The Mother And Her Child Part 43

Isolation should be maintained for ten days or two weeks after all symptoms have disappeared.

SCARLET FEVER

Scarlet fever is one of childhood's most dreaded diseases because of, first, its long quarantine; second, its terrible possibilities of contagion; and, third, its sequelae.

Absolute quarantine is necessary until ten days after the last signs of desquamation have disappeared.

This disease is always alarming because of the possibilities of its sequelae--the danger of pneumonia, inflammation of the ears, abscesses of the glands of the neck, and nephritis (inflammation of the kidneys).

Scarlet fever is highly contagious at any time during its onset and course. Among the first symptoms of the disease are sore throat, swollen glands, fever, etc. Vomiting on a street car or at the movie may spread the disease to more than one child who might otherwise have escaped. One child who may have only a very light form of the disease may give it to another child in the most severe form. Any such group of cla.s.sic symptoms--vomiting, fever, rapid pulse, and sore throat--should cause any parent immediately to isolate the little sufferer for several days--awaiting the "rash"--which usually puts in its appearance after three or four days of increasing temperature.

This rash has an appearance "all of its own," unlike any other.

Because the fine "meal-like" red points are in such close proximity, the skin a.s.sumes a smooth "lobster red" color that is never to be forgotten. After three days of increasing redness, the color begins slowly to fade, and after four or five days of this fading a peculiar peeling takes place, whose scales vary in size from a small fleck to casts of the whole of the soles of the feet and the palms of the hands.

During the height of the disease, the throat is very red, the tonsils are not only inflamed, but covered over with white patches, the head aches and the tongue possesses a peculiar coating through which peep the red points of the swollen papillae, presenting the cla.s.sic "strawberry tongue" of scarlet fever.

After ten days the fever disappears and the "real sick" stage of the disease is in the past.

Each morning of the ten previous days a small dose of Epsom salts is usually administered and the itching, which so often accompanies the rash, is relieved by carbolized-water sponge baths.

The nose, throat, and ears receive daily care--sprays to the nose and gargles to the throat, as well as special swabbing to the tonsils.

The physician in charge of the case will note the urinary findings, guard the heart and kidneys, prevent the spreading of the scales of desquamation by frequent rubbing of the skin with oil, and otherwise work for the future well-being of the patient.

MEASLES

Measles, one of the most common diseases of childhood, is not to be regarded lightly, for very often its sequelae--running ears, weak eyes, and bronchial coughs--may prove very serious and troublesome.

Tuberculosis of the lungs not infrequently follows in the wake of measles. The early symptoms of measles are so mild that often the child is out of doors, at school, or about his usual play, until the second or third day of the fever. He was supposed merely to be suffering from a simple "cold in the head."

On the third or fourth day the patient begins heavy sneezing and wears a stupid expression; and it is then that the mother ascertains that his temperature is perhaps 101 to 102 F. He is put to bed and the next day the rash usually appears. The rash is peculiar to itself, not usually mistaken for anything else, being a purplish red, slightly elevated, flattened papule, about the size of a split pea. The coughing, which is very annoying, usually remains until about the seventh or eighth day--at which time the fever also disappears.

The bowels must be kept open; a daily bath be given--in which has been dissolved a small amount of bicarbonate of soda (simple baking soda)--after which an oil rub should be administered. The nose should be frequently sprayed with three per cent camphor-menthol-alboline spray, while the throat is gargled with equal parts of alcohol and water. The feet should be kept warm by external heat, while the physician in charge may order additional attention to the chest, such as a pneumonia jacket, etc.

Care should be taken to guard against "catching cold," for bronchitis or pneumonia is quite likely to develop in many cases of measles. The eyes should be protected by goggles and the room should be darkened; under no circ.u.mstances should the little patient be allowed to read.

Carelessness in this respect may mean weakened eyesight all the rest of his life. Until two weeks after the rash has disappeared, the little fellow should be kept by himself, for the desquamation keeps up almost continuously during this time.

The food during the course of the disease is a liquid and soft diet.

Children should never be allowed to go to a party or gathering with a cold in the head; the mothers of a group of small children will never forget the time that one certain mother allowed her little fellow to attend a party with "simply a cold in the head." He laughed, talked, and sneezed during the afternoon and when he went home the rash appeared that night, while eight of the ten exposed children came down with measles during the next two weeks.

CHICKENPOX

The incubation period of chickenpox is from ten to seventeen days. It is a mild disease, with a troublesome rash consisting of widely scattered pimples appearing over the scalp, face, and body. These pimples soon became vesicles (small blisters), which in turn quickly become pustular, afterwards drying up with heavy crust formation.

Severe itching which attends these pustules may be greatly allayed by either the daily carbolic-acid-water bath or a baking-soda bath. The itching must be relieved by proper measures, for if the crust is removed from the top of the blebs by scratching, a scar usually results. The bowels should be kept open, the diet should be soft.

Rigidly isolate, for chickenpox is highly contagious.

SMALLPOX

This disease occurs oftenest during the cold season. It spares no one unless vaccinated, attacking children and adults alike. The early symptoms are: headache, pain in the back, high fever, vomiting, and general la.s.situde. In many respects these resemble the symptoms of the grippe, while on the third day the eruption appears. The pimples are hard and feel like shot under the skin. Within a day or two these shotlike pimples have grown and pushed themselves beyond the skin into little conical vesicles which soon turn to pus. By the eighth or ninth day crusts are formed over the vesicle, beginning to fall off about the fifteenth day.

Patients are quarantined usually eight weeks and when a case of smallpox in the home breaks out everyone in the family should be revaccinated. The strictest isolation is important from the first of the disease.

We will not enter into the treatment of smallpox, for medical aid is sought at once and usually the patient is removed to a special isolation hospital.

VACCINATION

The history of the change brought about in the Philippines since vaccination has been introduced is an argument of itself which ought to convince the most skeptical of the value of vaccination. By all means, every child in a fair degree of health should be vaccinated. It is wise to vaccinate babies before the teething period--from the third to the sixth month. Babies with any skin trouble or suffering from malnutrition, but not living in a smallpox district, should be vaccinated during the second year. In young babies, under six months, the leg is the proper place to receive the vaccination.

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 la.s.situde--a little drowsiness with loss of appet.i.te and a small amount of fever--but this pa.s.ses 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 la.s.situde 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 b.l.o.o.d.y, 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, ant.i.toxin 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 ant.i.toxin 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 ant.i.toxin. 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.

EYE INFECTIONS

Not long ago while in North Dakota near Canada, we took a trip one day just over the border to visit several villages of Russian peasants. We found the boys and girls of nearly the entire village suffering from trachoma--a dangerous, infectious disease of the eyes which spreads alarmingly from one child to another.

We saw the disease in all of its varying degrees among the children.

Some of them had swollen, reddened lids. A discharge of pus was coming from the eyes of others, and they could not look toward a light or the sun. This disease is spread in a hundred different ways--through the common use of wash basins, towels, handkerchiefs, tools, toys, door k.n.o.bs, gates, etc., and that is the reason why these isolated villages of foreign people who could neither read nor write the English language were nearly all so sorely afflicted.

The ordinary condition of "catching cold in the eye" ("pink eye") is just as infectious as the trachoma which we have mentioned, although it is more of an acute disorder and nothing like so serious.

In all such cases a physician is to be called immediately, isolate the patient, and give strict attention to carrying out the doctor's orders.