Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . physical condition of thepart percussed. The duration of sound depends upon the length of thewaves and their persistence, and varies directly withthe pitch and intensity. Fig. 22. Flatness. Dull tone. Tracheal or tubular tone. .Tympanitic and sketch of the relations of the elements of tone. The perpen-dicular line represents the pitch. The transverse line thevolume and duration. The elements of sound have a definite relationship
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . physical condition of thepart percussed. The duration of sound depends upon the length of thewaves and their persistence, and varies directly withthe pitch and intensity. Fig. 22. Flatness. Dull tone. Tracheal or tubular tone. .Tympanitic and sketch of the relations of the elements of tone. The perpen-dicular line represents the pitch. The transverse line thevolume and duration. The elements of sound have a definite relationship toeach other. (Fig. 22.) Sounds that have the highestpitch have the least intensity and minimum durationand resonance. Such a sound is described as flat orairless. As the pitch becomes lower the intensity increases,duration lengthens, quality of resonance becomes moremarked and the sound is described as dull, resonant ortympanitic, according to the pitch. Normal pulmonary resonance has a quality character-istic enough to be easily recognized although impossibleto describe, low pitch, great intensity and PERCUSSION. 79 It is this combination of the elements of sound thatis described by the clearness of the note. As these elements vary the different pathologicaltypes are produced. METHODS OF PERCUSSION. In order to elicit sound from the air-containing spacesof the lungs by percussion, vibrations are set up in thechest in a number of different ways. (1) Immediate, or Direct Percussion.—This was first usedby Auenbrugger, in 1761. In this method the blowis struck directly upon the chest wall, generally overthe bony structures. The sound produced is chieflythat made by striking the bony thorax, and its valueis to show the ease with which the thorax itself is throwninto vibration. Light immediate percussion over theclavicle is especially sensitive in showing slight differ-ences in resonance at the apex of the lung in beginningtuberculosis when no change can be detected b
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