Enteral Disorders of Childhood

Hogarth, J. C (1940) Enteral Disorders of Childhood. PhD thesis, University of Glasgow.

Abstract

The main object of the thesis is to clear up the uncertainty of classification of the various forms of enteritis of childhood which, of course, is a reflection of the great difficulty in diagnosis. However, while the subjects of classification and diagnosis were being investigated many other points of interest emerged which were followed up to a certain extent and some conclusions drawn. A short historical review from the time of Hippocrates to the nineteenth century is given. This is designed to show how certain basic facts such as the relationship between diarrhoea and teething, hot weather, artificial feeding and overcrowding came to be recognised. There then follows a discussion of the various classifications based upon clinical, pathological, bacteriological and biochemical findings and which have not proved to be very satisfactory. General etiological factors of enteritis of childhood then come under discussion with special emphasis upon the value of progressive public health legislation in causing a reduction in the death rate from enteritis as a whole. The suggestion is then made that one of the reasons for the difficulty in classification lies in the fact that the clinical basis which forms the foundation of every investigation is at fault. This, it is suggested, might he due to the true state of affairs being lost in a maze of biochemistry and bacteriology. CHAPTER I, deals with the non-infective forms of enteritis and shows that this group is not of great importance. The dyspeptic form of enteritis is shown to he easily treated. The mechanical form may include certain serious conditions such as hypertrophic pyloric stenosis and intussusception hut is rare. The symtomatic form is discussed at length and it is suggested that swallowed sputum and excretion of toxin through the intestinal wall might well he the two most likely causes. The association of enteritis with otitis media is noted and discussed fully. The conclusion is reached that undue importance has been attached to the symptomatic form of enteritis. An analysis of 492 cases of measles is used to support this view. CHAPTER II discusses the subject of infective enteritis of known etiology hut is confused mainly to Sonne dysentery. Seasonal incidence, incubation period, mode of spread, clinical features and complications are touched upon and finally the subject of diagnosis. Here I try to show that the only reliable method of diagnosis is by serum agglutination and figures are produced in support of this. This leads up to a discussion on the best routine method of dealing with a ward outbreak of some dysentery and the finding of mild cases and carriers. Treatment and pathology are also mentioned. Infective enteritis of uncertain etiology is then discussed and the division into two types- (1) Acute Toxic Enteritis and (2) Acute Choleraic Enteritis upon clinical and pathological grounds justified. Both types are fully discussed and theories advanced as to their etiology. It is suggested that the acute toxic type is a virus infection and that the choleraic form is of bacterial origin. Seasonal incidence, clinical picture, complications, pathology, diagnosis and treatment are dealt with fully. The question of the value of the various forms of treatment is gone into and personal experience of certain of these noted. CHAPTER III includes the unclassifiable forms of enteritis. These are probably mild forms of the dysentery group and of the dyspeptic group. CHAPTER IV deals with the routine investigation of cases of enteritis and makes certain suggestions which are in the main that serological examination must be carried out, clinical examina-tion must include examination of ears and urine together with a most thorough investigation of the respiratory tract. CHAPTER V describes briefly the enteritis unit at the Eastern Hospital in which the work recorded was carried out.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Medicine, Epidemiology
• Date of Award: 1940
• Depositing User: Enlighten Team
• Unique ID: glathesis:1940-79499
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 05 Mar 2020 09:02
• Last Modified: 05 Mar 2020 09:02
• URI: https://theses.gla.ac.uk/id/eprint/79499