A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ... ; translated from the latest French edition, with copious notes and a sketch of the author's life, by John Forbes ... ; from the fourth London edition, considerably enlarged and improved, with many additional notes and an extensive bibliography of the different diseases ; with plates.

Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826. De l'auscultation médiate. English

Date:: 1835

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ... ; translated from the latest French edition, with copious notes and a sketch of the author's life, by John Forbes ... ; from the fourth London edition, considerably enlarged and improved, with many additional notes and an extensive bibliography of the different diseases ; with plates. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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from that of adults in other respects besides its intensity. It is impossible to describe this peculiarity, but it will easily be under- stood by comparative trials. It appears as if, in children, we could distinctly hear the dilatation of all the air-cells to their full extent; whilst, in adults, these seem as if, from their stiff- ness, they could only bear a partial dilatation. This difference of sound is much less marked in expiration than inspiration. The dilatation of the chest in inspiration is also greater in the child; and both these peculiarities are more remarkable as the child is younger; they continue, in a greater or less degree, to the period of puberty or a little beyond it. The sound produced by respiration varies, also, very much in its intensity in different adults. In some men it is scarcely per- ceptihle unless they make a very deep inspiration, and even then, although sufficiently distinct, it is not one-half so audible as in the majority of persons. These individuals have generally a rather slow respiration, and are little subject to dyspnoea, or breathlessness, from any cause. Others, however, have the re- spiration very distinct even during a common inspiration, without being, on this account, at all more subject to shortness of breath than the former. Some few individuals, again, preserve through life a state of respiration resembling that of children, and which I shall therefore denominate jjuerile, in whatever age it may be perceptible. Such persons are almost all women, or men of a nervous temperament, and they preserve, in some other respects, the character of childhood. Some of these cannot be said to have any actual disease of the lungs, but they soon get out of breath, even though lean, by exercise, and are very liable to catch cold. Others of this class are affected with a chronic ca- tarrh, attended by dyspnoea, a condition constituting one of those cases to which the name of Asthma is usually given. With these exceptions, an adult cannot, by any effort, give to his respiration the sonorous character it has in childhood ; but in some morbid states, the respiration spontaneously acquires it, without being, at the time, performed more forcibly than usual. This is parti- cularly the case when one whole lung, or a considerable portion of both lungs, is rendered impermeable to air through disease, especially acute disease. In the sound portion of the lungs, in these cases, the respiration is perfectly similar to that of children. The same thing is observable throughout the whole extent of the lungs in some cases of fever, and in certain nervous diseases: [and also in cases in which tubercles are disseminated throughout lungs otherwise healthy; and in the earlier stages of diseases of the heart.]* At first we are tempted to believe that the superior intensity * The clause between brackets is supplied from a note of Dr. M. Laennec. Dr. Williams says, he has remarked the sound of respiration to be more distinct after meals.—(Rational Exp. p. 2B.)—Translation.

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