DISEASES OF THE RESPIRATORY ORGANS. 



It will be necessary here to point out tlie different methods of 

 making a physical examination, by which the diagnosis of these 

 diseases is accurately traced. Auscultation is listening to the 

 sounds of the interior by means of the ear applied to the surface 

 of the body. It may be practiced directly by the ear or by an 

 instrument called the stethoscope. In applying the stethoscope 

 to the chest, its funnel-shaped end is to be held firmly to the sur- 

 face and the opposite end must press closely to the ear. Imme- 

 diate auscultation does very well. The ear should be accurately 

 applied to the skin; a handkerchief or thin cloth may be allowed 

 to intervene. 



Percussion. — This consists in striking upon the surface with 

 the view of eliciting sounds, by the nature of which an opinion 

 may be formed as to the condition of the interior parts. It is 

 either immediate or mediate. In immediate percussion the ends 

 of the fingers are brought together and supported by the thumb, 

 and the parts are struck perpendicular to the surface. The 

 knuckles or closed hand may be used. 



In immediate percussion, the pleximeter is generally a flat, 

 oval, or circular piece of ivory, on the left index finger of the 

 operator. 



NASAL SOUNDS. 



The normal condition is simply a soft, blowing sound, heard 

 only Avhen the car is placed to the nostrils. 



Snoring is caused by a polypus, thickening of the Schneiderian 

 membrane or some other obstruction of the nasal chambers. A 

 snuffling sound is accompanied by a discharge as a result of some 

 disease. Whistling may be due to a turaorfied condition of the 



(357) 



