One of the first symptoms of diabetis is a preternatural keenness of appetite, but in most diseases the appetite is lost or impaired or perverted.
Thirst is generally great in diabetis, and there is commonly considerable thirst in inflammatory complaints.
The above named symptoms are mostly subjective, but are accompanied by others that are objective, that show that the functions of certain parts are disturbed or suspended; and it is of especial importance to notice the PULSE, as this is a valuable guide in treating disease.
Each contraction of the heart sends out a wave which distends the blood vessels, and they by their contractility or elasticity carry it on through the entire arterial system. This periodical distention is the pulse.
The PULSE BEATS can be felt wherever an artery approaches the surface; it is usually taken and counted at the wrist; in children it can be best taken at the temporal artery during sleep.
To take the pulse accurately place two or three fingers on the artery making moderate pressure, and note particularly its frequency, its regularity, its forces and its fullness.
The RATE varies with varying circumstances. The average number of pulsations in a healthy adult is from 70 to 75, but there are some persons who, when they are quite well have a pulse of 80 or 90 to the minute, and there are others in whom it seldom rises above 60. It is usually more rapid in women than in men, is much more frequent in early life than in old age, and the average rate in a healthy child is 120.
In disease, the pulse may acquire a great degree of frequency. It may reach 150 or even 200, but in such cases it is generally feeble and can hardly be counted. Besides observing the frequency of the pulse, its character in other respects must be noted.
Irregularity of the pulse generally indicates disease, and there are two varieties of it. In most instances of irregular pulse, succeeding beats differ in length, force and character; in the other variety a pulsation is from time to time left out; the pulse is said to intermit.
In the DICROTIC PULSE a secondary wave or undulation can be felt. It is often met in typhoid fever, and an inexperienced person might be led to count double the number of beats.