A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism / by Austin Flint.

  • Flint, Austin, 1812-1886.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A manual of auscultation and percussion : embracing the physical diagnosis of diseases of the lungs and heart, and of thoracic aneurism / by Austin Flint. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    278/292 (page 272)
    tumor occupies. If the tumor be of considerable size, it may produce condensation of lung around it; the area of dulness on percussion will be in this way extended beyond the limits of the tumor. Under these circumstances, bronchial respiration and bron- chophony may be produced. If the aneurismal sac be beneath the integument, there may be to the touch a sense of fluctuation. With the foregoing signs, the physical diagnosis scarcely admits of doubt. Some of the signs may be produced by a tumor, not aneurismal, so situated as to receive and conduct the aortic impulse. The chances of a tumor being so situated as to simulate the signs of an aneurism are few. I have met with a case of empyema in which perforation of the chest took place in the second intercostal space on the right side of the sternum, giving rise in this situation to a fluctuating tumor which had a strong pulsation. On a superficial examination the case seemed clearly one of aneurism; but an examination of the chest showed the right pleural cavity to be filled with liquid, and a puncture in the axillary region gave exit to a large quantity of pus, the pulsating tumor disappearing after a certain quantity of the purulent liquid had escaped. I have met with a similar pul- sating tumor, incident to empyema, on the posterior aspect of the chest. When, from its small size or its situation, an aneurismal tumor does not come into contact with the thoracic wall, and when it is situated beneath the sternum, signs obtained by palpation and inspec- tion being absent, the physical diagnosis is less easy. Important signs are, dulness within a circumscribed