Hints for clinical clerks in medical cases / Westminster Hospital.

  • Westminster Hospital
Date:
[1863?]
Catalogue details

Licence: Public Domain Mark

Credit: Hints for clinical clerks in medical cases / Westminster Hospital. Source: Wellcome Collection.

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    features of the living half of the face come into play, as in facial palsy:—The featui'es pinched and contracted, as during severe pain—the forehead being especially wrinkled and the brow knit, when the pain is in the head, the nostrils being drawn acutely upwards, when the pain is in the chest, the upper lip being raised and tightened, so as to expose the teeth, when thepain is in the abdomen:—The countenance pale, pasty, dry, and unperspiring, with puffiness about the eyelids, or more con¬ firmed oedema or anasarca, as in albuminuria:—The complexion pale and waxy, with the slight tinge of green indicated by the name, as in chlorosis:—The features wan, wasted, sallow and yellowish, with the whites of the eyes of a pearly lustre, and the eyes sunk and surrounded by a dark circle, as in advanced cases of cancer:—The complexion varying from yellow to greenish- yellow, with the whites of the eyes no less discoloured than the rest of the surface, as in jaundice:—and so on. 4. Posture* whether that of standing, sitting or lying, whether more or less fixed in a particular posi¬ tion, and so on. For example:—Supine, unshifting, with arms and legs ex¬ tended, and with a tendency to slip or sink down in bed, as in a state of great prostration:—With the thorax and the thighs in a state of gentle flexion upon the abdomen, the ab¬ dominal walls being relaxed and motionless, and all the muscles kept in a state of most cautious stillness, as in inflammation of the abdomen with acute pain:—Lying or falling more or less upon the paralyzed side, and especially upon the paralyzed arm, as in hemiplegia:—and so on. 5. Breathing* as to arterial or venous colour of lips and complexion, working of nostrils, number of respirations in the minute, temperature and odour of breath, dyspnoea, orthopnoea, thoracic breathing, abdominal breathing, crowing, stertorous, and other kinds of noisy breathing, &c. For example:—The sides of the chest more or less motionless, the breathing being carried on by the action of the diaphragm (abdominal breathing), as in certain cases of acute pleurisy:— The walls of the abdomen motionless, the breathing being carried on by the movement of the lateral walls of the chest (thoracic breathing), as in inflammation of the abdomen with acute pain:—The patient sitting up, with the nostrils work¬ ing, the complexion livid or violet, especially the lips, nose, and ears, the expression anxious, the cheeks and temples cool and per¬ haps damp, the legs hanging down, the lips apart, and the pomum Adami and even the chin drawn downwards at every inspiration, the auxiliary muscles of respiration (the sterno-cleidoids, cucul- lares, pectorals, &c.) in full action, and to allow this action, the shoulders fixed by resting firmly upon the hands, or upon the