When you can spare the time,--and no time is wasted which is spent in
getting a thorough and exhaustive knowledge of a serious case,--it is as
good as a play to let even your hypochondriac patients, and those who
are suffering chiefly from "nervous prosperity" in its most acute form,
set forth their agonies and their afflictions in their fullest and most
luxurious length, breadth, and thickness, watching meanwhile the come
and go of the lines about the face-dials, the changes of the color, the
sparkling and dulling of the eye, the droop or pain-cramp, or luxurious
loll of each group of muscles, and quietly draw your own conclusions
from it all. Many and many a time, in the full luxury of
self-explanation, they will reveal to you a clew which will prove to be
the master-key to your control of the situation, and their restoration
to comfort, if not health, which you couldn't have got in a week of
forceps-and-scalpel cross-examination.
In only one class of patients is this valuable aid to knowledge absent,
and that is in very young children; and yet, by what may at first sight
seem like a paradox, they are, of all others, the easiest in whom to
make not merely a provisional, but a final, diagnosis. They cannot yet
talk with their tongues and their lips, but they speak a living language
in every line, every curve, every tint of their tiny, translucent
bodies, from their little pink toes to the soft spot on the top of their
downy heads. Not only have they all the muscle-signs about the
face-dial, of pain or of comfort, but, also, these are absolutely
uncomplicated by any cross-currents of what their elders are pleased to
term "thought."
When a baby knits his brows he is not puzzling over his political
chances or worrying about his immortal soul. He has got a pain somewhere
in his little body. When his vocal organs emit sounds, whether the
gurgle or coo of comfort, or the yell of dissatisfaction, they are just
squeezed out of him by the pressure of his own internal sensations, and
he is never talking just to hear himself talk. Further than this, his
color is so exquisitely responsive to every breath of change in his
interior mechanism, that watching his face is almost like observing a
reaction in a test-tube, with its precipitate, or change of color. In
addition, not only will he turn pale or flush, and his little muscles
contract or relax, but so elastic are the tissues of his surface, and so
abundant the mesh of blood-vessels just underneath, that, under the
stroke of serious illness, he will literally shrivel like a green leaf
picked from its stem, or wilt like a faded flower.
Public-domain text, read in full here on John Shaqi.
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