The Hand in Clinical Medicine
It is no wonder that the diagnostic value of the facies has often been emphasised, for expression, form, colour, condition of the skin and hair and many other features can be studied from the beginning of the interview. In clinical practice it is common, after examination of the face, to take up the hand and feel the pulse. The experienced clinician may gain almost as much information from the hand as from the face, for the hands also show expression and character. Furthermore the hands are so highly developed that the blind and the dumb may use them as effective substitutes for reading and for speech, and many of us gesticulate for emphasis. Indeed, gestures made by patients to indicate the site and character of symptoms can be most helpful. Thus the flat of the hand is pressed upon the vertex of the head with psychogenic headache, both hands squeezing across the front of the chest commonly indicates ischaemic heart pain, or the tips of two or three fingers pressed into the epigastrium suggest the pain of peptic ulcer.
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