The treatment of such a disease must never be in any but trained medical hands. With out medical advice, the directions given under bronchitis, about the room, diet, bowels, &c., should be followed, and if the temperature rises very high, and the child is profoundly oppressed by it, cold sponging as suggested on p. 510, or the fever mixture on p. 511, may be employed with caution, and provided only com petent medical advice is unobtainable.
Bronchopneumonia is a more frequent form of pneumonia in children. It may begin very like the ordinary type just described, or it may occur as a consequence of some other disease, such as measles, diphtheria, whooping cough, or bronchitis. It has not a definite duration, like ordinary pneumonia, but after two or three days high fever, the temperature yields for a day or so, and then the fever re turns, and so on, relapse after relapse occur ring, as the disease spreads from one bit of lung to another.
Little can be added here to the directions given for the treatment of pneumonia. Ex haustion is common in this form, and stimulant frequently necessary. It is best given in the form of whisky in milk. A tea-spoonful of
whisky should be added to each tea-cupful of milk or milk mixture (see p. 565), and from 4 to 8 of such cups might be given in 24 hours Cough is present in most of the above affec tions, and is to be treated as described for But, not infrequently, especially when the back part of the throat is evidently red and congested, the cough may be very irritating and even suffocative. This is often relieved, in addition to the means already mentioned, by putting a small, mild, hot poultice on the front of the neck, just over "Adam's apple", and giving repeated small doses of ipecacuanha wine, and if necessary by using the steam from a kettle as noted above.
There is a cough, however, which should rouse instant attention, a hoarse muffled cough " like the distant bark of a puppy ", or a cough with a ringing metallic sound—a brassy cough. Let the mother or nurse be on guard against croup, of which this is strongly suspicious. (See p. 539.) Mothers who are concerned about the deli cacy of some child should take special pains in guarding and rearing it, after the manner sug gested on pp. 386 and 552.