The diseases of infants and children . frequently happens, however, that the stiffness of the neck is in-termittent, not being discovered at one examination although presentat another. Rigidity with anterior curving of the spine is common,and the children often lie on the side with the arms flexed stiffly anddrawn over the chest, the legs flexed, and the thighs drawn to the ab-domen;—^the so-called gun-hammer position. The muscles of theface may be tense and the risus sardonicus present (Fig. 113). Trismusmay occur, the abdomen is often scaphoid, and Kernigs sign—viz., theinability to extend t
The diseases of infants and children . frequently happens, however, that the stiffness of the neck is in-termittent, not being discovered at one examination although presentat another. Rigidity with anterior curving of the spine is common,and the children often lie on the side with the arms flexed stiffly anddrawn over the chest, the legs flexed, and the thighs drawn to the ab-domen;—^the so-called gun-hammer position. The muscles of theface may be tense and the risus sardonicus present (Fig. 113). Trismusmay occur, the abdomen is often scaphoid, and Kernigs sign—viz., theinability to extend the leg by passive movement when the thigh is atright angles with the trunk—is generally observed, as in all forms ofmeningitis. The tendon reflexes are uncharacteristic, being either normal,increased or absent. The mental symptoms are variable. Great restlessness is commonearly in the attack and may persist. The mind may be clear much ofthe time, but delirium is common and may be intense or even maniacal, CEREBROSPINAL FEVER 421. Fig. 111.—Opisthotonus in Cerebrospinal of 3 years in the Childrens Hospital of Philadelphia. See history with Fig. 117.
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