. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. ion of tympaniticresonance, especially posteriorly, the normal vesicular breathing isabsent on expiration and present o\er the area on deep inspiration. It is a peculiarity of the condition that there may be amphoricbreathing and metallic tinkle over the area, while anteriorly, just 650 DISEASES OF THE RESPIRATORY SYSTEM above it, from the second to the fourth rib, there is a sharp transitionand normal breathing is heard. Behind, however, on deep inspira-tion, even over the region of tympa
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. ion of tympaniticresonance, especially posteriorly, the normal vesicular breathing isabsent on expiration and present o\er the area on deep inspiration. It is a peculiarity of the condition that there may be amphoricbreathing and metallic tinkle over the area, while anteriorly, just 650 DISEASES OF THE RESPIRATORY SYSTEM above it, from the second to the fourth rib, there is a sharp transitionand normal breathing is heard. Behind, however, on deep inspira-tion, even over the region of tympanitic resonance, normal breathingmay be heard over the lower part of the chest. Over the situation ofthe abscess the metallic tinkle and succussion sounds may also beheard. As has been stated, the liver may be displaced downward,crepitations are heard anteriorly over the liver (perihepatitis), or itmay be impossible on account of intestinal conditions to make outthe lower border of the liver. I have seen a subphrenic abscess on theleft side displace the left lobe of the liver and the spleen Fig. 169.—Pneumothorax, left side (Roentgen ray). The heart is not displaced inward if the abscess is on the left side,but if displaced at all, is so in an upward direction. The lower thoraxregion may show no abnormalities to inspection, while the upperabdominal region may be normal, painful to pressure, or slightlyedematous. Diagnosis and Treatment.—Exploratory puncture is resorted to inall of these cases. Diagnosis will be aided if the fluid obtained con-tains, in addition to pus, elements which denote the origin of theabscess, such as food particles, feces, histological debris or pigmentfrom the liver. In many cases the liver sufiers from the vicinity ofthe The treatment is surgical. SECTION IX. DISEASES OF THE CIRCULATORY SYSTEM. DISEASES OF THE PERICARDIUM. Pericarditis.—Pericarditis is an inflammation of the pericardiumdue to infection, which may take place t
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