DISEASES OF THE RESPIRATORY ORGANS. 129 



may become prolonged, as in emphysema. Finally, the 

 murmur may be altered in character. 



If it become of higher pitch, louder and more prolonged 

 in expiration, it is then said to be ^ cxaggercdecV or ^ harsh 

 hreath'mgj and indicates changes in the consistence of the 

 lung-tissue, depending upon compression in the early stage 

 of bronchial and pulmonary inflammation. This harsh 

 breathing may subside and the breathing become normal ; 

 or, on the other hand, if the disease progresses, it may 

 become replaced by a very characteristic kind of breathing, 

 very important in diagnosis, termed ' Bronchial breathing.' 



Bronchial Breathing is similar to the variety of breathing 

 above described as being audible in the normal condition 

 at the bifurcation of the trachea at the anterior part of the 

 chest, but is louder and more distinct. 



"When it is heard over parts of the chest where it is 

 normally absent, it indicates disease, and is a marked sign 

 of consolidation of the lung. Sometimes it is heard in 

 emphysema. 



Cavernous and amphoric breathing are varieties of 

 breathing only heard in disease. They approach the 

 normal laryngeal or nasal sound, but they have a greater 

 hollowness. They are only heard in rare instances, in 

 cases where the air-tubes are in connection with cavities in 

 the lung-tissue. 



New Sounds heard in Auscultating the Respiratory 

 Organs. — We have as yet only spoken of sounds the 

 analogues of which may be heard in health. We have now 

 to consider sounds only heard in disease. They fall under 

 two headings : (1) Those produced in the lungs, pulmonary; 

 and (2) those produced in the pleural cavity. 



1. The Pulmonary Sounds. — To these sounds the term 

 ' rales ' is applied ; and they may be divided into crepita- 

 tion, rhonchus, and sibilus. 



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