Treating the Sick Child in Time by Kate Lindsay

Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · May 4, 1911

Treating the Sick Child in Time

By Kate Lindsay

KATE LINDSAY, M. D.

EVERY year hundreds and thousands of persons, especially children, lose their lives because the disease from which they were suffering was not treated in time. A child is ailing, seems feverish at night, chilly in the morning, is peevish and irritable, and has a capricious appetite. In the words of the mother, “Johnny is not like himself.” And truly he is not like his ordinary, healthy, happy self. Poison is working mischief somewhere in the little body, deranging and upsetting the nervous system, and making him feel generally uncomfortable and out of sorts.

Whether the indisposition is serious or not, is what mothers, nurses, and all having the care of children should seek to discover at once. A clinical thermometer, or a thermometer for testing the temperature of the body, should be a part of every household outfit; and whenever a child is ailing, its temperature should be taken, and its pulse and respirations counted. The temperature of a child in health is slightly above that of the adult, being 98.5° to 99.5°, while that of the average adult is from 98° to 98.5°. The temperature should be taken three times a day; when it reaches 101° or above for two days, it is an indication of something serious.

Respiration and Pulse

The respirations of a new-born baby are forty a minute, and usually decline to thirty or thirty-five by the end of the first month, continuing to decline until the child is four or five years old, when they are twenty to twenty-five a minute. They further decline to sixteen or eighteen at fourteen or fifteen years, which is the ordinary adult rate of respiration. The pulse at birth is usually one hundred twenty to one hundred forty; at one year, one hundred ten to one hundred twenty; and it gradually declines until fifteen, when it is from eighty to eighty-five. In adult life the normal rate is seventy to seventy-five. The pulse and the respirations are very difficult to count and very variable. In small children any exercise or other excitement may cause a rise of from ten to fifteen or twenty beats a minute, and the rate of breathing is increased in proportion. So a baby’s pulse and respirations are of value only when they are observed while it is sleeping; the temperature, not being specially affected by outside influences, is the most reliable indication.

Examining the Throat

After testing the temperature, pulse, and respiration, the next most important measure is to examine the throat for redness, swelling, or white patches, which may indicate either tonsillitis or diphtheria. Hundreds of children have died of the last-named disease because of a neglect of these measures. A child with an apparently slight sore throat was permitted, perhaps, to go to some child’s party, or some one in the family where the party was held had a sore throat. I know of a case where twenty-five children were exposed to tonsillitis by being allowed to take a ride with a child suffering with it. As the child’s temperature had not been taken, no symptoms of the disease had been discovered, and no danger was apprehended. Not only were the other children

exposed, but the little one itself was made much worse.

The Stomach and Bowels

After an examination of the throat and nose, the next inquiry should be as to the condition of the stomach. Many patients, especially children and young persons, owe all their trouble to a disordered condition of the stomach. The fever, headache, and boneache may all disappear with the emptying of the stomach and bowels. Often such cases have an alarmingly high temperature for a short time; but the symptoms soon become less marked, and disappear when once the decaying food has been unloaded from the system.

Constipation and accumulation of fecal matter in the bowels often cause a rise of temperature. Therefore mothers and others caring for children should know whether the bowels are regular. The writer has seen swellings in youth and children which were diagnosed as cases of tumor. In one case, when inquiry was made of the mother as to how long it had been since the bowels moved regularly, she could not tell; and by inquiry of the twelve-year-old girl herself, it was ascertained that at least a week had passed without any action, the child meanwhile eating heartily of all foods found at a farmer’s table. It was not until she was taken suddenly ill with chills and fever that the case was looked into, and a course of mild cathartics, enemas, fasting, and fomentations prescribed, which finally dispersed the swelling. The moving off of the impacted mass was the work of many days, however; and after it was over, the child was so weak and emaciated that it took weeks to recover her usual health.

Infectious Diseases

The next inquiry should be as to the possibility of infectious diseases, as typhoid fever or any of the eruptive fevers. Children are often victims of typhoid fever, and this should be borne in mind, especially if the disease is in the neighborhood, or if there has been any danger of an infected water-supply in traveling or otherwise. In small towns and villages without water-works, there are likely to be numerous cesspools, also many wells, shallow or deep; and it is only a matter of time, modified by the porous nature of the soil and the depth and location of the well, when the contents of the cesspool will drain into the well; or, worse still, the contents of the privy vault may contaminate the water, and whole families be thus poisoned with filth. There are always children who are running around the neighborhood, visiting other children, so that a case of typhoid fever may occur in a home possessing a faultless water-supply.

Boulder, Colo.