A practical treatise on the management and diseases of children / by Richard T. Evanson and Henry Maunsell.
- Evanson, Richard Tonson, 1800-1871.
- Date:
- 1843
Licence: Public Domain Mark
Credit: A practical treatise on the management and diseases of children / by Richard T. Evanson and Henry Maunsell. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![mostly white, (appearing as the urine cools, or remaining after it has evaporated,) makes its appearance ; or the urine is passed white, in the first instance. Gravel often forms in the child, particularly in the children of the poor, or in the offspring of gouty and dyspeptic parents ; but this usually consists of lithic acid, and is presented in the state of a red deposit, or as an amorphous sediment, and passed without irri- tation oft he urinary organs ; or in the form of crystallized Uthic acid, and accompanied in its passage by irritation more or less severe. Atten- tion to these circumstances are most important, that we may, by timely interference, prevent the formation of calculus, to which children — at least, the children of the poor* — are peculiarly liable. The calculus will, in this instance, mostly consist of the lithate of ammonia, being generally of a clay colour and small size, as occurring principally in children. (See Prout on Diseases of the Urinary Organs.) Symptoms of dysuria, however, are not confined to cases of stone in the bladder, but will attend irritation or inflammation of that organ itself, or of the abdominal viscera, as in the adult. Even ischuria, or total suppression of urine, may originate in this latter cause ; or more directly from disease of the kidney. But an opposite condition, one of irritability — increased flow of urine, or incontinence, is what par- ticularly appertains to childhood, and is oftenestmet with at that age. Dentition, so fertile a source of sympathetic irritation, not unfrequently displays its disturbing power in the urinary organs. A distressing state of dysuria attends the cutting of the teeth ; or more commonly, a great irritability of the bladder, with a frequent and copious flow of limpid urine. This symptom also attends nervous irritability, from any cause, in the child as in the adult. This flow of urine in the child we have seen antecedent to attacks of hydrocephalus ; occurring, pro- bably, at that period when nervous excitement precedes inflammatory action. Incontinence of urine, however, is the morbid condition most incident to childhood, and confined more exclusively to that period of life. We have already noticed some anatomical peculiarities in the formation of the bladder, which, at this early period of life, predispose to this affection ; although it may, perhaps, mostly be looked upon as sympathetic of a deranged state of health, particularly disorder of the digestive organs. It occurs generally about the same hour towards morning, and only in bed, being very irregular in its time of duration; but by no means confined to boys, as commonly thought, although much less frequent in the other sex. Scrofula is much a disease of childhood, though not confined to that period of life ; neUher does it often make its appearance before the second or third year. It is about the seventh year, or the period of second dentition, that scrofulous affections become most manifest. ' Sir BenjamiR Brodie remarks, in his Lectures on the Urinary Organs, that the deposit of red sand which occurs in adults among the rich, is found principally ia children among the pooT ; among whom, also, children are much more liable to calculi than adult persons. And this from the same cause, though originating in a different source, namely, derangement of the digestive organs, caused, in the rich, by indolence and luxurious living ; but in the children of the poor, by unwholesome diet and neglect: so do extremes meet. [Note to 4th Edition.]](https://iiif.wellcomecollection.org/image/b21118346_0078.jp2/full/800%2C/0/default.jpg)
