Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell. 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.

    46/458 (page 22)
    of air. This is known as subcutaneous emphysema. It may be caused by disease of, or accident to, the larynz or trachea, but it is much more commonly caused by a rupture of the tissues of the lung, which allows the air to escape from the air vesicles or bronchioles into the connective tissues, by which means it reaches the root of the lung, and thence passes by the mediastinum to the neck. In this condition the skin does not pit on pressure, or does so very slightly, and the finger feels a distinct sensation of crackling when it is passed over it. Special Affections. In studying the appearance of any skin disease, as much of the surface of the body should be seen as may be possible or expedient, and in the course of the examination attention should be systematically directed to the locality of the disease, the outline of the afiected regions, the type of the eruption, the nature of the lesion, and the structure invaded. Distribution.—The situation of the disease is a most use- ful guide in diagnosis. Certain affections are confined to particular spots—sycosis, for example, to the hairy parts of the face. Others have areas grouped anatomically, as in the case of eczema and psoriasis, the former of which exhibits a preference for the palms, soles, and flexor surfaces of the extremities, while the latter attacks the elbows, knee.s, and extensor aspects. Others, such as pityi-iasis rubra, are scattered indifferently over the body. Others again invade the whole surface, as may be seen in the cutaneous pheno- mena of the exanthemata. These remarks must not be accepted in the sense of absolute rules, for the points laid down are not of universal application. Diseases which are at first limited to definite regions have a tendency to spread from these areas j scabies, to take a common example, although at the onset confined to the hands, and more especially to the webs of the fingers,