The diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Sir James Goodhart, 1st Baronet
Date:
1891
Catalogue details

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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    necessui'ily mean liydroce])lialus. At the sanie time, it cannot be .said that tliere i.s any cof^ent rea^Jon again.st tlie on-set of tliis disease, for any delayed ossification of the sknll wonld to some extent seem to invite the occiirrence of a (ton^esfed brain, or of hydrocephalus, as J)r. Dickinson has insi.sted.* Craniotabes, fii'st described by Elsii.sser in 1843, has till lately always been held to he a sign of rickets. M. Pari’ot and others have called this doctrine in ques- tion, and consider the complaint a .sign, not of rickets, hut of congenital .syphilis. Craniotabes, or wasting of the skull, is a condition of softening of the bones, par- ticularly of the po.stero-parietal region by which, under modei’ate [)ressure from the fingei-, the bone caves iu- waI'd with a ci-ackle li ke that of stiff pai'chment. It is of two kinds : in very young infants the bones of the skull will yielil under pre.ssure and sometimes crackle, but this is not a diseased condition. The true disease generally exists in localised j)atches. It i.s .said to occur in thirty to forty per cent, of all cases of rickets, and is found to perfection from six months after birth onwards. It i.s an open (pie.stion how far this condi- tion is due to uncomplicated rickets, and how far to .syphilis; but it is a remarkable fact that, since the question was mooted, .some very weighty evidence has l)een produced in favour of its a.ssociation more with syphilis than with rickets. Dr. Thomas Barlow and Dr. Lees collected 100 cases of craniotabes, and hav'e publishedt the results of a mo.st careful inquiry upon its relationship both to .syphilis and rickets. From it they conclude that forty-seven per cent, of the total are almost cei'tainly syphilitic; and to this may be added the observation of Dr. Baxter, J that of the twenty-thi-ee per cent, of craniotabes in rachitic chil- dren, seventy-live per cent, were .syphilitic. My own opinion inclines in the same direction. For a long * “ Lectures on Chronic I r3’(lrocei)haliis LaucH, 1870, vol. ii. t Path. Soc. Trans., vol. xxxii. p. 323 e( seq. t Op. cit., p. 361.
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