The Book of Household Management

by Mrs. Beeton

HOOPING-COUGH, CROUP, AND DIARRHOEA, WITH THEIR MODE OF TREATMENT.

Hooping-Cough.

2564. THIS is purely a spasmodic disease, and is only infectious through the faculty of imitation, a habit that all children are remarkably apt to fall into; and even where adults have contracted hooping-cough, it has been from the same cause, and is as readily accounted for, on the principle of imitation, as that the gaping of one person will excite or predispose a whole party to follow the same spasmodic example. If any one associates for a few days with a person who stammers badly, he will find, when released from his company, that the sequence of his articulation and the fluency of his speech are, for a time, gone; and it will be a matter of constant vigilance, and some difficulty, to overcome the evil of so short an association. The manner in which a number of school-girls will, one after another, fall into a fit on beholding one of their number attacked with epilepsy, must be familiar to many. These several facts lead us to a juster notion of how to treat this spasmodic disease. Every effort should, therefore, be directed, mentally and physically, to break the chain of nervous action, on which the continuance of the cough depends.

2565. Symptoms.—Hooping-cough comes on with a slight oppression of breathing, thirst, quick pulse, hoarseness, and a hard, dry cough. This state may exist without any change from one to two or three weeks before the peculiar feature of the disease-the hoop-sets in. As the characteristics of this cough are known to all, it is unnecessary to enter here, physiologically, on the subject. We shall, therefore, merely remark that the frequent vomiting and bleeding at the mouth or nose are favourable signs, and proceed to the

2566. Treatment, which should consist in keeping up a state of nausea and vomiting. For this purpose, give the child doses of ipecacuanha and antimonial wines, in equal parts, and quantities varying from half to one and a half teaspoonful once a day, or, when the expectoration is hard and difficult of expulsion, giving the following cough mixture every four hours. Take of

Syrup of squills 1/2 ounce.
Antimonial wine 1 ounce.
Laudanum 15 drops.
Syrup of Toulou 2 drachms.
Water 1-1/2 ounce.

Mix. The dose is from half a spoonful to a dessertspoonful. When the cough is urgent, the warm bath is to be used, and either one or two leeches applied over the breastbone, or else a small blister laid on the lower part of the throat.

2567. Such is the medical treatment of hooping-cough; but there is a moral regimen, based on the nature of the disease, which should never be omitted. And, on the principle that a sudden start or diversion of the mind will arrest a person in the act of sneezing or gaping, so the like means should be adopted with the hooping-cough patient; and, in the first stage, before the hooping has been added, the parent should endeavour to break the paroxysm of the cough by abruptly attracting the patient's attention, and thus, if possible, preventing the cough from reaching that height when the ingulp of air gives the hoop or crow that marks the disease; but when once that symptom has set in, it becomes still more necessary to endeavour, by even measures of intimidation, to break the spasmodic chain of the cough. Exercise in the open air, when dry, is also requisite, and charge of scene and air in all cases is of absolute necessity, and may be adopted at any stage of the disease.

Croup.

2568. This is by far the most formidable and fatal of all the diseases to which infancy and childhood are liable, and is purely an inflammatory affection, attacking that portion of the mucous membrane lining the windpipe and bronchial tubes, and from the effect of which a false or loose membrane is formed along the windpipe, resembling in appearance the finger of a glove suspended in the passage, and, consequently, terminating the life of the patient by suffocation; for, as the lower end grows together and becomes closed, no air can enter the lungs, and the child dies choked. All dull, fat, and heavy children are peculiarly predisposed to this disease, and those with short necks and who make a wheezing noise in their natural breathing. Croup is always sudden in its attack, and rapid in its career, usually proving fatal within three days; most frequently commences in the night, and generally attacking children between the ages of three and ten years. Mothers should, therefore, be on their guard who have children predisposed to this disease, and immediately resort to the means hereafter advised.

2569. Symptoms.—Languor and restlessness, hoarseness, wheezing, and short, dry cough, with occasional rattling in the throat during sleep, the child often plucking at its throat with its fingers; difficulty of breathing, which quickly becomes hard and laboured, causing great anxiety of the countenance, and the veins of the neck to swell and become knotted; the voice in speaking acquires a sharp, crowing, or croupy sound, while the inspirations have a harsh, metallic intonation. After a few hours, a quantity of thick, ropy mucus is thrown out, hanging about the mouth, and causing suffocating fits of coughing to expel.

2570. Treatment.—Place the child immediately in a hot bath up to the throat; and, on removal from the water, give an emetic of the antimonial or ipecacuanha wine, and, when the vomiting has subsided, lay a long blister down the front of the throat, and administer one of the following powders every twenty minutes to a child from three to six years of age.

2571. Take of calomel, 12 grains; tartar emetic, 2 grains; lump sugar, 30 grains. Mix accurately, and divide into 12 powders. For a child from six to twelve years, divide into 6 powders, and give one every half-hour.

2572. Should the symptoms remain unabated after a few hours, apply one or two leeches to the throat, and put mustard poultices to the foot and thighs, retaining them about eight minutes; and, in extreme cases, a mustard poultice to the spine between the shoulders, and at the same time rub mercurial ointment into the armpits and the angles of the jaws.

2573. Such is a vigorous and reliable system of treatment in severe cases of croup; but, in the milder and more general form, the following abridgment will, in all probability, be all that will be required:—First, the hot bath; second, the emetic; third, a mustard plaster round the throat for five minutes; fourth, the powders; fifth, another emetic in six hours, if needed, and the powders continued without intermission while the urgency of the symptoms continues. When relief has been obtained, these are to be discontinued, and a dose of senna tea given to act on the bowels.

Diarrhoea.

2574. The diarrhoea with which children are so frequently affected, especially in infancy, should demand the nurse's immediate attention, and when the secretion, from its clayey colour, indicates an absence of bile, a powder composed of 3 grains of grey powder and 1 grain of rhubarb, should be given twice, with an interval of four hours between each dose, to a child from one to two years, and, a day or two afterwards, an aperient powder containing the same ingredients and quantities, with the addition of 2 or 3 grains of scammony. For the relaxation consequent on an overloaded stomach, or acidity in the bowels, a little magnesia dissolved in milk should be employed two or three times a day.

2575. When much griping and pain attend the diarrhoea, half a teaspoonful of Dalby's Carminative (the best of all patent medicines) should be given, either with or without a small quantity of castor oil to carry off the exciting cause.

2576. For any form of diarrhoea that, by excessive action, demands a speedy correction, the most efficacious remedy that can be employed in all ages and conditions of childhood is the tincture of Kino, of which from 10 to 30 drops, mixed with a little sugar and water in a spoon, are to be given every two or three hours till the undue action has been checked. Often the change of diet to rice, milk, eggs, or the substitution of animal for vegetable food, or vice versa, will correct an unpleasant and almost chronic state of diarrhoea.

2577. A very excellent carminative powder for flatulent infants may be kept in the house, and employed with advantage, whenever the child is in pain or griped, by dropping 5 grains of oil of aniseed and 2 of peppermint on half an ounce of lump sugar, and rubbing it in a mortar, with a drachm of magnesia, into a fine powder. A small quantity of this may be given in a little water at any time, and always with benefit.