R. Spiritus "-Ether. Nitrosi 3ij.
Liquor. Ammon. Acelat.
Syrupi Croci j.
Aqwre Destillatre ad Siv. Misce.
There is no difficulty as regards diet when the patient can take milk freely, as milk alone or diluted with half its amount of Lime-water, ox aerated water may be given in any quantity. Where the patient has a natural dislike to milk, weak soups, beef tea or any liquid nourishment may be given. It is, however, a mistake to force nourishment under these circumstances. Often a child who refuses milk can be tempted to take tea, and this may consist chiefly of milk flavoured with a little tea. In this biscuit may be soaked, or toast may be added.
Thirst increases with the temperature, and diluent drinks may be freely given ; it is wrong to refuse cold water when the patient craves for it. It should only be temporarily withheld in those instances where it is taking the place of nourishment. Weak barley water, to which lemon-juice and a littl esugar have been added, or home-made lemonade may be freely given. When thirst is very great, ice may be administered in small quantities.
Very high temperature must be checked, and, as there is a strong objection to the cold bath before the appearance of the eruption, when the thermometer remains above toe an antipyretic should be administered Quinine is the safest and best of these, and may be given in doses of about gr. for each year of the child's life every 4 or 6 hours; higher temperature: will require doses of double the above.
The newer antipyretics may be employed, but only for short periods. x gr. Antipyrine may be given every 3 hours to a child from one to try( years old. When hyperpyrexia occurs after the rash has come well and where the temperature reaches to6' or more, a tepid bath or cold pack should he at once given, and the patient kept in it till the temperature falls to normal. With a good nurse, sponging of the body in detachment: answers most requirements, and the water at first may be tepid and after wards cooled down. The bowels should receive one moderately smart clearing out by a saline purgative; further purgation is unnecessary unless constipation set in. Diarrhcea, if present, should not be interfered with unless it threaten to exhaust the patient's strength.
Coryza requires little interference, as it rapidly subsides upon the decline of the eruption, and is generally relieved by cutting off the supply of bright light. If congestion of the conjunctiva remains a 3 grs. per oz. Boric eye-wash may be used.
Cough is often severe, and in some cases almost alarming, and is liable to resist drugs till the eruption begins to fade. The diffusion of steam through the air or an inhalation of Hemlock Juice or a very weak Carbolic spray to the fauces, and Ipecacuanha Wine internally and warm poultices externally, generally afford relief. In adult patients Tartar Emetic (zo mins. of the wine, with 5 mins. of Liquor Morphiie) may be given with advantage to loosen the expectoration, but drenching with nauseating expectorants must be avoided when possible.
Laryngeal irritation, like the bronchial mischief, is best treated by warm inhalations.
Severe cephalalgia should be met by a small dose of Antipyrine and a sinapism to the nucha. A smart purge is indicated for the relief of this symptom if the bowels have not been already well moved.
Vomiting is relieved by mustard to the gastric region, small quantities of iced soda-water, and peptonisation of the milk.
Itching, when the eruption is well out, may be a troublesome symptom. It is generally relieved by sponging the limbs and face with a warm or tepid solution of Bicarbonate of Soda, and by anointing the skin with weak Carbolic or Eucalyptus Oil (i in 4o).
In the early stage, should convulsions occur, or where stupor with marked exhaustion is observed before the appearance of the eruption over the entire body, especially when traces of it have been observable for one or two days about the head, a hot bath should be given, with the view of causing a smart determination of blood to the cutaneous surface, and when in the bath cold affusion to the head is very valuable. After such a bath the body should be properly rubbed dry with warm towels, and the patient wrapped up in flannels and put to bed before the possibility of a chill occurs.