PEDIATRICS Vol. 48 No. 4 October 1971, pp. 600
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MANAGEMENT OF A CHILD IN A STATE OF FEVER ACCORDING TO DR. G. ACKERLEY OF NEW YORK CITY IN 1836

T. E. C. Jr. M.D.

Childhood fevers have always alarmed parents but perhaps even more so before the advent of modern medicine or the development of the clinical thermometer. In the 1830's when Dr. Ackerley offered the advice below on the management of a febrile child, most parents, as well as their physicians, considered fever a disease rather than a symptom. Dr. Ackerley wrote:

A child in a state of fever should be kept cool, but not cold. It should lie on a soft mattrass (sic), over which a few folds of a blanket and a sheet may be laid. Feather beds envelope the child too much, and in warm weather prevent the extra heat generated from passing off. The coverings should be light, as great injury is done by too much covering. The child should be frequently examined, and the covering added or removed according to its state at the time. The head of a child should be particularly attended to, and when hot and the seat of disease, should be kept as cool as possible. For this purpose the cap should be removed; and if there be much hair, it should be cut off close, in order that the cool air may come in contact with the skin. The feet and hands should be kept sufficiently warm. If the child be very hot and thirsty, its drink should be pure cold water, or very weak tea: its nourishment gruel or arrow root-milk should be avoided: even its mother's milk is improper in the quantities generally allowed to be taken.