Licence: Public Domain Mark
Credit: Lectures on the diseases of infancy and childhood / by Charles West. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![tion to your tact. If you grasp the hand, however gently, and try to feel the pulse, the little one will struggle to be free. If you place your hand as if accidentally on its arm, and gradually move your fingers downward to the wrist you will often unob- served and unsuspected count the pulse. Or if the nurse or mother takes the babe’s hand in her’s, it will leave it there with confidence, and will not heed the pressure of your fingers. Besides the pulse, the frequency of the respiration should, if possible, be noticed, since the results obtained by a comparison of the two are always more valuable than those of either taken alone. But if this is your first visit to the child, do not, for the sake of ascer- taining either of these points exactly, persevere in attempts which irritate or frighten it: probably you would, after all, be unsuccessful; and even though you were to succeed, the know- ledge would not repay you for the loss of the child's confidence, which it must be your grand object to acquire and to keep. With management and gentleness, however, you will compara- tively seldom fail; and while you are feeling the pulse, or with the hand on the abdomen are counting the frequency of the inspirations, you will also learn the temperature of the body and the condition of the skin. Supposing your examination has thus far been pretty well borne, you may now probably, venture to talk to the child, or to show it something to amuse it—as your watch or stethoscope; and while thus testing the state of its mental powers, you may pass your hand over the head, and note the state of the fontanelle, and the presence or absence of heat of the scalp. Often, though not always, it is important to ascertain the tem- perature with greater exactness than is possible without the aid of the thermometer; and its neglect would then be at least as culpable as the omission of auscultation, and would lead to just as grave mistakes. When practicable it is best to take the tem- perature in the axilla, but where the restlessness of the patient, as is often the case with infants and very young children, renders this impossible, the thermometer can almost always be p]aced in the fold of the groin without exciting resistance, and the results thus obtained are very little less accurate. The examination of the state of the abdomen, though too important to allow of its ever being omitted, will often lead to no satisfactory result unless carefully managed. If you allow the nurse to change the child’s posture and to lay it back in her lap, in order that you may pass your hand over its stomach, the child will](https://iiif.wellcomecollection.org/image/b21923735_0021.jp2/full/800%2C/0/default.jpg)
