THE DISABLING DISEASES: BRUCELLOSIS (UNDULANT FEVER)

There are several forms of undulant fever, an infectious disease that is known by various names. The word ‘undulant’ indicates that the fever comes in waves, or undulations, instead of being constant. Recently, all forms of the disease have been given the name ‘brucellosis,’ because they are all due to infections with some member of the germ family called Brucellaceae, which was named for Dr. David Bruce (1855-1931), the English bacteriologist, who discovered it.

Symptoms

The symptoms of brucellosis usually come on slowly and are rather indefinite, consisting of irregular fever, chills, sweating, and aches and pains in the joints and muscles. The death rate is not very high. However, it is rare for a person to recover after only one attack of the illness. As a rule, another attack follows the first after an interval, and this may be repeated almost indefinitely.

Transmission and prevention

Brucellosis is very rarely carried from one person to another. It is, however, constantly carried from animal to animal, and from animal to person. The animals that harbour the germ are chiefly domesticated goats, cattle, and hogs. Each species of animal has a particular kind of Brucella germ that is characteristic.

It is also possible to acquire brucellosis from contact with diseased animals or their carcasses. Farmers, veterinarians, slaughterhouse employees, and butchers are exposed to the infection, as well as housewives who handle infected meat in the kitchen.

The best way to prevent brucellosis is to eradicate the disease in animals. The danger of brucellosis is a powerful argument for universal pasteurization of public milk supplies. Infection by contact with diseased animals or their carcasses is less easy to prevent and is essentially a matter of industrial hygiene. Persons who are exposed to brucellosis in their jobs should be fully informed of the dangers and” should take precautions against unnecessary exposure.

Several of the antibiotics alone or in combination with sulpnonamides are extremely helpful in treatment. They are more effective in the early, acute stages than in the chronic form of the disease.

*299\68\2*

CARING FOR A SICK PERSON AT HOME

Good home nursing requires knowing how to make the bed, take the pulse, and give medicines, and a willingness to work hard. Sympathetic understanding and intelligent planning are also essential.

If there is a choice between home nursing and hospitalization, here are some of the points that should be taken into consideration.

1. Remember that once the decision has been made, it may be difficult or even impossible to change it. Do not decide impulsively. Always talk it over thoroughly with your doctor first.
   
2. In certain illnesses, a hospital is essential because of the treatment required or the special equipment that may be needed.
   
3. In general, a sick child is better off at home than in a hospital. However, certain diseases, such as rheumatic fever and poliomyelitis, are handled much more effectively in a hospital.
   
4. Very old people, like children, find it difficult to adjust to a new .environment. They, too, are usually better off if cared for at home.
   

5    Persons with certain communicable diseases must often be hospitalized for the protection of others. Tuberculosis presents a special problem.

6 A mentally ill person should never be cared for by nursing at home.

*245\68\2*

UNDERSTANDING CHILDREN’S BEHAVIOUR: THE ‘AVERAGE CHILD’ VERSUS YOUR CHILD

I want to make it very clear that the child I described above is the average child as described by statistics. Your child is an individual. It would be quite remarkable if he happened to be average in every detail. He is far more apt to be above the average in some respects, below it in others, and to alternate at various periods.

Growth

As far as growth is concerned, I think it is a good idea to record your child’s weight and height and the arrival of his teeth so that your doctor will know whether the rate is within normal limits. Leave that up to him and do not worry about it yourself. Your child must not be made to feel uncomfortable about his physical development, and comments by relatives on his size should be discouraged.

Sleep

Give your child the opportunity to obtain the average amount of sleep. It will not hurt to keep him up once in a while on special occasions, but do not make a habit of depriving children of the sleep they need just to suit your own convenience. Try to provide a reasonably comfortable place where he will be relatively free from being disturbed by household noise. Even more important, you should provide a proper attitude as far as sleep is concerned.

Sleep should not be a major problem. If there is any trouble, do not decide your child is being bad; try to find and eliminate the cause of the difficulty. For example, your child may at some time be afraid of the dark. A dim light or the door left open just a little will often help. A cuddly doll or teddy bear may be comforting company.

Children usually go to sleep more readily if the evening meal is a simple one, and they are not too stimulated at bedtime. A tapering-off period of quiet relaxation, perhaps a soothing story, are helpful.

Do not put a child to bed as a punishment. Be fair and considerate; make going to bed as pleasant as possible, but also be firm about it.

Eating

Similarly, eating habits often become an issue in the household. Self-regulation, usually gets a baby off to a good start, but at some time or other most children fail to eat as well as their mothers would wish. I advise mothers to place the food before their children and remove it without any comment if they do not eat it. They are usually ready for it by the next meal.

If a child is a poor feeder, either regularly or at certain stages of his development, the mother should calmly go about discovering the circumstances under which he eats best. Often being alone where he will not be distracted helps. Sometimes he does well with very small portions, or food that is easily chewed, or food that is easy to manipulate. Sometimes he prefers to be fed, even though he is old enough by the timetable of ‘averages’ to feed himself. Sometimes, especially if he is restless, teething, or overtired, it helps if you read one of his favourite stories to him while he is eating.

In regard to eating (and sleeping), remember:

1. Do not worry. Children do not starve themselves. Some carefully controlled investigations have shown that even very small children who are allowed to choose their foods select a reasonably well-balanced diet. They do not eat ice cream and sweets only.
   
2. Feeding problems are often problems that involve something other than, or in addition to, eating. It is best to discover what they are and solve them, but if you cannot, a general atmosphere of love and relaxation will help.
   
3. Your child is not the ‘average child.’ He may eat less or more because that is what he needs.
   
4. Your child grows and changes. At one time he may eat or sleep well; at another time, he may not. Most children eat less in hot weather, in teething periods, and during the second year of life.
   

*188\68\2*

YOUR PERSONAL HEALTH INVENTORY: CHECKING-UP ON YOURSELF

By regularly scheduled medical check-ups, you can be sure of discovering most serious illnesses before they have gone too far. By learning the danger signals, you will catch many diseases before they get under way.

However, some diseases may appear between check-ups and advance quite seriously. Thai is why I recommend a second line of defence in your health programme: your personal home medical check-up. Combined with your regular visit to the doctor, a few minutes spent once every two months on this health inventory will he an additional safe guard for your health. It would be wise to make a note on your calendar to look at this chapter on the fifteenth day of every other month.

If the answer to any of the following questions is Yes, you should see your doctor as soon as possible at his surgery. If you have a perfect score of No, the chances are reasonably good that your health is satisfactory, and that you can wait until your next scheduled periodic health examination—but no longer—before seeing your doctor. These symptoms may arise from mild or serious conditions; let your doctor make the correct diagnosis for you.

Have I noticed a sore on the skin, lips, or tongue which does not heal within a reasonable period of time?

Do I get short of breath when walking on level ground or climbing stairs or performing other types of exertion which did not bother me in this way previously?

Am I troubled with indigestion, nausea, abdominal pain or cramps, or the sudden appearance of constipation or diarrhoea?

Have I noticed that there is blood in my bowel movements?

Am I steadily losing weight? Or am I steadily gaining weight? Is my weight under or over the average weight for my height and build?

Am I getting nervous, irritable, or depressed? Have I been having crying spells? Do I have a persistent feeling that people are against me? Do I feel a nervous breakdown coming on?

Do I feel tired or run-down? Do I have a new persistent pain or any other new symptoms?

Has my skin colour changed? Am I unusually pale?

Have I a cough that has been lasting longer than one month? Have I coughed up blood?

Have I had persistent hoarseness?

Have I had any dimming or fogging of vision?

Have I had any persistent headaches?

Have I felt any discomfort in my chest without obvious cause?

Have I noticed swelling in my feet or ankles or both?

Have I had any prolonged aches in my back or limbs or joints? Special questions for women

Have I noticed vaginal bleeding at unexpected times?

Am I troubled with hot flashes?

18    Have I felt a lump in my breast, or have I been worried about cancer
or tumours there or in any other part of the body? Every woman
reader of this book should see page 331 about how to examine the
breasts for cancer without becoming a victim of worry or fear.

Special questions for men

Has my urination been abnormal recently—difficulty in starting or stopping, any dribbling, and so on?

Am I ruptured, or do 1 think-1 may be?

Could I have contracted some illness while in a foreign country?

Am I worried about having a venereal disease?

*134\68\2*

DENTAL CARIES

The part of the tooth called the crown lies above the surface of the gum and is covered with a coating of enamel. Fortunately, this is thickest on the grinding surface, where it wears down from use. The part of the tooth called the root that lies within the jaw is covered with a thin, bone-like layer—cementum. Beneath the enamel lies the resilient, leathery dentine, covering the pulp chamber, and running from the chamber is the root canal. The root canals contain blood vessels and nerve fibres.

It is important to realize that dental caries is a disease, not a mysterious rotting of the teeth that must be accepted fatalistically. Dental caries always starts on the outside of the teeth, in the enamel, with a pinhead-size collection of bacteria and food.

It is generally believed that most of these bacteria thrive best on starchy and sugary foods, which they change into lactic acid. Although tooth enamel is the strongest material in the body, able to withstand enormous biting pressures, lactic acid quickly and permanently dissolves it. Eating minute pits and furrows into the surface of the tooth, the acid opens up new territory for the bacteria. Soon they reach the softer, richer dentine, where they grow faster and spread rapidly. They proceed into the root canal, attacking the nerves and causing great pain. Infected pulp and decaying teeth make excellent breeding places for bacteria. They can cause localized abscesses, and may even enter the bloodstream to spread their poison to various parts of the body.

*78\68\2*