In children who are naturally predisposed to cerebral disease, the tendency of the whooping cough may be to assume a still more strongly-marked convulsive form. According to Watson, “when the disease occurs within the first two years of life, it is usually attended by convulsions; and many more die within those periods than afterwards. And it is in this direction especially that the Homoeopathic treatment will be found remarkably valuable. The remedies greatly moderate the violence of the disorder, even if they do not at once remove it; and by thus shortening its paroxysms and rendering them less frequent and severe, the little patient’s strength is saved. And the remedies carefully selected to meet the particular indications of each individual case, at the same time that they preserve the strength as much possible; and prevent the disease from assuming its most violent form in general, hinder also its particular development and complication in new forms of pulmonary or cerebral disorder. In the treatment of this affection, therefore, the Homoeopathic physician should not expect to find in any remedy, however highly lauded, a complete specific. Still less should he seek to compel the disorder to succumb to the massive doses of any such remedy. Let him be satisfied to prescribe for his patient, and adapt as accurately as possible the remedy to the existing conditions. A little extra pains taken in this direction, in the first visit, in ascertaining the totality of the symptoms, and in finding the true Homoeopathic similimum for them, in each case, will save him a world of trouble in the end. In some epidemics of whooping cough, the remedy which is thus found suited to the genus epidemicus, in one instance, may also apply in many other cases, but not absolutely in all; since always and in every instances, the medicine must be made to suit the individual patient, rather than the general form of the prevailing epidemic disorder.
Aconite. If a constant febrile condition seems to prevail, or if the patient grasps as its throat with every cough, as if it were in pain.
Arnica. When there is great prostration with waxy paleness and coldness of the skin.
Belladonna. The child gets very red in its face with every coughing spell; or the cough has produced such congestion as to cause the sclerotic to appear as one gore of blood.
Bryonia. Cough worse after eating or drinking, with vomiting of the ingesta.
Carbo veg. Great exhaustion after every coughing spell, with blueness of the skin, hot head and face.
Causticum. A dry cough remains a long time; it does not get entirely well.
Chamomilla. The cough is dry; the child is very fretful; must be carried in order to appease it; one red cheek.
Chelidonium. When a very loose, rattling cough remains a long time, and does not improve any more.
Cina. The child picks its nose much; or gets perfectly rigid in every coughing spell; ravenous hunger.
Coccus cacti. Every coughing spell is terminated by spitting of large quantities of ropy mucus.
Conium. When violent fits of coughing occur, mostly through the night.
Coralium rub. In some forms of violent spasmodic cough. “Firing minute guns of short, barking cough, all day; and for half an hour or so toward evening increasing to a violent spasmodic paroxysm. (*Dr. Richard Hughes, Brit. Jour. of Hom. No. CL., p. 501.)
Cuprum. With every paroxysm, the child coughs itself into a cataleptic fit;it appears as if it were really dead.
Drosera. When the child is worse particularly after twelve at night, with high fever; cough in violent spasmodic spells as if it would suffocate; sometimes bleeding at the nose and mouth.
Dulcamara. The child is made worse by the changes of the weather from warm to cold; or by exposure to cold damp air.
Ferrum. Vomiting of the ingesta after every cough.
Hepar. When the cough seems complicated with croup; worse towards morning; the cough sounds croupy, and it seems as if the patient would choke.
Hyoscyamus. The cough is always worse as soon as the child lies down; and is relieved by sitting up.
Ipecacuanha. Strangling with the cough, till blue in the face.
Kali carb. Sacculated swelling over the eyes.
Kali bichromicum Choking cough and spitting out tough, stringy mucus, which sticks to the throat, mouth and lips.
Lachesis. The child always awakens in a coughing fit; it seems very faint and weak.
Mephitis p. In some forms of spasmodic cough, this remedy is a specific.
Mercurius. The child sweats very much at night; and bleeds at the nose and mouth with every coughing spell. Either by day only, or by night only, it has always double coughing spells, which are separated by an interval of perfect rest.
Nux v. Hard dry cough with constipation; worse after four o’clock P.M. The child becomes blue in the face, and bleeds at the nose and mouth.
Phosphorus. Much hoarseness; almost total loss of voice from the effects of the cough.
Pulsatilla. Cough very loose, with vomiting of mucus; diarrhoea; worse at night.
Sepia. The cough is always much worse in the morning, when it is loose and terminates in an effort to vomit.
Silicea. May be useful in Vermiculous subjects, in whom Cina does not answer.
Sulphur. There are frequent relapses without any known cause, or where the cause consists in exposure to cold in scrofulous subjects. Sulphur is specific in a sort of suppressed cough, dry, suppressed cough, dry, suppressed, and choking.
Squilla. During the cough the child sneezes, waters at the eyes and nose; the child constantly rubs its eyes, nose and face with its fists during the cough.
Veratrum. After every fit of coughing, the child falls over exhausted, with cold sweat on its forehead.
ASTHMA OF MILLAR.
Under the names of Asthma of Millar; Thymic Asthma of Kopp; Laryngismus Stridulus; Child-crowing; Spasm of the Glottis; Spasmodic Croup, and False Croup, different authors have described an affection peculiar to infants and very young children, which is not indeed very common, but which for this reason, from its apparent resemblance, is apt to be confounded with croup.
The difficulty consists essentially in spasm of the glottis, which impedes respiration and occasions sonorous dyspnoea. “Spasm of the glottis occurs in paroxysms of varying intensity, according as the glottis is partially or entirely closed. The milder attacks are characterized by a short attack of dyspnoea, difficult and often sonorous inspiration, as in apnoea, accompanied by restlessness and anxious expression of the face; such attacks are first often unnoticed, as the health of the child does not appear affected in the intervals. A trifling mucous rattle in the larynx sometimes precedes. In the more violent paroxysms the apnoea approaches to suffocation, and the respiration is interrupted for seconds, and even for one or two minutes. The eyes are wide open and staring, the face becomes livid and cadaverous, the alae nasi and the muscles of the neck act violently, the arms are stretched out and rigid, asphyxia appears unavoidable, when at last the air penetrates with jerks and with a sonorous tone, and the paroxysm closes with a fit of crying and sobbing. Romberg, Diseases of the Nervous System, I. p. 331. These attacks may terminate with a loud sonorous inspiration; or by a long, deep-drawn inspiration, with a crowing noise. This particular mode of termination will be seen to be characteristic, and diagnostic of this affection from croup; in which no such distinct remission of the dyspnoea can be recognized, at least not in true membranous croup.
Dr. Levy, in his very able treatise on this disorder, An Essay on Laryngismus Stridulus, by Hugh Ley, M.D., London, 1836. gives the following still fuller resume of its symptoms: “The essential symptoms then of the laryngismus stridulus are, sudden attacks of breathlessness from partial or total obstruction to the admission of air into the windpipe, varying according to the degree of closing of the glottis, and commonly succeeded, or at all events attended, by a sonorous inspiration. Where the closure of this chink is not perfect, the child struggles for its breath, the respiration is hurried, the countenance generally bluish or livid, a the eyes staring; and each inspiration is attended with a crowing noise; where it is more complete, and this state at the commencement of the paroxysms, according to my observation, is much more frequent, the function of respiration is entirely suspended for a while, there is an effectual obstacle to the admission of air, the child makes vehement struggles, by some termed convulsive, to recover its breath; at varied intervals, from a few seconds up to a minute, or, upon some occasions, nearly two minutes, air is at length admitted through the glottis, now partially open, and the rush of air passing through a very narrow chink produces the peculiar sound. To these symptoms not unfrequently succeeds a fit of coughing or crying, which terminates the scene; or, if the glottis be not even thus partially open, the child, at the end of from two to three minutes, at the utmost, will die of asphyxia; pallid and exhausted, it falls lifeless upon the nurse’s arm, and it is then that the child is generally said to have died in a fit.
