OUR RABIES.

Taranaki Herald, Volume LXVII, Issue 16454, 5 June 1919, Page 5

OUR RABIES.

(By “Hygeia.”)

"It is ■wiser to put op a fence at the top of a precipice than to maintain an ambulance at the bottom.” Published under the auspices of the Royal (N.Z.) Society for the Health of Women and Children. New Plymouth ■ Plunket Nurse Williams. Hon. Secretary, Mrs. Sydney Allen, New Plymouth. Stratford: Plunket Nurse Wake. Eon. Secretary, Mrs. L. P.iera, Juliet Street. Hawera; Plunket Nurse Dix. Hon Secretary, Mrs. M. J. Jauson, Box 22. "MOTHER’S” LETTER. CONSTIPATION OF 18-MONTH-OLD BABY. The following letter has just come to baud;— Will you kindly advise me in Our Babies’ Column what to do in the following case;—My baby is now 18 mouths old, and has been more' or less constipated during his life. In the first 12 months 1 had to give him an average of one enema a week. Sometimes we would go a fortnight uithout requiring any, and sometimes he would require two enemas in the one week. Since 12 months old up to the xn’oseut time ho has required an average of two enemas per week, acting in the same way as before, sometimes going a fortnight without requiring any. He has been bottle-fed except for the first three months, when ho was part breast-fed. With regard to his ease, 1 have followed the instructions in the Plunket book with the exception of getting the bowels to move at the same time each day, although I have tried to manage to get a movement

at "some time” each day, and on an average of about once a week

f have lot him go on to the second day in the hope of a movement without using the enema. He has had orange juice as recommended until he was 14 months, .and now gets baked and raw apple, also as recommended. He has always had and still has a room to himself, sleeps perfectly at night, and has a three hours' nap every afternoon. He invariably wakes tip smiling, is very rarely cross, has never had a dav’s

illness, and appears to be a perfectly healthy baby. lam rather at a loss to understand this tendency to constipation, unless it is that he has inherited it from me and my mother, as both of us have been troubled with constipation all our lives. However, I shall bo very pleased and grateful to get your advice. COMMENT. There seems to be a distinct hereditary tendency to constipation in the case, ot this baby; but that ought to make ‘'Mother" all the more determined to overcome the trouble. Our correspondent docs not say what kind of enema she' has been in the habit of using. A.small tonic enema of 13 to 33 of normal saline (a level teaspoouful of common salt to a pint of boiling water), given by moans of a tiny softnc.Z7.ltHl bulb enema, may be used once; dr twice a week for a considerable time without much harm, though every effort should be made to secure a natural movement every day at the same hour.

A groat deal of harm is often done by the liabit of giving ordinary enemas to babies. It is (jiiito a common thing to find mothers giving a daily injection of from 23 to a quarter of a pint or more of soap and water. 'Phis is highly injurious, causing, as it docs, both distension and irritation, and rendering the bowel more and more slu ggkh. ,

It was a mistake not to fix a time at which ''the daily motion should bo brought about. The., forming of regular habits in infancy is most important, and it is especially important in connection with the daily action of tile bowels.

The injunction, "Don’t lot 10 o’clock in the morning pass without getting the bowels to more if there has not been a motion in the pro vious 24 hours,” should be a watchword in all homes where there arc young children. So much ill-health, misery, and incapacity in adults arc due to constipation that it is well worth taking some trouble to imjuce regularity at the start of life. MASSAGE OF THE ABDOMEN. Abdominal massage affords a very important means of toning and brac- | lug up not only the muscles of the abdominal walls but also the muscles of the bowel itself and . the glands which pour their digestive juices into the whole alimentary canal. It is wonderful what can bo achieved ir. counteracting constipation in babies by skilful massage following on the use of an enema of loss or 2oz; but this massage is rarely done efficiently. The groat point is to manipulate the abdomen gently and yet firmly and deeply, following round the horseshoe of the large intestine. A sausage-like tube starts just above the outer part of the right groin and runs upwards to tlio margin of the rib, then curves round across the abdomen above the navel, until it reaches the rib in the left flank, when it curves round sharply. and descends to reach the left groin. It then passes downwards and baeku ■ards to join the rectum from which the motions are expelled. The course of the large bowel is shown in the diagram on page 4, Fig. A, "Feeding and Care of Baby.” The first essentia! in treatment of this kind is to understand just wliat you wasn’t to arrive at. The abdomen must bo manipulated not merely ou tlio surface, but also by deep and firm, yet gentle, pressure in the right direction. If this pressure was exercised without allowing for the breathing, the child would struggle and resist at once, and the walls of the abdomen would become “as stilf as a board;’.’ but if the pressure is gently and tactfully applied mainly with each intake of the breath (when the abdomen naturally slackens), it is quite easy to use continuous pressure In successive waves as it was gradually getting deeper and deeper, without arousing the opposition of the muscles'. A really competent abdominal nurse could teach tins manipulation dexterity in a few lessons. SOME LEADING CAUSES OP CONSTIPATION. I shall now enumerate a few of the lending causes of constipation in addition to the lack of early training to perfectly regular evacuation of the bowels caen day, to which I have already referred." . (1) Not giving the baby the full benefit of all the simple essentials for ■health and vigour summed up ,on pages .1 and 2 of the Society’s book, "Feeding and Care of Baby.” ■ (2 )Tho lack of sufficiency of fluid in constipated babies will often be helped by giving an ounce or two of water between two of the meals.

(3) Unsuitability of the food as regards natural laxativeness. Certain foodstuffs are known to be laxative—for instance, oat jelly, oatmeal porridge, malt extract, baked apple, raw apple, well-cooked prunes, well-cooked spinnach made into a lino juice, olive oil. fresh fruit juice, etc. Ni.B.—While olive oil' is laxative, castor oil is one of the most binding of all substances, and should never be given for constipation.