g 
terminating ina fatal marasmus. It is 
not to be removed by emetics, purga- 
tives, or the warm bath, the usual reme- 
dies for obstructions in the ducts; and 
hence it; is conceived by the author'to 
arise from ~° t 
CHDYNE’S ESSAYS ON THE DISEASES OF CHILDREN. 
; oid —atrophia ablactatorum ; in_ the first 
place it will be found superabundant, and 
eventually it will appear to he possessed of ui- 
usual acrimony. In the icterus infantum 
there is ofter a coniplete obstruction to the 
passage of the bile. ; ; 
£6 Taking thesediseases in the order of time 
in which they occur, Lshall first mention 
‘that species of jaundice which attacks infants 
’ ‘@ few days afier birth.’ * Pils is always an 
alarming disease, for when infants do recover 
) itis with great difficulty. It generally comes 
on about the third day after birth; for itis 
necessary that this time should ¢lapse before 
the complete absorptiou and subsequent de- 
. position of the bile into the blood ean take 
place. It is attended with languor; flatulence, 
and bilious urine, and, continues many days 
or even weeks. Sometinies it goes gradu- 
ally away, but generally ends in a fatal ma- 
‘Yasmus.— Joy hea ba ¢ : 
«© When this disease is fatal, it in all pro- 
_ bability is so from an original malconforma- 
tion in. the liver; for we donot find, upon 
dissection, that it is a diseaseof the hepatic 
or of the common. ducts,. ayfiieh) thongh 
somewhat contracted, from the thickening 
of their coats, are always pervious. ‘I he mal- 
conformation is probably” an impermeable 
' thickening of the beginnings of the hepatic 
duct, or, as they are called, the port bi- 
eater ee alti adit nga 
a ee Sa wwe eek SAY Cet hte 
.. +’ Gentle laxatives, frictions of the abdo- 
men, and emeiics, ‘are the only, medi- 
eines which promise advantage. __ 
_ Another derangement of the function 
to which the liver is subject in early in- 
_ fancy, is a discharge of bile by vomiting 
or purging, which is often accompanied 
with convulsions, fever, gripings, .&c. 
The complaint originates from imp:oper 
food or cold, and is cured by vomits and 
7 
4 
wehaeg 4 2 > 
 eathartics, ; pa. 
especially catharticglysters; and should 
the disease, or any symptom of it denotng 
tion of these medicines, we must have re- 
course to opiates and testaceous powders ; 
_ but we must be cautious in giving opiates 
jBntil the purgative medicines have operated.” 
~~ When there is merely a purging, itvis 
sealled by nurses the green scours 1.) 
» The principal object of this essay is 
thé description of a disease, which jis . 
known in Scotland by the name of qwean- 
ing brash, and which the author thinks - 
_may properly be designated: atrophia ab- 
“Great irritation, continue after the fall opera- - 
751 
lactatorum. The purging which accom- 
panies this complaint has generally, by 
practitioners, been supposed to originate 
from teething, or from a mesenteric en- 
largement in scrophulous children; and 
for some time the author was himselt ins 
duced to adopt therlatter opinion. The 
indispositions which. sometimes accom- 
pany teething may occasionally meet in 
the same child with the weaning brash, 
but that there is no necessary connexion 
between them; he considers as proved, 
by the latter irequently existing where 
no affection of the gums, or appearance 
of pain in the mouth, are to be observed, 
and where the teeth have frequently been 
cut easily; but more particularly by its 
frequently ‘coming on in children long 
before the teething period. 
The weaning brash is an atrophy, says 
the author, 
“« —the consequence of weaning children 
too suddenly at an unfavourable season of the 
year. 
‘This disease sometimes comes on two or 
“thtee days after weaning; frequently not for 
‘three or four weeks; sometimes not before 
five or six weeks have elapsed. 
v<eThe first symptom is a purging, with 
griping pain, in which the dejections are 
usually ofa green colour.. When this purg- 
jing, ts, neglected, and afler continuing for 
some time, there, is added a reiching, with or 
“without vomiting; when accompanied by 
vomiting, the matter brought up is frequent- 
ly covered with bile. : 
\ «eT Hése’ iftcreased and painful actions of 
the alimentary~canal* produce a loathing of 
every kind of food, ain naturally are attended 
with emaciation and softness of theflesh, with 
testlessness, thirst,.and fever. ns 
“© After some weeks I have ofien observed. 
a hectic blush on ‘the cheek; but the most 
characteristic’ symptcm of this disease is a 
constant peevisimmess, the effect of unceasing 
gtiping pain, ‘expressed by the whine of thie 
ehild, but especially by tne settled: discontent 
of his features; and this éxpression of dis-’ 
content is strengthened towards the conclu- 
sion of the. disease, when the. coutitenance 
has‘shated in the emaciation of the body. 
“6° Tn the ‘progtess of the, disease, the eva- 
cuations ftom the? belly show very different 
actions of the intestines, and great changes in 
(the biliary: secretion ; for they are sometimes 
of ‘a nataralscolour, at other times'slimy and 
ashi-eoloured, and sometimesdienteric. 
‘*, Towards the end of the disease the ex- 
tremities, swell, and the child, becomes ex- 
ceedingly drowsy; but these I rather con- 
‘ceive to arise from debility than to be patho- 
enomit (pathognomonic) symptoms. It is 
reiiarkable, in the.advanced stages of the dis- 
-ease, that the purging sometimes ceases for'a 
day or two, but without any avelioration of 
