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.
718/774 page 692
![disease occurs in rheumatic families, though not ex- clusively so (nineteen out of twenty-nine cases, see p. 591). It is usually attended by apparent ill-health, but the temperature is hardly raised. It is hut seldom necessary to apply any local treatment, but, after paying attention to the bowels, a tonic of iron, or arsenic, or strychnia should be given. Sclerema Neonatorum — Scleroderma.—The formei- hardly comes within the range of pi'actical medicine in this country, it is so rarely seen. It appears to he a disease of the new-horn amongst the ])oor of large towns, and to he more common in the winter than the summer months. The affection is stated to begin in the lower extremities as a hard or Iwawny (edema, which gradually spreads over the body. The supplene.ss of the skin becomes lost, and it is impossible to raise it between the fingers from the deeper parts ; skin, mu.scle, and bone appear as one solid log. The body heat sinks at the same time, the ])ulse becomes imperceptible, the heart sounds almost inaudible, and maybe the respiration is invi.sible. The infant thus becomes exce.ssively feeble, sucks little, takes little from the breast, and sinks. Parrot distinguishes between sclerema—in which the .skin is hard and thickened by new material, whilst the fat is shrivelled and atrophied—and oedema of the new-liorn ; but these two conditions have usually been confused. In this distinction he is followed by Henoch, and no doubt correctly. Of the cause of .sclerema we are .still quite in ignorance, but of oedema some cases originate in erysij^elas, others in extreme atelectasis oi- weakness of the heart, and others, perhajjs, in nepliritis in eai'ly infancy, of which Henoch gives a case in an infant of four weeks old. In either case, however, the actual result seems much the same, and the post-mortem examination reveals vi.sceral changes of like character in both— viz., atelectasis, lobular pneumonia, and various other](https://iiif.wellcomecollection.org/image/b24990449_0718.jp2/full/800%2C/0/default.jpg)
