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Passive movement of the phalanges in all directions is practised in order to produce crepitation. When rotation of the parts does not occasion crepitation, gentle flexion and extension may do so. And in many instances, considerable manipulation of the phalanges is necessary before the pathognomonic symptom is to be recognized.

The pathognomonic symptom here is recognition of crepitation, but this may be very difficult to recognize in fracture of condyles, and in such instances, a careful examination is necessary. Gentle manipulation in a manner that pain is not aggravated will tend to inspire confidence on the part of the subject and relaxation of muscles will enable the operator to detect crepitation.

Puncture wounds of any kind may serve to perforate the joint capsule and such traumatisms are occasioned by falls, kicks and in various ways in runaway accidents, and open carpal joint may follow. Symptomatology. The pathognomonic symptoms of the existence of an open joint is the exposure to view of articular surfaces of bones or noting the escape of synovia from the joint capsule.

This pathognomonic symptom of dementia præcox frequently occurs in the onset to malignant stupors. In fact we often find in reviewing such cases that a plain dementia præcox reaction has been in evidence, that a diagnosis has not been made simply because the stupor picture blotted out this earlier psychosis before an opinion was formed.

This tendency of the stupor reaction to remain pure or change to hypomania is a peculiarity which seems to put stupor in a class by itself among the manic-depressive reactions, as all the other mood reactions frequently change from one to the other. Although apathy is the central pathognomonic symptom of stupor conditions, there are other mood anomalies to be noted.

This thrill is not often obtainable, and in any case is not pathognomonic of hydatids, as it may be elicited in ascites and in other abdominal cysts. Pressure of the cyst upon adjacent structures, and the occurrence of suppuration, are attended with characteristic clinical features. The diagnosis of hydatids will be considered with the individual organs.

The pathognomonic symptom of open stifle joint is the profuse escape of synovia, indicating perforation of the synovial capsule; by means of a probe the wound may be explored in a way that will clearly reveal the nature of the injury. After a few days have elapsed in cases where considerable infection has taken place, there is manifestation of pain as in all cases of infective arthritis.

Whether it be torn loose from its point of attachment or ruptured at some point proximal thereto, the position is the same heel flat on the ground, toe slightly raised and this raising of the toe varies in degree as the subject moves about. The pathognomonic symptom is the lax tendon during weight bearing, which may be felt by palpation of the tendon along its course in the metacarpal region.

A figure much below 60 certainly shows dangerous loss of pressure, and one far below this, except in profound heart weakness, is almost pathognomonic of aortic regurgitation.

It seems as though there were, as a pathognomonic sign of the morbid process, a lack of energy and loss of the normal élan vital. We may say, in fact, that the establishment of a specific type of emotional change is justification for classifying all milder stupor reactions with the deep stupors.