Jour. Obstet. and Dis. Women and Chil dren; Med. Record, Sept. 26, '96).
The successful management of the feverish stage in young children can be accomplished by hydrotherapy, by in testinal antiseptics, and by rest. The first step is to empty the stomach, if it has not already been accomplished, and then to give a slight enema. This, in young children from six months to two years, is accomplished by the use of glycerin and water. About 1 tea spoonful of glycerin may be used to a tablespoonful of warm water. After that high enema of 1 quart of tepid water and 1 tablespoonful of bicarbonate of soda is used. The child's buttocks are elevated at least to four inches higher than the shoulders; by means of a fountain-syringe holding two quarts and with the bag of the syringe one to two feet above the buttocks, the con tents are slowly allowed to enter by gravity into the intestinal canal. W. C. Hollopeter (Inter. Med. Mag., July, 1901).
Many physicians at this period advo cate strongly the administration of some drug which may act as an intestinal anti septic. Among the more important of these drugs we may mention resorcin, menthol, thymol, bismuth salicylate, sodium salicylate, ben2ol-naphthol, and others.
It is not to be forgotten, however, that many of these drugs are very distinct cardiac depressants, and we are con vinced that we have seen many instances in which they have been employed with too much freedom, to the disadvantage of the patient; at the same time it is questionable of how much practical value they are. Under this treatment the py rexia will be found to slowly subside, and the frequency and character of the stools to alter for the better. At this stage some of the milder astringents may be of service. Among the most frequently employed are the salts of bismuth: the subnitrate, the salicylate, and the subgal late. These may be given in full doses, suspended in mucilage with some aro matic water. Tannigen, a new astrin gent, having also distinct antiseptic properties, may, after all the inflamma tory symptoms have subsided, be of serv ice. It may be given in a powder, com bined with a little sugar, in doses of from 4 to 6 grains.
The disorder always commences in the stomach, and is most easily controlled by carbolic acid. But its hot taste and un pleasant smell, as well as the occasional occurrence of carboluria, rendered its use unpleasant. Resorcin is extremely pal atable to children; and is devoid of toxic properties when given in doses from 1 to 5 grains. Three grains given every four
hours to infants only a few weeks old without the least ill-effects.
In a hundred and twenty cases of in testinal dyspepsia in infants and young children this treatment was used with the following results: In 53 per cent. the disorder had lasted from one to two weeks, in 34 per cent. from two to four weeks, in 10 per cent. from four to eight weeks, and in the remaining 3 per cent. for a period of more than two months. Out of the entire number in only nine instances did the diarrhoea continue after the treatment had been pursued for a week, the majority ceasing within three days. IV. Soltau Fenwick (Brit. .Med. Jour., Dec. 21, '95).
In diarrhoea associated with very foetid motions the greatest benefit seen to follow the administration of creasote. W. H. Dickinson (Lancet, Mar. 2S, '96).
Tannigen successfully employed in twenty-eight cases of diarrhoea. Sixteen of the patients had acute gastro-enteritis, and eleven chronic diarrhoea. In all of the acute cases but one the remedy acted promptly. In the cases of chronic diar rhasa, all of which were under one year of age, tannigen gave excellent results. Diarrhoea, of several months' duration, which had resisted other remedies, yielded with wonderful rapidity. Strauss (Berliner klin. Woch., No. 3, '96).
Certain forms of summer diarrhoea of infants which are usually sudden in on set, and marked by some regurgitation of food; high temperature; copious brownish, then greenish, and finally often watery stools; and rapidly developing signs of collapse are amenable to prompt and vigorous treatment. The external temperature is low, while that in the rectum is high. The child moans, lies with upturned eyes, and occasionally gives a sharp cry such as that heard in meningitis. These are really cases of enterocolitis, the intensity of the symp toms depending on the degree of intoxi cation. The main indications are flush ing of the colon and use of tepid baths, and will cause the temperature to fall and the symptoms to abate. Two or three douches may be required daily. Small doses of opium, not to check the diarrhoea, but to allay nervous symptoms, may be given in the early stages. The following fornmlm are of value:— R. Bismuthi subgall., 29 to 36 grains. Pulv. opii, grain.