It must be laid down as a RULE never to be violated, that every child must have at least one passage a day from the day it is born, and it is the imperative duty of mother or nurse to see that it is accomplished. The infant of only a few days or weeks old may require only a few drops of olive oil, but if that delays in its effect it may become necessary to give relief at once, and for this purpose we have in a small warm water enema a most decided and effectual remedy. Soapsuds should never be used, except in very urgent cases, for I have known a diarrhoea to ensue from the irritation it caused which was very hard to control. If the feces are not very hard a soap suppository may be used with good advantage, and in the following manner: Take a piece of soap and pare it to a point the thickness of a lead pencil and about an inch long, moisten this and introduce carefully into the rectum; if the straining bring only the soap away it may be well to use the water enema afterward. If the constipation continues to be habitual a slight modification of the diet becomes necessary; starchy foods must not be given as often, and thinner than formerly; the milk too should be more diluted; broth or beef tea substituted once or twice each day will often have a good effect. When children are old enough to eat mixed food the diet can often be so regulated as to materially contribute towards opening the bowels. The children should be encouraged to drink a great deal of water; from the lack of that alone some children become constipated. Graham bread and boiled German prunes are especially to be recommended; so are ripe raw fruits, grapes, strawberries, apples, pears, etc. Children require fresh air and outdoor exercise to be well and robust; they run and jump more when in the open air, all of which gives tone and strength to the general system. If diet and outdoor exercise alone does not remedy the evil, then the Femina laxative syrup should be administered; it is efficient in its action, and pleasant to take, and unlike most laxative or aperient remedies, there is no danger of forming a habit of using purgatives.
(h) Whooping cough is the name of an affection deriving its significance from a characteristic which is peculiar to this cough. It commences like an ordinary bronchitis such as is the result of taking cold; there is the usual hoarseness, tickling in the throat, dry cough, sneezing, running from the nose; the eyes are red and watery, and there is more or less fever. Sometimes the cough is ordinary, but at other times it has a sharp metallic clang from the beginning. Owing to certain marked periods in the course of the affection it has been found convenient to divide it into three stages which may usually be distinguished, although in a certain proportion of cases the first stage (comprising some of the symptoms that have been enumerated above) may be submerged into the second or whooping stage. The first stage may last from four to five days to as many weeks. The second stage is when the peculiar sound or whoop begins; it consists of a great number of violent paroxysms, rapidly-recurring spasmodic coughs, until most of the air in the lungs is expired; there is then a sense of suffocation and the child becomes bluish red over the entire head and face, from which the German designation blue cough has originated. During this spell the face swells and the eyeballs become congested and bulge from their orbits and the nose often begins to bleed, while the urine and feces are often involuntarily ejected and the contents of the stomach thrown up from the violent contraction of the diaphragm. In a few moments the spell is broken by a protracted, whistling croupy inspiration, and this constitutes the whoop.
The whooping generally grows worse the first two or three weeks, after which time in favorable cases the cough gradually becomes milder, but this is not the rule by any means. I have had it in my own family to last, in two instances, six months, and in another eight months before the children had fully recovered.
Laughing or crying, swallowing dry, irritating morsels of food or cold and impure air will bring on a paroxysm of cough. When several children are affected together, the coughing of one will make the others cough.
The third stage is when the cough is wearing off and has lost its severity. The expectoration consists now of a yellowish or green-colored mucus; in otherwise healthy children this lasts only a few weeks, but in weakly or scrofulous ones it may last for several months. This disease is not as yet thoroughly understood. It is an epidemic, contagious bronchial catarrh, involving the nerves of respiration and attacks an individual but once. When complications arise the affection becomes exceedingly dangerous and the most common of these is pneumonia.
There is no specific cure for whooping cough; it has got to run its course, which may be either short or long. I have tried every agent so far known to scientific medicine, and there is none that will give prompt relief in every instance. Whooping cough being a bronchitis plus something else, it seems rational that the same precautions that are observed in a case of bronchitis should be followed here. Children with this affection must not be exposed to drafts or rough winds lest they get cold, which might seriously complicate matters. In summer when the weather is warm, outdoor life is beneficial in hastening recovery. Some children have the cough so light, that no extra precautions seem to be necessary; they have no fever, eat, feel and sleep well. But those who are feverish, who vomit freely, and whose appetite is capricious, require every attention. Their diet should be especially guarded, so that all dry, irritating nutriments are prohibited, and so that the diet consists principally of liquid nourishment. Warm drinks have a favorable influence on the disease; a plentiful supply of warm milk, first thoroughly beaten with an egg beater is the most suitable and convenient. The milk punch is often borne well, and the little whisky that enters into its composition is a needed stimulant to the sufferer; broths may be given for a change, and to these the yolk of an egg can be added with advantage. A great many remedies might be suggested, but the one which has served my purpose the best, is the following:
| Take: | Deodorized tincture, of opium | ½ dram |
| Fluid extract, of belladonna | 4 drops | |
| Fluid extract, of ipecac. | 10 drops | |
| Simple syrup | 2 ounces |
For a child five years old, give a teaspoonful three or four times a day; older or younger children in proportion. If the cough is hard and dry, ten to twenty drops of syrup of ipecac alone should be given instead of the mixture, and when the cough is loosened, the mixture can be again administered. When in the course of the affection the breathing suddenly becomes labored, and the fever increases, it is fair to presume that the case is complicated with pneumonia.
(i) Eruptive fevers, as their name implies, are characterized by an eruption or exanthema. The most virulent of this class is smallpox. The eruption of this disease is of the nature of vesicles, or pustules, while that of measles, scarlatina, and rose rash is dry, and is properly called a rash. Chickenpox, however, has also vesicles and pustules, and for this reason it is very liable in times of an epidemic of smallpox to be mistaken for a mild form of the latter disease. For obvious reasons it is not proper to consider smallpox in this connection; its gravity and its management require experience, and further, it generally comes under special quarantine regulations of the proper constituted authorities.