As you did me the honour, on a former occasion, to publish some
remarks in defence of _auscultation_, against its enemies and
detractors, I trust you will permit me to say a few words in
reference to a communication in a late number, from a gentleman
who appears to be a friend of that method of diagnosis, but whose
ignorance of the subject is likely to be more injurious to the
cause than either open enmity or secret detraction. The case in
question (page 780, vol. ii.) appears, from the dissection, to
have been clearly _emphysema of the lungs_, as there stated; but
I appeal to every one practically acquainted with the physical
signs of diseases of the lungs, whether the results of the
exploration with the stethoscope, as narrated in the case, were
those pathognomonic of that disease? I say they were not only
not pathognomonic of this affection, but they were actually
incompatible with its existence. The same ignorance of the subject
is shewn in relation to the disease of the heart, which, I boldly
maintain, no one was justified in pronouncing to be _hypertrophy of
the left ventricle_ from the stethoscopic indications stated in the
case.
It is just possible that the writer of the case may have made
further explorations on which his diagnosis was founded; but if he
had such in his case-book, it is equally unfortunate for the credit
of the stethoscope and his own, that he suppressed them in his
printed case.
I have the honour to be,
Gentlemen,
Your obedient servant,