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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![have sharp fever witli a slight sore throat. A number of children have a simple continued fever of hectic type—viz., normal in the morning and up at night—which puzzles us hy the absence of all other symptoms, and typhoid fever and tuberculosis liaunt the doctor. 1 will emphasize some of these remarks hy a note of a case which will give the .student !in idea of some of the difficulties as regards tempera- ture whicli are every-day realities in practice. A child of si.x years was taken suddenly ill, his .symptoms being slight sore throat, a eroujoy cough, high temperature, and rapid pulse. Ills cough and sore throat gave ground for anxiety that an attack of diphtheria might he impending; but he persistently complained of pain in the epigastrium, and this, with a short catchy respiration, suggested the po.ssibility of some diaphragmatic trouble. Jlis mother, many years hefoi’e, had had rheumatic fever, and a careful exami- nation of the child’s heart revealed an undoubted .sys- tolic prolongation of the first sound about the base, which was compatible with the exi.stence of an early pericarditis, but hardly less so with the long and thick first sound which is one of the common accompaniments of .sharp fever. The epigastric pain and peculiar breathing, wdth the altered heart-sound, and the famih' history, pointed to the po.ssibility of the onset of acute 23ericarditis and rheumatism, while the .sore throat and cough would also fit in with this ^^I’esentation of the symjjtoms. On the other hand, the child was in no distress, nor did he aj^pear to be seriously ill. lie had a bright eye, a flushed cheek, dry red li^as, a jaungently hot skin, and a frequent short dry cough, at least as suggestive of pleurisy or ^^neumonia., and, with this idea in mind, there were some slight indications in diminished resonance at the left a]>ex, and some ques- tionable, because distant, bronchial breathing about the root of the lung, that acute pneumonia might have set in. Lastly, at any rate in our purview, the children of this family were markedly excitable or neurotic.](https://iiif.wellcomecollection.org/image/b24990462_0032.jp2/full/800%2C/0/default.jpg)
