Page:Willich, A. F. M. - The Domestic Encyclopædia (Vol. 3, 1802).djvu/395

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PHY t!ie praftice of those physicians, vho degrade their profession into a trade ; which is comparatively less respectable than that of the lowest mechanic ! Having hazarded these observa- tions on the usual routine of a modern, or fashionable, physician (including both graduated and un- graduated, as well as associaied jn)d permitted, members of the dif- ferent Colleges), we deem it our duty to point out those circum- stances, and conditions, which de- serve minute attention in the Jirst examinxition of a patient. In order to obtain a clear and complete view oi chronical diseases, for which a physician is generally coijsulted, after the apothecary, together with the old matrons, have exhausted their stock of medicinal remedies, it will be requisite to proceed more systematica/lif, and to inquire into the following parti- culars : 1 . Duration of the disease, 2. Age and sex of the patient. 3. His external form and constitution of body. 4. His usual occupations, trade, or rank in life. 5. Whether married or single. 6. Climate ; na- tive country 5 and local situation with respett to dwelling. /. Do- mestic circumstances and employ- ment, if connetted with the disor- der. 8. Disposition of mind ; cha- racter 3 mode of thinking j if in- fluenced by political or religious views, 9, Extent of his mental capacity, or cultivation of mind, JO. Favourite pursuits. 11. Usual intercourse, or society. 12. Particu- lar habits or customs. 13. Mode of living, with respect to food and drink. 14. Local or external af- feftjons, 15. The peculiar tempe- lament. When these prclimiiiary incjui- ries have been cautiously instituted, PHY [373 without intruding on the patient j or appearing too olficious to his affable relations ; the systematic praftitioner will next endeavour to ascertain the following data, lead- ing to a more intimate knowledge of the disease : 1. The countenance of the patient. 2. His situation and posture in bed, or gait in the room. 3. His previous state of he;ilth. 4. The remedies and phy- sicians Le has employed on former occasions. 5. Idiosyncrasy, or pe- culiarity of constitution. 6. In- stinctive propensities. 7- Tlie pre- vailing charader of diseases at the time, whether of an infeftious, epi- demic, or endemic nature. Lastly, ill order to discover the exa6t deviation from a natural or healthy state, none of the following points ough.t to be disregarded j though it should be iiiipracticable to pay the most scrupulous atten- tion to each, at the first interview : namely, 1. The internal and exter- nal sensations of the patient. 2. The commencement and progress of the disease, 3. Pulse. 4. Breath- ing. 5. Muscular energy, 6. The appearance of the head and hair. 7. The throat and neck, S. Deglu- tition, or swallowing. 9. The chest. 10, The abdomen. 11. Appetite for eating or drinking. 12. The back or vertebrae. 13. The anus. 14, Vision, and the eyes, eye-lids, region about the eyes, and jachry- mal glands, 15. I'he skin, with resped: to its colour, and elasticity, 16. The nails, 17, The organ of smelling, 18. The prevalent taste in the mouth ; appearance of the tongue and palate, together with the lips. 19. The organs of hear- ing. 20. State of the bowels, whe- ther lax or costive, 21. Urine. 22. Insensible perspiration. 23. Ex- pectoration. 24. Nausea, retching, Bb3 or