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.

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    attended with cries, which indicate the occurrence of some painful sensa- tion, as that of colic, of stitch in the side in pneumonia and pleurisy, and sometimes of shooting pain in the head. The frequent carrying of the hand to the head, or to the ear, ouglit not to pass unnoticed, as tins is often indicative of headache or earache. So also of the constant application ol the hand to the mouth, or the introduction of the fingers into that cavity, which often occurs when the child is suffering from the odontalgic pain of dentition. Nor should the physician ever neglect to observe any peculiar and especially any automatic movements of the limbs, and particularly of the fingers or toes. Nature often heralds the approach of a convulsive seizure by certain peculiar muscular movements. The thumbs are drawn into the palms of the hand, and the fingers clasped over them; or the toes are strongly bent towards the sole of the foot, or rigidly extended; some- times the fingers are for an instant convulsively extended upon the hand and draw-n widely apart from each other ; or lastly, the muscular movements, instead of being easy, steady, and natural, are badly co-ordinated; they are irregular, uncertain, and tremulous. This last character, tremulous- ness and uncertainty, we have often noticed. The occurrence of paralysis will often be unperceived for some length of time by an inattentive observer. It is to be discovered by the failure of the child to move one limb, whilst the others are more or less agitated, or by taking hold of the limb, and comparing the total want of resistance in it, with a certain stiffness and opposition to movement almost invariably present in the healthful condition. The state of the cutaneous surface is always important, and ought to be carefully and systematically examined. The points most requiring to be noted are its temperature, dryness or moisture, color, and the presence of eruptions or swellings. By the temperature, and dryness or moisture, taken in connection with the rate of circulation, we must judge as to the existence of fever. The inferences to be drawn from the condition of the surface in these respects are the same in children as in adults, and they need therefore no particular consideration in this place. The color of the skin, on the contrary, owing to its great suscepti- bility to change in certain affections, becomes, in the diseases of early life, of very considerable importance in diagnosis, and deserves therefore some special remarks. The physician should be aware, in the first place, that the color of a new- born infant is some shade of red, varying from a deep brick-red tint, to one of a much lighter hue. The red appearance fades away usually in about four or five days, and leaves the surface of a yellowish-white, or in some instances of a decidedly yellow color. Tiie yellow color is sometimes so marked as to im])ose very readily upon an inexperienced person the idea that it must depend on an atif'ection of the liver, or, in other words, that it constitutes a true jaundice. In a very large majority of cases, however, the conjunctiva retains its natural wliite tint, the digestive func- tions go on with perfect regularity, there is no fever, and indeed no marks of decided disorder of the health, so that the icterode hue cannot depend, under these circumstances, on any serious lesion of the liver or its append-