If the patient is a breast-fed infant it can be allowed to nurse after the twenty-four-hour rest. The length of time it is permitted to stay at the breast should be about one-quarter of the time it was allowed before the attack began. If it does not vomit, the nursing can be repeated every four hours. As the case progresses toward recovery the interval between feedings can be shortened. Care, however, must be taken not to shorten the interval too rapidly.
If the patient is artificially fed and is not over four months old, a substitute for the milk must be found. The best substitutes are rice or barley water, either plain or dextrinized, the malted foods, chicken or beef broths, liquid peptonoids or bovinine. Water (boiled and cooled) may be allowed at all times if not vomited.
Older children are treated in the same way. All food is withheld while there is any vomiting. When vomiting stops begin with small quantities of beef broth, or chicken, or veal broth. Later kumyss or matzoon can be tried, and finally thin gruels made with milk.
If vomiting persists the stomach must be washed out; this can be done by giving the infant or child a large drink of cool boiled water. This will be immediately vomited and it will clean the stomach at the same time. The stomach-pump may be used to better advantage. One washing is usually sufficient. The vomiting will stop after the stomach has been washed out and the patient may then be given, frequently, small quantities of cold albumen water or barley water.
The bowel should be thoroughly cleaned out at the beginning of every summer diarrhea. Castor oil or calomel are the two best cathartics for this purpose. If the stomach is not upset use castor oil. If the stomach is upset use calomel; one-fourth of a grain every hour for eight doses will be sufficient. Give enough, however,—there is no danger at the beginning of the attack of too free movements of the bowel. Whatever cathartic is given, it should produce green, watery stools.
Irrigation of the bowel is an exceedingly effective way of cleaning out the poison-laden large intestine. It should be done in every instance unless the movements are watery and of such frequency as to render irrigation unnecessary. Once or twice daily will be sufficient in even the worst cases. The irrigation should be given at the temperature of 100° F, and should be the normal saline solution; a long rectal tube is used to give the irrigation.
SUMMARY:—
1st. Cholera infantum is one of the most dangerous, one of the most treacherous, and one of the quickest acting diseases of childhood.
2nd. Don't temporize, don't delay, don't regard lightly any diarrhea during the summer time.
3rd. Give a large dose of castor oil and withhold all nourishment until the doctor sees the little patient in every case of diarrhea during the warm weather.
4th. Keep the child in a cool, quiet place and don't handle or annoy it.
5th. Follow, your doctor's directions implicitly. The fight may be short, sharp, and decisive. Don't pave the way for regrets afterward. Do everything while you have the chance.
COLIC
Colic is a common condition in infancy. Very few children escape more or less colic during the first few months of life. It does not seem to injure permanently some infants; they go on growing according to standard, eat and sleep, and seem contented and happy despite occasional severe attacks of colic. Other children suffer seriously; the degree of indigestion is considerable, and the nutrition of the child is interfered with.