While these methods of treatment are being carried out, the strength • of the child must be upheld. Stimulants should be given early, and no attempt to lower the temperature should be made without at the same time administering brandy or the brandy-and-egg mixture. In this disease, as in all others rapidly depress the powers of the patient, children respond well to stimulants ; and alcohol should be given every two or three hours, or oftener, according to the strength of the pulse, the rapidity of the breathing, and the degree of pallor and lividity of the face. The effect of the stimulant is to give strength to the circulation, to reduce the number of the respirations and to further the aeration of the blood. If the child cannot or will not swallow the remedy, it may be administered, as in other exhausting forms of illness, by the syringe and elastic tube (see page 15), or through a caoutchouc tube passed into the stomach through the nose: The diet must consist of milk diluted with barley-water and guarded by a few drops of the saccharated solution of lime, of strong beef-tea, yolks of eggs, and meat essence. In the case of young infants the breast milk, white wine whey, and milk and barley-water with Mellin's Food should. be given.
With regard to medicines :—Emetics are useful at the beginning of the disease. A drachm of ipecacuanha wine, or half a grain of sulphate of cop per dissolved in a dessert-spoonful of water, may be given every ten minutes until vomiting is produced. This remedy must not, however, be repeated
after the first two or three days, as the strength of the child quickly fails. Narcotics are to be avoided, for our object is iu every way to promote cough in order to maintain efficient expansion of the air-cells and aid the expulsion of secretion. The best form of mixture is that which combines alkalies with stimulants. Thus, we can order a few grains of bicarbonate of soda or potash with four or five drops of sal volatile and an equal quantity of spirits of chloroform in glycerine and water every three hours. Later, the infusion of senega or serpentaria may be substituted for the water in the draught. Medication by drugs is, however, as a rule, of very secondary importance in the more acute forms of the illness ; but if the disease occur as a complication of pertussis, the special antispasmodic treatment for that disease may have to be continued.
When the inflammation runs a very subacute course much benefit is often derived from the free administration of iron. For a child five or six years old ten drops of the tincture of the perchloride of iron may be given every three hours, freely diluted ; and a rapid improvement, both in the physical signs and general symptoms, often follows very quickly. Directly the pyrexia subsides quinine and other tonics, and cod-liver oil should be given ; and the child should be removed, as soon as he is fit for the journey, to a bracing seaside air.