58S srmtADTC diseases. 



This increase of soniid on tlie ri^lit side is due to a resonance 

 from the arch of the colon. If the blows are lis'lit, this sound 

 is not brought out, and when heavy, it is more of a tympanitic 

 character, resembling that of an emphysematous lung. Along 

 the middle region louder sounds are elicited than either above 

 or below, more particularly between the fifth, sixth, seventh, 

 and eighth ribs, from whence it diminishes to the fifteenth, 

 and then becomes tympanitic or abdominal on the left, and dull 

 on the right side, owing to the opposition of the liver. In 

 the inferior part of the chest the sound is weak, but clear, 

 from the fifth to the eighth rib on the right side, where it 

 becomes dull, responding to the liver ; whilst on the left 

 side the resonance is almost absent over the fifth, sixth, and 

 seventh ribs, opposite to the heart ; it becomes clearer over the 

 eighth, behind which it loses its intensity, and is lost at about 

 the thirteenth rib. 



MORBID SOUNDS. 



The morbid sounds indicative of diseases of the respiratory 

 apparatus elicited by auscultation may be divided into bronchial, 

 pulmonary, and pleural. 



BRONCHIAL SOUNDS. 



These are of two kinds, namely, 1st. Dry ; and 2d. ]\Ioist. 



1. Dr?/ sounds are subdivided into large and small, or rhonchus 

 and sibilus. 



(«.) FJwnclms, a hoarse, sonorous murmur, sometimes of a 

 humming, cooing, or snoring character, compared to the bass 

 note of a violin or cooing of a pigeon, especially marked during 

 expiration, but coexistent with both movements, and due to a 

 narrowing of some part of the larger bronchial tubes. It may 

 be heard at the front of the chest very plainly, as well as behind 

 the shoulder. It is sometimes caused by portions of viscid 

 mucus adhering to and obstructing the larger tubes, acting as 

 vibrating tongues as the air passes by them. If the adherent 

 mucus be removed by coughing, the sound may disappear for a 

 time, and then reappear ; when not removed by coughing, it may 

 be due to tumefaction of the bronchial mucous membrane ; and 



