From GROUP III. a very large number of particular indications might be drawn ; we shall here enumerate only the more important a. Position in bed.
a. The head is elevated chiefly in disease connected with the heart, less fre quently in diseases of the lungs.
p. The head is leant forward when there is pressure on the trachea.
y. The patient may be unable to lie down from pain of the head or giddiness. E. Lying on the back is the position of debility; it is then combined with listlessness ; it is also the position of paralysis, when it is combined with inability to alter it; and of stiffness and pain in acute rheumatism, when it is chiefly characterized by stillness.
e. The same position is generally assumed in acute peritonitis, when it is combined with drawing up of the knees towards the abdomen.
C. The patient assumes a prone position generally only in abdominal spasm or colic ; much more rarely in consequence of the pressure of internal tumor.
v. When fixed on one aide, we may generally assume that the breathing is much obstructed in the lung of that side on which he lies. When he is unwilling to turn to either side, it is commonly from the sense of pain accompanying inflammation ; pressure produces pain on the affected side, while turning on the opposite causes a sensation of dragging.
b. Posture and gait.
a. Inability to stand depends on weakness, vertigo, or paralysis ; in the two former the patient reclines, in the latter he sits. i
s. The body is bent to one side in curvature of the spine, and also in dis ease of the hip.
y. The gait is quick in excitement ; 8. Slow in debility ; s. Laborious, staggering, or uneven, in diseases of the brain and paralysis. C. It is stiff and halting in rheumatism and disease of joints.
q. There is constant movement in chorea.
9. Tremor exists in nervousness, and more especially in delirium tremens ; it is seen in fever, sometimes with what is called floccitatio ; it also ac companies severe rigor.
a. Tonic spasm occurs in tetanus, in disease of the spinal cord, poisoning with strychnia, &c. When long continued, it is probably associated with inflammatory softening of the brain.
x. Catalepsy is a peculiar form of tonic spasm ; cramp is its mildest mani festation.
Clonic spasm occurs in epilepsy, eclampsia, chorea, and hysteria ; sub sidies is also a form of clonic spasm allied to tremor.
e. The muscular movements generally are exalted in mania and delirium, are diminished in idiocy and imbecility, are lost in paralysis. There is a certain restlessness sometimes belonging to hypochondrissis, and more rarely to hysteria, allying them with delirium in this external manifestation.