The hypothesis of a vasomotor and trophic vagus-neurosis (Mumcsci d'Agata) has found very few supporters.
Pathological anatomical findings are commonly negative. The usual findings are only those of atelectasis in the new horn, or else the evidences of a more or less acute enteritis in older nurslings. The extreme dryness is striking as well as the hardness of the tissues, on section of the skin and underlying connective tissue. The adipose tissue is firm, dry, stearin-like and resembles a piece of raw congested fat (Luithlen); concerning the histological features refer ence is made to the illustration (Fig. 19).
The diagnosis is made from the board-like stiffness of the skin together with the markedly abnormal temperature of the body. The decrease in volume of the members, the lack of the shiny appearance of the skin as well as the failure to pit serve to differentiate this condition from sclercedema (also see section on scleroderma). Sclero derma, which usually comes in older and stronger children, differs from sclercedema in its sharp demarcation and limitation to island-like patches and also in its favorable course (Cruse, IL Neumann).
The prognosis is generally bad in the newborn; but somewhat better in older children.
The prophylaxis consists, as with sclercedema, in the avoidance of sudden and violent chilling, especially with debilitated and premature nurslings.
The treatment resembles that of sclercedema (q.v.) in many re spects. The most important and beneficial measure is a subcutaneous injection of salt solution [50-100 Gin. (:;iss—Ui) of a 3d 1000 sodium chloride solution]. This can be injected two or three times daily or 10 Gm. (5iiss) normal salt solution [sodium chloride 4 Gm. (.5i) sodium bicarb. 3 Gm. (gr. xlv) water to 1000 Gin. (1 quart)] three times a day, thoroughly sterilized and given at a temperature of 40°-42° C. (104°— 107.5° F.). High recta-1 injections of normal salt solution can be used in conjunction with the subcutaneous method.