MUMPS.
The disease is very infectious from its onset, and even before the swelling of the jaws appears, and as the incubation stage varies from 14 to 25 days and the contagiousness may last for a month after apparent convalescence, a prolonged period of isolation is necessary to prevent the spread of the affection.
Rest in bed for a few days and a milk diet are all that ordinary cases require, but owing to the danger of complications the patient should, as a rule, not be permitted to leave his room for 14 days. The chief indication is to keep him protected from draughts, and the swollen region covered by warm, dry dressings. A pad of absorbent cotton-wool covered by a layer of oiled silk is all that is necessary in most cases. Where the tension gives rise to great pain and inability to open the jaws, a hot fomentation or warm poultice may be applied, but cold lotions should not be employed. The Green Extract of Belladonna may be smeared over the poultice. Should the pain continue, with much throbbing and local increase of temperature, suppuration may be feared, though this event is exceedingly rare. An antiseptic mouth-wash (weak Boric Acid or Condy's fluid) should be frequently employed.
Fluid nourishment is essential for several days till the swelling subsides. Where there is much increase of temperature and constitutional disturb ance, Antipyrine or Salicylates or a mixture like the following may be given: B. Spt. ,Ether. Nit. 3iv.
Tinctures A coniti illxij.
Syrupi Rosa 3iv.
Liquor. Ammon. .1cet. gj. Misce.
Fiat inistura. Ca/ iat cock. min. secundis horis.
Orchitis should be treated by a suitable splint on which to rest, as on a shelf, the swollen testicle. Belladonna is the favourite local application, but the standardised official preparations made from the root should never be employed, owing to the real danger of absorption through the delicate cutaneous covering of the scrotum. Any evaporating lotion, or Spirit r in 4 may be applied under oiled silk. Where pain is severe and continuous the Green Extract of Belladonna rubbed up with 3 parts Glycerin may be applied.
Meningeal symptoms must be promptly treated by the use of the ice cap, Bromides with Antipyrine and a smart Calomel purge, and though counter-irritation to the parotid region by a sinapism may be an unscientific method of treatment in such metastatic conditions, nevertheless it can do no harm. Leeches to the temples or behind the ear will also afford relief.
Pancreatitis may produce intense vomiting and abdominal pain, which will require poultices and Morphia hypodermically in conjunction with rectal feeding. This complication occurs much more frequently than is usually recognised.