1st. There is a form of jaundice caused by a defect in the development of the bile or gall tubes. These infants develop jaundice a day or two after birth and become intensely jaundiced within a very brief time. They lose flesh and strength to a marked degree and die in a few weeks. It is not possible to affect this condition favorably by any method of treatment. This type of jaundice is not very common.
2nd. There is a type of jaundice that appears between the second and fifth day of life that is very common. It lasts from one to two weeks and then disappears. It is never fatal and is not serious. It requires no treatment.
JAUNDICE IN OLDER CHILDREN—CATARRHAL JAUNDICE—GASTRO DUODENITIS
Symptoms.—This form of jaundice begins like an attack of ordinary indigestion. There are, as a rule, pain, fever, vomiting, and prostration. The pain is located in the upper part of the abdomen and may be quite severe. The vomiting may continue for a number of days. The bowels are usually constipated. After a few days the jaundice sets in and may be quite intense. After the jaundice is established the stools are gray or white in color and there is much gas in the bowel. The urine is very dark and may be yellow or yellowish-green in color. The child complains of headache, is dull and listless, and appears sick and weak. The condition lasts about two weeks, but the jaundice may last much longer. It is not a serious disease.
Treatment.—The diet should be cut down in quantity and should consist of rare meat, fruit, and a small quantity of milk. If vomiting continues the milk may diluted with lime water or vichy water. The child should drink water or vichy water freely. No starchy foods, or fats, or sugars should be allowed. The bowels should be kept open with calomel, one-tenth of a grain every hour until ten are taken, to be followed by citrate of magnesia every morning. If the pain is severe it may be relieved by a mustard paste or a turpentine poultice. The child should be given acid hydrochloric diluted, eight drops in one-half glass of water, ten minutes before each meal—and kept on it for at least one month.
INTESTINAL WORMS
There are three types of intestinal worms; they are known as the round-worm, the thread-worm, and the tape worm.
Round-Worm.—The round-worm is usually found in children of the run-about age. It is never seen in infancy. It occupies the small or upper intestine, and is from four to ten inches long. If there are round-worms in the bowel, there are usually a number of them and there may be hundreds.
Symptoms.—Round-worms give no definite symptoms. The only possible way to tell if they are present is actually to see them in the stools of the child. They are of a light gray color.
It is reasonable to expect that a child suffering from worms will have symptoms of abdominal distress from time to time; indigestion with colic and much gas may be present; children lose their appetites and are nervous and restless; sleep is disturbed; they may grind their teeth and talk in their sleep, and they may pick their noses unnecessarily during the day. These symptoms may, however, accompany other conditions when no worms are present in the bowel. My observation has been that in children in whom worms were present the nervous symptoms were distinctly accentuated. They are unreliable children; they seem well to-day and peevish to-morrow; they complain of headaches, dizziness, and chilly feelings. They are hysterical, noisy, uncontrollable. A child with these symptoms should be suspected of having worms and if no cause can be found to explain his temperamental vagaries he should be treated for worms. I have cured a number of children of excessive nervousness by giving them medicine for worms when no worms were present. Such results can only be explained on the assumption that these children were suffering from intestinal auto-toxemia or self-poisoning, and the thorough disinfection of the bowel apparently stopped the process by ridding the child's system of a mass of bacteria, which were undoubtedly causing the auto-toxemia and consequent nervousness.