( 328 .) 



HISTORY 



OBSTRUCTION OF THE RECTUM AT BIRTH, 



SUCCESSFULLY CURED BY OPERATION. 



[[Communicated to Dr Hope, and first Published in the Medical and 

 Philosophical Commentaries, Vol. iii- p. 419, London 1775.] 



On the 18th of August 1773, I was sent for to see a new- 

 born child at Bountyhall estate, belonging to John Simpson, 

 Esq. The child was a Negro boy, born the preceding day. 

 The midwife had given it repeated doses of castor oil, and 

 finding that no meconium, or any other feculent matter, was 

 discharged, she tried to give it a clyster ; but, upon finding 

 that the ivory pipe could only be introduced about a quarter 

 of an inch, she desisted from the attempt. When I came to 

 examine it, I found a firm resistance to a probe, and could 

 plainly discover, with my finger and thumb, a hard tumour 

 of a round form, nearly as large as a walnut. I concluded 

 this to be a callosity of the rectum ; and although I had never 

 heard of the success of an operation in a similar case, I told 

 the Negro parents and the proprietor that the child had no 

 other chance for life, but by an opening being made through 

 this obstruction. This was readily agreed to, and I called to 

 my assistance Mr Thomas Steel, an eminent surgeon. He 

 being fully satisfied of the propriety of this hazardous attempt, 

 we accordingly proceeded to the operation. 



The child was held in a horizontal posture, with his knees 

 drawn up towards his belly. I first enlarged the external orifice, 



