MEDICAL NOTES.

New Zealand Herald, Volume LVI, Issue 17270, 20 September 1919, Page 4 (Supplement)

MEDICAL NOTES.

> ♦ WHOOPING-COUGH. Whooping-cough has been . recognised since 1578, when Dr. Baillon, of Paris, described an epidemic of severe cough among children, to which he gave the name tussiß puerorem convulflva, and spoke of it as a disease not previously known. Epidemics were not common until sbout the middle of the eighteenth century, but the disease seems to have steadily increased since that time. The explanation ei the iapidly increasing epidemics in the last hundred years is, doubtless, the increasing facilities for inter-communication, public schools, especially the latter-day institution known as the free kindergarten, are some of the modern agents for disseminating contagious diseases, particularly those who do not confine their victims to bed. Frequently a mother or nurse may be seen in a crowded street car with a child in & paroxysm of whooping-cough ; indeed, the practice of many physicians is to send nurses out with such patients to give them an airing. A popular idea exists that whooping-cough is a trivial affection, that everyone must have it; thus proper care is not enforced to prevent its dissemination. Systematic effort should be made to educate the public in preventive measures. The exciting cause of this disease is a. contagion; it is doubtless a germ, but its nature has not been satisfactorily demonstrated. The germs, whatever they may be, tenaciously maintain their vitality, and are numerous in the sputum, saliva, and even the expired breath of the afflicted one. i Handkerchiefs, bedding, and wearing ] apparel may be the means of transmission j from one person to another. The disease is contagious in alt its stages, but particularly so during the paroxysmal period. TONSILITIS. Tonsilitis, or quinsies, is common during damp, raw weather. Some persons are specially susceptible and have attacks every spring and autumn. Their throats are their weak spot. Such persons, besides avoiding chills, should keep their mouths sweet by regular use of the toothbrush. Decayed teeth must have attention from the dentist. Every night and morning the throat should be gargled with boracic lotion, containing ten grains of the acid in one ounce of water. The disease begins suddenly with pain in the throat, headache and iever. The temperature may rise to 104 degrees. The throat swells. Swallowing is difficult and painful. If the inflammation does not subside, swallowing may be impossible, and food, instead of going down the throat, comes back through the nose. There are two forms of tonsilitis, one called follicular tonsilitis. where the follicles or crpyts in the tonsil inflame, and a more severe form, where an abscess forms in the substance of the tonsiL The latter variety causes much suffering and distress. Iso relief is obtained until the abscess bursts or is opened by a doctor. The glands under the jaw swell in sympathy with the inflammation in the throat, and add to the sad plight in which the sufferer finds himself. The patient must go to bed at once, and, if an adult, take 5 grains of Dover's powder in a basin of hot gruel. Dover's powder must not be given to children. If treatment is begun at the very outset ice should be sucked constantly, but if the case is not tackled at once gargling with hot liquids will suit better. A gargle of two tablespoonsful of solution of chlorinated soda in half a pint of hot water may be used every hour. Hot linseed poultices should be applied under the jaw, from one ear to the other, every two hours, by filling a stocking with the hot linseed meal and securing it by tapes over the head. Two tablespoonsful of the following should be given every three hours : Salicylate of soda it! drams, solution or acetate of ammonia loz., sal volatile 3 -drams, spirits of nitre 2 drams, water to Bozs. The diet should be entirely liquid, consisting of broths, tea, and milk gruel, whilst plenty of water may be drunk. This treatment, if begun as soon as the attack starts, will often cut it short. If, however, increasing difficulty of swallowing and swelling in the throat show that the formation of matter is threatening,, and after two days if the patient is not better, the following mixture should be substituted for that alreadv mentioned: Tincture of iron 2 drams, chlorate of potash 2 drams, glycerine 6 drams, water to Bozs. Raw eggs, alone or beaten up with mi'k, meat jellies, strong soup and broth, and as much soft food as can be swallowed should be taken. The mouth should be well washed out with gargle, and the teeth be attended to night and morning. If afterwards the tonsils remain enlarged it is wise to have them removed to prevent another attack.

OHKOHIO ARTHRITIS. Chronic arthritis is a painful disease affecting the joints. It may occur at any age, but is usually met with in later life, and seems more often to attack women than men. It closely resembles rheumatism, and cases predisposed to arthritis will readily contract rheumatism in a cold and damp atmosphere. In the earlier and more acute stage of this disease the joint affected becomes swollen and painful, the skin shiny and slightly red according to the severity of the attack. The onset may be gradual, attacking one or more of the joints, but in some cases all are involved, even the bones of the spinal column. Those most commonly affected are the phalanges, wrist, hip joints, and knees. Besides the stiffness mentioned above, there is usually marked deformity, due to changes and atrophy of the muscles. The charge of these cases calls for unremitting patience and watchfulness on the part of the nurse. She must be firm, gentle, and kind, sympathetic in all her movements a* the bedside and in handling the patient, exercising a constant watchful care as to his surroundings, remembering that the slightest touch of the bedclothes, a heavy step across the room, the least jar or knock on the bed, or any sudden noise, will cause a considerable amount of unnecessary pain and discomfort. Nursing. If the nurse has the selection of the room in which to nurse a chronic arthritis patient she should choose one with a sunny aspect. She will find a fairly narrow epring bedstead the most convenient, one I with a pulley being an advantage if the patient has the use of hands and arms. i Special attention should be devoted to the j clothing, flannel or flannelette being recom- I mended for these cases. The bedclothes j should be warm but not heavy. It is sometimes found advisable to nurse the patient between blankets. Great care must be paid to the back, heels, elbows, and shoulders. These should be carefully ■washed with warm, soapv water, lathering well with the palm of the hand, and ointment applied with a light, circulatory friction. This shou'd be done at least twice a day. if possible four-hourly. A good ointment to use for bedridden cases is composed of zinc, vaseline, and castor oil. It both nourishes and lubricates the skin. A water bed, air-pillow, or tow ring may add to the patient's comfort by relieving pressure. The pain accompanying this disease is often severe, tense, and throbbing, and is usually worse at night and in damp cold weather. Hot fomentations give temporary relief, and if ordered, should be applied frequently. Flannel or a piece of old blanket best retains the heat. Soda fomentations or soda baths (if several joints are affected) may be found useful, in which case ordinary washing soda is added to the water. If belladonna is ordered, the prescribed amount of the drug should be sprinkled on the fomentation after it has been wrung out of hot water. Belladonna and glycerine painted over the painful part may give relief; also the application of tincture of iodine or stimulating liniments applied with light friction. Immersing the inflamed joints in hot sand is often comforting. This is specially suitab'e where the wrists or feet and ankles are affected It is a simple remedy, and bus. the further advantage of not involving much work and preparation by the nurse, as the sard placed in bowls, can be heated in the oven and then brought to the patijnt.