Colic is a symptom of many patho logical states of the intestinal tract. The causes of infantile colic are (I) flatulence; (2) influences acting through the mother; (3) indigestion; (4) re frigeration. The reasons for flatulence in the infant may be found either in the infant or in the mother. The absence of pancreatic digestion in early infancy is perhaps one reason for the frequency of imperfect digestion at this time of life. Slow or insufficient digestion re sults in the development of flatus. If the mother is constipated, the infant is apt to be constipated; and the mother's milk under these circumstances is apt to produce flatulence. The diet of the mother is also responsible for much flatulence in the infant. Another com mon cause is taking salts, senna, and similar purgatives by the mother. and this, too, even when these drugs are not taken in sufficient quantity to produce any evacuation from the mother's bowel. Infantile colic sometimes arises from mental worry on the part of the mother or from suckling the infant immediately after sexual excitement. A case has been recorded in which a most obsti nate colic in an infant immediately sub sided when the mother had sought the aid of a dentist anci had a carious tooth extracted which had. caused her much toothache. The commonest cause is overfeeding, particularly too frequent nursing and feeding. Another common error is the giving of too large a quan tity of food, even though the latter is of the proper composition and given at suitable intervals. In comparatively rare instances infantile colic arises from a deficient supply of food. Refrigeration is produced commonly by laying in a wet diaper, walking over a cold floor, or exposure of the abdomen to a draft of cold air. In cases of colic associated with grave pathological conditions one does not see the kicking of the legs ob served in simple colic, nor does the child cry for a few minutes with pain and then relax into a smile. H. Illoway (Pediatrics, July ill, 1001).
Prognosis.—Simple functional diar rhoea, unless in infants of the weakest constitution, can never be regarded as presenting much cause for anxiety. The danger lies in neglect. An injudicious dietary, especially in hot weather, may prolong the attack or convert it into one of the inflammatory forms of the disease. cases where the diar rhoea appears to have removed the irri tant it will suffice to secure absolute rest to the alimentary tract for a period vary ing from twelve to twenty-four hours, permitting only sterile water in small quantities as frequently as may be sired. If the attack has been of a mild character, a thin rice- or barley- water containing a small amount of sugar of milk may be allowed after the first twelve hours have passed. Stimulants in the form of whisky or brandy are to be given only if any indications of prostration make their appearance. In the majority of cases this dietary may be increased after twenty-four hours. In infants who are breast-fed nursing may be allowed once every four or six hours, permitting the infant to take a little more than half its usual quantity at each nursing. Rice water or weak albumin-water may be given between-times. In those arti ficially fed the food for several days must be weak in character, and limited in amount. A small quantity of a creamy milk may be added to the rice- or barley water.
The foods of greatest value in the treatment of summer complaint, and the indications for their use, considered by the writer to be as follow:— "Whisky, one of the most useful, never contra-indicated; especially useful in acute eases during the last twenty-four hours of treatment, but may be given at any time in either acute or chronic cases.
"Meat-broths contain so little albumin and carbohydrates that they are never theoretically contraindicated. They may he given at any time, in either acute or chronic cases, but they are especially indicated in acute cases after the first twelve or twenty-four hours' treatment.
"Cream contains so little albumin that theoretically it is never contra-indicated. It can do no harm in any form of the disease, but it will be found to serve the best purpose in chronic cases, and after the third or fourth day in acute cases.
"Barley-water and oatmeal-water may be mixed with milk to advantage, as they mechanically facilitate the digestion of casein. In this combination they may be useful in chronic cases and in con valescent acute cases.
"White of egg is contra-indicated in all cases of summer complaint when there are marked constitutional symp toms present, or when the diarrhoea is putrid or mucous, but it may be used in that form of the disease dependent on an abnormal acid fermentation." Rachford (Archives of Ped., No. 6, '92).
In an acute attack of summer diar rhoea in a child under two years of age all albuminous and starchy foods should be withheld at once. Instead, toast-water —made by laying in a large bowl two pieces of stale white bread toasted brown on both sides, pouring on boiling water till covered, and. adding a pinch of salt and allowing to stand till cool, the clear water being then poured off into a fruit jar and kept cool by ice—is excellent. Barley-water, made by boiling a handful of pearl barley in a pint of water for one hour or more, a pinch of salt being added, can also be prepared, and after it is cool the supernatant liquid can be poured off for use. From one to three tablespoonfuls of either of these foods can be given every hour or two for forty eight hours if necessary. Alcoholic stimulants may be added if necessary. These drinks should always be given cold. When the vomiting and stools have improved, which usually occurs within forty-eight hours, nursing may be resumed at intervals of either two, three, or four hours. If sterilized milk be used it should not be for longer than the summer months, on account of the tend ency to produce radials. A mixture of cows' milk, diluted one-fourth with water and containing a little milk-sugar and a pinch of salt, is to be preferred. The prepared milk is placed into a double-boiler of agateware, and the water in the outer vessel is allowed to boil for fifteen minutes. The inner ves sel is then rapidly cooled, and the con tents poured into a well-scalded tight fruit-jar, and kept by the ice until re quired for use. The entire quantity re quired for use during the day can thus be prepared at once. After each feeding the child's mouth should be wiped out with a hit of absorbent cotton soaked in a saturated solution of boric acid. Plenty of water that has been boiled and cooled should be given. Dessau (Clip. Recorder, '97).