Diseases of the chest and the principles of physical diagnosis . re obtained: Whispering pectoriloquy 53 out of 58 () Tympany (on percussion) 39 out of 58 () Cavernous or amphoric breathing 38 out of 58 () Gurghng or consonating rales 33 out of 58 () 362 DISEASES OF THE BRONCHI, LUNGS, PLEURA, AND DIAPHRAGM Although none of the above signs are pathognomic of a cavity thepresence of anj^ one of them is suggestive and the probabihty of its exist-ence is increased by combinations of any two or more of them. Twosources of error are to be borne in mind: (1) Consohdated pulm
Diseases of the chest and the principles of physical diagnosis . re obtained: Whispering pectoriloquy 53 out of 58 () Tympany (on percussion) 39 out of 58 () Cavernous or amphoric breathing 38 out of 58 () Gurghng or consonating rales 33 out of 58 () 362 DISEASES OF THE BRONCHI, LUNGS, PLEURA, AND DIAPHRAGM Although none of the above signs are pathognomic of a cavity thepresence of anj^ one of them is suggestive and the probabihty of its exist-ence is increased by combinations of any two or more of them. Twosources of error are to be borne in mind: (1) Consohdated pulmonarytissue about a bronchus may give rise to the same phenomena. Thismistake was made in five instances in the series I studied. (2) The signsof a single cavity at the right or left apex may be transmitted across thespine and lead to a diagnosis of a cavity at both apices. This errorcan be avoided by tracing the sounds from their origin when they willbe found to diminish in intensity the farther the bell of the stethoscopeis moved from the site of the Fig. 262.—Two small cavities situated at some distance from the posterior pleura. Deeplyseated cavities are apt to escape detection by physical signs. The auscultatory signs over the remainder of the chest parallelthose of percussion. Below the cavity the infiltration is apt to be denseand the breath sounds bronchial or broncho-vesicular in character. Thelatter type of breathing is usually present over the base of the side mostaffected and, in addition, may be more or less suppressed. The voicesounds are more or less exaggerated depending on the density of theinfiltration. Over the opposite lung there maj^ be signs of a cavity at the apex andevidences of infiltration beneath it but rarely as well marked as on the DISEASES OF THE LUNGS 363 side most diseased. Over the lower lobe the breath sounds are usuallypuerile in type due to compensatory emphysema. Although at the au-topsy table scattered tubercles are usually foun
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
