In the Children's Hospital, Washing ton, D. C., most cases of bronchopneu monia are so slight as to call for little more than rest in bed, a liquid diet, and the cotton jacket. If the inflammation extends to considerable areas, more ac tive measures are pursued. Counter irritation is produced by mustard pastes, turpentine stapes, or camphorated oil applied to the chest, but never to the extent of blistering. Hot flaxseedmeal poultices are indicated when the pul monary congestion is intense or general. Samuel S. Adams (Archives of Pedi atrics, Apr., '93).
In bronchopneumonia applications of cold water to the affected side with cold applications to the head recommended, and, in the event of the temperature going above 103° F., cold plunges as hest method of treatment. M. S. Marcy (Archives of Pediatrics, Feb., '99).
Study of means other than the in ternal use of drugs based on over 600 cases in infants and young children. Very few cases are primary, while the most serious of the causes of secondary pneumonia are diphtheria and measles. As the disease has no limit, runs no cycle, the preservation of vital resist ance by not upsetting the stomach and disturbing the child is of great value. Little irritability, restlessness, or loss of sleep should be permitted. Good venti lation of the sick-room is essential; the temperature of the room should never pass 70° F. (21.1° C.); and a flannel undershirt alone is advised. He never used a cotton jacket. The child is kept in his crib, water is given between nurs ings,and the time of nursing is decreased, while the food is diluted. The bowels must be moved once a day. The child should not he needlessly disturbed, food and medicine being given at three-hour intervals. Steam inhalation with crea sole (10 drops to 1 quart of Water) under croup tent, for thirty minutes every three hours, advised, admitting fresh air every ten minutes. With much catarrh he used turpentine (7,) with oil but mustard applications make the best counter-irritation. The boundaries to be covered should be marked out, and the plaster is to be made with 1 part of mustard to 2 parts of flour, applied for ten to fifteen minutes once in six to eight hours. Later applications should be weaker. They are especially effective at the onset, as are mustard-baths, espe cially in cases with marked prostration. Drugs internally are only indicated symptomatically, and great ease is necessary not to disturb digestion. Ex pectorants are best given in powder or tablet form. dissolved in water, after feeding. The ammonium salts arc only given during- resolution, in 'A.-grail: (0.03 gramme) doses, a ml antipyretics are used only when the baths are badly borne. If there is mid: restlessness.
Dover's powder may he given, watching its effect on the bowels. Heart-stimu lants are, as a rule, used far too early. are needed When the pulse becomes soft, rapid, and irregular—such as 1,50 during sleep. He considers tincture of strophanthus best, but strychnine is also good when pushed to full doses or till some result is noted. Digitalis upsets the stomach easily: whisky or brandy is rarely needed and is best employed late, when other stimulants fail. .Nitro glycerin May be used, but frequently causes headache. A daily sponge-bath is advised, and When the fever renehes 104° F. (40° ('.) a sponge or a cold pack is to be given. For the sponging, salt (3j-4 grammes—to a quart of water) or alcohol (1 to 4 parts of water) is used. This is clone under a blanket, the water being gradually reduced to 30° F. (26.7° ('.), continued from ten to fifteen minutes. Toe frequent sponging tires 1 he patient. Cold have a very slight and temporary effect on this con dition. lie considers the cold pack the host hydrotherapeutie measure, given by using a large bath-towel, the entire body being covered to the knees. Warm water is first decreased gradually by sponging. The temperature is taken in a half-hour. Children may be turned from side to side and enjoy the cool pack. An ice-hag is applied to the head; hot-water bags to the feet. Oxygen, given for one-half minute every half hour. is also of value. (('. G. Kerley.) Dr. Wahrer, of Fort Aladison, Iowa, mentioned the fact that many children are literally smothered to death by the treatment of pneumonia, and referred to several cases. Dr. Williams, of Chicago, laid special stress on the conservation of the child's vital resistance. Dr. Gil bert, of Louisville, uses ammonium bromide, but objects to any opiate, even Dover's powder. Dr. Tuley, of Louis ville, said that the term eapillary bron chitis should be discarded, as all such eases are pneumonia. Poultices, internal antipyretics and nauseating remedies are all useless, Dr. Parks, of Birmingham, Ala., referred to several of asthma diagnosed bronchopneumonia. lie gives strychnine by rectal injection. Dr. Bar bour. of Louisville, insisted that drugs are always needed in the treatment of pneumonia. He advised the cotton jacket. Dr. Kerley had found that Dover's powder was the least dangerous sedative. Chloral should never be given, because it upsets the stomach. He be lieves in drogs properly used. but only when properly used. (Phila. Med. Jour., May 10, 1903).