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to the inferior extremities; and let the head and shoulders be well elevated.

XXIV. HYDROCEPHALUS. (Dropsy of the Brain.)

Hydrocephalus, (from the Greek, water and the head, Dropsy of the Brain, Dropsy of the head,) is distinguished by authors into external and internal.

Hydrocephalus externus, is a collection of water between the membranes of the brain, {the dura mater, pia mater and arachnoid membranes.)

Hydrocephalus internus, is applied when the water is effused between the ventricles of the brain.

Symptoms.—The usual symptoms denoting Dropsy of the Brain are, sickness of the stomach, a dull, stupid pain in the head, particularly across the brow, (which of course is only distinguishable in adult patients,) dilitation of the pupils, slow pulse, and sometimes convulsions. The child lies in a partial stupor, with the eyes half open, an occasional motion of its head on the pillow, and sometimes with a continual motion of the arms, or the arm and leg of one side.

Causes.—It is generally the result of inflammation, terminating in effusion; or it may be caused by a fall or blow, producing a violent concussive effect upon the brain. Children with large heads, and those of a scrofulous taint, are more predisposed to this disease than such as are differently constituted.

Treatment.—The most successful remedies in this affection, are, Belladonna, Merc., Digitalis, Ignatia, Lachesis, Arsenicum, and Helleborus-niger.

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Belladonna.—When the head appears swollen; the child bends it backward; the face is pale, pupils of the eyes are dilated, or the eyes are squinting.

Mercurius.—Swelling of the head and gums; swollen face; lead-colored or cadaverous paleness; and inclination to vomit.

Digitalis.—Heat about the head; pulse irregular and small; dilation and insensibility of the pupils; eyelids and lips blue; pale face, and nausea.

Ignatia.—When there are convulsive movements of the eyes and lids; or staring, with dilated pupils; and a tendency of the head to incline backward.

Lachesis.—When the face is pale, or distorted; the mouth is inclined to be drawn to the left side; and the left side is apparently most affected.

Arsenicum.—When the child is much emaciated; coldness of the limbs; pale, sunken face; lips bluish, or dark and parched.

Helleborus-niger.—After the administration of the Arsenicum, particularly if any thing like a reaction or feverish heat sets in.

Administration.—Repeat the remedy indicated every hour or two, until the symptoms appear more favorable; then extend the time to every three hours, or as the improvement indicates.

Diet—Must be light, if any can be taken. Keep the extremities warm, and the head and shoulders well elevated. If the bowels are constipated, there is no objection to moving them with an injection.

XXV. ASTHMA. (Choking.)

When this occurs suddenly, and threatens suffocation.

Ipecac.

When it is attended with distension of the stomach, shortness of breath, choking, anxiety, restlessness, and tossing about. Chamomilla.

When cold, lips livid, and perspiration covering the face. Arsenicum.

When there is a suffocative arrest of the breathing, or the breathing is quick, short, and attended with moaning.

Cuprum.

When the breathing is suffocative, coming on at night in spells, and especially if it is attended with a dry, spasmodic cough. Nux-Vomica.

For more particular indications, vide " Asthma."

Administration.—Repeat the remedy selected every five, ten, or fifteen minutes, until relief is obtained.

XXVI. CHOLERA IJVFAJVTUM.

A disease, as the term implies, " peculiar to children," and in many respects similar to the ordinary cholera morbus.

This disease generally commences with sickness of the stomach, and vomiting at first of the food, and afterward of an acid-smelling fluid; diarrhoea, with thin, watery discharges, sometimes white and frothy, resembling in appearance soap suds, and exceedingly offensive; an anxious expression of countenance; eyes heavy and sunken, with a dark streak beneath them; the skin pale, and below the ordinary temperature, particularly that of the extremities, which are quite cold; the head sometimes hot.

Great restlessness is manifest from the commencement of the attack; the little sufferer throws itself from one side of the couch to the other, with severe retching at almost every motion; there is an intense thirst for cold drinks, which are taken in a hurried manner, and almost immediately rejected; the pulse becomes feeble, and is frequently imperceptible at the wrist.

It is a disease peculiar to the summer months, and depends almost entirely upon errors in diet and other influences, which are more or less present in all large cities, such as impurity of air, want of proper exercise, etc. I have noticed that a large majority of cases occur about the time of weaning, which are unquestionably caused by neglect in adapting the delicate stomach by degrees to a change of food, which always requires great care. And in many instances when a milk diet is continued, it is a wicked substitution for the natural nourishment of the mother or nurse; the milk furnished in the city, is too frequently obtained from the distillery establishments, which have proved a more prolific cause of cholera infantum and marasmus, than all other causes combined, and yet there appears to be a wonderful neglect in remedying the evil, which almost amounts to absolute indifference.

Treatment.—I have found Ipecac., Arsenicum, and Veratrum, to be the principal remedies in this disease.

Ipecac.—At the commencement, when the vomiting and purging are of a bilious character.

But when the discharges are thin and watery, lightappearing, or dark; urgent thirst, pale skin, and great prostration. Arsenicum.

When in addition to the last symptoms, the mouth is parched, the tongue is dark, and the lips are black or cracked.

Veratrum alone, or in alternation with Arsenicum.

Administration.—The remedies should be repeated at short intervals, because the disease is acute in its character, and requires the most prompt and energetic treatment. I frequently repeat them every fifteen minutes, until there is a mitigation, and then extend the time as the little patient improves.

Diet And Eegimen.—During the attack nothing can be taken but cold water, which should be allowed in small quantities, and at a time when it will not induce vomiting. As the patient improves, and the irritation of the stomach and bowels subsides, a small quantity of arrowroot, farina, or corn starch, properly prepared, may be allowed.

The child should be kept quiet, in a well ventilated apartment. If it is necessary, external warmth should be applied to the abdomen and extremities, by means of heated flannels.

The End.

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