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To the Editor:—
Your current comment on "Auscultatory Respiratory Murmur" (Dec. 24, 1949, page 1238) is very interesting. As students, we were taught the value of four cardinal chest physical examination procedures: (1) inspection, (2) palpation, (3) percussion and (4) auscultation. The literature fails to reveal a fifth procedure, which I have been using for years and which I term compression auscultation.In the intermittans stage of asthma and bronchitis, rales are frequently inaudible. With the ear placed directly on the chest and by simultaneously compressing the chest anteriorly and posteriorly with the palms, while the subject inhales deeply with the mouth open, one can frequently detect rales. Even with negative roentgenography and the standard procedures, compression auscultation will elicit the rales.It has a practical significance to insurance examiners, during the intermittans phase of asthma and bronchitis when an applicant may deny these illnesses, as well as to the
Engelsher DL. CHEST EXAMINATION. JAMA. 1950;142(5):357. doi:10.1001/jama.1950.02910230059025