HOW TO EXAMINE THE PATIENT 25 



reveal to a very great extent the amount of tension or 

 tympany present. In a bad case of intestinal trouble 

 the whole of the abdominal muscles will feel hard, and 

 tense to the touch, conveying to one's fingers the sensa- 

 tion of a muscle in tetanus. Even in the flanks, where 

 a certain amount of resilience is expected, the same tense 

 condition is met with. 



In some cases palpation exposes the existence of pain or 

 tenderness, as, e.g., in peritonitis and enteritis. In others 

 the very reverse will be noticed, the pressure affording the 

 animal an appreciable amount of relief. It is wise to add, 

 however, that external pressure will not always cause the 

 animal to exhibit signs that may be absolutely relied 

 upon, It is often difficult to elicit symptoms of pain 

 from our patients, but it is still more difficult to distin- 

 guish between pain produced by pressure and ticklish- 

 ness, restlessness, and fretfulness, which may simulate 

 pain when pressure is brought to bear upon any part, 

 particularly the abdomen. Still, by palpation the surgeon 

 will be able to deduce a large amount of information, 

 favourable or unfavourable as the case may be. 



(2) By Auscultation. — This aid to diagnosis should 

 never be omitted. The sounds occasioned by peristalsis 

 will sometimes be in abeyance or altogether wanting, and 

 the appropriate remedy sufficiently pointed out. Or it 

 may be that peristalsis is abnormally in evidence, as in 

 the colic occasioned by the presence of fermenting foods. 

 Both flanks should be auscultated, and also the region of 

 the stomach. In the latter position evidence is some- 

 times obtained as to the condition — tympanitic or other- 

 wise — of that organ. If unduly full, regurgitations will 

 often be heard that are so slight as to be easily missed by 

 a mere observation of the oesophagus in the region of the 

 neck. 



