SEQUELAE.- The most important is Paralysis, coming on usually in the second or third week of convalescence, due to a peripheral neuritis. The chief palsies are (a) of the palate, causing the patient on attempting to swallow his food to bring it back through the nose, (b) of the eye-muscles, causing squint or dropping (ptosis) of the upper eyelid (c) a paralysis of the heart muscle, causing, it may be, a great slowing of the pulse or even sudden syncope, which may be fatal.
TREATMENT.- Allopathic mortality has undoubtedly been greatly reduced by the adoption of the antitoxin treatment. Homoeopaths are divided as to whether they should use antitoxin or not. a case treated with homoeopathic remedies from the very outset will probably never need anything else. But medical advice may not be sought until the case has advanced well beyond the initial stage; and besides, cases of very exceptional virulence may at any time crop up which task our therapeutic resources to the utmost. It is a question, then, under the circumstances whether it is not wise and right to use antitoxin.
It should be remembered that antitoxin is neither allopathic nor homoeopathic. The treatment consists in neutralizing a poison and so rendering it inert, much as Condy’s fluid (permanganate of potash) neutralizes opium when it has been taken poisonously into the stomach. There is no reason at all why homoeopathic remedies should not be administered concurrently with the injection of antitoxin. 2000 to 4000 units of a mild case, increased up to 1000 or 15000 for more severe cases, may be injected (with strict regard to asepsis) under the skin of the lower abdomen. A patient known to suffer from Asthma or to have had an antitoxin injection on a former occasion ought probably not to be injected (Goodall).
TREATMENT.- Belladonna should be given at once. In mild cases this medicine may be sufficient, given a dose every two hours. If no improvement follow its action in about forty-eight hours, Mercurius- Cyan. should be administered every three hours. Mur.-Ac. may afterwards be had recourse to if the Mercurius-cyan. fail to produce any satisfactory result.
INDICATIONS FOR THE ABOVE AND OTHER REMEDIES.
and mental prostration, especially in the last stage.
Arsenicum.- Cold, clammy sweats, frequent, small pulse, Diarrhoea, great thirst, and much prostration.
Belladonna.- Throat red and swollen, with white patches studded over it, dryness of the throat, thirst, etc. Gelsemium.- For resulting paralysis.
Iodium.- When the affection has spread to the wind-wipe, and produces symptoms of Croup.
Kali Bichrom.- When the disease extends into the nostrils this medicine may be selected.
Kali Permangan.- In some of the worst cases with intense foetor of the breath this medicine appears to have acted beneficially.
Mercurius-Bin.- Swelling and deep-red appearance of the throat, with specks of exudation, and excessive foetid secretions.
Mercurius-Cyan.- For pronounced Diphtheria; great depression; formation of false membranes.
Mur.-Ac.- Putrid state of throat, dry parched tongue, great weakness, relaxed bowels, etc.
ADDITIONAL REMEDIES.- China and Helonias (debility of convalescence); Conium and Digitalis (enfeebled heart); Phyto. and Phosph. (hoarseness).
LOCAL TREATMENT.- At the outset of the disease hot fomentations or poultices should be applied around the throat. Where the child will permit it, the throat and nose may be flushed out frequently with warm solution of boracic acid. Alternatively, he may inhale over a jug of boiling water in which is a teaspoonful of carbolic acid. When the larynx is involved, a steam tent should be rigged up over the bed.
Where dyspnoea becomes extreme from laryngeal obstruction, tracheotomy must be resorted to.
During convalescence the patient should “hasten slowly.” Any signs of Paralysis are a signal for putting the convalescent to bed for a protracted seasons. A change of air is highly desirable.
WARM BATHS.- These are valuable accessories in the early stage. The skin is hot and dry, the urine is often suppressed, the bowels confined, and thus the poison is retained in the system. Warm baths, and drinking freely of cold water, often restore the functions of the skin, the bladder and bowels.
DIET, ETC.- The strength of the patient must be sustained, from the very commencement of the disease, by nourishment, and he must be urged to swallow it in spite of the pain which it occasions. Eggs beaten up in milk, with sugar; beef-tea slightly thickened with rice or pearl-barely; arrowroot or sago.
If Vomiting occur, sucking small pieces of ice will tend to allay it. Ice also affords comfort to the patient, and favours the action of the kidneys.
PREVENTIVE MEASURES.- The cesspools should be emptied, and if too small or defective, new ones built. The house, water-closets, and local drainage should be thoroughly examined, and imperfections rectified; also, if necessary, chloride of zinc or of lime constantly kept therein, and thrown down the drains. All dust-holes and accumulations of refuse should be cleared away; a plentiful supply of water kept in the house, and every room regularly well-cleaned, whitewashed, and thoroughly ventilated.
25. Whooping-cough (pertussis)
DEFINITION.- A paroxysmal cough, chiefly affecting infancy and childhood; consisting of violent, spasmodic fits of coughing, ending in prolonged, shrill, crowing inspirations, and the vomiting of thick, glairy mucus.
Whooping-cough is both epidemic and contagious. Infants under three years of age are specifically liable to it; it is rare after ten. The younger the infant the more dangerous the disease. If frequently occurs as an epidemic about the same time as Measles, and though this may be at any time of the year, these disorders are specially prevalent in spring and autumn. The duration of the disorder varies from two or three weeks to many months. This depends very much on the temperament and constitution of the child. But the duration of the disease may be much abridged by homoeopathic treatment.
CAUSES AND MODE OF SPREADING.- The disease is doubtless of microbic origin, but it is not certain what the microbe is. The disease is apt to be epidemic and is mainly communicated from person to person. It often follows or precedes Measles and Scarlet fever.
SYMPTOMS.- Whooping-cough usually commences as a Catarrh, with cough, which returns in fits at intervals. In about a week the cough recurs at shorter intervals, in paroxysms of extreme severity, the child turning red or almost black in the face, and appears as if choking, during which the lungs are emptied of air to the last degree, and then a long, sonorous inspiration, taken to refill the, constitutes the “hoop”.
This “hoop” is the signal of the child’s safety, for where suffocation does take place it is before the crowing inspiration has been made. the attacks recurs at every two or three hours, or, in severe cases, oftener, and sometimes blood escapes from the nose, mouth, and even from the ears. The successive fits pass off with the expectoration of glairy, ropy mucus, and sometimes with Vomiting. Between the attacks there is such freedom from pain and ease of breathing that the child is lively and cheerful.
Weakness and loss of flesh are, however, occasioned by the repeated ejection of food from the stomach, and by the terror with which the child anticipates the attacks. The cough is generally worse at night, so that a decline of nocturnal attacks is a favourable symptom. But it may be brought back with all its severity by exposure to cold, by improper food, and by want of proper nursing during the period of convalescence. In any case it is rarely fatal, though danger is greater during the colder seasons of the year, and in young infants and delicate children.
COMPLICATIONS.- Whooping-cough may be complicated by haemorrhages under the skin, especially of the face, and by haemoptysis. Convulsions are not very rare. The most important complications are Bronchitis (practically always present more or less), Broncho-Pneumonia (the most fatal of all), which often becomes tuberculous, Lymphadenitis of the bronchial glands, Emphysema, and Cardiac Dilation. There may also be wasting and anaemia. These complications and sequelae made Whooping-cough a very fatal disease under non-homoeopathic treatment.
DIAGNOSIS.- If the “hoop” is not actually heard, the diagnosis may be difficult. The points that help are the paroxysmal character of the cough, the occurrence of Vomiting, the puffiness of the eyes, and the presence of a sublingual ulcer (due to protrusion of the tongue during cough and the catching of the frenum of the tongue against the lower incisor teeth). All paroxysmal cough is not Whooping-cough. The disease may be simulated by the cough caused by enlarged bronchial glands. A history of tubercle or of a former attach of Whooping-cough (which is not likely to be repeated by is very likely to be followed by enlarged bronchial glands) would point to Bronchial Lymphadenitis. The best way to establish such a diagnosis would be to examine the chest with the X-rays.
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."