The curability of consumption : being the reprint of a series of papers, presenting the most prominent and important practical points in the diagnosis, prognosis, and treatment of the disease / by Francis H. Ramadge.

  • Ramadge, Francis Hopkins, 1793-1867.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: The curability of consumption : being the reprint of a series of papers, presenting the most prominent and important practical points in the diagnosis, prognosis, and treatment of the disease / by Francis H. Ramadge. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    cation of the ear troublesome to the patient, I have known the con- trary the case, and the manner in which the stethoscope is used by many physicians bitterly complained of. There are likewise, when the patient is confined to his bed, many positions which force even the most skilful to press strongly on the instrument, to keep it in its place. For instance, when the bed is close to the wall, and it is necessary to examine the region of the chest opposite the side on which the physician stands, it becomes difficult to fix the instru- ment ; he is himself unsteady from having to bend so far forward, and sometimes lie is obliged to give up the attempt as an impos- sibility. Now, in those cases, there is no difficulty in immediate auscultation. As to the objection raised to the use of the naked ear, on account of the uncleanliness or perspiration of the patient, these in- conveniences are easily avoided by placing a handkerchief or napkin over the part. As one's ear is always more ready than a stetho- scope, the generality of medical men will be inclined to use the one oftener than the other. I may lay it down from my own experience, backed by that of most other observers, that immediate auscultation furnishes as clear and precise data as mediate, and that the latter becomes necessary in a very limited number of instances only. For example, it becomes indispensable, when we wish to auscult the lungs, in some cases of vicious conformation of the thoracic parietes, which prevent the close application of the ear, to render pectoriloquy more evident. With this exception, immediate auscultation has every advantage over the other method, and deserves the preference, since it is highly important to simplify the means of auscultation as far as possible ; and by proving to practitioners that its employment is independent of an instrument which they cannot always have about them, we make auscultation popular, and extend its practice. I have observed that the application of the ear to the eminences which project close to the depressed part requiring examination, answers quite as well as the application of the instrument over the part itself. The very projection serves as a conductor of the sound. Incipient Consumption.—There are few cases in which incipient consumption may not be detected, if the chest be carefully and ju- diciously examined. In the commencement, there will be found- slight absence of the respiratory murmur over the superior parts of either side of the chest; existence of a mucous rale in one or more points; sound of expiration increased in the neighbourhood; and ii the disease be slightly interrupted by natural causes, as by the inter- vention of bronchitis, or by change of residence producing in-