A treatise on the diseases of infancy and childhood . iration, and causes unusual prominence of the the expressions pigeon-breasted, resemblance to the prowof a ship, etc., applied to this deformity. The presence of the heartrenders the groove more shallow on the left side, at the fourth and fifthribs, than on the opposite side, since this organ affords partial supportto the chest-wall. On the other hand, the right groove is not as longas the left, as the lower ribs on this side are partially supported by theliver. On both sides, however, the lower part of the thorax, that belowt
A treatise on the diseases of infancy and childhood . iration, and causes unusual prominence of the the expressions pigeon-breasted, resemblance to the prowof a ship, etc., applied to this deformity. The presence of the heartrenders the groove more shallow on the left side, at the fourth and fifthribs, than on the opposite side, since this organ affords partial supportto the chest-wall. On the other hand, the right groove is not as longas the left, as the lower ribs on this side are partially supported by theliver. On both sides, however, the lower part of the thorax, that belowthe seventh, eighth, or ninth ribs, widens, being pressed outward andsupported by the abdominal viscera. There is, therefore, in additionto the longitudinal groove, an antero-posterior depression, sometimesalso spoken of as a furrow or groove, on either side, lying between thesixth and ninth ribs. The ribs with their attached muscles are important agents in respira-tion, but the soft and yielding nature of the ribs, in the rachitic, retards, Fro. Deformity of chest in rachitis. and to a great extent prevents, the lateral expansion of the thorax whichis necessary for normal and full inspiration. The action of the respira-tory muscles, and the pressure from within of the air descending alongthe air passages, is not sufficient to overcome fully the external atmos-pheric pressure, in the absence of proper resiliency of the ribs. Con-sequently, with each inspiration, we observe more or less sinking in ofthe thorax on either side, just as when a moderate obstruction to theentrance of air exists in the larynx or trachea. As the ribs become 124 KACHITIS firmer from the deposit of lime-salts, respiration is more regular andnormal. Changes in Bones of Ujyper Extremity.—Although swelling of thelower end of the radius (see Fig. 9) is one of the earliest signs ofrachitis, the bones of the upper extremities are less frequently curvedand distorted than those of the lower extremities. Th
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Keywords: ., bookcentury1800, bookdecade1880, bookidtreat, booksubjectchildren
