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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    Chap. Ill] HEMORRHAGES. 2J extravasation may take place into the parotid (/land, and Spencer suggests that the pressure thus exerted on the trunk of the facial nerve may be one of the causes of facial paralysis in the new-born. Haemorrhage may occur also into muscles during delivery. Of these accidents the most important is hcematoma of the sternomastoid, since it is a cause of wry-neck which may last for months, and is, in some cases, possibly a large proportion, permanent. It is due usually to great stretching of the muscle during delivery of the after-coming head. Less often it is caused by pressure of one blade of the forceps. It occurs also, occasionally, in vertex delivery. It is generally noticed first a few weeks after birth, when a small rounded or oval tumour is found in the muscle, generally in its upper part and on the right side. Sometimes, however, the first symptom which attracts attention is that the neck is not held straight. At a later stage the swelling is replaced by a sclerosis of the muscle, which is shortened and feels like a tendinous band under the skin. Petersen has sug- gested that in some, if not all cases, there is a con- genital defect in the development of the sternomastoid, which is shorter than natural, and therefore more easily injured. This suggestion finds support in the obser- vation that in many cases of congenital wry-neck the development of the whole of the face on the affected side is defective, so that it appears atrophied as compared with the other. The skin of a healthy infant, twenty-four hours old, when, that is to say, the congestion which so frequently attends birth has passed off, is of an almost uniform deep pink or red colour. This is due to hyperemia attended, perhaps, by some effusion of the colouring matter of the blood. As a rule, the red colouration disappears in about a week, when the skin assumes the natural flesh tint, but in some cases the red colour is succeeded by a distinct and almost universal yellow tint. To this condition is applied the term
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