HEALTH COLUMN.

Otago Witness, Issue 3102, 27 August 1913, Page 68

HEALTH COLUMN.

Mumps. Just beneath and in front of the lower part of the ear is a structure known as the ■‘parotid gland.” It is one of the glands which manufactures and supplies saliva for the mouth. The disease cailed ” mumps ” is an acute infectious malady which affects this parotid gland. Another term used for the disease is 11 parotitis,’’ which simply signifies inflammation of the parotid gland. The disease is accompanied by rather mild systematic symptoms, which may not be severe enough to demand notice. It occurs in the great majority of instances during childhood, between the fourth year and puberty, and one attack protects the patient from a second

Cause. — Mumps i? usually conveyed by contact from one patient to another, but it may bo carried by a third person or by garments to a susceptible individual. It is contagious from the beginning 10 the end of the attack, and it is probable that persons who have so far recovered as to have no visible swelling of the glands can still transmit the disease. For tins reason the patient should be kept separate from other thnelrcn for a period of 10 days after the swelling has disappeared. It is, however, a noteworthy fact that mumps is by no mentis so infectious as are the eruptive fevers, and many children escape the disease 1 even when thoroughly exposed to it. The period of incubation is uncertain. Sometimes it is brief, in other cases surprisingly prolonged. Some authorities found that it varied from three to 25 days. In all probability it >s about 15 days in the average case. Condition of Gland.— Lhe chief change in mumps, and, indeed, the only one which is characteristic, is the swelling of one or both parotid glands. Ihe swelling ;s due to a primary inflammation of the gland substance. Rarely the other salivary glands beneath the jaw beccrn.e swollen, and still more rarely does the swelling in the parotid lead to an abscess. 1 Ins result occurs only in chi clron who are impoverished by other diseases, and is due to an invasion of the gland by germs from the mouth. Symptoms.— In the majority of cases the child seems to bo suffering ironi a feverish cold for a few days before the local symptoms display themself.s; it is chilly, uncomfortable, oro.s, with quick pulse and thirst; then pain is felt about tno angle of one or both jaws, and difficulty in opining the mouth to speak or masticate. In other cases wo have no preliminary feverishness, but the disease commences at once with pain or swelling at the angle of the jaw. The pain is soon followed by swelling behind the angle of the jaw, extending upward to the car, forward a little on the cheek, and downwards towards the gland under the jaw. This swelling feels linn, hard, and hot, is painful on pressure, but, generally speaking, the colour of the skin is unchanged; in severe cases it becomes slightly red or pink. There is considerable pain and difficulty in opening the mouth and in moving the jaw, either to masticate or swallow, and jet it is clear that all this is not duo to anv soreness of the threat.

One or both sides of the face may bo thus affected, or, after the subsidence of the one, the opposite may succeed to the swelling, and it is from the extraordinary expression of sullenness thus given to the countenance that the name "mumps” has been given to the disease. Course of Disease.— If the attack be mild, the fever, swelling, and pain will be moderate. The swelling is usially at its height by the third day, and remains at this stage for two or throe days more, when it begins to decrease, and then gradually disappears. As a rule the child does not suffer much distress, but in some of the severe cases the pain is very groat, the tumour is large, hard, and exquisitely tender, t.io skin covering it is of a reddish tinge, the difficulty of opening the mouth so great that the child can scarcely take food, and even when in its mouth it is almost impossible to swallow it. The fever runs very high, the pulse is full and rapid and there may be delirium. In such cases the degree of swelling is so marked that the tissues of the face and neck share in it to Such an extent that tin; patient is unrecognisable. Such cases are fortunately very uncommon. Complications.— While mumps is a very mild disease in most cases, it at times becomes severe, chiefly because of the complications which arise. Those are more frequently met with in adults than in children. The most common of these complications is an acute inflammation, with swelling of the testicle, which may be on bofli sides, and severe enough to cause the patient intense suffering and force him to remain in bed. Before the age of puberty it is of frequent occurrence in this disease. The development of this swelling is usually associated with a second rise of temperature and a general sense of illness, which is in excess of that present at the onset of the mumps. The swelling lasts about a week.-and after the acute inflammation has passed the testicle may bo enlarged for a long period of time. Other complications, such as convulsions, meningitis, etc., are extremely rare. Treatment.— The treatment required by simple cases of mumps is very slight. If the patient can be persuaded to avoid exercise and to use a light diet, active treatment with drugs will not be required. Sour foods and acid diinks are to be avoided, for when they arc taken into the mouth they cause severe pain. Local applications to the swollen parotid glands are usually not needed, but if any aro employed, they should bo hot rather than cold. If any complication arises, such as that described above, rest in bed is imperative, since any exercise at such a time causes groat increase in the swelling and pain. A bandage to support the weight, and thereby relieve the pressure, is very acceptable. Broken Collar-bone. A very common accident, particularly amonjj persona who go in largely for athletics, is a broken collar-bone: the injury being easily caused by n fall or sudden jerk, stlch as occur frequently when cycling, running, or tennis-playing. The collarbones are the two bones which go from the breastbone or sternum to the

shoulders, and are very liable to injury, a fall on the elbow or shoulder being enough to fracture them. Fortunately, the bones rejoin with equal ease, and a fracture of them rarely causes any permanent inconvenience. The injury is first discovered after a fall or blow by a swelling above the bone which is broken, and if the swelling is pressed pain is felt, and a light grating noise may be heard, caused by the rubbing together of the ends of the broken bone. The injury should, if possible, bo at once attended to by a doctor, the arm having been placed in a sling until his arrival; but if a doctor is not available at once the fracture may bo treated by placing under the arm, well up in the armpit, a roll of linen or other material about Sin or 9in long and 4in thick, with a piece of tape attached to either end. by which it may be tied over the other shoulder. The elbow of the injured side should be bound down to' rhe bodv bv a bandage, and the forearm placed in a ‘sling. The arm must not b? used until the l>enrs are firmly united, and especial care shou’d bo taken for some time that no great strain bo put upon the affected side.