RIGHT AND WRONG USE OF CASTOR OIL.

King Country Chronicle, Volume VII, Issue 556, 5 April 1913, Page 3

RIGHT AND WRONG USE OF CASTOR OIL.

Last week 1 dealt with a letter in which the writer assumed, from what had been recently said in this column, that the Plunket nurse had done wrong in ordering har baby a dose of castor oil for diarrhoea. The mother's anxiety en the subject would have been allayed had she consulted the Society's books. "Feeding and Care of Baby," or "What Baby Needs," where the following passages occur:—

"If motions appear . green when passed, or if they contain much undigested fod, this indicates as a rale that less humanised milk and more boiled water should be given. Indeed, it is safer to give boiled water alone for one er more feedings. If the green motions are accompanied by obvious indigestion and diarrhoea, a teaspoonfu! of castor oil may be given and an instant change should invariably be made to pure boiled water for several meals, no food whatever of any kind fating allowed. "A motion looking like chopped spinnach usually calls for an immediate dose of castor oil; but repeated doses of oil should on no account be given. The extracts show the society's teaching with regard to the use of castor oil, and there was nothing in the article referred to by "Not Understood" which was not in accord with the above.

However, I have no - fault what ever to find with the writer's misgivings, and I can feel indebted to her for drawing attention to them —only it seems to me that it would have been better to have written to myself apking for an explanation instead of assuming that the nurse had done wrong, and publicly expressing loss of faith in the Society, because of the mare's nest she had found. From "Not Understood's" letter one gathers that her baby must have done well, and that she attributed the improvement —in part at least —to the dose of castor oil which she gave on the advice of the Plunket nurse when her baby was suffering from diarrhoea. Had this not been so she would not "have kept it in the house ever since in case of emergency"; nor would she have continued to "look upon castor oil as a friend in time of need," as she says she did until she read my re cent article.

Evidently the Plunket nurse impressed the mother with the fact that castor oil was only to be used in an emergency such as diacrhoea, and was not to be given habitually, so that instead of being blamed the Plunket nurse ought rather to have received full credit and application for the sound advice she gave.

Castor oil properly and sensibly use —that is, a single dose given to clear out the fermenting and germ-laden contents of the bowel when there is diarrhoea is indeed universally recognised as a vfriend in need" where the baby is concerned. The fact that after the use of castor oil there is a tendency to constipation adds to its value for diarrhoea. On the other hand, this "binding" property of castor oil makes it one of baby's worst and commonest enemies. Then, if given habitually to induce movement of the bowels or simply because castor oil is supposed to be good for baby, extreme and intractable constipation and indigestion are liable to be the result. It was just a case which led me to write about castor oil in the first instance. The following passage which I quoted from a mother's letter tells the story :

'There was a young mother with her first boy there (at the maternity home) at the same time as myself, and the nurse dosed them both every other day with castor oil," and told the mother it was the right thing to do. I saw her a week or so ago. The baby has always constipated, and so she always had to be giving him oil, or he would not have a motion for three daya, etc."

If these articles cause mothers to .pause and think before administering any drugs to their babies, "Mot Understood" will have done good by her letter; but it would have been more friendly to write direct, and I trußt she will do so next time if in any doubt.

With regard to the use of castor oil, it is well to keep three points clearly in view:—

1. Never give castor oil for chronic constipation, or, indeed, for ordinary constipation at all. 2. At the onset of diarrhoea give one dose of castor oil, but never repeat it except under competent advice. 3. Never give castor oil, or, indeed, an aperient to a child seized with sud den, acute abdominal pain. FINAL WARNING. To make quite sure of driving home the last point, I quote the following from-my original article—the article to which "Not Understood" took exception, and which she said caused her to lose faith in our advice. The references should be to Sir Berkeley Moynihan, as Dr Moynihan has since been knighted in appreciation of his distinguished services in the special field of intestinal trouble—indeed, in recognition of his being the leading provincial surgeon of the day in England:—

"Now, let us turn to what Dr Moynihan (the leading English authority of the day on the surgical aspect of intestinal disorders) is saying on this very subject. The British Medical Journal for April 1911, contains the following warning:— AVOID APERIENTS.

"By some means or another parents should be made to know that the dosing of children with aperients is an evil, and that they must put a check 'purgative-loving propen-

sities' which seem inseparable from motherhood. I would like to have the

power to write in every nursery in the kingdom in large lettera in the most prominent place the two words —'avoid aperients ' To give aperients to children suddenly seized with acute abdominal pain is homicidal, yet it hardly occurs to any mother or nurse to do anything but this, the most disastrous thing of all.

"The onset of sudden intense pain in the belly is nature's special dangersignal pointing to obstruction of the bowels by kinking or tuckhig-in, and ia also her way of proclaiming the onset of appendicitis. Nurses ought to know that the pain may not be in the lower part of the bally, where the appendix is situated, but at the top of the bells, in. Hie region of the 'Dit of the stomach.' This fact is most misleading both to parents and nurses, becausß they are apt to conclude that the child has 'swallowed something.' 'The first symptoms of an attack of acute appendicitis is pain. It is always pain, and never sickness or vomiting, nor mal-aise, nor any other symptom whatever. The pain is absolutely abrupt in onset. ... It

may be rapidly followed bv shivering, sharp rise of temperature, vomiting, diarrhoea, etc."