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rigidity; twitching; tremor; spasms; cramps; fits; ataxias; Chlorpromazine Thorazine dysarthria; aphonia; apraxia). Disturbances of sensibility (anesthesia; hyperesthesia; parathesia; defects of smell, taste, sight, and hearing). Mental disturbances (nervousness; insomnia; amnesia; losses of consciousness; delusions; exaltation; depres- sion; fears; indecision; feelings of unreality: social rtialadjustments). Obesity ; emaciation ; changes in weight. Signs of infection (fever; chills; sweats; petechiae ; etc.). Any Purchase Thorazine one who has difficulty in holding in mind such a catalogue of prominent symptoms in sys- tematic sequence will be helped by keeping the list before him on his office desk while he is Thorazine Online recording the anamnesis. I do not need to refer to the re- duction Buy Thorazine Online or the extension of the questionnaire that may be necessitated by the single case. The ex- perience and the common sense of the questioner must guide him in this, especially in his interroga- tions regarding sexual, psychical, arui social details. Even the wisest and most tactful inquirer will err in judgment sometimes ; and the beginner especially will do well to be on his guard to avoid making the impression of being offensively prying or inquisi- torial. In psychoneurotic states, patients are often very sensitive to questions bearing upon their per- sonal life and their social adaptations, and it is among these hypersensitive ones that it is, Thorazine 10 Mg unfor- tunately, most often necessary to make a thorough search for so called psychogenic data. When the approach to such material is difficult, it is usually wise to postpone the inquiry into the more intimate life of the patient until the sympathetic attitude of the physician and a better acquaintance have es- tablished full confidence and the rapport necessary for the breakdown of reticence. If the net of questions that I have just referred to be carefully drawn, the information disclosed will go far Thorazine 200 Mg toward enabling the examiner to appraise the physical, the psychical, and Generic Thorazine the social status of the Thorazine Uses person under sttidy. Thorazine Iv The facts thus decided will be most helpful too as a guide to the systematic physi- cal, chemical, and psychical study of the patient which is next to be taken up. 2. Dictaiing the results of the general physical and psychical examination. — Thorazine 25 Mg The general physical and psychical examination as at present conducted includes so many details that the examiner ought not to trust his meinory of the results, even in so far as to attempt writing Order Thorazine or dictating the report af- ter the examination is Purchase Thorazine Online made. Instead, he should dictate his notes to a stenographer familiar with medical terins, or to a stenotypist, item by item, as his examination proceeds, for only in this way Thorazine 100 Mg can a full, objective record be obtained. In making the general physical and psychical examination, it is most convenient first to Order Thorazine Online note cer- tain genera! points and then to examine the body by regions. A fter this has been Thorazine 50 Mg done, the regional method may to a certain extent be departed from in order to supplement the record with details regard- ing the state of the nervous system (or any other anatomical system that may require an especially intensive study). The general points that should be noted in every case are summarized in the accompanying table: a. Genera! points. i. Body temperature ; pulse at both wrists ; res- piration, ii. Height : weight : calculated ideal Thorazine Bipolar weight ; build ■ or habitus^ nutrition ; musculature, iii. Posture: gait; behavior. iv. Skin (color; thickness; moisture; eruptions; ulcers ; pigmentation ; scars ; striae ; super- ficial blood vessels; edema), v. Lymph glands (epitrochlear ; cervical; axillary; inguinal); bones: joints; muscles, vi. Blood pressure (systolic; diastolic). Continuing the general physical examination, I pre- fer Buy Thorazine exploration at first by regions rather than by sys- tems, for at this stage of the inquiry it is desirable to suppress, as far as possible, explicit diagnostic inferences, confining one's attention strictly to- the accumulation of facts in a systematic way without too much regard to their bearings tipon the con- clusions toward which the whole examination is 492 BARKER: GENERAL Buy Cheap Thorazine DIAGNOSTIC STUDY BY INTERNIST. [New York Thorazine Chlorpromazine Medical Journal,

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