Fig. 121.—Method of giving gavage. (Grulee.)
Treatment is by daily or hourly spanking, and by alternating hot and cold baths, by sprinkling with cold water or by massage to stimulate the skin reflexes. The treatment may have to be repeated every twenty or thirty minutes, and the earlier it is instituted, the more persistently carried out, the more chance of success.
Exercise is just as important to the infant as to the adult. The kicking of the legs, moving of the arms and lusty cry are all means of stimulating the circulation, the muscular development, and the expansion of the lungs. The position should be changed occasionally in the crib from back to side and from side to back. Also the child’s legs and back should be rubbed and massaged until the skin is red every time the bath is given.
Flushings.—The child is laid across the lap, or on a table. A rubber sheet is so arranged that the discharge will drain away.
A soft rubber catheter, No. 18–20 French scale, is attached to a small funnel. The apparatus is boiled and filled with normal saline, or sterile water, at a temperature of 85° F. to 95° F. Half a pint to a pint may be required.
The catheter is oiled and passed into the rectum just beyond the sphincter. It must not go farther. The funnel is then raised and the fluid flows into the bowel. This flushing must not be confused with the administration of an enema for constipation, for which, however, it is often an excellent substitute.
Gavage is forced feeding by means of a tube. A soft rubber catheter or tube, about No. 7, French scale, is lubricated with albolene, vaseline or sweet oil. The upper end is connected with a small tube or glass funnel holding two or three ounces.
The child is laid upon its back in the arms of mother or nurse, the baby’s arms are held and the head steadied.
In case of diphtheria or scarlet fever, the tube may be passed through the nose and down the pharynx and into the œsophagus five or six inches, or even into the stomach. It is more convenient and easier when possible to pass it through the mouth directly into the stomach. The food is then poured into the funnel, which, by elevation, empties itself into the stomach. If regurgitated, more food must be given. When withdrawn, the tube should be pinched to prevent leakage into the trachea.