Measures used to reduce temperature in FEVER. Varieties include cold-sponging, wet-packs, baths and diaphoretic (sweat-reducing) drugs such as QUININE, salicylates and ASPIRIN.
Also called acute coryza or upper respiratory infection, the common cold is characterised by in?ammation of any or all of the airways – NOSE, sinuses (see SINUS), THROAT, LARYNX, TRACHEA and bronchi (see BRONCHUS). Most common, however, is the ‘head cold’, which is con?ned to the nose and throat, with initial symptoms presenting as a sore throat, runny nose and sneezing. The nasal discharge may become thick and yellow – a sign of secondary bacterial infection – while the patient often develops watery eyes, aching muscles, a cough, headache, listlessness and the shivers. PYREXIA (raised temperature) is usual. Colds can also result in a ?are-up of pre-existing conditions, such as asthma, bronchitis or ear infections. Most colds are self-limiting, resolving in a week or ten days, but some patients develop secondary bacterial infections of the sinuses, middle ear (see EAR), trachea, or LUNGS.
Treatment Symptomatic treatment with ANTIPYRETICS and ANALGESICS is usually su?cient; ANTIBIOTICS should not be taken unless there is de?nite secondary infection or unless the patient has an existing chest condition which could be worsened by a cold. Cold victims should consult a doctor only if symptoms persist or if they have a pre-existing condition, such as asthma which could be exacerbated by a cold.
Most colds result from breathing-in virus-containing droplets that have been coughed or sneezed into the atmosphere, though the virus can also be picked up from hand-to-hand contact or from articles such as hand towels. Prevention is, therefore, di?cult, given the high infectivity of the viruses. No scienti?cally proven, generally applicable preventive measures have yet been devised, but the incidence of the infection falls from about seven to eight years – schoolchildren may catch as many as eight colds annually – to old age, the elderly having few colds. So far, despite much research, no e?ective vaccines have been produced.... cold, common
The explosive nature of coughing results in a spray of droplets into the surrounding air and, if these are infective, hastens the spread of colds (see COLD, COMMON) and INFLUENZA. Coughing is, however, a useful reaction, helping the body to rid itself of excess phlegm (mucus) and other irritants. The physical e?ort of persistent coughing, however, can itself increase irritation of the air passages and cause distress to the patient. Severe and protracted coughing may, rarely, fracture a rib or cause PNEUMOTHORAX. Coughs can be classi?ed as productive – when phlegm is present – and dry, when little or no mucus is produced.
Most coughs are the result of common-cold infections but a persistent cough with yellow or green sputum is indicative of infection, usually bronchitis, and sufferers should seek medical advice as medication and postural drainage (see PHYSIOTHERAPY) may be needed. PLEURISY, pneumonia and lung CANCER are all likely to cause persistent coughing, sometimes associated with chest pain, so it is clearly important for people with a persistent cough, usually accompanied by malaise or PYREXIA, to seek medical advice.
Treatment Treatment of coughs requires treatment of the underlying cause. In the case of colds, symptomatic treatment with simple remedies such as inhalation of steam is usually as e?ective as any medicines, though ANALGESICS or ANTIPYRETICS may be helpful if pain or a raised temperature are among the symptoms. Many over-the-counter preparations are available and can help people cope with the symptoms. Preparations may contain an analgesic, antipyretic, decongestant or antihistamine in varying combinations. Cough medicines are generally regarded by doctors as ine?ective unless used in doses so large they are likely to cause sedation as they act on the part of the brain that controls the cough re?ex.
Cough suppressants may contain CODEINE, DEXTROMETHORPHAN, PHOLCODINE and sedating ANTIHISTAMINE DRUGS. Expectorant preparations usually contain subemetic doses of substances such as ammonium chloride, IPECACUANHA, and SQUILL (none of which have proven worth), while demulcent preparations contain soothing, harmless agents such as syrup or glycerol.
A list of systemic cough and decongestant preparations on sale to the public, together with their key ingredients, appears in the British National Formulary.... cough
Clinical features There are various types. The oligoarthritic type involves 1–4 joints (usually knee or ankle) which become hot, swollen and painful. One complication is an in?ammation of the eyes – UVEITIS. The condition often ‘burns out’, but may reappear at any time, even years later.
The polyarthritic type is more like RHEUMATOID ARTHRITIS in adults, and the child may have persistent symptoms leading to major joint deformity and crippling.
The systemic type, previously called Still’s disease, presents with a high fever and rash, enlarged liver, spleen and lymph nodes, and arthritis – although the latter may be mild. In some children the illness becomes recurrent; in others it dies down only to return as polyarthritis.
Complications These include uveitis, which can lead to loss of vision; a failure to thrive; osteoporosis (see under BONE, DISORDERS OF); joint deformity; and psychosocial diffculties.
Treatment This includes ANTIPYRETICS and ANALGESICS, including NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS), intra-articular steroid injections, anti-tumour necrosis factor drugs and steroids.
Physiotherapy is vital, and children may need to wear splints or other orthotic devices to alleviate deformity and pain. Orthopaedic operative procedures may be necessary.... juvenile idiopathic arthritis (jia)
Many cases of pleurisy are associated with only a little e?usion, the in?ammation consisting chie?y in exudation of FIBRIN: to this form the term ‘dry pleurisy’ is applied. Further, pleurisy may be limited to a very small area – or, on the contrary, may affect, throughout a greater or less extent, the pleural surfaces of both lungs.
Causes Pleurisy is often associated with other forms of in?ammatory disease within the chest, more particularly PNEUMONIA, BRONCHIECTASIS, and tuberculosis; it occasionally accompanies PERICARDITIS. It may also be due to carcinoma of the lung, or be secondary to abdominal infections such as subphrenic abscess. Further, wounds or injuries of the thoracic walls are apt to set up pleurisy.
Symptoms The symptoms of pleurisy vary, being generally well marked, but sometimes obscure. DRY PLEURISY In the case of dry pleurisy, which is, on the whole, the milder form, the chief symptom is a sharp pain in the side, felt especially on breathing. Fever may or may not be present. There is a slight, dry cough, and breathing is quicker than normal and shallow. PLEURISY WITH EFFUSION is usually more severe than dry pleurisy, and, although it may in some cases develop insidiously, it is in general ushered in sharply by shivering and fever, like other acute in?ammatory diseases. Pain is felt in the side or breast, of a severe cutting or stabbing character. A dry cough usually occurs and breathing is painful and di?cult.
Treatment The treatment varies greatly with the form and severity of the attack. Bed rest, antibiotics, analgesics and antipyretics are advisable. A large pleural e?usion may need to be drained via an aspiration needle.... pleurisy
Quinine is generally used in the form of one of its salts, such as the sulphate of quinine, or dihydrochloride of quinine. All are sparingly soluble in water, much more so when taken along with an acid.
Action Quinine is a powerful antiseptic (see ANTISEPTICS). Its best-known action is in checking the recurrence of attacks of MALARIA, as it destroys malarial parasites in the blood. In fevers it acts as an antipyretic (see ANTIPYRETICS).
Among its side-effects are ringing in the ears, temporary impairment of vision, and sometimes disturbance of kidney function leading to renal failure.
Uses The most important use of quinine is its original one in malaria, attacks of which it quickly cuts short or prevents altogether. It has been largely replaced by more e?ective and less toxic antimalarial drugs; however, development of malarial parasites resistant to newer drugs has revived the use of quinine. For intravenous injection, when this is necessary in cases of malaria, a soluble form of quinine, the dihydrochloride, is used. Quinine can also be given in combination with other antimalarial drugs on medical advice. The drug is sometimes used in the treatment of cramps.... quinine
In humans the ‘normal’ temperature is around 37 °C (98·4 °F). It may rise as high as 43 °C or fall to 32 °C in various conditions, but the risk to life is only serious above 41 °C or below 35 °C.
Fall in temperature may accompany major loss of blood, starvation, and the state of collapse (see SHOCK) which may occur in severe FEVER and other acute conditions. Certain chronic diseases, notably hypothyroidism (see THYROID GLAND, DISEASES OF), are generally accompanied by a subnormal temperature. Increased temperature is a characteristic of many acute diseases, particularly infections; indeed, many diseases have a characteristic pattern that enables a provisional diagnosis to be made or acts as a warning of possible complications. In most cases the temperature gradually abates as the patient recovers, but in others, such as PNEUMONIA and TYPHUS FEVER, the untreated disease ends rapidly by a CRISIS in which the temperature falls, perspiration breaks out, the pulse rate falls, and breathing becomes quieter. This crisis is often preceded by an increase in symptoms, including an epicritical rise in temperature.
Body temperature is usually measured on the Celsius scale, on a thermometer reading from 35 °C to 43·3 °C. Measurement may be taken in the mouth (under the tongue), in the armpit, the external ear canal or (occasionally in infants) in the rectum. (See also THERMOMETER.)
Treatment Abnormally low temperatures may be treated by application of external heat, or reduction of heat loss from the body surface. High temperature may be treated in various ways, apart from the primary treatment of the underlying condition. Treatment of hyperthermia or hypothermia should ensure a gradual return to normal temperature (see ANTIPYRETICS.... temperature
Anti-depressants should not be given for bed-wetting, drugs for sleep problems or strong laxatives for the chronically constipated. Mild herbal alternatives exist. Fresh carrot juice daily helps a child to avoid some complaints. Some herbs are not advised for children under 12, except under the care of a qualified practitioner.
Parental smoking habits are known to be responsible for crying and digestive symptoms in infants. Sleeplessness. German Chamomile or Balm tea: children 2-10 years quarter to half a cup; over 10 years: 1 cup. Babies: 3-6 teaspoons in feeding bottle – sweeten with honey if necessary.
Night seizures, with screaming: Passion Flower tea. 1 heaped teaspoon to cup boiling water; infuse 5-15 minutes. Strain. A few teaspoons at bedtime. When a brain storm starts place pinch of salt on the tongue. Calcium deficiency. Nettle tea. Carrot juice. Cod Liver oil with fresh orange juice.
Colic. Any tea: Dill, Catnep, Spearmint or Fennel. Few teaspoons frequently. Abdominal massage: 3 drops Chamomile oil in teaspoon olive oil.
Constipation. Prune or carrot juice. Dandelion coffee.
Cough. Oil of Thyme – few drops in water.
Crusta Lacta (milk rash). Weak teas: Plantain, Heartsease, Red Clover. Anoint with St John’s Wort oil. Buttermilk, Wheatgerm.
Diarrhoea. Teas: Yarrow, Tormentil. Breast feeding during the first 4-6 months of life reduces the risk of children’s diarrhoea.
Digestion, weak. Teas: Fennel, Caraway, Dill. 1 teaspoon crushed seeds to cup boiling water. Infuse 15 minutes in a covered vessel. Teaspoon doses for under 2s; half-1 cup thereafter. Also for flatulence. Feverishness. Alarm at a baby’s fever and fractiousness may attract complete medical treatment including nose drops, cough linctus, antipyretics and antibiotics, together with something to let the parents get some sleep. Avoid where possible. Mild fevers: teas – Yarrow, Marigold, Thyme, Elderflowers and Peppermint, Catmint, Carragheen Moss. Sweeten with honey. Topical: Flannels wrung out in these hot teas. Zinc can cut short the common cold. Echinacea tablets/capsules offer antiviral protection.
It is common for a child to convulse with fever. A feverish child, kept cool, is less likely to have convulsions. Remove most of child’s clothes so he can lose heat through the skin. Fruit juices (Vitamin C) in abundance. Do not feed solid foods. Wash in lukewarm (not cold) water.
Eyes. Deep hollows under the eyes reveal exhaustion, for which blood and nerve tonics and iron supplements are indicated.
Growth problems. Under-developed children respond well to herbal aids: Gentian, Ginseng, Horsetail, Marigold, Oats, German Chamomile, Wood Betony, Kelp, Alfalfa. Supplementation with brewer’s yeast, Calcium, Pollen and Zinc yield convincing results.
Hyperactivity. Nerve restoratives for highly-strung children: Teas: Lime flowers, Chamomile, Lemon Balm, B-vitamins. Porridge. Tablets: Passion flower, Valerian, Skullcap. Vitamins B6 and C. Powders: formula. Passion flower 2; Valerian 1; Liquorice 1. Dose: 250mg (one 00 capsule or one-sixth teaspoon) thrice daily.
Irritability and impaired school performance may be due to Tartrazine and other additives, sugar, and anticonvulsant drugs. See previous paragraph.
Infection. Infection of the upper respiratory tract may manifest as inflammation of the middle ear, nasal discharge or tonsillitis. Echinacea tablets, powder or liquid extract indicated. For specific infection such as measles, see under MEASLES, or other appropriate entry.
Skin. Reject cow’s in favour of goat’s milk. See appropriate entry for each skin disease (ECZEMA, etc). Care of skin after bathing: St John’s Wort oil, Evening Primrose oil. ... children
Health Encyclopedia