INFANTS BOWELS


The diarrhoea ceases in the vicinity of 10 a.m. and the child remains well for the rest of the day. Podophyllum diarrhoea, though begins in the morning, has neither of these features, on the other hand it continues throughout the day though becomes less frequent in the afternoon. It is notorious for gushing diarrhoea, copious in quantity, exhausting the child every time.


Remember Sepia when milk causes constipation (Sil.).

It should be noted here that in the treatment of constipation in children laxatives of all sorts should be strictly avoided as they form a bad habit which becomes very difficult to correct in later years. In regulating diets of the child the writer recommends with benefit honey to lick. It can be given 3 or 4 times a day and 5 to 8 drops at a time.

DIARRHOEA.

Now let us take up diarrhoea in the treatment of which Homoeopathy has already won many laurels. Even a reputed friend of ours in the opposite camp will, sometimes, envy the success that an ordinary quack practising homoeopathy can display in the treatment of diarrhoea in children. In the treatment of diarrhoea the writer finds it convenient for selection of medicines if they are grouped according to their time of aggravation and distinguishing them next in accordance with the condition of stools and causation.

Let us take up morning diarrhoea to start with and the commonly indicated medicines are Sulphur, Natrum sulph and Podophyllum. Sulphur diarrhoea may begin any time in the morning, usually near about 4, but the urging is always sudden and violent. The child opens his eyes with the urge or rather the urging awakes the child. This peculiarity is the leading feature of Sulphur diarrhoea.

The diarrhoea ceases in the vicinity of 10 a.m. and the child remains well for the rest of the day. Podophyllum diarrhoea, though begins in the morning, has neither of these features, on the other hand it continues throughout the day though becomes less frequent in the afternoon. It is notorious for gushing diarrhoea, copious in quantity, exhausting the child every time. It is more suitable during dentition and in warm weather. Natrum-sulph. has yellow, watery stools associated with cold, more particularly damp cold.

Petroleum diarrhoea may begin in the morning and continues throughout the day like Podo. but no stool during night will distinguish it from all other remedies.

For afternoon aggravation, perhaps, Arsenicum-album, Cinchona and Calcarea-carb will be enough. Arsenicum has thirst, anguishness and small but offensive stools. Prostration is always very prominent where this remedy is required. Cinchona has yellow or yellowish watery stools but it is the presence of undigested foods in the stool and the painless character that lead us to its choice. Diarrhoea after each feeding (Arg-n., Ars.) To derive full benefit from Calcarea-carb the constitutional symptoms should be taken into consideration and they have been described under constipation.

Both Phosphorus and Pulsatilla have diarrhoea worse in the evening. The former may be needed in painless diarrhoea after some pulmonary troubles. Stools changing every time in color, quantity and quality, no two stools alike, is the keynote of the latter.

For diarrhoea worse at night think of Ars., Cinch., Cham., Merc., Puls. and Sulph. All these remedies have already been described with the exception of Chamomilla and Mercurius. Both of them have green diarrhoea, but the former is distinguished by its characteristic irritability of mood and is more suitable for teething complaints while the latter by its peculiar pain and tenesmus which continue even after the stools; the child continues to strain as if some stools has been left inside.

Diarrhoea after midnight is found under Ars. and Sulph first and Arg-n. and Nux-v. next.

Argentum-nit. diarrhoea is worse after every meal. The child passes the stools involuntarily immediately after he is nursed. The stools may have natural color when passed but become green after standing for some time on the diaper. This is our sheet anchor for sugar aggravation.

Now-a-days it has become a common practice to add glucose with the childs milk. If these children develop diarrhoea, particularly green diarrhoea, then Arg-n. will take over the charge. But glucose must be discontinued first. If it becomes necessary to add some sugar in the childs milk then Arg-n. can be given in lactose and put in the childs bottle.

Nux-vom. has frequent urging but the stools are notably scanty.

Now if we classify the medicines in accordance with the common conditions of stools selection will be easier. We can conveniently name these conditions first as (i) green diarrhoea, (ii) sour diarrhoea, (iii) painless diarrhoea and then as (1) lienteric stools, (2) achiled stools, (3) involuntary stools, (4) acrid stools and (5) offensive stools with putrid odor.

But the prescriber will find it more convenient for consultation if the other possible remedies are described first so that he may find them all in one place. Hence let us describe other common remedies for diarrhoea before entering into stool conditions.

Acid-Phos :- Painless, unexhausting diarrhoea of rachitic children. White, watery stools, coming out with much flatus. The stools are copious but do not weaken the child proportionately. On the contrary he may be seen jolly and playing merrily. It has also involuntary stools.

Aloe :- Much flatus, rumbling in abdomen, stools escape involuntarily while passing flatus. Diarrhoea with sudden and violent urging immediately after eating or drinking.

Apis :- Chronic diarrhoea with scanty urine and thirstlessness.

Bismuth:- Diarrhoea with great thirst and frequent micturition. Cholera infantum.

Borax will be suitable in diarrhoea with stomatitis of children. Dread of downward motions is its keynote.

Calcarea-phos is suitable for rachitic children with open fontanelles. Green stools and great flatulence.

Chamomilla is very often abused in diarrhoea of teething children. To derive full benefit from this drug its characteristic irritable mood should be given first consideration. The stools are green, watery, corroding and offensive. In colic the child gets no relief anywhere or in any position except being carried continuously. After Chamomilla Sulphur completes the case.

Colocynth is notorious for its colicky pains. The cutting pain in abdomen makes the child drag its legs over the abdomen. It is more suitable in dysentery with such cutting pains and it comes after Mercurius. The stools are green.

Croton-tig. will be indicated when the bowels are moved with a spasmodic jerk and it is all out like a shot. Diarrhoea as soon as the child eats or drinks anything. Copious watery stools, rather yellow than green.

Ferrum-met. should be thought of in diarrhoea if the child has motions while eating or drinking (after eating or drinking- Chin.). It has painless diarrhoea with lienteric stools.

Gambogia:- The urging is sudden but it is only after a long waiting and straining that the stool gushes out all at a time (compare Crot-tig.). The stools are watery yellow but sometimes colorless. The pains are relieved after stools.

Helleborus should be thought of in diarrhoea associated with acute hydrocephalus: the child rolls the head from side to side (Podo): involuntary and colorless watery stools with or without mucus.

Hepar-sulph:- Diarrhoea worse after eating, drinking and during the day time (Compare Petr., Podo.). The stools may be green, slimy and lienteric or whitish and sour smelling accompanied by sour vomiting and sour eructations.

Iodium:- will be useful in chronic diarrhoea with progressive emaciation and canine hunger, stools are light colored, and induration of some gland or glands is its accompanying feature.

Ipecac:- Persistent nausea is its chief characteristic, Grass- like green, frothy, watery stools, especially during summer. The child tosses about and cries. The stools are frequent small, yellow or green. The tongue is almost always clean.

Magnesia-carb:- This remedy will work like a specific if the stools are green and sour smelling. It has gripping colicky pain and tenesmus before stools. Remember this remedy when milk passes undigested in nursing children.

Mercurius dulcus:- This is perhaps the most frequently indicated remedy for green diarrhoea of children. Tenesmus is the most prominent symptom when this medicine is indicated.

Natrum-mur, will be useful in chronic diarrhoea with marked thirst in emaciated children. Its emaciation begins from and is more prominent around the neck.

Natrum-phos is Dr. Schusslers medicine for sour smelling stools may be green or yellow. It will be more suitable if worms are present.

Natrum-sulph will be suitable in chronic diarrhoea associated with liver affections. The stools are green and there is much rumbling in abdomen. It has a constant pain in the liver region which is sometimes, sensitive to touch.

Opium will be the remedy in chronic diarrhoea when the child has been in the habit of taking this hypnotic in crude form.

It is very bad practice of mothers in our country to create opium habit in their children. These ignorant mothers give this drug to quieten their children without thinking of its serious consequences. Opium in potentized form will help to reform this bad habit.

Phosphorus: – Painless diarrhoea worse in the morning. Its stools are watery and contain white particles like sago. In involuntary stools it seems as if the anus remain open and at times it actually remains so. The child is overgrown, thin and slender.

Rheum:- The sour odor is most prominent and persistent under this drug; even the whole body of the child smells sour and the mother cannot remove this odor however much she may wash the child. Remember that the stools of Magnesia-carb. are green while they are dark brown in Rheum.

Sulphur:- It has acrid stools and is a good curative when the anus is found red and excoriated. It has redness of all orifices. Even the palms of hands and soles of feet of Sulphur kids are usually red. The redness is however most prominent on the lips.

This polychrest is also helpful to clear up the incomplete cases of some other remedies, particularly of Aloe, Ars., Cham., Merc- s, and Podo.

Green diarrhoea:- Merc-dul. will usually prove sufficient. Think of Cham., Cal-p., or Ip. if Merc-dul does not fit well. Other possible medicines for this condition are Arg-n., Coloc., Crot- t., Mag-c., Merc-s., Nat-s., Podo., Puls. and Sulph.

Sour diarrhoea :- The principal remedies are being names here in order of their frequent applications:- Mag-c., Calc-c., Hep., and Rheum in the first group and Nap-p. and Sulph. in the next. In Rheum, Calc-c. and Hep. the sour odor persists even when the child has been washed well.

Painless diarrhoea :- China and Podo. should receive our first thought but if the symptoms do not suit a selection may be made from the following medicines – Aloe, Bismuth, Crot-t., Hep., Nat- m., Nat-s., Olnd., Phos., Phos-ac. and Sulph.

Involuntary stools:- Oleander will cover this condition if it is simple – diarrhoea and there is no other complication. Aloe also may come in for this trouble. But if the child remain unconscious, semiconscious, delirious or soporous then (1) Hyos. Op. (2) Apis, Cina or Mur-ac. will be the possibilities. Other remedies useful for this condition are – (1) Bell., Phos., Ph-ac. (2) Chin., Psor. and Sulph.

Lienteric stools:- China and Arsenicum are the principal remedies for this complaint and in the absence of any clear cut indication Chininum-Ars 3x or 6x trituration can be prescribed with confidence.

Other medicines that may be required for this condition are – (1) Calc., Olnd., Phos., Phos-ac., Podo. (2) Mag-c. and Nat-p.

Offensive stools. – (Smelling putrid) :- Remedies in general:- Ars., Bapt., Kali-ph., Olnd., Podo and Sulph.

Achiled or light colored stools :- Calc-c., Phos., Iod.

Causation: – (see stomach also).

Dentition: – Acon., Aeth., Calc-c., Cal-ph., Cham., Kreos., Podo.

Antim Crudum has diarrhoea from bathing. Thickly white coating over the whole tongue is its guiding symptom. The child is always very sleepy.

Sanguinaria when the diarrhoea sets in after suppression of bronchitis.

Opium will be suitable when diarrhoea is originated from nursing the child when the mother was frightened.

Chamomilla will be useful if the mother nurses the child after a fit of anger and the child gets diarrhoea.

Aconite is the chief remedy for diarrhoea after suppression of perspiration.

Bryonia may be of help in diarrhoea from suppression of eruptions.

Apis may be helpful in diarrhoea from suppression of exanthemata.

Thuja is our sheet-anchor for diarrhoea as bad effect of vaccination (Kali-m., Sil.).

Concomitants:- Think of Ipecac and Pulsatilla for diarrhoea associated with Measles, Drosera with Whooping Cough, and Argent- nit., with Conjunctivitis (Merc-s.) and Bapt., Hyosc., Mur-ac., and Rhus-t. with low type of fever.

DYSENTERY.

In the acute stage of dysentery, especially if it is caused from an exposure to cold or from getting cold when the body is warm, Aconite 1x or 3x in repeated doses will be sufficient. It has more or less fever, restlessness and increased thirst. Belladonna and Ferrum-phos are the other two medicines that may be found suitable in this stage. In the next stage we find Merc- sol. very useful. It has aggravation at night, colic and tenesmus without relief from stools. The stools are scanty and contains slims with, perhaps, marks of blood. But if blood is more prominent than mucus then Merc-cor. will serve better than Merc-sol. Some authors claim that in dysentery of children Ipecac in alternation with Petroleum works like a specific.

Nux-vom. has some similarity with Merc-s. Both have scanty stools with mucus, colic and tenesmus. But the child requiring Nux finds relief after each motion while the pain and tenesmus of Merc-sol continue long after the stools. Nux has also a history of patent medicine being abused.

Aloe will be indicated if the mucus is in jelly like lumps.

Podophyllum has small stools in dysentery while large in diarrhoea.

Sulphur may be required to clear up the cases after some improvements have been made by the indicated remedy.

For badly managed cases, especially when it takes the form of typhoid think of – Ars., Bapt., Phos. and Rhus-t.

In persistent cases of dysentery the writer recommends to wrap a piece of flannel or linen around the abdomen of the child as a protection against cold.

In some places thee water hampers the cure of dysentery. Boiled water is allowed to cool in an earthen pot, the sediments will settle down at the bottom. Take out this water in another pot very carefully leaving the sediments unstirred at the bottom of the first vessel. If all the diets of the child is prepared with this sedimentless preboiled water it will facilitate the treatment. Of course care should be taken that no other water enters into the stomach of the patient.

ENTERITIS: – This is another common complaint for which the children are brought to us. Inflammation of the bowel is called enteritis and is usually characterised by colicky pain, diarrhoea general malaise and rumbling in abdomen. This may be due to several causes. If the inflammation extends to the stomach it is named as gastro enteritis. Inflammation of the large intestine or colon is called colitis.

The principal remedies for this trouble are – Acon., Bell., Bry., and occasionally Coloc., or Rhus-t. Dr. Jahr further recommends Lachesis when Rhus-t. fails.

CHOLERA INFANTUM:- We shall deal with this condition in a separate chapter. But for the present it will not be difficult for a prescriber to find out the appropriate medicine according to the indications described under diarrhoea above in stomach chapter.

WORMS.

The remedies most frequently indicated for these complaints are – Calc-c., Cina., Spig., Sulph. Nat-p. and Sil. In the next group we can place the remedies like Acon., Bell., Ferr., Ipecac, Lyco., and Stannum. Other possible medicines are -Chenopodium, China, Filix-mas, Ign., Indigo, Mer-sol., Teucrium etc.

Aconite:- Fever due to ascarides (Merc-s., Cina., Sil.); bloated abdomen and itching of anus.

Belladonna:- Urine escapes involuntarily, the child grinds the teeth during sleep (Cina); plethoric subjects.

Caladium Sequinum is suitable when ascarides enter into the female genitalis and create leucorrhoea in little girls. (Calc).

Cina is no doubt our first remedy for all conditions brought on by this animalculae but to produce the desired effect it should be used judiciously. It has pale face with rings around the eyes, constant picking of nose; grinding of teeth and starting and screaming during sleep; pitiful weeping when wakes up and restless sleep. It is also the best remedy for convulsions from worms (Cicuta, Indigo).

Ignatia is our best remedy for itching of or crawling sensation in anus (Cina, Kali-m., Nat-p Teucrium). The child is very irritable and peevish.

Indigo is claimed to be a better remedy than Cina for convulsions of children from worms.

Ipecac:- Progressive emaciation with nausea and vomiting.

Kali-mur will be suitable for itching in anus if the tongue has a white coating.

Sometimes the ascarides crawl out to the anus during night and causes great irritation and itching there. It prevents the childs sleep. External application of mustard oil will give immediate, though temporary, relief.

Natrum phos. is the chief remedy in biochemistry for all sorts of worms and worm conditions.

Santonine 3x should be tried when Cina, though indicated, fails to bring the desired effect.

Silica:- If the child passes ascarides in masses.

Stannum is claimed as a specific to expel pin worms.

Teucrium :- During night the pin worms crawl down to the anus and torment the child with terrible itching (Ign.).

ASCARIDES: – Dr. Jahr advises to give Mercurius and Sulphur in frequently repeated doses. Calcarea in higher potency, preferably preceded by a dose of Sulphur, may be sufficient to extinct these worms, if allowed to act undisturbed for a sufficiently long time.

LUMBRICOIDES: Dr. Jahr considers Aconite is better than Cina to expel these worms. Some authors recommend Chenopodium also for this purpose. Three or four drops of chenopodium oil taken four times a day will help to expel these round worms. It acts better when taken in empty stomach.

For colic of children from worms think of Cina first and then Lycopodium or Mercurius.

For vomiting in association with worms think of Cina, Ip., and Sanguinaria first and Aconite and Ferrum next.

FLATULENCE.

When this condition is in association with constipation usually Lycopodium or Opium will be found sufficient. Graphites and Nux vom. may also come in occasionally. For flatulence with diarrhoea think of China or Carbo-veg. first and then Arg-n., Cham., or Colchicum according to symptoms present. China is suitable in the early stage while Carbo veg come in a later.

See also stomach.

PROLAPSUS OF RECTUM.

Podophyllum will cover the majority of these cases. Ignatia, Sepia, and Ferrum are the other remedies that may occasionally step in. Calcarea and Podophyllum have prolapsus in association with diarrhoea. For prolapsus before stools think of – Podo. and Ruta. For prolapsus during the stools consider the possibilities of Ign., Podo., Sep. and Calc. For prolapsus after the stool give Podo., Ign., Sep. or Sulph.

REMEMBER.

Aloe for masses of jellylike mucus.

Graphites for cracks or fissures of anus.

Natrum-mur. when the stool is so hard and large that it tears the anus and causes bleeding.

Petroleum for diarrhoea originated from riding in a car or train.

Ipecac for fermented, foamy and green stools.

Argent-nit. for stools which are of yellow color when passed but green afterwards.

Alumina when the child has to strain hard and long, no matter whether the stools are hard or soft.

When you see the parents anxious and worried standing by the side of a large diarrhoetic stool of a child while the child himself is jovial, playful and smiling you need not feel confused, but remember Phosphoric acid.

B K Goswami