OUR BABIES

Dominion, Volume 9, Issue 2647, 18 December 1915, Page 10

OUR BABIES

TBI HYOEIA.I Published under the auspices of tho , Royal New Zealand Health Society for the Health of Women nnd Children. "It is wiser to put up a fence at tho top of a precipice than to maintain an ambulance at the bottom." EVIDENCES . OF ILLNESS IN INFANTS. The following is a further adaptation of Dr. Leroy Yale's notes on "Evidences of Illness," with comments:— VARIOUS'.COUGHS. Coughs may have a good deal of character. Tho resounding, brassy, metallic bark of common "spasmodic" croup is well known. It compels attention. The smothered, hoarse cough of laryngeal obstruction is really more alarming to the physician. The cough of mere throat irritation is usually short and teasing. In bronchitis there is wheezing, and the cough is usually frequent aud not very tight, while if the chest be sore there'is apt to be a little cry with or after the cough. The cough of pneumonia is tighter, and suppressed on account of pain, the child seeming' to have no breath to waste in crying. It is surprising to see to what an extent a child with this disease will sometimes refrain from crying and eating, apparently to savo breath. The cough of influenza, -when characteristic, is persistent and. wearing, often recalling that of whooping cough. ' Tne cough of whooping cough is so characteristic that without its peculiar "whoop" the diagnosis may remain uncertain. The patient begins vyith a cough, a little spasmodic, which is repeated more and more rapidly, without proper indrawing of the breath,- until the stomach is emptied by vomiting, or the paroxysm ends with a long crowing inspiration, which is the "whoop." The performance may then bo repeated. ■ VOMITING. The stomach empties itself much moro easily in infancy than later. • The overfull suckling regurgitates or "puts up" its surplus without an effort, and this return is not a sign of illness. Real vomiting, however, is often seen as evidence of _ stomach indigestion (fermentation, wind, tough curds, etc.), as well as of other stomach and bowel troubles. • Vomiting is a frequent initial symptom of some of the eruptive fevers—notably scarlatina; also of pneumonia and of- malarial fever. In the- latter two disorders initial chills and shivering are rarely seen in . young children, while vomiting or .convulsions often occur. Peculiar types of vomiting are seen in special diseases, such, for instance, as the so-called "projectile" vomiting associated with some brain disorders, the matter being apparent relation to food or feeding times. t MEMO. BY "HYGEIA." PYLORIC STENOSIS. 'A more common cause of sudden, violent, and explosive vomiting which occurs during or just after feeding, especially in very young babies, is "Pyloric Stenosis." In this condition there is more or less obstruction to the passage of .food from the stomach into' the upper part of the intestine. This may be due. to mere irritative spasm or to organic narrowing of the orifice. In either case the matter is one for a doctor to deal with, Tho main symptom is the sudden, violent, explosive ejection of tho stomach contents, which, tend'to be shot out forcibly through both the nose and mouth. . Mothers and nurses should be alive to the fact that simple food. adjustments alone rarely suffice to overcome Pyloric Stenosis—indeed, it may occur in purely breast-fed babies. Delay is; always perilous. i Professor Holt, of New York, gives tho following account of Pyloric Stenosis:— ''The general clinical picture is a; striking one. An infant who, for the first two or three weeks, has shown no signs of gastric disorder, and often has been nursing and gaining regularly in weight, begins to vomit—at first occasionally, but : soon habitually. The change from the usual type of vomiting to tho forcible and constant, vomiting is often abrupt_ and without evident cause. The vomiting is not the ordinary gastrin regurgitation of indigestion, but is'forcible and projectile. Change^'in diet have but a temporary effect -upon it, or none at all. The bowels are constipated. The infant wastes steadily, the scales often showing a loss of one or two ounces a daj\ < There is no fever and little or no evidence of pain. "The symptoms of Pyloric Stenosis generally, begin after the first week and during the first month, very rarely as late as the sixth or seventh week after birtli." Vomiting often attends the'rally from the stunned condition (concussion) arising from a blow or fall upon the head. The vomiting of whooping-cough seems to be merely a ■ mechanical result of the violence of the paroxysm. The- abdomen will help to make a diagnosis in. case of colic. It is then Usually distended, : "hard as a board," and, if tapped- upon, resonant. The retracted abdomen of some brain troubles is rarely an early symptom.