Friday, April 4, 2008

THE BREATHING AND COUGH

The breathing of a child in health is formed of equal inspirations and
expirations, and it breathes quietly, regularly, inaudibly, and without
effort. But let inflammation of the air-tubes or lungs take place, and
the inspiration will become in a few hours so quickened and hurried,
and perhaps audible, that the attention has only to be directed to the
circumstance to be at once perceived.
Now all changes which occur in the breathing from its healthy
standard, however slight the shades of difference may be, it is most
important should be noticed early. For many of the complaints in the
chest, although very formidable in their character, if only seen early
by the medical man, may be arrested in their progress; but otherwise,
may be beyond the control of art. A parent, therefore, should make
herself familiar with the breathing of her child in health, and she
will readily mark any change which may arise.
Of cough I should not have said any thing in this chapter, as it can
never fail to be noticed, except that it is highly necessary to throw
out one caution. Whenever a child has the symptoms of a common cold,
attended by hoarseness and a rough cough, always look upon it with
suspicion, and never neglect seeking a medical opinion. Hoarseness does
not usually attend a common cold in the child, and these symptoms may
be premonitory of an attack of "croup;" a disease excessively rapid in
its progress, and which, from the importance of the parts affected,
carrying on, as they do, a function indispensably necessary to life,
requires the most prompt and decided treatment.
The following observations of Dr. Cheyne are so strikingly
illustrative, and so pertinent to my present purpose, that I cannot
refrain inserting them:--"In the approach of an attack of croup, which
almost always takes place in the evening, probably of a day during
which the child has been exposed to the weather, and often after
catarrhal symptoms have existed for several days, he may be observed to
be excited, in variable spirits, more ready than usual to laugh than to
cry, a little flushed, occasionally coughing, the sound of the cough
being rough, like that which attends the catarrhal stage of the
measles. More generally, however, the patient has been for some time in
bed and asleep, before the nature of the disease with which he is
threatened is apparent; then, perhaps, without waking, he gives a very
unusual cough, well known to any one who has witnessed an attack of the
croup; it rings as if the child had coughed through a brazen trumpet;
it is truly a tussis clangosa; it penetrates the walls and floor of the
apartment, and startles the experienced mother,--'Oh! I am afraid our
child is taking the croup!' She runs to the nursery, finds her child
sleeping softly, and hopes she may be mistaken. But remaining to tend
him, before long the ringing cough, a single cough, is repeated again
and again; the patient is roused, and then a new symptom is remarked;
the sound of his voice is changed; puling, and as if the throat were
swelled, it corresponds with the cough," etc.
How important that a mother should be acquainted with the above signs
of one of the most terrific complaints to which childhood is subject;
for, if she only send for medical assistance during its first stage,
the treatment will be almost invariably successful; whereas, if this
"golden opportunity" is lost, this disease will seldom yield to the
influence of measures, however wisely chosen or perseveringly employed.

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