The Eugenic Marriage.

by Grant Hague.

VOLUME IV

ACCIDENTS AND EMERGENCIES

CHAPTER x.x.xIV

COMMON DISEASES OF THE NOSE, MOUTH, AND CHEST

"Catching Cold"--Sitting on the Floor--Kicking the Bed Clothes Off--Inadequate Head Covering--Subjecting Baby to Different Temperatures Suddenly--Wearing Rubbers--Direct Infection--Acute Nasal Catarrh--Acute Coryza--Acute Rhinitis--"Cold in the Head"--"Snuffles"--Treatment of Acute Nasal Catarrh, or Rhinitis, or Coryza, or "Cold in the Head," or "Snuffles"--Chronic Nasal Catarrh--Chronic Rhinitis--Chronic Discharge from the Nose--Nervous or Persistent Cough--Adenoids as a Cause of Persistent Cough--Croup--Acute Catarrhal Laryngitis--Spasmodic Croup--False Croup--Tonsilitis--Angina--Sore Throat--Symptoms of Tonsilitis--Treatment of Tonsilitis--Bronchitis in Infants--Bronchitis in Older Children--"Don'ts" in Bronchitis--Diet in Bronchitis--Inhalations in Bronchitis--External Applications in Bronchitis--Drugs in Bronchitis--Chronic or Recurrent Bronchitis--Pneumonia--Acute Broncho-pneumonia--Symptoms of Broncho-pneumonia--How to Tell When a Child has Broncho-pneumonia--Treatment of Broncho-pneumonia--The After-treatment of Broncho-pneumonia--Adenoids--How to Tell When a Child has Adenoids--Treatment of Adenoids--Nasal Hemorrhage--"Nose-bleeds"--Treatment of Nose-bleeds--Quinsy--Hiccough--Sore Mouth--Stomat.i.tis--Treatment of Ulcers of the Mouth--Sprue--Thrush.

"CATCHING COLDS"

Mothers frequently wonder where their children get colds. Briefly we will point out some of the sources from which these apparently inexplicable colds may come.

A. Sitting on the Floor.--Children should not be allowed to sit or crawl upon the floor at any season of the year, but especially during the winter months. There is always a draught of cold air near the floor.

It is a bad habit to begin allowing a child to play with its toys on the floor. Use the bed or a sofa or a platform raised a foot from the floor.

B. Kicking the Bed Clothes Off During the Night.--The bed clothes should be securely pinned to the mattress by large safety pins.

When it is established as a habit a child who kicks off the bed clothes should wear a combination night suit with "feet," made of flannel during the winter and of cotton during the summer.

C. Inadequate Head Covering.--Professor Kerley states that this is one of the "most frequent causes of disease of the respiratory tract in the young." He calls attention to the fact that "mothers carefully clothe the baby with ample coats, blankets, leggings, etc., before they take him out for the daily walk. They dress him in a warm room taking plenty of time to put on the extra clothes, during which time the baby frets and perspires. When all is ready they place upon the hot, almost bald head of the baby a light artistically decorated airy creation which is sold in the shops as children's caps. The child is then taken out of doors and because of the inadequate covering of the hot perspiring head, catches cold and the mother never knows how it came." Every baby and child should wear under such caps a skull cap of thin flannel, especially in cold weather. In summer or windy day a light silk handkerchief folded under the cap is a very excellent protection.

D. Subjecting a Baby to Different Temperatures Suddenly, is liable to be followed by a cold--for example, taking the child from a warm room to a cold room, or through a cold hall, holding the child at an open window for a few moments.

E. The Practice of Wearing Rubbers Needs Some Consideration.--They should never be worn indoors for even five minutes. They should not therefore be kept on in school, nor should they be worn by women in stores when they go shopping. When it is actually raining, or snowing, or when there is slush or wet mud they are needful; but they should not be worn simply because the weather is threatening or damp. Children should not put them on to play--worn for any length of time when active they are harmful. If worn to and from school they should be taken off at once when in school or at home. Wearing rubbers prevents free evaporation of the natural secretion of the skin, keeps the feet moist and invites colds and catarrh. In damp weather, or when children play during winter months, they should be shod with stout shoes with cork insoles.

The same argument applies to storm coats of rubber, water-proof material. They should not be worn as overcoats all day, but only when going to and from school or business when it is actually storming.

Underclothing or hosiery should not be heavy enough to cause moisture of the skin. Health demands a dry skin at all times. The necessary degree of body heat should be attained by the quality of the outer clothing, not by the quant.i.ty of the underclothing. Many men and women wear heavy underclothing which causes moisture when indoors, with the result that they get surface chills when they go outside if the weather is cold and as a result catch cold. The underclothing should be just heavy enough to be comfortable indoors and the extra warmth necessary when outside should be supplied by a good overcoat or furs.

F. Direct Infection.--A baby may catch cold if kissed or "hugged" by an adult who has a cold.

Catching cold while bathing is possible, but scarcely probable, if ordinary precautions are taken. It is very bad practice to permit children to use one another's handkerchiefs or the handkerchief of an adult. Certain children are predisposed to attacks of "cold in the head"

or acute coryza or nasal catarrh (these being the medical names for this condition). Sometimes this is an inherited characteristic. There is no doubt, however, that most of these children acquire the habit by bad sanitary and hygienic surroundings. These children do not as a rule get enough fresh air. They are kept indoors most of the time in stuffy, overheated, badly ventilated rooms, unless the weather is absolutely perfect. The windows in their bedrooms are always kept closed, because they are "liable to catch cold." They are overdressed and perspire easily and as a result "catch cold." These conditions all tend to create an unhealthy condition of the nasal mucous membrane and of the throat, and this is rendered worse if the child lives in a damp, changeable climate, such as that of New York City. In these susceptible children the exciting cause of an attack may be trivial; exposure, cold or wet feet, inadequate head covering (as already pointed out), a draught of cold air even may excite sneezing and a nasal discharge; hence we have:

Acute Nasal Catarrh (Acute Coryza, Acute Rhinitis, "Cold in the Head", "Snuffles").--Acute nasal catarrh may accompany measles, diphtheria, influenza, and whooping cough.

Symptoms.--The onset is sudden with sneezing, and difficulty in breathing through the nose. In a few hours, or it may be not for a day or two, a mucous, watery, nasal discharge appears. There are redness and slight swelling of the nose and upper lip, caused by the discharge.

There is no fever as a general rule except in very young infants, in whom the fever may be very high. The discharge interferes with the nursing and the child suffers from lack of nourishment. The inflammation may extend to the eyes and ears, causing painful complications, or to the throat and bronchi, causing hoa.r.s.eness and cough. Less frequently we have disturbances of the digestive tract with vomiting, or diarrhea.

The mild form of the disease lasts for two or three days, the severe form from one to two weeks.

Repeated attacks are said to contribute to the production of adenoid growths.

An acute attack of this disease is seldom a serious affliction in older children; it may be, however, very serious and even dangerous in very young infants. The tendency of the disease to extend downward, causing bronchitis or pneumonia, explains in part the possible danger to a baby.

Another reason is because it may seriously interfere with suckling and with breathing in these little patients. It may even cause sudden attacks of strangulation. An infant, therefore, suffering with an acute attack of rhinitis requires constant attention. It may be necessary to feed it with a spoon, and if necessary mother's milk should be so fed.

Plenty of fresh air should be provided. It may be essential to keep the mouth open in order that it may get enough fresh air. Every effort should be made to keep the nostrils open. The secretions must be removed from time to time. Causing the child to sneeze by tickling the nose with a camel's hair brush will clear the nose for the time being.

The physician may be compelled to use a solution of cocaine for this purpose.

Treatment of Acute Rhinitis ("Taking Cold", Nasal Catarrh, Acute Coryza, "Snuffles").--A child suffering with an acute attack of "cold in the head" should be kept indoors in a room with a constant, uniform temperature; the particular reason for this is, that, if a child is exposed to cold at any time during an attack of "cold in the head," it may cause the disease to invade the chest,--a tendency which it has at all times. The bowels must be kept open; if they do not move every day of their own accord they must be made to move by means of an enema of sweet oil or of soap-suds. The amount of food should be reduced to suit the circ.u.mstances and the condition of the patient.

We treat the local condition in the nose with a menthol mixture. The following is a very good one: Menthol, 30 grains; Camphor, 30 grains; White Vaseline, 1 ounce. Put some of this on the end of the finger and push it gently into each nostril. When the nostrils become blocked and the child cannot breathe through the nose, tickle the nose with a feather until it sneezes; this will clear the pa.s.sage. Immediately after the sneeze place the menthol mixture in each nostril. When the child is about to sneeze place a handkerchief before the nose, as this discharge is full of germs and will infect others when dry. Internal remedies should not be used unless the child is distinctly sick and is running a fever, in which case a physician should look the child over and prescribe whatever is called for.

The upper lip and the nostrils of the child should be protected, because the discharge very quickly irritates the parts and renders them raw and painful. Vaseline or cold cream is very suitable for this purpose.

Mothers should not wash out the nose of a child with any solution advised for this purpose where force is used, as, for example, with a syringe. Any forceful irrigation of the nose is dangerous, because it would carry the infection into the deeper parts and set up a more serious condition.

If the above treatment is carefully carried out and the child unexposed to a fresh cold, two or three days will be sufficient to cure the disease.

It is not, however, the treatment of an acute attack of "cold in the head" that is important; it is intelligently to follow out a plan which will prevent these attacks from repeating themselves that is of consequence. The tendency to take cold is a real condition in childhood and a very common one. When mothers appreciate that it is possible to prevent this condition and to cure it when it is seemingly an established habit, more interest will undoubtedly be taken in the subject. Too frequently it is looked upon as an unfortunate affliction, but it is never regarded as a condition that is caused by neglect and ignorance.

It is an exceedingly common occurence to find a mother worrying over her child's cold, dosing it with cod liver oil or some other unnecessary tonic, rubbing it with camphorated oil or plastering it over with certain useless patent plasters, dressing it with extra pieces of flannel on its chest and extra clothes pinned snugly around it, then shutting it up in a warm, stuffy, unsanitary, ill-smelling room, in order to keep it from "catching a fresh cold." Can you imagine anything else she could do to defeat her purpose?

No quant.i.ty of cod liver oil, no medicine, no coddling, will remove the tendency to "catch cold." The child's life must be lived amidst sanitary surroundings and hygienic conditions first; then other expedients may be utilized if necessary. These children must be kept out of doors most of the time, unless during the severest wet weather. They should sleep in a room the windows of which are open at the top and bottom every night in the year. They should not, however, be in a draught. The rooms in which they live should be of a uniform temperature, never too hot and never too cold, between 68 and 70 F. These delicate catarrhal children should be accustomed to light clothing on their beds. Chest protectors, m.u.f.flers, cotton pads, and heavy wraps of any description should be absolutely prohibited. It is advisable to use flannel underwear winter and summer, light in summer and a medium weight in winter.

During the summer months the mother should begin cold sponging of the face, throat, chest, and spine every morning and carry it into the winter. The entire process need take only a moment or two. Always dry thoroughly with a fairly rough towel. If the cold sponging is begun in the warm summer time the child will become so accustomed to it that no objection will be made when the cold weather comes.

If the child continues to be "catarrhal," despite a course of this treatment, it would be well to investigate whether any adenoids or adenoid tissue exist in the naso-pharynx. If adenoids are found no treatment will be successful until they are removed.

It is a wise plan to place a flannel cap on an infant who has an acute attack of "cold in the head" (snuffles). This will prevent catching a fresh cold and it will aid in the speedy cure of the attack from which it is suffering when it is put on.

CHRONIC NASAL CATARRH--CHRONIC RHINITIS CHRONIC DISCHARGE FROM THE NOSE

Some children have a nasal discharge during all of their childhood. It is usually worse during the winter months. It may be a thin, watery discharge or a thick, nasty, yellow discharge.

It is a condition that is very frequently neglected even by the family physician. This is unfortunate because it may lead to serious disease, permanent damage sometimes being done to the hearing, the speech, the smell, and to the lungs of the child.

It may be caused by adenoids; disease of the bones or tissues in the nose; foreign bodies in the nose; or it may occur in children whose nutrition is bad. It may result from frequent acute attacks of "cold in the head." It also occurs in other less important conditions. The foreign bodies which usually cause a chronic nasal discharge are,--b.u.t.tons, peas, beans, beads, paper b.a.l.l.s, flies and bugs, cherry-stones, small pieces of coal, or stone, cork or other material. A child gets hold of a shoe-b.u.t.ton for example and pushes it into its nostrils. In the effort to get it out the child pushes it further in. It may or may not cause pain at the time, and it may be overlooked, but shortly the mother will notice a discharge from one nostril. This discharge becomes thick and foul and when an investigation is made the b.u.t.ton is found embedded firmly in the nose. It is sometimes quite difficult to get the b.u.t.ton out and this should always be done by a physician.

Treatment.--Remove the cause first then treat the catarrh. If it is a product of a const.i.tutional disease that causes general poor health, such as tuberculosis, syphilis, or scrofula, the child will need "building up" and a decided change of climate. Foreign bodies must be removed, adenoids taken out, large tonsils excised, and malformations of the nasal bones operated upon. The catarrh will in many cases be cured by removing its cause; if, however, it should persist it must be treated for some time with appropriate solutions. These solutions and the directions as to the method of giving them must be given by a physician, because there is great danger of carrying the disease to deeper structures if given wrongly.

SUMMARY:--

1st.--A chronic discharge from the nose is a sign that something is wrong and should be carefully and thoroughly investigated.

2nd.--The cause can usually be found out and the proper treatment will cure it.