. Physical diagnosis . is cranii. b, After onset of hyperostosis cranii. c, Later still. (a) Bulging fontanels mean increased intracranial tension (hydro-cephalus, hemorrhage, meningitis, or any acute febrile disease with-out dyspnoea). (b) Depressed fontanels are seen in severe diarrhoea,wasting diseases, collapsed states, and acute dyspnceic conditions. 3. The Hair. (a) A rachitic child often rubs the hair off the back of its headby constant rolling on the pillow. (This is associated with profusesweating of the head.) Patchy baldness occurs in the skin disease THE HEAD AND FACE 7 alopecia ar
. Physical diagnosis . is cranii. b, After onset of hyperostosis cranii. c, Later still. (a) Bulging fontanels mean increased intracranial tension (hydro-cephalus, hemorrhage, meningitis, or any acute febrile disease with-out dyspnoea). (b) Depressed fontanels are seen in severe diarrhoea,wasting diseases, collapsed states, and acute dyspnceic conditions. 3. The Hair. (a) A rachitic child often rubs the hair off the back of its headby constant rolling on the pillow. (This is associated with profusesweating of the head.) Patchy baldness occurs in the skin disease THE HEAD AND FACE 7 alopecia areata, and occasionally over the painful area in trigeminalneuralgia. (b) General loss of hair occurs normally after many acute feversand with advancing age. Early baldness (under thirty-five) is oftenhereditary. Syphilis may produce a rapid loss of hair, local or general,and the same is true of myxoedema; but in both these diseases thehair usually grows again in convalescence. m :-? . ??? .. ^q ^M . % IKte. ^^L. Fig. 3.—Multiple Myelomata. Fig. 4.—Multiple Myelomata. (c) Parasites (pediculi) are worth looking for in the dirtier classesand those associated with them (teachers). Their eggs adhere tothe hairs and are familiarly known as nits. An eczema or itchingdermatitis often results. II. The Forehead. Scars, eruptions, and bony nodes are important. (a) Scars may be due to trauma or to old syphilitic epileptic often cuts his forehead in falling. (b) Eruptions often seen on the forehead are those of acne, syphilis,and smallpox. These may resemble each other closely, and are to bedistinguished by the history, the presence of lesions on other parts ofthe body, and the concomitant signs (fever, prostration, etc.). 8 PHYSICAL DIAGNOSIS (c) Nodes may be the result of many bumps in childhood or maybe caused by a syphilitic periostitis or neoplasms (see Figs. 3, 4, 5and 7). The history must decide. (d) Evidence of frontal sinusitis may be found (see Fig. 9). III. Th
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
