Next to digestive disturbances, babies suffer more frequently from respiratory disorders—colds, bronchitis, and pneumonia. In fact, during very early infancy, pneumonia heads the list of infant deaths, only to be displaced a few months later by that most dreaded summer disease—diarrhea.

Little tiny babies are so helpless—they are so dependent upon their seniors for life itself—that our responsibility is indeed great. We should put forth our best endeavor to avoid and prevent common colds. Among all the common maladies that afflict the human race "colds" probably head the list; and, in the case of babies and the younger children, the common colds often go on into coughs, croup, bronchitis, and even pneumonia.

WHY BABIES CATCH COLD

1. Someone has brought the infection to him.
2. Somebody coughed in his face.
3. Germ-laden hands have handled the baby.
4. He has drunk from an "infected" glass.
5. There was not enough moisture in the air.
6. Somebody wiped his face with an infected towel.
7. Baby was allowed to play on the cold floor.
8. Baby's lowered vitality could not stand the combined strain of overeating and clogged up bowels.
9. Baby was kissed in the mouth by a "cold-germ" carrier.
10. Baby was dressed too warmly—and then taken out.
11. Somebody carelessly breathed in baby's face.
12. He slept in a stuffy room.
13. His extremities got chilled.
14. Baby has adenoids or diseased tonsils.

Babies should not be allowed to sit or play on cold, drafty floors. They may play on mother's bed whose open side is protected with high-back chairs, or they may play in their own bed whose raised sides are sheltered by blankets.

It is possible for a mother so to disinfect her hands, and so garb herself with clean, washable garments, that, although she may be suffering from an acute cold, she may continue to care for her baby and the baby need not contract the cold.

CORYZA—COLD IN THE HEAD

This most annoying ailment, a cold in the head, is particularly hard on babies because the obstruction of the nasal passages not only makes breathing difficult, but renders nursing well-nigh impossible.

The throat end of the eustachium tube (the ear tube) is found in the upper and back part of the throat, just behind the nose. The infection of the cold extends from both the nose and throat and there results a spreading inflammatory process on through these ear tubes into the middle ear itself. Now if this tube swells so much that it entirely closes, as so often happens in cases of "cold in the head" as well as in constant irritation from adenoids, then may follow a vast train of difficulties—earache, mastoiditis, etc.—with the result that the tiny bones in the middle ear which vibrate so exquisitely may become ankylosed (stiffened) and deafness often follow. Everything known must be done to prevent baby's catching "cold in the head." If the sinuses become infected it may also lead to serious consequences.

When the nose becomes clogged it may be opened up by repeatedly disinfecting the inside of the nose with oily sprays such as simple albolene or camphorated-albolene spray.

The bowels should be quickly opened by castor oil, and the feedings should be cut down at least two-thirds or one-half.

Public drinking cups should always be avoided and kissing the baby be tabooed.

GRIPPE

The treatment of influenza in infancy and childhood is to avoid contact with an older person suffering with the grippe. Ordinarily, the so-called "grippe" is a common, mixed infection—not true influenza. Coryza and cough are the chief respiratory symptoms which attend these widespread epidemics. Often vomiting and diarrhea are seen in the young sufferers.

In cases of grippe put the child to bed and call the doctor. In the case of the older children, the treatment and care to be recommended has been fully outlined by the author in the little work entitled The Cause and Cure of Colds.

Complications from the grippe are very frequent in children—such as severe diarrhea, enlarged glands of the neck, running ears, bronchitis, pneumonia, and sometimes tuberculosis.

Every effort should be put forth to isolate and quarantine the first member of the family to be stricken with grippe so that the remaining members may, if possible, escape an uncomfortable and unhappy siege.

SORE THROAT

The danger of permanent deafness which so often follows a sore throat as well as a cold in the head, should cause every mother or caretaker earnestly to begin treatment at the very first sign of a sore throat. When a little baby gulps or cries on swallowing, a sore throat should always be suspected and remedial measures promptly instituted.

A most convenient article with which to examine an infant's throat is a small pocket flashlight. The pillars of the throat or the tonsils or both may be much inflamed, and since tonsillitis, diphtheria, and scarlet fever all begin with a sore throat, it is wise early to seek medical counsel in order that the differential diagnosis may be promptly made. We urge the mother, as a rule, not to attempt to diagnose severe cases of sore throat. Send for the physician.

Tonsillitis is a severe form of sore throat which, fortunately, rarely troubles tiny infants; but for every sore throat, while waiting for medical help to arrive, lay your plans to empty the bowels, diminish the quantity of the food, swab or spray the throat, and later closely follow the physician's advice concerning the general treatment of the child.

ADENOIDS

Adenoid growths appear as grape-like lymphoid formations located in the upper and posterior-nasal pharynx. These adenoids secrete a very toxic, thickened fluid, which slowly makes its way down along the back wall of the throat, and reddens and inflames first the anterior and posterior pillars of the throat and then often inflames and enlarges the tonsils.

Adenoids not only obstruct the respiratory passage way to the throat and lungs, but they also exert a harmful influence on the general physical and mental development of the child.

It is nothing less than criminal for heedless parents to allow adenoid growths to remain in the child's post-nasal pharynx. The little fellow's face is disfigured, more or less for life, his mentality dulled, while he is compelled to breathe through his mouth.

An almost miraculous change often follows the complete removal of these obstructive adenoids—the child takes a renewed interest in everything about him. More oxygen finds its way to the tissues, his face takes on better color, he gains in weight, in fact, there appears to be a complete rejuvenation mentally and physically.

The signs or symptoms of adenoids are mouth breathing, restlessness at night, snoring, recurring colds, nasal discharge, swelling of the glands of the neck, poor nutrition, loss of appetite, bed wetting, impaired hearing, lack of attention, and mental dullness. The removal of adenoids is neither a serious or difficult procedure, and they may safely be removed at any age.

DISEASED TONSILS

Tonsils which remain permanently enlarged and show signs of disease and debilitation—filled crypts—may be removed as early as the fourth or fifth year, if necessary. If proper treatment does not improve the tonsils as the child grows older, their removal should seriously be considered. The tonsils may serve some special secretory or defensive function during the first few years of life and we think best, therefore, not to advise their removal—except in extreme cases—until the child is at least four or five years old.

When it is necessary to attack the tonsils, they should be thoroughly dissected out—not merely burned or clipped off. If they are properly removed, the danger of heart trouble, rheumatism, and many other infections may be considered as greatly lessened.

After five years of age the normal tonsils should begin to shrink, and at about the beginning of adolescence they should be no larger than a small lima bean, hidden almost completely out of sight behind the pillars of the throat. While healthy tonsils may serve some useful purpose even in the adult, it is almost universally conceded that the thoroughly bad and diseased tonsil is utterly useless to the body—only an open gateway for the entrance of infection.

BRONCHITIS

A very common disorder of early infancy and childhood is bronchitis—an inflammation of the bronchial tubes—accompanied by severe coughing. Its tendency to pass into pneumonia renders it a disease for skilled hands to treat—a disorder hardly safe for even the well-meaning mother to undertake to manage without medical advice and help. And since bronchitis is usually accompanied by alarming symptoms of high fever, weakened heart, embarrassed breathing, mottled or blue skin, green stools, troublesome cough, disturbed sleep, "stopped up nose," and "choked up throat," it is of utmost importance not only to seek medical aid early, but also that the mother, herself, should have definite ideas concerning the proper manner of doing the following things in the line of treatment:

1. Making and applying a mustard paste.
2. The fashioning of an oil-silk jacket.
3. Improvising a steam tent.
4. Flushing out the colon, and a score of other things which the watchful doctor may want given any moment.

Mustard Pastes are prepared by mixing one part of mustard and six parts of flour in warm water and applying to the chest between two pieces of thin muslin. It is left on just seven minutes and then talcum powder is thickly sprinkled on the moist, reddened skin; this powder quickly absorbs all the moisture and leaves the skin in a good condition—ready for another paste in three hours if it is so ordered.

The Oil-Silk Jacket, or pneumonia jacket, consists of three layers—the inside of cheesecloth, an inner thin sheet of cotton wadding, and an outside layer of oil silk (procurable at any drug store). It should open on the shoulder and under the arm on the same side. It is worn constantly (change for fresh cheesecloth and cotton every day) during the inflammatory stage; it is removed only during the mustard pastes.

A Steam Tent may be prepared by placing a sheet over the infant's crib and allowing steam to enter from a large paper funnel placed in the nose of a tea kettle of boiling water kept hot on a small stove of some sort.

The mattress and bedding are covered with rubber sheeting and the infant's clothes protected from moisture. The baby should remain in this steamy atmosphere ten minutes at a time.

Another method is to hold baby in arms near the large end of a big funnel placed in a tea kettle on the gas stove or range, and then have an assistant help hold a sheet tent over both the mother and babe. Or the baby carriage may be placed over a small tub of water into which are dropped several hot bricks. A sheet canopy spread over the carriage holds the steam in and baby reaps the benefits of the warm moisture.

Colonic Flushing is necessary when green stools accompany bronchitis. A well-lubricated end of a large Davidson's syringe is inserted into the rectum, and with the hips of the baby brought to the edge of a basin (the heels held in the hands of the assistant), water is forced into the rectum. Not more than one ordinary cup of water should be introduced at any one time. After expulsion, another may be gently injected.

The diet in bronchitis is always reduced so that no extra work will be thrown on the already overtaxed constitution of the child.

Absolute rest is necessary and perfect quiet should prevail. The humidity of the room should not be lower than 50 at any time, while the air should be moderately cool and fresh.

Numerous other details which may be necessary in the management of bronchitis will be directed by the physicians and nurses in charge of the case.

SPASMODIC CROUP

It is believed that children with enlarged tonsils and adenoids are much more subject to croup than others. Although very sudden in its onset and very alarming, spasmodic croup, fortunately, is seldom dangerous. A little child goes to bed in apparently normal condition and wakes up suddenly with a coarse metallic cough, difficult breathing, and with a distressed expression on the face.

Alternate hot and cold compresses should be applied to the throat—first the hot cloths (wrung from very hot water) being applied over the throat, which should be covered with a single thickness of dry flannel. Then after three minutes of the hot cloths a very cold cloth is applied to the skin itself for one half minute; then more of the hot compress, followed again by the short cold, until five such changes have been made. A bronchitis tent should be quickly improvised so that the child can be "steamed."

Vomiting must be produced by kerosene (three or four drops on sugar), alum and molasses, or ipecac (ten drops every fifteen minutes). Some remedy must be administered continuously until free vomiting occurs. A good dose of castor oil should be given after the spasm. Suitable treatment should be administered through the day to prevent a recurrence of the attack the next night.

The general vital resistance should be raised by outdoor life, improved circulation, good food; adenoids if present, should be removed.

Medical advice should be sought in every case of severe croup, for membraneous croup usually is indicative of diphtheria, and the diagnosis is important, as on it hangs the determination of the administration of antitoxin.

PNEUMONIA

Pneumonia is always a serious disease. It is accompanied by high fever, painful, very short cough, and rapid breathing with a moving in and out of the edges of the nose as well as the spaces between the ribs. The possibilities of complications are always great—the dangers are many—so that the combined watchfulness of both the mother and a proficient trained nurse are required; not to mention the skill of the physician.

The steam tent, the mustard paste, the oil-silk jacket and the colonic flushing (described earlier in this chapter) may all be asked for by the physician in his untiring efforts to prevent dangerous complications during the course of the disease.

Plenty of moderately cool, fresh air (without drafts) is of great benefit. Never allow blue finger tips, or cold ear tips to exist; send at once for the doctor and administer a hot bath, or wrap in a sheet dipped in hot mustard water while awaiting his arrival. No mother should think of attempting to carry her baby through an attack of bronchitis or pneumonia without the best medical help available.