In the case of severe colic in a baby, flannels wrung out of hot water should be applied to the belly, and a copious injection of warm soap and water, with or without the addition of a teaspoonful of castor-oil, should be administered without delay. If the infant seem depressed as a conse quence of the pain, he may be given a few drops of pale brandy in a tea spoonful of water, or may take three or four drops of sal volatile in a little aromatic water every few hours. If there be twitching, or any sigTi of convulsions, the child should be placed at once in a warm bath. If he suffer much from flatulence, a rhubarb and soda powder may be adminis tered, and afterwards a teaspoonful of the following mixture every three or four hours :— This may be given to a child of six months old.
In children, after the age of infancy, constipation must be treated by attention to diet, and by the enforcement of regular habits. The diet should be carefully selected with regard to its digestibility, avoiding ex cess of farinaceous and saccharine articles. Well-made oatmeal porridge is serviceable at breakfast, and broiled bacon at this meal is not only diges tible but useful. With his dinner the child may take a sufficiency of fresh vegetables and fruits, especially baked apples. AU children should be cautioned against resisting the desire to empty the bowel, and should be taught regularity in this respect, as has been already recommended.
As an occasional aperient, the compound liquorice powder (a teaspoon ful mixed with a small quantity of water or milk at bedtime) is very use ful, and much more to be recommended than the syrup of senna and other saccharine laxatives, which tend to promote acidity and flatulence. If the constipation is habitual, it must be treated after the manner followed in the case of an adult patient. The senna mixture recommended above for babies is useful given in suitable doses. If the child can take a pill, Sir Andrew Clark's prescription of small doses of poclophyllin and extract of belladonna (one-sixth of a grain of each taken at bedtime) will usually, after a short time, produce a regular daily movement ; or two grains of the exsiccated sulphate of iron, with three grains of the aloes and myrrh pill, taken every night or on alternate nights, will effect the same object. In cases where the scanty stools consist of hard, dry lumps, a nightly dose of Hunyacli Janos water (one to two ounces) will quickly produce a complete change in the character of the evacuations, and promote a daily action of the bowels. In all these cases, regular exercise is of the utmost importance.
If impaction of faeces in the bowel be complete, the treatment will vary according as to whether inflammation have or have not been excited in the. intestine. If inflammation have occurred, the case must be treated as de scribed in the chapter on typhlitis. If there be no inflammation, but the bowels are merely blocked by the accumulated scybalm, it is usually in the sigmoid flexure or rectum that the collection of fa2cal matters has taken place. In such cases, the persevering use of purgative enemata will event ually relieve the patient. The difficulty commonly is that the solid plug often prevents the passage upwards of the fluid, so that this returns at once by the side of the tube and escapes. If the impacted mass is within reach of the finger, it may usually be broken up by the use of a metallic sound. In a private house, a marrow-spoon, or even the handle of an ordinary spoon of suitable size, may be used for the purpose. In giving the injec tion, the tube of the enema syringe should be wrapped round with lint at its base, and. this, after introduction, should be firmly pressed against the anus so as to resist the escape of the fluid. A large quantity of thin warm gruel, with an ounce of castor-oil and half an ounce of turpentine, must be injected very slowly, and the patient should be instructed to retain it as long as possible. In some cases, especially if the impacting mass is out of reach from the anus, the solid plug may resist repeated enemata. In a ease recorded by Mr. Gay—a boy of seven years old who had suffered from complete stoppage of the bowels for three months—the constipation was eventually overcome by introducing a speculum into the rectum, so as to dilate the sphincter, and then directing a stream of water against the ob stacle. By this means, after the stream had played for half an hour or more against the mass, the latter became disintegrated, and a quantity of hard matter like cinders was brought away, to the great relief of the patient.
After the removal of the accumulated faeces, it is very important to keep the bowels regular for the future by the means which have been described.