Medical and surgical report of the Presbyterian Hospital in the City of New York . ary inhibition of the respiratory movement of the costal archaffects both sides ahke. The difference in the costal resistance in acase of this character is, however, easily appreciated, and only in thoseinstances (which must be very rare) in which the pathological processis symmetrically developed in the upper half of the abdominal cavitycould any difficulty in eliciting this symptom be encountered. Increase in costal resistance may or may not be associated with THE COSTAL ARCH IN DISEASES OF. ABDOMINAL ORGANS.
Medical and surgical report of the Presbyterian Hospital in the City of New York . ary inhibition of the respiratory movement of the costal archaffects both sides ahke. The difference in the costal resistance in acase of this character is, however, easily appreciated, and only in thoseinstances (which must be very rare) in which the pathological processis symmetrically developed in the upper half of the abdominal cavitycould any difficulty in eliciting this symptom be encountered. Increase in costal resistance may or may not be associated with THE COSTAL ARCH IN DISEASES OF. ABDOMINAL ORGANS. 23 tenderness on pressure. Resistance due to the presence of neoplasmmay usually be detected without pain or discomfort to the the other hand, pressure on the affected segment of the costal archin adjacent inflammatory conditions almost invariably elicits tender-ness if the process be acute, and occasionally in chronic cases as well. The behavior of the costal arch in the presence of painful inflam-matory conditions in the lower half of the abdominal cavity sometimes. Method of eliciting rigidity in lower part of- arch, e. g., kidney. deviates from the normal. In these cases, respiration is involuntarilylargely thoracic, and the abdominal muscles are held motionless inorder that there may be the least possible displacement of the inflamedorgan. This accordingly results in a symmetrical decrease of the costalrespiratory movement, and, on palpation, a corresponding symmetricalincrease of the costal resistance may be observed, although it is usuallynot well pronounced. Notwithstanding, however, that inflammatory 24 THE COSTAL ARCH IN DISEASES OF ABDOMINAL ORGANS. processes in the lower half of the abdommal cavity are not generallyassociated, in their early stages, with any appreciable change in thedegree of costal resistance, subsequent extension upward, should itoccur in any instance, will result in the gradual development of thisresistance as soon as the inflammatory
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