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> Is it his appendix, doctor? Part 2
We have mixed up all the articles (a, an, the) in the text below, try and find the correct place for each one..
Is it his appendix, doctor? Part 2 (Teacher: Michael)
Next, there is
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the
The
rather sudden bout of vomiting. This usually rouses
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The
whole household and often
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The
family doctor. By
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the
The
time he is called
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The
sufferer may begin to feel
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the
The
bit hot. He looks more than just in pain; he looks ill.
This is
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most usual course
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The
illness takes.
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The
wretched appendix (which doesn't even seem to serve any useful function) although fixed to
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The
lower bowel at one end, can lie pointing in any direction of
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The
compass. And this fact can change
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The
symptoms considerably.
If it is pointing upwards it can give rise to
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suspicion of pneumonia. If pointing outwards, that is towards
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loin, it can cause fears that
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pain may be due to
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kidney. If it points directly downwards diarrhoea may be
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early symptom and
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infection of
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bowel has to be considered.
These facts make diagnosis difficult for
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doctor in
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minority of cases, but for parents any abdominal pain in
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child is
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worry. What has gone before is often important - what
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doctor calls
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the
The
history of
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The
case. Has
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child been to
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The
party and eaten too much ice-cream or too many sour apples? Has he had
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sore throat
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The
day before and got
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virus infection? If
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pain is slight does he refuse any offer of food?
An American surgeon, when in doubt, used to ask
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The
child if he would like
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The
hot, roast pork sandwich. If he said 'yes',
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The
surgeon would wait before operating. It needs
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The
healthy child with
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the
The
good. appetite for this test to work.
Remember that in
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acute appendicitis
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the
The
pain does not get gradually better. If during
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attack
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child starts to want to play or asks for food,
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The
diagnosis is almost certainly not that of
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The
acute appendix. Be suspicious of
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the
The
youngster whose pains begin on consecutive Monday mornings just before school!
If in doubt, if
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The
pain persists or worsens, or if
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patient begins to look or feel hot, don't delay. Remember that
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operation done in good time is remarkably safe and
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The
youngster is quickly full of beans again.
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