Physical Signs in the Chest

Abstract

Part 1 of a Series of Two Articles

This article is a personal one, based on my own practice and techniques. The evidence of the x-ray has taught consultants modesty in the evaluation of physical signs in the chest. In the good old days when the Chief said that there were dullness and diminished breath sounds in some area of the chest, the referee had spoken and there was no appeal. Nowadays he is liable to look rather silly if the x-ray is normal or the abnormality is found on the other side he is likely, therefore, to be less dogmatic. We have also learnt, in the last few years, about “observer error”. We know how differently even skilled observers may interpret the same phenomena and how even a skilled observer may fail to notice something which may be spotted immediately by one of his colleagues, or by himself on another occasion.