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The angio-sarcomas are those in which blood vessels form a prominent element in the structure of the tumour. They are sometimes derived from innocent angiomas, and they may be so vascular as to pulsate and on auscultation yield a blowing murmur like an aneurysm. The glio-sarcoma, myxo-sarcoma, chondro-sarcoma, and myo-sarcoma are mixed forms which usually develop in pre-existing innocent tumours.
There was no evidence of any fracture, but the man suffered greatly from dyspnea, pain between the shoulders, and collapse. The breath-sounds on auscultation and the difficulty in swallowing led to the belief that one of the bronchi was blocked by the pressure of a hematoma.
The patient was the mother of nine children, the youngest of which was three years old. Young speaks of a woman who three months previously had aborted a three months' fetus, but a tumor still remained in the abdomen, the auscultation of which gave evidence of a fetal heart-beat.
B. W. Richardson succeeded in fitting it for auscultation of the heart and lungs; while Sir Henry Thompson has effectively used it in those surgical operations, such as probing wounds for bullets or fragments of bone, in which the surgeon has hitherto relied entirely on his delicacy of touch for detecting the jar of the probe on the foreign body.
The first signs, proving that the animal has been seized, can scarcely be detected by any but a professional man; though, if a proprietor of cattle were extremely careful, and had pains-taking individuals about his stock, he would invariably notice a slight shiver as ushering in the disorder, which for several days, even after the shivering fit, would limit itself to slight interference in breathing, readily detected on auscultation.
The course of croupous pneumonia is typical, and unless it terminates fatally in the first stage, the periods of congestion, hepatization and resolution follow each other in regular manner. Auscultation of the lungs is of great value in diagnosing and watching the progress of the disease.
The exploration of the chest by auscultation gives a true picture of it in pleurisy; and, by placing the dog alternately on his chest, his back, or his side, we can readily ascertain the extent to which effusion exists in the thoracic cavity; and, if we think proper, we can get rid of the fluid.
The doctor, of course, skilled in auscultation, will listen to the chest and give to all these symptoms their true signification. The lesson for the parent to bear in mind is never to neglect in a child the symptoms of what may seem to be but a common cold, but to seek for advice the moment the cough shows any disposition to become hard, or the breathing hurried.
He who should now undertake to practise general medicine without having first made himself proficient in the detection and interpretation of the sounds elicited by auscultation and percussion in diseases of the heart and lungs would foredoom himself to failure.
We repeat, that this auscultation brings encouragement; it is by this persistence in encouragement that we wish to conclude these pages, an austere interlude in a mournful drama. Beneath the social mortality, we feel human imperishableness. The globe does not perish, because it has these wounds, craters, eruptions, sulphur pits, here and there, nor because of a volcano which ejects its pus.
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