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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![part, be arrived at from the absence of symptoms indicative of any local disease. The infant does not get on, or gradually loses the plumpness it has gained, becomes pale and thin, and is always ciying. Still, it fails to attract notice by any dehnite signs of illness ; on the contrary, it is not unusually brightdooking and intelligent, it is easily attracted and pacified for the moment, doubtless solaced with the hope of a coming meal which it knows will bring freedom from its pangs, d’hcso children ai'e pale, sharp-featured, the fontanelle de2)ressed, the arms and legs and buttocks thin, the muscles flabby, and the skin cool and moist, d^hey are always crying, the cry being noisy and passionate, and in the best marked instances alternating with vigorous sucking at anything within reach, sometimes at the thumbs till they are raw. The meals are taken I’avenously, and as soon as tliey are finished, or in the intervals of the sucking, crying is repeated, in very young infants the child dozes at its meals, from the absence of that pleasurable stimulus which should be conveyed by suitable food. In the worst cases, when exhaustion is exticme, there may be persistent di-owsiness or even stu]5or, the eyes being sunken. The child may be restless or whine feebly when it is moved; the abdomen is generally soft, but dough-like; and the intestinal coils and peri- staltic action ai-e visible through the thin abdominal wall. There may be slight diarrhoea. The viscera must be carefully examined in every case, and should show no sign of disease. But inasmuch as even very young infants are not exempt from insidious complaints such as empyema, or bi’oncho-pneumonia, and wasting may be their only noticeable sign, the diagnosis can- not be reliable until a thorough examination has been made. To take one example out of many : a child of eight months old was brought to the Evelina Hospital for wasting. It had been fed upon bread and milk since the age of eight weeks. No wonder it had always been thin and lately had got thinner ! The](https://iiif.wellcomecollection.org/image/b24990462_0056.jp2/full/800%2C/0/default.jpg)
