The maternal management of children, in health and disease

by Thomas Bull

Under the foregoing treatment the disease generally runs its course without any untoward event, and the child recovers perfectly. Sometimes, however, although the patient is quite well, and the disease on the decline, the cough still continues. In these cases, and at this time, it is that change of air often proves so very serviceable. The sea-side is preferable, if the season of the year permit; and salt- water bathing, commencing with the warm or tepid bath, and passing gradually to the cold-bath (if no complication forbid it), will also prove certainly and rapidly remedial.

Crying, mental irritation, or opposition, frequently bring on a fit; and even the sight of another in a paroxysm will induce it in those affected by the disease. Running or other active exercise will generally cause the fits to be more severe. Young children, too, must be carefully watched at night, and be raised up by the nurse as soon as the fit is threatened. These hints the mother should bear in mind.

So much for the simple form of the disease, and that in which it most frequently and commonly presents itself to our notice: a mild disease; and, if carefully managed and watched over, certainly not a dangerous one.

Of what, then, is a parent to be afraid, or against what is she to guard? Lest other disease insidiously come on, and advance to an irremediable degree, masked by the cough, without attracting her attention. This is the great source of danger in hooping-cough. The physician, in a case of simple hooping-cough, is not in daily attendance upon his patient, and therefore not present to notice the commencement or first symptoms of those diseases which so frequently occur at this time, and the successful treatment of which will mainly depend upon their early detection, and the decision with which they are treated. When you hear of a child or several children in a family dying of hooping-cough, it is not this disease which proves fatal; but death is caused by some disease of lungs or brain, which has been super-added to the hooping-cough. The progress of hooping-cough, then, must be closely attended to by the parent, even in the most favourable cases.

The most frequent complication with hooping-cough is inflammation of the air-tubes of the lungs. This is extremely frequent during spring and winter, especially in the months of February, March, and April, owing to the prevalence of easterly winds at this season. It is not my intention to detail the symptoms of this affection, only to point out those which will enable a parent to recognise its approach. A parent then may take warning, and fear the approach of mischief, when she observes the fits of coughing become more frequent and more distressing to the child, and the breathing hurried in the intervals of the paroxysm; when any exertion or speaking causes increased difficulty of breathing or panting; when the expectoration becomes less abundant, and difficult to get up; when there is no longer, or at all events less frequent, vomiting after the cough, and more or less febrile symptoms present.

If the lungs themselves are attacked by inflammation, most of the symptoms already pointed out will occur; the cough will be frequent, in short paroxysms; the vomiting will not take place; the breathing will be very quick and hurried; and as the disease advances the hoop will cease.

If hooping-cough attack a child whilst teething, or from six months to two or three years of age, it is very common for the brain to suffer, and convulsions and water on the head to occur, particularly if the latter disease prevails in the family. Whenever the paroxysm of cough is increased in violence, the characteristic hoop disappearing, and the face becomes very livid; the hands clenched, and the thumbs drawn into the palms; the head hot, and marked fits of drowsiness and languor; and the child, during sleep, screaming out, or grinding its teeth,— something wrong about the head ought to be anticipated. Of the treatment we have here nothing to say, except that the gums must be carefully examined, and scarified if they require it, and the temperature of the head reduced by cold sponging, or the application of a bag of ice when necessary. The chief duty, however, of the parent is to be alive to these symptoms, and early to detect the incipient mischief, that by a prompt application of efficient means the accession of so formidable a malady may be prevented.

To specific remedies for this disease it is scarcely necessary to allude, after what has been advanced, except by way of warning. In the simple form of the complaint such medicines are superfluous, or rather some of them, from their violent properties, most dangerous; in the complicated forms of the disease they are inadmissible.

The indiscriminate use of purgatives, also, a parent should avoid. Bowel affections are not an infrequent attendant upon hooping-cough, and always aggravate the primary disorder.

Of external applications all that need be said is this, that if they are not violently stimulating they do no harm; if, however, they contain tartar emetic, in addition to their doing no good to the disease, they cause unnecessary suffering to the patient, and are sometimes productive of dangerous and even fatal sores.