THE PHYSICAL EXAMINATION 29 



have your watch tested by a number of seemingly 

 normal children so that you can have some judg- 

 ment as to how far from the ear it can generally 

 be heard. 



The Hands 



Several facts can be noticed by even a brief 

 examination of a child's hands. For instance, in 

 shaking hands with a child, it can be noticed if 

 the hand has a normal temperature, or whether it 

 is very dry, or hot, or cold and moist. It can be 

 noticed whether the grip is firm and reasonably 

 strong, or if it shows excessive, jerky, nervous 

 strength, or is flabby and lacking in energy. At 

 the same time you can see whether the finger- 

 nails are bitten, whether the back of the hand is 

 red, and if it is reasonably clean or not. If the 

 back of the hand is red, press the thumb upon it, 

 and so leave a white mark where the pressure 

 was exercised. In this connection it is important 

 to note how rapidly or slowly the blood flows 

 back again into the white area. If the hand is 

 not clean, then it is important to judge whether 

 it is the uncleanliness of the day — and there is 

 something the matter with a boy whose hands 

 are always scrupulously clean! — or the unclean- 

 liness of many days, which indicates something 

 concerning home environment — as does the pro- 

 verbial " low-water mark" not infrequently visible 

 behind the ears and along the back of the neck! 



