Article originally published in the Minneapolis Daily Times on March 27, 1892. Full article text provided by Newspapers.com below.
Nursing of the First Importance — No Disease More Likely to Have Lasting Ill Effects — Nature of the Infecting Agent in Mumps Not Known.
It seems to me that I have never seen so many scarlet fever and measles placards as there have been this winter, and as yet they show no signs of abating. Hardly a family in town numbering children among its members has escaped, and many have had one contagious disease after another, from scarlet fever, whooping cough, chicken pox and measles down to mumps. Every one pokes fun at the victim of the mumps, but I can tell you it is no laughing matter to have a face like a pumpkin in size and color, and have to take what little food is possible through a straw or a nursing bottle, because you can’t get your jaws open a quarter of an inch to save your life.
This winter we have run the gauntlet of children’s diseases in our own family, and the result of my experience and study, to say nothing of questioning the doctors, are boiled down and condensed for the benefit of those who are looking forward to having them. The most serious disease comes first.
Measles.
The measles is an acute infectious disease occurring mostly in childhood, but seldom in children under 6 months of age. It has been known from a very early period in the history of medicine — the famous Arabian physicians at the time of the crusades were perfectly familiar with it, but so late as the seventeenth century it was supposed to be a variety of small pox and treated accordingly.
It is only within the last 150 years that it has been regarded as a distinct and separate disease. Like all eruptive diseases it has several well marked stages. After the reception of the germ of contagion into the system, a period of incubation follows, usually lasting from 10 to 14 days before the rash appears. At the end of this time acute catarrh of the mucous membrane develops, often accompanied by nose bleed, and always by great redness of the eyes, with, in the majority of cases, cough with little or no expectoration. Sometimes diarrhoea sets in and is difficult to control.
In the second stage there is well marked fever, the temperature varying from 102 degrees to 104 or more, with rapid pulse and headache, excessive thirst and restlessness. In many cases, especially in young children, these are so slightly developed as to escape notice, or if they are observed, most likely the child is supposed to be a little out of sorts — has a cold, or perhaps indigestion — and goes to school as usual, spreading disease on every hand, for it is well known that the most contagious period is before, not after, the eruption has appeared. On the fourth or fifth day after fever sets in, often earlier, blotches are observed, at first on the brow, cheeks, chin and throat, bright red in color and raised above the surrounding flesh. Gradually they extend over the whole body, often itching intensely. The face becomes bloated and swollen, and this symptom, in connection with redness of the eyes and acute catarrh, enables one to diagnose the disease without the slightest difficulty.
The rash stays out for a day or two, then fades gradually as it came. At the beginning of the eruption, fever, catarrh and the fits of coughing become worse, the temperature rises to 105 or more and there is intense thirst, heavily coated tongue and sore throat, which upon examination will be found covered with raised blotches like those upon the body. These symptoms generally yield as soon as the eruption has fully appeared, and after this convalescence in favorable cases takes place rapidly, the patient feeling quite well often before the rash has disappeared. There is a malignant form of this disease, commonly known as black measles. The rash is suppressed, and when it does come out is of a dark purple color. The fever runs very high, and usually there is catarrh of the gastro-intestinal mucous membranes, with great difficulty in breathing.
Bronchitis is present in many cases, and often develops into pneumonia, which is likely to be fatal. If the patient does recover, he is so weakened and reduced that he falls an easy prey to the slightest illness or a mere cold.
Its Treatment.
In itself, measles is a mild disease. It is in complications that it is to be dreaded, for which reason no fever requires more watchfulness and careful nursing.
The least draught, a slight variation in temperature may suppress the eruption. Then, as the old nurses used to say, the measles “strike in” and death not infrequently results. It belongs to the earlier stages of childhood and is seldom met with in adults, which is due to the fact that most persons have had it while young. In 1875, one-fourth of the inhabitants of the Fiji islands were swept away by an epidemic of measles which lasted less than three months. In our army and navy, during the rebellion, measles were dreaded beyond almost any other contagious disease.
In camp there were few or no facilities for maintaining an even temperature or keeping the patient warm. Nurses were few and far between and the diet was uncertain. The result was that in an outbreak of measles, especially in the south, the men died like flies.
Danger of Contagion.
Contagion is most potent in the earlier stages before the rash comes out, and may be carried from one place to another in clothing or furniture, as is the case with smallpox or scarlet fever. After a case of it a thorough disinfection is absolutely necessary; the carpet should be taken up and cleaned, the paint washed, all draperies or upholstered furniture brushed and beaten, then disinfected by burning sulphur and alcohol underneath them. Mattresses should be treated in the same way and lightly sponged with a weak solution of carbolic acid, after which they may be hung on the line in the sun. All pictures should be carefully dusted and washed, and the floor scrubbed with hot soap suds in which a little chloride of lime has been dissolved. Before burning the sulphur, any brasswork, such as chandeliers, bureau handles and the like, should either be removed or carefully covered with cloth, otherwise the fumes of the sulphur will turn them black. Its effect on the mercury of mirror backs is bad, too. If possible they should be removed before fumigating.
One cannot be too careful in these things; blankets especially must be washed, and washed thoroughly, or the first person to sleep under them would be exposed to the danger of contagion, for the warm wool holds the germ as pictures and carpets are unlikely to do. It is generally believed that measles, like other acute infectious diseases, is due to bacilli which can be isolated and by inoculation communicated to selected subjects, but at present physicians are not agreed on the germ theory. Second attacks are so rare as hardly to deserve mention.
The great thing in treating measles is careful nursing, a light diet of mutton, chicken or clam broth, with tea or lemonade to quench the thirst, and, if the physician permits, milk or milk and lime water. Few medicines are used as a rule, occasionally aconite, sweet spirits of nitre or other specifics for fever are required. Flaxseed lemonade, drunk as hot as possible, is one of the best household remedies I know of, and approved by nearly all physicians. Mustard and salt foot baths are excellent, provided that one is well wrapped to prevent taking cold; so are hot sponge baths from head to foot, if the greatest care is exercised in giving them, not to fatigue the patient or expose him to the least chill. If the cough is obstinate, a mustard plaster on the lungs will give relief; hot fomentations are excellent, too, and will relieve congestion when everything else fails. There is only one objection to their use: the danger of rendering the bed clothes, pillows and night gown more or less damp, but with care, there is no necessity for doing so.
Until the fever subsides, no solid food of any kind must be taken, only broths, gruels, rice or milk, and it is best to be careful for some time after, for the coating of the stomach and bowels, remember, has been covered with just such an eruption as that on the body, and is weak and very easily over-taxed in consequence. It is doubtful if any disease, not excepting scarlet fever, is more likely to leave lasting ill effects than measles. Its victims are sometimes left blind, deaf, lame, or, in the case of very young children, dumb, in a few rare instances. The lungs and throat are still more apt to be affected, for most cases of measles are complicated to a greater or less extent with bronchitis. Altogether it behooves one to watch and nurse a case of measles with the greatest care, for nine-tenths of the battle lies in nursing.
What Mumps Are.
The medical works call them cynanche parotidea — but on the principle that a rose by any other name would smell as sweet, I prefer to call them mumps. This disease is characterized by swelling of the parotid and other salivary glands — a so-called children’s disease, and usually epidemic. The illness begins with symptoms of a cold or catarrh and slight fever, but soon the glands in front of the ear begin to swell, and before long the inflammation and stiffness spreads down the throat, underneath the jaw, involving the glands of that region.
The swelling is so excessive that the face is greatly disfigured — and there is more or less pain in the swollen parts, although it is seldom severe unless one catches cold, when the ear and teeth are very likely to give trouble. As a rule there is little redness and no tendency toward suppuration. The difficulty lies in opening the jaws far enough to enable one to take solid food — to masticate becomes almost impossible.
They’re Catching, Too.
That it is extremely contagious is proved by its spreading as it does in schools. Fortunately it seldom lasts longer than four or five days, and requires little treatment beyond a gentle laxative and hot fomentations in case the swelling becomes painful.
In most cases the generative organs are somewhat affected. The nature of the infecting agent is not known, but the medium by which it is communicated is undoubtedly the breath and the secretions of the mouth. As I have said, there is nothing to be done but to guard against taking cold, live upon “spoon victuals” and keep your temper when your family and friends try to be funny at your expense. In case they are very exasperating you can take your revenge by giving them the mumps. Keeping this in mind will enable you to bear their taunts with greater equanimity, perhaps.
— L. M. Y.
