. A practical treatise on medical diagnosis for students and physicians . n the imme-diate or direct method the ear is applied directly to the chest, a thin towelor napkin free from starch alone intervening. This method is of servicein ascertaining the general character of the sounds, but has the dis-advantage of imperfect localization. The mediate or indirect method ispractised by means of the stethoscope and phonendoscope ; but it is dis-advantageous in infants, because they can not be kept quiet or are sensi- THE STETHOSCOPE. 389 tive to its pressure, and in children, because to them instru
. A practical treatise on medical diagnosis for students and physicians . n the imme-diate or direct method the ear is applied directly to the chest, a thin towelor napkin free from starch alone intervening. This method is of servicein ascertaining the general character of the sounds, but has the dis-advantage of imperfect localization. The mediate or indirect method ispractised by means of the stethoscope and phonendoscope ; but it is dis-advantageous in infants, because they can not be kept quiet or are sensi- THE STETHOSCOPE. 389 tive to its pressure, and in children, because to them instruments arealarming. The disadvantages of the indirect over the direct method of ausculta-tion are appreciated when it is necessary to localize sounds. By meansof the stethoscope it is possible to ascertain the deiinite localized area inwhich the sound is produced, and to differentiate sounds in close prox-imity. In addition, the operator is more likely to escape from contagiousdiseases and vermin. Moreover, the stethoscope is preferable on the scoreof delieacv. Fig. Binaural stethoscope. The Stethoscope. The stethoscope consists of a bell which is placedon the patients chest, of one or two ear-pieces, and of a tube connectingthe bell with the ear-piece or pieces. The tube may be rigid or may be single and double, and vary in form with the prefer-ence of the operator. It should be an absolute rule with the student tobecome familiar with and to use but one form of stethoscope. Fig. ^92. Fig
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