564 
REMARKS ON AUSCULTATION. 
intestines are not the seat of disease, but; that some other of the 
abdominal viscera are affected : this would be indirect evidence, 
and, coupled with other recognised symptoms, will enable us to give 
a tolerably correct diagnosis, and to order our treatment accordingly. 
Again, “ auscultation” will inform us with the greatest accuracy 
of the part which may be the seat of disease among the thoracic 
viscera ; whether it be of the pleura or the substance of the lung , 
the mucous membrane lining the bronchi or the trachea , or the 
larynx. Furthermore, it will afford the strongest evidence as to 
the existence of induration, hepatization, or any irregularity that 
may exist in the respiratory action of the lungs. It will also indi- 
cate the existence of hydrothorax, and of effusion of lymph into 
the cavities of the pleura or pericardium ; and when these vari- 
ous points come to be carefully studied, and the symptoms indi- 
cated by different forms of disease understood, auscultation will 
very correctly point out whether effusions be of the serous or lym- 
phatic character ; the extent and nature of any obstruction that may 
exist in the substance of the lung ; or whether we are to refer any 
disease that may affect the heart itself to the substance of that 
organ or to the pericardium. 
Again, in ascites and in pregnancy, in the latter months, ausculta- 
tion proves of the highest value to us. 
It is impossible for any one person to be able to study so compre- 
hensive a subject through all the various and important forms of 
disease, so that he can accurately point out the nice distinctions 
between all the symptoms exhibited. I must, however, in justice 
say, I know many instances in which the auscultatic examination 
has shewn such very accurate results, as has been proved by the 
post-mortem examinations, that I am certain, ultimately, this sub- 
ject, when proved and verified by the observations of the many, 
will fully bear out any opinion, however high, that may may be 
entertained of its merits and importance. 
I have adopted the term “ auscultation,” meaning thereby the 
employing of the EAR alone, without aid from any instrument ; and 
though the medical profession always employ an instrument (the 
stethoscope) from motives of delicacy, we, in our practice, do not 
require such, not even if it were of any real utility, which it is 
not, but actually the reverse. 
About twenty years ago I commenced a series of observations 
on healthy and diseased respiration. I commenced with the ste- 
thoscope, and steadily employed the instrument for two years; but 
I must confess that, at the end of this time I knew but little more 
than when I began my experiments. I doubted the efficacy of 
the instrument itself, and the goodness of my own ear — I tried 
