A text-book on hygiene and pediatrics from a chiropractic standpoint

by J. H. Craven

ANALYZING INFANTS

One of the most baffling situations the chiropractor meets is in caring for sick babies. There are several reasons for this: The baby can give no assistance in the way of subjective symptoms. It is difficult to nerve trace with any degree of satisfaction and assurance of accuracy; it is even very difficult to keep the child still for palpation. Therefore, it becomes necessary to rely largely upon the objective symptoms and the palpation, with what verification may be obtained from nerve tracing and the spinograph. However, there is no class of patients in which the results are so gratifying as with the babies and small children, for they respond to adjustments more readily than does the adult.

There is no time in the practice of the chiropractor when he needs to have better self-control than when he is taking care of infants. There is great need of every faculty that is employed in the analyzing and adjusting, especially if the child is seriously ill. Usually the parents are more or less excited and worried and are likely to keep urging the chiropractor to do something and thus unduly influence him unless he is accustomed to such cases. If the child is in pain and crying it is likely to get on the nerve of every one present and this will tend to make the chiropractor nervous. He must be careful that these things do not influence him to act too hastily before he has had time to make a careful analysis.

History of the Case

Great care must of necessity be exercised in taking the analysis of the baby and of the small child. A very careful history should be taken. This, of course, must be obtained from the parents or nurse. This history should include such points as whether birth was instrumental or natural, whether it was premature or full term, whether there were any peculiarities of respiration at birth, whether there have been any convulsions and what sickness, if any, the child has suffered with. Inquiry should be made relative to the condition of the bowels and kidneys, how the child sleeps, and if there is a tendency to cry out during sleep. If the child refuses to nurse or nurses with difficulty it may indicate an incoördination of the mouth or the throat.

Objective Symptoms

In view of the fact that the child can give no aid in the way of subjective symptoms, it is necessary for the chiropractor to make most careful observations and substitute, as far as possible, the objective symptoms for the subjective ones. About the first thing we see when we begin the analysis is the baby’s face. It may reveal valuable information. A very careful study should be made of the facial expression and the condition of the eyes. In the face we take into consideration the color. We should look for pallor, cyanosis and jaundice; we notice whether there is perspiration, whether the face is cold and clammy or warm and moist; also we observe the expression as to the muscular condition, since there may be muscular spasms which will produce grimace. This is either the result of pain some place in the body or an abnormal action of the facial muscles. There may be a pinched expression or a look of fear or anxiety. In some severe cases the face will be expressionless, while in others it may be that of an adult.

The condition of the eyes is important. They may have a dull expressionless look. The lids may droop and the eyeballs be sunken. In cerebral incoördinations there may be strabismus, or the eyeballs may be rolled upward and inward. These symptoms are significant and should all be very carefully noted, for, as has been stated, there will be no chance to profit by subjective symptoms.

After a careful observation of the face and facial expression has been made, the child should be undressed and placed in a convenient position for further observation. Before the clothing is removed the room must be heated to a proper temperature so the infant will not take cold or be exposed to an atmosphere that will be distressing. A temperature suitable for the bath will be satisfactory. The child should be placed on his back and every movement of the body observed. Such movements as the flexing of the thighs on the abdomen, as in abdominal pain, may lead the chiropractor to a conclusion on the zone involved.

The general appearance of the child must be carefully considered, whether the child is properly developed and whether or not there are any deformities. The chiropractor should look for dyspnea and other objective symptoms. A very careful inspection should be made of the spine to determine any malformations or marked curvatures. The character of the cry is sometimes important, as for instance in pneumonia or bronchitis there is a short, catchy cry; the cry of laryngitis and croup will be hoarse. In extreme prostration, as in many cases of malnutrition, the cry will be very feeble.