The troublesome constipation met with in infants can be best overcome generally by giving them fresh air, proper food, and a rectal enema of warm water containing a little chloride of sodium at a stated time each day, with out any medicine by the mouth.
When there is alternately diarrhcea and constipation in infants the cause is usually due to an excess of proteids. Essence of pepsin, 10 or 15 drops, should be given after nursing, and abdominal massage is of value. An excellent plan to secure an action of the bowel at a regular time is the insertion of an oil paper suppository. The constipation of bottle-fed infants being commonly the result of a deficiency of fat in their food, the rational treatment embraces the addi tion of cream or butter. All forms of teas should be strictly prohibited, and in older children too ninch potato should not be allowed. Lawrence (Med. Record, July 1, '99).
In artificially-fed infants constipation may be due to an insufficiency in the fats or proteids. The addition of a tea spoonful of fresh cream for each tea spoonful of condensed milk used is an effective way of relieving the constipa tion following feedings of condensed milk. Beef-juice is occasionally laxative. When constipation is clue to congenital stricture of the anus or rectum, rectal examination will reveal the seat of the difficulty. When nutrition is defective, malt-extracts and codliver-oil may be tried. Enemata should be employed for a comparatively short period only, and saline solution is recommended. Black oder ("Progressive Med.," vol. i, Mar., '99).
ln infantile constipation excellent re sults obtained from administration of fresh butter. A half-teaspoonful is given to children of from one to three months, with a spoonful of coffee morn ing, noon, and night. Children of from five to twelve months are fed with from 1 to 3 teaspoonfuls of butter at evening, every two or three days, this being con tinued until the stools are regulated. When a normal condition of the bowels is reached the remedy should be discon tinued and resorted to again if the trouble recurs. Absolutely fresh butter should be employed. The butter seenis also to improve nutrition. M. Dorfler (La Presse MM., June 6, 1900).
In chronic constipation of infants and young children best results are obtained by careful attention to diet, exercise, and being much in the open air, avoidance of living in overheated apartments, massage, and regularity of time for the evacuation.
G. W. Cook (Amer. Jour. of Obstet., Oct., 1900).
In the rare cases in which a fair trial of enemas and suppositories does not succeed a few drops of the elixir of cascara sagrada may be given each even ing.
Excellent results have followed the use of both the oil and glycerin enemata in the treatment of constipation.
Obstinate constipation and intestinal diseases may be successfully treated by enemata, of oil, after the method of Reiner. Olive-oil is the best, but, as if is rather costly, pnrified rape-seed oil may be used. The injections are made slowly and carefully, and the patients are told to retain the oil as long as pos sible, sometimes for several hours. Every day an injection of I 'A to 8 iluidounces of oil is made, with the result that defe cation becomes easy, the flatulence dimin ishes, and in cases where the mucous membrane of the bowel is more seriously affected the ulcers and chronic catarrh improve. Halk (Ugeskrift f. lager, p. 601, '96).
[The method of ta eatment by glycerin enemata has received thus far only uni versa.' commendation. Administered in the form of suppositories it is equally efficient. The only objection to enemata of glycerin offered by patients is the tingling sensation felt in the rectum after the injection, and this can be obviated, without interfering with its action, by adding an equal quantity of water to the glycerin. W. W. JOHNSTON, Assoc. Ed., Annual, '92.] Massage is gradually affirming its value. In conclusions based upon study of 147 cases, le Marmel showed that (1) mechanical treatment can be classed among those therapeutic agents whose action on the circulation, respiration, and general nutrition is decidedly energetic; (2) that it modifies the abdominal cir culation and dispels certain passive con gestions, especially those of abdominal plethora; (3) that it increases the muscles in volume and strength; (4) that it is the best curative agent for constipa tion from muscular paresis or paralysis not due to central nervous disease; (5) that it is the best curative agent for con stipation dependent on hypoxsthesia or amesthesia due to local causes; and (6) finally, that it is formally contra-indi cated when the constipation is due to acute inflammation or to tumors.