A Syllabus of Diagnosis William Baker.01509 2

William Baker
A Syllabus of Diagnosis
Reading excerpt
of William Baker
Publisher: B. Jain
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CHAPTER II.
TEMPERATURE
1. What is the only accurate way for determining the

Bodily Temperature?
By observation of the same, with a good clinical
thermometer, allowing sufficient time-to obtain a correct
reading.
2. What are the necessary factors in order that the
observation with the Thermometer should be
accurate ?
(i) Accuracy of the instrument. (ii) Allowance
of sufficient time, (iii) Proper placing—avoiding the
seat of the local disease as the place of observation.
3. How long should a Thermometer be kept in situ when
taking the Temperature ?
An ordinary one—for 5 minutes. Rapidly-acting
thermometers—double the time instructed in the in-
strument.
4. How does the Age of the Thermometer affect its
Reading ?
After an year or so, the instrument records about
a degree above the correct temperature.
5. How do local diseases influence the reading of the
Thermometer ?
In the seat of local diseases the heat is much
higher than the general temperature of the body.
6. What places are available for Thermometric
observations ?
The mouth. The axilla. The rectum. The
vagina. The folds of the groins-
Chap. II. TEMPERATURE 5
7. What precautions are to be adopted when taking

Temperature Observations in the Mouth ?
The bulb should be placed well beneath the
tongue and completely covered by that organ. The
thermometer should be thoroughly disinfected after use.
8. What .precautions are to be observed when taking
Axillary Temperature ?
The bulb should be plao;d in the thoroughly
dried axillary folds, not too deep as to protrude poste-
riorly. The muscles must be thoroughly relaxed.
9. What precautions are to be adopted when taking
Temperature Observations in the Rectum and
Vagina?
The bulb should be inserted about 2 inches in
the verge of the anus or vagina.
10. In what class of cases would you use the Rectum or
Vagina for taking Temperature ?
In comatose and convulsive patients.
11. Under what circumstances is the taking of the Mouth
Temperature inadmissible ?
After partaking of any kind of food or when the
patient suffers from stomatitis or dental diseases.
12. What are the relative differences of Tempera-
tures taken in the Mouth, Axilla and
Rectum?
In the mouth about A a degree higher than those
taken in the axilla; in the rectum and vagina half a
degree higher than those of the mouth.
13. How frequently should Temperature Observations be
taken?
Depends upon the nature of the case; generally
4 times a day.
14. Name the Physiological Influences causing variations
in the Temperature.
Taking of food; exercise; atmospheric heat; age;
time of the day; and mental excitement.
CHAPTER III.
THE PULSE.
1. How do you examine the Pulse—(a) by Hand;
(b) by Instrument ?
(a) Conducted by palpating usually one of the
radial arteries of the patient with three fingers, in a
way, so that the index finger is placed towards the cir-
culatory centre, subject to precautions as enumerated
in answer to Q. 4 of this chapter.
(b) Conducted by Sphygmograph and Polygraph.
2. Give the methods for recording information learned
from the Pulse.
(a) When by hand—the pulse-rate, its ilhythm,
the size, force and character of the waves, the resistance
of the artery to pressure between the pulse-beats and
difference in the two radial pulses in their beats are
recorded in plain or printed sheets.
(b) When by instrument — recorded in a sphyg-
mogram.
3. When examining the Pulse to what points should you
pay attention.
CI) The frequency, (2) regularity, (3) force or
strength and (4) tensipn of the pulse. (5) The thickness
and size of the arterial walls. (6) The condition of the
arterial walls. (7) Thfe character of onset and subsidence
of the individual beats,
4. What precautions are necessary in order to avoid
errors in taking of the Pulse ?
Avoidance of the time of physical or mental
excitement of the patient. The counting should be for
full one minute to find its average frequency.
Chap. III. T H E PULSE 27
5. What is the Normal Pulse Frequency ?

The normal pulse frequency of an adult is 72
beats per minute.
6. What Physiological factors vary the Pulse ?
Age. Sex. Posture. Exercise. Excitement. Tempera-
ture. Diet. Time of day.
7. What is the effect of Age ?
At birth—140, at one year—120, at two years— v -
108, at ten years—90, in the old age 80 or thereabout,
beats per minute.
8. What is the effect of Sex ?
With the advent of puberty the female pulse be-
comes slightly greater in frequency which continues till
the old age.
9. What is the effect of (a) Posture : (b) Exercise ?
(a) The sitting posture increases the pulse rate
by about 10 beats per minute than while lying ; standing,
by about 10 beats more than sitting.
10. What is the effect of Temperature on Pulse ?
Intense heat may increase the pulse frequency to
a great extent, it may even double the pulse-rate. With
the cold it is the reverse.
11. Name the Pathological causes for increase in the
Pulse Rate.
Fevers. Asthenia. Pain. Reflex irritation. Pul-
monary diseases. Alcoholic excesses. Excessive indulgence
in Tobacco. Convulsions. Irritable heart Tachycardia.
Organic heart diseases.
12. What is the general rule for increase in the
Pulse Rate for every degree of rise in the
temperature ?
As a rule, each degree increases the pulse-rate by
8 to 10 beats per minute. Notable exceptions may be
found in Typhoid Fever, Meningitis, Scarlatina, Diph-
theria and Peritonitis. In the first two, it is dispro-
portionately slow, while in the last three, disproportion-
ately rapid.
William Baker
428 pages, pb
publication 1999
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William Baker

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1. What is the only accurate way for determining the

7. What precautions are to be adopted when taking

5. What is the Normal Pulse Frequency ?

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