Cina. 3.
–Delicate children troubled with worms, or in the habit of wetting the bed; spasms of the chest, followed, by rigidity of the limbs or whole body; itching at the nose and anus.
Opium 3.
–Convulsions caused by fright, and attended with much trembling over the whole body, tossing of the limbs, and loud screaming during the fits; when the child lies conscious as if stunned, or breathes heavily and with difficulty; distension of the abdomen, no stool or urine passed.
Hyoscyamus 3.
–Convulsions from sudden fright; twitching of muscles of face and foaming at the mouth.
Stramonium 3.
–Convulsions coming suddenly from fright, or, when occurring in fevers from repelled eruptions, with tossing of the limbs, and involuntary evacuations of faeces and urine.
Sulph. 6.
–Convulsions from repelled chronic eruptions.
Squinting.–This condition (which is due to loss of power of one or other of the muscles of the eyes, causing them to turn inwards or outwards, as the case may be) is commonly met with in children, and arises from a variety of causes. It is often due to worms. Association with other persons who squint will sometimes cause it. It follows fever at times. It may be due to position of the light with regard to the child’s bed: if the light is always on one side of the bed. It is often an inherited condition. If the condition is not recovered from, the patient habitually only uses one eye, and thus the other loses its seeing power, and by degrees becomes blind. This is a relief; for if the patient saw with both eyes, the focus of the two being different, he would never have a clear image.
General Treatment.–In many cases squinting is cured spontaneously–the child “grows out of it,” as it is said. But this must not be trusted to, and if it persists any length of time, active treatment should be adopted. During sleep the light should be in front of the child–that is, the feet should be towards the window. If this cannot be managed, a screen must be placed at the light side of the bed. During the day the eye which is unaffected should be bandaged, thus compelling the child to use the weaker eye properly. When both eyes turn outwards, put bits of black court- plaster on the tip of the nose: if both turn inwards, put “blinkers” of shining silk on each side of the head.
Medicines.–(Night and morning.)
Belladonna 3.–When there is great heat of the head.
Cina. 3.–When due to worms.
Rhus 3.–After scarlatina.
Gelsemium 3.–Squint from other causes, where the eye turns inward.
Teething or Dentition.–During the period in which the teeth are making their way through the borders of the jaws and the gums children are in a more or less precarious state of health. They are nervous, restless, and irritable, and are much more liable to suffer from nervous or other derangements that at ordinary times. There is often fever and sometimes convulsions; diarrhoea is also frequently met with. There is difficulty in sucking; the child is apt to bite the nipple suddenly. There is a constant flow of saliva from the mouth.
There are twenty teeth in the first set. The two middle (incisors) lower teeth usually appear first, at about six months old. Then the corresponding teeth (middle incisors) in the upper jaw, at about seven months. Very soon after these come the two lateral lower incisors, and after these the lateral upper incisors, the eight incisor teeth being complete about the ninth or tenth month. After this there is a pause of about two months. In the twelfth or fourteenth month the first four jaw-teeth (bicuspids), two below and two above, are cut; and soon after these, and springing between the latter and the outer incisors, the four eye-teeth or canines. This leaves only the four back- teeth (molars or “grinders” proper), which are cut at two or two and a half years.
There is often great irregularity in the times of appearance of the teeth. Some children are born with teeth, and some do not get any till they are more than a year old.
General Treatment.–Healthy children who are well cared for need not suffer at all during the period. The effect of teething is to put the child into a state in which he is very susceptible to disease, rather than to induce actual disease. The salivation and looseness of the bowels (provided the latter be not excessive) need not be regarded as diseases. The mother or nurse should pay great attention to her way of living, and avoid all indigestible or stimulating foods and drinks, especially spirituous and malt liquors. The child must be nursed at regular times, the nursery must be well ventilated, and whenever the weather is suitable the child must be taken out into the open air. Lancing the gums may be resorted to at times in children who are weak and irritable. It should only be done when the tooth can be felt, and the cut should be made down through the gum to the point of the tooth.
Medicines.–(Every two or three hours; oftener or less often according to the urgency or otherwise of the symptoms.)
Aconite 3.
–Fever, with much restlessness, sleeplessness, and pain, the child crying and starting.
Belladonna 3.
–Convulsions; the convulsion is followed by sound sleep, which continues for a time, or until another fit comes on. The child starts suddenly from sleep as if frightened, and looks around as if terrified; pupils large, eyes fixed, the whole body becomes stiff; burning heat in palms of hands and temples.
Chamomilla 6.
–The most useful of all medicines in teething. Child very uneasy at night; tosses about; wants drink often; wants to be constantly carried about; spasmodic jerks and twitches of the limbs during sleep; starts at slightest noise; general heat; redness of one cheek, or of the eyes; moaning; agitation; short, quick, noisy breathing and oppression of the chest; hacking cough; mouth dry and hot; diarrhoea, with watery, slimy, and greenish stools, worse at night.
Ignat.
–Child arouses from light sleep with piercing cries, and trembles all over; frequent flushes of heat, followed by sweat; convulsive jerkings of single limbs.
Cina. 3.
–Wetting the bed at night; grinding teeth; rubbing the nose; hard, distended abdomen; hard, dry cough.
Ipecac. 3.
–Nausea and vomiting, with diarrhoea; stools are mixed of different colours.
Mercurius 6.
–Copious salivation; red gums; green stools, with straining.
Calcarea c. 6.
–Teeth slow in appearing; especially suited to fair children inclined to be fat.
Sulph. 6.
–Stools whitish, or hot and sour-smelling, excoriating the part.
Urine, Retained.–One of the first things for the nurse to observe is whether the child passes water properly. It not infrequently happens that the water is retained, and the doctor’s attention should at once be called to the fact.
General Treatment.—The common cause of retention is a narrow foreskin, and it may be advisable to have the operation of circumcision performed. When the cause is not mechanical, medicines will generally give relief. These may be given until medical help can be obtained.
Medicines.–(Every twenty minutes until relieved.)
Aconite 3.
–To begin with.
Pulsatilla 3.
–If Aconite fails after a few doses.
Opium 3.
–If required after these.
Vaccination.–Vaccination is the operation by which the disease called “vaccinia,” or cow-pox, is communicated either to human beings or animals. There is a good deal of obscurity surrounding the question of the origin of the present supply of vaccine matter, and whether it is cow-pox, or horse-pox (as maintained by Jenner), or merely modified small-pox, the author cannot undertake to decide. But whatever its origin, inoculation with vaccine matter induces the disease now known by the name. This disease is characterised by the appearance a few days after inoculation of redness and swelling at the point where it was done, the development of a vesicle which becomes a pustule, swelling of the lymphatic glands in the neighbourhood, and swelling of the limb. These symptoms are attended with fever, varying in intensity and amount, and other constitutional symptoms, such as loss of appetite and disorder of the stomach.
Generally, the acute symptoms subside in a few days, the pustules dry up, a scab forms, and, in three weeks after the inoculation, falls off, leaving the characteristic scar. But this is not always the course of the disease. Occasionally, instead of the ordinary vesicle and pustule, a hard ulcerating sore is formed, which lasts much longer than the ordinary time. Sometimes a general eruption something like small-pox may come out as well as the vesicle at the part vaccinated. A more common occurrence then either of these is a great increase of redness which always surrounds the vesicles when the inflammation is at its height. The whole limb may become red and swollen, and this may extend beyond the limb. The inflammation may spread to the chest from the arm, and then the condition is one of great danger. When the lungs are attacked, and bronchitis develops under these conditions, the child rarely recovers.
Cow-pox is a blood diseases, and, like all blood diseases, is liable to leave effects behind it when its proper symptoms have passed away. The chief sequelae (as the remote effects of a disease are called) of vaccinia are an alteration of the constitution, which is met with in some patients after vaccination, rendering them less strong and more liable to catch ordinary complaints, and more severely affected by them when they do catch them; and a very obstinate kind of eczema. The risk of contamination with other human blood diseases may be a certain extent avoided by using only calf vaccine. This, however, may transmit diseases of animals; and as the vaccine with which the animal was inoculated may have been derived remotely from a human vaccinifer, there remains still some risk of human contamination. In my opinion vaccination does frequently render a person less liable to be affected with small- pox, but the protection is not anything like absolute, and vaccinia itself is a serious disease. So serious a disease is it, and so great are the risks attending it that no one ought to be compelled to undergo it, or to have his children vaccinated against his will.
