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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    questions in regard to the present state of the patient, the phj-sician ma}' loarn a great deal that is useful by an attentive observation of the general api)earance of the child as it lies before him. He should study its size and development, its state of embonpoint or emaciation, its decubitus and gestures, the color, temperature, and dryness or hu- midity of the skin, and tlie presence of eruptions or swellings of any kind. Having remarked these various matters during the early part of the examination, ho should proceed to inspect carefully the whole external surface by touch and sight, in order to acquire precise and ac- curate information upon these points. A child who has been healthy from its birth ought to have attained a certain average size and development at a certain age. If it be much below the average size, if at three months it look like a new-born child, or at a year old like one of six months, it is very clear that something has acted to determine such slow and insufficient gi'owth, and it be- comes the business of the practitioner to discover what the im])eding cause has been. Not only ought a child to have a certain size and stature, but it should also be possessed of a certain degree of embon- point. A perfectly healthy young child, one under four years of age, usually presents a much greater fulness and rotundity of the trunk and limbs than does the adult. Its tissues are firm and solid, its surface of a cool and pleasant temperature, its coloration of a clear and exquisite white, finelj' tempered with a faint rosy tint in a warm atmosphere, or slightly marbled with light bluish spots in a colder air. Few marks more certainly indicate a healthful temper of the constitution than the clear and exquisitely tinted pink color of the palmar and plantar sur- faces of the hands and feet of a young child. Nothing, indeed, can be more beautiful or perfect in shape or contour than the figure of a fine hearty young child; nothing more pleasing to the e3-e than its delicate but vivid coloring; and nothing more expressive of the fulness of health and vitality than its whole appearance. When, therefore, instead of these in;irks of a pure and active state of the health, we meet vvith stunted growth, emaciation, soft and flac- cid tissues, sallow and dingy tint of the cutaneous surface, pallid or bluish feet and hands, weak and listless movements,—how easy the conclusion that some jarring agent is at work to hinder and obstruct the machinery of life. In acute diseases emaciation takes place rapidly, but the tissues still retain some degree of elasticity and firmness. In chronic diseases the emaciation is of course slower, but it is more complete, so that, in some instances, the frame seems to consist merel}' of the bones wra])ped round with a dark and unhealthy skin. The tissues beneath the skin, the cellular, adipose, and muscular, are in great part absorbed, and the skin falls into wrinkles and irregularities on the least movement of the child. In some cases of disease, and particularly in those of the abdo- men, the derm loses almost entirely its elasticity, so that when ])inclied into a fold by the fingers, it retains for some time the form that has been given to it.