Cardiospasm in Infancy and in Childhood

Abstract

NEW YORKCardiospasm in infancy and childhood is extremely rare. This is evidenced by the fact that in over 20,000 roentgen-ray studies of the gastro-intestinal tract made at Bellevue Hospital over a period of six years, the case reported in this paper represents the first one encountered in a child 11 years of age.A survey of the literature from 1879 to the present time reveals reports of only eleven authentic cases. CASES REPORTED IN THE LITERATURECase 1 (Gottstein1).\p=m-\A boy, aged 4 years, complained of dysphagia and vomiting even when small amounts of food were eaten. A sound met with resistance at the cardia. Esophagoscopy showed a normal but contracted cardia, so that the instrument could not be passed. Narcosis failed to relieve this spasm.Case 2 (Freund2).\p=m-\A boy, aged 2 years and 3 months, was breast fed until he was 4 months old; then he was weaned and bottle fed. A milk mixture was

Schick reactions in recently confined women and their new-born infants

“…Messeloff & Karsh (1932) have determined the antitoxin content of the blood serum in several such cases. They have found this type of reaction in persons having less than the usual 30 unit of antitoxin per c.c.…”

“…Cases have also been recorded of deaths from diphtheria among new-born infants with a negative Schick reaction. On the other hand, Messeloff & Karsh (1932) have in no instance found a child with a negative reaction to the Schick test with no antitoxin in the blood. Of the children with a negative Schick reaction 94 % had at least 3ij unit of antitoxin per c.c.…”

Cardiac achalasia in childhood

“…A repeat barium meal 4 weeks later showed a normal-sized oesophagus with no narrowing at the lower end. Achalasia in infancy Though cases of cardiac achalasia are on record in the newborn period (Birnberg, 1929;Segar & Stoeffler, 1930;Van der Bogart, 1933;Haas, 1941;Thomson, 1950) and in infancy (Hess, 1914;Bruce, 1927;Messeloff, Shulman & Buckstein, 1928), it was doubted whether this disease existed in infancy at all, particularly in view of marked symptomatic improvement with simple procedures like gastric intubation and administration of atropine. However, the report of a 6-month-old infant by Paul & Pallawela (1961), who had radiologic evidence of achalasia and who subsequently showed thickened muscle coats in the distal oesophagus, puts all such doubts aside.…”