Medical diseases of infancy and childhood.

  • Dawson Williams
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Medical diseases of infancy and childhood. 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.

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    chest this is reinforced by the pull of the diaphragm on the ensiform cartilage and the lower costal cartilages. When called to treat a child supposed to be suffer- ing from disease of the respiratory organs, a thorough examination should be made on the first occasion. For this purpose the patient should, if possible, be seen under natural conditions, as any excitement causes a disturbance of pulse and respira- tion. Particular as to the date, mode of onset, and general character of the indisposition should be ascer- tained, but too much reliance must not be placed on the history. The general aspect of the child, the colour of its face, the existence or not of restlessness or great depression, and the presence or absence of dyspnoea, must be noted. Some insight into the nature of the dyspnoea, if present, may be obtained. Thus, the inspiration may be attended by laryngeal stridor, or the voice may lie hoarse ; or, again, it may be noticed that the child breathes through the mouth —and this, if respiration be not greatly hurried, points to obstruction in the nose or naso-pharynx. An infant should be put to the breast in order to observe whether it is able to suckle without the frequent pauses which nasal obstruction produces. The diagnosis of disease of the respiratory organs in the infant and child must be based almost entirely on physical examination ; this, however, it is not generally possible to conduct in the methodical manner which may be followed in the adult. A young child may permit itself to be looked at, but unless un- usually well and good tempered, or very ill, it is apt to resent auscultation a good deal, and palpation and percussion even more. In older children—say over two years old—the examination is best con- ducted with the child sitting on a high stool—if with a revolving top, so much the better. Unless the child be greatly exhausted, or show a natural disposition to lie down—and it is remarkable how acutely ill a child may be, and yet prefer to sit up or recline in c
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