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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    gleaned from the preliminary survey, it is a good [)lau to start with the oi'gan which is suspected to be at fault. If there be any reason for suspecting disease of the nervous system, it is as well at once to examine the eves with the ophthalmoscope, lest any subsequent action on our part may frighten the child and render the fundus oculi inaccessible. It is impossiljle to make anv satisfactory use of the ophthalmoscope if the child is, or has been recentl}’, crying. This done, and the state of the piq)il and movements of the eyeball ascei- tained, the sight and hearing can be tested by a watch and the [»recision of the various nuiscular movements of the extremities, by giving the child something tO' hold or pick up, and by making it walk, if old enough, oi- by watching the movements of the limbs in infants, too young to walk, as they lie on the mothe)''s lap. The gums can ho examined and the })i’ogress of dentition ascertained by gently rubbing the surface of the gum.s- with the tinger. The chest and alxlomen shmdd be examined in all cases. Some advise that the child should be stripped for this purpose, and this is a neces.sai’y measure in some cases. 1 do not recommend it as a lade, for the reason adopted throughout these suggestions—viz., that the child is to be frightened or put out of temper as little as possible. Children, all but the youngest infants, i-esent the process of undress- ing, and it is usually sutbcient for our purpose that all the clothing be loosened. The greater part of the front and back of the chest can he Ijy this means exposed and a, thorough examination made. Percussion must be light, or it will mislead. A crackcih])ot sound can be produced with facility in many .a liealtliy child. A light vertical ta[> with one or two tingei’S upon a linger of the other liand [)laced Hat upon tlie chest is all that is nece.s.sary, and special attention is to he paid to the intervei’tcbi-al grooves as ])aits which are more fr(>- quontly implicateil in children than in adults. In aus- cultation it is very essential to make careful conqiari.son of the two sides; of the hasc^s with the aj)ices ; and to