A practical treatise on disease in children / by Eustace Smith.

  • Smith, Eustace, 1835-1914.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on disease in children / by Eustace Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    DISEASE IN CHILDREN. INTRODUCTORY CHAPTER. The difficulties connected with the investigation of disease as it occurs in early life may be easily exaggerated. The subject is no doubt a special one ; but when the first strangeness has been overcome of dealing with patients who cannot describe their sensations, and who show their distress by cries and gestures which it requires experience to be able to interpret, the chief obstacle to progress has been surmounted. All necessary infor- mation as to the onset and early symptoms of the complaint can usually be obtained from the mother. Most women are good observers. Affection and anxiety increase their watchfulness, and make them fairly accurate re- corders of every outward change. The stress laid by them upon particu- lar phenomena is not, indeed, always a true measure of the real impor- tance of the symptoms ; but it is easy to correct any undue emphasis in the narrative by our own judgment and experience. Still, we must guard ourselves from being misled by the very fulness of the report: facts may be accepted with confidence, but volunteered explanation of these facts must on no account be allowed to influence our conclusions. When called to a sick child our first care should be to give an attentive hearing to the statement of the mother, supplying any gaps in the history by suitable questions. Having thus been enlightened as to the previous health of the child and the nature of the earliest symptoms, we have next to collect what information we can from the appearance and manner of the patient. To do this with success we must possess already a certain famil- iarity with the ways of infants and young children ; but this is easily ac- quired with a little practice. Again, we have so to regulate our own bear- ing as not to alarm the child, who is already perhaps in a state of disquiet. It has been said that a natural fondness for children is indispensable to success in this branch of medicine ; but this is an exaggeration. A quiet, genial manner with a pleasant smile and a gentle voice will soon dissipate the apprehensions of the patient and gain his confidence. Lastly, we pro- ceed to a physical examination of the various organs. This, if done de- liberately and without abruptness or hurry, can be effected in most cases without much trouble. The main difficulty in the diagnosis of disease in early life arises, not from the absence of intelligent speech on the part of the patient, nor from any uncertainty in the recognition of visible signs of suffering. It springs from the perplexity we often feel in referring these symptoms to their true origin. Children are not merely little men and women in whose bodies