Common disorders and diseases of childhood / by George Frederic Still.

  • Still, G. Frederic (George Frederic), Sir, 1868-1941.
Date:
1924
Catalogue details

Licence: In copyright

Credit: Common disorders and diseases of childhood / by George Frederic Still. Source: Wellcome Collection.

    34/1056 (page 14)
    upon the slightest thwarting which occur occasionally in chil¬ dren of markedly nervous temperament. The paroxysms in both cases are so violent and so obviously unnatural that medical advice is sought 5 unfortunately the condition is sometimes very intractable and is particularly distressing, as the screams of the child can be heard at a considerable distance, and might give neighbours the idea that the child was being ill-tioated. Photophobia is another rare result of the irritation of den¬ tition. It is so pronounced that the child will cover his eyes with his hands or bury his face in the pillow or against his mother’s breast, when exposed even to the moderate light of a sunless day. In a brighter light, he will screw up his eyelids tightly like a child with a corneal ulcer, but examination shows that there is nothing abnormal in the eyes or eyelids, though in some of these cases the eyes will c water ’ when exposed to light. In one child, aged fifteen months, the photophobia persisted for nine weeks ; in another, aged ten months, it began six days before the eruption of the first tooth, and lasted at least four months. In some cases the photophobia is so extreme that the child cries Oj. even screams violently as if in pain when exposed to any bright light, or even to ordinary daylight. I have seen cases in which, during the eruption of a tooth, meningitis has been simulated by head retraction, which passed off soon and which seemed to be due entirely to some reflex irrita¬ tion from the teeth. Increased tension in the middle ear sometimes produces head retraction in infancy, as has been proved by the rapid disappearance of head retraction after puncture of the membrana tympani ; and therefore it seems only natural that the irritation of a tense gum might have a similar effect. Of course it is possible that in such cases there is actually some middle ear catarrh, to which the head retraction is due rather than to any irritation of the gums, but if so there has been nothing else to suggest ear-irritation in the cases to which I refer. Parents very commonly attribute discharge from the ear to the influence of dentition, but although the two are often co¬ incident I know of no special tendency of otorrhoea to recur with recurring stress of teething, nor of any reason for supposing that there is any causal connexion : but if the bronchial catarrh which occurs with dentition spreads by extension from the oral mucosa, there may be some catarrhal condition of the pharynx and naso-pharynx also which would account for the otitis media. A rare disorder which is closely related to dentition is spasmus