INFANTS EMERGENCY CASES


INFANTS EMERGENCY CASES.
B.K. GOSWAMI.

 

CHOLERA INFANTUM.

Cholera Infantum is not a real …


CHOLERA INFANTUM.

Cholera Infantum is not a real cholera but is a dangerous type of summer complaint of children. It is characterized by frequent purging and vomiting in association with a rise of temperature. The stools are watery and copious. Dehydration and consequent weakness are always obvious accompanying factors. Hand-fed and bottle-fed children upto the age of two years are its more common victims than the children at breast and the elderly ones. The infection enters into the body through milk.

As a precautionary measure the childs bottle should be sterilized after every feeding. Milk should be boiled and kept in a covered place or it should be boiled every time before feeding.

In case of an attack the child should not be allowed to take anything else than boiled water until the vomiting ceases and thereafter he should be kept on whey water for some period.

As flies may carry the infections to milk affecting other children the patients napkins should be kept in a lysol solution till they are washed.

TREATMENT:

Although this is not a real cholera but the symptoms being identical, any polychrest useful in cholera will also be beneficial in this dangerous type of gastro-intestine trouble of little babies.

Medicines in general: Acon., Aeth., Amm-c., Ant-cr., Apis., Agg- n., Arn-m., Ars., Bell., Bism., Calc-c., Calc-p., Camph., Carb- v., Cham., China, Cina, Crot-t., Cup-met., Ferr-m., Ferr-ph., Ip., Kali-br., Kali-ph., Kreos., Naph., Nux-v., Olnd., Op., Phyt., Podo., Psor., Sil., Stram., Sulph., Verat-a., Zinc-m.

Therapeutic Hints: As in cholera so in this complaint of infants Aconite is the first remedy to arrest the trouble at the very onset. It should be given in a very low potency repeating after each motion or vomiting. Fever, restlessness, dry skin and an unquenchable thirst will lead to its choice. This drug has a close resemblance to Belladonna and Ferrum-phos. Sudden appearance and rapid development of the ailment with a red bloated face, high fever and perspiration, or at least a clammy skin are the keynotes of the former and is very suitable in summer complaints of sanguine children.

Both Aconite and Belladonna act better in strong and corpulent subjects who have a natural inclination to develop every complaint with all rapidity. When plethora is absent and the child is anaemic or weak the development of the disease is slow and here come in Ferrum-phos. in places in both Acon. and Bell. Besides, Ferrum-phos. will remain beneficial even in a later stage while the other two are useful only during the first stage. Again, the Ferr-phos. symptoms, though alike, are always milder than the other two.

Ipecac is also an efficient remedy in the first stage of cholera infantum, especially when it is an outcome of atmospheric influence. Deadly nausea, vomiting without relief and a clean tongue will single out this remedy in our whole materia medica. Green, frothy stools will further support its choice. Antim-cr. is another remedy so commonly needed in the summer complaints of children. Great sleepiness and a thick milk-white coating over the whole tongue will determine its choice and vomiting of liquids only, and not of solid foods, will be a further support.

Antim-t. is used when the symptoms of Ant-c. are present but not so well defined and are of a milder form. It has vomiting of bilious matter with nausea and retching. Thirst and restlessness are contra indications of this remedy. Next comes Veratrum album having a vomiting of bilious mucus and a diarrhoea consisting a thin papescent mucus accompanied by great lassitude and cold extremities. Cold sweat over the forehead is its principal characteristic.

LEADING INDICATIONS:.

Aethusa: It has the prostration and restlessness of Arsenic but not the thirst. It has both vomiting and nausea; the milk is ejected curdled in big lumps soon after nursing, exhausting the child so much that he falls asleep. He wakes up hungry and wants to nurse (baby prefers bottle Ant-c.) which he vomits again and the process goes on repeating.

Apis: It is a thirstless medicine and is useful when the condition improves for sometime and then relapses again; stool constantly escaping involuntarily as if the anus remained open; threatened hydrocephaloid from anaemia and nervous exhaustion. Scanty urine.

Argent-nit: Diarrhoea soon after every drink. The baby is very food of sugar and candies which upset his stomach. It is an excellent medicine when diarrhoea and colic are resultants of a mental excitement.

Arsenic: Thirst intense, but drinks little at a time; restlessness; vomiting immediately after drinking and prostration out of all proportion are some of its keynotes. It should be given in small and infrequent doses.

Belladonna: Flushed face; sudden outcry which stops as suddenly; sudden attack and rapid development of the disease associated with high fever; skin extremely hot to touch; the kid starts and his limbs jerk; sleepy but cannot sleep; soon becomes delirious and in delirium tries to escape from the bed. Thin stools and green or bloody mucus.

Bismuth: In high potency it is a valuable medicine in cholera infantum. Sudden attack and rapid development of the disease (Bell.). Watery profuse and cadaverous smelling stools without any pain. It has a marked thirst but water is ejected as soon as it reaches the stomach (in Arsenic both water and other foods are vomited but in Bismuth it is water alone). It has prostration (Ars., Verat-a.) but the body and limbs remain warm. As a rule it has no perspiration, but if perspiration is present it too is warm.

Calcarea-carb: Scrofulous diathesis; large head, open fontanelles; distended abdomen, looking like a saucer up-turned. Easy perspiration, more on the back of the head and when asleep. All the troubles of a Calcarea kid are worse in the afternoon and towards evening. Intoleration of milk which is vomited (Aethusa, but the large lumps of curd); sour vomiting, sour smelling stools; the stool is watery and white.

Calcarea-phos: Useful for puny children with open fontanelles (Calc-c.), but sunken abdomen (reverse of Calc-c). Weakness is a prominent symptom of this drug. After a few motions and vomiting the child becomes pale, face sunken, look hippocratic, whole body and the limbs cold to touch. Vomiting soon after every drink. Stools copious, watery, green, warm, slimy and lienteric.

China: It is an excellent remedy to relieve the weakness and exhaustion caused by the excessive drainage. Tympanitic condition, painless diarrhoea; stools yellow, consisting undigested foods, escape involuntarily; worse after eating.

Chloral: In the opinion of Dr. Hael it is a reliable medicine if the child becomes delirious inspite of marked improvement of the gastro-intestine troubles.

Croton-tig: The presence of all the three of the following characteristics will determine the selection of this medicine: (i) motions soon after eating and drinking, (ii) stools profuse and greenish, and (iii) shots out all at a time.

Cuphea: It is a new drug lately added to our materia medica and its usefulness in cholera infantum has been described by Dr. W. Boericke as follows.” Vomiting of undigested food. Cholera Infantum, much acidity; frequent green, watery, acid stools. Tenesmus and great pain. High fever; restlessness and sleeplessness.”.

Cuprum-met: Suitable in convulsions of children in association with uraemia.

Ferrum-met.: It is useful when the child has several motions of lienteric stools accompanied by vomitings in the later part of the night or in the morning (Kali-p.).

Ferrum-phos.: It is a valuable remedy in cholera infantum and in the Biochemistry the principal remedy to be administered in alteration with Calc-ph. Copious watery diarrhoea of undigested stools. The child is anaemic and excessive motions and ejections make him weaker, face becomes pale, eyes sunken and half-closed. There may be fever and thirst; the child starts during sleep. It is also of great value when stupor ensues with face flushed, pupils dilated, and the head rolling from side to side on the pillow (Bell.).

Ipecac: Persistent nausea is the chief characteristic of this remedy. Deadly nausea, almost constant, without relief even after vomiting. A peculiar and strange symptom of this medicine is that inspite of so much disorder of the stomach the tongue is always clean. It is very useful in every stage of the disease, especially when it is due to atmospheric influence. The stools are fermented, with green, (sometimes white) mucus.

Kreosote: An excellent remedy when the attack is associated with a difficult teething. It has both vomiting and purging and the stool is putrid, smelling like carrion. The leading indications of this drug are found in the teeth which begin to decay soon after they grow; gum is inflamed, spongy and easily bleeding.

Podophyllum: It is a remedy of invaluable service in summer complaints of teething children. Morning diarrhoea with copious gushing stools is more marked than vomiting under this drug. The child becomes more and more exhausted after each motion. Marks of dehydration are most prominent when Podo. is indicated.

Phytolacca: During dentition it is the habit of some children to press the gums together and to gnaw at whatever hard things they can put to the mouth. If this symptom is present Phytolacca will take over the charge, no matter what is the name of the disease (Podo.).

Veratrum-alb.: The chief characteristic of this medicine is a cold sweat over the forehead. Both purging and vomiting are equally prominent in this drug and in addition it has cramps (Cupr-met.). Great thirst for large draughts of ice-cold water (Ars. small sips). Vomiting of green or yellowish mucus, and stools contain present mucus. Great prostration is well marked when Verat. is indicated.

N. B. For further details please refer to “Vomiting” and “Diarrhoea” in chapters “Stomach” and “Bowels” respectively previously published in this journal.

B K Goswami