. Physical diagnosis . cold, moist handis most commonly felt in nervous people under forty. It is almost never seen in heart dis-ease, which its possessor oftenfears, and does not meanpoor circulation, but vaso-motor disturbances of neuro-tic origin. (p) Cold, dry extremities—hands, feet, nose, ears—maymean simply fatigue, expos-ure to low temperature, orinsufficient exercise; but inthe course of chronic diseasethey usually mean weaknessof the heart, and hence areserious. (c) Warm, moist handsare felt in Grares disease (ex-ophthalmic goitre), and if thewarmth and moisture arepresent most of th
. Physical diagnosis . cold, moist handis most commonly felt in nervous people under forty. It is almost never seen in heart dis-ease, which its possessor oftenfears, and does not meanpoor circulation, but vaso-motor disturbances of neuro-tic origin. (p) Cold, dry extremities—hands, feet, nose, ears—maymean simply fatigue, expos-ure to low temperature, orinsufficient exercise; but inthe course of chronic diseasethey usually mean weaknessof the heart, and hence areserious. (c) Warm, moist handsare felt in Grares disease (ex-ophthalmic goitre), and if thewarmth and moisture arepresent most of the time andnot only as a temporary phase—, after violent exercise—this disease is strongly sug-gested, and a search for trem-or, rapid heart, goitre, andbulging eyes should be Movements of theHands.—(«) The manner ofshaking hands gives us vaguebut useful impressions of thepatients temperament. The nervous, cramped, half-opened hand,which never really grasps and gets away as soon as possible; the. Fig. 25.—Radiographs of the Hand and Arm ofa Case of Hypertrophic Pulmonary Osteo-arthropathy (the left figure) compared withthe hand and arm of a normal individual ofthe same height (the right figure). Note espe-cially the thickening of the radius and ulna.(Thayer.) THE HANDS. 43 firm, hearty grasp; the limp, wilted hand—furnish hints ofcharacter that every physician must take account of. In fevers or toxsemic states (typhoid, alcoholism) there are twosets of movements which recur so often that names have been giventhem, viz. : 1. Carpliologia—picking and fumbling at the bed
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