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December 6, 1919


JAMA. 1919;73(23):1752. doi:10.1001/jama.1919.02610490016008

The object of this report is to describe and explain a most unusual—and to us, new—physical sign.

REPORT OF CASE  A man, aged 21, was admitted to the sanatorium, June 11, 1918, with a history of two years' illness. Because of repeated, large hemoptyses, in the presence of a unilateral left-sided tuberculosis, pneumothorax was induced, July 25. Moderate amounts of air (about 500 c.c.) were injected at intervals varying from a few days to four weeks, without reactions. November 1, he developed a spontaneous pneumothorax with an effusion two weeks later, at first serous but rapidly becoming purulent. Because of pressure symptoms, he was aspirated, April 9, 1919, 900 c.c. of purule[ill]t fluid being removed and replaced by 600 c.c. of air. This was repeated, September 4.June 20. 1919, the patient complained of a constant noise in his chest which seemed worse at night and prevented sleep.Physical examination