The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland.

  • Holt, L. Emmett (Luther Emmett), 1855-1924.
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of infancy and childhood : for the use of students and practitioners of medicine / by L. Emmett Holt and John Howland. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    60/1178 (page 36)
    From a large number of personal observations upon healthy infants, I have found that the rectal temperature under normal conditions varies between 98° and 99.5°.F.; occasionally the range may be as wide a!s 97.5° to 100.5° F. in apparently perfect health. The heat-regulating centre in the brain acts only imperfectly in the young infant, and slight causes are enough to disturb the temperature. The temperature in infants is always higher than from corresponding causes in adults. Moreover, very high temperatures may be met with in cases not serious, and not infrequently when no explanation can be found even after thorough examination. In such cases the temperature seldom remains at a high point for more than a few hours. It is a continuous high temperature rather than a single rise which is significant of disease in infancy. ISTothing is more perplexing to the young practi- tioner than the frequency with which a high temperature is seen in infants in cases of comparatively mild illness. It is common in chronic wasting diseases, in delicate infants and in those prematurely born, to find the temperature one or two degrees below the normal; 95° and 96° F. are of almost daily occurrence in hospitals, and much lower ones are not rare. Daily observations should be made with the thermometer in such conditions, just as in fever. Puzzling and apparently alarming temperatures are seen in infants as a result of the application of artificial heat. In* one of my patients, an infant two days old, a temperature of 107° F. was caused by the close proximity of two large hot-water bags placed in the baby's basket. The younger and feebler the child the more readily are such tempera- tures produced. Muscular and Mental Development.—The general muscular develop- ment is determined by seeing how well the child can hold up his head, sit alone, stand, or walk; the mental development in young infants by the intelligence of expression, the manner in which they respond to stimuli, the recognition of objects, fright at strangers, etc.; later in the first year, by the use of their hands, their understanding of speech, and their ability to pronounce words. Local Examination.—For the purpose of making a complete routine examination of an infant the entire clothing, with the exception of the napkin, should be removed, and the infant placed preferably upon the nurse's lap upon a blanket. With older children the clothing may be removed and the body examined, one part at a time, but with all children it is essential that the examination be complete. A warm room is indis- pensable, and a table covered with a blanket in many respects better than the nurse's lap, although the latter has usually to be employed. The local examination should be deliberate, the physician should pro- ceed cautiously, winning the child by gradual approaches, and avoiding excitement, force, or anything which may cause pain.