Smell for diagnosis

Musky Clothing
Body Odour
Alcohol
Smoke

Smell and odour are important clues in medical care. The most common and useful are listed. Those with good sense of smell may be able to detect more but will also have a to accept more! It is possible to diagnose tuberculosis of the lung on th ebasis of the musty leaf smell on the breath. Unwell people with diabetes often have a sweet smell of ketones on their breath or urine

Musky Clothing

Tends to indicate initial problems with awareness of self care. Can relate to the use of mothballs. An indication to check the social history. Are they living alone, how are they managing with cooking, washing and house care

Body Odour

An indicator of poor body hygiene that can contribute to skin disorders. May be associated reduction in sefl care so consider asking about social situation and diet

Alcohol

A key diagnostic feature that can avoid chasing for other causes of disease. If detected at the surgery and especially in the morning then it is likely to indicate a high intake of alcohol over time. Alcohol can be associated with anxiety and depression both as a marker and a cause. Early morning gastric symptoms are likely to be induced by alcohol and may relate to alcohol induced gastric ulcers. Look for the signs of skin aging, weight loss and liver disease. Enquire about the actual amount taken initially in general terms then specifically in terms of what type and quantity

Smoke

This should lead to questions about smoking frequency and advice on the significant health impact of smoking. Look for the yellow smoke stained fingers and hair of a self  imposed death sentance.  Advice can be tailored to the age and other medical problems faced. Just briefly giving advice can be effective and save a life. Briefly offering stop smoking support can led to the use of organisations such as quitter and a collective of steps that are effective in stopping smoking