Dr. Hooper's Physician's vademecum, or, A manual of the principles and practice of physic / [Robert Hooper].

  • Hooper, Robert, 1773-1835.
Date:
1842
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Licence: Public Domain Mark

Credit: Dr. Hooper's Physician's vademecum, or, A manual of the principles and practice of physic / [Robert Hooper]. Source: Wellcome Collection.

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    other parts of the chest a sound is heard which has been compared to that of a sleeper breathing gently through the nostrils, or to the sighing of a gentle breeze—this is called vesicular, from its pre- sumed seat, the air-cells. The student should familiarize himself with these sounds, especially the latter, by applying the ear to the healthy chest ; and, as this sound is most distinct in children he should examine it in them. This same sound is heard in expira- tion; but it is less distinct, and of shorter continuance.* The in- tensity of the sound varies in different healthy persons, and in the same person at different times. It is more intense, as has been stated, in young children; also in females, a fact which may perhaps be accounted for by the increased respiratory effort necessitated by the confinement of the chest by stays. It is also augmented by deep inspiration; hence, when the sound is naturally dull, it may be produced by causing the patient to breathe quick, or to draw a deep breath, or to cough whereby the lungs are emptied, and a full inspiration secured. The respiratory murmur is also rendered ore intense in one part of the chest by any impediment to the respiration in the rest of the lung : in this case it is called puerile from its resemblance to the respiratory murmur of the child Such partial increase of intensity is a pretty certain sign of consolidation of the remaining portion of the lungs. This sound is sometimes scarcely perceptible, and the absence of it is not always a sign of disease. As a general rule, it may be stated, that where the absence of this sound does not co-existwith any other morbid sounds,or with fulness on percussion, it should not be regarded as an indin Dort’0f d‘TT w respirat0ry murmur may be absent in limited poit.ons of the chest, in consequence of the bronchial tubes being obstructed by tenacious mucus ; but here percussion will give a ,fr or 'Jjpay be absent, because the air-cells unfilled with fluid from within or compressed from without. In this case the chest will sound dull on percussion, except where the pressure is occasioned by air in the pleura (pneumothorax) 1 rsS”•Jstasssafii t1 *■ not only loses its proper respiratory murmur W ul ’ 1 better conductor of sound, conveys to the ear the ’ b®comin& a in the bronchial tubes. Hence,'lironclSl resnirn °U'K pr°duC.ed unusual distinctness near the site of the bronchial' tT learc, Wlt]l on one side, when not audible on the other or with JLm’ °r^ Card intensity, or in parts where it is not heard’ in health 'ely‘dl.ft®r.mS tion of consolidation of the lung by inward disease^TouWd * It is generally stated, that in expiration ti,„ . sounds alone are heard; (see Lib. of Med vnl’ii- !I'onchmI »«d tracheal Diseases of the Lungs, by Dr. Williamsq'tot tW. L. : Art DiaK7108,s of in^au able revtew of Fournefs work, in’the JM* H