Presented at the I.H.A., Bureau of Obstetrics and Pediatrics, June 1930.].
GEORGE E. DIENST, M.D.
The books are full of this disease classified by many as a species of cholera. It is not cholera per-se however, but a severe form of dysentery. The principal characteristics are pain, dysentery, fever and prostration. These forms are marked by very peculiar modalities. These are not alike else we would soon control it, but modalities differ as to constitution, environments and food. The cure hinges upon understanding the meaning of the different modalities and here is where the critical point arises and makes some incurable cases for us. Not that they are so bad but that we are ignorant of their meaning.
This brings me to the point that I want to stress. In an early day we had a great deal more cholera infantum then we have today and with an experience extended over many, many years I have lost but one case of this so-called disease. I was so wrought up over my failure that it took me six months after the child was dead and buried before I saw my mistake. Mistakes are easily made and, as in this case, often result in death. I do not know why I should have made this mistake, but I did and the odds were therefore against me.
Early one morning in August I was called to see a very pretty little girl about five years of age. On looking my case over and noting the symptoms there was one thing I could not understand, but I called it a case of cholera infantum. I prescribed for the different symptoms, particularly the dysentery, and went about may work. Every time I saw this little child she had not improved but kept up that one symptom which I could not understand, namely the retracting and extending of the left leg and arm. I certainly watched it with great care. I never saw the like before, and still my child went down in the depth of despond. I tried to find the meaning of this move but could not.
I knelt by her bedside one hot night in August and watched those symptoms, which I am told were present day and night while awake and asleep. I was very much disturbed but could find no answer to this problem and my sweet little girl passed away. Ordinarily we let those things go as inevitable, but I did not. For six long months after the child was buried I kept up a constant research trying to find the remedy with the retraction or extension of right or left extremities. Finally I came upon a symptom similar but not just like this one but it was so near like it that I know if my little girl had only had a dose or two of the medicine she would have lived. This remedy was Chamomilla which I did not give. We are not in the habit of reporting lost cases but this was so serious that I did not rest until I found the remedy and I am sure it will not occur again.
This case is an exposure of my ignorance, for had I understood the law of materia medica, and learned to define what is rare, particular and peculiar I might have saved this child. Two things I wish to stress in this paper, first, personal ignorance for which there is little or no excuse; secondary, the important emphasis laid on the rare and peculiar by which we are often governed in the materia medica.