How to Nurse Sick Children.
As the education of the young, whether religious, moral, or intellectual, is more important than that of adults, so is the care of their physical life of more importance. Death aims to Ņout Herod Herod," and seeks the life of all infants, male and female, and in fact destroys one half of all below the age of five years.
But few know how to train and take care of children. It is a still more rare gift to know how to nurse them when sick. No person can properly nurse sick children who is in feeble health, or has a fretful temper, or is low spirited: for she can neither endure the fatigue, nor bear the trials, nor hear the prattle which such a responsibility would bring. Some will manage a well child very well, who are not fit to have the care of a sick one; for there is a great difference, between a child when well, and the same child when sick. When well, and full of fun and frolic and life, laughing and jumping and shouting aloud for very joy at being alive, it is an easy thing for a person of even a morose temper to attend upon them. But when sickness comes, and the child's playfulness is all laid aside; when it becomes so fretful that nothing goes right with it; when it cries to be laid down, and then cries to be taken up; stretches out itÕs band for drink, and pushes away the cup when it is presented, apparently made more angry by your attempts to serve it; when these things are repeated day and night, until the nurse is weary and exhausted, and even a change of disease and amendment only brings a cross and fractious temper, it is only by possessing peculiar qualifications that the nurse can maintain an even and unruffled disposition.
While passing through such scenes, it is hard for the nurse to remember that sickness does not destroy the little loving heart, but only hides its affection for a short time. INSERTIMAGES4-12
Signs of Disease in Children. It is important that the nurse of sick children should know what to observe, and the meaning of the signs of disease. A baby has only cries to express its sick feelings. To one person, these cries mean no more than that the baby has somesort of illness. To another, with more experience and better powers of observation, they point to the head, or chest, or stomach as the disorder. A baby with the stomach ache utters long, loud, and passionate cries, and sheds tears plentifully. Suddenly it stops for a moment, and then begins again, drawing up its legs to the stomach, and as the pain passes off, stretching them out again, and with many sobs, passing off into a gentle sleep.
If there be inflammation in the chest, it neither cries loud, nor sheds tears, but after every long breath or backing cough, it utters a short cry, which is out off before it is half finished, apparently because crying is painful.
If the disease be in the head~ the cries will be sharp, piercing shrieks. with low moans and wails between. Or, there will be quiet dozing, interrupted by startling pains.
When a child is taken ill, whatever the disease which is impending, there is always a change of some sort, which soon attracts attention. It either loses its appetite, or is fretful, or soon tired, or sleepy, or restless, or thirsty, or has a hot skin, or, rather, has a number of these symptoms. It vomits, or is purged or bound in its bowels. It loses its merry laugh and cheerful look; it no longer watches its mother's or its nurse's eye, as before, but clings to her more closely, and will not be out of her arms a moment. If lulled to sleep in her arms, it wakes immediately on being placed in its cot.
Such symptoms often continue a day or two before it can be determined what disease is impending. An intelligent nurse may do much towards solving the question. It is frequently proper at such times to place the child in a warm bath. When stripped for the bath, it should be carefully examined to see if there is any rash upon its body. If it be a rash from which it is about to suffer, the bath will help bring it out. The rash should be looked for at least every twelve hours, until the nature of the disease is determined.
The Appearance of the Different Rashes may be distinguished with a little care and experience. Measles has a number of dark red spots, in many places running into each other, and is generally seen first about the face and on the forehead, near the roots of the hair, and is preceded by running at the eyes and nose, and all the signs of a severe cold. Scarlet fever does not show separate spots, but presents a general bright red color of the skin, much like a boiled lobster. At first there is more of it about the neck and chest than on the face, and it is preceded by a sore throat. Chicken pox is attended by fever, but not so much running at the nose and eyes as in measles, nor is there so much cough. The spots, too, are smaller, and are not so much run together; and they come out more over the whole body. They appear a few hours earlier on the body than elsewhere; and in a day or two they are found to be enlarged, and turn into little bladders of water as big as the head of a shawl pin. (See table of comparison of these diseases.)
And now a few Words as to what should be Done in the sick room of a child. The room should be kept cool, and its temperature should be measured by a thermometer. This instrument, when hung away from the fire, should show a temperature of about 60'. That is about the right degree of warmth. Sick rooms are generally kept too hot. The room should be darkened; not made totally dark, but its light shaded down by closing the outside blinds, or by dropping the curtains, so as to give a kind of twilight; and the cot should always be so placed as to turn the little one's face away from the light. The room should be kept quiet; and this requires attention in the whole house, as well as among the persons in the room. Those present should never whisper, but speak in low and gentle tones, should not walk on tip toe, but move about carefully. There is a fussy quietness which disturbs the sick far more than noise. The child must be spoken to, and roused from its slumbers, and turned from side to side, and raised for its food or medicine, with a soothing tenderness, and a delicacy which never forgets itself.
Sometimes sickness and vomiting, from which a child may suffer, are increased by want of judgment in giving food and drink. When there is nausea, the stomach will bear only very small quantities of food at a time, while cold drinks are almost always borne much better than warm. When there is nausea, it is best, for an hour or two, not to attempt to give any food or drink. After the stomach has been thus completely rested, give a single teaspoonful of cold water. If this is not thrown up, it may be succeeded, in ten or fifteen minutes, by a second or a third. If this is borne, give a little water ' thickened with isinglass, or cold barley water, or cold milk and water; and then, with the same precautions, and in very small quantities, beef tea, or chicken broth, or whatever else the doctor in attendance may direct. The smallness of quantity, the coldness of the articles, and the giving it without moving or disturbing the child, if possible, are the important points to be attended to.
A child much exhausted by diarrhea, or other disease, should be moved or lifted out of its cot or cradle as little as possible. Suddenly moving it when very weak may cause fainting, or even convulsions. Let it be sponged and cleaned by merely turning it, with great gentleness, from side to side.
Marasmus, or infantile debility, is a condition which occurs when a child is unable to absorb nutrition from its food. The exact cause is unknown and usually there is some deeper seated trouble present to account for marasmus, which is really a symptom in these cases.
The debility is extreme and an atrophy or shrinkage of all portions of the body excepting the bones occurs. Practically speaking, the disease is one of auto starvation and in many cases the only symptom present is the continued diminution of weight, which is progressive and death may result.
Treatment.The treatment is by proper food, which consists of modifying cows' milk so that the child may take a weak food suitable to its needs where it would be unable to absorb ordinary milk. See articles on food for infants.
Neglect of Baby's Teeth.
The effects of a defective tooth are not merely the ache. This is only a symptom of the work of poisonous germs multiplying every minute, not only eating away the tooth, but rushing in droves to the stomach to interfere with digestion, dying by the millions and developing poisonous products that lower the vitality of the whole system.
A defective tooth may be either (1) one that is decayed, or (2) one that is unsound in its forming, or (3) a crooked, protruding, crowded tooth. Prevention of these conditions must begin before birth, and must continue as daily vigilance through infancy. The diet of the mother should include milk, whole wheat and other whole cereals, eggs and vegetables, all of which will furnish a liberal supply of lime for the baby.
(1) Profiles Showing the Squirrel Face or Overhanging Upper Jaw. (2) As the Jaws Should Be. Under Shot or Prognathous Jaw. Both of These Defective Jaws Can Be Corrected if Taken in Time.
While the first set of teeth are being cut the baby must have the supply of lime continued, at first through the milk and later through the same mineral supplying foods. Meat has no lime. White flour, barley, farina, cream of wheat, soda crackers, have practically no lime.
There must also be abundant exercise of the jaws and gums. During the first ten months it is not to be obtained from food. After that it may come from a bread crust, zweiback, a hard cracker or an educator whole wheat teething ring, but these are given only as part of a meal.
The increased circulation in the mouth, jaws and nose and the exercise of muscles that is caused by this munching upon hard substances not only brings the teeth their supply of Iiine but also causes normal enĀlarging of these parts so that there is room for the teeth, and the roof of the mouth being normally arched, there is less likelihood of adenoids forming.
Infantile Spinal Paralysis. Poliomyelitis.
The Diagram Shows How the Virus of Infantile Paralysis Makes its Way Through the Nose to the Small Nasal Nerves A; Thence to the Olfactory Bulb B; and Travels Thence Through a Part of the Brain to the Spinal Cord, Where it Produces Its Characteristic Lesions.
How to Fight the Scourge.
By Commissioner of Health, City of New York.
(1) Spray the child's nose several times a day with a solution of boric acid and water. Use a "dropper." If the child has sore lips or nose, touch these with dry boric acid powder every few hours.
(2) Any sickness of your child should demand instant medical observation.
(3) The moment you notice suspicious signs of sickness in your child separate him from all other children until medical diagnosis has been made. "Suspicious signs" are fever, digestive upsets (even of mild type), lameness of any joints, or any complaint of weakness.
(4) Remember, infantile paralysis is highly contagious. It can be spread by food handlers, flies and by personal contact with handlers.
(5) Don't let your children use common drinking cups or go to carelessly conducted soda water and ice cream stands.
This disease is now acknowledged to be due to some method of infection, the virulence of which is terrible in its results as the paralysis that follows is rarely recovered from. Although known since 1863 that it was a disease of the spinal cord, yet as early as 1784 the disease was observed. It is, however, within very recent years that it is conceded to be infectious and the great increase throughout the country has caused the State Boards of Health in several communities to require each case to be reported to them so that the study of the disease may be a help toward limiting the numbers liable to infection. The organism has never been recognized, although the damages that it causes to the spinal cord have for some time been noted. At times epidemics have occurred which would seem to be nearing the point that would throw light upon where the disease originated and then a single case will appear so isolated that it seems impossible to determine where the patient was infected. Most of the cases occur in the first three years of child life, although adults can contract the disease and when they do the symptoms are the same as in the young and the changes in the canal, if investigated after death, are similar to those observed in the child. It is rare after the tenth year to find this disease present.
Symptoms. The disease develops very rapidly. Within a few hours at most, the patient is suffering from high fever and within a day or so in light cases the child may seem to have almost recovered from some indefinite sickness. Later the child will be noticed to be uncertain on his legs, and if made to walk may fall down or stumble. In the more severe types, which are graduated from the moderate one just noted and the fatal ones, death may occur after five or six days; all degrees will be seen. The fever usually ranges from one hundred and one degrees to one hundred and four or one hundred and five degrees, and the loss of motion in the legs, which is more constant than that of the arms, comes on within a few hours in the severe cases rather than after a lapse of four or five days as in the moderate cases. Sometimes convulsions may occur early in the disease and are followed by sleep, the child waking up to go into another convulsion if the disease is progressing. There is usually very little pain apparently present, and if to any extent it is a complication where the nerves of sensation are affected in connection with those of motion. After a period extending over several months some recuperation of the muscular powers will usually be noted but complete recovery is almost unknown. The parts of the leg in which recovery does not occur soon become lax and flaccid due to the non use of the parts and care has to be taken that the child in learning to walk does not depend too much upon muscles not affected and cause change in the bones from improper modes of locomotion. As far as death is concerned it is not a common occurrence in this disease which is one of the hopeful sides of a question which is puzzling the medical fraternity so much at the present day.
Treatment. As the disease is of such short duration in the majority of cases which are of the moderate type nothing beyond general fever treatment is to be recommended. The child should be kept quiet and no disturbing influences allowed in or about the house. Later on in the disease strychnine in small doses should be given for its systemic effect on the body and its stimulant effect on the nerves. The faradic current of a good electric battery systematically applied to the weakened muscles twice a day over a long period of time will help in their nutrition and prevent the atrophy of the muscles which will occur by their non use. The deformity that may occur, as above alluded to, is treated by braces and supports with corrective apparatus, should the case appear serious. Many months will usually intervene before the real outcome of the seriousness of the disease can be determined.
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