It is sometimes a problem to renew feedings of milk without exciting a relapse of the diarrhea. It should not be tried until the stools are normal in color and consistency. This may not be for three or four days. In resuming the milk it should be given in smaller amounts and diluted with lime water or barley water for the first day. Gruels may be given to which skimmed milk may be added: later add the ordinary milk. If it is well digested and does not cause any return of the diarrhea, the quantity of milk can be slowly increased until the former feedings are resumed. It is often of very great advantage to boil the milk for some time. Peptonized milk is safe and can be used in bottle-fed infants after diarrhea. In older children, meat, broths, eggs, boiled milk, and dry toast bread may be used sparingly for some time. Cereals, vegetables, fruits, should be withheld for a considerable time and watched carefully when resumed. Kumyss, buttermilk, matzoon, bacillac, and other fermented milks are better borne than plain milk. All of these children need rest, fresh air, change of air, frequent bathing, and tonics, as an attack of this kind leaves them depressed, weak, languid, and anemic.
SUMMARY:—
1st. When a child complains of sharp, colicky, severe pains in the abdomen, around navel, which are shortly followed by foul, sour, frothy diarrhea,—greenish in color, it has acute intestinal indigestion.
2nd. Every mother should know that a green stool means danger. She should know to give at once a cathartic,—castor oil is good, but give a good large dose—then stop all food for twenty-four hours. If she learns this lesson she will have time to wait for the doctor; meantime, she may have saved her child's life.
CHILDREN WITH WHOM MILK DOES NOT AGREE
Contrary to the general belief, there are quite a large number of children in whom milk seems to act as a poison. These children are not necessarily constipated. They suffer, however, from a slow, continuous intestinal toxemia or poison. The symptoms of this condition are headache, disorders of speech, habitual sleep-talking, sleep-walking, and general nervous irritability without cause: they are listless, languid, and constantly tired. They may be bright in the morning and sleepy in the afternoon. They are irritable and cross and touchy.
Treatment.—Milk must be wholly discontinued. Eggs must be restricted to one every second day, and meat but once daily. The use of green vegetables is particularly suitable and should be given daily. Cereals and fruit also are good. Malted milk, kumyss, or matzoon may be given in place of milk. If constipation is present, rhubarb and soda mixture is an excellent laxative in these cases. A tonic should be prescribed for all these children.
DYSENTERY—ENTERITIS—ENTERO-COLITIS—INFLAMMATORY DIARRHEA
Cause.—Any cause which has been mentioned as a cause of ordinary diarrhea may result in this disease. It may occur at any time of the year and at any age. It may follow the infectious diseases. It may follow any other disease of the intestines.
Symptoms.—It may begin like an ordinary attack of acute intestinal indigestion. There is usually vomiting, fever, pain, and frequent yellow or green stools. The passages may be blood-stained and there may be little or much mucus. The stools at the beginning have no odor as a rule. The bowels move very frequently, often with little or nothing to pass. There may be pain with each movement. The blood may disappear in a few days, but the mucus remains, often in large quantity in each stool.
At the beginning the fever is high, but it soon falls and remains low during the attack. The child loses weight, is irritable, has no appetite, and looks and acts sick. When the attack is over these children do not gain their strength as readily as we would like; recovery is slow.