Physical Signs. In this stage cavities are formed. If the cavities be small, and considerable tuberculated lung surrounds them, the sound, upon percussion, is still dull.
If the cavity be large, and near the surface, there is occasionally a tympanitic sound with musical tone.
Sometimes a sound is heard like striking a cracked pot.
Gurgling; cavernous rattle; cavernous breathing; aniphoric breathing; now and then, metallic tinkling; pectoriloquy; cavernous cough.
General Symptoms. Great loss of flesh, and weakness; diarrhea and night sweats; swelling of the feet and legs; sore mouth; and like crumbs of cheese. raising of matter with specks of tubercle in it
Observations. The gurgling rattle is caused by air displacing liquids, and the formation and bursting of bubbles. It resembles the sound produced by blowing through a tube immersed in soap suds.
Cavernous breathing is nothing more nor less than the sound produced by air, breathed in and out, entering and retiring from a cavity. The air appears, sometimes, to one listening with the stethoscope, as if it were sucked into his ear during inspiration, and blown back again during expiration.
Amphoric respiration is simply an augmentation of cavernous breathing, and results, of course, from an increase of size in the cavity.
In pectoriloquy, words uttered by the patient seem to pass through the stethoscope into the ear of the listener. The cavity should be empty, moderate in size, and have dense walls, in order to furnish the best specimen of this sound.
Air suddenly driven backward through the windpipe, and out of the mouth and nose, by smart raps upon the chest over a cavity, gives the sound of the cracked pot. It is best heard when the patient's mouth is partly open. The same sound is produced, on the same principle, by locking the fingers of the two bands, and joining the palms, so as to leave a small space or cavity between them, and then expelling the air from that cavity, by gently striking the back of one hand upon the knee.
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