Practical diagnosis : the use of symptoms in the diagnosis of disease / by Hobart Amory Hare.

  • Hare, H. A. (Hobart Amory), 1862-1931.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Practical diagnosis : the use of symptoms in the diagnosis of disease / by Hobart Amory Hare. Source: Wellcome Collection.

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    abdominal colic is usually intermittent. If there be pain in the eav^ the hand will often be rubbed over the affected side of the head, and the child will not be pacified by the offer of the breast. If the child coughs, and then begins to cry, pneumonia or pleurisy maybe pres- ent ; or in other cases the pain is so great that the child is cryless. A sharp, piercing shriek of crying indicates the pain of meningitis in many cases. . If the crying child be placed at the breast, which it takes with avidity only to drop the nipple in a moment with a cry of pain or anger, one of two conditions is present: either the child has stoma- titis or the breast is empty ; or, again, if it seizes the breast and then lets go with a gasp, it probably has coryza, or syphilitic snuffles, which prevents it from breathing through the nose while sucking. Similar signs may be present in any other condition producing shortness of breath. If a child over four months of age cries and sheds no tears in the course of an illness, this is an unfavorable sign. It is important to notice whether there is languor or a tendency to play. A healthy infant, when awake and well-fed, is always kicking or cooing and moving its arms about, and has a happy expression on its face; whereas if any cerebral trouble is ]>resent, it often has an anxious frown, or its hands are placed to the side of its head or rubbed over the vertex. In a perfectly healthy child which is sleeping the respiration should be practically inaudible, and it is a good practice to note the regularity of the breathing in all patients while they are asleep, as it is then unaffected by voluntary effort. In children a sighing breathing, or one disturbed in rhythm, indicates a disturbed digestion or fever. The breath of the healthy child is invariably odorless and sweet, but is apt to become heavy and sour in fever and gastric disorders, and in tonsillitis and diphtheria it is apt to have a peculiar sickening odor of a sweet character. In cases of empyema opening into a bronchus or in gangrenous stomatitis the breath is very offensive. The physician should also, by careful questioning of the nurse or mother, find out how long the illness has lasted, the manner in which it began, the fact as to whether a similar attack has occurred before in this or other children of the family, and the state of the temper, appetite, bowels, and urine of the patient, for an irritable temper in a child means ill-health, as does also a poor appetite, con- stipation, diarrhcea, or abnormal urine.