In the new-born infant the color of the skin varies from a deep to a light shade of red. After the first week this redness fades away, leaving the surface yellowish-white. At times this yellow color is so marked that it might be mistaken for jaundice were it not that the whites of the eyes remain perfectly pearly, which is never the case in the disease mentioned. After the second week all discoloration disappears and the skin assumes its typical appearance.

With certain well-known natural variations in complexion the skin of a healthy child is beautifully white and transparent. The cheeks, palms of the hands and soles of the feet have a delicate pink color, while the general surface is rosy in a warm atmosphere and marbled with faint blue spots or lines in a cold one; this mottling is most marked on the extremities. As age advances the coloring becomes more pronounced, and until the completion of childhood the complexion is much fresher than in adult life.

Other characters of the healthy skin are a velvety smoothness and softness, a scarcely perceptible moisture, and a great degree of elasticity.

If an infant be stripped the large size of the head and trunk, and the relatively short arms and even shorter legs, will strike the observer at once. This disproportion, especially noticeable in the head, is an actual one. For if in a child of one year, for example, the distance from the lower edge of the chin to the top of the head be measured, it will be found to be equal to one-fourth of the entire length of the body. The vertical length of the head, too, falls but little short of that of the trunk, and the latter in turn is nearly as long as the legs.

Again, the abdomen is full and prominent, making the chest look, in comparison, rather contracted and narrow, and the navel is less deeply sunken than in adults.

These features, which will be referred to more minutely in a later section, are most marked in young infants, and undergo gradual alterations as growth progresses and the child develops into the lithe, active youth or maiden.

The shape of the head varies greatly between the round, bullet form and the elongated oval one. When it has been subjected to much pressure, instrumental or otherwise, during delivery, it is often so distorted as to shock the expectant mother. Little fear of permanent disfigurement need be entertained, however, as in time the deformed head usually assumes a natural shape. The same is true of less noticeable depressions, prominences and irregularities. But it should be remembered that restoration to symmetry must be left entirely to nature, as any attempt to press or mould the bones of the skull into shape rarely fails to injure the delicate brain beneath.

The anterior fontanelle, or, as it is called by nurses, "the opening of the head," is readily seen and felt in infants under a year old. In the normal state it is level with, or very slightly depressed below, the surrounding bones of the skull, and may be observed to pulsate, or rise and fall, rhythmically. It is soft to the touch and yields readily to pressure.

Examples of Variations in Disease. - Lividity of the eyelids and lips is a sign of imperfect oxidation of the blood, and points to disease of the heart or lungs. A decided yellow color of the skin and whites of the eyes is seen in jaundice; an earthy tinge of the face, in long-standing disease of the bowels; a waxy pallor in kidney disease, and paleness in any acute or chronic affection attended by exhaustion.

Marked squareness of the head with projection of the forehead, a widely-open fontanelle, and a relatively small face indicate rickets. A very large, globular head is characteristic of hydrocephalus or "water on the brain;" bulging of the fontanelle is also a symptom of this disease. In this connection it must be observed, however, that certain children, in every respect healthy, are born with relatively large globe-shaped heads. This peculiarity is especially apt to be observed when one of the parents - notably the father - has the same characteristic. In order to indicate disease, the deformity must be marked and combined with a widely open, bulging fontanelle, or with indications of impaired brain activity. Depression of the fontanelle shows general debility and the need of food or stimulants.

Fig. 1. - Diagram Showing Shape of Heads. a, Normal head; b, Hydrocephalic head; c. Rickety head.

The accompanying diagram (Fig. 1) will aid in explaining this subject.

Great distention of the abdomen is usually due to an accumulation of gas in the intestines, and indicates disease of this portion of the digestive tract; marked depression, on the other hand, is encountered in serious brain affections, in cholera infantum, inflammation of the intestines and dysentery.