Identifier: diseasesofchildr00grah (find matches)
Title: Diseases of children
Year: 1916 (1910s)
Authors: Graham, Edwin Eldon, b. 1864
Subjects: Children Disease
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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e place near the posterior angles of the ribs. Theribs in these cases johi the cartilage at an angle, instead of end to end,and there is partial or complete dislocation of the bony rib backward,so that frequently when posterior beading exists there is no beadingon the external surface of the chest.- The rachitic rosary can rarely be detected before the third month, 234 RICKETS and tends to diminish in size under proper treatment or when thedisease terminates spontaneonsly, so that there is scarcely a trace ofthese prominences after the fifth year, and they are not perceptiblein adults. Craniotabes, which is an early rachitic sign, is a softening of thecranial bones and the formation of thin spots from pressure withinthe skull as well as from external pressure. It is on the posteriorportion of the parietal bones and on the occipital bone that most ofthese thin areas are found, for this part of the skull is most frequentlysubjected to pressure when the child is lying down. They are most
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Fig. 27.—Rachitis. numerous about the lamboidal suture, seldom appearing on the frontalbones in the region of the coronary suture. They are sometimes aninch in diameter, and several may be found on the skull at one time.To detect them, light pressure should be made upon the skull ina direction away from the sutures. When an area is pressed upon,a parchment-like crackling sensation is transmitted to the fingers.Craniotabes rarely appears in infants who develop rickets after thesixth month, and it is much more marked in children who suffer fromboth congenital syphilis and rickets than in those who have congenitalsyphilis alone. DEFORMITIES 235 Racfiitic Deformities.—The head of a rachitic child appears to belarger than normal; but this is often due to the diminished size of thefacial bones, and to the disproportion between the head and the restof the body. In severe cases there may be an actual increase in thecircumference of the head which is due to abnormally thick cranialbones, t

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