The stethometer : an instrument for ascertaining the difference in the mobility of opposite sides of the chest, and thus facilitating diagnosis / by Richard Quain.

  • Richard Quain
Date:
[1850]
Catalogue details

Licence: Public Domain Mark

Credit: The stethometer : an instrument for ascertaining the difference in the mobility of opposite sides of the chest, and thus facilitating diagnosis / by Richard Quain. 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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    0 Fig. 4. thus used is intended to ascertain the modifications of the move- ments over a limited or circumscribed spot. On this spot, the foot is placed and held, (as shown in the figure,) by the fingers of the left hand, the cord directed towards this point is held between the fingers of the right hand. These fingers, being thus made the fixed point, must be kept steady and not allowed to touch the part under examination. The spring in the instrument is sufficiently strong to resist the gentle tension made by the fingers, and the instrument itself being pushed forward or raised by the elevation of the part during inspiration, the movement of the index, as when the case is applied on the flat surface, becomes the measure of this elevation. Such being the mode of using the instrument, it will be necessary to say a few words on the precautions which are required hi seeming accuracy in the result. 1st. It is absolutely imperative that corre- sponding portions of the chest be examined, and that the mode of ap- plying the instrument, and the point at which it is applied at each side, be identical. 2nd. Care must be taken that the patient breathes in the same manner whilst opposite sides are being examined. 3rd. It should be seen that the cord, when the observation is commenced, is held sufficiently tense to act on the index. All this requires attention and some little effort; for, as in all other matters, there is little that is of any value which can be obtained without some labour. Though to some few patients these carefully con- ducted examinations may be irksome, yet to the vast majority they are far otherwise. In the latter, they beget confidence in the medical at- tendant, and frequently at once inspire a feeling which renders all future intercourse not less pleasing than it is conducive to successful treatment. Uses of the Instrument. The expansive movements of the chest during inspiration may be said to be the measure of the capacity of the lungs for air. So they are; and by an accurate measure- ment of the one, we might estimate tolerably correctly the other, and thus be able to compare the relative breathing powers of different individuals. It is exceedingly difficult to make this comparison by external measurement; for the movements of analogous or correspond ing parts of the chest, even in those with unimpaired respiratory powers, are remarkably different in different individuals. For not only are such movements modified by age, sex, and occupation, but they are influenced by peculiarities beyond the influences apparently of any fixed or recognized rule. I therefore do not propose to use this instru- ment in testing whether A has a better breathing power than B. The spirometer of Dr. Hutchinson is a far more correct means of estimating this quality. I propose my instrument as a means of ascertaining any want of symmetry, independently of malformation, and therefore indi- cative of disease, in the movements of the corresponding parts of the same chest. It is not my intention to discuss here the various con- ditions, under which this want of symmetry may occur. Obstruction, for example, of a bronchus by a foreign body in, or by a tumour press-
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