Belladonna. – Crying without apparent cause; heat of the head; sparkling eyes; flushed cheeks; startings during sleep; Constipation.
Bryonia.- Constipation.
Camphor.- After Chamomilla when Chamomilla proves insufficient, and the child seems in great pain. (Dose: One or two drops upon a little loaf sugar; after crushing it well, a small portion of the powder may be placed on the tongue).
Chamomilla.- Constant crying, with drawing up of the legs; pain in, or distention of, the abdomen; looseness of the bowels.
Coffea.- Nervousness, restlessness, and tossing about; sleeplessness.
ACCESSORIES.- Hot flannel applied to the abdomen, or rubbing with the warmed hand; placing the child on the knee with the stomach downwards, and patting the back gently, will often prove soothing. A warm bath, as described in Section 7, is sometimes very beneficial.
82. Morbus Coxae – Tuberculous Disease of the Hip-joint
DEFINITION.- Tuberculous inflammation, sometimes originating in the synovial membrane (the membrane which covers the joints, secreting the “synovial” fluid which lubricates the joints and tendons), and sometimes in the articulating surfaces of the bones, commonly net with in children, and before the disease assumes an aggressive form, often attributed to “growing-pains”.
SYMPTOMS.- The first distinctive symptoms are – slight limping pain in waling, with disinclination to allow the entire weight of the body to rest on the affected limb. At this stage, the pain is chiefly referred to the knee. There may be even slight swelling in the knee-point, so as to lead to error regarding the real nature of the disease. This is probably due to pressure on, or irritation of, the branch of the obturator nerve, distributed to the capsular ligament, and ligamentum teres, referred to the terminal cutaneous branches of the same nerve.
The real seat of the pain may be proved by pressing either the front or back of the hip-joint, or by jerking the thigh-bone against the joint, as by a sharp tap on the heel, when pain will be felt in the hip. On close observation, the limb will probably be found slightly flexed, and there may be feverishness and restlessness in the evening, and perhaps slight twitching of the thigh in the night. As the disease progresses, the lameness becomes very decided, and the nates of the affected side waste and become flabby; the limb is shortened either by caries of the neck of the femur, or by ulceration and destruction of the ligaments of the joint, an consequent dislocation of the joint upwards on the dorsum ilii.
This is termed spontaneous dislocation. There is increased fulness about the limb, the pains increase in severity, especially at night, and there are often violent startings of the limb during sleep. Abscesses form and afterwards burst on the nates (buttocks) or groin, or burrow deeply and discharge their contents into the rectum. Wasting of the nates of the affected side is one of the earliest symptoms of the disease of hip.
The duration of the disease varies from two to three months to several years. But it is much modified, both as to duration and results, by skilful treatment.
INDICATIONS FOR TREATMENT
Aconitum.- If recognized in its early stages, a few doses of Aconite may be of service; the presence of fever further indicates this medicine.
Belladonna.- In the early state when the patient suffers great pain.
Calcarea Carb.- At the commencement of the second stage, when suppuration is threatening.
Colocynth.- Useful when there is much neuralgic pain attending the disease.
Mercurius Cor.- When the patient has a sallow complexion; syphilitic taint.
Silicea.- When ulceration has taken place in the bones.
Sulphur.- As a intercurrent remedy in protracted cases.
ADDITIONAL REMEDIES.- Arsenicum, Cantharis, China, Graphites, Hepar sulph., Nit., Ac., Phosph., Pulsatilla, Rhus Tox., Staphysagria
ACCESSORY MEANS.- Rest, with the limb kept straight, and absence of articular pressure; the latter is probably the more important element; surgical appliances are necessary to ensure it. The diet should be nourishing and include Cod-liver oil. Pure air, especially change to the seaside, will expedite the cure. When abscesses discharge, they should be kept free from foetor by means of Carbolic Oil.
83. Lateral Curvature of the Spine – (Skoliosis Gr., crooked).
DEFINITION.- A deviation of the spine to one side or other off the middle line.
CAUSATION.- Such curvature may be due to Rickets, in which case together with muscular weakness there is softening of the bones an other supporting structures. Or to Infantile Paralysis, or to Tuberculous Disease of the Spine. But by Scoliosis, not otherwise qualified, we mean static or adolescent Scoliosis, a condition due to diminished muscular tone. Where Scoliosis becomes habitual, there is in addition rotation of the vertebrae (usually the dorsal), and this leads to deformity of the whole thorax, the front of the chest being conspicuously flattened on one side and pushed forward on the other. The hips and scapulae are observed to be quite asymmetrical.
AGE AND TYPE OF PATIENTS.- The following excellent description of a typical case in a girl of twelve is quoted from Fairbank : “She is a pale, thin, unhealthy-looking child with an adenoid facies. She has stooped for some years; her chest is flat, and the respiratory movements are feeble. Many of her teeth are carious; her tonsils are enlarged and septic; adenoids are present; she has chronic enlargement of the cervical glands, below and behind the angles of the jaw, proving the absorption of septic material from the mouth and throat. She is anaemic, and a haemic murmur may be heard over the praecordium. Her school hours are too long; when in school she sits on a form, and when writing is allowed to assume any position her tired muscles suggest; the school- room is badly ventilated. Her play-hours she usually spends indoors. When standing she usually keeps one knee flexed and the pelvis tilted down on the same side; there is knock-knee, more marked on one side; both feet are ‘weak’. Her mother gives a history of snoring at night and of frequent colds and sore throats; the child never sleeps with the windows open on this account. Constipation is troublesome.”
TREATMENT.- The typical case just quoted indicates the general lines along which treatment should be instituted. The general health must be attended to and the patient placed under the best hygienic conditions. Bad teeth, septic tonsils, and adenoids should be removed. She should be trained in breathing exercises. School hours may need to be shortened. An open-air life must be encouraged, open-air exercise being graduated according to her strength. She must not be allowed to stand too long at a time, and the “standing at ease” position should be discouraged.
“A scoliotic patient should always use a chair, not a stool or form, and the back should have a cushion or pad adjusted so as to fit into the lumbar concavity. The desk should be sloping and close to the chair, and a footstool should be fixed beneath it” (Fairbank). In addition the patient should have massage, and Ling’s Swedish exercises from a person specially qualified to give them. The question whether and at what stage a patient will require a mechanical support should be referred to an orthopaedic specialist. The tendency to-day is to do without these things, and to depend upon physical exercise and general hygiene.
84. Swelling of Infants’ Breasts.
The breasts of infants usually contain at birth a secretion resembling milk. This, if uninterfered with, is soon absorbed, and the swellings subside. But many nurses will not leave nature to have her own way; they consider it necessary to effect a speedy removal of the fluid by squeezing the breasts, or else to rupture the “nipple-strings.” This may shortly lead to inflammation (Mastitis) and even Mammary Abscess. At a later date it may produce retracted nipple, a disfigurement and a handicap to women. APart from any ill-usage, inflammation of the breasts is quite common in the second week, and may go on to suppuration.
INDICATIONS FOR TREATMENT
Aconitum.- If the inflammation is high.
Arnica.- If the redness is but slight.
Belladonna.- If the redness assume an erysipelatous character.
Hepar.s.- If suppuration has taken place.
The medicine chosen should be given every four hours.
85. Ruptured Navel (Umbilical Hernia).
DEFINITION.- A protrusion from the abdominal cavity through the navel-ring, where it forms a smooth, avoid, tense tumour, easily returnable by pressure. It is sometimes congenital, but more frequently occurs soon after the separation of the navel cord.
CAUSES.- Violent crying or straining of the infant while the integuments which close the umbilical ring are but imperfectly developed.
TREATMENT.- Should there by any signs of a protrusion at birth, or soon after, a circular piece of cork should be applied, somewhat convex on both sides, covered, with soft leather, and secured by a moderately tight-fitting bandage around the abdomen. A flat piece of sheet lead, or ivory, protected with soft leather, with the convex surface over the aperture, may be substituted for the cork. If the pad slips off the part, it should be secured by cross pieces of adhesive plaster. If the pad is nicely applied, and continued for one or two months, a radical cure may be expected.
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."