Un manuel de la médecine clinique et diagnostic physique (EBAN) .. Le auricleis gauche couverts par l'oreillette droite et le poumon gauche. Le ventricule gauche se trouve la plupart du temps loin de la surface, son upperedge est couvert par le poumon gauche, mais son comesforward apex à la surface ci-dessous, et les battements entre couples lesvis et sixième côtes, un pouce ou peut-être moins à l'intérieur, et un an et demi pouces sous le mamelon gauche. Il sera vu qu'il y a un petit espace débutant le abovewhere le poumon gauche quitte ses concitoyens, à la quatrième,cartilage dans laquelle le cœur est découvert. La position relative, physique 204

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A manual of clinical medicine and physical diagnosis . ourth. The left auricleis covered by the right auricle and the left lung. Theleft ventricle lies mostly away from the surface, its upperedge is covered by the left lung, but its apex comesforward to the surface below, and beats between thefifth and sixth ribs, an inch or perhaps less to the inside, and one and a half inches below the left nipple. It willbe seen that there is a small space commencing abovewhere the left lung leaves its fellow, at the fourth cartilage, in which the heart is uncovered. The relative positionof 204 PHYSICAL DIAGNOSIS OF DISEASE. the heart and lungs around is well seen in the accompany-ing diagram. Fig. 5. It is supposed that the heart is seenthrough the lungs, the dark line at mid-sternum branch-ing outwards right and left below, representing the edgeof the lungs. (See also p. 228 et seq.) Description of the Methods of Physical Diag-nosis.•—The various means by which the physical signs of pul-monary and cardiac affections are elicited, are termed Fia. 5.. (After Sibson.) methods of physical diagnosis, and these methods consistof— 1. Inspection. 2. Palpation, or the application of the hand. 3. Mensuration. 4. Succussion. 5. Spirometry. 6. Percussion. 7. Auscultation. The general mode of practising these methods, and the INSPECTION. 205 signs to be deduced from the examiuations, have now tobe described and considered. 1. INSPECTION. By inspection or ocnlar examination of the externalsurface of the chest, we learn the general form of theframework, the shape of the sternum and rib cartilages, the size of the cavity, and the movements of its walls.The patient should be placed in an easy, comfortable po-sition ; sitting, if possible, opposite a good light, and withthe surface of tlie chest exposed. Inspection should bepractised anteriorly, posteriorly, and laterally, and theaction of the two sides of the chest should be closely com-pared ; since pulmonary diseases are in the majority of

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