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.

    21/32 page 21
    surface of the liquid ; below this the bronchial tubes are compressed, and neither the respiration nor the voice is distinctly audible ; hence the situation in which the sound is best heard will vary with the posture of the patient, and the consequent change in the level of the liquid. The sound disappears entirely when the liquid effusion is very great, so that the presence of aegophony may be considered, in a certain sense, a favourable sign in pleurisy. The situation in which aegophony is usually most distinct, is about the inferior angle of the scapula ; u and if an aegophonous patient lies on his belly, not only does the aegophony disappear from the inter¬ scapular region, but it is replaced by a bronchophony of greater or less intensity, according as the lung is sound or in a state of inflammation.” By attention to the various circumstances I have mentioned, we shall seldom have much difficulty in distinguishing aegophony from bronchophony. After having percussed the chest, and examined it by ausculta¬ tion, the results of the former method are to be compared with, and corrected by those of the latter; and, in addition, we must seek for all the assistance to be derived from an examination into the history and progress of the disease, as well as from a consideration of the general or constitutional symptoms, and of the character of the expectoration. Such a general review of all the circum¬ stances connected with a case is frequently necessary before we can correctly interpret the physical signs revealed to us by auscultation and percussion. I have hitherto spoken of certain sounds, chiefly with reference to the difficulty of distinguishing them from others to which they bear a certain resemblance. I shall now briefly consider these sounds, as well as some others, chiefly with the view of ascertaining the condition of the lung or pleura which they severally indicate. Small crepitation is, in the great majority of cases in which it is heard, a pretty certain sign of the existence of pneumonia. Strictly speaking, it indicates nothing more than the presence of a small quantity of liquid in the air-cells of the lung — a condition which may arise not only from inflammation of the lung, but from oedema, or from an effusion of blood into the vesicles. In order, then, to ascertain what condition of the lung has given rise to the small crepitation, the attendant circumstances must be con¬ sidered. Pneumonia will be attended by inflammatory fever, by more or less local pain or uneasiness, in most cases by the peculiar viscid and rusty sputa, and the small crepitation will soon be re¬ placed by bronchial breathing. If oedema of the lung be the c
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image