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A type of patient, very familiar to the physician interested in pædiatrics, is the well-known, sallow, neurotic anorexic child, the torment of herself, parents and the physician. She—for it is more frequently a she than a he—is as a rule dyspeptic, constipated, generally disordered in secretion and yet without demonstrable lesions.
What ails these children? If there happens to be a feverish exacerbation during the day, malaria is usually charged with their infirmities, but quinine aggravates their troubles instead of removing them. Gastric catarrh and the so-called bilious attacks are met with in a certain proportion of these cases but by no means in all; nor does the treatment of the gastric catarrh alone cure these children. General tonics, especially the feruginous, make matters worse, and the most careful physical examination fails to reveal anything except in a very few cases where moderate tenderness and enlargement of the liver may
HATFIELD MP. HEPATIC INCOMPETENCE IN CHILDREN. Read in the Section on Diseases of Children, at the Thirty-ninth Annual Meeting of the American Medical Association, May, 1888. JAMA. 1888;XI(26):906–908. doi:10.1001/jama.1888.02400770006001a
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