12, Great Marlborough Street,
Dec. 3, 1828.
On Tuesday, Nov. 25, I was called upon at the St. George's and St.
James's Dispensary to advise for an infant at the breast, of five
months and fourteen days of age, that had not passed any fæces
during six weeks up to the day before I saw it. After its birth
it had no passage till the fifth day, and this had apparently
been effected by the introduction of a bougie, and which was
subsequently continued at intervals for a short time. The infant
was otherwise healthy and strong at its birth, and remained so
until it had gone about three weeks without any evacuation, when it
was observed to be weak in the lower extremities; and at the period
of my seeing it the legs were much fallen away in flesh, hanging
flaccid and inert. Many aperient enemas and medicines had been
given, and, as a last resource, one drop of the croton oil had been
prescribed the preceding evening. The infant appeared to suffer
from distention, and to be disposed to coma, and the croton oil had
distressed it much some hours after it was given. The fæces could
be felt blocking up the intestine, but the irritation of the finger
produced no attempt at evacuation; very small pieces only having
been brought away. Hot baths also had frequently been used some
time ago.
Considering the case as one of paralysis in the parts naturally
employed to relieve the bowels, I recommended the suspension of
all purgative remedies by the mouth, and a table-spoonful of the
following injection to be substituted, and to be thrown up with
three table-spoonfuls of thin gruel occasionally during the day, by
means of a syringe.
℞ Spir. Terebenth. ʒiij.
Træ Zinzib. ʒj.
Aquæ, ℥iss. M.
The following liniment was also directed to be rubbed in frequently
along the course of the spine.
℞ Linimenti Saponis, ℥iss.
Liquor. Ammon. Comp. ℥ss. M.
The result justified my expectations; for, during the night after
this prescription, two injections having been given, some large
and hard ash-coloured lumps came away, and these were shortly
followed by a forcible spouting out of a continued stream of
feculent dark liquid; a brisk diarrhœa having been kept up till
the Saturday following. The infant's appetite is become voracious,
its appearance lively and healthy, and its legs as firm and strong
as is usual at such an age. Cold water is recommended to be dashed
upon the loins, the liniment to be continued occasionally, moderate
doses of magnesia and rhubarb to be given when required, and the
turpentine injection to be used if any return of the complaint
should be threatened.