Observations on the mechanism and diagnostic value of the friction vibrations perceived by the ear, and by the touch in peritonitis / by Robert Spittal.

  • Spittal, Robert, 1804-1852.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the mechanism and diagnostic value of the friction vibrations perceived by the ear, and by the touch in peritonitis / by Robert Spittal. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    I pressure, may not only modify the intensity, but also the tone and . quality of the vibrations. That the present state of our knowledge does not permit us to ! connect any particular species of vibration with a certain physical ! condition of the peritoneum, although reasonable grounds exist for ' this expectation. ! That although the friction vibrations ai*e no evidence of the ex- I istence of adhesions between the peritoneal surfaces, it has not I been proved, that in the case of partial adhesions,—and even when I the adhesions are general, provided the effused lymph be recent, I soft, and extensible,—an amount of motion sufficient to produce the ‘ friction vibrations might not occur. That the respiratory abdominal friction vibrations are chiefly c manifested at the upper part of the abdominal cavity, where its oj more solid contents are situated, and in the case of a large organic i\ tumour,—and may be regarded as indicative of the inflammation ex- 31 isting over a solid organ or tumour. That the indications from artificial movement of the parts have n been perceived, both where tumours were present, and where the in- ij: testines alone, or along with the omentum, were the site of the Ij inflammation. ' I That the peristaltic friction vibrations indicate that the perito- r| neum investing the corresponding portion of the intestinal tube is )ij the part affected. ’ I That wherever the peristaltic vibrations are mry distinctly 'per- si ceived^ they may be regarded as indicative of a lively and free mo- dtion of the folds of intestine upon one another, and upon the parie- Jtes; and of few or no adhesions existing between them. At all y| events, it shows that the intestines are not generally adherent, nor til matted together into an adherent mass, nor, to any great extent, (i adherent to the abdominal parietes. ! That in cases of peritoneal inflammation in the upper portions ]of the abdomen simulating pleuritis—as in Case 15—the presence I of any degree of the peristaltic friction vibration might very much •;assist us in the diagnosis. i I