Chamomilla. The child is exceedingly troublesome and must be carried up and down in order to be relieved.
China. In cases threatening to become anaemic, with diarrhoea or lienteria.
Cina. The child bores with its fingers in its nose; is very fretful so that nothing pleases him; the urine turns milky on standing; colicky pains, &c.
Coffea. In some cases of extreme wakefulness it may aid in bringing out the eruption, where from the predominance of the symptoms of nervous excitement over those of sanguineous excitement, it may appear indicated, rather than Aconite.
Conium. In cases where the parotid and submaxillary glands are swollen and hard as a stone; the lips and teeth are covered with black crusts; the skin is hot; and the patient delirious or senseless.
Cuprum acet. When repercussion of the eruption, or metastasis of this disorder to the brain, has occurred, and there are convulsions, vomiting or gagging; face pale and twitching. N.B. Under such circumstances but little hope of benefit from any medicine can be entertained; but this remedy has been known to restore the eruption, even though it did not save the life of the patient; may it not prove useful, in advance, where the suspicious, transitory nature of the eruption gives reason to apprehend that it will recede and thus cause convulsions?
Dulcamara. This remedy may be called for when suppression of the eruption has been caused by exposure to cold and damp air, unless some particular symptoms should require another medicine.
Ipecacuanha. Constant nausea and occasional vomiting.
Lachesis. Scarlatina maligna, with external swelling of the neck, and glands, and great sensitiveness of those swollen parts.
Nitric acid. This remedy resembles Nux vomica, only there is more dryness of the mouth.
Nux v. The mouth and fauces are full of small, fetid ulcers; the mouth is very sore, with flow of bloody saliva, and difficult deglutition.
Opium. When the brain seems oppressed; there are extreme drowsiness, stertorous breathing, vomit, &c.
Phosphorus. Indicated when the eruption suddenly disappears without apparent cause.
Rhus t. When the rash itches violently, and there is much restlessness at night; or when there is an ichorous or yellow thick discharge from the nose, with swelling of the glands in the throat.
Silicea. Suppuration of the glands. See Scrofula.
Sulphur. In psoric constitutions, liable to eruptions. The rash is intensely hot and itching.
DROPSY AFTER SCARLET FEVER.
The most common of the Sequelae of scarlet fever, is the dropsy, thence called post-scarlatina dropsy. While this affection is remarked to succeed as often to the mild as to the severer forms of scarlatina, it has never been observed to supervene in cases of scarlatina maligna. It is in these milder cases of scarlet fever that this sequela forms a disorder more dangerous than the original affection.
The dropsy appears first in the face, eyelids, hands and lower extremities; but gradually becomes a complete anasarca; and if not arrested in it progress involves the different serous cavities. In these latter it may cause copious effusion, a condition more or less imminently dangerous according to the particular according to the particularly cavity which is thus affected.
The post-scarlatina dropsy generally comes on in ten or twelve days from the disappearance of the rash; but its approach is sometimes earlier and sometimes later. The appearance of this disorder, in some cases, may be announced by a certain paleness of the countenance, increasing languor, loss of appetite, furred tongue, costive bowels, scanty and turbid urine, and considerable gastric disturbance. But in the majority of cases the dropsical appearance in the face attracts attention before any complaint is made of the other symptoms. The swelling beginning on the face and hands, may be confined to these parts; but in most instances it gradually extends till the whole body becomes oedematous. A puffy, or swollen appearance in the lumbar region, over the kidneys, should be regarded as indicating a very serious form of the disease. So long as the dropsical effusion is confined to the subcutaneous cellular tissue there is little immediate danger; but when the effusion has taken place into the cavity of the abdomen (Ascites); into the cavity of the chest (hydrothorax); or into the ventricles of the brain (hydrocephalus internus), the danger will be very great; and successively greater in a constantly increasing ratio, in these successive states. In the last mentioned stage of the dropsy, that in which the head has become involved, we find drowsiness, coma or convulsions. These fatal symptoms may result from the simple pressure of the effused fluid in the ventricles upon the cerebral substance; from uraemic poisoning, the result of a suspension of the function of the kidneys; or from the combined influence of both these causes.
The condition and appearances of the urine are very strongly marked and important in this disorder. In the milder cases, the urine will usually be found albuminous; this condition may be detected by boiling, or by the addition of a little nitric acid. “If the attack be more severe, the urine, which is very scanty, is of a brown or smoke color, deep red, or coffee colored, and throws down a deposit chiefly of a reddish brown color; which however does not entirely disappear when heated, while albumen is present in it in extreme abundance. It is to the presence of the coloring matter of the blood that this dark hue of the urine is to be attributed; but in some instances blood is present in great abundance, and for a season the case is strictly one of haematuria. Usually, though not invariably, the presence at any time of a large quantity of blood in the urine indicates a very serious disturbance of the functions of the kidney, and forebodes a slow and imperfect convalescence. On the other hand, an extreme degree of anasarca and haematuria are by no means generally associated; nor does the complete disappearance of the blood from the urine constantly imply a corresponding improvement in the patient’s general condition. West. Urine copious and red as madder dye may be a critical symptom of convalescence, under the severe and aggravating action of large doses of Homoeopathic medicines. See Am. Hom. Review, vol. ii., pp. 337 and 433, for detailed cases of this disease.
The cases of scarlatina dropsy are usually supposed to be found in some undue exposure to the air, or in some similar influence of a change of the weather upon the tender skin. The desquamation of the cuticle itself, by interfering very considerably with the excretory action of the skin, if not for the time totally suppressing it, no doubt throws upon the kidneys a double burden; a burden greater than they can bear; hence the serous accumulations in the cellular tissue and subsequently in the great (serous) cavities of the body. With this the constitution, as psoric or otherwise, of the individual patient, has doubtless much to do. And since this sequela make its appearance only after the milder, and not after the malignant cases of scarlet fever, it is supposed by some that it constitutes an ultimate and necessary development of the poison which had not been sufficiently eliminated by the eruption upon the skin and by the accompanying affection of the mucous membranes. But however this may be, there can be no doubt that in most cases the careful treatment of the original disorder with the appropriate Homoeopathic remedies, especially the antipsoric, will almost entirely remove the disposition to the subsequent dropsy. Yet it should not be forgotten in this connection, and it may be offered in support of the above mentioned opinion that the post-scarlatina dropsy is but an after-part of the original fever in some cases, that some epidemics of scarlet fever are remarkably characterized by a disposition to be followed by dropsical effusion.
Treatment. This affection, except in the very last stage when not only has the worst form of effusion taken place, but when even the kidneys themselves have already become disorganized, yields to the Homoeopathic remedy in the most grateful and admirable manner. This assertion will be seen to be amply sustained by examining the cases reported in the Homoeopathic Review, referred to above. The medicine should be carefully selected in accordance with all the symptoms, and if the true simile be not found among those indicated below, compare also those given in a subsequent chapter under Hydrocephalus; or administer, without hesitation, any remedy called for by the characteristic symptoms of the case, for these latter belonging exclusively to the idiosyncrasy of the patient may be different from any before observed in other cases.
Arsenicum. General anasarca of a waxy paleness. Thirst for water in small quantities but very frequent. Great restlessness, particularly after twelve at night.
Apis m. Very scanty urine. Waxy paleness of the feet and legs, which are much swollen.
