The best are diet, suppositories, and massage.
The changes to be made in the milk of constipated infants have been mentioned on page 82. The addition to the milk of some of the malted foods, such as Mellin's food or malted milk, is sometimes useful. For little children the fruit juices are particularly beneficial when given half an hour or more before the first morning feeding, with half a glass of water.
For older children the amount of white bread, toast, and potato, should be reduced, and green vegetables oatmeal, and Graham bread given, with plenty of fruit twice a day. Raw scraped apples are sometimes of more value than any other fruit.
The best suppositories for continuous use are probably the gluten suppositories of the Health Food Company. One should be given the first thing in the morning. They act rather slowly, usually in about two hours. In obstinate cases one may also be used at bedtime. Glycerine suppositories act more quickly, but are too irritating for regular use.
Massage consists in rubbing the abdomen, which may be done in one of two ways: Beginning at the right groin, the hand is carried up to the ribs, then across to the opposite side, then around to the left groin. The abdomen is stroked gently at first, and afterward deeper pressure used as the child becomes accustomed to it. The second method is by rubbing the deeper parts with a circular movement—the fingers not moving upon the skin—making a series of small circles, beginning at the right groin and following the same course as described above. Either method should be employed for six or eight minutes twice a day, at almost any regular time, except soon after a meal.
[ DIARRHOEA ]
In case a child is taken with diarrhoea, what should be done?
With a moderate looseness of the bowels in an older child, solid food should be stopped, and boiled milk given diluted with gruel; the child should be kept perfectly quiet, as walking about always aggravates such a disturbance. If the symptoms are more severe and attended by fever and vomiting, all milk should be stopped at once, and only broth, barley water, or some thin gruel given. Some cathartic, usually castor oil, is required with a severe attack.
If the patient is an infant, the milk should be diluted and especially should the fat be reduced [ (see page 76)]. In severe attacks with vomiting or frequent foul stools, all food should be stopped for at least twelve hours and all milk for a longer time, and the bowels freely moved by a cathartic.
Why is a cathartic necessary if the movements are already frequent?