The little patient had been vomiting a slimy, dark coloured
substance having all the characters of meconium ever since
birth. Nothing had been passed from the bowel through the
natural exit. When I saw the infant a short while after its
admission, it still continued to vomit, and what was very
serious, was that it was nearly suffocated by attempting
inspiration with the mouth full of vomited material, which
also gushed out through the nostrils.
The child was carefully examined. A very perfect anus
was present, and into this the little finger could be introduced
for at least one and a half inches without meeting any
obstruction. There was nothing upon the examining finger
but a little mucus. A probe and a soft catheter coufd also
be easily introduced for some distance further. This nega-
tived almost conclusively the idea that there was an imper^
forate rectum. Palpation of the abdomen, which was slightly
distended, failed to give evidence of any tumour. The
percussion note was everywhere resonant. The child showed
some signs of distress, but was not restless. It had passed
some urine about one hour after birth. Its temperature on
admission was 97'4°F. A few spoonfuls of milk given were at
once rejected.
As the child continued to vomit it was determined to
explore the abdomen, as giving the best chance for the frail
life. An incision was made as for left inguinal colotomy.
The sigmoid flexure was found to be quite empty, and the



REVIEWS AND NOTICES OF BOOKS. I35

■™^S^r, when passed toward the right side of the abdomen,

^"Ticountered adhesions and coils of intestines matted together^

^s a very distended loop of small intestine presented, it was

sUtched to the abdominal wound and immediately opened.
Some ounces of rather liquid meconium escaped.
