Cholera infantum is a gastro-intestinal disease of violent acute-ness, characterised by severe vomiting, purging by serous stools, collapse, very rapid emaciation, thirst, fever, and other symptoms.

According to Holt, between 2 and 3 per cent of the cases of diarrhoeal disease in infants are cholera infantum.

It does not occur in nursing infants, but only in those fed by artificial means. No specific micro-organism has been detected, although various germs abound in the watery evacuations. Vaughan believes it to be due to tyrotoxicon, which he has demonstrated in cow's milk, and which exists only in milk or some modified form of it, such as condensed milk, or baby food made in part of milk.

The disease prevails especially in hot weather, and is so rapidly fatal, usually within one or two days, that very prompt and vigorous treatment is imperative.

Dietetic Treatment

The giving of milk in any form must be immediately and peremptorily stopped, and, as Vaughan says: "Prepared baby foods should be thrown out of the window. Acute milk infection is a form of poisoning by a substance more powerful and deadly than white arsenic." The poison must therefore be washed out; and no matter how much vomiting and diarrhoea have already occurred, the stomach must be cleansed by lavage, and the colon must be irrigated by at least a gallon of warm Castile soapsuds and water, after which cool water with fifteen to thirty grains of tannic acid to the pint should be injected (Vaughan), with the object of precipitating poisonous proteids. The irrigation has a further advantage in that it replenishes by absorption a portion of the water which has been rapidly drained from the system by the violent purging, as in the case of Asiatic cholera, and the loss of which causes insatiable thirst. The lavage allays gastric irritability, and alcoholic stimulation must then be ordered in the form either of half a tea-spoonful of iced champagne or from ten to fifteen drops to a tea-spoonful or more of whisky or good brandy, diluted in water or Vichy.

From four to six or eight ounces may be given in twenty-four hours to avert collapse. If necessary, the brandy is to be given by rectum, or the whisky, in extreme cases, by hypodermic injection.

Accessory means are bathing in warm mustard water and friction. No nourishment except the alcohol is allowable for at least twenty-four hours, when warm meat juice, koumiss, zoolak, pancreatinised meat broths, or egg albumin with whisky is to be prescribed in tea-spoonful doses every half hour or hour. For a day or two this diet will suffice, and milk should not be again given until the expiration of that time, when the ordinary previous diet may be cautiously resumed.

Older children may be allowed to have junket and scraped beef which has been squeezed through a sieve.