This is a condition for the physician first of all. Hutchison recommends washing out the stomach once or twice a day with weak solution of bicarbonate of soda, and giving the breast (or failing that, peptonized milk diluted with an equal quantity of water) frequently and in small quantities- it may be ever half hour or every hour or at longer intervals. Internally; try Nux Vomica, Bismuthum, Cuprum Arsenicum, and May.-Phosphorus in that order. If after a fortnight of this treatment there is no definite improvement, operation ought probably to be resorted to.
Chronic Vomiting in older children takes several forms. It may be simply due to recurring Gastritis, very similar to the acute Gastric Catarrh described in Section 64, and to be treated in much the same way. (Remember, however, that this so-called recurring Gastritis is often really a manifestation of chronic relapsing Appendicitis, for which the only safe treatment is operation.) It may be the leading feature of recurring “bilious” attacks, which, when not due to Appendicitis, are often really a kind of nerve-storms, coming on in nervous children, especially under strain of excitement or fatigue.
They are often accompanied by a slight rise of temperature. The treatment is simple-bed, starvation for twelve or twenty-four hours, and Ignatia. There is a form of “bilious” attack in which in addition to Vomiting there is Constipation, dry furred tongue, a sweetish heavy breath, and drowsiness and slight fever. There is acetone in the urine. This acidosis or acid-intoxication (which accounts for the sweetish breath and is similar to what is observed in serious or terminal Diabetes) may if not promptly neutralized by alkalies, prove fatal.
“The main indication is to give bicarbonate of soda freely to counteract the acidosis. It may be given by the mouth ad lib., dissolved in water, and though much will be vomited, some is retained” (Hutchison). What is the cause of this kind of attack is not certainly known, but it appears to have something to do with an excess of fat or sugar or both in the diet. Such patients should have their milky, fatty, and sugary food drastically reduced.
INDICATIONS FOR TREATMENT
Arsenicum.- Dryness of the mouth, with bitter taste and disagreeable odour; Thrush; ulcerated, coated, or cracked tongue; Vomiting after food of watery fluid; great tenderness and Colic; prostration and emaciation; watery Diarrhoea.
Calcarea carb.- Chronic Vomiting, with swelling and hardness of the bowels, and constipated or offensive motions. Very suitable to small or weekly children.
Graphites.- Vomiting, great flatulence, Constipation of knotty stools covered with mucus.
Hydrastis.- Vomiting of ropy mucus, Constipation without desire for stool, ropy Naso-pharyngeal Catarrh.
Kreasotum.- A poor constitution, general ill-health, and persistent vomiting.
Nux Vomica.- This is an excellent remedy in some forms of Chronic Vomiting.
Pulsatilla.- Tongue covered with whitish mucus; vomiting of mucus or bile; mucous Diarrhoea. Most useful for fair children with blue eyes.
Veratrum Alb.- Excessive Vomiting, especially with watery, faintness; coldness of the face, tongue, and extremities.
66. Acute Infantile Diarrhoea.
The frequency of Diarrhoea in early childhood, especially during Dentition and its large contribution to infantile mortality, especially in summer and autumn, and the fact that it depends mainly on obvious and removable causes, render the due consideration of the subject of great importance.
VARIETIES.- Diarrhoea in childhood may be of varying degrees of severity, ranging from a simple passing looseness having no constitutional effects (simple or catarrhal Diarrhoea) up to acute epidemic Diarrhoea, which, having grave constitutional effects and being attended with a high mortality, is here more particularly considered. In any case remedies will be chosen from the same list, due regard being paid to the severity of the case.
CAUSES.- Epidemic Diarrhoea of children comes on chiefly in summer, and the hotter the summer the more prevalent and virulent is the disease. “It is when the thermometer, immersed four feet in the soil, begins to record a temperature of about 56oF. that epidemic Diarrhoea becomes most common” (Hutchison). The disease is microbic, and injection is encouraged by every kind of bad sanitation and by chill. The microbes are actually conveyed in the milk. Minor forms of Diarrhoea (as e.g. in Coeliac Disease and in Eustace Smith’s Mucous Disease, see Section 67), are often associated with an excess of starchy or sugary food. The dietetic remedy for these is obvious. But the severer forms are due to milk infection.
SYMPTOMS.- These vary extremely, even in recent and acute attacks, from a slight, painless increase in the quantity, frequency, and altered consistence of the normal evacuations, to violent, painful, and frequent purging; liquid evacuations, perhaps several times every hour, being ejected with spasmodic force. In the latter cases the motions are green or spinach-like, resembling those produced by administration of Mercury, but assume a yellow appearance during recovery. Frequently they contain the casein of undigested milk in the form of numerous white specks.
In the more severe stage, they are sometimes streaked with blood, and mixed with mucus. There is also generally sickness, thirst, and an interruption in the nutritive processes. Acute Diarrhoea rapidly reduces the firmness of the muscles, and if the drain be severe, in two or three days there is a marked loss of flesh and strength. The eyes are sunken, the features pinched and livid; the pulse rapid, feeble, and nearly imperceptible; and the extremities cold and shrunken. On the other hand, after the cessation of an acute attack, the lost flesh and vigour are quickly regained, and the child soon recovers his wonted colour and spirits.
INDICATIONS FOR TREATMENT.
Arsenicum.- Neglected or advanced cases, in which there is aggravation at night, and unquenchable thirst; when the various measures employed seem useless, and the pale, sunken face gives evidence that the disease is making serious inroads, Arsenicum often succeeds. But it is more often required in chronic than in acute Diarrhoea.
Chamomilla.- Diarrhoea during Dentition, or from cold, with fretfulness or restlessness; colicky pains; greenish, watery, frothy, and offensive evacuations; yellowness of the whites-of- the-eyes, and sallow skin.
Ipecacuanha.- Simple Diarrhoea, with straining or blood-streaked motions, from overloading the stomach, or during hot weather with sickness, the latter symptoms being more marked than the Diarrhoea.
Iris.- Bilious evacuations, with sickness; Cholera Infantum, especially when Vomiting is frequent.
Mercurius Corr.- Evacuation containing blood, and passed with excessive straining.
Mercurius Dulcis.- Stools green, whitish clay-coloured watery, or mixed with mucus; straining nausea, and thirst.
Podophyllum.- Profuse, sudden, foetid, exhausting discharges, worse in the morning and forenoon; frequent retching without vomiting; drowsiness; rolling and perspiration of the head; moaning and restlessness; Diarrhoea better at night.
Veratrum Album.- Choleraic Diarrhoea, with frequent, copious, watery discharges, occurring in gushes, and accompanied by excessive Vomiting and prostration; spasmodic drawing up of the legs, cold sweat on the forehead, and coldness of the abdomen. This remedy is often valuable after others have been uselessly administered.
China.- Loose foetid stools, with copious discharge of foetid flatus, preceded by painful Colic.
Phosphorus Painless profuse Diarrhoea, “pouring away as from a hydrant”; vomiting of what has been drunk as soon as it becomes warm in the stomach.
ACCESSORY TREATMENT.- In epidemic Diarrhoea the great thing is to withhold milk. Indeed in any Diarrhoea a child may for a time require no food but boiled water of albumin-water (white of egg is water), or some thin meat broth. Water it should have in plenty, and it should be kept warm in bed. As the child gets better, return may be made to normal diet via whey, and after whey milk and water in varying proportions, the milk, if necessary, being peptonized and the water always boiled.
If these instructions are followed and remedies given according to their homeopathic indications, the elaborate ritual recommended by some of washing out both stomach and rectum will hardly ever be necessary.
Virulent cases which in spite of every measure have come to the verge of collapse or which have not come under treatment until far gone, will require the hot mustard bath and an injection under skin of the flank of a few ounces of boiled normal saline solution (a teaspoonful of common salt to the pint), which may be given three times a day.
67. Chronic Gastro-Intestinal Catarrh (“Mucous Disease”)
DEFINITION.- This is a Dyspepsia of the second Dentition and one of the wasting diseases of childhood. Its importance lies, first, in the fact that it is quite common and if untreated or inadequately treated, very chronic; and secondly, in its liability to be mistaken for Tuberculosis. It is important in cases of this sort to take, and keep a record of, the temperature. A persistent slight temperature would point to Tuberculosis. “Mucous Disease” (As Eustace Smith called it), however, predisposes to Tuberculosis. (See “Tuberculous Ulceration of bowel,” Section 31).
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."