A treatise on diseases peculiar to infants and children

Front matter

Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

A TREATISE ON DISEASES

PECULIAR TO

Preface

In attempting the role of authorship before the republic of professional readers, I very well understand I am asking an audience at the hands of a most imperious tribunal, where the only avenue to acceptance is, ability to meet a necessity or gratify a desire. In presenting myself before this august tribunal, I shall not enter the stereotyped plea of importunity from others to do so ; nor shall I ask indulgence or forbearance, on the insincere, puling plea, of a self-conscious incompetency for the proper performance of my self-imposed task. If I have been right in supposing a new book in this department of medical literature a necessity, and have faithfully and competently supplied such necessity, I shall demand at the hands of the before- mentioned magisterial tribunal, my due meed of reputation and revenue.

Making this my first literary venture, in the maturity of professional manhood, with tastes, inclination, and an ample experience, as elements of qualification, for the work, I send it abroad with a confident assurance of that favorable acceptance at the hands of the profession which merit has a right to expect and demand.

It gives me very great pleasure to acknowledge my indebtedness to my very particular friend, Professor J. A. Campbell, of The St. Louis College of Homoeopathic Physicians and Sur-

X PREFACE.

geons, for two learned articles : one on Ophthalmia Neonatorum ; the other on Otitis, acute and chronic.

It is proper also I should acknowledge my indebtedness to valuable medical works by Drs. Duncan, Meigs and Pepper, West, Buchut, Hering, Hughes, and others, as valuable reference assistance in the execution of my work.

St. Louis, 1881.

Introduction

Subjects to which we have given much time and thought are very likely to assume a quality of importance which might not otherwise attach to them in our estimation. After all due allowance for such artificial color of importance, we think it may safely be affirmed, that no subject pertaining to civilized humanity is so difficult in its study and practice, or so important to humanity's physical, personal welfare, as the study and practice of medicine ; and that of all the various specialties and subdivisions of this subject, none are so difficult and important as the hygienic and medical management of infants and children.

This estimation has, to a considerable extent, been recognized in the fact, that this class of studies and duties has obtained separate rank in the profession under the title of paedology. The importance of the subject is involved in the fact that a healthy, vigorous infancy and childhood give the best guarantee for a happy and prosperous manhood and womanhood ; whilst a frail, delicate infancy and childhood offer little else to the future man or woman than pain, peril, and premature decay.

The difficulties that environ the professional pathway of the psedologist present themselves in the specially perilous violence of symptoms peculiar to the tender years of life, and the very great difficulty in many cases of getting any other than a few objective symptoms ; the subjective and more important ones

Xll INTRODUCTION.

being largely concealed or obscured by delirium, wilfulness, or a want of sufficient intelligence to communicate.

The object of the contemplated work will be, to furnish a suitable textbook for students, and a convenient reference-book for practitioners. The study only of such diseases as are peculiar to infancy and childhood will be attempted, to the exclusion of such as are common alike to the later as well as the earlier years of life. Nor will any symptom or group of symptoms, defects, or accidents be included, the proper management of which is purely surgical; such as clubfoot, harelip, atresia of natural outlets, strabismus, spinal curvature, etc. By such process of exclusion we shall hope to simplify the duties of authorship, complete the work within reasonable compass, and at such reasonable outlay in time and expense to the purchaser and reader as may furnish very decided inducement to patronage from the profession.

All nosological plans heretofore in vogue have been more or less arbitrary and inconsistent, not exactly pleasing either author or reader. We shall not hope to be more fortunate in these objectionable particulars than the learned and industrious predecessors who have gone before. The leading idea in classification will be to group together those diseases which implicate the anatomical integrity and physiological harmony of particular regions of the body. For instance, the respiratory group will include croup, bronchopneumonia, catarrhal fever, diphtheria; the buccal cavity group will include tonsillitis, stomatitis, aphthae, cancrum oris, etc. Others again will be grouped and treated together, because of having in common certain leading peculiarities, as the eruptive, contagious fevers. Still others will be grouped and treated because they have no special affinity for one another, or any of the subdivisions in classification.

INTRODUCTION. Xlll

The subject of potency we shall leave precisely where we find it, — an open question, — hoping that the industry and research of the near future may bring the profession into harmonious accord on this momentous topic.

Pathology and pathological anatomy may be safely and prudently trusted in the hands of the various learned and industrious specialists who have shown such zeal and ability in this most interesting and important department of professional investigation. We shall thus be left free to give the largest possible share of attention to the great practical end and aim of the profession : recognition of symptoms and their therapeutic relief.

As a most important factor, both in the cure and prevention of disease, hygiene, in addition to a chapter specially devoted to the subject, will receive very frequent incidental attention during the progress of the work. If we reflect that probably four-fifths of all the ills that flesh is heir to, come from irrational modes of life and adverse hygienic surroundings, and how much the duration, violence, or mildness and mortality in disease is influenced by the simple matter of rational modes of life and cleanly surroundings, it would be hard indeed to overestimate the value of correct views and intelligent practices in these matters.