The doctor at home and nurse's guidebook / edited by George Black.

Date:
1909
Catalogue details

Licence: In copyright

Credit: The doctor at home and nurse's guidebook / edited by George Black. Source: Wellcome Collection.

    597/684 (page 547)
    disorders ; as these, on the other hand, may be reasonably suspected of interfering with the natural cut- ting of the teeth. It is certainly unsafe to ignore the complications possibly due to dentition, if any derangement of the health of the child occur during the period of teething. As a rule, the amount of irritation holds a relation to the number of teeth advancing simul- taneously; but owing to the varying susceptibility of children, a single tooth may cause more disturbance in one case than half a dozen will in another. At the beginning of the cutting of the teeth there is generally an increased flow of saliva which keeps the mouth moist and cool. When the irritation increases and the mouth becomes hot and dry, other derangements are likely to follow : the child becomes feverish ; constipation or diarrhoea ensues— the latter, if not too severe or too protracted, being beneficial, how- ever, rather than hurtful, but re- quiring, nevertheless, great care lest it become a source of danger. An unusual redness of one or both cheeks, sometimes changing from one to the other, is a frequent symp- tom of nervous disturbance. Erup- tions are apt to appear, usually on the cheeks, but sometimes on the head, or even over the whole body, and ulcerations of the tongue, gums, lips, or on the inside of the cheeks are not infrequent. Itching of the nose, twitching of the muscles, dila- tation of the pupils, uneasiness and fretfulness, restless sleep or wake- fulness, thirst and loss of appetite are evidences of increasing irrita- tion, which, if not relieved, will be followed by more active manifesta- tions. The child becomes cross, resentful, moans when asleep, cries persistently when awake ; or if quiet for an instant will be found chewing its thumb or fingers, which operation seems to afford a momen- tary cessation of angish—but only momentary. It throws down its toys as though in a passion, refuses to be amused, resents all effort to divert it, compresses its lips, corru- gates its brow, shows an intolerance of light, pulls at its hair or ears, slaps or scratches its nurse, refuses its food or vomits it as soon as swal- , lowed. Further manifestations of increased constitutional disturbance are likely to appear in persistent and copious diarrhoea, nausea, high fever and, not infrequently, con- vulsions. There is reason to be- lieve that earache is often associated with and dependent upon the diffi- cult cutting of one or more teeth and that, apart from the aggrava- tion of the fever and the increased liability to convulsions, incident to this added anguish, there is also the possibility of the loss of hearing (entailing in young children the loss of speech) from the congestion and inflammation which result. But this is not the only, indeed, not the chief danger : the inflammation is liable to extend to the membranes of the brain and may conceivably end in death. The usual indications in the mouth of the advancement of the teeth are increased heat, redness, swelling and hardness of the gum and, later, the peculiar whiteness caused by the pressure of the com- ing teeth. Sometimes the swelling takes the form of a little tumour, like a boil, on the edge of the gum ; in other cases an ulceration will form over the presenting tooth. In all such conditions the gums are very tender, so sensitive that the slightest touch will cause pain and the child, on attempting to take the breast, will jerk back its head—a manoeuvre which is fre- quently mistaken as an evidence of