A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
Craniotabes requires some special care in regard to the head. The
pillow ought to be soft, but not hot; no feather pillow is permitted.
The copious perspiration of the scalp requires that it should be kept
cool, the perspiration wiped off frequently to avoid its condensing
into water, and the flattening side of the head may be imbedded in a
pillow with a corresponding depression. Copious perspiration indicates
the frequent washing with vinegar and water (1:5-6). The muscular
debility commands great caution. The baby must not be carried on the
arm, but on a pillow which supports both back and head, or in a little
carriage. No sitting must be allowed until the back will no longer bend
to an unusual degree. No walking must be encouraged at any time. The
patients will walk when their time has come. The bones are so fragile
that great care {163} is needed sometimes not to fracture or to infract
them and to avoid periosteal pain in lifting. The skin must undergo
some training by gradually accustoming the little patient to cool
water. It can be readily, but gradually, reduced to 70° for a bath at
any season. The addition of rock- or table-salt to the bath is a
welcome stimulant. And fresh air ought to be granted freely.
Laryngismus stridulus shares the indications for treatment furnished by
craniotabes. The general treatment remains the same. Prominent symptoms
and complications ought to be treated besides; constipation requires
the more attention the more convulsive attacks of any description may
arise from reflex action. The general nervous irritability may be
relieved by bromide of potassium, sodium, or ammonium. One gramme daily
(15 grains) of either, in three doses, is well tolerated for a long
period. When there are symptoms of an imminent convulsion, or to soothe
the convulsibility which may break out any moment, chloral hydrate,
eight or ten grains in from one hour to four hours, two grains in a
dose, will be convenient. If the stomach refuses or is to be spared,
from four to eight grains may be given in an enema of warm water. A
severe attack of convulsions ought to be checked with inhalations of
chloroform. When a warm bath is to be had, care should be taken that
the child be not tossed about. Hold the baby in a small sheet or a
large napkin, and immerge it thus into the water, raising the head and
cooling it with cold cloths or an ice-bag. Genuine attacks of
laryngismus with well-developed stages--the first paralytic, the second
spasmodic--give but little time for any treatment. The proposition to
apply the electrical current is well meant, but the attack has passed
by, or terminated fatally, or resulted in a general convulsion, before
the apparatus can possibly be in operation. I can imagine, however,
that a Leyden flask kept ready might be used to advantage during the
stage of apnoea for the purpose of bringing on inspiration. Sprinkling
with cold water, beating with a wet towel, shaking by the shoulders,
Public-domain text, read in full here on John Shaqi.
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