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.
Glandular swellings, suppurations and Caries are similar to those in Silicea. The appetite is good; he craves cold food, cries when he sees ice-cream, etc., often awakens at night, not and restless, and will drop off at once to sleep if fed. The stools are green; watery, bright-yellow, undigested, hot involuntary, coming out with force, worse mornings. Stools often contain little particles looking like tallow. Vomiting accompanies the diarrhoea; longs for cold water, but ejects it so soon as it becomes warm in the stomach.
Hydrocephaloid may ensue. The face is hippocratic, with sunken eyes, surrounded by blue rings. The tongue is dry; the pulse thready; breathing quick; the child lies half-comatose.
PETROLEUM stands between Sul. and Phosphorus on the one hand the Carbons on the other. It has emaciation, irritability; the child is vehement, susceptible to electric changes (like Phosphorus), Sudden urging in the morning, followed by profuse watery stool (like Sulphur) and Eczema, excoriations, cracked, bleeding rhagades (like Graphites Carbo veg. etc.) Its individuality, however, is maintained by the periodicity of the diarrhoea, stools only during the day, and by the colic arising from sleep in the morning, relieved by bending double. Hunger after stool. Its gushing stool and eruption make it a concordant of Croton Tiglium.
IODIUM causes rapid emaciation, even though the appetite is inordinate. The child is restless and continually desires to change position. The face is yellow or brownish and shrunken.
It is especially useful in enlarged mesenteric glands, with the above symptoms and with intolerable irritability; the child will be approached by no one. Glands are swollen and painless; Goitre.
LYCOPODIUM produces emaciation. The abdomen is bloated while the limbs are wasted. The face is earthy, With blue rings around the eyes. At other times it is wrinkled. Eruptions are well-described. The Crusta Lactea is thick, cracks and bleeds, and emits a mousy smell. TENDENCY to Capillary Bronchitis. The appetite is inordinate, but food soon produces a fulsome feeling, so the child begins hungry enough, but soon desists, and the abdomen seems distended, with much rumbling of wind, especially in the left hypochondrium. The child belches and is soon hungry again. The region of the stomach is distended and intolerant of any pressure, especially after nursing. The urine deposits a read sediment, or is suppressed. Sleep is disturbed by frequent awaking. The child springs up in bed, seemingly frightened, knows no one, pushes every one away angrily. The Lycopodium patient is weak, with well developed head, but puny, sickly body. When sick the child is irritable, nervous and unmanageable. After sleep he is cross, kicks or scratches at any one who approaches him.
PSORINUM stands forth as an ally of Sulphur. There are great debility and sweat from any exertion. The skin has the same irremovable odor that so distinguishes Sulphur. The eruptions are well-described. Crusta Lactea forms on face and scalp, appearing prominently down over either ear and cheek. It exfoliates numerous scales, or cracks and discharges a yellow foetid humour. Boils from on the scalp, which looks dirty and emits an offensive odor. The body itches intolerably at night, worse in the warmth of the bed.
The child is pale, sickly, emaciated; nervous, crying out at night, as from bad dreams; all medicines fail to relieve. The stool is distinctive, watery, brown or black, horribly offensive, worse by night. The child is worse when the weather changes.
The Antimonies have place here by reason of their resemblance to Sulphur, and because they are well-adapted to Scrofula, diarrhoea, etc., The child may look fleshy and well, but is subject to gastric catarrh. The eruptions are pustular (especially in the Tartrate); or develop thick horny crusts (Crudum). In the latter drug we find the nostrils and corners of the mouth covered with crusts, which crack and bleed.
The tongue in Ant.Crud. is white; the babe vomits sour curdled milk as soon as takes the bottle. Vomiting of food or drink as soon as taken. After nursing, the bowels move. Stools watery containing fecal lumps, or costive, the stools being white, dry, irregular or hard lumps of curd; Marasmus.
ANTIMONIUM TARTARICUM has nausea and retching, with vomiting, sweat on the forehead, afterwards languor, sleep. The stools are brown-yellow, fecal, watery, profuse, with sharp cutting colic. There are frequent jerks of the limbs during sleep.
In temperament, the Antimonies display marked irritability; the child will be neither touches nor looked at. ANTIMONIUM CRUDUM is adapted to complaints arising from the heat of Summer. While in Sulphur all bathing aggravates, in AntimoniumCrud. it is particularly cold bathing which cannot be borne.
The gastric symptoms and intolerance of summer-heat place Antimonium Crudum with Bryonia. But the Tartarate favor more Veratrum Album. (See Bell on Diarrhoea.)
BORAX reserved from the nurses, who gave it no higher function than that of awash for excoriated nipples or infant’s sore- mouth, takes a useful place in our list of remedies.
The child grows pale, relaxed, flabby, cries, loathes the breast and falls into a heavy sleep. The head and palms of the hands are hot, the face is pale, clay-coloured. Impaired nutrition is shown by the not mouth and aphthae on the tongue and cheeks, bleeding when rubbed. When awake or not sound asleep, the child is nervous, startled by sudden noises, as thunder, distant cannon-firing, etc. When rocked or lowered into its bed, it screams as if, affrighted. It can bear no downward motion. Every attempt to nurse cause screaming. The stools are light-yellow, slimy, green, consist of small pieces of yellow faeces, or are painless and if fermented, thin, brown, smelling like carrion.
Dr. Bell, in his oft-quoted Monograph, refers to the danger of mistaking Borax for Belladonna Both have screaming out and starting from sleep, with tossing about, clinging to those near, etc., but only Borax has the fear of downward motion and the aphthous mouth.
SEPIA bears some resemblance to Borax, as indeed it does to all Soda compounds. The child wastes rapidly, eyes are sunken, palms and soles burning hot. During dentition the child cannot take any milk, especially if boiled. The stools are green and painless; the child awakens frequently, especially wakeful after 3. A.M. Possibly suitable to females. Moist scabs on the scalp; forehead rough.
SARSAPARILLA is of service in those cases in which the child soon wastes away and looks withered like an old man and the skin hangs in folds. Eruptions are prone to appear in the Spring, their bases are inflamed, the crusts detach readily out of doors, and the adjoining skin becomes chapped. On the forehead the Crusta Lactea is thick, becoming moist when scratched. Herpes and offensive sweat about the genitals, as in children of sycotic parents.
The child becomes very restless and uneasy, screams before passing water, afterwards the diaper is found covered with white sand.
The stool is accompanied by much flatus, and is often followed by fainting.
GRAPHITES is selected by its skin symptoms principally. Like all Carbons, the discharges are apt to be offensive. Thus breath, stools, urine, sweat, all are offensive. The diarrhoea is brown, thin, fetid, mixed, containing half-digested food, or watery and scalding, or composed of white mucus, which also coats what fecal matter passes.
The child is impertinent and laughs at reprimands. It has a harsh rough skin, disposed to chafing. Eczema Capitis forms thick dirty crusts, which ooze a glutinous humour, matting the hair. The eye-lids thicken, their tarsi thicken, crack and bleed; crusts form in the nose, with soreness and oozing; a gluey discharges oozes from a raw surface behind the ears. The groins become sore and the inguinal glands swollen. Best-adapted to fair plump children, who look like the typical Calcarea-child but with well-marked skin symptoms.
CARBO VEG. is generally called for late in the disease, when the vital powers are failing and there is little or no reaction to well-chosen medicines. The skin is cold, pale, or blue, the face having a greenish hue. The feet and legs to the knees are as cold as death. The child may have an anxious look, but it is too lifeless to move or exhibit much restlessness. The breath may be cold and the pulse weak and rapid. The stools are dark, thin and cadaverous-smelling. Useful, too, in protracted sultry weather, when the days are hot and damp.
ARSENIC steps in here as a worthy concordant of Carbo Veg. The skin is dry, parchment-like; the face is sunken, pale, or earthy, and expressive of deep-seated distress. When eruptions are present the crusts are thick, on an angry, excoriated surface, or dry, forming branlike scales. As the child grows weaker the eruptions assume a darker hue, and Intertrigo may look even purple. Arsenic develops a perfect picture of Gastritis, acute and sub-acute. Food and drink cause instant vomiting and diarrhoea. The constant burning thirst demands iced drinks, ice, etc. but they invariably cause distress in the stomach, making the child writhe in agony until they are ejected.
The stools are green, slimy, bloody, dark, watery, undigested, excoriating and intolerably offensive. The urine may be suppressed, and the child lies in a stupor, hot and twitching. When aroused he is restless, demanding frequent change of position. On awaking, he is cross and violent, his pinched features looking more hideous as he contracts the muscles and draws the lips more tightly over the gums. The tendency is surely deathward; but in some cases, when the symptoms appear more slowly emaciation follows, but dropsy and great debility set in. The child looks like a living skeleton, cannot be raised from his pillow, vomits his food and purges when given drink.
Arsenic is adapted to such mummified cases, to bottle-fed babies, and to rapid decline, suddenly appearing in chronic cases.
When the symptoms rather favour Sulphur, Arsenicum Sulph. Flav. may be substituted. Stools are green slimy, watery and offensive, worse, during the day, while it is well-known that the Arsenicum Alb. has diarrhoea worse at night, after 12 P.M. When the glands are engorged with the usual Arsenic symptoms Arsenicum Iodatum may be substituted.
ARGENTUM NITRICUM is adapted to emaciated children who look old, yellow an wrinkled. The face is pale, sunken, the weakness is so great that every motion is attended with trembling. This exhaustion is the result of rapid loss of fluids, as in Cholera Infantum, or of long-protracted diarrhoea and defective nourishment. The gastro-enteric symptoms, which indicate it in Marasmus, are somewhat akin to those of Arsenic; but the inflammation is less intense, while the paresis is more marked in the Silver. Thus, with anaemia, weakness and emaciation, it is noticed that fluids taken seem to gurgle through at once. Also diarrhoea of green fetid mucus, with noisy emission of flatus at night. Child craves sweets, yet they aggravate the trouble.
NATRUM MURIATICUM is to be preferred when the child is emaciated, notwithstanding it has a good appetite. The tongue is mapped, and vesicles or herpes from about the mouth. The wasting is especially marked about the neck. (Compare VeratrumAlb).
In one case a child who though old enough, cold not talk, was cured with salt. The defect here was not Paralysis, but arose from imperfect development of the muscles of the tongue and larynx. So, similarly, Natrum Mur. may be used internally and topically for weak ankles in children; they stumble, or their feet turn under them. Salt here compares with Causticum, Sulphuric Acid etc. which, ceteris paribus, may relieve weak ankles.
CAUSTICUM is adapted to children who grow tardily, and who seem to suffer from a sort of paresis. The abdomen is swollen and hard, but the body is wasted and the feet are diminutive. They walk unsteadily and fall easily. This arises not only from weak ankles, but from weakness of brain also. Such children are timid, fear going to bed in the dark, and have a weak memory. They also have Intertrigo during dentition, and Eczema on the occiput.
BARYTA CARB. is very similar to Causticum in mental weakness, timidity and slowness in learning to walk. Both, also. have an eruption chiefly on the occiput. But in Baryta Carb. the brain may be actually undeveloped, as in the sclerosis of infants. The child is dwarfish; it does not want to play, but sits idly in a corner. It cannot be taught, for it cannot remember. The child is dwarfish; it dose not want to play, but sits idly in a corner. The face is red, the abdomen bloated, the rest of the body being wasted; stools imperfectly digested, loose and pappy, or hard and dry. Glands are enlarged, especially the cervical and the tonsils. Child wants to eat all the time, but is averse to sweet things and fruits. A little food satiates.