The students 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 students guide to diseases of children / by James Frederic Goodhart. Source: Wellcome Collection.

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    of patience, for a child's eye partakes of the rest- lessness of its whole muscular system, and no fixed look at any object, however attractive, can be counted upon for more than a second or two—there are few children or infants in whom the optic discs may not be seen. It is essential to success in many cases not to touch the child. As soon as a finger is placed on the forehead to steady the lens used for the indirect method, many a child will rebel. The same remark applies still more forcibly to pulling up the upper Hd to obtain a view of the pupil. The attention must be attracted by playing the Light on and off the eye, and skill will come with practice in ascertaining the state of the fundus by repeated momentary glimpses rather than by any one prolonged view. Even the hsemacy- tometer, for which it is necessary to prick the finger,, may be used without making a child cry, by making a rapid prick with a needle, and showing the resulting drop of blood to the child as a wonder- ful thing. Let me next say that the cliild is to- be restrained as little as possible in any examination that may be necessary. The mother or nurse will often hold its hands or its legs, or both, as the first step to auscultation, and there is nothing which a child resists more than restraint of this kind. Let it kick about, if it will, till it becomes unmanage- able, and this will but seldom be the case if we take care not to make it so. Let it play with the end of the stethoscope if i|3 likes; it is quite possible to distinguish the respiratory sounds, and after a time those of extraneous origin can be as readily ignored as can the noise made by a crying child. The fact that the child is crying is no excuse for not examining the chest—crying necessitates deep respiration, and is often advantageous, for this reason. All that we need is more patience. In auscultation, also, it is often necessary to listen to the respiratorv or heart sounds in snatches, and to fill in by repeated observations what is not permitted by continuous.