Diarrhoeal diseases, among malnutrition and upper respiratory infections, are the three major causes of infantile mortality, especially in developing countries, and all three can be found in a child at the same time.
Over the years, there have been conflicting teachings on diarrhoea management in children not only between different nations or cities but even between different hospitals in a given community as was exemplified by a lecture on “ORT- AN International Perspective” given by Dr Roy Brown, who is the chairman of Community Medicine Department, at St. Joseph’s Hospital, New Jersey, U.S.A.
The ancient concept and management of infantile diarrhoea have been outlined below:
- Stop diarrhoea as fast as possible: This was achieved by the use of :
- Bulk absorbents such as Kaolin and Bismuth.
- Drugs that reduce intestinal motility e.g. Codeine and Atropine-containing drugs like Lomotil.
- Antibiotics such as Sulphonamides, Penicillin and Neomycin, since all diarrhoea was thought to be caused by bacterial and other parasitic agents.
- Withhold food including Breast milk during the diarrhoea episode. This is because a sore in the stomach or spoilt food was held responsible for most cases of diarrhoea, and the digestive system was thus thought unfit to deal with an additional burden of food. Some hospitals even advised patients to restrict fluid intake during the period.
- The idea or concept of the loss of body fluids and electrolytes through the diarrhoeal stools which could lead to dehydration of the infant, and the need to replace these i.e. rehydration, was not all considered in the management of infantile diarrhoea until it was rather too late.
There was also the tendency to administer parenteral anti-emetics such as injection Largactil where diarrhoea was accompanied by vomiting.
The responsibility for those anomalies must be shared by all not only mothers, but all categories of health workers, both in the developed and developing countries.
The result was that a greater proportion of cases of infantile diarrhoea ended fatally due to severe dehydration and malnutrition and the few lucky ones that were saved at the hospitals had to be rehydrated by intravenous fluids such as ½ strength Darrow’s Solution.
© The Author(s) 1988. Published by the Pharmaceutical Society of Ghana (PSGH). This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.