Veratrum and Phos. acid, given alternately, at intervals, as frequently as the discharges from the bowels occur, will generally be sufficient. If there is nausea or vomiting, or cramping pains in the bowels, give Ipecac in alternation with one or both the former. If thirst and a burning of the stomach or bowels exist, use Arsenicum. This last medicine may be given in alternation with either of the others, but is most frequently indicated in connection with Veratrum. The intervals between the doses should be regulated by the frequency of the evacuations in all cases, lengthening them as the evacuations become less frequent, until they cease. In children, where the discharges are greenish or slimy, and contain undigested food, give Chamomilla and Ipecac alternately, as above directed. If the discharges are dark, or yellow, with distress in the stomach, give Podophyllin. The dose is from 3 to 6 pellets. In all cases of diarrhœa, adults should abstain from all kinds of food until cured, if possible, and eat but little at first, when food is taken. Children should be fed carefully, and but a small quantity at a time, being particular both for adults and children to use as little liquid as possible; drink water in small quantities, not very cold. Avoid exercise, and lie on the back quietly, when that is practicable. In a large majority of cases, Veratrum, if given in the early stages of the disease, will arrest it at once, and in many chronic diarrhœas of weeks or months standing, it is the surest remedy. In chronic diarrhœa of females, Podophyllin should be used in alternation with Veratrum.
Dysentery.
This disease is caused by inflammation of the mucous membrane of the colon and rectum, (the large intestine) generally confined to the lower part of the bowel. It is always painful. There is griping and straining in the lower part of the abdomen, and generally great bearing down when at stool, with a peculiar distress after the evacuation, called tormina.
The discharges often commence like a common diarrhœa, with copious liquid evacuations, but there is more or less griping pain, low down, from the beginning. The evacuations sooner or later become lessened, slimy or bloody, or both, the pain increasing accompanied with more or less fever, often quite severe. Sometimes the patient is costive, and has been so for several days, the dysentery coming on without being preceded by looseness. At others, especially in summer, when fevers are prevailing, the dysentery begins with a severe chill, followed by fever and the dysenteric symptoms above described.
TREATMENT.
If it begins with looseness without blood, give Arsenicum and Veratrum alternately, once an hour, or oftener if the evacuations are more frequent. If the discharges are bloody, use Mercurius cor. in place of the Arsenicum. If there is any sickness of the stomach, or the discharges are dark or yellow, use Podophyllin with Mercurius cor. If there are colic pains in the bowels, use Colocynthis alternately with the others, giving it between them. If the patient was costive previous to the attack, and the dysentery came on without much looseness, Nux Vomica should be given alternately with Mercurius cor. If the disease comes on with a chill, or a chill occurs at any time during the attack, followed by fever, Aconite, Baptisia and Podophyllin should be used in rotation half an hour apart until a free perspiration is produced, and the pain diminishes; or if bloody stools appear, use Mercurius cor, with the Aconite and Baptisia. A large proportion of the dysenteries of hot weather in miasmatic regions, will be arrested in a few hours by these three or four remedies, especially if the patient keeps still, and generally even if he keeps about his business. In very bad cases, much benefit will be derived from injections of Gum Arabic water, or mucillage of Slippery Elm thrown into the bowel in quantities of a pint or more at a time, as warm as can possibly be endured. I have often relieved patients immediately with injections of a strong solution of Borax in Rice water, as hot as bearable. Never apply cold water to any inflamed surface, much less a mucous surface. All food should be withheld as far as practicable and not starve, until the symptoms abate.
Colic.
The symptoms of this are cramping pains in the abdomen, without fever or looseness of the bowels. The colic sometimes occurs after the cessation of a diarrhœa that had been induced by severe cathartics. The pains are cutting and straining, drawing the bowels into knots, relieved temporarily by pressure.
TREATMENT.
For a male, Nux Vom., and for a female, Pulsatilla will generally afford immediate relief. In children, especially, where diarrhœa exists, Chamomilla should be used. If it is the result of severe cathartics, or if there is a soreness or a bruised feeling, Colocynth is the remedy. Hot injections into the rectum, and large quantities of warm water taken into the stomach, will often cure colic.