Rare Example of abnormal vocal resonance: a case from Balzacʼs novel

Zusammenfassung

Ungewöhnliche klinische Fälle wecken bei praktizierenden Ärzten immer wieder Interesse und ermöglichen es ihnen, ihre Wissensbasis zu erweitern und ihre Fähigkeiten zum klinischen Denken zu verbessern. Der Zweck dieser Studie besteht darin, einen klinischen Fall von Stimmresonanz beim Singen bei einem schwindsüchtigen Teenager aus dem Roman „Der Landarzt“ von Honoré de Balzac unter Verwendung induktiver und deduktiver Methoden des klinischen Denkens zu analysieren. Stimmresonanzen beim Singen in Schwindsucht können als pathognomonisches Zeichen für eine kavernöse Tuberkulose gewertet werden, da nur mit dem Bronchus verbundene Hohlräume als Helmholtz-Resonator wirken. Trotz der Einzigartigkeit ist das Gehäuse durchaus realistisch, da es nicht im Widerspruch zu den Gesetzen der Akustik steht. Praktizierende Ärzte verfügen über die Kenntnisse der medizinischen Physik, Morphologie und Physiologie, die zum Verständnis der Pathogenese der klinischen Manifestation einer Lungenhöhle erforderlich sind. Dieser Fall zeigt deutlich die Vor- und Nachteile klinischer Denkmethoden, die in der Praxis eingesetzt werden. Dank der Kombination aus Originalität und Realismus kann der Fall von Stimmresonanz aus Balzacs Roman „Der Landarzt“ seinen rechtmäßigen Platz in der persönlichen Sammlung klinischer Fälle eines jeden Lungenarztes einnehmen.

Abstract

Unusual clinical cases always arouse interest among practicing physicians, allowing them to expand their knowledge base and improve their clinical reasoning skills. The purpose of this study is to analyze a clinical case of vocal resonance in singing in a consumptive teenager from the novel “The Country Doctor” by Honoré de Balzac using inductive and deductive methods of clinical reasoning. Vocal resonance in singing in consumption can be considered a pathognomonic sign of cavernous tuberculosis, since only cavities connected to the bronchus act as a Helmholtz resonator. Despite the uniqueness, the case is quite realistic, since it does not contradict the acoustics laws. Practicing physicians have the knowledge of medical physics, morphology, and physiology necessary to understand the pathogenesis of clinical manifestation of a cavity in the lung. This case clearly demonstrates the advantages and disadvantages of clinical reasoning methods used in real medical practice. Thanks to the combination of originality and realism, the case of vocal resonance from Balzac’s novel “The Country Doctor” can take its rightful place in the personal collection of clinical cases of any pulmonologist.

Keywords

cavernous lung tuberculosis - vocal resonance - physical diagnostics - teaching clinical reasoning

Schlüsselwörter

kavernöse Lungentuberkulose - Stimmresonanz - physikalische Diagnostik - Vermittlung des klinischen Denkens

Publication History

Received: 29 October 2023

Accepted after revision: 17 January 2024

Article published online:
21 February 2024

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