XXXIV. Croup (Angina Trachealis).
DEFINITION. Inflammation of the lining of the windpipe and upper part of the air passage, with swelling from the pouring-out of fluid, and the separation from the blood of sticky mucus. There is no false membrane as in Diphtheria. But much difference of opinion exists on this question.
CAUSES. The smallness of the windpipe in infancy and early childhood. Exposure to cold; sudden changes of temperature, wet feet, poor or scanty food, especially improper diet on weaning; keeping a child in a room the floor of which has been newly washed; dark, damp, low-lying neighbourhoods.
SYMPTOMS. Fever, hoarseness, and a dry barking cough; the latter is a characteristic symptom, and probably exists two or three days before it is sufficiently marked to excite the mother’s anxiety. Alarming symptoms generally come on suddenly, and often in the night. The symptoms are very severe, but aggravated in frequent fits; there is great difficulty of breathing, so that the child throws its head back to put the parts on the stretch; every breath becomes increasingly difficult; the cough is loud and of bass-like sound, the voice is hoarse or absent, the pulse quick, and the skin hot and dry.
In fatal cases the lips and face becomes increasingly purple, the pulse small and thready, and the patient dies from suffocation.
REMEDIES. Aconitum. Feverish symptoms; cough following expiration. When another medicine is indicated, it is often desirable to continue Aconite in turns with it.
Spongia. Hard, barking, whistling cough with pain in chest and laboured breathing. Iodium is a better remedy for scrofulous children.
Bromine. Extreme congestion, so that the child breaths with great difficulty, throws its head back, grasps at the throat, and shows anxiety. Bromium should be administered (in turns with Aconite, if the skin is hot and dry) every thirty or sixty minutes, till improvement takes place.
Kali bichromicum Tough, stringy expectoration. Also when Bromium fails to relieve.
Hepar Sulph. Loose, metallic-sounding cough, with difficult expectoration; also to remove traces of the disease from the affected organs. But for this latter object, Dr. Nichol. of Montreal, recommends
Sanguinaria. According to the above authority, patients having a tendency to Croup, lose it under a course of this remedy.
Arsenicum. Great exhaustion; typhoid symptoms.
Antim tart. Much rattling in the chest, and defective ability to detach the phlegm; cold bluish face, cold perspiration, and sinking of strength.
Administration. A dose every fifteen, thirty, or sixty minutes in severe cases; or every two, four, or eight hours in mild cases, or during recovery.
INHALATION. Iodine, Bromine, and Kali bichromicum are specially valuable when administered in watery vapour. A few drops of the strong tincture may be dropped into a small kettle kept boiling over a fire or spirit-lamp, and fixing a tube to the spout to convey the vapour close for the patient to breathe. In vary bad cases, a sort of tent should be formed over the patient’s bed, and the steam conducted under it by a tube.
ACCESSORY MEASURES. Everything likely to excite the patient or make him cross should be avoided. A warm bath; the throat fomented with hot water, and a compress or flannel applied to the part when not fomenting; the body kept warm, and the air of the apartment raised to about 65* Fahr. by day and night. During the attack, water is almost the only article proper to be given, in small, frequent sips; when recovery sets in, milk-and-water, arrowroot, gruel, etc.
XXXV. Sniffles (Coryza)
Infants sometimes suffer from an affection of the lining of the nose with unhealthy discharge, occasionally so abundant as to interfere with breathing and sucking.
CAUSES. Exposure to draughts, cold, neglect, improper clothing, inherited Syphilis, etc.
REMEDIES. Aconitum. If given early, and repeated several times at short intervals, is often sufficient.
Euphrasia. When the affection extends to the eyes, with copious watery discharge.
Mercurius. Profuse watery discharge, with sneezing, soreness, and itching.
Arsenicum. Watery, harsh discharge.
Nux Vomica. Dry stoppage at night, and watery discharge during the day.
Sulphur. Old-standing cases.
Aurum. Old-standing cases of syphilitic origin.
ACCESSORY MEANS. The inside of the nose should be frequently smeared with simple cerate, cold-cream, or tallow.
XXXVI. Cold. Catarrh.
DEFINITION. Inflammation of the lining of the nose, eyes, and throat.
SYMPTOMS. Slight shiverings, pain, weight in the head, redness or itching of the eyes, stopping-up of the nostrils, with an increased discharge, which is thin and harsh. If neglected, hoarseness, sneezing, dry cough, chilliness, weakness, fever, and loss of appetite may follow.
EPITOME OF TREATMENT.
1, Earliest Symptoms. Camph., Aconite
2. Sneezing, running from nose, eyes, etc. Mercurius, Arsenicum, Euphrasia
3. Involvement of the throat and windpipe. Belladonna, Mercurius, Kali bichromicum, Spongia, Hepar sulph., Phosphorus
Camphor. For the chilly stage. It should be given early. (See p. 84.)
Aconitum. Febrile stage. A dose every second or third hour.
Arsenicum. Copious, thin, excoriating discharge from the nostrils; weariness and prostration.
Mercurius. Itching, redness, and swelling of the nose, with thick, or foetid discharge; sneezing; sore throat; symptoms worse at night, and when warm.
Chamomilla. Catarrh of infants and young children.
Nux Vomica. “Stuffy col.”
Euphrasia. Profuse watery discharge from the eyes and nose.
Dulcamara. Cold from damp, worse towards night and when resting.
ACCESSORY TREATMENT. A warm bath should be given on going to bed, and the child well wrapped in an extra blanket, so as to favour the free action of the skin; this is still further promoted by drinking freely of cold water.
XXXVII. Acute Bronchitis.
DEFINITION. Acute inflammation of the mucous lining of the air- tubes of the lungs, involving more or less the smaller tubes. When the upper portion of the chest is chiefly affected, it is said to be a “cold in the chest.”
Bronchitis is one of the most important diseases of childhood on account of its frequency, its liability to complication with Pneumonia, and the danger from suffocation which the blocking up of the tubes involves.
CAUSES. Cold, keen, and cutting winds, or sudden changes of temperature; insufficient clothing; inhalations of dust, smoke, or other irritative substances. Bronchitis may also arise during Measles, Whooping-cough, etc., especially in weakened children.
SYMPTOMS. Feverishness, headache, lassitude, cough, a feeling of tightness in the chest, especially the front portion; the breathing becomes difficult and hurried, with wheezing or whistling sounds; there is severe cough, which is at first dry, but is afterwards attended with sticky or frothy expectoration, which is sometimes streaked with blood, afterwards becoming thick, yellowish, and mattery. The pulse is frequent, often weak; the urine scanty and high-coloured; the tongue foul; and there are pains in the forehead and eyes, aggravated by the cough. Unfavourable symptoms are cold perspirations; pale and livid cheeks and lips; cold feet and hands; rapid breathing, the sides of the nostrils flapping widely at each breath; drowsiness; extreme prostration; rattling in the throat; and complete insensibility. In favourable cases the disease begins to decline between the fourth and eighth day.
REMEDIES. Aconitum. Febrile symptoms, especially at the commencement, when it may shorten the attack, or even arrest it at once. Further indications are a short, hard cough, from tickling of the windpipe and chest, causing frontal headache; burning and soreness in the chest.
Antimonium Tart. Wheezing in the chest; suffocative cough, with copious, loose expectoration, and sickness; short breathing, palpitation, and headache.
Bryonia. Rapid and difficult breathing, suffocative cough with pain, great aggravation and anxiety.
Kali bichromicum Catarrh running into Bronchitis, with stringy, sticky mucus, cough, and difficult breathing.
Ipecacuanha. Cough in fits; retching; vomiting of mucus.
Arsenicum. Weakly children, with anxious, laboured breathing, and defective ability to expel the mucus.
Phosphorus Veratrum-Vir., and Sulph. are sometimes required.
Calcarea phos. Ix trituration, 6 grains four times a day, in the tedious cases of delicate children.
Administration. A dose very two to four hours; during recovery, thrice daily.
ACCESSORY MEASURES. The patient should be kept in a warm atmosphere (65 to 70 degrees), which should be moistened by steam ( a kettle may be kept boiling on the fire). A warm wrapper should always be in readiness, so that if the child suddenly asks to be taken out of bed, he may not be exposed to any risk of taking cold. Another important point is the posture of the little patient. He should not be laid quite flat, but somewhat propped- up-in bed; this posture favours the general circulation, and enables the patient to take an easier and deeper breath. A large thick linseed meal poultice, or spongio-piline, to fit the chest in front and back like a bodice. The patient should be kept very quiet, have little pieces of ice to suck, gummy kinds of drink, and liquid farinaceous food. In feeble children, and in prolonged cases, exhaustion is liable to come on, requiring nourishing support, Cod-liver-oil etc.
Tedious cases are much helped by rubbing in sweet oil all over chest by a good fire; repeated night and morning.
XXXVIII. Inflammation of the Lungs (Pneumonia).
DEFINITION. An acute inflammation of the lung-substance with severe fever. The symptoms generally come on gradually.
VARIETIES. Pneumonia may affect one lung or both; it may also be complicated with Pleurisy. The base and back portions of the lung are most frequently affected.
SYMPTOMS. Feverish restlessness; a burning, dry skin; breathing more hurried than in Pleurisy, but not attended by the acute pain of the latter disease; frequent, short, dry cough, with expectoration of sticky matter, of a pale-green, yellow, or rusty colour the latter colour especially being characteristic. The nostrils flap, and there is no moisture in them, and no tears in the eyes; there is great thirst; impeded speech; variable pulse; scanty, high-coloured, hot urine; the child lies on the affected side or on the back, and chiefly breathers by his mouth. A weak, irregular, and thready pulse, lividity of the face, extreme difficulty of breathing, bluish lips, and great prostration are unfavourable indications.
CAUSES. Pneumonia often accompanies or follows severe Bronchitis; prolonged exposure to cold or wet; a through chill; living in a cold, damp atmosphere; removing the clothing, or lying on the grass after football, running etc.
EPITOME OF TREATMENT.
1. Early Symptoms. Aconite, alone for some time; to be alternated with Phosphorus if the symptoms do not yield.
2. Pleuritic Complication. Bryonia, alone or in turns with Phosphorus
3. Bronchial Complication. Antim tart.
4. With Typhoid Symptoms. Arsenicum, Baptisia, Rhus Tox., Veratrum-Vir.
LEADING INDICATIONS. Aconitum, Fever symptoms; short, rapid breathing; full pulse.
Belladonna. Short, dry cough; flushed face; headache. Chiefly useful in the first stage.
Phosphorus. Difficult breathing, rusty-coloured sputa; pain under the breast-bone. This is the chief remedy.
Bryonia. Pain on coughing, when taking a deep breath, or moving.
Antimonium Tart. White frothy expectoration; suffocative sensation.
Arsenicum Great prostration, or cases complicated with chronic Bronchitis. Iodium In scrofulous children; blood-streaked phlegm. Sulph. Tedious cases. Phosphorus, Arsenicum, Baptisia Brown lips, teeth, and tongue, prostration. Carbo.-Veg. or Arsenicum Foul breath, putrid expectoration. Verbascum-Vir. Severe fever, vomiting or purging; insensibility.
For “Accessory Means,” see the preceding Section.
Certain desperately severe cases that threaten a fatal issue recover on administrating Cuprum Acet., I. Five drops every hour.
XXXIX. Inflammation of the Pleura (Pleuritis).
DEFINITION. Acute inflammation of the covering of the lungs and lining of the chest, usually affecting one side only.
SYMPTOMS. Pleurisy generally comes on violently, with chills, and severe stabbing pains.
The breathing is hurried, the child does not take a full deep breath, and breathing is frequently interrupted by a stitch or catch, or by a cough; which is frequently short and dry, and occasions a sharp stabbing pain below the nipple. There is also parched tongue; flushed face; hard, wiry, quick pulse; scanty, high-coloured urine; and the patient desires to lie on the affected side or back. When the lung is also involved, the expectoration is copious and blood-streaked.
CAUSES. Exposure to atmosphere changes and checked perspiration, especially in persons of feeble constitution, fevers, and the extension of inflammation from a neighbouring organ; or it may be set up by injuries.
REMEDIES. Aconitum. If given early, Aconite, may alone be sufficient. A dose every two hours till the dry skin, thirst, and sleeplessness are relieved.
Bryonia. Short, laboured, anxious, catching breathing, frequent cough, which shakes and pains the side.
As long as the febrile symptoms continue Aconite, may be alternated with Bryonia
Arsenicum. Oppressed breathing, suffocative attacks, general coldness, and exhaustion.
Sulphur. During recovery, to complete the cure, and to prevent relapse.
ADDITIONAL REMEDIES. Kali Hyd. (chronic cases); Iodium (scrofulous children); Antim tart. (retching of mucus and profuse expectoration); Phosphorus (Pleuro-pneumonia).
XL. Cough (Tussis).
Cough is only a symptom, but at times it may be also prominent a one as to appear to demand exclusive attention. It may be caused by irritation of the lining of the air passages, breathing of dust, derangement of the stomach, etc.
REMEDIES. Aconitum. Hard, dry, irritative cough, with feverishness.
Belladonna. Tickling in the throat; dry, hoarse cough, worse in the night; spasmodic cough with flushed face.
Antimonium Tart. Wheezing and rattling of mucus, with defective power to remove is; inability to lie down.
Ipecacuanha. Retching or vomiting of phlegm; suffocative cough, in fits.
Bryonia. Pain in the chest when coughing; yellow or blood- streaked phlegm.
Phosphorus. Hoarse cough, with pain under the breast bone; rusty coloured phlegm.
Drosera. Spasmodic cough; especially if there is fear of Whooping cough also (Ipecac.).
Spongia. Dry, hard, barking cough; hoarseness.
Cina. Cough from the irritation of thread-worms.
ADDITIONAL REMEDIES. Hepar.-S., Coni., Hyoscyamus, Sambucus, Coral, Verat, Causticum, Mercurius, Iodium
ACCESSORY TREATMENT. Light diet in small quantity, particularly if there be fever. A cold sponge-bath every morning, and frequent out-door exercise, will often overcome a tendency to cough.
See also the Sections on “Whooping-cough,” “Croup,” “Pleurisy,” “Bronchitis,” and “Inflammation of the Lungs”.