The life insurance examiner : a practical treatise upon medical examinations for life insurance / by Charles F. Stillman.

Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The life insurance examiner : a practical treatise upon medical examinations for life insurance / by Charles F. Stillman. 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.

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    Note great excess of weight, or the opposite, especially whether it has been recently or rapidly acquired or lost. 4. The chest measurement should be taken by adjusting the tape under the vest, between the second and third ribs anteriorly, and below the lower border of the scapulae posteriorly. The respiratory expansion should be at least from one and one-half to two inches. Alimentary Canal. I. Dyspepsia is sometimes a prelude to consumption or organic disease of the stomach, liver or kidneys. Its nature should in all cases be inquired into and reported upon. Urinary and Generative Organs. I. Symptoms of disease of the urinary organs (stricture, enlargement of the prostrate gland, stone, etc.) should be carefully investigated. Examination of Urine. 1. The urine should always be voided in the presence of the Examiner or at the time of examination. It must be examined in all cases for albu- men and its specific gravity taken. Unless the specific gravity exceeds 1.025, no test for sugar need be made. 2. The urine of applicants for insurance of $30,000 and over must be examined microscopically as well as chemically. Other microscopical examination need not be made unless specially required by the home ofifice. 3. One great company directs as follows: In the matter of testing the urine, so apply your tests as to detect the presence of even small amounts of albumen or of sugar. For such ■detection of albumen, the common heat and nitric acid test is efficient enough if applied in the following manner: First acidify with a drop or two of acetic acid, then fill a long test tube three-quarters full and, holding the same by the bottom, boil the upper portion, only, of its con- tents. Holding the tube now a few inches in front of a black background set before a window, compare the upper, boiled, stratum of fluid with the lower unboiled one, and any pathologically important amount of albumen will be shown by a distinct cloudiness of the upper stratum of urine, distin- guishable from the cloudiness of precipitated phosphates by its persistence after addition of a drop of nitric acid. As regards sugar, test for this con- stituent in all cases, regardless of specific gravities. In the beginning of diabetes, as in temporary glycosuria, the amount of glucose in the urine is commonly not enough to run the specific gravity out of bounds. Take by preference, furthermore, the urine secreted during active digestion, since in the beginnings of both albuminuria and glycosuria, the morbid constitu- ents may be present during digestion while absent in the intervals.