The physical diagnosis of diseases of the lungs / By Walter Hayle Walshe.

  • Walshe, Walter Hayle, 1812-1892.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: The physical diagnosis of diseases of the lungs / By Walter Hayle Walshe. Source: Wellcome Collection.

    32/328 (page 16)
    and by coughing (éwssive), and also upon its oc- currence under circumstances which do not give rise to it in health. Of the latter kind are the vibrations produced by the bubbling of air through fluids in the lung (rhonchal); by the collision and rubbing together of plastic matter exuded upon the pleural surfaces (rubbing); and lastly, by pulsation of the substance of the lung (pulsatile). These require separate consideration. a. Vocal.— The natural fremitus produced by speaking is susceptible of zncrease or diminution. As in the case of other signs the amount of change existing is most effectually ascertained by com- parison of the two sides of the chest ; in making this comparison both hands may be applied at the same time, one to each side, or upon each side sue- cessively and repeatedly, at intervals of a very few moments, while the patient continues to speak un- interruptedly the same words in the same manner. It is scarcely necessary to add, that if either hand be more deficient in nicety of touch than its fellow, the latter only should be used. [§ 15. ] b. Tussive.—This species of vibration is liable to be affected in the same manner as the vocal. c. Rhonchal.—The only rhonchus which, as far as my experience goes, is ever attended with a dis- tinct sensation of fremitus on the surface, is the sonorous; and this only in some cases, when the rhonchus is of remarkable intensity. It is said by Laennec, that in very strong death-rattle a similar phenomenon may be detected. d. Rubbing. —In the natural state of the pleura, the motions of its costal and pulmonary laminz upon