All movement is information. In falls and road traffic accidents that is obvious because injuries tend to be musculoskeletal. It is less obvious in respiratory tract infections, heart failure and abdominal pain. Obvious or not, the information remains germane.
It is not possible to state explicitly the differences in the movements of patients with renal colic or cystitis or appendicitis, but the gestalt is distinguishable. A great deal of medicine is observation.
I often ask patients to move and those accompanying – friends, relatives and carers – frequently attempt to assist and I must ask that they do not. Always, I have to explain that I need to see them move themselves unless I wish to be misconstrued as callous. Sometimes, I expect, I am still so construed....
The drooping lid of myasthenia, the tremor of hypoglycaemia, the swallow-cough of stroke, the hunching of kidney stones and the pursing of emphysema all constitute relevant information.
Watch, observe and diagnose.
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