An essay on the value of auscultation and percussion, and the best mode of practising them: being the essay for which "the King's College Medical and Scientific Society" awarded their first prize in the year 1842 / [Sir George Johnson].

  • George Johnson
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: An essay on the value of auscultation and percussion, and the best mode of practising them: being the essay for which "the King's College Medical and Scientific Society" awarded their first prize in the year 1842 / [Sir George Johnson]. Source: Wellcome Collection.

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    resonance of the voice is less perfect, and the respiration is less distinctly cavernous, a deep inspiration or a cough being attended with a gurgling sound, while the expiration is blowing; the latter phenomenon arising, as I believe, not from the mere passage of the air out of the cavity, but from its transit along the bronchial tubes in the condensed lung surrounding the cavity ; for the same reason, when pectoriloquy is perfect, we frequently hear a short whiff accompanying each sound articulated slowly and distinctly ; this, of course, results from a small quantity of air being puffed from the cavity by each short expiratory effort, which is necessary for the production of an articulate sound. Pectoriloquy is said to be indistinct, when several bronchi enter the cavity, and when the cavity is of large size ; it may cease entirely for a time, in conse¬ quence of the tube or tubes, which enter it, becoming obstructed by a viscid secretion. Bronchophony is heard in the same cases, and results from the same condition of the lung, as that which gives rise to bronchial breathing ; but as the sound of the voice is much louder than that of respiration, bronchophony may often be heard before the lung has become sufficiently solid to render bronchial breathing audible, and, for the same reason, the former frequently continues to be dis¬ tinctly audible for some time after the latter has ceased to be so. We have frequent opportunities of observing both these facts during the progress of a case of pneumonia. Bronchophony differs from pectoriloquy, in appearing to stop at the surface of the chest; the sound does not so decidedly pass up the tube of the stethoscope; it is not circumscribed, but is frequently heard over a large portion of one or of both lungs ; but the two sounds merge into each other by imperceptible degrees, so that, in many cases, it is impos¬ sible to say which name is applicable; and the two sounds are not unfrequently combined; thus, bronchophony may result from solidification of the lung round a cavity, which gives rise to distinct pectoriloquy. .ZEgophony may be said to be bronchophony modified by the passage of the sound through a stratum of liquid. The modification thus acquired consists in a peculiar vibratory, or reedy, character; the voice being at one time like an echo, at another like the bleat of a goat, whence its name, or like the voice of Punch. The distinctness of segophony depends on the natural pitch of the patient’s voice, the sound being more characteristic when the pitch is high, than when it is low. iEgophony is heard only near the
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