Adolph Lippe
Cholera Infantum
Cholera infantum, or, as this form of disease is generally termed, "summer complaint," comprises all the various diseases of the digestive organs and brain with which children are attacked during the summer, and most frequently during dentition, during their second summer. The various forms of diseases of the digestive organs are those attacking the stomach as its principal seat, as catarrh, aridity, inflammation, ulceration, or softening of it, or the intestines alone are the seat of the disease, as an erythematous inflammation, catarrh, excoriations and ulceration.
The disease often appears in different forms, at different seasons and in different localities.
The brain is very frequently the seat of the disease from the very inception of it, and the erroneous idea that a later stage of the disease itself develops the various cerebral symptoms is only a proof that the first observations of the state of the patient's disturbed health were made inaccurately, and that the cerebral symptoms had been entirely overlooked. The most frequent brain disturbance from the very beginning of the disease, is hydrocephaloid.
If the observing healer has found the cerebral symptoms (dilated pupils, hot head, cold extremities, drowsiness) present in a child during hot weather and the prevalence of cholera infantum, he may avert all further anxieties (especially if the child also vomits) by administering a single dose of Belladonna.
The knowledge of the seat of the disease, its name, or a knowledge of the stage in which we find the disease, does not indicate a particular treatment, or indicate the truly curative remedy; but this knowledge is nevertheless necessary, for it facilitates the examination of the sick, and it enables the physician to classify the symptoms obtained, and to consider as most important in each individual case, the symptoms indicating the progress of disease in this or the other locality, and the changes or suppression of one or the other function of organs. As an illustration of these proposition, let us turn to a child supposed to suffer from epidemic cholera infantum. We are informed that the child has diarrhoea since midnight, but does not give signs of pain; it lies quiet, its eyes are only half closed, the anterior fontanel is elevated, the face is pale, the wrists and feet are cold, and upon further enquiry learn that the child has not passed any urine since the previous evening; the abdomen is flabby, not hot. It would be useless, in such a case to select the remedy guided by the nature of the evacuations. Here we are presented with a decided case of hydrocephaloid, a case of great gravity, possibly to end fatally within one, or at least a few a days; and we further know that should the patient pass urine within a few hours after the administration of the truly homoeopathic remedy (Sulphur in this case), the recovery becomes a certainty, and probably without any further medication. Another child has cholera infantum, and cries most persistently, has done so all night, is cutting teeth, and the distressed mother says this screaming has lasted all night; "we have to carry the child all the time to pacify it;" it has frequent green discharges from the bowels, preceded by an increase of pain, causing it to draw up its knees to the abdomen; the abdomen is hot, the thirst incessant; we are sure there is nothing the matter with the child's brain but the seat of tho inflammatory disease is in the small intestines. A dose of Chamomilla will soon quiet the child.
It has been proposed to begin the treatment of these grave cases of cholera infantum, having their origin in a disturbed condition of the brain, by administering Aconite and Bryonia in alternation. As this proposition is a violation of all and every fundamental principle of our school, the result will be a failure to cure. First and foremost, the character of the disease, its locality, or its kind, can never serve as a guide to our therapeutic action. Much less can the administration of two entirely differently acting drugs, as are Aconite and Bryonia, be followed by salutary results; either one or the other case stand in the proper relation as a therapeutic agent under the law of the similars, never both, and why, then, not adhere to the law, and administer the simillimum?
The therapeutics include also the dietetics, and in cholera infantum it becomes very important to see to it that the proper nourishment is given to the children. The better the dietetics of a child have been understood, and the more proper the nourishment has been from its birth, the less liable will it be to be attacked violently by the ordinary diseases of children during the hot weather. There are general dietetic rules for the children laid down in the books, and its all well to know them, but they lend to generalizations; each individual child wants its individual diet, adapted to its individual constitutional condition. The administration of crude substances supposed to be wanting in the organism is based on "materialism", the substances so wanting, or supposed to be wanting, can at best only be supplied by food containing them only in a greater proportion than its ordinary nourishment did. The instinct of children will very frequently indicate the requisite nourishment which then should never be withheld, even if it is contrary to speculative science. In properly nourished children we will rarely ever find a bad case of cholera infantum, and the more we have studied carefully the proper diet of each individual child under our care, the less will they be liable to diseases of the digestive organs. Many cases of children come under the treatment of the physician which he has never seen before, and the more general experience he has gained about the proper diet of the children, the easier will he be able to detect what mistakes have been made in each individual case, and he will at once endeavor to correct the erroneous diet.
The erroneous, but generally accepted notion, that children should be nursed during the second summer on account of the prevalence of cholera infantum during that season, causes more cases and is the frequent cause of the great mortality in that disease. There are nine months of the gestation, and exactly nine-months of lactation (nursing and feeding by the mother's milk). The appearance of the teeth is the first indication that farinaceous food is wanted and it must not be withheld, and as different children cut their teeth earlier or later during the first nine months, farinaceous food should be given as it is needed.
All the dietetics being properly attended to, the chief problem is to find in each individual case the corresponding similar remedy. In grave cases, the choice of a remedy must be made at once, as delay is attended by great danger. It is the aim of these short pages to give characteristic symptoms, and a concise description of frequently occurring combinations of symptoms in this form of disease, with their correspondingly similar remedy.
We shall first give the most frequently indicated remedies, and then those less often called for:
Apis Mellifica
The child is inclined to stupor, out of which it starts with a loud, shrill scream. The eyes have a reddish tint. The head is hot. The tongue is dry, and thirst is but seldom present. The skin is dry, the hands at times cold and blue. Suppression of urine. The abdomen is tender to pressure. The diarrhoea is worse in the morning, always mixed with mucus, sometimes very offensive or involuntary, or containing flakes of pus.
Belladonna
The child lies in a stupor; it frequently starts up suddenly in its sleep; when awake it is angry and violent, he head is hot, and is often rolled from side to side. The face is Generally purple, red and hot, or very pale and cold. The tongue is red on the edges, or coated whitish yellow, or has two white strips of coating extending down on both sides of the tongue. Thirst moderate, pulse very frequent, small and hard; occasionally full. Hands and feet cold; the hotter the head is, the colder are the feet. The abdomen is hot, the stools are day color or green, or consist of white or granular yellow slimy mucus, and very frequent.
Chamomilla
The child is exceedingly peevish; the guns are very hot, the cheeks are red, at times only one cheek; the child wants to be carried all the time; has attacks of colic, draws its knees up, and seems to be relieved for a short time after a passage from the bowels. Vomiting of food and sour mucus. The stools are green, or green mucus at times mixed with white mucus, or chopped; the discharges are hot, excoriating the parts; frequent sometimes smelling like rotten eggs.
Croton Tiglium
The child has a stool as often as it is fed or nursed. The discharge is sudden, noisy, and violent, consisting generally of yellow water.
Ipecacuanha
Diarrhoea and vomiting. Vomiting of food and drink as often as one drinks, or vomiting of green mucus. Much nausea, with pale face and oppressed breathing. Stools are of green mucus, or are bloody or fermented.
Natrium Sulphuricum
Frequent attacks of violent colic, with rumbling in the abdomen, relieved by the violent discharge of yellow water with large quantities of flatus. The stools are more frequent during the morning hours, after the child has been taken us and is moved about, like Bryonia.
Podophyllum Peltatum
Drowsiness or restless sleep, with grinding of the teeth or rolling of the head. Vomiting of frothy mucus, green, or of food. The diarrhoea is worse in the morning and the discharges are more frequent at night than during the day. Stools green watery or mixed with mucus; or like chalk; profuse and painless. During and after stool, prolapsus ani. During dentition; also catarrhal cough and catarrh of the chest. Cramps of the feet calves and thighs.
Sulphur
The disease generally begins after midnight; diarrhoea and vomiting, the discharges from the bowels are generally watery and green and involuntary; they sometimes smell sour, at other times they are very offensive; vomiting is frequent often smelling sour (like Calcarea); with cold perspiration on the face (Veratrum, Cold perspiration on the forehead). The face is pale the fontanels open, hands and feet cold the very first morning; the child lies in a stupor with its eyes half open; not much thirst and entire suppression of urine. The child does not scream out violently as under Apis, or roll his head as under Belladonna. In such a case as above described one single dose of Sulphur will Suffice to re-establish the urinary one secretions and cause the child to sit up again and take food.
Aconitum Napellus
He is seldom indicated, and then only at the beginning of the disease, especially where it has been caused by a check perspiration, mostly during the night, when the weather has changes from extreme heat to cold. The child is excessively agitated an restless, pulse very frequent and hard, abdomen very hot; much restless pulse very frequent and hard, abdomen very hot; much thirst; the discharges are watery and contain bloody mucus.
Arsenicum Album
Diarrhoea and vomiting; much thirst for cold water but everything the child drinks is thrown up at once; hot skin, great restlessness; the child continuously tosses about, changes its position and cries incessantly. Stools watery and very offensive, or black fluid, or dark, thick green mucus; very great weakness and emaciation.
Benzoic Acid
If during an attack, the urinary discharges becomes very scanty, and if the urine has a very pungent strong smell and if the urine easily becomes turbid.
Bismuth
Diarrhoea and vomiting. The vomiting prevails, and food and drink is thrown up at once; the abdomen is bloated the face is pale, blue rings under the eyes. (Comp.: Kreosote)
Bryonia Alba
The attacks return as the weather becomes hot. And are relived on cool days. (Aconite and Dulcamara have the reverse). Vomiting of bile, tongue coated yellow, thirst not frequent but drinking of large quantities (Aconite has the reverse); abdomen hot, the child does not want to be moved (Aconite has the reverse); every motions causes pain in the abdomen and discharge from the bowels. Worse in the morning when beginning to be moved.
Calcarea Carbonica
Open fontanels; stools grey-like clay, smelling sour, vomiting of food, especially mild, sour, profuse perspiration on the head, during sleep, swollen, distended abdomen. (Sacchroff); urine clear, (Benzoic acid had turbid urine), is passed with difficulty, and has a strong, pungent, fetid odor.
Carbo vegetabilis
Diarrhoea; stools very putrid or bloody; face pale or greenish; the gums recede from the teeth and bleed easily; abdomen distended; emission of large quantities of flatus skin cold; tongue and breath cold; voice hoarse or lost. Painless watery diarrhoea, yellow or blackish or of indicated food; worse after (Ferrum has diarrhoea while eating) and worse at night and after eating fruit, with much tendency to perspire.
Colocynthis
Diarrhoea with violent colic before, during or after stool; compelling the child to bend double, which seems to give relief (the colic of Belladonna is relived by hard pressure across the abdomen; that of Rhus tox is relived by lying on the abdomen.
Kreosote
Diarrhoea with vomiting the continuous vomiting and straining to vomit predominates; the child resents the tightening of anything the abdomen, which increases the restlessness and pain; much thirst; gums hot; coldness of the hands and feet (compare Bismuth).
Iris versicolor
Diarrhoea and vomiting; vomiting of food, bile or of a very sour fluid; profuse, frequent watery stools. Tympanitis.
Natrum Muriaticum
Watery diarrhoea with colic; incessant, thirst with nausea; emaciation beginning at or principally on the neck; abdomen bloated.
Nitric Acid
Diarrhoea, green, mucous or bloody, or putrid smell from the mouth;-copious flow of saliva; ulcers in the mouth and on the tongue.
Pauline Scibilis
Green profuse stools, inodorous.
Petroleum
Diarrhoea only during the day.
Phosphorus
Diarrhoea and vomiting; desire for cold water, which is thrown up as soon as it becomes warm in the stomach; diarrhoea is worse in the morning; stools consist of green mucus, brown fluid, white mucus, or containing little grains like tallow.
Silicea
Fontanels open; much perspiration on the head; great thirst; emaciation; rolling of the head; suppressed urinary secretions; watery, very offensive stools. (Calcarea has sour smelting stools).
Sulphuric Acid
Frequent, large, watery, very offer evacuation?, with aphthae and great irritability.
Veratrum Album
Diarrhoea and vomiting; greatness; vomiting of frothy substance; profuse watery diarrhoea with flakes; during stool cold perspiration on the forehead pale face; cold hands; voice weak or hoarse; suppression of urine.
If marasmus follows a protracted case of cholera infantum we have two great principal remedies to stay its progress and cure the patient.
Sarsaparilla
Great emaciation; the skin lies in folds; the face shriveled; aphthae on the tongue and on the roof of the mouth.
Iodine
The child has an inordinate appetite, but nevertheless continues to emaciate, if effusions on the brain have taken place, then, we may resort to Digitalis, Helleborus, Hyoscyamus, Opium, Zinc. cording to their respective indications.
These general indications will enable the practitioner to find the proper remedy in many cases, especially in cases requiring prompt and unhesitating prescriptions. The variety of cases is so great that it is utterly impossible to give a proper prescription for all and every variety of cholera infantum or any other disease.