CHAPTER XII. 



PHYSIOGNOMY OP DISEASE. 



WHEN the physician speaks of the physiognomy of disease in 

 man he refers, not to mere facial expression, but to all those 

 modes of outward physical expression by which disease makes 

 its presence probable or obvious. This comprehensive form 

 of morbid physiognomy is of the utmost value in the detec- 

 tion or diagnosis of human disease. The mere glance at a 

 patient by a physician experienced in the observation and 

 interpretation of the outward expressions or manifestations 

 of the presence of internal disease, of a serious kind, fre- 

 quently enables him to distinguish the malade imaginaire 

 from the real sufferer to suspect the existence of, by others 

 unsuspected, dangerous mischief The wise physician does 

 not, however, trust to his first impressions founded on the 

 mere general aspect, or on the facial character, of a patient. 

 He confirms his suspicion, or corrects it, by due examina- 

 tion with the stethoscope, microscope, and test-tube, or 

 other artificial aids to his diagnosis. But, in proportion to 

 his experience as an observer of the language of look and 

 gesture in man, of that language which is non-vocal, and 

 which so frequently characterises disease, will he find his 

 first suspicions abundantly confirmed. I have myself over 

 and over again had occasion to order to bed, for physical 

 examination, persons who were unaware of their own serious 

 condition, and whose state was never suspected by those 

 with whom they were in incessant contact patients who 

 had none of the ordinary indications of dangerous disease, 

 but who, nevertheless, were in a hopeless, doomed state, life 

 being a matter of but a few weeks longer. 



