Observation, to be of value, should be systematically made, and only one thing at a time can be noticed, which must be understood before passing to another, otherwise every thing is confused.
The condition and appearance of a single part should be looked at to see what is natural, and what is evidence of disease.
In practice, written notes taken at the time, are extremely valuable in teaching close and accurate observation, and cultivating an ability to clearly express to others the result.
For the purpose of suggestion and guidance, the following system for observation is given:
Observe the effect of medicine.
The face.—Observe if it is pale, and if the pallor is sudden, temporary or permanent; if flushed, if congested, if blue with venous blood, if there are any eruptions, bruises, or scars. Observe the expression of the face.
The tongue.—Observe if it is coated, and if so, if white, brown, red, black, glazed, dry, or cracked; if it is tremulous, or drawn to one side, or protruded with difficulty.
The lips.—Observe if pale, blue, dry and cracked, if there is tremulousness about the corners of the mouth; the teeth, if covered with sordes; the gums, if bleeding.
The breath.—Observe if sweet, sour, foul, or offensive.
The respiration.—Observe if slow or fast, quiet and natural, or loud, labored, and difficult, if puffing, wheezing, shallow, or irregular.