Bromine. When the disease commences in the larynx and comes up into the fauces; and in some cases in which it runs down into the larynx and produces a croupy cough with much rattling of mucus.
Capsicum. When, if a description can be given, the throat smarts, as if from Cayenne pepper; the diphtheritic deposit covers a considerable portion of the fauces. There is a sensation of constriction on swallowing.
Kali bichromicum The disease extends into the throat, (and bronchia,) producing a croupy cough, -in paroxysms, -with expectoration of viscid, tough mucus, which may be drawn out into long strings.
Lachesis. When the disease first makes its appearance in the left side of the throat, and there remains, or extends from thence to the right side.
Lachnanthes. If the child has a very stiff and painful neck, drawn to one side, with diphtheria.
Lycopodium. When it appears first on the right side, and from thence inclines to spread to the left. Or where it begins in the nose and extends down into the throat.
Mercurius. Much saliva; much perspiration; offensive breath; swelling of the submaxillary glands.
Phosphorus; Mercurius jod., Apis, Croton tigl., and Cubebs have also been curative in some epidemics or single cases.
SPASMS – CONVULSIONS.
Even in very young infants spasms, or general convulsions, are of frequent occurrence. They are present at the commencement of many diseases of children; and they attend the fatal termination of nearly all. Convulsions may be occasioned by morbid conditions of the nervous system, – idiopathic convulsions; or they may be merely sympathetic, -symptomatic of disorders in other organs, especially in those of the alimentary canal. Among the former may be enumerated those which arise from primary disease of the brain, or other large nervous centres; and those which result from general exhaustion of the vital forces, as in cases of difficult dentition, and in the advanced stages of whooping cough. Among the latter class or sympathetic convulsions, may be enumerated those cases which arise form the irritation of intestinal worms; from the presence of unwholesome food, -such as curdled milk; and from the influences which are about to develop eruptive disorders, or typhoid fevers. The convulsions, or rather local spasms of the glottis, which constitute laryngismus stridulus, seem to result either from direct pressure upon the trunk of some nerve, or form irritation of its peripheral extremities.
Convulsions or spasms, may be tonic, where the muscles are permanently, involuntarily contracted; or clonic, when the contraction more or less rapidly alternates with the relaxation. Tonic spasms are called tetanus; and if confined to the muscles which raise the lower jaw, they are called trismus. Spasms of separate muscles are called subsultus tendinum; these are clonic, and may be seen in severe nervous fevers. clonic spasms are more frequently observed and less dangerous than the tonic. Convulsions which appear immediately after nursing, and especially if there is vomiting of curdled milk, may be attributed to the unsuitable character of the milk. Such cases occur in the children even of mothers perfectly healthy, if they give suck while in a state of high physical excitement, or moral distress. In cases which come on suddenly, and without apparatus cause, especially if the convulsions are associated with fever, stupefaction, and vomiting, there may be reason to apprehend the accession of some eruptive disorder, such as scarlatina, variola, & c.; and this opinion will be strengthened by the prevalence of one or the other of these epidemics at the same time. Many cases of encephalic disease commence with vomiting and convulsions; in such instances upon minute inquiry it will always be found that some indications of cerebral disorder have been present for several days; and there is usually severe pain in the head immediately before the attack.
In general, clonic convulsions may be considered dangerous when the paroxysms become more and more prolonged; when they return after shorter intervals; and when, from the gradual development of opisthotonos or of emprosthotonos, the irritation is seen to extend itself along the entire course of the spinal cord. In most cases it will not be difficult to find out the exciting causes of the spasms; which may be suppression of some cutaneous eruption, or its too tardy appearance in the first instance; direct injury of the head, or some epidemic miasm; the onset of some form of cerebral disease, & c., & c.
Treatment – Remove as far as possible the exciting cause, whether it exists in the nurse or in the child itself; do not place the child in a warm bath; avoid every excitement, and keep the child perfectly quiet and free from every disturbing influence of noise, light, & c; and very carefully administer the remedy which appears to be indicated by the nature of the case and by the attendant conditions.
Aconite. -The febrile excitement is very great; hot, dry skin; anxiety and anguish.
Arnica. Where the spasms arise in consequence of a fall, or other injury.
Arsenicum. The child lies as if dead; pale but warm; is breathless for some time; finally it twists; its mouth first to one side then to other; a violently jerk appears to pass through the whole body; and its respiration and consciousness gradually return. These spasms return at longer or shorter intervals, unless relieved by this remedy, -until death closes the scene.
Belladonna. Starting from sleep with a wild look, dilated pupils, heat of the head and hands, red eyes and flushed face; soporous after the spasm.
Bryonia. When the spasms recur from the repercussion of measles.
Camphor. When the spasms result from suppressed catarrh, either of the head or chest.
causticum. Convulsive motions of the upper part of the body with feverish heat and coldness of the hands and feet. Convulsive motions of the extremities in the evening when the child is sleeping, with disturbed eyes and icy coldness of the body.
Chamomilla. One cheek red, the other pale; very cross and fretful; jerking and twitching in its sleep; -or the nurse may have had a fit of anger which causes the convulsions in the child.
Cicuta vi. Violent shocks through the head, arms and legs, which cause them to jerk suddenly. Spasmodic rigidity of the body, -either opisthotonos, or emprosthotonos. The child seems well and in great spirits, when suddenly it becomes rigid, -then relaxation sets in, with much prostration.
Cina. The child exhibits vermiculous symptoms; discharges worms; picks its nose or anus; has a hacking cough, -continually making attempts at deglutition, as if to swallow something down; is very difficult to be pleased with any thing.
Coffea. The attack has been brought on by excessive laughing and playing. The child is very excitable, and weakly, and in consequence frequently suffers with spasms.
Cuprum. The spasm is often preceded by violent vomiting of phlegm. After the convulsions, the child screams and turns and twists in all direction till another spasm occurs.
Cuprum aceticum. When the spasms result from retrocession of the eruption in scarlet fever.
Helleborus. The urine is very dark and a sediment like coffee grounds.
Hydrocyanic acid. When the muscles of the back, face and jaws principally affected; and the body assumes a bluish tint.
Hyoscyamus. Every muscle in the body is convulsed, -the eyes, the eyelids the muscles of the face, and all, -and there is frothing at the month.
Ignatia. The spasms return at the same hour every day. Screaming and violent trembling all over. Single parts seem to be convulsed; the muscles or single limbs.
Ipecacuanha. Much nausea and vomiting, either before, during or after the spasms; the child is spasmodic drawn in some direction.
Kreosote. When the convulsion occurs from the swelling of a gum over a tooth which is not quite through.
Lachesis. The spasms come on during sleep.
Laurocerasus. There is much gasping for breath, either before, during or after the spasm; and there may also be a bluish tint of the skin.
Mercurius sol. Much salivation; swelling of the gums; hard, distended abdomen. May generally be relied upon, when spasms occur from suppressed salivation.
Nux v. The spasm appears to result from indigestion; there is constipation; -or the nurse lives high, making use of coffee, wines, and rich food.
Opium. If the spasms occur from fright; or if in new-born babes there is screaming before or during the spasm.
Secale c. Twitching of single muscles; twisting of the head to and fro; contortion of the hands and feet; labored and anxious respiration.
Silicea. Spasms which re turn at the change of the moon.
Stannum. In some forms of vermicular affections (see also Spigelia) when neither Cina nor Silicea seem indicated. There is more excitability; more disturbance of the brain, and more fear.
Stramonium. Suppression of an eruption is the cause; or the eruption does not come out sufficiently. The child seems afraid, and shrinks back from objects on first seeing them.
