Diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Goodhart, James Frederic, Sir, 1845-1916.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

    122/792 (page 106)
    io6 -But there may still be a future in store for it if all unnecessary delay is avoided. Intussusception is so usually fatal that it should be taken in hand at once and treated; and, if the ti’eatment be unsuccessful, the abdomen should at once be opened. Early opera- tion gives the best security against finding the intus- susception irreducible, and the prolonged operation which irreducibility involves has probably had much to do with the great fatality which has hitherto attended the resort to surgical measures. The method of operation is a surgical question ; I shall therefore only say that it consists in making an incision in the median line of the abdominal wall, opening the peri- toneum, finding the intussusception, and working it back at the neck, much as a hernia is reduced. Sometimes traction reduces it readily. Antiseptic precautions should be adopted, but great care should be exercised not to expose the surface of the child to cold. There is a tendency to neglect this precaution in the present age of spi'ays and vapours, though few are more absolutely essential for the well-being of the child. I am convinced that if abdominal section is to be successful in infants, the operation must be con- ducted with all possible celerity, and the surface— whilst it is going on—must be uncovered as little as possible. In older children, from three years upwards, the symptoms of intussusception are generally less urgent, and in all the cases that I happen to have seen, perhaps some half-dozen, they have disappeared more or less rapidly upon the free administration of opium and belladonna. Four or five drops of opium and ten drops of tincture of belladonna may be given every four hours to a child of five or six years old. Should these fail, inflation or water distension must be tried, and aa a last resort an operation must be discussed.