INFANTS. 



J I. Connate Iiufierfe3hns. — Cliildren are not always born 

 in a Hate of pcrfcftion in refpecl to tlie llrufture of their bo- 

 dies ; for fometimes they have deficient, fupcrfluous, or 

 mifpUced parts, natural paffagcs clofeJ, and various 

 marks on the furface. Many of thcfe iinpeifjclions admit of 

 no remedy ; while others may be eafily reflified. The fol- 

 lowing are thofe wliich are mod frcqiiciitly met with. 



FilT'ures in the lips not only coiilUtulc a remarkable de- 

 formity, but commonly prevent the child from fuckiig. 

 They appear under various forms. Sometimes the fifl'ure 

 exifts only in one lip, generally the upper one, and is occa- 

 fioned merely by a divifioii of the foft parts : in other cafes, 

 there ia aconliderable lofs of fubilance between the divided 

 parts : in fon;e ifillances, again, there are two liffures in one 

 lip, or both lips are affetled : and in others, the fiiTure is 

 not confined to the lips, but extends along the roof of tlie 

 mouth. All thefe different fpecies of the fame deformity 

 receive the general name of harc-Itp ; which fee. 



The tongue is naturally bound do\rn to rhe lower part of 

 the mouth by a membranous cord, to prevent it from too 

 <:;reat a degree of motion. Sometimes, however, the cord 

 lixes it fo nuich, that the infant caiinot fuck, in which cafe 

 it is commonly faid to be /w-..i--//.-v/. Women very often 

 imagine tiiat their children have this detect, when it does not 

 really exill : and perhaps one iniluoce of it does not occur 

 in feveral hundreds of thofe that are born. The difeafe may 

 be always difcovered by putting a finger gently into the 

 child's mouth ; for if he be abie to grafp it, as he would 

 do the nipple in fucking, or if the tip of the tongue appear 

 difengaged, the membrane doe.i not require to be cut. 

 The operation of dividing tXiifnnum, trifling as it may ap- 

 pear, requires fome caution, in order to avoid wounding the 

 fublingual veins, and cutting too deep ; for in the firit cafe, 

 a fatal hxmorrhage may enfue ; and in the fecond, if the 

 tongue is loofened too much, tlie tip may be turned back, 

 and clofe up the throat ; an accident that mud foon occafion 

 death. It may be difcovered by the threatcjiing fuffocation 

 or convulllons, and by the introduflion of the finger into 

 the mouth, by which alfo the tongue may be pulled back, 

 and the confequences avoided. This, however, is a very rare 

 accident : it has been abfurdly called " fwallowing the point 

 of the tongue." See Underwood on the Difeafes of Chil- 

 dren, vol. ii. p. 17. 5th edit. 



The natural pafages, efpecially the r.nns, vagina, and 

 vrethra, are fometimes imperforate, preveiuing altogether, or 

 in great part, the ufual excretions. In iume cafes, a collec- 

 tion of mucus alone proves the obftacle ; but in others, 

 membranous fubftances clofe up the paflages, in which lalt 

 i.iltances, an operation will be reqnifite to open the parts, 

 .thich mud be performed by a flvilful furgeon. In refpetl 

 to the vagina, Dr. Underwood obferves that he never found 

 the external parts totally imperforate, there being always a 

 fniall opening at the msatus urinar'ius : but the aperture to 

 t!.: vagina itlelf fometimes requires to be opened, either by 

 the point of a lancet, or by the fingers only, which is gene- 

 rally eafiiy efFefted, there being always a raphe, or line, 

 where the natural opening fhould be. The anus is fometimes 

 clofpd only by a thin membrane, fo that the day after birth 

 the meconium may be dillinftly felt, and in a manner feen 

 (hining through it. A (light punfture with a lancet, and 

 paffing a bougie or the point of a finger into the bowel for 

 two or three days afterwards, is fufficient to remove this 

 impediment. But more commonly the imperforate anus is a 

 melancholy cafe, allowing of no effeftual remedy, as the 

 gut often terminates in a cul-de-fac : fo high as not to 

 be reached. The imperforate penis is not quite fo com- 



mon a cafe ; but is not unfrequently fufpeftcd, when 

 the aperture of the paffage is merely iloppcd up by a 

 little mucus. Under fuch circumftances, wadiing the 

 part with warm milk and water, or at moll a little affift- 

 ance with a fmall probe, or any fuch blunt-pointed inllru- 

 mcnt, will be fufficient to open the paflage. When the 

 urethra is perfeflly open nearly to the extremity, as ofteiv 

 happens, it is necefjary only to make a fmall aperture with a 

 lancet, or a fine trocar, and to k'Sep the part open by the oc.^ 

 cafional introduclion of a ilcnder bougie. 



Tumours about the back-bone of infants are always dan- 

 gerous. If they be fuft, partly tranlpareiit, and obvioudy 

 connected with the fpine, conilituting the difeafe called_;^/n(i 

 liifJa, or hydrorachtth, they moft generally prove fatal ulti- 

 mately ; although in fome inllances, the progrofs to that 

 event has been very flow, the child having lived to the thir-i 

 tcenth year. Fortunately, h:>wever, it more commonly ter- 

 minates within a few months after birth : where it is pro- 

 tratled, the individual is in a mifi-rable Hate, being paralytic 

 in his lower limbs, &c. 



Retcntiati of the Meconium, — The meconium is that black, 

 vil'cid matter, which every infant difcharges from the intef- 

 tines for the nrd two or three days after birth ; and many 

 complaints have been afcribed to the undue retention of it, 

 and confequently a great vcLricty of purgative medicines have 

 been recommer;dt>d to be given, alnioll as foon as the child is 

 born, will] a view to expel it. But experience has taught 

 that the natural evacuant of this matter is the firft milk of 

 the mother, wb.ich is ilightly laxative in its properties : the 

 infant, therefore, (liould be put to the breall as foon after 

 birth as tiie fituation of the mother will allow. The per- 

 nicious praftice of giving infants purging medicines. Dr. 

 Hamilton remarks, as foon as they are born, cannot be too 

 much reprobated ; for the retention of the meconium for fome 

 hours after birth certainly produces lefs inconvenience than is 

 cccafioned by the acrimony of the fubftances which the child 

 is often iorced to fwallow. Tlie mod fimple artificial means, 

 he adds, for removing this matter, are Lifbon fngar diflblved 

 in water, or a folution of manna. Wlicre thefe fail, a tea- 

 fpoonfiil of cold drawn cador oil is to be given. 



Jaundice, or, as the nurfes term it, \.\vi2 yeilo-jn gum, is among 

 the difeafes which take place within a few days after birth. 

 It is preceded by drowfinefs, and difinclination to fuck, and 

 is foon difcovered by the univerfal yellownefs of the (kin. 

 Sometimes the whites of the eyes appear yellow for a day 

 or two before tlie other f\ mptoms iippear : the tinge of the 

 Ran is feldom deep, and the difeafe is more readily removable 

 than the jaundice of adnlts ; but cafes are occafionally met 

 with, where the colour of theikin is of a dark yellow, the in- 

 fant moans conftantly, and convulfions follow, which at lad 

 deftroy life. In regard to the treatment of this difeafe, if 

 the child feem to fuffer no uneafinefs, although its iliin be 

 quite yellow, and if his bowpls be open, it will be unnecef- 

 fary to adminider any medicines. But if he be unable to 

 fuck, and have a diipofition to eondant flecp, aflivc mea- 

 furcs (hould be adopted. Thefe confid principally in eva- 

 cuating the vifcid matter, which probably clogs up the 

 biliary dufts. An emetic of ipecacuan, and brilk laxatives, 

 as of rhubarb, or frequent dofes of a fohition of manna, 

 will then be found neceffary, and their effeiSs may be much 

 promoted by the vs'arm bath. When violent colic pains or 

 convulfions accompany the yellow gum, there is reafon to 

 fear that the liver is difeafed, and little can be expetted from 

 any remedy. 



The thrujh, fore month, or aphihe, is fo common a difeafe 



in early infancy, that it has been imagined to be a falut^lry 



5 effort 



