HOME MANAGEMENT OF SOME COMMON DISEASES OF CHILDREN.
CROUP.
Although this disease is said to be more severe in Europe than in our own country, and more frequent in our northern than in our southern States, most American mothers, in all parts of the country, know and dread its alarming and often fatal attacks. It is a disease of childhood, but not of early infancy, being rarely met with under the first or after the tenth year of life.
Children who have once had this affection are very liable to another attack upon exposure to any of the causes which excite it. It has been noticed also that croup runs in certain families, and not unfrequently, children of a ruddy complexion and of a fleshy and apparently vigorous appearance are those most subject to it.
Among the _causes of croup_, which should be specially guarded against by mothers of croupy children, are checking of the perspiration, sudden alterations in the dress, change of climate, and even in some cases a residence at the sea-side. Croup also often follows measles, and at times is epidemic.
The unmistakable _symptoms of croup_ quickly show themselves at the outset of the disease. Sometimes a sore throat, a short, dry cough, and a slight harshness of breathing, usher in the affection; in other instances, that which first attracts attention is hoa.r.s.eness in the cry or tone of the voice, attended with, or quickly followed by, feverishness, thirst, and dulness, or fretfulness; while in another cla.s.s of cases the disease suddenly developes itself without any noticeable premonitory signs. In all these cases the characteristic symptoms of the disease commonly make their appearance at night. The child"s sleep is disturbed by a peculiar clanging cough, which, when once heard, will ever afterwards be remembered and easily recognised.
The skin becomes hot and dry, the breathing difficult, the cough more frequent, and the child is soon awakened, frightened, and struggling for breath. With flushed face and staring eyes, the little sufferer starts up, grasping the throat with the hand as if seeking to remove some encircling pressure which is choking it. Each drawing in of the breath is attended with a hissing sound, the redness of the face and neck increases, and speech becomes impossible. This attack may pa.s.s off in a few minutes, or be prolonged, with varying degrees of intensity, for an hour. Almost invariably, however, it is followed by a period of relief, in some instances so complete as to deceive the anxious relatives into the belief that the disease is over and the child safe. This false confidence is, unfortunately, generally soon rudely dissipated by a return of the attack in all its first violence.
The disease attains its height by the end of the second, or at the latest the close of the third day. The fever is now the hottest, the tongue becomes white, the face and forehead red and covered with perspiration, the lips at times purple, the veins of the neck and temples distended, the countenance distressed, and the voice whispered or suppressed. The cough is now also most frequent and noisy; its peculiar sound has been compared to that made by a fowl when caught in the hand. The thirst is great, but swallowing difficult. The child often inserts its fingers in the mouth as if trying to clutch something which closes the air pa.s.sages. These symptoms may either increase to the rapid exhaustion of the patient or take a favorable turn. One of the first evidences of the latter is a change in the character of the cough, which, although it may not lessen in force or frequency, becomes lower in tone, less dry, and finally moist.
The _treatment_ should be most prompt, active, and energetic. Few diseases require, for the safety of the patient, such quick and efficient aid at the outset. Prepare at once sufficient hot water for a bath, and make a fire in the room. In the meanwhile, immerse the child"s arms in some hot water, and apply cloths, wrung thoroughly dry from it, to the throat. Give the child a tea-spoonful of powdered alum in a little syrup, mola.s.ses and water, or honey. Repeat the dose in a quarter of an hour if full vomiting be not excited by the first tea-spoonful. So soon as the warm bath is ready (the water should have the temperature of 98 Fahrenheit), place the child in it, and keep up the heat of the bath by the occasional addition of hot water. Have hot towels in readiness to dry the skin completely, and a warm blanket in which to wrap the patient. See that the temperature of the room is raised to about 66 Fahrenheit, and that it does not fall below this. Moisten the air by putting a kettle of boiling water on the fire and diffusing the steam from it by means of a long roll of paper fixed to the spout.
The warm bath and the emetic will usually relieve the breathing; but no matter how complete this relief may appear to be, nor how quietly the little one may sleep, it must be carefully watched all night, so that the first return of unfavorable symptoms may be promptly treated. In all instances also, however favorably the case may progress, the patient must be confined to bed for several days, and the temperature of the room, and the moisture of the air, carefully maintained, as directed for the first treatment of the attack. If the child has had previous attacks, or if the weather be cold and inclement, it should be kept in this warm moist atmosphere for two weeks. Were these precautions known and heeded we should have to lament fewer fatal cases of croup.
Of course in this, as in all other serious diseases, skilled medical advice should be secured as quickly as possible. We have given the above directions, not only for those so situated that they cannot secure medical aid, but also for all others, in order that no valuable time may be lost in commencing the treatment, that the efforts of the physician may be intelligently seconded and carried out, and that the importance of _promptness_ at the outset, and _prolonged care_ during convalescence, maybe impressed upon every mother who consults these pages.
HEAD COLDS.
Young infants are very liable to take cold when being washed, or carried about the house into rooms and pa.s.sages of different temperatures. This cold often shows itself by sneezing and "snuffles" in the nose. In a short time a discharge from the nostrils appears, the eyes become watery, and the voice sounds "through the nose." The skin is hotter than natural, and the infant cross. If the child be able to talk, it will complain of headache, some soreness in the limbs and back, and of a burning, uncomfortable feeling in the nose. These symptoms last for three or four days, when in mild ordinary cases they begin to disappear.
After one or more attacks of this kind the child is very liable to a return on every slight exposure to cold.
The _treatment_ required in these cases is mild and simple, but must not be neglected. A warm bath should be taken at bed-time for a number of days; the patient should be kept in an even temperature and out of draughts. The best relief to the distress in the nose, from which the child suffers, is afforded by dipping a hollow sponge in hot water, squeezing it nearly dry, and applying it over the nose and forehead. The common domestic practice of greasing the nose is also beneficial. The wearing of a flannel cap until the disease is cured is a remedy strongly recommended by the late Dr. Meigs. A flannel cap will also often prevent the recurrence of the complaint in those very subject to it.
FITS.
Infants and young children are much more liable to fits and convulsions than adults. The causes which excite them are numerous, and should be generally known, that they may be as far as possible avoided.
Many infants are born with a tendency to fits. The children of feeble parents, or of those who have married very early or very late in life, are apt to be afflicted with a predisposition to them. Great fright or severe shock received by the mother during the latter months of her pregnancy may give rise to convulsions in the child soon after birth.
Pale, badly nourished, soft, flabby children, and those of a sensitive, nervous temperament, are more liable to fits than those who are ruddy and hardy. Hence we find convulsions more common and fatal among the poor and miserable than among the "well-to-do" and comfortable. City children are more subject to the complaint than the country born and bred.
Fits are very frequent among infants while teething. In such cases lancing the gum secures immediate relief. Another cause of fits, and one which every mother should know, is the giving of meat to the child before its teeth are cut. In such cases the attack is sudden, and often very severe. Children most affected in this way by animal food are those with water on the brain, and those of a very delicate const.i.tution. The juice or broth of meat is in some such instances sufficient to produce fits. The remedy consists in the inst.i.tution of a milk diet. In all doubtful cases avoid a meat diet in any form, and watch the result.
Strong mental emotions, such as fright, shame, or anger, may cause a fit in a child. A nurse in England threatened to throw a child out of the window if he did not stop crying; the little boy fell at once into convulsions, from which he died.
Among other known causes of fits are confinement to heated, badly ventilated rooms, tight bandaging, and sudden exposure to severe cold or heat.
In treating of the influence of the mother"s mind over the nursing child (p. 251), we mentioned a number of instances of children thrown into convulsions by changes in the quality of the milk caused by the mental emotion of the mother. The importance of the subject induces us to quote here the corroborating remarks of Dr. Churchill, in the last edition of his standard work on diseases of children. "During the first year of life, convulsions may not unfrequently be traced to the milk of the mother or nurse disagreeing with the infant, or having been disordered temporarily by fright, pa.s.sion, or suffering. Smmering mentions a curious case of a woman whose milk agreed with her own child, but caused convulsions in all others. M. Guersant relates the instance of a woman deserted by her husband, and in her distress her infant had an attack each time it took the breast. Dr. Underwood mentions a mother who nursed her child immediately after witnessing a sudden death; the child was attacked by convulsions, after which it remained comatose for thirty-six hours, but ultimately recovered. Numerous cases are on record of convulsions supervening upon violent pa.s.sion in the nurse. I have witnessed more than one case resulting from the mother suckling her child during a time of severe affliction and distress."
We deem it useless to describe a fit. Almost every one has seen it, and at once recognises it. We shall proceed, therefore, at once to the _treatment._
When a child is attacked with a fit the dress should be loosened, all tight bandages and pins removed, and plenty of fresh air admitted into the room. It should not be held upright in the arms, but placed in a lying position. A warm bath (that most useful remedy in so many of the ailments of children) should be speedily prepared, and the child immersed for a few minutes, then removed, dried, and wrapped in a blanket. A hot mustard foot-bath is also of service. The cause of the fit should be at once sought, for upon it will of course depend to a great extent the treatment required. If the child be teething, and the gums be found to be red and swollen, they should be lanced. If the child has eaten too much, or of improper food, an emetic should be given. A little mustard and salt mixed in a tumbler of warm water affords a ready, safe, and effectual emetic.
The dashing of cold water upon the face will sometimes promptly end the fit. The application of powdered ice in a bladder, or of cold water cloths to the head, is of service where the face is much flushed and the movements very violent.
Children subject to fits should live in a well warmed house. By this we do not mean that the rooms and hall ways should be kept hot, still less that they should be close and improperly ventilated. The temperature of the bed-room should not be lower than 70 degrees, and great care should be taken during cold weather to avoid chilling the child outdoors.
Rubbing of the child"s body once a day with good salad oil is an excellent and readily applied remedy in these cases. The little patients do not ordinarily object to it. As it is a procedure calculated to improve the general health, we strongly recommend every mother whose child has frequent fits, to try it.
The dress of the child should be warm, loose, and comfortable. Perfect quietness is important for a time after attacks. Do not excite the child by seeking to amuse it. Let it sleep as much as it will.
In those cases in which a fit has been followed by weakness of the limbs, medical a.s.sistance will of course be procured. As a rule, recovery in such instances is slow, but, when properly directed, perfect. Change of scene, country air, and exercise, friction of the body with a flesh-brush or salt towel, salt water baths, and electricity, are all valuable agents towards cure.
NOSE-BLEED.
Bleeding from the nose may be produced by a blow or by over-exercise of the child at play. In either case the trouble is usually a trifling one. Some children, however, are liable to attacks of nose-bleed coming on without any a.s.signable causes. One of the consequences of scarlet fever and whooping cough is sometimes a tendency to repeated and serious spells of bleeding from the nose.
The _treatment_ in these cases consists in quieting the alarm of the child if it be frightened, and in applying cold water or pounded ice to the nose and forehead and to the back of the neck. It is because of its coldness that the key placed down the back, as so commonly advised in domestic practice, does good.
An exaggerated idea of the amount of blood lost is often a cause of distress to parents. They forget that the child has been bleeding in a vessel of water, and that a very little blood darkly colors a large quant.i.ty of water.
Bleeding from the nose is sometimes a favorable symptom, as when it occurs during a fever, or when in girls approaching womanhood it precedes the expected signs of p.u.b.erty. It is an unfavorable symptom, however, in scrofulous children and in girls affected with green-sickness, as in these instances it aggravates the existing disorders.
In those rare cases of protracted bleeding which resist the remedies we have mentioned, it may be necessary for the surgeon to plug the nostrils, both in front and at their opening into the throat.
This extreme measure is fortunately scarcely ever called for, and can only be carried out by the physician.
WORMS.
Children are often thought to have worms when entirely free from them.
There is hardly a symptom of any disease which has not been supposed by some to be a sign of the presence of worms. A child suffering from some other complaint is, therefore, not unfrequently dosed with vermifuges to its injury. We can give the mother one symptom of worms which is infallible. It is the only one upon which she can rely, namely, the detection of worms in the stools of the child. Until these expelled intruders are actually found she should be slow to believe that the child is thus affected, and still slower to give worm medicine. Before beginning treatment, let the mother wait until the need of it is made out by the result of the examination we have mentioned.
The _treatment_ of the ordinary worms to which children are subject is simple and usually speedily efficacious. Commence with a dose of Epsom salts, of magnesia, or of cream of tartar, as may be preferred. The next day administer a vermifuge, of which the best and pleasantest is _santonine_. Obtain from the druggist three or four three-grain powders of this medicine. Give the half or the whole of one of these powders, according to the age of the child, at bed-time. The next morning administer a purgative dose of oil or salts. Repeat this treatment every other day until three doses of santonine have been taken. Or, from two to six grains, according to the age of the patient, may be dissolved in two table-spoonsful of castor-oil, and a tea-spoonful given every hour until it operates.
An excellent domestic remedy for worms, one which was a great favorite with the celebrated Dr. Rush of Philadelphia, is common salt. For a child two or three years old, the proper dose is a tea-spoonful mixed in a wine-gla.s.sful of water. When the child can be got to take it in sufficient quant.i.ty, this remedy is a very efficient one.
Most cases of supposed worms in children are best treated by regulating the diet, by attention to the air and exercise of the child, by warm baths, and by endeavoring to improve the appet.i.te, the digestion, and the strength. The food should be plain and unirritating (bread, milk, rice, arrowroot, chicken, lamb or mutton broth, beef-tea, mutton chop, young chicken); the meals should be taken in smaller quant.i.ties than usual, and at regular intervals. Sweets and confectionery should be forbidden, and but few vegetables permitted for awhile. A perseverance in this regimen for a short time will usually cure the little patient without the necessity of resorting to any vermifuge.
Worms are most frequent between the ages of three and ten years. Girls are oftener affected than boys. A tendency to worms is hereditary. Cases occur more frequently during the spring and autumn than during the other seasons. A residence in cold, damp, unhealthy situations leads to their production in many instances.
BED-WETTING.
This troublesome disorder is not unfrequently met with in children--more especially boys--under twelve years of age. It is a mistake to suppose, as is done by some parents, that slothfulness or negligence is the invariable and only cause of this infirmity; on this point Dr. Vogel says:--"In most cases which I have observed, the children through their own sense of honor or on account of repeated punishments, had a lively interest in avoiding the accident, and yet were unable to do this without appropriate treatment pursued for months, and even years." Dr.
Tanner states:--"Very frequently this affection is the consequence of bad habits; being favored by the free use of fluids during the after part of the day, by exposure to cold in the night, and by lying on the back."
The presence of worms in the bowels is one of the causes of this annoying ailment, and they should be sought for in all cases. Stone in the bladder sometimes occasions the affection, but in such instances other symptoms will soon point to the true nature of the trouble.