If her child be feverish and irritable, if his stomach be disordered, if he have urgent vomitings, if he have a foul breath, if his appetite be capricious and bad, if his nights be disturbed (screaming out in his sleep), if his bowels be disordered, more especially if they be constipated, if he be more than usually excited, if his eye gleam with unusual brilliancy, if his tongue run faster than it is wont, if his cheek be flushed and his head be hot, and if he be constantly putting his hand to his head; there is cause for suspicion. If to these symptoms be added, a more than usual carelessness in tumbling about, in hitching his foot in the carpet, or in dragging one foot after the other; if, too, he has complained of darting, shooting, lancinating pains in his head, it may then be known that the first stage of inflammation (the forerunner of water on the brain) either has taken, or is about taking place. Remember no time ought to be lost in obtaining medical aid; for the commencement of the disease is the golden opportunity, when life might probably be saved.
200. At what age, and in what neighbourhood, is a child most liable to croup, and when is a mother to know that it is about to take place?
It is unusual for a child until he be twelve months old to have croup: but, from that time until the age of two years, he is more liable to it than at any other period. The liability after two years, gradually, until he be ten years old, lessens, after which time it is rare.
A child is more liable to croup in a low and damp, than in a high and dry neighbourhood; indeed, in some situations, croup is almost an unknown disease; while in others it is only too well understood. Croup is more likely to prevail when the wind is either easterly or north-easterly.
There is no disease that requires more prompt treatment than croup, and none that creeps on more insidiously. The child at first seems to be labouring under a slight cold, and is troubled with a little dry cough, he is hot and fretful, and hoarse when he cries. Hoarseness is one of the earliest symptoms of croup, and it should be borne in mind that a young child, unless he be going to have croup, is seldom hoarse, if, therefore, your child be hoarse, he should be carefully watched, in order that, as soon as croup be detected, not a moment be lost in applying the proper remedies.
His voice at length becomes gruff, he breathes as though it were through muslin, and the cough becomes crowing. These three symptoms prove that the disease is now fully formed. These latter symptoms sometimes come on without any previous warning, the little fellow going to bed apparently quite well, until the mother is awakened, perplexed and frightened, in the middle of the night, by finding him labouring under the characteristic cough and the other symptoms of croup. If she delay either to send for assistance, or if proper medicines be not instantly given, in a few hours it will probably be of no avail, and in a day or two the little sufferer will be a corpse.
When once a child has had croup the after attacks are generally milder. If he has once had an attack of croup, I should advise you always to have in the house medicine—a 4 oz. bottle of Ipecacuanha Wine, to fly to at a moments notice, [Footnote: In case of a sudden attack of croup, instantly give a teaspoonful of Ipecacuanha Wine, and repeat it every fire minutes natal free vomiting be excited.] but never omit, where practicable, in a case of croup, whether the case be severe or mild to send immediately for medical aid. There is no disease in which time is more precious than in croup, and where the delay of an hour may decide either for life or for death.
201. But suppose a medical man is not IMMEDIATELY to be procured, what then am I to do? more especially, as you say, that delay might be death?
What to do.—I never, in my life, lost a child with croup with catarrhal croup where I was called in at the commencement of the disease, and where my plans were carried out to the very letter. Let me begin by saying, look well to the goodness and purity of the medicine, for the life of your child may depend upon the medicine being genuine. What medicine! Ipecacuanha Wine! At the earliest dawn of the disease give a few spoonful of Ipecacuanha Wine every five minutes, until free vomiting be exerted. In croup, then, before he be safe, free vomiting must be established, and that without loss of time. If, after the expiration of an hour, the Ipecacuanha Wine (having given during that hour one or two tea-spoonfuls of it every five minutes) be not sufficiently powerful for the purpose—although it generally is so—(if the Ipecacuanha Wine be good)—then let the following mixture be substituted—
Take of—Powdered Ipecacuanha, one scruple,
Wine of Ipecacuanha, one ounce and a half