Clinical lectures on the principles and practice of medicine . ould lie on theabdomen and chest; a position which allows any ascitic fluid that maybe present to gravitate duwnwards, whilst the intestines float dulness and great resistance offered by the renal organs are, undersuch circumstances, at once determined (Figs. 27 and 29). Theirexternal margins may for the most be easily limited, in consequence ofthe loud tympanitic note of the intestines, which can be elicited roundtheir external circumference in the two flanks. Internally the dulnessmerges into that of the spinal column
Clinical lectures on the principles and practice of medicine . ould lie on theabdomen and chest; a position which allows any ascitic fluid that maybe present to gravitate duwnwards, whilst the intestines float dulness and great resistance offered by the renal organs are, undersuch circumstances, at once determined (Figs. 27 and 29). Theirexternal margins may for the most be easily limited, in consequence ofthe loud tympanitic note of the intestines, which can be elicited roundtheir external circumference in the two flanks. Internally the dulnessmerges into that of the spinal column. Enlargement of one or both ofthese organs from calculous or scrofulous nephritis, pyelitis, or other Fig. 34. Dropsy of the abdomen, enlarged heart, and aneurism. 1, Aneurism pro-jecting from the arch of the aorta on the right side; 2, Hypertrophied heart, es-pecially of the right auricle ; 3, Liver, pushed upwards; 4, Ascitic fluid, gravitatinginferiorly, the patient being on the back; 5 and 6, Stomach and intestines, superiorlyand anteriorly.—(Piorry.). 62 EXAMINATION OF THE PATIENT diseases, may in this manner be made out, as seen (Fig. 29) on the leftside. Atrophy of these organs is more difficult to determine with ex-actitude, but may be demonstrated by careful percussion. Bladder.—This viscus is only to be detected by percussion, when itis more or less distended, and rises above the pubes. It may then be dis-tinguished, and its circular margin limited, by observing the tympaniticsound of the intestines, on the one hand, and the dull sound furnishedby the bladder, with increased resistance on the other. When coveredby intestines, it will be necessary to press down the pleximeter withtolerable firmness, but not in such a manner as to give the patient the infant, the situation of the bladder is not so deep in the pelvis, anda small quantity of fluid renders it cognizable by means of percussion. A ready approximation of the state of the bladder will be found ofg
Size: 1343px × 1860px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1870, booksubjectmedicine, bookyear187
