The student's guide to diseases of children.
- Sir James Goodhart, 1st Baronet
- Date:
- 1886
Licence: Public Domain Mark
Credit: The student's guide to diseases of children. 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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![resents more tliaii restraint of tliis kind. Let the limbs be free to play or kick till they become unmanageable, and this u ill but seldom be the case if a little care be exercised. I./et a bal)V play u-ith the end of the stethoscope if it will ; it is (|uite possible to distinguish the I'espiratory sounds, and after a time those of extraneous origin can be as readily ignored as can the noise made by a crying child. The fact that the child is crying is no excuse for not examining the chest—crying necessitates deep I'espiration, and is often advantageous for this reason. All that we need is more patience. In auscultation, also, it is often necessary to listen to the i'espiratory or heart sounds in snatches, and to till in by repeated obser- vations what is not permitted by continuous examina- tion ; and in many cases it is advisable to e.xamine the back of the chest first. II aving given these few hints upon what to avoid, a few may follow concerning Avhat has to be done— and first we must be careful to maintain an attitude of close observation. TTie points to be observed are often apparently trivial and difficult to keep in mind in any systematic way. There is the complexion of the child ; the formation of its bones; the state of its skin and muscle—is it fat, spare, firm, or flabby; its size in proportion to its age ; its genei'al build ; the shape of its head; the state of its fontanelle; the relativ’e proportions of head and face ; the condition of cornea; and pupils; the lines u])on the face; the state of the nostrils ; the gums, the teeth, the tongue ; the ears ; the shajie of the chest and its movement; the alidomen and its movement; the character of the cry and the state of the nervous system. All these facts and many more, indicating as they do jxiints negative and positive which are absolutely essential to the formation of a diagnosis and for forecasting the issues of the case and for treatment, must yet, being but ])reliminaries, often be taken in hurriedly, almost at a glance. 'Po allow of this being done in any sense](https://iiif.wellcomecollection.org/image/b24990462_0025.jp2/full/800%2C/0/default.jpg)
