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Biochemic Treatment: In accordance with Dr. Schusslers Biochemistry the principal remedies are Calc-phos, Ferr-phos, Natrum-phos, Kali-phos, and Mag-phos, and are recommended in the third or sixth decimal triturations. Earlier we have described the leading features of Calcarea phos and Ferrum Phos. Natrum- phos is suitable in vomiting of curdled milk and green sour smelling diarrhoea.
Evidence of worms and a creamy yellow coating at the base of the tongue will further determine its choice. Magnesia-phos. is recommended in alteration with the indicated tissue salt when there are cramps, spasms or convulsions. It is a marvellous remedy to relieve the spasmodic abdominal pain of cholera. Kali-phos. is useful if the complaint sets in in the later part of the night with putrid stools. It is also useful in delirious and in the collapse stages.
The tissue remedies are to be selected one, two or more at a time according to the prevailing symptoms and can be administered either by mixing them together or in alternations. They further advise to take some tepid hot water every time with the medicine. As a rule tissue remedies should be more frequently repeated than dynamized polychrests.
Collapse Stage: For a homoeopath with a fair knowledge of his materia medica it is not very difficult to find the appropriate medicine promptly in this stage. It is needless to stress on the promptitude required in tackling this condition when every minute wasted takes the patient nearer to the journeys end.
Remedies required in this condition being very limited and their special and leading features being well marked on the patient the physician does not find it difficult to make a quick decision. The only thing necessary for the physician is to recognise the characteristic sure leaders.
This is the stage when the vitality is ebbing down and the physician has to spur it up once again to bring reaction. This is not the time to wait long for the reaction to start after giving a high potency. Repeat the medicine frequently, indeed every 10, 15, or 30 minutes till the patient warms up.
It has been found that in many of these cases of relapse the first medicine acts no more, however high may be the potency and however frequently may be the repetitions. The reason of this failure is that during the course of reaction and improvement the condition usually changes and runs into the precinct of some other medicine. Hence the symptoms appearing during the course of improvement foretell the medicine required in cases of a relapse. Observe these symptoms carefully and be guided by them if a relapse takes place.
It should be noted here that even in this stage under the appropriate potentized remedy reaction starts within an hour or two, and if it does not it indicates an error in selection and demands to take stock afresh for the correct similimum.
Treatment: In the cholera infantum Arsenic doses not fit well in the early stage when the stools are generally copious and the prostration is not so well marked. Its utility is well felt in a later stage when the stools become scanty but the exhaustion is extremely great, and the temperature tends to fall. The restlessness, anguish cry and thirst are still the prominent features and the child wants to sip cold water incessantly.
Veratrum-album comes next with its exhaustion, prostration and coldness of body accompanied by cold sweat all over, but most prominently over the childs forehead. Some authors recommend it in alternation with Cuprum-metallicum when cramps predominate. Carbo veg. will be required when the collapse sets in although the purging and vomiting have improved or ceased.
It has cold sweat and cold body and the coldness is more marked on the extremities and on the tip of nose; more particularly on the legs from the feet to the knees. Face pale and sunken. Opium is required by the infants more often than by the grownups. When it is indicated there will always be a history of cerebral affection from the very beginning of the attack. The child will be lying still, soporous, with eyes half-open; total indifference,even to immediate surroundings; bloated and red face.
In the next group we find Antim-tart. as the most commonly needed medicine. Profound sleep and marks of cyanosis are its leading indications. Vomiting with a thick white coated tongue; cold sweat over the forehead appearing after each vomiting (after evacuation, Verat-a.). The child becomes more exhausted after a vomiting than after motions. In short, vomiting prevails over motions under this drug.
Camphor brings in collapse too early. From the beginning of its attack breathing troubles indicate that the heart failure is threatened and the child begins to collapse with signs of cyanosis. The child does not keep the covering although the body is so cold. The next consideration should be given to ophidius, a study of which is often found worthwhile in the treatment of cholera. They are suitable in collapse stage with an asthmatic breathing difficulty, worse after sleep.
Fear will be well marked on the face of the child requiring Naja, and cheerfulness when one requires Lachesis. Tabacum will be useful when the evacuation improves but the vomiting and nausea persist, resulting in collapse with cold sweat and suffocative breathing. In the collapse of Secale-cor. we find an internal burning sensation inspite of the body being externally cold and hence the child does not keep any covering over the body (Camph.). Unquenchable thirst, and weak, thin pulse are its accompanying features. Hydrocyanic-acid should be thought of in convulsions from uraemia (Cupr-m.) with cardiac weakness and breathing difficulty.
Remember: In cramps of cholera Cuprum is indicated when vomiting is prominent, Secale when diarrhoea, and Veratrum when both purging and vomiting are equally severe.
When this condition is accompanied by pain in abdomen Cuprum-m. deserve our first consideration and then Verat-alb. Antim-tart. is suitable for both painful and painless varieties.
In painless type of cholera our first choice is for Bism. and Podo., and then Antim-tart.
For copious watery stools think of Podo., Verat-alb., Ars., Bism., and Antim-t.
In Verat-alb. born purging and vomiting are copious but still the motions are more prominent than the vomiting.
We have to distinguish between Arsenic and Bismuth for vomiting immediately after eating or drinking. Croton-tig. also deserves a consideration.
For vomiting in association with retching give Ant-t., Bism., Podo.
Aethusa is notorious for vomiting of curdled milk in big lumps. It has also vomiting of a frothy, milk-white substance. Remember Valeriana when Aethusa fails. Other medicines for vomiting of a frothy or fermented substance are Ant-t. and Verat-alb.
Kreosotum has vomiting of food taken several hours before. Natrum-phos has acid vomiting.
Antim-cr. has severe nausea with relief after vomiting (without relief, Ip.) which is also copious and frequent.
Arsenic is no doubt our first choice for restlessness. Next come Acon., Bism., and Verat-alb. Other restless remedies are Carbo- veg., Cuphea, Ip., Kreos., etc.
When thirst predominates Arsenic comes first to our mind but it has “drinks often but little at a time” and does not suit the unquenchable thirst for large droughts as we find in (1) Acon., Jatro., Verat. (2) Bism., Colch., Ip.
Caution: Dr. J. T. Kent says “I want to warn you against the too promiscuous use of Arsenic in the summer complaints of young babies, for dysentery and cholera infantum. It has so many little symptoms that are so common to these complaints that if you do not look out and are not warned you will be likely to give your patient Arsenic, suppress some of the symptoms, changing the aspect of the case so that you cannot find a remedy for it, and yet not cure the case with Arsenic”.