The diseases of children : a short introduction to their study / by James Frederic Goodhart.
- Sir James Goodhart, 1st Baronet
- Date:
- 1891
Licence: Public Domain Mark
Credit: The diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![iit night—wliich puzzles by the absence of all other syinptoins, ami raises false alaniis of typhoid fever or tuberculosis. I will emphasise some of these I'emarks by a note of a case which will give the student an idea, of some of the difficulties as regards temperature which are every-day I'ealities in practice. A child of six years was takm suddenly ill, his symptoms being slight soi'e throat, a croupy cough, high temperature, and rapid pulse. II is cough and sore throat gave ground for anxiety that an attack of diphtheria might l)e im- jjcnding; but he persistently complained of pain in the epigastrium, and this, with a short catchy resiiira- tion, suggested the j)o.ssibility of some diaphragmatic trouble. His mother, many years before, had had I’heuniatic fever, and a cai’eful examination of the child's heart revealed an undoubted systolic prolonga- tion of the first .sound about the base, which was com- patible with the existence of an early pericairlitis, but hai’dly less so with the long and thick fir.st sound which is one of the common accom])animents of sharp fever. The epigastric pain and peculiar breathing, with the altered heart-souml, and the family history, pointed to the [)0ssibility of the onset of acute pericaiditis and rheumatism, while the sore throat and cough would also lit in with this presentation of the symptoms. On the other hand, the child was in no distre.ss, nor did he appear to be seriously ill. lie had a bright eye, a hushed cheek, dry red lii)s, a pungently hot skin, and a frerpient .short dry cough, .at lea.st .as suggestive of pleurisy or pneumonia, and, with this idea in mind, there were some slight indications in diminished resonance at the left apex, and some questionable, because distant, bronchial breathing about the I’oot of the lung, that acute pneumonia might have set in. Lastly, .at any rate in our purvieAV, the children of this family were markedly excitable or neurotic. Such children, from inexplicable reasons, are liable to sudden sharp febrile attacks, in which cough and rapidity of pulse .are prominent symptoms, and which closely](https://iiif.wellcomecollection.org/image/b24990449_0034.jp2/full/800%2C/0/default.jpg)
