A practical treatise on the diseases of children / by J. Forsyth Meigs and William Pepper.

  • J. Forsyth Meigs
Date:
1874
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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    is a fret rather than a scream; it is occasioned bj' the least distnrhance offered to the child, by the attempt to move it, to dress it, to attend to any of its wants, even to look at or notice it; it is moreover possible, generally, to still such a cry b}' soothing treatment, or by the endeavor to amuse the little thing with toj-s. Lastly, a child will sometimes attempt to cry, but is unable to utter any or onlj' a verj^ faint sound. This depends commonly upon some laryngeal impediment, but may be also the result of pure exhaustion; there is not suflSeient 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 diflferentlj- affected in different diseased conditions, it is impor- tant that we should be aware of their existence, and of the effects pro- duced 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 pro- longed, 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 consider- able extent. The cry may exist alone, or in combination with the re- turn ; or again the return only may be heard, whilst the cry is from some cause suppressed. The distinction between the two portions of the cry may always be distinctly perceived in a child who is crying violently from anj^ 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 function. Aftei- a time, however, when the infant has become fatigued with its efforts, the cry pi'oper ceases in part, and we have onlj- the return, which is heard from time to time between the sobs. According to IVT. Valleix, it is the return which becomes enfeebled and disappears first, whenever one portion only of the cry is heard. Towards the fatal termi- nation of all diseases, 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 dis- ease, 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 se- cretion becomes, according to M. Trousseau, a valuable aid to progno- sis, as this su])pression occurs generally in all dangerous acute diseases. The occurrence 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 suj^pressed, is, on the contrary, a highly favorable omen. General Appearance OF tfie Child; Development; Embonpoint; State op the Skin, Etc.—While occupied in hearing the account of the sickness given by the mother or attendants, and even while asking