Another defect that new-born infants are liable to is, to have their fundaments closed up, by which they can neither evacuate the new excrements engendered by the milk they suck, nor that which was amassed in their intestines before birth, which is certainly mortal without a speedy remedy.  There have been some female children who have their fundaments quite closed, and yet have voided the excrements of the guts by an orifice which nature, to supply the defect, had made within the neck of the womb.

Cure.  Here we must take notice, that the fundament is closed two ways; either by a single skin, through which one may discover some black and blue marks, proceeding from the excrements retained, which, if one touch with the finger, there is a softness felt within, and thereabout it ought to be pierced; or else it is quite stopped by a thick, fleshy substance, in such sort that there appears nothing without, by which its true situation may be known.  When there is nothing but the single skin which makes the closure, the operation is very easy, and the children may do very well; for then an aperture or opening may be made with a small incision-knife, cross-ways, that it may the better receive a round form, and that the place may not afterwards grow together, taking care not to prejudice the sphincter or muscle of the rectum.  The incision being thus made, the excrements will certainly have issue.  But if, by reason of their long stay in the belly, they become so dry that the infant cannot void them, then let a clyster be given to moisten and bring them away; afterwards put a linen tent into the new-made fundament, which at first had best be anointed with honey of roses, and towards the end, with a drying, cicatrizing ointment, such as unguentum album or ponphilex, observing to cleanse the infant of its excrement, and dry it again as soon and as often as it evacuates them, that so the aperture may be prevented from turning into a malignant ulcer.

But if the fundament be stopped up in such a manner, that neither mark nor appearance of it can be seen or felt, then the operation is much more difficult, and, even when it is done, the danger is much greater that the infant will not survive it.  Then, if it be a female, and it sends forth its excrements by the way I mentioned before, it is better not to meddle than, by endeavouring to remedy an inconvenience, run an extreme hazard of the infant’s death.  But when there is no vent for the excrements, without which death is unavoidable, then the operation is justifiable.

Operation.  Let the operator, with a small incision-knife that hath but one edge, enter into the void place, and turning the back of it upwards, within half a finger’s breadth of the child’s rump, which is the place where he will certainly find the intestines, let him thrust it forward, that it may be open enough to give free vent to matter there contained, being especially careful of the sphincter; after which, let the wound be dressed according to the method directed.