Veratrum. Much exhaustion after every passage, with cold sweat upon the forehead and upon the skin in general.
DYSENTERY, COLITIS-INFLAMMATORY OF THE LARGE INTESTINES.
Inflammation of the large intestines, descending colon, rectum, ileum, seldom occurs excepted in connection more or less obvious with that of the small intestines. As indeed this latter, especially in infants and little children, is usually connected with a greater or less amount of gastro-enteric inflammation. Thus dysentery, or colitis, at it is sometimes termed, may come on as a consequence of the extension of inflammation, which commencing in the stomach involves the entire digestion tract in its course. There are however many instances of pure idiopathic dysentery, which are directly traceable to exposure of the child the cool, damp air, especially at night, with its abdomen and lower, limbs insufficiently clothed. According to Dr. Condie, “Colitis would appear in the majority of cases to be the result of sudden transitions of atmospherical temperature, particularly the sudden change from warm and dry, to cold and damp weather. It is most prevalent during the latter part of summer, or the commencement of autumn, when the days are hot, but the nights chilly and damp. It is apt to prove endemic in unhealthy localities, especially those favorable to the production of intermittent and remittent fevers, and often prevails epidemically, with fevers of a catarrhal character. A few days of cool, rainy weather, occurring in the summer, will often cause the prevailing bowel complaints of children to assume a dysenteric character.
Except when the result of such endemic or epidemic influences, aggravated perhaps by personal exposure, dysentery is seldom met with in children before dentition has commenced. In these latter cases it evidently arises in consequences or in continuation of the gastro-enteric inflammation which so frequently attends difficult dentition.
Symptoms. Dysentery is usually attended with considerable fever, with evening aggravation and thirst; there may be vomiting, especially of the copious drinks, or other ingesta; but usually the development of colitis tends to relieve in some degree the previously existing gastric irritation. The abdomen is tense, and tender to the touch, especially along the course of the descending colon. But the most characteristic symptoms of this disorder are the painful discharges per anum, which are very frequent; but very small in quantity, and either composed of bloody mucus, pure blood, or mucus alone; and the tenesmus which precedes, attends, or follows the discharges or which may very frequently compel an abortive and exceedingly distressing effort sat stool. In some cases the irritation is kept up by the pressure in the bowel of retained feces; the usual peristaltic action of the intestine having been suspended by the influence of sudden change in the temperature. Such cases are marked by incessant calls to stool and almost constant tenesmus, which are either totally ineffectual, or result in the evacuation of minute portions of fecal matter with much slime tinged with blood.
But the symptoms of dysentery are so evident, that there is no necessity for enumerating them more at length; select that one of the following to the condition of the patient; and be particularly careful of exposure to the night air, but only during the continuance of the disorder, but he even after convalescence has set in, for the relapse which would be sure to follow might prove more intractable than the original disorder.
Aconite. Much fever; dry heat; restless distress; an irritable or inflammatory state of the system. This remedy is often the specific for the entire case.
Aloes. Stools in consistence like jelly-cakes; a quantity of clear jelly, which may be green or white.
Alumina. Has to strain as stool in order to pass water; can pass water only while so doing.
Apis. Frequent bloody stools, without pain.
Arnica. Frequent stools of clear mucus, with tenesmus.
Belladonna. Much tenderness about the abdomen, so that even a little jar is painful. Flushed face, red eyes; much bearing down pain.
Bryonia. When caused by cold drinks; or by very hot weather.
Cantharis. The discharges are apparently the scrapings from the mucous membranes, streaked with blood; the urine is burning and very scanty, often passed in drops, and with much pain.
Carbo veget. In very advanced cases; coldness of the breath; heat about the head; desire to be fanned; putrid evacuations; great debility; a venous condition is gaining the ascendancy.
Chamomilla. One cheek red, the other being pale; very cross and fretful; thirsty; bloody and mucous stools. The child wants to be carried all the time. The difficulty has been cause by checked perspiration.
China. The child is worse other day; much flatulency, and distention of the abdomen, particularly in the afternoon.
Colchicum. Autumnal dysentery; passages like transparent mucus; or like jelly.
Colocynth. The crampy pains are very severe, causing the child to double up with every stool.
Dulcamara. If the dysentery is caused by exposure to cold and damp; or if it becomes worse as the weather grows cooler.
Ipecacuanha. Much nausea and vomiting, or constant nausea
Mercurius corros. Very much pure blood is passed with the stool, with much tenesmus.
Mercurius sol. Not so much blood, more bloody mucus, with tenesmus become and after stool.
Nux v. A small portion of natural feces is passed with every evacuation; no appetite; sleepless towards morning.
Phosphorus. Green and bloody passages, the thus remaining constantly open. If able to talk, the child will complain of a weak, empty feeling across the abdomen.
Podophyllum p. Evacuations of bloody and green mucus, with tossing of the head from side to side. (Worse in the forenoon.)
Pulsatilla. Mucus streaked with blood, worse in the evening and through the night; no thirst.
Rhus t. Is almost if not quite a specific where the pain runs in streaks down the limbs with every evacuation. Useful in cases with typhoid type.
Sulphur. The passages make the perineum red all around the anus. In scrofulous patients, and in those with eruption more or less numerous upon the body.
Veratrum a. Great prostration after every evacuation, with cold sweat upon the forehead.
CHOLERA INFANTUM.
Much of that has already been said under the head of Diarrhoea, will apply to Cholera Infantum. This disease very often proves fatal, even under the best of treatment, since it appears usually in the latter part of the summer, when the young infant’s system is already somewhat exhausted by the previous heat; when the air is impure and the weather sultry, or warm and damp, and since it seems to spring up as an epidemic from some atmospheric miasm which is the little less than malignant. In this worst form of infantile diarrhoea, all the symptoms seem to vie with each other in intensity; and the disorder runs a very rapid course. This course, however; is not always marked by a steady uniformity; sometimes the violence of the gastric symptoms will temporarily abate, and the diarrhoea continue in intensity; at other times the diarrhoea appears to become less frequent and painful, and the stomach more severely affected in proportion. And sometimes also a similar more severely affected in proportion. And sometimes also a similar dull may be observed in the force of the whole disease; and the poor, worn-out mother can hardly realize that her child is not out of danger; can scarcely understand the physician who sadly explains to her that the improvement should come in a gradual decline, and not in a sudden subsidence of the symptoms. The former condition affords ground for hope; but the latter, in some distressing cases that have come under my observation, but preceded the onset of fatal convulsions.
In Cholera Infantum the vomiting and diarrhoea form the most remarkable symptom. The symptoms is so irritable that it rejects immediately, and sometimes with violence, every thing which it receives; in the advanced stages of the disorder, the vomiting becomes spontaneous and the fluids ejected resemble those thrown off from the bowels. The discharges from the bowels are ordinarily composed entirely of a perfectly colorless and inodorous fluid, often containing minute mucous floculi. These stools are discharged without the least effort, sometimes unconsciously. In some cases, however, they are very small in quantity and are squired from the anus, as if from a syringe. In such cases there is usually more or less tormina and tenesmus. Sometimes the stomach seems to lose its irritability, and to allow whatever food or drink in taken in to pass through both in and the intestines unchanged, and to be immediately thrown off from the bowel in the same condition. But the extreme languor and prostration, and rapid emaciation, are as characteristic of this affection in infants and very young children, as of the corresponding Asiatic cholera in adults.
As the disease advances, the discharge becomes still more frequent, involuntary, “profuse, dark colored like dirty water, or the washings of state meat, and very offensive. The emaciation of the patient become extreme; his eyes are languid, hollow, and glassy; his countenance pale and shrunken; his nose sharp and pointed; and the lips dry, thin and shriveled. The surface of the body becomes cool and clammy, of dirty brownish hue, and often covered with petechiae. The tongue is dark-colored, smooth and shining, or covered, as well as the parietes of the mouth, with aphthae. In many cases of the child lies constantly in an imperfect doze, with half-closed eyes, and so insensible to external impressions that flies will frequently light upon the half-covered eyeballs, without the patient exhibiting the least consciousness of their presence. The abdomen becomes more or less tympanitic, and the hands and feet of a leaden hue, or pallid and oedematous. The fauces becoming dry, causes a sense of uneasiness, which often induces the patient to thrust the hand deep in the mouth, as if to remove some offending substances. (Belladonna.) The patient, unless relieved from his sufferings by a judicious treatment, becomes daily more and more exhausted, rolls his head about when awake, and utters constantly short, plaintive, scarcely audible cries. He falls at length into a state of complete coma, death being frequently preceded by a convulsive attack. Not unfrequently, at an early period of the disease, the brain becomes affected, and the child dies with all the symptoms of acute meningitis. Watson.
