"Never in the history of mankind have children been of­fered such devoted care by the medical profession and allied sciences as they receive today, particularly in the United States."—MD Medical News Magazine, December 1959.

Most children in the United States who have adequate medi­cal care today probably will have immunizing inoculations for whooping cough, diphtheria, tetanus, smallpox, polio­myelitis, and possibly other diseases.

Several generations ago, immunization was sought for children, but not quite so scientifically.

For instance, let's go back across the years to a small girl name Eloise Pritchard, 9 years old, and one of five children in the Lemuel Pritchard family.

The Pritchard farm was near a country schoolhouse where the children were taught by a young woman schoolteacher in a large room that housed all classes in the school.

On this late autumn morning a fire was burning in the huge school stove, and the air was becoming warm. But more than the warmness was obvious in the air, and the pretty young schoolteacher frowned a little and wished she knew if there was anything to asafetida.

Little Eloise Pritchard sat directly in front of the teacher's desk, and suspended from around Eloise's neck, and under the collar of her dress, was a small flannel bag containing a small chunk of asafetida, a gum resin with a most un­pleasant odor.

Not only did Eloise wear a small bag of the resin, but virtually every child in the room wore one. The combined odor was stifling.

The young teacher, Miss Grummert, asked Mrs. Pritchard about asafetida at a church social the following week.

"Well, perhaps they don't use it in the city where you come from," Mrs. Pritchard explained. "But out here we all use it with the children."

"For protection?"

"Of course!" Mrs. Pritchard smiled knowingly. "Like my mother did and her mother before her! How else can you protect the young'ns from measles, scarlet fever, and all the rest?"

Mrs. Lambert, who was sitting next to Mrs. Pritchard, nod­ded agreement. "I even go a step further, Miss Grummert. I sprinkle sliced onions about the sleeping room when we are having an epidemic of one kind or another. And we know for a fact—in our family—that carrying an onion in your pocket will prevent smallpox!"

"And against snakebite," Mrs. Pritchard nodded emphati­cally. "My brother and his family live out West in snake country and all the children carry onions to prevent snake bite."

"I never heard of that!" Miss Grummert said in surprise.

"Well, there are some things I don't hold with," said Mrs. Pritchard with a meaningful look at Mrs. Lambert. "Remem­ber Grandma Toscher, Sarah? She always swore that if you cut a child's hair before it's a year old, it will shorten the child's life. And if a baby looked into a mirror before it's nine months old his life will be full of trouble."

Mrs. Lambert smiled indulgently. "Grandma Toscher al­ways said you could cure whooping cough with a bag of little ground-bugs hung around the neck. And I well remem­ber that she used to tie the right front foot of a mole around a youngster's neck with a blue thread if the youngster was getting the croup."

"Well," said Mrs. Pritchard. "My grandmother on my mother's side was from the South and she always said if a baby kisses a Negro before the age of one it will prevent whooping cough."

Whatever the charm that asafetida may have had to ward off illness, it seemed to have failed for Eloise Pritchard during that winter. Shortly after Christmas she came down with a severe cold which eventually ran its course, but Mrs. Pritch­ard added a small bit of camphor to the asafetida that the other children wore.

The youngest Pritchard child, Jonas, 5, came down with croup during this period. On the advice of the preacher's wife, Mrs. Allentown, the mother gave the youngster a warm bath for a quarter of an hour and then put the child to bed. Mrs. Pritchard then mixed a teaspoonful of powdered alum with twice as much honey and gave it to the sick boy. She also bedded the boy on the couch in the living room so she could keep a pan of boiling water on the stove.

"If it doesn't work," Mrs. Allentown suggested, "try ipecac or mustard water."

Within a few days time Jonas was showing some relief from his ailment, probably mostly from the moist air, which still is recommended. Meanwhile, Simon, age 7, developed impetigo which Mrs. Pritchard treated with apple cider, which she also used for ringworm when it appeared in any of the children.

One day in February Mrs. Lambert sent for Mrs. Pritchard. Howard Lambert, 6, was down with a fever and a rash. Mrs. Pritchard examined the rash and nodded.

"It's scarlet fever, Sarah. I'm certain. Perhaps you'd better call in Dr. Dunsmuir."

"He's sick himself, Letty. But you know what to do, don't you?"

"I remember what Mama did for us and I used it for Elizabeth when she came down with it a couple of years ago. We can ease the rash by rubbing it with lard or a piece of fat bacon. If his throat is sore we can use vinegar and water for a gargle, but if it gets real sore you may have to see if Dr. Dunsmuir wants to use leeches."

Howard's scarlet fever was light and he recovered without complications. Fortunately none of the other children in the home contracted the disease.

A siege of whooping cough took over for a short time and most of the children were treated with tea of chestnut leaves, hay tea, quinine, and syrup of wild cherry bark.

Several children had measles during the school year. Teas made of sage, saffron, and catnip were used plentifully for some of the measle cases. A bag of pounded slippery elm bark was placed over eyes to draw out fever. A case of mumps called for some mustard liniment and a hot poultice of corn meal, bread, and milk to relieve the discomfort accompanying the disease.

The year before when several cases of diphtheria appeared in the community, and Dr. Dunsmuir had been in Boston to attend his father's funeral, Grandma Toscher had supervised much of the treatment.

She had slaked freshly burned lime in a vessel and then directed the vapor from the concoction into a child's mouth through a cone made of a newspaper. For another child— when the lime vapor had failed to bring relief—she had blown flour of sulphur into the back of the mouth and throat through a goose quill. Inhalations and steam and hot water seemed to help others.

Grandma Toscher also insisted upon bathing children in warm water with a dessertspoonful of mustard in the bath to bring out the rash of scarlet fever or measles. For round-worms, she advocated a teaspoonful of powdered wormseed mixed with molasses, and for pinworms she insisted that a tablespoonful of linseed oil injected with a syringe was the best cure.

With the coming of spring, every household in the farming community became the scene of the usual springtime medi­cations, most of them designed to "thin" the blood and purge the winter illnesses.

Early one morning Letty Pritchard busied herself in the kitchen mixing equal parts of sulphur and molasses. Then, despite the bitter objections, attempts to run away, and out­right wailing of the younger children, each of the Pritchard children had a spoonful of the mixture before breakfast. Nor was Lemuel Pritchard overlooked, and even Letty Pritchard took a rather small spoonful when she had finished minister­ing to her family.

Grandma Toscher also advised a spring tonic she had learned about from Indians. The golden blossoms of sassafras were boiled into a tea which was taken by everyone in the household every morning for three weeks. She said she was certain it was better than sage tea that some took, although she believed much in dandelion greens as soon as they were available.

As a final touch she made certain her great-grandchildren had generous lubrication, inside and out, from grease saved from the Christmas goose.

Annabella Allentown, who was 16 that spring, became so dreamy-eyed and lackadaisical that her mother became wor­ried about her. Finally, on the advice of Sarah Lambert, Mrs. Allentown gave Annabella sarsaparilla, which was said to be helpful in such cases, especially if it was Dr. J. C. Ayer's sarsaparilla, which also contained a little mandrake, yellow dock, and a few other ingredients for "debility peculiar to spring."

The same Annabella, later in the year when freckles began to sprout out over her face, joined Catherine Lambert—who was the same age and had the same abundance of freckles— in trying to do away with them by vigorously applying horse­radish and buttermilk on the freckles each night for several weeks.

Meanwhile Annabella's brother, Justin, a year older than she, developed a boil on the back of his neck. His father suggested that they try a hot poultice of mutton tallow and onions, which eventually seemed to bring the boil to a head. (Probably due to the heat.) This young man also was trou­bled with a large wart on his left hand. Variously, he tried a number of "cures" for it. He rubbed it with slit beans, corn, a green walnut, raw potatoes, bacon rinds, and several other "sure fire cures" passed on to him by others. The wart remained.

Most children in the neighborhood were cautioned to eat a small bit of poison ivy leaf or root to protect them from poison ivy during the summer. Since they went barefooted, they frequently wore a white woolen cord around the ankles to protect them from ground itch.

Cuts and burns were treated with crushed horseradish leaves in vinegar; poultices made of flaxseed or elm; and some families used a more complicated salve made of flour, eggs, honey, sweet oil and pokeberry leaves. When little Claude Allentown stepped barefooted on a rusty nail and drove the nail into his foot, Grandma Toscher was consulted and advised the smoke of burning honeycomb to draw the poison from the wound.

"Summer complaint" became common. Some mothers tried syrup of rhubarb with niter, or slippery elm for the disorder that summer. A mixture of slippery elm with bitter root and yellow root was highly recommended for erysipelas.

When Eloise Pritchard had sore eyes she was treated with a wash made of diluted essence of sassafras. When it was only partially successful, Grandma Toscher insisted that they try water from March snow that she had saved for just such purposes. The eye trouble cleared up a few days later, probably of its own accord.

When illnesses persisted, there always was the purge, the enema, the castor oil, the salts.

So were the illnesses of children treated during the pioneer days. These are only a few of the "cures" and "remedies" of the old folk medicines handed down from generation to generation.

Along with the specifics, there undoubtedly was a good measure of common sense that put ill children in bed where they belonged, and in other ways contributed to the body's own ability to heal itself.

Some treatments undoubtedly were effective to a degree. A few still are in use. Most of them are not.

The comment in MD Magazine tells the story to a large degree. Never before has so much medical skill and devotion been devoted to children.

Whereas the lore of child care was passed down from mother to daughter, from generation to generation over the years, the real impact of common knowledge available to all parents was never as great as it is now, thanks to the mass communications media.

Certainly the great physicians gave much study to problems involving children, and down through history they have written about child care. But the real avalanche of study, discoveries and information, has come during the compara­tively recent years.

Within these recent years an estimated 7,500 different books have been written on the subject of child care. Almost every magazine of any importance that caters to the family, wives, and home life, make child care a routine part of editorial comment.

Some of the child and baby care books have enjoyed huge success. One such book—Dr. Benjamin Spock's Baby and Child Care has sold more than 11 million copies, in about 60 printings.

With a baby crop of about 4,500,000 a year in this coun­try, the importance of child care assumes greater proportions every year. Even as adults are living greater life spans, fewer and fewer babies and children are being lost.

When today's baby is born he has the best chance the world has ever known of escaping serious illness. The possi­bility that he will die in his first year is less than one-third of what it was only 25 years ago.

Immunization will protect him from some of the worst diseases. Proper nutrition will help him withstand the attacks of bacteria and viruses. Antibiotics and sulfa drugs will quickly clear up many disorders in the event he succumbs to some.

Highly trained medical people are ready to help him with the most modern treatments and equipment if he needs them. Close to 7,500 pediatricians in the nation guard the children's health. Some 2,500 more physicians devote most of their time to children. Child psychiatrists and psychologists devote their skills and working years to children. Educators, sociologists, scientists, industrialists concentrate on the lives and welfare of children. In the nation there are more than 200 specialized children's hospitals.

All of this has not come about without considerable tugging back and forth by generation upon generation, idea upon idea, and concept upon concept.

There was a time when the child was considered to be, as MD puts it, ". . . simply a troublesome little adult chock-full of original sin who must be induced by constant precept, admonition and discipline to fit as speedily as possible into the surrounding world."

This was especially true up until about the middle of the 18th century, and the idea still lingered on rather strongly through the 19th century. However, there was beginning to be a feeling among many experts that children also had minds and emotions of their own.

Sigmund Freud crystallized this thinking into far-reaching psychoanalytical concepts that still echo from our centers of learning. Some call this new period of exploration into psychological problems that may stem from childhood: "The Century of the Child."

Truly scientific studies of the child began. Dr. Arnold Lucius Gesell established the Clinic of Child Development at Yale University in 1911.

Three years later, in July 1914, the U. S. government took a major step by issuing the first government bulletin on "Infant Care." The bulletin was produced by the Children's Bureau of the Department of Labor. About 40 million copies of these booklets have been distributed or sold since then.

Of one thing there was little doubt.

Although the mothers before the 20th century had to rely largely on instinct and "folk medicine" in rearing their children, the women who bore children after the new century began had plenty of advice and "how-to-do-it" literature.

As the study of children increased in tempo, the ideas about rearing them changed from time to time.

Mothers were advised not to "smother" the child with affection. By 1928 it was believed by many that making a fuss over babies was detrimental to the children. Dr. John B. Watson, one of the most quoted doctors in that field at that time, frankly said: "Kissing and coddling infants is taboo."

Strict child discipline came in for a drubbing. "Spare the rod and spoil the child" had been the approved system. Vic­torian children were strictly brought up.

After World War I a reaction began to set in over this country. A new type of child training called "permissiveness" became popular. Dr. Karl Menninger recommended that a child should be "understood" rather than "managed."

Other specialists said: "Affection and serenity in the home are infinitely more important than direction and discipline." The desire to coddle and fondle was exercised a little more. The theory of "permissiveness" in some instances progressed to virtually a "demand" theory in which the child's demands were occasionally heeded far beyond the bounds of ordinary common sense, with disastrous results, according to some observers.

The swing now is back again to more strictness.

"A child needs authority as much as he needs nourish­ment, but the middle course is best: authority does not mean oppression and freedom does not mean indulgence," says the noted pediatrician Dr. I. Newton Kugelmass, author of Complete Child Care in Body and Mind.

Thus, over the last 30 years or so, the psychological growth of the child has become a major field of study and accomplishment.

The physical side has become even more complex and progressive.

For one thing, the relationship between the child's physical and psychological growth has become more obvious and a factor in the care of the child.

Susan Maas, 15, weeps in the solitude of her bedroom. Her mother hears her and finally manages to get the reason for the tears.

"I'm so tall, Mother. No one wants to go with me. All the boys are shorter. I could just die!"

A boy who is much smaller than the other boys in his class becomes morose and introverted. A fat boy wishes he were thin. A weak boy wishes he were strong. Each may become a psychological problem.

As child studies were intensified, it became almost immedi­ately obvious that there should be a definition of what a "normal" child would be.

This proved to be somewhat of a problem. The old height-weight-age tables were inadequate and not accurate. Children differed even when healthily normal.

Eventually, systems were worked out so that normalcy could be fairly well determined. For the last 20 years or so a system called the Wetzel Grid, devised by Dr. Norman C. Wetzel of Cleveland, has been used quite extensively.

A chart is assigned to each child observed by the system. The chart is divided into the seven most common types of body build. Then by periodically checking the child's height and weight and comparing it with the "channel" signified for his body type, it is possible to determine if he is growing as he should. If he moves out of his "channel" something may be wrong and medical attention is recommended to find the cause of the deviation.

Whether the child is being watched by a Wetzel Grid chart, or simply by ordinary checkups, or parental observation, the medical attention that he can receive today is exceptionally efficient and complete.

Today it is customary for most complete books about child care to contain charts for children in the family.

A typical one will have spaces to enter information about: height, weight, high points of development (recognizes mother, smiles, holds head erect, etc.), inoculations for whooping cough, diphtheria, tetanus, poliomyelitis, smallpox and others, as well as notes of formulas and feedings.

A more complete health record—frequently kept for all members of the family—will include dates for tests such as tuberculin skin or X-ray, Schick, and others including some for allergies. It may include dates concerning contraction of diseases such as chicken pox, measles, German measles, rose­ola (3-day measles), mumps, whooping cough, scarlet fever, pneumonia, tonsillitis, bronchitis, and otitis. Injuries may be listed with dates. The blood type and RH information may be listed.

With such procedures becoming more and more common in thousands of homes, it is obvious that the day of asafetida is becoming very much a thing of the past. No longer do children wear the vile smelling "protection" from disease; nor the camphor, nor the slices of onion.

True protection from many diseases indirectly got its first good start in the 18th century when Edward Jenner, an English physician, introduced vaccination against smallpox.

Jenner found that by infecting a person with cowpox by means of a vaccine made of the cowpox virus, the person became immune to both cowpox and smallpox.

Probably millions of adults today remember when vacci­nation for smallpox was about the only immunization they had during childhood.

Today there are few children who have not had immuni­zation by injections of toxoids, toxins, and vaccines against smallpox, whooping cough, diphtheria, typhoid, tetanus, in­fluenza, poliomyelitis, and other diseases.

Mrs. Mark Sanford a bewildered mother from a big Mid­western city recently discussed inoculations with her physician, Dr. Ulford.

"I don't understand, Doctor," she frowned. "Don't you give inoculations for diphtheria and whooping cough, too?"

"Not separately. At our clinic we prefer to give a combi­nation of whooping cough vaccine along with diphtheria and tetanus toxoids."

"My grandmother used to say it's best to expose the chil­dren to a lot of these things and let them get over it. Measles, for instance."

The doctor shook his head doubtfully. "That's not neces­sarily true, although children usually get measles sooner or later. However, it's not good for youngsters under three or four to have them since they can lead to complications. We can give gamma globulin to protect youngsters for a short period of time."

"Gamma globulin?"

"A substance extracted from the blood of persons who have had measles. It supplies the antibodies that fight the disease."

"What about German measles?"

"We're not quite as concerned about them, except with pregnant women. Besides, we're not sure how effective gamma globulin is against German measles."

"Can there be any long-lasting harm from the other measles?"

"More than we once thought, Mrs. Sanford."

The doctor was echoing the more recent studies of the disease. Time Magazine, August 8, 1960, sums up the situ­ation succinctly: "In the comic strips, measles is a joke. In much of the world the disease is treated lightly, partly from ignorance, partly because it is an almost certain incident of growing up. But measles is, in fact, all too often a killer or the cause of mental crippling."

The report goes on to reveal that Virologist John F. Enders of Harvard and 18 research colleagues in this country and abroad, are evidently making dramatic progress toward a safe, sure vaccine against measles.

For some fifteen years it has been thought that German measles contracted by a woman early in pregnancy could re­sult in crippling of eyes, ears, hearts, and brains of the unborn baby.

As a killer, measles is not to be dismissed lightly. In 1958, in the United States, 552 deaths were officially listed as caused by measles, compared with 255 deaths caused by poliomyelitis.

The virus has a tendency to attack the middle ear, which may cause permanent deafness. It sometimes is the cause of fatal pneumonia. One of its worst results has been the setting off of encephalitis, brain inflammation, which may cause death or sometimes leaves the victim as an idiot.

Fortunately, the new vaccine undergoing tests gives promise of protecting the human brain against invasion and damage.

As we noted in the study of rheumatic fever, a childhood illness may have long-reaching results. Chicken pox can result in skin infection. A common cold can cause complications such as otitis (inflammation of the middle ear), bronchitis, pneumonia, and sinusitis. Diphtheria can damage the nervous system and the heart. Dysentery can result in liver disease and colitis. Encephalitis can damage hearing, sight, nerves, and bring about behavior changes. Erysipelas can result in nephritis and rheumatic fever. Hepatitis can result in a severe liver disease.

Thus the dependence upon immunization is great and important. One of the most dramatic developments of recent years has been, of course, the famous Salk vaccine for polio, which has been followed by oral vaccines against the disease, as will be more fully explained in a subsequent chapter.

Tests have been developed to determine immunization, among them the Schick for diphtheria, the Dick for scarlet fever, tuberculin for tuberculosis, one for mumps, and a number of others, including a large number of allergy tests.

Treatments for the various diseases have progressed amaz­ingly. In some instances the use of serum has been replaced by a sulfa drug or an antibiotic. In speaking of them, in 1953, on the anniversary of 75 years of medical progress, Dr. Irvine McQuarrie, University of Minnesota Medical School, wrote: "The most fundamental and far-reaching therapeutic achieve­ment of the entire jubilee period followed the introduction of the sulfanamide drugs and the antibiotics (penicillin, aureo-mycin, streptomycin, etc.). Many acute infectious diseases, which were responsible for enormous suffering and innumer­able deaths in infants and children each year less than two decades ago, are now curable through proper use of these new therapeutic tools . . . Millions of lives of children are saved annually by such treatment."

A young mother, Gladys Enright, of Los Angeles, anxiously took the temperature of her only child, Edward, age 6.

"Is your throat any better at all?" she asked anxiously.

The small boy shook his head on the pillow.

"It hurts to swallow."

"Let Mother look again . . ." Gladys inspected her son's throat and glanced up at her own mother who was spending the afternoon with them. "It looks awfully sore."

"It might be scarlet fever," her mother said. "Only there isn't a rash."

"There's no sign of a rash, but I don't like the looks of the white spots."

"Tonsillitis?"

"I don't know. What did you used to do about sore throats with us, Mother?"

"Salt water gargles, mostly. But I don't suppose Edward knows how to gargle."

"No. Isn't there something else?"

"Well, your grandmother used to use bacon rind in a cloth around our necks and—"

"Oh, Mother . . ." Gladys said impatiently. "You know better than that. I looked it up and he could be coming down with a good many things. Tonsillitis, diphtheria, flu, measles, polio—only he's had shots for most of those things."

"Maybe . . . well, maybe we just shouldn't guess."

"I'm not going to guess or try something I don't know about," Gladys said. "I'm going to call the doctor. It could be a strep throat or almost anything. And there's no use guessing—not when Edward might get rheumatic fever or something because I did guess. I'm going to make sure—as long as we can these days!"

She called the doctor, who subsequently diagnosed the sore­ness as a streptococcus infection and treated it effectively.

In another city, in a Rocky Mountain state, a young couple looked anxiously at the heart specialist called in by the pedia­trician who was looking after their three-year-old daughter.

The specialist carefully explained the heart condition suf­fered by the child. "It can be remedied by surgery," he told them.

"Can you do it? Isn't there a terrible risk?" asked the father.

"I can't do it. We'll need a highly trained surgical team to do this work, with the latest equipment. Probably in Chicago. And soon. This week."

"But how . . . ?

"We'll fly her there, if that's agreeable with you."

Within the week the child had the necessary surgery and was assured of a normal life. The incident serves to illustrate another important factor in medical care for children—the wonders of modern transportation and communication that make the finest care in the nation available within a matter of hours, from almost any community.

Open heart surgery has been a comparatively recent and exciting development in medical care for children. Also, some types of corrective surgery have progressed almost beyond be­lief, including replacement of a damaged or abnormal part of an esophagus with a segment of colon.

Detection of heart disease among children recently was dramatically demonstrated in Chicago. There, an automated tape recording unit was employed to record the heartbeat and heart sounds of children in grammar school. The results dis­closed that between 2500 and 5000 children in the city's pub­lic and parochial schools have some form of heart disease.

Meanwhile, a new field for specialists may bring help to the tall girl, and the boy who is too short. The endocrinolo-gist is the newly important specialist. The hormone is his tool. While he cannot help all children who are too tall, too short, too thin, too plump, he can help those who have less common and more serious growth disturbances.

They are young girls like Susan Maas, embarrassed by her tallness, who actually was not too tall a little later on when most of her contemporaries "caught up" with her, but her problem was not as serious as Caroline Fowler's.

Caroline, who was 8 years old, already was exceedingly conscious of her split lip and the nose that was so badly turned out of shape. Her speech was so defective there were few who could understand her.

Again, the ease of today's travel helped solve Caroline's problem. With her mother she went to a large and distant medical center where specialists were expert in corrective surgery and treatment of cleft lip and palate disorders. More recently, such cases are now surgically treated shortly after birth.

As Howard Earle says in Today's Health, September, 1960: "Vaccines, antibiotics, hormones, and other drugs combine with the miracles of modern surgery and orthopedics to create a better world of health for children."

And even as these words are written, newer, greater, more exciting developments are in sight or just around the corner.

COMMON CHILDHOOD DISEASES AND EMERGEN­CIES—Henry H. Work, M.D., writing for Parents Magazine, has given excellent advice to parents in his warning to call a doctor for an ill child under the following conditions:

1.   Any constant or recurring pain.

2.   Persistent or severe vomiting.

3.   Diarrhea.

4.   A running temperature of over 100 degrees or sudden temperature of 102 degrees or over. Even if a child has gone to bed apparently well, call your doctor if he wakes during the night with a fever of 103 degrees or more.

5.   A rash, swelling or other eruption.

6.   Stiffness of the back or neck.

The importance of Dr. Work's suggestions cannot be em­phasized too much. A child's life is far too precious to be endangered by ill-advised home medications, or amateur diag­nosis and treatment. When the above symptoms occur, it is only good sense to get trained medical help. When you call the doctor you may ask what you can do for the child until he arrives.

The following suggestions of what to do while waiting for him are frequently observed:

First of all, the sick child should be put to bed. Do not give the child medicine not ordered by the doctor. If the child does not have diarrhea, or is not vomiting, some doctors sug­gest that the child may have liquids such as water, fruit juice, milk, or broth. If possible, check first with your doctor. Every four hours, take the child's temperature and make a record of it for the doctor. Also report any changes in symptoms.

The following descriptions and suggestions about care are a summary from authoritative medical sources.

Chicken Pox usually is a mild disease and ranks second to measles in frequency among children's diseases. It is caused by a virus. Symptoms include a headache, moderate fever, and malaise. Sometimes the child may not feel ill at all. The rash appears as pink blotches rather than like beginning pimples. These change into tiny blisters which break, dry, and crust. The blisters come out in fresh crops each day. (This varies from smallpox in which lesions are all in the same stage of development at the same time.) Since the rash may itch a great deal, the child's fingernails should be cut short to pre­vent infection from scratching. Usually the itching is more severe with older children. Doctors frequently recommend calamine lotion, a starch bath, or dabbing with a solution of baking soda to relieve the itching; or a doctor may prescribe an antihistamine. The doctor should be questioned for his recommendation. Unless there are complications, chicken pox requires no special treatment with serum, antibiotics, or sul­pha drugs.

Croup (acute obstructive laryngitis) causes swelling of the larynx, which narrows the air passages and makes breathing difficult. Usually it is a disease of early childhood. A child may have appeared to be feeling well during the day, or pos­sibly he may have had symptoms of a slight cold before be­ing put to bed. Late in the night he may awaken with a loud, shrill, barking cough. He breathes noisily and apparently with difficulty.

A doctor should be called. Until he arrives, emergency treatment usually calls for moist air. A vaporizer is best for this purpose. If one isn't available, a pan of water boiling on a hot plate in the sickroom will help, or the child may be taken to the kitchen and held near a stove with an umbrella covering the child's head and a pan of boiling water to keep moist air around the child.

Diphtheria usually begins with sore throat, fever, headache, and malaise. At first the throat is red, then grayish white spots develop on the tonsils. As the disease progresses the spots become larger and spread to other parts of the throat. The throat feels worse and becomes swollen. After another day the spots may run together and give the appearance of a grayish-white or yellowish-white membrane. A doctor should be called. There is an effective antitoxin and penicillin and other antibiotics may be useful.

German Measles has no relation to ordinary measles, is caused by a different virus, and gives no immunity to the other disease. It is also called rubella and three-day measles. It is mild and contagious. Swollen glands behind the ears are typi­cal of the disease. Usually the child is simply kept in bed with­out particular treatment unless the fever is especially high, or the child is especially ill. The rash begins on the face and spreads over the whole body, usually within a day, and is gone in a few days. Antibiotics are considered unnecessary for the disease. Gamma globulin treatment is reported to be of no particular value. Pregnant women should avoid the disease.

Measles begins like a cold, but the victim usually feels more ill than with a cold. The disease is the most common of child­hood diseases. There are an estimated million cases a year in the United States. Caused by a virus, one attack usually gives lifelong immunity, although second attacks do occur occasion­ally. It is contagious.

In addition to a running nose, cough, and fever, the eyes usually become inflamed and swollen and may become sensi­tive to light. The cough is dry. The fever usually rises each day. About the end of the third day, or beginning of the fourth, the rash breaks out, behind the ears and on the face and then over the rest of the body. Usually the child feels better after the rash appears. If not, and if the temperature rises, bronchopneumonia may be suspected.

Consult a doctor. Measles can be a serious disease unless it is treated adequately. While a child's eyes are sensitive, dim­ming the room lights may be helpful. The doctor may pre­scribe an antibiotic or a sulpha drug to avoid complications or to treat any that have developed. A vaccine against measles may soon be available. It is now being tested.

Mumps is a virus infection that usually attacks the salivary glands just below the ear, although it actually is a more gen­eral infection and involves not only the salivary glands, but the testicles or ovaries, the pancreas, the nervous system, and even—on occasion—the heart. Undoubtedly there are light cases of mumps, with almost no swelling of glands, that have never been diagnosed.

The child should be put to bed and kept there until all signs of active disease have disappeared. The doctor should be called. Usually treatment involves fever control and eas­ing the pain of swollen glands. Ice bags, cold compresses, or camphorated oil on the child's swollen cheeks may comfort him. Aspirin and other pain-relieving medicines may be pre­scribed. Good oral hygiene is imperative, including mild cleansing mouthwashes, to guard against secondary bacterial infections. Various drugs have been tried for the disease, but seem to help little in speeding recovery.

The testicles may become involved—orchids. (Some doc­tors administer gamma globulin as soon as there is a diag­nosis of mumps rn an adult male to reduce the possibility of the complication.) Cortisone or hydrocortisone may reduce inflammation of mumps orchitis.

Scarlet Fever combines a "strep" throat with a skin rash, usually beginning with fever, sore throat, swelling of the glands in the neck, headache, and sometimes vomiting. Whit­ish spots may appear in the throat. The face may be flushed but pale around the mouth. The rash usually begins on the neck, behind the ears, and spreads down the back and chest, arms, legs, abdomen, and buttocks.

A doctor should be called. He probably will prescribe an antibiotic. He may also prescribe aspirin and applications of cold cream or oil lotions for itching.

Usually the doctor wishes to check the child three or four weeks after the scarlet fever has passed as the disease occa­sionally may be followed by rheumatic fever or nephritis.

Whooping Cough usually begins like a cold with a cough. The cough is hacking, frequent, and difficult to control. After ten to fourteen days it seems to get worse. The coughing comes in bouts so frequently that they may prevent the pa­tient from getting any rest. Usually a bout comes in eight or ten fast coughs in one breath. Sometimes the spells are fol­lowed by vomiting.

Call a doctor. He may prescribe streptomycin or other drugs used in treating the infection. Steam inhalations and an even temperature in the sickroom may be helpful. Holding the patient's forehead and abdomen during a coughing spasm helps prevent vomiting.

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