Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine.

Babcock, Robert H. (Robert Hall), 1851-1930

Date:: 1910

Credit: Diseases of the heart and arterial system : Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. 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.

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$-.Maolike's Method of Pali-atouy Pekclssion. each other. Ebstein dechires also that by his method one can obtain satisfactory results in .cases of emphysema and in persons with a thick ])annic\ihis of fat or large mammary glands, all of which nsually preclude accu- rate percussion after the ordi- nary .method. Robert Maguire, of Eng- land, advocates palpator}^ per- cussion by tapping lightly with the soft palmar cushion of the terminal phalanx of one finger, and claims equally accurate re- sults (Fig. S). lie expressly states that the stroke must be not short and quick, but long and ])ressing, as if one were feeling or palpating with the finger. It is applicable, he says, not only to all solid or- gans, spleen and kidneys, as well as heart and liver, but also to collections of fluid in thoracic and peritoneal cavities. In cases which are at all obscure it is well to verify the con- clusions derived by any one method—plessimetric, auscultatory, or palpatory—by each of the others. For my part I value the aus- cultatory method the least highly, because so liable to error in exactly those cases ^\■llicll oflVr the greatest difficulty to ordinary percussion—that is, ('iii])]iyscuiatous, fat, and rigid chests. Auscultation of the Heart is another and indispensable means of making cardiac examinations, and by the inexperienced is apt to be relied upon, if not exclusively, at least to a degree out of pro- portion to its inij)()rtance as comjiared with ])ercussion. Neither can be comjiletc without the other. I desire also to emphasize the folly of iittcinpting to do accurate work without the use of a stothoscoj)e. Whatever form or kind of instrument enables one to liear tlu? most distinctly is, in my opinion, the best for him, re- gardless of the arguments advanced in favour of certain sorts. I make; use of a simple biiumi-al and of a inoiiaui'al stctlioscojx', em- ploying the laftci- when <h'siring such information as is sometimes$