"Examination of lump or a swelling" That means the number, position, size, surface, etc. are noted. Of these the position is important, as it will not only give an idea as to which group of lymph nodes is affected, but also the diagnosis e.g. Hodgkin's disease and tuberculosis affect the cervical group of lymph nodes in the beginning; filariasis and lymphogranuloma inguinale affect the inguinal group of lymph nodes; secondary stage of syphilis involves the epitrochlear and occipital groups. Number is important - whether single or multiple groups are involved. A few conditions are known to produce generalised involvement of lymph nodes. These Hodgkin's disease, tuberculosis, lymphosarcoma, lymphatic leukaemia, brucellosis sarcoidosis etc. Skin over the swelling - in acute lymphadenitis the skin becomes inflamed with redness, oedema and brawny induration. In chronic lymphadenitis the skin over the swelling does not show such angriness. Skin over tuberculous lymphadenitis and cold abseces remains 'cold' in the true sense till they reach the point of bursting when the skin becomes red and glossy. Over a rapidly growing lymphosarcoma the skin becomes tense, shining, with dilated subcutaneous veins. In secondary carcinoma, though the skin remains free in thje early stage, yet it becomes fixed to the swelling at later stage when the disease has gone beyond the scope of surgery. Not infrequently a scar, a sinus or an ulcer mayh be present by the side of or over the swelling. Scar often indicates previous bursting of cold abscess or a previous operation. So far as an ulcer or a sinus is concerned, the students are advised t examine them as described in chapter 4 & 5 respectively. Ulceration and sinus formation are not infrequent in lymphogranuloma inguinale. Pressure effects. - Careful inspection must be made of the whole body to detect any pressure effect due to enlargement of lymph nodes. Oedema and swelling of the upper limb and lower limb mnay occur due to enlargement of axillary and inguinal groups of lymph nodes respectively. Swelling and venous engorgement of face and neck may occur due to pressure effect of lymph node at the root of the neck.