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Image from page 267 of "The medical diseases of children" (1911)

Identifier: 39002086410900.med.yale.edu

Title: The medical diseases of children

Year: 1911 (1910s)

Authors: Miller, Reginald

Subjects: Pediatrics Infant Child

Publisher: New York : William Wood and Co.

Contributing Library: Yale University, Cushing/Whitney Medical Library

Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

 

 

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tion of the right heart consequent upon the paroxvsm ofcoughing. Post mortem the right ventricle is often found dilated,with its wall thinned, and the brain, which is congested, shows well-marked cedema. Although re-covery is general, cases — moreespecially in wasted children —showing no pulmonary affection,and apparently doing well, maydie from these nervous conditions.When at all frequent they are ofmost serious import. Sequelae.—The tendency of per-tussis to start a tuberculous infec-tion or to light up some quiescentfocus of tuberculosis is well recog-nized. Occasionally, epilepsy maydate from an attack of whooping-cough. The funnel-chest {Fig. 49)and other thoracic deformities mayfollow pertussis. Diagnosis.—During its initialstages this disease cannot be recog-nized unless the child is known to have been exposed to the possibilityof infection. As the cough becomes more paroxysmal in character, accompaniedby vomiting and by increasing congestion of the face, the diagnosis

 

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WHOOPING-COUGH 249 can usually be made without difficulty, and is confirmed by thedevelopment of the whooping inspiration. Where whooping-coughis suspected, the examination of the throat by means of a spatula maybring on a characteristic attack. It must be remembered that infantsunder one year of age often do not whoop at all during the illness. Enlarged tuberculous mediastinal glands may produce a similarcough, but without the whooping inspiration ; in such cases, however,the signs of tuberculosis are usually patent. The progress of the casewill decide the matter. Some cases of empyema show a paroxysmalcough resembling that of pertussis, but ending without any whoop.The crow of laryngismus stridulus somewhat resembles in sound thewhoop of pertussis, but the history of the case is so different that noreal difficulty arises from the similarity. Course and Prognosis.—In an uncomplicated case in a favourablesubject the disease runs a course of about eight to ten weeks fromstart to fini

 

 

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