Excerpt from The Archives of Pediatrics, Vol. 5: A Monthly Journal Devoted to the Diseases of Infants and Young Children, January to December, 1888
As intellect and knowledge are required for finding those indications, so there is need of tact and experience to apply and fulfil them. Some of them are plain enough. It is clear that in conditions of great debility there must be no further reduction of strength; an irritated cerebrum must not be excited; hemorrhages, peritonitis, dysentery, perityphlitis require absolute rest; a hyper?sthetic stomach must not be overfed; a gastro-enteritis resulting from the presence of ferments must do without milk; convalescence and acute inflammatory fevers must be protected. Still, there are chronic fevers with fair digestion, which permit of generous feeding. All these indications and rules are equally valid for both the adult and the young. Still, the latter have some peculiarities which alter the application of general rules to a considerable extent, for several reasons. Of these I shall mention but a few in this connection. Habits, which play an all-important part in the nosology of adults, such as alcohol, narcotics, sexual abuses, are not observed - unless very exceptionally - in the child. Cardiac debility, which is the constant danger of the senile period, and a frequent one in the adult, is not so frequent in the very young, partly because the heart is larger and more powerful, compared with the rest of the body, and partly because it has not had so much time and opportunity to become diseased. On the other hand, general metamorphosis is very rapid in the young, because of both the rapidity of the vital processes, and the constant necessity of adding to the tissue of the body, besides keeping up the equilibrium. Therefore inanition is not tolerated for a long time. Thus the child cannot long remain without being fed, and, therefore, its digestive organs require permanent attention. Their physiology must be carefully studied in both the healthy and morbid conditions. What the child eats is of but little consequence compared with what it digests. Nor are its subjective sensations the proper guides for the selection of foods or the times of feeding. It is not always true that where there is no appetite there is no digestion. Nor are the pangs of hunger or the temptations of cravings safe counsellors.
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