A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; tr. from the latest French edition, with notes and a sketch of the author's life, by John Forbes ; with plates.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; tr. from the latest French edition, with notes and a sketch of the author's life, by John Forbes ; with plates. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    dull or loud; sometimes it is very momentary, and resembles the chirping of birds, the sound emitted by suddenly sepa- rating two portions of smooth oiled stone, or by the action of a small valve. These different kinds often exist together in different parts of the lungs, or successively in the same part. The peculiar nature of the sound, and the appearances on dissection, seem to prove the sibilant rattle to be owing to minute portions of very viscid mucus obstructing, more or less completely, the small bronchial ramifications. This ex- planation applies more especially to the variety resembling the sound of a valve, which is indeed only a variety of the mucous rattle : the kind more strictly sibilous, is probably occasioned rather by a local contraction of the smaller bron- chia, from thickening of their inner membrane. 5. The dry crepitous rattle, with large bubbles *. This species is observed only during inspiration. It conveys the impression as of air entering and distending lungs which had been dried—and of which the cells had been very unequally dilated,—and entirely resembles the sound produced by blow- ing into a dried bladder. This variety is the pathognomonic sign of emphysema of the pulmonary substance, and of the interlobular emphysema. In the last disease, it is much more distinct. We have a sound like this in the common sub-cutaneous emphysema, on pressing interruptedly with the ear on the stethoscope, or with the fingers, in the vicinity of the affected part. Besides the peculiar sound produced by the various species of rattle, there is also to be noticed a slight vibration commu- nicated to the cylinder when the seat of the phenomenon happens to be immediately beneath it. This sensation, like that occasioned by the voice (p. 32), may sometimes be felt by the hand very distinctly. It is usually very strongly mark- ed in the mucous and sonorous rattles, less in the crepitant, and still less in the sibilous. When the rattle has its seat re- mote from the point where the instrument rests, although it is heard very strongly, no vibration is felt; and when this can be discovered in no point of the chest, we may conclude that the cause of the rattle exists in the central parts of the lungs. • Lc Rale crepitant sec, a grosses bulks ou Craquement.