The Mother's Manual of Children's DiseasesWest, Charles
Science
The Mother's Manual of Children's Diseases
West, Charles
Pediatrics -- Handbooks, manuals, etc.
The frequency of the breathing is less difficult to ascertain, while at
the same time it furnishes more reliable information than the pulse.
This is best tested when the child is asleep, remembering always that
the breathing is then slower than in the waking state. The open hand,
well warmed, should be laid flat and gently over the child's night-dress
on the lower part of the chest and the pit of the stomach. Each heaving
of the chest, which marks a fresh breath being taken, may be counted,
and the information thus obtained is very valuable. Up to the age of two
years the child breathes from 30 to 40 times in a minute, and this
frequency gradually declines to from 25 to 30 till the age of twelve,
and then settles down to from 20 to 25 as in the grown person. You would
thus know that a sleeping infant who was breathing more than 30 times,
or a child of five who breathes more than 25 times, has some ailment in
its chest, and that the doctor should be sent for in order to ascertain
its exact nature.
It would answer no good purpose to give a description of the information
to be obtained by listening to the chest. To learn from this, needs the
well-trained ear; and harm, not good, comes from the half-knowledge
which serves but to lead astray.
A child may be very suffering, seem very ill, and its suffering and
illness may depend on pain in the stomach owing to indigestion,
constipation, or even to an accidental chill. After early infancy it is
not difficult to make out the seat of the child's suffering: the warm
hand placed gently on its stomach will soon ascertain whether it is
tense or tender, whether the tenderness is confined to one particular
spot, or whether it is more acute at one spot than at another; and,
lastly, whether, as is the case when pain is produced by wind in the
intestines, the pain and tenderness are both relieved by gentle rubbing.
In the young infant the character of the cry will, as I have already
said, give some clue to the seat of its pain, while, if you lay it down
in its cot or in its nurse's arms in order to examine its stomach, it
will often resist and begin to cry. Its stomach then becomes perfectly
tense, and you cannot tell whether pressure on it causes pain or whether
the cries are not altogether the consequence of fretfulness and fear. It
is therefore the best plan to pass your hand beneath the child's clothes
and to examine its stomach without altering its posture, while at the
same time the nurse in whose arms it is talks to it to distract its
attention, or holds it opposite the window, or opposite a bright light,
which seldom fails to amuse an infant. If there is no tenderness of the
stomach the child will not cry on pressure; or if during your
examination the presence of wind in the intestines should occasion pain,
gentle friction, instead of increasing suffering, will give relief.
Public-domain text, read in full here on John Shaqi.
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