If proper surgical cleanliness is practiced and ample protection is afforded in after dressing, vaccination need not be a taxing process. The child suffers from general lassitude—a little drowsiness with loss of appetite and a small amount of fever—but this passes off in a reasonable length of time, especially if he is not overfed and his bowels are looked after. On the second or third day after vaccination a red papule appears which soon grows larger, and, after five or six days, it becomes filled with a watery fluid. By the tenth day it has the appearance of a pustule about the size of a ten-cent piece, surrounded by a red areola about three inches in diameter. At the end of two weeks the pustule has dried down to a good crust or scab, in another week it falls off, leaving a pitted white scar.
If the vaccination does not take, it should be repeated after an interval of two months.
DIPHTHERIA
Diphtheria is a disease much dreaded during childhood and adolescence. It may attack any age—even little babies are susceptible. It begins with a general feeling of heavy, drowsy lassitude with a sore throat. White spots appear on the tonsils which may resemble a simple follicular tonsillitis, while in a short time white patches spread over the throat and tonsils.
It is not at all uncommon for this membrane to attack the nose, producing a bloody, pustular discharge; and when it does attack the nose, it is none the less contagious and must be regarded just as seriously. A physician is called at once, and, not only to the child, but to the other members of the family, antitoxin is immediately administered. The disease runs a regular course and its most dangerous complication is the membrane which forms in the larynx and threatens to suffocate the child unless prompt intubation is performed—the slipping of a silver tube in the larynx to prevent suffocation and death. The early use of antitoxin greatly lessens all these serious complications.
Care must be exercised to prevent sudden heart failure; and this is done by raising the child to an upright position with the utmost care; while you insist upon him lying quietly upon his back or his side, long after the disease has left his throat. While the throat or nose is the seat of disease, the toxins from these most dreaded diphtheritic microbes spread through the lymph channels and the blood vessels to the heart itself—so weakening that organ that it sometimes suddenly fails, or becomes more or less crippled for life. These serious results are to be prevented by the science of good nursing and the prompt use of antitoxin. In these days the "Schick test" may be administered for the purpose of ascertaining whether one is susceptible to contracting diphtheria.
A physician is always in charge of diphtheria, and he will supply directions for the bowels, the diet, and the sprays for the nose and throat, and the general well-being of the suffering child. Isolation and quarantine should continue for two weeks, and in bad cases three weeks, after the membrane has disappeared from the throat.
WHOOPING COUGH
A child suffering from a continuous cough, particularly if it is accompanied by a whoop or a condition which is so often seen in children who cough—not able to stop—should not be taken to church, nor to the movies, nor allowed to go to school; neither should he be allowed to leave his own yard. The average duration of the disease is usually six weeks. The child should have an abundance of fresh air, should spend much of his time out of doors, and while in the house should avoid dust of every kind; at night he should not be exposed to drafts. Call the physician early in the case and he may attempt to thwart the progress of the disease by certain administrations of vaccine medication.
In very bad cases, where a young child cannot catch his breath and gets blue in the face—which, fortunately, is uncommon—he should be slapped in the face with a towel wet in cold water; or, he may be lifted into a tub of warm water, then quickly in cold water, then back into the warm, etc. Hygienic measures should prevail, such as keeping the bowels open, the skin clean, and the use of the usual throat gargles and nasal sprays. Do not be misguided by the old-time thought that whooping cough must run its course; for, if medical aid is promptly secured, the disease may often be cut short and the severe paroxysms greatly lessened.