Hippocrates described facial features that he associated with a poor prognosis and impending death.


Pathophysiology: may include a combination of dehydration and malnutrition resulting in loss of subcutaneous fat and muscle wastage, often with pain


Nose: sharp with pinched skin

Eyes: sunken/hollow, appear "bright"

Temples: sunken

Ears: cold, with lobes turned outward

Tongue: dry and shrivelled

Skin: rough, stretched, parched, cold, clammy

Skin Color: may be greenish or livid

Mental status: mind sharp, may be excited or anxious



• The onset of delirium is a bad sign.



(1) advanced peritonitis

(2) advanced cancer

(3) typhoid fever

(4) advanced heart disease

(5) after trauma


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