SECTION IV.. General Treatment of Cholera Infantum, Medical and Domestic.

GENERAL TREATMENT OF CHOLERA INFANTUM, MEDICAL AND DOMESTIC.

Unfortunately for many children, it is usually in the last stage of the disease that a physician is consulted. Probably any number of palliatives have been given with good intentions and high hopes of success. For one, the old cleaning-out remedy, so much thought of by old ladies, and doctors not a few,—castor-oil. Whatever may be deemed as proper treatment, it should be remembered that nothing short of the most untiring vigilance on the part of the attendant, guided by Divine aid, can bring success in raising a child on whom cholera has fastened its blighting fangs. Yet what encouragement it is to know that by those means it can be saved.

My course for the last fifteen years has been to first ascertain, if possible, the cause of cholera, and have it removed; also particularly to inquire how long it has been since the child has been noticed to fail in the effort to suck; then as to the color and frequency of the discharges. I have never known, through my observations of over twenty-three years, any better corrector of acidity, sourness in the human bowels, than calcined magnesia. After giving from two to three grains every hour, or according to the degree of acidity, until it is all apparently changed, then, as cautiously as needful, I proceed to quiet the motion of the bowels, as in case of purging within the month, by the use of mixture No. 1, which if put up by a regular chemist, and given according to directions, can be no more objectionable because inserted in this little book than thousands of other recipes scattered over the community by tons in expensive books.

No. 1, R. Mixtura Creatæ, preperata, zj.—Chalk Mixture, Aquæ Cinnam. zss.—Cinnamon Water. Add Opii Tinct. Gutta vj.—Laudanum.

Shake well before using. Dose—A small teaspoonful after each stool. Increase the dose according to age of patient. Of course it is not expected that the inexperienced would attempt to administer anything other than domestic remedies, unless put up according to the rules of art.

For a decided case of cholera, it is best to begin with half a teaspoonful of the mixture; which, by the by, should be sucked down by the patient very slowly, in order to have it remain on the stomach. No time should be wasted listening to the old story of working off a bowel complaint; few are the adults that ever have survived the experiment, much less the weakly infant. Deaths from cholera cannot possibly be so numerous in consequence of the discharges having been checked too soon, for the usual precaution is not to arrest them; so they are let to go on increasing, till all hopes of contracting the vessels are vain. It would be well in all cases before administering Mixture No. 1, to fill a flannel bag with hops, wring it out of warm, salt water and lay it over the chest and belly, re-wetting every two hours; this done will alone sometimes prove successful.

When the mouth remains dry and hot, a little cool water, sucked slowly from a spoon, does seem to revive the little sufferer, and I have no reason to doubt its efficacy in abating the suffering, if not the disease. Stimulant astringents are what is needed after the passages are checked. The least mite of Nature’s stimulant—common salt—laid on the back part of the tongue, will excite a flow of saliva, and greatly assist in removing a sort of hair-worm which has been noticed to infest the throat in some patients. When there is a continuance of vitality, and the passages continue to be green, or tinged with blood, and external cooling applications, as of flaxseed poultices, have been well tried, an effort should be made to stimulate the liver; this is very likely to be the case where the age and constitution of the child is sufficient to permit the disease to run on for quite a while. Hydrargium chloridum-calomel, is sometimes the most reliable drug that can be used to correct that. This drug is unsafe in the hands of the inexperienced, but quick and safe when under the guidance of medical skill. The dose for a child six months old should never exceed one-sixteenth of a grain, or one grain in sixteen hours, followed by a sip of warm milk.

The nourishment during this time should consist of the breast-milk, if possible; if not, arrow-root boiled in milk and gum-water, fed from a spoon twice a day, or oftener. But either should always be given about a half hour after any medicine, unless otherwise directed. Cold water should never be allowed to a patient while medicine is being administered, the nature of which is unknown. Light, air, sponging the body with warm salt water, a change of clothing or bedding, each tends to stimulate the pores, quench thirst, and give tone to the whole system. Thin flour-gruel acts as a pasty lining to the entrails. After the irritation has ceased, great care is required to prevent a relapse; therefore in all cases when the breast-milk cannot be obtained, the various vegetable astringents should be relied on to build up the muscles, the different grains, as corn-meal, starch and oatmeal, given often but in small quantities, will build up the fat cells. If, after the liver has been acted upon, the green stools do not cease, and there seem to be a general weakness of the digestive organs, the juice of the blackberry, raspberry, or whortleberry, will, in most cases, effect a cure; also, the rinds of ripe peaches boiled in milk till well done, strained, and given when cool—a teaspoonful five or six times during the day, and about as often at night—is excellent. The effect of either of these remedies should be closely watched, as by their astringent nature they might induce constipation.

With a view to the comfort of the sick one, and the convenience of the nurse, it is better to prepare a bed of some light material, on which the patient can lie with its body flexed. Too often the little creature is forced to lie in a narrow place, or more frequently on the lap, in one position, till it would seem as if it would be paralyzed. There should be two sets of bedding in order to expedite recovery. The material should consist of goods that could be easily washed, and kept clean. It is essential, too, that flannel be worn by the sick one; but it is a sad mistake to imagine that flannel clothes do not need changing as often as cotton ones.

When I have suggested a bed for sick infants, some grandmas have thought me cruel. But in such critical cases as the one in question, a few moments’ trotting and rolling on the lap might undo all that it had taken weeks to do. Should the stomach become settled, but the lower bowels remain rather weak and liable to looseness, and there is no fever present, I think much of the burnt brandy in small doses. I prepare it in the following manner: Take a wineglassful of the best brandy, one tablespoonful of refined sugar, dissolve it well, then pour it in a shallow dish and set fire to it with a lighted paper, not a match; when the blue flame is off it is fit for use, and should be put in a clean vial and labelled. Of this, I give to a child six weeks old and upward, six drops in a little water, say about three times within twelve hours. To one six months and upward, I give ten to fifteen drops twice a day. This warms up the stomach and stimulates the digestive fluid glands to action. After the brandy has had the desired effect, a speedy recovery may be hoped for. The bathing, nourishing diet, quietness, and, above all, patience, need to be continued with greater zeal when recovery is apparent. The recovery from cholera is probable only when the surroundings are favorable; it is doubtful where the locality is densely inhabited, the disease prevalent, and where there is a lack of means to provide ample care and nourishment. Patients recovering from a disease like cholera, which so undermines the nervous system, require a deal of determination to prevent the undoing of what has been done by catering to their whims.