During the present year, I have frequently met with the following conditions, occurring especially in children. I desire to know what remedies are especially indicated for these symptoms:
The child is irritable, either one or both of the cheeks has a bright red spot on it without any fever, there is a moderately dilated pupil, and a white circle around the mouth.
With the above symptoms, we have been having a number of cases of watery cholera, or a true gastro-interitis, resembling somewhat that form of diarrhea which occurs in hot weather. With bottle-fed babies, it begins with vomiting of curded milk. Coincident with this, there are large watery movements from the bowels. These symptoms may be accompanied with some fever, although the temperature is not usually high.
What is the most directly indicated treatment of the above symptoms?
S. RINEHART, M. D.
COMMENT:—The circumscribed red-ness of the cheeks with the white circle around the mouth, point directly to intestinal irritation. While these symptoms are found in those cases where intestinal worms are present, they will quite commonly follow any intestinal irritation, whatever the cause may be.
While santonin is seldom used except as a worm remedy, it can be depended upon with positiveness in relieving this condition. From ¼ to ½ grain three or four times a day is given to a two year old child. I have made it a custom to triturate it with the sugar of milk, and it is surprising how prompt its influence is.
The enteric symptoms, with the watery diarrheal demand the arsenite of copper. A tablet containing the 1/50 of a grain, dissolved in half a glass of boiling water, should be stirred until cool enough to administer. This should be given as hot as the child will take it, every ten minutes for from two to four hours, depending upon the severity of the symptoms. In fact, I have continued it from eight to ten hours, but it usually causes a marked improvement in the diarrhea in a few hours, when the doses may be given farther apart.
It may be necessary to previously evacuate the intestinal tract with a high, colonic flush, and if there is an inclination to vomit after curds have been expelled, some soothing remedy should be given to allay gastric irritation.
Aconite would be indicated for the fever, or very minute doses of colocynth if colicky pains are present.