For infants and young children Castor Oil is the best drug, and a daily very small dose—half a teaspoonful—generally removes the condition. A glycerin or preferably a soap suppository may be used. This remedy is not objectionable in the case of very young children, as the writer thinks that the act of evacuation in them is more dependent upon the state of the great intestine higher up than the rectum, and the fact of accustoming the rectum to a smart stimulus from day to day does not appear to blunt its sensibility so as to interfere with the act of defecation after the sup positories are stopped, as appears to be the result in adults.
Gentle massage of the abdomen is very serviceable in the constipation of infants and young children, but as a rule injections of watery fluids are to be avoided unless fecal accumulations are present.
owing to the ease with the colon can be dilated and its tonicity injured.
The constipation of older children will seldom require drug treatment, the condition usually speedily yielding when errors in diet are corrected and when the hour of defecation is punctually adhered to and active exercises prescribed.
Compound Liquorice Powder, or 2 to 5 gr. doses of Sulphur, may be given for considerable periods with advantage.
To acute attacks of constipation occurring in a person otherwise healthy, and where there is no abdominal obstruction, it will be seen that the fore going remarks do not apply, and the treatment for such attacks is a smart purge. Any of the remedies already mentioned may be given in large doses. The old-fashioned method is the best, of giving at night a com bination of cathartics, whose slow action upon different parts of the intes tinal tube is " overtaken " by smart dose of a Saline early in the morn ing. Thus, 5 grs. Pil. Hydrg. and 5 grs. Pil. Col. Co. taken at bed-hour, and 2 oz. Black Draught early in the morning, are a very efficient purge for robust men.
In elderly people, diarrhoea is sometimes caused by a mass of scybal lodged in the colon, and the proper treatment in such a case is to commence with large enemata of tepid water, given whilst the patient is placed upon his left side. Should the mass be high up in the colon, the patient should be placed upon his knees and elbows, and afterwards turned over upon his right side, so as to assist the water to gravitate towards the ileo meal valve. A large dose of Castor Oil or other purgative should be given after the obstruction has been removed.