Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

231. What are the symptoms of Modified Small-pox?

The Modified Small-pox—that is to say, small-pox that has been robbed of its virulence by the patient having been either already vaccinated, or by his having had a previous attack of small-pox—is ushered in with severe symptoms, with symptoms almost as severe as though the patient had not been already somewhat protected either by vaccination or by the previous attack of small-pox—that is to say, he has a shivering fit, great depression of spirits and debility, malaise, sickness, headache, and occasionally delirium. After the above symptoms have lasted about three days, the eruption shows itself. The immense value of the previous vaccination, or the previous attack of small-pox, now comes into play. In a case of unprotected small-pox, the appearance of the eruption aggravates all the above symptoms, and the danger begins; while in the modified small-pox, the moment the eruption shows itself the patient feels better, and, as a rule, rapidly recovers. The eruption, of modified small-pox varies materially from the eruption of the unprotected small-pox. The former eruption assumes a varied character, and is composed, first, of vesicles (containing water); and, secondly, of pustules (containing matter), each of which pustules has a depression in the centre; and, thirdly, of several red pimples without either water or matter in them, and which sometimes assume a livid appearance. These "breakings-out" generally show themselves more upon the wrist, and sometimes up one or both of the nostrils. While in the latter disease—the unprotected small-pox—the "breaking-out" is composed entirely of pustules containing matter, and which pustules are more on the face than on any other part of the body. There is generally a peculiar smell in both diseases—an odour once smelt never to be forgotten.

Now, there is one most important remark I have to make,—the modified small-pox is contagious. This ought to be borne in mind, as a person labouring under the disease must, if there be children in the house, either be sent away himself, or else the children ought to be banished both the house and the neighbourhood. Another important piece of advice is,—let all in the house—children and adults, one and all—be vaccinated, even if any or all have been previously vaccinated.

Treatment.—Let the patient keep his room, and if he be very ill, his 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, [Footnote: See page 178] 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, &c. 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.

232. 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 favourite 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 inside 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 in chicken-pox are small—much smaller than the pustules in modified small-pox.

233. 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.

234. 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.