The stools are more frequent and always softer than usual, possibly fluid.
Diarrhœa means increased intestinal action due to irritation from something. It may be due to indigestion, to the presence of hard curds, to acidosis, or it may accompany almost any disease of infancy as a symptom merely. The odor is due to gases formed in the canal by bacterial action. There is but little odor in fermentation, but much in putrefaction. Mucus appears either as balls or strings. The balls come from the small intestine, strings from colon. Blood indicates ulceration at some point in the bowel, or an erosion just above the sphincter.
Fig. 127.—Proper position for introduction of a suppository. (Grulee.)
Fatty curds may be either white, granular, sand-like masses, or small, soft, and yellow. The protein curd is large and smooth, or white and bean-like. Both occur only when the artificially fed infant is given raw milk (Brenneman). If the milk is boiled for two minutes these masses will not form.
The cause must be determined. The frequent stools, however, are exhausting, and may have to be checked with opiates or mechanical astringents.
When due to indigestion, all food by mouth may be stopped for two or three days and only barley water administered.
In a breast-fed child, diarrhœa is sometimes checked by diluting the milk with a little barley water, given just before nursing. With these infants, not much change in the sugar content can be made by alterations of the maternal diet, but where artificial food is used, the amount of sugar is easily reduced to a satisfactory degree.
Colic is a cramp-like pain of the bowels. Previous to the attack the child is restless, expels some gas, and has the “colic smile,” which leads the mother to believe the child is quite well. When the attack comes on, the thighs are flexed on the abdomen, and the legs on the thighs. The child has a sharp cry, that is nearly continuous, but in some way related to the nursing period, for the attack comes on a few minutes, and sometimes an hour, after taking the breast. The belly is rigid, the arms wave aimlessly. Diarrhœa may be present, and the movements are accompanied by much flatus. Distention is nearly always present. When the belly is tapped it gives a drum-like note and the child belches gas, sometimes accompanied by milk, which seems to relieve.
Treatment.—Colonic flushings to relieve the bowel of irritating curds. The child may be laid face down with a bag of hot water under the belly. Mixture of asafœtida gtts. xx to xl, or whiskey and hot water should be given for the attack, followed later by a full dose of castor oil. The diet should be rigorously investigated.