This disease is confined to infants, generally between the age of four and twenty months, and occurs mostly during the summer months.

The attack is sometimes preceded by diarrhoea, but in most cases the vomiting and purging commence together, and are attended with great prostration; sometimes there are premonitory symptoms, such as languor, fretfulness, loss of appetite, or craving for food. At first the discharge from the bowels usually consists of a turbid frothy fluid, mixed with portions of green bile, or of a nearly colorless water containing small flocculi of mucus, but after the disease is fully developed, it loses all trace of bilious matter. In some cases the disease proceeds with such violence as to terminate in death in a single day, but usually the vomiting and purging, though violent are not so rapid as to prostrate the system immediately. Sometimes the vomiting after four or five hours, gradually ceases, while the diarrhoea goes on until it assumes a chronic character. In the early stage of the disease, there is a peculiarly distressing sensation in the stomach and bowels, and where the discharges are violent and frequent, there may be cramps or spasms in the muscles of the abdomen and extremities.

If the disease continues even for a few days, rapid emaciation ensues, the countenance becomes pale and contracted, the eyes sunk, the nose sharp, and the lips thin, dry, and wrinkled. The thirst is great, but the cold water so much desired, is thrown up almost as soon as swallowed. At length, if the disease is not checked, the patient becomes somnolent, sleeps with its eyes half open, rolls its head about when awake, and at last sinks into insensibility and coma, and dies in convulsions, or under symptoms resembling acute hydrocephalus. If the disease is of long duration, the discharges at length become offensive and acrid, and food passes undigested through the bowels. Aphthae appears on the tongue, and inside of the cheeks, and the face has a bloated appearance.

Treatment

The treatment should be prompt and active, as the delay of a few hours will often allow the disease to gain such headway as to bid defiance to all efforts at control.

Ipecac. should be given at the commencement of the disease in alternation with Veratrum. Its indications are nausea, vomiting; diarrhoea of fermented stools, or watery diarrhoea with white flocks; great thirst.

Veratrum is indicated by the great exhaustion, violent vomiting and diarrhoea; vomiting produced by the slightest movement, or even taking cold water, for which there is great desire; sensitiveness over the pit of the stomach and sometimes cramps.

Dose

Veratrum, in alternation with Ipecac. or following that remedy, will usually be sufficient to arrest the violent symptoms. Mix two drops, or twelve globules, in a tumbler half full of water, and give a teaspoonful in alternation, ten or fifteen minutes apart, increasing the intervals and as the symptoms abate.

Arsen to, - If there are cold extremities; nausea and vomiting; great prostration, thirst and offensive diarrhoea.

Dose - A powder, or three globules, once in two hours.

For other remedies indicated during the progress of the disease, see Hydrocephalus, page 387, also Diarrhoea, page 229 and 394.

Diet And Regime V

The food should consist mostly of gruels. Cold water may be given a little at a time.