MUMPS (Parotitis).—This is an acute infectious disease of one or both of the parotid glands, located at the angle of the jaw, and extending up to the ear, and, also, to other salivary glands. It appears only once. One attack gives immunity. It may come at any age; but appears mostly before the age of fifteen. It comes on one side first and may pass over to the other side in a few days, as it usually does, and gives the face a broad appearance, under the ears, or ear, and makes chewing and swallowing almost impossible. There is no soreness of the throat in mumps. In well-marked cases there is considerable fever and pain. It may last from a few days to a week. The usual length of time the disease lasts is one week. There is no tendency to form pus, even when the face is very hard and swollen and tender. It will occasionally leave the face and appear in the breasts and ovaries in the females or in the testicles of the males, and in both places it causes much pain.
Treatment.—The patient should be kept in the house and isolated in bed as long as the symptoms last. When there is much pain, laudanum diluted one-third with water may be applied continually with a soft warm cloth. Oil of hyoscyamus applied twice daily to the sore parts is good if laudanum is not used. When the swelling goes down I know of nothing as good as a hot bean poultice, which must be changed often so as to keep hot. Bean poultice.—Simply boil the beans in water until they are soft and thick enough to use as a poultice. The bowels should be kept open with salts. The food must be liquid, such as milk, soups and gruels. If there is not much fever, soft boiled eggs and milk toast from the beginning. Do not use vinegar, acids or astringents.
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WHOOPING-COUGH (Pertussis).—Whooping cough is an acute specific infectious, disease caused by a micro-organism. It is characterized in a majority of cases by a spasmodic cough, accompanied by a so-called whoop. It is not only infectious, but very contagious. It is propagated through the atmosphere in schools and public places; the air of which is contaminated with the specific agent of the disease. This agent is thought to reside in the sputum and the secretions of the nose and air passages of the patient. It is very contagious at the height of the attack. The sputum of the first or catarrhal stage is thought to be highly contagious. The sputum in the stage of decline is also thought to be capable of carrying the disease. It prevails in all countries and climates. During the winter and spring months it is most frequent. At times it prevails as an epidemic. It occurs most frequently in infancy and childhood, but a person can take it at any age. Second attacks are rare. It is most frequent between the first and second year; next most frequent between the sixth and twelfth month. After the fifth year the frequency diminishes up to the tenth year, after which the disease is very infrequent. Not everyone who is exposed contracts the disease. It seems that whooping-cough, measles, and influenza frequently follow one another in epidemic form. This is one of the diseases much dreaded by parents. It is very tedious and endangers the life of weak and young children by exhaustion. It is a terrible thing to watch one with this disease, day in and day out. It can be known by the impetuous, continuous and frequent coughing spells, following each other rapidly until the patient is out of breath, with a tendency to end in vomiting. When it comes in the fall or winter months there will likely be spasmodic coughing until summer through the usual colds contracted. Summer is the best time to have it.
Symptoms.—There is an incubation stage, but it is hard to determine its length. After the appearance of the symptoms there are three stages; the catarrhal, the spasmodic, and the stage of decline.
The First Stage.—This is characterized by a cough which is more troublesome at night. One can be suspicious, when instead of getting better in a few days, it gets worse and more frequent, without any seeming cause. After four or five days the cough may be accompanied by vomiting, especially if the cough occurs after eating. There may be some bronchitis, and if so there will be one or more degrees of fever. Fever is present as a rule, only during the first few days, unless there is bronchitis. As the case passes into the spasmodic or second stage, the paroxysms of coughing last longer, the child becomes red in the face and spits up a larger amount of mucus than in ordinary bronchitis. This period of the cough without a whoop, may last from five to twelve days. In some cases there is never a whoop. The child has a severe spasmodic cough, followed by vomiting. Usually at the close of this stage the incessant cough causes slight puffiness of the eyelids and slight bloating of the face.
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Spasmodic or Second Stage.—The peculiar whoop is now present. The cough is spasmodic. The child has distinct paroxysms of coughing which begin with an inspiration (in-breathing) followed by several expulsive, explosive coughs, after which there is a deep, long-drawn inspiration which is characterized by a loud crowing called the "whoop." This paroxysm may be followed by a number of similar ones. When the paroxysm is coming on the face assumes an anxious expression, and the child runs to the nearest person or to some article of furniture and grasps him or it with both hands. It is so severe sometimes that the child will fall or claw the air, convulsively. In the severest and most dangerous types, a convulsion may come on in a moderate degree, the face is red or livid, the eyes bulge and when the paroxysm ends a quantity of sticky tenacious mucus is spit up. In other cases there is vomiting at the end of the paroxysm. There is frequently nose-bleed. In the intervals the face is pale or bluish, eyelids are puffy and face swollen. There is little bronchitis at this period in the majority of cases. In some cases the number of paroxysms may be few. There are generally quite a number during the twenty-four hours.
Stage of the Decline.—In this stage the number and severity or the paroxysms lessen. They may subside suddenly or gradually after four to twelve weeks. The whoop may reappear at times. The cough may persist, more or less, for weeks after the whoop is entirely gone.
Complications.—Bronchitis is common, it may be mild or severe. It may run into capillary bronchitis and this is dangerous.