Medical diseases of infancy and childhood

Front matter

MEDICAL DISEASES

OF

INFANCY AND CHILDHOOD

Preface To The American Edition

It has been the object of the reviser, iu preparing this book of Dr. AVilliams' for its second American issue, to adapt it more closely to the special requirements of this country.

The original text is here presented entire, no part having been omitted. The additions, requisite to bring the work up to date and to represent American views, have been enclosed in brackets. The prescriptions have been scattered through the text for convenience of connected reading. They have been conformed to the United States Pharmacopeia. The reviser however would not imply that a specific prescription refers to a specific instance. To avoid the possibility of misinterpretation the Appendix of Prescriptions as a whole is retained as in the original edition.

Particular attention has been given to infant-feeding, both on account of its importance and because in this respect the original edition seems to depart most from American ideas and standards.

The reviser wishes to acknowledge his indebtedness to the various authors consulted, especially to Dr. T. M. Rotch. He wishes particularly to express to Dr. Williams the interest and profit found in the study of his work, and trusts that the additions made may be of value to the public. -

F. S. C.

Chicago, III., August, 1900.

Preface To The English Edition

The object of this handbook is to give to young practitioners of medicine, and to those who have not previously paid much attention to the subject, a guide to the clinical study of disease as it occurs in infancy and childhood.

Xo attempt has been made — nor was it, indeed, possible within the space at my disposal — to attain an ideal completeness in the enumeration of all the forms of disease wliich may occasionally be met with in infants and children. Pathological processes are essentially the same in children as in adults. The differences to be observed are traceable in the main to two causes. In the first place, the organism in childhood is growing, and while it is peculiarly \'ulnerable to external agencies, it possesses also a special power of adaptation and recuperation. In the second place, the organism in childhood has not yet acquired immunity to the acute specific infectious diseases which are, as a matter of fact, responsible for a very large part of the enormous mortality of the early years of life.

I have not deemed it to be my dut^' to attempt to describe fully diseases which present symptoms similar at all ages. My object has been rather to indicatis the special incidence of disease in childhood ; to elucidate as far as possible the causes of this special incidence ; to point out the peculiarities which the circumstances of child-life impress upon familiar diseases ; and to detail the treatment rendered appropriate by the nature of the disease itself and by the peculiar susceptibility of the growing organism. While it would be difficult to mention any disease — except, perhaps, rickets — which is peculiar to childhood, yet certain morbid processes present special features or a peculiar distribution in childhood, and others, common at that period, are rare in adult age. Moreover, the relative importance of diseases varies greatly at different ages. Diarrhoea, for instance, which at adult ages and in temperate climates is usually a trivial,

6 PREFACE.

seldora a fatal, affection, is in infancy and early childhood the most deadly of all disorders.

In discnssing the subject of treatment, prominence has been given to the rational basis afforded by pathology, and by clinical observation. While it is hoped that few remedies which experience has proved to be valuable have been omitted, it has not been thought worth while to compile long lists of drugs which have been recommended and employed without a reasonable measure of success. I have been guided throughout, both in clinical description and in the treatment recommended, by experience gained during many years' service at the East London Hospital for Children, Shadwell. The opportunities for observation there afforded are very extensive, but they have failed me in regard to two forms of disease. Malaria is seldom seen in London in children, but I have been so fortunate as to obtain the assistance of Dr. Manson, who has been good enough to revise the chapter on Malarial Fever. Hydatid disease also is extremely rare in this country, and I am greatly indebted to my friend, Mr. G. Twynam, formerly Surgeon to the Prince Alfred Hospital, Sydney, New South Wales, who has read the chapter on this subject, and has made many valuable suggestions which are embodied in the text. In conclusion, I must express my acknowledgments to Miss Mary Gordon, L.R.C.P. & S. Ed., who has read the proofs, and assisted me in seeing the volume through the press.

Chapter I. Introductory

PAGE.

The Ages of Childhood— Growth— The Mortality of Childhood— Its Causes- Influence of Sex — Sleep — Clothing — Baths — Change of Air 17

Chapter II. Clinical Examination

Clinical Examination of Infants and Young Children — General Observations — Physical Examination of the L'pper Air Passages — Of the Chest — Of the Circulatory System — Of the Abdomen — Of the Head — Retraction of the Head — The Temperature in Infancy and Early Childhood o:

Chapter III. Diseases Incidental To Birth

Hjemorrhagic Extravasations during Parturition ; Meningeal Hemorrhage — Icterus Neonatorum — Acute Fatty Degeneration of the New-Born— Acute Haemoglobinuria of the New-Bom — Mastitis — Erysipelas Neonatorum — Erythema Neonatorum — Diseases of the Navel — Tetanus Neonatorum — Sclerema Neonatorum — (Edema Neonatorum — Melfena Neonatorum — Pemphigus Neonatorum — [Haemorrhagic Diseases of the Nevr-Born] 36

CHAPTER lY.

FOOD.

The Stomach and Intestines at Birth — Milk — Physiolog}' of Digestion — The Quantity of Milk taken at Various Ages — Rate of Increase in "Weight — [Management of Breast Feeding] — Artificial Feeding of Infants — Fresh Cow's Milk— Condensed Milk— Infants' Foods— The Bottle— Efl'ects of Boiling — Bacteriology of Milk — Sterilization — Pasteurization — Milk Laboratories — [Modification of Cow's Milk — Indications for Modifying — Diet in Second Year] 52

Chapter V. Acute Specific Infectious Diseases: Intkoductory

Mortality due to the Acute Specific Infectious Diseases — Incubation Period — Propliylaxis— Complications and Sequelae — General Remarks on Treatment : Nui-sing, Food, Drink, Alcohol — Hydrotherapeutic Treatment — Antipyretic Drugs — Treatment of Adynamia 83

CHAPTEK yi.

ACUTE SPECIFIC INFECTIOUS DISEASES {continued).

Small-pox — Vaccination — Symptoms and Treatment of Small-pox — Varicella —

Measles — Rubella — Scarlet Fever 94|

CHAPTER VII. ACUTE SPECIFIC INFECTIOUS DISEASES {continued)

Influenza — Whooping-cough — Mumps — Glandular Fever — Cerebro-spinal Meningitis — Enteric Fever 112

CHAPTER YIII.

ACUTE SPECIFIC INFECTIOUS DISEASES {concluded).

Diphtheria — Incubation Period — Pathology — Symptoms — Diphtherial Palsy — Diagnosis — Prognosis — Antitoxin Treatment — General and Local Treatment — [Immunization] 132

Chapter IX. Malarial Fever

The Hfematozoon — Varieties of Malarial Fever : Quotidian ; ^stivo-autumnal ;

Pernicious — Malarial Cachexia — Diagnosis — Prognosis — Treatment 152

Chapter X. Tuberculosis: Etiology; Pathology

The Tubercle Bacillus— The Tuberculous Diathesis— Sources of Infection- Milk— Predisposing Diseases— Sites of Primary Infection : Naso-Pharynx and Cervical Glands ; Ear ; Intestines— Varieties of the Tuberculous Process—Age Incidence— Prevalence of Tuberculosis in Childhood— Sex 156

CHAPTER XL

CLINICAL VARIETIES OF TUBERCULOSIS.

Tuberculosis and Scrofula— General Tuberculosis : Acute and Chronic— Tuberculosis of Bones and Joints— Tuberculosis of Lymphatic Glands ; the Cervical and Tracheo-bronchial Glands 163

CONTENTS. B

DISEASES OF THE MOUTH.

The Mouth — Dentition — Disorders of Dentition — Stomatitis — Partial Desquamation — Catarrhal Stomatitis — Membranous Stomatitis — Ulcerative Stomatitis — Aphthous Stomatitis — Thrush — Noma 285

Chapter XXV. Diseases Of The Upper Respiratory Passages

Rhinitis — Acute Laryngitis — Chronic Laryngeal Catarrh — Papilloma of the Larynx — Acute Pharyngitis — Acute Tonsillitis — Otitis Media — Chronic Pharyngitis — Adenoid Vegetations — Chronic Tonsillitis — Deformities of the Chest produced by Naso-Pharyngeal Obstructions — Retro-Pharyngeal Abscess — Respiratory Spasm 297

Chapter XXVI. Acute Bronchitis, Broncho-pneumonia, And Pneumonia

Acute Bronchitis and Broncho-pneumonia : Pathology ; Symptoms ; Prognosis ; Treatment — Acute Lobar Pneumonia : Etiology ; Pathology ; Symptoms ; Complications ; Diagnosis ; Treatment 314

Chapter XXVII. Pleurisy

Sero-fibrinous Effusion — Purulent Effusion — Symptoms of Pleurisy — Course —

Physical Signs — Loculated Empyema — Treatment 332

CHAPTER XXYIII.

CHRONIC AFFECTIONS OF THE BRONCHI.

Chronic Bronchitis and Emphysema — Bronchiectasis — Asthma — "Hay Fever" ' 340

ACUTE DISORDERS OF THE GASTRO-INTESTINAL SYSTEM.

Etiology — Dyspepsia — Catarrhal Enteritis — Gastro-intestinal Catarrh — Acute Gastro-enteritis — Acute Summer Diarrhoea — [Bacteriology] — Cholera Infantum — Complications — Treatment 365

Chapter XXXII

CHRONIC DISORDERS OF THE GASTRO-INTESTINAL SYSTEM. Chronic Gastro-enteritis — Dilatation of the Stomach — Infantile Atrophy — The Hydrocephaloid Condition — Congenital Stenosis of the Pylorus — Constipation — Prolapsus Ani 383

CHAPTER XXXIIL

INTESTINAL OBSTRUCTION.

Congenital^ Acquired — Symptoms — Diagnosis — Treatment 395

Chapter XXXIV. Intestinal Parasites

Tsnia Solium — Taenia Mediocanellata — Bothriocephalus Latus — Tsenia Canina ; Symptoms of Tape-worm ; Prophylaxis ; Treatment — Ascaris Lurabricoides ; Treatment — Oxyuris Vermicularis ; Treatment 399

CHAPTEK XXXV.

HYDATID DISEASE.

Taenia Echinococcus — Geographical Distribution — Hydatid of the Liver ; of

the Lung ; of the Heart ; Intracranial : of the Kidney and Spleen 406

Chapter XXXVI. Diseases Of The Genito-urinary System

The Urine — Albuminuria — Albuminuria of Puberty — Haematuria — Hsemoglobinuria — ^Pyuria — Diseases of the Kidney : Diffuse jS^ephritis ; Glomerulo- Nephritis ; Amyloid Degeneration ; Uric Acid Diathesis ; Renal Calculus ; Hydronephrosis ; Pyelitis ; Perinephritic Abscess ; Congenital Cystic Disease of the Kidneys ; Tumors of the Kidney 411

INTEACKANIAL ABSCESS, THROMBOSIS, AND TUMOUR.

Abscess of the Brain ; Course ; Diagnosis ; Treatment — Thrombosis of Cerebral

Sinuses — Intracranial tumour 473

Chapter XLIII

HEMIPLEGIA. SPASTIC RIGIDITY. HEREDITARY ATAXY. - Secondary Hemiplegia — Congenital and infantile Hemiplegia — Spastic Rigidity - -Hereditary Ataxy 481

CHAPTER XLIY.

LESIONS OF NERVES.

The Motor Nervous Apparatus — Reaction of Degeneration — Birth Palsies —

Facial Paralysis — Multiple Neuritis 489

Chapter XLV. Amyotrophy

Muscular Atrophy — Infantile Paralysis — Progressive Neural Muscular Atrophy — Primary Muscular Dystrophies — Pseudo-h'ypertrophic Muscular Paralysis 494

CHAPTER XLYI.

DISEASES OF THE SKIN.

Urticaria — Urticaria Papulosa — Raynaud's Disease — Prurigo — Urticaria Pigmentosa — Er}*thema Simplex — Erythema Intertrigo — Erythema Scarlatiniforme — Erythema Multiforme — Purpura — Peliosis Rheumatica — Chilblain — Pemphigus — Herpes — Pruritus — Itching; Pediculosis; Scabies.. 504

CHAPTER XLVII. DISEASES OF THE SKIN {cmtinued)

Pyococcal Dermatitis — Impetigo — Catarrhal Dermatitis — Furuncle — Ringworm

— Alopecia Areata — Seborrhoea — Lichen — Miliaria — Eczema and Psoriasis. 517

MEDICAL DISEASES

OF

Infancy and Childhood.