Kalmia.- Shifting Rheumatism. Rheumatic iritis. Weak, slow pulse and palpitation.
Pulsatilla.- Rheumatic synovitis. Rapidly shifting Rheumatism. Dyspepsia with aversion to fat. Better from cold and in open air. Anaemic. Female remedy.
Rhododendron.- Rheumatic pains and swellings, worse at rest. Worst before a storm; better after it breaks.
Rhus Tox.- Pain in muscles, tendons, and ligaments; worse at night and in damp cold weather; better from movement.
Ruta.- Pain deeply situated, in bones and periosteum, especially or wrist.
Spigelia.- Rheumatic headache of forehead and temple, especially on left side. Rheumatism of eye. Rheumatic Carditis – cutting pain in heart and shortness of breath.
ACCESSORY TREATMENT.- Something may be done to prevent Rheumatism, by clothing children properly, particularly the legs and feet, and by seeing that they don not sit in damp cloths. The soundness of the boots should specially be attended to. The tonsils, as a main avenue of infection should be attended to (see Tonsils and Adenoids, Section 59). The digestion should be attended to, as children are better without much meat; they should certainly not have it more than once a day, and it is well to vary it with fish and eggs.
As regards the actual treatment of Rheumatism, certain rules must be regarded like the laws of the Medes and Persians. The patient must wear wool or flannel next to the skin day and night, summer and winter (in varying thicknesses). Bathing is good, but may easily be too cold. If the child does not “reach” after a cold bath, is blue, chilly, or miserable, the bath must be given up. Rheumatic pains, however slight, are to be treated by putting the child to bed until the pains have passed off. After an attack of acute Rheumatism the child should be kept at rest for several weeks. The object of this is to prevent Rheumatic Carditis. Rest is also the supreme necessity when Rheumatic Carditis has actually supervened. For the treatment of Chorea, see Section 38.
28. Rickets (Rachitis)
DEFINITION.- A constitutional disease characterized by bony changes (thickening in some parts, as e.g. at the lower end of the leg and arm bones; softening in other parts owing to the deficiency of mineral phosphates, with resulting deformities), by catarrhs (of bronchial tubes, producing Bronchitis; of the bowel, producing Diarrhoea and flatulence), and by nervous manifestations (Convulsions, see Section 34; and Laryngismus Stridulus, see Section 35).
SYMPTOMS.- when a child reaches the tenth month without any appearance of a tooth, or if at two years old he is unable to walk, Rickets may be strongly suspected. A prominent symptom of this disease is profuse perspiration of the head, neck, and upper portion of the trunk immediately the child falls asleep, the perspiration standing upon the forehead of beads, or making the pillow wet. The patient desires to lie cool, and kicks off the bed cloths, both in summer and winter.
The child is late in walking, the bones of the leg are curved, and the joint-ends enlarged, especially of the wrists and ankles. The fontanelles are late in closing; the head becomes flat and more square than natural, and the little patient desires to lie still and be undisturbed by playthings or company. The appetite is often voracious and the food passes rapidly, and almost unchanged, through the intestinal canal; there is much straining, and stools are of variable consistency, and often very loose and offensive. Much generation of gas causes “pot-belly”. The flesh is flabby, and there is much muscular weakness and laxity of ligaments; the child is drowsy in the daytime, but restless and uneasy in the night.
In severe cases not merely the leg-bones, but also the spine and pelvis, lose their proper shape; the teeth fallout or soon decay, and the first and second teeth are generally delayed. The chest also becomes narrow and prominent.
DIAGNOSIS.- Rickets may be confounded with Hydrocephalus; but in the former disease the fontanelles (unclosed spaces in the skull of infants) are depressed, while in the latter they are elevated, and often communicate a sensation of pulsation to the hand. The head in Rickets is flat on the top; the head in Hydrocephalus is globular. The distinction between the back in Pott’s disease or tuberculous disease of the spine (angular curvature, as distinct from lateral curvature) is that the prominence is Rickets straightens out at once if the child is held up by the armpits; this is not the case in Pott’s disease.
CAUSES.- Insanitary surroundings, overcrowding, want of air and especially in sunshine, and a defective dietary – often an excess of some starchy proprietary food with deficiency of animal fat and protein (nitrogenous food).
CONSEQUENCES.- These include all kinds of deformities, bow-legs, pigeon-breast, curvature of the spine, deformed pelvis (and, in females, consequent difficult and dangerous labours), and compression of the internal organs. If treated early, however, this disease is very remediable, little or no deformity resulting.
TREATMENT.- If commenced early, the best results, with little or no deformity, may be expected. The disease has no definite course to run and at any point the degenerative process may be stayed, a nutritive process initiated, the normal functions restored, and the growth of the child renewed. The medicines in most repute are – Phosph.-Acid, Silicea, Phosph., Calcarea carb., and Calcarea phos.
INDICATIONS FOR THE ABOVE AND OTHER REMEDIES.
Calcarea carb.- Teething unduly protracted, early decay of teeth, curvature of the spine and limbs, enlargement of the joints and head, belly enlarged, appetite voracious, Diarrhoea.
Calcarea-Phosph.- Very similar to the above, but Diarrhoea and prostration more marked.
Phosph.-Acid and Phosph.- With low fever, distended abdomen, Diarrhoea, milky urine, or turbid urine which deposits a white sediment.
Silicea.- Skin morbidly susceptible to ulceration, scabby eruptions on the scalp, suppuration of glands, discharge from ears.
Sulphur.- An excellent medicine to commence the treatment with, and to be employed for three or four days, when a remedy that has been productive of good has ceased to operate beneficially.
ACCESSORY MEANS.- Country air, dry, and bracing; abundance of sunlight, and out-of-door exercises. These wonderfully promote the cure, by imparting tone to the digestive organs, energy to the nervous system, and, in short, invigorating the whole constitution. Patients not able to walk should sit or recline in the open air, warmly clad, during portions of the day; this will aid recovery far more than passing the chief part of the day in the confined air of a sickroom. Exposure to ultra-violet rays acts in the same way as sunlight. Tepid or cold bathing, every morning, especially in salt water, followed by general massage for five or ten minutes, is valuable.
DIET.- Nourishing food, well masticated, is of great importance. It should include milk, meat, eggs, animal fat (especially cod- liver oil and beef dripping), brown bread, etc. The administration of a moderate quantity of finely shaved juicy beef, once or twice a day, is advisable in some cases. Malt or barley-food is suitable for rickety children. If finely ground, the sediment from the husk need not be removed from the prepared food, as it is very nutritious, and rich in none-forming materials.
Boil four tablespoonfuls of ground malt in a pint of water for ten minutes. Pour off the liquid, and add an equal quantity of new milk. This food is very agreeable to children, and highly nutritious. An excellent food for rickety children is made by gently simmering groats in milk. A tablespoonful of groats is put into a vessel containing a pint of milk; this is then placed in a saucepan or other vessel containing water, which is allowed to boil. When the milk has lost a quarter of its bulk, it should be strained, and is then ready to be given. The groats remaining behind are also an excellent food.
SURGICAL MEASURES.- If mechanical support be necessary for curvatures of the lower limbs, simple straight wooden splints, kept in place by a good bandage, are the best. But weekly children should be first treated by the administration of Cod- liver oil, and other remedies we have prescribed, and splints applied when the child’s condition is improved, should they still appear necessary. As just stated, Cod-liver oil is an important remedy, but it should only be given in small doses, ten to twenty drops at first and the quantity gradually increased to a teaspoonful. Small pieces of ice put into each dose render the oil almost tasteless. During its administration the evacuations should be examined, for the appearance and odour of the oil in them are signs that the quantity should be reduced.
29. Tuberculous Disease of Bones and Glands.
DEFINITION.- The old-fashioned terms Struma and Scrofula, interpreted in the light of modern knowledge, signify a constitutional disease, Tuberculosis, localizing itself especially in bones and glands. In children Tuberculosis shows itself seldom as Tuberculosis of the lungs (“Consumption” as it is popularly called), but very often as Tuberculosis of bones, glands, and membranes (especially the peritoneum – Tuberculous Peritonitis, and the covering of the brain – Tuberculous Meningitis).
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."