Simple Diarrhoea is due usually to improper feeding, either because the wrong kind of food is given, or because too much is given at a time, or because it is given too frequently. The child usually suffers from griping pain, followed by the discharge from the bowel. It is restless, squirming and kicking with the pain, usually lying quiet and exhausted in ap pearance in the intervals. There may be a little feverishness, and if the irritation of the bowel be severe there may be convulsions. Similar symptoms may be produced by other conditions within the abdomen, besides mere intestinal irritation, and it would be proper for the nurse to examine the belly, in the manner described in the paragraphs on vomiting (p. 600), unless medical aid is speedily obtainable.
In all cases of diarrhcea the material passed from the bowel should be carefully examined, and, when the doctor has been summoned, kept for him to see. In the case of older children, when the motion has been passed into a vessel, it may be rendered perfectly inoffensive by pouring over it a couple of pints or so of cold water, in which two tea-spoonfuls of common salt have been dissolved. In the case of infants the soiled napkins should be placed in a vessel, a chamber utensil, kept covered with a damp cloth and a lid if possible. In all cases the vessel containing these things should be kept in a corner of the bath-room, the door of which is shut and the window open, never in the nursery or sick-room.
It makes one's flesh creep to see how mothers and nurses handle such soiled napkins, dropping them on to the floor, or a chair, or pushing them under the bed with the foot, and to observe how, after handling them, the mother or nurse will go, with unwashed hands I to look after the child's food.
In the case of simple diarrhcea from over. feeding, the motions are at first semi-solid, somewhat greenish, and pieces of white curd are scattered through the motions. If the motions are distinctly green, these little lumps of curd may be stained, but, if cut into, even the small pieces will appear quite white inside, and will be quite clearly curd of milk.
Meantime two things should be done—all feeding should be immediately stopped for several hours, and a tea-spoonful of castor-oil should be given to sweep all offending matters out of the bowel. In four or six hours the castor-oil may be repeated in half tea-spoonful doses, till the bowels are satisfactorily cleansed, as shown by the character of the stools. Dur
ing this time, though food is not given, water ought to be given, and preferably water con taining half a small tea-spoonful of salt to a tumbler of water, boiled and then cooled and kept covered. A tea-spoonful of this may be regularly given every half-hour.
Warmth to the belly, applied by a piece of flannel wrung out of water, comfortably warm, will be found useful. Medicines other than castor-oil should be avoided, and opiates are too dangerous, except in the hands of those who know how to use them.
These steps will usually be sufficient. In six or twelve hours the child should be comfortable, and indicating its hunger.
But feeding should be resumed very cau tiously. What has been said about the suitable diet according to the child's age should be referred to on p. 565, and those which follow. The beet way would be to make a little of " the milk mixture", suited to the child's age, to add a table-spoonful of that to two table spoonfuls of the boiled water with salt, and to go on giving tea-spoonful doses of this "milk mixture " and water every half-hour. The child remaining comfortable, in a couple of hours the proportion of "milk mixture" should be in creased to a half, and tea-spoonful doses given as before. If this continues to agree "the milk mixture" should again be increased, say 3 of " milk mixture" to 1 of water with salt, and so on till "milk mixture" alone is being given.
The quantity of " milk mixture" could then be increased and the intervals lengthened till full quantities and intervals were gradually restored.
Chronic Diarrhea is apt to arise from a continuance of improper feeding. The child becomes fretful, emaciated, sleepless, much troubled with wind in the bowels, the skin around the outlet of the bowel being red, very tender, and excoriated, and the bowel fre quently conies down.
The motions in this case are semi-solid or watery, the lumps of undigested curd and fat from the milk are easily distinguished, and they are usually coated with mucus stained green in many cases. The smell is usually very offensive. Sometimes the motions are more clay-like ; and the odour of such stools is apt to be even worse, because of the absence of bile, which is the great deodorizer of the motions.