Diagnostic symptoms in nervous diseases / by Edward Livingston Hunt.

  • Hunt, Edward Livingston, 1871-1967.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Diagnostic symptoms in nervous diseases / by Edward Livingston Hunt. Source: Wellcome Collection.

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    Examine the Gait.—The two ways to determine a man’s gait are by observing and hearing him walk. A patient is much more apt to walk in a normal and un- affected way if he is not being observed than when he is aware of the fact that he is the object of close inspection. Therefore, contract the habit of observing a patient’s manner of walking when he first enters the room. Next have him walk a straight line, either a stripe in the carpet or a crack on the floor. Finally, if it is not too dangerous and difficult, have him walk backward and with eyes shut. Shoes are often so constructed as to modify a gait; therefore, always test a patient’s manner of walking with and without shoes. Another important point is to take notice of the manner and direction in which a patient wears out his shoes. The second method of examining a gait is by the sense of hearing. Accustom yourself to listen to a patient’s steps. The drop-foot flops, the paralytic drags, and the ataxic stamps. Examine for Ataxia.—This will be found described at length in the chapter on Ataxia. The most important test for ataxia is that known as Romberg’s. The exami- nation for ataxia must include not only muscles, but also speech and handwriting. Examine for Convulsions.—This can readily be done by getting a detailed history. To understand this sub- ject see the chapter on Convulsions. Examine the Sensory Impulses.—First test the epi- critic, the protopathic, and the sense of deep or joint sensibility. Test for touch, pain, and temperature. These methods have all been explained in the chapter on Sensory Disturbances. Next examine, by means of the tuning-fork, the vibration sense; by means of mov-