CHAPTER XXVIII

CONTAGIOUS DISEASES

Never under any circ.u.mstances knowingly expose a child to any of the so-called "childhood diseases." The old method of "have the child get them as quickly as possible and get over them," has laid the foundation for many chronic disorders later in life. For instance, eye troubles and running ears are often the sequelae of measles; chronic coughs, tuberculosis and bronchitis frequently follow in the wake of whooping cough; heart disorders follow diphtheria, while kidney disease often follows in the course of scarlet fever.

CATCHING DISEASE

Under all circ.u.mstances keep the children away from these dangerous childhood diseases. When a contagious disease breaks out in a school and the little fellow has, along with the other pupils, been exposed to it, begin at once systematically to keep the nose and throat very clean with such well-known sprays as the champhor-menthol-albolene spray, which should be used in the nose morning, noon, and night.

Throat gargles, such as listerine, or equal parts of alcohol and water, help to keep the throat in condition to resist the microbic invasion.

During this anxious time of patient waiting the bowels should move every day and the food should be cut down at least a third. In other words, moderate eating and a clean bowel tract go a long way toward keeping a child well and preparing him for an attack of disease. The skin at this time should be kept well bathed and free from the acc.u.mulated skin secretions which clog up the sweat glands and otherwise lower the vitality.

Stuffy, close rooms, where the ventilation is poor, not only harbor disease germs, but also lower the vitality of the child. Never take your child into a household where there is any form of sickness, for it may turn out to be a contagious disease--no matter how it began, it must be remembered that many contagious diseases, in their earlier stages, much resemble a simple cold.

Measles come on rather gradually, and one might suspect that the child was simply suffering from a severe cold in the head.

Scarlet fever usually begins with a sore throat, while chickenpox has very few initial symptoms; usually the first thing noted is the rash itself. Diphtheria begins with a sore throat, while whooping cough begins very insidiously.

The most important thing is to keep children away from people who are sick, and if a contagious or infectious disease is prevalent in the neighborhood discourage the mingling of the children in hot, illy ventilated rooms. Put a stop to "parties" and all similar gatherings.

Let the little folks have good books, plenty of toys, in a well-ventilated room, and the more they keep to themselves at this particular time the better they are off.

THE SPREAD OF CONTAGION

It is possible to "stamp out" any known disease if only proper cooperation takes place and certain sanitary regulations are maintained. It is within the memory of most of our readers when yellow fever was put to flight and the cause of malaria discovered. We learned to screen our camps and no longer did our soldiers contract the fever; while the simple covering of stagnant pools with oil, together with proper screenage, stopped the ravages of malaria.

Likewise, many of the woeful tragedies of infant summer diarrhea and dysenteries have been tracked to the so-called "innocent house fly."

We have all learned--only recently--that if we move the manure pile once in seven days the hatching of the maggots may be prevented, and so millions, yes trillions, of these carriers of disease may never be born.

If there is one sweet morsel above another for this fly pest it is tubercular sputum or feces, and from these feasts they go directly to walk over baby's hands, crawl over his cheek, and wash their feet in his milk. Proper screenage will prevent such contamination of food, such opportunities for carrying disease.

Sunshine, hot water, soap, and fresh air, are the best ordinary every-day disinfectants. It is possible so to conduct the treatment of a contagious or infectious disease that no other member of the family may contract it. A few simple but very important hints are:

1. Door k.n.o.bs are one of the very greatest avenues of contagion--disinfect them.

2. Cleanse the hands both before and after attending to the sick; first, scrub with stiff brush, soap and water, then dip in alcohol.

3. An epidemic of sore eyes may be stopped by absolute "hand disinfection" and using separate towels.

4. Do not go visiting when you have a "common cold."

5. Kissing is one of the best ways of spreading many diseases.

6. In cases of contagious and infectious diseases completely cover all excretions from the body with lime.

7. Country homes would be as healthy as city homes if the privies and stables were screened.

8. In the country, the well water should be boiled; one infected well may be the cause of the death of a score of beautiful children.

INCUBATION PERIODS

The incubation period of scarlet fever is from one to seven days.

Measles, ten to twenty days.

Whooping cough, from one to two weeks.

Chicken-pox, fourteen to sixteen days.

German measles, seven to twenty-one days.

Diphtheria, any time from one to twelve days.

Mumps, from one week to three weeks.

Of all the diseases, measles and chicken-pox are probably the most contagious. In scarlet fever and diphtheria, close contact is necessary for exposure, while whooping cough can actually be contracted in the open air, young babies being particularly susceptible.

TYPHOID FEVER

Typhoid fever is a disease of the small intestine. Typhoid germs acc.u.mulate in the little lymph nodes of the small intestines and that is the reason why we often have so many hemorrhages from the bowel--actual ulcerations take place--and if an ulcer is situated in the neighborhood of a blood vessel hemorrhage may result.

Typhoid fever begins rather insidiously with a slight debility and loss of appet.i.te, but if a temperature record is kept the fever will be found to rise from one-half to a degree higher each day. A steady climb in the temperature curve is noted until the end of the first week, when it remains for a week, possibly 103 or 104 F. After one week it begins slowly to decrease and, if all goes well, the early part of the fourth week usually finds the temperature about normal. It is exceedingly important that the child be kept in bed during the entire course of the disease. The bed pan must be used at each bowel movement or urination.

_First Week Treatment._ During this week the child may feel quite well, but he should be kept in bed and sustaining treatments begun--such as wet-sheet packs and cold frictions to the skin (during which time there should always be external heat to the feet). The diet must be full and nourishing, but all pastries and "knicknacks" should be avoided. Abundance of fresh fruit that has been well washed before paring, eggs, pasteurized milk, baked potatoes, and toasted bread may be taken at regular periods--with an interval of not less than five hours between meals.

The bowels should be opened in the beginning of the disease with a liberal dose of castor oil, after which daily colonic irrigations should be employed. These enemas should be given at least once a day, the temperature being about that of the body, with a smaller terminal enema about five degrees cooler at the close of each bowel cleansing.

_Second Week Treatment._ The normal temperature at this time is no longer 98.6, it is 101.5 F. This fever is essential to the curative and defensive processes of the body; and while we do not care to have the fever fall below 101.5, at the same time nothing is to be gained by allowing the fever to go up much above 102.5 or 103 degrees F. And so, during the second week, while the disease is at its height, we make frequent use of the wet-sheet pack, always remembering that the extremities must be kept warm and never permitting the skin to become blue or mottled while the cold treatment is being administered. Since the real disease is localized in the small intestine, we will now describe a very important treatment for the diseased bowel--and one which is also very useful in combating high temperature.

_The Cooling Enema._ The temperature of this enema begins one degree higher than that of the body (supposing the body temperature to be 103, the temperature of the enema would start at 104 F.). This is allowed to flow into the colon and out again, under low pressure, without disturbing the patient, by means of a gla.s.s tube connection (See Fig. 15). The temperature is quickly brought down to 100, then to 98, then to 90, usually finishing up at 80 or 85 F. The water is allowed to enter the r.e.c.t.u.m slowly through a soft rubber catheter (not a hard rectal point), and as it comes out it will be noted that the water is very warm, sometimes registering 105, and it is needless to add that if the water goes in at 80 and comes out at 105 F., much heat has been taken from the body; and so, of all the treatments we have to suggest for typhoid fever, the one just mentioned is possibly the most important. When it is necessary to keep up this enema for an hour or two, the cool water may cramp the bowels, but this may be entirely obviated by applying hot compresses to the abdomen.

Another treatment of great importance in this second week is the cold abdominal compress. Much fever is occasioned in the abdomen because it is the seat of disease, and the much dreaded hemorrhages which often cause the death of the patient are usually avoided by the use of abdominal compresses--wrung out of water at 55 F.--the temperature of ordinary well water--and changed every twenty minutes.

[Ill.u.s.tration: Fig. 15. The Cooling Enema]

I recall one mother in my dispensary practice who was so poor she could not afford a nurse, her only helper being a son twelve years old. A nurse went to the house twice each day and taught this lad of twelve years to give his mother the cooling colonic irrigation; he was also taught to warm up the abdomen by a hot application and afterwards to apply the cold compresses. The mother made a good recovery.

During this second week the diet should be sustaining. It should consist of boiled milk, eggs, fresh fruit and fresh fruit juices, dextrinized grains (hard toast, toasted corn flakes, shredded wheat biscuits, etc.). The mouth should be kept scrupulously clean, for in all the infectious and contagious diseases there is always the possibility of gangrene in the mouth if it is neglected.

_Third Week Treatment._ This is the week we look for hemorrhage from the bowel unless the abdomen has been well treated during the second week; and even so, the cool compresses to the abdomen will be continued well into the third week--also the daily or semi-daily enema. The skin is kept in good condition with soap washing and friction baths, and a fairly liberal diet is maintained. During the whole course of the disease the skin is never allowed to get blue or mottled, being quickly restored to the normal red color by the mustard sheet bath, the short hot-blanket pack, or the dry-blanket pack with hot-water bottles. Under no circ.u.mstances let the child leave the room or his bed for at least another week.

MUMPS

Infants are rarely affected with mumps. It is a disease of the salivary glands and (as a rule) is usually preceded by pain between the ear and the angle of the jaw, accompanied in a short time by swelling and temperature. It is distinctly contagious even during the incubation period. There is much tenderness on pressure, and chewing is difficult and may be impossible. It usually occurs on the face and only one side may be affected. The bowels should be kept open, the mouth should be kept clean, and the side of the face should be protected by a layer of cotton held in place by bandages.

Hot fomentations may be applied if the pain is severe. The electric light bulb on an extension cord, that was mentioned in connection with earache, is very comforting in this condition.