A practical treatise on medical diagnosis : for students and physicians . aken for retro-pharyngeal abscess. The expression and contour of the face is of much significance incerebral disorders. Affections which cause an increase in intra-cranial pressure cause,also, striking external features, as in hydrocephalus. 122 GENERAL DIAGNOSIS. Hydrocephalus. The external enlargement of the skull is veryconspicuous, and the undue proportion of the cranium to the face isstriking. The cranium is rounded or globular in shape, and thefontanelles are seen to be very large, tense, and bulging, and thesuture
A practical treatise on medical diagnosis : for students and physicians . aken for retro-pharyngeal abscess. The expression and contour of the face is of much significance incerebral disorders. Affections which cause an increase in intra-cranial pressure cause,also, striking external features, as in hydrocephalus. 122 GENERAL DIAGNOSIS. Hydrocephalus. The external enlargement of the skull is veryconspicuous, and the undue proportion of the cranium to the face isstriking. The cranium is rounded or globular in shape, and thefontanelles are seen to be very large, tense, and bulging, and thesutures widely separated. The disproportion in size of the face andhead is increased by the projection of the front portion of the axis of the eyes is directed downward, and they are partly coveredby the eyelids, because of the oblique direction of the orbital head is supported with difficulty; the eyeballs roll from side toside. There is frequently strabismus. The skin is stretched tightlyover the cranium, and the hair is scanty. (See Fig. 10.) Fig. Congenital hydrocephalus. Female, aged seventeen. (The thinnessof the hair could not be represented.) The enlargement of the head must not be confounded with rickets(see under Skeleton) or enlargement and thickening of the bones. In theformer the head is square in shape, not globular, and the fontanelles,though large, do not bulge. Other signs of rickets aid in the states that thickening of the cranial bones may simulate hydro-cephalus at almost any age. He thinks it doubtful whether the nature ofthe latter rare cases can be ascertained during life. The thickeningthat attends osteitis deformans and acromegalia have been alreadydescribed. THE DATA OBTAINED BY OBSERVATION. 123 The Lips. The color of the lips is pale in anaemia, and livid incyanosis from chronic lung or heart disease with feeble circulation. Vesi-cles (herpes) are apt to appear upon them in common colds, in certainfebrile disease
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