The diseases if infancy and childhood; for the use of students and practitioners of medicine / by L. Emmett Holt.

  • Holt, L. Emmett (Luther Emmett), 1855-1924.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: The diseases if infancy and childhood; for the use of students and practitioners of medicine / by L. Emmett Holt. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    whether it is rapid, or slow, easy, natural, and quiet, or whether there is nasal obstruction with snoring and mouth-breathing due to tonsillitis, diphtheria, scarlet fever, or adenoid vegetations of the pharynx. The best evidence of dyspnoea is the recession of the supraclavicular and suprasternal regions, the sinking in of the intercostal spaces, sometimes with lateral recession of the chest walls. There is usually present active dilatation of the nostrils. 4. Pulse—whether it is rapid or slow, full and strong or soft and com- pressible. The frequency of the pulse in infancy is of much less impor- tance than the force and rhythm. A slow, irregular pulse is always sig- nificant, and should suggest meningitis; an irregular pulse, when rapid, has no special significance. 5. Skin—whether it is dry and hot, or covered with perspiration. The existence of pallor, general cyanosis, or blueness of the lips and finger nails should be noted; also the circulation in the extremities, whether they are warm, or cold and clammy. 6. Facial expression—whether this is calm and peaceful, drawn and anxious, intelligent or stupid, and whether the features are contracted from time to time as if from pain. 7. Cough—whether this is frequent, difficult, or severe. 8. Cry: Since this is the chief means by which the infant expresses discomfort or displeasure, it becomes exceedingly important but not always easy to determine whether an infant cries from pain, discomfort, hunger, temper, or from habit. In very many instances the cry under these con- ditions is so characteristic that one who is familiar with the child's language readily divines what is wrong. It is something which should never be disregarded, even though it may be the only obvious symptom. Tears are not seen until the second month, so that their absence before that time is not to be taken as an evidence that the cry is not from pain. The cry of hunger is apt to be interrupted by vigorous sucking of the fingers. It is not usually sharp and piercing, like the cry of pain, but it is a worrying, fretful cry. It ceases immediately when the hunger has been satisfied. The cry of indigestion is often mistaken for that of hunger, but in such cases, although crying may cease for a few minutes after taking food, from the temporary relief which this gives, it is likely soon to return with unabated vigour. Under such circumstances a frequent repetition of feeding or nursing should never be allowed, although very often this is just what is done. The character of the cry of pain will depend somewhat upon the se- verity of the pain. When it is acute like that of colic or earache, it may be sharp and piercing, and accompanied by contraction of the features, drawing up of the legs, and other evident signs of distress. The child falls asleep only when exhausted, and soon wakes, often with a scream. In