ON AN OBSTltUGTION <>| THE KI'.cmai ,'J2f) 



by cutting through the constrictor ani. My assistant then held 

 the tumour fast, and in the position in which it naturally was. 

 I introduced a directory to the middle and most prominent part 

 of the tumour, and, with a common lancet, I made an incision 

 quite through the resistance, in the direction of the rectum. 

 We had the pleasure of immediately seeing a large quantity 

 of meconium come away, and there was at the same time a 

 considerable discharge of wind. The child's belly, which be- 

 fore was very hard, and much swelled, soon subsided ; the 

 symptomatic fever abated, and a subsultus tendinum, which 

 had accompanied it, entirely disappeared. A clyster of milk 

 and sugar was then thrown up, which brought away a con- 

 siderable quantity of meconium and excrement. 



From this operation the child's most urgent complaints 

 seemed to be removed. But we were farther informed, that, 

 from the time of its birth, it had discharged no urine. Upon 

 examination, we discovered that the prepuce was imperforated. 

 The child was directly circumcised, and the urine then flowed 

 in abundance We contented ourselves by dressing, at that 

 time, with a soft roll or dossil of lint, and a poultice external- 

 ly ; and we directed that these, with fomentation to the part, 

 should be used twice a day. 



By the 25th of the month, the tumour in the rectum had 

 entirely collapsed ; but the train of threatening symptoms with 

 which the child had before been affected again made their ap- 

 pearance, and upon examination we found that the parts be- 

 fore divided were again united. In this situation we had re- 

 course to the lancet a second time, and not only made a 

 thorough perforation, but extended the incision quite through 

 the sides of the callosity. In other respects we proceeded as 

 at first. After this, nothing remarkable occurred in the cure, 

 which was completed in five weeks, and my patient is now a 

 stout healthy boy. 



