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.

    43/1058 (page 39)
    1. The daily range of temperature is greater in the healthj' child than that recorded in healthy adults—amounting to 2° F. 2. There is invariably a fail of temperature in the evening, amounting to 1, 2, or 3 degrees. 3. This fall may take place before sleep begins. 4. The greatest fail is usually between 7 and 9 p.m. (at least under the conditions of life in hospital). 5. The minimum temperature is usually observed at or before 2 a.m. 6. Between 2 and 4 a.m. the temperature usually begins to rise, such rise being independent of food being taken. 7. The fluctuations between breakfast and tea-time, are usually trifling in amount. 8. There seems to be no very definite relationship between the fre- quency of the pulse and respirations, and the amount of temperature; the former being sulijeet to many disturbing influences. Eespiration; its IwVTE AND GENERAL CHARACTERS.—The respiration, like the pulse, to be examined with anj' advantage to the explorer, must be investigated Avhilst the child is still and quiet. In the j'oung infant it should be done during slee]i, as it is only then that we can find the breathing uninfluenced by disturbing causes other than those connected with deranged health. In the older child, the play of whose functions is more steady and regular, and less readily jirrcd by trivial causes, this part of the clinical exploration may be made during the waking staffc; but, still, it must be done whilst the patient is quiet and tranquil, else the results obtained will necessarily be less certain and reliable than under the opposite state of things. The respii'ation ought always to be counted by the watch, if possible, especially bj' the young practitioner. This is the only mode in which a perfectly accurate idea of the frequency of the respiration is to be ob- tained. It sometimes happens that a greatly increased rate of the breathing will pass unnoticed by the physician, from the fact that it continues to be regular and without effort. We have known children to breathe eighty times in tlie minute, without presenting any appear- ance of labor or effort in the act; without cough, and without the least wheezing or sound to be heard at a short distance from the patient. Under these cii-cumstances, the great rapidity of the respiration might very well pass unnoticed, especially by inexperienced practitioners; and, be it remarked, this would be particularly apt to happen were the attention of the physician addressed to some other part of the economy than the thorax, as the seat of the sickness. For instance, in latent pneumonia, when this simulates meningitis, or when it is conjoined with gastro-intestinal symptoms, the failure to note a greatly increased rate of the breathing might very well occur. In many cases of second- ary pneumonia, it might also take place. In children, who have been lono- sick with diseases that debilitate and impoverish the health, a sudden aggravation of the symptoms dependent on collapse of the lung, might be misundcrstooii and falsely explained, for the want of this precaution. It is therefore a good and useful rule, for the young