XXIII. Infantile Convulsions Fits.
SYMPTOMS. In simple cases there is slight twitchings of the muscles of the face, rolling of the eyes, and some irregularity of breathing, which soon pass off. Severe cases are marked by sudden loss of sensibility; violent movements of the arms, legs, and head; turning of the eyes so that the pupils are almost invisible; pallor or redness of the face; blueness of the lips; clenching of the hands, the thumb being under the fingers; and bending of the great toes upon the soles of the feet. The fit may last for one or two minutes, when it passes off either altogether, or to return after a longer or shorter interval. The slighter attacks are common to newborn infants.
CAUSES. Teething, Indigestion, Worms, etc.; a blow or fall; fright; disease of the brain; impure or deficient supply of blood to the brain; suppressed eruptions; or powerful emotions, or Indigestion in the nursing mother. Also ill-health of the parents, too early or too late marriage, and inherited taint of constitution.
EPITOME OF TREATMENT.
From Teething. Belladonna, Aconite, Chamomilla
From Mental Emotions. Aconite, Opi., Coffea.
From Stomach Derangements. Ipecac. (vomiting), Nux V. (Constipation), Pulsatilla (fatty food).
From Brain Diseases. Belladonna, Aconite, Hyoscyamus, Helleborus, Gelsemium, Veratrum- Vir.
From Repelled Eruptions. Bryonia, Belladonna, Ammonium-Carb.
LEADING INDICATIONS. Belladonna. Red face; brilliant eyes; heat of the head, starting at the least noise.
Aconitum. Fever; restlessness; fits caused by fright or excitement.
Opium. Dark-red or purple, swollen and hot face, snoring breathing, suppressed urine, confined bowels.
Chamomilla. Redness of one cheek; twitching of the face; sour vomiting.
Camphor. Depression of the spaces between the several bones of the head. (For infants, one or two drops on a little loaf sugar, which should be crushed and mixed, and a small quantity of the camphorated sugar placed on the child’s tongue). Also Cuprum.
Hyoscyamus. Much starting and twitching in sleep, and fretfulness.
ACCESSORY TREATMENT. At once loosen the clothing, raise the head and sprinkle the face with cold water, and let fresh air be admitted. Should the child not at once recover, place him in a hot bath immersed in water up to the neck, and soon afterwards a sponge, squeezed out in cold water, applied to the head; the patient being kept in the bath for ten or fifteen minutes. The temperature for a hot bath should be 98* to 100*, or what can be comfortably borne by the back of the hand. Although a common test, this is very untrustworthy; a bath thermometer should form part of the furniture of every nursery or by the bared elbow, and for a warm bath about 90*; the temperature should be fully maintained, till the patient is taken out, by additions of hot water, carefully poured down the side of the bath. The bath should be given before a good fire, and a warmed blanket be in readiness to wrap the patient in directly he leaves the bath.
If there be sickness without vomiting, warm water should be used, or the throat tickled with a feather. For constipation, an injection is necessary. When due to mental emotion in the nursing mother, the milk should be drawn, and she should take a few doses of Aconite or Opium before the child is again nursed.
XXIV. Spasmodic Croup Child Crowing (Laryngismus Stridulus)
DEFINITION. A purely nervous affection of early childhood, inducing Spasm of the throat.
SYMPTOMS. Croup comes on suddenly, most frequently in the night, with a loud crowing inspiration, so that the child struggles to get his breath, and becomes blue in the lips. The spasm may last several minutes, and then relax; or, neglected cases, death may occur from suffocation. Cough and fever are absent.
REMEDIES. Aconitum and Spongia, in turns, may be given several times, or until the spasm gives way. If much wheezing remain, Spong, or Iodium may follow.
Gelsemium. An excellent medicine for an occasional attack, which does not yield promptly to Aconite
Phosphorus. Cough, with soreness of the chest, after an attack.
Carbo Veg. of Hepar sulph. Hoarseness and wheezing cough.
Administration. The remedy may be given in drop-doses in half of a teaspoonful of water every ten minutes for three or four times. After an attack, a dose three or four times a day, for two or three days, to prevent a return.
ACCESSORY MEANS. Fomenting the throat by means of a sponge wrung out of hot water; the warm bath; and the removal of any known exciting cause.
XXV. Epilepsy. Falling-Sickness.
DEFINITION. Sudden and complete loss of consciousness, with violent action of the muscles, followed by deep sleep.
PREMONITORY SYMPTOMS. Headache, shooting pains, giddiness, indistinctness of sight, sparks of various colours, strong odours, sneezing, strange tastes, hoarseness, humming noises, loud reports, irritability, dejection, and various illusions. But the most striking premonition is a peculiar sensation passing along the limbs, the head, or stomach, which, as soon as it stops, is followed by the fit.
SYMPTOMS. The patient utters a loud shriek, and falls, convulsed and insensible. The movements are often violent, one side being more affected than the other; the jaws are clenched, foam issues from the mouth, often tinged with blood from the tongue being bitten; the eyes are fixed and staring, or roll about; the hands are clenched over the thumbs; urine and motions sometimes escape without control; breathing is difficult; the face pale; the veins of the forehead distended; the heart’s action violent and irregular, and death seems inevitable. After from one to three minutes the fit relaxes. On awaking, the child generally seems bewildered.
There is a milder form, in which the child suddenly leaves off play, stands stupefied for a few seconds, the face turning pale, then resumes his play as if nothing had occurred. But this may grow into the severer form already described.
CAUSES. Hereditary tendency; injury of the skull; tumours; inflammations; insects in the brain; malformation of, or deposits in, the skull. The exciting causes in children are fright, nervous derangement, hysteria, mental and physical prostration. Fits are most liable to occur between the second and tenth years, during the period of the second dentition.
Other causes are, fits of rage, stomach disorder, worms, repelled eruptions, especially about the head. The disease is most yielding to treatment in children; but hereditary tendency is unfavourable.
TREATMENT. During a Fit. The patient’s tongue should be put back into his mouth, and a cork or pad fixed between his teeth; he should be laid on a couch or rug, fresh air freely admitted around him, his head slightly raised, and the dress loosened. Throwing cold water on the face does no good; and restraint should not be exercised beyond what is absolutely necessary. After the fit, the patient should be allowed to pass undisturbed the period of sleep which follows.
REMEDIES. Glonoine. Sudden changes in the colour of the face, the face being pale during the attack.
Belladonna. Redness of the face, sparkling of the eyes, heat of the head.
Cuprum. Severe convulsions.
Cina. From worms.
Nux Vomica. Attacks preceded by constipation and anger.
Chamomilla. Epilepsy in irritable children; colic; sour vomitings; and paleness of one neck and redness of the other.
Arnica. When from a fall or blow.
Opium. Dark coloured face; heavy, snoring breathing.
Kali Bromium Slight attacks in sleep.
Sulphur. From suppressed eruptions on discharge; chronic cases in scrofulous children.
ACCESSORY MEANS. Sponging the body, especially the head, every morning with cold water, followed by rapid and thorough drying. All violent emotions, over-study, and excesses of every kind must be strictly prevented.
Epileptic patients require much rest and frequent change. Studies and open-air-recreation should be pleasantly blended.
XXVI. St. Vitus’s Dance (Chorea).
SYMPTOMS. Slight twitching movements of the hands and arms, gradually increasing and extending to the other parts.
It is frequently associated with Rheumatism; most common in females under twenty and occasionally may prove fatal.
CAUSES. Fright; Teething; Worms; poverty of blood; Hysteria; or descent from hysterical women, and disease of the nerve-centres. Patients seeing others suffering is a frequent cause, and persons are liable to contract it by imitation. Stammering and Stuttering are local manifestations of Chorea.
REMEDIES. Aconitum. From fright, or if there be fever.
Ignatia. Hysterical patients; or from depressing emotions or worms.
Cina. In cases due to thread-worms (in turn with Ignatia). Should these fail, Santonine should be given.
Mercurius. From round worms; salivation; foetid breath; constant tremor.
Cimicifuga. Complicated with Rheumatism.
Arsenicum. Simple obstinate cases.
ADDITIONAL REMEDIES. Iodium, Phosphorus (consumptive patients); Sulph. (constipation); Viscum Album, Cuprum, Belladonna, Agaricus, Stram, Hyos, Zincum.
Rest in bed for several days is advisable; it secures an equal temperature, and repose for the system; at the same time it reduces the wear and tear to the smallest degree. Change of air also of great advantage.
The diet should be plain, and taken regularity at three meals daily.
Headache may be either a symptom of simple disturbance of the brain or other organs, or an early symptoms of disease of the brain.
When a child complains of headache, or shows by his desire to lie down, or to have the head supported, by restlessness and peevishness, that his head aches, it is always well to inquire if he had received any injury to the head, been exposed to a hot sun, or to great heat, or if he has taken indigestible food. Should the affection have no definable cause, we must, by carefully noting the condition of the child, endeavour to discover the source of the ailment. Should the head be hot, and the eyes bright and staring, congestion is probable. Should the head be large, and the spaces between the several bones of the infantile head open, the sleep restless, Inflammation of the coverings of the brain may be suspected. If the head becomes square, and the flesh waste, then water in the head in to be feared. The occasional discharge of a clot of blood from the nostrils, with headache and restlessness, is often of serious import. But headache, and the disease on which it depends, may be generally cured if early treatment be adopted.
EPITOME OF TREATMENT.
From Exposure to Heat. Aconite, Gloninum, or Belladonna
From Indigestible Food. Ipecac., Pulsatilla, or Iris.
From Injury. Arnica, Belladonna
Belladonna. Pain and heat in the head, red face, bright eyes, starting and screaming in sleep.
Glonoine. Severe pain, coming on suddenly; paleness of the face; inability to hold up the head.
Hyoscyamus. Restlessness; starting and pricking; dull, heavy eyes.
Helleborus. Headache, with coolness of the skin.
Arsenicum. Flabbiness and waste of flesh.
Bryonia. Pain over the eyes; Constipation.
ACCESSORY TREATMENT. The wet compress, in the form of a thick soft canvas cap, with an oiled-silk cover, is an admirable application in almost all kinds of Headache.
Sleeplessness is a symptom rather than a disease in itself. It may depend upon a disease, or upon irritation of the nervous system. We purpose here to treat principally of the complaint as it occurs unconnected with any grave disease; but inasmuch as the remedies suitable for simple sleeplessness are often the most useful in overcoming sleeplessness connected with serious disease, the latter will be casually mentioned.
REMEDIES. Coffea. Sleeplessness due to, or accompanied with, agreeable excitement, and without feverishness.
Aconitum. Sleeplessness from fright, agitation, or anxiety, with febrile heat.
Belladonna. Great desire, but inability to sleep; fear, agitation, and frightful visions; continued crying without assignable cause; heat and throbbing in the head.
Hyoscyamus. Sleeplessness in sensitive or irritable children, from nervous excitement.
Ignatia. When due to grief, depressing emotions, or thread- worms,
Nux Vomica. Flow of ideas preventing sleep; Indigestion or Constipation.
Opium. Hideous visions after a fright.
Pulsatilla. From over-eating or indigestible food.
ACCESSORY MEANS. When a child cannot fall asleep at the accustomed hour, he should be turned from the light, or the room should be darkened, and kept quiet. Bathing the head and neck with cold water, and rubbing them dry with a rough towel, is useful. Smoothing back the hair, or singing in a low monotonous tone, is often soothing.