What to observe at the bed-side and after death in medical cases.

  • 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. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    132. AtucultalioH; (s«c Phvstnl ex.itnination of the abdomen generally, 112; of liver, 116; spleen, 120; stomach, 12 t; and colon, 128.) — Impulsive sound;—diastolic shock.—Arterial murmHf : its exact seat and extent; extent of vessel upwards and down* wards from tumour over which heard;— port of tumour at which heard, iu front only or laterally also? foUowiag a line on surface of tumour;—characters; loud, soft, harsh, etc.;—systolic, diastolic, or both P accompanied or not by shuck or pulsation ?—etfect of strong pressure upon it; of pressure on cither side of stethoscope; of change of posture, fnmi recumbent to erect, or rice tertd; of posture on bauds and knees, etc.effect of displacing tiunour upon it (see also, Swellituie eomneeted with arteries, p. 42j; —effect of any other circumstances upon its loudness or other characters.— Fenotn mmr- aiur: its exact seat; extent; characters;—circumstances modifying it.—Continuoue murmur: its loudness {'heard at a distwee from patient 7); effect of art« rial systole or inspirations upon its intensity.— Utentte eoutul: its scat; extent; character; intensity; influenced or not by posture of patient ?—Ilydat%e sound. Gene-ral symptoms referable to the Abdomen. 133. Abnormal sensations.—Pain: precise seat, ex- tent;—severity, seat of grcatint intensitydirection; towards the spine,chest,shoulders, pclvis.etc.;—special character; like a weight, twisting, lancinating, burning, etc.—Time of its occurrence; constant, paroxysm^, periodica];- when stomach is full or empty ? if after a meal, after which meal and how soon after it r— effect of solid food and of hot, tepid, or cold liquids, or of alcoholic or stimulant liquids, in inducing or relieving it.—Duration.— Kffcct of posture upon it (note pos- ture of patient during its presence);— effect of pressure with flat hand or points of fingers in increadng or relieving it;—effect of inspiration or coughing upon it; —effect of agitation of bed or ajiartment upon it;—its connexion with mental agitation.—Does it prec^c or fuilowactsof deftecatiou?—has it any connexion in point of time with other symptoms, (borborygmi, voraitinu, eructations, etc.)?- -is it i^ieved by expulsion of gaseous, lUjuid, or solid matters from stomach or rectum ?—has the patient any contrivance for relieving it?—Other abnormal sensations : of sinking, heat, weight, fulness, dragging, constriction (particulars as—Sensation 29 ! Auscultation— arterial mur- mur. I venous mur- mur. continuous ; murmur. j uterine sound. I hfdstic sound. I iimfral syntp. I toms. i AlinormsJ sensa- tions-- pain. other tenia- tions.