Nugent Robinson.

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termining a corresponding amount of congestion inwardly. Ex
it in some part previoiisly weakened and made susceptible to
disease ; or, in still plainer language, the cold flies to the
weakest part, which accounts for one person getting rheu-
matism, another congestion of th^ lungs, a third a sore
throat, and a fourth, perhaps, merely a cold in the head or
chest.

To core a cold is to restore the action of the skin and
induce perspiration, and this, if done at the proper time, when
the symptoms are first observed, is exceedingly simple. People
may sneer as they will at the mention of the word gruel, but a
basin-full of hot gruel, made thin, and taken when in bed, will
invariably arrest an ordinary catarrh. If the chill be severe,
the child's feet should be placed in warm water, a little extra
clothing be placed on the bed, and the patient allowed to lie
n bed a little longer than usual the next morning ; but the
apartment must not be too warm or close, or the additional
clothing be too great, as, though the cure may be accelerated
thereby, the susceptibility is increased, and the child rendered
more liable to a recurrence of the attack.

To those who will not believe in anything old-fashioned or
simple, the plan of a " wet sheet pack " will be found equally
efficacious. This is managed by spreading three blankets on
the bed and putting on the top a sheet, which has been satur*
ated in hot water and wrung out The child is then placed
upon the sheet, enveloped in it, and the blankets wrapped
tightly round the whole body excepting the head, and allowed
to remain in this situation for about an hour, when a quick
sponging of cold water should be given, followed by a brisk
and thorough rubbing with dry towels.

Another remedy believed in by many of our medical breth-
len is the *' dry" pkui, which, at any rate, has the merit of



sunplicity, for it consists in merely abstaining bom eveiy kind
of liquid until the disorder is gone.

Although opinions may differ, however, as to the precise
method of cure, and any of those given will be found equally
efficient, there is no diffierence of opinion as to the cause and
prevention. The too frequent cause is simply the result of
carelessness or imprudence in not protecting the body against
the variation of temperature, an insufficient use of cold or
warm water to the body, or, plainly, undeanliness, sleeping
under too much clothing, or by sleeping in badly-ventilated
rooms ; but the first mentioned, the passing from a hot room
out into the open air, or into a room where the temperature is
less, without being suitably attired, is the most frequent and
the most to be guarded against with children.

The prevention of cold is best achieved by diminishing the
susceptibility of the system by abstemious living, taking regu^
lar and daily exercise in the open air, and a morning bath of
cold water if the child be strong enough, and if not, a tepid
one ; but the best prevention and cure for colds is ** the cold
water cure.**

TEETHING

is one of the most distressing of the ordinaiy ailments of
children, for it comes to them at an age when they are incapa-
ble of making the nature of their sufferings known, and as
they do suffer most acutely sometimes during the process ol
dentition, it is very trying to mothers and nurses to have to
witness their torture and be unable to alleviate it because the
poor little mites cannot explain their symptoms.

Being one of the very common ills that flesh is heir to, it ia
a time frequently regarded by some as more troublesome than
important — a great mistake, to prevent which a simple state-
ment showing the action of one of the phases of the disease
may be advisable. The chief disorders of the first set of
teeth are caries and inflammation in the periosteal mem-
branes, terminating in abcess, or what is commonly called
gumboiL The first effect of inflammation in the periosteum is
to create pain, tenderness and swelling in that part of the gum
in close proximity to the tooth, and an effusion of fluid be-
tween the fang and its investing membrane, which b thus
converted into a sort of cyst or tiny sack of skin. Repeated
attacks of inflammation at length end in the formation of pu^
which either bursts through the tumor in the gum or may be
removed by lancing. Sometimes after the abscess has burst
or been opened, a fungus springs up from the diseased mem-
brane lining the cavity. With some children the presence of
the abscess having produced absorption of a portion of the
alveolar process at its lower part, it effuses its contents through
the aperture thus formed, and matter forces itself along the
surface of the lower jaw, and forms an external tumor near
its base.

With regard to the procees of dentition in actual m-
fants, the time at which it takes place is naturally subject to
slight variation, when it is sUted that many medical men give
instances in their experience of children being bom with
teeth, or having cut them almost immediately after birth —
Loub XrV., of France, and Richard III., of England, being
historic cases in point ; the usual time, however, when babies
begin to be troubled with the advent of teeth is at the seventh



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moDth, the period of the first dentition lasting np to the age
of two years or two and a half years.

The symptoms of teething in a healthy child are that for
some time before the gums are much swollen^ there is an ex-
cessive flow of saliva from the mouth, and the child indulges
in what is known to most as ** dribbling/' at the same time
evincing a very strong desire to drag anything upon which it
can fix its tiny little clutch into its mouth, while, if we place
our finger into its mouth we perceive at once a decided
attempt to bite, which affords a relief to the irritation of the
gums. Where the child is inconvenienced only to the extent
described there is no remedy required provided there is no
constipation, but where this is the case small doses of castor
oil are the safest. As to the article it should be given to suck,
I personally prefer an ivory ring or a ** finger " of crust of
bread, great care being observed in the latter case that it is
taken away before there b a possibility of its being broken or
bitten off.

When the child is extremely restless, cross and uneasy,
crying bitterly without any apparent cause, and refuses all
ordinary attempts at pacification, its suffering is very consid-
erable, which is increased by its ineffectual efforts to sleep for
any length of time. The cheeks become flushed at this time,
and if the local inflammation continue to increase the gums
may ulcerate ; in this case apply a little borax and honey to
them, but where the irritation continues and the pain is ob-
viously great it will be necessary to lance the gums, for which
purpose it is almost unnecessary to add the services of a sur-
geon should be secured at once. At this time it is more than
ever necessary to keep the bowels well open, a mild attack of
diarrhea being far more preferable under the existing circum-
stances than the reverse state of things.

All food requires to be carefully chewed in order that
the various organs may perfectly perform their proper func-
tions, and this can only be the case when the meat, or what-
ever it may be, is broken into minute portions and duly mixed
with saliva, without which it will not be properly digested.
The horrors and evils of indigestion are too well known to
need commenting upon here, but the necessity for a due at-
tention to the mastication of food by children will be seen
when it is stated that a weak stomach acts tardily and imper-
fectly upon anything introduced into it not properly chewed ;
and the consequences are, the warmth and moisture of the
stomach evolve gases, acids are formed, and then follow those
distressing s3rmptom8 such as loss of appetite, flatulence,
furred tongue, etc.

The period of " teething " is more than interesting, from
the fact that, at this stage of child life, the whole organization
seems to undergo a transition. The features, hitherto more
or less expressionless, become decided and distinct ; the eye
I ;comes endued with expression, through which the mind
teems to speak, as it were ; the round appearance of the facial
outline appears elongated, the result of the teeth expanding
the jaws ; the forehead is perceptibly developed, and, in short,
the entire face assumes an animation previously unknown, but
most precious to mothers, on account of its being the ordinary
time when •• baby is beginning to notice."

The order in which teeth usually make their appearance



is, first, the two central incisors of the lower jaw appear ; then
shortly after those of the upper jaw, followed by the lower
lateral incisors, and then by the upper lateral incisors. At the
age of a year or fourteen months the four first molar teeth
should begin to show, and at the sixteenth to the twentieth
month the lower and upper canine teeth, followed by the four
last molars.

Although the suffering of infants from the process of denti-
tion arises mainly from irritation of the gums, owing to the
teeth working their way through, it is not in the month alone
that pain is caused ; and where thb is excessive, or in children
whose constitutions are naturally irritable, the irritaticm is
reflected by the nervous S3rstem to some other organ or system
of organs.

The most ordinary effect of this is stomach-adie, or
diarrhea, with griping pain, which, if in a mild form, is the
least to be feared of all the unpleasantnesses arising from
teething , and though its violence may be moderated, it should
not be entirely arrested. Under these circumstances, a diiU
soon gets weak and thin, and its flesh soft and flabby ; but,
generally speaking, this need not (except, of course, in an ez>
treme case) be viewed with alarm ; for, as soon as the teeth
are through, nature soon rights itself, and the little one wHl
resume its wonted good looks. When, however, the symp-
toms are very distressing, by the quantity and frequency of
the discharge, a chalk mixture, with a drop or two of laudanum
to the ounce, according to the age of the child, may be given,
in the event of a medical man not being procurable. Where
there is a great pain and flatulence, an occasional warm bath,
and the use of liniment, composed of half a drachm of lauda-
num to two ounces of compound camphor liniment, or a mus-
tard or linseed-meal poultice, composed of one-third of the
former to two-thirds of the latter. When the foregoing symp-
toms are accompanied by vomiting, it is exceedingly trouble-
some, and, if the sickness is not relieved by the division of
the gums, it should be checked by administering a half-drop
or a drop of laudanum.

Besides the maladies mentioned that are the outcome ai
teething, there are many others, such as eruptions of the sldn,
spasm of the glottis, and affections of the nervous system
generally, of too complicated a nature to treat in thb article,
as the remedies necessitated are as complex as the diseases ;
but there is one serious disorder connected with dentition un-
fortunately too common. I allude to convulsions, the treat-
ment of which should be known to alL

Convulsions Hn their mild form consist of muscular twitdi-
ings of the face, accompanied by an obvious diflBculty in
breathing and a rolling of the eyes. When severe, the child
becomes insensible, and the muscles of the head, neck, and
extremities are convulsed in various directions. The eyes are
insensible to light, and turned rigidly up to one side. The
appearance and symptoms vary, of course, for, in addition to
those named, with some children the face is congested, but
sometimes pale, the lips livid, and there is frothing at the
mouth. The hands are usually tightly clinched, and the
thumbs turned inward, with the fingers on them, and in some
cases the soles of the feet are turned together, with the great
toe bent into the sole.



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The treatment for eonvnlsions is, as a rule, a warm bath»
and, in the absence of a doctor, the best thing to be done is
to immerse the child in wann water of about ninety degrees
temperature ior about ten minutes or a quarter of an hour,
applying at the same time a cold, wet towel for two or three
minutes to the little sufferer's head. Previous to the bath,
which will take a few minutes at least to get ready, loosen all
the clothing about the neck, chest and body, raise the head,
sprinkle the face with water, and admit plenty of fresh air.

With regard to the general treatment of children during
teething, their heads should be kept cool and their feet warm,
and, if the weather will admit, they should be bathed in cold
water, especially about the head, and taken out daily in the
open air. At night it is equally essential that their heads be
kept cool, and therefore no caps or coverings should be used.

As before stated, diarrhea during dentition, unless very
severe, should not be stopped, but regarded as an effort of
nature to relieve congestion to the head ; and where the oppo-
site effect b the case, purgatives should be avoided, and the
bowels regulated by suitable diet ; in obstinate cases by injec-
tions. Constipation in infants may be almost entirely at-
tributed to defective diet, and if, while nursing, mothers and
nurses would carefully avoid any article of food or drink of
an indigestible or stimulating character, this ailment would be
comparatively unknown.

HOOPING-COUGH.

This disease, almost absolutely confined to Infants and
children, is, luckily for them, more distressmg in its symptoms
than dangerous m its effects, a case of boopmg-cough, puret
simple^ being rarely fatal. Like croup, it u more common
with very young children, the usual age when they are more
subject to it being from two to ten years ; but, unlike croup,
it is more common to girls than to boys, and appears but once
in a lifetime, though cases have been known where the cough
continued daily at a certain hour for several months, and,
after ceasing for some time, returned for two successive
seasons.

The symptoms which usually precede this malady are those
of ordinary influenza. First and foremost there is a languor,
restlessness, feverishness and unaccountable irritation, except
that the little one is thought '* to have caught a slight cold/'
then loss of appetite, sneezing, coughing, follows, with a run-
ning at the nose ; this is in the case of an ordinary and not
severe attack. Where the disease is in an aggravated form
the fever is more intense, the thirst greater, the pulse quicker,
and the oppression and distress in proportion, the cough very
frequent and painful, dry at first, but with excessive expectora-
tion afterward. This may be called the first stage of the
disease, and is the customary prelude to hooping, but it is
perfectly possible to dispense with these preliminaries, and
for a child to be suddenly seized with the too well-known
cough. These symptoms ordinarily continue from ten days
to a fortnight.

The second stage is marked by the dying-out of the
symptoms of cold and the commencement of the fits of cough-
ing, which are best described as a number of expirations made
with such violence, and repeated in such quick succession, that



the child seems almost in danger of soffocatfea. lEbs In»
and neck are swollen and livid, the eyes protruded sad baSi j|
tears ; at length, oue or two inspirations are made with similar
violence, and by them the peculiar hooping sound Is iModnoed;
a little rest probably follows, and is succeeded liysaotlist fit
of coughing, and another hoop, until after a soooSMhMi of
these actions, the paroxysm is terminated by ■nwiHlug^ oi a
discharge of mucus from the lungs, or perhaps bOtiL l*h0
duration of this stage b usually from six weekstoaoonple
of months, but sometimes continues for a much l oii ge i p eri>.<^
the disease, in some cases, lasting from the '*•£'■"*»■*£ sf
Winter until the end of Spring.

The debilitating results of the disease depend to a great
extent upon tl : violence and duration of the attack, and the
strength or weakness of the constitution, but as a rule, if there
are no complicauons, these are of no great moment The
frequent vomiting decreases the appetite, and disturbs diges-
tion, which interferes with nutrition, and the child naturally
loses flesh, which is more or less flabby, and the skin is unu-
sually dark, especially underneath the eyes.

The subsiding of the attack is marked by the fiu of cough-
ing becoming less frequent, though possibly they may be as
fierce as ever, the paroxysms lasting from a minute to a quat-
ter of an aonr. In proportion to their violence and duration
will be the child's breathlessness and fright and its efforts to
respire. If in a recuml>ent position it will suddenly jump up
and seize hold of whatever or whoever is nearest, in order to
be assisted in overcoming the spasm. Wlien the fit is over
the child appears exhausted, and requires a short rest to
recover itself ; but then and during the interval to the next
cough, it IS comparatively easy and cheerful, often playing
about as usual, and not averse to food, except where the case
is a severe one, when extreme languor supervenes.

The period at which these paroxysms recur varies consider-
ably i during the early part of the attack they are very fre-
quent—about every half-hour, and in some extremely severe
cases as often as every ten minutes — the chief cause of their
return being the accumulation of mucus. Consequently, if
this be got rid of by the coughing, the fit will be light ; but if
it is expelled with difficulty the efforts will be greater, and the
cough renewed almost immediately. These fits are produced
by many things — a hearty meal, a fit of passion, crying, fright
or laughter, will either of them be sufficient to bring on an
attack.

Although we have stated that this disease is rarely attended
with fatal results, it must be distinctly understood that this
statement applies to hooping-cough per se ; it is perfectly cor-
rect, but for fear any one should not be sufficiently careful, it
is a disorder which, if improperly treated, or if the case be
one of an extremely acute character, may lead to something
of a complicated and highly dangerous nature.

It is a complaint which lends itself a great deal more to
careful nursing than to an elaborate coarse of medicine, for it
will run its course, and requires guidmg and watching more
than checking, great care being necessary to note the symp-
toms, lest they assume a conspicuous or alarming character,
and by appropriate treatment prevent the affection having
those complications alluded to which constitnte it a disease



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of danger. On the slightett appearance either of inflamma-
tory affection of the longs or of a tendency to convnlsion a
medical Bian ihoold be sent for immediately.

Daring the first stage an emetic of ipecacoanha, followed
by an txpectoffant erery four hoars, should be given, the latter
consisting of ipecacnanha wine, sirup of squills, a little sirup
of white poppies and almond milk, and some mild aperient^
such as castor oil or salts and senna, the emetic only to be re-
peated occasionally. The rooms to which the child should
be confined should be of an equable temperature, about sixty-
five degrees, the bedroom being ventilated during the day and
the sitting-room during the night ; but the windows of the
apartment must on no account be opened while the patient is
in them.

When the second stage arrives, while proper attention is
paid to temperature, the cough will be found much
slighter and the expectoration much less than If the child were
permitted to be exposed to the external air, the emetic being
continued occasionally, and alio the mixture, with a few drops
of laudanum added to it.

With regard to change of air, there is no doubt that
while the attack is unsubdued, no matter what the weather
may be, the patient should be confined not only to the house
but to rooms, as already stated, but when the disease is on
the wane the change from a cold situation to one of warm
temperature is most beneficial in accelerating a return to con*
▼alescence, though the greatest caution is needed in this
matter.

The diet of the child during the entire illness is a most im-
portant feature in connection with the treatment, and should
consist chiefly of milk and farinaceous foods, meat being of
too heating a nature, unless the child is very vreak and low,
in which case tolerably good broth will be the best mode of
giving animal food.

VACCINATION-

Unfortunately that dangerous and much dreaded malady^^
smallpox — is prevalent, and it would be well for parents and
others to be reminded of the necessity of revaccination every
seven years.

1 1 is astonishing that though this discovery is undoubtedly
one of the very greatest blessings to poor htunanity it should
r tw be thou^^ so little of, and that there should be some
wno actually decry and refuse to accept it as such, when there
h no doubt that if every one had followed the instructions as
tr revaccination, by this time smallpox would have ceased
altogether.

No language can be too strong to depict the horrors of this-
ducase, or to denounce the culpable ignorance of those who,
blinding themselves to the blessings of vaccination, set the
law at defiance and thus endanger the lives of their fel-
Jow-creatures. Supposing it could be proved (which it can-
not) that in some cases it has been the means of imparting
disease, the overwhelming number of cases where it has not,
but has been a preventive of this terrible malady, ought to
show its necessity on the beneficent principle of studying the
greatest happiness of the greatest number.

To children smallpox has ever been distressingly fatal, and



though it is impossible to give any coarse of treatment for its
cure in an artide of this chancter^ as so modi depends upon
the violence of the cue^ the state of the patient's constitntkn,
and the stage of the complaint, it may be said that the old
practioe of dote, hot rooms, warm dodiing, and hot diinks
are proved mistakes ; cool, well-ventilated apartments^ ooon-
f ortably cool bedclothes and cooling drinks having been foond
to be not only more pleasant but mote saccessfnl in their re-
sults. When the disease first makes its s|>pearuice, if die
fever be moderate and no professional advice be procomble,
the patient should be confined to bed, and cool drinks and a
dose or two of puigative medicine administered.

FEVERS.

Measles.— An acute specific disease — afebrile and infec-
tious, ushered in with catarrhal symptoms and characterised
by an ernpHon on the skin, which appears usually on the
fourth day.

Usual Sjmptoms.^ After a period of mcubation varying
from twelve to fourteen days (the period of incubation in cases
produced by inoculation is seven days), there is manifested
alternate chilliness and heat, a quickened pulse, aching in the
Umbs, slight headache, soon followed by redness of the eyes,
coryza, huskiness and hoarse cough. On the fourth day there
is an eruption of soft, drci^, very slightly devated dusky
red spots, which appear first on the forehead, and extend over
the face, neck and whole body. The spots gradually coalesce
and present a peculiar crescentic or horseshoe shape. The
spots disappear on pressure. They attain their greatest in-
tensity on the fourth day from their invasion, and by die
seventh day they fade away with a slight desquamation of die
cudde. As a rule the fever does not abate on the appearance
of the erupdon.

The contagion of measles is acdve during, the prodromis
stage. Red spots are visible on the vdum palad foor, five,
or six days before the erupdon appears on the skin.

Occasional Symptoms. — ^There may be no prodromata
whatever, or the attack may be ushered in with convulsions
(especially in children), or there may be delirium, or there
may be a great amount of fever, or there may be and often
is sore throat ; more rarely severe headache, and s(unetimes
absence of the coryza.

The erupdon may be scanty, or most abundant and con-
fluent, but the quandty of the erupdon/^ u does not affect
the gravity of the attack ; the color of the eruption may be
dark, con^itituting so called *' black measles " ; there may be
petechise, which do not fade on pressure and resemble pu^
pura ; these do not ^ se affect the prognosis. Miliary vest*



Online LibraryNugent RobinsonCollier's cyclopedia of commercial and social information and treasury of ... → online text (page 124 of 148)