The maternal management of children, in health and diseaseBull, Thomas
Science
The maternal management of children, in health and disease
Bull, Thomas
Child care
SYMPTOMS.--The symptoms are more severe than in the mild form of this
disease, and, in the majority of instances, the inflammation of the
throat appears with the eruption, and goes through its progress of
increase and decline with the cutaneous eruption. Sometimes, however,
it precedes the fever; whilst at others it does not appear until the
rash is at its height.
It is generally in the course of the second day that the child
complains of considerable stiffness in the muscles of the neck,
extending to the lower jaw, and under the ears;--of a roughness of the
throat, and difficulty in swallowing;--and some degree of hoarseness
will be noticed: all so many indications that the throat is affected.
Very shortly, an increased secretion of the mucus of these parts
occurs, and, collecting about the tonsils, aggravates the child's
sufferings, from the frequent and ineffectual efforts made to expel it.
If the inflammatory action be more severe, exudations of lymph will
also be poured out, and intermingling with the mucus, greatly augment
the difficulty of swallowing. At this time the lining membrane of the
mouth, as also the tongue, assume a florid red colour; the red points
of the latter becoming much elongated.
The febrile symptoms are severe from the first; amongst others, there
will be headach, sometimes accompanied by slight delirium, nausea,
intense heat of skin, languor, and considerable inquietude and anxiety:
and as the inflammation approaches its height, the fever increases, the
pulse rises, the breathing becomes oppressed, the skin becomes more
pungently hot and dry, and the thirst urgent. All these symptoms being
increased towards evening, when the febrile restlessness is often
succeeded by delirium.
The rash is seldom perceptible before the third day, and then comes
out in irregular patches on various parts of the body, particularly
about the elbows and wrists; thus differing as to the time and mode of
its appearance, from the mild form of the disease. It frequently
recedes, or entirely vanishes, the day after it first comes out, and
then reappears partially, and at uncertain times. This generally
protracts the duration of the disorder, without, however, producing any
perceptible change in the other symptoms. On the fifth or sixth day of
the disease, the fever and inflammation of the throat begin to abate;
at the same time the rash declines, and the peeling off of the cuticle
soon follows.
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