=Spasmodic Croup.=—Spasmodic croup is due to a sudden closure of the
glottis.
_Causes._—Exposure to a cold, damp atmosphere, indigestion, or
irritation of the throat. There may be some hoarseness a few hours
preceding the attack and the child awakens suddenly in the paroxysm of
the sharp croup cough, experiences difficulty in breathing and has the
cyanotic appearance so terrifying to the mother, but which need give no
cause for serious alarm.
_Treatment._—Apply hot compresses about the throat. If the attack is
severe give an emetic—one dram of salt or mustard in one-half cup of
warm water, and repeat in twenty minutes if necessary; an enema of warm
water should be given and steam inhalation resorted to. Keep the child
in an even temperature, restrict diet for a few days, and keep bowels
active.
=Parotitis (Mumps).=—An infectious disease characterized by
inflammation of the parotid glands. Incubation is from two to three
weeks.
_Symptoms._—The disease comes on with a mild chill, pain below the ear
and swelling of the glands. There is great discomfort and the tension
is very disagreeable.
_Treatment._—Keep patient in bed during the height of the disease. Give
liquid and soft diet. Bowels should be opened freely. No medicine is
required unless fever is high. Apply cold compresses to the affected
part, though, if preferred, hot ones may be used. A pad of cotton with
oiled silk is the best application. In cases of extreme redness or
tenderness of the glands, leeches may be applied. In cases of delirium
use the ice-cap. For orchitis, lubricate the parts with camphorated oil
and support with a soft cotton pad.
Duration of disease, from seven to ten days.
=Whooping-Cough.=—An infectious disease, beginning with catarrh of
the air-passages, like an ordinary cold. The short expiratory coughs
following each other in rapid succession and the period of drawing a
long breath give rise to the whoop characterizing pertussis.
_Incubation._—A week to ten days.
_Treatment._—Isolate patient and if attack is severe put him in bed.
Fresh air is the most essential element. If the cough is distressing,
ipecacuanha wine and paregoric may be given. During convalescence the
child should be watched carefully, as at this period bronchopneumonia
and tuberculosis are apt to develop. Change of air is advisable.
Tonics and cod-liver oil should be employed. The diet should be easily
digestible, nourishing food. After each paroxysm and after the child
has recovered from the exhaustion it produces give nourishment. There
will be a partial if not complete absorption of the food before another
attack. Duration of the disease from six to twelve weeks.
=Colic.=—_Causes._—Constipation, indigestible foods, flatus,
overfeeding, improper foods and exposure to cold.
_Symptoms._—Child cries out very suddenly and sharply. There is a
convulsive movement of the extremities, the hands are tightly closed,
abdomen is tense.
_Treatment._—Gentle pressure and massage with warm oil over the abdomen
and a few doses of hot or peppermint water will expel the gas. Burnt
brandy is good. The simple warm enema is a common remedy. Wrap warm
flannels around the lower parts of the body and keep the hands warm.
=Diarrhea.=—Frequent loose evacuations without tenesmus.
_Causes._—Impure water or food; irritating secretions poured into the
bowels; bottled milk.
Diet should be restricted to cereal and albumin water. Flush the bowels
very gently with warm water.
=Dysentery.=—_Symptoms._—Fever, tenesmus and frequent small mucous,
bloody stools. Treat as diarrhea. Keep child warm, especially about the
abdomen.
=Cholera Infantum (Summer Complaint).=—_Symptoms._—Fever, intense
thirst, continuous vomiting, and purging of the bowels. Stools
soon become watery and pale-green in color, and the child has all
appearances of complete prostration.
_Treatment._—Stomach washing and intestinal irrigation carefully given.
Restrict diet to barley water containing a few drops of brandy and give
hourly for a few days.
=Rickets.=—A disease of infants, characterized by impaired nutrition of
the entire body and alteration of growing bones.
_Causes._—Not positively known. Heredity may be a predisposing factor.
Another theory given is want of sunlight, impure air, prolonged
lactation, and suckling. As it is a constitutional disease it is almost
certain to be due to a disturbance of nutrition. _It is much less found
in the breast-fed than in the artificially fed and more common when the
artificial feeding is bad than when it is properly given._
=Scurvy= is a constitutional disease of metabolism _due to a faulty
diet_. Probably the absence of some constituents in the nature of
vitamins. _Scurvy and rickets are two distinct diseases_, and yet both
may be due to _impure, improper infant feedings_.
_Three General Symptoms of Great Importance._—First, a diffuse soreness
of the body, so that the child cries when an attempt is made to move
it; second, slight fever; third, profuse sweating. Deformities may
often be prevented if, in the early stages, constant care is taken that
the child is properly held.
=Thrush.=—_Aphthæ._—Small white, furry mouth ulcers developing during
the first and second year of infancy.
_Cause._—Lack of cleanliness in the care of the mouth, especially after
feeding with bottled milk. The patches are tenacious, grow larger,
until sometimes they involve the entire gastro-intestinal tract,
resulting in acute indigestion and bowel disorders.
The first symptom is usually some evidence of painful distress in the
infant’s efforts to nurse; fever, diarrhea and vomiting occur and the
trouble may become acute.
_Treatment._—Absolute sterile cleanliness in the preparation and
administering of the patient’s food. The mouth must be cleansed with
warm boric acid solution after every feeding. The patches should be
touched gently with the same solution, and the lips anointed with a
soothing lotion.
=Convulsions.=—The principal predisposing causes are infancy conditions
affecting the nutrition of the brain and hereditary influences. The
brain grows more during the first year than in later life, and this
rapidity of growth is in itself an important predisposing cause of
functional derangement. After infancy attacks of convulsions are much
less frequent, and after seven years they are relatively rare. Death
may take place from a single attack in very young infants, especially
those who are rachitic.
Convulsions may be thought to indicate the onset of some acute disease
when they occur in a child over two years old, and when they come on
suddenly or with only slight premonition in a child previously well;
but the most important point is that they are accompanied by a high
temperature—104°-106° F. Acute meningitis is the only other condition
likely to produce these symptoms. Whether the convulsions mark the
onset of lobar pneumonia, scarlet fever, malaria, or some other disease
can be determined only by carefully watching the patient’s symptoms for
24 or 36 hours.
In convulsions depending upon some disorder of the alimentary tract,
we may get a history of chronic constipation or improper feeding,
and in nursing infants, sometimes of passion or intoxication in the
wet-nurse. Convulsions are so frequently due to digestive derangement
that the condition of these organs should be one of the first things
to be looked into. Examination of the urine should never be omitted
in any case of convulsions of doubtful origin, even where no dropsy
is present. This, both in infants and older children, is too often
overlooked. In all cases of convulsions of doubtful or obscure origin
occurring in infants, rickets should be suspected as the underlying
cause, and the child carefully examined for other evidences of that
disease.
_Treatment._—Cold should be applied to the head, best by means of an
ice-cap or cold cloths, and dry heat and counterirritation to the
surface of the body and extremities.
_The Mustard Pack._—The child is stripped and laid upon a blanket,
and the trunk is surrounded by a large towel or sheet saturated with
mustard water. This is made as follows: 1 tablespoonful of mustard,
1 quart of water. In this the towel is dipped and, while dripping,
wound around the entire body. The patient should then be rolled in the
blanket. This pack may be continued for 10 or 15 minutes; at the end of
which time there will usually be a very decided redness of the whole
body. It may be repeated, according to indications. Where it is desired
to produce general counterirritation, the mustard pack is not quite
as efficient as the mustard bath, but it has the advantage in causing
much less disturbance to the patient. The mustard pack is useful in
the conditions of collapse, or of great prostration from any cause
whatever, in convulsions, and in cerebral or pulmonary congestion. The
degree to which the counterirritant of the skin should be carried will
depend upon the condition of the pulse and the cyanosis. The feet may
be placed in mustard water while the child lies in its crib (Holt).