INFANTS EMERGENCY CASES


INFANTS EMERGENCY CASES.
B. K. GOSWAMI.

 

As a principle the practitioner of homoeopathy has to co…


As a principle the practitioner of homoeopathy has to collect all the symptoms of the patient before he prescribers medicine. To obtain these symptoms he has to examine the patient thoroughly and carefully, to give a patient hearing to the narration of the case, to trace out the anamnesis, to take note of the patients occupation, position, movements, feelings, sensations, etc.; and then to collect further datas from the nurse, relations, neighbors and friends.

After gathering all these preliminary informations he has to consult his materia medica to find out a medicine covering the highest number of these symptoms. It is true that experience gained from long practice, however, enables a prescriber to collect the necessary symptoms accurately in a shorter method without going through the drudgery of putting so many verbal questions for every detail; but even then the method remains traditionally long and vexatious.

Every law has its exceptions and so has the law of Similars. Occasions arises when the prescriber has to deviate from this time-honoured principle and has to prescribe hurriedly but not haphazardly. These are called “Emergency Causes” and in tackling these cases every minute counts.

These are situations when either the patient is raving and and tossing with terrible pains or the disease is fast developing endangering the life or may be a situation when the vitality itself is ebbing down. The situation demands a hurried prescription. But truly speaking this is not what is actually meant by the term ” hurried prescription”; it is in fact, a well considered one as will be evident from its instantaneous result.

These emergency cases are intensely acute conditions when all the symptoms fully develop and present a clear picture of the medicine required. It may be to the great amazement of everyone present that an experienced eye finds his medicine from a glance at the patient and cures at sight but it is quite possible and practicable in homoeopathy.

Any homoeopathic practitioner can achieve this skill by acquiring a fair knowledge of his materia medica. In the following lines it has been described how under homoeopathic treatment relief can be rendered, cure established and health restored in the shortest possible time in some of such emergencies.

ASPHYXIA NEONATORUM.

(Apparent Death).

Asphyxia is a Greek word literally meaning “no pulse” but in practice it refers to a condition of blood caused by want of air. In this condition the blood is in such state as to render impossible a sufficiently free exchange of carbonic acid for oxygen and the oxygen which was already in the blood is rapidly used up leaving the blood of a dark colour. Hence the childs face first becomes cyanotic and then ecchymotic.

This complaints is not so common but as this is one of the first trouble in human life let us take up this subject as the first emergency call. This is so uncommon a condition that Dr. Jahr had had only one such case in his extensive practice of long 40 years.

Immediately after the birth sometimes a child neither moves, nor cries but remains quite listless and motionless as if dead. This may be due to constriction of throat caused by the umbilical chord being tightly pressing round the throat or from some obstruction inside the throat. In either instance the cause must be removed immediately and respiration should be restored artificially.

When there is any obstruction inside the mouth or throat, such as an accumulation of mucous, it can be removed by inserting a finger. If it fails the infant should be placed over the abdomen, on the palm of the left hand and slapped gently on the back with the right hand. When the obstruction has been removed the physician should blow slowly into the mouth of the baby from his own mouth.

Care should be taken against blowing too much air at a time into the childs lung. Pressing softly on the lower chest the lung should be emptied next. Repeating this process several times at 3 or 4 minutes intervals regular respiration can be established.

During the course of broncho-pneumonia of children sometimes this condition appears and the child turns blue. Bathing the child simultaneously in tepid hot and cold waters or putting the child in hot water and douching with cold water on the chest will be helpful to restore normal respiration in such cases.

MEDICAL TREATMENT:– One globule of the indicated medicine has to be put on the childs tongue every 5 to 10 minutes until normal breathing is restored.

The first two medicines to be thought of for this condition are Antim-tart and Laurocerasus. Dr. Farrington describes their indications as under. Antimonium-tart: when there is rattling of mucous in throat. Laurocerasus is useful when there is great blueness of the face, with twitching of the muscles of the face, and gasping without really breathing. We may further add Aconite when the face is congested (Bell); Opium where sopor is the predominating feature and the face looks bloated. Lachesis also has a blue or purple countenance.

Like Laurocerasus it is one of our ophidias and has many similarities with that medicine. Carbo- veg. is an invaluable remedy in the collapse stage and can act equally well in asphyxia NEONATORUM where weakness is marked, and the face and the finger nails become blue. Venous symptoms are very prominent under this drug. Arnica-mont: is our sheet anchor for asphyxia from charcoal gas. But if the asphyxia of a new born baby can be traced to mechanical injury during a difficult labor then again Arnica will be first medicine.

ERYSIPELAS NEONATORUM.

The above name means this condition of new born babies which does not necessarily imply that others may not suffer from this dangerous complaint. In fact, these eruptions may appear at any age though children are its more common victims, perhaps due to their habitual uncleanliness. As this tormenting and rapidly spreading condition sometimes occurs even in new born infants we have selected it as the second of the series.

It is a spreading inflammation of the skin caused by certain germs through some wound, scratch or crack and the inflamed part becomes red and swollen always accompanied by a high fever, 104F or above. Although it may appear on any part of the body but the face is its most common and favourable site. The red area is remarkable with a well defined margin and raised edge. Blisters frequently form on it and the face becomes so swollen that the child cannot open his eyes. The temperature falls down suddenly after five days and the redness disappears after a week or so when peeling starts. Although it is a disease of short duration but its effects on the general health is severe and the delirium is common.

In enfeebled children sometimes the eruptions retrocede giving rise to delirium and meningeal symptoms, and often endangering the life.

Caution: All sorts of external applications and local treatment are not only altogether unnecessary in this condition but they are also very often harmful. The only local treatment than can be allowed is the application of a soft linen wring out of a saline solution to relieve the tension caused by the dryness as is seen in some cases.

MEDICAL TREATMENT: Although the name of the condition in young babies is named differently it has no different course of treatment from elderly ones. The indications described below will be as useful in the adults cases as any medicine referred there will be in the NEONATORUM complaint, provided always that the symptoms agree.

PRINCIPAL MEDICINES: Apis, Bell., Bry., Graph., Hep-s., Lach., Merc-s., Phos., Rhus-t, Sulph.

THERAPEUTIC HINTS: Dr. Jahr considers Belladonna is sufficient to effect a perfect cure of smooth erysipelas, no matter what part of the body is affected. It has excitable delirium, high fever, intensely bright red swelling, smooth and shining, which spreads in streaks darting out of a central point. The pupils are dilated and the child is efficacious in the treatment of smooth erysipelas. The child is dull, heavy and listless, and the swelling is usually across the nose, thence spreading to the face or to the eyelids.

One of its peculiarity is that the swellings are often found white in the center and have a tendency to extend from right to left. Its violent stabbing pains make the child cry out in sudden loud shrills. Rhus-tox. often comes next to Bell. and is suitable when the erysipelatous swelling spreads from left to right. Its swellings have a dusky redness and the vesicles contain a bloody serum. It will be especially suitable in erysipelas of hairy parts such as the scalp (Nat-m.). Delirium, drowsiness and constant restlessness are some of its accompanying features.

Lachesis will be indicated in a later stage when gangrene is threatened and the swelling, which is bluish red, becomes oedematous. Its vesicles appear on the left side and extends towards the right. It has a low type of fever and delirium, and all its troubles aggravate during sleep. Graphites will be useful when the eruptions show a recurring tendency and begin on the nose.

Its chief characteristic is that the vesicles contain a honey-like sticky matter forming crusty scales when they are broken. Its eruptions are of phlegmonous type spreading erysipelas, shifting from place to place in an irregular course. Considerable prostration of strength; anguish cry and restlessness manifesting the burning pain that the child is suffering from are some of its close associates. Dr. Jahr advises to depend on Bryonia and Cuprum-met. when the eruptions disappear suddenly or are suppressed from some local applications.

SPECIAL FEATURES:.

Rhus-tox is the chief remedy for vesicular erysipelas and next is Apis, while in some cases Graphites too may be required. Other possible remedies are Euphorb., Bell., Lach.

Erysipelas appearing first on the right side and thence spreading towards the left: Apis and Graph. And extending from left to right Rhus-t. is the first medicine and Lach. next.

Erysipelas in association with jaundice; Merc-s., and Hep-s.

REMEMBER: Belladonna has a bright red swelling; Apis, pale red or pinkish; Rhus-t., dark-red; and Lach. bluish or purplish red.

Belladonna is the first medicine to begin with and in cases where it fails Rhus-t. has a greater chance to bring success than Apis, while Graph. has to be tried only when all the three prove ineffective.

TETANUS NEONATORUM.

This condition has been given third place in our discussion not because it is less dangerous than the preceding too. On the contrary it is a more dangerous disease often proving fatal within the first two or three days; only in rare cases it prolongs for a longer time rendering a cure possible. We have given it the third place and only a casual deal firstly because new-born babies are less liable to this infection than elderly ones and secondly because its symptoms and treatment are the same as for the grown-ups.

Tetanus is more commonly known as “Lockjaw” as the early manifestations of the disease are stiffness of the throat-muscles and difficulty in swallowing, followed by the lower jaw becoming tightly fixed (trismus) and soon the spasm involves the rest of the face, the neck, the trunk and the limbs; which also become fixed likewise (tonic spasm). When the head is drawn back it is called ophisthotonos condition. The spasm may, however, relax temporarily from time to time to be renewed readily from a noise or bright light. The cause of the disease is said to be an infection with drum-stick (tetanus) bacillus through some wound.

Here are some of the possible remedies for this conditions:– Acon., Arn., Bell., Camph., Lyco., Merc., Nux-v., Stram.

B K Goswami