HOW TO EXAMINE THE PATIENT 21 



observation I have advised, and the beginner may be- 

 Heve me when I say that the owner of the animal is far 

 more Hkely to be impressed with the man who makes a 

 careful and systematic examination of this nature than 

 with the man of rapid diagnosis. The latter he may 

 admire, the former he will trust. 



Now and again you may meet with a client who is 

 visibly struck with the ' lightning diagnosis business,' 

 and, whenever you see a chance, and a safe one, of 

 exhibiting this ability yourself, by all means take advan- 

 tage of it with that particular client. It is not, how- 

 ever, to be recommended as a usual plan of procedure. 

 Methodical carefulness will tell the best in the long-run, 

 and will lead you into fewer blunders. 



3. The actual examination of the patient may 

 now commence. 



The ptdse, that grand tale-bearer in these cases, should 

 be carefully noted both in regard to the number of beats 

 and its general character — constantly frequent, or its 

 number of beats only increasing with each paroxysm 

 of pain, etc. — wiry and thin, or full and bounding, etc. 



While taking the pulse, the hand in the axilla should 

 note the amount of perspiration present, and also ascer- 

 tain the condition of the external temperature — whether 

 the sweats are warm and comfortable, or chilly and 

 deathlike. 



The rectal tempevature, though not alone of diagnostic 

 aid, should always be taken ; for, considered in conjunc- 

 tion with the pulse and number of respirations, it will 

 sometimes prove of help in prognosis — e.g., see the 

 chapter on Subacute Obstruction of the Double Colon. 



4. The examination of the abdomen should then 

 proceed in the following manner : 



(i) By Palpation. — This method of examination will 



