ihe d-lor^ers of the whole of the alimentary canal, and of the 

 organs connected witli it, both hy fun nion and ftrufture. 



Thefe conllitu'e, pcrliaps, the moil important triSe of the 

 diffaf-s of children ; inafmuch as they not only produce con. 

 fiderable diilrcfs by their dirccl: clFecl in deranging the 

 fuuftions, but are likewife indiretlly the fource of nurtierous, 

 feverc, and even fatal conllitutional maladies, both chronic 

 and acute. Tlie diibrdcrs of the ftomach, indeed, arc feldom 

 vcrv formidable or Iroublcfome in early life ; but the de- 

 rangements of the biliary fecrction, of the intellinal caiial, 

 and of the mefenteric glands and abforbents, wliich are 

 much connected with each other, are produftive of much 

 mifchief during the whole period of infancy and childhood. 



Siclnffs and Vomit'ing. — A flight degree of ficknefs is_a 

 very common occurrence in infants, as their lloinach is fo 

 irritable, tiiat it readily rejects any overload of food. But 

 this fpontaneous puking is attended with little violence to the 

 Romach ; the milk, or other aliment, feems to come up 

 without anv fenfible aftion of the part, or any reaching effort 

 of the child : and wlien the food is brought up im;nediately 

 after fucking or feeding, and in an almoll unchanged Itate, 

 fuch licknefs is obferved to be not incompatible with a 

 thriving itate. Unlefs when the ficknefs is extremely vio- 

 lent, therefore, or long continued, it is feldom neceflary to 

 interfere. But when means are required to moderate or to 

 allay it, we muft endeavour to afcertain the caufe of the 

 vom'iting, and apply them accordingly. The caufes of 

 ficknefs at the ftomach in infants are either fome altered con- 

 dition of the nurfe's milk, or the prefence of fome indigcf- 

 tible fubftance in the ftomach. If the nurfe have been under 

 the influence of any violent emotion of the mind, or if fhe 

 have begun to be out of order, or even to have the feeiings 

 preceding that event, it may be concluded that there is fon'.e 

 morbid change in the milk. During the progrefs of leeth- 

 JBg, the increafed quantity of faliva, together with its acri- 

 mony, proves occafionally the caufe of ficknefs. In fuch 

 cafes the ftomach may require the difcharge of its contents 

 by means of a gentle emetic : a little warm water or chamo- 

 mile tea, or, at the moft, fome preparation of ipecacuan, will 

 anfwer this purpofe. Antimonials, in dofes which excite 

 vomiting, are frequently injurious to infants, and fometimcs 

 adually fink, with great rapidity, the hving powers. When 

 the vomiting is kept up by irritability of the ftomach, which 

 is fometimesthe confequence of its actions havingbeendifturb- 

 ed bv a caufe already removed, flight cordials and aromatics 

 may be given to ftrengthen the organ and abate its fenfibility, 

 and if thefe fail, fome" iiimulant or anodyne may be applied 

 external'y. 



It mult be obferved, however, that habitual vomiting from 

 over-diftention of the ftomach, to which many infants are 

 liable, may lay the foundation for future weaknefs of the 

 digeltive organs, and (hould therefore be guarded againlt by 

 every precaution. For this reafon, infants ought not to be 

 allow*! to fuck too much at a time, and large quantities of 

 fpoon-meat Ihould never be given in the early months. 



Diarrhaa or Loof-nefs. — The natural appearance of the 

 ftools of infants ftiould be familiar to every praaitioner. In 

 general the colour is that of a bright orange, the conliftence 

 i» pulpy and curdled, and the fmell is not offenfue. Any 

 deviation in thefe refpects marks fome difeafed ftate ot the 

 ftomach or bowels. During infancy, from two to four 

 evacuations, within the twenty-four hours, feem neceflary and 

 ufef.il ; and even where that number is exceeded, it is not 

 to be regarded as injurious, unlefs the health be impaired, or 

 the flrfti be rendered flabby. The appearance of the ftools, 

 io cafes of diarrhoea, is very various. When they arc green, 

 and at the fame time emit a four fmell, which arifes froiK the 



INFANTS. 



prevalence of acidity in the firft palTagPS, there is n"-n»rally 

 griping and fretfulnefs, but the complumt is not d.. ig.rous 



It generally yields to a laxative, or, in very youn ; -nfants, 

 to a medicine compofed of a little magnefia and riiubarb, 

 with a little diftiUed water of dill or penny-royal, with a 

 few drops of a.mmoniacal fpirit, or of the compound tinfture 

 of camphor. The nurfe's food ftiould be regulated in this 

 caf'. and the infant ought to have no other food, in addition 

 to the milk, than arrow-root. 



Slimy ftools are generally the cfTeA of expofiire to cold, 

 though they occafionally arife from fome irritation or accu- 

 mulation in the bowels. In both cafes they are apt to be 

 flightly ftreaked with blood. If there be violent pain, or 

 fvmptoms of fever, introfufception is to he dreaded. A- 

 dofe of cold-drawn caftor oil, together with the warm-bath, 

 or fomentation of the belly with flannf is wrung out of hot^ 

 water, arc commonly all that are necifiary, if the dileafe be 

 attended to at the beginning. Where flimy ftools are of 

 the colour of clay, and emit a putrid fmell, the infant foon 

 becomes emaciated, and the dileafe often terminates fatally, 

 though its progrefs be flow. Alteratives, with opiate fric- 

 tions" and occalional purgatives, afford the chief means «£ 

 relief. If the infant be ft'ill at the breaft, the milk fliould be 

 changed, a pradice which ought to be adopted in every iu- 

 ftance where there is great tendency to loofenefs._ 



The moft diftrefllng cafes of diairliaa are chole in which 

 the ftools are liquid, brown, black, or clay-coloured, and 

 of an offeniive fmell. As the dilordcr proceeds, very un- 

 favourable fymptoms occur, fuch as emaciation ai.d drynefs 

 of the fttin, fwelh'ig or flirinking of the belly, with an al- 

 tered appearance of the countenance ; and there is a conftant 

 fretting or peevifnnefs of temper. Swellingsof the glands 

 of the groin, and a little unealinefs of breathiug, as if there 

 were a (liirht tendency to cough, are alfo very unfavourable 

 fymptoms. In m.any of thefe cafes the purging is the ef- 

 fect of a difeafed ftate of fome of the digeftive organs, or of 

 the mefenteric glands ; but in others it arifes from an ir- 

 regular action of'the former organs. In thefe diforders fome 

 practitioners begin the treatment by the ufe of emetics ; 

 but the advantages of thefe medicines are not very obvious, 

 while the dil",jdvaiitages rofultiiig from their debilitating and 

 irritating qualities in the ftomach are fometimes unequivocal. 

 On the whole, the continued ufe of alterative medicines, 

 which maintained a fteady but genlle action upon the ali- 

 mentary canal and the adjoining vifcera, feems to be the 

 moft fuccefsful treatment i:i thefe c(m.pla;uts ; the phyfician, 

 at the fame time, corrtcting and modifying their operatio.i. 

 according to circumftances, and palliating urgent fymptoms. 

 Part ofVtiediet, in thefe cafes, fliould coiiiift of weak beef, 

 tea or chicken broth, with rioe, or boiled cow :■ milk with 

 baked flour, or arrow-root. The oceafional ufe ol injections 

 of thin flarch and laudaQum, m the proporllun uf eight or 

 ten drops of the latter to l-.\o table-fjioonfids of the forx;.T, 

 may be employed to ir.ud.i-ate the difcharge when th.s 

 ftrerigth is much leduccd. 



Of the frvere and often fatal fpecies of dianhcra, jufl 

 alluded to, there is one form which is known in Scotland 

 by the name of the " ivea,.<ng hrafi," and which has been, 

 well dofcribed by Dr Clieyne. (Eflays on the Difeafes 

 of Children. Efl". ii.) It occurs after weaning a child too 

 fuddenly, efpecially at an unfavourable k-afon, as the autumn. 

 It commences, fometimes two or three days after weaning, 

 but frequently not for three or four weeks, with a purging 

 and griping, 'and green ftools. This, being crroneouily 

 afcribed to teething, is perhaps neglcfted, and tlie fymp- 

 toms increafe, a retching and vomiting fupervene, and are 

 cradiially followed by a loalliing of every kind of food, 

 ** ' emaciatioa- 



