DISEASES OF THE CHEST AND AIR-PASSAGES. 117 



air rushing into the air cells, and is much greater in the young 

 than in the old subject. When the lungs are partially indurated, 

 the cells being filled up, there is at that part an absence of the 

 usual murmur, and an increase of it elsewhere. This result 

 sometimes attends the presence of fluid in the chest. After 

 exercise the murmur is increased ; and if in a state of rest the 

 sound at one part is increased, and not at another, the latter part 

 is probably in a state of disease. 



The principal indication of a diseased state of the lungs is de- 

 rived from a sound called bronchial respiration, and somewhat 

 resembles the sound made in sawing wood. It is occasioned by 

 the air rushing in and out of the large bronchial tubes, there 

 being some impediment to its passage. This sound is heard in 

 peripneumony and in acute pleurisy, and more jDarticularly when 

 both diseases are combined. 



There are various other alterations of sound noticed, but they 

 are of minor importance, and less readily detected ; they may, 

 however, be found described in ]\Ir. Percivall's work on the Dis- 

 eases of the Chest, &c., where tlie essay of M. Delafond on the 

 subject is translated. 



The employment of auscultation is much assisted by per- 

 cussion. On tapping the chest sharply with the knuckles, the 

 sound elicited, if the lungs are indurated, or there is water in 

 the chest, will be much more dead than in a healthy state; 

 whilst, on the other hand, when the lungs are emphysematous, 

 as in broken wind, the sound will be augmented. 



The treatment of this disease must depend on the particular 

 stage in which we may find it, and must be modified by the 

 peculiar symptoms that may be present. In the first place, let 

 us suppose a horse is blown in hunting; ridden till nature is ex- 

 hausted, and the animal can go no further. In such case the 

 lungs are in a congested state, and the proper changes in the 

 blood cannot take place ; the breathing is of course accelerated 

 to the greatest degree, and the pulse quick and weak, and pro- 

 bably imperceptible. If the vein be opened, the blood flows 

 with difliculty, and is exceedingly dark and thick. In such case 

 it is of little use to abstract blood until the pulse becomes per- 

 ceptible, and our best plan is at once to administer a stimulant. 

 A bottle of wine, administered in the hunting-field, has in many 

 a case proved of essential service, and in some instances saved 

 the animal. Two ounces of spirit of nitrous ether, administered 

 in a pint of warm ale or water, is still better: its eftect will be 

 to equalise in some degree the circulation, and to rouse the nerv- 

 ous system ; and soon after its administration we shall pro- 

 bably find the pulse becoming fuller and more perceptible. In 

 this state we should abstract blood — as much as we can obtain 



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