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The tendency of the mind of the young doctor, and some times of the older one, is to look for the classical and typical changes in all chest diseases. He knows well what ideal bronchial breathing is; what rales are and the different sorts; what pectoriloquy, egophony, amphoric sounds and metallic tinkling mean, fie knows flatness on percussion and dulness when marked; and cracked-pot percussion sound with open-mouth breathing. And if these or a combination of them are found in any case, diagnosis is supposed to be thereby relatively easy.
In our early studies we learn to look for these signs, and are disappointed sometimes when the symptoms have led us to expect to find them and we do not find them. Failing to discover them we sometimes wholly fail to detect other ample physical signs, that are however less prominent and pronounced.
BRIDGE N. SOME USUALLY OVERLOOKED PHYSICAL SIGNS AND SYMPTOMS IN CHEST DISEASES. JAMA. 1898;XXXI(6):272–275. doi:10.1001/jama.1898.92450060010001b
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