528 AUSCULTATION. 



A gurgling or splashing sound is sometimes heard, and, 

 like the above, is referable to the pleura. The sound can 

 only be produced when both gas and liquid are present in 

 the pleural sac. Even with these conditions, the sound is 

 rarely heard, and too often have gurgling sounds in the 

 intestines been mistaken for this. When hydro-pneumo- 

 thorax exists in the smaller animals, a gurgling sound may 

 be developed by succussion that is, quick shaking and in 

 the larger, movements of the body may give rise to it. 



The cough cannot be auscultated with the same advantage 

 in the lower animals as in man. We can readily cough the 

 former by compressing the first tracheal ring between the 

 finger and thumb, but we cannot, as the physickn can, get 

 our patients to take a full inspiration, and succeed this by a 

 short, quick cough, the sound of which is conveyed through 

 the air compressed in the bronchial tubes to near the sur- 

 face of the lungs. Again, in the coughing of our larger 

 patients, the sudden movement of the chest renders it diffi- 

 cult to keep the ear in close apposition to the thoracic walls. 

 When this can be effected, some useful indications may be 

 obtained from the cough. As heard over the healthy lung, it 

 gives a short, dull, indistinct sound. In consolidation of the 

 lungs from compression, hepatisation, or pleural effusions, it 

 becomes loud, and is heard over a greater or less extent of 

 chest according to circumstances; the same sign may arise 

 from dilated bronchia. When a considerable cavity commu- 

 nicates with a bronchial tube, and extends to near the surface 

 of the lung, the sound is even louder and more distinct as 

 heard by the ear applied directly over the part. Should such 

 a cavity communicate with the bronchia by a narrow orifice, 

 the sound becomes clear and metallic, like that produced by 

 coughing into a narrow-necked vessel. These are respectively 

 designated bronchia*, cavernous, and amphoric sounds. 



