Clinical pocket-book : an aid to the study of clinical medicine for the use of students of the Manchester Royal Infirmary.

  • Manchester Royal Infirmary
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Clinical pocket-book : an aid to the study of clinical medicine for the use of students of the Manchester Royal Infirmary. Source: Wellcome Collection.

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    Next ascertain if there be any adventitious sounds (rales, or friction sounds). The most common of these are:—Sibilant and sonorous rales (in bronchitis); crepitant rales or crepitation^ dry or moist (in tubercular softening) ; large crepi- tant and liquid or mucous rales (in bronchitis and phthisis); fine crepitation (in pneumonia, capillary bronchitis, and pulmonary oedema); gurgling rMes (in vomicae containing fluid); friction sounds (in pleurisy). Eales and friction sounds are made more audible by causing the patient to breathe deeply or to cough ; sometimes these sounds are audible only on deep inspiration. Vocal resonance follows the same rules as vocal fremitus—i.e. it is intensified in consolidation of the lung, and diminished or abolished in pleuritic effusion or intra-thoracic tumour. If there be sus¬ picion of vomica, the existence of whispering pec¬ toriloquy should be tested. Symptoms.—Enquire respecting the actual or past existence of the following symptoms: -Short¬ ness of breath, either in rest or exercise, continuous or paroxysmal; cough and expectoration, character of expectoration ; hcemoptysis, its quantity and recur¬ rence ; pains about the chest, their character and recurrence. c
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