Part 266 (2/2)

Grey powder 6 grains.

Antimonial powder 4 grains.

Lump sugar 20 grains.

Mix thoroughly, and divide into three powders, which are to be taken as advised for an infant one year old; for younger or weakly infants, divide into four powders, and give as the other. For thirst and febrile symptoms, give drinks of barley-water, or cold water, and every three hours put ten to fifteen drops of spirits of sweet nitre in a dessert-spoonful of either beverage.

THRUSH, AND ITS TREATMENT.

2523. This is a disease to which infants are peculiarly subject, and in whom alone it may be said to be a disease; for when thrush shows itself in adult or advanced life, it is not as a disease proper, but only as a symptom, or accessory, of some other ailment, generally of a chronic character, and should no more be cla.s.sed as a separate affection than the petechae, or dark-coloured spots that appear in malignant measles, may be considered a distinct affection.

2524. Thrush is a disease of the follicles of the mucous membrane of the alimentary ca.n.a.l, whereby there are formed small vesicles, or bladders, filled with a thick mucous secretion, which, bursting, discharge their contents, and form minute ulcers in the centre of each vessel. To make this formal but unavoidable description intelligible, we must beg the reader's patience while we briefly explain terms that may appear to many so unmeaning, and make the pathology of thrush fully familiar.

2525. The whole digestive ca.n.a.l, of which the stomach and bowels are only a part, is covered, from the lips, eyes, and ears downwards, with a thin glairy tissue, like the skin that lines the inside of an egg, called the mucous membrane; this membrane is dotted all over, in a state of health, by imperceptible points, called follicles, through which the saliva, or mucous secreted by the membrane, is poured out.

2526. These follicles, or little glands, then, becoming enlarged, and filled with a congealed fluid, const.i.tute thrush in its first stage; and when the child's lips and mouth appear a ma.s.s of small pearls, then, as these break and discharge, the second stage, or that of ulceration, sets in.

2527. _Symptoms._--Thrush is generally preceded by considerable irritation, by the child crying and fretting, showing more than ordinary redness of the lips and nostrils, hot fetid breath, with relaxed bowels, and dark feculent evacuations; the water is scanty and high-coloured; whilst considerable difficulty in swallowing, and much thirst, are the other symptoms, which a careful observation of the little patient makes manifest.

2528. The situation and character of thrush show at once that the cause is some irritation of the mucous membrane, and can proceed only from the nature and quality of the food. Before weaning, this must be looked for in the mother, and the condition of the milk; after that time, in the crude and indigestible nature of the food given. In either case, this exciting cause of the disease must be at once stopped. When it proceeds from the mother, it is always best to begin by physicking the infant through the parent; that is to say, let the parent first take the medicine, which will sufficiently affect the child through the milk: this plan has the double object of benefiting the patient and, at the same time, correcting the state of the mother, and improving the condition of her milk. In the other case, when the child is being fed by hand, then proceed by totally altering the style of aliment given, and subst.i.tuting farinaceous food, custards, blanc-mange, and ground-rice puddings.

2529. As an aperient medicine for the mother, the best thing she can take is a dessert-spoonful of carbonate of magnesia once or twice a day, in a cup of cold water; and every second day, for two or three times, an aperient pill.

2530. As the thrush extends all over the mouth, throat, stomach, and bowels, the irritation to the child from such an extent of diseased surface is proportionately great, and before attempting to act on such a tender surface by opening medicine, the better plan is to soothe by an emollient mixture; and, for that purpose, let the following be prepared.

Take of

Castor oil 2 drachms.

Sugar 1 drachm.

Mucilage, or powdered gum Arabic half a drachm.

Triturate till the oil is incorporated, then add slowly--

Mint-water One ounce and a half Laudanum Ten drops

Half a teaspoonful three times a day, to an infant from one to two years old; a teaspoonful from two to three years old; and a dessertspoonful at any age over that time. After two days' use of the mixture, one of the following powders should be given twice a day, accompanied with one dose daily of the mixture:--

Grey powder 20 grains.

Powdered rhubarb 15 grains.

Scammony 10 grains. Mix.

Divide into twelve powders, for one year; eight powders, from one to two; and six powders, from two to six years old. After that age, double the strength, by giving the quant.i.ty of two powders at once.

2531. It is sometimes customary to apply borax and honey to the mouth for thrush; but it is always better to treat the disease const.i.tutionally rather than locally. The first steps, therefore, to be adopted are, to remove or correct the exciting cause--the mother's milk or food; allay irritation by a warm bath and the castor-oil mixture, followed by and conjoined with the powders.

2532. To those, however, who wish to try the honey process, the best preparation to use is the following:-Rub down one ounce of honey with two drachms of tincture of myrrh, and apply it to the lips and mouth every four or six hours.

2533. It is a popular belief, and one most devoutly cherished by many nurses and elderly persons, that everybody must, at some time of their life, between birth and death, have an attack of thrush, and if not in infancy, or prime of life, it will surely attack them on their death-bed, in a form more malignant than if the patient had been affected with the malady earlier; the black thrush with which they are then reported to be affected being, in all probability, the petechae or purple spots that characterize the worst form, and often the last stage, of typhoid fever.

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