Stomach Affections of the Mouth

dose, bowel, water, children, child, food, night, till, milk and olive-oil

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Children brought up on the bottle are likely to be more troubled with constipation than breast-fed children, and boiling the milk tends to make it constipating. In these cases it is often possible, by varying the amount of sugar and cream in " the milk mixture ", the proportion that suits the child. For it is well to remember that milk deficient in cream makes a firmer curd, and so encourages constipation while the form of sugar in golden syrup en courages the movement of the bowel more than cane-sugar.

In older children constipation may be over come by substituting brown for fine white bread, by the use of large-grain oatmeal por. ridge, or wheat-meal porridge, by increase in the diet of vegetables and fruits.

It must not be forgotten, also, that daily active exercise is of great value.

When medicine is necessary, castor-oil or olive-oil should be given. Olive-oil--the finest Italian olive-oil—is an excellent remedy, and has the advantage of being more of a food than a medicine. Children take it quite readily. One should begin with a small dose, say a tea spoonful given without addition the last thing at night and the first thing in the morning. The nightly dose is gradually increased, till the desired result is obtained of a soft, pulpy, well•coloured stool at a regular hour. If a sufficient dose can be given at night, the morn ing dose is omitted. Olive-oil used in this way may be continued indefinitely, and when regu larity has been perfectly established, the dose may be very gradually diminished till it ceases.

If olive-oil does not succeed, castor-oil may be used in the same way. Find the smallest possible dose, which, given at night or in the morning, secures no more than the proper daily soft movement. Continue this amount till the hall* Is t 3tAbIliolked, and then, drop 11 drop, diminish the amount. Other remedies are discussed on p. 244.

When on any occasion it is advisable to empty the lower bowel without delay, as when it may have become blocked with dry bard masses, washing out with tepid water (see p. 592) may be advisable. The lower bowel may also be stimulated by an injection of a tea-spoonful of glycerine, or if thorough empty ing is urgent, a mixture of olive-oil 1 to 2 ounces, glycerine 1 to 2 tea-spOonfuls, and warm soapy water 5 to 6 ounces, thoroughly shaken up into an emulsion, and injected by means of an enema syringe, will almost certainly prove effective.

• may be often prevented by the careful avoidance of improper kinds of food, and by proper seasoning of the food with salt. They are often introduced with animal food. Great care should, therefore, be exer cised in the thorough cooking of all butcher meat, especially pork, ham, and sausages. They are of three kinds—(l) Tape-worm, passed in pieces like flat white tape, (2) round-worm, and (3) thread-worm. They, and all the symptoms they produce, have been sufficiently described on p. 257 and following pages. It is specially thread-worms that affect children. The best treatment is 1 to 3 grains of santonin given in the morning in cream ; and, some hours after wards, repeated injections of tepid water, in every half-pint of which a table-spoonful of salt has been dissolved, serve to bring them away. Steel-wine or a tonic of some kind

should thereafter be given to the child, as well as good food, as debility favours the presence of worms. For the method of injection see p. 592.

Falling of the may arise from debility, from diarrhoea, or from costive ness owing to straining. It is to be prevented by getting the child into a proper state of health, relieving the costiveness, or checking the diarrhoea. The bowel must not be allowed to remain down. To return it, bathe the part gently with cold water, form the fingers into a cone, and, embracing the part, gently push it upwards.

Rupture. — This may occur at the navel within a month or two after the child's birth. It is a swelling which increases with crying or straining. It is caused by a portion of the bowel being forced through the little opening at the navel under the skin. The bowel must be kept within the belly by a small firm pad, secured by a bandage. Rupture in the groin shows a swelling in one or other groin passing downwards and inwards to between the legs. It may exist at birth or be brought on by strain ing, coughing, or crying. The bowel should be returned at once into the belly, and a proper truss obtained for keeping it constantly in place. Refer to p. 267.

(Incontinence of is a frequent affection, and is due very often to the presence of some irritant in the bowels, such as worms, or about the private parts. Careful search should therefore be made for such a cause. Attention should be given to the diet, to avoid an irritating quality of the urine. Only simple food should be given, pastries and such things being avoided, and simple drink also, milk or water. Little or no fluid should be given the child to drink after 5 p.m., and the child should be roused to pass water about 10 p.m., and once during the night.

Benefit is said sometimes to be obtained by raising the foot of the bed 6 inches or so, on wood blocks, to keep the urine from irritating the neck of the bladder, and it is also recom mended that the child should be prevented sleeping on its back by some simple contriv ance, such as binding on a thread bobbin'. If these measures fail, a doctor should be speedily consulted, lest the habit become confirmed. Mothers should be careful that children are not punished for what may be a weakness rather than a fault. If a doctor is not easily obtainable, the drug that may prove useful is tincture of belladonna. A dose of 4 drops in a tea-spoonful of water may be given about 4 p.m., and another of the same at bed-time. Every second night the dose may be increased by one drop, till ten drops are being given each time. Of course if a small dose is successful there is no need to increase it.

Many cases yield to no treatment, but con tinue throughout childhood, spontaneously ceas ing about the twelfth or fourteenth year.

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