The student's guide to diseases of children / by James Frederic Goodhart.

  • Goodhart, James Frederic, Sir, 1845-1916.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to diseases of children / by James Frederic Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    547/668 (page 531)
    changes one may expect to find in young children, and of the conditions which lead to death. The pericar- dium was firmly adherent, and the heart large and no doubt dilated. The mitral valve was considerably thickened, but not'yet substantially contracted, for it admitted one finger, which is a fair capacity for the heart of a child of five years old. Acute pericarditis occurred in twelve cases in all— in six associated with acute valvular changes in chorea, in six with acute rheumatism. In comparison, there- fore, with endocarditis, it would seem to be un- common.* But the student must remember that it is found in many other conditions than these, and, perhaps as commonly as in any, in those acute inflam- mations of bone which are not infrequent in childhood and adolescence, and which go by the name of infective osteo-myelitis. Such cases almost always suffer from abscesses in the heart, and, as a natural consequence, acute pericarditis follows, and should the pattient live long enough, pus collects in the sac. Pericarditis may also be met with after scarlatina (when, perhaps, it is rheumatic); by extension of disease from the neighbouring pleura; and occasionally, but very rarely, though more often in children than in adults, with a tubercular affection of the serous membrane, and as a sequel of acute Bright’s disease. Should there at any time be evidence of a large accumulation of fluid in the sac, the possibility of it being purulent must be considered, particularly if the inflammation have extended from a left-sided empyema, or be secondary to the existence of tubercle. A septic form of pericarditis is described by most authors as occur- ring in the new-born infant, and originating in the umbihcal sore. * I am now only dealing with my series of hospital cases. I have seen it more commonly than these figures indicate, but that is probably, as I have remarked for empyema, because outside the hospital, more than inside, the practice of the hospital physician lies amongst the worst cases, not those that are mild. M M 2