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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![gleaned from the preliminary survey, it is a good plan to start with the organ which is suspected to he at fault. If there he any reason for suspecting disease of the nervous system, it is as well at once to examine the eyes with the ophthalmoscope lest any subsequent action on our jjart may frighten the child and I'ender the fundus oculi inaccessible. It is impossible to make any satisfactory use of the ophthalmoscope if the child is, or has been recently, crying. This done, and the state of the pupil and movements of the eyeball ascer- tained, the sight and hearing can be tested by a watch; and the precision of the various muscular movements of the extremities, by giving the child something to hold or pick up, and by making it walk, if old enough, or by watching the movements of the limbs in infants, too young to walk, as they lie on the mother’s hq). The gums can be examined and the progress of dentition ascertained by gently rubbing the surface of the gums with the finger. The chest and abdomen should be examined in all cases. Some advise that the child should be stripped for this purpose, and this is a, neces- sary measure in some cases. I do not advise it as a rule, for the reason which I have adopted throughout thesesuggestif)us—viz., that the child is to be frightened or put out of temper as little as possible. Children, all but the youngest infants, re.sent the process of undress- ing, and it is usually sufficient for our purpose that all the clothing bo loosened. The greater part of the front and back of the chest can be by this means exposed and a thorough examination made. Percussion must be light,or it will mislead. A ci-acked-])ot sound can be produced with facility in many a healthy child. A light vertical tap with ojie or two lingers upon a linger of the other hand placed Hat upon the. chest is all tliat is necessary, and special attention is to bo ]>aid to the intervei’tebral grooves ns parts which are nioi'e fre- quently implicated in children than in adult?^. In aus- cultation it is very essential to m.akc careful comparison of the two .sides ; of the bases with the .apices ; and to](https://iiif.wellcomecollection.org/image/b24990462_0029.jp2/full/800%2C/0/default.jpg)
