This disposition need never be urged by attendant, nor forced by the

patient. Old ladies often say, “Bear down! make an effort!” supposing

that this will facilitate labor. The fact is that these attempts to

assist nature are retarding instead of helpful, and are often the cause

of accidents. Nature indicates all effort essential to progress.

_The bag of waters_ consists of the membranes which enclose the fetus

and liquor-amnii.

Protruding through the os, when dilatation is effected, it precedes the

head, prepares the way for it, and lessens the liability of contusion

of the soft parts. These membranes usually rupture with an expulsive

effort, before the close of the labor. The uterus then contracts firmly

on the body of the child, and labor advances rapidly to completion. In

rapid labor, however, the bag is sometimes expelled entire with the

child.

The physician requires the assistance of but one attendant besides the

husband. This should be an educated nurse or a friend, who can command

herself in emergencies. The old time custom of having a neighborhood

party on the occasion of an increase of the family, has happily gone

out of date.

When this custom was in vogue both patient and physician were often

seriously annoyed by the crowd of neighbors who thronged the house.

Many times the grand “set out” for the table was so expensive as to

take the whole month’s salary of the working man, while perhaps the

“doctor’s bill” remained long unpaid.

Conversation should be cheery and foreign to the occasion. Obscene

anecdotes and direful childbirth experiences should be avoided.

During the entire process of parturition, the patient should have the

advantage of pleasant, comfortable and sanative surroundings. Her mind

should be free from care and anxiety. The best in the house should be

appropriated to her use. Her room should be light and airy.

Every necessity and convenience should be in readiness for the

occasion. Provide two yards of rubber cloth for protecting the bed,

a fountain syringe, a hot water bottle, safety pins, antiseptic

absorbent cotton, glycerine, arnica, ammonia, carbolic and castile

soap, calenduline, olive oil, and cosmoline. Also have an abundant

supply of soft rags. They should be large and clean. Remove the seams

and buttons. Old sheets torn in quarters or pillow slips are the most

desirable.

Make the bed as if one were going to sleep in it. Place the rubber

cloth over the under sheet. Cover it with an old quilt or comfort that

will wash easily. Have the bed set out from the wall so that both sides

can be used. Prepare the side for the patient that will enable the

physician to use the right hand.

Let the patient wear the garments she desires to have on after

confinement, having care to protect them by folding back smoothly,

and fastening a sheet loosely about the waist. After labor begins,

she should take only liquid food. The bladder should be relieved

frequently. If the bowels have not been moved within twenty-four hours,

a copious enema of warm water should be taken.

Until the last stage, the patient can assume any position affording the

most comfort. Usually, she is inclined to change frequently, sitting,

lying, walking and even kneeling. When expulsive efforts occur, she

ordinarily prefers to recline upon her back, with knees flexed and hips

elevated. At this time, she naturally pushes with her feet, and pulls

with her hands. A padded box should be firmly fixed at the foot of the

bed for the feet. She can grasp the hand of an assistant, or have some

reliable mechanical contrivance for her hands. The simplest is a strip

of new muslin, ten inches wide, put around the foot of the bed, and

tied, leaving it the desired length for a good purchase. In a prolonged

labor, the _obstetric harness_ is the most valuable assistance. This

is a padded belt for the back, with straps extending to the knees and

feet. From the knees are counter straps, with handles for the hands.

With this simple contrivance, a physician requires less assistance.

_Supporting the perineum is not only absolutely unnecessary, but also

apt to be exceedingly injurious._ Meddlesome midwifery is always to

be deprecated. A natural labor needs no manual local interference.

Although many authors and teachers recommend support to the perineum in

the last stages, yet more ruptures may be attributed to this practice

than to leaving it entirely untouched. A Canadian physician asserts

that he has attended 1,700 women in confinement without giving support

to the perineum, and yet in no case did rupture occur.

When the head is born receive it in the hand and support it until the

shoulders are expelled. If the next contraction does not bring them,

put a finger in the axilla of the child, and make slight traction. The

whole body will soon be born. Pass both hands under the child and lay

it as far from the mother as possible without stretching the cord.

Place it upon the right side, shoulders and head slightly elevated.

Wipe any mucus there may be from mouth and nostrils. Cover baby with a

warm, soft flannel. Make the mother comfortable. Change her position,

straighten the bed, put dry cloths to her, give her a drink, etc.,

leaving the infant _until the pulsation has entirely ceased in the

cord_. This will require from ten minutes to half an hour.

Usually, as the child is ushered into the world, it sets up a lusty

cry, indicating that respiration is established. Crying is not

essential, as some authors claim, and the prompt covering usually

causes it to desist. If it does not breathe at once, a little brisk

spatting on the breast and thigh may establish respiration. If this is

not effectual, dash cold water in the face and on the chest. Still

failing, artificial respiration must be established. To do this, close

the nostrils with two fingers, blow into the mouth, and then expel the

air from the lungs by gentle pressure upon the chest. Continue this as

long as any hope of life remains.

_Sever the cord when pulsation has entirely ceased in it._ Use a dull

pair of scissors, cutting about two inches from the child’s navel.

Following these directions, _no tying is essential_. This method has

its advantages. By tying, a small amount of blood is retained in

vessels peculiar to fetal life. This blood by pressure or irritation

may prevent perfect closure of the foramen ovale, and be a cause

of hemorrhage. Besides, it must be absorbed in the system, causing

jaundice and aphtha, so common in young babes. Prejudices exist against

adopting this treatment, as it is contrary to that usually adopted.

I first heard of this manner of treating the cord in 1870. It was so

clearly explained that I was convinced that leaving the cord untied

would result in great gain to the child. Still, my education and habit

had been to the contrary, and my prejudices prevented my venturing

upon the new method. A few years after this I met a German physician

who had not tied a cord in eighteen years. He said: “Don’t be afraid;

your babies will do better, and there is less danger of losing them.” I

tested it and proved to my own satisfaction that it is the best method.

One has only to recollect to wait until the _pulsation in the cord

ceases entirely_, and sever as before stated.

_By no means wash and dress the baby as soon as it is born._ Consider

the marvelous change that has taken place in all its functions.

Respiration is established and the blood, instead of going to the

placenta for oxygenation, goes to the lungs; the stomach and all the

organs of digestion and elimination are brought into action; the skin,

also, with its innumerable perspiratory ducts, begins its work. Give

nature time to establish these processes before the system is taxed

by being washed and dressed. An Indian papoose might be plunged into

water at once without detriment, but no white baby of this country has

sufficient vitality to safely undergo this shock. Rub the baby all over

with olive oil, cover warmly, and leave it to rest and sleep.

While the baby is resting the mother demands especial attention.

Contractions of the uterus will soon be renewed to expel the placenta.

Usually these do not recur for half an hour, and it may be two hours

before the after-birth is expelled. Should there be no hemorrhage and

the walls of the uterus contract, there is no cause for uneasiness.

_For expelling the placenta_ contractions can be induced by laying upon

the bowels cloths wrung from cold water, or by manipulating the abdomen

after dipping the hands in cold water. Also, the patient may blow into

her closed hand, or give a slight cough. If there is hemorrhage, the

vein of the umbilical cord should be injected with cold water. This, in

many cases, removes a retained placenta. This valuable suggestion is

a fact unknown to many practitioners. The placenta does not adhere as

often as some suppose. If attached there is seldom danger from delay in

removal, unless there is hemorrhage. After it is expelled it should be

burned or buried.

The mother must be bathed in tepid water, sponging carefully her back,

abdomen, thighs and perineum. Lay a cloth to the vulva wrung from a

lotion of arnica, one tablespoonful to a quart of water. If there is

soreness in the pelvic region a compress wet in the same lotion can be

worn.

_The parturient woman requires no bandage._ If a compress is needed

a towel can be pinned around to keep it in place. Also, if there is

discomfort from undue enlargement and relaxation of the abdomen, a

bandage applied loosely will give relief. Otherwise no bandage is

essential. The common belief that it restores a woman’s form is a

mistake. She returns to her former size better without than with it.

If worn at all snug it is likely to cause inflammation that will

produce bloating. It also presses the uterus down in the pelvis and in

the relaxed condition of all the parts may cause prolapsus uteri. The

frequency with which prolapsus occurs may justly be attributed to the

unnatural pressure thus exerted. A parturient woman makes a more speedy

and excellent recovery without the bandage.

After the bath, change the soiled quilts and cloths for fresh ones.

Apply a large cloth over the arnica cloth at the vulva, make the

bed look tidy, and leave the patient to rest. The house should be

made quiet and every means used to encourage complete repose. If it

is night, let the attendants retire and darken the room, the nurse

remaining within call.

In case of thirst let her have cold or hot water, weak tea or thin

gruel, as she feels inclined. Ordinarily she needs no remedies. Nature

simply demands rest. Only a few years since a woman was not allowed

to go to sleep until she had taken a bowl of panada and the inevitable

dose of castor oil. One woman told me she dreaded the castor oil more

than having the baby. It is unnecessary and likely to produce harm.

For a few days torpidity of the bowels is natural, and if forced to

action, inflammation and piles are likely to result. Surgeons have

long been familiar with this same state of the bowels in other cases.

Constipation is the natural sequence of amputation or fractures. The

system rallies to meet one great demand and temporary torpidity of the

bowels may be expected. Do not be influenced to take any drug. Simply

rest. Surely at no time in one’s life is rest so sweet.

The long months of anticipation, doubt and endurance are over, the hour

long feared has culminated in the bestowment of a gift which an angel

might receive with rapture. A babe, the object of woman’s profoundest

and most sacred passion has been given her for her very own, to

nourish, guide, develop and instruct, of which even death cannot rob

her. A solemn joy beyond words fills her soul, which none should

needlessly disturb.

He comes--she clasps him; to her bosom pressed,

He drinks the balm of life, and drops to rest.

CHAPTER XIV.

DYSTOCIA.

In difficult labor a physician’s skill and knowledge is imperatively

demanded. Yet a few practical hints for emergencies may be advantageous.

Presence of mind, with the knowledge given in the preceding chapter,

will enable even an inexperienced person, in the chance absence of the

doctor, to conduct a case of natural labor satisfactorily.

_Prolonged and difficult labor may occur_ when one has not had the

benefit of the “fruit diet” and other hygienic measures herein

recommended, or who on account of disease and deformity, has not been

able to accomplish desired results. In malformations of the pelvis,

in face or shoulder presentations, placenta previa, etc., surgical

interference will be required.

Muscular contractions may be inefficient or the os slow to dilate from

rigidity. Caustic treatment, so prevalent for ulceration, destroys

the natural elasticity of the cervix. Severe and prolonged suffering

without dilatation is often the consequence. (See Chap. XXI.) Few women

realize the injury done by the prevalent use of caustic treatment. One

lady told me that she had been treated by eleven physicians, every one

using similar measures. At last in despair she “gave up doctoring,” and

by hygienic methods had attained to a comfortable degree of health.

The time must come when people will protest against the burning of

mucous surfaces as they now protest against blistering and bleeding,

which only a few years since were universal.

The head advancing may meet with resistance from dryness, heat, and

rigidity of external parts.

The _hot sitz-bath_ is the best temporary means to overcome rigidity

of both os and vulva, and to relieve pains that are neuralgic in

character. Seat the patient in a sitz-bath tub, containing very hot

water, her feet also in a hot foot bath. Envelop her with blankets and

increase the temperature of the water by pouring in hot water as she

can bear it. Let her remain until profuse perspiration is induced. Dry

her under the blankets and let her lie down without removing them.

Sometimes she can remain in the bath an hour with advantage, though a

shorter time is usually sufficient. The pains entirely or partially

subside, and she seldom fails to fall into a refreshing sleep. Local

relaxation will be accomplished, the pains assume an effective

character, and a speedy termination of the case can be expected. To

accomplish the desired result, the bath must be _hot_, not warm, and

continued until perspiration is induced. When prolonged labor is caused

by rigidity of the soft parts, good and speedy results are sure to

follow. The following cases prove the value of the hot bath:

Mrs. N---- engaged my services for her seventh confinement, stating

that I might expect a tedious case, as in all previous labors the skill

of physicians had been baffled. She had lingered in labor from 48 to

96 hours, attended with convulsions and other distressing symptoms;

several times had been delivered with instruments. Summons came for me

on a bright June morning at 5 o’clock. She had had irregular pains all

night, was very nervous and had great dread of her sufferings, having

no hope of relief for at least two days. I found no dilatation, and no

real contractions were taking place.

I gave her remedies, hoping to arrest the suffering until relaxation

could be produced, and left her. At 10 o’clock I returned, armed

with one of Dickens’ novels, for a two days’ pastime. Found the

pains increased in severity, attended with rigidity of os, still no

dilatation, but pressure of the uterus upward. Although a woman of

great self-control, she could not repress the most piercing screams

with each pain. A hot sitz-bath was administered, increasing the

temperature until most copious perspiration was induced, after which,

enveloping her in blankets, I bade her sleep, while I sat down to

Dickens.

She obeyed orders, slept soundly, having contractions every fifteen

minutes, when she would rouse and exclaim, “What relief!” “Heaven

surely can be no sweeter than this rest!” “What a blissful change!” I

would say, “Don’t talk, don’t bear down, sleep all you can,” and still

read Dickens. About one o’clock expulsive pains came on. Examination

revealed full dilatation of cervix, and head advancing. At 3:30 P. M.

the child was born, no spasms, no instruments, and no medicine had

been required. This is only one of many that I have seen relieved

in the same way, and always find the bath effectual where there is

no deformity of the pelvis. I am confident that this hot bath, if

generally used, would save thousands of instrumental deliveries.

Mrs. N. was a very grateful patient, and believes that the same means

would have given relief in former labors, as the first symptoms were

the same. The only unpleasant sequel in the case was, the novel

remained unfinished.

Mrs. L----, primapara, aged thirty-three, a severe, tedious labor,

with slow dilatation. Gave the hot bath with the happiest effect;

patient, nurse, and all but the husband went to sleep. Contractions

continued, accompanied by profuse perspiration, but for two hours

did not awaken the patient. Expulsive efforts finally setting in,

labor was completed in one hour. It was, however, almost immediately

followed by violent hemorrhage inducing fainting. Examination revealed

the placenta attached, the fibers so closely adhering to the uterus

that the least attempt at removal caused the greatest suffering. The

placenta was grasped and partially brought down into the cervix. By

this interference the hemorrhage was arrested, and the placenta allowed

to remain for about twelve hours, when it was expelled without any

assistance. The patient made a rapid recovery.

At first I feared that the excessive relaxation from the bath caused

the flowing, but became convinced that it was only exposure of the

bloodvessels from the partial adhesion of the placenta. Its removal

from the body of the womb allowed the organ to contract upon the

exposed bloodvessels, and consequently the hemorrhage ceased.

The hot bath is also effectual for flagging pains that are annoying

and worrying, and “seem to do no good.” In such cases the patient

takes a long rest after the bath, and real contractions and expulsive

efforts may not occur for hours or even days. This gives nature time to

overcome all obstacles, and the final termination is more satisfactory.

ERGOT AND COHOSH are administered by physicians of all schools for

insufficient contractions. These cause violent uterine contractions and

great expulsive efforts. If the soft parts are relaxed, labor will be

facilitated. If not, great injury may be done. Rupture of the uterus

and laceration of the perineum are frequently the consequence. The

effects after confinement are liable to be even more disastrous. Among

these are violent hemorrhage, puerperal peritonitis which runs a rapid

course, cellulitis, milk leg, nervous chills, gathered breasts, etc.

These drugs are well understood to be poisonous to any one in a normal

state. Surely no reason can be given why a parturient woman may hope

to escape their dire effects. Without doubt they lay the foundation

for many chronic uterine ailments. Please mark the following, which

are only a few of the toxicological symptoms of these drugs taken by a

person in health.

_Ergot_ induces rigors, pinched, pale countenance, extreme anxiety,

great fear of death, violent headache, stupor, loss of voluntary

motion, spasmodic jerking, sudden paralysis, debility and fainting,

cold, dry, shriveled skin, knotted veins, tongue cold, livid and pale,

_vomiting violent_, enlargement and pain in the liver, watery diarrhea,

swelling of the limbs with cold surface, _violent_, _cramp-like_,

_intermittent pains_ in the pelvis and groin, hemorrhage, congestion of

the womb, local gangrene.

_Macrotis_, _or black cohosh_, causes weak but rapid pulse, pains in

the back with debility, rheumatic pains in the muscles, limbs seem

powerless, drawing pains with trembling, great restlessness, headache

with soreness of the eyes and of the base of the brain, heat and pain

in the top of the head, dimness of vision with objects floating before

the eyes, prickling of the skin, cold extremities, bruised feeling

all over, dizziness, loss of memory, great nervousness resulting

in hysteria, vomiting, leucorrhea, hemorrhage, etc. Both of these

drugs are violent in their action and poisonous in the doses usually

administered in labor.

It is rare that one recovers entirely from their effects. They cause

uterine inflammation, ulceration, displacement, etc., that are

accompanied by amaurosis, loss of memory, headache and many nervous

symptoms which are ignorantly attributed to the “last confinement.”

Rupture of the cervix, for which ladies so often must be treated in

these days, is frequently the result of rapid forced labor by the use

of these drugs. As you value good health, never take these remedies in

poisonous doses. If uterine contractions can not be increased by the

hot bath or cold compresses placed on the abdomen, an _attenuated_ dose

of the drug will be followed with as speedy results as a cup full of

the infusion or a drachm of fluid extract, and the toxicological effect

will be avoided.

PROTEST POSITIVELY AND PERSISTENTLY against taking a poisonous dose of

ergot or black cohosh. Better wait for nature than suffer the effects

that are sure to follow.

INSTRUMENTS will rarely be called in use if women learn the laws of

life and obey them. Malformed and diseased as women are, instruments

are resorted to far more frequently than necessary. There is a feeling

in the profession that dextrous instrumental delivery often saves

women suffering, and consequent nervous prostrations. Most women, on

the contrary, have a horror of forceps, and this, with the temporarily

increased suffering aggravates rather than lessens the prostration.

Remember, the physician has selfish temptations for instrumental

interference. It entitles him to an extra fee, it saves him time, and

possibly gives him _eclat_ as an accoucheur.

In most cases where instruments are now used, speedy results could

be obtained from the _hot sitz-bath_, without danger of subsequent

difficulties. Occasionally a case may require instruments, but the

experience of many successful physicians, especially the women in the

profession, proves that if there is careful preparatory treatment,

artificial delivery need seldom be called in requisition. In several

hundred obstetric cases in my own practice, instruments were never

required where the previous preparation of the patient had been under

my own direction.

Women have it in their power to produce such healthful conditions that

obstetrical instruments shall be known only in tradition.

CHAPTER XV.

POST PARTUM DISEASES.

“Mysterious to all thought,

A mother’s prime of bliss,

When to her eager lips is brought

Her infant’s thrilling kiss.”

Proper bathing and diet are as essential after as before confinement.

At least once a day the patient requires a bath. Ordinarily use tepid

water. Sponge and dry a portion of the body at a time, keeping the

balance protected. If there is heat in the back, bathe it several times

a day. Should the patient be nervous and uneasy, try dry hand friction.

A compress, too, is often serviceable, worn across the back for two or

three hours, followed by bathing and rubbing. The breasts should be

bathed frequently, and the colder the water the better. This prevents

sensitiveness to cold, and may consequently prevent gathered breasts.

Three to five days after confinement the patient can be put into a

sitz-bath with benefit. Let the temperature of the water be from 85°

to 95°. This bath is restful, cleansing and restorative, and is really

as beneficial after as before parturition. A woman can often sit in a

bath for a few moments when the same time spent in a chair would prove

injurious.

Change the linen of bed and person daily, and the napkins every three

or four hours. Keep the room light and well ventilated. The temperature

of the room should never exceed 70°. A few years since not a ray of

light or a breath of fresh air was allowed in the parturient room, and

if the woman was to touch cold water, it was deemed sure death. In

some parts of this country, within twenty years, the bed even was not

changed for nine days after confinement. With frequent bathing and a

constant supply of fresh air the patient will not be sensitive to cold,

and inflammation and other post partum diseases will in consequence be

rare.

The vagina must be syringed at least twice a day with water in which

there are a few drops of carbolic acid. Use a fountain syringe, and

have the patient recline over a bed pan. Thus the parts will be kept

cleansed, and carbolic acid prevents septic poisoning. If the bowels do

not move naturally by the third or fourth day, give an enema, one quart

of tepid water. The regimen advised in this book having been followed,

one will rarely be troubled with constipation. Beware of cathartics.

Most of them have a specific action upon the uterus as well as upon

the bowels, and will do harm. This is notably the case with aloes and

podophyllum.

The _food_ must be simple in character and easy of digestion,

especially until after the milk is established. Bran or graham gruel is

the _very best food_ the first day or two. Having been withheld from

the diet during pregnancy, on account of containing the phosphates

which have a tendency to harden the bones, it should now be taken for

that very purpose.

Many are prejudiced against graham gruel, yet it has been proven that

most women relish it better than anything else after labor. In the Home

of the Friendless, Leavenworth, Kan., are many cases of confinement

every year. Almost universally the inmates are prejudiced against

graham in any form, and rarely taste it before confinement. A former

matron had been a nurse in a Water Cure. Invariably she brought a bowl

of graham gruel to the mother a few hours after delivery. She never

had one express any repugnance to it. On the contrary, they would say,

“That tastes good;” “That goes right to the spot;” “Can any one eat too

much of anything that is so good?” and similar expressions, showing

that there was an actual relish for the dish. The gruel should be made

thin at first, and without cream or milk. After a few days it can be

made thick like mush, and eaten with fruit or cream and sugar. New

milk, wheatlet, cracked wheat, barley, oatmeal, graham gems, fruit,

etc., can be added to the diet as desired.

_There is no need of milk fever._ Women have been led to expect more or

less constitutional disturbance accompanying the advent of the milk.

With the bathing and diet recommended above, even if she has not had

the best conditions during pregnancy, one hardly realizes any change

in the system at that time. When patients were fed on brandy panada,

wine whey, strong tea, and beef broth, were kept in unventilated rooms,

deprived of water externally and internally, and besides were poisoned

with drugs, it is no wonder they had milk fever, and were liable to

other post partum diseases.

The child should be placed to the breast several times a day, even if

there seems to be no milk. The act of nursing stimulates secretion,

prevents engorgement, and from sympathetic relation causes uterine

contractions. When the breasts become filled and are knotty and tender,

bathe them in hot water and have them drawn. If the child does not

empty them sufficiently, the nurse or some member of the family should

do it. This is better than a breast pump, and can be easily done by

remembering to lap the tongue around the nipple until it meets the

upper lip.

The old tradition used to be that a woman, on no account, must leave

her bed before the _ninth day_. No matter how well she felt, the

nine days must be spent in bed. There is no positive rule. One must

be guided by her strength. Probably few women can expect to be about

before four or five days. The cases where they can leave their beds

earlier than that are exceptional.

MAMMARY ABSCESS, or inflammation of the breast, often called “gathered”

or “bealed” breast, is usually ushered in with a chill, succeeded by

feverish symptoms. Darting pains are felt in the breast, which, as the

disease progresses, extend to the arm-pits. The breasts swell, become

hard and tender to the touch--even nursing is painful. If pus forms,

the skin becomes dark red, the enlarged breast softens, accompanied

by a throbbing pain. The patient is feverish, nervous, irritable, has

irregular chills, night sweats, debility, etc.

_Hot fomentations_ should be used promptly and thoroughly at the first

threatening symptoms. Wring a cloth out of an infusion of phytolacca,

and _keep hot_ by applying the water bottle containing a small

quantity of very hot water. If too much water is put into the bottle it

is made uncomfortably heavy. If the fresh root cannot be obtained, use

the fluid extract, ten drops to a pint of water. Keep the breast well

drawn and persevere in the hot applications; suppuration can usually be

prevented. Farmers know the value of phytolacca, and use it with their

new milch cows in case of caked bag.

_Aconite_ should be taken internally if there is alternate chill and

fever, with thirst and throbbing pulse, one drop of tincture in ten

tablespoons of water, a spoonful every half hour.

_Bryonia_, 2d.--Constant aching in the bones and soreness of the flesh.

Dose, six pellets every hour.

Use only liquid food until the disease is surely arrested. Keep quiet

and have plenty of fresh air. Unless the suppuration is very deep the

breast should never be lanced.

FOR EXCORIATED NIPPLES, bathe in a warm borax lotion, two grains to

one cup of soft water; after which apply carbolated cosmoline or

calenduline. If the base of the nipple is deeply cracked, before using

the cosmoline, wash with a solution of nitrate of silver, one grain to

two ounces of water. Protect with a shield while the child is nursing.

None of the above preparations are harmful to the child, except the

nitrate of silver, and the cases where this is needed are rare.

FOR INSUFFICIENT MILK, drink freely of new warm milk. Have it brought

to the bed, and drink at least a pint. Take it one or two hours before

breakfast. If milk cannot be obtained possessing animal warmth, take

new milk, add one-tenth water, and heat over a water bath to a

temperature of 120 degrees. Cheese makers testify that the addition of

water prevents rennet from coagulating the casein. In the stomach also,

warm water prevents the pepsin from curdling the milk. If it is as warm

as the stomach, and does not coagulate, it will be taken up by the

absorbents and conveyed directly to the blood, without going through

the process of digestion. Mothers who have a great aversion to milk,

learn to cultivate a decided relish for it for the sake of the child.

Dr. R. P. Harris, in speaking of milk as a diet for delicate mothers,

says: “Those who with ordinary food invariably fail to nurse longer

than a few weeks, are capable by this diet of becoming not only

good nurses, but also of gaining flesh while secreting the milk in

abundance. When a delicate mother of eighty-six pounds’ weight, who

had failed after a month with each of three infants, is enabled by it

to nurse a child eighteen months, and gain at the same time nineteen

pounds, the diet must be an effective one.” The article next best for

promoting the secretion of milk is cocoa or chocolate, prepared with

plenty of milk.

_Every form of malt and spirituous liquors_ should by all means be

_avoided_. They derange the nervous and digestive systems of both

mother and babe. Custom, happily, has to a large extent done away with

the idea that “nursing women _must_ have ale or beer.” To those who

still maintain this view, I would recommend the study of the question,

whether the help expected is at all commensurate with the danger

incurred of a pernicious appetite being cultivated in both mother and

child.

Good digestion is usually all that is essential for an abundant flow

of milk. The food should be simple but nutritious. Depend upon grains

and fruits mainly, and by no means exclude the bran from the wheat

flour. The saline elements in the bran not only stimulate digestion,

but excite the secretion of milk as well. Try the experiment of feeding

an Alderney cow upon fine flour, excluding the bran. By the lack of

milk you will prove that the bran contains elements pre-eminently

stimulating to lacteal secretions.

Oysters eaten raw or slightly cooked are said to increase the flow

of milk. Honey, too, often proves invaluable. With bread and gems,

instead of the carbonaceous butter, eat honey. It stimulates all the

secretions. It is evident that foods rich in phosphates are the best

to increase lactiferous flow. Therefore, study well the food table in

Chapter IX, and partake of foods which were avoided in pregnancy.

In the first days after confinement, if the milk is slow to secrete,

apply bruised castor bean leaves.

FOR EXCESSIVE FLOW OF MILK, once or twice a day use hot fomentations

upon the breast, and apply cosmoline, in which there is a trace of

camphor. Avoid salt and liquid food. Wear folds of cotton batting over

the breast. In either insufficient or excessive flow of milk, guard

against pressure of clothing. It is absolutely essential that the blood

should circulate freely to and from the breasts.

(No one thing more frequently causes atrophied breasts in any woman

than the pressure of corsets and padding ordinarily worn. It is not

unusual for a fine development of the breast to result from the

removal of all pressure, accompanied by bathing daily with cold water,

and following the bath by friction. Should this fail, an apparatus on

the principle of dry-cupping is used. This seldom fails of giving the

desired results.)

AFTER PAINS often accompany the contraction of the uterus. It is

not true that women never have them with the first child and always

have them subsequently. Like most of the sufferings of maternity,

they are the effect of abnormal conditions. Women, who, in two or

three confinements have suffered days with after pains, threatened

with spasms and not relieved except by chloroform, have by previous

preparation recovered without a twinge of pain.

After pains usually occur periodically every ten or fifteen minutes.

They are cramp-like pains accompanied by a feeling as if pricked by

many needles. They make one very impatient and nervous, depriving

her of needed rest. They are often the result of poisonous doses of

ergot taken during labor. The _hot water bag or hot fomentations_

will usually give relief. Must be very hot and kept hot, consequently

dry heat is to be preferred. Administering a hot sitz-bath is also

excellent treatment. If relief is not obtained, and the physician is

not within call, inhale ether moderately. Do not take it internally.

THE LOCHIA is the flow from the vagina which occurs after confinement.

At first it has the appearance of fresh blood, then becomes lighter

in color, and finally is only a glairy mucus. This varies greatly

in amount and duration. As a rule the healthier the woman, and more

natural the labor, the less the flow. Cases have come to my knowledge

where there was no sanguineous flow, and the patient made a rapid

recovery. It is said that healthy squaws have no flow of blood with

menstruation, or after delivery. If there is no constitutional

disturbance, there need be no anxiety about a scanty flow. If caused

by a chill, fever or inflammation, etc., prompt attention will be

required, according to accompanying symptoms.

METRORRHAGIA, or profuse flow, often requires treatment before

medical aid can be secured. Hot fomentations, hot sitz-bath and hot

vaginal injections are the very best applications. Recently the

medical profession recognize that heat is better than cold, to arrest

hemorrhage. In surgery, hot water is applied to exposed bleeding

vessels. Cases are known where hot vaginal injections have instantly

arrested bleeding that had resisted applications of ice, styptics and

the tampon.

A lady in Michigan, during the menopause, was taken suddenly with

violent hemorrhage. For seven days and nights everything was tried in

vain to arrest the bleeding. She became cold and clammy, had frequent

fainting spells, and death seemed imminent. An old nurse came to take

care of her over night. She set aside the physician’s potions and

applications. She filled the big wood stove with bricks, and as fast

as they were heated wrapped them in wet cloths and put them about

the patient, who thus obtained her first sleep for days. The hot

bricks were kept to her four days and nights. There was no return of

hemorrhage. She made a rapid recovery.

If there are clots, retained placenta or membranes, or any foreign

growth present in the uterus, they must be removed by surgical

interference, before uterine contractions can be effected and

maintained.

PELVIC PERITONITIS, PUERPERAL OR CHILD-BED FEVER. “There is a word of

fear that I shall pronounce when I utter the name of Puerperal Fever;

for there is almost no acute disease that is more terrible than this.

The small pox itself, which reduces the fairest form of humanity to

a mass of breathing corruption, can not be looked upon with greater

dread. Child-bed fever, like an inexorable Atropos, cuts the thread of

life for those to whom Clotho and Lachesis would give the longest span.

“There is something so touching in the death of a woman who has

recently given birth to a child; something so mournful in the

disappointment of cherished hopes; something so pitiful in the deserted

condition of the new-born, helpless creature, forever deprived of those

tender cares and caresses necessary to it, that the hardest heart is

not found insensible to the catastrophe. It is a sort of desecration

for an accouchee to die.”

Thus feelingly writes Prof. Meigs, of Philadelphia, of this disease,

the very thoughts of which strike terror to the stoutest heart. This

disease is an inflammation of the uterus and its peritoneal covering,

and often extends to the entire membrane lining the abdominal cavity,

and possibly involves all the pelvic viscera.

The attack ordinarily commences from the third to the ninth day after

delivery. Previous to this, the patient has seemed all right, when

suddenly, often apparently without cause, she is taken with a chill.

Rigors more or less severe extend up and down the spinal column.

Clothing does not seem to impart any warmth. Almost simultaneously with

the chill, periodical pains will be felt in the womb, and if there is

not much constitutional disturbance, may be taken for _after pains_.

Usually, however, they are accompanied by great soreness and tenderness

in the pelvis; the abdomen soon bloats and becomes tympanitic; the

legs are flexed to relieve the tension; the weight of the clothes,

even, cannot be borne. The milk dries up, the lochia cease, there is

headache, great thirst, increase of temperature, a quick, wiry or

bounding pulse.

All of these appalling symptoms are accompanied by great anxiety of

mind and distressed expression of countenance. A dark circle forms

about the eyes, which are sunken, the nose pinched, and the lips drawn,

and the face is flushed or very pale. The course of this dread disease

is extremely rapid. “It will not unfrequently happen that she shall die

within thirty-six or forty-eight hours from the onset of the malady,

and some cases terminate fatally even in eight hours. They are to be

cured promptly or not at all. Such a malady as this hurries with hot

and furious haste to a turn, beyond which there is not and cannot be

any useful therapia.”

Perhaps I shall be condemned for picturing to the sensitive imagination

of the pregnant woman the possible dangers of this dread disease.

Her attendants will look out for it, and she should not be led to

anticipate it. For two reasons, however, she should be forewarned:

_First, that she may at once summon her medical attendant._

_Second, that the causes of this disease being known, she may avoid

them._

Do not delay one moment in calling your physician. Having the symptoms

indicated, procrastination is suicidal. The doctor would better come

ten times for a nervous chill or after-pains, if by chance the mistake

should be made, than that you should fail once to notify him of an

attack of puerperal fever.

Under improved methods of treatment this disease does not terminate

fatally as frequently as formerly.

The causes of this disease are:

_First._ The inflammatory condition of the system before delivery. If

the _fruit diet_ has obviated this, there is nothing to fear.

_Second._ The use of ergot in confinement. Puerperal fever following

poisoning by ergot is very rapid in its course, and soon terminates in

gangrene. If this drug were banished from practice, child-bed fever

would be rare.

_Third._ Contusions and bruises from instruments not handled dextrously

cause inflammation.

_Fourth._ The use of cathartics, tonics, stimulants and other drugs

after delivery.

_It is within the power of every woman_ that she shall not be subject

to these causes of puerperal fever.

Some late teachers claim that all child-bed fever is pyæemia,

blood-poisoning, and can not be avoided. Why is it, then, that it is

notably absent in those who have led a hygienic life? Why is it that

those physicians who insist on preparatory treatment seldom meet with

it in their practice? Others claim that the disease is contagious, and

that the poison can be conveyed by physician and nurse.

Dr. W. S. Playfair, of London, who gives to this disease the name

of Puerperal Septicæmia, says: “The whole tendency of recent

investigations is daily rendering it more and more certain that

obstetricians have been led into error by the special violence and

intensity of the disease, and that they have erroneously considered it

to be something special to the puerperal state, instead of recognizing

in it a form of septic disease, practically identical with that which

is familiar to surgeons under the name of pyæmia or septicæmia.

“If this view be correct, the term ‘puerperal fever,’ conveying the

idea of a fever such as typhus or typhoid, must be acknowledged to

be misleading, and one that should be discarded as only tending to

confusion.

“According to this theory, the so-called puerperal fever is produced by

the absorption of septic matter into the system. It is not essential

that the poison should be peculiar or specific; for, just as in

surgical pyæmia, any decomposing organic matter either originating

within the generative organs of the patient herself, or coming from

without, may set up this morbid action.”

THE TREATMENT OF PERITONITIS should be prompt and thorough. Sweat the

patient as soon as possible. Place several steaming bricks or ears

of boiled corn about her. Frequent hot enemas by rectum and vagina

are beneficial. If gangrene threatens, it is often arrested by the

application of a yeast and charcoal poultice. Take any good lively

yeast, make a sponge of corn meal and graham flour, equal parts. When

light, add two tablespoons of charcoal to one pint, put on to a large

cloth covered with thin gauze and lay over the entire abdomen. Must be

changed frequently, not allowing it to get dry. An injection should be

given per rectum every three hours, of weak carbolic soapsuds.

The nutriment should be diluted hot milk, or oatmeal gruel. Small

pieces of ice will be grateful.

When these directions are followed faithfully, accompanied by

appropriate remedies, most cases can be saved.

Even if it should be proven that this disease is septic poisoning,

a healthy tone of the organs resists the absorption of the foreign

agent, which proves a poison. In twenty years of general practice

I never had a fatal case outside of the hospital. My experience

emphasizes what I have stated, that the hygienic life and habits,

and the avoidance of drugs and instruments go far toward preventing

child-bed fever.

CHAPTER XVI.

INFANTS.--THEIR CARE AT BIRTH AND DURING EARLY INFANCY.

“What am I?

An infant crying in the night;

An infant crying for the light;

And with no language but a cry.”

--TENNYSON.

What more helpless and dependent than the newborn infant! A human soul,

with all the possibilities of life, yet of itself it cannot supply its

slightest need.

No wonder that so great a wealth of maternal love is called forth in

administering to such helplessness! No wonder that the mother’s heart

is humbled at the greatness of her mission as special guardian of the

little one! May divine love and wisdom aid and guide her!

The newborn babe has had a sleep, at least a rest. It has entered upon

its new life, and all the functions of the body are well established.

The first thing in lending a helping hand to the little stranger is to

give him a bath. This is done ordinarily by using soap and warm water.

The _vernix caseosa_, a thick, white, unctuous material that usually

covers the child, and is abundant in the axilla and groin, is much more

easily and thoroughly removed by cleansing it entirely with some oily

substance. For this purpose olive oil or lard can be used. It should

be applied with a soft, worn piece of flannel, keeping the child well

covered. When it is entirely clean, rub all over with a fresh piece of

flannel, and the skin is left in a soft, smooth condition.

R. P. Harris, M. D., says: “As the _vernix caseosa_ is readily miscible

with pure lard, and can be easily removed by its means, the practice

prevails with many obstetricians in the United States of ordering the

infant well anointed, and then wiped from head to foot with soft rags,

until all the vernix disappears, and the skin retains an oily trace,

not enough to soil the clothing. By this means water is avoided, and

with it much risk of taking cold; the skin is left much less sensitive,

after the sudden change which it is made to endure at birth than when

subject to soap and water.”

DRESS THE NAVEL with absorbent antiseptic cotton. Put a piece three

or four inches square on the left side of the abdomen, just above the

navel, the remnant of the cord laid upon it, with its cut end pointing

to the left, and upward--the cotton arranged to embrace the base of the

cord, and another piece of cotton the same size placed over the cord,

the whole kept in place by a soft flannel band. This is preferable to

linen. It absorbs the secretion more readily, making less liability

of an unpleasant odor. It is kept in place better, and the cord comes

off much sooner. Can often be entirely removed the fourth day. There

needs to be no grease or oil upon the cotton. After the separation of

the cord, the navel should be dressed with a little simple cerate or

cosmoline, and still use the absorbent cotton.

_Any pouching of the navel_ can be relieved by using a thin slice of

cork or a piece of thick pasteboard two inches in diameter. Wrap it

with several thicknesses of linen and place it outside of the cotton,

applying the bandage sufficiently snug to keep it in place.

THE CLOTHING of the child should be soft, warm, light, loose, and

easily adjusted. Superfluous garments should be avoided, and waistbands

dispensed with.

Activity is so natural to child-life that it seems almost life itself.

Months before it is born a babe is in ceaseless motion, and after birth

it is never still during its waking hours. This activity is synchronous

with its development and should be encouraged rather than hindered. A

child’s dress, while it serves the purposes of warmth, protection and

adornment, should in no way prevent this activity.

Only a few years since, the dress for all infants was cut low in the

neck and with short sleeves. A sensible reform made it fashionable

to protect the necks and arms of the little ones. It is equally as

essential and is just as desirable a reform, that the dress should be

so constructed that the natural activity of any part of the body is not

hindered. To accomplish this the skirts must be shortened and all bands

abolished. Is there any reason why a child’s clothes should be so long

that they are a burden to him and an inconvenience to all who handle

him?

Many mothers, noting their babies’ constant struggle for exercise,

frequently uncover their feet in order to give them an opportunity to

kick and stretch. It is not unusual, also, for them to get them out of

long clothes by the time they are three months old.

One lady writes that she tried making her baby’s first clothes very

short. They were only twenty-seven inches in the entire length, from

the shoulder to the hem at the bottom. This experiment proved so

satisfactory that she says she will never put long dresses on a child

again. Not only was her baby so much more comfortable, but he was so

much more easily handled that she felt repaid in the comfort it was

to herself. Aside from this, there was no necessity of making short

clothes for him until he walked, which was a saving in time and money.

A new-born child requires the following garments:

A Shirt and Band Combined: This should be made of soft flannel or

knitted wool. If of flannel, turn hems but once, and cross-stitch down

smoothly. Finish the neck and arm’s eye with a button-hole stitch,

using silk or worsted. Lay a fold in back of shirt, to make it fit the

child, and stitch down smoothly and lap in front and fasten as if it

were a band. The shirt has this advantage over the ordinary band, that

it cannot wrinkle up if the napkin is pinned to it as it should be.

One-half yard of thirty-six inch flannel will make four shirts. This

garment is worn mainly to keep the dressing upon the navel in place,

and can be discarded when that necessity no longer exists.

Foot blanket: Made of flannel, twenty-seven inches square, and hemmed

on three sides. Lay a double box-plait in the center of fourth (or

upper) side, stitch down one inch, and face the same width, with

a strip of cotton, cut bias. Fasten over the diaper with a small

safety-pin. This garment protects other clothing and wraps the feet up

nicely until the child is large enough to wear socks. If the weather

is cold woolen socks are advisable from the first. However, it is not

absolutely necessary, and some mothers dispense with it altogether.

A Flannel Skirt: Is made with long sleeves, and is cut from the same

pattern as a night-dress or day-slip. Fine, all-wool flannel is

generally used for this skirt, but I would recommend the use of the

eider-down flannel, which is also so desirable for baby cloaks. The

outside dress can be made as a Mother Hubbard, or slip, and where

taste inclines, it may be of finest material and exquisite embroidery.

Besides the diaper, the flannel skirt and slip are all the clothes a

young baby actually requires. The skirt should be put inside of the

dress and the two put on the child at the same time.

Thus an infant may be dressed in less than five minutes, instead of the

long, tedious process of the customary dress.

Once clothing a baby in this simple fashion, one would never be

inclined to again adopt the long full skirts, the bands and pins, that

are a torture to infants and trying to the patience of the mother.

The same general principle may be followed for a child’s wardrobe until

he is put into drawers; then these require to be attached to a light

waist without sleeves.

The first few months the child’s feet are most comfortable in crocheted

socks. The first shoes may be made like moccasins, of broadcloth or

chamois skin. A lady in Cincinnati makes many of the latter for the

trade, supporting her children and an invalid husband by their sale.

These directions for infants’ clothing are so simple that many may

think they are not worth following, but when we see the little ones

bandaged and burdened as we do, is it not time to make a protest that

will reach every mother? A child’s dress should always serve the

purposes of protection and warmth without any hindrance to its activity

and development.

HABITS OF CLEANLINESS can be taught every child. The clumsy diaper can

be dispensed with by the time it is three or four months old. Let the

mother practice holding out her baby immediately after nursing it, and

it will easily be taught to urinate at this time, and also to have a

passage from the bowels at a stated time in the morning and evening.

The actual comfort secured to mother and child through this habit,

more than repays for the labor and patience in securing it. Teach your

children to be cleanly. _A dirty child is a mother’s disgrace._ When

a child begins to creep and walk, the diaper (necessarily large and

bulky) has to be pinned too tightly for comfort and health, in order to

keep it in place.

A BATH may be given to the child every day or every other day. By the

time it is two months old, it can be put into a bath daily. Should

remain in the water not more than five minutes. The temperature should

not exceed 90°, and it is quite as well to accustom the child to a

lower temperature gradually. Don’t trust the hand to determine the

heat. _Always have a thermometer._ Do not bathe a child immediately

after nursing. Avoid the use of soap. A child’s skin is naturally oily,

and should be preserved so.

NURSING.

“The starting beverage meets the thirsty lip;

’Tis joy to yield it, and ’tis joy to sip.”

_The newborn infant needs no artificial food._ It should be put to the

breast whenever it shows an inclination. The true mother will delight

in the privilege of nursing her child, and will allow nothing but the

most entire inability to prevent the exercise of this maternal office.

The mother’s milk is the natural food, and nothing can fully take

its place. Every means should be used to secure and maintain this

natural nutriment before resorting to artificial food. The nursing

process, by sympathetic action, assists in restoring the uterus to

normal conditions. A few years since everybody supposed the baby must

be fed artificially the first two days of its life, that there was a

break in nature’s provision for its sustenance. The consequence was

the poor little victim was dosed with all sorts of slops, catnip tea,

panada, gruel, cracker water, cream tea, etc., etc. Remember, it _needs

nothing_ but the secretion that is in the breast, which is laxative at

first, and removes the meconium from the bowels. If for any reason the

mother has not milk for her child, or is separated from it, the best

substitute is a wet nurse, whose babe should be near the same age. The

nurse should be well and strong, having abundant and nourishing milk.

THE BEST ARTIFICIAL FOOD is cream reduced and sweetened with sugar of

milk. Analysis show that the human milk contains more cream and sugar

and less casein than the milk of animals. The reduced cream, sweetened,

closely approximates human milk. The difference in the quality of cream

presents a great difficulty. No rule can be given for its reduction.

Most nurses leave it too rich, and the child’s system is soon deranged.

To obviate this difficulty, let new milk stand from four to six hours,

take the top off, reduce one-half with hot water; to one pint add one

teaspoonful of sugar of milk and one grain of phosphate of lime. When

the child is from three to five months old, oatmeal, barley or bran

gruel can be added.

_Children have not sufficient secretion of saliva to convert starch

into sugar._ Therefore never use arrowroot or corn starch; these do not

digest in the stomach, and intestinal derangement is likely to follow.

Bran or barley gruel furnishes phosphates, which are essential to

stimulate digestion.

Microscopical examination of the artificial foods prepared and sold

for infants, proves many of them deficient in gluten and too abundant

in starch to make them desirable nutriment. The following extract from

“Playfair’s Midwifery” explains the

“CAUSES OF MORTALITY IN HAND-FED CHILDREN.--Much of the mortality

following hand-feeding may be traced to unsuitable food. Among the

poorer classes especially there is a prevalent notion that milk alone

is insufficient, and hence the almost universal custom of administering

various farinaceous foods, such as corn-flour or arrowroot, even from

the earliest period. Many of these consist of starch alone, and are

therefore absolutely unsuited for forming the staple of diet, on

account of the total absence of nitrogenous elements. Independently of

this, it has been shown that the saliva of infants has not at first

the digestive action on starch that it subsequently acquires, and this

affords a further explanation of its so constantly producing intestinal

derangement. Reason, as well as experience, abundantly proves that

the object to be aimed at in hand-feeding is to imitate as nearly

as possible the food which nature supplies for the newborn child,

and therefore the obvious course is to use milk from some animal, so

treated as to make it resemble human milk as nearly as may be.

“ARTIFICIAL HUMAN MILK.--An admirable plan of treating cow’s milk, so

as to reduce it to almost absolute chemical identity with human milk

has been devised by Professor Frankland, to whom I am indebted for

permission to insert the receipt. I have followed this method in many

cases, and find it far superior to the usual one, as it produces an

exact and uniform compound. With a little practice nurses can employ

it with no more trouble than the ordinary mixing of cow’s milk with

water and sugar. The following extracts from Dr. Frankland’s work will

explain the principles on which the preparation of the artificial human

milk is founded: ‘The rearing of infants, who can not be supplied with

their natural food, is notoriously difficult and uncertain, owing

chiefly to the great difference in the chemical composition of human

milk and cow’s milk. The latter is much richer in casein, and poorer in

milk-sugar than the former, whilst asses’ milk, which is sometimes used

for feeding infants, is too poor in casein and butter, although the

proportion of sugar is nearly the same as in human milk. The relation

of the three kinds of milk to each other are clearly seen from the

following analytical numbers, which express the percentage amounts of

the different constituents:

Woman. Ass. Cow.

Casein 2.7 1.7 4.2

Butter 3.5 1.3 3.8

Milk-sugar 5.0 4.5 3.8

Salts .2 .5 .7

These numbers show that by the removal of one-third of the casein from

cow’s milk, and the addition of about one-third more milk-sugar, a

liquid is obtained which closely approaches human milk in composition,

the percentage amounts of the four chief constituents being as follows:

Casein 2.8

Butter 3.8

Milk-sugar 5.0

Salts .7

The following is the mode of preparing the milk: Allow one-third of

a pint of new milk to stand for about twelve hours, remove the cream

and add to it two-thirds of a pint of new milk, as fresh from the cow

as possible. Into the one-third of a pint of blue milk left after the

abstraction of the cream, put a piece of rennet about one inch square.

Set the vessel in warm water, until the milk is fully curdled, an

operation requiring from five to fifteen minutes, according to the

activity of the rennet, which should be removed as soon as the curdling

commences, and put into an egg cup for use on subsequent occasions,

as it may be employed daily for a month or two. Break up the curd

repeatedly, and carefully separate the whole of the whey, which should

then be rapidly heated to boiling in a small tin pan placed over a

spirit or gas lamp. During the heating a further quantity of casein,

technically called ‘fleetings,’ separates, and must be removed by

straining through muslin. Now dissolve 110 grains of powdered sugar of

milk in the hot whey, and mix it with the two-thirds of a pint of new

milk, to which the cream from the other third of a pint was added, as

already described. The artificial milk should be used within twelve

hours of its preparation, and it is almost needless to add that all the

vessels employed in its manufacture and administration should be kept

scrupulously clean.

Any babe can be fed from the first with a spoon, and in a few weeks

it will drink from a cup or glass. When it seems necessary to use the

nursing bottle the utmost care should be taken to keep it clean and

sweet. Two bottles should be used alternately. The one not in use

should be thoroughly rinsed, and then laid (without the nipple) in an

earthen or granite dish, containing a solution of common soda. Let it

remain there until needed, then rinse it well, and you may feel that it

is in good condition. Cleanse the nipple by hand. Do not use the rubber

tube.

A young babe should not be fed more frequently than once in two

hours, and by the time it is three months old once in three hours

is preferable. Most children, when four or five months old, can be

taught to sleep all night without nursing. Nothing deranges a child’s

digestion more than irregular and constant nursing. I have seen a

mother give her child the breast five times during a half-hour’s

conversation. It is unreasonable to suppose that a child is hungry

every time it nestles and frets. Consider the time since it has nursed,

and look for other causes of uneasiness before giving it the breast.

A babe should be weaned when it is from twelve to eighteen months

old. The exact time depends largely upon its development, and also

upon the mother’s condition. Begin weaning by omitting nursing once

a day for several days, then twice a day, and so on. In this way the

little one is weaned almost, or quite unconsciously, is never for a

minute unhappy, and the mother is saved great anxiety and worry. Before

weaning and some time after, it should be fed upon oatmeal, barley

meal, wheat meal, graham bread and milk, wheatlet, etc. The digestive

organs are not in a condition for a mixed diet until the teeth are

developed, and, as has been indicated above, the saliva is not yet

an efficient aid for digesting starchy food. Many a case of summer

complaint, convulsions, etc., is due to the meat, pie and cake upon

which the child has been fed.

Meat-fed children are cross, irritable and quarrelsome. Some three

years since a kind, conscientious mother said: “The greatest trial

of my life is that my children quarrel so with each other. I cannot

understand the reason. Nothing they do annoys me so much, and by

teaching, persuasion or punishment I have been unable to change their

habit.”

Hoping to give her aid, I asked many questions--among other things in

regard to diet. She told me they were great meat eaters; her husband

and brother must have it three times a day, and the children often

ate scarcely anything else. I told her the story of the bear that was

kept at the museum in Giessen; when fed on bread only it was quiet

and tractable--even children could play with it with impunity--but a

few days’ feeding upon meat would make it ferocious, quarrelsome and

dangerous.

She agreed to try the experiment upon her children. I counseled her,

as her husband did not dine at home, to make a special dinner for the

children. Instead of giving them scraps of cold meat, pies and cake,

etc., make them milk toast, tiny graham or corn meal gems, cracked

wheat or wheatlet moulded in small cups with fruit sauce, fruit

puddings, etc. Spare no pains in making it attractive and palatable.

Decorate the table with fruit and flowers, and make the occasions

frequent when their own holiday presents of china should be used.

Follow this with a light lunch at night, of simple, farinaceous food

before the ordinary family dinner. In this way they would be tempted

with the meat only at breakfast, and even then, fresh fish, fish balls,

omelets, etc., might often be made to supplant the platter of steak or

ham.

This lady entered into the plan heartily, and was more than amply

paid. In less than a month she could see a difference in the habits of

her children, and a year later she testified that it would hardly be

recognized as the same family. The children were cheerful, playful,

gleeful, and full of spirit--but in place of fretfulness and quarrels,

were kind, benevolent and considerate to each other. They were

also more than ordinarily exempt from acute attacks of fevers and

inflammation.

CHAPTER XVII.

DISEASES OF INFANTS.

The diseases herein treated are mainly those for which a physician is

seldom called. A few suggestions are also added upon those in which the

severity of the attack necessitates attention before medical aid can be

obtained.

APHTHA is sometimes the result of scrofula, otherwise it is caused by

improper quality or quantity of food, either natural or artificial.

In bottle-fed babes it often results from the milk not being

sufficiently diluted, or from the use of starchy food. Neglect of

general cleanliness in many cases give rise to this ailment. The

child is feverish, fretful, and often refuses the breast on account

of pain experienced in nursing. Sometimes there is vomiting and thin

watery diarrhea. The tongue, gums, palate and inside of cheeks and

lips are thickly specked with white flecks; sometimes there is a dirty

diphtheritic-like membrane. Aphtha usually runs its course in a few

days. Those cases are exceptional which are followed by unpleasant

results.

TREATMENT.--Sometimes the case requires merely the washing of the mouth

two or three times a day with a weak solution of borax, ten grains to

one ounce of water. The mouth should be cleansed after each meal, as

should also the mother’s nipple.

℞ Hydrastis 10 gr.

Sugar, 100 gr.

Pulverize thoroughly and put a small quantity into the mouth two or

three times a day.

_Arsenicum, 3d._--Patches of a dark color; severe, watery, painless

diarrhea, thirst and great prostration. Dose, six pellets every three

hours.

_Merc. Sol., 3d._--Dribbling saliva, offensive breath, greenish

diarrhea with pain. Dose, six pellets every four hours.

EXCORIATION of groin and axilla frequently trouble very fat, scrofulous

or bottle-fed babies. The surface becomes raw, inflamed, and often

painful.

Bathe frequently in tepid soft water, or what often proves better, milk

and water. Dry with a soft linen cloth. Or hold the sufferer over a

tub or basin, and from a large sponge squeeze tepid soft water on the

affected part. Repeat every two or three hours. This is grateful and

healing. The occasional use of cosmoline or of sweet cream in which

clover blossoms have been steeped is beneficial. Avoid nursery powders.

If the methods advised fail, scorch flour and apply several times a

day. Should there be eruptions or ulcers use a powder of the following:

℞ Scorched Flour ℥j

Powdered Hydrastics ʒj

Mix. Apply through a powder bag after washing.

_Borax_, half a drachm to a pint of soft water, gives relief where

great inflammation attends the excoriation. Lay upon the affected

part for an hour or two at a time soft cloths wet in the cold lotion.

Frequent washing and perfect cleanliness are really the best

preventives and cures.

COLIC is the torture of babyhood, as well as a constant source of

parental solicitude. It is not considered a dangerous disease, but the

sufferings of the little one are a great tax upon sympathetic nerves.

There is no special age when the infant is subject to colic. It occurs

more frequently when it is from two to five months old. However,

children may suffer from it before they are two weeks old.

Severe colics are usually the result of derangements of the liver, and

when mothers are badly nourished, the child is frequently born with the

trouble. The condition is largely due to a deficiency of nitrogenous

elements and phosphates in the food. The system is over supplied with

carbonates in the shape of starch, fats and sugar, and deficient in

elements that build up the tissues, such as gluten, fibrin, albumen,

etc. The mother partakes of food that produces an inflammatory

condition, and lacks in that which makes muscle, bone and nerve. She

should be cautious about eating of mixed dishes and also of greasy and

highly seasoned food.

Let her diet be chiefly of barley, wheatlet, rolled wheat, and bread

from graham flour, or Lockport entire wheat flour, with the addition of

fish, milk and eggs. Fruits can be partaken of freely, avoiding those

that are exceedingly acid. It is only when fruit is not eaten all the

time, that colic in the child is caused by the mother’s partaking of

it. If it has been eaten freely during pregnancy, it will do no harm

during lactation. Until the causes of colic can be removed, palliative

treatment must be resorted to.

A colicky baby must be kept warm, avoiding all changes in

temperature.[2] A rubber bag or bottle filled with hot water and put in

the crib will keep the child, once quieted, asleep for hours. During

the paroxysms put the child’s feet in a basin of hot water, or place

cloths wrung from hot water over its bowels, and if the attack is very

severe, a full hot bath will often give relief.[3]

[2] An interesting account has lately appeared in medical journals,

entitled, “Incubating Babies.” Some physician had charge of foundlings,

and tried the experiment of keeping them devoid of clothing in

ventilated boxes, at an even temperature of 80°. They were fed at

regular intervals. They slept most of the time. During the waking

periods, kicked, laughed and crowed, but seldom cried. He lessened

the mortality very greatly, and possibly proved to the world that the

_hardening_ or toughening process is begun too soon for the best vigor

of childhood.

[3] A warm bath, indeed, let the cause of “griping” be what it may,

usually affords instant relief.--_Chevasse._

_Avoid giving opiates._ They constipate the bowels and derange

digestion. In acute attacks following their use, the brain and spine

are likely to be seriously involved. Nearly all cordials sold for colic

contain opium. Analysis reveals morphine, one grain to the ounce, in

Winslow’s soothing syrup.

The following from a daily paper only shows that many medicines are

the mother’s enemy, instead of the “Mother’s Friend.” “The Tewksbury

almshouse horror once more calls attention to the frightful abuse

of narcotics for which the medical profession is to a great extent

responsible. In the Tewksbury child’s hospital the nurses were provided

with morphine in half-pint bottles! No wonder the babies were kept so

still that they died at a rate never before heard of. An idea of the

extent to which narcotics are given to infants in English manufacturing

towns is gleanable from the deposition of a Hanley chemist before a

coroner’s jury. He testified that he made up and sold six gallons a day

of an article called ‘Mother’s Friend.’ This stuff contains seven and

one-half drops of laudanum to the ounce. With this it is customary to

dose their babies so that they shall sleep during the time the young

mothers are engaged at the factories. Of course the infant mortality of

the place is frightful.

“In contradistinction to this practice of barbarously working young

mothers, Mr. Schneider, the owner of the great Creuzot iron works in

France, compels a mother to stay from work for a few months before and

after a child is born. For the carrying out of this humane purpose he

has created a fund out of which the wages of the mother during the

period of her incapacity are paid.”

Convulsions, brain fever, summer complaint, etc., are often the result

of the early use of opiates. I can recall many cases where spasms in

summer complaint were caused evidently and directly by the use of

opiates employed to check a slight ailment, in itself harmless.

FOR COLIC.--Some diffusible stimulant is preferable to narcotics. In

mild cases, a few tea-spoonfuls of hot water suffice, and there is but

little objection to the old-fashioned catnip tea.

_Peppermint essence._--One drop in six tea-spoons of hot water often

affords relief. Feed slowly.

_Camphor, tincture._--Pain is severe and cramp-like, knees flexed,

hands and feet cold, face livid, especially if there is diarrhea;

put one drop on a tea-spoonful of sugar, mix thoroughly, then add six

tea-spoons of hot water. Dose--A tea-spoonful every ten minutes.

_Chamomilla, 2d._--Stools are green and every diaper is stained. The

child is very restless, nurses often, constantly desires change of

position and attendants, wants to be carried from room to room. If the

homeopathic preparation does not give relief, make an infusion of the

blossoms. To six grains of the bloom, pour one gill boiling water. Feed

slowly. Four or five tea-spoonfuls are usually sufficient. Any of these

preparations, except camphor, should not be sweetened.

_Nux Vomica, 3d._--Constipation or undigested curds of milk in the

feces. Child starts in its sleep, has short naps and throws its head

back when it cries. To one grain add six tea-spoons of warm water,

and give every ten minutes in half tea-spoonful doses. For colic of

children and grown people, I have found more frequent relief from

this remedy than all others. It promotes digestion, equalizes the

circulation and feeds the nervous system. The nursing mother should

also take it once or twice a day when the child has these symptoms, and

an occasional dose taken by both, prevents subsequent attacks. She must

remember, too, to take sufficient rest and sleep, using every means to

promote her own best health.

CONSTIPATION is not a very frequent ailment of infants, but is

occasionally met with, and sometimes becomes very obstinate. When a

nursing child is thus affected, the mother will usually be found to be

suffering from the same conditions. In such a case, she should follow

the directions in Chap. V, and through correct habits in her own

system, she will doubtless find the child relieved.

Want of regularity in its habits often produces costiveness in an

infant. If he is fed or nursed regularly, and held out at the same time

of each day, and as he gets older is put upon a chair, he will seldom

be troubled with this complaint. It is wonderful how soon the bowels in

most cases, by this simple plan, may be brought into a regular habit.

_A soap suppository_ should be used after a day or two, if this method

fails. This is a safe, speedy and certain method of moving the bowels.

Make it by paring a piece of white castile soap round. Should be about

the size of a lead-pencil, pointed at the end, and two inches in

length. Moisten in warm water and introduce nearly the whole length.

After remaining from one to five minutes it will be expelled and the

bowels will be comfortably and effectually relieved.

If the feces are very hard, like little balls, it is better to give an

enema of castile soapsuds, to one cupful of which, one tea-spoonful

of sweet oil has been added. Squeezing cold or tepid water over the

child’s bowels, followed by hand friction, aids to stimulate them to

action.

Some advise rubbing the bowels with castor oil, getting thereby the

aperient effect, without the irritation of an internal dose.

Do not begin by giving a little baby aperient drugs. Chevasse says: “If

you once begin, and continue it for a while, opening medicine becomes a

dire necessity, and then woe betide the poor unfortunate child.”

Purgative medicines irritate beyond measure the tender organs of an

infant and ordinarily result in constipation.

DIARRHEA of infants is nature’s first method of removing obstructions

and overcoming derangements of the system, and in nine cases out of ten

should not be interfered with.

The natural movements are usually thin, and of a bright orange color.

One author describes them as being of the “consistence and color of

mustard mixed for the table.” They are nearly devoid of smell, or at

least have only a faint, disagreeable odor. Many children at first have

from three to six movements in a day. If they should increase to from

six to twelve and still not change materially in consistence, color or

odor, there is no cause for uneasiness.

Many an attack of sickness is the result of checking a diarrhea with

opiates and astringents. If the discharges become watery, green,

attended with griping, or streaked with mucus or blood, are of an ashen

or chalk color, or if they have undigested curds of milk, then they

demand attention. Above all, keep the child quiet and apply heat. The

hot water bottle is most excellent. An enema of hot water often gives

entire relief without the use of other remedies. I have known large

families of children, in which for years no other means was used for

the successful control of this disease.

DYSENTERY is indicated by mucus and blood with straining. It is an

inflammation of the rectum and large intestines. Warm flaxseed tea

injections after the discharge give great relief. Compresses should be

put on the bowels for an hour or two at a time, three or four times a

day.

_A general pack_ is exceedingly helpful where fever attends this or

other affections.

To pack a child, remove all its clothing, put on its nightdress, lay in

the crib on a woolen blanket: wet the nightdress in tepid water, using

a sponge, put a hot bottle to the feet.

Wrap the child closely in the blanket and be sure reaction takes place.

Let it lie in this one hour, when it should be sponged carefully and

wiped dry. This pack is indicated in any disease of children where

there is sufficient fever and heat to produce reaction. Remember, the

simplest measures are often the most effectual. (The above suggestions

are equally valuable in giving packs to adults.)

SUMMER COMPLAINT is an inflammation or irritation of the mucus membrane

of the intestines. Owing to dentition and change of food, children

are more liable to this affection in their second summer. They are

then constantly the subject of anxious solicitude by their parents and

friends.

If the discharges are only frequent and yellow, unaccompanied by pain

and fever, there is no cause for anxiety. It is simply an effort of

nature to restore normal conditions, and should not be interfered with.

Too hastily checking this diarrhea is frequently the cause of spasms

and other serious affections.

The symptoms of summer complaint proper, are frequent, watery

movements; at first may be green but soon become gray, brown and

frothy, sometimes having a mixture of phlegm and mucus; frequently are

fetid, and, at times, contain undigested food. It may or may not be

accompanied by pain. Nausea and vomiting are frequent symptoms, and if

severe, constitute cholera infantum. The surface of the body is cold,

often in a cold perspiration, while the soles of the feet and palms of

the hands are dry and hot. It is usually attended with great thirst, a

quick pulse and increased temperature.

Some children are prostrated at once by the attack, losing flesh and

strength rapidly, while others keep about many days. Appetite fails, or

else there are morbid cravings, often for the very things that increase

the irritation. If the disease is not abated, the fever and thirst

increase, the tongue becomes dry and brown, pulse is more rapid, the

strength fails, great restlessness ensues, the brain becomes affected,

coma ensues, and death closes the scene.

Impure air and improper diet are the principal causes of this disease.

Sleeping and living rooms not being sufficiently ventilated, the blood

becomes poisoned. Children are fed a mixed diet too soon. Rich and

highly seasoned food that is even unsuitable for adults, except in

a vigorous outdoor life, is given them, and at irregular hours. The

delicate organs are overtaxed, and inflammatory conditions produced.

When a child is weaned it should be fed upon oat, wheat and corn meal

mush, bread and milk, rice, cracked wheat, wheatlet, barley, and ripe

fruits. Meats, condiments, tea and coffee, and food containing fats

should be avoided. Even most of the vegetables are not adapted to

children.

Give them simple but nutritious diet, turn them, like colts, outdoors

to run and play, and you will save yourselves anxiety, save doctor’s

bills, and best of all, save your children. Blood that is too

carbonaceous can be oxygenized by plenty of outdoor exercise, both by

adults and children. The less clothing a child wears in hot weather

the better, only I would advise that flannel be worn next the skin.

This will prevent sudden checking of perspiration. By all means let the

little children go barefoot. A child that has a sand pile to play in,

and is allowed to run barefoot, must be of a very delicate organization

if he can have summer complaint. By direct contact with the earth,

superabundance of electricity is carried off, and thus is lessened the

possibility of inflammation. _The child that spends most of its waking

hours outdoors, barefooted, seldom gets summer complaint._ He has:

“Sleep that wakes in laughing day;

Health that mocks the doctor’s rules;

Outward sunshine; inward joy;

Blessing on thee, barefoot boy!”

In summer complaint give but little food, and that only in a liquid

form. Barley water, rice water, oatmeal gruel, bran jelly, lemon jelly

and orange whey, are all good. Milk can be used, if relished and

digested. It is ordinarily better to be reduced by adding one-third

boiling water. All of these must be given in small quantities and at

regular intervals. The best drink is soft water. If there is vomiting,

a drink made by steeping whole parched corn, is excellent. Also oatmeal

coffee is good. The juice of acid fruits is beneficial, and can be used

freely. But on no account allow the pulp, seed or skin to be eaten.

Remember, very little nourishment can be appropriated. The child,

especially if nursing, often takes food on account of thirst.

A COMPRESS wrung from cold water should be applied if there is local

heat, and allowed to remain for two or three hours, then removed, and

the parts bathed in tepid water. If there is pain, hot fomentations or

hot enemas, will be advantageous.

Under all circumstances avoid opiates and astringents. These stop the

discharges without removing the cause, and if the disease does not

recur in the same form, some other organ is liable to become affected.

If the child seems to need nourishment and is not able to take it, an

enema of a thin bran tea will prove nourishing without being irritating.

_Keep the child quiet_, in a well ventilated room, or in the open air.

A bed made of the inside corn husks stripped fine, is the best. A new

material for bedding made of Florida moss is excellent. A child, sick

or well, should not sleep on bed or pillows of feathers. By observing

these simple directions most cases of this dread disease can be saved.

REMEDIES for dysentery and summer complaint.

_Arsenicum, 3d._--The discharges are thin, watery, yellow, accompanied

by thirst, hands and feet hot. Six pellets every two hours.

_Cuprum, 3d._--Discharges green, frequent and small, with much pain.

Six pellets every two hours.

_Camphor tincture._--Discharges watery, frequent vomiting, coldness of

extremities. Prepared and given as on page 221.

_Mercury sol., 3d._--Discharges watery, gush out, followed by sinking,

have a bad odor. Six pellets every three hours.

_Mercury cor., 3d._--Green discharges streaked with mucus or blood,

accompanied by straining effort. Six pellets every four hours.

_Veratrum Viride, 3d._--Coldness of extremities, head hot, thirst,

nausea, vomiting. Six pellets every two hours.

_Phosphorus, 3d._--Odorless, clay colored discharges. Four pellets

every hour.

INFLAMMATION OF THE BOWELS is inflammation of the intestines, involving

either all their coats or only their mucus lining. The symptoms are

rigors, followed by dry, hot skin; quick, wiry, strong pulse; thirst,

nausea or vomiting, diarrhea or constipation; severe pain in the

abdomen, especially around the navel, aggravated by pressure. Lies on

his back with his knees drawn up.

_Causes._--Errors in diet, cold, use of drugs, especially of purgatives

and strong medicines used to check diarrhea. Remember what is said

of diarrhea on page 224, and do not be in haste to check the first

symptoms. Use liquid food only. It is seldom necessary to give remedies.

_Hot fomentations_ alternated with _cold compresses_ carefully

adjusted, will prove very efficacious. _Hot enemas_ should also be

given.

DENTITION under natural and proper conditions should not be accompanied

by constitutional disturbances. Some law must have been violated to

have caused derangements with teething.

The symptoms of the disorders of dentition are hot, swollen gums,

accompanied by feverishness and restlessness, starting, as if in

fright, or interrupted sleep, increased flow of saliva, various

eruptions on the head or body, derangements of the digestive organs.

Summer complaint is the most frequent of the ailments peculiar to

teething, which see page 225.

The most prevalent and serious cause for these ailments is to be found

in the adoption of a mixed diet at too early an age. A teething infant

cannot with impunity be thus fed. This is sufficiently proved by the

lack of a full complement of teeth needful for mastication. Disturbed

conditions of the mother, as worry, anger, over-heating, and fatigue

often result in serious effects on the nursing child.

Let the gums be bathed frequently in cold water. Lancing is seldom

necessary.

Starchy foods and sweets should be avoided. It has been proven that the

love for sweets often manifested by children is an unnatural appetite.

It is doing injury to the teething infant to cultivate this taste by

universally sweetening its food. Supplement the milk diet with graham

mush, wheatlet, granula, or bread of the fine flour of the entire wheat.

Keep the child much in the open air. See that the head is cool and the

feet warm. Bathe daily in cold water, and keep a flannel band or shirt

about the abdomen.

_Chamomilla, 2d._--An excellent medicine for most cases of disordered

dentition, especially in the absence of fever. Also when there is

bilious purging, intestinal irritation, cough, nervousness and

fretfulness. Six pellets every hour.

_Aconitum, 2d._--Feverishness, restlessness, inflamed gums. Ten drops

in half a glass of water, teaspoonful every half hour. A cloth wet in

this preparation given to a child to hold in its mouth will alleviate

heat and pain in the gums, and will be highly appreciated by the little

one.

_Calcarea Carb., 3d._--Slimy diarrhea in scrofulous patients. Six

pellets every three hours.

_Arsenicum, 3d._--Thirst, hot hands and feet, great emaciation. Six

pellets every hour.

_Bell., 3d._--Flushed face, nervous irritability, uneasiness in sleep.

Six pellets every hour.

_Pod., 2d._--Diarrhea with pain of an intermitting character, prolapsus

ani. Six pellets every three hours.

_Silicea, 6th._--Perspiration about the head upon falling asleep. Six

pellets three times a day.

CHAPTER XVIII.

DISEASES OF INFANTS.--CONTINUED.

Worms--_Thread or pin worms_ and _round worms_ are most common.

_Thread-worms_ are about half an inch in length, white in color, and

move rapidly. They are found in the anus or lower part of the rectum.

Thread-worms give rise to restlessness and itching about the anus,

especially in the evening after first falling asleep. Give with a

child’s syringe a small injection of a tablespoonful of raw linseed

oil. In some instances annointing externally with the oil or with

cosmoline will give relief. Keep the parts well cleansed, using suds

of carbolic soap. The _round-worm_ is from six to fifteen inches long,

resembling the common earth-worm, but of a paler color. It is supposed

to feed on the chyle, and lives generally in the small intestines,

but it sometimes passes upward into the stomach, and is expelled by

vomiting, or downward, and is ejected with the evacuations.

The presence of the round-worm may be indicated by indigestion,

swelling of the abdomen, restlessness, grinding of the teeth in sleep,

convulsion, etc. It is the result of a mixed diet, and is rarely found

when the child has been fed on the product of the grains.

_Santonine, 1st._--Grain doses, three times a day for three days.

Follow this on the fourth day by a copious enema, one pint of water, to

which one tea-spoon of salt has been added. After three days, if the

symptoms still continue, repeat treatment.

INCONTINENCE OF URINE.--This annoying ailment is common among children.

Mothers and nurses often deal impatiently with the unfortunate child,

believing it to be a _habit_, which may be easily overcome. It is

more often a malady than a habit. In neither case is it ever cured by

scolding. If a habit, a promised reward is more effective than harsh

treatment. Give the child a light supper devoid of liquids. Take him up

once or twice in the night to urinate. Bathe the spine at bedtime with

equal parts of alcohol and ammonia, followed by hand friction.

RETENTION OF URINE.--The child is restless, uneasy and unable to pass

water, beyond perhaps a small quantity, though there is frequent

urging. It may be caused by cold, injuries or acute disease. _A full

hot bath, or hot fomentations_ nearly always produce relief.

_Aconitum, 3d._--Retention from cold, fever, or inflammation, hot, dry

skin, thirst, etc.

_Cantharis, 3d._--Frequent urging, with total suppression; or the

discharge, with pain, of a few drops of bloody urine.

CROUP is liable to attack a child any time from the age of one month,

until nine or ten years old. The attacks occur most frequently when

about two or three years of age. Nothing will more quickly make a

mother’s heart stand still with alarm and terror than to hear the

hoarse, whistling, sonorous breathing of croup. A few directions will

be of service until medical attendance can be obtained.

Authors recognize two varieties, the spasmodic and membranous,

and recently some speak of diphtheritic croup. In the first, the

inflammation does not run so high, and the hoarseness may be simply

nervous. It runs its course rapidly. Usually the child goes to bed all

right and awakens about 11 or 12 o’clock with a loud ringing or rasping

cough, and some difficulty of breathing. The attack relieved, will

seem all right through the following day, unless an occasional cough.

Usually recurs three or four successive nights, is seldom fatal.

In _membranous croup_, there may be a slight hoarseness and difficulty

of breathing several days before the attack becomes severe. The mucus

membrane of the throat becomes red and inflamed, with a thick ropy

exudation that forms in a membrane, covering the entire fauces. Fever

may or may not be present. Symptoms remain much the same, day and

night. Duration of the disease from two to fourteen days.

The following are a few of the symptoms to aid in distinguishing

between the different forms of croup:

TRUE OR MEMBRANOUS CROUP

Begins any time.

First symptoms catarrhal.

Symptoms slight at first.

Cough harsh and rough.

Voice weak, whispers.

Membrane always visible.

No fetor.

Membrane lies upon mucus membrane, is loose, and can be removed easily.

Membrane invades the larynx from below and progresses upward. Membrane

always continuous and glairy.

FALSE OR SPASMODIC CROUP.

Begins from ten to twelve o’clock at night.

Severe at first.

Cough loud and ringing.

Voice hoarse.

No membrane.

DIPHTHERIA.

Fetid breath.

Membrane dips down in the mucus membrane.

Is tenacious, firm, adherent.

Membrane invades the larynx from above and progresses downward, and

often is seen in patches.

Many cases of spasmodic croup are relieved entirely by using promptly a

compress of ice cold water; should be worn day and night, and kept well

covered with a woolen cloth. Apply to the throat only. Renew in one or

two hours, if the first application does not give relief. Many families

never resort to any other means for croup, being confident that this

will give certain relief.

The following remedy I have used for years with the happiest result.

Families that have croupy children keep it in the house, and I seldom

have to be called out at night for croup by regular patrons. It can

be put up at any homeopathic pharmacy. Do not try to get it at the

drug store, as the ordinary drug clerk has no inkling of homeopathic

trituration.

℞ Tartar Emetic, 2d trit. ʒ ij

Aconite Tincture, gtts. ij

Mix. Dry out, triturate half an hour. Put six grains in twelve

tea-spoons of water, and give in tea-spoonful doses every ten or

fifteen minutes. It is not necessary that the emetic effect of the drug

should be secured. It has a specific action upon the air passages, and

is an invaluable remedy in many of the acute affections of throat and

lungs. _Aconite_ alone gives relief frequently, and many physicians

use no other remedy. The two together in the above preparation have

seldom failed me, and as an old friend I recommend it. During the day

following the attack give a tea-spoonful of the remedy once in two

hours. Keep the child on a light diet and free from exposure.

In membranous or diphtheritic croup, the services of a physician will

always be secured if possible.

_Proto-iodide of mercury_ is my “sheet anchor” for both these

affections. Of this I give the second trituration in grain doses every

two hours. Often give the prescription recommended for spasmodic croup

at the same time, a tea-spoonful every twenty or thirty minutes. Other

remedies, such as _iodine_, _bromine_, _nitrate of amyl_, _bichromate

of potassa_, _phosphorus_, etc., are used as the symptoms indicate; but

the _proto-iodide_ or _bin-iodide_ of mercury will meet the exigencies

of more cases than any other one known remedy. Of course hot baths,

hot fomentations and cold compresses must be brought into requisition.

I have seen great relief, even where the disease seemed in the last

stages, from a poultice of fresh phytolacca (pokeroot), applied to

the throat. This is made by pounding the root and mixing it with hot

flaxseed or meal poultice. Not being able to procure the root, fluid

extract can be used.

DIPHTHERIA is now considered an infectious disease, produced by

bacteria or infusoria that inoculate the patient. Many claim to be able

to cure the disease by local means only, while the invasion is only

local, before the entire system is poisoned. A child in robust health

will usually resist the infection. The following methods of treatment

are highly vaunted for their efficacy. Both of the drugs recommended

are invaluable in destroying infusoria, and are used in the hands of

eminent practitioners with success:

_Sulphur._--Put a teaspoonful into a wine glass of water and stir it

with the finger instead of a spoon, as it does not readily amalgamate

with water. When well mixed, it is to be given to the patient to

gargle. When the fungus is too nearly closing to allow the gargling,

the sulphur should be thrown through a quill into the throat, and after

the fungus has shrunk to allow it, then the gargling. If the patient

cannot gargle, take a live coal, put it on a shovel, and sprinkle a

spoonful of flour of brimstone upon it; let the sufferer inhale it by

holding the head over it, and the fungus will die. Sulphur kills every

species of fungus in man, beast and plant, in a few minutes. At one

time at Princess Mary’s Cottage Home, London, an outbreak of diphtheria

attacked fifty of the inmates. One of the lady nurses cured them all by

causing the patients to gargle with sulphur, and to take it internally.

_Permanganate of potassium._--Take ten grains and mix with one ounce

of cold water. As soon as dissolved it must be applied with a rag or

sponge, mop or swab, to the whitish places in the tonsils and other

parts, on which is seen the diphtheritic membrane. Do this very gently,

but thoroughly, every three hours until better; then every six hours

until well. It does not give pain but is rather nauseous to the taste.

In the stinking form of diphtheria this solution soon destroys all

odor, and in most cases it destroys the membrane without leaving any

bad effect behind.

The following is given if the tongue is coated white.

℞ Hyposulphite of soda, ʒi.

Oil of sassafras, gtts. v.

Glycerine and water, aa ℥ij.

Mix. Give a teaspoonful every one to three hours.

If the tongue is not coated,

℞ Phytolacca tincture, gtts. xx.

Glycerine and water, aa ℥ij.

Tea-spoonful doses every one to three hours.

The phytolacca is the common poke-root, and as it loses its strength by

drying and age, the tincture should be from the fresh root, or it is

worthless.

CONTAGIOUS DISEASES common to infants usually need cause no

apprehension. Under favorable conditions they run their course in a few

days. Ordinarily, the danger, and ailments following these diseases are

the result of the prevailing drug treatment. Give the patient light,

fresh air and all the water he wants, with frequent bathing, and in

most cases the physician will not be required. This is especially true

of measles. The prevailing custom of confining the patient in heated

and darkened rooms, smothering him with blankets, and dosing him with

hot teas will bring about the very conditions to be avoided.

Give him no food unless he craves it, then for a few days liquids only.

Remember that all eruptive diseases are only the expression of existing

conditions, and if not interfered with will leave the child in a

better state of health. If the intelligent mother has given birth to a

healthy child, she need not fear to encounter these affections in their

simple form. Indeed, children most in harmony with nature escape them

altogether.

SCARLET FEVER, or scarletina is more liable to assume a malignant form

than any other eruptive fever. When this threatens, the case should be

placed in the hands of a competent physician. It spreads by infection

rapidly and insiduously. The rash first appears on the breast, then on

neck, face, body and limbs. This is preceded by a sore throat, with the

usual symptoms of fever. Thorough and abundant ventilation is a most

vital point in the treatment. Use carbolic acid freely. Keep a sheet

wet in a solution of it hanging in the room. The patient should be

frequently sponged. If the throat is troublesome apply a wet compress,

and occasionally inhale steam. The wet pack, as prescribed on page 225,

is most valuable, if administered by an experienced person. An eminent

physician testifies that he never lost a case of scarlet fever in which

he used the wet pack.

In suppression of the eruption a hot bath or pack is efficacious in

bringing it out.

_Diet._--New milk and hot milk (reduced one-third). Milk is a good

antidote for poison, and lessens the virulence of the fever. Grapes,

oranges and fruit juice are excellent.

MEASLES. SCARLET FEVER.

1. Rash appears on fourth day. 1. Rash appears the second day.

2. Catarrhal symptoms are 2. Catarrhal symptoms are usually

prominent, watery discharge from absent, but there is great

the eyes and nose, sneezing, heat of the skin, sore throat, and

harsh cough, etc. sometimes delirium.

3. The rash begins near the 3. The rash begins on the neck

roots of the hair. and face.

4. The rash is of a pinkish red 4. The rash is of a bright scarlet

or raspberry color. color, and by pressing with

the finger a white spot is produced,

lasting a few seconds.

5. The eruption is somewhat 5. Eruption usually presents no

rough, so as to be felt by passing inequalities to sight or touch, and

the hand over the skin. is so minute and closely crowded

as to give the skin a uniformly

red appearance.

6. Has a peculiar fetid odor.

7. Liquid, tender, watery eye. 6. A peculiar brilliant glistening

stare of the eyes.

8. The cuticle is thrown off in 7. The cuticle is thrown off in

minute portions, like fine scales large patches, especially from the

of bran. hands and feet.

WHOOPING COUGH is both epidemic and contagious. It is usually mild in

a healthy child, but severe and sometimes fatal in others. The younger

the child the more dangerous the disease. The cough is generally

worse at night. Even after apparent recovery it may be brought back

by exposure to cold, by improper food, or by want of careful nursing.

A reasonable amount of outdoor exercise is conducive to the favorable

progress of the malady. Dampness should be avoided, as the skin is

generally sensitive to cold, especially after a fit of coughing.

Infants should be carefully watched, day and night, that they may be

placed in a favorable position during the paroxysms.

Light, digestible food in moderate quantities should be given

frequently. Hot milk is especially soothing and nutritious,

particularly during the first days of the attack, and may well take the

place of all other food.

CONVULSIONS rarely attack very young infants, unless from malformation

of the heart. Convulsions usually accompany teething, indigestion,

whooping cough, fevers, worms, indeed any disease that causes a reflex

action upon the brain. Occasionally a child has a convulsion without

any premonitory symptom, but usually there will be a restlessness in

sleep, a rolling of the head, twitching of the limbs, with clenched

fists, stertorious breathing, and heavy, lethargic sleep. From this

condition there is suddenly involuntary muscular contractions, rolling

of the eyes, frothing at the mouth, and the head drawn backward.

Whatever is to be done must be done quickly, and generally before

medical aid can be summoned. First, the mother and attendants must

command themselves. Nothing is more frightful than to see a little one

in convulsions, but upon no occasion is self-possession more needed.

Remember children rarely die in the first paroxysm.

Get the child into hot water as soon as possible. Don’t wait to remove

its clothing; put into a foot-tub or child’s bath having the water as

hot as can be borne, supporting it on two hands. And from time to time

as much hot water as the hands will bear. It should remain in the bath

until relaxation is produced, and then be wrapped in thoroughly heated

blankets.

If there is not sufficient warm water in the house for a bath, it is

often quite as effectual to take a pitcher of hot water, turn the child

upon its face, hold it over a pail, and pour the water on the back of

the neck. This is more easily managed than a bath, and often is all

that is requisite to bring about relaxation. A bag of hot salt laid to

the back of the neck will prevent a return. If there is constipation or

irritation in the bowels, give a copious enema of warm soft water. If

worms are suspected, add salt, a tea-spoonful to one pint of water.

For further treatment, as there are so many different things that will

cause spasms, one should better depend upon medical advice.

In closing these brief hints upon diseases of children, I wish to

impress upon the parent’s mind the fact that in nine cases out of

ten children need no treatment for their ailments. Their natural

recuperative power gives them ability to throw off disease in a

marvelous manner.

Too much care and nursing is quite as harmful as too little. It is

ordinarily better to make light of their ailments, and teach them the

power of self-resistance to the encroachments of disease. A cheerful,

hopeful manner, accompanied by the encouraging word, is quite as

helpful in sickness of children as in that of adults.

Do not discuss their ailments before them. Avoid hinting that sickness

is possible, or anticipating it for them as results of certain conduct.

Keep it from your own mind also. Never allow yourself to say: “If you

go out in the cold you will get sick.” “Don’t sit by the window you

will take cold.” “Now do get out of that draft.” “You must not eat so

much. Now, there, not one mouthful more, you will be sick.” “Do put on

your overcoat and rubbers.”

Now, dear mothers, this may be a new thought to you, but this very

caution, born of love and solicitude, creates a _fear_ that may make

it possible for your children to be sick. Let a child lead an active,

rollicking life in harmony with nature, and in himself will certainly

be developed power to resist disease.

It is possible to make health contagious.

“Cheerily, then, my little man,

Live and laugh as boyhood can.”

CHAPTER XIX.

ABORTION.

Abortion or miscarriage is the term applied to the death and expulsion

of the fetus previous to six months; after that and before full term it

is called premature delivery.

The liability to abortion is more frequent at the beginning and during

the third month. It is usually preceded by occasional loss of blood,

which rarely is excessive at first, but in from three days to three

weeks increases in frequency and quantity until it may absolutely

amount to hemorrhage. The first symptom in some instances is a violent

chill. In such cases soreness, heat and pain are soon located in the

pelvis and the flowing may be deferred for a few days. One may have

continuous pain, more or less severe, until the embryo is expelled; or

it may come up at irregular intervals from day to day for some two or

three weeks, there being such complete intermissions that the patient

hopes each time that all danger is over, and that gestation may be

completed.

The danger to the mother is from hemorrhage before the expulsion of the

embryo, and from retention of membranes after the fetus is born. These

decaying in the uterus, the poison is absorbed into the system and

septicæmia is the result.

The _causes_ of abortion, both remote and exciting, are numerous.

Any diseases of the womb that take away its vitality or prevent its

enlargement will result in death of the fetus. Any general disease or

condition of the system that results in weakness or feebleness may make

the continuance of life in the embryo impossible.

_Lack of room_ in the pelvis and abdomen is a frequent cause of

abortion in first pregnancies. This is the result of tight and heavy

clothing and insufficient exercise. Remaining too much in-doors and

suffering the debilitating effects of impure, heated atmosphere, is

also a remote cause. The violation of the laws of sexual congress is

another. Immoderation in this respect is exceedingly harmful, as it

diverts from its needed purpose the mother’s energies, and weakens

embryonic life. Any incontinence during pregnancy endangers a woman who

has once miscarried.

The recent causes are lifting, straining, a fall, a jar, a blow, a

violent cold, or an acute attack of disease, sudden mental emotions,

etc. The system so soon takes on any habit that, having once aborted,

one is very liable to a recurrence of the same results in subsequent

pregnancies, at the same period.

To _prevent_ a miscarriage, observe faithfully the hygienic rules

laid down in this book. Make the best possible conditions for health

in every direction. Especially observe the law of continence. Once

threatened with abortion, hemorrhage ever so slight having set in,

a woman should by all means take her bed and observe perfect quiet.

She must run no risks. Apply compresses and take frequent short,

tepid sitz-baths, live on a mild, cooling diet, and the danger may be

averted.

_Aconite._--Chill or fever, with quick pulse and flow of bright red

blood. Six drops of first dilution in a glass full of water; take a

tablespoonful every hour.

_Secale, 3d._--Cramp-like pains, blood clotted and dark, cadaverous

expression of face. Dose: Six pellets every two hours.

_Cimicifuga, 2d._--Pain in the back of the neck, aching in the limbs,

back and groin, with pressing, bearing down. Dose: One grain every two

hours.

A woman requires the same attention and treatment during and after a

miscarriage that she requires in a confinement. A labor at full term is

natural; a miscarriage is unnatural, and often requires a longer time

for the system to recover from the shock.

_Feticide is a produced abortion_, whether by drugs, intentional

shocks, electricity, or by instrumental interference, either by one’s

own hand or by the hand of a surgeon.

Many women have been taught to think that the child is not viable until

after quickening, and that there is no harm in arresting pregnancy

previous to the feeling of motion; others believe that there is no

_life_ until birth, and the cry of the child is heard.

A high legal authority says: “The absurdity of the principle upon which

these distinctions are founded is easy of demonstration. The fetus,

previous to the time of quickening, must be either dead or living. Now,

that it is not the former, is most evident from neither putrefaction

nor decomposition taking place, which would be the consequence of an

extinction of the vital principle. The embryo, therefore, before the

crisis, must be in a state different from that of death, and that can

be no other than life.”

When the female germ and male sperm unite, then is the inception of

a new life; all that goes to make up a human being--body, mind and

spirit, must be contained in embryo within this minute organism. _Life

must be present from the very moment of conception._ If there was not

life there could be no conception. At what other period of a human

being’s existence, either pre-natal or post-natal, could the union of

soul and body take place? Is it not plain that the violent or forcible

deprivation of existence of this embryo, the removal of it from the

citadel of life, is its premature death, and hence the act can be

denominated by no more mild term than murder, and whoever performs the

act, or is accessory to it, in the sight of God and human law is guilty

of the crime of all crimes.

The life of the babe in her arms is to the mother more precious than

all else; her heart is thrilled with a pang of agony at thought of the

least danger to its life. By what false reasoning does she convince

herself that another life, still more dependent upon her for its

existence, with equal rights and possibilities, has no claim upon her

for protection? More than this, she deliberately strikes with the red

hand of murder, and terminates its existence with no thought of wrong,

nor consciousness of violated law.

The woman who produces abortion, or allows it to be produced, risks her

own health and life in the act, and commits the highest crime in the

calendar, for she takes the life of her own child. She defrauds the

child of the right to its existence.

By a wise provision we are placed in this world for growth, development

and preparation for another life. As we leave this life, we must enter

the other. In so far as a human being is deprived of this existence,

to that extent he is deprived of schooling and preparation for the

other life. Pause for one moment and think of the thousands of stunted,

dwarfed beings that are prematurely ushered into an existence that can

not be normal and designed. Were infants to have been born into spirit

life, provision would have been made to that effect. That they are

born into this life is proof that this world is best adapted for their

growth and education.

There may be no harm in _preventing_ the conception of a life, but once

conceived it should not be deprived of its existence in that world

which in all its appointments is specially adapted to its development.

What are some of the incentives to produce abortion? An unmarried

woman seduced under false representations by a man who feels no

responsibility for his own offspring, suffers alone all the shame and

contumely of the act, and is tempted to cause miscarriage to shield her

good name.

Married women who fear that maternity will interfere with their

pleasures, are guilty of forcibly curtailing embryotic life. Others,

again, who are poor or are burdened with care or grief, or have

licentious or drunken husbands, shrink from adding to an already

overburdened existence.

The first class, the girls who have lost their virtue under promise of

marriage are most deserving of sympathy and commiseration, though none

receive less. “Let him who is without sin cast the first stone.” At the

least imputation against a fair girl’s character, even those professing

to be the followers of the loving Christ, often have so little

leniency, so little of the Father’s love in their hearts, that they hug

their Christian robes to their bodies, lest they be contaminated by the

polluting touch of the victim. They “pass by on the other side” and

leave the poor broken-hearted child bleeding by the wayside.

The girl’s lessons of life and purity have been learned mainly from one

she loved and trusted, only to be betrayed. What wonder that in her

ignorance of the value of life she should be tempted to add a second

wrong to the first? She knows the shadow that has darkened her path;

she realizes:

“Alas! for the rarity

Of Christian charity

Under the sun.”

And if she can conceal the evidence of her guilt, she may hope by

honest endeavor to retrieve her good name, and thus is tempted to

produce an abortion.

_Two wrongs can not make one right._ Before God and her own conscience,

the only tribunals that in justice have any right to accuse her, she

can not by any act gain absolution.

When girls are given proper instruction upon the relation of the sexes

and understand how to govern and guard themselves; when young men are

taught that virtue has as high a meaning for one sex as another, that

the protective chivalry of which they boast does not imply that they

shall force the woman with whom they associate to the defensive; and

that the _paternal_ interest in, and responsibilities for a child are

equal to the _maternal_, then the temptation to produce abortion for

the purpose of shielding one’s character will not exist.

Of the second class, who produce miscarriage for pleasure and selfish

interest, there is little to say in extenuation. They may be victims of

ignorance or of a false education. The maternal instinct is inherent in

every woman’s heart. It seems strange that any morbid idea of pleasure

could antagonize the natural aspiration to such an extent that one

could destroy the viability of her own offspring.

I well remember years ago the wife of a well-to-do lawyer making

application to me to produce abortion. She had but one child, and he

three years of age. She was surrounded by every comfort a prosperous

business man could afford. I sought the cause of the unnatural

promptings of this intelligent woman’s heart. It seems that a trip

to Europe was contemplated and planned for in the early summer, and

that this unanticipated and chance maternity would thwart their

expectations. With all the arguments I then possessed, I showed her

the wrong she sought to do, but nothing seemed to weigh against the

proposed trip. She returned the second and third time even, armed with

a lawyer’s sophistry to endeavor to persuade me to be accessory to

the diabolical deed. No doubt one cause of her persistency was fear

of trusting her secret to me unless she could persuade me to be an

accomplice.

She probably found some one to assist her out of the “trouble,” for

she took the proposed trip, but I was not astonished to learn three or

four years later that she was lying at death’s door with consumption.

How many times she produced abortion I know not but I was told that

for months she suffered from uterine hemorrhages and in the weakened

state of her system a violent cold settled upon her lungs which soon

terminated her life. This was the physical result of the crime she had

committed.

Of the last class, who have an apparent need to limit the size of the

family, what can be said in extenuation of their committing this crime?

Shall not the mother who already has many children, who is herself

sick, nervous and prostrated, or else has a husband who is diseased

or a drunkard, leaving her the support of the family, save herself

additional care by arresting the life of the embryo? The heart goes out

in sympathy for all such, but even the most aggravating circumstances

can not atone for the crime. The whole nature of every true woman

revolts against forced maternity.

Thoughtful minds must acknowledge the great wrong done when children

are begotten under adverse conditions. Women must learn the laws of

life so as to protect themselves, and not be the means of bringing

sin-cursed, diseased children into the world.

_The remedy is in the prevention of pregnancy, not in producing

abortion._ When men and women have learned the wise control of the

procreative functions, then may we hope that children will be begotten

in love and unselfishness. It is the undesired and undesigned maternity

that is revolting to the nature of woman. As long as men feel that they

have a right to indulgence of the passions under law, no matter what

the circumstances, what the condition of the wife, or the probabilities

of maternity, so long will the spirit of rebellion take possession

of women and the temptation enter their souls to relieve themselves

of this unsought burden. May the day soon arrive when men will learn

that even passion should serve reason, and that gratification should,

at least, not be sought at the expense of conjugal happiness and

_unwelcome children_.

CHAPTER XX.

MENSTRUATION.

Menstruation is the sanguineous flow accompanying the maturation of the

ovum in the ovaries. It generally occurs regularly every twenty-eight

days, and in temperate climates continues from about the fifteenth year

to the forty-fifth.

Physiologists differ as to the cause of this phenomenon. It was for a

long time believed to be a cleansing process peculiar to women; that

Eve, having through her transgression entailed upon her daughters a

curse, they needed more renovation and regeneration than men; and that

aside from ordinary depurition this special secretion was given to them.

The theory now prevails that accompanying the maturation of the

ovum there is a flow of blood to the generative organs, which in

medical parlance is called hyperemia. The exudation of this venous

blood from the membrane of the uterus constitutes menstruation; also

that this menstruation is a provision of nature for the supply of a

superabundance of blood, which during pregnancy is appropriated to

the growth of the fetus. Thus is it allied to maternity leading us to

regard this function with reverence.

In a normal state the discharge is slight, being from one to three

ounces, and lasts two or three days.

Certain physiologists claim that all sanguineous flow is abnormal,

that there should be no show of blood in a perfectly healthy woman.

It is averred that the squaws of some Indian tribes have no show

accompanying either ovulation or parturition.

_Menstruation_ should be entirely devoid of suffering. A woman should

have no cognizance of this function, save by the discharge. Could

this be the rule, instead of the prevalent exception, the capacity of

strength and endurance either for work or pleasure would be increased

one hundred fold. The nation not only needs strong men but strong

women, strong in physical as well as mental development. This strength

is required for prosecuting a persistent warfare against prevailing and

existing wrongs, as well as for transmitting health and vigor to the

coming generation.

_A woman in perfect health_ need take no especial care and make no

change in her manner of life at this period. But under our artificial

habits of life, such a woman is the exception rather than the rule,

and in most cases some attention must be paid to the recurrence of the

menses.

Many young ladies in attendance upon school, feel a need of some

indulgence at that time, and are often granted respite from duty. Women

following any regular occupation have learned to plan a day of lighter

work at the recurrence of the period. Yet on the contrary some have

found that congestion and pain are relieved by occupation sufficient to

interest the mind, with exercise adapted to increase the circulation.

THE DISORDERS incident to menstruation are: Amenorrhea, Dysmenorrhea

and Menorrhagia.

_Amenorrhea_ is absence or suppression of the menses caused by cold,

a chronic ailment, an anemic condition or some ovarian or uterine

affection. It is also often the result of mental conditions, as grief,

fright or severe mental strain.

One need not be uneasy about suppression when there is no special

constitutional disturbance. Our grandmothers taught that the absence

of the menses was always greatly to be feared, the prevailing idea

being that serious results would follow to some vital organ. This is a

mistake.

Patients during treatment for uterine ulceration and inflammation often

gain steadily in health, although the menses cease for months. This has

been observed especially in hygienic institutions.

At all events, in treating suppression avoid strong remedies, such

as old-fashioned tansy tea, steel filings and ergot. These produce

congestion, and may be the source of severe chronic ailments.

See to it that a general condition of health is attained. With plenty

of out-door exercise, congenial employment and freedom from care, the

young girl may, with rare exceptions, trust to nature for correction of

suppression.

_Dysmenorrhea_, or painful menstruation, is of such frequent occurrence

that it deserves especial attention. Most young ladies experience more

or less suffering at this time. It may be only nervousness, wakeful

nights, a slight headache, some pain in the back or pelvic regions,

and a disposition to be alone; or the attacks may be severe, with pain

in the back and pelvis, running down into the limbs; the surface and

extremities cold, face pallid, with nausea, vomiting or fainting, and

perhaps spasms.

This ought not to be, and, in most instances, need not be. With our

present knowledge, the conditions for and causes of dysmenorrhea may be

removed.

Among causes we find inflammation of the ovaries, oviducts, or mucous

membrane of the womb, mechanical closure of the outlet of the womb, or,

simply constipation, neuralgia or rheumatism.

With inflammation of the ovaries there is, previous to the recurrence

of the menses and throughout its course, a dragging pain in the pelvis

with swelling and soreness of the breasts, and more or less mental

distress. These symptoms are not always relieved by the flow.

Inflammation of the mucous membrane of the uterus is the most frequent

cause of dysmenorrhea. With this the pain begins with the flow and

increases as the flow increases. There may be a discharge of shreds

of membrane or clotted blood, and sometimes a membrane having the

entire form of the cavity of the womb. This is produced by deposits of

fibrine, like that of membranous croup.

When there is undue closure of the cervix the pain precedes the

menstrual flow, and is relieved as the discharge becomes free.

The _remote causes_ for dysmenorrhea are errors in dress and diet, want

of exercise, etc.

_To errors in woman’s dress_ more than any other one thing is the

unnatural pain due. Women are burdened with heavy clothing, and every

vital organ restricted by bands and bones. It is not unusual to count

from sixteen to eighteen thicknesses of cloth worn so tightly about the

pliable structure of the waist that actual deformity is produced.

The pelvis and chest are naturally well guarded from intrusion by the

ribs and pelvic bones. But just at the point where belts are adjusted

there is no protecting wall. Thus these parts are easily deformed,

consequently digestion becomes imperfect, the circulation obstructed,

the respiration restricted, and what is worse than all, the viscera

crowd down upon the womb, the citadel of life.