12 Noon. Very listless and nervous; temperature 104. Has coughed a great deal. Gave mustard paste to chest, front and back, and wet-sheet pack.

1:30 P. M. Temperature 101.8; 4 ounces of water to drink; looks better.

3 P. M. Has slept 1 hours; temperature 102.5; pulse 134; respiration 40; 6 ounces of food given (3 ounces of milk, 2 ounces of barley water and 1 ounce of lime water).

A record like this is a great help to the physician, and such a record may be kept by anyone who can read and write. There are printed record blanks which may be procured from any medical supply house and most drug stores.

BAD-TASTING MEDICINES

Castor oil has neither a pleasant smell nor taste, and nothing is accomplished by telling the child that it does smell good or taste good. If the patient is old enough to drink from a cup, put in a layer of orange juice and then the castor oil and then another layer of orange juice, and in this way it often can be easily taken. Someone has suggested that a piece of ice held in the mouth just before the medicine is taken will often make a bad dose go down without so much forcing. A taste of currant jelly, or a bit of sweet chocolate, or the chewing of a stick of cinnamon is a great adjunct to the administration of bad-tasting medicines. All oily medicines must be kept in a cool place and should always be given in spoons or from medicine gla.s.ses that have first been dipped in very cold water. Very often the addition of sugar to bad-tasting medicines will in no wise interfere with their action, while it often facilitates the administration of the disagreeable dose. The majority of bad-tasting medicines are now put up in the form of chocolate-flavored candy tablets.

TEMPERATURES AND PULSE

The normal temperature of a baby is 98.5 to 99 F. in the r.e.c.t.u.m. After shaking the mercury of the thermometer down below the 97 mark it is well lubricated with vaseline and then carefully, gently, pushed into the r.e.c.t.u.m for about an inch and a half or two inches, and left there for three minutes before removing.

Mothers should exercise self-control in taking the temperature, for nothing is gained by allowing a panicky fear to seize you should the mercury register higher than you antic.i.p.ated. Notify your physician when the temperature registers above 100 F.

The respirations of a child are fairly regular and rhythmic and occur about forty times per minute during the first month of life and about thirty times per minute during the remainder of the year. From one to two years, twenty-six to twenty-eight is the average. Breathing is somewhat irregular when the child is awake and may be a bit slower when asleep. Before the baby is born the fetal pulse is about 150. At birth it ranges from 130 to 140. During the first month the pulse is found to be from 120 to 140. By the sixth month it gets down to 120 or 130, and from that on to a year the normal pulse beat of the baby is about 120. The pulse is influenced very much by exercise and is often increased by crying or nursing or any other excitement.

FEVER

Children get fever very easily--the digestive disturbance of overeating, constipation, a slight bilious attack--all produce fever which disappears quite as suddenly as it came. The first thing to do under such circ.u.mstances is to withhold food, give plenty of water to drink, produce a brisk movement of the bowel by giving a dose of castor oil, give a cleansing enema, and treat the fever as follows:

After removing all of the clothes from the child, place him in a warm blanket and then prepare a sponge bath which may be equal parts of alcohol and water; expose one portion of the body at a time and apply the water and alcohol first to one arm and then to the other arm, the chest, one leg, the other leg, the back and then the b.u.t.tocks. Do not dry the part but allow evaporation to take place, and this, accompanied by the cooling of the blood which is brought to the skin by the friction, readily reduces the fever. Another procedure which may be employed if the fever registers high is the wet-sheet pack which is administered as follows:

Three thicknesses of wool blankets are placed on the bed and a sheet as long as the baby and just enough to wrap around him once, is wrung out of cool water and spread over these blankets. With a hot-water bottle to the feet, the child is then laid down in the wet sheet which is now brought in contact with every portion of his body, then the blankets are quickly brought around, and he is allowed to warm up the sheet--which lowers his temperature.

Another valuable procedure is the cooling enema. Water the same temperature as that of the body, is allowed to enter the bowel and is then quickly cooled down to 90 or 85 F.; in this manner much heat is taken out of the body and the fever quickly reduced. (For further treatment of fevers see Appendix.)

CHAPTER XXVI

BABY'S SICK ROOM

Visitors should never be allowed in the sick room during the height of a disease, and during convalescence not more than one visitor should be allowed at one time, and the visit then should be only two or three minutes in length. The order and the quietness and the system of the sick room should be perfect. Visitors and loitering members of the family do no good and they may do much harm to the recuperating nervous system of the child.

LOCATION OF THE SICK ROOM

In these days of high rents, we realize that the greater per cent of our readers are living in apartments and homes just big enough conveniently to care for the family during health, and while it would be pleasant and convenient to have a spare room or an attic chamber that could be used in case of illness, it is the exception rather than the rule that the families to whom sickness comes have these extra apartments. When a contagious or an infectious disease comes to the family, it is of great importance that the sick child be isolated, preferably on another floor, from that used by the immediate family.

Those living in homes, more than likely can fix up a room on the attic floor for the isolation, and those living in apartments may put the sick child in one end of the apartment, while they inhabit the other end. One family under my observation not long ago had a child stricken with the measles. In the same apartment there lived a puny baby not quite two years old. Coming as it did in February, the mother of the child was apprehensive, fearing that measles would leave a severe bronchitis which might mean the death of the already too-delicate baby. She was instructed to move the baby's bed to the sun parlor in the front of the flat, while the boy with the measles was put in the parents' room in the rear end of the flat. A sheet was suspended in the middle of the hall leading from the living-room to the bedrooms.

Door k.n.o.bs were disinfected daily, a caretaker was put in charge of the measles patient, the mother very frequently was compelled to go back and administer a treatment, but each time she donned a large ap.r.o.n and completely covered her hair with a towel, she administered the treatment, took off her wrappings, thoroughly washed her face and hands--disinfected them--and returned to her baby in the front part of the house.

At night this mother slept on the floor on springs and mattress in the living-room, and to that home the measles came and departed, and the baby did not get them at all, so perfect was the isolation, so vigilant the disinfection, and so scrupulous the care to prevent contamination. So you see from this one instance that it is altogether possible to make isolation complete even on the same floor. But, mind you, the dishes that the lad ate from were all kept in his room. Food was brought to the sheet and there the caretaker held her dishes while the cook poured or lifted the food from her clean dishes to the dishes the caretaker brought from the sick room.

Whether the sick room is in the attic or whether it be the rear end of an apartment, if the principles of contagion and disinfection are understood I believe it is perfectly possible to isolate even scarlet fever without danger to the other members of the family.

NECESSARY FURNISHINGS

For slight indispositions and trifling disorders, it is not necessary to strip the room of its adornment, but it is well to clear off the dresser tops, protect them well with many thicknesses of newspapers covered over by a folded sheet so that alcohol, witch-hazel and other necessaries will not injure the mahogany or oak-top dresser. Whenever the children are sick, rob the room of anything that is going to be in your way. In instances of infectious or contagious diseases, take down all silk or wool hangings, replace them by washable curtains or inexpensive ones that can be burned if necessary, and remove valuable paintings and other bric-a-brac that later fumigation will harm or that may gather the dust during the days of illness.

Just as it is necessary for the man who mines the coal to wear suitable garments, and for the woman who does the scrubbing to dress accordingly, and for the nurse who cares for the case to wear washable clothes--so it is necessary to dress the sick room in garments that are suitable, convenient, and capable of being thoroughly disinfected, fumigated, or even burned if the occasion demands. Hence, expensive rugs should be replaced by rag carpets or no rug at all, while unnecessary articles and garments should be removed from closets, etc.

Remembering that the little fellow is to remain in this room for possibly two weeks or maybe six weeks, let us put up some bright-colored pictures that he will enjoy, bring in some books and magazines by which he may be entertained, secure a few simple toys that will not tax the brain, but serve as a help to pa.s.s away the long hours. There are many paper games that may be had, such as transfer pictures, picture puzzles, kindergarten papers, drawing pictures, as well as toys that may be put together to fashion new articles. A whole lot of fun can be gotten out of a bunch of burrs that can be stuck together to make men, animals, houses, etc. Scissors and pictures are entertaining as well as paper dolls with their wardrobes. Rubber balloons, or a target gun for the boy of six will be a great source of delight to him; as will a doll with a trunk full of clothes for the little girl during her convalescent days. A tactful nurse and a resourceful mother will think of all the rest that we have not mentioned--which will amuse, entertain and keep happy our convalescent children, help them to forget that they are "shut ins."

THE NURSERY REFRIGERATOR

It is wise in instances of the more severe childhood troubles, such as infectious and contagious diseases, to keep as many things in the sick room as possible, and so we remind our reader of the home-made ice box, described elsewhere in this book, in which may be kept the fruit juices and the fruits, as well as the milk and the b.u.t.termilk. Many medicines, particularly the oily medicines, should be kept in this home-made ice box and five cents worth of ice a day will not only make things taste better, especially during the warm months, but will protect the other members of the family, for the family ice box is a big central station which must be protected against infections and carriers of disease.

In connection with the ice box, we are reminded that it would be a great convenience to have a simple contrivance for heating bouillon, milk, or making a piece of toast, which can be readily done with an electric heater, an alcohol stove, or a small apparatus fitting over the gas jet.

SICK ROOM DISINFECTANTS

The most important thing which we are going to mention in this division of the chapter is the disinfection of the door k.n.o.bs.

According to the directions on the poison bottle, place an antiseptic tablet into a small amount of water which will make a solution of 1 to 1000 of bichlorid of mercury, and several times a day disinfect the door k.n.o.bs, particularly in the sick end of the house--thoroughly washing and adequately rubbing with a towel moistened in this solution.

All stools and urine from the sick one will receive attention as directed by the physician. The stools from a typhoid patient should stand for one-half hour in a chamber covered with a layer of lime.

It is not at all necessary to have vessels containing disinfectant substances standing about the room and in the closet. In a room adjoining should be kept all of the dishes used by the sick patient, his tray, half a dozen napkins, knife, fork, spoon, serving dishes, drinking gla.s.s, pitcher, etc. All bedding and all linen used by the sick member should be allowed to stand in a solution of disinfectant for several hours when they may be wrung out of the solution, dropped into a bucket and carried to the laundry without any danger to other members of the family.

The nurse is not allowed to leave this room in the garments that are worn while caring for the sick. She should have her meals in an adjoining room which is also under strict isolation.

THE MEDICINE CHEST

The sick room medicine chest should be so placed on the wall that it is outside the reach of the smaller members of the family, for in it should be placed poisons for external use that are capable of producing death if taken internally. Bottles that hold these poisons--such as bichlorid of mercury, lysol, carbolic acid, laudanum, paregoric, belladonna, etc.--should be so different from the other bottles in the medicine chest that if one should reach for them with his eyes shut or in the dark he would at once recognize that he had hold of a poison bottle. This is absolutely necessary. It usually means a bit of extra expense, but when we realize what tragedies may be avoided by such slight expense, it must not be considered.

Bottles may be procured that have been molded with points of gla.s.s projecting from the outside which make them rough to the touch, or they may be covered with a wire mesh or with a wicker covering which may easily be told from the other bottles in the case.

One woman lost her life because the nurse placed two ounces of carbolic acid in the enema instead of two ounces of saline solution.

Saline solution is nothing but salt and water, while carbolic acid cost the woman her life, simply because the carbolic acid was not placed in a specialized poison bottle and the attendant could not read the label in the dark.

Under no circ.u.mstances keep from one year to another the remnants of unused medicine of a former sickness, for medicines do not keep well and often lose their strength if kept longer than the physician intended.

In this medicine chest should be found the following articles:

A gla.s.s graduate marked with fluid drachms (1 teaspoon), and fluid ounces (8 teaspoons).

A medicine dropper.

Absorbent cotton.