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ble of originating sound-waves within the acoustic cham- ber. And, lastly, I made reference to the organ of hearing and to the instruments and methods of auscultation, me- diate and immediate. This brings us naturally to the practical application of chest acoustics, to the Levothroid Vs Synthroid true interpretation of the physical signs of the heart and lungs in health and in disease. Sound is caused by vibrations which send off sound- waves into the air, the universal sound medium, spreading out in every direction until they finally die away from di- minished force. Causes of primary vibrations are readily illustrated by air forced through a tube, by a tense cord over which a bow is drawn, Generic Levothroid by a bell, or Levothyroxine Vs Levothroid a bar of steel fastened at one end, set in motion by a stroke of a hammer or other- wise. It is necessary, in order that the Order Levothroid Online vibrations should pro- duce sound-waves, that they should have definite force and frequency. The force of the primary vibrations must be sufficient to send oflE sound-waves into the air, and of fre- quency somewhere between thirty-two and forty thousand. Less than thirty-two produces a sensation of distinct noises, and more than forty thousand ceases to give off sound-waves. The designations of high pitch and low pitch have reference to the frequency of vibrations, and are of practical impor- tance in determining the density of sonorous bodies under examination. High pitch denotes density, low pitch po- rosity. The pitch enables us to measure the number of vibrations in a second in any body under examination, de- termining the density ; for, with an instrument called the siren, we can measure the number of vibrations in a second in any pitch, which brings Levothroid 100 Mcg acoustics under Levothroid 25 Mcg mathematical demonstration as an exact science, especially including auscultation of the human chest. | There are other limitations of hearing than those of pitch and loudness, which are more readily understood by com- paring them with color-blindness in sight, the persons with Order Levothroid such deficiency in either case not being themselves aware of it. Engineers and flagmen on railroads are examined in regard to their perceptions of differences in color in the pro- tection of the lives and bodily safety of the traveling public. Why should not also the medical student, before devoting I himself to physical diagnosis, test himself, or have himself * Read before the Medical Society of the State of New York at its eighty-third annual meeting. tested, in regard to clang *-deafness before taking upon him- self the responsibility of making delicate diagnoses where failure to appreciate the tone differences in the acoustic signs may lead to a plan of management fatal to the patient? These inquiries approach the domain of aesthetic taste at the same time that they have the solid foundation of practical truth. The entirely correct ear in auscultation gives its pos- sessor pleasure in listening to natural sounds in the fields, in the forests, on the extended plains, or on the mountain- tops — all of which are but dreariness to one who has Levoxyl Vs Levothroid not that inner sense of the beautiful in nature dependent upon tone appreciation. In the wonderful music drama of Siegfried the natural sounds in the forest — the singing of birds, the drone of in- sects, the sighing of the wind among the leaves of the trees — are reproduced in music, the " Waldweben." The correct acoustic sense that fits Levothroid 0.1 Mg Levothroid 100 Mg the student for an auscultator will Levothroid Vs Levothyroxine be delighted and Levothroid 88 Mcg appreciative ; but the clang-deaf will not see or hear the melody. It must be noted that this higher quality of tone recognition is entirely different from memory of a tune, which is memory with a sense of time and rhythm only, and enables its possessor to learn and sing "The Marseillaise" or "God save the Queen " without a thrill of delight in their harmonious chords and spiritual sugges- tions. It is an interesting point to determine Purchase Levothroid Online by trial whether the color-blind are also clang-deaf, which would show, if de- cided in the affirmative, that the deficiency is not owing to any mechanical fault in the structural formation Is Levothroid Generic of the or- gans of sight or hearing, but is essential in Levothroid 125 Mcg the organic or spiritual life of the body. One fact is demonstrable — that the senses of hearing and sight may be greatly extended in range and accuracy by cultivation. This is seen in experts in music and painting. Culture increases the power of discrimination and delight in color and in tone in the masses, while the exceptionally sensitive sense of sight or hearing will be increased thereby to expert excellence. Primary vibrations may be conducted, Synthroid Vs Levothroid reflected, or con- sonated. If there is in contact with the vibrating body an- other body or structure capable of being set into vibrations, the vibrations of both will be in unison ; or, as in case of the lung connected by adhesions to the chest-wall or by intermediate structures, or by tense cord-like adhesions of any length, then the secondary body — as the chest-wall is when the lung is adherent — may give Levothroid Synthroid off sound-waves which will pass into the air the same as if coming from a primary source. The familiar example of direct conduction Levothroid 75 Mg is the one given of scratching the end of a log with a pin by one person while another listens at the other end, fifty feet away, and hears by illusion the sound under the ear. In such a case there is no solution of continuity, nor is there Levothroid Generic in the consolidated lung, by which also there is direct con- duction. Indirect conduction of sound takes place when there are adhesions of parts to parts adjacent, as of the

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