Treatment.—If an infant be taken with diarrhcea, the treatment will vary according to the period at which the child comes under observation. If he is seen early, and there are signs of abdominal discomfort, especially if the motions contain lumps of undigested curd and starch, it is always best to assist the discharge of the offending matters by a teaspoonful of cas tor-oil, or a small dose of rhubarb and soda (gr. iv.–vj. of each with gr. j. of powdered cinnamon). This the child will take readily if it be made into a paste with a few drops of glycerine. Afterwards an antacid can be ordered with a carminative. The following, slightly altered and modernised from an old prescription by Boerhaave, is very useful : Sig. A teaspoonful to be given every eight hours fo a child between six and twelve months of age. To older children it can be given every six hours.
If, after the action of the laxative, the stools still continue to contain lumps of undigested food, or if the belly remain hard and distended, it is well to repeat the aperient until the defections assume a more healthy character.
Even if the diarrhoea appears to be occasioned by a chill, it should be treated in the same way ; for there are in such cases acrid secretions which cause great irritation of the bowels until they are removed. At the same time, care should be taken that the abdomen is kept warm with a flannel binder, and that the child, if nursed, is restricted to the breast. If he be fed by hand, the milk should be diluted with barley-water, or with water in which a little gelatine has been dissolved, to insure fine division of the curd, and should be alkalinised by the addition of ten or fifteen drops of the saccharated solution of lime.
In the large majority of cases, an attack of simple cliarrhcea is quickly arrested by this means, especially if care be taken that the child is confined to the house and guarded from further chill. If, however, the looseness continue, a powder composed of rhubarb (gr. iij.) and aromatic chalk (gr. v.) should be given at night-time ; and in the day, a small quantity of laudanum should be prescribed with an antacid and warming aromatic : Oxide of zinc (gr. j.) ; bismuth and chalk (gr. iij.—v. of each) ; and the old-fashioned but not the less useful chalk and catechu mixture, are all of service, especially if the stools are acid and frothy. So long, indeed, as
signs of fermentation are visible, chalk with an aromatic should form part of the mixture, whatever be the combination adopted. If afterwards the evac uations become thin and watery, an astringent is indicated. Such cases, however, ought strictly to come under the head of inflammatory diarrhoea, and full directions for their treatment will be given in the next chapter.
If the diarrhoea occur in the course of teething, there is often hesitation as to the course to be adopted. Some authorities have been of opinion that the purging should not in such a case be hastily arrested, lest the fever and local inflammation be thereby aggravated. There is, however, no founda tion for such apprehensions. I have never seen ill effects follow from the suppression of the intestinal flow. On the contrary, if the infant be weakly and the bowels habitually irritable, the continuance of the relaxation may cause such depression .of the strength as to place the child's life in immi neat danger. The wisest course to follow is, first to remove irritating secre tions by a mild aperient, such as the rhubarb and soda powder, or castor oil, and afterwards to prescribe one of the antacid mixtures given above. Boerhaave's aromatic soap draught is very useful iu these cases.
After the age of infancy children must be treated for the mild form of diarrhea upon precisely similar principles to those laid down above. They should be confined to the house, and restricted in acid-making articles of food, such as fruit and sweets. A dose of rhubarb and magnesia, followed by a draught, several times in the clay, containing spirits of sal volatile with chloric ether and a few drops of laudanum, or chlorodyne in some aromatic water, will soon restore the alimentary mucous membrane to a healthy condition.
Lienteric diarrhoea must not be treated with astringents. The loose ness is quickly arrested by small doses of arsenic and nux vomica. For a child of six years old one drop of Fowler's solution of arsenic may be given, with two drops of tincture of nux vomica, three times a day, before food. One or two drops of laudanum may be added if the looseness does not quickly yield.