A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper.

  • J. Forsyth Meigs
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper. 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.

    29/1096 (page 27)
    GENERAL APPEARANCE—DEVELOPMENT, ETC. 2T of its wants, even to look at or notice it; it is moreover possible, jjenerally, to still such a cry by soothing treatment, or by the endeavor to amuse the little thing with toys. Lastly, a child will sometimes attempt to cry, but is unable to utter any or only a very faint sound. This depends commonly upon some laryngeal impediment, but may be also the result of pure exhaustion ; there is not sutficient strength to sound a cry. The cry of the young child has been divided by M. Billard into the cry proper and the return; and inasmuch as these two portions of the cry are differently affected in different diseased conditions, it is important that we should be aware of their existence, and of the effects produced upon their manifestations by disease. The cry proper is produced during the act of expiration, while the return occurs during inspiration. The cry proper is sonorous, and prolonged, the return is much shorter and sharper. The return is feeble in young infants, and becomes stronger as they advance in age. In different states of health, the mode of crying will vary to a considerable extent. The cry may exist alone, or in comltination with the return; or again the return only may be heard, whilst the cry is from some cause suppressed. The difference be- tween the two portions of the cry may always be distinctly perceived in a child who is crying violently from any recent cause, whether ill-temper, fright, or pain, unless one or other has been suppressed by some morbid condition which interferes with the perfect performance of the vocal func- tion. After a time, however, when the infant has become fatigued with its efforts, the cry proper ceases in part, and we have only the return, which is heard from time to time between the sobs. According to M. Valleix, it is the return which becomes enfeebled and disappears first, whenever one portion only of the cry is heard. Towards the fatal termination of all dis- eases, the return ceases more or less completely, and the cry assumes a peculiar moaning or murmuring character, which must be familiar to all who have been much in the sick-rooms of children. With a remark upon the condition of the lachrymal secretion in disease, we shall conclude this division of the subject. The infant does not begin to secrete tears until towards the third or fourth month, and of course this function can furnish no sign previous to that time. After that period, however, the suppression of this secretion becomes, according to M. Trousseau, a valuable aid to prognosis, as this suppression occurs generally in all dangerous acute diseases. The occur- rence of this symptom in any acute case should be looked upon, therefore, as one of dangerous augury, while the continuance of the secretion, or its reappearance after it has been suppressed, is, on the contrary, a highly favorable omen. General Appearance of the Child ; Development ; Embon- point; State of the Skin, Etc While occupied in hearing the account of the sickness given by the mother or attendants, and even while asking questions in regard to the present state of the patient, the ]>hysician may learn a great deal that is useful by an attentive observa- tion of the general appearance of the child as it lies before him. He should