After the acidity has been corrected by medicines, unlike a simple looseness, the purging and vomiting of infantile cholera still continue, showing conclusively the inactivity of the internal organs of digestion. In some cases the remedies that are scientifically administered pass out into the napkin unchanged; in others, they seem to lodge somewhere and dry up. The chances are always considered favorable to recovery if the remedies have a desirable action.
A child may drool or throw up its food at any time, yet be quite healthy. If a babe is sucking, and the mother indulges in a mixed or meat and vegetable diet too early, the first passages after it is taken sick will show signs of heat, fermentation and inflammation; they will either be of a deep yellow, or more or less green, and slimy. In such instances it is always advisable to take the infant from the breast for a while and feed it on arrow-root boiled in water, till the acidity is corrected; then in milk, no sugar being added, alternating with gum-arabic water. The mother, or wet-nurse, having been put under strict diet for a week, might with propriety resume nursing. Robust, perfectly developed children are apt to exhibit considerable vitality through the different phases of the disease; but as far as my experience has been, they succumb to the worst more quickly than the more delicate-appearing.
As the disease progresses the little sufferer will thrust its fingers in its mouth, as if to intimate hunger or dryness, and gag, as though something was sticking in the throat. The hands and arms are the most active. The lower extremities are seldom moved from one position; and when moved by any one, they are quickly reversed. Every movement of the body, in bathing or changing, is followed by a discharge from the bowels. These discharges vary in consistence even before any medicine has been given. After the bowels have been purged, as is recommended by most physicians to begin with, the discharges from the bowels may run off frequently, and in small quantities, depositing in the napkin a whitish, frothy fluid, which settles down to a chalky substance, giving out the smell of lime. If such emissions continue, they will effect a rapid destruction; or they may have the same appearance from the beginning if the internal organs have been previously rendered weak from starvation, or rather where the food has been but little better than water sweetened; and, too, these frothy emissions greatly chafe the parts if they are allowed to remain soiled.
The tongue is dry and stiff, as a general thing, throughout the disease. The body, with the exception of the belly, is dry and cool. The mouth is apt to be hot from the beginning, a sign remarked by mothers who have suckled babes with cholera; in the last stage, the disposition to sleep, but start at the least noise; the mouth lying half open, the intelligent attempts to suck; the decrease of the discharges from the bowels; the cessation of retching; the sinking in of the features; the nervous grasping, as if to catch some passing object; jerking of the body, and moaning, may be looked upon as unfavorable signs.
It is a great mistake to conclude that infants will have cholera if weaned early, or if they are to be artificially nursed. The fear comes from persons having been so educated within the last half century.
All kinds of preparations are advertised and eagerly sought for baby diet; as if the internal organs of babes were entirely different from what they were before, and must needs be supplied with something more supernatural than those of the adult. The symptoms of cholera are by no means uniform. For instance, they may be cut short, or aggravated by overdosing, before the facts in the case are made known. Thus, if paregoric, laudanum, or any alcoholic carminatives are habitually put in the drink, the most marked signs will be the smell of the breath, the presence of constipation, stupor and sinking in of the features more or less, with very little vomiting. Such cases, no doubt, are seldom admitted, the victims being dead, or nearly so, when medical aid is called.
SECTION IV.
GENERAL TREATMENT OF CHOLERA INFANTUM, MEDICAL AND DOMESTIC.
Unfortunately for many children, it is usually in the last stage of the disease that a physician is consulted. Probably any number of palliatives have been given with good intentions and high hopes of success. For one, the old cleaning-out remedy, so much thought of by old ladies, and doctors not a few,—castor-oil. Whatever may be deemed as proper treatment, it should be remembered that nothing short of the most untiring vigilance on the part of the attendant, guided by Divine aid, can bring success in raising a child on whom cholera has fastened its blighting fangs. Yet what encouragement it is to know that by those means it can be saved.
My course for the last fifteen years has been to first ascertain, if possible, the cause of cholera, and have it removed; also particularly to inquire how long it has been since the child has been noticed to fail in the effort to suck; then as to the color and frequency of the discharges. I have never known, through my observations of over twenty-three years, any better corrector of acidity, sourness in the human bowels, than calcined magnesia. After giving from two to three grains every hour, or according to the degree of acidity, until it is all apparently changed, then, as cautiously as needful, I proceed to quiet the motion of the bowels, as in case of purging within the month, by the use of mixture No. 1, which if put up by a regular chemist, and given according to directions, can be no more objectionable because inserted in this little book than thousands of other recipes scattered over the community by tons in expensive books.
No. 1, R. Mixtura Creatæ, preperata, zj.—Chalk Mixture, Aquæ Cinnam. zss.—Cinnamon Water. Add Opii Tinct. Gutta vj.—Laudanum.