. A practical treatise on medical diagnosis for students and physicians . icited by percussionover a cavity communicating with a large bronchus changes when thepatient alternately opens and closes his mouth, becoming Louder, moredistinctly tympanitic, and higher in pitch when the mouth is open. [nterrupted \\ intuitu* Change of Sounj>. Wintrichs phe-nomenon may be distinct in some positions of the body, but indistinct orabsent in others. This is a positive sign of a cavity containing fluid,which occludes the communicating bronchus in one position but leaves itopen in the other. Friedreichs
. A practical treatise on medical diagnosis for students and physicians . icited by percussionover a cavity communicating with a large bronchus changes when thepatient alternately opens and closes his mouth, becoming Louder, moredistinctly tympanitic, and higher in pitch when the mouth is open. [nterrupted \\ intuitu* Change of Sounj>. Wintrichs phe-nomenon may be distinct in some positions of the body, but indistinct orabsent in others. This is a positive sign of a cavity containing fluid,which occludes the communicating bronchus in one position but leaves itopen in the other. Friedreichs Respiratory Change of Sound. The note over acavity is higher in pitch at the end of inspiration than after is due to increased tension of the chest-wall, of the lung tissue, andof the walls of the cavity, and to the widening of the glottis duringinspiration. Gerhardts Change of Sound. The tympanitic sound elicitedover a cavity containing fluid may change its pitch with change of the Fig. 160. Gerhardts phenomenon Stethoscope Bienr0mmeern^he- Stethoscope. = red = space = air. Illustrating Gerhardts and Biermers phenomena, interrupted Wintrichs ph<coin-percussion. position of the patient, especially if the cavity be longer in one diameterthan in the others. This is due to the change in the relative positions ofthe air and the fluid contained in the cavity. Biermers Change of Sound. The percussion-note over a pneumo-hydrothorax changes in pitch with alteration of the patients position, onaccount of the change in the relative position of the air and the fluid. Bell Tympany. This is elicited in pneumothorax by person listens at the back of the chest while a second person percussesthe front of the chest with two large coins, using one as a pleximeter and ABNORMAL BOUNDARIES OF THE LUNGS. 489 the edge of the other as a plessor. Air in the pleural cavity will con-duct the sound so that it is heard on the opposite side of the chest as a
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