INFANTILE BILIARY CIRRHOSIS 409 



All food is refused. The thirst becomes intense. 

 Prolapse is common. Gangrene sets in, spreads rapidly, and is 

 fatal. 



TREATMENT. 



As practised by the natives. 

 For animals. 



An enema of strong- lemon-juice mixed with diluted white rum 



(aguadiente) thrice daily. 



Dust tlie anus with wood ashes. 



An oil purgative is given. 



This appears to be successful in early cases. 

 For children. 



Give an enema of juice from the stalks and leaves of Spigelia 



anthelmentica (Pasote). 



A decoction of the same is given bv mouth thrice dailv. 

 (This mixture is also given as an anthelmintic.) 



A portion of roasled lemon inserted into the rectimi once or 



twice daily. 

 It is said to be caused b}' children chewing the green tender stalks 

 of unripe maize. 



INFANTILE BILIARY CIRRHOSIS. 



This is a rapidly fatal disease attacking young native children in 

 Calcutta and some other large Indian towns. 



iETIOLOGY. 



Children are attacked in their first year during dentition as a rule. 

 They are rarely attacked from the first to the third year. 



Hindoo children in Calcutta had a mortality of 1,616 (1891-1893), 

 and Mahommedan children in the same citv had 80 dead during the 

 same period. 



The children of the rich suffer more than those of the poor. 



It tends to run in families, and attacks them as the young are born. 

 Nearly if not all of those attacked die. 



Alcohol, syphilis, and malaria have been excluded. 



The cause is unknown. 



Some suggest that it is a variety of kala-azar. 



SYMPTOMATOLOGY. 



The onset is insidious. The liver enlarges even to the umbilicus. 



There is nausea, sometimes vomiting, sallow skin, constipation, 

 irritability and anorexia. Low fever sets in with jaundice, pale stools 

 and dark urine. 



