36.3 MEDICAL Chicken-pox is a mild disorder of childhood characterised by an eruption of groups of vesicles associated with slight fever. The symptoms are chilliness or fever, and the early appearance of a rash of pink papules or pimples, which, after twelve hours, become what is called vesicular, because they contain fluid. These vesicles or blisters increase in size, become depressed in the centre, dry up, and fall off in about five days. The rash appears on the chest and neck, and spreads over the back. The face and hands generally escape. A useful diagnostic feature of t^he eruption is that it appears in successive crops.- The condition is contagious so long as the rash is present, so that it is as well to keep an infected child apart from the others, because, although chicken-pox is a trivial disorder, it is never wise to expose a child to any ailment unnecessarily. The attack is usually over in a week or ten days, but it is apt to leave some weakness afterwards. The treatment consists in guarding against chill, in giving the child light diet, and gentle aperients. The rash is accompanied by itching, which is often troublesome, and soothing applica- tions arc generally necessary, especially in the caseof a sensitive child. A teaspoon ful of creolin mixed with a little cold water, and then added to the child's bath, relieves the irritation. Calamine lotion may be applied to any irritating spots. Chilblains are painful inflammatory condi- tions of the skin, due to the action of cold on people whose circulation is poor and whose constitution is feeble. They generally appear on the hngers and toes, and they are attended with itching and tenderness. The condition sometimes goes on to ulceration. Children and old people suffer most from chilblains, which may appear every winter when the cold weather comes. Local treatment consists in applying stimulating lotions, such as iodine, but if the chilblains are broken they should be treated like an ordinary ulcer by bathing with boracic solution and applying a dressing of boracic lint. It is most important to treat the general health and to do all that is possible to improve the circulation. Long-sleeved Shetland-wool vests should be worn, and warm woollen stockings. The feet and hands should be bathed with cold water twice daily, then rubbed with a rough 'HEALTH AMB I ^^■TT'HE health of the children during the cold ^^H ■*• weather requires special care. Colds, ^^Bsore throats, and chest affections are things to ^^Hbe avoided. There are mothers who complain ^^Vthat the children have " weak chests," and that every winter one attack at least of bronchitis is inevitable. Sometimes it is the throat that is delicate, or the child is constantly having feverish attacks with pain in the joints, which arc, of course, rheumatic in origin. These ailments can be prevented by proper care, and it is greatly to the interests of the child that he should escape bronchitis and rheumatic attacks, which seriously affect the constitution. When a mother knows that a particular child is hable, for exanlple, to rheu- matism, she must take special precautions in the matter of diet, clothing, etc., to guard that child, as every attack weakens the resisting power, and may injure the heart. In the same way, repeated cold in the head towel to improve the circulation. Outdoor exer- cise is necessary, and warming the feet or hands over the fire should be prohibited. Warmth must be obtained by exercise and friction, and not by artificial heat. Chorea (St. Vitus Dance) is a fairly common nervous disorder, chiefly occurring in childhood, associated with awkward spasmodic inovemcnts of the limbs and other nervous symptoms. The movements generally affect the muscles of the face and hands, but any group of muscles may be affected. True chorea, or St. Vitus dance, must be distinguished from mere habit spasms. Chorea is much more serious than habit spasm, because of the tendency to be associated with disease of the valves of the heart. It very often follows rheumatism or scarlet fever, but fright or sudden emotion may bring on an attack. It generally lasts a few months, and the important point is to watch for any evidences of heart disease or rheumatism. The child should be removed from school and treated by a medical man. A quiet life must form part of the treat- ment, and hygienic conditions in the shape ot fresh air, moderate exercise out of doors, and plenty of sleep must be observed. Certain authorities consider that chorea, or St. Vitus dance, is infectious, and there is no doubt that other children are apt to develop the spas- modic symptoms by so-called " imitation." The disease, however, is now coming to be considered microbic in origin, and good management will help considerably to avoid recurrence of an attack. As in the case of rheumatism, the child must be guarded from damp. The strain of a too severe curriculum at school is certainly a factor in producing the disease. The bright, intelligent child, who is encouraged to apply himself too closely to lessons, is only too apt to break down with an attack of chorea. Early symptoms of the condition, such as restless- ness, emotional disturbances, night terrors, headache, should receive every attention. When they occur in children of a neurotic family, mental and bodily quiet must be ordered, and the child should be confined to bed in a recumbent position. These measures are often sufficient without drugs. To he continued. E NURSERY flYQIEME IN T: CHILDREN'S WINTER AILMENTS The'Pfcvention and Cure o£ Colds — Sore Throits — Too Much Clothing — Wet Garments or frequent sore throats can be prevented, because there is always a cause for such a tendency, which can be discovered and removed. Hygienic care in the matter of well-ventilated nurseries, sensible diet and clothing, and out- door exercise, are the best hiethods of preventing winter ailments. Sometimes, however, in spite of all pre- cautions, colds, sore throats, and chest ailments appear in the nursery. This series of articles, therefore, will deal in turn with the commonest winter ailments. A Feverish Attack A great many nursery ailments begin with what might be called a feverish attack. In the winter these attacks are by no means un- common even in the best-regulated nursery. They may be due to a great many causes, and may easily be dealt with by simple measures. On the other hand, they may be the beginning of one of the infectious fevers.
