Diagnostics of the diseases of children

Preface

Diagnosis of disease in the adult takes advantage of the subjective as well as of the objective symptoms. And in nearly every instance the physician may secure a clear history of the present and previous conditions.

But diagnosis of disease, or the discovery of conditions which may lead to the establishment of disease in the infant and child, encounters many difficulties. The infant cannot define his feelings, and the accuracy of the older child's definition is proportionate to its intellectual development. For information as to the child's feelings and the history of the condition the physician is in great measure dependent upon the observations of an over-anxious parent or a disinterested nurse-maid, and under ordinary circumstances either of such observers is apt to be inaccurate.

Confined, therefore, largely to the objective symptoms of disease, their correct interpretation is of absolute importance. For this reason among others I was led to write upon this subject. It is my hope that this volume may be the means of stimulating a closer study of the child life; may, in short, do something to secure for the child a "square deal" in the practice of medicine.

One aim has been kept constantly in view — to be practical, to help those who are engaged in the general practice of medicine to an early recognition of disease when it occurs in a child. Just so much of etiology and pathology have been introduced as is useful in diagnosis, and the sequelae of diseases are considered only as they are helpful in the identification of immediate or possible dangers. It has been my endeavor to approach the subject as the child is approached in the sick-room, with the idea of arriving at right conclusions.

The usual custom of dividing the work into two parts, considering differential diagnosis separately, has not been followed.

8 PREFACE

I have tried to impress the importance of an early diagnosis by taking up the differential diagnosis even under the circumstances where there are present only the few symptoms of the onset of some disease. Under appropriate headings ^he symptomatology of each disease is fully discussed, so that its recognition may be marked clearly.

A large part of what is worth while in what a man says and does has been caught by the contagion of great characters in great teachers and great books. It may be that these teachers have "gone on before" and that their books are out-of-date, but their influence abides. For the inspiration of these men and their books, the encouragement of my fellow-practitioners and friends, and for the appeal of the mother's words and eyes which have driven me to harder endeavor, I am profoundly grateful.

I would especially acknowledge the great kindness of Dr. C. B. Bacon and Dr. N. T. Beers, for suggestions and help in the making of photographs for use in this volume, and to Dr. C. D. Napier, Dr. J. M. Winfield, and Dr. G. F. Little, for the use of illustrations.

I would err in gratitude if I failed to acknowledge the uniform courtesy and hearty cooperation of my publishers, who not only do, but are cheerful in the doing.

LeGrand Kerr.

110 Cumberland Street, Brooklyn, New York.