may occur if the liver is enlarged or congested, for then it seems to drag upon the suspensory ligaments when the patient lies upon the left side, and thus he is obliged to turn round that the liver may be supported by the ribs. If a heavy meal has been taken shortly before retiring to rest the person may be unable to lie upon his left side because the stomach drags upon its pyloric end. On the other hand, if the stomach is distended by flatulence, the gases sometimes will not escape while the patient is lying on his right side, and he must either be raised into a sitting posture or be turned on his left side to allow the gas to eructate by the œsophagus and the tension in the stomach to be relieved,[1] for the œsophagus joins the stomach at such an angle that when the patient is on his right side the gases appear to accumulate and not to find an exit through the oesophagus, but when he is on his left side they pass upward with comparative ease. This, of course, is a matter of very slight moment to patients who are able to move readily, because they adjust their own position at will and soon find out which is the most easy one for them. But when a patient is so weak that he is unable to move himself he is frequently allowed to lie flat on his back and to suffer much from abdominal distention and even from difficulty of breathing, due to the diaphragm being pushed upward, when he might be relieved by simply sitting him up for a few minutes or turning him over on his left side.
In this short paper I have made no reference to many other postures in disease, neither have I attempted to discuss the postures due to trade, nor have I attempted to make the paper complete. I have merely tried to give an illustration of an easy method of recording posture in a tolerably precise and easily understood way, and have attempted to connect external signs with physiological conditions as an illustration of the method of tracking which I mentioned in a former paper in the hope of inducing others to prosecute the same line of work.—London Lancet.
- ↑ I have found this practice useful. The explanation I have given of its utility was, I think, suggested to me several years ago by John Haddon, M. A., M. D.
