Treatment of disease in children

INTRODUCTORY.

IN medicine, as in the universe, all things are relative. The dissimilarities between the physiology and pathology of children and adults are differences in degree. Doubtless these differences in degree may be explained as the effect of unfinished growth and development of all parts, but especially of the nervous system, heart, and respiratory apparatus.

Irritability, irregularity and variability are notions never to be absent from the mind in thinking of children and their diseases.

There is a natural tendency in the mind to erect everything into a standard, type, or test. We do this in pathology, and expect diseases to conform to the standard or type. Disease and health in infancy and childhood are very erratic, and refuse, often in a tantalizing way, to be put into the harness of a type or standard. It is the unexpected that happens in infantile physio-pathology. Perhaps this noncomformity of disease and health to the type or test is the most striking characteristic of children, and especially infants. A dissimilarity between adults and children is always intensified, the younger is the infant:

The above generalities may be illustrated by reference to the particular case of the child's circulatory apparatus.

The heart is smaller in infants; its first sound is less long

and less loud; it is more irritable, irregular and variable, as the effect of any new condition in the infant's internal or external environment readily demonstrates; it refuses to be bound down by the standard set up for it-its apex beat is variable in force and position, and may, without disease, be found beating a larger or smaller area of the chest wall either in the usual place or in the fourth space and in the nipple line. The pulse follows the heart in its erraticalness, and also possesses an irregularity of its own, in addition to the mere physical and nervous conditions rendering its investigation difficult. An irregular pulse developing in any acute affection is of less diagnostic import in an infant than in an adult. It is a mistake, still committed by writers on children's diseases, to suppose that an irregular pulse specially points to brain disease, and generally meningitis. Alone as an isolated symptom, it is of no diagnostic value whatever. Here is again an illustration of nonconformity to type.

Further, the arterial tension is not steady in childhood. Sphygmographic and digital observations attest the variability and sudden changes in this phenomenon, especially in disease. Sudden temporary failure of the myocardium, both in the midst of apparent health and in the course of disease, is of greater frequency in children than adults: witness the state of the circulation and heart in scarlatina and diphtheria.

CONTENTS.

CHAPTER I.

GENERAL TREATMENT OF DISEASE.

Fundamental Principles-Drugs-Depletion, Antiphlogistics, Sedatives-
Venæsection-Leeches - Mercury-Antimony-Opium -Blisters
Treatment of Child-Stimulants-Toleration of some Drugs-
Plea for proper use of Drugs-General Health-Personal Hygiene
-Effects of Exercise-Sleep-Analysis of Dampness-Clothing
-Fresh Air-Cubic Space - Gymnastics: value of, methods,
apparatus - Climacteric periods

CHAPTER II.

I-12

THE PRINCIPLES AND PRACTICE OF FEEDING INFANTS AND CHILDREN.

Human Milk-Digestive and Assimilative Organs-The Mother as a

Nurse-Contra-indications to the Mother's Nursing-Method and
Times of Nursing-Selection of a Wet Nurse-Ass's Milk, Goat's
Milk-Artificial Human Milk-Dilute Cow's Milk-How to Divide
the Curd-Quantity of Food Required-Times of Feeding-Schema
of Diet-Cleanliness of Vessels-Condensed Milk-Various Foods
-Whey--Voltmer's Artificial-Strippings-Food Warmers and
Preservers-Temperature and Reaction of Food-Constipation-
Feeding Bottle-Importance of Measurement-Posture of Hand-
Fed Child During Feeding-Diet at Seven Months-At Twelve
Months-Foods-Peptonised Foods-Dietary for Healthy Children
Above the Age of Two Years-Dietary for a Child from Four
Years of Age till Puberty
13-34

...

CHAPTER III.

...

INDIGESTION DYSPEPSIA-SIMPLE GASTRIC CATARRH.

Symptoms-Neurotic Children-Indigestion of Proteids, Fats and

Starches

Examination of Stools

Indigestion of Liquids,

of Mother's Milk - Food Utensils Food -Stomach - Nervous

Apparatus - Maintenance of General Health