Rhus t. Has cured several cases under my care; a greater number than any other remedy.
Sulphur. May also be studied when it appears to correspond to the disposition of the patient, and to the cause of the disease.
Thuya. When the tumor is decidedly of a blue color; or complicated with syphilis.
INTERTRIGO OR CHAFING.
Excoriation, soreness or chafing, frequently occurs in those parts of the skin of infants which are either rubbed together in the natural movements of the limbs, or liable to be fretted by friction of the diaper or other articles of clothing. Thus the groins, the surfaces between the genitals and the thighs, between the nates, behind the ears, the axillae, and even the folds of the neck in fleshy children, may become the seat of these excoriations.
Such tenderness of the skin is due in the first instance, in great part at least, to psoric dyscrasia in the constitution; and for its complete removal it will require therefore a suitable antipsoric remedy. But this original disposition to such excoriation will be greatly increased by want of proper attention to the state of the skin, and by neglecting to removed as soon as possible all those excretions form the bladder and bowels and form the skin itself which, alone are capable or originating such irritations and of causing them to proceed to ulceration. Very fat children are particularly liable to be troubled in this manner.
Directly contrary to the general custom, no powder, or other external application, should ever be used to keep the skin form chafing. It will be far better to pay strict attention to cleanliness, to wash clean and dry the skin carefully and as perfectly as possible with soft towels never using the first particle of powder. If the parts become very sore, omit washing entirely; use no external application of any sort whatever, not even linen; but with the greatest care select the most appropriate medicine.
Calcarea c. Will be suitable in leucophlegmatic constitutions; in very fat and fleshy infants.
Carbo vegetabilis If there is much rawness of the parts opposed; and a general disposition to excoriation, particularly in very warm weather.
Chamomilla. If the child is very irritable, cries much, and requires to be carries continually up and down the room.
Graphites. The affected parts discharge a quantity of transparent glutinous fluid; especially behind the ears, and between the thighs.
Hepar. The intertrigo seems to extend by means of pimples which arise just beyond the raw surface; these become involved in the excoriation, and new pimples appear a little beyond.
Lycopodium. The excoriation becomes offensive and bleeds much; worse after four P. M., and better after eight in the evening.
Mercurius sol. The excoriation is much worse at night, it is very raw and bloody; the child does not sleep much.
Pulsatilla, or Ignatia, may be indicated, and are recommended where much chamomile tea has been taken by the nurse.
Sepia. The skin is very delicate; the least injury tends to ulceration.
Sulphur. There is much itching of the skin in general, and of the parts affected.
INDURATION OF THE CELLULAR TISSUE. This affection is more common in foundling hospitals than in private practice; it chiefly attacks the children of persons suffering from impoverished nutrition; and usually appears in the first five or ten days after birth. The infants in whom the induration of the cellular tissue is developed are weakly and often premature; and difficulty is thought to result from imperfect expansion, atelectasis pulmonum, or from subsequent collapse, of the lungs. In many instances a livid redness of the whole surface is obvious form birth; but appearance of a circumscribed hard spot on one or the other extremity, or on some prominent part of the face, as the end of the chin, or the cheek-bone, is the first sign of the commencement of this affection. Other spots of a similar kind are soon discovered on different parts of the surface; and the body generally and the hardened spots in particular are found to present a temperature much below the natural warmth of the body. “The skin which covers the diseased part is slightly rose- colored, or purple, violet, or livid. IF the disease runs a rapid course, the temperature of the body decreases rapidly, the pulse is scarcely perceptible, the breathing becomes more and more labored, the child’s cries diminish and gradually cease altogether; the face becomes livid, and the little ones die as of suffocation, generally on the third day. Sometimes the disease is more chronic, and passes off again from the fourth to the eight day; but cases are exceedingly rare and under the old treatment most children die in a few days. Jahr.
In this country, as in Great Britain, this disease is comparatively rare; its occurrence in the ill-ventilated wards of foundling hospitals in large cities on the continent, especially in Paris, is more common. Jahr, who seems to have better opportunities for observing this disease than any other writer of our school, affirms that it is readily cured under Homoeopathic treatment; and he recommends Aconite, Bryonia, and Sulphur, to which may be added conium, Calcarea c., and Dulcamara.
INDURATION AND SWELLING OF THE BREASTS.
These little organs, in female infants, are liable to welling, inflammation, and induration, or suppuration, in consequence of the absurd practice in vogue with some nurses of squeezing them, on pretence that unless the milk is squeezed out of them they will subsequently prove useless for lactation. Such notions, remnants of old wives’ fables, and the fruits of erroneous views in physiology, cannot be too strongly discountenanced. But unless the physician is on the watch such things may be done; just as the nurse will incontinently pour a little “catnip tea” down the helpless infant’s infant’s throat, right before his face, and pretend to be surprised that he disapproves! Such a course of procedure as squeezing the child’s breast, should it result in suppuration, as is not unlikely, may, by causing structural disorganization of the gland, produce the very mischief it was intended to prevent. In these cases Hepar or Silicea, or even Phosphorus, may be needed. In the milder cases, where only the inflammation and swelling appear, the disorder must be treated with reference to its causes, and to the totality of the symptoms present..
Aconite. If there is much fever at the outset, this remedy may dispel the whole difficulty.
Arnica. If the breasts are merely hard, with no apparent inflammation, or if the redness has not yet appeared.
Belladonna. The inflammation is of an Erysipelatous kind; it runs in radii as it extends to the adjacent parts.
Bryonia. The breasts are quite hard, and of a pale red color.
Calcarea c. This remedy will be found indicated in some cases of leucophlegmatic temperament; with very large fontanelles, light, fair complexion, breasts hard but not red.
Chamomilla. The child is very fretful; it must be carried in order to be appeased; the breasts are very tender to the touch.
Hepar. Will be useful if matter or pus has already formed.
Silicea. This remedy will be needed sometimes, after Hepar, particularly to heal the ulceration.
CYANOSIS.
The patency of the foramen ovale, or imperfect closure at birth of the opening through which the blood in the foetal circulation had passed directly from the right heart to the left, was formerly supposed to occasion a partial mixture of the venous blood with the arterial. Hence the Cyanosis or Blue skin disease.
In cases of cyanosis there is a general bluish or blue color of the integuments; but it is principally marked in situations where the skin is delicate and highly vascular and in the extremities. The blue tint, when limited to certain spots, is a result of local congestion. A transient blueness of the skin also been noticed in a few cases, in various parts of the surface, but its internal cause in unknown. ( Rockitansky, III., p. 71).
The term chronic cyanosis is used, by Virchow, to express the general venous congestion which is congestion which is consequent upon chronic affections of the heart and lungs. Acute cyanosis he states occurs in acute affections of the lungs, as for example, in pertussis. This eminent pathologist affirms, contrary to the opinion formerly entertained, as stated above, that cyanosis, even when produced by congenital malformation of the heart, does not arise form a commingling of arterial and venous blood, but from obstruction to the venous circulation. ( Plus Cellular Pathology, p. 373).
This affection generally destroys life at an early period; but sometimes the adult age may be reaches, according to Leadam, with some distress and impaired health. The following remedies may be administered, according to the concomitant indications, in single doses, at long intervals, or oftener repeated, according to the acute or chronic nature of the case.
Aconite. If a any time should be much vascular excitement heat, or restlessness, this remedy may be needed; if so, let it act as long as the improvement continues, it may entirely cure.
