The Cry

In pneumonia, or capillary bronchitis, the child's cry is labored and half suffocated, sounding as though coming from an adjacent room. In croup, it is hoarse, with crowing respiration. In disease of the brain, especially water on the prain, or hydrocephalus, it is sharp, shrill, and solitary, while in marasmus, or wasting disease of the bowels, it is moaning and wailing. Long continued crying, from which the child cannot be diverted, is due to either earache or hunger. A peevish cry, attended by a slight, dry cough, is indicative of inflammation of the lungs. A very loud, shrill cry produced by coughing or suddenly moving the child, is usually due to pleurisy.

A cry accompanied by writhing and wriggling when the bowels move, is due to intestinal disease. Moaning is particularly characteristic of disease of the stomach and bowels.

As a general rule, children shed no tears before they are three or four months old. Some authors consider that in children under seven years of age the shedding of tears is a favorable symptom, while the absence of tears is very unfavorable.

Posture

When the child cannot breathe lying down, and shows a great desire to sit up, or to be held in an upright position, disease of the respiratory organs is indicated. If the child lies on the side, with the legs strongly drawn up, with the arms close to or on the chest, some serious brain affection is indicated.

The Eye

Squinting occurring suddenly in acute disease, is a serious symptom, indicating irritation of the nervous system. It may occur in connection with convulsions, and is likely to remain after the child has recovered from the fit When a child suffering from tubercular meningitis becomes cross-eyed, it will probably die. A very small pupil indicates congestion of the brain. Large pupils which do not respond to light, indicate some disease of the nervous system. Inequality of pupils, that is, one contracted and the other dilated, when occurring in connection with acute disease, is a very serious symptom. Inequality of pupils is sometimes produced by the irritation of worms in the intestines.

The Tongue

A furred tongue covered with small particles of whitish curd, indicates dyspepsia and intestinal irritation. A white fur usually indicates fever, and yellow fur, chronic derangement of the stomach and liver. Brown fur is present in typhoid fever, or the typhoid condition. A red and dry tongue indicates inflammation of the mouth, stomach, and bowels. A strawberry tongue, when accompanied by fever and an eruption, indicates scarlatina. A glassy tongue is an indication of dyspepsia. The tongue of a young infant can be seen when it is crying, or, if it can not, it can be made to protrude the tongue by placing the finger on the lip.

Development

The child should grow from six to seven inches the first year. From the fourth to the sixteenth year, about two inches should be annually added to the height. From the sixteenth to the seventeenth year, the average growth is one and a half inches. In the next three years, the usual addition to the height is about one inch each year. Retarded growth is indicative of disease of the bones, rickets, or scrofula. Most of the diseases of youth and childhood accelerate the growth, which gives rise to the idea that too rapid growing produces disease, which is exactly the opposite of the truth; the disease being the cause of too rapid growth.

The child should be able to run alone at the end of twelve months. When it begins to walk, attention should be given to the manner in which it uses its limbs. If it walks simply on the toe of one foot with a limping gait, and complains of pain in the knee whenever the limb is handled, it may be suspected that hip disease is beginning. The child does not usually raise its head till it is six or eight weeks old, and cannot sit upright until four or five months of age.

Careful attention should be given to the teeth. The first incisors, or front teeth, should appear by the seventh month; the first back teeth by the twelfth month; the eye teeth and stomach teeth at the end of a year and a half, and the second back teeth, or molars, at twenty months.

Attention should also be given to the gums, to ascertain whether they are hot, swollen or tense, indicating the approaching eruption of the teeth.