bed. Let the chamber be well ventilated. If it be winter time, a small
fire in the grate will encourage ventilation. If it be summer, a fire is
out of the question; indeed, in such a case, the window-sash ought to be
opened, as thorough ventilation is an important requisite of cure, both
in small-pox and in _modified_ small-pox. While the eruption is out, do
not on any account give aperient medicine. In ten days from the
commencement of the illness a mild aperient may be given. The best
medicine in these cases is, the sweetened acidulated infusion of roses
(See question 209), which ought to be given from the commencement of the
disease, and should be continued until the fever be abated. For the
first few days, as long as the fever lasts, the patient ought not to be
allowed either meat or broth, but should be kept on a low diet, such as
on gruel, arrow-root, milk-puddings, etc. As soon as the fever is abated
he ought gradually to resume his usual diet. When he is convalescent, it
is well, where practicable, that he should have change of air for a
month.
227. _How would you distinguish between Modified Small-pox and
Chicken-pox?_
Modified small-pox may readily be distinguished from chicken-pox, by the
former disease being, notwithstanding its modification, much more severe
and the fever much more intense _before_ the eruption shows itself than
chicken-pox; indeed, in chicken-pox there is little or no fever, either
before or after the eruption; by the former disease, the modified
small-pox, consisting _partly_ of pustules (containing matter), each
pustule having a depression in the centre, and the favorite localities
of the pustules being the wrists and the inside of the nostrils: while,
in the chicken-pox, the eruption consists of vesicles (containing
water), and _not_ pustules (containing matter), and the vesicles having
neither a depression in the centre, nor having any particular partiality
to attack either the wrists or the wings of the nose. In modified
small-pox each pustule is, as in unprotected small-pox, inflamed at the
base; while in chicken-pox there is only very slight redness around each
vesicle. The vesicles, too, in chicken-pox are small—much smaller than
the pustules are in modified small-pox.
228. _Is hooping-cough an inflammatory disease?_
Hooping-cough in itself is not inflammatory, it is purely spasmodic; but
it is generally accompanied with more or less of bronchitis—inflammation
of the mucous membrane of the bronchial tubes—on which account it is
necessary, _in all cases_ of hooping-cough, to consult a medical man,
that he may watch the progress of the disease and nip inflammation in
the bud.
229. _Will you have the goodness to give the symptoms, and a brief
history, of Hooping-cough?_
Hooping-cough is emphatically a disease of the young; it is rare for
adults to have it; if they do, they usually suffer more severely than
children. A child seldom has it but once in his life. It is highly
contagious, and therefore frequently runs through a whole family of
children, giving much annoyance, anxiety, and trouble to the mother and
the nurses; hence hooping-cough is much dreaded by them. It is amenable
to treatment. Spring and summer are the best seasons of the year for the
disease to occur. This complaint usually lasts from six to twelve
weeks—sometimes for a much longer period, more especially if proper
means are not employed to relieve it.
Hooping-cough commences as a common cold and cough. The cough, for ten
days or a fortnight, increases in intensity; at about which time it puts
on the characteristic “hoop.” The attack of cough comes on in paroxysms.
In a paroxysm the child coughs so long and so violently, and _expires_
so much air from the lungs without _inspiring_ any, that at times he
appears nearly suffocated and exhausted; the veins of his neck swell;
his face is nearly purple; his eyes, with the tremendous exertion, seem
almost to start from their sockets; at length there is a sudden
_inspiration_ of air through the contracted chink of the upper part of
the windpipe—the glottis—causing the peculiar “hoop;” and, after a
little more coughing, he brings up some glairy mucus from the chest; and
sometimes, by vomiting, food from the stomach; he is at once relieved
until the next paroxysm occurs, when the same process is repeated, the
child during the intervals, in a favorable case, appearing quite well,
and after the cough is over, instantly returning either to his play or
to his food. Generally, after a paroxysm he is hungry, unless, indeed,
there be severe inflammation either of the chest or of the lungs.
Sickness, as I before remarked, frequently accompanies hooping-cough;
when it does, it might be looked upon as a good sign. The child usually
knows when an attack is coming on; he dreads it, and therefore tries to
prevent it; he sometimes partially succeeds; but if he does, it only
makes the attack, when it does come, more severe. All causes of
irritation and excitement ought, as much as possible, to be avoided, as
passion is apt to bring on a severe paroxysm.
A new-born babe, an infant of one or two months old, commonly escapes
the infection; but if at that tender age he unfortunately catch
hooping-cough, it is likely to fare harder with him than if he were
older—the younger the child the greater the risk. But still, in such a
case, do not despair, as I have known numerous instances of new-born
infants, with judicious care, recover perfectly from the attack, and
thrive after it as though nothing of the kind had ever happened.
A new-born babe laboring under hooping-cough is liable to convulsions,
which is, in this disease, one, indeed the great, source of danger. A
child, too, who is teething, and laboring under the disease, is also
liable to convulsions. When the patient is convalescing, care ought to
be taken that he does not catch cold, or the “hoop” might return.
Hooping-cough may either precede, attend, or follow an attack of
measles.
230. _What is the treatment of Hooping-cough?_
We will divide the hooping-cough into three stages, and treat each stage
separately.
_What to do._—_In the first stage_, the commencement of hooping-cough:
For the first ten days give the ipecacuanha wine mixture, a teaspoonful
three times a day. (For the prescription of the ipecacuanha wine
mixture, see question 202.) If the child be not weaned, keep him
entirely to the breast; if he be weaned, to a milk and farinaceous diet.
Confine him for the first ten days to the house, more especially if the
hooping-cough be attended, as it usually is, with more or less of
bronchitis. But take care that the rooms be well ventilated, for good
air is essential to the cure. If the bronchitis attending the
hooping-cough be severe, confine him to his bed, and treat him as though
it were simply a case of bronchitis. (For the treatment of bronchitis,
see question 205.)
_In the second stage_, discontinue the ipecacuanha mixture, and give Dr.
Gibb’s remedy—namely, nitric acid—which I have found to be an
efficacious and valuable one in hooping-cough:
Take of—Diluted Nitric Acid, two drachms;
Compound Tincture of Cardamoms, half a drachm;
Simple Syrup, three ounces;
Water, two ounces and a half:
Make a Mixture. One or two teaspoonfuls, or a tablespoonful, according
to the age of the child—one teaspoonful for an infant of six months,
and two teaspoonfuls for a child of twelve months, and one
tablespoonful for a child of two years, every four hours, first
shaking the bottle.
Let the spine and the chest be well rubbed every night and morning
either with Roche’s Embrocation, or with the following stimulating
liniment (first shaking the bottle):
Take of—Oil of Cloves, one drachm;
Oil of Amber, two drachms;
Camphorated Oil, nine drachms:
Make a Liniment.
Let him wear a broad band of new flannel, which should extend round from
his chest to his back, and which ought to be changed every night and
morning, in order that it may be dried before putting on again. To keep
it in its place it should be fastened by means of tapes and with
shoulder-straps.
The diet ought now to be improved—he should gradually return to his
usual food; and, weather permitting, should almost live in the open
air—fresh air being, in such a case, one of the finest medicines.
_In the third stage_, that is to say, when the complaint has lasted a
month, if by that time the child is not well, there is nothing like
change of air to a high, dry, healthy, country place. Continue the
nitric acid mixture, and either the embrocation or the liniment to the
back and the chest, and let him continue to almost live in the open air,
and be sure that he does not discontinue wearing the flannel until he be
quite cured, and then let it be left off by degrees.
If the hooping-cough have caused debility, give him cod-liver oil, a
teaspoonful twice or three times a day, giving it him on a full stomach
after his meals.
But, remember, after the first three or four weeks, change of air, and
plenty of it, is for hooping-cough the grand remedy.
_What_ NOT _to do_.—Do not apply leeches to the chest, for I would
rather put blood into a child laboring under hooping-cough than take it
out of him—hooping-cough is quite weakening enough to the system of
itself without robbing him of his life’s blood; do not, on any account
whatever, administer either emetic tartar or antimonial wine; do not
give either paregoric or syrup of white poppies; do not drug him either
with calomel or with grey powder; do not dose him with quack medicine;
do not give him stimulants, but rather give him plenty of nourishment,
such as milk and farinaceous food, but _no_ stimulants; do not be
afraid, after the first week or two, of his having fresh air, and plenty
of it—for fresh, pure air is the grand remedy, after all that can be
said and done, in hooping-cough. Although occasionally we find that if
the child be laboring under hooping-cough and is breathing a pure
country air, and is not getting well so rapidly as we could wish, change
of air to a smoky, gasladen town will sometimes quickly effect a cure;
indeed, some persons go so far as to say that the _best_ remedy for an
_obstinate_ case of hooping-cough is for the child to live the great
part of every day in gas-works!
231. _What is to be done during a paroxysm of Hooping-cough?_
If the child be old enough, let him stand up; but if he be either too
young or too feeble, raise his head, and bend his body a little forward;
then support his back with one hand, and the forehead with the other.
Let the mucus, the moment it is within reach, be wiped with a soft
handkerchief out of his mouth.
232. _In an obstinate case of Hooping-cough, what is the best remedy?_
Change of air, provided there be no active inflammation, to any healthy
spot. A farm-house, in a high, dry, and salubrious neighborhood, is as
good a place as can be chosen. If, in a short time, he be not quite
well, take him to the sea-side: the sea breezes will often, as if by
magic, drive away the disease.
233. _Suppose my child should have a shivering fit, is it to be looked
upon as an important symptom?_
Certainly. Nearly all _serious_ illnesses commence with a shivering fit:
severe colds, influenza, inflammations of different organs, scarlet
fever, measles, small-pox and very many other diseases, begin in this
way. If, therefore, your child should ever have a shivering fit,
_instantly_ send for a medical man, as delay might be dangerous. A few
hours of judicious treatment, at the commencement of an illness, is
frequently of more avail than days and weeks, nay months, of treatment,
when disease has gained a firm footing. A _serious_ disease often steals
on insidiously, and we have, perhaps, only the shivering fit, which
might be but a _slight_ one, to tell us of its approach.
A _trifling_ ailment, too, by neglecting the premonitory symptom, which,
at first, might only be indicated by a _slight_ shivering fit, will
sometimes become a _mortal_ disorder:
“The little rift within the lute,
That by-and-by will make the music mute,
And ever widening slowly silence all.”
The above extract from Tennyson is, in my humble opinion, one of the
most beautiful pieces of poetry in the English language. It is a perfect
gem, and a volume in itself, so truthful, so exquisite, so full of the
most valuable reflections: for instance—(1) “The little rift within the
lute,”—the little tubercle within the lung, “that by-and-by will make
the music mute, and ever widening slowly silence all,” and the patient
eventually dies of consumption. (2) The little rent—the little rift of a
very minute vessel in the brain, produces an attack of apoplexy, and the
patient dies. (3) Each and all of us, in one form or another, sooner or
later will have “the little rift within the lute.” But why give more
illustrations? a little reflection will bring numerous examples to my
fair reader’s memory.
234. _In case of a shivering fit, perhaps you will tell me what to do?_
_Instantly_ have the bed warmed, and put the child to bed. Apply either
a hot bottle or a hot brick, wrapped in flannel, to the soles of his
feet. Put an extra blanket on his bed, and give him a hot cup of tea.
As soon as the shivering fit is over, and he has become hot, gradually
lessen the _extra_ quantity of clothes on his bed, and take away the hot
bottle or the hot brick from his feet.
_What_ NOT _to do_.—Do not give either brandy or wine, as inflammation
of some organ might be about taking place. Do not administer opening
medicine, as there might be some “breaking-out” coming out on the skin,
and an aperient might check it.
235. _My child, apparently otherwise healthy, screams out in the night
violently in his sleep, and nothing for a time will pacify him: what is
likely to be the cause, and what is the treatment?_
The causes of these violent screamings in the night are various. At one
time, they proceed from teething; at another, from worms; sometimes,
from night-mare; occasionally, from either disordered stomach or bowels.
Each of the above causes will, of course, require a different plan of
procedure; it will, therefore, be necessary to consult a medical man on
the subject, who will soon, with appropriate treatment, be able to
relieve him.
236. _Have the goodness to describe the complaint of children called
Mumps._
The mumps, inflammation of the “parotid” gland, is commonly ushered in
with a slight feverish attack. After a short time, a swelling, of stony
hardness, is noticed before and under the ear, which swelling extends
along the neck toward the chin. This lump is exceedingly painful, and
continues painful and swollen for four or five days. At the end of which
time it gradually disappears, leaving not a trace behind. The swelling
of mumps never gathers. It may affect one or both sides of the face. It
seldom occurs but once in a lifetime. It is contagious, and has been
known to run through a whole family or school; but it is not dangerous,
unless, which is rarely the case, it leaves the “parotid” gland, and
migrates either to the head, to the breast, or to the testicle.
237. _What is the treatment of Mumps?_
Foment the swelling, four or five times a day, with a flannel wrung out
of hot chamomile and poppy-head decoction; and apply, every night, a
barm and oatmeal poultice to the swollen gland or glands. Four
poppy-heads and four ounces of chamomile blows to be boiled in four
pints of water for half an hour, and then strained to make the
decoction. Debar, for a few days, the little patient from taking meat
and broth, and let him live on bread and milk, light puddings, and
arrow-root. Keep him in a well-ventilated room, and shut him out from
the company of his brothers, his sisters, and young companions. Give him
a little mild, aperient medicine. Of course, if there be the slightest
symptom of migration to any other part or parts, instantly call in a
medical man.
238. _What is the treatment of a Boil?_
One of the best applications is a Burgundy pitch plaster spread on a
soft piece of wash-leather. Let a chemist spread a plaster, about the
size of the hand; and, from this piece, cut small plasters, the size of
a shilling or a florin (according to the dimensions of the boil), which
snip around and apply to the part. Put a fresh one on daily. This
plaster will soon cause the boil to break; when it does break, squeeze
out the contents, the core, and the matter, and then apply one of the
plasters as before, which, until the boil be well, renew every day.
The old-fashioned remedy for a boil—namely, common yellow soap and brown
sugar, is a capital one for the purpose; it should be made into a paste,
and spread on a piece of coarse linen, the size either of a shilling or
of a florin (according to the size of the boil); it eases the pain and
causes the boil soon to break, and draws it when it is broken; it should
be renewed daily.
_If the boils should arise from the child being in a delicate state of
health_, give him cod-liver oil, meat once a day, and an abundance of
milk and farinaceous food. Let him have plenty of fresh air, exercise,
and play.
_If the boils should arise from gross and improper feeding_, then keep
him for a time from meat, and let him live principally on a milk and
farinaceous diet.
_If the child be fat and gross_, cod-liver oil would be improper; a mild
aperient, such as rhubarb and magnesia, would then be the best medicine.
239. _What are the symptoms of Earache?_
A young child screaming shrilly, violently, and continuously, is
oftentimes owing to earache; carefully, therefore, examine each ear, and
ascertain if there be any discharge; if there be, the mystery is
explained.
Screaming from earache may be distinguished from the screaming from
bowel-ache by the former (earache) being more continuous—indeed, being
one continued scream, and from the child putting his hand to his head;
while, in the latter (bowel-ache), the pain is more of a coming and of a
going character, and he draws up his legs to his bowels. Again, in the
former (earache), the secretions from the bowels are natural; while, in
the latter (bowel-ache), the secretions from the bowels are usually
depraved, and probably offensive. But a careful examination of the ear
will generally at once decide the nature of the case.
240. _What is the best remedy for Earache?_
Apply to the ear a small flannel bag, filled with hot salt—as hot as can
be comfortably borne, or foment the ear with a flannel wrung out of hot
chamomile and poppy-head decoction. A roasted onion, inclosed in muslin,
applied to the ear, is an old-fashioned and favorite remedy, and may, if
the bag of hot salt, or if the hot fomentation do not relieve, be tried.
Put into the ear, but not very far, a small piece of cotton-wool,
moistened with warm olive oil. Taking care that the wool is always
removed before a fresh piece be substituted, as if it be allowed to
remain in any length of time, it may produce a discharge from the ear.
Avoid all _cold_ applications. If the earache be severe, keep the little
fellow at home, in a room of equal temperature, but well ventilated, and
give him, for a day or two, no meat.
If a discharge from the ear should either accompany or follow the
earache, _more especially if the discharge be offensive_, instantly call
in a medical man, or deafness for life may be the result.
A knitted or crocheted hat, with woolen rosettes over the ears, is in
the winter time, an excellent hat for a child subject to earache. The
hat may be procured at any baby-linen warehouse.
241. _What are the causes and the treatment of discharges from the Ear?_
Cold, measles, scarlet fever, healing up of “breakings-out” behind the
ear; pellets of cotton-wool, which had been put in the ear, and had been
forgotten to be removed, are the usual causes of discharges from the
ear. It generally commences with earache.
The _treatment_ consists in keeping the parts clean, by syringing the
ear every morning with warm water, by attention to food, keeping the
child principally upon a milk and a farinaceous diet, and by change of
air, more especially to the coast. If change of air be not practicable,
great attention ought to be paid to ventilation. As I have before
advised, in all cases of discharge from the ear, call in a medical man,
as a little judicious medicine is advisable—indeed, essential; and it
may be necessary to syringe the ear with lotions, instead of with warm
water; and, of course, it is only a doctor who has actually seen the
patient who can decide these matters, and what is best to be done in
each individual case.
242. _What is the treatment of a “sty” in the eye-lid?_
Bathe the eye frequently with warm milk and water, and apply, every
night at bedtime, a warm white-bread poultice.
No medicine is required; but if the child be gross, keep him for a few
days from meat, and let him live on bread and milk and farinaceous
puddings.
243. _If a child have large bowels, what would you recommend as likely
to reduce their size?_
It ought to be borne in mind that the bowels of a child are larger in
proportion than those of an adult. But, if they be actually larger than
they ought to be, let them be well rubbed for a quarter of an hour at a
time night and morning, with soap liniment, and then apply a broad
flannel belt. “A broad flannel belt worn night and day, firm but not
tight, is very serviceable.” (Sir Charles Locock, in a _Letter_ to the
Author.) The child ought to be prevented from drinking as much as he has
been in the habit of doing; let him be encouraged to exercise himself
well in the open air; and let strict regard be paid to his diet.
244. _What are the best aperients for a child?_
If it be _actually_ necessary to give him opening medicine, one or two
teaspoonfuls of syrup of senna, repeated if necessary, in four hours,
will generally answer the purpose; or, for a change, one or two
teaspoonfuls of castor oil may be substituted. Lenitive electuary
(compound confection of senna) is another excellent aperient for the
young, it being mild in its operation, and pleasant to take; a child
fancying it is nothing more than jam, and which it much resembles both
in appearance and in taste. The dose is half or one teaspoonful early in
the morning occasionally. Senna is an admirable aperient for a child,
and is a safe one, which is more than can be said of many others. It is
worthy of note that “the taste of senna may be concealed by sweetening
the infusion, adding milk, and drinking as ordinary tea, which, when
thus prepared, it much resembles.” Infusion of senna may be procured of
any respectable druggist. It will take about one or two tablespoonfuls,
or even more, of the infusion (according to the age of the child and the
obstinacy of the bowels), to act as an aperient. Of course you yourself
will be able, from time to time, as the need arises, to add the milk and
the sugar, and thus to make it palatable. It ought to be given warm, so
as the more to resemble tea. Honey, too, is a nice aperient for a
child—a teaspoonful ought to be given either by itself, or spread on a
slice of bread.
Some mothers are in the habit of giving their children jalap
gingerbread. I do not approve of it, as jalap is a drastic griping
purgative; besides, jalap is very nasty to take—nothing will make it
palatable.
Fluid magnesia—solution of the bicarbonate of magnesia—is a good
aperient for a child; and, as it has very little taste, is readily
given, more especially if made palatable by the addition either of a
little syrup or of brown sugar. The advantages which it has over the old
solid form are, that it is colorless and nearly tasteless, and never
forms concretions in the bowels, as the _solid_ magnesia, if persevered
in for any length of time, sometimes does. A child two or three years
old may take one or two tablespoonfuls of the fluid, either by itself or
in his food, repeating it every four hours until the bowels be opened.
When the child is old enough to drink the draught off _immediately_, the
addition of one or two teaspoonfuls of lemon-juice, to each dose of the
fluid magnesia, makes a pleasant effervescing draught, and increases its
efficacy as an aperient.