File:Pediatrics. (1900) (14578870788).jpg

Identifier: pediatrics9190unse (find matches)
Title: Pediatrics.
Year: 1900 (1900s)
Authors:
Subjects: Pediatrics Children Infants Pediatrics Disease Disease
Publisher: New York : Van Publishing
Contributing Library: Columbia University Libraries
Digitizing Sponsor: National Endowment for the Humanities (NEH)

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gle made by thebending of the softened rib is to be found. Tumefaction issometimes well marked on the interior and absent on theexterior surface of the rib. This will rarely occur without thepresence, at least in certain of the ribs, of the characteristicangle. 2. The Head in Rickets.—The typical rickety cranium isillustrated in Fig. 2, a case which was complicated by tuber-cular meningitis and which shows also the characteristic \1 boatbelly of the latter disease. Most noteworthy, of course, isthe familiar prominence of the parietal bones, giving to thehead its box-like shape. The anterior fontanelle instead ofclosing completely as it normally should, between the sixteenthand nineteenth months, remains widely open, often havinglarger dimensions at two or two and a half years than it shouldhave at the period of its greatest size in health. The suturesmay also be more or less separated and the bony plates of theskull greatly thinned, or completely softened. The latter PEDIATRICS. 487
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Fig. li 488 PEDIATRICS. symptom (craniotabes) sometimes occurs in heads which areotherwise perfect in shape. The writer saw recently an exag-gerated craniotabes of more than half the parietal bones in aninfant of 8 months that had been improperly fed. The babyshead was perfect in external contour. The wasting of the boneswould not have been discovered unless it had been carefullylooked for. 3. The Liver and Spleen in Rickets.—No case of ricketsshould be treated without a thorough investigation into theshape and size of the liver and spleen. In the first place thechronic intestinal indigestion which rickety infants suffer fromfurnishes toxic matter enough to cause a simple tumefactionof these organs,—a swelling very similar to that occurring withcatarrhal jaundice. To this the influence of the secondaryanemia of rickets is superadded. These two causes, with per-haps others due to the specific nature of the disease itself,often produce when working in conjunction a splenic andhepati

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