[Illustration: AT HOME.]
THE
PHYSICAL TRAINING
OF
CHILDREN.
BY P. H. CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE
MEDICO CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A WIFE ON
THE MANAGEMENT OF HER OWN HEALTH,” ETC., ETC.
WITH
A PRELIMINARY DISSERTATION,
BY F. H. GETCHELL, M.D.,
CLINICAL LECTURER ON THE DISEASES OF WOMEN AND CHILDREN AT THE JEFFERSON
MEDICAL COLLEGE, OBSTETRICIAN TO THE CATHARINE STREET DISPENSARY, FELLOW
OF THE COLLEGE OF PHYSICIANS, AND MEMBER OF THE PATHOLOGICAL SOCIETY,
PHILADELPHIA; CORRESPONDING MEMBER OF THE GYNŒCOLOGICAL SOCIETY OF
BOSTON; AUTHOR OF “THE MATERNAL MANAGEMENT OF INFANCY,” ETC., ETC.
[Illustration]
PHILADELPHIA, PA.:
NEW-WORLD PUBLISHING COMPANY,
MIDDLETOWN, CONN.: PARMELEE & CO.
BURLINGTON, IOWA: R. T. ROOT.
1871.
Entered according to Act of Congress, in the year 1871, by
NEW-WORLD PUBLISHING COMPANY,
(JOHN C. COPPER.—S. J. VANDERSLOOT,)
In the Office of the Librarian of Congress at Washington, D. C.
CONTENTS.
INFANCY.
PAGE
PRELIMINARY CONVERSATION 17
ABLUTION 19
MANAGEMENT OF THE NAVEL 26
CLOTHING 29
DIET 33
VACCINATION 53
DENTITION 58
EXERCISE 69
SLEEP 71
THE BLADDER AND THE BOWELS 76
AILMENTS, DISEASE, ETC. 77
CONCLUDING REMARKS ON INFANCY 106
CHILDHOOD.
ABLUTION 108
CLOTHING 111
DIET 118
THE NURSERY 133
EXERCISE 151
AMUSEMENTS 155
EDUCATION 160
SLEEP 164
SECOND DENTITION 169
DISEASE, ETC. 170
WARM BATHS 253
WARM EXTERNAL APPLICATIONS 254
ACCIDENTS 256
BOYHOOD AND GIRLHOOD.
ABLUTION, ETC. 274
CLOTHING 282
DIET 286
AIR AND EXERCISE 290
AMUSEMENTS 294
EDUCATION 298
HOUSEHOLD WORK FOR GIRLS 305
CHOICE OF PROFESSION OR TRADE 305
SLEEP 308
ON THE TEETH AND THE GUMS 313
PREVENTION OF DISEASE, ETC. 315
INDEX 347
INTRODUCTION.
Nothing is more to be regretted than the fact that the females of this
country grow up to womanhood in entire ignorance of all that relates to
their future condition as parents, and the physical and mental
development of the young for whose welfare they may yet be so deeply
responsible. “It is not to be wondered at that when the young wife finds
herself a mother, she is kept in a state of painful alarm and
apprehension by the most trifling occurrence, or allows real danger to
steal on in a state of the most fatal, because unguarded, security.” The
alarming mortality of childhood, amounting to nearly half the children
born, before the age of five years is reached, leads us to inquire
whether it is an unavoidable fatality of our race, and therefore must be
patiently submitted to, or is to a great extent the result of ignorance
on the part of those to whom the care of the infant man is intrusted?
The perfection of the human frame, and its admirable adaptation to
external nature, together with the fact that the preservation or
destruction of life in infancy bears a marked and direct relation to the
nature of the treatment to which the young being is subjected, solves
the question beyond the possibility of a doubt.
The want of success in the management of the infant cannot be charged to
neglect on the part of the parent, for “the kindest feelings flow out
instinctively towards a helpless offspring.”
“Morning and evening thou hast watched the bee
Go forth on her errand of industry;
The bee for herself hath gathered and toiled,
But the mother’s toils are for her child.”
The sole cause of the difficulty is that the mother has never been
instructed,—no pains has been taken to teach her, and she has neglected
to inform herself, and now that she finds the life and welfare of her
offspring dependent on her care and management, she applies to her
friends for assistance and receives advice of so contradictory a nature
that she is ready to give up in despair. It is to relieve mothers from
this dilemma, which is one frequently observed by the physician, that
the author gives the advice and instruction contained in this volume;
and most admirably has he succeeded in his very difficult undertaking to
write on a subject so little understood as physical education, and make
it perfectly clear to the understanding of all.
J. F. P. Richter says of children: “I would create a world specially for
myself and suspend it under the mildest sun; a little world where I
would have nothing but little lovely children, and these little things I
would never suffer to grow up, but only to play eternally. If a seraph
were weary of heaven, or his golden pinions drooped, I would send him to
dwell a month upon my happy infant world; and no angel, so long as he
saw their innocence, could lose his own.”
The arrangement of the book is in the form of questions and answers.
This is an excellent idea, the long experience of the author, as a
physician, enabling him to suggest many important questions that would
escape the inexperienced mother or nurse.
The first chapter treats of the management of the infant from the moment
of its birth; and, although the care of the infant is not intrusted to
the mother at this time, it is very important that she should know just
how it should be managed, and she will then be able to instruct her
nurse, and prevent her carrying into execution many of the hobbies of
which old nurses are often very fond. The most of them are founded on
error, and may be of the greatest injury to the infant at this tender
period of its existence. For instance, the author tells us that the
infant should be put to the mother’s breast soon after its birth, and
should receive food of no other kind. Now there is the strongest desire
on the part of many nurses to feed the child with some one of the many
preparations used for this purpose as soon as it is dressed, or, at any
rate, before the mother’s milk makes its appearance—forgetting that
nature has made no mistake in her affairs here, and will not be
interfered with without requiring the poor victim to pay the
penalty;—and so we find that if the child’s stomach be filled with pap,
gruel, or anything of the kind, the result will be acidity, griping,
colic, and vomiting, and you will have made a bad beginning by
interfering with nature, instead of a good one by leaving her alone. In
very many cases the harm is done by trying to assist nature, and, on
account of an ignorance of the natural laws, the intended assistance
becomes a positive interference; and it is in view of this fact that the
author tells us what not to do, as well as what to do; and whenever the
mother is in doubt as to her course, she has only to turn to the chapter
treating of the subject under consideration, and her mind is at once
relieved.
Full instruction is given in regard to the clothing of infants. And
nothing is more important; for one would suppose we should find deaths
from pulmonary complaints, such as pneumonia and bronchitis, more
frequent in adult life,—our occupations being of such a nature as to
constantly expose us to the vicissitudes of the weather,—but the
opposite is the fact, and the mortality from these diseases is far
greater during childhood. The sources from which animal heat is derived,
are smallest at birth, and increase till the child is full grown; but,
instead of realizing this fact, and protecting the child with sufficient
clothing, it is supposed to be comfortable when large portions of the
body are entirely uncovered, while the parents find much more clothing
requisite for both comfort and health—and the result is that many
perish, and others are compelled to go on through life with impaired
constitutions, for the condition of the pulmonary organs in after life
depends, to a very great extent, on the treatment the person received
during the tender period of infancy.
“’Tis the work
Of many a dark hour and of many a prayer
To bring the heart back from an infant gone.”—N. P. WILLIS.
After a few months the child requires other food than that derived from
the mother, and it is of great importance that no mistake be made in the
kind of food given the child; for, as we have already seen that the
condition of the pulmonary organs of the adult depends to a very great
extent upon the clothing of the infant, so will the condition of the
digestive organs depend upon the selection of the food for the infant at
this period of its existence, and if it be of the proper character all
will be well, but if, as is too often the case, the food given be of an
indigestible nature, the ground-work of dyspepsia is laid, and it will
torment the unfortunate creature as long as he lives. In a great
majority of cases children are given table-food far too early, and
nothing is more common than to be told by the mother that her child
grows “thinner and thinner,” though she is giving it all the meat it
will eat. Now, our author shows us that the reason the child does not
thrive is because its digestive organs are not far enough advanced to
extract the nutriment from food of this kind, but that it irritates, and
is a positive injury to the infant. And he then explains the important
fact that the child does not thrive on that kind of food that contains
the most nutriment itself, but on that which is best adapted to the
condition of the digestive organs at the time it is given. And then he
tells us what that is, and takes us on from step to step, making all the
changes necessary in the diet throughout the entire period of infancy
and childhood. He also calls our attention to those articles of food
that are indigestible at all times, and gives many important directions
in regard to the preparation of the food, time for giving it, and the
amount that should be given.
Perhaps no part of the work is more important than the instruction given
in regard to the raising of children by hand (as it is called); for here
the life of the infant may be said to depend, to a very great extent,
upon the treatment it receives from those who have it in charge, and it
is for this reason that the author has been very explicit in his
instructions. He has, in fact, left nothing to be wished for; he gives
the minutest directions as to the kind of food, the mode of preparation,
the time for feeding, and the general management of the infant who is so
unfortunate as to be deprived of the sustenance nature intended for its
support. The wet-nurse comes in, also, for her share of attention, and
we are told how to select one, and rules are laid down for her diet,
exercise, etc. And it is not a matter of indifference whether these
rules are attended to or not; for, on the condition of the health of the
nurse will depend the character of her milk, and of course we cannot
expect a child to be healthy that receives impure milk from its nurse.
Very important instruction is given for our guidance in the management
of the child when sick. Everything relating to the sick-room is fully
discussed, and the most minute directions given for the assistance of
the mother at this critical period of the child’s existence.
Considerable space is taken with prescriptions and the administration of
medicine, which is of much value to those not within the reach of the
family physician. But if the child is sick the physician should always
be notified at once, if it be possible, for much depends upon the early
treatment of the disease; and in no case should the limited knowledge of
the mother be substituted for that of the experienced physician. It must
be remembered that this book is not intended exclusively for those who
are always within the reach of a physician, but it is also for the
guidance and assistance of whose who are far from, or unable to obtain,
medical advice, and to those located on the frontier, and at the
missionary stations, this part of the work has proved to be of the
greatest advantage.
Sound advice is given in regard to dosing children with many quack
cordials, carminatives, and syrups, that fill the shops, all of which
are advertised to contain no opium, and yet the busy practitioner hardly
passes a month without being called to attend a child dangerously
narcotized by some one of these preparations.
It is to induce sleep that these preparations are given, the mother not
being aware that if an anodyne be used to-day, a larger dose will be
required to-morrow to produce the same effect, and also that by its
interference with digestion the habitual use of narcotics always injures
the health of the child. For these reasons laudanum, paregoric, or any
preparations containing opium in any form, should never be given to the
infant, unless under the control of a physician.
The management of the nursery is not overlooked, and very judicious
rules for selecting, warming, and ventilating the apartment are given.
As the child advances, the teeth begin to make their appearance, and
this is always a source of more or less irritation; but, by a little
care at this time, the child passes through it with little discomfort,
and serious consequences are avoided. The importance of proper
regulation of the diet, and the soothing effect of fresh air upon the
irritated nervous system at this time, cannot be over-estimated.
The modes of exercising the child are explained, and as the development
of the muscular system depends to so great an extent on judicious
exercise, no mother should fail to become acquainted with the
instruction given on this subject.
The infant man, like the adult one, is a creature of habit, and, with a
little systematic training, it is very easy to form good habits,
provided you begin early; but, if you delay until bad habits have been
formed, it then becomes an entirely different matter. In the simple
operation of getting the child to sleep, the difficulty experienced is
generally the result of not beginning with it until bad habits have been
formed. It is just as easy for the infant to go to sleep at a regular
time every day by being placed quietly in the bed, as it is for it to go
to sleep after being patted, trotted, and walked about the room for an
hour or two; but, if it is walked to-day, of course it will expect it
to-morrow. The ill effects of this kind of treatment, together with the
way in which it is to be avoided, the author has plainly given us.
Bathing, if properly conducted, is always agreeable, and of advantage to
the child, and mothers often ask how often they should bathe their
children, and whether in warm or cold water, and, as even the bathing of
the child may be done improperly, directions are given which should
always be followed. The child may be bathed too often, or not often
enough, or in an improper manner. For instance, it may be seated in a
bath-tub with the water half way up the body, and then water splashed up
over the shoulders, leaving the chest subjected to the chilling effects
of evaporation, and material harm may thereby result.
The amusement of the child very properly comes in for a share of the
author’s attention. All parents should realize the importance of making
the child’s home cheerful, and should not forget that the happiness of
the child has much to do with its health and the development of its
mental nature. It is astonishing at how small an expense, with a little
contrivance, the gloomy, quiet nursery may be converted into a cheerful,
happy one, and a small plot of ground into a full-sized farm in the mind
of the infant farmer.
“Oh! happy age, when harmless pleasures please,
Gay as the lark, and fickle as the breeze:
Well may we sigh, in after years of pain,
To think that hour will never come again.
How small the grief that dims the sunny eye—
How light the thoughtless tear—how quickly dry;
A toy, a butterfly, thy smiles renew,
As from the flow’r the sunbeams chase the dew.”
Parents are too apt to overlook these, to them, unimportant little
things, and it is for this reason that the author calls attention to it,
and shows us that rational amusements not only develop the physical, but
exert an immense influence on the intellect of the child.
The views of the author in regard to the education of the child are
clearly given. In this country children are sent to school far too
young. The mind is overtaxed before the body has had time to develop,
and a debilitated constitution is too often the result. It is of little
consequence whether a child reads at six years or not until it is ten.
First develop the physical, then at the proper time the vigorous
intellect will climb the hill of knowledge, leaving far behind the
student whose constitution was destroyed by overcrowding the brain
during the tender age of childhood.
“The main design of nature in early youth, is _not_ the speedy
development of the mind,—for she has designedly, as it were, withheld
this agent,—but the development and growth of the body, by means of the
nutritive functions so carefully provided for the purpose. All the
energies of the constitution are then required for the promotion of this
object; and if the brain be then cultivated too assiduously, these
energies are abstracted from their legitimate purpose, and physical
debility, ending most probably in disease and decay is produced. Does it
not thus clearly and manifestly appear, that premature and too exclusive
mental cultivation is to thwart nature by interfering with her
operations in the careful development of the physical constitution of
youth?”
It was the opinion of Rosseau “that the chief art of education in
childhood is _to lose time_; that every delay should be considered an
advantage, care being taken not to give that instruction to-day which
may be deferred, without danger, till to-morrow.” The same writer says:
“The most critical interval of human life is that between the hour of
birth and twelve years of age. This is the time wherein vice and error
take root, without our being possessed of any instrument to destroy
them; and when the implement is found they are so deeply grounded that
they are no longer to be eradicated.
“If children took a leap from their mother’s breast and at once arrived
at the age of reason, the methods of education now usually taken with
them would be very proper; but, according to the progress of nature,
they require those which are very different. We should not tamper with
the mind till it has acquired all its faculties; for it is impossible it
should perceive the light we hold out to it while it is blind, or that
it should pursue, over an immense plain of ideas, that route which
reason hath so slightly traced as to be perceptible only to the sharpest
sight.
“The first part of education, therefore, ought to be purely negative. It
consists neither in teaching virtue nor truth, but in guarding the heart
from vice and the mind from error.”
“Meantime a smiling offspring rises round,
And mingles both their graces. By degrees,
The human blossom blows; and every day,
Soft as it rolls along, shows some new charm—
The father’s luster, and the mother’s bloom.”
THOMSON’S SEASONS.
After this brief review, the only conclusion that we can come to is,
that everything depends upon a proper system of physical training.
Without a systematic development of the physical frame, a healthful and
vigorous intellectual condition need not be looked for. The mental and
the physical parts of education are as inseparable as the action of the
mind from that of the bodily organs—they are created for and adapted to
each other, and so sympathize as to form an harmonious whole. Now, if
the mothers of the land will give their attention to the subject of
Physical Education, the mortality of childhood will decrease, the
condition of mankind improve, enjoyment be promoted, and, by enabling
all to cultivate the higher faculties and affections, the human family
will effect the nearest approach to perfection that it is possible to
attain on earth.
F. H. GETCHELL,
1432 Spruce Street, Phila.
_October, 1870._
INFANCY.
_I hardly know so melancholy a reflection, as that Parents are
necessarily the sole directors of the management of Children; whether
they have, or have not judgment, penetration, or taste, to perform the
task._—GREVILLE.
_Man’s breathing Miniature!_—COLERIDGE.
PRELIMINARY CONVERSATION.
1. _I wish to consult you on many subjects appertaining to the
management and the care of children,—will you favor me with your advice
and counsel?_
I shall be happy to accede to your request, and to give you the fruits
of my experience in the clearest manner I am able, and in the simplest
language I can command—freed from all technicalities. I will endeavor to
guide you in the management of the health of your offspring;—I will
describe to you the _symptoms_ of the diseases of children;—I will warn
you of approaching danger, in order that you may promptly apply for
medical assistance before disease has gained too firm a footing;—I will
give you the _treatment_ on the moment of some of their more pressing
illnesses—when medical aid cannot quickly be procured, and where delay
may be death;—I will instruct you in case of accidents, on the
_immediate_ employment of remedies—where procrastination may be
dangerous; I will tell you how a sick child should be nursed, and how a
sick room ought to be managed;—I will use my best energy to banish
injurious practices from the nursery;—I will treat of the means to
prevent disease where it be possible;—I will show you the way to
preserve the health of the healthy,—and how to strengthen the
delicate;—and will strive to make a medical man’s task more agreeable to
himself,—and more beneficial to his patient,—by dispelling errors and
prejudices, and by proving the importance of your _strictly_ adhering to
his rules. If I can accomplish any of these objects, I shall be amply
repaid by the pleasing satisfaction that I have been of some little
service to the rising generation.
2. _Then you consider it important that I should be made acquainted
with, and be well informed upon, the subjects you have just named?_
Certainly. I deem it to be your imperative duty to _study_ the subject
well. The proper management of children is a vital question,—a mother’s
question,—and the most important that can be brought under the
consideration of a parent; and, strange to say, it is one that has been
more neglected than any other. How many mothers undertake the
responsible management of children without previous instruction, or
without forethought; they undertake it as though it may be learned
either by intuition or by instinct or by affection! The consequence is,
that frequently they are in a sea of trouble and uncertainty, tossing
about without either rule or compass; until, too often, their hopes and
treasures are shipwrecked and lost!
The care and management, and consequently the health and future
well-doing of the child, principally devolve upon the mother; “for it is
the mother after all that has most to do with the making or the marring
of the man.” Dr. Guthrie justly remarks that—“Moses might never have
been the man he was unless he had been nursed by his own mother. How
many celebrated men have owed their greatness and their goodness to a
mother’s training!” Napoleon owed much to his mother. “‘The fate of a
child,’ said Napoleon, ‘is always the work of his mother;’ and this
extraordinary man took pleasure in repeating, that to his mother he owed
his elevation. All history confirms this opinion.... The character of
the mother influences the children more than that of the father, because
it is more exposed to their daily, hourly observation.”
I am not overstating the importance of the subject in hand when I say
that a child is the most valuable treasure in the world, that “he is the
precious gift of God,” that he is the source of a mother’s greatest and
purest enjoyment, that he is the strongest bond of affection between her
and her husband, and that
“A babe in a house is a well-spring of pleasure,
A messenger of peace and love.”
In the writing of the following pages I have had one object constantly
in view—namely, health—
“That salt of life, which does to all a relish give;
Its standing pleasure, and intrinsic wealth,
The body’s virtue, and the soul’s good fortune—health.”
ABLUTION.
3. _Is a new-born infant, for the first time, to be washed in warm or in
cold water?_
It is not an uncommon plan to use _cold_ water from the first, under the
impression of its strengthening the child. This appears to be a cruel
and barbarous practice, and is likely to have a contrary tendency.
Moreover, it frequently produces either inflammation of the eyes, or
stuffing of the nose, or inflammation of the lungs, or looseness of the
bowels. Although I do not approve of _cold_ water, we ought not to run
into an opposite extreme, as _hot_ water would weaken and enervate the
babe, and thus would predispose him to disease. Lukewarm _rain_ water
will be the best to wash him with. This, if it be summer, should have
its temperature gradually lowered, until it be quite cold; if it be
winter, a _dash_ of warm water ought still to be added, to take off the
chill.
It will be necessary to use soap—Castile soap being the best for the
purpose—it being less irritating to the skin than the ordinary soap.
Care should be taken that it does not get into the eyes, as it may
produce either inflammation or smarting of those organs.
If the skin be delicate, or if there be any excoriation or
“breaking-out” on the skin, then Glycerin soap, instead of the Castile
soap, ought to be used.
4. _At what age do you recommend a mother to commence washing her infant
in the tub or in the nursery-basin?_
As soon as the naval-string comes away. Do not be afraid of water,—and
that in plenty,—as it is one of the best strengtheners to a child’s
constitution. How many infants suffer, for the want of water, from
excoriation!
A nursery-basin (Wedgwood’s make is considered the best) holding either
six or eight quarts of water, and which will be sufficiently large to
hold the whole body of the child. The basin is generally fitted into a
wooden frame, which will raise it to a convenient height for the washing
of the baby.
Sir Charles Locock strongly recommends that an infant should be washed
_in a tub_ from the _very_ commencement. He says: “All those that I
superintend _begin_ with a tub.”—_Letter to the Author._
5. _Which do you prefer—flannel or sponge—to wash a child with?_
For the first part of the washing a piece of flannel is very useful—that
is to say, to use with the soap, and to loosen the dirt and the
perspiration; but for the finishing-up process, a sponge—a large
sponge—is superior to flannel, to wash all away, and to complete the
bathing. A sponge cleanses and gets into all the nooks, corners, and
crevices of the skin. Besides, sponge, to finish up with, is softer and
more agreeable to the tender skin of a child than flannel. Moreover, a
sponge holds more water than flannel, and thus enables you to stream the
water more effectually over him. A large sponge will act like a
miniature shower bath, and will thus brace and strengthen him.
6. _To prevent a new-born babe from catching cold, is it necessary to
wash his head with brandy?_
It is _not_ necessary. The idea that it will prevent cold is erroneous,
as the rapid evaporation of heat which the brandy causes is more likely
to give than to prevent cold.
7. _Ought that tenacious, paste-like substance, adhering to the skin of
a new-born babe, to be washed off at the first dressing?_
It should, provided it be done with a soft sponge and with care. If
there be any difficulty in removing the substance, gently rub it, by
means of a flannel, either with a little lard, or fresh butter, or sweet
oil. After the parts have been well smeared and gently rubbed with the
lard, or oil, or butter, let all be washed off together, and be
thoroughly cleansed away, by means of a sponge and soap and warm water,
and then, to complete the process, gently put him for a minute or two in
his tub. If this paste-like substance be allowed to remain on the skin,
it might produce either an excoriation or a “breaking-out.” Besides, it
is impossible, if that tenacious substance be allowed to remain on it,
for the skin to perform its proper functions.
Mrs. Baines (who has written so much and so well on the Management of
Children), in a _Letter_ to the Author, recommends flannel to be used in
the _first_ washing of an infant, which flannel ought afterward to be
burned; and that the sponge should be only used to complete the process,
to clear off what the flannel had already loosened. She also recommends
that every child should have his own sponge, each of which should have a
particular distinguishing mark upon it, as she considers the promiscuous
use of the same sponge to be a frequent cause of _ophthalmia_
(inflammation of the eyes). The sponges cannot be kept too clean.
8. _Have you any general observations to make on the washing of a
new-born infant?_
A babe ought, every morning of his life, to be thoroughly washed from
head to foot; and this can only be properly done by putting him bodily
either into a tub, or into a bath, or into a large nursery-basin half
filled with water. The head, before placing him in the bath, should be
first wetted (but not dried); then immediately put him into the water,
and, with a piece of flannel well soaked, cleanse his whole body,
particularly his armpits, between his thighs, his groins, and his hams;
then take a large sponge in hand, and allow the water from it, well
filled, to stream all over his body, particularly over his back and
loins. Let this advice be well observed, and you will find the plan most
strengthening to your child. The skin must, after every bath, be
thoroughly but quickly dried with warm, dry, soft towels, first
enveloping the child in one, and then gently absorbing the moisture with
the towel, not roughly scrubbing and rubbing his tender skin as though a
horse were being rubbed down.
The ears must after each ablution be carefully and well dried with a
soft dry napkin; inattention to this advice has sometimes caused a
gathering in the ear—a painful and distressing complaint; and at other
times it has produced deafness.
Directly after the infant is dried, all the parts that are at all likely
to be chafed ought to be well powdered. After he is well dried and
powdered, the chest, the back, the bowels, and the limbs should be
gently rubbed, taking care not to expose him unnecessarily during such
friction.
He ought to be partially washed every evening; indeed it may be
necessary to use a sponge and a little warm water frequently during the
day, namely, each time after the bowels have been relieved. _Cleanliness
is one of the grand incentives to health_, and therefore cannot be too
strongly insisted upon. If more attention were paid to this subject,
children would be more exempt from chafings, “breakings-out,” and
consequent suffering, than they at present are. After the second month,
if the babe be delicate, the addition of two handfuls of table salt to
the water he is washed with in the morning will tend to brace and
strengthen him.
With regard to the best powder to dust an infant with, there is nothing
better for general use than starch—the old-fashioned starch _made of
wheaten flour_—reduced by means of a pestle and mortar to a fine powder;
or Violet Powder, which is nothing more than finely-powdered starch
scented, and which may be procured of any respectable chemist. Some
mothers are in the habit of using white lead; but as this is a poison,
it ought _on no account_ to be resorted to. In one case related by Koop
(_Journ. de Pharm._, xx. 603), a child was destroyed by it.
9. _If the parts about the groin and fundament be excoriated, what is
then the best application?_
After sponging the parts with tepid _rain_ water, holding him over his
tub, and allowing the water from a well-filled sponge to stream over the
parts, and then drying them with a soft napkin (not rubbing, but gently
dabbing with the napkin), there is nothing better than dusting the parts
frequently with finely-powdered Native Carbonate of Zinc. The best way
of using this powder is, tying up a little of it in a piece of muslin,
and then gently dabbing the parts with it.
Remember excoriations are generally owing to the want of water—to the
want of an abundance of water. An infant who is every morning well
soused and well swilled with water, seldom suffers either from
excoriations or from any other of the numerous skin diseases.
Cleanliness, then, is the grand preventive of, and the best remedy for,
excoriations. Naaman the Syrian was ordered “to wash and be clean,” and
he was healed, “and his flesh came again like unto the flesh of a little
child, and he was clean.” This was, of course, a miracle; but how often
does water, without any special intervention, act miraculously both in
preventing and in curing skin diseases!
An infant’s clothes, napkins especially, ought never to be washed with
soda; the washing of napkins with soda is apt to produce excoriations
and breakings-out. “As washerwomen often deny that they use soda, it can
be easily detected by simply soaking a clean napkin in fresh water and
then tasting the water; if it be brackish and salt, soda has been
employed.” [Communicated by Sir Charles Locock to the Author.]
10. _Who is the proper person to wash and dress the babe?_
The monthly nurse, as long as she is in attendance; but afterward the
mother, unless she should happen to have an experienced, sensible,
thoughtful nurse, which, unfortunately, is seldom the case. [“The
Princess of Wales might have been seen on Thursday taking an airing, in
a brougham in Hyde Park, with her baby—the future King of England—on her
lap, without a nurse, and accompanied only by Mrs. Bruce. The Princess
seems a very pattern of mothers, and it is whispered among the ladies of
the Court that every evening the mother of this young gentleman may be
seen in a flannel dress, in order that she may properly wash and put on
baby’s night-clothes and see him safely in bed. It is a pretty subject
for a picture.”—_Pall Mall Gazette._]
11. _What is the best kind of apron for a mother, or for a nurse to
wear, while washing the infant?_
Flannel—a good, thick, soft flannel, usually called bath-coating—apron,
made long and full, and which of course ought to be well dried every
time before it is used.
12. _Perhaps you will kindly recapitulate, and give me further advice on
the subject of the ablution of my babe?_
Let him by all means, then, as soon as the navel-string has separated
from the body, be bathed either _in_ his tub, or _in_ his bath, or _in_
his large nursery-basin; for if he is to be strong and hearty, _in_ the
water every morning he must go. The water ought to be slightly warmer
than new milk. It is dangerous for him to remain for a long period in
his bath; this, of course, holds good in a tenfold degree if the child
has either a cold, or a pain in his bowels. Take care that, immediately
after he comes out of his tub, he is well dried with warm towels. It is
well to let him have his bath the first thing in the morning, and before
he has been put to the breast; let him be washed before he has his
breakfast; it will refresh him and give him an appetite. Besides, he
ought to have his morning ablution on an empty stomach, or it may
interfere with digestion, and might produce sickness and pain. In
putting him in his tub, let his head be the first part washed. We all
know, that in bathing in the sea, how much better we can bear the water
if we first wet our head; if we do not do so, we feel shivering and
starved and miserable. Let there be no dawdling in the washing; let it
be quickly over. When he is thoroughly dried with warm _dry_ towels, let
him be well rubbed with the warm hand of the mother or of the nurse. As
I previously recommended, while drying him and while rubbing him, let
him repose and kick and stretch either on the warm flannel apron, or
else on a small blanket placed on the lap. One bathing in the tub, and
that in the morning, is sufficient, and better than night and morning.
During the day, as I before observed, he may, after the action either of
his bowels or of his bladder, require several spongings of lukewarm
water, _for cleanliness is a grand incentive to health and comeliness_.
Remember it is absolutely necessary to every child from his earliest
babyhood to have a bath, to be immersed every morning of his life in the
water. This advice, unless in cases of severe illness, admits of no
exception. Water to the body—to the whole body—is a necessity of life,
of health, and of happiness; it wards off disease, it braces the nerves,
it hardens the frame, it is the finest tonic in the world. Oh, if every
mother would follow to the very letter this advice, how much misery, how
much ill health, might then be averted!
MANAGEMENT OF THE NAVEL.
13. _Should the navel-string be wrapped in_ SINGED _rag_?
There is nothing better than a piece of fine old linen rag, _unsinged_;
when singed, it frequently irritates the infant’s skin.
14. _How ought the navel-string to be wrapped in the rag?_
Take a piece of soft linen rag, about three inches wide and four inches
long, and wrap it neatly round the navel-string, in the same manner you
would around a cut finger, and then, to keep on the rag, tie it with a
few rounds of whity-brown thread. The navel-string thus covered should,
pointing upward, be placed on the belly of the child, and must be
secured in its place by means of a flannel belly-band.
15. _If, after the navel-string has been secured, bleeding should (in
the absence of the medical man) occur, how must it be restrained?_
The nurse or the attendant ought immediately to take off the rag, and
tightly, with a ligature composed of four or five whity-brown threads,
retie the navel-string; and to make assurance doubly sure, after once
tying it, she should pass the threads a second time around the
navel-string and tie it again; and after carefully ascertaining that it
no longer bleeds, fasten it up in the rag as before. Bleeding of the
navel-string rarely occurs, yet if it should do so—the medical man not
being at hand—the child’s after-health, or even his life, may, if the
above directions be not adopted, be endangered.
16. _When does the navel-string separate from the child?_
From five days to a week after birth; in some cases not until ten days
or a fortnight, or even, in rare cases, not until three weeks.
17. _If the navel-string does not at the end of a week come away, ought
any means to be used to cause the separation?_
Certainly not; it ought always to be allowed to drop off, which, when in
a fit state, it will readily do. Meddling with the navel-string has
frequently cost the babe a great deal of suffering, and in some cases
even his life.
18. _The navel is sometimes a little sore after the navel-string comes
away; what ought then to be done?_
A little simple cerate should be spread on lint, and be applied every
morning to the part affected; and a white-bread poultice, every night,
until it be quite healed.
19. _What are the causes of a rupture of the navel? What ought to be
done? Can it be cured?_
(1.) A rupture of the navel is sometimes occasioned by a meddlesome
nurse. She is very anxious to cause the navel-string to separate from
the infant’s body, more especially when it is longer in coming away than
usual. She, therefore, before it is in a fit state to drop off, forces
it away. (2.) The rupture, at another time, is occasioned by the child
incessantly crying. A mother, then, should always bear in mind that a
rupture of the navel is often caused by much crying, and that it
occasions much crying; indeed, it is a frequent cause of incessant
crying. A child, therefore, who, without any assignable cause, is
constantly crying, should have his navel carefully examined.
A rupture of the navel ought always to be treated early—the earlier the
better. Ruptures of the navel can only be _cured_ in infancy and in
childhood. If it be allowed to run on until adult age, a _cure_ is
impossible. Palliative means can then only be adopted.
The best treatment is a Burgundy pitch plaster, spread on a soft piece
of wash-leather about the size of the top of a tumbler, with a properly
adjusted pad (made from the plaster) fastened on the center of the
plaster, which will effectually keep up the rupture, and in a few weeks
will cure it. It will be necessary, from time to time, to renew the
plaster until the cure be effected. These plasters will be found both
more efficacious and pleasant than either a truss or an elastic bandage;
which latter appliances sometimes gall, and do more harm than they do
good.
20. _If a child has a groin rupture (an inguinal rupture), can that also
be cured?_
Certainly, if, soon after birth, it be properly attended to. Consult a
medical man, and he will supply you with a well-fitting truss, _which
will eventually cure him_. If the truss be properly made (under the
directions of an experienced surgeon) by a skillful surgical-instrument
maker, a beautiful, nicely fitting truss will be supplied, which will
take the proper and exact curve of the lower part of the infant’s belly,
and will thus keep on without using any under-strap whatever—a great
desideratum, as these under-straps are so constantly wetted and soiled
as to endanger the patient constantly catching cold. But if this
under-strap is to be superseded, the truss must be made exactly to fit
the child—to fit him like a ribbon; which is a difficult thing to
accomplish, unless it be fashioned by a skillful workman. It is only
lately that these trusses have been made without under-straps. Formerly
the under-straps were indispensable necessaries.
These groin ruptures require great attention and supervision, as the
rupture (the bowel) must, before putting on the truss, be cautiously and
thoroughly returned into the belly; and much care should be used to
prevent the chafing and galling of the tender skin of the babe, which an
ill-fitting truss would be sure to occasion. But if care and skill be
bestowed on the case, a perfect cure might in due time be insured. The
truss must not be discontinued until a _perfect_ cure be effected.
Let me strongly urge you to see that my advice is carried out to the
very letter, as a groin rupture can only be _cured_ in infancy and in
childhood. If it be allowed to run on, unattended to, until adult age,
he will be obliged to wear a truss _all his life_, which would be a
great annoyance and a perpetual irritation to him.
CLOTHING.
21. _Is it necessary to have a flannel cap in readiness to put on as
soon as a babe is born?_
Sir Charles Locock considers that a flannel cap is _not_ necessary, and
asserts that all his best nurses have long discarded flannel caps. Sir
Charles states that since the discontinuance of flannel caps infants
have not been more liable to inflammation of the eyes.
Such authority is, in my opinion, conclusive. My advice, therefore, to
you is, by all means discontinue the use of flannel caps.
22. _What kind of a belly-band do you recommend—a flannel or a calico
one?_
I prefer flannel, for two reasons—first, on account of its keeping the
child’s bowels comfortably warm; and, secondly, because of its not
chilling him (and thus endangering cold, etc.) when he wets himself. The
belly-band ought to be moderately but not tightly applied, as, if
tightly applied, it would interfere with the necessary movements of the
bowels.
23. _When should the belly-band be discontinued?_
When the child is two or three months old. The best way of leaving it
off is to tear a strip off daily for a few mornings, and then to leave
it off altogether. “Nurses who take charge of an infant when the monthly
nurse leaves are frequently in the habit of at once leaving off the
belly-band, which often leads to ruptures when the child cries or
strains. It is far wiser to retain it too long than too short a time;
and when a child catches hooping-cough while still very young, it is
safer to resume the belly-band.” [Communicated by Sir Charles Locock to
the Author.]
24. _Have you any remarks to make on the clothing of an infant?_
A baby’s clothing ought to be light, warm, loose, and free from pins.
(1.) _It should be light_, without being too airy. Many infants’ clothes
are both too long and too cumbersome. It is really painful to see how
some poor little babies are weighed down with a weight of clothes. They
may be said to “bear the burden,” and that a heavy one, from the very
commencement of their lives! How absurd, too, the practice of making
them wear _long_ clothes. Clothes to cover a child’s feet, and even a
little beyond, may be desirable; but for clothes, when the infant is
carried about, to reach to the ground, is foolish and cruel in the
extreme. I have seen a delicate baby almost ready to faint under the
infliction. (2.) _It should be warm_, without being too warm. The parts
that ought to be kept warm are the chest, the bowels, and the feet. If
the infant be delicate, especially if he be subject to inflammation of
the lungs, he ought to wear a fine flannel, instead of his usual shirts,
which should be changed as frequently. (3.) _The dress should be loose_,
so as to prevent any pressure upon the blood-vessels, which would
otherwise impede the circulation, and thus hinder a proper development
of the parts. It ought to be loose about the chest and waist, so that
the lungs and the heart may have free play. It should be loose about the
stomach, so that digestion may not be impeded; it ought to be loose
about the bowels, in order that the spiral motion of the intestines may
not be interfered with; hence the importance of putting on a belly-band
moderately slack; it should be loose about the sleeves, so that the
blood may course, without let or hindrance, through the arteries and
veins; it ought to be loose, then, everywhere, for nature delights in
freedom from restraint, and will resent, sooner or later, any
interference. Oh that a mother would take common sense, and not custom,
as her guide! (4.) _As few pins_ should be used in the dressing of a
baby as possible. Inattention to this advice has caused many a little
sufferer to be thrown into convulsions.
The generality of mothers use no pins in the dressing of their children;
they tack with a needle and thread every part that requires fastening.
They do not even use pins to fasten the baby’s napkins. They make the
diapers with loops and tapes, and thus altogether supersede the use of
pins in the dressing of an infant. The plan is a good one, takes very
little extra time, and deserves to be universally adopted. If pins be
used for the napkins, they ought to be the Patent Safety Pins.
25. _Is there any necessity for a nurse being particular in airing an
infant’s clothes before they are put on? If she were less particular,
would it not make him more hardy?_
A nurse cannot be too particular on this head. A baby’s clothes ought to
be well aired the day before they are put on, as they should _not_ be
put on warm from the fire. It is well, where it can be done, to let him
have clean clothes daily. Where this cannot be afforded, the clothes, as
soon as they are taken off at night, ought to be well aired, so as to
free them from the perspiration, and that they may be ready to put on
the following morning. It is truly nonsensical to endeavor to harden a
child, or any one else, by putting on damp clothes!
26. _What is your opinion of caps for an infant?_
The head ought to be kept cool; caps, therefore, are unnecessary. If
caps be used at all, they should only be worn for the first month in
summer, or for the first two or three months in winter. If a babe take
to caps, it requires care in leaving them off, or he will catch cold.
When you are about discontinuing them, put a thinner and a thinner one
on, every time they are changed, until you leave them off altogether.
But remember, my opinion is, that a child is better _without_ caps; they
only heat his head, cause undue perspiration, and thus make him more
liable to catch cold.
If a babe does not wear a cap in the day, it is not at all necessary
that he should wear one at night. He will sleep more comfortably without
one, and it will be better for his health. Moreover, night-caps injure
both the thickness and the beauty of the hair.
27. _Have you any remarks to make on the clothing of an infant, when, in
the winter time, he is sent out for exercise?_