26 GENERAL EXAMINATION. 



in great hemorrhage, in icterus gravis (acute cougestion of the 

 liver, with yellowness of the mucous membranes and dark color- 

 ing of the mucous membranes), in all acute diseases of the 

 brain, in various cases of poisoning, in cases of distemper, and 

 in septicaemia. 



Increase or Decrease of Local Temperature. Increased 

 heat of a part is generally due to some injury or a surgical dis- 

 ease, and, as a rule, has with it tenderness to the touch and swell- 

 ing. A local heat can alSo be felt in all inflammations that are 

 not located too far from the surface of the body. 



Coldness of any part indicates an impaired circulation in the 

 part. In all cases of collapse the extremities are the first to be- 

 come cold, as they are furthest from the heart. In cases of com- 

 pression of an artery by ligatures, or tumors, or an embolus, or 

 thrombus, the part of the body that is cut off becomes cold from 

 impaired circulation. Paralyzed extremities are always slightly 

 colder to the touch than active parts. 



