EARACHE.
Ear-pain or otalgia is an inflammation of the ear-canal or of the middle ear. This inflammation is termed as “Otitis”. Some foreign bodies entering into the ear may also create acute pain there. A purulent discharge from the ear is the common consequence of otitis. In some cases the septic lesion extends further involving the mastoid process. Negligence in the early stage or maltreatment may affect the hearing in later life.
auxiliary MEASURES: Hot applications often relieve the pain quickly. A fomentation with a piece of flannel wrung out of hot water will serve the purpose. Taking some common salt in piece of linen it can be warmed on a hot pan and applied over and around the ear. To put a few drops of Plantago Tincture, Olive oil or Glycerine may also relieve the pain. But if there is any foreign body in the ear passage it must be taken out first.
MEDICINE IN GENERAL: Acon., Apis., Bell. Bor., Bry., Caps., Cham., Coffee., Ferr-ph., Hep., Iod., Kali-bi., Kali-iod., Kali- m., Mag-ph., Merc-s., Plant., Puls., Sil.
THERAPEUTIC HINTS: In otalgia of children our first choice lies between Chamomilla and Belladonna. Fretfulness is the determining indication of the former. In this drug we find that fretting and pain go hand in hand. The child wants to be affected side is red and hot right upto the cheek while the other cheek is pale and cold. In the child requiring Belladonna we find the pain is most violent and comes and goes suddenly. The pain causes delirium and the tiny sufferer jumps and cries in sleep or he cannot sleep at all though noticeably sleepy.
Slightest jar aggravates the pain and hence, unlike Chamomilla, the child would prefer to remain on the bed. The whole face is remarkably flushed. Whenever we deal with an inflammatory condition Aconite deserves our first consideration in the early stage. Although it is not an oft indicated medicine in ear-pain but it marvelously and promptly relieves the maddening pain of otitis media when caused from an exposure to cold or when the atmospheric temperature falls down suddenly. It has dark redness of the affected ear, pains worse at night and from warm applications.
Let Ferrum-ph. be your substitute for any of the preceding two medicines when their leading features are not wellmarked. Its pain comes in paroxysms and it is more suitable if the condition is brought on from an exposure to damp cold (dry cold Acon.). But we have let Pulsatilla which is a rival of Belladonna in otalgia of children. It will be more suitable if there is a purulent discharge from the ear in conjunction with the pain. All its troubles are worse at night and better in open air and warm applications. The medicines mentioned before are more indicated in the early state while Pulsatilla may be equally suitable in the sub-acute form of the complaint.
If the condition runs still further threatening mastoid complications Capsicum will arrest the development and prevent the need of an operation. When this drug is indicated there will be a bluish colour on and around the ear, which may not be so noticeable in the artificial light at night but is wellmarked in the day light. Its pains are more felt behind the ear than in the ear itself. The mastoids become more tender too. Its child gets relief from warmth. Hepar-sulph. is our most sensitive polychrest and is useful in ear-pain when suppuration is imminent.
You will recognise this medicine at once when you find that your approach for an examination makes the child cry with the thought that you will touch his ear; the touch increases the pain intensely. In the absence of this hyperaesthesia Mercurius-sol. will be better if suppuration is threatened. Dr. Benjamine recommends Bryonia also for this inflammatory condition if the child remains lying on the painful side and resents to be moved.
REMEMBER: Acon., Bell., Ferr-ph. and Cham. are medicines for the first stage but if the child gets nightly attacks for several days or every now and then it is better to start the treatment with Pulsatilla; especially if it is right sided (left sided Sil.). Belladonna too acts better in the affection of the right ear.
When inflammation predominates the condition it is better to give Acon., when congestion, Bell and if both inflammation and congestion are equally marked give Ferrum-ph. Chamomilla has more mental irritation.
Acon., and Bell are suitable for plethoric, Ferrum-phos. for feeble and anemic, and Capsicum for corpulent and heavy type of children.
When warm application makes the pain worse Aconite will be the possible medicine.
COLIC.
Irregular spasmodic contractions of the intestines causing severe pain are called colic of infants. It is usually due to exposure to cold particularly during the bath, or cold feet. When milk is not digested properly it also may create a colic. The colic pains may be in association with constipation or diarrhoea. Warm fomentations usually give relief and the child may be also given some warm water to sip. Great care should be taken that the skin is not burnt when fomenting. When their babies suffer from colic the nursing mothers should avoid all sort of stimulating and patient foods.
MEDICINES IN GENERAL: Acon., Aeth., Asaf., BELL, Calc-c., Calc- p., CHAM., Chin., Cina., COLOC., Jalapa., Lyco., Mag-ph., Menth- pip., Nux-v., Rheum., Senna., Staph.
THERAPEUTIC HINTS: The majority of these cases yield to Belladonna. Flushed countenance, dilated pupils, and full bounding pulse will suggest its choice. Its pains are not constant but come in spells and are of short durations as will be manifested by the sudden shrilling out-cry of the little sufferer. Aconite has always a similarity to Belladonna although it is not very difficult to differentiate them. In the first attack the extreme pain surely terrifies the child greatly and drive him crazy, so that he bites his own fists.
A dry skin, green diarrhoea, restlessness and sleeplessness are the guiding symptoms of Aconite. Chamomilla will be the remedy if the pains drive the child mad with rage. Anger and pain are equally marked or possibly the former is out of all proportion to the latter. He becomes furious with rage and behaves most uncivilly. Nothing can pacify the childs rage, nothing can relieve his pain; carrying the child constantly to and fro may only give him temporarily partial relief. A green diarrhoea of acrid stools is almost always its accompanying feature.
We find a similar irritable mood in Cina child who also wants to be carried all the time, but in Cina we usually trace up some evidence of worms and the Cina stools, no matter whether loose or watery, are always white (Cham, green). Colocynth has a very good reputation in relieving the colic pains and when this drug is indicated we find the child whirling all round, twisting his limbs and drawing up the legs over the abdomen. Finds relief from pressure and hot applications. It also may have a green diarrhoea.
Magnesia-phos. has a close resemblance with Colocynth and should be tried when the latter fails to give quick relief. Mag-ph. is also suitable in wind colic. Lycopodium will be sufficient for colic from constipation (Op.), especially if it comes or aggravates between 4 and 8 p.m. Senna will be indicated in wind colic of children if the little sufferer turns blue when he cries.
SPECIAL FEATURES: (1) Nux-v., (2) Op., (3) Lyco; with diarrhoea; Cham. first and Coloc. next; with flatulence; Bell., Cham., Lyco., Mag-ph.
Nux-vom. will be useful when the colic is due to the mothers indulgence in stimulating foods.
REMEMBER: Cina when you find the child lying on abdomen during the colic and if you take him up he turns over again on the abdomen.
CROUP.
This is a very troublesome disease and appears all of a sudden at night when the child sleeps. The child is all right all the day long, even in the evening he moves and plays without any previous indication of the impending attack; a healthy child goes to bed and while sleeping he suddenly starts up and holds his breath. This breathing difficulty, however, soon passes off and the child falls asleep again, perhaps to be roused again by another attack or perhaps not. When it goes on repeatedly, being unattended, for several successive nights it proves fatal after five or six days. Death also occurs, though in very rare cases, within 24 or 48 hours.
The chief characteristic symptom of this condition is a husky voice resembling crowing or croak from which, probably, the name “Croup” has been derived. This crowing is termed as “stridor” and is a sure indication of insufficiency of air supply to the lungs causing great difficulty in breathing. The stridor is noticeable only during an attack. Fever and cough are two of its accompanying features.
There are three types of croup. The real croup is due to a spasm of the sound box, generally caused by a cold. This trouble is also found on the very outset in some cases of measles.
The second type is due to a false spasm of the vocal chord, them real spasm being somewhere else, perhaps in a distinct part like the wrist of had. This type is usually found in children who suffer from rickets. The popular name of this type is “Crowing”.
