Vol. 60, 1909 - University of North Carolina at Chapel Hill

ABSTRACT. 187
a general peritonitis, and was operated tinal method of entrance is much more rare
upon. Later she developed a purulent peri- than has been supposed, especially since
carditis, necessitating a second operation, milk has been sterilized habitually, and so
which was followed by death. The point much care taken to get it free from tubercle
of great interest in this case is the age of bacilli. It is much more important to conthe
patient. Xo history of tuberculosis in sider the pulmonary or naso-pharyngeal
this case was obtainable. entrance of germs. The principal factor is
always human contagion, often in the
Kyphosis witb Spinal Crest.—Marie
family. To preserve the infant he must be
Nageotle-W.lbouchewitch ( Arch de Med.
^ j^^^ ^„ contagion, separated from his
des hnf.) describes a form of kyphosis
tuberculous parents or relatives, placed in
which IS very rebellious to treatment It
^ s^^^toHum, if necessary, or in the counoccupies
the preferred location of kyphosis
Tuberculosis may be arrested at all
m the adult, the maximum curve oemg at
^^^ latent tuberculosis progresses favthe
sixth or seventh dorsal vertebra, and is
^.^^ly for the infant as soon as he is recharacterized
by prominence of the spinous
^^^.^^ ^^^^^ j^i^ surroundings to the free air
processes of three or four vertebrae, forming
^^^ « ^^^ j^^ i^,,^ ^f jl^^ country.
t>
.
an elongated crest at about the angle ot the
scapula. The vertebrs forming the crest Use and Abuse of Proprietary Foods
aregenerally the sixth, seventh, and eighth, m Inlant-Iccdinfl.-Cantley, in The Lon-
More rarelv the crest is lower down. The don Practitioner, savs that proprietary foods
mobility of the spine at this location is al- are not really necessary in ordinary circumways
less than normal. When the child stances. They are, however, often of very
lies on his stomach the crest does not en- great value, more especially the malted
tirely disappear, and on raising the legs do foodg^ provided that they are used with disnot
form a concavitv, as would be the case crimination as additions to the diet, and not
in the normal child. When pressure is as substitutes for cream or milk. Generally
made on the summit of the crest the neigh- speaking, in the first three months of life,
boring regions become incurved, that is the t^g only permissible proprietary foods are
cervical and dorsal regions become more those made from condensed milk, with or
curved. There is no true ankylosis, for vvithout the addition of cane-sugar, or of a
suspension restores the contour gradually, completely malted flour. These foods are
The crest is the key of an arch, and the also useful, under certain temporary conpoint
of departure of a more extended ditions, in the second three months of life.
kyphosis of the cervicodorsal region. This At this age. too, we can make use of the
kyphosis increases with age and appears completely malted carbohvdrate foods as
very early in .the life of the child, at from a„ addition to the milk mixtdre instead of
three to five years of age. It is believed by sugar; of the more or less malted foods, in
the author to result from a congenital mal- a similar manner, provided that they are
formation of the vertebrx, since the same given in small quantities and do not procondition
is seen in parents and children, duce flatulent distention of the intestines;
The treatment consists of suspension, re- and even of the foods consisting of unspiratory
gymnastics to develop the thorax changed starch, especially those which
and counterbalance the kyphosis, correct
attitude when working, and repose on the
undergo partial conversion in the process of
preparotion, and, at the same time, partially
back.
The Principal Ways ot Tuberculizapeptonize
the milk proteins. In the third
three months of life, mothers constantly
tion in the Young iniant.— Terrien (.Ami- clamor for the addition of some food to the
de .Med. et Chir. Inf.) discusses various milk mixture. Simple barley water, gradumetliods
of entrance of tubercle bacilli into ally thickened, is sufiicient, and will eduthe
organism of the young infant. The cate the child in the digestion of starch.
writer discards as almost negligible the Almost all of the meat preparations consist
theories of hereditary transmission of the of extractives of no nutritive value, perhaps
germs and of the predisposition to tubercu- stimulating to the digestive functions, poslosis.
Tracheobronchial adenopathies are sibly throwing an extra strain on the liver
almost constant in tuberculosis in the child,
and are a common location of early tuberand
kidneys. The high proportion of salts
and extractives is liable to cause thirst and
culosis, whether it be brought from the respiratory
organs or not. Still it cannot be
diarrhea. Diarrhea is especially apt to be
induced by peptone preparations. Some of
regarded as a positive sign of i)ulmonary the meat jellies, though not nutritious, have
entrance of the bacilli. The ways of entrance
of tuberculosis are multiple, includa
pleasant flavor and are comforting to a
feverish infant who refuses food. They are
ing the bronchial, naso-pharyngeal, and still more comforting to the anxious mother
intestinal mucous membranes. The intes- who fears that her child will ttarve and has