Physical Examination of the Abdomen in Health and Disease. Part First

Abstract

ALTHOUGH practitioners have long (even before the examination of the chest became a study) been in the habit of proving the condition of the state of the abdominal viscera by means of inspection and palpation, yet it does not appear that any systematic attempt has been made to reduce this mode of investigation to fixed principles, which, by render- ing it more rational and intelligible, would facilitate and extend its application in practice. The signal aid which the diagnosis of thoracic diseases has derived from the light of physical science, is a sufficient encouragement to attempt the elucidation of abdominal diseases in the same rational point of view. If it be objected, that the signs of the state of the abdomen, being derived chiefly from the touch, are rather to be learnt by experience than taught by precept, it may be answered, that although experience is absolutely necessary for proficiency in all matters in which the senses are concerned, yet a proper analysis of the objects of examination will render this experience much more intelligible and instructive. And this applies as much to the sense of touch as to those of vision and hearing. The tactus expertus, a fine delicacy of toueb, capable of very nicely feeling and discriminating between im- pressions, may be more or less acquired by mere experience: but the tactus eruditus, the faculty of properly interpreting these impressions, and their differences, includes an exercise of the understanding, and requires a due consideration of the subject in its relations of cause and effect.