These children should wear woolen underwear all the year round. They should be encouraged to drink water or vichy freely between meals.
In the treatment of an acute attack as given above it will be observed that no drugs are mentioned. This is intentional because it would be unjust to encourage the home treatment of a disease that is so treacherous, even in its mildest forms. Because of its tendency to recur and with each recurrence the danger of the heart being affected, it is advisable to put these children on cod liver oil or iron or some other good tonic. Every precaution should be taken to prevent these children from getting their feet wet or being out in the rain.
SUMMARY:—
Rheumatism is a dangerous disease in children.
In its mildest forms it can affect the heart badly.
It has a distinct tendency to recur.
Rheumatic children are afflicted with a number of diseased conditions which do not respond to treatment unless the rheumatism is treated.
Acute rheumatism should never be treated except by a physician because of its treacherous character.
MALARIA. INTERMITTENT FEVER
Malaria occurs quite often in infants and children. As a rule the child gives evidence of gastro-intestinal disturbance for a short period before the malarial symptoms appear. The chilly stage is often absent. Sometimes the hands and feet are cold and may be slightly blue and the child may appear to be in collapse. This stage may last for an hour or longer. The chilly stage may, however, be replaced by nervous symptoms,—restlessness, dizziness, irritability, nausea, etc.,—or a convulsion may take place. In the second stage the temperature may rise quite high, the pulse may be quite rapid; the child is flushed, restless, and cries. This period may last from half an hour to two hours. The sweating stage is not as a rule well marked in a child. It may be very slight or not at all.
Between the attacks some children may be entirely well; others remain restless, have little appetite and poor digestion. Malaria in children does not always follow a typical course. We often see children suffering from spasms, fainting spells, neuralgias, diarrhea, vomiting, and skin eruptions, all due to the malarial condition. This often leads to a mistake in diagnosis. Intermittent fever is often mistaken for pneumonia. Malaria is not a favorable disease for an infant to have. It rapidly weakens the child and great debility and anemia follows.
Treatment.—The treatment for malaria in children is by the administration of quinine as in adults. It must, however, be given with care and intelligence; for this reason no mother should begin dosing her child with it without consulting a physician.
REGARDING MOSQUITOES
The following is an extract from a circular in relation to the causation and prevention of malaria and the life history and extermination of mosquitoes issued by the Department of Health, City of New York: