Cough is a constant and incessant symptom. It disturbs rest and sleep and may cause frequent vomiting. There is no expectoration. A strong cough is a good symptom; if it stops it is a bad symptom.
Pain is seldom present.
Blueness of the skin is a bad sign and indicates failure of respiration and suggests constant and careful watching.
Delirium may be present during the disease. It is not necessarily a bad sign. Accompanying stomach troubles are frequent if the patient is very young, and are very important. The bowels may be loose; they may be green in color and contain much mucus. Large quantities of gas may accumulate in the intestines and may cause much distress and convulsions. Death may occur at any time or the process may be arrested and recovery take place at any stage of the disease. Broncho-pneumonia is not necessarily a fatal disease in a fairly healthy child. It is, however, always a serious disease.
Various complications may occur in the course of the disease. The most frequent are: pleurisy, emphysema, abscess of the lung, meningitis, heart disease, stomach troubles, thrush, intestinal disease.
How to Tell When a Child Has Broncho-Pneumonia.—If a child develops a high fever, breathes rapidly, coughs, and is content to lie in bed because of the degree of prostration, broncho-pneumonia is almost certain to be the disease present. If in addition to these symptoms there is any blueness of the fingers or around the mouth it is more strongly suggestive of pneumonia.
If the child has been suffering with bronchitis it is sometimes difficult to tell just when the pneumonia begins. The child will appear more profoundly sick, the fever will go higher, and the respiration will be more frequent when pneumonia sets in on top of bronchitis.
Treatment.—The nursing of a little patient with pneumonia is the most important part. He must get plenty of fresh air; consequently he should be kept in a well-ventilated room. It is an excellent plan to change the patient twice daily from the sick room into another which has previously been thoroughly aired. While he is in this room the sick room should be as thoroughly aired as is possible. Keep this plan up all through the disease; change the position of the patient in bed every two hours. He should never be allowed to lie on his back for hours at a time. In this way the different parts of the lungs get a chance to air themselves,—the air cells expand and the oxygen in the air and the fresh blood tend to heal the parts more quickly.
It would be distinctly wrong to go into the detailed symptomatic treatment of broncho-pneumonia in a book of this character. Inasmuch as this is one of the most serious diseases of infancy, no mother should attempt to treat it alone. A physician is absolutely necessary and the most the mother can hope to do is to follow out his directions to the letter.
He may direct the use of mustard pastes but it is essential to know where to apply them. If he should request the use of the cotton jacket, the height and character of the fever must regulate its use. Stimulants are always necessary, whisky and strychnine being given in every case, but if given at the wrong time they may do more harm than good. Cough mixtures may be necessary, but frequently they are contra-indicated. Drugs and cold sponging may be used to reduce the fever, but they are dangerous if used when conditions do not justify their use. Complications must be diagnosed when they occur, and the correct methods of treatment promptly instituted. A competent physician alone can assume the responsibility of these various phases of the disease.