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The condition generally begins, or rather is preceded for some days, by diarrhea ; this is soon followed by violent vomiting, and for a time the vomiting and purging constitute the prominent features of the complaint. After two or three days, sometimes only hours, the vomiting ceases, while the looseness of the bowels persists. The child loses all inclination for the breast; is peevish, fretful, and subsequently listless and apathetic ; the head is hot, the abdomen usually swollen and often tender. In severe cases the stools, at first green and frothy, become quite watery and almost devoid of all the usual characteristics. Such cases often terminate fatally within four or five days or sooner; during the latter part of the attack the infant becomes cold, its features pallid and sunken, the abdomen retracted ; the general appearance suggests an emaciation such as follows a long and wasting sickness.
Such is the rapid course of this complaint during the very hot weather and in the more closely settled parts of our cities. If the heat be not so intense the affection is usually of longer duration or of less immediate severity; for weeks and months, indeed, throughout the entire summer, the child is tormented with diarrhea ; vomiting is frequent; the stools are usually green and very offensive ; there is but little inclination for food, and whatever is swallowed usually reappears within an hour, so that it seems impossible for the child to subsist upon the small quantity of nourishment retained. The infant emaciates rapidly and often becomes a really painful object to look upon. All the symptoms are aggravated during the unusually hot days, and improve correspondingly when the temperature falls ; indeed, if the child be kept at home the result seems to depend largely upon the weather. This affection is especially apt to attack the child during the teething process, and rarely occurs after all the teeth have been cut.
So far as the home management is concerned, the treatment must be simply an attempt at prevention ; and if certain measures can be adopted, it will be usually possible either to avert this trouble entirely or to cut it short upon the manifestations of the first symptoms. The mother of every child born during the warmer season should anticipate and prepare for this trouble during the following summer. The first measure for prevention consists in the precautions already mentioned for the avoidance of intestinal derangements in general; precautions as to the quality and quantity of the diet, as to the regularity in the times of nursing, and as to the observance of proper intervals between these times ; care in the arrangement of clothing, etc. If, in spite of all precaution, the symptoms of the disease manifest themselves, there remains one, and but one, sovereign remedy-removal of the child into the country. This change, made of course with all due precaution, will almost certainly save any child in the early stage of the disease, and will often even restore the emaciated infant that has been for weeks wavering between life and death. The unfortunate thing about this is, that summer complaint affects with especial frequency and malignancy the children of those who are pecuniarily unable to secure the advantages of country air for their infants. For them there remains merely the effort to secure as much of these advantages as their means afford; the child may be not only carried in the parks and on the shores of neighboring streams, but should be taken out for the day, at least, away from the debilitating influences of the city. It is often surprising to observe how much good results from these simple daily excursions out of the city, even though the child must be brought back every evening. The value of this principle has been well illustrated in the floating hospitals in operation in several of our larger cities.
These are charitable organizations whereby infants with their mothers or nurses are transported upon the water, and receive the benefits of fresh air and cooler temperature for several hours during the hot days of summer. The marked improvement resulting, even in desperate cases of summer complaint, should encourage all parents to repeat in a small and private way, if necessary, this plan of securing a change of surroundings for the sick child during the day, even if a sojourn of several weeks in the country be impossible.
As for the employment of drugs in this affection it is unadvisable for any but a medical man to attempt their use.
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