A high thoracic continually sighing inspiration, the upper part of the thorax doing the work of breathing, and with a sighing or groaning sound, shows the commencement of HEART WEAKNESS, CARDIAC PARALYSIS OR FATTY DEGENERATION OF THE HEART, and will probably be followed by such symptoms as cyanosis, coldness of the extremities, &c.
Strongly marked diaphragmatic expiration accompanied by a fine, high whistling sound, points to BRONCHIAL ASTHMA. This sound, however, resembles that made in croup. If there is a pause between the end of expiration and the beginning of inspiration, croup may be excluded.
Sleepiness, lasting twenty-four to thirty-six hours, occurring without fever or other disturbance to account for it, is an initial symptom of MENINGITIS, though it might be caused by narcotics or uremia.
A prominent, firm fontanelle means increase in quantity of the contents of the cranium-exudation of some sort. It cannot be caused by fullness of the vessels alone if it is firm and resisting. We know that we have cerebral disease with DROPSY or exudation (Hydrocephalus).
When the fontanelle is deeply sunken, it points to loss of blood or other nutritive juices, as in cholera, &c.
A sharp, shrill cry, accompanied by an expression of fright or great anxiety, and occurring about an hour after the child has fallen asleep, is the only symptom of the “Alp”—night terrors, sudden awaking from bad dreams.
Periodical crying, lasting from five to ten minutes, should always make us think of spasm of the bladder or PAINFUL URINATIONS.
Violent crying at stool with fear of the act, and general avoidance of it, points to FISSURE OF THE ANUS, and is usually accompanied with constipation.
A violent cry full of pain and almost continuous, with the throwing about of the head on the pillow and grasping it with the hands, means OTITIS or EARACHE.
Weakness or immobility of the child, after a comparatively slight or short illness, points to SPINAL PARALYSIS.