A practical treatise on the diseases of children / By J. Forsyth Meigs ... and William Pepper.

  • Meigs, J. Forsyth (John Forsyth), 1818-1882.
Date:
1877
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Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / By J. Forsyth Meigs ... and William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    84/1064 (page 78)
    In giving our own experience in regard to the treatment of this disease, we shall speak first exclusively of the mild, and then of the severe form, since the measures proper and necessary in the one, are very different from those called for in the other. Treatment of the Mild Form—Emetics.—The great majority of cases will recover perfectly well under the use of emetics employed alone, or in combination with warm baths and revulsives. Of late years we have often succeeded in warding off the slight attack, where there has been good reason to expect it, by the administration of an opiate with syrup of ipecacuanha, at bedtime (early in the evening). At two years of age, three or four drops of laudanum, with ten to twenty drops (ac- cording to the gastric susceptibility) of syrup of ipecacuanha; at three or four years, five drops of laudanum with twenty of the ipecacuanha, are about the proper doses. Even when the child has had one attack early in the night, the use of the opiate is most successful, after vomiting, in preventing the usual return towards morning. If the physician is not called until the day after the first attack, this treatment is excellent in the evening of the second day. In cases attended with violent dyspnoea, hoarse cough, and loud stridulous respiration, the emetic should be given until it produces a full effect. In milder cases, in which there is merely loud croupal cough, with an occasional stridulous sound, nauseating doses alone will generally suffice. The most suitable emetic is, as a general rule, ipecacuanha. The best preparation for children is the syrup, of which from twenty to thirty drops may be given to those two years of age, to be repeated every ten or twenty minutes until vomiting is produced, or until the paroxysm is relieved. In very sudden cases, the Syrupus Scillse Compositus, which is more active in its effects in consequence of the tartar emetic which it contains, might be preferable; about twenty drops of this may be given, and repeated every ten or fifteen minutes, until vomiting or the resolution of the paroxysm is obtained ; but, in its employment, care should always be observed not to continue it for too long a time, lest it produce the injurious effects of tartar emetic. Of late years we have almost entirely abandoned the use of this latter emetic, as we succeed per- fectly well with the ipecacuanha, and dislike more and more the autimo- nial preparation in children. When the dyspnoea is very urgent, or when other means fail to produce emesis, we have found nothing so effectual as powdered alum, in doses of a teaspoonful mixed with honey or molasses. (See Treatment of Pseudo-membranous Laryngitis.^) A simple and good method of treating the paroxysm is that recom- mended by Dr. Charles D. Meigs, in the paper referred to. It is to direct a small teaspoonful of powdered ipecacuanha to be diffused in a wine- glassful of water, of which mixture doses of a teaspoonful are to be given every ten, fifteen, or twenty minutes, according to the urgency of the symptoms. This is a plan of treatment often resorted to by parents in this community, where the disease is so common and so well understood, that there are few mothers who have several children, and who have had some little experience, who do not know how to treat a nocturnal attack of mild spasmodic laryngitis.