Clinical medicine; a manual for the use of students and junior practitioners.

  • Bury, Judson Sykes.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Clinical medicine; a manual for the use of students and junior practitioners. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    155/498 (page 131)
    cartilages; collectively they form the rickety rosary. These beads are most manifest about the fifth and sixth ribs; they are generally symmetrical on the two sides; they are usually distinct at the age of three months, and may increase in size up to the end of the second year, but are rarely found in children over five years of age, and no vestige of them remains in adult life. (2.) By the presence of two grooves, one in front of the beads, the other behind them. The former is a slight groove, and is usually more easily felt than seen (see Fig. 72); the latter is a broad shallow de- pression, which begins outside the nipples on each side, and extends obliquely from above downwards and outwards (see Fig. 71, also Fig. 4, p. 34). Thus the contour of the rickety chest tends to resemble that of a guitar (see Fig. 73). (3.) By increased convexity of the costal cartilages, which, with the Fig. 73.—Tracing of a Rickety Thorax of Young Child, showing extreme deformity. sternum, form a broad rounded projection. This convexity, as well as the lateral grooves, is shown by a cyrtometer tracing taken a little below the level of the nipples. (4.) By the presence of Harrison's sulcus. The Pigeon Chest.—The essential feature of the pigeon chest is that the outline of a horizontal section approximates to the triangle, the true ribs being straightened in front of their angles and the sternum carried forward. This type of thorax may be found without any beads or other signs of rickets. It occurs most commonly in children over two years of age who have suffered from some chronic respiratory trouble which interferes with the entrance of air; and, unlike the rickety, the pigeon chest often persists in adult life. Bilateral Enlargement of the Chest.—This is nearly always the