Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1892-01-10
ICATCHING A COUGH.
Novel Use of the Photograph in Di-
agnOsing Chest Diseases.
RECORDS MADE UPON CYLINDERS
By Which the Doctors Can Study Mans
Cough After He Is Dead.
A LOCAL PHYSICIANS EXPERIMENTS
WRITTEN FOR THE DISPATCH. ]

WRITTEN FOR THE DIsPATCH.1
The use of the phonograph as an instru-
ment for recording disease has been effect
lively introduced by a local physician. In
lecture delivered few days ago in the
Wsetern Pennsylvania Medical College the
records of variety of coughs, which had
been faithfully preserved upon the cylin-
ders of phonograph, were presented to the
students and served as clinic. Monday
evening last, at the meeting of the South
side Medical Society, very remarkable in
terest was created by practical demonstra-
tion of the important strides possible in the
study of chest diseases by recording in the
phonograph the auditory characteristics of
various phases of disease, thus permitting
OF deliberate study of phenomena now OBJ
served only in transitory manner.
The credit for the addition of this adjunct
to the paraphernalia of the physician is due
to DR.. w. 7. English, professor of physical
diagnosis in the medical college. Speaking
yesterday, after some persuasion, of what
he had accomplished, the doctor said he be-
lieves that the phonograph is destined to
become an important instrument in the
clinical laboratory.
The Cough Is Diagnostic.
sit will become important" he said, Gas
recorder, not only of history and facts,
but as a preseryer of those auditory phe-
nomena belonging to certain cases and
maladies, and which are characteristic. The
perfection of its records and the realistic
character of the reproductions make it
80
former method. It affords opportunities for
analyzing sounds, normal and abnormal,
with deliberation and at our leisure. The
teachings of authorities are that cough is
not and cannot be diagnostic. However,
the deliberative study of the elements they
include betrays the fact that there are modi-
fcations incident to each malady, and
changes which are characteristic OF the vari-
Gus stages of the same disease.
"The phonograph enables repeated study
of these elements, which include quality.
intensity, duration, pitch and rhythm, and
which familiarize these notifications to
addition SO thoroughly that once acquired
they can be instantaneously detected. The
more carefully we study coughs the more
certainly they appeal to us as characteristic
and diagnostic. In the presence of some
one or more elements they will differ, and
with greater constancy than hitherto be-
ieved.
Distinguishing Stages OF Bronchitis.
cat the meeting of the Southside Medical
Society recently / presented through the
phonograph the dry cough of the earlier
stages of bronchitis, and upon the same
cylinder, in contrast, appeared that moist
or mucus reproduction of the later stages of
the same malady, Another cylinder pre-
sented pertussiS of the adult and also of q
child 15 months old. The violent exploratory
efforts by which the special auditory
phenomena were produced, which we de-
nominate cough were in marked contrast
with that inspiratory Growing or 'whooping'
which gives to this malady the appellation,
'whooping cough
''The record of cases of true Group, men,
braneous or diphtheritic, were reproduced in
such manner as to make is possible to
separate these dangerous diseases from spas
modic or simple Group through the medium
of addition alone, though not in the
presence of either. These ailments may be
studied without the unpleasant necessity of
unduly forcing the patient to cough, and
saving the disappointment of failure to
secure the sounds when they are most
desirable for it is well known to every
clinician that when we most wish patient
to cough or exhibit Characteristic signs, the
very knowledge of such desire postpones
their production and causes the spasm to
subside. Especially is this the case with
children.
A Mans Cough After He Is Dead.
"Severe maladies, which, from their
rarity, cannot often be studied, may thus,
by means of the phonograph, appeal to the
hearing, and diseases may continue their
clinical representation long after the sub
iect has passed away. The laryngeal rales
are reproduced, though the patient is not in
the land of the living. The distinctive
death rattle, which intimates to the ex-
perienced ear the approach of dissolution,
still teaches us how to distinguish this sign
of impending death. expect shortly to
obtain records by which it may be possible
to separate the various forms of rales and
also those chest noises which will suffice to
familiarize us with heart abnormalities as
well as respiratory changes, that may be
studied deliberately and leisurely."
The doctor is convinced that the study of
coughs from the cylinders of phonograph
will enable the student to acquaint himself
with the special auditory signs of each par
ticular disease with much increased facil-
ity By the use of resonators specially con-
structed, the sounds, both on reception and
delivery. are amplifed to such an extent
that these which are not now received by
the instrument may be recorded. Within
this realm are included the heart sounds
and cardiac murmurs, also the normal and
abnormal noises of the lungs. This adjunct
to the clinic cannot be overestimated in its
advantages to the student of medicine, as
cases may be presented at any time and as
often repeated as is essential to perfected
knowledge. The doctor is constantly re-
cording interesting cases, making compari-
sons and noting the differences which he
hopes NAV be Of advantage to the profess
sion. FRANK j. KELLY.