A frequent change of air is exceedingly useful in hooping cough, particularly short voyages at sea; at the same time flannel is to be worn next the skin. Young children should lie with their heads and shoulders raised; and when the cough occurs, they ought to be placed on their feet and bent a little forward, to guard against suffocation. The diet should be light, and the drink warm and mucilaginous.
THE CROUP.
The croup is a disease peculiar to children, and generally fatal, if care is not taken in the commencement. It commonly approaches with the usual signs of a catarrh, but sometimes the peculiar symptoms occur at the first onset; namely, a hoarseness, with a shrill ringing sound both in speaking and coughing, as if the noise came from a brazen tube. At the same time there is a sense of pain about the larynx, and some difficulty of respiration, with a whizzing sound in inspiration, as if the passage of air was diminished; which is actually the case. The cough is generally dry, but if any thing is spit up, it is a purulent matter, sometimes resembling small portions of a membrane. There are also a frequent pulse, restlessness, and an uneasy sense of heat. The inside of the mouth is sometimes without inflammation, but frequently a redness, and even a swelling exist. Sometimes there is an appearance of matter on them like that rejected by coughing.
Remedies.
As soon as possible a brisk emetic should be administered for the purpose of freeing the patient from the coagulable lymph which is already secreted. Topical bleeding, by means of leeches, should immediately succeed, and the discharge be encouraged. As soon as it diminishes, a blister, sufficiently large to cover the whole throat, should be applied, and suffered to lie on for thirty hours or longer. The steam of warm water should be inhaled, and the bowels should be evacuated by calomel.
As soon as the emetic has operated sufficiently, opium may be administered, by which means the breathing will in general be soon relieved; but should it become more difficult in the course of a few hours, the emetic is to be again repeated, and after its operation the opium again employed. This practice is to be alternately used till the patient is out of danger, which will, in general, be in the course of three or four days. The child should be kept nearly upright in bed.
Children, until the age of six years, are liable to be attacked by bilious fever, which is gradually developed, by irregularity in the bowels, which are either too costive, or too much relaxed.
On its first appearance, the child becomes peevish and fretful, his lips are dry, his hands hot, accompanied by shortness of breath, pains in the head, and quickness of pulse, which beats from 110 to 112 in a minute; he shows an unwillingness to stir or speak, starts in his sleep, and has a loathing for food. The stools have often a mucous and slimy appearance; some children are affected with delirium, others dull and stupid, and many are for a time speechless. Several slight accessions of fever take place in the course of the day, during which the child is usually drowsy; in the intervals of these paroxysms he appears tolerably well, though, at times, unusually peevish.
These symptoms are more or less prevalent for eight or ten days, when suddenly a more violent paroxysm of fever will ensue, preceded by a shivering fit, and sometimes an incessant vomiting of bile. The pulse rises to 140; the cheeks are flushed, the child’s drowsiness increases, and when awake, he resorts to picking at the skin of the nose, lips, and eyes, to a most painful degree.
This species of fever is mild at the commencement, slow in its progress, and very uncertain in its event. The desire for food is destroyed, and the child will take neither aliment nor medicine. The stools are changed from their natural appearances, being sometimes black, and smelling like putrid mud; and at other times they are curdled, with shreds of coagulable lymph floating in a dark green fluid.