None
pelvic, 485 radiography of, 191 Diaphragmatic phenomenon, 75 abolition of, 76 pleura, 30 XDleurisy, 306 Diastasis, of recti, 522, 534 Diastolic collapse, jugular, 331 murmurs, 382 aortic, 386 pulmonary, 390 pressure, 397 Diathesis, gouty, 209 Dicrotic notch, 349 pulse, 349 wave, 349 Dilatation, auricular, left, 476, 478 right, 476, 478 bronchial, 214 cardiac, 474 diagnosis, 478 differential, 478 pathology, clinical, 474 physical signs, 476 ventricular, left, 476 right, 476 with hypertrophy, 475 with thinning, 475 Diplegia, 662 Diphtheria, nasal, 615 Disease, Addison's, 609 Banti's, 566 congenital, of heart, 478 Corrigan 's, 425 Hodgkin's, 573, 634 Little's, 660 Morvan's, 641 Paget 's, 655 Pott's, 634 Eaynaud's, 641 Stokes-Adams, 377 valvular, chronic, 423 Woillez's, 239 Diseases, of bronchi, 205 of circulatory organs, 407 of endocardium, 418 of lungs, 232 of myocardium, 418 of pericardium, 407 of pleura, 297 of respiratory organs, 205 Displaced kidney, 588 Dittrich's plugs, 209 Diverticulum, esophageal, 270 Double murmur of Duroziez, 395 pneumonia, 234 Dry rales, 159 Duct, common, 553 cystic, 553 hepatic, 553 Dullness, 1^ at apices, 129 at bases, 129 cardiac, area of, 359 relative, 126, 359 absolute, 130, 359 displacement of, 362 general decrease, 362 increase, 362 increase to left, 363 to right, 363 upward increase, 363 variations in, 361 hepatic, 563 absence of, 564 decrease of, 565 increase of, 566 in bronchopneumonia, 243 in cardiohepatic angle, 130 in chronic bronchitis, 210 in chronic interstitial pneumonia, 248 in chronic ulcerative phthisis, 129 in lobar pneumonia, 129 in pulmonary edema, 129 in serofibrinous pleurisy, 129 of lung, 130 scapular, 129 over Traube 's semilunar space, 130 paravertebral, 129 sloping, 535 sternal, 129 unilateral, of thorax, 129 vascular, 365 Duodenojejunal flexure, 533 Duodenum, clinical anatomy, 533 Dupuytren 's contracture, 644 Duration, of percussion sound, 118 of pulse, 356 Duroziez 's sign, 395 in aortic regurgitation, 395 Dyspnea, 79 anemic, 81 cardiac, 80 expiratory, 79 hemic, 80 inspiratory, 79 in atelectasis, 273 bronchial asthma, 80, 221 bronchopneumonia, 242 chronic adhesive pleurisy, 312 emphysema, hypertrophic, 276 phthisis, 261 pulmonary congestion, 227 edema, 228 toxemic, 80 E Ear, congenital defects, 603 cyanosis, 604 cysts, 604 INDEX 713 Ear— Cont 'cl. discharge from, 604 examination of, 603 hematoma, 604 keloid, 604 otomycosis, 604 tophi, 604 Ebstein's cardiohepatic angle, 121, 360 dullness of, 130 Echinococcus cyst, of kidney, 593 of liver, 559 lung, 105 Echolalia, 610 Edema, angioneurotic, 617 of eyelids, 611 of forearm, 647 of glottis, 33 of lungs, 227 acute, 227 chronic, 228 diagnosis, 229 general, 227 local, 227 pathology, clinical, 227 physical signs, 228 of thigh, 653 of thorax, 55 Effects of valvular lesions, 423 Effusion, pericardial, 410 pleural, 299 Egophony, 158 in lobar pneumonia, 158 serofibrinous pleurisy, 158, 304 Elbow, miner's, 649 Ellis' curve, 305^ Embolic abscess of lung, 286 gangrene of lung, 290 Embryocardia, 379 Emphysema, acute vesicular, 281 pathology, clinical, 281 physical signs, 282 atrophic, 278 diagnosis, 279 pathology, clinical, 278 physical signs, 279 thorax of, 278 chronic, 274 compensatory, 279 diagnosis, 281 pathology, clinical, 279 physical signs, 280 diffuse, 274 hypertrophic, 274 diagnosis, 278 differential, 278 Freund's theory of, 275 pathology, clinical, 274 physical signs, 276 thorax of, 60 idiopathic, 274 Emphysema — Cont 'd. palpation of, 562 surface markings, 549 Galloping consumption, 254 Gallop-rhythm, 371 Gallstone crepitus, 563 Ganglion, 644 Gangrene, of fingers, 641 of lung, 289 after lobar pneumonia, 234 circumscribed, 290 diagnosis, 294 diffuse, 290 pathology, clinical, 289 physical signs, 292 sputum in, 292 of toes, 650 Gastrectasis, 522 Gastritis, acute, 525 Gastrodiaphany, 524 Gastroptosis, 506, 522 abdominal contour in, 506 Geographical tongue, 624 Gerhardt's change of sound, 138 Gland, Blandin-Nuhn's, 625 mammary, 45 as landmark of thorax, 45 hypertrophy of, 55 thyroid, 631 palpation of, 631 Glands, enlarged, cervical, 632 epitrochlear, 638 inguinal, 498 occipital, 633 parotid, 633 submaxillary, 632 supraclavicular, 634 tracheobronchial, 30, 34 Glandular enlargement, 632 Glenard's belt sign, 526 Globe, of eye, 612 position of, 613 Goiter, cystic, 632 exophthalmic, 610, 612, 632 fibrous, 631 Gout, toe of, 650 tophi of, 604, 638 Grinder's rot, 271 Grocco 's sign, 129 in purulent pleurisy, 311 serofibrinous pleurisy, 129 Groove, Harrison's, 67 Gumma ^ pulmonary, 267 Gums, blue line, 621 examination of, 621 in copper poisoning, 621 in mercurial poisoning, 621 in pellagra, 621 in plumbism, 621 in pyorrhea alveolaris, 621 in scorbutus, 621 716 INDEX Gums — Cont 'cl. in ulcerative stomatitis, 621 red line, 621 sponginess, 621 tumor, 621 Gurgling, in hourglass stomach, 532 rales, 164 Gutta cadens, 167 Habit spasm, 610 Hair, color, 602 crepitus, 147 falling, circumscribed, 601 general, 601 Hand, accoucheur's, 644 ape, 644 claw, 643 examination of, 636 hemiplegic, 643 seal-fin, 644 shape, 641 spade, 641 tremor of, 644 Hare-lip, 620 Harrison's sulcus, 67 Haygarth's nodosities, 640 Head, bones, 600 cretinoid, 600 deviation, lateral, 602 examination of, 599 fixation, 602 • fontanelles, 600 hydrocephalic, 600 movements, 603 position, 602 rachitic, 599 radiography, 187 shape, 599 size, 599 sutures, 600 Heart, 317 aneurysm, 468 apex of, 317, 325 displacement of, 336 site of, 334 thrill at, 345 arrhythmia, 372 clinical types, 374 atrophy, 337 auricles, 318 auscultation, 366 automaticity, 372 base, 317, 324 pulsation at, 328 thrill at, 345 beat, myogenic, 373 neurogenic, 373 block, arrhythmia, 378 complete, 378 Heart block^Cont 'd. partial, 378 borders, 317, 324, 325 conductivity, 372 cycle, 372 dilatation, 474 (see Dilatation, car- diac) disease, congenital, 478 diagnosis, 480 pathology, clinical, 478 physical signs, 480 dullness, area of, 359 decreased, 363 displaced, 362 increased, 362 extrasystole of, 378 failure cells, 228 flatness, area of, 359 hypertrophy, 470 (see Hypertro- phy, cardiac) impulse, 334, 346 irritability, 373 nerve sui^ply, 374 palpation, 343 palpitation, 376 rapid, 375 rhythmicity, 373 slow, 376 sounds, 366 accentuation of, 368 adventitious, 380 diminution of, 368 duration of, 372 equalization of, 380 fetal, 518 first, 366, 369 accentuation of, 369 enfeeblement of, 369 reduplication of, 371 in acute myocarditis, 468 in aortic regurgitation, 433 stenosis, 440 in cardiac dilatation, 477 hypertrophy, 474 in chronic adhesive pericarditis, 415 myocarditis, 470 in lobar pneumonia, 236 in mitral regurgitation, 449 stenosis, 455 in pulmonary regurgitation, 458 stenosis, 461 in serofibrinous pericarditis, 412 in tricuspid regurgitation, 464 stenosis, 465 intensity of, 368 reduplication of, 371 second, 366, 369, 370 accentuation of, 369 enfeeblement of, 370 reduplication of, 371 INDEX 717 Heart— Cont 'd. surface markings, 324 tonicity, 372 valves, 320, 326 ventricles, 319 Heberden's nodes, 640 Hematoma auris, 604 Hemeralopia, 675 Hemianopia, 677 homon}anous, 677 heteronymous, 677 nasal, 677 temporal, 677 Hemiatrophy, facial, 608 Hemic murmurs, 390 Hemichorea, 662 Hemihypertrophy, facial, 609 Hemiplegia, 643, 662 contractures in, 643 gait in, 659 hand in, 643 Hemopericardium, 416 pathology, clinical, 416 physical signs, 416 Hemopneumothorax, 314 Hemoptysis, in Ijronchiectasis, 216 in phthisis, 261 in pulmonary gangrene, 230 infarction, 230 syphilis, 268 Hemorrhage, in phthisis, 257 internal, signs of, 313 Hemorrhagic infarction, of lung, 229 Hemothorax, 313 pathology, clinical, 313 physical signs, 313 Hepatic pulsation, 329 Hepatization, gray of lung, 233 red, of lung, 232 Hepatoptosis, 568 Hernia, diaphragmatic, 337 femoral, 655 umbilical, 497 Herpes labialis, 239, 617 in lobar pneumonia, 239 Hippocratic fingers, 641 succussion sound, 168 Hippus, 679 His, bundle of, 321, 373 Hissing respiration, 78 Hodgkin's disease, 573, 634 Holmgren test, 675 Hordeolum, 612 Horseshoe kidney, 586, 594 Hourglass stomach, 531 Housemaid's knee, 653 Hum, venous, 395 Humming-top murmur, 395 Hutchinson's teeth, 621 Hydatid fremitus, 105 Hydrocephalus, facies of, 605 Hydronephrosis, 586, 589 fluctuation in, 593 Hydropericardium, 416 pathology, clinical, 416 physical signs, 416 Hydropneumothorax, 314 (see Pneu- mothorax) Hydrops, percardii, 416 Hydrothorax, 313 in cardiac disease, 314 in renal disease, 313 pathology, clinical, 313 physical signs, 313 Hyperosmia, 674 Hyperresonance, 130 in compensatory emphysema, 130 hypertroi)hic emphysema, 130 local, 130 pulmonary, 130 relaxation as cause^ 139, 140 Hypertension, 356 Hypertrophic emphysema, 274 (see Emphysema, hypertrophic) Hvpertrophv, auricular, left, 473 right, 473 cardiac, 470 concentric, 470 cor bovinum in, 471 diagnosis, 474 eccentric, 470 general, 470 pathology, clinical, 470 physical signs, 473 pulse in, 474 of nails, 638 ventricular, left, 472 right, 473 Hypochondriac region, 49, 492 Hypogastric region, 492 enlargement, 507 Hypostatic congestion, 226 Hypotension, 356 Ileocecal valve, clinical anatomy, 534 Heum, clinical anatomy, 534 obstruction of, 534 ulceration of, 534 Iliac artery, common, 489 external, 489 crest, 487 region, 492 spine, 487 Illumination, direct, 53 oblique, 53 Immediate auscultation, 145 percussion, 112 Impaction, fecal, 542 Impaired resonance, 116 Impulse, bathmotropic, 373 718 INDEX Impulse — Cont 'd. cardiac, 334, 346 absence, 334 displacement, 336 downward, 337 to left, 337 to right, 339 upward, 337 double, 340 extent, 339 force, 340 site of, 334 in child, 334 chronotropic, 374 dromotropic, 374 inotropic, 373 Incisura cardiaca, 40 Incurvation, of nails, 637 Infarction, of lungs, 229 of spleen, 573 Infective endocarditis, 418 Infiltration, carcinomatous, of lung, 295 purulent, of lung, 286 Infraaxillary region, 50 Infraclavicular fossa, 44 region, 49 Infrascapular line, 47 region, 50 Inguinal adenitis, 654, glands, enlarged, 498, 654 Innominate artery, 358 aneurysm of, 358 Inorganic murmurs, 390 Inspection, of abdomen, 495 of bladder, 597 epigastrium, 521 gall bladder, 553 intestine, large, 538 small, 534 kidneys, 586 liver, 553 precordia, 327 spleen, 572 stomach, 521 thorax, 52, 327 Inspiration, prolonged, 77 Instrumental estimation of blood pressure, 397 percussion, 112 Insufficiency, aortic, 425 mitral, 441 pulmonary, 457 tricuspid, 462 relative, 462 Intensity, of murmurs, 382 of percussion sound, 118 Intention tremor, 644 Intercostal nerves, 25 spaces, 44, 55, 61, 64, 84, 107 as landmark of thorax, 44 Intercostal spaces — Cont 'd. bulging, 55 narrowing, 55 retraction, 55, 61, 84 tenderness, 107 widening, 55, 61, 64 muscles, 25 neuralgia, 299 Interlobar pleurisy, 307 Intermission, 353 false, 375 Intermittence, 375 Intermittent claudication, 654 Interrupted change of sound, Win- trich's, 135 Interscapular region, 50 contents of, 50 Interstitial keratitis, 613 myocarditis, 469 pneumonia, chronic, 245 circumscribed, 246 diagnosis, 248 diffuse, 246 insular, 247 pathology, clinical, 245 physical signs, 247 pleurogenous, 246 Intertubercular line, 491 Interventricular septum, defects of, 479 Intestinal obstruction, 534 visible peristalsis in, 534 Intestine, large, clinical anatomy, 535 examination of, 538 small, clinical anatomy, 532 examination of, 534 obstruction, 500, 534 Intussusception, 534 Janeway's sphygmomanometer, 400 Jaw-jerk, 671 Jejunum, clinical anatomy, 534 Joint, Charcot 's, 652 Joints, enlarged, of fingers, 640 Jugular veins, auscultation, 395 diastolic collapse, 331 engorgement, 331 murmur in, 395 systolic pulsation in, 331 K Keel breast, 68 in rickets, 68 tonsillar hypertrophy, 68 Keloid, 604 Keratitis, interstitial, 613 Kernig's sign, 652 Kidneys, auscultation of, 591 clinical anatomy, 583 cyst of, 593 INDEX 719 Kidneys — Cont 'd. displaced, 588 enlarged, 586 examination of, 586 fluctuation of, 593 floating, 588 horseshoe, 594 inspection of, 586 mobility of, 592 movable, 588 degrees of, 588 palpation of, 587 polycystic, 593 pulsation of, 594 sensibility of, 589 surface markings of, 585 tumor of, 594 volume of, 591 Knee, housemaid's, 653 jerk, 669 Knock-knees, rachitic, 655 Koplik's spots, 626 Kyphosis, 63, 66, 69 Laennec's catarrhe sec, 208 pituiteux, 209 crachats perles, 208 Lagophthalmos, 612 Landmarks, anatomic, of abdomen, 489 of thorax, 44 Laryngeal stenosis, 77, 225 breathing in, 225 Larynx, clinical anatomy, 31 cavity of, 32 deflection of, 32 movements of, 631 obstruction of, 77 prominence of, 32, 64 Laryngophony, 155 Left auricle, clinical anatomy, 318 ventricle, 319 Legs, atrophy, 651 bowing, 651 examination of, 651 nodes, 651 ulcer, 651 varicose veins, 651 Leontiasis ossium, facies of, 608 Leprosy, facies of, 608 Leukemia, lymphatic, 573 splenomedullary, 573 Leukoplakia, 624 Ligament, coronary, 551 falciform, 549 Poupart's, 486 Ligamentum arteriosum, 323 latum pulmonis, 36 Ligneous phlegmon, 635 Limb, anacrotic, 349 catacrotic, 349 Limit, of resonance, 123 variations in, 123 Line, axillary, anterior, 46 posterior, 46 clavicular, 47 costal, sixth, 47 third, 47 costoarticular, 570 cricoclavicular, 46 infrascapular, 47 intertubercular, 491 mammary, 46 midaxillary, 46 midclavicular, 46 mid-Poupart, 491 midspinal, 46 midsternal, 46 nipple, 46 of transmission of murmurs, 382 scapular, 46 spinal, 47 sternal, 46 subcostal, 491 twelfth dorsal, 47 Linea alba, 489 nigra, 480, 496 semilunaris, 488 Lineae albicantes, 495 transversae, 489 Lips, chancre, 617 cyanosis, 616 enlargement, 617 epithelioma, 618 fissures, 617 herpes, 617 mucous patch, 617 pallor, 616 parted, 617 pendulous, 617 rhagades, 617 Litten's phenomenon, 75 absence of, 76 Liver, abscess of, 566 amyloid, 560 areas of dullness and flatness, 563 atrophy, 559 auscultation of, 568 carcinoma of, 559 clinical anatomy, 549 consistence of, 560 corset, 552 cyst of, 559 decreased size of, 565 displacement of, 568 dullness of, 563 enlargement of, 558 flatness of, 563 floating, 564 fluctuation of, 560 720 INDEX Liver — Cont 'cl. inspection of, 553 mobility of, 554, 561 palpation of, 556 percussion of, 563 pulsation of, 563 Eiedel's lobe, 552 sensibility of, 560 surface markings, 553 syphilis of, 559 tumors of, 554 Lobar pneumonia, 232 abscess of lung after, 234 apical, 234 central, 234 cirrhosis of lung after, 234 clinical types, 234 decubitus in, 234 diagnosis, 236 differential from acute pneumonic phthisis, 238 bronchopneumonia, 238 pulmonary congestion, 239 edema, 239 infarction, 238 serofibrinous pleurisy, 239 distribution. 234 double, 234 gangrene of lung after, 234 heart sounds in, 236 massive, 234 pathology, clinical, 232 physical signs, 234 pleurisy in, 233 pulse in, 235 purulent infiltration in, 286 rale indux in, 236 re dux in, 236 sputum in, 233 stage of engorgement, 232 gray hepatization, 233 red hepatization, 232 resolution, 233 Lobe, Riedel's, 552 Lobes, of lungs, 35, 42 Lobular pneumonia, 240 {see Bron- chopneumonia) Local bulging, 70 pulsation, 85, 108 retraction, 71 pleurisy, 306 Loculated pleurisy, 307 Lordosis, 45, 66, 69 Lorenz's sign, 260 Louis, angle of, 44 Ludovici, angulus, 44 Ludwig's angina, 635 Lumbar region, 492 Lungs, abscess of, 283 albinism of, 276 alveoli of, 38 Lungs — C»nt 'd. apex of, 34 auscultation of, 145 base of, 34 borders, 35, 41 bronchioles, 37 capillaries, 38 carcinoma of, 295 catarrhal pneumonia, 240 cavities, tympany in, 262 circulation of, 38 circulatory disturbances of, 226 cirrhosis of, 245 clinical anatomy of, 34 collapse of, 272 congestion of, 226 costal surfaces of, 35 diseases of, 232 dullness of, 128 edema of, 227 emphysema of, 282 endothelioma of, 295 excursion of, 36, 125 fibroid retraction of, 245 fissures of, 35 fistula, sound of, 171 flatness of, 130 gangrene of, 289 hepatization of, 232 hilus of, 35 induration of, 270 infarction of, 229 infundibula of, 38 inspection of, 52 ligamentum latum of, 36 lobes of, 35 lower borders, 41 lymphatics of, 35, 39 mediastinal surfaces, 35 normal limits of, 41 palpation of, 86 pancreatization of, 267 percussion of. 111 apices, 115 auscultatory, 116 palpatory, 115 resonance of, 119 root of, 35 sarcoma of, 295 sclerosis of, 270 splenization of, 241 surface markings of, 41 syphilis of, 266 tuberculosis of, 249 tumors of, 295 primary, 295 secondary, 296 tympany of, 130 Lymphatics, pulmonary, 39 Lymph nodes, mediastinal, 39 pulmonary 39 tracheobronchial, 30, 39 INDEX 721 M Macrochcilia, 617 Maeroglossia, 621 Macrotia, 603 Main-en-griffe, 643 Malignant endocarditis, 418 diagnosis, 421 physical signs, 420 Mai perforante, 650 Mammary gland, 45 as landmark of thorax, 45 hypertrophy of, 55 line, 48 region, 49 contents of, 49 Manubrium sterni, 30 Mastoid tenderness, 601 McBurney's point, 539 Mechanical bronchitis, 207 Mediastinal glands, 39 pleura, 30 Mediastinopericarditis, 270, 413 Mediastinum, 29 anterior, 30 contents of, 31 middle, 30 contents of, 31 posterior, 30 contents of, 31 superior, 30 contents of, 30 Mediate auscultation, 146 percussion, 112 rules governing, 112, 113 Megalonychosis, 638 Mensuration, of abdomen, 518 of thorax, 173 Metallic tinkle, 167 Meteorism, 503 abdominal contour in, 503 Microtia, 603 Midaxillary line, 46 Midclavicular line, 46 Mid-Poupart line, 491 Midspinal line, 46 Midsternal line, 46 Miliary tubercle, 250 tuberculosis, acute, 251 diagnosis, 252 pathology, clinical, 251 physical signs, 251 Millstone maker 's phthisis, 271 Miner's elbow, 649 Mitral area, 367 insufficiency, 441 incompetence, 441 murmurs, 383 presystolic, 383 systolic, 384 regurgitation, 441 diagnosis, 449 Mitral regurgitation — ^Cont 'd. differential, 450 pathology, clinical, 441 physical signs, 445 pulm.onary sound in, 449 pulse in, 447 relative, 442 sourd, accentuation of, 369 diminution of, 369 stenosis, 451 buttonhole orifice in, 451 diagnosis, 455 diifeicntial, 455 pathology, clinical, 451 physical signs, 453 pulse in, 454 thrill in, 454 valve, 320 anatomical site, 367 auscultatory area, 367 Moist rales, 159, 162 Monaural stethoscope, 145 Money-chink resonance, 142 i\Ionoplegia, 661 Morbus ceruleus, 480 Morvan 's disease, 641 Movable kidney, 588 Macous click, 163 patch, 617, 626 rales, 163 Multiple murmurs, 391 sclerosis, tremor of, 644 Mural endocarditis, 418 Murmurs, accidental, 390 aortic, 384 diastolic, 386 systolic, 385 arterial, 394 diastolic, 394 systolic, 394 cardiorespiratory, 392 diastolic, 382 double, in aortic regurgitation, 434 Duroziez 's, 395 endocardial, 380 Flint, 384 functional, 390 differentiated from organic, 391 relative incidence of, 391 generation of, 380 hemic, 390 humming-top, 395 inorganic, 390 intensity of, 381 line of transmission of, 382 mitral, 383 presystolic, 383 systolic, 384 multiple, 391 separation of, 392 nun 's, 395 722 INDEX Murmurs — Cont 'd. organic, 380 point of maximum intensity of, 381 presystolic, 382 properties of, 381 pulmonary, 389 diastolic, 390 systolic, 389 quality of, 382 safety-valve, 462 systolic, 382 time of, 382 tricuspid, 387 presystolic, 388 systolic, 388 vascular, 394 venous, 395 Muscles, papillary, 319 Musculature, of thorax, 54 wasting of, 54 Mydriasis, irritative, 680 paralytic, 680 Myocarditis, acute, 467 diagnosis, 468 interstitial, 467 nonsuppurative, 467 parenchymatous, 467 pathology, clinical, 467 physical signs, 468 suppurative, 467 chronic, 469 diagnosis, 470 fibrous, 469 interstitial, 469 pathology, clinical, 469 physical signs, 470 Myocardium, 318 diseases of, 467 properties of, 372 Myoidema, 262 Myomalacia cordis, 469 Myosis, irritative, 680 paralytic, 680 Myotonia congenita, 622 Myxedema, 601, 605, 632 facies of, 605 foot of, 651 hand of, 641 head of, 600 N Nails, arrested growth, 638 atrophy, 638 brittleness, 638 capillary pulse, 636 cyanosis, 636 examination of, 636 grooves, 636 hypertrophy, 638 Nails — ConVd. incurvation, 637 indolent sore, 638 pallor, 636 paronychia, 638 ridges, 637 spots, 636 Neck, elongation, 629 examination of, 629 sears, 635 shape, 629 short, 629 Neoplasms, pulmonary, 295 Nerve, abducent, examination of, 678 auditory, examination of, 684 facial, examination of, 682 glossopharyngeal, examination of, 696 hypoglossal, examination of, 697 oculomotor, examination of, 678 olfactory, examination of, 673 optic, examination of, 674 pneumogastric, examination of, 696 spinal accessory, examination of, 697 trigeminal examination of, 681 trochlear, examination of, 678 Nerves, intercostal, 25 Nervous system, examination of, 657 Neuralgia, intercostal, 299 Neurone, motor, lower, 657 upper, 657 sensory, 658 Nipple, as landmark of thorax, 45 Nodding spasm, 603 Node, sinoauricular, 321 of Tawara, 379 Nodes, bronchial, 30, 39 Heberden's, 640 inguinal, enlarged, 498 tracheobronchial, 30, 34 Nodosities, Haygarth's, 640 Noma, 620, 626 Nose, examination of, 614 pseudomembrane of, 615 redness of, 614 saddle, 614 shape of, 614 ulceration of, 615 Notch, dicrotic, 349 episternal, 44 pulsation in, 329 suprasternal, 44 umbilical, 549 Nun's murmur, 395 Nyctalopia, 675 Nystagmus, 680, 685, 688 aural, 680 induced, 688 spontaneous, 685 INDEX ^23 O Obesitj^, abdominal contour in, 501 Obturation atelectasis, 224 Occipital glands, enlarged, 633 Oculocardiac reflex, 613 Oligopnea, 77 Oliver's estimation of venous pres- sure, 406 sign, 34, 483, 631 Onycliogryposis, 638 Onychia, 638 Opacity, corneal, 614 Orifice, aortic, 322 auriculoventricular, 319 cardiac, 520 23yloric, 520 Orthopnea, 81 Osteal resonance, 121 Osteitis deformans, 655 facies of, 605 Osteoarthropathy, pulmonary, 641, 655 Osteoma, 185 Osteomalacia, 655 Osteomyelitis, 185 Osteosarcoma, 185 Othematoma, 604 Otitis media, 604 Otomycosis, 604 Ovarian cyst, 547 Paget 's disease, 655 Palate, cleft, 620 paralysis of, 627 perforation of, 627 Palpation, of abdomen, 511 of bladder, 597 of cardiac impulse, 346 of epigastrium, 524 of gall bladder, 562 of intestine, large, 538 small, 534 of kidney, 587 of liver, 556 of pancreas, 547 of preeordia, 343 of siDleen, 574 of stomach, 524 of thorax, 86 of ureter, 598 technic of, 86 ulnar, 87 Palpatory percussion, 115 Palpitation, 376 Pancreas, clinical anatomy, 544 carcinoma of, 547 cyst of, 547 examination of, 546 tumor of, 547 Pancreatitis, acute, 525 Pancreatization, of lung, 267 Papillary muscles, 319 Paradoxical pulse, 354 in chronic adhesive pericarditis, 415 serofibrinous pericarditis, 411 Paralysis, abducent, 681 agitans, gait of, 661 propulsion in, 661 retropulsion in, 661 tremor of, 644 brachial, 647 bulbar, chronic, 617 Duchenne-Erb type, 647 facial, 683 flaccid, 661 glosso-labio-laryngeal, 621 glossopharyngeal, 696 hypoglossal, 697 Kulmpke type, 647 musculospiral, 644 of leg, 655 of palate, 627 of tongue, 622 pneumogastric, 696 spastic, 661 spinal accessory, 697 trigeminal, 682 trochlear, 681 Paralytic thorax, 63 Paramyoclonus multiplex, 648 Parasternal line, 46 Paratyphilitis, 539 Paravertebral dullness, 129 Grocco 's triangle of, 129 Paresis, 613 Paronychia, 638 Parosmia, 674 Paroxysmal tachycardia, 376 Past-pointing, 686 Patch, mucous, 617, 626 smoker's, 624 salmon, 614 Patent ductus arteriosus, 479 foramen ovale, 479 Pause, compensatory, of heart, 373 Pectoriloquy, 157 whispering, 157 Pectus carinatum, 68 Pellagra, forearms in, 647 gums in, 621 tongue in, 625 Pelvis, 485 Percussion, auscultatory, 116 cardiac, 361 deep, 117 finger, 112 flicking, 516 force of, 117 immediate, 112 instrumental. of abdomen, 516 of anterior chest wall, 111 of axillary region, 111 of back. 111 of bladder, 597 of epigastrium, 527 of heart, 359, 361 of intestine, large, 542 small, 534 of kidney, 595 of liver, 563 of lungs. 111 of precordia, 359 of spleen, 578 of stomach, 527 of thorax. 111, 359 palpatory, 115 respiratory, 117 scratching, 529 sense of resistance in, 117 sound, 118 abnormal, 126 amphoric, 141 attributes of, 118 cracked-pot, 142 dull, 128 duration of, 118 flat, 130 hyperresonant, 130 impaired, 126 intensity of, 118 normal, 119 pitch of, 118 quality of, 118 resonant, 119 Skodaic, 139 special, 130 tympanitic, 130 superficial, 117 Pericardial friction, 393 fremitus, 344 succussion, 393 Pericarditis, 407 adhesive, chronic, 413 Broadbent 's sign in, 414 diagnosis, 415 Friedreich 's sign in, 414 Kussmaul's sign in, 414 pathology, clinical, 413 physical signs, 414 clinical types, 407 external, 413 exudativa, 410 fibrinous, acute, 407 diagnosis, 409 differential, 409 pathology, clinical, 407 physical signs, 408 internal, 413 primary, 407 Pericarditis»— Cont 'd. secondary, 407 serofibrinous, 410 Auenbrugger's sign in, 411 Bamberger 's sign in, 412 diagnosis, 412 differential, 412 Ewert's sign in, 411 milk spots in, 410 pathology, clinical, 410 physical signs, 410 pulse in, 411 Botch's sign in, 411 sicca, 407 with effusion, 410 Pericardium, clinical anatomy, 321 diseases of, 407 Perichondritis, of auricle, 604 Perihepatitic friction, 516, 568 Perilymphadenitis, bronchial, 270 Perinephritic abscess, 594 Period, refractory, of heart, 373 Perisplenitic friction, 516, 577 Perisplenitis, 516, 577 peritoneal friction in, 516, 577 Peristalsis, visible, of intestine, 499, 500, 534 of stomach, 499, 500, 525 Peritoneal friction, 516, 568, 577 in perihepatitis, 516, 568 in perisplenitis, 516, 577 in peritonitis, 516 Peritonitis, acute, 501 tuberculous, 534 Perity23hilitis, 539 Pes planus, 650 Pharynx, bulging of, 627 eruptions of, 627 examination of, 627 redness of, 627 ulceration of, 627 Phenomenon, Biermer 's, 139 Litten's, 75 absence of, 76 Phlegmasia alba dolens, 655 Phlegmon, ligneous, 635 AYOody, 635 Phthisical thorax, 63 Phthisis, bronchopneumonic, acute, 254 chronic ulcerative, 255 (see Cliron- ic ulcerative phthisis) fibroid, 264 (see Fibroid phthisis) florida, 254 millstone maker's 271 pneumonic, acute, 252 stone-cutter 's, 271 tuberculopneumonic, acute, 252 Physiologic venous pulse, 332 INDEX 725 Pigeon breast, 68 cross section of, 68 in rickets, 68 Pit, of stomachy 44 Pitcli, of percussion sound, 118 of tymj^any, 132 Plastic pericarditis, 407 pleurisy, 297 Plateau, systolic, 350 Pleura, clinical anatomy, 29 costal, 29 diseases of, 297 diaphragmatic, 30 mediastinal, 30 parietal, 28 surface markings of, 39 visceral, 30 Pleural adhesions, 311 cavity, clinical anatomy, 29 dropsy of, 313 (see Hydrotho- rax) effusion into, 299 friction, 169 fremitus, 103 sinus, complementary, 41 Pleurisy, adhesive, chronic, 311 diagnosis, 312 pathology, clinical, 311 physical signs, 312 diaphragmatic, 306 diagnosis, 307 pathology, clinical, 306 physical signs, 306 encysted, 307 fibrinous, acute, 297 diagnosis, 299 differential, 299 pathology, clinical, 297 physical signs, 298 interlobar, 307 diagnosis, 308 pathology, clinical, 307 physical signs, 308 local, 306 loculated, 307 pathology, clinical, 307 physical signs, 307 plastic, 297 purulent, 308 Baccelli's sign in, 157 diagnosis, 311 Grocco 's sign in, 311 pathology, clinical, 308 physical signs, 310 thorax in, 311 visceral displacement in, 311 sacculated, 307 serofibrinous, 299 Baccelli's sign in, 304 decubitus in, 301 diagnosis, 304 Pleurisy, serofibrinous — Cont 'd. differential, 304 egophony in, 304 Ellis's curve in, 305 Grocco 's sign in, 303 mensuration in, 304 pathology, clinical, 299 physical signs, 301 unilateral bulging in, 301 visceral displacement in, 301 Pleuritis, exudativa, 299 sicca, 297 Pleurodynia, 299 Pleuropericarditis, 298, 410, 413 Pleximeter, 112 Plexor, 112 Pneumonia, alba of fetus, 266 apical, 234 aspiration, 240 catarrhal, 232 central, 234 clinical types, 234 croupous, 232 deglutition, 240 disseminated, 242 interstitial, chronic, 245 lobar, 232 lobular, 240 massive, 234 migratory, 234 productive, 245 pseudolobar, 242 syphilitic, 268 Pneumonic phthisis, acute, 252 Pneumonokoniosis, 268 clinical types, 269 diagnosis, 272 pathology, clinical, 268 phthisis and, 271 physical signs, 271 sputum in, 271 Pneumopericardium, 416 diagnosis, 417 pathology, clinical, 416 physical signs, 417 Pneumothorax, 314 Biermer's phenomenon in, 316 closed, 315 coin test in, 316 cracked-pot sound in, 316 diagnosis, 316 gutta cadens in, 316 lung-fistula sound in, 316 open, 315 pathology, clinical, 314 physical signs, 315 succussion in, 316 tympany in, 316 Point, McBurney's, 539 Signorelli 's, 576 Valleix's, 25 726 INDEX Poliomyelitis, anterior, acute, 603 Polypnea, 76 Polysystole, 375 Pomum Adami, 32 displacement of, 32 Portal vein, obstruction, 49G caput medusae in, 496 Postdicrotic wave, 349 PostpliaryngeaP abscess, 627 Potain's sign, 365 Potter's asthma, 271 Pott 's disease, 634 Poupart 's ligament, 486 Power, muscular, 661 Precordia, 326 auscultation of, 366 bulging of, 327 inspection of, 327 palpation of, 343 percussion of, 359 retraction of, 328 Pregnancy, abdominal contour in, 501 Pressure, arterial, 396 blood, 396 diastolic, 397 pulse, 397 systolic, 397 venous, 406 instrumental estimation, 405 Oliver 's method, 406 Presystolic murmur, 382 mitral, 383 tricuspid, 388 thrill, 345 Prevost's sign, 681 Productive pneumonia, 245 Prolonged expiration, 77 inspiration, 77 Psoas abscess, 655 Pterygoid thorax, 63 Ptosis, of eyelid, 611 of intestine, 506 of liver, 568 of stomach, 506 Pubic sj)ine, 486 symphysis, 486 Puerile resx)iration, 154 Pulmonary area, 367 artery, 324 circulation, 38 congestion, 226 incompetence, 457 infarction, 229 diagnosis, 231 pathology, clinical, 229 physical signs, 230 insufficiency, 457 murmur, 389 Pulmonary - :spurmur — Cont 'd. diastolic, 390 systolic, 389 neoplasms, 295 diagnosis, 296 pathology, clinical, 295 physical signs, 296 osteoarthropathy, 641, 655 regurgitation, 457 diagnosis, 459 pathology, clinical, 457 physical signs, 457 relative, 457 sound, accentuation of, 370 diminution of, 371 stenosis, 459 diagnosis, 461 differential, 461 pathology, clinical, 459 physical signs, 460 relative, 459 syphilis, 266 tuberculosis, 249 valve, 320 veins, 324 Pulsations, abnormal, areas of, 85, 328 at base of heart, 85, 328 of left lung, 85, 108 at. in apoplexy, 77 in bronchial asthma, 77 in cerebral abscess, 77 hemorrhage, 77 tumor, 77 in diabetes mellitus, 77 in edema of glottis, 78 in emphysema, 77 in laryngeal stenosis, 77 in laryngismus stridulus, 77 in lobar pneumonia, 77 in meningitis, 77, 79 in phthisis, 77 in pleurisy with effusion, 77 in postpharyngeal abscess, 77 in quinsy, 77 INDEX 729 Eespiration — C'oiit 'd. in tonsillar liypertrox^liy, 77 in uremia, 77 meningeal, 78 movements of, 72 normal, 72 pathological variations, 76 phases of, 72 prolonged expiration, 77, 154 insi)iration, 77 puerile, 154 rapid, 76 slow, 77 sterterous, 77 stridulous, 78 upper thoracic, 74 vesicular, 151 normal distribution, 151 pathological variations, 154 Eespiratory arrhythmia, 375 organs, diseases of, 205 examination of, 52 percussion of, 117 Eetraction, of abdomen, 510 of head, 602 precordial, 327 systolic, of thorax, 333 unilateral, of thorax, 70 Ehagades, 617 Ehonchal fremitus, 102 Ehonchi, 159 Ehythm, canter, 371 gallop, 371 of pulse, 352 Eibs, as landmarks of thorax, 44 course of, 60, 64 incurvation of, 56 method of counting, 45 nodules of, 108 obliquity of, 56, 60 64 overlapping of, 56 prominence of, 56, 64 tenderness of, 107 Eickets, 599 bowing of tibiae in, 655 bow-legs in, 655 epiiohyseal swelling in, 647 funnel chest in, 68 Harrison's sulcus in, 67 head of, 599 keel-breast in, 68 knock-knees in, 655 , rosary in, 56, 599 thorax of, 64 Eiedel's lobe, 552 Eight auricle, clinical anatomy, 318 ventricle, 319 Eigidity, of abdominal wall, 513 of rectus, 513 Einia glottidis, 33 Eiva-Eocci sphygmomanometer, 397 Eoentgenogram, in aneurysm, aortic, 201 in bronchopneumonia, 196 in chronic interstitial pneumonia, 196 in lobar pneumonia, 196 in mediastinal neoplasm, 198 in pericarditis, 200 in pleural thickening, 197 in pleurisy with effusion, 197 in pneumothorax, 198 in pulmonary neoplasm, 197 syphilis, 194 abscess, 196 gangrene, 196 in tuberculosis, pulmonary, 191 of diaphragm, 191 of heart, 199 of thorax, 188 of urinary tract, 201 Eoentgenography, 188 Eoentgen rays, 188 Eogers' sphygmomanometer, 402 Eomberg 's sign, 659 Eosary, rachitic, 56 Eose spot, 496 Eot, grinder's, 271 Eotch's sign, 411 Eothschild's sign, 260 Saccular bronchiectasis, 215 Sacculated pleurisy, 307 Saddle nose, 614 Safety-valve murmur, 462 Salmon patches, 614 Sarcoma, of kidney, 593 of lung, 295 Scaphoid abdomen, 510 Scapula, angle of, 45 as landmark of thorax, 45 alar, 63 mobile, 63 winged, 35, 63 Scapular line, 46 spinal, 47 region, 50 contents of, 50 Scarpa's triangle, bulging in, 655 Scars, of abdomen, 655 of forehead, 611 of neck, 635 of thorax, 54 Sclera, blue, 614 yellow, 614 Scleritis, 614 Sclerosis, amyotrophic lateral, 643, 670 730 INDEX Sclerosis — Cont 'd. multiple, 644 hand of, 643 tremor of, 644 Scoliosis, 45, 66, 69 Scotoma, 676 absolute, 677 relative, 677 Scratching percussion, 529 Scrobiculus cordis, 44 Seal-fin hand, 644 Semilunar space of Traube, 130, 520, 530, 582 valves, 320 Sensation, muscular, 666 pain, 665 pressure, 664 stereognostic, 666 tactile, 663 temperature, 664 Septa, cardiac, 479 absence of, 479 interauricular, 479 interventricular, 479 Serofibrinous pericarditis, 410 pleurisy, 299 Shock, valve, 343 aortic, 343 diminished, 343 increased, 343 pulmonary, 343 Sibilant rales, 160 Sibson's fascia, 28 Siderosis, 269 Sigmoid flexure, clinical anatomy, 537 palpation of, 542 Sign, Abadie 's, 610 Auenbrugger 's, 411 Babinski's, 669 Baccelli's, 157 Bamberger 's, 412 Biermer's, 139 Broadbent's, 333, 414 Duroziez's, 395 Erni's, 262 Ewart's, 411 Friedreich's, 137, 331, 414 Gerhardt's, 138 Glenard's, 520 Grocco's, 129 Kernig 's, 652 Kussmaul 's, 414 Litten's, 75 Lorenz's, 260 Oliver's, 34, 483, 631 Potain's, 365 Prevost's, 681 Eomberg's, 659 Botch's, 411 Sign— Cont '^1. Eothschild's, 260 Von Graeffe's, 613 Williams', 191 Wintrich's, 135 Signorelli's point, 576 Simple arrhythmia, 374 endocarditis, 418 Sinus, complementary, 41 node, 321 of Valsalva, 320 venosus, 318 Sixth costal line, 47 Skin, of abdomen, 495 color of, 496 eruptions of, 496 scars of, 495 of thorax, 53 eruptions of, 54 pigmentation of, 53 striae of, 54 Skodaic resonance, 139 in bronchopneumonia, 243 in lobar pneumonia, 235 in serofibrinous jiericarditis, 140 pleurisy, 302 Skull, fracture of, 179, 604 Smoker's patch, 624 Snoring respiration, 77 Sonorous rales, 160 Souffle, umbilical, 518 uterine, 518 Sound, aortic, accentuation of, 369 diminution of, 370 cracked-pot, 142 deglutition, 532 falling-droj), 167 friction, pericardial, 344, 393, 409 perihepatitic, 516 perisplenitic, 516, 577 peritoneal, 516, 577 pleural, 169 lung-fistula, 171 in hydropneumothorax, 171 mitral, accentuation of, 369 diminution of, 369 percussion, 118 abnormal, 126 amphoric, 141 attributes of, 118 Biermer 's, 139 change of, Friedreich's, 137 Gerhardt's, 138 Wintrich's, 135 cracked-pot, 142 dull, 128 duration of, 118 flat, 130. Gairdner's, 144 INDEX 731 Sound, percussion — Cont 'd. hyperresonant, 130 impaired, 126 intensity of, 118 interrupted, of Wintrich, 135 normal, 119 pitch of, 118 quality of, 118 resonant, 119 pulmonary, accentuation of, 370 diminution of, 371 splashing, 168 suceussion, 526, 532 pericardial, 393 tracheal, of Williams, 141 Sounds, adventitious, 159, 380 cardiac, 366 accentuation of, 368 diminution of, 368 reduplication of, 371 endocardial, 380 exocardial, 380 extraneous, 145 respiratory, 148 abnormal, 153 normal, 148 Space, Traube 's semilunar, 130, 520, ■ 528, 582 borders of, 528 dullness of, 130 Spaces, intercostal, 25, 44, 61, 107 bulging of, 55 narrowing of, 55 retraction of, 55, 61, 84 tenderness of, 107 widening of, 55, 61, 64 Spade-hand, 641 Spasm brachial, 610 choreic, 610 clonic, unilateral, 611 facial, 610 habit, 610 lingual, 622 nodding, 603 professional, 645 tetanic, 610 Spastic gait, 659 Sphygmogram, arterial, 349 clinical significance, 349 variations in, 350 Sphygmomanometer, Cook 's, 397 Erlanger's, 399 Faught's, 403 Janeway's, 400 Riva-Rocci's, 397 Rogers', 402 Stanton's, 398 Sphygmomanometry, auscultatory method, 401 palpatory method, 399 Sphygmomanometry — Cont 'd. examination of, 620 grinding of, 621 Hutchinson's, 621 loosening of, 620 premature, 620 Tenderness, of abdomen, 513, 524 points of, 513 of epigastrium, 524 of kidney, 589 of spleen, 576 of thorax, 105 Tension, of pulse, 356 Test, anvil, 144 Barany's, 685 caloric, 69'3 coin, 144 Gairdner 's, 144 in pneumothorax, 144 Holmgren, 675 pointing, 686 rotation, 687 Thomson's, 676 Tetanus, 602, 610 risus sardonicus in, 610 Tetany, hand of, 644 Thigh, edema of, 653 examination of, 653 tumor of, 654 Third costal line, 47 Thomson's test, 676 Thoracentesis, 174 Thoracometry, 173 Thorax, abnormalities of expansion, 82 alar, 63 auscultation of, 145 bilateral deformities of, 60 bony, 25, 58 cavity of, 28 clavicles, as landmarks of, 44 clinical anatomy of, 25 contour of, 60, 65 crepitation, 105 deformities of, 59, 60, 70, 71 acquired, 59 bilateral, 60 congenital, 59 local, 71 unilateral, 70 diminution, unilateral, 70 divisions of, 29 edema of, 55 general, 55 local, 55 elongation of, 63 emphysematous, 60 enlarged veins of, 54 enlargement, unilateral, 70 Thorax, enlargement — Cont 'd. local, 71 eruptions of, 54 examination of, 52 expansion of, 82, 88 general decrease, 82 increase, 82 local variations, 83 unilateral decrease, 83 increase, 82 expiratory type of, 57 flat, 63 fluctuation of, 108 funnel, 68 inlet of, 44 inspection of, 52 inspiratory type of, 57 intercostal spaces as landmarks, 44 landmarks of, 44 lines of, 46 local deformities of, 70 enlargement of, 70 retraction of, 71 localized pulsations of, 85, 108 mammary gland as landmark, 45 mensuration of, 173 movements of, 72 frequency of, 73 rhythm of, 78 musculature of, 54 wasting of, 54 nipples as landmarks, 44 normal, 56 cross-section of, 58 landmarks of, 44 of child, 58 cross-section of, 58 palpation of, 86, 343 paralytic, 63 percussion of. 111 deep, 117 superficial, 117 phthisical, 63 pigeon, 68 cross-section of, 68 pigmentation of, 53 pterygoid, 63 pulsation of, 85 rachitic, 64 cross-section of, 68 radiography of, 188 regions of, 46 ribs as landmarks of, 44 scapulae as landmarks of, 45 scars of, 53 shape of, 56 size of, 56 skin of, 53 spine as landmark of, 45 734 INDEX Thorax— Cont'd. sternum as landmarks of, 44 strise of, 54 subcutaneous tissues of, 54 surface of, 54 systolic retraction of, 333, 341 tenderness of, 105 thickness of, 28 unilateral contraction of, 70 deformities of, 70 enlargement of, 70 veins of, 54 vibrations of, 89 wall, 28 Thrill, 344 at apex, 345 at aortic area, 345 at base of heart, 345 at pulmonary area, 346 at tricuspid area, 346 cardiac, 344 diastolic, 344 hemic, 344 in aortic aneurysm, 345 in mitral stenosis, 345 intensity of, 344 presystolj^c, 344 quality of, 345 systolic, 344 vascular, 344 Thrush, 625 Thyroid gland, abscess of, 632 atrophy of, 632 enlargement of, 631 fluctuation of, 631 murmur over, 631 palpation of, 631 thrill over, 631 Tic, convulsive, 610 Tinkle, metallic, 167 in pneumothorax, 316 Tinnitus, 685 Toes, examination of, 650 gangrene of, 650 in gout, 650 perforating ulcer of, 650 Tone, tracheal, Williams ', 141 Tongue, atrophy of, 621 color of, 625 cysts of, 625 dryness of, 625 examination of, 621 geographical, 624 hypertrophy of, 621 acquired, 621 congenital, 621 indentations of, 625 in pellagra, 625 leukoplakia, 624 Tongue— Cont 'd. movements of, 622 paralysis of, 622 size of, 621 smoker 's patch, 624 spasm of, 622 strawberry, 626 thrush, 625 tremor of, 622 ulceration of, 622 Tonsillitis, follicular, 627 Tonsils, enlargement of, 628 examination of, 627 inflammation of, 627 pseudomembrane on, 628 ulceration of, 628 Tophi, 604, 638 Torticollis, congenital, 629 rheumatic, 602 spasmodic, 603, 629 Tortuosity, of abdominal veins, 496 of thoracic veins, 54 Toxemic dyspnea, 80 Tracheal tone, Williams', 141 tug, 34, 483, 631 Trachea, bifurcation of, 33 clinical anatomy of, 33 deflection of, 629 movements of, 631 surface markings of, 42 Traehealis muscle, 33 Tracheobronchial stenosis, 224 diagnosis, 225 pathology, clinical, 225 X^hysical signs, 224 resx)iration in, 77 Tracheophony, 156 Tract, gastrointestinal, radiography of, 203 urinary, radiography of, 201 Traube 's semilunar space, 130, 520. 530, 582 borders of, 528 gastrocardiac, 528 gastrocolic, 528 gastrohepatic, 528 gastropulmonary, 528 decrease of, 531 dullness of, 130 increase of, 530 Tremor, convulsive, 662 intention, 644, 662 of hand, 644 of tongue, 622 pill-rolling, 644, 662 ' Trichinosis, 611 Tricuspid area, 367 incompetence, 462 INDEX 735 Tricuspid area — Cont 'd. insufficiency, 4G2 regurgitation, 462 diagnosis, 464 jDathology, clinical, 462 physical signs, 463 pulse in, 464 relative, 462 murmur, 387 presystolic, 388 systolic, 388 stenosis, 465 diagnosis, 466 pathology, clinical, 465 X3hysical signs, 465 valve, 320 anatomic site, 367 auscultatory area, 367 Trismus, 682 Tubercle, miliary, 250 Tuberculopneumonic phthisis, acute, 250 Tuberculosis, pulmonary, 249 of bone, 183 of vertebrae, 183, 627 Tug, tracheal, 34, 483, 631 Tumor, intraabdominal 515 of arm, 647 of kidney, 593 of liver, 559 of intestine, small, 534 of stomach, 524 pulmonary, 295 diagnosis, 296 pathology, clinical, 295 physical signs, 296 Turgescence, jugular, 331 Tussile fremitus, 104 Twelfth dorsal line, 47 Tympanites, abdominal contour in, 503 Tympany, 130 bell, 144 colonic, 542 gastric, 521, 527 decrease of, 531 increase of, 530 intensity of, 132 intestinal, 534 in ascites, 75 in bronchiectatic cavities, 132 in pneumothorax, 132 in pulmonary cavities, 132 laws governing, 113 on percussion, 130 pitch of, 132 Skoda 's 139 Typhilitis, 539 U Ulcer, carcinomatous, 615, 624 corneal, 614 of leg, 651 nasal, 615 perforating, of foot, 650 simple, 622 syphilitic, 615, 623 tuberculous, 615, 623 Ulceration, of intestine, 539 peritonsillar, 628 pharyngeal, 627 Umbilical hernia, 497 _, notch, 549 region, 492 contents of, 492 souffle, 518 Umbilicus, as landmark of abdomen, 487 eruptions of, 495 inflammation of, 496 protrusion of, 496 retraction of, 496 Unilateral bulging of thorax, 70 retraction of thorax, 70 Unrest, pupillary, 679 Ureters, examination of, 597 palpation of, 598 surface markings of, 598 tenderness of, 598 Uremia, breath in, 620 Urinary tract, radiography of, 201 Uterine souffle, 518 Uvula, elongation of, 627 Valsalva, sinus of, 320 Valve, aortic, 320, 326 anatomic site, 326 auscultatory area, 367 areas, 367 ileocecal, 534 mitral, 320, 326, 367 anatomic site, 326 auscultatory area, 367 pulmonary, 320, 326 anatomic site, 326 auscultatory area, 368 shock, 343 tricuspid, 320, 326 anatomic site, 326 auscultatory area, 367 Valves, cardiac, 320, 326 diseases of, 418 of heart, 320, 326 perforation of, 426 Valvular disease, chronic, 423 effects of, 423 incidence of, 423 736 INDEX Valvular— Cont 'd. endocarditis, 418 Varicose veins, 651 Vascular dullness, 365 murmurs, 394 Vegetations, adenoid, 615 Vein, common iliac, surface mark- ing, 489 external iliac, surface marking, 489 portal, obstruction of, 496 caput medusae in, 496 Veins, cervical, engorgement of, 331 distended, of abdomen, 496 of thorax, 54 fluid, 380 jugular, diastolic collapse of, 331 pulsation of, 331 engorgement of, 331 pulmonary, 324 varicose, 651 Vena azygos major, 34 Vena cava, 324 inferior, surface marking, 489 superior, 324 Venous hum, 395 murmurs, 395 pressure, 406 pulse, auricular, 332 centripetal, 333 negative, 332 physiologic, 332 positive, 332 presystolic, 332 systolic, 333 Ventricle, left, clinical anatomy, 319 dilatation of, 476 hypertrophy of, 472 right, clinical anatomy of, 319 dilatation of, 477 hypertrophy of, 477 Vermiform appendix, 535 palpation of, 538 Vertebrae, deformity of, 69 method of counting, 45 Vertiginous gait, 661 Vertigo, 685 induced, 689 spontaneous, 687 Vesicular resonance, 119 respiration, 151 intensity, 152 pitch, 153 Vibrations, thoracic, 89 Vincent 's angina, 628 Viscera, abdominal, clinical anatomy of, 485 examination of, 485 thoracic, clinical anatomy of, 31 examination of, 52 Visceral pj^eura, 30 Visceroptosis, abdominal contour in, 506 Vision, acuity, 675 color, 675 field of, 676 Vocal fremitus, 89 absence of, 101 decrease of, 99 increase of, 98 intensity of, 91 normal variations of, 94 Vocal resonance, 155 absence of, 156 decrease of, 156 increase of, 157 modified, 158 Voice, cavernous, 158 Volume, of pulse, 354 Volvulus, 534 Von Graeffe 's sign, 613 W Wall, abdominal, 511 edema of, 513 palpation of, 511 rigidity of, 513 suppuration of, 513 tenderness of, 513 thickness, estimation of, 511 arterial, 350 changes in, 350 thoracic, 25, 28 Water-hammer pulse, 357 Wave, dicrotic, 349 fat, 514 fluid, 513 post-dicrotic, 349 Wavy expansion, 84 Wernicke's reaction, 677 Whispering pectoriloquy, 157 White spots, of nails, 636 Whitlow, 638 Williams' sign in j)hthisis, 191 tracheal tone, 141 Winged scapulae, 45, 63 Wintrich's change of sound, 135 interrupted, 135 Woillez's disease, 239 Woody phlegmon, 635 Wrist-drop, 644 Wry-neck, 602 Xanthelasma, 625 Xanthoma, 611 Xerostomia, 626 X-ray, 176 {see Koentgen rays). 