Bajapore and Golconda, and the barren province of Assam, but it was internally decaying, and ready to crumble away before the first vigorous assault. Two causes principally had tended to weaken the Moghul power. The one was the intense bigotry and intolerant policy of Aurungzebe, which had alienated the Hindus and roused the fierce animosity of the haughty Rajputs. The other was the rise and rapid growth of the Mahratta power. Under their able leader, Sevaji, these daring freebooters plundered in every direction, nor could all Aurungzebe s efforts avail to subdue them. At the close of the long contests between them, the Moghul power was weaker, the Mahratta stronger than at first. Still the personal ability and influence of the emperor were sufficient to keep his realms intact during his own life. His last years were embittered by remorse, by gloomy forebodings, and by constant suspicion, for he had always been in the habit of employing a system of espionage, and only then experienced its evil effects. He died, on the 21st February 1707, at Ahmadnagar, while engaged on an extensive but unfortunate expedition against the Mahrattas.
AUSCHWITZ, or OSWIECIM, a town in Galicia, Austria, on the right bank of the Sola, a tributary of the Wechsel, 33 miles W.S.W. of Cracow. It has a population of upwards of 3800, and carries on a trade in salt. Previous to the first partition of Poland in 1773, it was the seat of a dukedom, which had been united by Sigismund Augustus with the duchy of Zator in 1564.
AUSCULTATION (auscidtare, to listen), a term in medicine, applied to the method employed by physicians for determining, by the sense of hearing, the condition of certain internal organs. The ancient physicians appear to have practised a kind of auscultation, by which they were able to detect the presence of air or fluids in the cavities of the chest and abdomen. Still no general application of this method of investigation was resorted to, or was indeed possible, till the advance of the study of anatomy led to correct ideas regarding the locality, structure, and
uses of the various organs of the body, and to the alterations produced in them by disease. In 1761 Auenbrugger of Vienna introduced the art of percussion in reference more especially to diseases of the chest. This consisted in tapping with the fingers the surface of the body, so as
to elicit sounds by which the comparative resonance of the subjacent parts or organs might be estimated. Auenbrugger's method attracted but little attention, till Corvisart, in 1808, demonstrated its great practical importance; and then its employment in the diagnosis of affections of the chest soon became general. Percussion was originally
practised in the manner above mentioned (immediate percussion), but subsequently the method of mediate percussion was introduced by Piorry, and is that now largely adopted. It is accomplished by placing upon the spot to be examined some solid substance named a pleximeter
(stroke-measurer), upon which the percussion strokes are made either with the fingers or with a small hammer tipped with india-rubber. The pleximeter consists of a thin oval piece of ivory ; but one or more fingers of the left hand applied flat upon the part answer equally well, and this is the method which most physicians adopt. Percussion must
be regarded as a necessary part of auscultation, particularly in relation to the examination of the chest ; for the physician who has made himself acquainted with the
normal condition of that part of the body in reference to
percussion is thus able to recognise by the ear alterations
of resonance produced by disease. But percussion alone,
however important in diagnosis, could manifestly convey
only limited and imperfect information, for it could never
indicate the nature or extent of functional disturbance, or
Sistinguish between different forms of disease, even in
those organs which it had proved (to be in an abnormal
condition, while in other cases, and notably in many affections of the heart, it could afford no assistance whatever.
In 1819 the distinguished French physician, Laennec,
introduced the method of auscultation by means of the
stethoscope ([Greek], the chest, and cr/coTrew, to examine),
with which his name stands permanently associated. For
some time previously, physicians, more especially in the
hospitals of Paris, had been in the habit of applying the
ear over the region of the heart for the purpose of listening
to the sounds of that organ, and it was in the employment
of this method that Laennec conceived the idea that these
sounds might be better conveyed through the medium of
some solid body interposed between his ear and the
patient s chest. He accordingly, by way of experiment,
rolled up a quire of paper into the form of a cylinder and
applied it in the manner just mentioned, when he found,
as he states, that he was able to perceive the action of the
heart more distinctly than he had ever been able to do by
the immediate application of his ear. He thence inferred
that not merely the heart s sounds, but also those of other
organs of the chest might be brought within reach of the
ear by some such instrument, and he, therefore, had con
structed the wooden cylinder, or stethoscope, which bears
his name. This consisted of a cylindrical piece of wood,
about 12 inches long, with a narrow perforation from end
to end, the extremity for applying to the chest having a
movable piece of conical form fitting into the cylinder,
which was withdrawn by the physician while listening to
the sounds of respiration, the complete instrument being
used for examining the sounds of the voice and those of
the heart. This instrument, though rendered portable by
being made to screw into two halves, was inconveniently
large and heavy, and was subsequently modified by Piorry
to the form now generally used of a thin narrow cylinder
of about 7 inches long, with an expansion at one end for
applying to the chest, and a more or less flattened surface
at the other for the ear of the listener. Having ascertained
by careful observation the sounds elicited on auscultation
of the healthy chest, Laennec studied the modifications of
these as produced by disease ; and by comparing cases
with one another, and especially by investigating the state
of the affected parts after death, he was able, in his celebrated Traite de I Auscultation mediate, to lay the foundation for a rational system of diagnosis of the great classes
of pulmonary and heart complaints. It does not, how
ever, appear to be the case, as Laennec supposed, that
mediate auscultation by the stethoscope is superior in an
acoustic point of view to immediate auscultation by the
unaided ear. On the contrary, sounds are heard louder by
the latter than by the former method. Nevertheless, the
stethoscope possesses special advantages, among the chief
of which are that by its use particular areas can be examined and compared with greater accuracy ; that it can
be applied to all parts of the chest, and that it can be used
in all cases where, from the sex or the bodily condition of
the patient, the direct application of the ear is inadmissible.
On the other hand, immediate auscultation is to be preferred
in the examination of young children, who are readily
frightened by the sight, and still more by the pressure
upon them, of the stethoscope.
The whole subject of auscultation has been greatly
elaborated since the time of Laennec, and while some of
his opinions have been found to require modification, continued investigation only serves more clearly to demonstrate
the value of this method of diagnosis, and to elicit fresh
and more accurate results from its employment. Although
much remains to be done in the way of the correct interpretation of the phenomena observed in auscultation, yet
the facts already established are among the most important
