M. D. S.
Teaspoonful every three hours until yellow stools are produced.
Large quantities of water should be given.
To cleanse the colon, an ordinary rec tal soft-rubber tube (No. 6 to 10) is anointed with glycerin or vaselin and gently pressed into the rectum; the rec tum is then thoroughly flushed with lukewarm (SO° to 100° F.) decinormal salt-water solution. Several quarts should be used. The tube should he gradually pushed through the rectum into the colon.
Hypodermoelysis can be carried out in every household where a fountain syringe exists. It is only necessary to adjust a long, sharp-pointed hypodermic needle (antitoxin needle) to the rubber tubing connected with the syringe. Nothing is so stimulating to an en feebled heart, nothing will stimulate the circulation of the blood quicker than this method of salt-water infusion.
Hypodermic injections of camphorated oil, 10 to 15 minims per dose, repeated every two or three hours, if necessary, should not be forgotten. Louis Fischer (Inter. Med. Mag., July, 1901).
Occasionally one of the milder anti septics is added to the solution; we are convinced, however, that using them in this way, either for lavage of the stomach or lavage of the intestines, the risk of absorption of an overdose more than counterbalances any possible advantage.
A few hours after the administration of the purgative, an effort should be made to wash out the colon. The infant at the first should be placed on its back with its hips well elevated, and a normal saline solution at a temperature of 9S° F. be allowed to flow slowly into the intes tines through a large-sized rubber cathe ter introduced for six or eight inches. The pressure in the tube should be slight, the reservoir not being higher than twelve inches above the hips of the pa tient. If the hips are sufficiently ele vated a little gentle massage over the region of the sigmoid flexure secures the free passage of the fluid into the descend ing colon, and afterward, turning the in fant on its right side, favors its entrance into the transverse and ascending colon. Should there be much pyrexia after the current has been once established, the temperature of the water may be lowered 10° or 15°. Lower than this has been recommended by some physicians, but the very interesting experiments of Dr. R. Coleman Kemp warn us that we may in this way produce too much depression.
The injection should be continued until the water returns clear. If done care fully, the pulse after the injection should evidence more strength, the blood-pres sure should be raised, not depressed. Afterward a cool or warm compress-70° to 100° over the abdomen and covered with oiled silk and a flannel binder soothes and assuages the pain. This lavage of the intestines may be re peated every six or twelve hours for the first two or three days; afterward less frequently.
Most desirable position for injection is the dorsal, with the thighs flexed and the pelvis elevated and a pressure of not more than one to one and one-half me tres. In 200 patients experimented upon ileo-caccal valve offered effectual resist ance in only 27. Sokolow (Amer. Jour. Med. Sci., Apr., '95).
Intestinal lavage with warm, boiled water, Vichy water being added. Infant lying on the side, first the right, then the left; tube inserted 15 centimetres and water slowly introduced. If discharges foetid, calomel; also 1 drop of laudanum every hour. If obstinate vomiting, lay age of stomach and egg-albumin in water given. Grancher (Revue Gen. de Clin. et de Tiler. Jour. des Prat., May 1S, '95).
In infectious diarrhoea in infants, the food-supply is to be stopped, the products of imperfect digestion removed from the intestinal tract by irrigation, continued until the water returns free from ad mixture of focal matter. A solution of 20 grains of tannic acid in a pint or more of sterilized water injected and retained in the bowel about an hour. When vomiting persists the stomach should be washed out also. To neutral ize the toxins calomel in V„-grain doses hourly for the first twenty-four hours is recommended. First among antipyretics is the cooled bath. When watery dis charges continue after the irrigation, hyp odermics of grain of morphine and of atropine can be given. Stim ulants are indicated in the severe cases, and whisky is the best that can be given. After the urgent symptoms have sub sided the child can be nourished with the white of an egg stirred in cold water or the mixture recommended by Jacobi: 5 ounces of barley-water, the white of 1 egg, 1 or 2 teaspoonfuls of brandy or whisky, some salt, and sugar. A tea spoonful every five or ten minutes is indicated. No milk should be given for several days. H. M. McClanahan (Amer.