Identifier: practicaldiagno00hare (find matches)
Title: Practical diagnosis: the use of symptoms in the diagnosis of disease
Year: 1899 (1890s)
Authors: Hare, H. A. (Hobart Amory), 1862-1931
Subjects: Diagnosis
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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with goitre (not exophthalmic). (G. R. Murray.) The head of hydrocephalus is greatly enlarged above the level ofthe ears, and this causes the face, already having a tendency tofaulty development, to look small and wizened. The eyes seemsomewhat bulging, the orbital plates are oblique, and the back ofthe head is flattened. Sometimes in true hydrocephalus the fonta-nelle remains pulsating for a long period. Again, in true hydro- 52 THE MANIFESTATION OF DISEASE IN ORGANS. cephalus choked disk is sometimes manifested quite early. (SeeChvosteks and Trousseaus Signs.) In microcephalus, ou the otherhand, the head is small and often narrow. Technically, the termmicrocephalia is applied to idiots whose heads are less than seven-teen inches in circumference. Nearly always the head of an idiotis abnormally formed. The cretinoid head is large, heavy, andmassive. When a young child has unusually prominent parietal and frontalbones, which seem bulging, and there is a general resemblance in Fig. 12.
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Exophthalmic goitre. (Meltzer.) the shape of the skull to that of hydrocephalus, we suspect thepresence of rickets. As a rule, the forehead is broad and high, thetop of the head flat, and the shape of the head more round than inthe genuine disease. Sometimes in such a child we find, in addi-tion to these changes from the normal, spots of thinned bone in theoccipital and parietal regions. These may be also somewhat soft-ened, and this condition, called cranio-tabes, is usually a sign of THE FACE AND HEAD. 53 rickets which exists in association with infantile syphilis. Ricketsis seen nearly twice as often in boys as in girls, and there is usuallyto be found deficient development of the bones everywhere, particu-larly in the ribs and legs. The condition of the fontanelles in young children is of impor-tance in diagnosis. In the healthy child all the fontanelles savethe anterior fontanelle close during the early weeks of life, but thelatter opening does not close entirely till the infant

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