A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
Tenderness on pressure is significant either of local inflammation,
whose other signs are then to be discerned, or of non-inflammatory
hyperæsthesia. The origin of the latter may require careful
examination of various organs for its discovery. If pain is relieved
by pressure, we may be sure of the absence of severe acute local
inflammation.
Not infrequently the seat of disease may be at some distance from that
of pain, as in the familiar instances of pain at the top of the head
in uterine derangement; in the glans penis from calculus in the
bladder; in the knee from hip-joint disease; under the shoulder-blade
in liver disorder; about the heart or between the shoulders from
dyspepsia.
Anæsthesia, loss of sensibility, has much value as a symptom in
neurotic affections, as paralysis, etc. Its discussion will find place
in connection with diseases of the Nervous System in other portions of
this work.
As an example of the diversified associations of pain, cephalalgia
(headache) may be mentioned as having at least the following possible
causes: congestion of the brain, neuralgia, rheumatism of the scalp,
uterine irritation, disease of the kidneys, early stage of remittent,
typhoid, or yellow fever, alcoholic intoxication, chronic disease of
the brain.
Abdominal pain may, in like manner, be traced, in different cases, to
many morbid conditions, such as flatulent colic, lead colic, neuralgia
or rheumatism of the bowels, intestinal obstruction, dysentery,
passage of a gall-stone or of a nephritic calculus through one or the
other duct {166} respectively; cancer, aneurism of the aorta, caries
of the spine; in the female, dysmenorrhoea, metralgia or
ovaralgia--_i.e._ neuralgia of the uterus or ovaries.
Similar diversity in the origins of pain might, but for want of space,
be pointed out in morbid states of the contents of the chest and of
other parts of the body.
Subjective symptoms often affect the special senses.
Taste and touch have been already referred to. Of sight we may have
photophobia, connected with exaggerated sensibility of the retina or
of the brain; muscæ volitantes, specks, rings, or chains of spots from
floating semi-opaque particles in the vitreous humor; diplopia, double
vision; hemiopia, seeing only half of an object at a time; amblyopia,
indistinctness of vision of all objects.
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