In the days of old, when medical knights were bold in
the use of drugs for the treatment of 'diseases peculiar to babies,'
the mortality was great. Some preparations of calomel--particularly the gray
powder--calomel and chalk--and some of the lighter preparations of opium and
morphine, were in daily use.
The enervating influence of hot weather and improper
care, and the poisoning from food improperly prepared, will often bring on
gastric disturbances in children. If the child nurses the mother, her milk may
be ruined as a food because of improper foods, work, and unreasonable marital
demands. The milk of a mother subjected to such influences will surely cause a
child to have stomach and bowel derangements, and, when the summer heat is
intense, kill many by what is called cholera infantum (cholera in infants). The
symptoms of this disease are intense restlessness, high fever, frequent
vomitings, at first curdled milk, then water in which there may be specks of
white resembling rice. The bowel movements are called rice-colored discharges,
and are considered characteristic of cholera. The rice specks are small curds
The whole aspect of the child is one of intense suffering
and great prostration. The vomiting and bowel movements are almost incessant.
In a few cases the prostration comes on rapidly, and death ends the suffering
in a few hours. Those who do not die within twenty-four hours will often settle
into a state of bowel derangement named in text-books gastro-enteritis
(inflammation of the stomach and small intestines) or muco enteritis (catarrhal
inflammation of the small intestines).
Cholera infantum is indigenous to the Mississippi Valley
and other parts of the country where the climate is hot and moist. It is a
disease seldom met with in high and dry altitudes.
purging, with great prostration. Rapid drain of water from the blood
through the stomach and bowels by way of vomiting, and frequent watery
evacuations from the bowels, deplete the body rapidly and bring on fatal
exhaustions in a few hours. Plump babies weighing fifteen to twenty-five pounds
will sometimes lose half their weight in from twelve to twenty-four hours.
Treatment.--Obviously the rapid drain of water
from the body will make a strong demand, by way of thirst, for water to supply
the waste. Warm water may be given--never cold; for the heat of the body must
be conserved by keeping artificial heat to the entire body to prevent fatal
chilling. A hot tub-bath must be used as frequently as appears necessary to
relieve the pain and restlessness. Hot baths, by stimulating the surface
skin--circulation, draw the blood from the mucous membrane of the stomach and bowels,
and prevent, as far as possible, the fluid drain that takes place from the
congested mucous membrane.
Thirst is often interpreted as hunger, and the
accustomed food is given. No greater mistake could be made; for food given
under such circumstances becomes a rank poison, and millions of children have
been killed from overzealousness in trying to prevent starvation. Even water is
rejected by the stomach and bowels, and, when the vomiting and purging is at
its worst, a teaspoonful of hot water may be given occasionally. As much as the
child will take will aggravate the vomiting. The lips and mouth may be wet with
a small gauze swab. The swab may be put into boiling water after using it, or a
fresh one may be made at each swabbing.
When even water is rejected, the discerning should
realize how impossible feeding would be. Thirst can be assuaged slightly by
keeping a soft towel, wet in warm water, on the stomach and bowels, retained by
a binder. Keep the towel warm by using an electric pad, or a hot-water bottle.
The hot bath cannot be stressed overmuch; for its
tendency is to draw the blood to the surface, relieving the engorgement of the
mucous membrane. It soothes the nervous system and gives a little rest. In
desperate cases, the bath should be prolonged for an hour, and repeated as
often as necessary to get as much relief as possible. Hot water should be
added, and the cool run out. Keep the water in the tub as near 104 degrees as
possible. The child should be watched closely. So long as the symptoms indicate
that the bath is soothing, continue it. When the heart indicates weakness or
when there are signs of oppressed breathing, wrap the child in a soft blanket
and give fresh air, but avoid cold extremities.
If symptoms improve, and the vomiting and purging grows
less frequent, do not meddle, but encourage any improvement by perfect quiet.
Do not, however, neglect warmth. As soon as the stomach will tolerate water,
increase the amount given by slow degrees, until the child can take all it
wants. Gradually reduce the artificial heat. Keep heat to the feet and abdomen.
When the bowels are fully relieved, leave off the heat, rub with oil, and keep
a dry pad on the abdomen.
Feeding should not start until the blood-vessels and
tissues have had their loss of water supplied. The blood has been dehydrated.
When the water has been replaced, give of the accustomed food up to one-tenth
the usual supply. If the first day's test-feeding is received kindly, the
second day two-tenths may be given. Increase each day by one-tenth, until
regulation meals are given. Then stop the regular ten o'clock feed, and give
fruit or vegetable juices at this meal time throughout young child-life.
When children have been carried through cholera
infantum carefully, as directed above, they will not develop a gastritis or
gastro-enteritis, which is supposed to be a sequel of the disease. This,
however, is a mistake. The so-called sequel of the disease is caused by feeding
too soon, or by overfeeding, medicating, etc.
Few realize that enervated
mothers impart enervation to their children. The following is an incident among
many similar ones that have come within my experience:
Fifty years ago I was making a professional visit to
the wife of a wealthy farmer. Mr. Howard, the owner of one of the show farms in
complimented Mr. and Mrs. Howard on their beautiful home and farm, and remarked
that they should be very happy. This brought from both the confession that they
were not happy, because they had lost seven beautiful children in infancy, all
having died from summer complaint--a blanket term for stomach and bowel
diseases of infants.
The husband, after visiting with me for a while,
excused himself, saying that he must give some orders to his foreman; but,
before going, he invited me, when through with my professional call, to come
out to the barn and see some of his fine stock, which I did. Besides other
prize animals, he showed me a young Kentucky
mare with foal by one of the greatest racing sires of that day.
I saw a chance to point a moral, and said: 'Mr.
Howard, my horse needs a few weeks of rest out on your splendid pasture. Allow
me to take this beautiful mare and use her while my horse takes a rest. I
promise to take good care of her and feed her well. A little road work will
give her some needed exercise.' Mr. Howard looked at me in amazement, and
replied: 'My dear doctor, you don't know the consequences of what you ask!
If her colt can stand on its feet at birth, it will be worth three hundred
dollars. If you should drive the mare in your buggy for a while, the colt would
probably die of scours.' I said: 'Mr. Howard, did it ever occur to
you that you have lost seven children from the scours?' He dropped his
head, knit his brow, and, after a short silence, came to me, took my hand in
his, and said: 'You make a fiend of me. How stupid I have been! I see it
all now. I have allowed Mrs. Howard to kill our children. She is ambitious and
has worked too hard.'
I was entertained in the Howard home twenty-five years
later, and saw five splendid children. Mrs. Howard told me that they had never
had occasion to call a doctor to prescribe for any of them.
An enervated mother will impart enervation to her
children. An enervated child has low resistance, and will give down easily from
the depressing influences of hot weather, excitement, etc.