INFANTS. 



abfolutely nffcefTary, in order to have full information of their 

 ^ffffts, to infpeft daily what is paifed by ftool. The fmell 

 and appearance of the fxces are a criterion of tlie progrels 

 that is made in the cure, and dircA the farther adiuiniilra- 

 tion of the purgatives. Tliis infpeftion is the more nccef- 

 fary, as we cannot expect tlie information we want fi-om 

 our little patients, and we fhall often look for it in vain 

 from the attendants, whofe prejudices, and whofe ignorance 

 of our views, prevent them from feeing the propriety of the 

 inquiry. During the prevalence of this difeafe, the fvcces 

 are dark, foetid, and varying from a coftive conlillcncc to 

 that of clay, and are often fluid ; and fuck they appear 

 upon the firll exhibition of the purgative medicines. It 

 may be obferved, that the recovery of the I'lck keeps pace 

 with the return of feces of a natural colour, form, and 

 fmell, — a change which the repetition of purgatives doesnoL 

 fail to produce. 



While the purgatives are given in this manner, in the 

 confirmed (late of marafmus, in whicli the obllinacy of the 

 difeafe is fometimes great, and the danger attending it im- 

 minent, nourifliing food, of light and digelliblc quality, 

 and fuited to the talle of the patie;U, and the moderate ufe 

 of wine, are much required. For tome ti.iie alter the 

 fymptoms have difappeared, it is expedient to continue a 

 mild ilimulus to the bowels. As they have recently Aif- 

 fered, and have been v.eakened by over-diltention, they are 

 apt to favour fubiequcnt accumulation of fasces, the fore- 

 runner of a relapfe, which is to be dreaded the more, as the 

 patients have been weakened by the previous difeafe. And 

 fo far from being attended with any danger, this gentle fo- 

 licitation of the alvine difcharge, ( for it ought to be gentle,) 

 is the greateft promoter of recovery. (Hamilton's Obf. on 

 Purg.) At the clofe of the difeafe, ilrengthening mcdicinei>, 

 fuch as chalybeates, and the infufions of bitter vegetables, 

 may be employed with foHie advantage to complete the 

 cure. 



As marafmus proceeds from fymptoms of flight indifpo- 

 fition, which are eafily obviated by proper ftimulus and eva- 

 cuation of the bowels, through a feries of others which 

 become daily more and more obftinate and dangerous, the 

 health of children (hould be watched with great afiiduity. 

 Proltration and depravity of appetite, a changing complex- 

 ion, tumefattvjn of the abdomen, fcanty and unnatural 

 llools, and foetid breath, indicate approaching danger. When 

 thefe, therefore, are obferved, the afiillance of medicine 

 (hould be reforted to, by the prompt ufe of which much 

 eventual dillrefs, and even death itfelf, may be prevented. 

 But otlier confiderations call for this affiduity. Marafmus 

 has a clofe connexion with fome other formidable difcafes, 

 and either precedes or feems to accompany them ; of thefe 

 we may- notice more particularly two, hydrocephalus and 

 epHcbfy. 



Qi tlie HvDUOCEPll.\LU,s inhrnus, the bane of infancy 

 and of childhood, we have given an ample account under 

 its proper head. The pathology of the difeafe has been the 

 fubject of much variety of opinion, and is ftill involved in 

 fome obfeurity. Thus much, however, is known, that it 

 often Heals {lowly on, with fymptoms refembling thofe of 

 incipient marafmus ; and that where it has been believed to 

 exili, from tlie prefence of fome of its mod charaAeriftic 

 fymptoms, a diligent exhibition of purgative medicines has 

 fucceeded in relloi-iiig health. Too much attention, there- 

 fore, cannot be paid, to prevent the confirmed Hate of ma- 

 rafmus. See Hvd«0(:ki'HALU.s. 



Epilcpfy, which is a difeafe moll diftreirmg to the patient, 

 and perpk'xing to the phyfician, alfo often appears in child- 

 kood. It is coHllrmed by the repetition of the fits, till their 



frequency and the force of habit fix it, and make it a oonRi- ' 

 tutional difeafe for life. Now it is generally underftood, 

 that tlie iirll attacks of epilepfy are not always idiopathic, 

 but arc frequently the effedt of particular irritation of tiie 

 body or mind. There are numerous inftances, indeed, of 

 irritation of the body inducing epilepfy ; and, in children, 

 when no other is evident, the loaded intelline, and the 

 morbid change induced in its conlents, in the courfe of 

 the marafmus above dcfcribed, may be fufpected of giving 

 the irritation in quelHon. In faft, wwrnio in the inteftines 

 (or vtarafmus, for we may thus inUrpret the language of 

 medical wriiert.) have been iii'-iuion.-d an.ong the caufcs of 

 epikpfy, Surely, thtielore, itii, couiidL-ration fuggefts 

 another cogent rcafon for watching the nfe and progrefs 

 of mara&nus: and it will induce us, on the firft at- 

 tack of epilepfy in childreu, ariling from an uncertain 

 caufe, to fct on foot a decided and aflivc courfe of pur- 

 gative medicines : and not to incur the rilk of allowing 

 the difeafe to ftrikc root, while we are idly employed iii 

 the exhibition of inert and ufelefs vermifwge medicines ; 

 or are groping in the dark in queft of other caufes of the 

 difeafe, or of uncertain lemedies for their removal. 



Colic pahit arc not uncommon in infants at the bread; 

 for the dencacy of the bowels renders them liable to be af- 

 fected by the moll apparently trifling caufe'^. Hotice expo- 

 fure to cold, inattention to changing the clothes vvlien they 

 become wet, loo great a quantity of fpoou-meat, fome 

 fault in the milk, too large dofos of magnefia, and a col. 

 ledlion of acid (lime, or of air in the flomach and bowels, 

 may fevenJly be produdlive of this complaint. If an in- 

 fant be fretful by -fits, or at intervals, if its upper lip look 

 blueiih or livid, if it writhe or contort its body, and draw 

 up its linrbs towards the llomach, and more efpecially if it 

 occaiionally pafs wind, which feems to afford relief, there 

 is good rcafon to fuppofe it afTtcled with colic. The leffer 

 degrees of this complaint are uf temporary duration, and 

 fo well underllood, that a medical practitioner is feldom 

 confulted on the fubjecl. But the more violent degrees af- 

 iume an appearance, which feldom fails to occafion much 

 anxiety and alarm. Excelfive and long continued flirieking, 

 great fever, indicated by the heat of the ikin and flulbing 

 of the face, opprelfed breathing during the intei-vals of the 

 fcreaming, and the evidence of pain being occalioned by the 

 llighteft prcffure on the belly, are the ordinary fytnptomt 

 in fuch cafes. 



With refpeft to one of the caufes of colic above-men- 

 tioned, the exhibition of too much magnefia, it may be ohi 

 ferved, that many women, from the befl motives, but the 

 moll improper views, torment their infants with the frequent 

 adininiilration of this drug : becaufe it has little tafte, they 

 naturjlly imagine that it can do no injury. But its opera- 

 tion depends on its undergoing a change, by combination 

 with acids, in the llomach and bowels, which gives it the" 

 fame properties as tlic laxative falts ; and it is obvious, if 

 too large a dofe of thefe occafion cohc pains in grown 

 perfons, the magnefia mull, when given in too great quan- 

 tity, or when there is much predominant acid in tlie firft 

 pafTages, produce the fame elfecls in infants. Too much 

 fugar, put into the meat of children, tends to generate 

 much acid ; whence it gives occafion to thefe pains, as well 

 as to the green colour and four fmell of the ilools, the, 

 green colour being occafioned by the mixture of an acid with: 

 the bile. 



In (light degrees of colic, a fev\r drops of Dalby's car- 

 minative, mixed with fugar and water, and a dofe of cold 

 drawn caftor-oil, if the bowels be confined, are all that are 

 iieceflaryi The top common pradlice of giving fpirits and 



water 



