The Physical Training of Children

by Pye Henry Chavasse

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 (See question 209), 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, etc. 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.

227. 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 favorite 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 wings 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, too, in chicken-pox are small—much smaller than the pustules are in modified small-pox.

228. 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.

229. 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.

Hooping-cough commences as a common cold and cough. The cough, for ten days or a fortnight, increases in intensity; at about which time it puts on the characteristic “hoop.” The attack of cough comes on in paroxysms.

In a paroxysm the child coughs so long and so violently, and expires so much air from the lungs without inspiring any, that at times he appears nearly suffocated and exhausted; the veins of his neck swell; his face is nearly purple; his eyes, with the tremendous exertion, seem almost to start from their sockets; at length there is a sudden inspiration of air through the contracted chink of the upper part of the windpipe—the glottis—causing the peculiar “hoop;” and, after a little more coughing, he brings up some glairy mucus from the chest; and sometimes, by vomiting, food from the stomach; he is at once relieved until the next paroxysm occurs, when the same process is repeated, the child during the intervals, in a favorable case, appearing quite well, and after the cough is over, instantly returning either to his play or to his food. Generally, after a paroxysm he is hungry, unless, indeed, there be severe inflammation either of the chest or of the lungs. Sickness, as I before remarked, frequently accompanies hooping-cough; when it does, it might be looked upon as a good sign. The child usually knows when an attack is coming on; he dreads it, and therefore tries to prevent it; he sometimes partially succeeds; but if he does, it only makes the attack, when it does come, more severe. All causes of irritation and excitement ought, as much as possible, to be avoided, as passion is apt to bring on a severe paroxysm.

A new-born babe, an infant of one or two months old, commonly escapes the infection; but if at that tender age he unfortunately catch hooping-cough, it is likely to fare harder with him than if he were older—the younger the child the greater the risk. But still, in such a case, do not despair, as I have known numerous instances of new-born infants, with judicious care, recover perfectly from the attack, and thrive after it as though nothing of the kind had ever happened.