A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
Thus, the prognosis would, as a general thing, be sufficiently
favorable if it were not for the number of complications or severe
symptoms. The chronic catarrh of the lungs accompanying rachitis, the
enlargement of the tracheal and bronchial glands and the lymphatic
glands in general, are apt to lead to inflammatory disease of the
lungs, which, after having returned several times, leads to
infiltration of the lungs with caseous deposits, and not infrequently
results in phthisis. The nervous symptoms accompanying craniotabes may
prove very dangerous. Spasm of the larynx and laryngismus stridulus may
prove fatal in a single attack by suffocation, or general convulsion
may set in during an attack of laryngismus or without it, in which the
child may perish. Therefore the prognosis in every case of laryngismus
and in every case of craniotabes has to be very guarded. It is my rule
to wait from six to eight weeks before giving expression to a decided
prognosis, because during that time medicinal and dietetic treatment
will probably have resulted in such an improvement of the symptoms and
condition as to render the prognosis more favorable. Under no
circumstances, however, ought we to lose sight of the fact that, though
rachitis may disappear, the causes leading to it may still linger on.
Defective nutrition, diseases of the lungs, and intestinal affections
which gave rise to or accompanied rachitis will complicate the
prognosis, though rachitis itself, as far as the bones were concerned,
be no longer in existence.
TREATMENT.--To meet the cause of a disease by preventive measures is
the main object and duty of the physician. He thus either obviates a
malady or relieves and shortens it. Now, if the original disposition to
rachitis, as has been suggested, is to be looked for in early
intra-uterine life, when the blood-vessels begin to form and to
develop, we know of no treatment directed to the pregnant woman or
uterus which promises any favorable result. But the more we recognize
an anatomical cause of the chronic disorder, the more we can appreciate
the influence upon the child of previous rachitis in the mother, and
are justified in emphasizing the necessity on the part of the woman to
be healthy when she gets married, and to remain so while she is
pregnant. After the child is born the most frequent cause of rachitis
is found within the diet or the digestion of the patient. To attend to
the former is in almost every instance equal to preventing disorders of
the latter; for most of the digestive disturbances during infancy and
childhood are the direct consequences of errors in diet. It is,
however, impossible to write an essay on infant diet in connection with
our subject. I have elaborated the subject in my {159} _Infant Diet_
(2d ed. 1876), in the first volume of Buck's _Hygiene_, and of C.
Gerhardt's _Handbuch d. Kinderk._ (2d ed. 1882). Still, the importance
of the subject requires that some points should be given, be they ever
so aphoristic.
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