The signs of internal disease, with a brief consideration of the principal symptoms thereof . of signs revealedby inspection, as diminished respiratory rhythm and widening of thelower interspaces. The friction fremitus will have disappeared. Insmall effusions the tactile fremitus is generallj diminished. This signis more valuable in men than in women and children. It must be re-membered that fremitus is usually stronger on the surface of theright chest than on the left; stronger in men than in women. Mensuration shows little if any variation in small and moderateeffusions. In right-handed indi
The signs of internal disease, with a brief consideration of the principal symptoms thereof . of signs revealedby inspection, as diminished respiratory rhythm and widening of thelower interspaces. The friction fremitus will have disappeared. Insmall effusions the tactile fremitus is generallj diminished. This signis more valuable in men than in women and children. It must be re-membered that fremitus is usually stronger on the surface of theright chest than on the left; stronger in men than in women. Mensuration shows little if any variation in small and moderateeffusions. In right-handed individuals, especially men of the labor-ing class, the circumference of the right chest is normally greater thanthat of the opposite side. Percussion. Dullness increasing to flatness over the area of the 118 PLEURISY effusion is the most important sign of the exudate. In adults it isdifficult if not impossible to demonstrate effusions of less than fivehundred cubic centimeters. The dullness is usually most marked andfirst obtainable posteriorly, then in the axillary region, lastly in Fig- 33—Physical signs in effusion into left pleura (Patton). A Skodiac per-cussion resonance, exaggerated vocal resonance, tubular quality of breath-ing. B Complete dullness, absence of vocal fremitus, no respiratory Purile respiration, prolonged expiration, exaggerated percussion reson-ance. D More or less well marked pulsation. F Displaced area of cardiacdullness. Upper limit of shading indicates anterior line of Ellis curve. Along the upper border of the effusion percussion dullness is ob-tained and increases to flatness as we percuss from above absence of vibration, coupled with an increased sense of re- PLEUEISY 119 sistance under the pleximeter finger, much grieater than that observedin cases of lung consolidation, are most noteworthy and significantsymptoms. The prevalent, in fact almost universally accepted, belief that thelevel of pleural effusions changes w
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectdiagnos, bookyear1906
