Clinical pediatrics / by John Lovett Morse.

  • John Lovett Morse
Date:
1926
Catalogue details

Licence: In copyright

Credit: Clinical pediatrics / by John Lovett Morse. Source: Wellcome Collection.

    31/854 page 31
    Symptomatology.—The chief symptom is, of course, vomiting. This may begin as soon as the baby begins to take food or not until after the attempt is made to give solid food. When it begins in early infancy, there is nothing characteristic about it. It usually, however, occurs as soon as the milk is taken or not at all. It is never explosive. It may occur with more or less severity at almost every feeding or it may occur only occasionally, or in attacks lasting a few days at a time at intervals of weeks. It makes very little difference whether the baby is on the breast or the bottle or what the character of the milk mixture. It is evident that secondary spasm must play an important part in the causation of the vomiting, especially when it is intermittent. In other instances vomiting does not begin until the attempt is made to take more solid food. Some children are unable to swallow even soft Fig. 12.—Congenital stenosis of esophagus. Fig. 13.—Congenital stenosis of esophagus. Lateral view after opaque meal. Front view after opaque meal. solids; others can take them, but are unable to swallow solid food. As there is usually but little dilatation above the stricture, vomiting occurs at once or after only a little food has been taken. The retention of food to be vomited later is very uncommon. The vomiting is not explosive. Not infrequently articles of food which can be taken at one time are vomited at others, presumably because of secondary spasm. Attacks often occur in which nothing, not even liquids, can be swallowed for several days. In such instances the attacks are due to irritation with secondary spasm or the impaction of food or of some foreign substance, like a coin, which has been swallowed. The nutrition is more or less impaired according to the severity of the symptoms and the care which has been exercised in the selection of the food given. Deformity of the jaws is likely to develop from lack of use. Diagnosis.—Congenital narrowing of the esophagus is seldom recog¬ nized as early as it should be. In infancy, the symptoms are almost always attributed to indigestion, while even in childhood they are attrib¬ uted to poor appetite, capriciousness about the food or indigestion.
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