Then I think the next thing about them is the thing that comes out on your questioning; you will be told that mostly these children are definitely irritable, and their irritability is pretty characteristic; they will go along perfectly happily, playing with others kids and they will suddenly, apparently for no reason, break out into violence; very often they are playing perfectly happily with a brother or sister and they suddenly pick up something and smite them. It is that sudden, impulsive irritability that is the typical Iodine mental characteristic. Then you very often find that after an attack of irritability like that the kid is horribly depressed, not weepy but just silent, depressed, rather losing interest in things.
Then the next thing that you will get from the parents mostly is that these kids almost always have inordinate appetites; they are hungry for their meals, and they are hungry between meals. They get absolutely exhausted if they go too long without a meal, and are very liable to get hungry headaches.
Then all these Iodine children are very sensitive to heat, and it is heat of any kind, hot rooms, hot sun, hot fire, hot baths, heat in any form aggravates the typical Iodine child.
Then you practically always get a history that these children are eating well and yet they cant ever be fattened, they remain thin, they may actually be losing weight.
And very often you will get in these Iodine children a rather inactive skin. They are very liable to get attacks of acute infection of their nose, with a tendency to spread into the frontal sinuses, and if they get such an attack they will get an irritant, watery discharge, a feeling of obstruction at the root of the nose; very often there is actual swelling at the root of the nose, and it is tender on pressure.
And very often with that coryza you will get a very hot discharge, a tendency to sneeze, and with the discharge you always get very watery eyes. You very commonly get a history of repeated attacks of that sort, and then following one of these attacks a development of typical asthmatic breathing; and if you get one of these thin children with a good appetite, with that sort of history, and the asthma is definitely better in the open air, you can very often clear it off with Iodine.
Then, as you would expect, with that kind of extending catarrhal infection, you very often get these Iodine children with a degree of deafness, and it is usually associated with a chronic eustachian catarrh.
Then another thing that you often come across in these Iodine kids that type, where they are getting catarrhal infections, is an involvement of their larynx, they are very often hoarse, and they have a painful larynx, which is painful on pressure. And with their laryngitis they are very apt to get acute croupy attacks which are extremely painful. And one of the distinguishing points about their croupy attacks is that they get very hot, and they have an intensely hot, dry skin.
And very often in these croupy attacks the kid is terrified. You are rather liable to mistake them for an Arsenical croup; there is the same feeling of heat, burning in the larynx, thee is the same kind of choking feeling. But your Arsenic kid is chilly; the Iodine kid is hot and wants air. The Arsenic will perspire a bit; the Iodine kid will be dry and hot.
Then another common disturbance in these Iodine kids is a digestive disturbance. They have got abnormal appetites, they are very liable to get all sorts of abdominal disturbances, and most of these abdominal disturbances are associated with very typical diarrhoeic attacks, with very frothy, fatty, whitish stools. You may get that associated with an abdominal Tabes, enlarged mesenteric glands; I have seen it associated with pretty general enlargement of the liver and spleen without any very definite blood change. You may get it associated with definite pancreatic dysfunction, with the typical pancreatic fatty stool, and you may get definite glycosuria.
Well, that is the one common disturbances that you meet with. There is another that you quite commonly meet with in the Iodine child, particularly the Iodine children with a fair amount of colour, they sometimes have quite bright red cheeks, and in these highly coloured Iodine kids you are very liable to get rheumatic symptoms. It is usually pretty acute rheumatism, pretty violent pains which are more comfortable for moving, and are very much worse from heat. The pains are usually very definite sharp, stabbing pains in character, and I have seen two Iodine rheumatisms who got a definite dry pericarditis with very acute sharp pericardial pain.
There is one thing about the pericardial cases which is apparently a contradiction to the ordinary Iodine restlessness and relief from motion in their chest pains they have an aggravation from moving, the pains are brought on, they are made more acute, by movement. And if you thing of the rather dark skinned, flushed type of patient, rather depressed, with sharp, stabbing pains which are worse from motion, you are awfully apt to confuse it with a Bryonia case.
They are both worse for heat, but you dont get the typical Bryonia tongue in the Iodine patient, and you dont get the intense thirst as a rule. And most of the Bryonia cases are rather more dull, heavy, and the Iodine patients are apt to be more mentally alert. You will practically always have a complete aversion to food in the Bryonia ones, and you very often have a surprising amount of hunger even in the acute Iodine conditions.
I think that pretty well covers the typical Iodine child, sand you see it has a certain amount of similarity to the Bromine child but you are dealing with an entirely different type of child, and yet if you just contrast the various symptoms they are very much alike, but once you spot the child the type of child you cant ever confuse them. You can very easily confuse it with Sulphur, but you dont usually get the intense irritability of skin, the intense itching, that you almost always get in a similar type of Sulphur.
There is one other thing that I have seen crop up in Iodine in these rheumatic cases, and that is that you quite frequently get a history of an acute diarrhoeic attack immediately preceding the rheumatic attack.
Then, the next drug I want to touch on is ABROTANUM, and I only want to touch on it. I think the reason why I only want to touch on it is that I dont know an awful lot about it, but there are one or two conditions in which I have found it immensely useful. I think the clinical picture that always stands out in my mind as characteristic of the Abrotanum small baby is quite characteristic. It is the picture you get with a congenital pyloric stenosis. In other words, you have got the child who is emaciated, with a deadly hydrated skin wrinkled, you can pinch it up and it does not return to its normal state.
It has an inordinate appetite, because it is vomiting all its food. It is hungry all the time: probably has a comparatively big abdomen and spindly legs, it is always cross and peevish because the poor little devil is being starved. It is usually chilly, and it is very often sensitive when handled, it is tender to touch. I think that is the typical small Abrotanum baby, and in these you not infrequently find a delay in the healing of the umbilicus after the cord has dropped off again lack of vitality, lack of nourishment probably. I have seen three of these now, who either had a pyloric stenosis or spasm, who got perfectly well on Abrotanum.
And I know another who had pyloric stenosis who lost all his symptoms for a period of our weeks after Abrotanum, then relapsed and was operated on and had a typical pyloric stenosis and completely recovered. So whether the others were really a spasm, not true stenosis, I cannot tell you, but I have seen three in whom I had given a diagnosis of pyloric stenosis and they did recover, and that is the type of small baby that I look on as typical Abrotanum.
There is another older type of Abrotanum child that I do recognize, and that again is a hungry child, a child with an inordinate appetite, and again it is a thin child, but it is always a child who has tendency to recurring attacks of diarrhoea, usually attacks of diarrhoea alternating with rheumatic pains, and always with a certain amount of numbness in the hands or feet or legs; you very often get the statement from the parents that they cant trust the child with any valuable china or it will knock it over or drop it in other words, it is verging on a chorea.
They are usually rather peevish, bad tempered kids, and you very often get a history that they have got a strangely cruel streak in their make up. Then these kids are definitely chilly; they are not like the other drugs I have mentioned, they are aggravated by cold, and they are aggravated by damp, and their rheumatic pains are liable to be very much worse at night than during the day.
Well, as I say, I do not know very much about the drug but these are two sides of it which I have seen and which are very useful. I cannot tell you any more about it but it is one of the drugs that is very difficult to spot, and it is difficult to remember, and yet it has a very definite clinical picture if you get it.
