TETANUS IN INFANTS
This is a condition which is occasionally found in young infants and is the result of an infection usually of the umbilical wound. It is most prevalent where conditions are unsanitary. Tetanus is characterized by a tonic spasm of the muscles. It may affect all the muscles of the body or it may be limited to the muscles of the jaw, producing what is known as trismus or lockjaw.
Symptoms
The first symptom to appear may be the spasm in the masseter muscle which interferes with nursing the child. The muscle of the face and jaws appear firm and hot and the lips slightly protrude. Intervals will occur when the muscles will be completely relaxed. At first these paroxysms appear at intervals, between which the relaxation is complete; but later they become more frequent and the relaxations less marked until there is more or less of a continuous rigidity. This contraction grows more exaggerated until the entire body becomes rigid. The jaws become set and may be separated only slightly, if at all. There is a peculiar characteristic facial expression due to the contraction of the facial muscles. Swallowing becomes very difficult. There is a weak, rapid pulse. In the mild cases there is only a slight temperature, but in the more severe cases the temperature may become extremely high. The cry becomes weak and whining. The incoördination is of short duration. The child soon dies from exhaustion or from suffocation due to the rigidity of the respiratory muscles or it may be due to a spasm of the larynx. While tetanus is not a very common incoördination, the mortality is very high. Authorities place the fatality as high as 90% and even 95%.
Equation and Family
The equation is excretion minus (E-). The family is poison and contractures.
Major Adjustment
If these cases are adjusted at an early stage excellent results will be obtained. There is a combination major at At.P., C.P., and K.P.
PEMPHIGUS NEONATORUM
This is a rather unusual condition seldom found in general practice. It usually occurs as epidemics in institutions where large numbers of children are cared for. Outside of such institutions it is more common among children in unhygienic surroundings. It is characterized by an eruption of blebs containing a serous fluid.