The sore throat is best treated by barley-water and other mucilaginous drinks. A draught containing perchloride of iron and glycerine, taken three times a day, is often of service.
At the end of the second week we must be on the watch for complica tions. Laryngitis is often the first to appear, and indeed this intercluTent disorder may begin as early as the tenth day. When this complication oc curs, the room must be kept warm (a temperature of 70° is sufficient) ; the cot must be surrounded with an atmosphere of steam from some one of the many apparatus constructed for this purpose ; and the throat should be enveloped in hot linseed-meal poultices. Stimulants must be given as seem desirable. If signs of suffocation are noticed, tracheotomy should be performed at once. In cases of oedema of the glottis, where life is in the greatest danger, and immediate measures have to be taken to avert a fatal issue, much benefit may be derived from rapid vesication. This is best done by means of boiling water. Dr. Owen Bees directs that the corner of a towel should be soaked in water as this boils on the fire, so as to ac quire the full temperature, and that it should be then applied rapidly to the region of the throat. Before doing so, the surrounding parts which it is not wished to blister must be covered with thick cloths.
Diarrhoea, if it be troublesome, must be treated with a small dose of castor-oil, followed up, if necessary, by a draught containing dilute sul phuric acid and a drop or two of tincture of opium. An enema of starch with five or ten drops of laudanum is also useful. If the diarrhoea resist this treatment and become exhausting, nitrate of silver or gallic acid and opium must be resorted to.
The various forms of chest affection must be treated upon general prin ciples. They are excessively dangerous. As the patient is usually by this time in a state of great exhaustion, stimulants must be given liberally ; and strong beef-essence and other forms of food containing much nourishment in small bulk must be administered in small quantities at a time.
If an ulcer appear upon the cornea, it should be touched with a solution of nitrate of silver (g,r. xx. to the ounce), and afterwards some olive-oil should be dropped into the eye. A blister to the temple is also of service. The conjunctivitis may be treated in mild cases by a solution of sulphate of zinc (gr. iij. to the ounce), dropped into the eye three or four times a day ; or a
solution of the nitrate of silver (gr. j. to the ounce) may be used. If the case is severe, with much muco-purulent discharge, Mr. Makuna recommends the stronger solution of the nitrate to be dropped into the eye once a day. The lids may be prevented from adhering by bathing frequently with warm water, and then placing a drop of castor-oil between them.
Abscesses must be opened early. Any sign of suppuration is a signal for stimulants, and for quinine with or without perchloride of iron.
If haemorrhage occur, the patient must be kept perfectly quiet, and stim ulants must be given as required.
In all cases where the skin eruption is profuse, cleanliness is of the ut most importance. Dr. Collie especially directs the removal of all crusts about the nostrils and lips as they form, for they poison the air as it enters the body of the patient. He also insists upon the early removal of all scabs under which pus is forming, and recommends that the patient be bathed daily in a bath medicated with carbolic acid. He also points out the necessity of frequent changing of the body linen. If, as often happens, the child's head is slow in recovering, the scabs must be removed by poul ticing, and zinc ointment must be applied, or the following : Cod-liver oil and iron are also indicated.
In the malignant form of the disease no treatment is successful, and the patient invariably dies.
Mumps, or Parotiditis, is one of the milder infectious disorders of child hood. It is rare in infancy, and cannot be said to be common before the fourth or fifth year. Again, after puberty the liability to the disease di minishes. It seldom occurs a second time in the same subject. Mumps is usually epidemic, and is especially common in the spring of the year. Its infectiousness is extreme, so that if the complaint break out in a school, or other institution where young people are congregated together, few are likely to escape. The virus is supposed to be conveyed in the breath. The duration of the illness is from a week to ten, twelve, or four teen days. There is, besides, a period of incubation which has been variously estimated at from one to three weeks.