The maternal management of children, in health and disease

by Thomas Bull

MATERNAL MANAGEMENT.—Measles, in its ordinary and simple form, is a mild, and by no means dangerous, disease: it is sometimes, however, accompanied or immediately followed by symptoms of a very serious character, and which, it is to be feared, in many instances, owe their origin to the carelessness of the attendants in the sick chamber. A mother's superintendence, therefore, is much required at this time to insure a careful attention to the medical directions, as also to those general points of management upon which the well-doing of her child much depend, of which the following are the most important:—

VENTILATION OF THE BED-ROOM, ETC.—The child must be kept in bed from the onset of the attack. He must have so much clothing only as will secure his comfort, avoiding equally too much heat or exposure to cold. To these points the parent's attention must be particularly directed. It is the practice with some nurses, in the belief that a breath of cool air is most pernicious, to keep the child constantly enveloped in a smothering heap of bed-clothes, with curtains closely drawn, and the room well heated by fire, by which means the fever and all its concomitant dangers are greatly augmented. It is equally a popular error (and yet by many it is still held and acted upon) to suppose that because in small-pox exposure to cold is useful, that therefore it must be of equal advantage in measles. It cannot be too generally known that the nature of the fevers accompanying the two diseases are widely different, and that the adoption of this error is productive of the most serious consequences; for it would most likely produce in measles inflammation of the lungs, which, in truth, is commonly the result of carelessness upon this point.

The bed-room should be large and airy; free from currents of cold, but well ventilated, and not hot. The room, also, must be darkened, on account of the tenderness of the eyes; all noise excluded, and mental excitement or irritation carefully avoided.

REGIMEN.—Little or no food must be allowed, and whatever is taken must be of the simplest kind, and in a liquid form. Mild mucilaginous drinks, and warm, may be given liberally; as barley-water, or thin gruel, etc.

SPONGING, ETC.—The face, chest, arms, and hands should be sponged occasionally with vinegar and warm water (one fourth and three fourths). This will be productive of great comfort to the little patient; it removes the heat, dryness, and itching of the skin, which are often very distressing; and is especially useful at night in relieving wakefulness. If the cough be troublesome, it will be useful for the child to breathe the steam of warm water; not through an inhaler, but over a large basin, with the head covered with flannel large enough to hang over its edges. By this means the tender and inflamed eyes will at the same time derive advantage from the soothing effect of the vapour.

CAUTIONS.—Whenever the measles is known to be prevalent in a neighbourhood, and a child manifests symptoms of cold in the head and fever, it should at once be a reason for carefulness on the part of the parent. The diet should be light, cooling, and scanty; and the child should be carefully kept in doors.

It has been before remarked, that in its ordinary course measles is a disease unaccompanied with danger, but that the mildest form may be speedily converted into the most dangerous. That is to say, a sudden change may lake place in the symptoms, arising out of circumstances which could not have been foreseen, and therefore unavoidable; or may be produced by improper management on the part of the nurse, such as the giving of stimulants, by too much heat, or by exposure to cold. Now it is for the parent early to notice any change which may occur from the first source, and by her watchfulness to guard against the possibility of its arising from either of the second.

In reference to the first, if the child should complain at any period of the disease of severe headach, with piercing pain through the temples, and if this is accompanied by wandering of mind, great increase of suffusion of the eyes, as also intolerance of light, the immediate attention of the medical man is demanded. So, if towards the dose of the eruption, that is, from the seventh to the ninth day, the breathing should again become hurried (this symptom is very generally present during the height of the eruption, and is not necessarily connected with disease of the lungs), with pain and oppression felt at the chest, the cough becoming hacking and incessant, etc. (all symptoms cognizable by the mother, and indicative of inflammation of the lungs), no time must be lost in seeking medical aid.

With regard to the last cause (improper management), it may be well, in reference to it, to observe, that it sometimes happens that the rash comes out imperfectly, or, having appeared properly, suddenly retrocedes and disappears; and that under such circumstances the nurse will almost certainly, if not well watched, give the child "a good dose of sulphur in diluted spirit, or a glass of punch containing saffron," which are considered specifics for bringing out the eruption. Nothing can be more injurious than such remedies, for generally the disappearance of the rash will be dependent upon the existence of some internal inflammation, or of too high a fever; for the removal of which the medical man ought to be instantly applied to. Sometimes, however, it may be fairly traced to a careless exposure to cold: under such circumstances the child should be instantly, and without hesitation, put into the warm bath.

Measles are frequently followed by cough, and deranged bowels; and there is always great susceptibility about the child for some time. On this account he should be carefully screened from a cold or damp atmosphere; the diet should be carefully regulated; and flannel worn next to the skin. If the cough should continue, it must not be neglected on the supposition that it will wear off; for it demands the skilful and careful attention of the medical man.