an abscess, the consequence of peripneumony; 4. by the evacuation of a cyst into the bron- chia ; and probably also by a fistulous communication between the bronchia and an abscess of the mediastinum. Pectoriloquism offers great varieties, in respect of intensity and completeness. I divide it into i^erfccty imiicrfect, or doubtful.