Diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Goodhart, James Frederic, Sir, 1845-1916.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

    155/792 (page 139)
    tonsils after the first onset of the menses. It is, of course, sometimes continued on into adult life, and sometimes causes trouble in young adults in the same way as in children—viz., by inducing repeated sore throat. It is a particularly troublesome affection in those who have a voice for singing. It is associated with certain symptoms: First, it leads to snoring when the child sleeps—not in itself a matter of much concern; secondly, to deafness, from the pressure upon the orifices of the Eustachian tubes, and the associated hypertrophic or inflammatoiy changes which take place in the surrounding mucous membrane. This is of importance,because such children often appear dull and stupid simply because they are deaf. It interferes too with free vocalisation, and gives a nasal twang to the voice. It causes a frequent cough. Lastly, by partial occlusion of the air passage, the lungs fill badly, and the chest becomes distorted; and, it is said that from the want of full use the nostrils contract, the upper jaw fails to develop, and, in con- sequence, the arch of the palate remains high, and the teeth become cramped, from want of room. The chest becomes pigeon-breasted—that is to say, the ribs are flattened in laterally, and the sternum and costal car- tilages become prominent, sometimes quite pointed. This is the natural result of interference with the ingress of air to the lungs. The respiratory effort con- tinues, but the lungs fail to be distended by reason of the obstruction in the throat; and the ribs yield in obedience to the atmospheric pressure along their line of least resistance—in other words, in those parts of greatest movement—at their junction with the costal cartilages backwards to them point of greatest curvature. Treatment.--No treatment is of much avail but excision, and if it should appear that any of the more serious consequences are in progress, this shoidd be at once advised. But it is by no means always that an operation is necessary, and fortunately so, for parents often manifest great repugnance to it. Parrish’s food.