In the treatment of infantile diarrhoea an absolute sterilized milk diet should be given, and the use of some mild alkaline water, such as that of Vals or Vichy, to which may be added some white of egg to form albumin-water.
Should the diarrhoea be so active as to deplete the patient to a dangerous extent hypoderinoclysis or the subcu taneous injection of artificial serum or even of real serum should be employed. Lesage (Revue de Therap. Medico-Chir., Dec. 15, '96).
Cases that a change of climate after the regulation of diet and other treat ments have failed to cure will often, ap parently of itself, with the same identical diet and therapeutics, give rise to a rapid and complete recovery. McClanahan (Jour. Amer. Med. Assoc., Aug. 5, '99).
We have before insisted upon the ne cessity of placing the patient under the most perfect hygienic conditions pos sible, and of securing abundance of fresh air. In the treatment of these cases our chief therapeutic reliance must be upon the administration of injections into the colon. Weak solutions of silver nitrate, if the bowels are thoroughly irrigated beforehand by simple sterile water, may prove of much service. The readiness with which this drug is decomposed ap pears to offer serious objections to its use. Preferable to it, in our opinion, will be found one of the salts of zinc (gr. iv-0j), or tannic acid (gr. xxx-Oj), or the fluid extract of hamamelis (3i-5ii to Oj), or the colorless fluid extract of hydrastis (3i-0j). Any one of these may be employed as a high injection after thorough irrigation by the normal saline solution. Opium should be made use of only to moderate excessive peristalsis, and in these cases is best given in a little starch-water by rectal injection.
High rectal injections of value in the chronic diarrhom of infancy in which there is a glairy mucous discharge due to an enteritis. In addition to ordinary water some extract of rhatany and mucil age of acacia may be injected. If there is any doubt as to the purity of the water, it should be boiled before it is injected. In other instances hypo sulphite of sodium in the proportion of 2 drachms per pint of water, to which has been added a little mucilage of acacia, may be given night and morning in this manner, with advantage. Dau chez (Revue Mensuelle des Sciences des l'Enfance, May, '96).
The value of the administration of opium in this disease is a subject on which there has been much difference of opinion. All writers, however, agree that it should be avoided at the outset; but many indications for its employment, in our opinion, may arise during the latter stages of the disease.
Case of chronic tharrhrea in which petroleum emulsion proved of great value. A child. aged 2 years, when brought to the hospital was said to he having about twelve motions a clay. The patient was given 2 drachms (S grammes) three times daily of a med icine composed of equal parts of a simple chalk mixture and petroleum emulsion. At the end of a week the bowels were said to have been opened on an average from two to three times a day. There was then no petroleum emulsion in the dispensary and the child was given drachms (6 grammes) of the chalk mixture three tittles a day, but at the end of the second week the dierrhma was nearly as had as before treatment was commenced. One grain ( OM gramme) of betanaphthol was added to 2-draclun (8 grammes) doses of the chalk mixture, but at the end of another fortnight the bowels were still moved eight or nine times a day. The mixture containing 1 drachm (4 grammes) of petroleum emulsion was then given again and the frequency of the motions immediately fell to twice a day. Fisher (Lancet, Feb. 1, 1902).
Stimulants, in our opinion, are neces sary in the majority of cases; they should be used cautiously at first, but liberally in the later stages of the dis ease. Good whisky and brandy are preferable to wines; aromatic spirit of ammonia may occasionally be of service in small frequently repeated doses. Caf feine may also be employed either in a single solution or in the form of a well prepared tea or coffee.
In all instances where the temperature runs an elevated course we have much confidence in the value of hydrotherapy. This treatment may be employed in the form of cool baths, the cold wet pack, or cool irrigation of the intestines. Of the three methods our preference is for cool baths; whenever the temperature of the body rises above 102° F. the infant should be placed in a bath containing water at the temperature of about 95° F., which temperature should be quickly lowered to 90° F. or 35° F. A °loth wrung out of cold water should, at the same time, be kept on the head. The infant should remain in the bath from three to ten minutes; the duration vary ing according to the age and feebleness of the infant. It is to be remembered that infants are affected by a cold bath more promptly than adults, and are more easily depressed by it. Care should be taken, therefore, to watch its effects, and, if necessary, to use stimulants after it is over.