nvariably produces an evacuation. This use of the
suppository, according to my observation, can usually be dispensed with
in a very few days; the use of the oil, however, may have to be
continued for several weeks. When the child has had the oil nightly and
an evacuation the next morning without assistance for two weeks, I
direct that the oil be omitted for a night and the effect noted. If the
usual passage occurs after breakfast, the oil is given for five nights
and then omitted. If the case progresses satisfactorily the use of the
oil is gradually omitted, being given at first every second night, then
every third, fourth, or fifth night, etc. A considerable number of cases
have been completely relieved in two months. In the event of no passage
following the omission of the oil, its use is continued for two weeks
longer, when it is again omitted for a night." To illustrate this point
the following case is cited.

"ILLUSTRATIVE CASE.--A boy three years of age had never had a bowel
evacuation without drugs, soap enemas, or suppositories since birth, and
finally these were no longer effective. The mother, thoroughly
frightened, brought the child to me. Eight months of diet and the use of
the oil were required before he was entirely well. It is now three
months since the local treatment was discontinued and the bowel function
remains normal.

"The diet with the absence of milk must be continued for months after
the patient is apparently well, and he must not be allowed to pass a
single morning without an evacuation at the usual time. In assuming the
management of one of these cases I explain to the mother or nurse that
the treatment is not pleasant for the child or the attendant, and that
it may have to be persisted in for weeks, and unless she is willing to
carry it out to the end, it would better not be undertaken. I assure
her, however, that with her cooeperation, which is usually readily given,
the child will make a complete recovery. Cases that are slow in
responding to treatment, I usually give the additional advantage of
abdominal massage from twenty minutes to one-half hour, before the child
is placed at stool. The massage should practiced by one skilled in the
work.

"The above local measures apply particularly to children after the
eighteenth month. They may be used earlier, however, following out the
diet along the lines laid down for bottle-fed children who suffer from
constipation. In very young children a