Archives of internal medicine . unconfused on the acoustics of the under-lying viscera whose alterations alone are of clinical importance. The 1. Sewall, H.: On the Use of Stethoscopic Pressure in Physical Examinationof the Heart. New York Med. 1897. lxvi. 50 THE YRCH1YEA OF IXTERXAL ULIKIM. reader must tesl this maneuver ;it the base of a norma] chest duringvocalization tc be impressed with the predominance of mural vibrationsin our estimate of the vocal characters of thai region. The more powerfulcal resonance, a~ Indicated by tactile fremitus, the more astonishingis the damping effec
Archives of internal medicine . unconfused on the acoustics of the under-lying viscera whose alterations alone are of clinical importance. The 1. Sewall, H.: On the Use of Stethoscopic Pressure in Physical Examinationof the Heart. New York Med. 1897. lxvi. 50 THE YRCH1YEA OF IXTERXAL ULIKIM. reader must tesl this maneuver ;it the base of a norma] chest duringvocalization tc be impressed with the predominance of mural vibrationsin our estimate of the vocal characters of thai region. The more powerfulcal resonance, a~ Indicated by tactile fremitus, the more astonishingis the damping effect of stethoscopic pressure. In the -aim mannerpowerful, echoing resonance heard on gentle contact with the manubriumsterni may often be completely annulled by firm pressure through the31 piece; that is, the sternum is a sounding board which has givenfactitious power to the vibrations from below. When the sound is notthus damped the fad is significant of abnormal underlying conductingmedia 1»< tween trachea and breast Fig. ;,. Male, aged aboul 36. Arrested tuberculosis. Infiltration at eaeo;i|x\. most marked on right. An isolated tuberculous <i»-|«««^it occurs in outer pariol left second intercostal Bpace, anteriorly. The finer fibrillations are thought torepresent bronchial fibrosis. Note 11 •«- group of apparent bronchi, in optical seclinn, just outside r<»t of left lung. Note the comparative dissociation of infll-11 ated areas from the bilus radial ions. There are two qualitative modifications of the ordinary vocal reso-nance which deserve specific mention. In the 6re1 the Bound is of a deep,powerful, drumlike, resonant, chesl tone. It is accompanied b\ agood deal of tactile fremitus and is especially developed in healthy,.;,- young men. This resonance belongs almosl wholly to ilif chesl HENRY 8EWALL—8. li. CHILDS 51 wall and is. especially over the lower parts of the lungs, nearly obliteratedby stethoscopic pressure. The second form of resonance ha
Size: 1762px × 1417px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookpublish, booksubjectmedicine
