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37 Passive position – the patient cannot move independently (stroke, coma, severe cachexia, etc.), retains the position assigned to him, which can be extremely un- comfortable. Forced position  – a position that the patient takes to ease their health (reduce pain, shortness of breath, etc.). At the same time, the patient is able to change this position at will, to take another under the influence of aggravation (increase) of painful phenomena. Sometimes the forced position of the patient is so characteristic of a particular syndrome that it allows you to make a correct diagnosis at a distance. 1. Forced standing position-observed in attacks of angina, caught by pain by surprise, tormented by a sense of approaching death, patients spend the entire at- tack on their feet; less often, the standing position is taken by patients with bladder and prostate damage. 2. Forced sitting position (orthopnoe) – in patients suffering from severe shortness of breath, regardless of the causes of its origin. The patient assumes a sitting posi- tion, with his legs lowered, resting his hands on the edge of the bed, on the back of a chair, on his knees. This allows you to fix the shoulder girdle and connect additional respiratory muscles, in particular the neck, back, and chest muscles. In the sitting po- sition, the movements of the diaphragm are facilitated; the obstacle to uniform expan- sion during inspiration in all directions of the chest is eliminated, which is impossible while lying down; some of the blood is deposited in the lower extremities and turned off from the General blood flow; blood supply to the brain improves, which facilitates shortness of breath due to a decrease in the excitability of the respiratory center. 3. Forced position, lying on the side. Patients with unilateral processes in the lungs (lung abscess, bronchiectasis, effusive pleurisy) try to lie on the patient’s side. This position facilitates the respiratory excursion of a healthy lung, and also reduces the flow of sputum into the large bronchi, which reflexively causes a painful cough. Patients with inflammation of the pleural leaves (dry pleurisy, pleuropneumo- nia) also take a forced position on the affected side, or sit, pressing the chest on the side of the lesion. This position restricts the breathing movements of inflamed pleural leaves and their friction against each other, which helps to reduce pain. When the ribs are broken, the patient lies on the healthy side, as the pressure on the affected side causes sharp pain. Patients with certain cardiovascular diseases, mainly accompanied by hyper- trophy of the heart, lie on their right side. The position on the side with the head thrown back and the legs brought to the stomach, bent at the knee joints, is typical for patients with cerebrospinal meningi- tis (the position of the «question mark», «frog dog»). 4. Forced lying on the back occurs with severe abdominal pain (peritonitis, perforated stomach ulcer or duodenal ulcer). Often, patients bend the lower limbs in the knee joints, seeking to reduce the tension of the abdominal muscles.