The diseases of children / by James Frederic Goodhart.

  • Goodhart, James Frederic, Sir, 1845-1916.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of children / by James Frederic Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    532/792 (page 516)
    HjEmorrhage into the cord (hsemato-myelia) appeai-s sometimes to occur, and a diagnosis might indeed be exceedingly difficult in some cases. It might be ex- pected to be less localised in its effects, and thus rather to produce the symptoms of central softening, with its ansesthesia, its tendency to bed-sores, paralysis of sphincters, and exaggerated reflexes. Late cases may also be confounded with the atrophic stage of pseudo hypertrophic paralysis, or progres- sive muscular atrophy. The latter, however, is rare. In late cases of infantile paralysis the atrophied muscles may be replaced by fat, and pseudo-hyper- trophic paralysis is followed by extreme wasting of the muscles. The history must, in these cases, be relied upon. The slow progress of the pseudo-hyper- trophy, the characteristic walk, and slow atrophy with long-retained electrical reactions, must serve in most cases to distinguish them. Before quitting this part of the subject, and as I have already alluded to the occasional occurrence in adults of a similar affection, and now again to the occasional appearance of progressive muscular atrophj'- in children, it seems worth while, from a diagnostic point of view, to draw attention to the interesting conti-ast that exists between infancy and adult age as regards the diseases of the spinal cord to which the two epochs are liable. Acute spinal paralysis is common in children, it is most rare in adults; chronic spinal paralysis is com- mon in adults, and very rare in childhood. Looking a little further into the matter, we can see that this is just what might be expected. Children are subject to sudden and violent febrile attacks, and their tissues are constantly in a state of change and development. Adults are far less liable to the exciting cause, and their tissues have reached such a condition of stability that they do not take offence so readily, but when they are disturbed they recover more tardily. On the other hand, the conditions which lead to chronic