General signs of disease
- Benson A.R
Acute diseases
Vomiting : In a large majority of cases, serious illness in infants and children is ushered in by vomiting. This symptom takes the place of the chill, which so often marks the onset of disease in adults. It is not always easy to tell, at first, whether the attack of vomiting indicates the beginning of a serious illness or is due to acute indigestion. In the latter case it is usually possible to trace the attack to some indiscretion of diet, and these sudden attacks of indigestion are likely to be relieved within a few hours after the stomach is emptied. In the onset of more serious diseases, however, although the vomiting may cease, the general condition of the child does not improve and the temperature remains high.
Temperature : The temperature should be taken in the rectum or the fold of the groin, the thermometer remaining in place for two minutes. In selecting a thermometer for use with children, one made of heavy glass is preferable. In taking the rectal temperature, the thermometer should be lubricated with vaseline and inserted very gently and with a rotary motion. The thermometer will take the right direction itself if inserted slowly and gently. Never use force in passing the thermometer into the rectum.
In taking the temperature in the groin, the thermometer is laid in the fold of the groin, with the lower end of the thermometer pointing inward. The thigh and leg are flexed so that the thermometer is held firmly in place by the pressure. If the leg is held firmly in this position and the tip of the thermometer steadied by the thumb and finger for the required length of time, no harm can come from the movements of the child.
The temperature is apt to vary from 98° to 100°. The temperature in the rectum is approximately a degree higher than in the groin.
Slight causes will produce an increase of temperature in a child. For example, it is not uncommon even in mild attacks of indigestion to find a temperature of 103° or 104°. Such temperatures, however, disappear quickly when their cause is removed. Any temperature over 100°, unless the cause is perfectly clear, should be considered alarming. This is especially true if the rise of temperature lasts more than 24 hours. A high temperature of short duration is not necessarily a sign of serious illness, but any prolonged rise of temperature or a gradually increasing temperature, especially if the cause is doubtful, requires immediate attention.
Respiration : The character as well as the rapidity of the respiration is of importance. Labored breathing, breathing in which there is a "catch" at the end of the inspiration, shallow breathing, and breathing which is gasping in character, are all important types found in serious diseases. When one of these abnormal types of breathing occurs in connection with a high temperature, there is ground for suspicion of pneumonia or other serious disease of the lungs, whether cough exists or not.
The respiration is affected by excitement and other causes, and should always be counted while the child is asleep. Respiration exceedingly 45 to the minute should be investigated.
Pain : Pain is indicated by the character of the cry, by the movements of the infant, and by indication of pain when it is touched or moved. Older children will often indicate the location of the pain, but their sensations are oftentimes misleading. For example, it is very frequent in pneumonia or pleurisy to find the child placing its hand on its stomach as the seat of pain, instead of the chest.
Sleep : Whether the child sleeps quietly and comfortably is of great importance. Sick children are restless, tossing about in the bed, sleep lightly with frequent waking, and often awaken with pain or a sharp cry. In some diseases the eyes are rolled upward during sleep so that only the whites can be seen, or the eyes may be only partially closed.
Children who breathe through their mouths or snore during sleep, should be examined by a physician for adenoids or other growths in the posterior part of the nasal passages.
Skin : The normal color of the skin of a healthy infant is best described as rosy. In sickness the skin becomes pallid, sometimes almost bluish. In the onset of acute diseases the skin is likely to be dry and hot to the touch. The face either becomes pale and drawn, or, where there is a high temperature, the cheeks are brightly flushed.
To recapitulate, then, acute diseases are marked by vomiting at the onset, temperature above 100° which remains constant, rapid respiration, restlessness, hot, dry, flushed skin, and pain.
Acute diseases
Vomiting : In a large majority of cases, serious illness in infants and children is ushered in by vomiting. This symptom takes the place of the chill, which so often marks the onset of disease in adults. It is not always easy to tell, at first, whether the attack of vomiting indicates the beginning of a serious illness or is due to acute indigestion. In the latter case it is usually possible to trace the attack to some indiscretion of diet, and these sudden attacks of indigestion are likely to be relieved within a few hours after the stomach is emptied. In the onset of more serious diseases, however, although the vomiting may cease, the general condition of the child does not improve and the temperature remains high.
Temperature : The temperature should be taken in the rectum or the fold of the groin, the thermometer remaining in place for two minutes. In selecting a thermometer for use with children, one made of heavy glass is preferable. In taking the rectal temperature, the thermometer should be lubricated with vaseline and inserted very gently and with a rotary motion. The thermometer will take the right direction itself if inserted slowly and gently. Never use force in passing the thermometer into the rectum.
In taking the temperature in the groin, the thermometer is laid in the fold of the groin, with the lower end of the thermometer pointing inward. The thigh and leg are flexed so that the thermometer is held firmly in place by the pressure. If the leg is held firmly in this position and the tip of the thermometer steadied by the thumb and finger for the required length of time, no harm can come from the movements of the child.
The temperature is apt to vary from 98° to 100°. The temperature in the rectum is approximately a degree higher than in the groin.
Slight causes will produce an increase of temperature in a child. For example, it is not uncommon even in mild attacks of indigestion to find a temperature of 103° or 104°. Such temperatures, however, disappear quickly when their cause is removed. Any temperature over 100°, unless the cause is perfectly clear, should be considered alarming. This is especially true if the rise of temperature lasts more than 24 hours. A high temperature of short duration is not necessarily a sign of serious illness, but any prolonged rise of temperature or a gradually increasing temperature, especially if the cause is doubtful, requires immediate attention.
Respiration : The character as well as the rapidity of the respiration is of importance. Labored breathing, breathing in which there is a "catch" at the end of the inspiration, shallow breathing, and breathing which is gasping in character, are all important types found in serious diseases. When one of these abnormal types of breathing occurs in connection with a high temperature, there is ground for suspicion of pneumonia or other serious disease of the lungs, whether cough exists or not.
The respiration is affected by excitement and other causes, and should always be counted while the child is asleep. Respiration exceedingly 45 to the minute should be investigated.
Pain : Pain is indicated by the character of the cry, by the movements of the infant, and by indication of pain when it is touched or moved. Older children will often indicate the location of the pain, but their sensations are oftentimes misleading. For example, it is very frequent in pneumonia or pleurisy to find the child placing its hand on its stomach as the seat of pain, instead of the chest.
Sleep : Whether the child sleeps quietly and comfortably is of great importance. Sick children are restless, tossing about in the bed, sleep lightly with frequent waking, and often awaken with pain or a sharp cry. In some diseases the eyes are rolled upward during sleep so that only the whites can be seen, or the eyes may be only partially closed.
Children who breathe through their mouths or snore during sleep, should be examined by a physician for adenoids or other growths in the posterior part of the nasal passages.
Skin : The normal color of the skin of a healthy infant is best described as rosy. In sickness the skin becomes pallid, sometimes almost bluish. In the onset of acute diseases the skin is likely to be dry and hot to the touch. The face either becomes pale and drawn, or, where there is a high temperature, the cheeks are brightly flushed.
To recapitulate, then, acute diseases are marked by vomiting at the onset, temperature above 100° which remains constant, rapid respiration, restlessness, hot, dry, flushed skin, and pain.
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