The signs of internal disease, with a brief consideration of the principal symptoms thereof . The cracked-pot sound may beelicited by percussion below the clavicle, while»the patient expires withthe mouth held open. Below the fluid level absolute flatness extend-ing to points lower than the normal limits o| the lung is present. Auscultation. Vocal fremitus is absent, but Baccelli has notedthat the whispered voice sometimes may be transmitted to the earwhen the spoken sounds are inaudible. He states that this is not thecase if the fluid be purulent, hence this sign, if present, denotes serousef
The signs of internal disease, with a brief consideration of the principal symptoms thereof . The cracked-pot sound may beelicited by percussion below the clavicle, while»the patient expires withthe mouth held open. Below the fluid level absolute flatness extend-ing to points lower than the normal limits o| the lung is present. Auscultation. Vocal fremitus is absent, but Baccelli has notedthat the whispered voice sometimes may be transmitted to the earwhen the spoken sounds are inaudible. He states that this is not thecase if the fluid be purulent, hence this sign, if present, denotes serouseffusion. If the effusion is sufficiently large to squeeze the lung up-ward and backward into the spinal gutter, then the breath soundswholly disappear. Usually, however, some breath sounds, feeble anddistant, but of a bronchial character, may still be heard over the spinal 122 PLEUEISY gutter when the patient folds the arms tightly over the chest, so asto widely separate the scapulae. Bronchophony is heard in the sameregion. Sometimes auscultation will enable us to locate the apex of the. Fig- 35-^Physical signs (posterior regions) in effusion into left pleura (Patton).A Diminished respiratory sounds. B Very faint or absent voice sounds, ab-sent breath sounds, dullness, no vocal fremitirs. C Dullness, no vocalfremiitus, no voice or respiratory sounds. D Voice sound is tubular ornasal in quality, sometimes approaching segophony. Upper limit of lightshading indicates the posterior line of Ellis curve. heart when it can neither be seen nor felt. On the opposite side therespiratory sounds are exaggerated. Absorption Stage. Inspection shows that, the enlargement of theaffected side is disappearing, that the widening interspaces are re- PLEURISY 123 turning to their normal condition. The absent* respiratory movementsreturn, and the obscured apex may now be seen. Unfortunately the process does not generally stop here, but con-tinues by reason of contractions and adhesions until variou
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectdiagnos, bookyear1906
