The lordosis resembles the similar deformity which develops in cases
of primary myopathy, when the spinal muscles have undergone complete
atrophy. As in myopathy the movements are very uncertain. The
children are apt to fall heavily when the centre of gravity is
suddenly displaced, because their upright posture is maintained by
balancing the trunk upon the support of the pelvis. The frequency and
severity of the falls which these children suffer is a common
complaint of the mother. The faulty posture is often associated with
slight albuminuria. Its appearance is very capricious, but it is
dependent to a great extent upon the assumption of the erect posture.
There has been much discussion as to its explanation. It has been
argued that the lordosis itself produces the albuminuria by mechanical
compression of the renal vein, and it is said that albuminuria can be
produced, even in the prone position, by placing the child in a
plaster jacket applied so as to maintain the position of lordosis.
Other observers, however, have not obtained this result. It seems most
likely that the albuminuria is due to defective tone in the vasomotor
musculature, comparable in every way to the defective tone in the
muscles of the skeleton. We have often further evidence of vasomotor
weakness. Fainting attacks are so common as to be the rule rather than
the exception. Again, mothers are likely to complain of the child's
pallor and of dark lines under the eyes, especially after exertion or
in the reaction which follows excitement of any sort. As a rule a
blood count will not show any very striking evidence of true anæmia.
The pallor is of vasomotor origin, determined by faults in the
distribution of the blood from vasomotor weakness and not by deficient
blood formation. Circulatory and vasomotor disturbance probably also
accounts for the dyspeptic pains and vomiting which commonly accompany
any emotional excitement, or follow any unusual exertion or fatiguing
experience. Constipation is a common, and mucous diarrhoea an
occasional, symptom. The abdomen is often pigmented. The hands and
feet are usually cold and cyanosed.
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