Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    aj^preciated, but until then no reliable conclusions can be drawai from them, and meanwhile they, or any other abnormal appearances, ought simply to be recorded. Local Inspection.—In addition to the foregoing, the in- spection of the various regions, especially of the thorax and abdomen, is necessary. In this are included shape, degree of plumpness or emaciation, movements, and so forth. It may also be made to include mmmration, that is, the deter- mination of the size of the part. Palpation,—By means of the hand or hands placed on a part are noted its degree of resistance, its hardness or soft- ness, whether fluctuation be present or not, the degree and kind of movement, the presence of abnormal sensations, and similar facts. Under this head may be included vocal fremitus, a term which is confined to the examination of the lungs. It is the sensation which is felt by the hand when placed flat on the thorax while the patient speaks, or repeats the numeral one, one, one, or any combination of numerals. The physical explanation of the phenomenon is that speaking sets up vibrations in the column of air in the trachea; these vibrations are propagated into the air in the bronchi and air vesicles, and pass through the lung tissue and chest wall to the hand placed on it. Its intensity varies greatly in diff'erent individuals, and depends on factors which will be considered under palpation of the lungs. For its production it is of course necessary that there should be no obstruction in the bronchi, as any such would arrest the passage of the vibrations. Percussion.—This term is employed to denote the method of determining the physical condition of the viscera by the sound elicited on tapping the surface of the body. For a thorough understanding of the results obtained by this method of investigation it is necessary to consider the con- ditions under which sound is produced and conducted. Sound consists of undulations produced in a body which has been caused to vibrate. These are transmitted through
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