An Index of treatment / by various writers ; edited by Robert Hutchison and H. Stansfield Collier.
- Date:
- 1907
Licence: In copyright
Credit: An Index of treatment / by various writers ; edited by Robert Hutchison and H. Stansfield Collier. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
863/904 page 843
![TREATMENT VOM An occasional form of vomiting which, if it continues, may reduce an infant to a state of extreme emaciation, and even prove fatal, is that which results from monotony of diet, the child being fed morning, noon, and night on the same thing. Each meal is vomited with little effort, quite unchanged, and the infant seems to keep almost nothing on his stomach. If a change be made to another food the vomiting ceases for a day or two, but returns as soon as the stomach has got used to the alteration. The simple remedy for this state of things is variety in the meals, and a mere difference of flavour is all that is needed. A teaspoonful of Mellin's food or extract of malt added to each alternate bottle during the day, with a third food for the night, usually makes a sufficient variety ; but in exceptional cases the diet must be so arranged that no two meals in the twenty-four hours shall have quite the same taste. In the case of older children, vomiting must be treated on exactly the same lines. A revision of the dietary is essential. Sweets and fruit must be forbidden, and milk and starch only allowed in very small quantities ; indeed, in many, if not in most children, vomiting is apt to persist as long as milk continues to be taken. If the attack is acute, it is best to allow nothing but water, hot or cold according to the taste of the patient, and to apply a hot linseed-meal poultice containing ] part of mustard to the epigastrium for six or eight hours. The withholding of food is readily submitted to, as there is complete distaste for nourishment of every kind. It is judicious, however—more, perhaps, for the sake of the friends than for the benefit of the patient—to make use of a nutritive suppository several times in the day. While the vomiting goes on, the washing bath must, of course, be discontinued, for so sensitive does the patient become to impressions of cold that the smallest exposure tends to keep up the derangement. It is best to forbid washing of any kind except sponging of the face and hands, and to keep the child in bed with a hot bottle to his feet and a layer of cotton-wool over his abdomen and chest. For medicine he may take the sulphate of zinc mixture recommended above, increasing the dose of the sulphate to rV or A gr. ; or use, as alternatives, any of the other remedies which have been suggested. When vomiting ceases, weak veal or chicken broth with rusk or dry toast can be given ; afterwards, as the appetite improves, an ordinary diet can be returned to, but the change must be made cautiously and by gradual steps. These attacks are probably due to acute gastric catarrh. They are accompanied by a rise of temperature, which may reach 103° or higher on the first day, and the liver is generally congested. If it can be felt to be obviously enlarged, an aperient dose of calomel should be given as soon as the stomach can keep it down. In cases where the attacks occur, as they may do, at regular intervals— every few weeks or months—they are often spoken of as periodic or cvclical vomiting. There is one other form of vomiting in infants which must not be omitted. It begms at or soon after birth, and is the consequence of interference with the passage through the pyloric opening of the contents of the stomach. The obstruction at first is probably purelv spasmodic, but its continual repetition sets up hypertrophy of the pyloric wall and narrowing, or even practical closure at that point, of the channel of the tube. If the case be seen and treated early, before the muscular hypertrophy has begun or made much way, the spasmodic contractions may often be put a stop to and the thickening process averted by suitable measures. The spasms seem to be set up by the mere presence of food in the stomach. We must therefore, take care that the food is as little irritating as possible. If, then, the mother cannot suckle her infant herself it is advisable to procure](https://iiif.wellcomecollection.org/image/b21509244_0863.jp2/full/800%2C/0/default.jpg)
