In the third chapter, he introduces the history and physical examination of the patient with chest disease. Lehrer discusses sound characteristics, the hearing mechanism, and the stethoscope as an instrument. The second chapter shifts attention to the other end of the stethoscope: the listener. Lehrer also introduces common pathological conditions, briefly exploring their auscultatory findings. Lehrer continues the work, as the transmitter of a grand tradition.The first chapter reviews the anatomy of the lung and the physiology of ventilation, omitting blood gas interpretation. Mentor and student defined the chest examination as we know it. Laennec was a pupil of Jean Nicholas Corvisart, the leading advocate and systematizer of chest percussion. Laennec codified his work in 1819 in his book Traité de l'auscultation médiate, an effort that exhausted him and extracted a two-year period of recovery from his career. The sketch is too brief to elaborate on the fascinating history of auscultation, which at the time was a monumental undertaking. The kit is an excellent learning system and is highly recommended as an introduction to the topic.The book begins with an homage by Victor McKusick to the Golden Age of auscultation, introduced by Rene Theophile Hyacinthe Laennec in 1816. It may also be useful for critical care and pulmonary service nurses. Intended to educate the ear as much as the mind, his kit is a self-contained learning experience for the medical student. Steven Lehrer's introduction to auscultation is a primer of pulmonary diagnosis using lung sounds as its unifying theme. The script to the accompanying tape, a glossary, and an index round out the book. Mixing clinical observation with experimental findings, Lehrer explains the origins of abnormal lung sounds and interprets them in keeping with structural and functional changes in the lung. Chapter 5 is what most students will consider the meat of the program, an outstanding and comprehensive treatment of abnormal lung sounds that does not ignore minor phenomena such as mouth noises. The novice may find this tedious, but the visual display of a waveform does help to prepare one for informed listening. The interested specialist may welcome the discussion of recording systems and waveform analysis. It also introduces a simple graphic system of notation. This is a fine outline of physical examination of the chest, worth a complete physical diagnosis teaching session with students. Chapter 4 discusses normal breath sounds. Here he departs from the emphasis on auscultation to provide the student with a context for the auscultatory examination-an appreciation for the findings that are likely to accompany the abnormal sounds. The first chapter reviews the anatomy of the lung and the physiology of ventilation, omitting blood gas interpretation. Lehrer continues the work, as the transmitter of a grand tradition.

The book begins with an homage by Victor McKusick to the Golden Age of auscultation, introduced by Rene Theophile Hyacinthe Laennec in 1816. The kit is an excellent learning system and is highly recommended as an introduction to the topic. Understanding Lung Sounds, by Steven Lehrer, 2nd ed, 150 pp. Guidotti, MD, MPH University of Alberta Edmonton JAMA 1995 273(12):971.

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