time; but it should be borne in mind (so wonderful are the works of God)
that the _second_ crop of teeth _in embryo_ is actually bred and formed
from the very commencement of his life, _under_ the first tier of teeth,
but which remain in abeyance for years, and do not come into play until
the _first_ teeth, having done their duty, loosen and fall out, and thus
make room for _the_ more numerous, larger, stronger, and more permanent
teeth, which latter have to last for the remainder of his existence. The
_first_ set is sometimes cut with a great deal of difficulty, and
produces various disease; the _second_, or permanent teeth, come easily,
and are unaccompanied with any disorder. The following is the process:
one after another of the _first_ set gradually loosen, and either drop
out, or with little pain are readily pulled out; under these, the
_second_—the permanent teeth—make their appearance, and fill up the
vacant spaces. The fang of the tooth that has dropped out is nearly all
absorbed or eaten away, leaving little more than the crown. The _first_
set consists of twenty; the _second_ (including the wise teeth, which
are not generally cut until after the age of twenty-seven) consists of
thirty-two.
I would recommend you to pay particular attention to the teeth of your
children; for, besides their being ornamental, their regularity and
soundness are of great importance to the present as well as to the
future health of your offspring. If there be any irregularity in the
appearance of the _second_ set, lose no time in consulting an
experienced and respectable dentist.
DISEASE, ETC.
196. _Do you think it important that I should be made acquainted with
the symptoms of the_ SERIOUS _diseases of children_?
Certainly. I am not advocating the doctrine of a mother _treating
serious_ diseases; far from it; it is not her province, except in
certain cases of extreme urgency where a medical man cannot be procured,
and where delay might be death; but I do insist upon the necessity of
her knowing the _symptoms_ of disease. My belief is, that if parents
were better informed on such subjects, many children’s lives might be
saved, much suffering might be averted, and much sorrow might be spared.
The fact is, the knowledge of the symptoms of disease is, to a mother,
almost a sealed book. If she were better acquainted with these matters,
how much more useful would she be in a sick-room, and how much more
readily would she enter into the plans and views of the medical man! By
her knowledge of the symptoms, and by having his advice in time, she
would nip disease in the bud, and the fight might end in favor of life,
for “sickness is just a fight between life and death.”
It is really lamentable to contemplate the amount of ignorance that
still exists among mothers in all that appertains to the diseases of
children; although, fortunately, they are beginning to see and to feel
the importance of gaining instruction on such subjects; but the light is
only dawning. A writer of the present day makes the following remarks,
which somewhat bear on the subject in question. He observes: “In spite
of the knowledge and clear views possessed by the profession on all that
concerns the management of children, no fact is more palpable than that
the most grievous ignorance and incompetency prevail respecting it among
the public. We want some means of making popular the knowledge which is
now almost restricted to medical men, or at most, to the well-educated
classes.”
In the earlier editions of this work, I did not give the _treatment_ of
any serious diseases, however urgent. In the three last editions I have
been induced, for reasons I will presently state, to give the
_treatment_ of some of the more urgent _serious_ diseases, when a
medical man cannot instantly be procured, and where delay might be
death.
Sir Charles Locock, who has taken a kind interest in this little work,
has given me valid reasons why a mother should be so enlightened. The
following extracts are from a letter which I received from Sir Charles
on the subject, and which he has courteously allowed me to publish. He
says: “As an old physician of some experience in complaints of infants
and children, I may perhaps be allowed to suggest that in a future
edition you should add a few words on the actual treatment of some of
the more urgent infantile diseases. It is very right to caution parents
against superseding the doctor, and attempting to manage serious illness
themselves; but your advice, with very small exceptions, always being to
‘to lose no time in sending for a medical man,’ much valuable and often
irremediable time may be lost _when a medical man is not to be had_.
Take, for instance, a case of croup: there are no directions given at
all, except to send for a medical man, and always to keep medicines in
the house which he may have directed. But how can this apply to a first
attack? You state that a first attack is generally the worst. But why is
it so? Simply because it often occurs when the parents do not recognize
it, and it is allowed to get to a worse point than in subsequent
attacks, when they are thoroughly alive to it. As the very best remedy,
and often the only essential one, if given early, is a full emetic,
surely it is better that you should give some directions as to this in a
future edition, and I can speak from my own experience when I say that
an emetic, _given in time_, and repeated to free vomiting, will cut
short any case of croup. In nine cases out of ten the attack takes place
in the evening or early night, and when vomiting is effected the dinner
of that day is brought up nearly undigested, and the severity of the
symptoms at once cut short. Whenever any remedy is valuable, the more by
its being administered _in time_, it is surely wiser to give directions
as to its use, although, as a general rule, it is much better to advise
the sending for medical advice.”
The above reasons, coming from such a learned and experienced physician
as Sir Charles Locock, are conclusive, and have decided me to comply
with his advice, to enlighten a mother on the _treatment_ of some of the
more urgent diseases of infants and of children.
In a subsequent letter addressed to myself, Sir Charles has given me the
names of those _urgent_ diseases which he considers may be treated by a
mother, “where a medical man cannot be procured quickly, or not at all;”
they are—Croup; Inflammation of the Lungs; Diphtheria; Dysentery;
Diarrhœa; Hooping-Cough, in its various stages; and Shivering Fit. Sir
Charles sums up his letter to me by saying: “Such a book ought to be
made as complete as possible, and the objections to medical treatment
being so explained as to induce mothers to try to avoid medical men is
not so serious as that of leaving them without any guide in those
instances where every delay is dangerous, and yet where medical
assistance is not to be obtained or not to be had quickly.”
In addition to the above, I shall give you the _treatment_ of
Bronchitis, Measles, and Scarlet Fever. Bronchitis is one of the most
common diseases incidental to childhood, and, with judicious treatment,
is, in the absence of the medical man, readily managed by a sensible
mother. Measles is very submissive to treatment. Scarlet Fever, _if it
be not malignant_, and if certain rules be strictly followed, is also
equally amenable to treatment.
I have been fortunate in treating Scarlet Fever, and therefore think it
desirable to enter fully into the _treatment_ of a disease, which is
looked upon by many parents, and according to the usual mode of
treatment, with just cause, with great consternation and dread. By
giving my plan of treatment fully and simply, and without the slightest
reservation, I am fully persuaded, through God’s blessing, that I may be
the humble means of saving the lives of numbers of children.
The diseases that might be treated by a mother, in the absence of a
medical man, will form the subject of future Conversations.
197. _At what age does Water on the Brain usually occur, and how is a
mother to know that her child is about to labor under that disease?_
Water on the brain is, as a rule, a disease of childhood; after a child
is seven years old it is comparatively rare. It more frequently attacks
delicate children—children who have been dry-nursed (especially if they
have been improperly fed), or who have been suckled too long, or who
have had consumptive mothers, or who have suffered severely from
teething, or who are naturally of a feeble constitution. Water on the
brain sometimes follows an attack of inflammation of the lungs, more
especially if depressing measures (such as excessive leeching and the
administration of emetic tartar) have been adopted. It occasionally
follows in the train of contagious eruptive diseases, such as either
small-pox or scarlatina. We may divide the symptoms of water on the
brain into two stages. The first—the premonitory stage—which lasts four
or five days, in which medical aid might be of great avail; the
second—the stage of drowsiness and of coma—which usually ends in death.
I shall dwell on the first—the premonitory stage—in order that a mother
may see the importance without loss of time of calling in a medical man:
If her child be feverish and irritable, if his stomach be disordered, if
he have urgent vomitings, if he have a foul breath, if his appetite be
capricious and bad, if his nights be disturbed (screaming out in his
sleep), if his bowels be disordered, more especially if they be
constipated, if he be more than usually excited, if his eye gleam with
unusual brilliancy, if his tongue run faster than it is wont, if his
cheek be flushed and his head be hot, and if he be constantly putting
his hand to his head, there is cause for suspicion. If to these symptoms
be added, a more than usual carelessness in tumbling about, in hitching
his foot in the carpet, or in dragging one foot after the other; if,
too, he has complained of darting, shooting, lancinating pains in his
head, it may then be known that the _first_ stage of inflammation (the
forerunner of water on the brain) either has taken or is about taking
place. Remember, no time ought to be lost in obtaining medical aid; for
the _commencement_ of the disease is the golden opportunity, when life
might probably be saved.
198. _At what age, and in what neighborhood, is a child most liable to
Croup, and when is a mother to know that it is about to take place?_
It is unusual for a child until he be twelve months old to have croup;
but, from that time until the age of two years, he is more liable to it
than at any other period. The liability after two years gradually, until
he be ten years old, lessens, after which time it is rare.
A child is more liable to croup in a low and damp, than in a high and
dry neighborhood; indeed, in some situations, croup is almost an unknown
disease; while in others it is only too well understood. Croup is more
likely to prevail when the wind is either easterly or northeasterly.
There is no disease that requires more prompt treatment than croup, and
none that creeps on more insidiously. The child at first seems to be
laboring under a slight cold, and is troubled with a little _dry_ cough;
he is hot and fretful, and _hoarse_ when he cries. Hoarseness is one of
the earliest symptoms of croup; and it should be borne in mind that a
young child, unless he be going to have croup, is seldom hoarse; if,
therefore, your child be hoarse, he should be carefully watched, in
order that, as soon as croup be detected, not a moment be lost in
applying the proper remedies.
His voice at length becomes gruff, he breathes as though it were through
muslin, and the cough becomes crowing. These three symptoms prove that
the disease is now fully formed. These latter symptoms sometimes come on
without any previous warning, the little fellow going to bed apparently
quite well, until the mother is awakened, perplexed, and frightened, in
the middle of the night, by finding him laboring under the
characteristic cough and the other symptoms of croup. If she delay
either to send for assistance, _or if proper medicines be not instantly
given_, in a few hours it will probably be of no avail, and in a day or
two the little sufferer will be a corpse!
When once a child has had croup the after-attacks are generally milder.
If he has once had an attack of croup, I should advise you always to
have in the house medicine—a 4 oz. bottle of ipecacuanha wine, to fly to
at a moment’s notice; but never omit, where practicable, in a case of
croup, whether the attack be severe or mild, to send _immediately_ for
medical aid. In case of a sudden attack of croup, _instantly_ give a
teaspoonful of ipecacuanha wine, and repeat it every five minutes until
free vomiting be excited. There is no disease in which time is more
precious than in croup, and where the delay of an hour may decide either
for life or for death.
199. _But suppose a medical man is not_ IMMEDIATELY _to be procured,
what then am I to do? more especially, as you say, that delay might be
death_.
_What to do._—I never in my life lost a child with croup where I was
called in at the _commencement_ of the disease, and where my plans were
carried out to the very letter. Let me begin by saying, Look well to the
goodness and purity of the medicine, for the life of your child may
depend upon the medicine being genuine. What medicine? _Ipecacuanha
wine!_ At the earliest dawn of the disease give a teaspoonful of
ipecacuanha wine every five minutes, until free vomiting be excited. In
croup, before he is safe, free vomiting _must_ be established, and that
without loss of time. If, after the expiration of an hour, the
ipecacuanha wine (having given during that hour a teaspoonful of it
every five minutes) is not sufficiently powerful for the
purpose—although it generally is so (if the ipecacuanha wine be
good)—then let the following mixture be substituted:
[Illustration: CHILDHOOD—STRAYED FROM HOME.]
Take of—Powdered Ipecacuanha, one scruple;
Wine of Ipecacuanha, one ounce and a half:
Make a Mixture. A teaspoonful to be given every five minutes, until
free vomiting be excited, first _well_ shaking the bottle.
After the vomiting, place the child for a quarter of an hour in a warm
bath. (See “Warm baths”—directions and precautions to be observed.) When
out of the bath give him small doses of ipecacuanha wine every two or
three hours. The following is a palatable form for the mixture:
Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:
Make a Mixture. A teaspoonful to be taken every two or three hours.
But remember, the emetic which is given at _first_ is _pure ipecacuanha
wine, without a drop of either water or of syrup_.
A large sponge dipped out of very hot water, and applied to the throat,
and frequently renewed, oftentimes affords great relief in croup, and
ought during the time the emetic is being administered in all cases to
be adopted.
If it be a _severe_ case of croup, and does not in the course of two
hours yield to the free exhibition of the ipecacuanha emetic, apply a
narrow strip of _Smith’s tela vesicatoria_ to the throat, prepared in
the same way as for a case of inflammation of the lungs (see the
Conversation on the _treatment_ of inflammation of the lungs). With this
only difference, let it be a narrower strip, only one-half the width
there recommended, and apply it to the throat instead of to the chest.
If a child has a very short, fat neck, there may not be room for the
_tela_, then you ought to apply it to the _upper_ part of the chest—just
under the collar-bones.
Let it be understood that the _tela vesicatoria_ is not a severe remedy,
that the _tela_ produces very little pain—not nearly so much as the
application of leeches; although, in its action, it is much more
beneficial, and is not nearly so weakening to the system.
Keep the child from all stimulants; let him live on a low diet, such as
milk and water, toast and water, arrow-root, etc.; and let the room be,
if practicable, at a temperate heat—60° Fahrenheit, and be well
ventilated.
So you see that the _treatment_ of croup is very simple, and that the
plan might be carried out by an intelligent mother. Notwithstanding
which, it is your duty, where practicable, to send at the very _onset_
of the disease for a medical man.
Let me again reiterate that if your child is to be saved the
_ipecacuanha wine must be genuine and good_. This can only be effected
by having the medicine from a highly respectable chemist. Again, if ever
your child has had croup, let me again urge you _always_ to have in the
house a 4 oz. bottle of ipecacuanha wine, that you may resort to at a
moment’s notice in case there be the slightest return of the disease.
Ipecacuanha wine, unfortunately, is not a medicine that keeps well;
therefore, every three or four months a fresh bottle ought to be
procured either from a medical man or from a chemist. As long as the
ipecacuanha wine remains _clear_, it is good; but as soon as it becomes
_turbid_ it is bad, and ought to be replaced by a fresh supply.
An intelligent correspondent of mine makes the following valuable
remarks on the preservation of ipecacuanha wine: “Now, I know that there
are some medicines and chemical preparations which, though they spoil
rapidly when at all exposed to the air, yet will keep perfectly good for
an indefinite time if hermetically sealed up in a _perfectly full_
bottle. If so, would it not be a valuable suggestion if the
Apothecaries’ Hall, or some other London firm of _undoubted_
reliability, would put up 1 oz. phials of ipecacuanha wine of guaranteed
purity, sealed up so as to keep good so long as unopened, and sent out
in sealed packages, with the guarantee of their name. By keeping a few
such ounce bottles in an unopened state in one’s house, one might rely
on being ready for any emergency. If you think this suggestion worth
notice, and could induce some first-rate house to carry it out, and
mention the fact in a subsequent edition of your book, you would, I
think, be adding another most valuable item to an already invaluable
book.”
The above suggestion of preserving ipecacuanha wine in ounce bottles,
quite full, and hermetically sealed, is a very good one. The best way of
hermetically sealing the bottle would be to cut the cork level with the
lip of the bottle, and to cover the cork with sealing-wax, in the same
manner wine merchants serve some kinds of their wines, and then to lay
the bottles on their sides in sawdust in the cellar. I have no doubt, if
such a plan were adopted, the ipecacuanha wine would for a length of
time keep good. Of course, if the wine of ipecacuanha be procured from
the Apothecaries’ Hall Company, London (as suggested by my
correspondent), there can be no question as to the genuineness of the
article.
_What_ NOT _to do_.—Do not give emetic tartar; do not apply leeches; do
not keep the room very warm; do not give stimulants; do not omit to have
always in the house either a 4 oz. bottle, or three or four 1 oz.
bottles of ipecacuanha wine.
200. _I have heard Child-crowing mentioned as a formidable disease;
would you describe the symptoms?_
Child-crowing, or _spurious croup_, as it is sometimes called, is
occasionally mistaken for _genuine croup_. It is a more frequent
disorder than the latter, and requires a different plan of treatment.
Child-crowing is a disease that almost invariably occurs only during
dentition, and is _most perilous_. But if a child laboring under it can
fortunately escape suffocation until he has cut the whole of his first
set of teeth—twenty—he is then, as a rule, safe.
Child-crowing comes on in paroxysms. The breathing during the intervals
is quite natural—indeed, the child appears perfectly well; hence the
dangerous nature of the disease is either overlooked, or is lightly
thought of, until perhaps a paroxysm worse than common takes place, and
the little patient dies of suffocation, overwhelming the mother with
terror, with confusion, and dismay.
The _symptoms_ in a paroxysm of child-crowing are as follows: The child
suddenly loses and fights for his breath, and in doing so makes a noise
very much like that of crowing; hence the name child-crowing. The face
during the paroxysm becomes bluish or livid. In a favorable case, after
either a few seconds, or even, in some instances, a minute, and a
frightful struggle to breathe, he regains his breath, and is, until
another paroxysm occurs, perfectly well. In an unfavorable case, the
upper part (chink) of the windpipe remains for a minute or two closed,
and the child, not being able to breath, drops a corpse in his nurse’s
arms. Many children, who are said to have died of fits, have really died
of child-crowing.
I have entered thus rather fully into the subject, as many lives might
be saved if a mother knew the nature of the complaint, and the _great
necessity, during the paroxysms, of prompt and proper measures_. For,
too frequently, before a medical man has had time to arrive, the child
has breathed his last, the parent herself being perfectly ignorant of
the necessary treatment; hence the vital importance of the subject, and
the paramount necessity of imparting information, in a _popular_ style,
in a work of this kind.
201. _What treatment, then, during a paroxysm of Child-crowing should
you advise?_
The first thing, of course, to be done is to send _immediately_ for a
medical man. Have a plentiful supply of cold and of hot water always at
hand, ready at a moment’s notice for use. The instant the paroxysm is
upon the child, plentifully and perseveringly dash _cold_ water upon his
head and face. Put his feet and legs in _hot_ salt, mustard, and water;
and, if necessary, place him up to his neck in a hot bath, still dashing
water upon his face and head. If he does not quickly come round, sharply
smack his back and buttocks.
As soon as a medical man arrives, he will lose no time in thoroughly
lancing the gums and in applying other appropriate remedies.
Great care and attention ought, during the intervals, to be paid to the
diet. If the child is breathing a smoky, close atmosphere, he should be
immediately removed to a pure one. In this disease, indeed, there is no
remedy equal to a change of air—to a dry, bracing neighborhood. Change
of air, even if it be winter, is the best remedy, either to the coast or
to a healthy farm-house. I am indebted to Mr. Roberton, of Manchester
(who has paid great attention to this disease, and who has written a
valuable essay on the subject), for the knowledge of this fact. Where,
in a case of this kind, it is not practicable to send a child _from_
home, then let him be sent out of doors the greater part of every day;
let him, in point of fact, almost live in the open air. I am quite sure,
from an extensive experience, that in this disease, fresh air, and
plenty of it, is the best and principal remedy.
202. _When is a mother to know that a cough is not a “tooth-cough,” but
one of the symptoms of Inflammation of the Lungs?_
If the child has had a shivering fit; if his skin be very hot and very
dry; if his lips be parched; if there be great thirst; if his cheeks be
flushed; if he be dull and heavy, wishing to be quiet in his cot or
crib; if his appetite be diminished; if his tongue be furred; if his
mouth be _burning_ hot and dry; if his urine be scanty and high-colored,
staining the napkin or the linen; _if his breathing be short, panting,
hurried, and oppressed; if there be a hard, dry cough; and if his skin
be burning hot_; then there is no doubt that inflammation of the lungs
has taken place. If you put your finger into the mouth of a child
laboring under inflammation of the lungs, it is like putting your finger
into a hot apple-pie, the heat is _so_ great.
No time should be lost in sending for medical aid; indeed, the _hot, dry
mouth and skin, and short hurried breathing_ would be sufficient cause
for your procuring _immediate_ assistance. If inflammation of the lungs
were properly treated at the _onset_, a child would scarcely ever be
lost by that disease. I say this advisedly, for in my own practice,
_provided I am called in early, and if my plans are strictly carried
out_, I scarcely ever lose a child from inflammation of the lungs.
You may ask—What are your plans? I will tell you, in case _you cannot
promptly obtain medical advice_, as delay might be death.
_The treatment of Inflammation of the Lungs, what to do._—Keep the child
to one room, to his bed-room, and to his bed. Let the chamber be
properly ventilated. If the weather be cool, let a small fire be in the
grate; otherwise, he is better without a fire. Let him live on low diet,
such as weak black tea, milk and water, and toast and water, thin
oatmeal gruel, arrow-root, and such like simple beverages, and give him
the following mixture:
Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:
Make a Mixture. A teaspoonful of the mixture to be taken every four
hours.