THE following collection of symptoms is the result of a protracted study of a case which cost the writer many anxious hours. Failing by carefully selected remedies to even relieve the patient, it was determined to sift our Materia Medica as thoroughly as time and other engagements would permit, in order to find whether any anti-psoric or deep-acting drug could be found suitable to the case.
This fact will explain the lack of complete system in the paper, and also the defective relation existing between the first and second parts, the latter containing some symptoms and additional drugs not found in the former. These defects there was not time to correct.
In arranging the symptoms the writer has not restricted himself to the pathogenesis of genuine Atrophy, the Tabes Mesenterica, which is essentially tubercular, but has included; symptoms of Rachitis, Scrofula, and simple indigestion, with attending Marasmus.
In several instances, however, especially in the repertory, mention is made of symptoms known to be characteristic of some one or other of the diseases included under the general term Atrophy. But in so doing the writer by no means wishes it to be inferred that he would teach that therapeutics is dependent upon Pathology. The latter helps him in obtaining his “totality”, abridges his phraseology ( as, for example, when he writes scorbutic sore-mouth- Mercurius-meaning thereby all the well- known buccal symptoms of that remedy), and acquaints him with the unmodified course of disease. But when he has his case well- understood, the symptoms, subjective and objective, must be submitted to the rules of Homoeopathy, not to the restrictions of so general a science as that of Pathology.
If omissions are noticed, let it be the pleasure of each one to mention them. If the paper does but call forth a healthy criticism, it will fulfil a useful purpose, and save some one hours of labour, and mayhap a mother her darling child.
PART. I ANTIPSORICS IN THE TREATMENT OF ATROPHY OF INFANTS.
SULPHUR is characterized by emaciation; the skin is dry, harsh and wrinkled, giving the child an “old-man” look. The body has an offensive odor, not removable by washing. Eruptions are chiefly Eczema Capitis, generally dry, easily bleeding; itching more at night; scratching relieves, but causes bleeding; excoriations; Intertrigo especially at the anus.
Glands swollen, particularly the cervical, axillary and inguinal.
Appetite voracious; child eagerly graphs at everything within reach and thrusts it into its mouth. Abdomen distended and hard. Constipation or diarrhoea; the stools are slimy, green, watery and changeable; worse at night; sudden urging awakens him in the morning followed by copious watery stools.
If Hydrocephaloid sets in, the child lies in a stupor, its face pale, lower jaw dropped, eyes half-open, and forehead, covered with cold sweat. The urine is suppressed and there are frequent muscular twitches.
In less severe cases the child is restless at night; sleeps in “cat-naps”; awakens often screaming, or on going to sleep is annoyed by sudden jerking up of the limbs. At other times an almost unbroken fever obtains, the skin for days remaining dry and hot.
The child is cross, obstinate; cannot bear to be washed or bathed. Its face is pale, sunken, with deep and hollow eyes. Dentition is slow; muscles and bones develop very tardily so that a year-old child looks scarcely larger than a new-born babe. Complains of fatigue every little while; sits bent forward, refuses to stand long, but crawls or runs about.
CALCAREA CARBONICA is very similar. The emaciation is more marked in other than adipose tissue. There are atrophy of muscle, soft bones, retarded teeth, all evidences of defective nutrition, and yet an excess of fat gives a deceptive appearance of plump health. When wasting shows itself in fact too, the body dwindles, the pale skin hangs in folds, but the abdomen seems to remain disproportionately enlarged. Partial sweats are more prominent than in Sul. The scalp is covered with a cold sweat; the knees are clammy; the feet feel damp and cold. The eruptions, especially Crusta Lactea, develop on the face, or quickly spread thence; crusts are dry or yield a mild thick pus. At times, they appear isolated and look like chalky masses. Again the eruption forms in rings or spreads like Ringworm. The child’s scalp seems thin, blue veins show distinctly, and the little one scratches its head on awakening.
The glands are engorged, particularly the mesenteric. Appetite is voracious, yet emaciation persists. Morbid appetite for indigestible articles of food. The child is thirsty and feverish every afternoon. The stools are green, watery, sour, or pungent or clay-like, and worse in the afternoon; or again creamy, fetid, frequent; urine strong, foetid, clear.
If Hydrocephaloid sets in the child is hot and dry or bathed in cold sweat. The fontanelles are open and sunken, the face is pale and pinched, the child frequently scratches at its head; cries, as if, hurt when lifted from the cradle. The stools are white and slimy, and the urine is clear, but very strong- smelling, fetid, and is passed with difficulty.
Vomiting is very marked in both remedies, but in the Lime it is principally sour food or lumps of curdled milk; in the Sulphur it is sour, watery, fetid. The differences are only in degree, curdled milk more frequently calling for the Lime.
The child is obstinate, self-willed, cross before stool and faint after. Its face is pale, bloated or sunken and emaciated, looking like a tiny doll. At other times it is more like Sulph. Old and wrinkled and cold. Growth is retarded; the child, though old enough, will not put its feet to the ground. Spine seems weak, it sits stooped. The legs are often curved, and the bones can be bent quite readily. While the Sulphur-child dreads washing, the Calcarea-patient has less dread, but is made worse by bathing.
CALCAREA PHOS. has numerous similarities with both the foregoing. It is distinguished by the following Complexion is sallow; the whole child is emaciated and poorly developed; the posterior fontanelle is also very large, showing greater nutritive defect than in the Carbonate. The abdomen is shrunken and flabby. The stool is watery, hot; or green, slimy, passed with much offensive flatus. The child is attacked with pain so soon as it eats. When lifted, breathes short, has an anxious look.
If Hydrocephaloid ensues, the child is exhausted and limp, its slender neck refuses to support the head, while the fingers are all skin and bones. The child craves food, is greedy, like Sulph and Calcarea C. but while the latter longs for eggs, the Calc Phosphorus craves salt meat, bacon, etc.
CALCAREA IOD. is to be preferred to other Lime salts when the child, though looking plump and healthy, shows well-defined Scrofulosis, with thick scabby eruption, Otorrhoea and engorged glands and enlarged tonsils.
HEPAR necessarily resembles both Sulphur and Lime. Under an apparent plumpness, the attentive physician detects that the flesh is flabby, the muscles withered and digestion weak. The child is intolerant of pressure about the stomach after eating. Food seems to temporarily relieve the debility. If the child were old enough, he would describe the feelings as one of invigoration, like a stimulant in the stomach. The stools are green, watery, undigested, or white, sour-smelling and painless, and worse during the day.
There is but little tendency to cerebral symptoms. The glands are swollen, and the child is subject to catarrhs from the least draught of cool air. In dry, cold, windy weather, Croup develops. It has Eczema, which is worse in the morning, when it itches, burns and smarts.
SILICEA again changes the picture. The whole body is wasted, while the head is exceedingly large. The face is earthy or wax- pale and the bones are diseased. Pain in the sternum and lumbar spine; Rachitis. The eruptions are prone to ulcerate or suppurate. Small pricks or cuts fester. The toenails fester and grow into the flesh. The Crusta Lactea is moist, oozing and is worse from scratching. The appetite is often lost, with an especial aversion to the mother’s milk, which, even if taken, is at once vomited. The stools are watery and offensive, or the child is costive. In Hydrocephaloid there are rolling of the head, suppressed urine and great weakness. Electric changes, as an approaching thunder-storm, depress the child and cause extreme prostration.
The child is nervous, irritable, susceptible to mental impressions, however sluggish may be its scrofulous symptoms. It is susceptible and timid. The whole head is covered with a sweat and the forehead often becomes cold. This, however, is quickly relieved by wrapping the head warmly. Like Sul, Calcarea and Hepar, the skin readily ulcerates and refuses to heal. Hepar is distinguished by the soreness and tenderness of its ulcers and eruptions.
PHOSPHORUS exhibits emaciation combined with nervous debility. Brain and spine have suffered severely. The child is over- tall but is slender, emaciated but bid-bellied; face pale, almost waxen. Delicate eye-lashes, soft hair, and rapid breathing indicate what belongs to the sequel. Even thus early the diarrhoea is associated with dry cough. The child, however, shows well-marked nervous excitability. He is irascible, vehement, which results in tremor and weakness; he is susceptible to external impressions and so also to electric changes in the atmosphere.
