Common Disorders And Diseases of Childhood

Cover Common Disorders And Diseases of Childhood
Common Disorders And Diseases of Childhood
George Frederic Still
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Was seen by me at the age of ten months, when he had a loud systolic bruit with a marked systolic thrill over the inner end of the left second costal cartilage. I particularly noted that he had no cyanosis and no clubbing of fingers. I saw him again at the age of 7 2 years, when the bruit had become so small that it was only heard on careful auscultation, but the cyanosis had become so marked that his face was a livid leaden colour and his lips a deep blue and his fingers had become clubbed to ...an extreme degree.
In some cases where there is no cyanosis while the child is quiet, a little exertion such as running about or crying makes the lips distinctly blue; in others without any definite cyanosis 506 COMMON DISORDERS OF CHILDHOOD the fingers and toes are always slightly bluish, more rarely a bright scarlet, as I saw in one child with an abnormally large pulmonary artery and patency of the foramen ovale at six years.
In the most severe cyanosis the conjunctivas are congested, and the tongue, as well as the lips, is a livid leaden colour ; in such cases the venous congestion is very conspicuous in the fundus oculi on ophthalmoscopic examination, where the veins are not only extremely full and dark but also show a remarkable tortuosity.


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