(f) As a last resort tracheotomy and catheterization through the wound. Only required in most exceptional cases. Risks Attending Artificial Respiration.-Injuries, as apoplexies; Schultze's method may injure the spine; hemorrhagic effusions in the pleuræ and lungs; rupture of the air-vesicles in insufflation; trachea and larynx may be injured. Lung may be punctured if the clavicle is broken. DISEASES OF THE NEWBORN INFANT. 1. Atelectasis. I. Diseases of the Lungs. 1. Atelectasis. 2. Syphilis of the Lung. 3. Septic Infection. 5. Pneumonia. 6. Pulmonary Apoplexy. Cause. Not known. Sometimes obstruction to entrance of air, as by an enlarged thymus, clot of blood, curd of milk, etc. Diagnosis.-Usually not made. Dullness on percussion usually on one side. Respiration slightly accelerated and imperfect. Absence of fever. These signs present at birth. Pathological Anatomy.-One lung is found shriveled up, is not crepitant, and sinks when placed in water. Prognosis.-Not necessarily grave. Treatment. If the diagnosis is made, gentle sufflation of lung with catheter might be made. 2. Syphilis of the Lung.-The diagnosis can be made by a history of syphilis in the parents, by the signs of foetal syphilis together with the cyanosis and physical signs of pneumonia. The temperature is very low, necessitating the use of an incubator. Treatment is of no avail, the child usually dying within 24-36 hours. Pathological Anatomy.-An enormous overgrowth of connective tissue is found, compressing the blood vessels and diminish ing the capacity of the air-vesicles. As some air has entered the lung, a cut-off portion never sinks, but does not float buoyantly. The "white pneumonia" of syphilitic infants is rare. It is the result of proliferation, desquamation, and fatty degeneration of the epithelial cells in the lungs, giving the latter a white appearance, and distending them so that the thoracic cavity is well filled out and the lungs bear the imprint of the ribs. Respiration is impossible. 3. Septic Infection.-Rare since the introduction of antisepsis, Results from the inspiration of septic matter. 4. Tuberculosis.-Caused by mouth to mouth respiration by a tuberculous person. Very rare. 5. Pneumonia-Is caused by the inspiration of maternal discharges, resulting from intrauterine respiratory efforts when asphyxia is threatened. Pneumonia arising from this cause develops twenty-four hours after birth, in a child apparently healthy, temperature at this time beginning to rise and respirations growing more rapid. Cough, although a variable symptom, is often incessant. The child is restless, refuses nipple, is cyanotic, at times gasps for breath, and there may be dullness over one or both lungs. The diagnosis cannot always be made by the physical signs; only a small patch may be involved. There is usually a history of dystocia. When a newborn infant has a high temperature, septic infection or pneumonia should be suspected, and when in doubt treat as for the latter. Prognosis.-Grave. Recovery or death in a few days. Treatment.—§ to 1 gr. carbonate of ammonium in 3ss −3j mucilage of acacia every four hours. Tinct. digitalis, drop doses every two or four hours. Mustard bath once, twice, or thrice daily.* Cotton jacket. Mother's milk, from medicine dropper, every hour, and with this a few drops of brandy every two or three hours. Pathological Anatomy.-Shows the features of catarrhal pneu The bath is made as follows: Three large pitchersful of water 100 F., and a tablespoonful of mustard; allow the child to remain in the bath for five minutes, or until the temperature of the latter falls to 950, when the infant should be removed to a warmed blanket. |