A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper.

  • J. Forsyth Meigs
Date:
1886
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Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children : By J. Forsyth Meigs and William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    ment. During the day, the child generally seems perfectly well, or at most merely a little pale and languid, and he coughs but moderately, but as soon as night comes on, and especially when he is put to bed, the cough liegins and goes on for hours, as stated above, unless some remedy, and ]iarticularly some opiate, be given to check it. It is most annoying to the practitioner, for he tiuds that his usual remedies act merely as palliatives. They check and modify, perhaps overcome it for a time, but the next change in the weather, and especially the least exposure to cold and damj), start it afresh, and he has to resort again to the same round of treatment to subdue it. To the members of the family also it gives great anxiety. At first, they fear it must run into croup, which, however, it very seldom does, and then, finding how difficult it is to cure, and how often it recurs, they can scarcely be persuaded that it does not depend on some serious dis- ease of the lungs. The principal cause of this form of chronic laryngeal irritation is, so far as we have been able to ascertain, an unusual susceptibility of the laryn- geal mucous membrane, sometimes the result of a congenital idiosyncrasy, and at other times the result of influences coming into action after birth, and especially of improper dress. We have generally met with it in chil- dren dressed upon the hardening system so much in vogue with many of our most highly educated citizens. The low frock, leaving the neck and upper half of the chest exposed to the air, the bare arms and bare legs, jiersevered in through our cold autumns, winters, and springs, have cer- tainly, in most cases, been the cause of this troublesome and chronic cough. Our experience since the publication of the earlier editions of this work fully confirms the truth of these remarks upon the style of clothing just referred to. We certainly do not see so many cases of obstinate laryngeal cough as we formerly did, for the simple reason that but few of the families we take care of, adhere to the old-fashioned system of leaving their chil- dren half naked. The duration of the disease varies according to its form and the circum- stances under which it occurs. When primary, it lasts usually from a few days to one or two weeks, but when it becomes chronic, as we have known to happen in a good many instances, it has lasted from two to four or six weeks, and even two or three months. The duration of secondary cases de- pends, of course, upon that of the disease during which they occur. Diagnosis The diagnosis of simple laryngitis is very easy. The hoarseness of the cry, voice, and cough, the redness of the mucous mem- brane of the pharynx, and the absence of general symptoms, will distin- guish it from any other affection. In somewhat severer cases of this form, in which the cough is more frequent and harassing, the general symptoms more strongly marked, and the respiration somewhat hurried and op- pressed, the attack may at first view present the appearances of bronchitis or pneumonia. Tiie absence of the physical signs of these affections will show at once, by negative evidence, the true nature of the case. In some cases in which there is little or no hoarseness of the voice or