A practical treatise on medical diagnosis for students and physicians / by John H. Musser.

  • Musser, John Herr, 1856-1912.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on medical diagnosis for students and physicians / by John H. Musser. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    487/1378 (page 461)
    The Subcutaneous Tissue and the Muscles. In disease: oedema or sub- cutaneous emphysema may occur in the conditions mentioned under gen- eral inspection. If there is too much fat over the surface of the chest, the muscles may be wanting in tone, thus preventing an estimation of the respiratory capacity. The Ribs. In disease: wasting of the fat and muscles is seen in phthisis, carcinoma, diabetes, muscular atrophy, and paralysis. The degree of softness of the ribs can be diagnosticated in a measure by undue depres- sion of the ribs at the costocartilaginous articulations and at the base of the chest (about the sixth rib) during the act of inspiration. It is an indication of rhachitis. Eigidity of the thorax, equal to the senile fixa- tion, occurs in some adults in middle life, and, as Roberts points out, in young subjects may be due to congenital syphilis. Transverse section of healthy male adult chest. Semicircumference, right side, 16% inches; left side, 16% inches; expansion, 3% inches. (Ward 6, Philadelphia Hospital.) The Shape and Size of the Chest. An acquaintance with the normal shape and size is a necessary preliminary to an understanding of the altera- tions in disease. In Health. The shape of the chest is the shape of its transverse sec- tion, which depends upon the relations of the anteroposterior and the transverse diameters. It is that of an ellipse, and has been described as reniform. (See Fig. 133.) The anteroposterior diameter is about one-fourth less than the transverse. In children the transverse section is more cir- cular, the anteroposterior and transverse diameters being almost equal. (See Fig. 134.) In health the chest should be symmetrical, the right side probably a little larger than the left. The muscles of respiration should be well developed, and there should be a moderate amount of subcutaneous fat. The sternum should project forward from above downward, and the por- tion where the manubrium and the gladiolus join should be a little more prominent than any other part. It is not unusual to see a clearly marked