Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

  • Bedford Gunning S., 1806-1870.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the diseases of women and children / by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    318/696 page 296
    Tlie case before you, gentlemen, is one of singular interest, for severaj reasons. In the first place you see a little infant but a weeK old, who has had no evacuation from its bowels since its birth; and it seems to have resisted every attempt by medicine to effect this object. It is now, as you perceive, suffering severely; its abdomen very much distended, with irritable stomach, and no desire for the breast.. Its moans indicate great distress, and its whole aspect portends a fatal issue. Is there one of you who is not strikingly impressed, in looking at this little sufferer, with the soundness of that principle which I have so often told you is fundamental in the investigation of disease, viz.: a just distinction be- tween the substance and shadow ? The feature in this case which, at the sacrifice of every other consideration, has attracted attention, is the fact that the bowels have not been moved since birth. To overcome this supposed torpor of the system various medicines have been admin istered, but all without avail; and the result of this partial or abstract view’, is protracted suffering w’hich will result most probably in death. In his contemplation of disease, the observation of the physician must be critical—his reasoning based on a broad foundation, and his deduc- tion, if not always just, should at least be rational. I do not yet know certainly, for I have made no examination to ascertain the fact, but 1 am disposed to suspect from the whole history of the case that this infant has had no evacuation because of a mechanical obstruction, constituting occlusion of the anus. [Here the infant w’as examined by the professor, and his suspicions were soon confirmed. There was occlusion of the anus, and the want of action in the bowels at once accounted for.] You perceive, I am right j and you understand, too, at w’hat little cost I have been enabled to arrive at a correct judgment as to the true cause of this infant’s distress. In this case, the inactivity of the bow'cls is the shadow, while the occlusion of the anus is the substance. In other words, the latter is the cause, the former the effect. The absurdity, therefore, of attempting to produce an evacuation by medicine is too manifest to need one word of argument. In my lectures on Midwifery, I have spoken very fully of the duties of the practitioner to the new-born infant; and among these duties, there is one of special interest j it is this: as soon as the infant has been properly washed, it should be minutely examined, with a view' of ascertaining whether or not there exists any congenital deformity. The urethra and anus should be inspected—for if either of these outlets be occluded, the future safety of the child may very mate- rially depend upon the fact being known early. “ Madam, it is not necessary for me to tell you that this child is in a very dangerous situa- tion.” “ Oh! no, sir, I see it, poor little dear.” “ There is but one thing, my good woman, that presents the slightest ground of relief, and thaUs an operation.” “ What, sir, to open its stomach ?” “ No, mad- am we do not open stomachs here—and you need have no fear of the ope’ration of which I speak. Shall I do what I think is proper, and
    digitised image 1
    digitised image 2
    digitised image 3