A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt.

  • Oswald Vierordt
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    sion] and the so-called Sibson's furrow (the under border of the pec- toralis major) are sometimes, although not very practically, useful as points for locating internal organs. For determining the breadth the vertical lines now to be mentioned are useful (the subject is supposed to be standing): the middle line, drawn through the sternum; the two sternal lines, drawn parallel along the sides of the sternum ; the mammillary lines, drawn through the male nipple; and the parasternal lines, drawn midway between the sternal and the mammillary lines. On the two sides we determine the height by the ribs, which we count in front, and the breadth by the middle axillary line (drawn through the middle of the axilla, the arm being extended sidewise), the anterior and posterior axillary lines (drawn perpendicularly from the points where the pectorahs major and latissimus dorsi muscles leave the thorax, with the arm raised sidewise to the horizontal). Upon the back we name the fossa supraspinata; above that, the suprascapular space, the fossa infraspinata, the interscapular space, between the two scapulae, the infrascapular space, under the shoulder- blades. Exact determination of height is made by counting the ribs, which, however, are difficult to count, especially in fat persons. They can be determined by three methods : [a) By counting the vertebral prominences from the vertebra prominens (the seventh cervical). {b) By counting from the lower angle of the scapula: this over- hangs the seventh rib in the average person when the shoulders hang comfortably and the arms rest against the chest with the forearms folded lightly. ic) By the point of the twelfth rib, which is easily felt (the best way for the lower ribs). Moreover, we have the scapular hne, which is drawn upon the two sides of the spine through the lower angle of the scapulae (at the point already mentioned under {B)). It is to be observed that some of the vertical lines are not deter- mined exactly. This is true regarding the mammillary line (always very important) more than any other. In women it is generally very variable. On this account it is always to be thought of as drawn upon a male thorax. But even in the male the nipple is an uncertain point. By much practice the eye is cultivated so as to recognize what is to be regarded as the average location of the nipple in the male, and by this we must always correct the mammillary line. The various attempts to substitute other lines for this one have failed. The designation infrascapular space is little used. The expres- sions right, left, behind, below, correspond to it, and are much to be recommended: behind or below the right, the left, scapula. The Anatomical Boundaries of the Lungs with Reference to the Thorax. In front the lungs reach to the sixth, and behind to the tenth, rib, and are almost everywhere directly in contact with the chest-wall.