The diseases of infants and children . fontanelle in rickets is larger than normal, and its time of closing 592 . THE DISEASES OF CHILDREN is delayed, occurring sometimes not until after the 2d 3^ear. In severecases the posterior fontanelle and the sutures remain open until the end ofthe 1st year. In the posterior portion of the skull thin, soft membranousspots are often found in the 1st year (craniotabes, Vol. II, p. 428). Theveins of the scalp are distended, especiallj^ over the temporal regions. Thehair is quite commonly worn away from the back of the head by the frequentrocking movements.
The diseases of infants and children . fontanelle in rickets is larger than normal, and its time of closing 592 . THE DISEASES OF CHILDREN is delayed, occurring sometimes not until after the 2d 3^ear. In severecases the posterior fontanelle and the sutures remain open until the end ofthe 1st year. In the posterior portion of the skull thin, soft membranousspots are often found in the 1st year (craniotabes, Vol. II, p. 428). Theveins of the scalp are distended, especiallj^ over the temporal regions. Thehair is quite commonly worn away from the back of the head by the frequentrocking movements. The face seems small, the upper jaw being nar-rower than normal and the lower somewhat square. These variousdeformities usually disappear as recovery takes place, but the relative in-crease in size may persist in severe cases to some extent throughout teeth usually appear late and out of the normal order, not infre-quently none having erupted during the 1st year. They often decayearly, and have a tendency to exhibit Fig. 202.—Moderate Rachitic Alteration of the the prominent frontal bosses, in a patient, aged 9 months, in the ChildrensHospital of Philadelphia. Thorax.—Beading of the ribs at the costochondral articulations is themost frequent and the earliest osseous symptom. It is quite visible to theeye unless the infant is well covered with fat. Morse ^ found it in all of318 cases of rickets, and the only symptom in 41 per cent, of these. Inall well-marked cases there is in addition a depression of the cartilagesanterior to the epiphyseal enlargements. A flattening or even a concavityof the sides of the thorax in a vertical direction develops, extending back-ward] to the posterior axillarj^ line and downward about as far as the 7thrib. As a result of this alteration the sternum is unusually prominent,producing a condition suggesting pigeon breast, but usually differingsomewhat from the typical instances of this seen in certain other condi-tio
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Keywords: ., bookcentury1900, bookdecade1910, booksubject, booksubjectchildren
