What to observe at the bed-side and after death in medical cases / published under the authority of the London Medical Society of Observation.

Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: What to observe at the bed-side and after death in medical cases / published under the authority of the London Medical Society of Observation. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    49/177 (page 21)
    swallowing or at other times;—sense of constriction, burning, globus, etc. 106. Deglutition:—pain during the act; its seat, extent, duration, character. — Deglutition difficult; period of act at which difficulty is perceived ;—attempt to swallow productive of sense of suffocation, of spasm of muscles of throat or pharynx;—is difficulty greatest with solids or liquids ?—what matters are swallowed most easily ?—is a large gulp of liquid swallowed more easily than a small one ?—has the patient any con- trivance for rendering the act easier ?—does the act produce cough ?—do swallowed matters return by nos- trils?—is the act affected by temperature of matters?— is the site of obstruction distinct to patient, and how ? —is deglutition favoured by a recumbent posture? (see also 280.)—Frequently or constantly repeated efforts at deglutition. 107. Regurgitation:—period after swallowing at which it occurs; attended with effort, anxiety, or nausea? accompanied by any stethoscopic sound?— Physical characters of regurgitated matters; their reaction. Physical examination of the Abdomen generally. IQS.Inspection:—Development of subcutaneous fat; rndema of wall, its seat;—hernial protrusions;— swellings over recti muscles ;—form of organs visible on exterior, stomach, colon, intestinal convolutions, etc.—General enlargement of abdomen, its form;— local fulness or enlargement, its seat, form ; alteration in form and seat of enlargement or fulness with changes in posture of patient, with varying states of stomach and bowels;—eversion of cartilages of false ribs, of tip of ensiform cartilage;—size of costal angles.*—De- pression or retraction of abdomen; general, partial.— Umbilicus: position, vertical and transverse;—aspect; convex, concave, flat with or without stretching;— ulceration; discharge from umbilicus;—presence and condition of a portion of umbilical cord. — Venous enlargements: on one or both sides ? extent; size ; * “ Costal angle—i. e., the angle included between the middle line of the abdomen and the margin of the carti- lages of the false ribs. 21 Deglutition— painful, other charac- ters. Regurgitation. regurgitated matters. Physical exami- nation of Abdo- men generally. Inspection— fat etc. in wall. form of organs visible. enlargement. depression, state of umbi- licus. venous enlarge- ments.