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

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ABSTRACT. 187<br />

a general peritonitis, and was oper<strong>at</strong>ed tinal method <strong>of</strong> entrance is much more rare<br />

upon. L<strong>at</strong>er she developed a purulent peri- than has been supposed, especially since<br />

carditis, necessit<strong>at</strong>ing a second oper<strong>at</strong>ion, milk has been sterilized habitually, and so<br />

which was followed by de<strong>at</strong>h. The point much care taken to get it free from tubercle<br />

<strong>of</strong> gre<strong>at</strong> interest in this case is the age <strong>of</strong> bacilli. It is much more important to conthe<br />

p<strong>at</strong>ient. Xo history <strong>of</strong> tuberculosis in sider the pulmonary or naso-pharyngeal<br />

this case was obtainable. entrance <strong>of</strong> germs. The principal factor is<br />

always human contagion, <strong>of</strong>ten in the<br />

Kyphosis witb Spinal Crest.—Marie<br />

family. To preserve the infant he must be<br />

Nageotle-W.lbouchewitch ( Arch de Med.<br />

^ j^^^ ^„ contagion, separ<strong>at</strong>ed from his<br />

des hnf.) describes a form <strong>of</strong> kyphosis<br />

tuberculous parents or rel<strong>at</strong>ives, placed in<br />

which IS very rebellious to tre<strong>at</strong>ment It<br />

^ s^^^toHum, if necessary, or in the counoccupies<br />

the preferred loc<strong>at</strong>ion <strong>of</strong> kyphosis<br />

Tuberculosis may be arrested <strong>at</strong> all<br />

m the adult, the maximum curve oemg <strong>at</strong><br />

^^^ l<strong>at</strong>ent tuberculosis progresses favthe<br />

sixth or seventh dorsal vertebra, and is<br />

^.^^ly for the infant as soon as he is recharacterized<br />

by prominence <strong>of</strong> the spinous<br />

^^^.^^ ^^^^^ j^i^ surroundings to the free air<br />

processes <strong>of</strong> three or four vertebrae, forming<br />

^^^ « ^^^ j^^ i^,,^ ^f jl^^ country.<br />

t><br />

.<br />

an elong<strong>at</strong>ed crest <strong>at</strong> about the angle ot the<br />

scapula. The vertebrs forming the crest Use and Abuse <strong>of</strong> Proprietary Foods<br />

aregenerally the sixth, seventh, and eighth, m Inlant-Iccdinfl.-Cantley, in The Lon-<br />

More rarelv the crest is lower down. The don Practitioner, savs th<strong>at</strong> proprietary foods<br />

mobility <strong>of</strong> the spine <strong>at</strong> this loc<strong>at</strong>ion is al- are not really necessary in ordinary circumways<br />

less than normal. When the child stances. They are, however, <strong>of</strong>ten <strong>of</strong> very<br />

lies on his stomach the crest does not en- gre<strong>at</strong> value, more especially the malted<br />

tirely disappear, and on raising the legs do foodg^ provided th<strong>at</strong> they are used with disnot<br />

form a concavitv, as would be the case crimin<strong>at</strong>ion as additions to the diet, and not<br />

in the normal child. When pressure is as substitutes for cream or milk. Generally<br />

made on the summit <strong>of</strong> the crest the neigh- speaking, in the first three months <strong>of</strong> life,<br />

boring regions become incurved, th<strong>at</strong> is the t^g only permissible proprietary foods are<br />

cervical and dorsal regions become more those made from condensed milk, with or<br />

curved. There is no true ankylosis, for vvithout the addition <strong>of</strong> cane-sugar, or <strong>of</strong> a<br />

suspension restores the contour gradually, completely malted flour. These foods are<br />

The crest is the key <strong>of</strong> an arch, and the also useful, under certain temporary conpoint<br />

<strong>of</strong> departure <strong>of</strong> a more extended ditions, in the second three months <strong>of</strong> life.<br />

kyphosis <strong>of</strong> the cervicodorsal region. This At this age. too, we can make use <strong>of</strong> the<br />

kyphosis increases with age and appears completely malted carbohvdr<strong>at</strong>e foods as<br />

very early in .the life <strong>of</strong> the child, <strong>at</strong> from a„ addition to the milk mixtdre instead <strong>of</strong><br />

three to five years <strong>of</strong> age. It is believed by sugar; <strong>of</strong> the more or less malted foods, in<br />

the author to result from a congenital mal- a similar manner, provided th<strong>at</strong> they are<br />

form<strong>at</strong>ion <strong>of</strong> the vertebrx, since the same given in small quantities and do not procondition<br />

is seen in parents and children, duce fl<strong>at</strong>ulent distention <strong>of</strong> the intestines;<br />

The tre<strong>at</strong>ment consists <strong>of</strong> suspension, re- and even <strong>of</strong> the foods consisting <strong>of</strong> unspir<strong>at</strong>ory<br />

gymnastics to develop the thorax changed starch, especially those which<br />

and counterbalance the kyphosis, correct<br />

<strong>at</strong>titude when working, and repose on the<br />

undergo partial conversion in the process <strong>of</strong><br />

preparotion, and, <strong>at</strong> the same time, partially<br />

back.<br />

The Principal Ways ot Tuberculizapeptonize<br />

the milk proteins. In the third<br />

three months <strong>of</strong> life, mothers constantly<br />

tion in the Young iniant.— Terrien (.Ami- clamor for the addition <strong>of</strong> some food to the<br />

de .Med. et Chir. Inf.) discusses various milk mixture. Simple barley w<strong>at</strong>er, gradumetliods<br />

<strong>of</strong> entrance <strong>of</strong> tubercle bacilli into ally thickened, is sufiicient, and will eduthe<br />

organism <strong>of</strong> the young infant. The c<strong>at</strong>e the child in the digestion <strong>of</strong> starch.<br />

writer discards as almost negligible the Almost all <strong>of</strong> the me<strong>at</strong> prepar<strong>at</strong>ions consist<br />

theories <strong>of</strong> hereditary transmission <strong>of</strong> the <strong>of</strong> extractives <strong>of</strong> no nutritive value, perhaps<br />

germs and <strong>of</strong> the predisposition to tubercu- stimul<strong>at</strong>ing to the digestive functions, poslosis.<br />

Tracheobronchial adenop<strong>at</strong>hies are sibly throwing an extra strain on the liver<br />

almost constant in tuberculosis in the child,<br />

and are a common loc<strong>at</strong>ion <strong>of</strong> early tuberand<br />

kidneys. The high proportion <strong>of</strong> salts<br />

and extractives is liable to cause thirst and<br />

culosis, whether it be brought from the respir<strong>at</strong>ory<br />

organs or not. Still it cannot be<br />

diarrhea. Diarrhea is especially apt to be<br />

induced by peptone prepar<strong>at</strong>ions. Some <strong>of</strong><br />

regarded as a positive sign <strong>of</strong> i)ulmonary the me<strong>at</strong> jellies, though not nutritious, have<br />

entrance <strong>of</strong> the bacilli. The ways <strong>of</strong> entrance<br />

<strong>of</strong> tuberculosis are multiple, includa<br />

pleasant flavor and are comforting to a<br />

feverish infant who refuses food. They are<br />

ing the bronchial, naso-pharyngeal, and still more comforting to the anxious mother<br />

intestinal mucous membranes. The intes- who fears th<strong>at</strong> her child will ttarve and has

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