The diseases of children, medical and surgical / by Henry Ashby ... and G.A. Wright.
- Henry Ashby
- Date:
- 1897
Licence: Public Domain Mark
Credit: The diseases of children, medical and surgical / by Henry Ashby ... and G.A. Wright. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
129/878 (page 99)
![Experimental research has shown that there is a diminution in the amount of hydrochloric acid and pepsin secreted, while there is an excessive forma- tion of mucus, lactic, acetic, and butyric acids. Much gas is given off from the decomposing food. This gastro-intestinal atrophy rarely occurs in children over 18 months of age, and indeed is most common in infants under 6 months. Older children suffer from chronic intestinal catarrh, which rarely goes on to atrophy, though it is frequently the precursor of tuberculosis of the mesenteric glands. In the majority of cases, chronic gastro-intestinal catarrh is the result of improper feeding. Infants who come of a healthy stock and are nursed at the breast of healthy mothers rarely, if ever, suffer from it, at least as a primary disease. It is the infants who are fed from the first on cow's milk -or the various forms of starchy foods that chiefly suffer. The infant may go on fairly well for the first few weeks or more, suffering more or less from dyspepsia ; then comes an attack of diarrhcea or vomiting, and forthwith it begins to go downhill ; no food seems to suit it, however often changed, and it never recovers its digestive powers, which appear to have been hopelessly damaged. Some infants appear to get on fairly well till they suffer from an attack of broncho-pneumonia, or measles, or whooping-cough, which they survive only to begin gradually to waste. In some few instances, more especially in dispensary practice, atrophic infants may be seen of a few months old, who have been, according to their mothers' accounts, entirely oreast-fed. In these cases the infants have been congenitally weak or pre- mature, and very probably the mother's milk has been deficient in quality and quantity, or the child may have been fed whenever it cried, and in every way been badly cared for. Symptoms.—Infants. The history which is generally obtained from such cases is that they were suckled for a few weeks or months after birth, then the mother had to go to work or her milk failed, and the infant was made over to a friend or hireling to be artificially fed, and from this time it began to waste. On cross-questioning the mother or caretaker, it is found that it has been fed on sopped bread or biscuits, because cow's milk did not appear to satisfy it, or it vomited the milk curdled, and it has constantly suffered from colic, vomiting, or more commonly diarrhcea. On the other hand, there is sometimes constipation, but this usually has been preceded by diarrhcea ; the diarrhcea] symptoms being most marked in those suffering during the summer months. If the symptoms be analysed, three stages in the course of the disease may be recognised as first clearly pointed out and emphasised by Parrot, whose description of these cases under the name of athrepsia leaves nothing to be desired. The early symptoms or first stage are those of a simple gastric or intestinal catarrh, in the second the progressive wasting be- comes the prominent phenomenon, and in the last stage the infant passes into an exhausted condition in which cerebral symptoms make their appearance. First stage. The infant suffers from a simple diarrhcea or looseness of the bowels ; the stools, instead of being bright yellow and homogeneous, are liquid, curdy, and often green in colour, or contain an excess of mucus ; sometimes they consist almost entirely of stinking curd, or remains of milk ; the abdomen is distended with gas and remains constantly in this condition, the tongue is ■coated, and patches of aphthous stomatitis appear in the mouth. The infant](https://iiif.wellcomecollection.org/image/b21035507_0129.jp2/full/800%2C/0/default.jpg)
