Maternal management of the disease.—­The early detection of this disease is of great importance.  The chances that the medical treatment will terminate successfully much depend upon the early and prompt application of remedial means.  The reason why these cases have so often terminated fatally has arisen from the physician being consulted when irremediable mischief had already taken place.  It would be difficult, however, to point out the signs of its approach in all its forms (for this disease does not always commence in the same way, sometimes with fever, etc.), still it most frequently occurs preceded by certain striking and well-marked symptoms; and whenever the following are noticed by the parent apprehensive of mischief, she should at once send for her medical adviser:—­watchfulness, or starting from sleep with a cry of alarm; prolonged screaming without any obvious cause; moaning and drowsiness; rolling the head from side to side on the nurse’s arm, or thrusting it back against the pillow; knitting the brows and aversion from light, with heat of head, and constant carrying the little hand up to it; half closing the eyelids, and frequent vomiting.

The chief and principal point in the maternal management (for it includes every other) is promptly and faithfully to administer the remedies prescribed by the medical attendant.  A vigilant maternal superintendence is more necessary in this than almost any other disease; and it is highly desirable, therefore, that the mother should have a day and night nurse—­individuals upon whom she can depend.  A careful notice of symptoms and changes in the patient, in the intervals of the medical man’s visits, and a true and faithful report to him upon his return, are of essential importance.  A sleepy nurse will neglect the application of the most important remedies, and necessarily give an unfaithful report of symptoms; hours the most valuable to the child’s well-doing are thus lost, and the chances of saving its life worse than problematical.

The temperature of the room should be kept rather cool than warm, and the bed-clothes only sufficient to preserve the natural heat of the body.  Strong light must be excluded.  Great quiet should be observed.  Freedom from all excitement of the senses, and irritation of the temper, should be carefully avoided:  this is particularly necessary where the child is naturally of a quick and sensitive disposition.

All the excretions must be put aside for the inspection of the physician, but not kept in the sick chamber, which must be well aired, and perfectly free from closeness.  The regimen must be only such as is ordered, and any departure therefrom will be attended with mischievous consequences.  During the early periods of the disease, all that is required are cooling diluents, given frequently, and in small quantities at a time; and upon approaching convalescence great carefulness must be paid to the amount of nourishment allowed, lest the disease be rekindled:  strict compliance, therefore, to medical directions must be given.