are usually cut in pairs. "I may say that nearly invariably the order
is--1st, the lower front incissors [cutting teeth], then the upper
front, then the _upper_ two lateral incissors, and that not uncommonly
a double tooth is cut before the two _lower_ laterals; but at all
events the lower laterals come 7th and 8th, and, not 5th and 6th, as
nearly all books on the subject testify." [Footnote: Sir Charles
Locock in a _Letter_ to the Author.] Then the first grinders, in the
lower jaw, afterwards the first upper grinders, then the lower
corner-pointed or canine teeth, after which the upper corner or
eye-teeth, then the second grinders in the lower jaw, and lastly, the
second grinders of the upper jaw. They do not, of course, always
appear in this rotation. Nothing is more uncertain than the order of
teething. A child seldom cuts his second grinders until after he is
two years old. _He is, usually, from the time they first appear, two
years in cutting the first set of teeth_. As a rule, therefore, a
child of two years old has sixteen, and one of two years and a half
old, twenty teeth.
60. _If an infant be feverish or irritable, or otherwise poorly, and
if the gums be hot, swollen, and tender, are you an advocate for their
being lanced_?
Certainly; by doing so he will, in the generality of instances, be
almost instantly relieved.
61. _But it has been stated that lancing the gums hardens them_?
This is a mistake--it has a contrary effect. It is a well-known fact,
that a part which has been divided gives way much more readily than
one which has not been cut. Again, the tooth is bound down by a tight
membrane, which, if not released by lancing, frequently brings on
convulsions. If the symptoms be urgent, it may be necessary from time
to time to repeat the lancing. It would, of course, be the height of
folly to lance the gums unless they be hot and swollen, and unless the
tooth, or the teeth, be near at hand. It is not to be considered a
panacea for every baby's ill, although, in those cases where the
lancing of the gums is indicated, the beneficial effect is sometimes
almost magical.
62. _How ought the lancing of a child's gums to be performed_?
The proper person, of course, to lance his gums is a medical man. But
if, perchance, you should be miles away and be out of the reach of
one, it would be well for you to know how the operation ought to be
performed. Well, then, let him lie on the nurse's lap upon his back,
and let the nurse take hold of his hands in order that he may not
interfere with the operation.
Then, _if it be the upper gum_ that requires lancing, you ought to go
to the head of the child, looking over, as it were, and into his
mouth, and should steady the gum with the index finger of your left
hand; then, you should take hold of the gum-lancet with your right
hand--holding as if it were a table-knife at dinner--and cut firmly
along the inflamed and swollen gum and down to the tooth, until the
edge of the gum-lancet grates on the tooth. Each incision ought to
extend along the ridge of the gum to about the extent of each expected
tooth.
_If it be the lower gum_ that requires lancing, you must go to the
side of the child, and should steady the outside of the jaw with the
fingers of the left hand, and the gum with the left thumb, and then
you should perform the operation as before directed.
Although the lancing of the gums, to make it intelligible to a
non-professional person, requires a long description, it is, in point
of fact, a simple affair, is soon performed, and gives but little
pain.
63. _If teething cause convulsions, what ought to be done_?
The first thing to be done (after sending for a medical man) is to
freely dash water upon the face, and to sponge the head with cold
water, and as soon as warm water can be procured, to put him into a
warm bath [Footnote: For the precautions to be used in putting a child
into a warm bath, see the answer to question on "Warm Baths."] of 98
degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No
family, where there are young children, should be without Fahrenheit's
thermometer.] you must plunge your own elbow into the water: a
comfortable heat for your elbow will be the proper heat for the
infant. He must remain in the bath for a quarter of an hour, or until
the fit be at an end. The body must, after coming out of the bath, be
wiped with warm and dry and coarse towels; he ought then to be placed
in a warm blanket. The gums must be lanced, and cold water should be
applied to the head. An enema, composed of table salt, of olive oil,
and warm oatmeal gruel--in the proportion of one table-spoonful of
salt, of one of oil, and a tea-cupful of gruel--ought then to be
administered, and should, until the bowels have been well opened, be
repeated every quarter of an hour; as soon as he comes to himself a
dose of aperient medicine ought to be given.
It may be well, for the comfort of a mother, to state that a child in
convulsions is perfectly insensible to all pain whatever; indeed, a
return to consciousness speedily puts convulsions to the rout.
64. _A nurse is in the habit of giving a child, who is teething,
either coral, or ivory, to bite: do you approve of the plan_?
I think it a bad practice to give him any hard, unyielding substance,
as it tends to harden the gums, and, by so doing, causes the teeth to
come through with greater difficulty. I have found softer substances,
such as either a piece of wax taper, or an India-rubber ring, or a
piece of the best bridle leather, or a crust of bread, of great
service. If a piece of crust be given as a gum-stick, he must, while
biting it, be well watched, or by accident he might loosen a large
piece of it, which might choke him. The pressure of any of these
excites a more rapid absorption of the gum, and thus causes the tooth
to come through more easily and quickly.
65. _Have you any objection to my baby, when he is cutting his teeth,
sucking his thumb_?
Certainly not: the thumb is the best gum-stick in the world:--it is
convenient; it is handy (in every sense of the word): it is of the
right size, and of the proper consistence, neither too hard nor too
soft; there is no danger, as of some artificial gum-sticks, of its
being swallowed, and thus of its choking the child. The sucking of the
thumb causes the salivary glands to pour out their contents, and thus
not only to moisten the dry mouth, but assist the digestion; the
pressure of the thumb eases, while the teeth are "breeding," the pain
and irritation of the gums, and helps, when the teeth are sufficiently
advanced, to bring them through the gums. Sucking of the thumb will
often make a cross infant contended and happy, and will frequently
induce a restless babe to fall into a sweet refreshing sleep. Truly
may the thumb be called a baby's comfort. By all means, then, let your
child suck his thumb whenever he likes, and as long as he chooses to
do so.
There is a charming, bewitching little picture of a babe sucking his
thumb in Kingsley's _Water Babies_, which I heartily commend to your
favourable notice and study.
66. _But if an infant be allowed to suck his thumb, will it not be
likely to become a habit, and stick to him for years--until, indeed,
he become a big boy_?
After he have cut the whole of his first set of teeth, that is to say,
when he is about two years and a half old, he might, if it be likely
to become a habit, be readily cured by the following method, namely,
by making a paste of aloes and water, and smearing it upon his
thumb. One or two dressings will suffice as after just tasting the
bitter aloes he will take a disgust to his former enjoyment, and the
habit will at once be broken.
Many persons I know have an objection to children sucking their
thumbs, as for instance,--
"Perhaps it's as well to keep children from plums,
And from pears in the season, and sucking their thumbs." [Footnote:
_Ingoldsby Legends_.]
My reply is,--
P'rhaps 'tis as well to keep children from pears;
The pain they might cause, is oft follow'd by tears;
'Tis certainly well to keep them from plums;
But certainly not from sucking their thumbs!
If a babe suck his thumb
'Tis an ease to his gum;
A comfort; a boon; a calmer of grief;
A friend in his need--affording relief;
A solace; a good; a soother of pain;
A composer to sleep; a charm; and a gain.
'Tis handy, at once, to his sweet mouth to glide;
When done with, drops gently down by his side;
'Tis fix'd, like an anchor, while the babe sleeps.
And the mother, with joy, her still vigil keeps.
67. _A child who is teething dribbles, and thereby wets his chest,
which frequently causes him to catch cold; what had better be done_?
Have in readiness to put on several _flannel_ dribbling bibs, so that
they may be changed as often as they become wet; or, if he dribble
_very much_, the oiled silk dribbling-bibs, instead of the flannel
ones, may be used, and which may be procured at any baby-linen ware
house.
68. _Do you approve of giving a child, during teething, much fruit_?
No; unless it be a few ripe strawberries or raspberries, or a roasted
apple, or the juice of five or six grapes--taking care that he does
not swallow either the seeds or the skin--or the insides of ripe
gooseberries, or an orange. Such fruits, if the bowels be in a costive
state, will be particularly useful.
All stone fruit, _raw_ apples or pears, ought to be carefully avoided,
as they not only disorder the stomach and the bowels,--causing
convulsions, gripings, &c.,--but they have the effect of weakening the
bowels, and thus of engendering worms.
69. _Is a child, during teething, more subject to disease, and, if so,
to what complaints, and in what manner may they be prevented_?
The teeth are a fruitful source of suffering and of disease; and are,
with truth, styled "our first and our last plagues." Dentition is the
most important period of a child's life, and is the exciting cause of
many infantile diseases; during this period, therefore, he requires
constant and careful watching. When we consider how the teeth elongate
and enlarge in his gums, pressing on the nerves and on the surrounding
parts, and thus how frequently they produce pain, irritation, and
inflammation; when we further contemplate what sympathy there is in
the nervous system, and how susceptible the young are to pain, no
surprise can be felt, at the immense disturbance, and the consequent
suffering and danger frequently experienced by children while cutting
their _first_ set of teeth. The complaints or the diseases induced by
dentition are numberless, affecting almost every organ of the
body,--the _brain_, occasioning convulsions, water on the brain, &c.;
the _lungs_, producing congestion, inflammation, cough, &c.; the
_stomach_, exciting sickness, flatulence, acidity, &c,; the _bowels_,
inducing griping, at one time costiveness, and at another time
purging; the _skin_, causing "breakings-out."
To prevent these diseases, means ought to be used to invigorate a
child's constitution by plain, wholesome food, as recommended under
the article of diet; by exercise and fresh air; [Footnote: The young
of animals seldom suffer from cutting their teeth--and what is the
reason? Because they live in the open air, and take plenty of
exercise; while children are frequently cooped up in close rooms, and
are not allowed the free use of their limbs. The value of fresh air
is well exemplified in the Registrar-General's Report for 1843; he
says that in 1,000,000 deaths, from all diseases, 616 occur in the
town from teething while 120 only take place in the country from the
same cause.] by allowing him, weather permitting, to be out of doors a
great part of every day; by lancing the gums when they get red, hot,
and swollen; by attention to the bowels, and if he suffer more than
usual, by keeping them rather in a relaxed state by any simple
aperient, such as either castor oil, or magnesia and rhubarb, &c.;
and, let me add, by attention to his temper: many children are made
feverish and ill by petting and spoiling them. On this subject I
cannot do better than refer you to an excellent little work entitled
Abbot's _Mother of Home_, wherein the author proves the great
importance of _early_ training.
70. _Have the goodness to describe the symptoms and the treatment of
Painful Dentition_?
Painful dentition may be divided into two forms--(1) the Mild; and (2)
the Severe. In the _mild_ form the child is peevish and fretful, and
puts his fingers, and everything within reach, to his mouth, he likes
to have his gums rubbed, and takes the breast with avidity, indeed it
seems a greater comfort to him than ever. There is generally a
considerable flow of saliva, and he has frequently a more loose state
of bowels than is his wont.
Now, with regard to the more _severe_ form of painful dentition--The
gums are red, swollen, and hot, and he cannot without expressing pain
bear to have them touched, hence, if he be at the breast, he is
constantly loosing the nipple. There is dryness of the mouth, although
before there had been a great flow of saliva. He is feverish,
restless, and starts in his sleep. His face is flashed. His head is
heavy and hot. He is sometimes convulsed. [Footnote: See answer to
Question 63.] He is frequently violently griped and purged, and
suffers severely from flatulence. He is predisposed to many and
severe diseases.
The _treatment,_ of the _mild_ form, consists of friction, of the gum
with the finger, with a little "soothing syrup," as recommended by Sir
Charles Locock, [Footnote: Soothing syrup--Some of them probably
contain opiates, but a perfectly safe and useful one is a little
Nitrate of Potass in syrup of Roses--one scruple to half an
ounce.--_Communicated by Sir Charles Locock to the Author._ This
'soothing syrup' is not intended to be given us a mixture but to be
used as an application to rub the gums with. It may be well to state
that it is a perfectly harmless remedy even if a little of it were
swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit,
every night at bed time, attention to diet and to bowels, fresh air
and exercise. For the mild form, the above plan will usually be all
that is required. If he dribble, and the bowels be relaxed, so much
the better. The flow of saliva and the increased action of the bowels
afford relief, and therefore must not be interfered with. In the
_mild_ form, lancing of the gums is not desirable. The gums ought not
to be lanced, unless the teeth be near at hand, and unless the gums be
red, hot, and swollen.
In the _severe_ form a medical man should be consulted early, as more
energetic remedies will be demanded; that is to say, the gums will
require to be freely lanced, warm baths to be used, and medicines to
be given, to ward off mischief from the head, from the chest, and from
the stomach.
If you are living in the town, and your baby suffers much from
teething, take him into the country. It is wonderful what change of
air to the country will often do, in relieving a child who is
painfully cutting his teeth. The number of deaths in London, from
teething, is frightful; it is in the country comparatively trifling.
71. _Should an infant be purged during teething or indeed, during any
other time, do you approve of either absorbent or astringent medicines
to restrain it_?
Certainly not. I should look upon, the relaxation as an effort of
nature to relieve itself. A child is never purged without a cause;
that cause, in the generality of instances, is the presence of either
some undigested food, or acidity, or depraved motions, that want a
vent.
The better plan is, in such a case, to give a dose of aperient
medicine, such as either castor oil, or magnesia and rhubarb; and thus
work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS
PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so
important and is often mistaken.--C. Locock.] If he be purged more
than usual, attention should be paid to the diet--if it be absolutely
necessary to give him artificial food while suckling--and care must be
taken not to overload the stomach.
72. _A child is subject to a slight cough during dentition--called by
nurses "tooth-cough"--which a parent would not consider of sufficient
importance to consult a doctor about: pray tell me, is there any
objection to a mother giving her child a small quantity either of
syrup of white poppies, or of paregoric, to ease it_?
A cough is an effort of nature to bring up any secretion from the
lining membrane of the lungs, or from the bronchial tubes, hence it
ought not to be interfered with. I have known the administration of
syrup of white poppies, or of paregoric, to stop the cough, and
thereby to prevent the expulsion of the phlegm, and thus to produce
either inflammation of the lungs, or bronchitis. Moreover, both
paregoric and syrup of white poppies are, for a young child, dangerous
medicines (unless administered by a judicious medical man), and _ought
never to be given by a mother_.
In the month of April 1844, I was sent for, in great haste, to an
infant, aged seventeen months, who was labouring under convulsions and
extreme drowsiness, from the injudicious administration of paregoric,
which had been given to him to ease a cough. By the prompt
administration of an emetic he was saved.
73. _A child, who is teething, is subject to a "breaking-out," more
especially behind the ears--which is most disfiguring, and frequently
very annoying what would you recommend_?
I would apply no external application to cure it, as I should look
upon it as an effort of the constitution to relieve itself, and should
expect, if the "breaking-out" were repelled, that either convulsions,
or bronchitis, or inflammation of the lungs, or water on the brain,
would be the consequence. The only plan I should adopt would be, to be
more careful in his diet, to give him less meat (if he be old enough
to eat animal food), and to give him, once or twice a week, a few
doses of mild aperient medicine, and, if the irritation from the
"breaking-out" be great, to bathe it, occasionally, either with a
little warm milk and water, or with rose water.
EXERCISE.
74. _Do you recommend exercise in the open air for a baby? and if so,
how soon after birth_?
I am a great advocate for his having exercise in the open air. "The
infant in arms makes known its desire for fresh air, by restlessness,
it cries, for it cannot speak its wants, is taken abroad and is
quiet."
The age at which he ought to commence taking exercise will, of course,
depend upon the season and upon the weather. If it be summer, and the
weather be fine, he should he carried in the open air, a week or a
fortnight after birth, but if it be winter, he ought not on any
account to be taken out under the month, and not even then, unless the
weather be mild for the season, and it be the middle of the day. At
the end of two months he should breathe the open air more
frequently. And after the expiration of three months, he ought to be
carried out _every day_, even if it be wet under foot, provided it be
fine above, and the wind be neither in an easterly nor in a
north-easterly direction. By doing so we shall make him strong and
hearty, and give the skin that mottled appearance which is so
characteristic of health. He must, of course, be well clothed.
I cannot help expressing my disapprobation of the practice of
smothering up an infant's face with a handkerchief, with a veil or
with any other covering, when he is taken out into the air. If his
face be so muffled up, he may as well remain at home, as under such
circumstances, it is impossible for him to receive any benefit from
the invigorating effects of the fresh air.
75. _Can you devise any method to induce a babe himself to take
exercise_?
He must be encouraged to use muscular exertion, and, for this purpose,
he ought to be frequently laid either upon a rug, or carpet, or the
floor. He will then stretch his limbs and kick about with perfect
glee. It is a pretty sight, to see a little fellow kicking and
sprawling on the floor. He crows with delight and thoroughly enjoys
himself. It strengthens his back, it enables him to stretch his limbs,
and to use his muscles, and is one of the best kinds of exercise a
very young child can take. While going through his performances his
diaper, if he wear one, should be unfastened, in order that he might
go through his exercises untrammelled. By adopting the above plan, the
babe quietly enjoys himself--his brain is not over excited by it; this
is an important consideration, for both mothers and nurses are apt to
rouse, and excite very young children to their manifest detriment. A
babe requires rest, and not excitement. How wrong it is, then, for
either a mother or a nurse to be exciting and rousing a new born
babe. It is most injurious and weakening to his brain. In the early
period of his existence his time ought to be almost entirely spent in
sleeping and in sucking!
76. _Do you approve of tossing an infant much about_?
I have seen, a child tossed nearly to the ceiling! Can anything be
more cruel or absurd! Violent tossing of a young babe ought never to
be allowed, it only frightens him, and has been known to bring on
convulsions. He should be gently moved up and down (not tossed), such
exercises causes a proper circulation of the blood, promotes
digestion, and soothes to sleep. He must always be kept quiet
immediately after taking the breast, if he be tossed _directly_
afterwards, it interferes with his digestion, and is likely to produce
sickness.
SLEEP
77. _Ought the infant's sleeping apartment to be kept warm_?
The lying-in room is generally kept too warm, its heat being, in many
instances, more that of an oven than of a room. Such a place is most
unhealthy, and is fraught with danger both to the mother and the
baby. We are not, of course, to run into an opposite extreme, but are
to keep the chamber at a moderate and comfortable temperature. The
door ought occasionally to be left ajar, in order the more effectually
to change the air and thus to make it more pure and sweet.
A new born babe, then, ought to be kept comfortably warm, but not very
warm. It is folly in the extreme to attempt to harden a very young
child either by allowing him, in the winter time, to be in a bedroom
without a fire, or by dipping him in _cold_ water, or by keeping him
with scant clothing on his bed. The temperature of a bedroom, in the
winter time, should be, as nearly as possible, at 60 deg. Fahr. Although
the room should be comfortably warm, it ought from time to time to be
properly ventilated. An unventilated room soon becomes foul, and,
therefore, unhealthy. How many in this world, both children and
adults, are "poisoned with their own breaths!"
An infant should not be allowed to look at the glare either of a fire
or of a lighted candle, as the glare tends to weaken the sight, and
sometimes brings on an inflammation of the eyes. In speaking to, and
in noticing a baby, you ought always to stand _before_, and not
_behind_ him, or it might make him squint.
78. _Ought a babe to lie alone from the first_?
Certainly not: at first--say, for the first few months--he requires
the warmth of another person's body, especially in the winter; but
care must be taken not to overlay him, as many infants, from
carelessness in this particular, have lost their lives. After the
first few months he had better lie alone, on a horse-hair mattress.
79. _Do you approve of rocking an infant to sleep_?
I do not. If the rules of health be observed, he will sleep both
soundly and sweetly without rocking; if they be not, the rocking might
cause him to fall into a feverish, disturbed slumber, but not into a
refreshing, calm sleep. Besides, if you once take to that habit, he
will not go to sleep without it.
80. _Then don't you approve of a rocking-chair, and of rockers to the
cradle_?
Certainly not: a rocking-chair, or rockers to the cradle, may be
useful to a lazy nurse or mother, and may induce a child to sleep, but
that restlessly, when he does not need sleep, or when he is wet and
uncomfortable, and requires "changing;" but will not cause him to have
that sweet and gentle and exquisite slumber so characteristic of a
baby who has no artificial appliances to make him sleep. No! rockers
are perfectly unnecessary, and the sooner they are banished the
nursery the better will it be for the infant community. I do not know
a more wearisome and monotonous sound than the everlasting rockings to
and fro in some nurseries, they are often accompanied by a dolorous
lullaby from the nurse, which adds much to the misery and depressing
influence of the performance.
81. _While the infant is asleep, do you advise the head of the crib to
be covered with a handkerchief, to shade his eyes from the light, and,
if it be summer time, to keep off the flies_?
If the head of the crib be covered, the babe cannot breathe freely,
the air within the crib becomes contaminated, and thus the lungs
cannot properly perform their functions. If his sleep is to be
refreshing, he must breathe pure air. I do not even approve of a head
to a crib. A child is frequently allowed to sleep on a bed with the
curtains drawn completely close, as though it were dangerous for a
breath of air to blow upon him [Footnote: I have somewhere read that
if a cage containing a canary, be suspended at night within a bed
where a person is sleeping, and the curtains be drawn closely around,
that the bird will, in the morning, in all probability, be found
dead!] This practice is most injurious. An infant must have the full
benefit of the air of the room, indeed, the bed room door ought to be
frequently left ajar, so that the air of the apartment may be changed,
taking care, of course, not to expose him to a draught. If the flies,
while he is asleep, annoy him, let a net veil be thrown over his face,
as he can readily breathe through net, but not through a handkerchief.
82. _Have you any suggestions to offer as to the way a babe should be
dressed when he is put down to sleep_?
Whenever he be put down to sleep, be more than usually particular that
his dress be loose in every part, be careful that there be neither
strings nor bands, to cramp him. Let him, then, during repose, be more
than ordinarily free and unrestrained--
"If, whilst in cradled rest your infant sleeps.
Your watchful eyes unceasing vigil keeps
Lest cramping bonds his pliant limbs constrain,
And cause defects that manhood may retain."
83. _Is it a good sign for a young child to sleep much_?
A babe who sleeps a great deal thrives much more than one who does
not. I have known many children, who were born [Footnote: It may be
interesting to a mother to know the average weight of new born
infants. There is a paper on the subject in the _Medical Circular_
(April 10, 1861) and which has been abridged in _Braithwaite's
Retrospect of Medicine_ (July and December 1861). The following are
extracts--"Dr. E. von Siebold presents a table of the weights of 3000
infants (1586 male and 1414 female) weighed immediately after
birth. From this table (for which we have not space) it results that
by far the greater number of the children, 2215 weighed between 6 and
8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to
8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight
to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at
9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11
lbs. The author has never but once met with a child weighing 11
lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It
is a remarkable fact, that until the weight of 7 lbs the female
infants exceeded the males in number, the latter thenceforward
predominating.
From these statements, and those of various other authors here quoted,
the conclusion may be drawn that the normal weight of a mature new
born infant is not less than six nor more than 8 lbs., the average
weight being 6 1/2 or 7 lbs., the smaller number referring to female and
the higher to male infants."] small and delicate, but who slept the
greatest part of their time, become strong and healthy. On the other
hand, I have known those who were born large and strong, yet who slept
but little, become weak and unhealthy.
The common practice of a nurse allowing a baby to sleep upon her lap
is a bad one, and ought never to be countenanced. He sleeps cooler,
more comfortably, and soundly in his crib.
The younger an infant is the more he generally sleeps, so that during
the early months he is seldom awake, and then only to take the breast.
84. _How is it that much sleep causes a young child to thrive so
well_?
If there be pain in any part of the body, or if any of the functions
be not properly performed, he sleeps but little. On the contrary, if
there be exemption from pain, and if there be a due performance of all
the functions, he sleeps a great deal, and thus the body becomes
refreshed and invigorated.
85. _As much sleep is of such advantage, if an infant sleep but
little, would you advise composing medicine to be given to him_?
Certainly not. The practice of giving composing medicine to a young
child cannot he too strongly reprobated. If he does not sleep enough,
the mother ought to ascertain if the bowels be in a proper state,
whether they be sufficiently opened, that the motions be of a good
colour--namely, a bright yellow, inclining to orange colour--and free
from slime or from bad smell. An occasional dose of rhubarb and
magnesia is frequently the best composing medicine he can take.
86. _We often hear of coroner's inquests upon infants who have been
found dead in bed--accidentally overlaid what is usually the cause_?
Suffocation, produced either by ignorance, or by carelessness. From
_ignorance_ in mothers, in their not knowing the common laws of life,
and the vital importance of free and unrestricted respiration, not
only when babies are up and about, but when they are in bed and
asleep. From _carelessness_, in their allowing young and thoughtless
servants to have the charge of infants at night, more especially as
young girls are usually heavy sleepers, and are thus too much
overpowered with sleep to attend to their necessary duties.
A foolish mother sometimes goes to sleep while allowing her child to
continue sucking. The unconscious babe, after a tune, looses the
nipple, and buries his head in the bed-clothes. She awakes in the
morning, finding, to her horror, a corpse by her side, with his nose
flattened, and a frothy fluid, tinged with, blood, exuding from his
lips. A mother ought, therefore, never to go to sleep until her child
have finished sucking.
_The following are a few rules to prevent an infant from being
accidentally overlaid_--(1.) Let your baby while asleep have plenty of
room in the bed. (2.) Do not allow him to be too near to you; or if he
he unavoidably near you (from the small size of the bed), let his face
be turned to the opposite side. (3.) Let him lie fairly either on his
side, or on his back. (4.) Be careful to ascertain that his mouth be
not covered with the bed-clothes; and, (5.) Do not smother his face
with clothes, as a plentiful supply of pure air is as necessary when
he is awake, or even more so, than when he is asleep. (6.) Never let
him lie low in the bed. (7.) Let there be _no_ pillow near the one
his head is resting on, lest he roll to it, and thus bury his head in
it Remember, a young child has neither the strength nor the sense to
get out of danger; and, if he unfortunately either turn on his face,
or bury his head in a pillow that is near, the chances are that he
will be suffocated, more especially as these accidents usually occur
at night, when the mother, or the nurse, is fast asleep. (8.) Never
intrust him at night to a young and thoughtless servant.
THE BLADDER AND THE BOWELS OF AN INFANT.
87. _Have you any hints to offer respecting the bowels and the bladder
of an infant during the first three months of his existence_?
A mother ought daily to satisfy herself as to the state of the bladder
and the bowels of her child. She herself should inspect the motions,
and see that they are of a proper colour (bright-yellow, inclining to
orange), and consistence (that of thick gruel), that they are neither
slimy, nor curdled, nor green; if they should be either the one or the
other, it is a proof that she herself has, in all probability, been
imprudent in her diet, and that it will be necessary for the future
that she be more careful both in what she eats and in what she drinks.
She ought, moreover, to satisfy herself that the urine does not smell
strongly, that it does not stain the diapers, and that he makes a
sufficient quantity.
A frequent cause of a child crying is, he is wet, and uncomfortable,
and wants drying and changing, and the only way he has of informing
his mother of the fact is by crying lustily, and thus telling her in
most expressive language of her thoughtlessness and carelessness.
88. _How soon may an infant dispense with diapers_?
A babe of three months and upwards, ought to be held out, at least, a
dozen times during the twenty-four hours; if such a plan were adopted,
diapers might at the end of three months be dispensed with--a great
_desideratum_-and he would be inducted into clean habits--a blessing
to himself, and a comfort to all around, and a great saving of dresses
and of furniture. "Teach your children to be clean. A dirty child is
the mother's disgrace," [Footnote: Hints on Household Management, By
Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS
THE MOTHER'S DISGRACE.
AILMENTS, DISEASE, ETC.
89. _A new born babe frequently has a collection of mucus in the air
passages, causing him to wheeze: is it a dangerous symptom_?
No, not if it occur _immediately_ after birth; as soon as the bowels
have been opened, it generally leaves him, or even before, if he give
a good cry, which as soon as he is born he usually does. If there be
any mucus either within or about the mouth, impeding breathing, it
must with a soft handkerchief be removed.
90. _Is it advisable, as soon as an infant is born, to give him
medicine_?
It is now proved that the giving of medicine to a babe _immediately_
after birth is unnecessary, nay, that it is hurtful--that is, provided
he be early put to the breast, as the mother's _first_ milk is
generally sufficient to open the bowels. Sir Charles Locock [Footnote:
In a _Letter_ to the Author.] makes the following sensible remarks on
this subject:--"I used to limit any aperient to a new-born infant to
those which had not the first milk, and who had wet nurses, whose milk
was, of course, some weeks old, but for many years I have never
allowed any aperient at all to any new born infant, and I am satisfied
it is the safest and the wisest plan."
The advice of Sir Charles Locock--_to give no aperient to a new-born
infant_--is most valuable, and ought to be strictly followed. By
adopting his recommendation, much after misery might be averted. If a
new born babe's bowels be costive, rather than give him an aperient,
try the effect of a little moist sugar, dissolved in a little water,
that is to say, dissolve half a tea-spoonful of pure unadulterated
_raw_ sugar in a tea-spoonful of warm water and administer it to him,
if in four hours it should not operate, repeat the dose. Butter and
raw sugar is a popular remedy, and is sometimes used by a nurse to
open the bowels of a new born babe, and where there is costiveness,
answers the purpose exceedingly well, and is far superior to castor
oil. Try by all means to do, if possible, without a particle of
opening medicine. If you once begin to give aperients, you will have
frequently to repeat them. Opening physic leads to opening physic,
until at length his stomach and bowels will become a physic shop! Let
me, then, emphatically say, avoid, if possible, giving a new born babe
a drop or a gram of opening medicine. If from the first you refrain
from giving an aperient, he seldom requires one afterwards. It is the
_first_ step, in this as in all other things, that is so important to
take.
If a new-born babe have _not_ for twelve hours made water, the medical
man ought to be informed of it, in order that he may inquire into the
matter, and apply the proper remedies. Be particular in attending to
these directions, or evil consequences will inevitably ensue.
91. _Some persons say, that new-born female infants have milk in their
bosoms, and that it is necessary to squeeze them, and apply plasters
to disperse the milk_.
The idea of there being real milk in a baby's breast is doubtful, the
squeezing of the bosom is barbarous, and the application of plasters
is useless. "Without actually saying," says Sir Charles Locock, "there
is milk secreted in the breasts of infants, there is undoubtedly not
rarely considerable swelling of the breasts both in _female_ and
_male_ infants, and on squeezing them a serous fluid oozes out. I
agree with you that the nurses should never be allowed to squeeze
them, but be ordered to leave them alone." [Footnote: _Letter_ to the
Author.]
92. _Have the goodness to mention the SLIGHT ailments which are not of
sufficient importance to demand the assistance of a medical man_?
I deem it well to make the distinction between _serious_ and _slight_
ailments, I am addressing a mother. With regard to serious ailments, I
do not think myself justified, except in certain _urgent_ cases, in
instructing a parent to deal with them. It might be well to make a
mother acquainted with the _symptoms_, but not with the _treatment_,
in order that she might lose no time in calling in medical aid. This I
hope to have the pleasure of doing in future Conversations.
_Serious diseases, with a few exceptions_, and which I will indicate
in subsequent Conversations, ought never to be treated by a parent,
not even in the _early_ stages, for it is in the early stages that the
most good can generally be done. It is utterly impossible for any one
who is not trained to the medical profession to understand a _serious_
disease in all its bearings, and thereby to treat it satisfactorily.
There are some exceptions to these remarks. It will be seen in future
Conversations that Sir CHARLES LOCOCK considers that a mother ought to
be made acquainted with the _treatment_ of _some_ of the more
_serious_ diseases, where delay in obtaining _immediate_ medical
assistance might be death. I bow to his superior judgment, and have
supplied the deficiency in subsequent Conversations.
The ailments and the diseases of infants, such as may, in the absence
of the doctor, be treated by a parent, are the following:--Chafings,
Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of
the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of
the Nose, Sickness, Thrush. In all these complaints I will tell
you--_What to do_, and--_What NOT to do_.
93. _What are the causes and the treatment of Chafing_?
The want of water: inattention and want of cleanliness are the usual
causes of chafing.
_What to do._--The chafed parts ought to be well and thoroughly
sponged with tepid _rain_ water--allowing the water from a well-filled
sponge to stream over them,--and, afterwards, they should be
thoroughly, but tenderly, dried with a soft towel, and then be dusted,
either with finely-powdered starch, made of wheaten flour, or with
Violet Powder, or with finely-powdered Native Carbonate of Zinc, or
they should be bathed with finely-powdered Fuller's-earth and tepid
water.
If, in a few days, the parts be not healed discontinue the above
treatment, and use the following application:--Beat up well together
the whites of two eggs, then add, drop by drop, two table-spoonfuls of
brandy. When well mixed, put it into a bottle and cork it up. Before
using it let the excoriated parts be gently bathed with luke-warm rain
water, and, with a soft napkin, be tenderly dried; then, by means of a
camel's hair brush, apply the above liniment, having first shaken the
bottle. But bear in mind, after all that can be said and done, _that
there is nothing in these cases like water_--there is nothing like
keeping the parts clean, and the only way of thoroughly effecting this
object is _by putting him every morning INTO his tub_.
_What NOT to do_.--Do not apply white lead, as it is a poison. Do not
be afraid of using _plenty_ of water, as cleanliness is one of the
most important items of the treatment.
94. _What are the causes of Convulsions of an infant_?
Stuffing him, in the early months of his existence, _with food_, the
mother having plenty of breast milk the while, the constant physicking
of child by his own mother, teething, hooping-cough, when attacking a
very young baby.
I never knew a case of convulsions occur--say for the first four
months--(except in very young infants labouring under hooping-cough),
where children lived on the breast-milk alone, and where they were
_not_ frequently quacked by their mothers.
For the treatment of the convulsions from teething, see page 46.
_What to do_ in a case of convulsions which has been caused by feeding
an infant either with too much or with _artificial_ food. Give him,
every ten minutes, a tea-spoonful of ipecacuanha wine, until free
vomiting be excited then put him into a warm bath (see Warm Baths),
and when he comes out of it administer to him a tea-spoonful of castor
oil, and repeat it every four hours, until the bowels be well opened.
_What NOT to do_--Do not for at least a month after the fit, give him
artificial food, but keep him entirely to the breast. Do not apply
leeches to the head.
_What to do in a case of convulsions from hooping cough_--There is
nothing better than dashing cold water on the face, and immersing him
in a warm bath of 98 degrees Fahr. If he be about his teeth, and they
be plaguing him, let the gums be both freely and frequently
lanced. Convulsions seldom occur in hooping-cough, unless the child be
either very young or exceedingly delicate. Convulsions attending an
attack of hooping-cough make it a _serious_ complication, and requires
the assiduous and skilful attention of a judicious medical man.
_What NOT to do in such a case_--Do not apply leeches, the babe
requires additional strength, and not to be robbed of it, and do not
attempt to treat the case yourself.
95. _What are the best remedies for the Costiveness of an infant_?
I strongly object to the frequent administration of opening medicine,
as the repetition of it increases the mischief to a tenfold degree.
_What to do_.--If a babe, after the first few months, were held out,
and if, at regular intervals, he were put upon his chair, costiveness
would not so much prevail. It is wonderful how soon the bowels, in
the generality of cases, by this simple plan, may be brought into a
regular state. Besides, it inducts an infant into clean habits, I know
many careful mothers who have accustomed their children, after the
first three months, to do without diapers altogether. It causes at
first a little trouble, but that trouble is amply repaid by the good
consequences that ensue; among which must be named the dispensing with
such encumbrances as diapers. Diapers frequently chafe, irritate, and
gall the tender skin of a baby. But they cannot of course, at an early
age be dispensed with, unless a mother have great judgment, sense,
tact, and perseverance, to bring her little charge into the habit of
having his bowels relieved and his bladder emptied every time he is
either held out or put upon his chair.
Before giving an infant a particle of aperient medicine, try, if the
bowels are costive, the effect of a little _raw_ sugar and water,
either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or
two of water, or give him, out of your fingers, half a tea-spoonful of
raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure
and unadulterated sugar, and which you can only procure from a
respectable grocer. If you are wise, you will defer as long as you can
giving an aperient. If you once begin, and continue it for a while,
opening medicine becomes a dire necessity, and then woe betide the
poor unfortunate child. Or, give a third of a tea-spoonful of honey,
early in the morning, occasionally. Or administer a warm water
enema--a tablespoonful, or more, by means of a 2 oz. India Rubber
Enema Bottle.
_What NOT to do_.--There are two preparations of mercury I wish to
warn you against administering of your own accord, viz.--(1) Calomel,
and a milder preparation called (2) Grey-powder (mercury with
chalk). It is a common practice in this country to give calomel, on
account of the readiness with which it can be administered it being
small in quantity, and nearly tasteless. Grey powder also, is, with
many mothers, a favourite in the nursery. It is a medicine of immense
power--either for good or for evil, in certain cases it is very
valuable, but in others, and in the great majority, it is very
detrimental. This practice, then, of a mother giving mercury, whether
in the form either of calomel or of grey powder, cannot be too
strongly reprobated, as the frequent administration either of the one
or of the other weakens the body, predisposes it to cold, and
frequently excites king's-evil--a disease too common in this
country. Calomel and grey-powder, then, ought never to be administered
unless ordered by a medical man.
Syrup of buckthorn and jalap are also frequently given, but they are
griping medicines for a baby, and ought to be banished from the
nursery.
The frequent repetition of opening medicines, then, in any shape or
form, very much interferes with digestion, they must, therefore, be
given as seldom as possible.
Let me, at the risk of wearying you, again urge the importance of your
avoiding, as much as possible, giving a babe purgative medicines. They
irritate beyond measure the tender bowels of an infant, and only make
him more costive afterwards, they interfere with his digestion, and
are liable to give him cold. A mother who is always, of her own
accord, quacking her child with opening physic, is laying up for her
unfortunate offspring a debilitated constitution--a miserable
existence.
For further information on this important subject see the 3d edition
of _Counsel to a Mother (being the companion volume of Advice to a
Mother)_, on the great importance of desisting from irritating, from
injuring, and from making still more costive, the obstinate bowels of
a costive child,--by the administration of opening medicine,--however
gentle and well-selected the aperients might be. Oh, that the above
advice could be heard, and be acted upon, through the length and the
breadth of the land, how much misery and mischief would then be
averted!
96. _Are there any means of preventing the Costiveness of an infant_?
If greater care were paid to the rules of health, such as attention to
diet, exercise in the open air, thorough ablution of the _whole_
body--more especially when he is being washed--causing the water, from
a large and well-filled sponge, to stream over the lower part of his
bowels; the regular habit of causing him, at stated periods, to be
held out, whether he want or not, that he may solicit a stool. If all
these rules were observed, costiveness would not so frequently
prevail, and one of the miseries of the nursery would be done away
with.
Some mothers are frequently dosing their poor unfortunate babes either
with magnesia to cool them, or with castor oil to heal their bowels!
Oh, the folly of such practices! The frequent repetition of magnesia,
instead of cooling an infant, makes him feverish and irritable. The
constant administration of castor oil, instead of healing the bowels,
wounds them beyond measure. No! it would be a blessed thing if a babe
could be brought up without giving ham a particle of opening medicine;
his bowels would then act naturally and well: but then, as I have just
now remarked, a mother, must be particular in attending to Nature's
medicines--to fresh air, to exercise, to diet, to thorough ablution,
&c. Until that time comes, poor unfortunate babies must be,
occasionally, dosed with an aperient.
97. _What are the causes of, and remedies for, Flatulence_?
Flatulence most frequently occurs in those infants who live on
_artificial_ food, especially if they be over-fed. I therefore beg to
refer you to the precautions I have given, when speaking of the
importance of keeping a child for the first five or six months
_entirely_ to the breast; and, if that be not practicable, of the
times of feeding, and of the _best_ kinds of artificial food, and of
those which are least likely to cause "wind."
_What to do._--Notwithstanding these precautions, if the babe should
still suffer, "One of the best and safest remedies for flatulence is
Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce
and a half of water" [Footnote: Sir Charles Locock, in a _Letter_ to
the Author Since Sir Charles did me the honour of sending me, for
publication, the above prescription for flatulence, a new "British
Pharmacopoeia" has been published in which the sal volatile is much
increased in strength it is therefore necessary to lessen the sal
volatile in the above prescription one half--that is to say, a tea
spoonful of the solution of _half_ a drachm to an ounce and a half of
water.] Or, a little dill or aniseed may be added to the food--half a
tea-spoonful of dill water Or, take twelve drops of oil of dill, and
two lumps of sugar, rub them well in a mortar together, then add, drop
by drop, three table-spoonfuls of spring water, let it be preserved in
a bottle for use. A tea-spoonful of this, first shaking the vial, may
be added to each quantity of food. Or, three tea-spoonfuls of bruised
caraway-seeds may be boiled for ten minutes in a tea-cupful of water,
and then strained. One or two tea-spoonfuls of the caraway tea may be
added to each quantity of his food, or a dose of rhubarb and magnesia
may occasionally be given.
Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at
a time, by means of the warm hand, over the bowels, will frequently
give relief. Turning the child over on his bowels, so that they may
press on the nurses' lap, will often afford great comfort. A warm
bath (where he is suffering severely) generally gives _immediate_ ease
in flatulence, it acts as a fomentation to the bowels. But after all,
a dose of mild aperient medicine, when the babe is suffering severely,
is often the best remedy for "wind."
Remember, at all times, prevention, whenever it be--and how frequently
it is--possible, is better than cure.
_What NOT to do_--"Godfrey's Cordial," "Infants' Preservative," and
"Dalby's Carminative," are sometimes given in flatulence, but as most
of these quack medicines contain, in one form or another, either opium
or poppy, and as opium and poppy are both dangerous remedies for
children, ALL quack medicines must be banished the nursery.
Syrup of poppies is another remedy which is often given by a nurse to
afford relief for flatulence; but let me urge upon you the importance
for banishing it from the nursery. It has (when given by
unprofessional persons) caused the untimely end of thousands of
children. The medical journals and the newspapers teem with cases of
deaths from mothers incautiously giving syrup of poppies to ease pain
and to procure sleep.
98. _What are the symptoms, the causes, and the treatment of
"Gripings" of an infant_?
_The symptoms._--The child draws up his legs; screams violently; if
put to the nipple to comfort him, he turns away from it and cries
bitterly; he strains, as though he were having a stool; if he have a
motion, it will be slimy, curdled, and perhaps green. If, in addition
to the above symptoms, he pass a large quantity of watery fluid from
his bowels, the case becomes one of _watery gripes_, and requires the
immediate attention of a doctor.
The _causes_ of "gripings" or "gripes" may proceed either from the
infant or from the mother. If from the child, it is generally owing
either to improper food or to over-feeding; if from the mother, it may
be traced to her having taken either greens, or port, or tart beer, or
sour porter, or pickles, or drastic purgatives.
_What to do._--The _treatment_, of course, must depend upon the
cause. If it arise from over-feeding, I would advise a dose of castor
oil to be given, and warm fomentations to be applied to the bowels,
and the mother, or the nurse, to be more careful for the future. If it
proceed from improper food, a dose or two of magnesia and rhubarb in a
little dill water, made palatable with simple syrup. [Footnote:
Take of--Powdered Turkey Rhubarb, half a scruple;
Carbonate of Magnesia, one scruple;
Simple Syrup, three drachms;
Dill Water, eight drachms;
Make a Mixture, One or two tea-spoonfuls (according to the age of the
child) to be taken every four boors, until relief be obtained--first
shaking the bottle.) If it arise from a mother's imprudence in eating
trash, or from her taking violent medicine, a warm bath, a warm bath,
indeed, let the cause of "griping" be what it may, usually affords
instant relief.
Another excellent remedy is the following--Soak a piece of new
flannel, folded into two or three thicknesses, in warm water, wring it
tolerably dry, and apply as hot as the child can comfortably bear it
to the bowels, then wrap him in a warm, dry blanket, and keep him, for
at least half an hour, enveloped in it. Under the above treatment, he
will generally soon fall into a sweet sleep, and awake quite
refreshed.
_What NOT to do_--Do not give opiates, astringents, chalk, or any
quack medicine whatever.
If a child suffer from a mother's folly in her eating improper food,
it will be cruel in the extreme for him a _second_ time to be
tormented from the same cause.
99. _What occasions Hiccup, and what is its treatment_?
Hiccup is of such a trifling nature as hardly to require
interference. It may generally be traced to over feeding. Should it be
severe, four or five grains of calcined magnesia, with a little syrup
and aniseed water, and attention to feeding are all that will be
necessary.
100. _Will you describe the symptoms of Infantile Diarrhoea_?
Infantile diarrhoea, or _cholera infantum_, is one of the most
frequent and serious of infantile diseases, and carries off, during
the year, more children than any other complaint whatever a knowledge
of the symptoms, therefore, is quite necessary for a mother to know,
in order that she may, at the proper tune, call in efficient medical
aid.
It will be well, before describing the symptoms, to tell you how many
motions a young infant ought to have a day, their colour, consistence,
and smell. Well, then, he should have from three to six motions in
the twenty four hours, the colour ought to be a bright yellow,
inclining to orange, the consistence should be that of thick gruel;
indeed, his motion, if healthy, ought to be somewhat of the colour
(but a little more orange-tinted) and of the consistence of mustard
made for the table; it should be nearly, if not quite, devoid of
smell; it ought to have a faint and peculiar, but not a strong
disagreeable odour. If it have a strong and disagreeable smell, the
child is not well, and the case should be investigated, more
especially if there be either curds or lumps in the motions; these
latter symptoms denote that the food has not been properly digested.
Now, suppose a child should have a slight bowel complaint--that is to
say, that he has six or eight motions during the twenty-four
hours,--and that the stools are of a thinner consistence than what I
have described,--provided, at the same time, that he be not griped,
that he have no pain, and have not lost his desire for the
breast:--What ought to be done?_Nothing_. A slight looseness of the
bowels should _never_ be interfered with,--it is often an effort of
nature to relieve itself of some vitiated motion that wanted a
vent--or to act as a diversion, by relieving the irritation of the
gums. Even if he be not cutting his teeth, he may be "breeding"
them--that is to say, the teeth may be forming in his gums, and may
cause almost as much, irritation as though he were actually cutting
them. Hence, you see the immense good a slight "looseness of the
bowels" may cause. I think that I have now proved to you the danger of
interfering in such a case, and that I have shown you, the folly and
the mischief of at once giving astringents--such as Godfrey's Cordial,
Dalby's Carminative, &c.--to relieve a _slight_ relaxation.
A moderate "looseness of the bowels," then, is often a safety-valve,
and you may, with as much propriety, close the safety-valve of a steam
engine, as stop a moderate "looseness of the bowels!"
Now, if the infant, instead of having from three to six motions,
should have more than double the latter number; if they be more
watery; if they become slimy and green, or green in part and curdled;
if they should have an unpleasant smell; if he be sick, cross,
restless, fidgety, and poorly; if every time he have a motion he be
griped and in pain, we should then say that he is labouring under
Diarrhoea; then, it will be necessary to give a little medicine, which
I will indicate in a subsequent Conversation.
Should there be both blood and slime mixed with the stool, the case
becomes more serious; still, with proper care, relief can generally be
quickly obtained. If the evacuations--instead of being stool--are
merely blood and slime, and the child strain frequently and violently,
endeavouring thus, but in vain, to relieve himself, crying at each
effort, the case assumes the character of Dysentery. [Footnote: See
Symptoms and Treatment of Dysentery.]
If there be a mixture of blood, slime, and stool from the bowels, the
case would be called Dysenteric-diarrhoea. The latter case requires
great skill and judgment on the part of a medical men, and great
attention and implicit obedience from the mother and the nurse. I
merely mention these diseases in order to warn you of their
importance, and of the necessity of strictly attending to a doctor's
orders.
101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_
Improper food; overfeeding; teething; cold; the mother's milk from
various causes disagreeing, namely, from her being out of health, from
her eating unsuitable food, from her taking improper and drastic
purgatives, or from her suckling her child when she is pregnant. Of
course, if any of these causes are in operation, they ought, if
possible, to be remedied, or medicine to the babe will be of little
avail.
102. _What is the treatment of Diarrhoea_?
_What to do._--If the case be _slight_, and has lasted two or three
days (do not interfere by giving medicine at first), and if the cause,
as it probably is, be some acidity or vitiated stool that wants a
vent, and thus endeavours to obtain one by purging, the best treatment
is, to assist nature by giving either a dose of castor oil, or a
moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and
magnesia mixture prescription, see page 71 (_note_).] and thus to work
off the enemy. After the enemy has been worked off, either by the
castor oil, or by the magnesia and rhubarb, the purging will, in all
probability, cease; but if the relaxation still continue, that is to
say, for three or four days--then, if medical advice cannot be
procured, the following mixture should be given:--
Take of--Aromatic Powder of Chalk and Opium, ten grains;
Oil of Dill, five drops;
Simple Syrup, three drachms;
Water, nine drachms;
Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half
a tea-spoonful to be given to an infant of six months and under, and
one tea-spoonful to a child above that age, every four hours--first
shaking the bottle.
If the babe be at the breast, he ought, for a few days, to be kept
_entirely_ to it. The mother should be most particular in her own
diet.
_What NOT to do._--The mother must neither take greens, nor cabbage,
nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of
her babe continues, she had better abstain from wine, as well as from
fermented liquors. The child, if at the breast, ought _not_, while
the diarrhoea continues, to have any artificial food. He must neither
be dosed with grey-powder (a favourite, but highly improper Remedy, in
these cases), nor with any quack medicines, such as Dalby's
Carminative or Godfrey's Cordial.
103. _What are the symptoms of Dysentery_?
Dysentery frequently arises from a neglected diarrhoea. It is more
dangerous than diarrhoea, as it is of an inflammatory character; and
as, unfortunately, it frequently attacks a delicate child, requires
skilful handling; hence the care and experience required in treating a
case of dysentery.
Well, then, what are the symptoms? The infant, in all probability, has
had an attack of diarrhoea--bowel complaint as it is called--for
several days; he having had a dozen or two of motions, many of them
slimy and frothy, like "frog-spawn," during the twenty-four hours.
Suddenly the character of the motion changes,--from being principally
stool, it becomes almost entirely blood and mucus; he is dreadfully
griped, which causes him to strain violently, as though his inside
would come away every time he has a motion,--screaming and twisting
about, evidently being in the greatest pain, drawing his legs up to
his belly and writhing in agony. Sickness and vomiting are always
present, which still more robs him of his little remaining strength,
and prevents the repair of his system. Now, look at his face! It is
the very picture of distress. Suppose he has been a plump, healthy
little fellow, you will see his face, in a few days, become
old-looking, care-worn, haggard, and pinched. Day and night the enemy
tracks him (unless proper remedies be administered); no sleep, or if
he sleep, he is, every few minutes, roused. It is heart-rending to
have to attend a bad case of dysentery in a child,--the writhing, the
screaming, the frequent vomiting, the pitiful look, the rapid wasting
and exhaustion, make it more distressing to witness than almost any
other disease a doctor attends.
104. _Can anything be done to relieve such a case_?
Yes. A judicious medical man will do a great deal. But, suppose that
yon are not able to procure one, I will tell you _what to do_ and
_what NOT to do_.
_What to do_.--If the child be at the breast, keep him to it, and let
him have nothing else for dysentery is frequently caused by improper
feeding. If your milk be not good, or it be scanty, _instantly_
procure a healthy wet-nurse. _Lose not a moment;_ for in dysentery,
moments are precious. But, suppose that you have no milk, and that no
wet-nurse can be procured: what then? Feed him entirely on cow's
milk--the milk of _one_ healthy cow; let the milk be unboiled, and be
fresh from the cow. Give it in small quantities at a time, and
frequently, so that it may be retained on the stomach. If a
table-spoonful of the milk make him sick, give him a dessert-spoonful;
if a dessert-spoonful cause sickness, let him only have a tea-spoonful
at a time, and let it be repeated every quarter of an hour. But,
remember, in such a case the breast milk--the breast milk alone--is
incomparably superior to any other milk or to any other food whatever.
If he be a year old, and weaned, then feed him, as above recommended,
on the cow's milk. If there be extreme exhaustion and debility, let
fifteen drops of brandy be added to each table-spoonful of new milk,
and let it be given every half hour.
Now with regard to medicine. I approach this part of the treatment
with some degree of reluctance,--for dysentery is a case requiring
opium--and opium I never like a mother of her own accord to
administer. But suppose a medical man cannot be procured in time, the
mother must then prescribe, or the child will die! _What then is to
be done?_ Sir Charles Locock considers "that, in severe dysentery,
especially where there is sickness, there is no remedy equal to pure
Calomel, in a full dose without opium." [Footnote: Communicated by Sir
Charles Locock to the Author.] Therefore, at the very _onset_ of the
disease, let from three to five grains (according to the age of the
patient) of Calomel, mixed with an equal quantity of powdered white
sugar, be put dry on the tongue. In three hours after let the
following mixture be administered:--
Take of--Compound Powder of Ipecacuanha, five grains;
Ipecacuanha Wine, one drachm;
Simple Syrup, three drachms;
Cinnamon Water, nine drachms;
To make a Mixture, A tea-spoonful to be given every three or four
hours, first _well_ shaking the bottle.
Supposing he cannot retain the mixture--the stomach rejecting it as
soon as swallowed--what then? Give the opium, mixed with small doses
of mercury with chalk and sugar, in the form of powder, and put one of
the powders _dry_ on the tongue, every three hours:--
Take of--Powdered Opium, half a grain;
Mercury with chalk, nine grains;
Sugar of Milk, twenty-four grains;
Mix well in a mortar, and divide into twelve powders.
Now, suppose the dysentery has for several days persisted, and that,
during that time, nothing but mucus and blood--that no real stool--has
come from the bowels, then a combination of castor oil and opium
[Footnote: My friend, the late Dr Baly, who had made dysentery his
particular study, considered the combination of opium and castor oil
very valuable in dysentery.] ought, instead of the medicine
recommended above, to be given:--
Take of--Mucilage of Gum Acacia, three drachms;
Simple Syrup, three drachms;
Tincture of Opium, ten drops (_not_ minims);
Castor Oil, two drachms;
Cinnamon water, four drachms:
Make a Mixture. A tea spoonful to be taken every four hours, first
_well_ shaking the bottle.
A warm bath, at the commencement of the disease, is very efficacious;
but it must be given at the _commencement_. If he has had dysentery
for a day or two, he will be too weak to have a warm bath; then,
instead of the bath, try the following:--Wrap him in a blanket, which
has been previously wrung out of hot water; over which envelope him in
a _dry_ blanket. Keep him in this hot, damp blanket for half an hour;
then take him out, put on his nightgown and place him in bed, which
has been, if it be winter time, previously warmed. The above "blanket
treatment" will frequently give great relief, and will sometimes cause
him to fall into a sweet sleep. A flannel bag, filled with hot
powdered table salt, made hot in the oven, applied to the bowels, will
afford much comfort.
_What NOT to do_.--Do not give aperients unless it be, as before
advised, the castor oil guarded with the opium; do not stuff him with
artificial food; do not fail to send for a judicious and an
experienced medical man; for, remember, it requires a skilful doctor
to treat a case of dysentery, more especially in a child.
105. _What are the symptoms, the causes and the treatment of
Nettle-rash_?
Nettle-rash consists of several irregular, raised wheals, red at the
base, and white on the summit, on different parts of the body; _but it
seldom attacks the face_. It is not contagious, and it may occur at
all ages and many times. It comes and goes, remaining only a short
time in a place. It puts on very much the appearance of the child
having been stung by nettles--hence its name. It produces great heat,
itching, and irritation, sometimes to such a degree as to make him
feverish, sick, and fretful. He is generally worse when he is warm in
bed, or when the surface of his body is suddenly exposed to the air.
Rubbing the skin, too, always aggravates the itching and the tingling,
and brings out a fresh crop.
The _cause_ of nettle-rash may commonly be traced to improper feeding;
although, occasionally, it proceeds from teething.
_What to do_.--It is a complaint of no danger, and readily gives way
to a mild aperient, and to attention to diet. There is nothing better
to relieve the irritation of the skin than a warm bath. If it be a
severe attack of nettle-rash, by all means call in a medical man.
_What NOT to do_.--Do not apply cold applications to his skin, and do
not wash him (while the rash is out) in quite _cold_ water. Do not
allow him to be in a draught, but let him be in a well-ventilated
room. If he be old enough to eat meat, keep it from him for a few
days, and let him live on milk and farinaceous diet. Avoid strong
purgatives, and calomel, and grey-powder.
106. _What are the symptoms and the treatment of Red-gum_?
Red-gum, tooth-rash, red-gown, is usually owing to irritation from
teething; not always from the cutting but from the evolution--the
"breeding," of the teeth. It is also sometimes owing to unhealthy
stools irritating the bowels, and showing itself, by sympathy, on the
skin. Red-gum consists of several small papulae, or pimples, about the
size of pins' heads, and may be known from measles--the only disease
for which it is at all likely to be mistaken--by its being unattended
by symptoms of cold, such as sneezing, running, and redness of the
eyes, &c., and by the patches _not_ assuming a crescentic--half-moon
shape; red-gum, in short, may readily he known by the child's health
being unaffected, unless, indeed, there be a great crop of pimples;
then there will be slight feverishness.
_What to do_.--Little need be done. If there be a good deal of
irritation, a mild aperient should be given. The child ought to be
kept moderately, but not very warm.
_What NOT to do_.--Draughts of air, or cold should be carefully
avoided; as, by sending the eruption suddenly in, either convulsions
or disordered bowels might be produced. Do not dose him with
grey-powder.
107. _How would you prevent "Stuffing of the nose" in a new-born
babe_?
Rubbing a little tallow on the bridge of the nose is the old-fashioned
remedy, and answers the purpose. It ought to be applied every evening
just before putting him to bed. If the "stuffing" be severe, dip a
sponge in hot water, as hot as he can comfortably bear; ascertain that
it be not too hot, by previously applying it to your own face, and
then put it for a few minutes to the bridge of his nose. As soon as
the hard mucus is within reach, it should be carefully removed.
108. _Do you consider sickness injurious to an infant_?
Many thriving babies are, after taking the breast, frequently sick;
still we cannot look upon sickness otherwise than as an index of
either a disordered or of an overloaded stomach. If the child be sick,
and yet be thriving, it is a proof that he overloads his stomach. A
mother, then, must not allow him to suck so much, at a time. She
should, until he retain all he takes, lessen the quantity of milk. If
he be sick and does _not_ thrive, the mother should notice if the milk
he throws up has a sour smell; if it have, she must first of all look
to her own health; she ought to ascertain if her own stomach be out of
order; for if such be the case, it is impossible for her to make good
milk. She should observe whether in the morning her own tongue be
furred and dry; whether she have a disagreeable taste in her mouth, or
pains at her stomach, or heart-burn, or flatulence. If she have all,
or any of these symptoms, the mystery is explained why he is sick and
does not thrive. She ought then to seek advice, and a medical man will
soon put her stomach into good order; and, by so doing, will, at the
same time, benefit her child.
But if the mother be in the enjoyment of good health, she must then
look to the babe himself, and ascertain if he be cutting his teeth; if
the gums require lancing; if the secretions from the bowels be proper
both in quantity and in quality; and, if he have had _artificial_
food--it being absolutely necessary to give such food--whether it
agree with him.
_What to do_.--In the first place, if the gums be red, hot, and
swollen, let them be lanced; in the second, if the secretion from the
bowels be either unhealthy or scanty, give him a dose of aperient
medicine, such as caster oil, or the following:--Take two or three
grains of powdered Turkey rhubarb, three grains of pure carbonate of
magnesia, and one grain of aromatic powder--Mix. The powder to be
taken at bed-time, mixed in a tea-spoonful of sugar and water, and
which should, if necessary, be repeated the following night. In the
third place, if the food he be taking does not agree with him, change
it (_vide_ answer to question 33). Give it in smaller quantities at a
time, and not so frequently; or what will be better still, if it be
possible, keep him, for a while, entirely to the breast.
_What NOT to do_.--Do not let him overload his stomach either with
breast milk, or with _artificial food_. Let the mother avoid, until
his sickness be relieved, greens, cabbage, and all other green
vegetables.
109. _What are the causes, the symptoms, the prevention, and the cure
of Thrush_?
The thrush is a frequent disease of an infant, and is often brought on
either by stuffing or by giving him improper food. A child brought up
_entirely_, for the first three or four months, on the breast, seldom
suffers from this complaint. The thrush consists of several irregular,
roundish, white specks on the lips, the tongue, the inside and the
angles of the mouth, giving the parts affected the appearance of curds
and whey having been smeared upon them. The mouth is hot and painful,
and he is afraid to suck; the moment the nipple is put to his mouth he
begins to cry. The thrush, sometimes, although but rarely, runs
through the whole of the alimentary canal. It should be borne in mind
that nearly every child, who is sucking, has his or her tongue white
or "frosted," as it is sometimes called. The thrush may be mild or
very severe.
Now with regard to what to do.--As the thrush is generally owing to
improper and to artificial feeding, _if the child be at the breast_,
keep him, for a time, entirely to it. Do not let him be always
sucking, as that will not only fret his month, but will likewise
irritate and make sore the mother's nipple.
_If he be not at the breast_, but has been weaned, then keep him for a
few days entirely to a milk diet--to the milk of ONE cow--either
boiled, if it be hot weather, to keep it sweet; or unboiled, in cool
weather--fresh as it comes from the cow, mixed with warm water.
The best medicine is the old-fashioned one of Borax, a combination of
powdered lump-sugar and borax being a good one for the purpose: the
powdered lump-sugar increases the efficacy, and the cleansing
properties of the borax; it tends, moreover, to make it more
palatable.--
Take of--Borax, half a drachm;
Lump Sugar, two scruples;
To be well mixed together, and made into twelve powders. One of the
powders to be put dry on the tongue every four hours.
The best _local_ remedy is Honey of Borax, which ought to be smeared
frequently, by means of the finger, on the parts affected.
Thorough ventilation of the apartment must be observed; and great
cleanliness of the vessels containing the milk should be insisted
upon.
In a bad case of thrush, change of air to the country is most
desirable; the effect is sometimes, in such cases, truly magical.
If the thrush be brought on either by too much or by improper food; in
the first case of course, a mother must lessen the quantity; and, in
the second, she should be more careful in her selection.
_What NOT to do_.--Do not use either a calf's teat or wash leather for
the feeding-bottle; fortunately, since the invention of India-rubber
teats, they are now nearly exploded; they were, in olden times,
fruitful causes of thrush. Do not mind the trouble of ascertaining
that the cooking-vessels connected with the baby's food are perfectly
clean and sweet. Do not leave the purity and the goodness of the cow's
milk (it being absolutely necessary to feed him on artificial food) to
be judged either by the milk-man, or by the nurse, but taste and prove
it yourself. Do not keep the milk in a warm place, but either in the
dairy or in the cellar; and, if it be summer time, let the jug holding
the milk be put in a crock containing lumps of ice. Do not use milk
that has been milked longer than twelve hours, but if practicable,
have it milked direct from the cow, and use it _immediately_--let it
be really and truly fresh and genuine milk.
When the disease is _severe_, it may require more active
treatment--such as a dose of calomel; _which medicine must never be
given unless it be either under the direction of a medical man, or
unless it be in an extreme case,--such as dysentery_; [Footnote: See
the Treatment of Dysentery.] therefore, the mother had better seek
advice.
In a _severe_ case of thrush, where the complaint has been brought on
by _artificial_ feeding--the babe not having the advantage of the
mother's milk--it is really surprising how rapidly a wet-nurse--if the
case has not been too long deferred--will effect a cure, where all
other means have been tried and have failed. The effect has been truly
magical! In a severe case of thrush pure air and thorough ventilation
are essential to recovery.
110. _Is anything to be learned from the cry of an infant_?
A babe can only express his wants and his necessities by a cry; he can
only tell his aches and his pains by a cry; it is the only language of
babyhood; it is the most ancient of all languages; it is the language
known by our earliest progenitors; it is, if listened to aright, a
very expressive language, although it is only but the language of a
cry--
"Soft infancy, that nothing canst but cry."--_Shakspeare_.
There is, then, a language in the cry of an infant, which to a mother
is the most interesting of all languages, and which a thoughtful
medical man can well interpret. The cry of a child, to an experienced
doctor, is, each and all, a distract sound, and is as expressive as
the notes of the gamut. The cry of passion, for instance, is a furious
cry; the cry of sleepiness is a drowsy cry; the cry of grief is a
sobbing cry; the cry of an infant when roused from sleep is a shrill
cry; the cry of hunger is very characteristic,--it is unaccompanied
with tears, and is a wailing cry; the cry of teething is a fretful
cry; the cry of pain tells to the practised ear the part of pain; the
cry of ear-ache is short, sharp, piercing, and decisive, the head
being moved about from side to side, and the little hand being often
put up to the affected side of the head; the cry of bowel-ache is also
expressive,--the cry is not so piercing as from ear-ache, and is an
interrupted, straining cry, accompanied with a drawing-up of the legs
to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the
cry of inflammation of the lungs is more a moan than a cry; the cry of
croup is hoarse, and rough, and ringing, and is so characteristic that
it may truly be called "the croupy cry;" the cry of inflammation of
the membranes of the brain is a piercing shriek--a danger signal--most
painful to hear; the cry of a child recovering from a severe illness
is a cross, and wayward, and tearful cry; he may truly be said to be
in a quarrelsome mood; he bursts out, without rhyme or reason, into a
passionate flood of tears--into "a tempest of tears:" tears are
always, in a severe illness, to be looked upon as a good omen, as a
"The tears that heal and bless"--_H. Bonar_.
Tears, when a child is dangerously ill, are rarely, if ever, seen; a
cry, at night, for light--a frequent cause of a babe crying--is a
restless cry:--
"An infant--crying in the night;
An infant crying for the light:
And with no language hat a cry."--_Tennyson_.
111. _If an infant be delicate, have you any objection to his having
either veal or mutton broth, to strengthen him_?
Broths seldom agree with a babe at the breast I have known them
produce sickness, disorder the bowels, and create fever. I recommend
you, therefore, not to make the attempt.
Although broth and beef-tea, when taken by the mouth, will seldom
agree with an infant at the breast, yet, when used as an enema, and in
small quantities, so that they may be retained, I have frequently
found them to be of great benefit, they have in some instances
appeared to have snatched delicate children from the brink of the
grave.
112. _My baby's ankles are very weak: what do you advise to strengthen
them_?
If his ankles be weak, let them every morning be bathed, after the
completion of his morning's ablution, for fire minutes each time, with
bay-salt and water, a small handful of bay-salt dissolved in a quart
of rain water (with the chill of the water off in the winter, and of
its proper temperature in the summer time); then let them be dried;
after the drying, let the ankles he well rubbed with the following
liniment:--
Take of--Oil of Rosemary, three drachms;
Liniment of Camphor, thirteen drachms:
To make a Liniment
Do not let him be put on his feet early; but allow him to crawl, and
sprawl, and kick about the floor, until his body and his ankles become
strong.
Do not, on any account, without having competent advice on the
subject, use iron instruments, or mechanical supports of any kind: the
ankles are generally, by such artificial supports, made worse, in
consequence of the pressure causing a further dwindling away and
enfeebling of the ligaments of the ankles, already wasted and
weakened.
Let him wear shoes with straps over the insteps to keep them on, and
not boots: boots will only, by wasting the ligaments, increase the
weakness of the ankles.
113. _Sometimes there is a difficulty in restraining the bleeding of
leech bites. What is the best method_?
The difficulty in these cases generally arises from the improper
method of performing it. For example--a mother endeavours to stop the
haemorrhage by loading the part with rag; the more the bites discharge,
the more rag she applies. At the same time, the child probably is in a
room with a, large fire, with two or three candles, with the doors
closed, and with perhaps a dozen people in the apartment, whom the
mother has, in her fright, sent for. This practice is strongly
reprehensible.
If the bleeding cannot be stopped,--in the first place, the fire most
be extinguished, the door and windows should be thrown open, and the
room ought to be cleared of persons, with the exception of one, or, at
the most, two; and every rag should be removed. "Stopping of leech
bites.--The simplest and most certain way, till the proper assistance
is obtained, is the pressure of the finger, with nothing
intervening. It _cannot_ bleed through that." [Footnote: Sir Charles
Locock, in a _Letter_ to the Author.]
Many babies, by excessive loss of blood from leech bites, have lost
their lives from a mother not knowing how to act, and also from the
medical man either living at a distance, or not being at
hand. Fortunately for the infantile community, leeches are now very
seldom ordered by doctors.
114. _Supposing a baby to be poorly, have you any advice to give to
his mother as to her own management_?
She must endeavour to calm her feelings or her milk will be
disordered, and she will thus materially increase his illness. If he
be labouring under any inflammatory disorder, she ought to refrain
from the taking of beer, wine, and spirits, and from all stimulating
food; otherwise, she will feed his disease.
Before concluding the first part of my subject--the Management of
Infancy--let me again urge upon you the importance--the paramount
importance--if you wish your babe to be strong and hearty,--of giving
him as little opening physic as possible. The best physic for him is
Nature's physic--fresh air, and exercise, and simplicity of living. A
mother who is herself always drugging her child, can only do good to
two persons--the doctor and the druggist!
If an infant from his birth be properly managed,--if he have an
abundance of fresh air for his lungs,--if he have plenty of exercise
for his muscles (by allowing him to kick and sprawl on the floor),--if
he have a good swilling and sousing of water for his skin,--if, during
the _early_ months of his life, he have nothing but the mother's milk
for his stomach,--he will require very little medicine--the less the
better! He does not want his stomach to be made into a doctor's shop!
The grand thing is not to take every opportunity of administering
physic, but of using every means of with-holding it! And if physic be
necessary, not to doctor him yourself, unless it be in extreme and
urgent cases (which in preceding and succeeding Conversations I either
have or will indicate), but to employ an experienced medical man. A
babe who is always, without rhyme or reason, being physicked, is sure
to be puny, delicate, and unhealthy, and is ready at any moment to
drop into an untimely grave!
I will maintain that a healthy child _never_ requires drugging with
opening physic, and that costiveness is brought on by bad
management. Aperient medicines to a healthy child are so much poison!
_Let me impress the above remarks on every mother's mind;_ for it is a
subject of vital importance. Never, then, give a purgative to a
healthy child; for, if he be properly managed, he will never require
one. If you once begin to give aperients, you will find a difficulty
discontinuing them. Finally, I will only say with _Punch_,--"Don't"
CONCLUDING REMARKS ON INFANCY.
115. In concluding the first part of our subject--Infancy--I beg to
remark: there are four things essentially necessary to a babe's
well-doing, namely, (1) plenty of water for his skin; (2) plenty of
fresh genuine milk mixed with water for his stomach (of course, giving
him ONLY his mother's milk during the first six, eight, or nine
months of his existence); (3) plenty of pure air for his lungs; (4)
plenty of sleep for his brain: these are the four grand essentials for
an infant; without an abundance of one and all of them, perfect health
is utterly impossible! Perfect health! the greatest earthly blessing,
and more to be coveted than ought else beside! There is not a more
charming sight in the universe than the beaming face of a perfectly
healthy babe,--
"His are the joys of nature, his the smile,
The cherub smile, of innocence and health."--_Knox._