. Physical diagnosis . bevery lightly struck, either upon the chest itself or upon the fingerused as a pleximeter in the ordinary way. Some observers use ashort stroking or scratching touch upon the chest itself withoutemploying any pleximeter. PERCUSSION 127 This method is used especially in attempting to map out theborders of the heart and in marking the outlines of the the hands of skilled observers it often yields valuable results,but one source of error must be especially guarded against. Theline along which we percuss, when approaching an organ whose bor-ders we desire to mark
. Physical diagnosis . bevery lightly struck, either upon the chest itself or upon the fingerused as a pleximeter in the ordinary way. Some observers use ashort stroking or scratching touch upon the chest itself withoutemploying any pleximeter. PERCUSSION 127 This method is used especially in attempting to map out theborders of the heart and in marking the outlines of the the hands of skilled observers it often yields valuable results,but one source of error must be especially guarded against. Theline along which we percuss, when approaching an organ whose bor-ders we desire to mark out, must neither approach the chest piece ofthe stethoscope nor recede from it. In other words, the line alongwhich we percuss must always describe a segment of a circle whosecentre is the chest piece of the stethoscope (see Fig. 102). If wepercuss, as we ordinarily do, in straight lines toward or away from theborder of an organ, our results are wholly unreliable since every Percussion arc. Chest piece Fig. 102.—Auscultatory Percussion, Showing the Arc along which such Percussion should be made. straight line must bring the point percussed either closer to thestethoscope or farther from it, and the intensity and quality of thesounds conducted through the instrument to our ears vary directlywith its distance from the point percussed. It will be readily seen that the usefulness of auscultatory per-cussion is limited by this source of error, and that considerablepractice is necessary before one can get the best results from thismethod. Nevertheless it has, I believe, a place, though not a veryimportant one, among serviceable methods of physical examination. (c) Palpatory Percussion. Some German observers use a method of percussion in whichattention is fixed directly or primarily on the amount of resistance 128 PHYSICAL DIAGNOSIS offered by the tissues over which percussion is made. Even in or-dinary percussion the amount of resistance is always noted by expe-ri
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