DIGESTIVE TRACT
GASTRITIS
Incoördinations of the stomach alone are less frequent in infancy
than are those of the intestines. Usually the stomach and intestines
are involved at the same time and it becomes impossible to
differentiate the two. The greater part of digestion during infancy
takes place in the intestinal tract, the stomach acting more as
a receptacle for the milk from which food passes slowly into the
intestinal tract to be properly digested. In an infant one month old
the stomach will be empty one and one-half hours after nursing; in
bottle-fed babies it will take a little longer. From two to eight
months of age the time is about two hours for breast-fed babies and
from two and a half to three hours for those taking cow’s milk.
Symptoms
The symptoms of gastritis come on very suddenly with pain and
tenderness in the epigastric region, and with a high temperature
which after the onset decreases. There is thirst, loss of appetite,
and vomiting. The vomited matter is usually sour and may be streaked
with blood. If there is an excessive amount of blood it indicates
ulcers. This is rather unusual, however, in small children. Vomiting
is excited by anything taken into the stomach. The thirst is intense,
although the water will be vomited as soon as taken. The tongue is
heavily coated and the breath is foul. If these symptoms continue
intestinal symptoms will soon develop.
The different kinds of gastritis are given as: catarrhal, ulcerative,
membranous and corrosive; but the symptoms are all very much the
same and from a chiropractic standpoint a knowledge of the particular
pathology would be of no value as the adjustment would be the same.
In these cases the difference, or rather specific diagnosis, cannot
be made, medically, until after the autopsy. In the ulcerative type
the condition is more prolonged and there is a greater tendency to
hemorrhage which results in a greater amount of blood in the material
vomited. Corrosive gastritis is the result of a corrosive poison
being taken into the stomach, such as carbolic acid.
Major Adjustment
From a chiropractic standpoint it is immaterial what form of
gastritis the child may be suffering from with the exception of the
corrosive type which may require the administration of an antidote.
In this event the condition passes out of the realm of Chiropractic
the same as any other traumatic condition. The adjustment in all
cases of gastritis the same as in any other incoördination of the
stomach is S.P. If there are symptoms which indicate that the poison
family is involved the combination would include K.P.
If adjustments are given at the onset results will be obtained almost
instantly. The temperature will soon be reduced, the pain will
be relieved and in a remarkably short time the symptoms will all
disappear.
CHRONIC GASTRITIS
There are no characteristic peculiarities associated with gastritis
when it becomes chronic. There is no advantage in differentiating
the chronic from the acute. The symptoms are somewhat less severe,
and run a longer course. There is vomiting following meals. Between
meals there will be a regurgitation of the food. This form of
indigestion is not common among infants but may be found with older
children. The most prominent symptom is that of malnutrition. There
is restlessness at night, loss of appetite, constant loss of weight
and anemia.
Major Adjustment
The adjustment in the case of chronic gastritis is the same as in the
acute attacks. Stomach place is the condition of the stomach with
kidney place for the elimination of the waste products which result
from the lack of digestion. The kidney place adjustment is also to
correct any abnormality in the serous circulation resulting from
faulty digestion.
STOMATITIS
Dr. James N. Firth, in his “Chiropractic Symptomatology,” states
that “There are five forms of stomatitis, viz.: simple, ulcerative,
follicular, thrush and gangrenous.” It is not our thought to cover
this subject in detail as he has done, but only to point out that
which is characteristic of stomatitis in infants and small children.
In this incoördination the mucous membrane lining the mouth becomes
inflamed and swollen. The mouth is hot and the lips dry. The child
is fretful and even though hungry refuses to nurse or will cry while
trying to nurse. There is quite an increase in the secretion of
saliva.
Stomatitis in infants often accompanies the acute febrile dis-eases
or may appear alone. There will be more or less indigestion with
possibly some diarrhea. If the condition remains for a great length
of time the child becomes emaciated from the lack of food ingestion.
It is not necessary for us to take up the different forms of
stomatitis since the adjustment is the same in all cases. Upon the
first indication of stomatitis or the slightest symptom of sore
mouth, the infant should receive prompt attention. Strict hygienic
measures should be used, especially if the child is being bottle fed.
Equation
In stomatitis the equation is C+ for the simple form; for the
suppurative form it is N.C.R.
Family
Simple stomatitis is classified in the fever family. The other forms
involve the poison and degeneration families.
Major Adjustment
The adjustment for simple stomatitis is S.P. in combination with
M.C.P. If there is any suppuration involving the poison and
degenerations family the major will include K.P.
GLOSSITIS
Glossitis is not very common among infants. It is an inflammatory
condition of the tongue with hyperemia and swelling. There is
usually a slight temperature and the swelling may involve the mucous
membrane of the mouth. The tongue may be so greatly swollen that it
becomes very difficult for the child to take food. Glossitis is often
associated with stomatitis or any involvement of the mucous membrane
of the mouth.
Equation
The equation for glossitis is C+ with T+ for the hyperemia. If there
is suppuration it is N.C.R.
Family
This condition is in the fever family overlapping the degenerations
family in case of suppuration.
Major Adjustment
The major adjustment for glossitis is S.P. and in cases involving
suppuration K.P.
STENOSIS OF THE PYLORUS
There are two types of stenosis of the pylorus in infancy. One
is a stenosis due to a muscular spasm of the pylorus called a
pylorospasm. The other is a stenosis due to a hypertrophy of the
pylorus known as hypertrophic stenosis of the pylorus. It is possible
for both conditions to be present at the same time. The stenosis
may be congenital and is usually called stenosis of infancy. It is
considered a serious condition and the mortality is very high.
This incoördination is characterized by constipation, persistent
wasting, projectile vomiting, and a marked visible tumor.
Symptoms
The symptoms begin to appear during the first or second week of life.
Up to this time the child may have been gaining and showing all signs
of perfect health. Vomiting is usually the first symptom to appear
and this may be at irregular times but without apparent cause. It
soon becomes very forcible and later projectile. The symptoms of
indigestion are absent; there is no eructations of gas; the breath
is sweet and the appetite is good. There is no evidence of pain and
there is no fever, yet the child steadily wastes and loses in weight.
The contests of the stomach are sometimes expelled with such force
that the food will be thrown a distance of two or three feet. The
food sometimes comes through the nose. The vomiting takes place
immediately after feeding and sometimes while the child is nursing.
The fact that the child will nurse after vomiting and sometimes
will leave the breast only while the food contents of the stomach
are being ejected shows that the vomiting is not the result of
indigestion; the fact that the food is all expelled at one time and
not regurgitated at intervals is further proof. The food seldom
remains in the stomach long enough for gastric digestion to take
place, therefore the vomited food is not digested but it is just
about in the same stage as it was when taken into the stomach. In
some cases, however, the vomiting may not take place immediately; in
some cases the food may even be retained for two or three feedings,
although this is unusual.
The constipation is very obstinate from the fact that the food is
vomited and does not pass into the intestinal tract. In the severe
cases the stools resemble meconium. There is very little fecal matter
in the stool. In the severe cases there is persistent loss of weight
which may amount to two or three ounces per day. The constipation is
very marked and the urine is scanty.
In the mild cases the symptoms are all less marked. The vomiting may
be only occasional, the loss of weight is not so great, fecal matter
is passed in the stools and there may even be a gain in weight at
times.
Due to the character of the vomiting which is projectile the symptoms
are sometimes mistaken for cerebral symptoms. The scanty urine
and the vomiting confuse the condition with renal dis-ease. It is
not difficult to distinguish stenosis of the pylorus from gastric
indigestion. The latter rarely develops suddenly, but is very common
in infants. The vomiting usually occurs shortly after feeding.
Equation
If the condition is the result of hypertrophy of the pylorus the
equation is X+. If it is a case of pylorospasm the equation would be
M+. The equation for the loss of weight and wasting is N-.
Family
The family of the hypertrophic condition of the pylorus would be
tumor family while the pylorospasm would come in the spasms family.
Major Adjustment
The adjustment for this condition would be stomach place in
combination with kidney place. The adjustment results in a relaxation
of the muscular fibers of the pylorus and permits the food to pass
from the stomach. In case of hypertrophic stenosis of the pylorus
there is not only a relaxation of the muscular fibers, but Innate
Intelligence removes the hypertrophy and thus enables the food to
pass from the stomach. Excellent results are obtained in these cases.
Care should be exercised in making the analysis and the adjustments
should be given as early in the progress of the condition as possible.
ACUTE INTESTINAL INDIGESTION
This is quite a common incoördination and is very much more prevalent
in hot weather. It is found often in very young infants, but more
often in children during their second summer. There are many forms
and degrees of acute intestinal indigestion among infants and
small children. The attacks come on usually very abruptly and may
be severe from the beginning. The most outstanding feature of the
incoördination is the characteristic diarrhea. In the mild form
the symptoms develop suddenly with marked gastric disturbances. At
the beginning there is colicky pain and tympanites. There is great
restlessness and typical symptoms of colic. The diarrhea appears in
a very short time. The color of the stool is at first yellow, then
it becomes a yellowish green and finally a grass green. It will
usually contain undigested foods. The odor is very foul, grass green,
and very much thinner than normal. This mild form may develop into
the more severe type or the more severe form may develop suddenly
from the very beginning. The temperature rises rapidly. The skin is
hot and dry. At the beginning the child is very restless and cries
a great deal, but later he lies in a stupor, the eyes are sunken,
pulse is weak and there is all the appearance of an attack of serious
illness. There may be anorexia. There is usually great thirst and
nausea and vomiting. In a few hours there is marked diarrhea. The
stools are yellow and of a thin consistency with a very offensive
odor. There is usually much gas expelled. There may be as many as
four or five stools an hour. This incoördination is responsible for a
great many deaths among children. They respond, however, very quickly
to chiropractic adjustments.
Major Adjustment
The subluxation responsible for intestinal indigestion will be found
in the lumbar region, usually upper lumbar. It may be necessary to
include kidney place for the elimination of the products of the
indigestion. This condition is in the fever family overlapping the
poison family.
CHOLERA INFANTUM
When the severe type of intestinal indigestion is accompanied with
gastric disturbances and severe vomiting, it is known as cholera
infantum. In this form the temperature rises rapidly and the symptoms
develop quickly and become very severe in a remarkably short time.
The vomiting is very severe and usually appears simultaneously with
the diarrhea. After the stomach has been emptied of food the vomitus
becomes serum and mucous. The contents of the small intestines may
regurgitate into the stomach and be vomited up. Vomiting may be
induced by taking water into the stomach. The stools are frequent,
are of a pale green, yellow or brownish color at the beginning, but
later become almost entirely serous. In the severe cases the bowels
may be evacuated every few minutes. This type differs from that
previously described in that the stools are practically odorless.
In rare cases, however, they may be exceedingly offensive. There is
probably no other incoördination during childhood in which there is
such a rapid loss of weight. The picture which the patient presents
is characteristic. There is great weakness and prostration from the
very beginning. The fontanel is depressed and in some cases there
may even be an overlapping of the cranial bones. The features become
sharp, the eyes are deeply sunken and the angle of the mouth is
drawn down. The nose is pinched, the skin over the forehead is tense
and dry, the temples are sunken. There is pallor, stupor, marked
relaxation of the lips and there will be convulsions and collapse.
Statistics show that under medical treatment fully three-fourths of
the cases die.
Major Adjustment
Most excellent results are obtained in these cases under chiropractic
adjustments. In the severe attacks it will be found necessary to
adjust the child as often as once every six hours. The subluxations
will be found at stomach place and kidney place and middle lumbar.
Some very severe cases have come under our personal observation and
in the cases that we have handled personally the results have been
100%. Such cases must be analyzed very carefully, and must have the
very best care in every way.
CHRONIC INTESTINAL INDIGESTION
Chronic intestinal indigestion is a very common incoördination
affecting children. It is more likely to be found among children
who are artificially fed. Intestinal indigestion is responsible for
a great variety of symptoms that are sometimes considered separate
dis-eases.
Symptoms
Children suffering with intestinal indigestion usually present
symptoms of malnutrition. They are anemic, the extremities being
usually very small. The most striking feature of such a case will
be the extremely large abdomen. The colon is usually dilated as
are also the small intestines. There is marked tympanites, which
usually increases during the daytime but diminishes during the
night. This is one of the principal symptoms which differentiate
intestinal indigestion from tubercular peritonitis. Such children
are easily fatigued, have a very sallow complexion with dark rings
under the eyes. They are usually very much below the average weight
and are very cross and irritable. They do not sleep well, often
grinding their teeth and crying out in their sleep. There is usually
alternating constipation and diarrhea, the odor of the stools being
very offensive. In extreme cases there may be convulsions and other
cerebral symptoms. There is seldom any fever.
Major Adjustment
The local major subluxation will be found in the lumbar region with
the combination at kidney place. Kidney place is used only when there
has been an accumulation of products of indigestion which makes it
necessary to increase elimination to take care of these products. In
many of these cases the liver is involved and therefore will call for
liver place in combination with kidney place and the local lumbar.
These cases will respond very readily to chiropractic adjustments.
COLIC
Colic is a common incoördination of infancy and is very prevalent
during the first three months. Colic is a symptom rather than a
dis-ease and usually indicates intestinal indigestion or some
inflammatory condition of the intestines. It is characterized by
sharp paroxysmal pains in the intestines. A child who is subject to
colic will usually be suffering also from constipation. The crying of
a colicky child is characteristic, being very violent and paroxysmal,
which presently subsides only to be followed with another attack.
During these spells the lower extremities will be drawn up and the
abdomen will be tense from the accumulation of gas. In mild cases
the child will not cry out but will be fretful. This may be wrongly
construed to be the result of hunger. When the attacks of colic come
on the child will show a desire to nurse and will take the breast as
though very hungry. This may be followed by relief from the pain, but
this relief is only temporary and when the pain returns it is usually
more severe. There is probably no incoördination of childhood that is
quite so trying to a chiropractor as an acute attack of colic, due to
the violent crying of the child and the eager desire on the part of
the chiropractor and the attendants to relieve the pain. It is often
quite hard to obtain a correct analysis in such cases because of the
difficulty experienced in getting the child into a proper position
for palpation. In making the palpation the chiropractor should take
plenty of time and should never endeavor to force the child to be
still, rather he should adapt himself to the constant moving about of
the infant.
Major Adjustment
The major varies somewhat in these cases so far as a specific
vertebra is concerned, but the local will always be found in the
lumbar region, usually the first or second lumbar vertebra. Kidney
place should be used as a combination.
VOMITING
During nursing the infant swallows quite a little air and not
infrequently this is the cause of vomiting immediately following
feeding. It is not uncommon for an infant to vomit without effort
after overfilling the stomach. This is a natural thing among healthy
children and needs no attention from a corrective standpoint. In such
cases the milk is but little changed.
In gastric indigestion and gastritis vomiting is always present, but
in these cases it does not take place until some time after feeding,
perhaps several hours. In gastritis the vomiting is more constant.
In the more severe cases there will be not only the partially
digested food but also bile and mucus and sometimes traces of blood.
Obstructive vomiting is sometimes found among infants and may be
due to intestinal obstruction or to an obstruction of the pyloris.
The obstruction may be congenital or it may develop after birth.
Obstruction of the pyloris may be the result of hypertrophic
stenosis. In this condition the child vomits immediately following
feeding and with great force. This is thoroughly described in the
article on Hypertrophic Stenosis of the Pylorus. If the obstruction
is in the intestinal tract it may be the result of a congenital
malformation or due to intussusception. The vomiting is forceful and
the vomitus may contain fecal matter.
Vomiting is often associated with peritonitis and appendicitis. In
these conditions there is distention of the abdomen with abdominal
pains which may be localized. There may also be a slight temperature.
Vomiting is purely adaptative on the part of Innate Intelligence. The
food cannot be digested and carried through the digestive tract so
Innate realizes that the best thing to do is to free the body from it
in the quickest manner.
Vomiting often precedes such incoördinations as pneumonia, scarlet
fever and malaria and may precede any of the febrile dis-eases.
Vomiting may be produced by the accumulation and absorption of
toxines in the body.
Infants suffering with nervous disorders such as acute meningitis,
tumors of the brain and other central conditions will often have
cerebral vomiting. In this event the vomiting is spontaneous and
does not necessarily occur at feeding time. Other cerebral symptoms
present will aid in determining the analysis.
Vomiting may be produced by the presence of worms that come up
into the throat from the stomach and intestinal tract. Hunger may
occasionally bring on an attack of vomiting. This is more common in
older children than in infants.
RECURRENT VOMITING
This is also known as cyclic vomiting and periodical vomiting.
It is characterized by recurrent attacks which may be weeks or
months apart. They come on without any apparent cause and from the
descriptions and explanations given in medical science very little
can be done medically to control the vomiting which at the end of
two or three days will cease spontaneously. The attacks recur at
different intervals, usually less often, gradually decreasing until
they cease altogether when the patient is about the age of ten or
twelve years.
Symptoms
There is loss of appetite and malaise. The pulse becomes rapid and
in some cases there is slight temperature. There is usually headache
and excessive thirst. During the attack of vomiting there is extreme
retching and great distress. The symptoms are similar to migraine
in adults. This condition must be differentiated from tubercular
meningitis in which there is vomiting without apparent cause. The
course of the symptoms will soon enable a positive differentiation.
In acute indigestion there is vomiting, but the history of the case
reveals the fact that the attack was brought on by undigested food.
It is very easy to distinguish this type of vomiting from that of
appendicitis, since in appendicitis there is marked tenderness at
McBurney’s point, also pain and the characteristic rigidity and
muscular contraction. In intussusception the symptoms are usually
more severe and there is blood and mucus in the stool.
Major Adjustment
Since there seems to be no particular indication of indigestion or
impaired functions, and no pathological changes, it is evident that
the function involved is that of motor. But regardless of the primary
function that is interfered with a subluxation will be found at S. P.
and in most cases there will be a hot box during the acute attack.
The vertebra most commonly subluxated is the sixth dorsal. In most
cases there is no combination and results will be obtained in a very
short time by adjusting nothing but the S.P. subluxation. In the
severe cases it may be necessary to adjust as often as once every six
hours until the vomiting ceases. Ordinarily the vomiting will cease
in a short time and in most cases marked improvement will be noted
after the first adjustment.
Vomiting occurs in gastric indigestion, intussusception, meningitis,
peritonitis, pyloric stenosis, uremic poisoning, and in many other
acute incoördinations.
CONSTIPATION
The first bowel movement after birth is known as meconium and is a
dark brownish-green color, and of a semi-solid consistency. During
the first two or three days the bowels move from four to six times
daily. On the third day the character of the stools begin to change
and by the fourth day the feces has become normal.
The normal stool of a normal nursing infant is about the color of
the yolk of an egg, and may be slightly green. The average amount is
about two ounces daily. The stools should never be watery, but of
a butter-like consistency. During the first few weeks the infant’s
bowels will move on an average of four times daily. After about six
weeks the average will be two a day. The stool changes in character
as soon as the child is placed upon a mixed diet. It then becomes
more like that of an adult but remains softer.
Constipation is one of the most common incoördinations of infancy and
childhood. There are many factors to be considered and many things
that contribute to the condition. In older children habit plays no
small part in aggravating constipation. For this reason the child
should be very carefully trained early in life to obey the first call
on Nature in this respect.
Normally the infant should have two bowel movements a day, although
some have more while others may have only one. Frequent movements
do not, however, mean that the child is not constipated or costive.
With two or three dry hard stools per day the child would be costive.
Constipation is the result of a lack of motor function in the
muscular walls of the intestines while costiveness is the result of a
lack of secretion due to interference with transmission of secretory
mental impulses. The two conditions are often associated. When there
is a lack of motor function in the muscular walls the fecal matter
will not be forced out of the intestinal tract fast enough and much
of the moisture will be absorbed, thus leaving the fecal matter dry
and hard. This is not a true costiveness and should not be mistaken
for such.
In costiveness there may be colicky pains which may be increased,
and may at times be quite severe, when the hard dry fecal matter is
passed. The general health of the child may be seemingly normal. In
severe cases hemorrhoids and even hernia may be developed from the
constant straining.
Major Adjustment
These cases are simple and respond readily to chiropractic
adjustments. The combination varies somewhat in different cases. In
constipation the major will be a lumbar vertebra. In costiveness,
where secretions are involved, the combination will include a Li.P.
and K. P. In some cases excellent results are obtained by adjusting
ninth dorsal.
INTUSSUSCEPTION
Intussusception is a condition wherein there is a telescoping of the
intestines in which one portion passes into the adjacent portion and
produces an obstruction.
This condition occurs most often in early infancy, although not very
commonly. The most frequent site is at the ileocecal valve. It may,
however, occur at any point in the intestinal tract. When it occurs
in the small intestine it is known as enteric intussusception; in the
colon as colic; and at the ileocecal valve as ilecocecal.
Intussusception may be chronic or acute. In the chronic cases there
may be adhesions which will make it very difficult for Innate to
accomplish a reduction.
Symptoms
The onset is usually accompanied with paroxysmals of pains and
vomiting. The pains may be very severe and the vomiting projectile.
The pain may be mistaken for that of ordinary colic, but it is much
more severe and may continue through the entire attack.
The vomiting is persistent, especially at the onset, and occurs
as soon as food enters the stomach. In older children it may be
stercoraceous after the third or fourth day. It never occurs,
however, in infancy. The vomiting is the result of the intestinal
obstruction and is adaptative on the part of Innate Intelligence. It
is quite obvious that it is better not to have food in the stomach
than it is to have it and not be able to complete the process of
intestinal digestion.
The character of the stools is of importance. At first the bowel
movements may be diarrheal and later there will be no fecal matter,
but the stool will contain nothing but blood and mucus. A paroxysm
of colicky pain may be followed by a mucous and bloody stool several
times daily. At the onset the abdominal walls are soft and relaxed,
or may even be retracted. Tympanites may occur about the second or
third day.
The symptoms in the acute cases are those of shock. There is an
extremely anxious look on the face which is pallid, cold extremities,
subnormal temperature and cold perspiration. There is restlessness
and in many cases convulsions. Later there will be stupor. A sudden
rise in temperature indicates a turn for the worse and may mean death
in a short time. In the chronic cases there is marked inanition which
progresses very rapidly.
Major Adjustment
The subluxation interfering with the transmission of mental impulses
causing intussusception will be found in the lumbar region, the
specific vertebra depending upon the location of the intussusception,
whether in the upper or lower intestinal tract. Most excellent
results have been obtained in these cases, and there should be
no hesitancy in adjusting. The function involved is motor, which
prevents a coördinate action of the muscular walls of the intestines.
As soon as this action becomes normal Innate Intelligence will
correct the condition and all symptoms will subside.
ICTERUS
Icterus is a rather common incoördination of infancy. It is
characterized by yellowish discoloration of the skin produced by the
accumulation of bile pigment. This is the result of an occlusion
usually of the common bile duct, which prevents the bile from passing
into the duodenum. There are two forms: the physiological and the
pathological. In the physiological there is an inflammation in the
mucous membrane lining the common bile duct. This causes a decrease
in the size of the lumen, which obstructs the flow of bile. In the
pathological there may be a complete obstruction due to malformation
or there may be a congenital absence of the bile duct. While the
common bile duct is the most common seat of the pathological type,
yet the hepatic and cystic ducts may also be involved.
Symptoms
The most prominent symptoms is the discoloration of the skin. In the
severe obstructive jaundice the stools are white, the urine dark
brown and bile-stained and the liver and spleen often enlarged. There
may be severe convulsions. In the more common and less exaggerated
cases the foregoing symptoms are present but in a milder form. There
is typical jaundiced discoloration which in some cases will appear
soon after birth. This will continue for a few days and may become
quite marked. The stools will be colorless, while the urine will be
highly colored.
Equation and Family
The equation is secretion plus (T+) and excretion minus (E-) for the
accumulation of the bile. The family is the poison family. In case of
temperature it overlaps the fever family.
Major Adjustment
The chiropractor must not conclude that the case is one of congenital
malformation or absence of the bile duct merely because of the
extreme discoloration of the infant. Cases have come under our
observation in which the symptoms would all indicate that the case
was hopeless, but under chiropractic adjustments they have recovered.
It must be recognized, of course, that if there is a congenital
absence of the bile duct the case is hopeless, but since there is no
way of determining whether it is a mere obstruction or congenital
absence, the case should by no means be considered hopeless. Every
effort should be made to locate and adjust the subluxation. The
subluxation will be found at liver place which must be adjusted in
combination with kidney place. Kidney place is required for the
elimination of the accumulated bile. These cases will respond very
quickly and satisfactorily under chiropractic adjustments.