The diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Goodhart, James Frederic, 1845-1916.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    advise that the temperature should be taken in the rectum, and no doubt one is more safe from possible error by so doing : but I do not think, all round, it is the best way. 1 prefer the axilla if the medi- cal man is making the observation himself, but I often take it in the groin, or well tucked down between the scrotum or labium and thigh. The latter is the place if the child be asleep, but the reading will be, probably, not quite so high as in the axilla, and still less so than in the rectum. Whenever the sur- face has been exposed by bathing, or otherwise, the »-ectal temperature is alone reliable, at any i-ate in babies ; in older children the mouth may be availal)le. With the ophthalmoscope, again, try to get the in.stru- ment considered as a toy, the examination a game of jjlay, and—with plenty of patience, for a child’s eye par- takes of the restlessness 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 mav not be seen. 11 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 foi’cibly to pulling u]^ the upper lid to obtain a view of the pupil. The attention must be utti’acted 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 hamiacy- tometer, for which it is necessaiy to prick the finger, may be used without causing a child to cry, by making a rapid prick Avith a needle, and shoAving the resulting drop of blood to the child as a Avonderful thing. Let me next say that the child is to be restrained as little as possible in any examination that may be necessaiw. ’J’he mother or nurse Avill often hold hands or legs, oi- crunch the head down uptm the chest, as the first stop to auscultation, and there is nothing Avhich a child