Intussusception in children / by W.E. Forest.

  • Forest, W. E. (William E.)
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Intussusception in children / by W.E. Forest. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    I hare described be used, it will be found in most cases that the pain becomes less as the force of the injection is increased, up to of course a safe limit. It was so in the cases I have re- ported in this paper and it is so given in reports of other cases. My answer to the question would be that a pressure of six pounds to the square inch may be employed in any case seen within three or four days of the inception of the attack, pro- vided, of course, that a lesser pressure does not succeed. This pressure could be reached very gradually by elevating the reser- voir up to a height, if necessary, of fifteen feet above the patient. My reasons for deciding upon this particular amount of force as the limit to which we may go, if a lesser force does not suf- fice, will appear from the following experiments. Experiment I.—Child ten days old, died of marasmus not accompanied with any fever. Opened the abdomen without disturbing the intestine. Injected cold water from a fountain syringe, the reservoir suspended five and one-half feet above the point of delivery, this giving a pressure of a little over two pounds to the square inch within the intestine. The liquid dis- tended the colon and penetrated to the ileo-cecal valve, but did not pass that point. Manipulating the intestine so as to make slight traction on the ileum at its point of junction with the cecum, opened the valve so that the liquid passed easily while the pressure remained as before. Suspending the child by the feet, with the head downwards, also made the ileo-cecal valves pervious, without increasing the pressure. These experiments would seem to show that massage and po- sition may, in some cases, aid in opening the ileo-cecal valve to the passage of an injection. Experiment IL— Reservoir suspended nine feet above the point of delivery, thus making the pressure within the colon about four pounds to the square inch. This caused the liquid to pass the valve when aided by the position of the child, with its head downwards. The liquid, however, did not penetrate beyond the middle of the small intestine, owing to the friction in the small intestine and the obstruction from numerous sharp turns. Experiment repeated several times, with the same result each time. The practical deductions from this experiment would be, that the pressure from the rectal injection will always be greater in the