Note the patient’s apparent age with any indications of disguised age, signs of weakness—whether corpulent or bloated; note any deformities, swellings or wounds, and notice the attitudes and expression of the countenance.
A sufferer instinctively takes THE POSITION most conducive to ease. When one lung is affected the patient lies on that side, that the healthy one may have the greater freedom of motion. When there is peritonitis (inflammation of the bowels), he lies on his back with his knees drawn up to relax the abdominal muscles. If there is colic alone he may lie on the abdomen, as pressure may relieve his pain. When a patient has been persistently on his back, if he turns onto his side it is a sign of improvement.
Inability to breathe termed ORTHOPNŒA, occurs in affections of the heart, and also in asthma. Lying quietly in bed is usually a favorable sign. Restlessness and slipping to the foot of the bed, in low stages of fever, are bad signs.
Of the uneasy, morbid symptoms, pain is the most important, and most common. Pain occurs in nearly all inflammations, and it may occur where there is no inflammation at all.
Bones, muscles, tendons, ligaments, the bladder, the kidneys, the uterus, all modify in a manner that is peculiar to themselves the pain that is produced by injury or disease. Such terms as the following are used to express a peculiar character of pain: It is said to be sharp, shooting, growing, burning, dull, heavy, tearing, and so on.
If pain is felt in any part when pressure is made upon it the heightened sensibility is called TENDERNESS, the part is said to be tender. A part may be both painful and tender, as it usually is if the pain continue for a time; it may be tender without being painful as it is usually, if pain continued for a time and then ceased.
Itching is an uneasy sensation allied to pain. It often affects the natural outlets of the body. It occurs about the rectum from the motions of little worms that nestle there, and other causes; and this itching of the rectum, and likewise of the pudendum, are distressing complaints, harassing the patient continually, preventing sleep and requiring medical treatment (F. 195). The tingling and pricking often felt in the windpipe, and provoking coughing, has some analogy to itching.
Nausea is sometimes a direct symptom of gastric disorder, at other times it is a very important indirect result of disease at some distance from the stomach. The nausea which is so troublesome to pregnant women, is an instance of a morbid sensation, sympathetic of irritation in a distant organ.
Dizziness or vertigo results sometimes from disease within the head, and sometimes it is the indirect result of disease of the stomach or of mere debility.
A sensation of sinking, sensations of weight and lightness, of drowsiness, tenesmus, strangury, heartburn, and various conditions of the special senses are mostly SUBJECTIVE SYMPTOMS.