8 DISEASES OF CHILDREN. 



very like a rupture. In all cases of rupture or internal obstruction nothing is passed, 

 not even wind, by the bowels. The child complains of great pain, and after a time 

 vomiting occurs, which becomes very offensive. The combination of constipation, pain 

 in the stomach, and vomiting, should always make one chary in giving purgatives, 

 and it is wise in all such cases to lose no time in calling in the help of an expert. 



Children are liable to suffer from a trouble in the bowels which is almost peculiar 

 to childhood. This is the intus-susception of the bowel, as it is called, or the slipping 

 of one part of the bowel into the part below, just as we may draw back the linger of 

 a glove within itself. When this accident occurs, there is usually sudden and intense 

 pain at the moment of its occurrence. The child is absolutely constipated, and there 

 are generally eructations of flatus (belching of wind) and vomiting. So far these are 

 the signs common to all cases of complete obstruction of the bowel. At the end of 

 two or three days we are confronted with a very characteristic symptom, viz., the 

 passing of blood and mucus by the bowel. It is not a common thing for children 

 to pass blood from the bowel, and if they do so in any quantity, we should always 

 think of intus-susception as a possible cause of it. The part of the bowel which 

 gets ensheathed in the part below passes gradually onwards, so that it may occa- 

 sionally be felt, or even seen, at the lower opening of the bowel. Sometimes the 

 mass of ensheathed bowel can be felt like a sausage through the wall of the belly. 

 Peritonitis, or general inflammation of the bowels, is a common consequence of this 

 condition, and is the usual cause of death in these cases. Intus-susception is not, of 

 course, to be treated by giving purgatives, which would only increase the trouble. 

 Our aim must rather be to restrain the action of the bowels by giving opiates. The 

 condition has been " reduced " by injecting air into the bowels, and distending them 

 until the ensheathed portion slips out of the part below. If it can be satisfactorily 

 made out that the child is suffering from this condition (and attention to the 

 symptoms we have mentioned will generally enable a physician or surgeon to come 

 to a right conclusion), it may be advisable to open the child's belly by a slight 

 incision, and hunt for the ensheathed bowel, and pull it out with the fingers. Many 

 cases in which this has been successfully accomplished have been reported of late. If 

 this be not done, the child has but a small chance of recovery, although a few cases 

 have been reported in which a spontaneous cure took place. It is certain, however, 

 that if relief be not afforded, either by natural or artificial means, death will result. 



As to the treatment of ordinary constipation, we would impress upon the reader 

 that it is never justifiable to give a dose of medicine to a child if this can be avoided. 

 The practice of indiscriminate dosing cannot be too strongly condemned, for it is 

 certain that it has acted to the prejudice of very many children. A child should be 

 taught as early as possible that the bowels ought to act at regular times, and it 

 should never be allowed to neglect this important natural function. If a child 

 becomes constipated, it is often sufficient to attend to its diet, and give a little fresh 

 vegetable, fresh fruit, or stewed fruit, to excite a slight laxative action. If this be 

 not sufficient, it is a good plan to give an injection of tepid water into the bowel 

 occasionally : this, however, is a measure which should not be too often repeated. If 

 drugs become necessary, the phosphate or sulphate of soda dissolved in hot broth or 

 milk is very effectual. Rhubarb and soda powders, or a dose of Gregory's powder, 



