is wholesome, it may be substituted for butter when the bowels are
inclined to be costive. One part of bran to three parts of flour, mixed
together and made into bread. A roasted apple, eaten with _raw_ sugar,
is another excellent mild aperient for a child. Milk gruel—that is to
say, milk thickened with oatmeal—forms an excellent food for him, and
often keeps his bowels regular, and thus (_which is a very important
consideration_) supersedes the necessity of giving him an aperient. An
orange (taking care he does not eat the peel or the pulp), or a fig
after dinner, or a few Muscatel raisins, will frequently regulate the
bowels.
Stewed prunes is another admirable remedy for the costiveness of a
child. The manner of stewing them is as follows: Put a pound of prunes
in a brown jar, add two tablespoonfuls of _raw_ sugar, then cover the
prunes and the sugar with cold water; place them in the oven, and let
them stew for four hours. A child should every morning eat half a dozen
or a dozen of them, until the bowels be relieved, taking care that he
does not swallow the stones.
A suppository is a mild and ready way of opening the bowels of a child.
When he is two or three years old and upwards, a _candle_ suppository is
better than a _soap_ suppository. The way of preparing it is as follows:
Cut a piece of dip-tallow candle—the length of three inches—and insert
it as you would a clyster pipe, about two inches up the fundament,
allowing the remaining inch to be in sight, and there let the
suppository remain until the bowels be opened.
245. _What are the most frequent causes of Protrusion of the lower
bowel?_
The too common and reprehensible practice of a parent administering
frequent aperients, especially calomel and jalap, to her child. Another
cause, is allowing him to remain for a quarter of an hour or more at a
time on his chair; this induces him to strain, and to force the gut
down.
246. _What are the remedies?_
If the protrusion of the bowel have been brought on by the abuse of
aperients, abstain for the future from giving them; but if medicine be
absolutely required, give the mildest—such as either syrup of senna or
castor oil—_and the less of those the better_.
If the _external_ application of a purgative will have the desired
effect, it will, in such cases, be better than the _internal_
administration of aperients. Dr. Merriman’s Purgative Liniment is a good
one for the purpose. (See question 95.) Let the bowels be well rubbed
every night and morning, for five minutes at a time, with the liniment.
A wet compress to the bowels will frequently open them, and will thus do
away with the necessity of giving an aperient—_a most important
consideration_. Fold a napkin in six thicknesses, soak it in _cold_
water, and apply it to the bowels, over which put either a thin covering
or sheet of gutta-percha, or a piece of oiled silk; keep it in its place
with a broad flannel roller, and let it remain on the bowels for three
or four hours, or until they be opened.
Try what diet will do, as opening the bowels by a regulated diet is far
preferable to the giving of aperients. Let him have either bran-bread,
Robinson’s Patent Groats made into gruel with new milk, or Du Barry’s
Arabica Revalenta, or a slice of Huntley and Palmer’s lump gingerbread.
Let him eat stewed prunes, stewed rhubarb, roasted apples, strawberries,
raspberries, the inside of grapes and gooseberries, figs, etc. Give him
early every morning a draught of _cold_ water.
Let me, again, urge you _not_ to give aperients in these cases, or in
any case, unless you are absolutely compelled. By following my advice
you will save yourself an immense deal of trouble, and your child a long
catalogue of misery. Again, I say, look well into the matter, and
whenever it be practicable, avoid purgatives.
Now, with regard to the best manner of returning the bowel, lay the
child upon the bed on his face and bowels, with his hips a little
raised; then smear lard on the forefinger of your right hand (taking
care that the nail be cut close) and gently with your forefinger press
the bowel into its proper place.
Remember, if the above methods be observed, you cannot do the slightest
injury to the bowel, and the sooner it be returned the better it will be
for the child; for, if the bowel be allowed to remain long down, it may
slough or mortify, and death may ensue. The nurse, every time he has a
motion, must see that the bowel does not come down, and if it does, she
ought instantly to return it. Moreover, the nurse should be careful
_not_ to allow the child to remain on his chair more than two or three
minutes at a time.
Another excellent remedy for the protrusion of the lower bowel is to use
every morning a cold salt and water sitz bath. There need not be more
than a depth of three inches of water in the bath; a small handful of
table salt should be dissolved in the water; a dash of warm water in the
winter time must be added to take off the extreme chill, and the child
ought not to be allowed to sit in the bath for more than one minute, or
while the mother can count a hundred, taking care the while to throw
either a square of flannel or a small shawl over his shoulders. The sitz
bath ought to be continued for months, or until the complaint be
removed. I cannot speak in too high praise of these baths.
247. _Do you advise me, every spring and fall, to give my child
brimstone to purify and sweeten his blood, and as a preventive
medicine?_
Certainly not: if you wish to take away his appetite and to weaken and
depress him, give him brimstone! Brimstone is not a remedy fit for a
child’s stomach. The principal use and value of brimstone is as an
external application in itch, and as an internal remedy, mixed with
other laxatives, in piles—piles being a complaint of adults. In olden
times poor unfortunate children were dosed every spring and fall with
brimstone and treacle, to sweeten their blood! Fortunately for the
present race, there is not so much of that folly practiced, but still
there is room for improvement.
To dose a _healthy_ child with physic is the grossest absurdity. No, the
less physic a delicate child has the better it will be for him, but
physic to a healthy child is downright poison!—and brimstone of all
medicines! It is both weakening and depressing to the system, and by
opening the pores of the skin and by relaxing the bowels, is likely to
give cold, and thus to make a healthy a sickly child. Sweeten his blood!
It is more likely to weaken his blood, and thus to make his blood
impure! Blood is not made pure by drugs, but by Nature’s medicine: by
exercise, by pure air, by wholesome diet, by sleep in a well-ventilated
apartment, by regular and thorough ablution. Brimstone a preventive
medicine! Preventive medicine—and brimstone especially in the guise of a
preventive medicine—is “a mockery, a delusion, and a snare.”
248. _When a child is delicate, and his body, without any assignable
cause is gradually wasting away, and the stomach rejects all food that
is taken, what plan can be adopted likely to support his strength, and
thus, probably, be the means of saving his life?_
I have seen, in such a case, great benefit to arise from half a
teacupful of either strong mutton broth, or of strong beef-tea, used as
an enema, every four hours. An enema apparatus is an important requisite
in every nursery; it may be procured of any respectable surgical
instrument-maker. The india-rubber enema bottle is, for a child’s use, a
great improvement on the old syringe, as it is not so likely to get out
of order, and, moreover, is more easily used.
It should be administered slowly, in order that it may remain in the
bowel. If the child be sinking, either a dessertspoonful of brandy, or
half a wineglassful of port wine ought to be added to each enema.
The above plan ought only to be adopted if there be _no_ diarrhœa. If
there be diarrhœa, an enema must _not_ be used. Then, provided there be
great wasting away, and extreme exhaustion, and other remedies having
failed, it would be advisable to give, by the mouth, _raw_ beef of the
finest quality, which ought to be taken from the hipbone, and should be
shredded very fine. All fat and skin must be carefully removed. One or
two teaspoonfuls (according to the age of the child) ought to be given
every four hours. The giving of _raw_ meat to children in exhaustive
diseases, such as excessive long-standing diarrhœa, was introduced into
practice by a Russian physician, a Professor Weisse, of St. Petersburg.
It certainly is, in these cases, a most valuable remedy, and has
frequently been the means of snatching such patients from the jaws of
death. Children usually take raw meat with avidity and with a relish.
249. _If a child be naturally delicate, what plan would you recommend to
strengthen him?_
I should advise strict attention to the rules above mentioned, and
_change of air_—more especially, if it be possible, to the coast. Change
of air, sometimes, upon a delicate child, acts like magic, and may
restore him to health when all other means have failed. If a girl be
delicate, “carry her off to the farm, there to undergo the discipline of
new milk, brown bread, early hours, no lessons, and romps in the
hay-field.” This advice is, of course, equally applicable for a delicate
boy, as delicate boys and delicate girls ought to be treated alike.
Unfortunately, in these very enlightened days! there is too great a
distinction made in the respective management and treatment of boys and
girls.
The best medicines for a delicate child will be the wine of iron and
cod-liver oil. Give them combined in the manner I shall advise when
speaking of the treatment of Rickets.
In diseases of long standing, and that resist the usual remedies, there
is nothing like _change of air_. Hippocrates, the father of medicine,
says:
“In longis morbis solum mutare,”
(In tedious diseases to change the place of residence.)
A child who, in the winter, is always catching cold, whose life during
half of the year is one continued catarrh, who is in consequence likely,
if he grow up at all, to grow up a confirmed invalid, ought, during the
winter months, to seek another clime; and if the parents can afford the
expense, they should, at the beginning of October, cause him to bend his
steps to the south of Europe—Mentone being as good a place as they could
probably fix upon.
250. _Do you approve of sea bathing for a delicate young child?_
No: he is frequently so frightened by it that the alarm would do him
more harm than the bathing would do him good. The better plan would be
to have him every morning well sponged, especially his back and loins,
with sea water; and to have him as much as possible carried on the
beach, in order that he may inhale the sea breezes.
When he be older, and is not frightened at being dipped, sea bathing
will be very beneficial to him. If bathing is to do good, either to an
adult or to a child, it must be anticipated with pleasure, and neither
with dread nor with distaste.
251. _What is the best method of administering medicine to a child?_
If he be old enough, appeal to his reason; for, if a mother endeavor to
deceive her child, and he detect her, he will for the future suspect
her.
If he be too young to be reasoned with, then, if he will not take his
medicine, he must be compelled. Lay him across your knees, let both his
hands and his nose be tightly held, and then, by means of the patent
medicine-spoon, or, if that be not at hand, by either a tea or a
dessertspoon, pour the medicine down his throat, and he will be obliged
to swallow it.
It may be said that this is a cruel procedure; but it is the only way to
compel an unruly child to take physic, and is much less cruel than
running the risk of his dying from the medicine not having been
administered.
If any of my medical brethren should perchance read these Conversations,
I respectfully and earnestly recommend them to take more pains in making
medicines for children pleasant and palatable. I am convinced that, in
the generality of instances, provided a little more care and thought
were bestowed on the subject, it may be done; and what an amount of both
trouble and annoyance it would save! It is really painful to witness the
struggles and cries of a child when _nauseous_ medicine is to be given;
the passion and the excitement often do more harm than the medicine does
good.
252. _Ought a sick child to be roused from his sleep to give him physic,
when it is time for him to take it?_
On no account, as sleep, being a natural restorative, must not be
interfered with. A mother cannot be too particular in administering the
medicine, at stated periods, while he is awake.
253. _Have you any remarks to make on the management of a sick-room, and
have you any directions to give on the nursing of a sick child?_
In sickness select a large and lofty room; if in the town, the back of
the house will be preferable—in order to keep the patient free from
noise and bustle—as a sick-chamber cannot be kept too quiet. Be sure
that there be a chimney in the room—as there ought to be in _every_ room
in the house—and that it be not stopped, as it will help to carry off
the impure air of the apartment. Keep the chamber _well ventilated_, by,
from time to time, opening the window. The air of the apartment cannot
be too pure; therefore, let the evacuations from the bowels be instantly
removed, either to a distant part of the house, or to an out-house, or
to the cellar, as it might be necessary to keep them for the medical
man’s inspection.
Let there be a frequent change of linen, as in sickness it is even more
necessary than in health, more especially if the complaint be fever. In
an attack of fever clean sheets ought, every other day, to be put on the
bed; clean body-linen every day. A frequent change of linen in sickness
is most refreshing.
If the complaint be fever, a fire in the grate will not be necessary.
Should it be a case either of inflammation of the lungs or of the chest,
a small fire in the winter time is desirable, keeping the temperature of
the room as nearly as possible at 60° Fahrenheit. Bear in mind that a
large fire in a sick-room cannot be too strongly condemned; for if there
be fever—and there are scarcely any complaints without—a large fire only
increases it. Small fires, in cases either of inflammation of the lungs
or of the chest, in the winter time, encourage ventilation of the
apartment, and thus carry off impure air. If it be summer time, of
course fires would be improper. A thermometer is an indispensable
requisite in a sick-room.
In fever, free and thorough ventilation is of vital importance, more
especially in scarlet fever; then a patient cannot have too much air; in
scarlet fever, for the first few days the windows, be it winter or
summer, must to the widest extent be opened. The fear of the patient
catching cold by doing so is one of the numerous prejudices and baseless
fears that haunt the nursery, and the sooner it is exploded the better
it will be for human life. The valances and bed-curtains ought to be
removed, and there should be as little furniture in the room as
possible.
If it be a case of measles, it will be necessary to adopt a different
course; then the windows ought not to be opened, but the door must from
time to time be left ajar. In a case of measles, if it be winter time, a
_small_ fire in the room will be necessary. In inflammation of the lungs
or of the chest, the windows should not be opened, but the door ought
occasionally to be left unfastened, in order to change the air and to
make it pure. Remember, then, that ventilation, either by open window or
by open door, is most necessary in all diseases. Ventilation is one of
the best friends a doctor has.
In fever, do not load the bed with clothes; in the summer a sheet is
sufficient, in the winter a sheet and a blanket.
In fever, do not be afraid of allowing the patient plenty either of cold
water or of cold toast and water; Nature will tell him when he has had
enough. In measles, let the chill be taken off the toast and water.
In _croup_, have always ready a plentiful supply of hot water, in case a
warm bath might be required.
In _child-crowing_, have always in the sick-room a supply of cold water,
ready at a moment’s notice to dash upon the face.
In fever, do not let the little patient lie on the lap; he will rest
more comfortably on a horse-hair mattress in his crib or cot. If he have
pain in the bowels, the lap is most agreeable to him: the warmth of the
body, either of the mother or of the nurse, soothes him; besides, if he
be on the lap, he can be turned on his stomach and on his bowels, which
often affords him great relief and comfort. If he be much emaciated,
when he is nursed, place a pillow upon the lap and let him lie upon it.
In _head affections_, darken the room with a _green_ calico blind; keep
the chamber more than usually quiet; let what little talking is
necessary be carried on in whispers, but the less of that the better;
and in _head affections_, never allow smelling salts to be applied to
the nose, as they only increase the flow of blood to the head, and
consequently do harm.
It is often a good sign when a child, who is seriously ill, suddenly
becomes cross. It is then he begins to feel his weakness, and to give
vent to his feelings. “Children are almost always cross when recovering
from an illness, however patient they may have been during its severest
moments, and the phenomenon is not by any means confined to children.”
A sick child must _not_ be stuffed with _much_ food at a time. He will
take either a tablespoonful of new milk or a tablespoonful of
chicken-broth every half hour, with greater advantage than a teacupful
of either the one or the other every four hours, which large quantity
would very probably be rejected from his stomach, and may cause the
unfortunately treated child to die of starvation!
If a sick child be peevish, attract his attention either by a toy or by
an ornament; if he be cross, win him over to good humor by love,
affection, and caresses, but let it be done gently and without noise. Do
not let visitors see him; they will only excite, distract, and irritate
him, and help to consume the oxygen of the atmosphere, and thus rob the
air of its exhilarating health-giving qualities and purity; a sick-room,
therefore, is not a proper place either for visitors or for gossips.
In selecting a sick-nurse, let her be gentle, patient, cheerful, quiet,
and kind, but firm withal; she ought to be neither old nor young; if she
be old, she is often garrulous and prejudiced, and thinks too much of
her trouble; if she be young, she is frequently thoughtless and noisy;
therefore choose a middle-aged women. Do not let there be in the
sick-room more than, besides the mother, one efficient nurse; a great
number can be of no service—they will only be in each other’s way, and
will distract the patient.
Let stillness, especially if the head be the part affected, reign in a
sick-room. Nurses at these times ought to wear slippers, and not shoes.
Creaking shoes and rustling silk dresses ought not to be worn in
sick-chambers—they are quite out of place there. If the child be asleep,
or if he be dozing, perfect stillness must be enjoined, not even a
whisper should be heard:
“In the sick-room be calm,
Move gently and with care,
Lest any jar or sudden noise
Come sharply unaware.
You cannot tell the harm,
The mischief it may bring,
To wake the sick one suddenly,
Besides the suffering.
The broken sleep excites
Fresh pain, increased distress;
The quiet slumber undisturb’d
Soothes pain and restlessness.
Sleep is the gift of God:
Oh! bear these words at heart,—
‘He giveth his beloved sleep,’
And gently do thy part.”
If there be other children, let them be removed to a distant part of the
house; or, if the disease be of an infectious nature, let them be sent
away from home altogether.
In all illnesses—and bear in mind the following is most important
advice—a child must be encouraged to try and make water, whether he ask
or not, at least four times during the twenty-four hours; and at any
other time, if he expresses the slightest inclination to do so. I have
known a little fellow to hold his water, to his great detriment, for
twelve hours, because either the mother had in her trouble forgotten to
inquire, or the child himself was either too ill or too indolent to make
the attempt.
See that the medical man’s directions are, to the very letter, carried
out. Do not fancy that you know better than he does, otherwise you have
no business to employ him. Let him, then, have your implicit confidence
and your exact obedience. What _you_ may consider to be a trifling
matter, may frequently be of the utmost importance, and may sometimes
decide whether the case shall either end in life or death!
_Lice._—It is not very poetical, as many of the grim facts of everyday
life are not, but, unlike a great deal of poetry, it is unfortunately
too true that after a severe and dangerous illness, especially after a
bad attack of fever, a child’s head frequently becomes infested with
vermin—with lice! It therefore behooves a mother herself to thoroughly
examine, by means of a fine-tooth comb, her child’s head, in order to
satisfy her mind that there be no vermin there. A fine-tooth comb ought
_not_ to be used at any other time except for the purpose of
examination, as the constant use of a fine-tooth comb would scratch the
scalp, and would encourage a quantity of scurf to accumulate. As soon as
he be well enough, he ought to resume his regular ablutions—that is to
say, that he must go again regularly into his tub, and have his head
every morning thoroughly washed with soap and water. A mother ought to
be particular in seeing that the nurse washes the hair brush at least
once every week; if she does not do so, the dirty brush which had,
during the illness, been used, might contain the “nits,”—the eggs of the
lice,—and would thus propagate the vermin, as they will, when on the
head of the child, soon hatch. If there be already lice on the head, in
addition to the regular washing every morning with the soap and water,
and after the head has been thoroughly dried, let the hair be well and
plentifully dressed with camphorated oil—the oil being allowed to remain
on until the next washing on the following morning. Lice cannot live in
oil (more especially if, as in camphorated oil, camphor be dissolved in
it), and as the camphorated oil will not, in the slightest degree,
injure the hair, it is the best application that can be used. But as
soon as the vermin have disappeared, let the oil be discontinued, as the
_natural_ oil of the hair is, at other times, the only oil that is
required on the head.
The “nit”—the egg of the louse—might be distinguished from scurf
(although to the _naked_ eye it is very much like it in appearance) by
the former fastening firmly on one of the hairs as a barnacle would on a
rock, and by it not being readily brushed off as scurf would, which
latter (scurf) is always loose.
254. _My child, in the summer time, is much tormented with fleas: what
are the best remedies?_
A small muslin bag, filled with camphor, placed in the cot or bed, will
drive fleas away. Each flea-bite should, from time to time, be dressed
by means of a camel’s-hair brush, with a drop or two of spirit of
camphor, an ounce bottle of which ought, for the purpose, to be procured
from a chemist. Camphor is also an excellent remedy to prevent bugs from
biting. Bugs and fleas have a horror of camphor; and well they might,
for it is death to them!
There is a famous remedy for the destruction of fleas, manufactured in
France, entitled “_La Poudre Insecticide_,” which, although perfectly
harmless to the human economy, is utterly destructive to fleas. Bugs are
best destroyed by oil of turpentine; the places they do love to
congregate in should be well saturated, by means of a brush, with the
oil of turpentine. A few dressings will effectually destroy both them
and their young ones.
255. _Suppose a child to have had an attack either of inflammation of
the lungs or of bronchitis, and to be much predisposed to a return: what
precautions would you take to prevent either the one or the other for
the future?_
I would recommend him to wear fine flannel instead of lawn shirts; to
wear good lamb’s-wool stockings _above the knees_, and good, strong, dry
shoes to his feet; to live, weather permitting, a great part of every
day in the open air; to strengthen his system by good nourishing food—by
an abundance of both milk and meat (the former especially); to send him,
in the autumn, for a couple of months, to the sea-side; to administer to
him, from time to time, cod-liver oil; in short, to think only of his
health, and to let learning, until he be stronger, be left alone.
I also advise either table salt or bay salt to be added to the water in
which the child is washed with in the morning, in a similar manner as
recommended in answer to the 123d question.