A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper.

  • Meigs, J. Forsyth (John Forsyth), 1818-1882.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper. 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.

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    Study its size and development, its state of embonpoint or emaciation, its decubitus and gestures, tlie color, temperature, and dryness or humidity ot the skin, and the presence of eruptions or swellings of any kind. Having remarked these various matters during the early part of the examination, he should proceed to inspect carefully the whole external surface by touch and sight, in order to acquire precise and accurate information upon these points. A child who has been healthy from its birth ought to have attained a certain average size and development at a certain age. It, it be much below the average size, i^ at three months it look like a new-born child, or at a year old like one of six months, it is very clear that something has acted to determine such slow and insufficient growth, and it becomes the business of the practitioner to discover what the impeding cause has been. Not only ought a child to have a certain size and stature, liut it should also be possessed of a certain degree of embonpoint. A perfectly healthy young child, one under four years of age, usually presents a much, greater fulness and rotundity of the trunk and limbs than does the adult. Its tissues are firm and solid, its surface of a cool and pleasant temperature, its color of a clear and exquisite white, finely tempered with a faint rosy tint in a warm atmosphere, or slightly marbled with light bluish spots in a colder air. Few marks more certainly indicate a healthful temper of the constitution than the clear and exquisitely tinted pink color of the palmar and plantar surfaces of the hands and feet of a young child. Nothing, indeed, can be more beautiful or perfect in shape or contour than the figure of a fine, hearty young child ; nothing more pleasing to the eye than its delicate but vivid coloring; and nothing more expressive of the fulness of health and vitality than its whole appearance. When, therefore, instead of these marks of a pure and active state of the health, we meet with stunted growth, emaciation, soft and flaccid tis- sues, sallow and dingy tint of the cutaneous surface, pallid or bluish feet and hands, weak and listless movements,—how easy the conclusion that some jarring agent is at work to hinder and obstruct the machinery of life. In acute diseases emaciation takes place rapidly, but the tissues still retain some degree of elasticity and firmness. In chronic diseases the emaciation is of course slower, but it is more complete, so that, in some instances, the frame seems to consist merely of the bones wrapped round with a dark and unhealthy skin. The tissues beneath the skin, the cel- lular, adipose, and muscular, are in great part absorbed, and the skin falls into wrinkles and irregularities on the least movement of the child. In some eases of disease, and particularly in those of the aI)domen, the derm loses almost entirely its elasticity, so that wlien pinched into a fold by the fingers, it retains for some time the form that has been iven to it. The decuUtus and gestures of the child ought to be noticed. Healthy children are, when awake, almost always in motion. Those who have at- tained tlie habit of walking are tempted to active exercise by their various plays and amusements. Infants, though they sleep much more than older children, are also, when awake, constantly moving their limbs; they are