Lectures on diseases of children ... / by Edward Henoch.

  • Henoch, Eduard Heinrich, 1820-1900.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of children ... / by Edward Henoch. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    PART II. DISEASES OF INFANCY. I.—The Atrophic Conditions of Children, At no time does nutrition play so important a part as in the period from birth to the end of the first year. You are aware that a number of obstacles may prevent the nourishment of the child at the breast of the mother, as should naturally occur. Diseases of the mother, poverty, un- developed condition of the nipples, are some of the most frequent and excusable obstacles, wliile, on the other hand, many mothers, especially among- the higher classes, simply neglect this duty. Among this class, a wet nurse can readily ])e obtained, but, among the poor, resort must be had to artificial feeding. I do not deny that the latter plan, when care- fully and properly carried out, often furnishes satisfactory results. But the struggle for existence, illegitimate birth, frivolity and ignorance, foolish superstition—all these factors act as disturbing elements, and ex- plain the enormous frequency of disorders of nutrition and the terrible mortality among infants belonging to the poorer classes. But this is caused not only by insufficient and improper nourishment; it is also due in part to the bad air which these children are compelled to breathe, to the want of cleanliness, and to neglect during the first stages of diseases from wliich they may be suffering. Some of these causes are also active in children's hospitals and foundling asylums, where we have abundant opportunity of observing their effects. These are included under the term atrophy. The symptomatology of this condition naturally varies according to the stage in which it comes under observation. The first sign is the cessation of development, which can be determined only by carefully weighing the children from week to week. But the deteriora- tion soon becomes evident of itself, the adipose tissue disappears more and more, the integument of the face and entire body becomes flabby, wrinkled, yellow in color, and not infrequently presents a branny de- squamation of the epidermis. At this stage the functions of the organs, especially of the digestive tract, are still entirely intact or nearly so, and proper nourishment and care may lead to a favorable termination. But, in the majority of cases, this is prevented on account of the poverty of the patient; disturbances of the digestive organs, especially vomiting^ and diarrhoea, are superadded and lead to the development of the most severe forms of emaciation, which exclude all hope. The face is pale yellow, pointed, with marked prominence of the bones, and numerous