Auscultation and percussion : together with other methods of physical examination of the chest / by Samuel Gee.

  • Gee, Samuel (Samuel Jones), 1839-1911.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Auscultation and percussion : together with other methods of physical examination of the chest / by Samuel Gee. Source: Wellcome Collection.

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    of the lower thorax becomes manifest when, during inspiration, an insufficient supply of air enters the lungs in consequence of obstruction in the respiratory passages. What air can enter goes to the part of the chest most powerfully kept expanded, so that the feeble lower thorax gets little or none, and succumbs to the external pressure. Catarrh is that obstruction in most cases. Nor need the catarrh be at all severe, or the impediment at all great, inasmuch as a necessary concurrent cause of the groove is found in the yielding character of the ribs during infancy and early child- hood, and especially of ribs rendered (as they so often are) praeternaturally yielding by rickets. When the impediment is severe and protracted, the depression, although proportionally great, ceases to exist alone; other deformities are produced, a pigeon breast, or a cup-like hollow. But when the deformity stops short of a pigeon breast, that is, when the depression is not so great as to involve the whole of the front base of the thorax from the xiphoid level downwards, it is the abdominal viscera which determine the position of the sulcus by maintaining the expansion of the base of the chest. The depression occurs as low down as possible, namely, immediately above the upper surface of the abdominal viscera, or what comes to the same thing, the sulcus corresponds to the vault of the diaphragm. This fact