europathy by a
few doses of a sedative. There are, however, not a few babies in whom
there develops soon after birth a sort of vicious circle. They can
suck efficiently and digest without pain only when they sleep soundly.
If they are put to the breast after much crying and restlessness,
each meal is followed by flatulence, colic, and renewed crying. The
only effective treatment is to secure sleep and to carry a slumbering
or drowsy infant to the breast. Then the sucking reflex comes to its
own again, the breast is drained steadily and well, and digestion
proceeds thereafter without disturbance and during a further spell of
sleep. Two or three times in the day we may be forced, as meal-time
approaches, to cut short the restlessness of the child by giving a
teaspoonful of the following mixture:

Pot. brom., grs. ii. [2 grains]

Chloral hydrate, gr. i. [1 grain]

Syrup, M x. [10 minims]

Aq. menth. pip., ad 3 i. [1 dram]

After this has been taken the child should be laid down for a quarter
of an hour until soundly asleep. Then very gently he can be carried to
his mother and the nipple inserted. If in this way a few days of sound
sleep and less disturbed digestion can be secured, the difficulty will
in most cases permanently be overcome. The steadier suction and more
efficient emptying of the breast will promote a freer flow of milk,
and the deeper and more prolonged sleep will lower greatly the needs
of the child for food. Most of the babies who show this fault are
thin, meagre, and fidgety, and with some increase of muscular tone.
The head is held up well, the limbs are stiff, the hands clenched, the
abdomen retracted, with the outline of the recti muscles unusually
prominent. If we can relax this exaggerated state of nervous tension,
if we can help them to become fatter and to put on weight, the
dyspepsia will disappear with the other symptoms.

It is a question still to be answered whether the rare conditions of
pyloric spasm and pyloric hypertrophic stenosis are not further
developments of the same disturbance. Certainly these grave
complications appear most commonly in infants with a pronounced
nervous inheritance, and, as might be expected, they are more commonly
found in private practice than among the hospital classes.

In passing, we may note that there are babies who exhibit the opposite
fault, and in whom the contrary regimen must be instituted. Premature
children, chil