< Hie KEN POX CHILBLAINS. 



becomes pustular (that is, mattery), while in chicken pox it remains vesicular (that is, 

 watery), except in a few very rare cases. The eruption of small pox is umbilicated, 

 that Ls, it is "tucked in" in the centre like the navel or the top of a cottage loaf. 

 This is, however, rarely the case in chicken pox. 



Chicken pox hardly requires treatment of any kind, and happily the children 

 get well in spite of anything which may or may not be done for them. Keep the 

 child from catching cold, and take care that it does not pick the' scabs, or trouble- 

 some liberations may result. The vesicles should be protected from irritation of 

 all kinds, and if they occur on parts of the body which are liable to be rubbed by 

 the dress, or to come in contact with neighbouring folds of skin, they should IK- 

 protected by a piece of soft rag which has been lightly covered with a thin layer of 

 cold cream. 



Although the disease itself is trivial, it often leaves the child in a very weak 

 condition, and we sometimes find that children who have been perfectly well 

 previous to their attack of chicken pox fall off in health very much afterwards, 

 and lose flesh, and become generally sickly. If there is any family tendency to 

 tubercular disease, this is a peiiod at which they are very liable to contract it. 

 The vesicles occasionally leave scars about the body. 



Chilblains are a very common source of trouble to children. They consist of red 

 and swollen patches, the result of mild inflammatory action, and they are caused by 

 exposure of the part to cold or damp. They are most liable to occur at the extremi- 

 ties, where the circulation is feeble, and are most common on the toes and fingers. 

 They may occur also 011 the lobes of the ears, the tip of the nose, and elsewhere. 

 Children who suffer from chilblains are often weak and sickly, of a sluggish and 

 lymphatic habit, and indisposed for active pursuits. The tendency to chilblains is 

 increased by any weakening and debilitating disease, or by bad feeding, or other 

 causes which tend to depress the health. The mildest kind of chilblain consists 

 merely of slight redness and swelling, accompanied by intolerable itching. In worst* 

 forms, the skin gets bluish over the swelling, and this is not unfrequently followed by 

 the excoriation of the skin, and the " breaking " of the chilblain. Broken chilblains 

 a iv far more serious than simple chilblains, and are often accompanied by a large 

 amount of discharge, are liable to become exceedingly chronic in their course, and 

 not unfrequently they cripple the patient for many months at a time. 



The treatment of chilblains is both general and local. The health must be most 

 carefully attended to ; tonics may be freely administered cod liver oil, iron, and 

 quinine are all of use combined with a liberal diet and a fair amount of stimulant. 

 The parts which are the seat of chilblains must be kept thoroughly warm, and the 

 child must be encouraged to take as much exercise as possible. The stockings must 

 be woollen, and the boots or gloves warm and roomy, so as not to compress the 

 hands or feet. The parts may be further stimulated by rubbing, and it is often 

 advisable to use some mild stimulating liniment, such as soap liniment or ammonia 

 liniment. Spirit of any kind, such as brandy or gin, may be employed for rubbing 

 the part. When the chilblains become broken, the parts must be kept at rest, and 

 it may be necessary to apply poultices or warm-water dressing for a time, until the 



