Manual of the diseases of children / by John Madison Taylor and William H. Wells.

  • J. Madison Taylor
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Manual of the diseases of children / by John Madison Taylor and William H. Wells. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    25/872 (page 19)
    During the first six months the increase in length of the ave- rage infant is from 4 to 5 inches ; in the second half of its first year the increase is from 3 to 4 inches ; during the second year the gain is from 3 to 5 inches ; during the third year, from 2 to 3 l/2 inches ; and in the fourth year, from 2 to 3 inches. From this time on the increase in length averages about from 1^ to 2 inches every year. The length of .the child at any given age should bear some sort of relation to its weight ; this is shown in the second table on page 18. Slow or arrested growth, if continuous, is always a sign of some pathologic condition. The most common of these is malas- similation of food, but more serious conditions, such as rickets or syphilis, must be considered. Arrested growth is very com- monly found in children affected with chronic diseases of the brain and in cretins. In infancy the tissues are softer and more elastic than those of the adult or even of older children. The body and limbs are well rounded by a plentiful covering of fat, giving the character- istic plumpness and roundness so familiar in the infantile form. A downy growth, known as lanugo, frequently covers the body at this time ; the nails are well formed, and extend to the end of the pulp of the fingers and toes. A glance at the body as a whole will at once reveal the fact that the upper part of the trunk, with the arms and head, is much larger than the lower part of the body, with the exception of the abdomen. The cause of this will easily be seen when we study the changes in the circulation of the blood which follow the cessation of placental and the establishment of pulmonary circulation. It has been taught by the older writers that the general aspect—the roundness of body and limbs, the formation of the nails, the plentiful growth of hair on the head, and the attainment of the average weight—is suffi- cient evidence of normal development of the infant at birth. Yet observations made on a large number of infants show us that certain parts of the infant's body must attain certain definite rela- tions to one another in regard to size, in order to show that it has attained a perfect state of development. A short rule for computing this is the following : As has been before stated, the length of the average child at birth is about 20 inches, or 50 cm. If the infant is normally developed, the circumference of the tho- rax should measure one-half the entire length of the body plus IO (50 divided by 2 equals 25 ; plus 10, equals 35 cm.). Therefore 35 cm. is the circumference of the thorax in the normal infant. The circumference of the skull should equal the circumference of the thorax plus 2, or 37 cm. (50 divided by 2, plus 10, equals 35 ;