. A practical treatise on medical diagnosis for students and physicians . both maybe heard at the same time. The dry rales are heard in the early stages ofbronchitis, when the mucous membrane is swollen and thickened, but hasnot begun to secrete mucus or mucoi)urulent matter. They are alsoheard in asthma, in which there is spasm of the bronchial tubes, and inthe chonic bronchitis of emphysema. In the latter the smaller rales aremore common. Moist Rales. These are due to the vibrations produced by the passageof air through fluid (mucus, serum, pus, and blood), and to the forcingopen of air-cell
. A practical treatise on medical diagnosis for students and physicians . both maybe heard at the same time. The dry rales are heard in the early stages ofbronchitis, when the mucous membrane is swollen and thickened, but hasnot begun to secrete mucus or mucoi)urulent matter. They are alsoheard in asthma, in which there is spasm of the bronchial tubes, and inthe chonic bronchitis of emphysema. In the latter the smaller rales aremore common. Moist Rales. These are due to the vibrations produced by the passageof air through fluid (mucus, serum, pus, and blood), and to the forcingopen of air-cells agglutinated by lymph. They are produced in the air-vesicles, bronchioles, bronchi, and cavities. They may be (1) fine orcrepitant; (2) small or suberepitant; (3) large, coarse, or mucous {bub-bling or gurgling). Crepitant Eales. The crepitant rale is a fine rale, created in thealveoli, due to inflation of the cells whose walls have been held togetherby exuded lymph, or to agitation of fluid. It is a fine rale distinctly Fig. 173. CrepitantSales. Showing origins of the different kinds of r^les. localized, resembling the sound produced by rubbing a lock of hairbetween the fingers or by putting salt on a hot plate. In the early stagesof pneumonia and in oedema of the lungs it is said to be may, however, be heard whenever there is a small amount of fluid inthe alveoli and respiratory action is feeble. SuBCREPiTANT Rales. The small, moist, or suberepitant rales arecreated in the smaller bronchioles and in the alveoli. They may begeneral or local. If general, they are due to bronchitis in the secondstage, there being an abundance of secretion in the terminal air-passageswhich is thrown into vibration by the current of air during the act ofbreathing. The element of moisture is pronounced and gives to thesentles their quality, to which the term crackling is sometimes rales are found in congestion with outpouring and stagnati
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