The following facts respecting the deviations from the condition of health as seen in children, will be of great value in enabling the mother or nurse to detect the early evidences of disease, and so apply the necessary and appropriate treatment

General Appearance

A peculiar or unnatural attitude, flush or pallor of the face, white or livid color of the lips, unusual dryness of the skin or excessive or irregular perspiration,-as of the head and forehead only,-a disturbed or painful expression, moaning, starting, muscular twitching, grinding of the teeth, strong working of the nostrils, staring, etc., are all symptoms which should arouse suspicion of disease.


In children under two years of age, the pulse ranges from ninety to one hundred and thirty beats per minute. After two years, it is rarely more than a hundred, though it may be as low as seventy. Any great deviation from these limits indicates disease. A pulse as low as forty or fifty in a young child is a grave symptom; for instance, if a child seems feverish and sick, and has a pulse of one hundred and twenty, it is very likely due to some indiscretion in diet. If the same symptoms are present with a pulse of forty or fifty, it is very probable that the child is suffering tubercular meningitis, a very fatal malady.


The number of respirations in a child vary from thirty to fifty per minute. About forty is the usual average under two years. The respiration in children over two years of age should be about eighteen during sleep, and from twenty to twenty-five while awake. In children under one year of age, respiration is generally forty to fifty a minute.

Expression of Countenance

The upper portion of the face is affected chiefly in brain disease, which is indicated by a knitting of the brow, contracted forehead, and rolling, fixed, or staring eyes. In heart and lung affections, the middle portions of the face are affected, the symptoms being sharp, distended and working nostrils, a bluish circle around the mouth and dark rings under the eyes. The lower portion of the face exhibits symptoms relating to the bowels. The cheeks are changed in color, being either pale or flushed. They may be sunken or puckered, the mouth being drawn to one side. The lips are livid or pale, often giving the expression which the famous Sir W. Jenner describes as "a Voltaire-like look." Unnatural contraction or dilatation of the pupils is significant of nervous disorders.


The motions of a child are often very significant. In brain disease the child puts its hand to its head, pulls at its ear, rolls its head on the pillow, and beats the air.

In abdominal diseases, the legs are drawn up, the countenance is anxious, cheeks sunken, and the child picks at the bedclothes. When distressed for breath from diseases of the respiratory organs, the child tears its throat, or puts its hand in its mouth.