Text book of veterinary medicine, Volume 1 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 1 (of 5)
Law, James
Veterinary medicine
A =mucous râle= is caused by air passing through any liquid contained in
the bronchial tubes, such as mucus, pus, or blood. It may be imitated by
blowing a large number of soap bubbles in a thick lather and noticing
them burst simultaneously or successively. It is chiefly observed in
bronchitis after the preliminary dry stage of the mucous membrane has
passed off and an abundance of mucus has been secreted. The nature of
the sound will vary according as it comes from the larger or the smaller
tubes or in other words as to whether the bubbles are large or small.
That from the smaller tubes is sometimes called a =submucous râle=.
Either of these râles may be temporary or permanent as the mucus may be
momentarily cleared away by coughing.
The =crepitant râle= is a sound of very fine crackling which has been
variously compared to the crackling of salt when put on red hot coals,
the noise of a sponge expanding in water and the rubbing of a small lock
of hair between the finger and thumb close to the ear. The existence of
the _crepitant râle_ usually denotes the existence of the early stage of
inflammation of the lungs, and the progress of hepatization in such
cases may be traced by the advance of the line of crepitation which
precedes it. So the progressive absorption of exuded matter in recover
may be equally followed by a line of crepitation gradually decreasing in
area until it meets in a point. The observations will be corroborated by
the dull sound elicited on percussing the parts. The production of the
sound has been attributed to the passage of air through the thick mucus
in the smallest bronchial tubes or more plausibly to the separation of
the walls of the air sacs and cells during inspiration, they having been
previously adherent by reason of the secretions.
_Crepitation_ is not heard in all pulmonary inflammations. In weak
animals with a low type of inflammation tending to gangrene, and in
those cases of broncho-pneumonia in which a viscid mucus blocks up the
bronchial tubes passing to the affected lobes, it may be altogether
absent.
_Crepitation_ may further occur without inflammation. Thus in pulmonary
œdema (dropsy of the lung) and capillary hemorrhage in which liquids are
effused in the smaller bronchial tubes and air sacs a crepitation is
sometimes heard.
A =modified crepitation= (=dry crepitant râle= of Delafond) is usually
heard over an emphysematous lung. The noise in this case has been
compared to that induced by handling a sheet of paper.
The =subcrepitant râle= is another modification holding a place
intermediate between the crepitant and the mucous râles. It has been
likened to the sound of a moderate effervescence in beer or other
liquid. It is referable to the presence of mucus in the smaller
bronchial tubes and indicates bronchitis or broncho-pneumonia.
Still other sounds are heard in diseased conditions of the pleuræ. These
are =friction sound=, =creaking=, =metallic tinkling=, and =gurgling= or
=splashing=.
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