Rheumatic fever in young children is generally the result of inherited tendency. The symptoms are redness and swelling of the larger joints, with pain, perspiration, and fever. The fever is not, as a rule, high, seldom rising above 102 degrees Fahr., and is not long continued; but when it rises even thus, it is generally due to the heart being affected, and affections of the heart are those which have to be dreaded whenever a child suffers from this complaint. Where there is a hurried breathing, a dry cough, or uneasiness or pain about the heart, the case should be looked upon as serious from this point of view. Pleurisy is also a common sequel to rheumatic fever, and one of the diseases most closely associated with it is St. Vitus's dance, which seems in some way dependent upon the affection of the heart to which this disease gives rise.
Eruptions on the skin, such as nettle rash, or a rash resembling red gum, are very common, and seem to be caused by the intense acidity and poverty of the blood, which are common in rheumatic children, and last for a long time after an attack.
The disease, as a rule, lasts from two to three weeks, slight cases getting well in between ten and fourteen days. The child should be kept at rest, and well protected from every possibility of chill. It should lie in bed in a flannel nightgown between the blankets. Food should at first be
farinaceous with bread and milk, and later on broths and fish may be added. The affected joints should be wrapped in cotton wool, and when they are painful a solution may be made of one drachm of nitrate of potash and twenty drops of laudanum in an ounce of water, and a flannel soaked in this applied. The rubbing in of iodine ointment is of service for the swelling which lingers during convalescence.
Any internal remedies will, of course, be prescribed by the doctor in attendance; but the most important part of the treatment is that by the nurse or mother, as so much care is necessary with reference to the warmth of the clothing, the digestibility of the food, the avoidance of exposure to cold and damp, and saving the child from much fatigue, over-exercise, and over-excitement.
Muscular Rheumatism is found in the form of stiff neck or lumbago, and in the muscles of the arms and those of the head. Treatment consists in rest, the application of warmth by hot
fomentation and the use of liniments, such as the compound camphor liniment; while perspiration should be assisted by the use of sweet spirits of nitre, and keeping the child in bed between the blankets. If the case lasts, bromide of ammonium is a useful remedy. Chronic rheumatism is rare in childhood, and is best treated by warm baths with plenty of carbonate of soda in them, and massage, while iodine may be painted on the affected joints.
Source:
Home Notes, 1895
Labels: camphor, child, children, farinaceous, fomentation, heart, iodine, laudanum, liniment, nitre, perspiration, potash, redness, rheumatic fever, rheumatism, soda, swelling
