The force of habits should never be lost sight of by those having the

charge of children. They constitute a power of which parents should

early avail themselves. J. J. Rousseau has said, 'The only habit which

one ought to permit the child, is of not contracting any.' But this is

impossible and undesirable. When it is remembered that _a good habit is

just as hard to break as a bad one_, the importance of seeking from the

very cradle to frame good habits is evident. It is easy to create, but

difficult to reform. What then are some of the principal hygienic habits

which it is desirable to teach children?

First we will mention, _a liking for proper food at regular times_. The

indigestion, or weakness of digestion, from which many children suffer,

is in some cases hereditary or the result of feeble health. But most

frequently it is the effect of bad management. The giving to the child

of pastry and cakes at meals instead of simple and nutritious food, the

encouragement of capriciousness of appetite instead of teaching it to

like everything that is healthful, and the neglect to inculcate the

habit of eating at regular hours, these are the principal causes of many

cases of diarrhoea, vomitings, weak appetite, colicky pains, and

indigestion among children.

The daily use of at least a sponge-bath of the entire person is an

excellent habit. Cold water should be employed after the fifth or sixth

year. This simple practice of a cold sponge-bath every morning, if more

generally taught children, would avert many a cold and rheumatic attack

in after life.

The habit of quenching the thirst with only simple drinks, milk and

water, should be early and thoroughly formed. No American mother would

think of giving spirits to her child, excepting under medical advice;

but many permit almost from infancy the use of tea and coffee. These

drinks are not only unnecessary in childhood, but to a certain extent

injurious. They excite the nervous system and disorder the digestion.

Before the age of puberty, neither tea nor coffee should be allowed.

ON THE TRAINING OF THE SPECIAL SENSES.

The special senses, sight, hearing, smell, taste, and touch, have been

called the windows of the soul, by which it observes what passes

without. The most noble and intellectual of these are the sight and

hearing. Neither of them receives the attention at the hands of parents

and educators which it should. Indeed, the Indians who yet inhabit our

western plains, have better eyes and ears than we. The reason of this is

evident. The savage is obliged to make other use of his eyes than to

dreamily admire the beautiful landscape, and other use of his ears than

to listen to the singing of birds and the murmuring of wind and stream.

These senses are the defenders of his life. He depends upon them for

food, clothing, and protection against his enemies. Hence, urged by

necessity, he trains them from infancy, and brings them to a perfection

which astonishes us. It will be said, however, that we in our civilized

life, have no need of any such acuteness of sense. True, but we cannot

avoid the consciousness that our organs of sight and hearing do not

afford us the service they ought, and that they commence to fail us too

early. The remedy is to be sought in the training of the special senses

in early life. These senses, which are the first of our faculties to

form and develope, should be the first to be educated; yet, as has been

well said, they are nearly the only ones which are forgotten, or at

least they are the most neglected.

The education of a sense has been compared to the education of a

child,--it has its physical, its intellectual, and its moral side. It is

necessary to maintain the organ in a condition of health in order that

it may perform its work well; this is the physical education of the

sense. The mind must learn to properly elaborate the impressions thus

conveyed to it, this is the intellectual education of the sense.

Finally, in the service of morality and justice, these impressions ought

to be turned to the advantage of the good and the beautiful, this is the

moral education of the sense. The subject of the training of the special

senses is therefore, when properly viewed, a serious and most important

one. It might well demand more attention at our hands than we have space

to give it here. We will make our remarks as concise and practical as

possible commencing first with

THE TRAINING OF THE SENSE OF SIGHT.

A recent French writer on the hygiene of the sight has brought forward

striking evidence in support of his statement, that in our time the

sense of sight is growing markedly weaker. The number of the

near-sighted is augmenting, as is also the number of those who become

'far-sighted' before old age. Cases of debility and disease of the eyes

seem to be multiplying at a rate which should awaken general attention

to this matter. The causes are to be found in the neglect, often the

hurtful management, of the eyesight of children; in the influence of

improperly regulating artificial light; and in the injury done by bad

printer's ink and paper.

In the education of the child's eyesight, _acuteness_ of vision is one

of the first objects to be sought for. That this is largely a matter of

training is apparent from the fact that persons in certain professions

can readily distinguish objects too small or too distant for ordinary

eyes. Children brought up in the country or at the sea-side, have a

power of vision unknown to city children, with their limited range of

observation. But it is not only necessary that the eyes should be able

to make out the forms of distant or small objects, but that they should

be quick to detect shades of color and delicacies of outline. The child

should be stimulated and encouraged to make efforts in this direction.

Here, also, there is room for the skill of the intelligent toy-maker,

for toys can be made very useful educators.

One of the forms of sensorial _memory_ which it is most desirable to

develope is that of objects seen, that is to say, the fixing in the

thoughts, to be brought up before the mind's eye when wanted, the

recollection of visual impressions. This embraces the memory of forms,

of dimensions, of the relations between various objects and between

different parts of the same object, and of colors. When applied to

places it is what is known as _local_ memory, applied to the human face,

it is the memory of _physiognomy_; applied to objects, it is _graphic_

or _descriptive_ memory; applied to colors, it is _chromatic_ memory.

_Local_ memory is sometimes developed to an extraordinary degree. It is

only necessary for some persons to have once traversed a locality, a

street, a city, in order to preserve of it a most minute and vivid

recollection. This topographical memory is enjoyed by a number of the

inferior animals; the elephant, the dog, and the horse, for instance,

are well-known as being capable of noticing a road taken and of

returning by it, of recognising readily a place once seen, and of

showing a tendency to stop of their own accord at places where they have

been arrested or kept. This local memory, useful as it is to every one,

is necessary to the painter who draws upon it for the elements of his

artistic creations.

The faculty of recollecting faces is a peculiar one, and possessed by

different persons in vastly different degrees. There are those who

recognise invariably every face they have once seen, and who by a simple

effort can at any time recall with the utmost distinctness the features

of the absent. On the other hand, there are those so wanting in this

special form of memory that they are constantly exposed to serious

social inconveniences, and, for fear of failing in politeness, often

salute perfect strangers. The ancient Greeks possessed to an

extraordinary degree the power of seizing and retaining types of face

and form; it is to this, doubtless, that they owe, to a great extent,

their unapproached excellence in sculpture and painting.

_Graphic_ or _descriptive_ memory is that which photographs, as it were,

upon the brain the visual impressions that objects have made upon the

retina, in such a manner that the thought can reconstruct them ideally.

This, in particular, is the form of memory required by designers of all

kinds, and, like the other forms of visual memory, is susceptible of

education. The child is first taught to copy with his pencil and produce

exact _imitations_ of the objects about him. Then, little by little, he

is to be taught in closing his eyes to reconstruct mentally the contours

of objects, at first simple, then more complicated, and finally to

penetrate into their details and give to the fictitious mental image all

the relief of reality. This exercise not merely trains the child in

correct observation, but quickly leads to the conquest of descriptive

memory.

_Chromatic_ memory, or the memory of colors, is a form of visual memory

different from those we have enumerated. It is more difficult, perhaps,

and technical than the others. The attention of the child should early

be directed to the colors of natural and artificial objects, and he

should be encouraged to imitate them.

But it is not our intention to go further into this important subject,

the education of the sense of sight. Our space will not permit it. By

these few elementary remarks, we have merely wished to remind parents

that they can do much towards the development of this important faculty

in their children.

TO PREVENT NEAR-SIGHTEDNESS.

Near-sightedness is, as we have said, greatly increasing. In Germany,

this is particularly the case, and has led there to a careful study of

the subject within the last few years.

Near-sightedness, like most of the disorders of the eyesight, is to be

traced to causes which act during childhood, _and which causes are all

entirely preventable_. Imperfect lighting of rooms in which children

study or play is one of the chief among these preventable causes. When

the windows are improperly constructed or placed, or when the artificial

light is faulty in school-rooms, the book is naturally brought close to

the eyes in order that it may be more easily read. The consequence of

this is either that near-sightedness is quickly produced, or that the

eyes soon become fatigued and permanently weakened. No less injurious is

the effort to read 'between the lights' or before the fire. School-books

with too small type, and school-desks which are too low or too far from

the seats, are the direct cause of much mischief to many young eyes. Let

parents, therefore, see to it that the school-rooms to which they send

their children are clearly and properly lighted, that the books which

they study are printed in a bold, clear type, and that no reading or

study is permitted by a flickering or a dim light, nor before a desk or

table which forbids a tolerably erect position of the head and

shoulders.

THE EDUCATION OF THE SENSE OF HEARING.

The education of this sense is second only in importance to that of the

sight. First of all, attention should be directed to the preservation of

the _health_ of the organ.

Many cases of deafness among children originate in long standing

diseases of the nose and throat; others in obstinate skin affections;

while not a few are caused by a want of cleanliness, which permits of

the accumulation of wax in the passage of the ear.

The sensibility of the nerve which conveys impressions of sound from the

ear to the brain can be greatly increased by exercise and training, when

the organ is in a condition of health. It can be so highly developed

that the ear will readily catch very feeble sounds.

A learned physician has recently pointed out with some force that

sufficient attention is not paid to the conformation of the pavilion of

the ear. Upon this conformation much of the delicacy of hearing depends.

The hats which children wear, usually compress and deform the pavilion.

Physiologists have shown that it ought to make an angle of about thirty

degrees with the skull, in order to best collect sonorous vibrations.

This angle is very much diminished by our artificial head-dresses, and

to the detriment of acuteness of hearing.

Can education do much for the improvement of hearing? Everyday

experience answers in the affirmative. There is an exercise which cannot

be too highly commended to parents, which consists in inducing in play

their children, even those very young, to detect from as far as they can

faint and fading sounds. It is a game which amuses them much, and it is

a pleasing sight to see the rivalry of several young children, each of

whom with head bent forward, is earnestly trying to distinguish a

receding sound longer than its fellows. A little ingenuity will readily

devise amusing and useful plays with this object in view.

The training of the remaining special senses is of comparatively minor

importance to that of those we have been considering, and need not

detain us. We will only remind the reader of the wonderful adroitness

and delicacy of touch possessed by the blind as an example of what this

sense is capable of when educated.

HOME MANAGEMENT OF SOME COMMON DISEASES OF CHILDREN.

CROUP.

Although this disease is said to be more severe in Europe than in our

own country, and more frequent in our northern than in our southern

States, most American mothers, in all parts of the country, know and

dread its alarming and often fatal attacks. It is a disease of

childhood, but not of early infancy, being rarely met with under the

first or after the tenth year of life.

Children who have once had this affection are very liable to another

attack upon exposure to any of the causes which excite it. It has been

noticed also that croup runs in certain families, and not unfrequently,

children of a ruddy complexion and of a fleshy and apparently vigorous

appearance are those most subject to it.

Among the _causes of croup_, which should be specially guarded against

by mothers of croupy children, are checking of the perspiration, sudden

alterations in the dress, change of climate, and even in some cases a

residence at the sea-side. Croup also often follows measles, and at

times is epidemic.

The unmistakable _symptoms of croup_ quickly show themselves at the

outset of the disease. Sometimes a sore throat, a short, dry cough, and

a slight harshness of breathing, usher in the affection; in other

instances, that which first attracts attention is hoarseness in the cry

or tone of the voice, attended with, or quickly followed by,

feverishness, thirst, and dulness, or fretfulness; while in another

class of cases the disease suddenly developes itself without any

noticeable premonitory signs. In all these cases the characteristic

symptoms of the disease commonly make their appearance at night. The

child's sleep is disturbed by a peculiar clanging cough, which, when

once heard, will ever afterwards be remembered and easily recognised.

The skin becomes hot and dry, the breathing difficult, the cough more

frequent, and the child is soon awakened, frightened, and struggling for

breath. With flushed face and staring eyes, the little sufferer starts

up, grasping the throat with the hand as if seeking to remove some

encircling pressure which is choking it. Each drawing in of the breath

is attended with a hissing sound, the redness of the face and neck

increases, and speech becomes impossible. This attack may pass off in a

few minutes, or be prolonged, with varying degrees of intensity, for an

hour. Almost invariably, however, it is followed by a period of relief,

in some instances so complete as to deceive the anxious relatives into

the belief that the disease is over and the child safe. This false

confidence is, unfortunately, generally soon rudely dissipated by a

return of the attack in all its first violence.

The disease attains its height by the end of the second, or at the

latest the close of the third day. The fever is now the hottest, the

tongue becomes white, the face and forehead red and covered with

perspiration, the lips at times purple, the veins of the neck and

temples distended, the countenance distressed, and the voice whispered

or suppressed. The cough is now also most frequent and noisy; its

peculiar sound has been compared to that made by a fowl when caught in

the hand. The thirst is great, but swallowing difficult. The child often

inserts its fingers in the mouth as if trying to clutch something which

closes the air passages. These symptoms may either increase to the rapid

exhaustion of the patient or take a favorable turn. One of the first

evidences of the latter is a change in the character of the cough,

which, although it may not lessen in force or frequency, becomes lower

in tone, less dry, and finally moist.

The _treatment_ should be most prompt, active, and energetic. Few

diseases require, for the safety of the patient, such quick and

efficient aid at the outset. Prepare at once sufficient hot water for a

bath, and make a fire in the room. In the meanwhile, immerse the child's

arms in some hot water, and apply cloths, wrung thoroughly dry from it,

to the throat. Give the child a tea-spoonful of powdered alum in a

little syrup, molasses and water, or honey. Repeat the dose in a quarter

of an hour if full vomiting be not excited by the first tea-spoonful. So

soon as the warm bath is ready (the water should have the temperature

of 98° Fahrenheit), place the child in it, and keep up the heat of the

bath by the occasional addition of hot water. Have hot towels in

readiness to dry the skin completely, and a warm blanket in which to

wrap the patient. See that the temperature of the room is raised to

about 66° Fahrenheit, and that it does not fall below this. Moisten the

air by putting a kettle of boiling water on the fire and diffusing the

steam from it by means of a long roll of paper fixed to the spout.

The warm bath and the emetic will usually relieve the breathing; but no

matter how complete this relief may appear to be, nor how quietly the

little one may sleep, it must be carefully watched all night, so that

the first return of unfavorable symptoms may be promptly treated. In all

instances also, however favorably the case may progress, the patient

must be confined to bed for several days, and the temperature of the

room, and the moisture of the air, carefully maintained, as directed for

the first treatment of the attack. If the child has had previous

attacks, or if the weather be cold and inclement, it should be kept in

this warm moist atmosphere for two weeks. Were these precautions known

and heeded we should have to lament fewer fatal cases of croup.

Of course in this, as in all other serious diseases, skilled medical

advice should be secured as quickly as possible. We have given the above

directions, not only for those so situated that they cannot secure

medical aid, but also for all others, in order that no valuable time may

be lost in commencing the treatment, that the efforts of the physician

may be intelligently seconded and carried out, and that the importance

of _promptness_ at the outset, and _prolonged care_ during

convalescence, maybe impressed upon every mother who consults these

pages.

HEAD COLDS.

Young infants are very liable to take cold when being washed, or carried

about the house into rooms and passages of different temperatures. This

cold often shows itself by sneezing and "snuffles" in the nose. In a

short time a discharge from the nostrils appears, the eyes become

watery, and the voice sounds "through the nose." The skin is hotter than

natural, and the infant cross. If the child be able to talk, it will

complain of headache, some soreness in the limbs and back, and of a

burning, uncomfortable feeling in the nose. These symptoms last for

three or four days, when in mild ordinary cases they begin to disappear.

After one or more attacks of this kind the child is very liable to a

return on every slight exposure to cold.

The _treatment_ required in these cases is mild and simple, but must not

be neglected. A warm bath should be taken at bed-time for a number of

days; the patient should be kept in an even temperature and out of

draughts. The best relief to the distress in the nose, from which the

child suffers, is afforded by dipping a hollow sponge in hot water,

squeezing it nearly dry, and applying it over the nose and forehead. The

common domestic practice of greasing the nose is also beneficial. The

wearing of a flannel cap until the disease is cured is a remedy

strongly recommended by the late Dr. Meigs. A flannel cap will also

often prevent the recurrence of the complaint in those very subject to

it.

FITS.

Infants and young children are much more liable to fits and convulsions

than adults. The causes which excite them are numerous, and should be

generally known, that they may be as far as possible avoided.

Many infants are born with a tendency to fits. The children of feeble

parents, or of those who have married very early or very late in life,

are apt to be afflicted with a predisposition to them. Great fright or

severe shock received by the mother during the latter months of her

pregnancy may give rise to convulsions in the child soon after birth.

Pale, badly nourished, soft, flabby children, and those of a sensitive,

nervous temperament, are more liable to fits than those who are ruddy

and hardy. Hence we find convulsions more common and fatal among the

poor and miserable than among the 'well-to-do' and comfortable. City

children are more subject to the complaint than the country born and

bred.

Fits are very frequent among infants while teething. In such cases

lancing the gum secures immediate relief. Another cause of fits, and one

which every mother should know, is the giving of meat to the child

before its teeth are cut. In such cases the attack is sudden, and often

very severe. Children most affected in this way by animal food are those

with water on the brain, and those of a very delicate constitution. The

juice or broth of meat is in some such instances sufficient to produce

fits. The remedy consists in the institution of a milk diet. In all

doubtful cases avoid a meat diet in any form, and watch the result.

Strong mental emotions, such as fright, shame, or anger, may cause a fit

in a child. A nurse in England threatened to throw a child out of the

window if he did not stop crying; the little boy fell at once into

convulsions, from which he died.

Among other known causes of fits are confinement to heated, badly

ventilated rooms, tight bandaging, and sudden exposure to severe cold or

heat.

In treating of the influence of the mother's mind over the nursing child

(p. 251), we mentioned a number of instances of children thrown into

convulsions by changes in the quality of the milk caused by the mental

emotion of the mother. The importance of the subject induces us to quote

here the corroborating remarks of Dr. Churchill, in the last edition of

his standard work on diseases of children. 'During the first year of

life, convulsions may not unfrequently be traced to the milk of the

mother or nurse disagreeing with the infant, or having been disordered

temporarily by fright, passion, or suffering. Soemmering mentions a

curious case of a woman whose milk agreed with her own child, but caused

convulsions in all others. M. Guersant relates the instance of a woman

deserted by her husband, and in her distress her infant had an attack

each time it took the breast. Dr. Underwood mentions a mother who nursed

her child immediately after witnessing a sudden death; the child was

attacked by convulsions, after which it remained comatose for thirty-six

hours, but ultimately recovered. Numerous cases are on record of

convulsions supervening upon violent passion in the nurse. I have

witnessed more than one case resulting from the mother suckling her

child during a time of severe affliction and distress.'

We deem it useless to describe a fit. Almost every one has seen it, and

at once recognises it. We shall proceed, therefore, at once to the

_treatment._

When a child is attacked with a fit the dress should be loosened, all

tight bandages and pins removed, and plenty of fresh air admitted into

the room. It should not be held upright in the arms, but placed in a

lying position. A warm bath (that most useful remedy in so many of the

ailments of children) should be speedily prepared, and the child

immersed for a few minutes, then removed, dried, and wrapped in a

blanket. A hot mustard foot-bath is also of service. The cause of the

fit should be at once sought, for upon it will of course depend to a

great extent the treatment required. If the child be teething, and the

gums be found to be red and swollen, they should be lanced. If the child

has eaten too much, or of improper food, an emetic should be given. A

little mustard and salt mixed in a tumbler of warm water affords a

ready, safe, and effectual emetic.

The dashing of cold water upon the face will sometimes promptly end the

fit. The application of powdered ice in a bladder, or of cold water

cloths to the head, is of service where the face is much flushed and the

movements very violent.

Children subject to fits should live in a well warmed house. By this we

do not mean that the rooms and hall ways should be kept hot, still less

that they should be close and improperly ventilated. The temperature of

the bed-room should not be lower than 70 degrees, and great care should

be taken during cold weather to avoid chilling the child outdoors.

Rubbing of the child's body once a day with good salad oil is an

excellent and readily applied remedy in these cases. The little patients

do not ordinarily object to it. As it is a procedure calculated to

improve the general health, we strongly recommend every mother whose

child has frequent fits, to try it.

The dress of the child should be warm, loose, and comfortable. Perfect

quietness is important for a time after attacks. Do not excite the child

by seeking to amuse it. Let it sleep as much as it will.

In those cases in which a fit has been followed by weakness of the

limbs, medical assistance will of course be procured. As a rule,

recovery in such instances is slow, but, when properly directed,

perfect. Change of scene, country air, and exercise, friction of the

body with a flesh-brush or salt towel, salt water baths, and

electricity, are all valuable agents towards cure.

NOSE-BLEED.

Bleeding from the nose may be produced by a blow or by over-exercise of

the child at play. In either case the trouble is usually a trifling

one. Some children, however, are liable to attacks of nose-bleed coming

on without any assignable causes. One of the consequences of scarlet

fever and whooping cough is sometimes a tendency to repeated and serious

spells of bleeding from the nose.

The _treatment_ in these cases consists in quieting the alarm of the

child if it be frightened, and in applying cold water or pounded ice to

the nose and forehead and to the back of the neck. It is because of its

coldness that the key placed down the back, as so commonly advised in

domestic practice, does good.

An exaggerated idea of the amount of blood lost is often a cause of

distress to parents. They forget that the child has been bleeding in a

vessel of water, and that a very little blood darkly colors a large

quantity of water.

Bleeding from the nose is sometimes a favorable symptom, as when it

occurs during a fever, or when in girls approaching womanhood it

precedes the expected signs of puberty. It is an unfavorable symptom,

however, in scrofulous children and in girls affected with

green-sickness, as in these instances it aggravates the existing

disorders.

In those rare cases of protracted bleeding which resist the remedies we

have mentioned, it may be necessary for the surgeon to plug the

nostrils, both in front and at their opening into the throat.

This extreme measure is fortunately scarcely ever called for, and can

only be carried out by the physician.

WORMS.

Children are often thought to have worms when entirely free from them.

There is hardly a symptom of any disease which has not been supposed by

some to be a sign of the presence of worms. A child suffering from some

other complaint is, therefore, not unfrequently dosed with vermifuges to

its injury. We can give the mother one symptom of worms which is

infallible. It is the only one upon which she can rely, namely, the

detection of worms in the stools of the child. Until these expelled

intruders are actually found she should be slow to believe that the

child is thus affected, and still slower to give worm medicine. Before

beginning treatment, let the mother wait until the need of it is made

out by the result of the examination we have mentioned.

The _treatment_ of the ordinary worms to which children are subject is

simple and usually speedily efficacious. Commence with a dose of Epsom

salts, of magnesia, or of cream of tartar, as may be preferred. The next

day administer a vermifuge, of which the best and pleasantest is

_santonine_. Obtain from the druggist three or four three-grain powders

of this medicine. Give the half or the whole of one of these powders,

according to the age of the child, at bed-time. The next morning

administer a purgative dose of oil or salts. Repeat this treatment every

other day until three doses of santonine have been taken. Or, from two

to six grains, according to the age of the patient, may be dissolved in

two table-spoonsful of castor-oil, and a tea-spoonful given every hour

until it operates.

An excellent domestic remedy for worms, one which was a great favorite

with the celebrated Dr. Rush of Philadelphia, is common salt. For a

child two or three years old, the proper dose is a tea-spoonful mixed in

a wine-glassful of water. When the child can be got to take it in

sufficient quantity, this remedy is a very efficient one.

Most cases of supposed worms in children are best treated by regulating

the diet, by attention to the air and exercise of the child, by warm

baths, and by endeavoring to improve the appetite, the digestion, and

the strength. The food should be plain and unirritating (bread, milk,

rice, arrowroot, chicken, lamb or mutton broth, beef-tea, mutton chop,

young chicken); the meals should be taken in smaller quantities than

usual, and at regular intervals. Sweets and confectionery should be

forbidden, and but few vegetables permitted for awhile. A perseverance

in this regimen for a short time will usually cure the little patient

without the necessity of resorting to any vermifuge.

Worms are most frequent between the ages of three and ten years. Girls

are oftener affected than boys. A tendency to worms is hereditary. Cases

occur more frequently during the spring and autumn than during the other

seasons. A residence in cold, damp, unhealthy situations leads to their

production in many instances.

BED-WETTING.

This troublesome disorder is not unfrequently met with in children--more

especially boys--under twelve years of age. It is a mistake to suppose,

as is done by some parents, that slothfulness or negligence is the

invariable and only cause of this infirmity; on this point Dr. Vogel

says:--'In most cases which I have observed, the children through their

own sense of honor or on account of repeated punishments, had a lively

interest in avoiding the accident, and yet were unable to do this

without appropriate treatment pursued for months, and even years.' Dr.

Tanner states:--'Very frequently this affection is the consequence of

bad habits; being favored by the free use of fluids during the after

part of the day, by exposure to cold in the night, and by lying on the

back.'

The presence of worms in the bowels is one of the causes of this

annoying ailment, and they should be sought for in all cases. Stone in

the bladder sometimes occasions the affection, but in such instances

other symptoms will soon point to the true nature of the trouble.

This subject is one of an importance which demands some attention from

us in a work for parents. In the language of Dr. Vogel, 'the effects of

this malady are unpleasant, for the psychical development in particular

suffers. The repeated punishments which these children undergo blunt

their sense of honor considerably; they become cowardly and deceitful,

and have no personal spirit. If great and expensive cleanliness is not

practised, the bed, and even the whole room, acquires a urinous odor,

which contaminates the atmosphere and begets conditions by no means

favorable to healthy growth. Such children may be ultimately attacked by

indolent ulcers on the nates and lower extremities, the results of

urinous excoriations.'

The only _symptom_ ordinarily present is that the child towards morning

or in the middle of the night wets the bed without waking. This may

happen several times during the sleep, and recur every night. In some

cases the act takes place only every other night, but it is rare that

there is an interval of more than one night.

The _cause_ of this failing is sometimes very simple and one easily

remedied; for it is often the result of neglecting to take young

children up once during the many hours they require for sleep. By

attention to this matter and to the diet, the habit may be speedily

broken. Unfortunately most cases are not so quickly amenable to

treatment.

In the _treatment_ of this infirmity, corporal punishment should not be

thought of. It is useless, cruel, and unnatural. The child might as well

be punished because it squints or has club-foot.

Care must be taken to see that the little patient eats or drinks nothing

for several hours before bed-time. The child should also be awakened a

little before midnight, and at a very early hour in the morning, and

made to empty its bladder. It is of great importance to get the child to

sleep upon its side or face, as lying upon the back is sure to increase

the trouble. Indeed, it is frequently observed that the child always

remains clean when it is prevented from turning upon its back during

sleep. The difficulty lies in the prevention. The plan of tying a cloth

or towel around the child with a knot over the spinal column, to awaken

it by the pain when it rolls over upon the back, so often proposed,

seems good advice easily followed. But practically it fails, as it is

impossible, without making the bandage too tight, to keep it in place.

The benefit which, in some instances, has followed the employment of a

succession of small blisters directly over the lower part of the spinal

column, is doubtless due to their forcing the child to sleep upon the

face or side. The remedy is somewhat a painful one, but should be tried

in obstinate cases.

The child's general health, if enfeebled, should be improved by cold

baths, bitter tonics, and if possible a change of air. In no case should

any mechanical means be employed to arrest the infirmity. Serious and

even fatal results have followed such attempts.

If the precautions and simple remedies we have mentioned fail, recourse

must be had to the family physician. The drugs which are of benefit are

too powerful to be entrusted to any other hands. The hygienic method of

cure we have pointed out will, if instituted early, be effectual in all

excepting very obstinate cases, which latter indeed sometimes resist for

a long time the best efforts of medical skill.

LOOSENESS OF THE BOWELS.

Children under one year of age should have two movements of the bowels

in the twenty-four hours, and those from one to three years at least

one stool a day.

A slight attack of looseness is often beneficial if it passes away

within a day or two. It is easy, however, for such an attack to become

hurtful, especially if the food be improper, or the weather warm. A

looseness which is of no consequence in the winter may well excite

uneasiness during the summer months.

Diarrhoea in a healthy child is ordinarily preceded by vomiting. If the

diarrhoea persist long, the little patient is much prostrated by it, and

rapidly reduced in flesh. Such an attack should never, therefore, be

neglected.

In the case of an infant not weaned, it should be removed from the

breast for half a day or more, that the stomach may have little or

nothing to do. Barley or rice water, or ordinary water, may be given in

small quantities at a time to relieve the thirst. This in many cases

will be all the treatment required.

In the case of an elder child, all meat and vegetables should be at once

forbidden, and the only food allowed for a day or two must be rice and

milk, arrowroot, or milk and water.

The dose of castor oil which is so frequently given by nurses in these

cases under the impression that the oil is 'healing,' is only of service

when the diarrhoea has been caused by food of improper quality or

quantity. It then aids nature in her efforts to get rid of the offending

matter, which by its irritation is doing the mischief. In such instances

one dose of the oil is quite sufficient. It has no 'healing' virtues,

and should not be repeated from day to day.

Children who are teething are frequently affected with looseness. A warm

bath every evening, and attention to the gums, will be ordinarily all

that is required in these cases, at least during the cold months. It is

of the utmost importance, however, during the summer that such patients,

if living in the city, should be at once removed into the country;

otherwise their lives are in danger.

Looseness of the bowels in children is usually best treated by careful

management of the clothing and diet, by attention to all that affects

the health, and by avoiding as much as possible the administration of

medicines. No case should be allowed, however, to run on without seeking

competent medical advice.

An excellent remedy for the diarrhoea of children is the subnitrate of

bismuth.

This medicine may be disguised in the food, as in a case narrated by Dr.

Inmann. A lad about ten years old was brought to him by an aunt, who

stated that the boy suffered much from diarrhoea, and was emaciating

visibly; that he would not try any domestic remedy, was an obstinate

fellow, and determined to take no medicine. After sending the lad to

another room the doctor recommended the lady to get some white bismuth

and give it to the cook, telling her to mix a large pinch of it with

some butter, and to send in the bread and butter so arranged that the

lady would know which was for the boy. This was done. The lad was duly

drugged without his knowledge, and the diarrhoea stopped in two days.

INDIGESTION.

Infants and young children suffer often from indigestion, or

_dyspepsia_, as well as adults. One of the most frequent signs of this

disorder is vomiting. But every infant which throws up its milk is not

suffering from indigestion. Vomiting is sometimes a sign of health, and

shows that the stomach is vigorous enough to free itself promptly from

excess of food. The child is thus saved from the effects of

over-feeding. The obvious remedy is to diminish the quantity of milk

taken at each nursing or meal.

But vomiting from over-feeding is very different from that caused by

irritation of the stomach, which causes it to reject proper food. The

common sense of the mother will enable her easily to distinguish between

the two sorts. In the former, the child remains cheerful, happy, and

well nourished, scarcely changing countenance even while the

superabundant milk is being returned from its stomach. In the latter,

the child soon becomes pale, feeble, and distressed looking.

Over-feeding, if persisted in, may occasion indigestion.

Indigestion during the first year of life shows itself by languor,

pallor, and evident discomfort. The child wishes to be constantly at the

breast, and suckles eagerly, but vomits the milk shortly after, usually

curdled. The bowels are either constipated or too loose. The most

prominent and often the only symptoms are this alternation of vomiting

and an eager desire to take the breast, associated with loss of flesh

and strength. The child is evidently not nourished by the food it takes,

and if relief be not afforded it sinks, and dies from starvation in the

course of a month or two.

Children who are _weaned abruptly, and at a very early period_, are

liable to a serious form of indigestion, which may come on in a few days

after weaning, or not for several weeks.

Older children are liable to slight attacks of indigestion, which are

attended with vomiting or purging, or both, for a few days, when the

stomach recovers its health. In some cases, however, the derangement

continues longer, the child then losing its appetite, and suffering from

colic, and becoming fretful, pale, and weak. The breath becomes sour,

and the passages green. Such cases require careful watching and

treatment, especially during the hot weather of the summer.

In infants at the breast indigestion is usually caused by giving the

breast too often or by an excess or change in the quality of the milk.

Errors in diet on the part of the mother, and other faults which we have

pointed out in our chapter on nursing, are the most frequent causes of

this ailment. In children who are weaned the causes are almost

invariably improper food or food taken too frequently, or in too large

quantities. The hint should be taken when a child rejects its food, to

change it, or give it less. Instead of this, too frequently the child is

urged to take more, and thus derange the stomach.

The _treatment_ of indigestion in childhood is usually easy and

satisfactory. The first thing is to look to and regulate the quantity

and quality of the food. If it be due to excess of food, this is easily

remedied. If due to improper quality, change it promptly. When the

mother's health is such that her milk is found to frequently or

constantly disagree with her child, a suitable wet-nurse must be

procured.

In most cases the attack is mild, and readily yields to a few hours'

abstinence from food. As it often happens, especially in

artificially-fed infants, that the gastric juice is more acid than it

should be, great benefit is derived from the use of _precipitated chalk

or carbonate of soda_. A few grains of either of these, given several

times a day for a few days, will be found to effect a surprising change

and alone restore the appetite and digestion.

In older children an attack of indigestion should be the signal for

putting them upon a simpler and more restricted diet for a time. Milk,

eggs, arrowroot, tapioca, sago, panada, &c., are better than animal

food. If the child becomes much weakened, jellies, chicken, lamb,

mutton, or oyster broth, beef tea, or wine whey, should be given to

check the tendency to exhaustion.

We repeat, that most cases of indigestion in infants and children yield

promptly to an immediate change in the diet, without medicine.

HINTS ON HOME GOVERNMENT.

On this subject, as it may be regarded as outside of our domain of

hygiene, we have but few words to say. We wish, however, in the

interests of medicine and hygiene, to insist upon the necessity of

training children to prompt, implicit obedience to the parental voice.

As physicians, we have seen the spoilt, undisciplined child, when sick,

rebellious alike to persuasion and command, refusing food and medicine,

revolting against the slightest examination, and by its violence and

capriciousness, converting a slight illness into a dangerous one. For a

child unaccustomed to obedience there is no proper treatment possible

when sick; nor when well is there any proper care possible for the

preservation of the health. What it wants, and not what it ought to

have, is given it, and every one knows that a child's instincts are no

guide to health. With health, happiness is sacrificed also. There is no

surer way of making a child miserable than by accustoming it to obtain

all it wishes, and to encounter no will but its own. Its desires grow by

what they feed upon. As a French writer on education has well expressed

it: 'At first it will want the cane you hold in your hand, then your

watch, then the bird it sees flying in the air, and then the star

twinkling overhead. How, short of omnipotence, is it possible to gratify

its ever-growing wants?' Accustom the child to hear 'no' and 'must,' but

let these hard words be softened by voice and manner--an art in which

every true mother excels.

But, on the other hand, do not harass the child by needless

restrictions, nor worry it by excess of management. We desire to call

attention here to the words of an eminent English divine and learned

writer, Archbishop Whately:--

'Most carefully should we avoid the error which some parents, not

(otherwise) deficient in good sense commit, of imposing gratuitous

restrictions and privations, and purposely inflicting needless

disappointments, for the purpose of inuring children to the pains and

troubles they will meet with in after life. Yes; be assured they _will_

meet with quite _enough_ in every portion of life, including childhood,

without your strewing their paths with thorns of your own providing. And

often enough you will have to limit their amusements for the sake of

needful study, to restrain their appetites for the sake of health, to

chastise them for faults, and in various ways to inflict pain or

privations for the sake of avoiding some greater evils. Let this always

be explained to them whenever it is possible to do so; and endeavor in

all cases to make them look on the parent as never the _voluntary_ giver

of anything but good. To any hardships which they are convinced you

inflict reluctantly, and to those which occur through the dispensation

of the All-wise, they will more easily be trained to submit with a good

grace, than to any gratuitous sufferings devised for them by fallible

man. To raise hopes on purpose to produce disappointment, to give

provocation merely to exercise the temper, and, in short, to inflict

pain of any kind, merely as a training for patience and fortitude--this

is a kind of discipline which man should not presume to attempt. If such

trials prove a discipline not so much of cheerful fortitude as of

resentful aversion and suspicious distrust of the parent as a capricious

tyrant, you will have only yourself to thank for the result.' It is a

matter of common observation that those who complain of their fortune

and lot in life have often to complain only of their own conduct. The

same is true of those who complain of their children. They have

themselves only to blame in each case.

Parents who do not appreciate the responsibilities of their position

usually err on the side of over-indulgence to their children; on the

contrary, those fully alive to the importance of home discipline often

err on the side of over-regulation. To the latter, we commend the reply

of an old lady to the anxious inquiry made by the mother of a too

rigorously disciplined child as to what course should be pursued, 'I

recommend, my dear, a little wholesome neglect.'

Lessons of truthfulness; of fortitude in bearing pain and

disappointment; of the duty of right doing, because it is right and not

because it is the best policy; of frugality and industry; of

self-denial, contentment, and charity, should be early impressed upon

the plastic mind of infancy. We wish also, in this connection, to quote

the words of a wise physician and observer of men, that 'the little

child who is brought up to repeat short and simple prayers at his

mother's knees, has a rule of conduct thereby instilled into him which

will probably never be forgotten; and, in after life he may not only

look back to these beginnings with feelings of reverence and love, but

the recollection of them may serve to strengthen him in some good

resolution, and help him to resist many a powerful temptation.'

We have had occasion frequently in various parts of this work to point

out the intimate relations which exist between the physical and mental

nature of parents and their offspring. Like parent, like child. The same

close connection and sympathy extends to the moral and religious

character; hence that direction and training which relies largely upon

the _force of parental example_ is the most effective method of home

government. Virtuous precepts, or rigidly enforced rules of conduct,

avail little unless the parent keeps the path to which he points the

child.

'Well, upon my word, Mrs. Primrose, you have the handsomest children in

the whole country.' 'Ah! neighbor,' replied the wife of the Vicar of

Wakefield, 'they are as heaven made them--handsome enough if they be

good enough--handsome is that handsome does.'

IS THE RACE DEGENERATING?

This is a question which perplexes some minds in our times. A German

author of note has recently written a volume to prove that each

generation is feebler than the preceding. Old physicians say that in

their youth diseases of exhaustion were rarer than now-a-days. For this

our habits of life, the pressure on our nervous systems, the prevalence

of hereditary diseases, and the excessive use of narcotics and

stimulants, are held responsible. 'The fathers,' say these croakers,

'have eaten sour grapes, and the children's teeth are set on edge.'

We attach little weight to these gloomy views. There are plenty of facts

on the other side. The suits of old armour still preserved in our

museums prove that, as a rule, we have slightly gained in weight and

size. Tables of life insurance companies and reports of statistics show

that the average length of human life is greater than it ever was. Dr.

Charles D. Meigs used to state in his lectures that the size of the head

of American infants at birth is somewhat greater than in the Old World.

That there are more numerous diseases than formerly, is not true; but it

is true that we know more, for we have learned to detect them more

readily and to examine them more minutely. This is especially true of

such as are peculiar to women. Within the last ten or twenty years so

much that is of sovereign importance has been contributed to this

department of medical science, that it is hardly possible for one to

become an expert in it unless he gives it his whole attention.

To avoid the tendency to debilitated frames and chronic diseases, woman

should therefore learn not only the laws of her own physical life, but

the relations in which she stands to the other sex. Thus she can guard

her own health, and preserve her offspring from degeneracy. It is only

by enlightenment, and the extension of knowledge on the topics relating

to soundness of body and mind, that we can found rational hopes of a

permanent and wide-spread improvement of the race.

Some have maintained, not understanding the bearing of the facts, that

such degeneracy is more conspicuous in the frame of woman than anywhere

else. They quote the narratives of travellers, who describe with what

fortitude--we might almost say with what indifference--the Indian women,

and those of other savage races, bear the pangs of childbirth, and how

little the ordeal weakens them. A squaw will turn aside for an hour or

two when on the march, bear a child, wash it in some stream, bind it on

the top of her load, and shouldering both, quietly rejoin the vagrant

troop. Our artificial life seems indeed, in this respect, to be to

blame; but if we look closer, we can learn that these wild women often

perish alone, that they are rarely fertile, that unnatural labors are

not unknown, and that the average duration of their life is decidedly

less than among the females in civilised States.

HEALTH IN MARRIAGE.

_THE PERILS OF MATERNITY._

In the early part of this work we quoted some authorities to show that

those women who choose single life as their portion do not escape the

ills of existence, nor do they protract their days, but, on the

contrary, as shown by extensive statistics, are more prone to affections

of the mind, and die earlier. While, therefore, nature thus rewards

those who fulfil the functions of their being, by taking part in the

mysterious processes of reproduction, and perpetuating the drama of

existence, it is true also that she associates these privileges with

certain deprivations and suffering. We do not wish to throw around the

married state any charms which are not its own. Rather is it our aim to

portray with absolute, and therefore instructive, fidelity all that this

condition offers of unfavorable as well as favorable aspects.

Let us say at once, maternity has its perils,--perils as peculiar and as

inevitable as those which pertain to single life. Our present purpose is

to mention these, and by stating their nature and what are their causes,

so far as known, to put married women on their guard against them. Some

are almost trifling, at least not involving danger to life; others most

harassing to the sufferer and to her friends.

We shall now consider the principal diseases to which married women are

exposed from pregnancy, from childbirth, and from nursing.

DISEASES OF PREGNANCY.

In treating of pregnancy we have pointed out that it was a healthy and

happy condition to most women. The exceptional cases are mainly those in

which the health is injured by mental trouble or anxiety. Thus the young

and delicate girl newly married is full of vague alarms in regard to the

pains and dangers of her untried path to maternity. She frets herself

and embitters her life during those months in which tranquility is of

the utmost importance. Is it surprising, then, that her health should be

disordered, and that she should suffer from some of the diseases

incident to the pregnant state?

Again, the mother of a large family, but the mistress of a small income,

is distressed by the thought of additional expense, which it seems to

her, particularly in her nervous state, impossible to meet. This

condition of protracted anxiety is ill fitted to enable her to resist

any tendency to disease to which she may be exposed. Indeed, prolonged

vexation from these and other causes not unfrequently tend to _puerperal

mania_ (a disease of which we shall shortly have something to say), or

to some other nervous affection.

The wife during pregnancy should therefore be treated with unusual

kindness by those about her, and every attempt made to soften her lot.

The erroneous impression prevails among some that the pregnant wife

should enure herself to toil and hardship. This notion is doubtless due

to the observation that domestic animals that are subjected to a life of

labor bring forth their young with little suffering. 'The cow in the

country farm living unfettered in the meadow until the day of calving,

has in general a safe and easy labor. The poor beast, on the contrary,

which is kept in a town dairy, has a time so incredibly dangerous that

the proprietor generally sells off his stock every year, and replaces it

with cows in calf; such cows not being put into the stalls till within

six or eight days of the expected period of labor. The deduction from

this is that an artificial mode of life--a life maintained by improper

food, and without a sufficient supply of pure air, or a due amount of

exercise--has a most deleterious influence upon the process of labor;

and not that a toilsome existence, embittered with all the pains and

anxieties of poverty, gives comparative immunity from danger in the hour

of childbirth.' One of the discomforts of pregnancy is--

MORNING SICKNESS.

This affection, when confined, as is usually the case, to the morning

and early part of the day, rarely requires much medical care. Its

absence, which, as we have said, is a frequent cause of miscarriage, is

more to be regretted than its presence especially as it is apt to be

replaced by more serious troubles.

Relief will be afforded by washing the face and hands in cold water, and

taking a cup of milk or a little coffee and a biscuit or sandwich,

_before raising the head from the pillow_ in the morning, remaining in

bed about a quarter of an hour after this early meal; then dressing

quickly, and immediately going out for a half-hour's walk. Rest in a

half-recumbent posture during the day, particularly after meals, is

beneficial. The affection is mostly a nervous one, and is best combated

by eating. The food should be plain and unirritating, but nutritious,

and should be taken frequently, in small quantities at a time.

When the nausea and vomiting are excessive, and continue during the day,

there is generally some disordered condition of the digestive apparatus.

This may be corrected by taking at night a tea-spoonful of the

confection of senna, a pleasant preparation of this ordinarily

disagreeable medicine, and by drinking three times a day, before each

meal, a wine-glassful of a tea made with columbo. Half an ounce of

powdered columbo should be added, for this purpose, to a pint of boiling

water.

Dr. John H. Griscom of New York recommends the bromide of potassium,

which is a harmless medicine for domestic practice, as affording the

most useful means of arresting the nausea attendant on pregnancy.

The following prescription may be compounded by any druggist, and will

often be found very effective:

Take of Bromide of Potassium, two drachms,

Cinnamon water, three fluid ounces.

Of this a dessert spoonful may be taken two or three times a day. It may

be used with confidence as an entirely safe and harmless remedy in this

troublesome affection.

A prescription frequently ordered for the nausea of pregnancy by the

late distinguished Dr. Meigs, consisted of equal parts of sweet tincture

of rhubarb and compound tincture of gentian--a dessert spoonful to be

taken after meals.

_Pain in the abdomen_, caused by the distension of its walls, may be

relieved by the application of equal parts of sweet oil and laudanum.

Another common and annoying, but rarely dangerous, trouble during

pregnancy is--

VARICOSE VEINS.

The veins of the legs become distended, knotted, and painful. Women who

have borne a number of children suffer most from this affection. It

seldom attacks those passing through their first pregnancies. It

ordinarily first shows itself during the second pregnancy, and becomes

rapidly worse during the third or fourth.

Although it is difficult to cure this disease during the continuance of

the pregnancy, much can be done to prevent its occurrence, and to

relieve it when present. Tight garters worn below the knee, and closely

laced corsets, tend to cause and increase this swollen condition of the

veins. Neither should be used during pregnancy.

Relief is best afforded to the suffering parts by means of a well-made

and adjusted _elastic stocking_, which may be readily procured from a

druggist or surgical instrument maker. In severe cases it may be

necessary for the patient to keep herself as much as possible in the

recumbent position on the bed or sofa. In all cases the feet should be

supported when seated, so as to keep the blood from further distending

the already swollen veins.

PILES.

That painful condition of the veins of the lower bowel known as

hæmorrhoids, or piles, is a not unfrequent annoyance to pregnant women.

Sometimes it is caused by prolonged constipation. During the period of

pregnancy, therefore, constipation should be guarded against.

Ordinarily the piles are small, and of little consequence beyond the

slight uneasiness they occasion. The trifling loss of blood from them is

of no account, and often beneficial. The case is different, however,

when the piles are large and painful, and give rise to much pain and

copious bleeding. They then require prompt treatment.

In the _treatment_ of piles the first point to be aimed at is to keep

the bowels moderately open. It must not be forgotten, however, that

during pregnancy only the mildest of purgatives are ever to be given.

Castor oil, although a disagreeable, is a most excellent prescription in

these cases. A small dose, repeated when necessary, will be found to

act most kindly. If this remedy be too repugnant to the patient, small

quantities of citrate of magnesia, or of cream of tartar, or of some of

the natural mineral waters, may be employed. Small injections of

lukewarm water are also of great service, and may be tried instead of

laxatives.

After every movement the parts should be well sponged with cold water,

and an ointment of galls and opium, procured from the druggist, applied.

If the parts become very much inflamed, warm poultices or hot chamomile

solutions should be used, and the patient kept in bed until the

inflammation subsides.

No attempt is to be made to effect the radical cure of piles during

pregnancy. Any such attempt, besides being dangerous, is unnecessary,

for the piles usually disappear of their own accord after the

confinement. Every effort to make the sufferer more comfortable in the

manner we have suggested is, however, right and safe.

DIARRHOEA.

Some women always suffer from looseness of the bowels during pregnancy;

others are very liable to attacks of it during this period, either

coming on without any assignable cause or easily excited by any slight

indiscretion in eating. In many instances these attacks alternate with

constipation or with morning sickness.

The diarrhoea, if at all severe or prolonged, should not be allowed to go

on unchecked, for it quickly weakens the patient and predisposes her to

abortion. The foetus is especially endangered when the passages are

attended with much bearing-down pain. In some exceptional cases,

however, a slight diarrhoea seems to be beneficial, for every attempt to

remove it appears to do harm; but these instances are very rare.

The _treatment_ required is a simple, and must be a cautious one.

Ordinarily no medicine will be needed. If the patient will merely

confine herself to milk and arrowroot and rice for twenty-four hours a

cure will be effected in mild cases. When it is apparent that the attack

has been caused by improper food, a table-spoonful of castor-oil or a

tea-spoonful or two of tincture of rhubarb will remove the offending

material in the bowels, upon the presence of which the diarrhoea depends.

A small injection of a tea-spoonful of rice water and thirty or forty

drops of laudanum will often speedily arrest the excessive discharges,

and relieve the pain.

CONSTIPATION.

No woman while pregnant should allow several days to elapse without a

movement from the bowels. The symptoms of constipation, slight at the

outset, soon cause great inconvenience. Among the effects, which, sooner

or later, show themselves, may be feverishness, sleeplessness, headache,

distressing dreams, sickness at the stomach, severe bearing-down pains,

and piles.

Medicines are rarely required in the treatment of constipation, and the

pregnant woman should never take an active purgative, excepting under

medical advice. Outdoor exercise and regularity in soliciting nature's

calls, together with a change in the diet, will usually have the desired

effect. Brown bread, wheaten grits, oatmeal gruel, ripe fruits, fresh

vegetables, stewed prunes, or prunes soaked in olive oil, baked apples,

figs, tamarinds, honey, and currant jelly, are all laxative articles

which should be tried.

In some instances a tumbler of cold water drunk the last thing at night,

and another the first thing in the morning, will act in a most

satisfactory manner. If the constipation should resist these safe and

homely remedies, which will rarely be found the case, then medical

assistance should be called in. On no account should the wife herself,

or in accordance with the counsel of any non-medical friend, resort to

purgative drugs.

COUGH.

A troublesome cough sometimes affects delicate, nervous women during the

early months of pregnancy. If it be not very frequent nor severe, it

requires no attention, as it will pass away of itself in a short time.

When, however, it disturbs the sleep at night, renders the patient

anxious, and causes headache and weariness, it is time to do something

for it. It may, indeed, be so violent as to threaten abortion on account

of the forcible concussion of the abdomen it produces.

A tea-spoonful of paregoric occasionally repeated during the day will be

found a most efficient soothing remedy.

WAKEFULNESS.

Sleeplessness, always distressing, is particularly so to pregnant women.

If prolonged, it leads to serious consequences. It should receive,

therefore, the most prompt attention.

The _causes_ of sleeplessness during pregnancy are numerous. Dyspepsia

is one of them. Whenever indigestion is present the diet should be plain

and simple, and everything avoided which produces heartburn, sourness,

or flatulency. It is important also not to take tea or coffee late in

the afternoon or evening--a late cup of either being a frequent cause in

itself of sleeplessness.

Sometimes the reason for the wakefulness will be found in a want of

exercise or too constant confinement to closely-heated rooms. Or, it may

be that exciting novels are read late in the evening. Perhaps the

evening meal is too heavy and taken too late.

The _treatment_ of sleeplessness consists first, of course in the

removal of the apparent cause. The patient should have a regular hour

for retiring, which should be an early one. The bed-room should be

quiet, well ventilated, and slightly warmed. The bed coverings must not

be too heavy nor the pillows too high.

A warm bath of the temperature of 90 to 96 degrees Fahrenheit, taken

just before going to bed, often invites sleep. A rapid sponging of the

body with warm water may have the same effect. A tumbler of cold water,

when the skin is hot and dry, swallowed at bed-time, sometimes affords

relief. If the bowels are constipated relief should be sought in the

manner we have just mentioned in speaking of constipation.

When there is nervous excitement at night, and the means we have advised

fail to propitiate 'nature's soft nurse,' there is a sedative medicine

which may be used with safety and effect--it is bromide of potassium.

The same proportion which we have given for the treatment of morning

sickness (see page 355) may be now used. Have the three-ounce mixture

put up by the druggist, and take a dessert-spoonful or a table-spoonful

just before bed-time. It frequently acts almost as if by magic. On no

account should recourse be had to opiates or dangerous sedative drugs.

DISEASES OF CHILDBED.

Childbirth being a healthful physiological condition, is usually neither

attended nor followed by mischievous results. Occasionally, however, the

mother suffers in consequence of the prolonged or difficult character of

her labor. The longer the labor the greater the danger to both mother

and child. Thus childbirth pangs prolonged beyond twenty-four or

thirty-six hours are much more apt to be attended with danger or

followed by disease than those terminated within a few hours.

The following aphorisms were laid down by the late distinguished

Professor James Y. Simpson, namely:--

The mother is more liable to suffer under diseases of the womb after

long than after short labors. The child for some time after birth is

more liable to disease and death, in proportion as the labor has been

longer in its duration. First labors are longer in duration than

subsequent ones, and in a proportionate degree more complicated and

dangerous to mother and child. Male births are longer in duration than

female births, and in a proportionate degree more complicated and

dangerous to mother and child.

Many tedious confinements, however, are happily terminated without the

slightest injury to mother or child. Whenever the labor has been

unusually prolonged, unusual care and caution should be exercised in the

treatment of the mother and infant for many weeks after the event.

One of the most distressing affections to which women are exposed from

childbirth is

PUERPERAL MANIA.

This is a variety of insanity which attacks some women shortly after

childbirth, or at the period of weaning a child. The period of attack is

uncertain, as it may manifest itself first in a very few days, or not

for some months after the confinement. Its duration is likewise very

variable. In most instances a few weeks restore the patient to herself;

but there are many cases where judicious treatment for months is

required, and there are a few where the mental alienation is permanent,

and the wife and mother is never restored to her sanity.

The question has been much discussed, Whether such a condition is to be

imputed to a hereditary tendency to insanity in the family, and also

whether a mother who has had such an attack is liable to transmit to

her children, male or female, any greater liability to mental disease.

We are well aware what deep importance the answers to these inquiries

have to many a parent; and in forming our replies, we are guided not

only by our own experience, but by the recorded opinion of those members

of our profession who have given the subject close and earnest

attention. To the first query, the reply must be made that in one-half,

or nearly one-half, of the cases of this variety of insanity there is

traceable a hereditary tendency to aberration of mind. Usually one or

more of the direct progenitors, or of the near relatives of the patient,

will be found to have manifested unmistakable marks of unsoundness of

mind. In the remaining one-half cases no such tendency can be traced,

and in these it must be presumed that the mania is a purely local and

temporary disorder of the brain. The incurable cases are usually found

in the first class of patients, as we might naturally expect.

The likelihood of the children, in turn, inheriting any such

predisposition, depends on the answer to the inquiry we first put. If

the mania itself is the appearance of a family malady, then the chances

are that it will pass downward with other transmissible qualities. But

if the mania arise from causes which are transitory, then there is no

ground for alarm.

An inquiry still more frequently put to the physician by the husband and

by the patient herself after recovery, is, Whether an attack at one

confinement predisposes her to a similar attack at a subsequent similar

period. There is considerable divergence of opinion on this point. Dr.

Gooch, an English physician of wide experience, is very strenuous in

denying any such increased likelihood, while an American obstetrician of

note is quite as positive in taking the opposite view. The truth of the

matter undoubtedly is, that where the mania is the exhibition of

hereditary tendency, it is apt to recur; but where it arises from

transient causes, then it will only occur again if such causes exist.

THE IMPORTANCE OF PREVENTION.

Here, therefore, we perceive the importance of every woman, who has had,

or who fears to have, one of these distressing experiences, being put on

her guard against disregarding those rules of health the neglect of

which may result so disastrously. One of the most powerful of these

causes is _exhaustion_. We mean this in its widest sense, mental or

physical. In those instances where mania appears at weaning, it is

invariably where the child has been nursed too long, or where the mother

has not had sufficient strength to nourish it without prostrating

herself. It should be observed as a hygienic law, that no mother should

nurse her children after she has had one attack of mania. The mere

nervous excitement is altogether too much for her. She must once and for

ever renounce this tender pleasure. We even go so far as to recommend

that no woman in whose family a mental taint is hereditary shall nurse

her children.

Anxiety, low spirits, unusual weakness from any cause, are powerful

predisposing causes; and therefore in all cases, especially in those

where the family or personal history leads one to fear such an attack,

they should be avoided. The diet should be nourishing and abundant, but

not stimulating. Cheerful society and surroundings should be courted,

and indulgences in any single train of ideas avoided. As for directions

during the attack, they are unnecessary, as to combat it successfully

often tasks the utmost skill of the physician; and it will be for him to

give these directions.

WHITE-FLOWING.

This affection, though not confined to married women, is quite common

during pregnancy and after confinement. There are few married women who

pass through their lives without at some time or other having suffered

from it.

We will consider first that _form of white discharge which affects

pregnant women_. It ordinarily comes on during the latter half of

pregnancy. Not only does it occasion much inconvenience, but it may,

when copious, seriously weaken the system and impair the health.

The best treatment consists in a regulated, but supporting, diet without

stimulants, the avoidance of all marital relations, plenty of rest in

bed or on a sofa, a warm hip bath every morning, and the use of

injections. One of the best injections for this purpose is made by

adding a table-spoonful of lead-water to a pint of water, and injecting

the whole twice a day, by means of a rubber, hard-ball syringe. As this

solution will stain the body-linen, due precautions should be taken.

Instead of this injection, a small tea-spoonful of alum dissolved in a

pint of water and injected once a day may be used.

We will now say a few words upon the _form of white-flowing which

affects women after childbirth_. It is a common result of too frequent

confinements or of successive abortions. In women of a tendency to

consumption it has been observed that white-flowing is more apt to arise

in connection with child-bearing. Prolonged nursing, resulting in great

debility of the mother, often produces very profuse white discharges.

In warm countries this affection is much more frequent than elsewhere.

Moist and damp climates are said also to render women particularly prone

to it.

The _treatment_ must have regard to the general health of the patient.

The mode of life must be regulated. A change of scene, if it can be

procured, is often of the greatest benefit. Baths are also very useful.

They may be taken in the form of a 'sponge bath,' or 'hip bath.' If the

former be preferred, the patient should every morning, in a warm room,

sponge the whole body, at first with tepid water and, after a time, with

cold, the skin being well dried and rubbed with a coarse towel. The

hip-bath may be employed either of simple, or of salt, or of medicated

water. It should be at first warm, and afterwards cold. The skin is to

be well rubbed after the hip as after the sponge-bath. The hip-bath may

be medicated with three or four table-spoonfuls of alum, or with a

quarter of a pound of common household soda.

In connection with this treatment, injections should be employed in the

manner just directed for the white-flowing of pregnancy.

MILK-LEG.

This affection usually appears about ten days or two weeks after

confinement. The first symptoms which show themselves are general

uneasiness, chills, headache, and a quickened pulse. Then pains in the

groin, extending down the thigh and leg of that side are complained of.

Soon the whole limb becomes enlarged, hot, white, and shining.

Feverishness and sleeplessness now naturally show themselves.

The disease rarely lasts more than two or three weeks, although the limb

remains stiff, perhaps, for a number of weeks longer. It is painful, but

not dangerous--rarely proving fatal.

When one leg is recovering, the disease sometimes attacks the other, and

runs through the same course.

The treatment consists in enveloping the limb in turpentine stupes,

followed by the application of poultices to the groin and a light diet

at first. So soon as the severity of the attack is over, tonics and a

generous diet should be given. The limb is then to be painted with

tincture of iodine, or rather a mixture of one part of the tincture of

iodine with two parts of alcohol, and afterwards wrapped in a flannel

bandage.

The term 'milk-leg' has been applied to this inflammation, for such it

is, from the notion that in some way the milk was diverted from the

breasts to the limb causing the white swelling. It is scarcely

necessary to say this theory is entirely erroneous.

INWARD WEAKNESS.

Many, we may say most, married women whose health is broken down by some

disease peculiar to their sex, refer the commencement of their suffering

to some confinement or premature birth. Perhaps, in four cases out of

five, this breaking down is one of the symptoms of a displacement of the

internal organs,--a malposition, in other words, of the uterus. This is

familiarly known as an 'inward weakness;' and many a woman drags through

years of misery caused by a trouble of this sort.

It is true that these malpositions occur in unmarried women, and

occasionally in young girls. But it is also true that their most

frequent causes are associated with the condition of maternity. The

relaxation of the ligaments or bands which hold the uterus in its place,

which takes place during pregnancy and parturition, predisposes to such

troubles. It requires time and care for these ligaments to resume their

natural strength and elasticity after childbirth. Then, too, the walls

of the abdomen are one of the supports provided by nature to keep all

the organs they contain in proper place by a constant elastic pressure.

When, as in pregnancy, these walls are distended and put on the strain,

suddenly to be relaxed after confinement, the organs miss their support,

and are liable to take positions which interfere with the performance of

their natural functions. Therefore we may rightly place the greater

tendency of married women to this class of diseases among the perils of

maternity.

Within the last fifteen years, probably no one branch of medical science

has received greater attention at the hands of physicians than this of

diseases of women. Many hitherto inexplicable cases of disease, much

suffering referred to other parts of the system, have been traced to

local misfortunes of the character we have just described. Medical works

are replete with cases of the highest interest illustrative of this. We

are afraid to state some of the estimates which have been given of the

number of women in this country who suffer from these maladies; nor do

we intend to give in detail the long train of symptoms which

characterize them. Such a sad rehearsal would avail little or nothing to

the non-medical reader. It is enough to say, that the woman who finds

herself afflicted by manifold aches and pains, without obvious cause;

who suffers with her head and her stomach and her nerves; who discovers

that, in spite of the precepts of religion and the efforts of will, she

is becoming irritable, impatient, dissatisfied with her friends, her

family, and herself; who is, in short, unable any longer to perceive

anything of beauty and of pleasure in this world, and hardly anything to

hope for in the next,--this woman, in all probability, is suffering from

a displacement or an ulceration of the uterus. Let this be relieved, and

her sufferings are ended. Often a very simple procedure can do this. We

recall to mind a case described in touching language by a distinguished

teacher of medicine. It is of an interesting young married lady, who

came from the Southern States to consult him on her condition. She could

not walk across the room without support, and was forced to wear, at

great inconvenience to herself, an abdominal supporter. Her mind was

confused, and she was the victim of apparently causeless unpleasant

sensations. She was convinced that she had been, and still was,

deranged.

The physician could discover nothing wrong about her system other than a

slight falling of the womb. This was easily relieved. She at once

improved in body and mind, soon was able to walk with ease and freedom,

and once more enjoyed the pleasure of life. In a letter written soon

after her return home, she said, 'This beautiful world, which at one

time I could not look upon without disgust, has become once more a

source of delight.' How strongly do these deeply felt words reveal the

difference between her two conditions!

There is one source of great comfort in considering these afflictions.

It is, that they are in the great majority of cases traceable to

CAUSES WHICH ARE AVOIDABLE.

Most of them are the penalties inflicted by stern nature on infractions

of her laws. Hence the great, the unspeakable, importance of women being

made aware of the dangers to which they are exposed, and being fully

informed how to avoid them. This task we now assume.

There is, we concede, a tendency in the changes which take place during

pregnancy and parturition to expose the system to such accidents. But

this tendency can be counteracted by care, and by the avoidance of

certain notorious and familiar infractions of the laws of health. It is

usually not until she gets up and commences to go about the house, that

the woman feels any pain referable to a displaced womb. Very frequently

the origin of it is leaving the bed too soon, or attempting to do some

work, too much for her strength, shortly after a premature birth or a

confinement. Not only should a woman keep her bed, as a rule, for

nineteen days after every abortion and every confinement, but for weeks

after she commences to move about she should avoid any severe muscular

exertion, especially lifting, long walks, straining, or working on the

sewing-machine. Straining at stool is one of the commonest causes. Many

women have a tendency to constipation for weeks or months after

childbirth. They are aware that it is unfavorable to health, and they

seek to aid nature by violent muscular effort. They cannot possibly do a

more unwise act. Necessarily the efforts they make press the womb

forcibly down, and its ligaments being relaxed, it assumes either

suddenly on some one well-remembered occasion, or gradually after a

succession of efforts, some unnatural position. The same reasoning

applies to relieving the bladder, which is connected in some persons

with undue effort.

Constipation, if present, must, and almost always can, be relieved by a

judicious diet, and the moderate use of injections. These simple methods

are much to be preferred to purgative medicines, which are rarely

satisfactory if they are continued for much time. When anything more is

needed, we recommend a glass of some laxative mineral water, which

should be taken before breakfast.

For the difficulty with the bladder we mentioned, diet is also

efficacious. It is familiarly known that several popular articles of

food have a decided action in stimulating the kidneys: for instance,

asparagus and water-melon. Such articles should be freely partaken, and

their effect can be increased by some vegetable infusion, taken

warm,--as juniper-tea or broom-tea. The application to the parts of a

cloth wrung out in water as hot as it can conveniently be borne, is also

a most excellent assistant to nature.

Similar strains on the muscles of the abdomen are consequent on violent

coughing and vomiting. Therefore these should be alleviated, as they

always can be, by some anodyne taken internally. Any medical man is

familiar with many such preparations, so that it seems unnecessary to

give any formula, particularly as it would have to be altered, more or

less, to suit any given case.

OTHER CAUSES OF INWARD WEAKNESS.

Women of languid disposition and relaxed muscles are frequently urged to

'take exercise,' and to 'go to work.' Their condition sometimes excites

censure rather than commiseration, because it is thought that they do

not exert, and thus strengthen, themselves as much as they should. We

are quite as much in favour of work and vigorous muscles as any one. But

often it were the most foolish advice possible to give a woman, to tell

her to seek active exercise. It is just what she should avoid, as it may

ultimately give rise to that very trouble which, now only threatening,

is the cause of her listlessness. Many instances are familiar to every

physician of extensive experience, where a long walk, a hard day's work,

a vigorous dance in the evening, or a horseback ride, has left behind it

a uterine weakness which has caused years of misery. Especially after

confinement or premature delivery it is prudent for a woman to avoid any

such exertion for months and months. Moderate employment of her muscles

in any light avocation, short walks and drives, fresh air, with

judicious exercise,--these are well enough in every instance, but beyond

them there is danger. We know too well that advice like this will sound

like mockery to some who read these lines. They have to work, and work

hard; they have no opportunity to spare themselves; the iron hand of

necessity is upon them, and they must obey. We can but sympathize with

them, and cheer them with the consolation that many a woman has borne

all this and lived to a healthy and happy old age. Nature has surrounded

the infinitely delicate machinery of woman's organization with a

thousand safeguards, but for all that, the delicacy remains; and it is

because so many women are forced to neglect their duties to their

ownselves, that so many thousands walk the streets of our great cities,

living martyrs.

But no. We must modify what we have just written. In justice to our own

sex, and in all truthfulness, we cannot allow the blame to be removed

altogether from women themselves. They alone are responsible for one of

the most fruitful causes of their wretchedness. The theme is a

threadbare one. We approach it without hardly any hope that we shall do

good by repeated warnings utterly monotonous and tiresome. But still

less can we feel comfortable in mind to pass it over in silence. We

refer to the foolish and injurious pressure which is exerted on the

lower part of the chest and the abdomen by tight corsets, belts, and

bands to support the under-clothing; in other words,

TIGHT LACING.

Why it is, by what strange freak of fashion and blindness to artistic

rules, women of the present day think that a deformed and

ill-proportioned waist is a requisite of beauty, we do not know.

Certainly they never derived such an idea from a contemplation of those

monuments of perfect beauty bequeathed to posterity by the chisels of

Attic artists, nor from those exquisite figures which lend to the canvas

of Titian and Raphael such immortal fame. Look, for instance, at that

work of the former artist, now rendered so familiar by the

chromo-lithographic process, called 'Titian's Daughter.' It is the

portrait of a blonde-haired maiden holding aloft a trencher heaped with

fruits. She turns her face to the beholder, leaning slightly backward to

keep her equilibrium. Her waist is encircled by a zone of pearls; and it

is this waist we would have our readers observe with something more than

an æsthetic eye. It is the waist of health as well as beauty. Narrower

than either the shoulders or the hips, it is yet anything than that

'wasplike waist,' which is so fashionable a deformity. With such a

waist, a woman is fitted to pass through her married state with health

and pleasure. There is little fear that she will be the tenant of

doctors' chairs, and the victim of drugs and instruments. Let women aim

at beauty, let them regard it as a matter of very high importance, worth

money and time and trouble, and we will applaud them to the echo. But

let them not mistake deformity, vicious shape, unnatural and injurious

attitudes, and hurtful distortions for beauty. That not only degrades

their physical nature, but it lowers their tastes, and places them in

æsthetics on a level with the Indian squaw who flattens her head and

bores her nose, and with the Chinese woman who gilds her teeth, and

compresses her foot into a shapeless mass. True beauty is ever

synonymous with health; and the woman who, out of subservience to the

demands of fashion, for years squeezes her waist and flattens her

breast, will live to rue it when she becomes a mother. Away, then, with

tight corsets and all similar contrivances.

Of a similar objectionable character are many of the devices which

ignorant men connected with the medical profession urge upon the public

for the sake of remedying curvature of the spine, restoring the figure,

or supporting the abdomen. Not a few of such braces and supporters are

seriously dangerous. A good brace, well-fitting, carefully adjusted,

suited to the particular case, is often of excellent service; but the

majority of them do not answer this description. Our advice is, that no

girl, and still more no mother, should wear one of these without it is

fitted upon her by an experienced hand. We have known more than one

instance where the binder put on after childbirth has been wrongly

placed, and pinned so firmly that it has resulted in producing falling

of the womb. This, too, should be sedulously looked after.

All these are causes which are strictly under the control of the woman

herself. They are therefore such as she should have in mind and be on

her guard against. There are others, but they are less frequent, which

are beyond her power; and it would be labor lost, therefore, for us to

mention them.

Equally vain would it be for us to speak of the various means by which

difficulties of this nature are removed. Probably no one branch of

medical surgery has been more assiduously cultivated than this; and the

number of supporters, pessaries, braces, and levers which have been

recently brought before the medical profession for this purpose is

simply appalling. There are women and men who make it their business to

carry them through the country and sell them on commission. We

distinctly warn our readers against this class. They are almost

invariably ignorant and unscrupulous, rich in promises, and regardless

of performances. She who patronizes them will be sure to lose her money,

and will be lucky if she does not forfeit her health also.

The most we shall do is to give some advice how to treat such complaints

on principles of hygiene. And indeed this means nearly one-half the

battle. For without these simple cares, treatment of any kind is

useless, and sure to fail; and with them, many complaints are remedied

as well as avoided.

THE HYGIENIC TREATMENT OF INWARD WEAKNESS.

The first point we would urge is, that the woman who finds herself thus

afflicted should seek to have such a position that she can _rest_. If

she is burdened with family cares, let her, if possible, diminish or

escape them for a time. A rest of a month or two, not at a fashionable

watering-place, nor at a first-class hotel in some noisy city, but in

quiet lodgings, or with some sympathizing friend, will be of great

advantage. This she should obtain without travelling too far. Prolonged

motion in railway carriages is in every instance injurious. If it must

be undertaken, for instance, in order to consult a qualified physician

or to reach some friends, the modern appliances of comfort, such as

air-cushions, foot-rests, and head-supports, should be provided. They

cost but little, and to the invalid their value is great. No such

journey should be undertaken at or near the time when the monthly

illness might come on, as the suffering is always greater at these

periods.

The pleasant associations which group themselves around a _happy home_

are an important element in the treatment of diseases which, like these,

are so intimately connected with the mind and nervous system. It will

not do heedlessly to throw such advantages away. When the home _is_

pleasant, and rest can there be had, the patient, in the majority of

instances, will do well to abide there. But when this is not the case,

for any reason, be it domestic infelicities, in which the husband has a

share,--be it disagreeable relatives, or importunate and tedious

visitors,--then the sooner such a mental weight is removed or avoided

the better.

The _diet_ is a very common subject of error. It is popularly supposed

that everybody who is weak should eat a 'strengthening' diet,--meat

three times a day,--eggs, ale, and beef-tea to any extent. This is a

great error. Frequently such a diet has just the contrary effect from

what is expected. The patient becomes dyspeptic, nervous, and more

debilitated than ever. The rule is, that only that diet is strengthening

which is thoroughly digested, and taken up in the system. Frequently, we

may say in the majority of cases, a small amount of animal food,

especially game, fowls, fish, and soups, with fresh vegetables, and ripe

fruits, will be far more invigorating than heavier foods. Pastry, cakes,

and confectionery should be discarded, and great regularity in the hours

of meals observed. Stimulants of all kinds are, as a rule, unnecessary,

and highly spiced food is to be avoided. There is an old German proverb

which says, 'Pepper helps a man on his horse, and a woman to her grave.'

This is much too strong; but we may avail ourselves, in this connection,

of the grain of truth that it contains.

_Cleanliness_, in its widest sense, is an important element in the

treatment. Not only should the whole surface of the body be thoroughly

washed several times a week, but the whole person should be _soaked_ by

remaining in the water for an hour or more. This has an excellent

effect, and is far from unpleasant. It was regarded in the days of

ancient Rome as such a delightful luxury, and such a necessity, indeed,

that every municipality erected public bathing establishments, with

furnaces to heat the water to such a temperature that persons could

remain in it for several hours without inconvenience.

The use of public baths is almost unknown in this country; but, in place

of them, every modern house of even moderate pretensions has its own

bath-room, so that the custom of cleanliness might appear to be hardly

less general among all classes than in old Rome.

The difficulty is, that so few people appreciate that to thoroughly

cleanse the skin, still more for the bath to have a medicinal effect, it

must be prolonged far beyond the usual time we allow it. The European

physicians, who, as a rule, attach much greater importance to this than

ourselves, require their patients to remain immersed two, three, four,

and occasionally even ten or twelve hours daily! This is said to have

most beneficial results; but who would attempt to introduce it in this

country?

Local cleanliness is of equal importance. This is obtained by means

of----

INJECTIONS AND IRRIGATIONS

of simple water, or of some infusion or solution. The use of the syringe

as an article of essential service in preserving the health of married

women should never be overlooked. Even when they are aware of no

tendency to weakness or unusual discharge, it should be employed once or

twice a week; and when there is debility or disease of the parts

actually present, it is often of the greatest service.

There are many varieties of female syringes now manufactured and sold,

some of which are quite worthless. Much the most convenient, cleanly,

and efficient is the self-injecting india-rubber syringe, which is

worked by means of a ball held in the hand, and which throws a constant

and powerful stream. They come neatly packed in boxes, occupying small

space, and readily transported from place to place. Much depends on

knowing how to apply them. The patient should be seated on the edge of a

low chair or stool with a hard seat, immediately over a basin. The tube

should then be introduced as far as possible without causing pain, and

the liquid should be thrown up for five or ten minutes. About one or two

quarts may be used of a temperature, in ordinary cases, a little lower

than that of the apartment. Water actually cold is by no means to be

recommended, in spite of what some physicians say to the contrary. It

unquestionably occasionally leads to those very evils which the

judicious use of the syringe is intended to avoid.

No fluid but water should be used in ordinary cases. When, however,

there is much discharge, a pinch of powdered alum can be dissolved in

the water; and when there is an unpleasant odor present, a sufficient

amount of solution of permanganate of potash may be added to the water,

to change it to a light pink color. This latter substance is most

admirable in removing all unpleasant odors; but it will stain the

clothing, and must on that account be employed with caution.

We will add a few warnings to what we have just said about injections.

There are times when they should be omitted,--as for instance during the

periodical illness, when the body is either chilled or heated, and

generally when their administration gives pain. There are also some

women in whom the mouth of the womb remains open, especially those who

have borne many children. In such cases, the liquid used is liable to be

thrown into the womb itself, and may give rise to serious troubles.

These should either omit the use of the syringe altogether, or obtain

one of those which throw the water backward and not forward. This

variety is manufactured and sold by various dealers.

_Irrigations_ are more convenient in some respects than injections. They

are administered in the following manner:--A jar holding about a gallon

of water, simple or medicated, as may be advisable, is placed upon a

table or high stand. A long india-rubber tube is attached to the bottom

of the jar, ending in a metallic tube, and furnished with a stopcock.

The patient seats herself on the edge of a chair over a basin,

introduces the tube, and turns the stopcock. The liquid is thus thrown

up in a gentle, equable stream, without any exertion on her part. No

assistant is required, and the force and amount of the liquid can be

exactly graduated by elevating or lowering the jar, or by turning the

stopcock. When there is much debility, or when it is desirable to apply

the liquid for a long time, this method is much preferable to syringing.

The necessary apparatus can readily be obtained in any large city. It

has, however, the drawback that the jar is large, and not convenient to

carry on journeys.

We shall close this chapter on Health in Marriage by a few words on some

of the _ailments to which mothers are subject while nursing._

GATHERED BREASTS.

Gathering of the breasts may occur at any time during the period of

nursing, but it is most frequently met with within the first three

months after childbirth, and is more common after the first than after

subsequent confinements. All women are more or less liable to it, but

those who are weakly, and particularly those who are scrofulous, are

most prone to its attacks.

The _causes_ of inflammation of the breast are numerous. It may be

created by a blow or fall, by a cold, by mental excitement, by

indiscretions in eating or drinking, and by moving the arms too much

when the breasts are enlarged, but its most common cause is undue

accumulation of milk in the breasts. Dr. Bedford is of the opinion that

in nineteen cases out of twenty it is the result of carelessness--of

neglect in not having the breasts properly drawn. 'For example, the

child may be delicate, and not able to extract the milk; or the nurse,

in the gratification of some ancient prejudice derived from a remote

ancestry, does not think it proper to allow the infant to be put to the

breast for two or three days after its birth. In this way, the milk

ducts become greatly distended, inflammation ensues, which, if not

promptly arrested, terminates in suppuration.'

Often the love of pleasure brings with it this punishment to the nursing

mother who neglects her maternal duties. During an evening spent in

society or at the theatre the breasts cannot be relieved in the manner

required for the preservation of their health.

Soreness of the nipples, which renders suckling painful, often leads the

mother to avoid putting the child to the breast as often as she should.

It is only when forced by the pain in the over-distended parts that she

can summon courage to permit of their being emptied. This partial and

irregular nursing is very dangerous, and cannot fail, in most cases, to

lead to the very painful affection of which we are now speaking.

No nursing mother is safe whose breasts are not properly and daily

emptied. If this cannot be done by the child, another infant should be

applied, or a small puppy, either of which expedients is preferable to a

breast-pump, which, however, is much better than neither. If the tender

or chapped condition of the nipples interferes with free nursing, this

condition must be promptly remedied. When undue accumulation of milk is

threatened gentle friction of the breasts with sweet oil and camphor is

also of service; and they should be supported by means of a handkerchief

placed under them and tied over the shoulders.

It must not be forgotten, however, that though _gentle_ rubbing afford

relief to the breasts when they are hard, knotty, and over-distended,

any friction is injurious if gathering has actually commenced. In all

cases, therefore, it is of importance to distinguish between

over-distension (which may _lead_ to inflammation) and a condition of

already established gathering of the breasts. This it is not difficult

to do. In the former case the skin is pale, there is little or no

tenderness, and the hardness is evenly diffused over the whole of the

breast; whereas, when gathering has taken place there is a blush of

redness on some portion of the breast, which is always painful to the

touch, and which will be found to be particularly hard and sore in some

one spot.

The _symptoms_ of gathered breasts we have just described in part. The

severity of the symptoms will depend upon the extent and depth of the

inflammation. The affection is always ushered in by shivering, followed

by fever and a shooting pain in the breasts. A small, hard, painful

swelling will be noticed in the breast even before the skin shows any

sign of redness. This swelling increases in size and the suffering

becomes very great and difficult to bear, preventing sleep and

prostrating the whole system. The secretion of milk is suspended at

least during the first active stage of the disease.

The object of _treatment_ is to prevent the formation of an abscess by

subduing the inflammation as speedily as possible. This is to be sought

first by keeping the breast as nearly empty as possible. For this reason

the child should be assiduously applied to the affected rather than to

the well side, although suckling will be painful. Indeed, it is better,

if it can be done, to procure an older child and let it keep the milk

under. When, however, the inflammation is fully established, the pain

will compel the restriction of the child to the well side. The

application of warmth is both grateful to the part and beneficial. This

may be done by means of poultices or fomentations, or by immersing a

wooden bowl in hot water and putting the breast, wrapped in flannel,

within it. This latter means will be found an easy and agreeable one of

keeping up the application of dry heat. The bowels should be briskly

purged by a dose of citrate of magnesia or cream of tartar. The diet

must be mild, and the breasts supported in a sling. If, in spite of all

these efforts, an abscess actually forms, the attending physician will

doubtless advise its immediate opening, to which advice the patient

should accede, as that is the course which will afford her quicker and

more effectual relief than she can hope for from nature's unaided

efforts at effecting a discharge of the pent-up matter.

It is interesting for the mother to know that if her child be

still-born, or if unfortunately she be unable from any of the reasons

mentioned in our chapter on Hindrances to Nursing to give the breast at

all to her child, she is not liable to gathering on this account. This

is contrary to what might be expected. It is not the mother who is

unable to nurse at all who suffers, but she who does so in an

unsatisfactory manner and who fails to have her breasts properly

emptied.

The first milk which makes its appearance in the breast towards recovery

from inflammation is likely to be stringy and thick, and should,

therefore, be rejected before nursing is resumed.

THE SINGLE LIFE.

A few words, ere we pass to another branch of our subject, on the

physical relations of her who by choice or other reasons never marries.

It is a common observation among physicians who have devoted themselves

to the study of woman's physical nature, that, in spite of those perils

of maternity which we have taken no pains to conceal, the health of

single women during the child-bearing period is, as a general rule, not

better, not even so good, as that of their married sisters. Those

insurance companies who take female risks, do not ask any higher premium

for the married than the unmarried.

Various suggestions have been made to account for this unexpected fact.

Some writers have pointed out that in many diseases marriage exerts a

decidedly curative influence, especially in chronic nervous ailments.

Chorea, for instance, or St. Vitus's dance, as it is popularly termed,

has been repeatedly cured by marriage. As a rule, painful menstruation,

which always arises from some defect or disease of the ovaries or

adjacent organs, is improved, and often completely removed, by

the same act. There are, as is well known, a whole series of

emotional disorders,--hysteria, and various kinds of mania and

hallucination,--which are almost exclusively confined to single persons,

and only occur in the married under exceptional circumstances. An

instance has lately been detailed in the medical journals by a Prussian

physician, of a case of undoubted hereditary insanity which was greatly

benefited--indeed temporarily cured--by a fortunate nuptial relation. Few

who have watched a large circle of lady acquaintances but will have

observed that many of them increased in flesh and improved in health when

they had been married some months. An English writer of distinction

accounts for these favourable results in a peculiar manner. Success, he

says, is always a tonic, and the best of tonics. Now, to women, marriage

is a success. It is their aim in social life; and this accomplished,

health and strength follow. We are not quite ready to subscribe to such a

sweeping assertion, but no doubt it is applicable in a limited number of

cases. Our own opinion is, that nature gave to each sex certain

functions, and that the whole system is in better health when all parts

and powers fulfil their destiny.

Common proverbs portray the character of the spinster as peevish,

selfish, given to queer fancies, and unpleasant eccentricities. In many

a case we are glad to say this is untrue. Instances of noble devotion,

broad and generous sympathy, and distinguished self-sacrifice, are by no

means rare in single women. But take the whole class, the popular

opinion, as it often is, must be granted to be correct. Deprived of the

natural objects of interest, the sentiments are apt to fix themselves on

parrots and poodles, or to be confined within the breast, and wither

for want of nourishment. Too often the history of those sisterhoods who

assume vows of singleness in the interest of religion, presents to the

physician the sad spectacle of prolonged nervous maladies, and to the

Christian that of a sickly sensibility.

In this connection we may answer a question not unfrequently put to the

medical attendant. Are those women who marry late in their sexual life

more apt to bear living children than the married of the same age; and

are they more likely to prolong their child-bearing period by their

deferred nuptials? To both these inquiries we answer No. On the

contrary, the woman who marries a few years only before her change of

life, is almost sure to have no children who will survive. She is

decidedly less apt to have any than the woman of the same age who

married young. If, therefore, love of children and a desire for

offspring form, as they rightly should, one of the inducements to marry,

let not the act be postponed too long, or it will probably fail of any

such result.

THE CHANGE OF LIFE.

After a certain number of years, woman lays aside those functions with

which she had been endowed for the perpetuation of the species, and

resumes once more that exclusively individual life which had been hers

when a child. The evening of her days approaches; and if she has

observed the precepts of wisdom, she may look forward to a long and

placid period of rest, blessed with health,--honored, yes, loved with a

purer flame than any which she inspired in the bloom of youth and

beauty. Those who are familiar with the delightful memoirs of Madame

Swetchine or Madame Recamier will not dispute even so bold an assertion

as this.

But ere this haven of rest is reached, there is a crisis to pass which

is ever the subject of anxious solicitude. Unscientific people, in their

vivid language, call it _the change of life_; physicians know it as the

_menopause_--the period of the cessation of the monthly flow. It is the

epoch when the ovaries cease producing any more ova, and the woman

becomes therefore incapable of bearing any more children.

The age at which it occurs is very variable. In this country from

forty-five to fifty is the most common. Instances are not at all

unusual when it does not appear until the half century has been turned;

and we have known instances where women past sixty still continued to

have their periodical illnesses.

Examples of very early cessation are more rare. We do not remember to

have met any, in our experience, earlier than thirty years, but others

have observed healthy women as young as twenty-eight in whom the flow

had ceased.

The physical change which is most apparent at this time is the tendency

to grow stout. The fat increases as the power of reproduction decreases.

And here a curious observation comes in. We have said that when the girl

changes to a woman, a similar deposit of fat takes place (though less in

amount), which commences at the loins. This is the first sign of

puberty. In the change of life the first sign is visible at the lower

part of the back of the neck, on a level with the bones known as the two

lowest cervical vertebræ. Here commences an accumulation of fat, which

often grows to form two distinct prominences, and is an infallible index

of the period of a woman's life.

The breasts do not partake of this increase, but become flat and hard,

the substance of the gland losing its spongy structure. The legs and

arms lose their roundness of outline, and, where they do not grow fat,

dry up, and resemble those of the other sex. The abdomen enlarges, even

to the extent occasionally of leading the wife to believe that she is to

be a mother,--a delusion sometimes strengthened by the absence of the

monthly sickness. Finally, a perceptible tendency to a beard at times

manifests itself, the voice grows harder, and the characteristics of the

female sex become less and less distinct.

Some who are more fortunate than their neighbours do not experience the

least discomfort at the change of life. They simply note that at the

expected time the illness does not appear, and for ever after they are

free from it. These are the exceptions. More commonly, marked

alterations in the health accompany this important crisis, and call for

sedulous hygienic care. It is gratifying to know that nearly all these

threatening affections can be avoided by such care, as they depend upon

causes under the control of the individual. Another fact, to which we

have already referred, is full of consolation. It is an unexpected

fact--one that we should hardly credit, did it not rest on statistical

evidence of the most indisputable character. The popular opinion, every

one knows, is, that the period of the change of life is one peculiarly

dangerous to women. If this is so, we might expect that, if the number

of deaths between the ages of forty and fifty years in the two sexes be

compared, we should find that those of females far exceed those of

males. This is, however, not the case. On the contrary, the deaths of

the males exceed in number those of the females.