The diseases of infants and children / by Edmund Cautley.

  • Cautley, Edmund, 1864-1944.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of infants and children / by Edmund Cautley. Source: Wellcome Collection.

    138/1070 (page 118)
    asphyxia at birth, a feeble cry during the first few days, somnolence, and often a subnormal temperature. Physical signs are doubtful or absent. Cyanosis is out of proportion to the other symptoms, and is generally present in the cases which have not been completely resuscitated from the asphyxia. They gradually get worse, and die in a few days from asphyxia, asthenia, or convulsions. In others there is no cyanosis, yet the lungs are not completely expanded. The infant remains feeble, sucks badly, cries feebly or not at all, progresses slowly or actually wastes, and has cold extremities and a low temperature. Cough and catarrhal sounds in the chest, paroxysms of dyspnoea, twitching, and lividity, general convulsions, and sudden cyanosis are sometimes present, or induced by slight causes, and last for 3 or 4 minutes. The prognosis must be guarded, for these attacks may be slight and easily recovered from, or at any moment severe and fatal from collapse or con¬ vulsions. Fatal syncope may occur quite suddenly. The duration and prospect of recovery vary with the extent of the mischief. The diagnosis depends more on the history of asphyxia at birth, feeble¬ ness of the child and its circulation, the presence of cyanosis or temporary attacks of blueness, and malnutrition, than on physical signs. The latter are often slight or absent. If symmetrical and of a medium extent, it is impossible to be certain that the note is impaired, but a limited affection of one lung may give rise to differences in the physical signs on the two sides. As a rule the non-expanded areas are surrounded by over-expanded ones, and there is very little or no alteration in percussion. In prolonged cases dulness is found, perhaps limited to one base or apex, and the breath sounds are weak, and only occasionally somewhat bronchial. Attacks of cyanosis in newborns generally indicate atelectasis or congenital morbus cordis, and are often induced by over-distension of the stomach, by food or wind. Secondary pneumonia gives rise to crepitations and fever. Treatment.—Encourage crying in the newborn and in delicate infants ; make them cry vigorously, at least twice a day for 10 minutes at a time, to induce lung expansion. Stimulating liniments to the chest, and a hot or mustard bath, twice a day for 5 minutes, are useful. Do not allow the child to lie much on its back ; feed it on the breast or breast-milk by spoon ; keep it in a temperature of 70-80° F., in an incubator if necessary. Sal volatile, brandy, and oxygen are necessary during the attacks of asphyxia.