Excerpt from British Journal of Children's Diseases, 1904, Vol. 1

From the appended summary often cases, it will be noted that there were eight males and two females. Such a preponderance of males is not seen when larger numbers are taken, and there is no reason why males should be more susceptible than females. The family history does not seem to have any influence. As a general rule the other children of the family are healthy. A neurotic his tory was markedly present in two cases (5 and and might be thought of importance by those who, like Dr. Thomson, hold the view that the cause lies in defective innervation, naming' the affection congenital gastric spasm. In one case (7) the grandmother 011 the father's side lost a sister in infancy whose death was ascribed to nothing passing through her stomach. This child vomited everything. In Case 10 it was also a coincidence that the ma ternal grandmother had had some operation 011 the pylorus in later life.

Symptoms. In almost every case it has been noted that the child was a fine baby born. Sometimes it is the firstborn, at others it is a later child, the first children being quite unaffected. The first symptoms may come O11 a few hours after birth, or may not appear for a month or more. Usually they appear in the second or third week. Until the child starts vomiting there may be no indication of anything wrong. In some instances it has been noted that the babe has not taken food as readily as previous infants, that it is more easily satisfied. Or there may be flatulence and constipation. Vomiting is the most important and the most characteristic symptom. It is not accompanied by nausea, and the intervals between the attacks may be fairly long ones. In the best marked cases two or three feeds are kept down and then apparently the whole lot is brought up at once. Gradually the vomiting becomes more and more frequent, and may occur on the administration of the smallest quantities of food. In rare instances it is not a marked feature. The act of vomiting is a forcible one, like that seen in older children. It causes some pain, but the babe is most comfortable when the stomach is empty. The character of the vomit depends upon the diet. There is no bile present. In late stages there may be mucus in it. Constipation may be present throughout, and may be a marked feature. It is not invariably present, being dependent upon the amount of stenosis.' Sometimes there is actual diarrhoea, though the stools may be small. This results from irritation from decom posing Or unsuitable food which has passed through the pylorus. The tongue 1s clean and the breath sweet in typical cases. O11 inspection of the abdomen there are no signs of intestinal obstruction.

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