. A practical treatise on medical diagnosis for students and physicians . of hysteria ; (2) its sudden occurrence aftershock, emotional disturbance, or trauma ; (3) the absence of a cause inthe auditory apparatus for the deafness ; (4) impairment of bone conduc-tion and aerial conduction to the same degree ; (5) the frequent coexist-ence of anaesthesia of the pinna and external meatus; (6) the tendencyto sudden recovery. Hysterical deaf-mutism is a rare condition, characterized by (1) sud-den origin; (2) absolute aphasia and aphonia ; (3) absence of signs ofparalvsis of the lips and tongue and
. A practical treatise on medical diagnosis for students and physicians . of hysteria ; (2) its sudden occurrence aftershock, emotional disturbance, or trauma ; (3) the absence of a cause inthe auditory apparatus for the deafness ; (4) impairment of bone conduc-tion and aerial conduction to the same degree ; (5) the frequent coexist-ence of anaesthesia of the pinna and external meatus; (6) the tendencyto sudden recovery. Hysterical deaf-mutism is a rare condition, characterized by (1) sud-den origin; (2) absolute aphasia and aphonia ; (3) absence of signs ofparalvsis of the lips and tongue and of any paralytic phenomena excepthysterical hemiplegia ; (4) preservation of intellectual faculties and powerof writing ; (5) frequent coexistence of hysterical stigmata; (6) usuallyrapid recovery. CHAPTER XXII. EXAMINATION OF THE EXTREMITIES. THE NAILS. • Shape. The appearance of the nails enables lis to estimate theduration of certain diseases, or the time when convalescence began ; italso indicates local interference with the nutrition of the parts. Thus Fig. Clubbed fingers with curved nails, middle finger slightly flexed. (Original.) curving of the nails, with clubbed fingers, occurs only in chronic diseases,as phthisis or emphysema, or in chronic cardiac disease and aneurism. Inthe latter it is sometimes found on one hand only. It is sometimes seenin other chronic wasting diseases. The nails may curve transversely orlongitudinally. In transverse curvature the appearance is like that of afilbert, and in longitudinal curvature the nails are said to be change in shape may occur without clubbing of the fingers. Theshape is altered in acromegaly and pulmonary osteo-arthropathy. (SeeChapter XXVIL, Part I.) Color. White marks or transverse grooves on the surface are usuallyseen after an illness, and may indicate the date of recovery. The marksdevelop at the root of the nail, and as the nail grows the marks approachthe tips of the fingers, and thus their
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