In cases of ascites, when one side of the abdomen is tapped with the finger and the other side is auscultated, two sounds similar in timing to the normal heart sounds have been observed. The first sound is caused by the sound wave being transmitted through the fluid; the second is the result of the fluid wave crossing the abdomen and striking against the auscultated side. These two sounds are heard more clearly in thin, tense abdomens as opposed to flat, soft, flabby ones and are best heard at the level of the fluid and intestine, as demonstrated by an experiment with a closed rubber bag partially filled with air and water. There seems to be no reference to this auscultatory sign in cases of ascites in any of the standard textbooks on physical diagnosis.
It is stated by several of the German writers that, when fluid is injected into