The essentials of physical diagnosis of the chest and abdomen ...
- Anderson, J. Wallace (James Wallace)
- Date:
- 1889
Licence: Public Domain Mark
Credit: The essentials of physical diagnosis of the chest and abdomen ... 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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![iuto a metal or glass cup, and as a morbid phenomenon has been supposed to be caused by drops falling from tiio roof of an air-filled cavity (pulmonary, or in pneumo- thorax) into the fluid below. It is very doubtful if this tinkling is ever exactly so caused. It probably arises rather from the bursting of large bubbles in large air-filled cavities. The metallic bell sound is a term applied to the clear ringing metallic sound which is heard if one auscultates over a pneumo-thorax while an assistant strikes a coin placed on the chest wall with another of a similar kind. The resulting sound heard is sometimes, as Gee says, not much infei'ior to the clihne of a small clock. The sounds which have just been under discussion, known technically as rales, are al], it will be noticed, intra-pulmonary. We pass now to one that is extra-pulmonary, which is connected with the pleura and is not usually termed a rale but simply a sound:— Friction Sound (Friction Rale—Gairdner). In health there is absolutely no sound caused by the play of the two pleural surfaces on each other. The movement is perfectly free. But let either surface lose its perfect softness and polish, and friction sound, the pleuritic rub as it has been called, becomes possible. In its ordinary form it can hardly be mistaken. What it really is, the sound of one roughened](https://iiif.wellcomecollection.org/image/b21229843_0087.jp2/full/800%2C/0/default.jpg)
