CHOLERA INFANTUM
When the severe type of intestinal indigestion is accompanied with gastric disturbances and severe vomiting, it is known as cholera infantum. In this form the temperature rises rapidly and the symptoms develop quickly and become very severe in a remarkably short time. The vomiting is very severe and usually appears simultaneously with the diarrhea. After the stomach has been emptied of food the vomitus becomes serum and mucous. The contents of the small intestines may regurgitate into the stomach and be vomited up. Vomiting may be induced by taking water into the stomach. The stools are frequent, are of a pale green, yellow or brownish color at the beginning, but later become almost entirely serous. In the severe cases the bowels may be evacuated every few minutes. This type differs from that previously described in that the stools are practically odorless. In rare cases, however, they may be exceedingly offensive. There is probably no other incoördination during childhood in which there is such a rapid loss of weight. The picture which the patient presents is characteristic. There is great weakness and prostration from the very beginning. The fontanel is depressed and in some cases there may even be an overlapping of the cranial bones. The features become sharp, the eyes are deeply sunken and the angle of the mouth is drawn down. The nose is pinched, the skin over the forehead is tense and dry, the temples are sunken. There is pallor, stupor, marked relaxation of the lips and there will be convulsions and collapse. Statistics show that under medical treatment fully three-fourths of the cases die.