I shall conclude this essay by the following remarks:
1. Camphor has often been suspended in a bag from the neck, as a preservative against this disease. Repeated observations have taught me, that it possesses little or no efficacy for this purpose. I have had reason to entertain a more favourable opinion of the benefit of washing the hands and face with vinegar, and of rinsing the mouth and throat with vinegar and water every morning, as means of preventing this disease.
2. Whenever I have been called to a patient where the scarlatina appeared to be in a forming state, a vomit of ipecacuanha or tartar emetic, mixed with a few grains of calomel, has never failed of completely checking the disease, or of so far mitigating its violence, as to dispose it to a favourable issue in a few days; and if these observations should serve no other purpose than to awaken the early attention of patients and physicians to this speedy and effectual remedy, they will not have been recorded in vain.
3. When the matter which produces this disease has been received into the body, a purge has prevented its being excited into action, or rendered it mild, throughout a whole family. For this practice I am indebted to some observations on the scarlatina, published by Dr. Sims in the first volume of the Medical Memoirs.
4. During the prevalence of the inflammatory constitution of the atmosphere, between the years 1793 and 1800, this disease occurred occasionally in Philadelphia, and yielded, like the other epidemics of those years, to copious blood-letting, and other depleting remedies.
AN ACCOUNT
INTO
THE CAUSE AND CURE
OF
THE CHOLERA INFANTUM.
By this name I mean to designate a disease, called, in Philadelphia, the “vomiting and purging of children.” From the regularity of its appearance in the summer months, it is likewise known by the name of “the disease of the season.” It prevails in most of the large towns of the United States. It is distinguished in Charleston, in South Carolina, by the name of “the April and May disease,” from making its first appearance in those two months. It seldom appears in Philadelphia till the middle of June, or the beginning of July, and generally continues till near the middle of September. Its frequency and danger are always in proportion to the heat of the weather. It affects children from the first or second week after their birth, till they are two years old. It sometimes begins with a diarrhœa, which continues for several days without any other symptom of indisposition; but it more frequently comes on with a violent vomiting and purging, and a high fever. The matter discharged from the stomach and bowels is generally yellow or green, but the stools are sometimes slimy and bloody, without any tincture of bile. In some instances they are nearly as limpid as water. Worms are frequently discharged in each kind of the stools that has been described. The children, in this stage of the disease, appear to suffer a good deal of pain. They draw up their feet, and are never easy in one posture. The pulse is quick and weak. The head is unusually warm, while the extremities retain their natural heat, or incline to be cold. The fever is of the remitting kind, and discovers evident exacerbations, especially in the evenings. The disease affects the head so much, as in some instances to produce symptoms not only of delirium, but of mania, insomuch that the children throw their heads backwards and forwards, and sometimes make attempts to scratch, and to bite their parents, nurses, and even themselves. A swelling frequently occurs in the abdomen, and in the face and limbs. An intense thirst attends every stage of the disease. The eyes appear languid and hollow, and the children generally sleep with them half closed. Such is the insensibility of the system in some instances in this disease, that flies have been seen to alight upon the eyes when open, without exciting a motion in the eyelids to remove them. Sometimes the vomiting continues without the purging, but more generally the purging continues without the vomiting, through the whole course of the disease. The stools are frequently large, and extremely fœtid, but in some instances they are without smell, and resemble drinks and aliment which have been taken into the body. The disease is sometimes fatal in a few days. I once saw it carry off a child in four and twenty hours. Its duration is varied by the season of the year, and by the changes in the temperature of the weather. A cool day frequently abates its violence, and disposes it to a favourable termination. It often continues, with occasional variations in its appearance, for six weeks or two months. Where the disease has been of long continuance, the approach of death is gradual, and attended by a number of distressing symptoms. An emaciation of the body to such a degree, as that the bones come through the skin, livid spots, a singultus, convulsions, a strongly marked hippocratic countenance, and a sore mouth, generally precede the fatal termination of this disease. Few children ever recover, after the last symptoms which have been mentioned make their appearance.