R J .19 !& 5 Class _/]. Cop)-rightN"L^f/t5 COPYRIGHT DEPOSIT FIRST AID IN NURSERY AILMENTS By EMELYN LINCOLN COOLIDGE, M. D. Author of 'The Mothers" Manual and Editor of The Babies' Department of the Ladies" Home Journal, Formerly House Physician of The Babies* Hos- pital, NeiAJ York City; Attending Physician in Diseases of Children and Society of the Lying-in Hospital of the City of Ne^ York New and Revised Edition STURGIS & WALTON COMPANY 1915 All rights reserved 1^^ Copyright, 1910, 1915 By Emelyn Lincoln Cooudge New Edition set up and electrotyped. Published September, 1915 nnj -I 1915 ©CI.A411757 TO MOTHERS The aim of this little book is to assist young mothers in caring for their children when any of the simple ailments of the nursery arise, and to teach them how to act in an emergency. It is neither safe nor advisable for a mother to attempt to treat her own child when he is seriously ill; such is the province of the physi- cian only. Many are forced to live at great distances from a doctor however, and unless the mother has some idea what to do in the beginning of an illness much valuable time may be lost and the child's condition becomes really serious before the doctor can arrive. In such cases it is better to have a reliable guide at hand, than to depend upon the advice of neighbors. When travelling, or away from home during the summer vacation, the young mother is 3 TO MOTHERS often at a loss to know what to do, without the accustomed guidance of her physician; it is hoped that this book may be of assistance to her at such times. The drugs mentioned in the book are per- fectly harmless when used as advised (see page 60) and are those that should be found in every nursery medicine chest. The subjects of Nursery Hygiene, Food, Clothing, etc., are not considered in this book, as they are fully treated in the author's book for mothers, entitled, The Mothers' Manual. — Emelyn Lincoln Coolidge, M. D. New York, August, 1910 PREFACE TO THE SECOND EDITION The earlier edition of this little book has been received so graciously by mothers all over the United States and Canada that we are sending this new edition out with the hope that it may help many more homes. The object of the book is to help the mother to act in an emergency or when it is not possible to secure the services of a reliable physician. No mother should attempt to carry her child through a prolonged illness without the aid of a physician but in many cases prompt action by the mother in the beginning of an illness before a doctor can arrive, will ward off a more serious attack if it does not prevent the disease altogether. Great caution should be observed by all mothers when handling medicines, the directions given in this book should be minutely followed and then 5 PREFACE TO THE SECOND EDITION no bad results will occur. It Is much better to have a reliable guide at hand than to take the advice of neighbors. Many times minor illnesses may be most ef- fectually treated by changes in the food or gen- eral hygiene but there are times when medicine is required and until the doctor can arrive it is well for the mother to know what is best to give. Food, clothing, and general hygiene of the nurs- ery are fully treated of in the author's book, The Mother's Manual and are therefore not discussed in this little volume. — Emelyn Lincoln Coolidge, M. D. September, 191 5. CONTENTS To Mothers 3 Preface to Second Edition 5 Diarrhoea 9 Constipation 11 Colic 13 Vomiting 14 Headaches 17 Care of Children's Teeth 18 Toothache 19 Convulsions 20 Fevers 21 Colds 26 Bronchitis 27 Croup 31 Chills z^ Sore Throat Z3 Enlarged or Swollen Glands of the Neck 36 Bruises 37 Sprains 38 Cuts 39 Burns 40 Earache 41 Nosebleed 42 Foreign Bodies in the Nose 43 Disorders of the Eye 43 Styes 44 Foreign Bodies in the Eye 45 Sprue 45 Ulcers or Cold Sores 46 Foreign Bodies Swallowed and in the Throat ... 47 Chafing 47 Eczema 48 Milk Crust 49 7 Boils 49 Prickly Heat 50 Hives 50 Chapped Hands 51 Scabies or Itch 51 Ring Worm 52 Lice or Vermin in the Hair S3 Cold Sores or Fever Blisters S3 Frost Bites and Chilblains 54 Eruptions, Rashes and Contagious Diseases .... S4 Measles S5 German Measles S5 Scarlet Fever 55 Chicken Pox S5 Diphtheria S^ Whooping Cough 56 Mumps S7 Poisons and Their Antidotes 57-^i Drugs Mentioned in the Book : Their Uses and Doses 62-70 Albolene — Alcohol — Alum — Antiphlogistine — Balsam of Peru Ointment — Benzoin — Boric Acid — Borolyptol — Brandy — Brovi^n Mixture — Calomel — Castor Oil — Cold Cream — Elixir Lactopeptine — Epsom Salts — Glycerine — Ich- thyol — Iodine — Ipecac — Iron — Lassar's Paste — Liquid Peptonoids — Manhattan Gargle — Mercury — Milk of Magnesia — Mustard — Nitre — Olive Oil — Potash — Pumice Stone — Resorcin Ointment — Rhinitis — Rochelle Salts — Rhubarb — Soda Bicarbonate — Soda Mint Tablets — Unguentine — Vaseline — Whiskey — White Precipitate Ointment — Witch Hazel. Index 71 8 First Aid in Nursery Ailments Diarrhoea When an infant or a child has diarrhoea the first thing to be done is to stop all milk, and to give barley, rice or granum water in its place. If the baby is over six months old, one or two feedings of mutton broth may be substituted for the gruel, or better still, half gruel and half broth may be given. For medicine give one teaspoonful of castor oil for an infant under one year; from one to five years give a dessert spoonful; after this age a tablespoonful. Give it on an empty stomach if possible and it will be more apt to stay down and not be vomited. Give the child plenty of water to drink. The day after the castor oil has been given it is often well to give spiced syrup of rhubarb. A baby under one year may have ten drops every three hours for one or two days ; after this age twenty drops every three hours may be given. If after this treatment there is still diarrhoea or any fever it is well to give calomel; one tenth of a grain every hour for ten doses may 9 FIRST AID IN NURSERY AILMENTS be given a baby of six months to one year; after this age one fifth of a grain every hour for five doses may be given. For children over one year it is best to give something the next morning after the calomel to carry off any of it that may remain in the system. Rochelle or Epsom salts are usually given for this purpose, and these salts must be given in water before breakfast. The dose of Epsom salts is one- half teaspoonf ul for a child of eighteen months ; for a child of three years one teaspoonful. The dose of Rochelle salts for the same ages is one- half teaspoonful to two teaspoonfuls. If there is mucous or blood in the movements, or much gas and distention of the abdomen it will be best to wash out the child's bowels. For this purpose use the fountain syringe with a long, soft rubber catheter attached to it. Place the child on a table on his left side. Put a rubber cloth under him, letting this hang over the edge of the table into a basin so the water will run into this. Put into the fountain syringe one quart of salt solution (one teaspoonful of salt to a pint of boiled water) and hang it about three feet higher than the table. Give the irriga- tion at a temperature of 98 degrees. Lubricate the catheter with oil or vaseline and gently insert 10 FIRST AID IN NURSERY AILMENTS it into the rectum for about one inch, then turn on the water and gradually work the catheter up higher until at least nine inches have been inserted. Let the water flow in and out as it will, thus washing out the intestines. When no more water is left in the syringe detach the cath- eter from the rest of the syringe but leave it in the intestines and then gently knead the abdo- men until all the water is out of them; then pinch the catheter and draw it out quickly. Once daily is enough for this irrigation of the bowels. If after these simple remedies have been tried for twenty-four hours the baby does not seem much improved a doctor should be called in at once. It is dangerous to allow diarrhoea to continue for any length of time. Constipation When a child is constipated the mother should try to regulate the bowels through the food first, before she resorts to medicines or enemas. Orange juice, prune juice, beef juice, oatmeal gruel, malted food added to the milk in place of sugar, cornmeal mush, equal parts of oat- meal and graham flour made into a mush, bran gems, and green vegetables if the child is old II FIRST AID IN NURSERY AILMENTS enough to eat them, are all laxative foods. Massage of the abdomen, plenty of water to drink before breakfast and between meals, laxative foods taken by the mother if the baby is being fed by the breast, are other methods often used when a baby or child is constipated. Placing the baby on a small chamber held in the mother's lap at exactly the same time after a meal every morning will often establish a regular habit of inducing the bowels to move. As a means of teaching the child what this is for, a soap stick may be gently inserted into the rectum. Only when all other means fail should the mother give medicine for constipa- tion. When this is absolutely necessary milk of magnesia is the safest laxative to give. It must be given either with the food in the milk or else diluted with an equal amount of water. A baby under one year will usually require one teaspoonful once or twice daily; after this age the dose may be increased to one table- spoonful if necessary. Try to give as small a dose as will be effectual in moving the bowels. Do not make the mistake of giving castor oil for constipation, for this only makes the child worse. If the trouble seems to be low down in the 12 FIRST AID IN NURSERY AILMENTS bowels as shown by soft movements but inability to pass them, try inserting a soap stick or a suppository, as advised above. If these do not have the desired eflfect give an injection with a little bulb syringe, using one teaspoonful of glycerine to one ounce of olive oil or one or two syringes full of tepid soapsuds. These injec- tions should never be given for any length of time, however, without the orders of a physician. They will often serve when the bowels must be moved quickly. Colic Many babies are subject to colic. If the attacks are frequent there is usually some fault with the food and to really cure the colic the difficulty with the food must be found out and remedied. In the breast-fed babies colic is often caused by nervousness or worry on the part of the mother or by very sour food which she may have eaten. For an attack of colic warm the baby's hands and feet, and give it an ounce of very warm water in which one half a soda mint tablet has been dissolved; heat a flannel and put it over the baby's stomach, or let him lie on a hot water bag. If the abdomen is hard and tense and seems to be full of gas, give an 13 FIRST AID IN NURSERY AILMENTS injection of hot water with the bulb syringe on which the rubber catheter has been placed. Oil the catheter >vell and gently insert it into the bowels, working it gradually up; when it is nearly all in then squeeze the bulb so that the hot water is injected; now remove the bulb syringe but leave the catheter in place in the bowels and gently kneed or massage the abdo- men until the water and gas with it is expelled, then remove the catheter. Vomiting Vomiting is caused by many different things and consequently the treatment must be varied, depending to a great extent upon the cause. In infants and young children who vomit, the food is generally at fault. A breast fed baby may be taking his food too often or too rapidly, or the mother's diet may be wrong, making the milk too rich. Perhaps the mother does not take enough exercise or she herself may be constipated; all these things must be thought of and corrected before one can hope to help the baby. It is often a good plan to give a nursing baby an ounce of boiled water just before each nursing. A tiny pinch of bicarbonate of soda may be added to the water. 14 FIRST AID IN NURSERY AILMENTS The same amount of barley water may also be given. If curds are vomited or found in the movements 20 drops of elixir lactopeptine may be added to the water or barley water. A bottle-fed baby who vomits may be using a nipple with too large a hole, may be having his food at too frequent intervals, or may be fed irregularly or else there may be something wrong with the composition of the food itself. Too much top milk or cream in the food will often cause vomiting, especially in warm weather. In such cases the interval between feeding should be increased, or the quantity at each meal lessened; a rubber nipple with a small hole may be used; a formula containing plain milk in- stead of top milk or cream should be tried; a little more lime water or bicarbonate of soda may be used in the formula of the food. If none of these suggestions help, then try the elixir lactopeptine, adding 20 drops to the bottle of food just before it is given to the baby. Should the vomiting still continue a doctor should be consulted at once. It may be necessary to wash out the baby's stomach or use other treat- ment which the mother is not capable of doing herself. When older children vomit it generally means 15 FIRST AID IN NURSERY AILMENTS an attack of indigestion, a regular bilious attack, or that one of the contagious diseases is beginning. One-tenth of a grain of calomel given every hour for ten or twelve doses followed by a dose of Epsom or Rochelle salts the next morning, is often needed to clear out the digestive tract. All milk must be stopped and gruels of barley or rice, mutton or chicken broths free from all fat and a little zwieback should be used for twenty- four hours. If even these cannot ;be retained koumyss, matzoon, or zoolak may be tried in doses of one or two ounces, or vichy water in small amounts given very cold may be used. Sometimes when everything else is vom- ited, liquid peptonoids will be retained. Small doses from fifteen to thirty drops, given in a little cold water or vichy every hour or two, many times will tide the child over for a day until the stomach is strong enough to retain other food. Even when other food can again be taken, it is advisable to continue the liquid peptonoids three or four times a day until the child has gotten back some of his lost strength. When vomiting is severe a mustard paste placed over the pit of the stomach, for five or ten minutes or until the skin is reddened, just i6 FIRST AID IN NURSERY AILMENTS before the food is given will often enable the child to retain it when otherwise it would be vomited. When the vomiting ceases the usual diet should be resumed gradually. It is often well, for several days after such an attack, to give one-half to one teaspoonful of the rhubarb and soda mixture in a little water three times daily after meals. Headaches Children old enough to talk sometimes com- plain of headache without any definite cause being known. Headache in children often comes from indigestion or constipation. It is therefore a good rule to give the child a dose of castor oil or citrate or milk of magnesia, followed by rhubarb and soda mixture for a few days after- wards. This will often prove all that is needed. The usual diet should be reduced for a day or two and if there is really much pain the child should be kept in bed in a quiet room with a rather subdued light. Cold compresses or an ice bag may be kept on the head. A small mustard plaster made of one tablespoonful of mustard to six of flour and mixed up with a little cold water may be placed at the nape of 17 FIRST AID IN NURSERY AILMENTS the neck until the skin is well reddened. Head- aches often come from eye strain, so if the child is frequently troubled by them he should be taken to an oculist to have his eyes tested. Care of Children's Teeth A mother should be careful not to lay every ill during infancy to "only teething." But coming teeth no doubt do cause more or less trouble, at least with many babies. For hot, swollen gums dilute borolyptol with equal parts of water and frequently rub the gums with a piece of clean linen or absorbent cotton dipped in this solution. This will help take the heat out of the gums and will at any rate relieve the child a little. If there is diarrhoea or vomiting give a dose of castor oil and stop all milk for twenty- four hours at least, using a gruel instead. If the trouble still continues send for a doctor as it is not safe to allow the diarrhoea to run on. When the baby has ten or twelve teeth it is time to begin to use a small, soft, tooth brush. This should be dipped in borolyptol or boric acid solution and the teeth carefully brushed. When the child is two or three years old a reliable tooth powder may be used. If little black specks or a black rim is seen on the teeth it i8 FIRST AID IN NURSERY AILMENTS may sometimes be removed by the use of powdered pumice stone. Firmly twist a small piece of absorbent cotton on the end of a wooden toothpick; after moistening it dip it in the pumice stone and with it rub the black specks until they disappear. The first, or milk teeth, should receive as careful attention as the permanent set. From the time the baby is two years old he should be taken to a dentist every six months and all cavities filled. If this is done the permanent set will be much better in every way. A child's teeth should be brushed after each meal. Dental floss may also be used to advantage. Toothache To relieve a toothache, dry heat should first be tried in the shape of a hot water bag held on the face. If this does not help try something very cold such as ice water held in the mouth or a small piece of ice wrapped in absorbent cotton and held over the gum where the tooth aches. Small dental plasters often give relief. The gum over the aching tooth should be dried first with a piece of cotton then the little plaster firmly pressed onto the gum until it will remain there 19 FIRST AID IN NURSERY AILMENTS by itself. If none of these remedies relieve the pain the child should be taken to a dentist. Convulsions The nervous system of infants and young children is very easily upset, hence they are quite subject to convulsions. Convulsions are many times caused by indigestion, approaching con- tagious diseases, high fevers, worms, and diseases of the brain. When a child has a convulsion the first thing to do is to send for a doctor as soon as possible, but until he can arrive the child should be un- dressed, put to bed and kept quiet. If there is an ice cap in the house it should be filled with cracked ice, wrapped in a thin towel and placed on the child's head. If there is no ice cap, cloths should be wrung out of ice water and kept on the head, changing them frequently so that they may be kept cold. The child's feet should be put in a mustard bath until they are red, then taken out and wrapped in a hot flannel and placed near a hot water bag. Towels wrung out in mustard water (one heaping tablespoonful of mustard to one quart of tepid water), may be wrapped about the child's body and left there until the skin is red. They should then be re- 20 FIRST AID IN NURSERY AILMENTS moved and the child wrapped in a blanket. This mustard pack disturbs the child less than a mustard bath, and it is best to let the doctor de- cide whether or not a bath should be given. If it is thought best to give a mustard bath, it may be prepared as follows: Care must be taken not to burn the child. The temperature of the water should be 105 degrees or hot enough to feel comfortable, but not burning hot to the tip of the mother's elbow. The skin on the mother's hand is often not sensitive enough to be able to tell whether the baby's tender skin can stand the heat or not. One-half a teacup ful of mustard to a small bath tub of water should be used and the child left in it long enough to redden the skin. As soon as the child can swallow, a dose of castor oil should be given. It is often well to irrigate the bowels with tepid water or salt and water as already described on page 10. It is best to give only boiled water for the first six hours after a convulsion, then for the next twenty-four hours at least the food should be light, such as gruels or broths. Fevers Babies and young children are very apt to have a fever from even small ailments, so the fact 21 FIRST AID IN NURSERY AILMENTS that a baby's temperature suddenly becomes elevated need not cause the alarm naturally felt with older patients. The fever, however, should not be allowed to run on without finding out the cause. Almost anything from teething to typhoid fever may cause a fever in a baby. Since the digestive tract is so easily upset in these young patients, we first look here for the cause and cut down the food; or give only barley water for twenty-four hours if the fever is high, 103 or over. For the same reason we give either castor oil or calomel in doses suitable to the child's age or if we wish an immediate action of the bowels, we also give an enema or high irrigation of soap suds and water with a bulb syringe or salt and water with the rubber catheter attached to the fountain syringe. The water should be 98 degrees F. in most cases, but may be colder if the fever is high and the patient very restless. A baby or child with fever should be undressed and put to bed and kept there as long as the temperature remains elevated. It is a great mistake to allow him to run about the room or to be constantly held in someone's arms. One of the best means of reducing fever is an alcohol sponge bath. One tablespoonful of al- 22 FIRST AID IN NURSERY AILMENTS cohol should be added to half a small basin of tepid water and with this the head, face and body- sponged. This may be repeated every two or three hours if necessary. It will often induce a quiet sleep. An ice cap filled partly full of finely cracked ice and wrapped in cheese cloth may be placed on the child's head if he is rest- less and uncomfortable from a high fever. If the fever cannot be reduced by the above means and rises to io6 degrees it will often be neces- sary to give the child an ice pack. This, how- ever, must be done only by order of a physi- cian. If there is no nurse available the mother herself may have to give it. A rubber sheet should be placed on the bed and a pad over it. The child should be stripped and wrapped in a sheet wrung out of tepid water. He should then be "ironed" with small pieces of ice about the size of one's fist. The entire body should be gone over in this fashion several times especially under the arms and in the groin. The ice of course should not touch the bare skin of the child, only the wet sheet in which he is wrapped. If the child grows blue or shivers much this ironing should be stopped at once and the wet sheet removed. A warm blanket should be substituted and hot water bottles 23 FIRST AID IN NURSERY AILMENTS placed at the child's feet. If the child's color remains good the rubbing may be kept up from five to ten minutes, then he should be left wrapped in the sheet a half hour, at which time the temperature should be taken again and if it is lower the sheet should be removed and the ice cap left on the head for an hour or so longer. At any time when the feet and hands are cold and the child has a fever, hot water bags should be placed near them while the ice cap should be left on the head. This will often prevent a convulsion. When the child has a full, bounding pulse and seems very uncomfortable from fever in spite of the sponge baths, etc., sweet spirits of nitre may sometimes be given with benefit, but it is best to let the doctor order this. To a baby under one year old three drops in a teaspoonf ul of water may be given every three hours, five drops to a child from one to three years old and ten drops to older children. All drugs for reduc- ing fever are dangerous to a greater or less ex- tent and mothers should beware of such and should not try any experiments with them, with- out explicit orders from the doctor in charge. Every mother should know how to use a clinical thermometer. It is impossible to judge 24 FIRST AID IN NURSERY AILMENTS accurately as to the child's fever by simply touching him. It is foolish to take a baby's tem- perature every day, if he is not at all ill, but when there are any symptoms of illness, it is one of the first things that should be done. If the child is under four years of age the temper- ature should be taken in the rectum. The thermometer should be well oiled with vaseline, then introduced about an inch into the rectum and allowed to remain there from one to three minutes according to the make of the thermome- ter used. After the thermometer has been read it should be carefully shaken down in order to be ready for the next time. It should be washed in alcohol and cold water, and placed in its case where it may be kept very clean. Older children may have the temperature taken by placing the thermometer under the tongue and closing the lips about it. The temperature in the mouth, however, is lower than a rectal temperature. If it is possible to reach a doctor every case of fever over loo F. should be reported to him. Many of the contagious diseases begin with fever and a physician, not the mother, should be the one to judge as to the best method of procedure in such cases. The doctor cannot be 25 FIRST AID IN NURSERY AILMENTS present all the time, however, and if the mother knows how to intelligently use a thermometer it will be much better for everyone concerned. Well-trained children do not object to having their temperature taken if the mother goes about it in an entirely matter-of-fact manner and does not instill the dread of it into the child's mind. A child who has been taught implicit obedience from the start stands a much better chance of recovery when he is very ill, because he does not waste valuable strength in struggles over every little thing that must be done for him. Colds The first thing to do when a baby or child has a cold is to give him a dose of castor oil. One teaspoonful is enough for a baby under a year old. To a baby from one to two years of age two teaspoonfuls may be given. After this time a tablespoon ful will be needed. The castor oil helps to carry off the mucous which the child cannot expectorate and clears out the intes- tines generally. If there is any fever with the cold the child should be kept in bed and the food diluted. Often if given at the very be- ginning of a cold, rhinitis tablets are helpful. 26 FIRST AID IN NURSERY AILMENTS For children the half strength should be used and one tablet given every hour for half a day or even for one whole day if necessary. If the child flushes much the medicine should be stopped. Warm olive oil dropped up the nose of a baby or child who has a cold in the head is often beneficial in clearing out the breathing passages. Spraying the nose with a mild anti- septic solution like borolyptol diluted with two parts of water or using liquid albolene in a spray several times a day will often add much to the child's comfort. This is about all that can be done for a simple cold in the head. To prevent frequent colds the child should be accus- tomed to plenty of fresh air, but should not be allowed to be in drafts. A cold sponging of the throat and neck every morning followed by a brisk rub are helpful. A child who has fre- quent colds should always be examined for ade- noids and enlarged tonsils and if they are found, a nose and throat doctor should remove them as there is danger of deafness if they are allowed to remain. Bronchitis When a cold extends down into the bronchial tubes and there is a cough and wheezing on the 27 FIRST AID IN NURSERY AILMENTS chest it is known as *' bronchitis '' and great care must be taken or it will turn into pneumonia. The first steps in the treatment are the same as for colds already described on page 24, but in addition to this something must be done for the cough and wheezing on the chest which often makes the breathing very difficult. The best thing for this is to make a mustard paste out of English mustard (one tablespoonful of the mus- tard and six of flour) mixed with a little cold water like a cake batter. This paste should be spread between two layers of muslin long enough to reach all the way around the child's chest, back and front, covering the chest completely. Before the paste is put on the child it should be warmed a little by holding it near the fire. The paste should be left on for five or ten minutes, long enough to redden the skin well, but not long enough to burn the child. It should then be removed and the chest wiped dry and rubbed with a little warm olive oil. This treatment may be used three or four times a day if it seems to relieve the breathing, but the child must be kept in bed and not allowed to go out of doors for at least one or two days after the treatment. Inhalations of steam with one teaspoonful of 28 FIRST AID IN NURSERY AILMENTS compound tincture of benzoin in the water will often relieve an irritating cough. A Httle steam vaporizer or inhaler is best to use for this and a tent may be made by draping a large sheet over the crib, or if this seems to frighten the child or to be too much for him the steamer may be held near him so that the steam blows in his face but does not bum him. He should never be left alone for one moment while the steam inhalation is being given, for serious results might occur. It is generally best to give the steam for ten or fifteen minutes at a time, and it may be repeated as often as every three hours if the cough is severe. If necessary an ordinary- tea kettle may be substituted for the vaporizer. If the cough is still frequent and serious after the steam and mustard pastes have been used it may be necessary to give medicine, in which case brown mixture is about the best thing for a baby or a child. A baby under one year may be given fifteen drops of brown mixture every three hours; a child from one to three years may have one-half teaspoonful every three hours ; and an older child one teaspoonful. If there is much fever the child should be given a tepid sponge bath. Every time the temperature reaches 102 or 103 degrees, if he is at all restless, FIRST AID IN NURSERY AILMENTS give the bath, as this cool sponge will soothe him and help reduce the fever. One tablespoon- ful of alcohol to a small basin of tepid water may be used for the sponging. This is much better than giving medicine to bring down the fever. If this does not answer, however, and the child is burning hot and very restless with a strong throbbing pulse some sweet spirits of nitre in water may be tried. For a baby under six months old, three drops in a teaspoonful of cold water may be given every three hours; from six to twelve months five drops every three hours may be used ; from one to three years ten drops may be given every three hours; even in an older child this will usually be all that is safe to give. This must not be kept up for more than one day unless by the doctor's orders. If there is much mucous present it is well to give castor oil every two or three days to clear out the mucous that will accumulate. Sometimes calomel may be given in place of the castor oil, especially if the child has a tendency to consti- pation. One-tenth of a grain every hour for ten doses is usually the best proportion. For an older child it should be followed up the next morning by a dose of either the citrate or the milk of magnesia or else Epsom or Rochelle salts. 30 FIRST AID IN NURSERY AILMENTS A doctor should be in attendance on every case of bronchitis but the above suggestions may be tried if a physician is not accessible for sev- eral days, as sometimes occurs in remote places. An examination of the chest by a doctor is very necessary for it is often very difficult to tell whether the attack is bronchitis alone or whether there is pneumonia present. A good tonic of cod liver oil or iron is gener- ally needed after bronchitis. Croup Croup generally comes on very suddenly, most often at night when the child is wakened from a sound sleep by a harsh, metallic cough that sounds like a bark. There is also more or less difficulty in breathing. If the child can be made to vomit quickly the attack will be much relieved. Syrup of ipecac is generally used for this purpose. For a baby under one year two drops of syrup of ipecac may be given every fifteen minutes until the child vomits; from one to two years five drops every fifteen minutes until vomiting occurs ; in later childhood as much as ten or fifteen drops may be given until the ropy mucous is vomited. If the ipecac is not at hand a little mustard 31 FIRST AID IN NURSERY AILMENTS dissolved in lukewarm water may be given the child to produce vomiting. Inhalations of steam are of the greatest value in croup. To be most effectual it is best to put the child in a tent as described on page 29. Either the plain steam or steam with compound tincture of benzoin in the water may be used, the inhalation may be kept up half an hour or longer until the child's breathing is relieved. One or two teaspoonfuls of castor oil should also be given after the mucous is vomited because this will move the bowels and help to carry off any mucous that may remain. A child should not be allowed to go out of doors the next day after an attack of croup and it is usually best to begin to give small doses of ipecac about three or four o'clock on the day succeeding the real attack, for in this way an- other attack may be warded oflf. Two to five drops every two or three hours are usually enough to give at this time. Chills Children are not so apt to have chills as adults. But when chills occur undress the child, wrap him in a heated blanket and give him a mustard foot bath, letting the water come 3^ FIRST AID IN NURSERY AILMENTS well up over the legs. Or he may be put in a mustard bath, then wrapped in hot blankets. For this bath one-half cupful of English mustard to a tubful of water may be used or one table- spoonful to a gallon of water. The child should be left in the bath only long enough to redden the skin. Hot lemonade may also be given. Chills may mean that the child has malaria, that one of the contagious diseases is coming on or that he has caught a severe cold, a cold which may possibly be followed by pneumonia. It is therefore best to keep the child in bed for at least a day after the chill and carefully watch for other symptoms to develop. Sore Throat When a child has a sore throat the safest thing to do is to call in a doctor as soon as pos- sible to examine the throat. He alone can tell just what form of " sore throat " the child may have. Since children are subject to diphtheria, in case of sore throat, it is a great deal safer to have a physician's opinion whenever it is pos- sible. There are times, however, when a doctor is not accessible and in such cases the mother may treat the throat as follows until her doctor can arrive. — No matter what form of sore throat 33 FIRST AID IN NURSERY AILMENTS the child may have he should be kept away from other children. A laxative should be given to clear out the intestines; castor oil, calomel, or citrate of magnesia may be used. If there are any spots in the throat the calomel, followed the next morning by magnesia, is to be preferred. A cold compress made from several layers of cheese cloth wrung out of witch hazel and cov- ered with a piece of oil silk should be placed around the child's throat, and changed often enough to keep it cool and wet. It is best to keep the child in bed and on a fluid diet or soft food if he is old enough to take such things as cereals, junket, blancmange, wine jelly or milk toast. As a local treatment, if the child is old enough, have him gargle every hour or two with any of the following gargles ; — Manhattan gargle (one tablet dissolved in a third of a glass of hot water) ; or equal parts of borolyptol and cold water; or as much chlorate of potash as can be gotten on a ten cent piece, in half a glass of cold water. If the child cannot gargle then any of the above may be used in a spray or atomizer. I much prefer the Manhattan gargle to anything else but it must be used as hot as can be borne to be effectual. It is valuable in follicular tonsillitis. If the spots do not yield 34 FIRST AID IN NURSERY AILMENTS to the $pray alone, or if there Is very much swelling of the tonsils and spots also in the throat, it will be necessary to swab the throat. This may be done with two parts of glycerine mixed with one part of tincture of the chloride of iron. For this purpose a piece of absorbent cotton should be very firmly twisted on a small stick of wood notched at the end so the cotton will not slip off. The cotton should be dipped in the mixture of iron and glycerine and then the spots and tonsils gently but thoroughly touched. This may be repeated every four or six hours, at the same time continuing the use of the spray or gargle. If a sore throat proves to be diphtheria, the early use of antitoxine means so much to the patient that every effort should be made to administer it early in the attack. Therefore, too much stress cannot be laid upon getting a doctor's opinion as soon as possible. If there is much fever with the sore throat there is less likelihood of its being diph- theria than if there is little or none. To con- trol the fever and make the child comfortable frequent sponge baths with a little alcohol in tepid water may be given; also if the pulse is full and throbbing and the child very uncom- fortable sweet spirits of nitre may be given; five 35 FIRST AID IN NURSERY AILMENTS drops in a teaspoon ful of water every three hours for a child under two years, or ten drops for older children. Enlarged or Swollen Glands of the Neck After grip, a severe cold, or tonsillitis, the glands of the neck frequently enlarge, becoming much swollen and sometimes hard and painful. The inflammation may go on to such an extent that the gland will break down, pus form, or a regular abscess result or they may absorb. As enlargement of the glands of the neck often occurs with diphtheria, it is always well for a doctor to see the child as soon as possible, but if a doctor cannot be quickly obtained the mother should look down the child's throat herself, and if no membrane or white spots are visible she may try one of the following things to reduce the swelling. — First try a cold com- press of equal parts of witch hazel and water, bound onto the gland and covered by a piece of oil silk or rubber tissue. This must be changed often enough to keep the compress really cold. A small ice bag may be bound on while the child is in bed. Next try antiphlo- gistine spread on a piece of compress or gauze folded and applied as hot as possible without 36 FIRST AID IN NURSERY AILMENTS burning the child. This should be changed every four or six hours. As the swelling sub- sides a little ichthyol ointment (twenty per cent) may be spread on a piece of folded gauze and bound onto the gland. This should be changed every six hours. After the swelling has almost disappeared to massage the gland night and morning for a few minutes with a little warm olive oil on the tips of the fingers will be all that is necessary. It is a good plan to give a dose of calomel followed by citrate of magnesia or Rochelle salts as soon as the swell- ing is noticed. If the tonsils are red and swollen the throat should be sprayed every two or three hours with borolyptol and water, equal parts. If the gland becomes very red and hot and the swelling does not reduce at all, it is probably going to break down and will have to be lanced by a doctor as soon as it is ripe or soft enough. Bruises When a child has a bruise the discoloration, so apt to follow, may be lessened and in some cases prevented by quickly placing something very hot or else very cold over the part. Com- Z7 FIRST AID IN NURSERY AILMENTS presses wrung out of hot water as hot as the hand can stand without burning, may be laid on the bruise and changed at once when they grow cool. Ice wrapped in a piece of absorbent cotton and held on the bruise will answer very well in many cases. Afterwards the part may be wrapped in a wet compress of witch hazel. This compress should be changed often enough to keep the part wet. Sprains A sprain should be treated at first very much like a bruise. If the ankle or knee has been sprained it should be immersed in hot water, or if cold water feels more comfortable, it may be used. After this a rather tight bandage, wrung out of equal parts of witch hazel and water, should be bound around the injured part. If a doctor or nurse can be found quickly they will often strap the part with narrow strips of adhesive plaster and allow the patient to use it almost at once. But if this strapping cannot be done properly, it is best to keep the parts at rest until some skilled person can see them. 38 FIRST AID IN NURSERY AILMENTS Cuts Children are always getting cut, and care should be taken to cleanse the wound thoroughly and keep it clean until it is healed. A small cut should be simply well washed with clean, cold water, a small pad of gauze placed on it and over this a narrow bandage. If the cut is deeper or some time has elapsed since it was done, so that there is probability of unclean substances having found their way into it, it should be washed in a solution of bichloride of mercury (i to looo) and a wet pad of this placed over the cut before it is bound up. The pad may be kept wet by placing a small square of rubber tissue over it and renewing the wet dressing as often as necessary. Pressure will often stop bleeding when nothing else will, so if there is much bleeding the pad should be firmly pressed against the cut until the blood ceases to flow. After the first day or two if there is no inflammation around the cut it may be simply covered with a piece of court plaster to keep out dirt. If an artery has been cut the blood will spurt out in jerks. In such a case tie a handkerchief or towel very tightly above the bleeding point ; then put a stick through the knot and twist 39 FIRST AID IN NURSERY AILMENTS it until the bandage is very tight, and then hold it until a doctor can be summoned. To make the i to looo bichloride of mercury solution, dissolve one bichloride tablet in one pint of boiling water. Great care must be taken to keep these tablets (also the solution) out of reach of the children, because they are deadly poison. Bums One of the most important things in treating a burn is to keep air away from it, as soon as possible. If the skin is not badly broken, sprinkle bicarbonate of soda (ordinary baking soda) on the burn, wrap it in clean linen and over this bind a layer of cotton. If the skin is more or less burnt off, put on olive or linseed oil, then the soft clean linen, cotton and a bandage. If one can obtain a substance already prepared called " unguentine," spread it rather thickly on the clean linen that is to cover the burn, it will often hasten the healing process. It is a very serious thing to get a burn infected and if there is much swelling, an unpleasant odor or discharge from the burn a doctor should be asked to inspect it as soon as possible. As a result of a severe burn there is often a 40 FIRST AID IN NURSERY AILMENTS good deal of shock. The child should be made to lie down and keep quiet while hot water bags are placed at the feet and a little whiskey or brandy is given in an ounce or two of hot water. Earache Many babies suffer much from earache with- out the cause of their pain being suspected. When a baby screams sharply as if in severe pain and jumps when pressure is made just in front of the ear, earache should be thought of and if possible a doctor should be asked to ex- amine the ear. Earache is very common during and after a severe cold, grip, or any of the con- tagious diseases, especially scarlet fever and measles. Older children will usually locate the seat of their pain by putting the hand to the ear. To relieve earache, dry heat is best. A small hot water bag placed over the ear, a salt bag bound on, very hot flannels changed often enough to keep them hot, are all valuable aids in checking the pain until a physician may be seen. Syringing the ear with hot boric acid solution (one-half teaspoonful of the boric acid powder to a cup of hot water) is often helpful. A small, soft rubber ear syringe should be used. 41 FIRST AID IN NURSERY AILMENTS It is not advisable to drop hot oil, or even laudanum, into the ear. When there is a discharge from the ear it means that an abscess has formed back of the drum and broken, perforating the drum mem- brane. In such cases the ear should be syringed v^ith warm boric acid solution every two or three hours and a doctor consulted as soon as possible. If a foreign body has been pushed into the ear of a child, it is best to let it alone unless it can be readily removed with the fingers, because there is danger of working it farther into the ear if it is tampered with by inexperienced people. In such a case the child should be taken to a physician as soon as possible. Nosebleed When there is bleeding from the nose the child should be placed in a semi-upright posi- tion while a piece of ice wrapped in absorbent cotton is held on the bridge of the nose; another piece may be held at the back of the neck. Pressure on the upper lip just below the nose often helps to stop a nosebleed. Packing tissue paper or cotton under the upper lip may also be tried. 42 FIRST AID IN NURSERY AILMENTS If a child has very frequent attacks of nose- bleed he should be examined by a doctor; there may be some local trouble that needs correction or the general system may need attention. Foreign Bodies in the Nose Children often push a button, pebble, pea or some small object up the nose, where it may become wedged. To remove it try compressing the opposite side of the nose and at the same time make the child blow hard. If this does not dislodge the substance try to make the child sneeze by tickling the nose with a feather or letting the child smell of a little pepper. A hard sneeze will often remove the substance. If these simple methods do not prove effectual consult a doctor as soon as possible. Trying to remove the article with a hairpin usually does more harm than good. Disorders of the Eye Too much care cannot be given to the eyes of a baby. There are many cases of blindness due simply to neglect. If there is any secretion of pus or the eyes are inflamed they should be carefully washed with a solution of boric acid (one teaspoonful to a 43 FIRST AID IN NURSERY AILMENTS pint of boiled water). This should be done every hour or two or as often as needed to pre- vent the pus from collecting. A special blunt pointed eye dropper or syringe is excellent to use for irrigating the eyes. It should be gently placed under the lids, care being taken not to press on the eye-ball, squeeze the rubber bulb and the fluid will run over the eye. The eyes should then be dried with clean absorbent cotton. Use a separate piece of cotton for each eye. If only one eye is affected cover the well eye with cotton before treating the diseased one. If the lids stick together a little pure white vaseline may be kept on them. If there is not a very marked improvement after using this treatment for twenty-four hours a doctor should be called at once, as something stronger is then needed and delay in its use may cause loss of eyesight. Styes Styes are not uncommon among growing children. When one appears it should be bathed often with hot boric acid solution made as indi- cated above. Hot applications may be kept on for fifteen minutes applied every two or three hours if there is much pain. If the stye 44 FIRST AID IN NURSERY AILMENTS becomes very large and inflamed it may have to be lanced by a doctor. When there is a succession of styes a general tonic is often needed. Foreign Bodies in the Eye When something is in the eye of a child, try to keep him from rubbing it if possible. Have the child blow his nose, flush the eye with boric acid solution; pull down the lower lid and examine the inner surface to see if the irritating particle can be found and if so gently remove it with the corner of a clean piece of linen. It is very difficult to roll over the upper lid but if a doctor cannot be had, this may be attempted by taking a small pencil, narrow in diameter and holding the upper lid back over it. An eye stone may be tried if other means fail. After moistening it place the stone in one comer of the eye. It will work its way around, often bringing the foreign body with it. An eye cup filled with boric acid solution is often useful in giving an inflamed eye a bath. Sprue If a baby's mouth or the nipples of the nurs- ing bottle are not kept clean, thrush or sprue 45 FIRST AID IN NURSERY AILMENTS IS apt to develop. This is seen as small, white flakes like curds of milk on the inside of the mouth, tongue and throat. One teaspoonful of the bicarbonate of soda should be added to a cup of boiled water and the mouth washed out gently with this solution every hour. Twice a day the mouth should also be washed with boric acid solution. Honey and borax so often used for this purpose by old- fashioned nurses is very injurious and only makes bad matters worse. Scrupulous care should be taken of the nursing bottles and nipples and if the baby has been allowed to suck a pacifier it should be burnt and never re- placed. Ulcers or Cold Sores Sometimes little ulcers will form in, or at, the corners of the mouth; in such cases make a swab of a small piece of absorbent cotton firmly twisted on a wooden tooth pick; dip it in equal parts of burnt alum and bismuth powder and touch the sore spots three or four times daily. This often helps better than anything else to dry up a cold sore or fever blister. 46 FIRST AID IN NURSERY AILMENTS Foreign Bodies Swallowed and in the Throat If a child swallows a foreign body and appears to be choking, try a sharp slap on the back between the shoulder-blades. If this does not bring up the substance then hold the child up- side down by the feet and shake him. Putting the finger into the throat and trying to extract the substance may sometimes be effectual. When the substance has really been swallowed give the child oatmeal porridge or mush of any kind, potato or bread and milk. This food will form a soft coating about the article and will usually carry it safely through. It is a very bad plan to give a laxative, like castor oil, to hurry the article along. Chafing If a baby is not kept dry or the napkins are not well cared for or the bowel movements are abnormal, chafing of the buttocks and surround- ing parts is very apt to occur. In such a case the parts must be kept very dry and washed with olive oil instead of water. An ointment known as " Lassar's paste '' should be spread on old, soft linen and kept on the sore parts. 47 FIRST AID IN NURSERY AILMENTS If the chafing is only slight a one per cent solution of ichthyol (one teaspoonful to a pint of water) may be frequently sopped on and chen the parts dusted with a very pure talcum powder. Eczema Eczema is quite common in babies and the cause is often some error in diet. What will suit one child in this respect will not do at all for another. The food must, therefore, be changed until the exact thing for the individual baby is found. The bowels must be kept open. Milk of magnesia is the safest laxative to use for this purpose. Many ointments are used locally but one of the most successful is " Las- sar's paste'' spread on linen and kept in close contact with the affected surface. The parts must be washed with olive oil in place of water. No ointment will be of avail unless it is kept closely applied. Therefore it is often necessary to make an eczema mask out of canton flannel (soft side out), or heavy muslin. If the eczema is on the face, or other parts of the body, the linen spread with ointment must be bound on with bandages. It is absolutely necessary to prevent the child from scratching if a cure is to be effected. 48 FIRST AID IN NURSERY AILMENTS Milk Crust Milk Crust is a form of eczema found on the scalp. It is a thick crust as a rule and often takes some time to remove. An ointment of two per cent resorcin should be spread on linen and bound on the scalp by means of a tightly fitting cap. The ointment should be applied fresh twice a day. Do not use water on the scalp but continue this treatment for three or four days, then wash the scalp well with olive oil and much of the crust will come away. Repeat the process until the head is clear. Then apply it for a week or more, once or twice a week at night, to prevent its return. Boils Babies and young children sometimes are afflicted with boils. To bring a boil to a head and to soften and ease the pain, make applica- tions of antiphlogistine bound on as hot as can be comfortably borne and changed every four or six hours. When the little core softens and comes away the boil should be washed with warm boric acid solution, and then a dressing of ichthyol ointment spread on gauze should be bandaged on the part. This will disinfect and 49 FIRST AID IN NURSERY AILMENTS help heal the sore. When many boils appear something is usually wrong with the child's diet or he may need an iron tonic or some other preparation. A doctor should be consulted as to the best thing for the particular case. Prickly Heat Many babies are much troubled in summer by prickly heat. A little linen shirt worn next to the skin under the wool band or shirt will relieve the irritation. Frequent tepid sponge baths with one teaspoonful of bicarbonate of soda to half a basin of water is also excellent. After the bath, pure talcum powder or powdered corn starch should be dusted on. If there is much inflammation of the skin, it will often help to sop on frequently one per cent ichthyol solution and then to dust with powder. Bran baths and starch baths are sometimes used. Hives Hives are frequently seen in many children, especially those having a delicate digestion. They are often very irritating, itching greatly. They may be bathed with a solution of bicar- bonate of soda, one teaspoonful to a half basin of water. The bowels should be opened by 50 FIRST AID IN NURSERY AILMENTS means of the milk or citrate of magnesia, then the rhubarb and soda mixture given, in a little water, after meals for several days. A child under one year will usually require twenty drops three times daily ; from one to two years, half a teaspoonful and for older children one teaspoon- ful three times daily. The child should be watched and if an attack of hives occurs every time after eating any one article of food, this article should be omitted from the diet. Straw- berries and fish often cause hives in children. Chapped Hands In cold weather babies and children are apt to have chapped hands and faces. A few drops of glycerine in an ounce of water may be rubbed on the chapped parts. Cold cream is also excellent to use and may be put on the hands and cheeks of the child before he is taken out into the cold. Scabies or Itch This is a most annoying skin disease and very contagious. It often appears in children who have not been kept very clean or who have attended public school and have come in con- tact with someone who already has the disease. 51 FIRST AID IN NURSERY AILMENTS The little red marks with a black centre appear as a rule between the fingers and toes then spread to other parts of the body and are intensely "itchy/' It seems impossible to keep from scratching. The child's clothing should be boiled. He should be soaked for ten or fifteen minutes in a hot bath and scrubbed with a brush, dried, and balsam of Peru ointment (lo per cent) spread on linen and covered with a piece of rubber tissue bound on the parts with a bandage. This should be done every night at bed time and left on the next day. It should be repeated until the child is completely rid of the disease. The child should not be allowed to sleep with anyone else nor use the same linen while the dis- ease is present. Ring Worm Ring Worm is another contagious skin disease. A round, red ring often on the scalp or face but sometimes on other parts of the body characterizes this disease. School children often contract it from each other or from dogs and cats. The spot should be painted with equal parts of iodine and olive oil mixed together and applied with a camel's hair brush or a swab 52 FIRST AID IN NURSERY AILMENTS twice daily. The entire surface and a little way beyond the border of the ring should be covered. If the disease is on the scalp all hair must be shaved off before the treatment is begun. Lice or Vermin in the Hair School children, also those who take long journeys on sleeping cars, are very apt to con- tract these pests. It is often impossible to rid the hair of the little nits unless it is cut closely to the head. White precipitate ointment (five per cent) may be rubbed into the hair and scalp, then a cap or towel tied over the head during the night. The next morning the head should be washed with warm water and castile soap and well combed with a fine toothed comb. It may be necessary to repeat this several times; tincture of larkspur is also often used for this purpose, and even kerosene may be used when nothing better can be had. Cold Sores or Fever Blisters Many children are frequently subject to cold sores on the lips. Camphor ice frequently applied is helpful in such cases, or the sore may 53 FIRST AID IN NURSERY AILMENTS be bathed with boric acid solution, then a powder of equal parts of burnt alum and bismuth dusted on. Frost Bites and Chilblains After being out on a cold, windy day a bright red spot may appear on the baby's tender cheeks, which will soon feel quite hard. This is a frost bite. Cold water should be applied to the spot followed by an application of an ointment of balsam of Peru. When these red spots appear on the feet or hands they are called ''chilblains." The same treatment as indicated above is good for them. The child should never be allowed to go close to the fire after being out in the snow. He should get warm gradually. Eruptions, Rashes and Contagious Diseases Babies and children are very prone to rashes of various kinds. As the contagious diseases usually take place during childhood, it is not very safe for a mother to attempt either to diagnose or treat a skin eruption herself. A bright red rash may be almost anything, from simple indigestion to a case of scarlet fever, 54 FIRST AID IN NURSERY AILMENTS