CASE OF LONG PROTRACTED CONSTIPATION.
To the Editors of the London Medical Gazette.
Gentlemen,
Perhaps the following case may interest some of your readers, and if you think so, its insertion in your Journal will oblige
Your obedient and
humble servant,
S. D. Broughton.
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.
Spir. Terebenth.
iij.
Træ Zinzib.
j.
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.
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.