The medical diseases of children . -Scurvy : Hemorrhage causingClosure of L,eft Eye. ing degrees of organization. The mube infiltrated with blood. In verychronic cases the separated periosteummay go on forming bone, so that alayer of poorly developed bone isfound on the surface of the haemor-rhage (Fig. 22). The bone itself israrefied and the marrow highly vascu-lar. The changes due to rickets mayalso be present. Separation of theepiphysis or fracture near the epiphy-seal line of the bone may be blood shows a diminished al-kalinity. There may be a chloroticchange present unaccompanie
The medical diseases of children . -Scurvy : Hemorrhage causingClosure of L,eft Eye. ing degrees of organization. The mube infiltrated with blood. In verychronic cases the separated periosteummay go on forming bone, so that alayer of poorly developed bone isfound on the surface of the haemor-rhage (Fig. 22). The bone itself israrefied and the marrow highly vascu-lar. The changes due to rickets mayalso be present. Separation of theepiphysis or fracture near the epiphy-seal line of the bone may be blood shows a diminished al-kalinity. There may be a chloroticchange present unaccompanied by anydefinite leucocytosis. The anaemia isnot entirely due to liEemorrhage. Diagnosis.—There is seldom anydifficulty in recognizing scurvy if itspossibility be remembered. The ageof the child, the characteristic ten-derness, the condition of the gums,and the changes in the urine, as arule make the diagnosis clear. The pain in the limbs may suggest. 22.—Scurvy : Subperiosteal Hemor-rhage and New Bone Formation. INFANTILE SCURVY 79 rheumatism ; but this mistake should never be made, for rheu-matism does not occur at the scurvy age. The screaming some-times leads to a diagnosis of meningitis ; but this sign is by no meanssufficient to lead to such a conclusion. Infantile paralysis may showconsiderable hypera?sthesia, and the immobile tender limb of scurvymay be thought to be due to acute poliomyelitis : in the latter, how-ever, there is no swelling of the limb, while the other signs of scurvywill be absent. Two conditions are with much greater difficulty distinguished fromscurvy ; namely, syphilitic epiphysitis, and acute osteomyelitis. Inthe former of these, the limb is very tender and is kept unmoved as inscurvy ; but it occurs in younger children (practically always underthree months) showing signs of inherited syphilis, while the swellingof the limb is more localized to the epiphysis. To determine whetherthe swelling in the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
