CHAPTER XLII.

Physiology of Life, as illustrated by Respiration, Circulation, and

Digestion.

2445. The infantine management of children, like the mother's love for

her offspring, seems to be born with the child, and to be a direct

intelligence of Nature. It may thus, at first sight, appear as

inconsistent and presumptuous to tell a woman how to rear her infant as

to instruct her in the manner of loving it. Yet, though Nature is

unquestionably the best nurse, Art makes so admirable a foster-mother,

that no sensible woman, in her novitiate of parent, would refuse the

admonitions of art, or the teachings of experience, to consummate her

duties of nurse. It is true that, in a civilized state of society, few

young wives reach the epoch that makes them mothers without some

insight, traditional or practical, into the management of infants:

consequently, the cases wherein a woman is left to her own unaided

intelligence, or what, in such a case, may be called instinct, and

obliged to trust to the promptings of nature alone for the well-being of

her child, are very rare indeed. Again, every woman is not gifted with

the same physical ability for the harassing duties of a mother; and

though Nature, as a general rule, has endowed all female creation with

the attributes necessary to that most beautiful and, at the same time,

holiest function,--the healthy rearing of their offspring,--the cases

are sufficiently numerous to establish the exception, where the mother

is either physically or socially incapacitated from undertaking these

most pleasing duties herself, and where, consequently, she is compelled

to trust to adventitious aid for those natural benefits which are at

once the mother's pride and delight to render to her child.

2446. In these cases, when obliged to call in the services of hired

assistance, she must trust the dearest obligation of her life to one

who, from her social sphere, has probably notions of rearing children

diametrically opposed to the preconceived ideas of the mother, and at

enmity with all her sentiments of right and prejudices of position.

2447. It has justly been said--we think by Hood--that the children of

the poor are not brought up, but _dragged up_. However facetious this

remark may seem, there is much truth in it; and that children, reared in

the reeking dens of squalor and poverty, live at all, is an apparent

anomaly in the course of things, that, at first sight, would seem to set

the laws of sanitary provision at defiance, and make it appear a perfect

waste of time to insist on pure air and exercise as indispensable

necessaries of life, and especially so as regards infantine existence.

2448. We see elaborate care bestowed on a family of children, everything

studied that can tend to their personal comfort,--pure air, pure water,

regular ablution, a dietary prescribed by art, and every precaution

adopted that medical judgment and maternal love can dictate, for the

well-being of the parents' hope; and find, in despite of all this care

and vigilance, disease and death invading the guarded treasure. We turn

to the foetor and darkness that, in some obscure court, attend the

robust brood who, coated in dirt, and with mud and refuse for

playthings, live and thrive, and grow into manhood, and, in contrast to

the pale face and flabby flesh of the aristocratic child, exhibit

strength, vigour, and well-developed frames, and our belief in the

potency of the life-giving elements of air, light, and cleanliness

receives a shock that, at first sight, would appear fatal to the implied

benefits of these, in reality, all-sufficient attributes of health and

life.

2449. But as we must enter more largely on this subject hereafter, we

shall leave its consideration for the present, and return to what we

were about to say respecting trusting to others' aid in the rearing of

children. Here it is that the young and probably inexperienced mother

may find our remarks not only an assistance but a comfort to her, in as

far as, knowing the simplest and best system to adopt, she may be able

to instruct another, and see that her directions are fully carried out.

2450. The human body, materially considered, is a beautiful piece of

mechanism, consisting of many parts, each one being the centre of a

system, and performing its own vital function irrespectively of the

others, and yet dependent for its vitality upon the harmony and health

of the whole. It is, in fact, to a certain extent, like a watch, which,

when once wound up and set in motion, will continue its function of

recording true time only so long as every wheel, spring, and lever

performs its allotted duty, and at its allotted time; or till the limit

that man's ingenuity has placed to its existence as a moving automaton

has been reached, or, in other words, till it has run down.

2451. What the key is to the mechanical watch, air is to the physical

man. Once admit air into the mouth and nostrils, and the lungs expand,

the heart beats, the blood rushes to the remotest part of the body, the

mouth secretes saliva, to soften and macerate the food; the liver forms

its bile, to separate the nutriment from the digested aliment; the

kidneys perform their office; the eye elaborates its tears, to

facilitate motion and impart that glistening to the orb on which depends

so much of its beauty; and a dewy moisture exudes from the skin,

protecting the body from the extremes of heat and cold, and sharpening

the perception of touch and feeling. At the same instant, and in every

part, the arteries, like innumerable bees, are everywhere laying down

layers of muscle, bones, teeth, and, in fact, like the coral zoophyte,

building up a continent of life and matter; while the veins, equally

busy, are carrying away the _débris_ and refuse collected from where the

zoophyte arteries are building,--this refuse, in its turn, being

conveyed to the liver, there to be converted into bile.

2452. All these--and they are but a few of the vital actions constantly

taking place--are the instant result of one gasp of life-giving air. No

subject can be fraught with greater interest than watching the first

spark of life, as it courses with electric speed "through all the gates

and alleys" of the soft, insensate body of the infant. The effect of air

on the new-born child is as remarkable in its results as it is wonderful

in its consequence; but to understand this more intelligibly, it must

first be remembered that life consists of the performance of _three_

vital functions--RESPIRATION, CIRCULATION, and DIGESTION. The lungs

digest the air, taking from it its most nutritious element, the

_oxygen_, to give to the impoverished blood that circulates

through them. The stomach digests the food, and separates the

nutriment--_chyle_--from the aliment, which it gives to the blood for

the development of the frame; and the blood, which is understood by the

term circulation, digests in its passage through the lungs the

nutriment--_chyle_--to give it quantity and quality, and the _oxygen_

from the air to give it vitality. Hence it will be seen, that, speaking

generally, the three vital functions resolve themselves into

one,--DIGESTION; and that the lungs are the primary and the most

important of the vital organs; and respiration, the first in fact, as we

all know it is the last in deed, of all the functions performed by the

living body.

THE LUNGS.--RESPIRATION.

2453. The first effect of air on the infant is a slight tremor about the

lips and angles of the mouth, increasing to twitchings, and finally to a

convulsive contraction of the lips and cheeks, the consequence of sudden

cold to the nerves of the face. This spasmodic action produces a gasp,

causing the air to rush through the mouth and nostrils, and enter the

windpipe and upper portion of the flat and contracted lungs, which, like

a sponge partly immersed in water, immediately expand. This is succeeded

by a few faint sobs or pants, by which larger volumes of air are drawn

into the chest, till, after a few seconds, and when a greater bulk of

the lungs has become inflated, the breast-bone and ribs rise, the chest

expands, and, with a sudden start, the infant gives utterance to a

succession of loud, sharp cries, which have the effect of filling every

cell of the entire organ with air and life. To the anxious mother, the

first voice of her child is, doubtless, the sweetest music she ever

heard; and the more loudly it peals, the greater should be her joy, as

it is an indication of health and strength, and not only shows the

perfect expansion of the lungs, but that the process of life has set in

with vigour. Having welcomed in its own existence, like the morning

bird, with a shrill note of gladness, the infant ceases its cry, and,

after a few short sobs, usually subsides into sleep or quietude.

2454. At the same instant that the air rushes into the lungs, the valve,

or door between the two sides of the heart-and through which the blood

had previously passed-is closed and hermetically sealed, and the blood

taking a new course, bounds into the lungs, now expanded with air, and

which we have likened to a wetted sponge, to which they bear a not unapt

affinity, air being substituted for water. It here receives the _oxygen_

from the atmosphere, and the _chyle_, or white blood, from the digested

food, and becomes, in an instant, arterial blood, a vital principle,

from which every solid and fluid of the body is constructed. Besides the

lungs, Nature has provided another respiratory organ, a sort of

supplemental lung, that, as well as being a covering to the body,

_in_spires air and _ex_pires moisture;--this is the cuticle, or skin;

and so intimate is the connection between the skin and lungs, that

whatever injures the first, is certain to affect the latter.

2455. _Hence the difficulty of breathing experienced after scalds or

burns on the cuticle, the cough that follows the absorption of cold or

damp by the skin, the oppressed and laborious breathing experienced by

children in all eruptive diseases, while the rash is coming to the

surface, and the hot, dry skin that always attends congestion of the

lungs, and fever._

2456. The great practical advantage derivable from this fact is, the

knowledge that whatever relieves the one benefits the other. Hence,

too, the great utility of hot baths in all affections of the lungs or

diseases of the skin; and the reason why exposure to cold or wet is, in

nearly all cases, followed by tightness of the chest, sore throat,

difficulty of breathing, and cough. These symptoms are the consequence

of a larger quantity of blood than is natural remaining in the lungs,

and the cough is a mere effort of Nature to throw off the obstruction

caused by the presence of too much blood in the organ of respiration.

The hot bath, by causing a larger amount of blood to rush suddenly to

the skin, has the effect of relieving the lungs of their excess of

blood, and by equalizing the circulation, and promoting perspiration

from the cuticle, affords immediate and direct benefit, both to the

lungs and the system at large.

THE STOMACH--DIGESTION.

2457. The organs that either directly or indirectly contribute to the

process of digestion are, the mouth, teeth, tongue, and gullet, the

stomach, small intestines, the pancreas, the salivary glands, and the

liver. Next to respiration, digestion is the chief function in the

economy of life, as, without the nutritious fluid digested from the

aliment, there would be nothing to supply the immense and constantly

recurring waste of the system, caused by the activity with which the

arteries at all periods, but especially during infancy and youth, are

building up the frame and developing the body. In infancy (the period of

which our present subject treats), the series of parts engaged in the

process of digestion may be reduced simply to the stomach and liver, or

rather its secretion,--the bile. The stomach is a thick muscular bag,

connected above with the gullet, and, at its lower extremity, with the

commencement of the small intestines. The duty or function of the

stomach is to secrete from the arteries spread over its inner surface, a

sharp acid liquid called the _gastric_ juice; this, with a due mixture

of saliva, softens, dissolves, and gradually digests the food or

contents of the stomach, reducing the whole into a soft pulpy mass,

which then passes into the first part of the small intestines, where it

comes in contact with the bile from the gall-bladder, which immediately

separates the digested food into two parts, one is a white creamy fluid

called chyle, and the absolute concentration of all nourishment, which

is taken up by proper vessels, and, as we have before said, carried

directly to the heart, to be made blood of, and vitalized in the lungs,

and thus provide for the wear and tear of the system. It must be here

observed that the stomach can only digest solids, for fluids, being

incapable of that process, can only be _absorbed_; and without the

result of digestion, animal, at least human life, could not exist. Now,

as Nature has ordained that infantine life shall be supported on liquid

aliment, and as, without a digestion the body would perish, some

provision was necessary to meet this difficulty, and that provision was

found in the nature of the liquid itself, or in other words, THE MILK.

The process of making cheese, or fresh curds and whey, is familiar to

most persons; but as it is necessary to the elucidation of our subject,

we will briefly repeat it. The internal membrane, or the lining coat of

a calf's stomach, having been removed from the organ, is hung up, like a

bladder, to dry; when required, a piece is cut off, put in a jug, a

little warm water poured upon it, and after a few hours it is fit for

use; the liquid so made being called _rennet_. A little of this rennet,

poured into a basin of warm milk, at once coagulates the greater part,

and separates from it a quantity of thin liquor, called _whey_. This is

precisely the action that takes place in the infant's stomach after

every supply from the breast. The cause is the same in both cases, the

acid of the gastric juice in the infant's stomach immediately converting

the milk into a soft cheese. It is gastric juice, adhering to the calf's

stomach, and drawn out by the water, forming rennet, that makes the

curds in the basin. The cheesy substance being a solid, at once

undergoes the process of digestion, is separated into _chyle_ by the

bile, and, in a few hours, finds its way to the infant's heart, to

become blood, and commence the architecture of its little frame. This is

the simple process of a baby's digestion:-milk converted into cheese,

cheese into _chyle_, chyle into blood, and blood into flesh, bone, and

tegument-how simple is the cause, but how sublime and wonderful are the

effects!

2458. We have described the most important of the three functions that

take place in the infant's body-respiration and digestion; the third,

namely, circulation, we hardly think it necessary to enter on, not being

called for by the requirements of the nurse and mother; so we shall omit

its notice, and proceed from theoretical to more practical

considerations. Children of weakly constitutions are just as likely to

be born of robust parents, and those who earn their bread by toil, as

the offspring of luxury and affluence; and, indeed, it is against the

ordinary providence of Nature to suppose the children of the hardworking

and necessitous to be hardier and more vigorous than those of parents

blessed with ease and competence.

2459. All children come into the world in the same imploring

helplessness, with the same general organization and wants, and

demanding either from the newly-awakened mother's love, or from the

memory of motherly feeling in the nurse, or the common appeals of

humanity in those who undertake the earliest duties of an infant, the

same assistance and protection, and the same fostering care.

THE INFANT.

2460. We have already described the phenomena produced on the new-born

child by the contact of air, which, after a succession of muscular

twitchings, becomes endowed with voice, and heralds its advent by a loud

but brief succession of cries. But though this is the general rule, it

sometimes happens (from causes it is unnecessary here to explain) that

the infant does not cry, or give utterance to any audible sounds, or if

it does, they are so faint as scarcely to be distinguished as human

accents, plainly indicating that life, as yet, to the new visitor, is

neither a boon nor a blessing; the infant being, in fact, in a state of

suspended or imperfect vitality,--a state of _quasi_ existence, closely

approximating the condition of a _still-birth_.

2461. As soon as this state of things is discovered, the child should be

turned on its right side, and the whole length of the spine, from the

head downwards, rubbed with all the fingers of the right hand, sharply

and quickly, without intermission, till the quick action has not only

evoked heat, but electricity in the part, and till the loud and sharp

cries of the child have thoroughly expanded the lungs, and

satisfactorily established its life. The operation will seldom require

above a minute to effect, and less frequently demands a repetition. If

there is brandy at hand, the fingers before rubbing may be dipped into

that, or any other spirit.

2462. There-is another condition of what we may call "mute births,"

where the child only makes short ineffectual gasps, and those at

intervals of a minute or two apart, when the lips, eyelids, and fingers

become of a deep purple or slate colour, sometimes half the body

remaining white, while the other half, which was at first swarthy,

deepens to a livid hue. This condition of the infant is owing to the

valve between the two sides of the heart remaining open, and allowing

the unvitalized venous blood to enter the arteries and get into the

circulation.

2463. The object in this case, as in the previous one, is to dilate the

lungs as quickly as possible, so that, by the sudden effect of a

vigorous inspiration, the valve may be firmly closed, and the impure

blood, losing this means of egress, be sent directly to the lungs. The

same treatment is therefore necessary as in the previous case, with the

addition, if the friction along the spine has failed, of a warm bath at

a temperature of about 80°, in which the child is to be plunged up to

the neck, first cleansing the mouth and nostrils of the mucus that might

interfere with the free passage of air.

2464. While in the bath, the friction along the spine is to be

continued, and if the lungs still remain unexpended, while one person

retains the child in an inclined position in the water, another should

insert the pipe of a small pair of bellows into one nostril, and while

the month is closed and the other nostril compressed on the pipe with

the hand of the assistant, the lungs are to be slowly inflated by steady

puffs of air from the bellows, the hand being removed from the mouth and

nose after each inflation, and placed on the pit of the stomach, and by

a steady pressure expelling it out again by the mouth. This process is

to be continued, steadily inflating and expelling the air from the

lungs, till, with a sort of tremulous leap, Nature takes up the process,

and the infant begins to gasp, and finally to cry, at first low and

faint, but with every gulp of air increasing in length and strength of

volume, when it is to be removed from the water, and instantly wrapped

(all but the face and mouth) in a flannel. Sometimes, however, all these

means will fail in effecting an utterance from the child, which will

lie, with livid lips and a flaccid body, every few minutes opening its

mouth with a short gasping pant, and then subsiding into a state of

pulseless inaction, lingering probably some hours, till the spasmodic

pantings growing further apart, it ceases to exist.

2465. The time that this state of negative vitality will linger in the

frame of an infant is remarkable; and even when all the previous

operations, though long-continued, have proved ineffectual, the child

will often rally from the simplest of means--the application of dry

heat. When removed from the bath, place three or four hot bricks or

tiles on the hearth, and lay the child, loosely folded in a flannel, on

its back along them, taking care that there is but one fold of flannel

between the spine and heated bricks or tiles. When neither of these

articles can be procured, put a few clear pieces of red cinder in a

warming-pan, and extend the child in the same manner along the closed

lid. As the heat gradually diffuses itself over the spinal marrow, the

child that was dying, or seemingly dead, will frequently give a sudden

and energetic cry, succeeded in another minute by a long and vigorous

peal, making up, in volume and force, for the previous delay, and

instantly confirming its existence by every effort in its nature.

2466. With these two exceptions,--restored by the means we have pointed

out to the functions of life,--we will proceed to the consideration of

the child HEALTHILY BORN. Here the first thing that meets us on the

threshold of inquiry, and what is often between mother and nurse not

only a vexed question, but one of vexatious import, is the _crying_ of

the child; the mother, in her natural anxiety, maintaining that her

infant _must be ill_ to cause it to cry so much or so often, and the

nurse insisting that _all_ children cry, and that nothing is the matter

with it, and that crying does good, and is, indeed, an especial benefit

to infancy. The anxious and unfamiliar mother, though not convinced by

these abstract sayings of the truth or wisdom of the explanation, takes

both for granted; and, giving the nurse credit for more knowledge and

experience on this head than she can have, contentedly resigns herself

to the infliction, as a thing necessary to be endured for the good of

the baby, but thinking it, at the same time, an extraordinary instance

of the imperfectibility of Nature as regards the human infant; for her

mind wanders to what she has observed in her childhood with puppies and

kittens, who, except when rudely torn from their nurse, seldom give

utterance to any complaining.

2467. We, undoubtedly, believe that crying, to a certain extent, is not

only conducive to health, but positively necessary to the full

development and physical economy of the infant's being. But though

holding this opinion, we are far from believing that a child does not

very often cry from pain, thirst, want of food, and attention to its

personal comfort; but there is as much difference in the tone and

expression of a child's cry as in the notes of an adult's voice; and the

mother's ear will not be long in discriminating between the sharp

peevish whine of irritation and fever, and the louder intermitting cry

that characterizes the want of warmth and sleep. All these shades of

expression in the child's inarticulate voice every nurse _should_

understand, and every mother will soon teach herself to interpret them

with an accuracy equal to language.

2468. There is no part of a woman's duty to her child that a young

mother should so soon make it her business to study, as the voice of her

infant, and the language conveyed in its cry. The study is neither hard

nor difficult; a close attention to its tone, and the expression of the

baby's features, are the two most important points demanding attention.

The key to both the mother will find in her own heart, and the knowledge

of her success in the comfort and smile of her infant. We have two

reasons--both strong ones--for urging on mothers the imperative

necessity of early making themselves acquainted with the nature and

wants of their child: the first, that when left to the entire,

responsibility of the baby, after the departure of the nurse, she may be

able to undertake her new duties with more confidence than if left to

her own resources and mother's instinct, without a clue to guide her

through the mysteries of those calls that vibrate through every nerve of

her nature; and, secondly, that she may be able to guard her child from

the nefarious practices of unprincipled nurses, who, while calming the

mother's mind with false statements as to the character of the baby's

cries, rather than lose their rest, or devote that time which would

remove the cause of suffering, administer, behind the curtains, those

deadly narcotics which, while stupefying Nature into sleep, insure for

herself a night of many unbroken hours. Such nurses as have not the

hardihood to dose their infant charges, are often full of other schemes

to still that constant and reproachful cry. The most frequent means

employed for this purpose is giving it something to suck,--something

easily hid from the mother,--or, when that is impossible, under the plea

of keeping it warm, the nurse covers it in her lap with a shawl, and,

under this blind, surreptitiously inserts a finger between the parched

lips, which possibly moan for drink; and, under this inhuman cheat and

delusion, the infant is pacified, till Nature, balked of its desires,

drops into a troubled sleep. These are two of our reasons for impressing

upon mothers the early, the immediate necessity of putting themselves

sympathetically in communication with their child, by at once learning

its hidden language as a delightful task.

2469. We must strenuously warn all mothers on no account to allow the

nurse to sleep with the baby, never herself to lay down with it by her

side for a night's rest, never to let it sleep in the parents' bed, and

on no account keep it, longer than absolutely necessary, confined in on

atmosphere loaded with the breath of many adults.

2470. The amount of _oxygen_ required by an infant is so large, and the

quantity consumed by mid-life and age, and the proportion of carbonic

acid thrown off from both, so considerable, that an infant breathing the

same air cannot possibly carry on its healthy existence while deriving

its vitality from so corrupted a medium. This objection, always in

force, is still more objectionable at night-time, when doors and windows

are closed, and amounts to a condition of poison, when placed between

two adults in sleep, and shut in by bed-curtains; and when, in addition

to the impurities expired from the lungs, we remember, in quiescence and

sleep, how large a portion of mephitic gas is given off from the skin.

2471. Mothers, in the fullness of their affection, believe there is no

harbour, sleeping or awake, where their infants can be so secure from

all possible or probable danger as in their own arms; yet we should

astound our readers if we told them the statistical number of infants

who, in despite of their motherly solicitude and love, are annually

killed, unwittingly, by such parents themselves, and this from the

persistency in the practice we are so strenuously condemning. The mother

frequently, on awaking, discovers the baby's face closely impacted

between her bosom and her arm, and its body rigid and lifeless; or else

so enveloped in the "head-blanket" and superincumbent bedclothes, as to

render breathing a matter of physical impossibility. In such cases the

jury in general returns a verdict of "_Accidentally overlaid_" but one

of "Careless suffocation" would be more in accordance with truth and

justice. The only possible excuse that can be urged, either by nurse or

mother, for this culpable practice, is the plea of imparting warmth to

the infant. But this can always be effected by an extra blanket in the

child's crib, or, if the weather is particularly cold, by a bottle of

hot water enveloped in flannel and placed at the child's feet; while all

the objections already urged--as derivable from animal heat imparted by

actual contact--are entirely obviated. There is another evil attending

the sleeping together of the mother and infant, which, as far as regards

the latter, we consider quite as formidable, though not so immediate as

the others, and is always followed by more or less of mischief to the

mother. The evil we now allude to is that most injurious practice of

letting the child _suck_ after the mother has _fallen asleep_, a custom

that naturally results from the former, and which, as we hare already

said, is injurious to both mother and child. It is injurious to the

infant by allowing it, without control, to imbibe to distension a fluid

sluggishly secreted and deficient in those vital principles which the

want of mental energy, and of the sympathetic appeals of the child on

the mother, so powerfully produce on the secreted nutriment, while the

mother wakes in a state of clammy exhaustion, with giddiness, dimness of

sight, nausea, loss of appetite, and a dull aching pain through the back

and between the shoulders. In fact, she wakes languid and unrefreshed

from her sleep, with febrile symptoms and hectic flushes, caused by her

baby vampire, who, while dragging from her her health and strength, has

excited in itself a set of symptoms directly opposite, but fraught with

the same injurious consequences--"functional derangement."

THE MILK.

2472. As Nature has placed in the bosom of the mother the natural food

of her offspring, it must be self-evident to every reflecting woman,

that it becomes her duty to study, as far as lies in her power, to keep

that reservoir of nourishment in as pure and invigorating a condition as

possible; for she must remember that the _quantity_ is no proof of the

_quality_ of this aliment.

2473. The mother, while suckling, as a general rule, should avoid all

sedentary occupations, take regular exercise, keep her mind as lively

and pleasingly occupied as possible, especially by music and singing.

Her diet should be light and nutritious, with a proper sufficiency of

animal food, and of that kind which yields the largest amount of

nourishment; and, unless the digestion is naturally strong, vegetables

and fruit should form a very small proportion of the general dietary,

and such preparations as broths, gruels, arrowroot, &c., still less.

Tapioca, or ground-rice pudding, made with several eggs, may be taken

freely; but all slops and thin potations, such as that delusion called

chicken-broth, should be avoided, as yielding a very small amount of

nutriment, and a large proportion of flatulence. All purely stimulants

should be avoided as much as possible, especially spirits, unless taken

for some special object, and that medicinally; but as a part of the

dietary they should be carefully shunned. Lactation is always an

exhausting process, and as the child increases in size and strength, the

drain upon the mother becomes great and depressing. Then something more

even than an abundant diet is required to keep the mind and body up to a

standard sufficiently healthy to admit of a constant and nutritious

secretion being performed without detriment to the physical integrity of

the mother, or injury to the child who imbibes it; and as stimulants are

inadmissible, if not positively injurious, the substitute required is to

be found in _malt liquor_. To the lady accustomed to her Madeira and

sherry, this may appear a very vulgar potation for a delicate young

mother to take instead of the more subtle and condensed elegance of

wine; but as we are writing from experience, and with the avowed object

of imparting useful facts and beneficial remedies to our readers, we

allow no social distinctions to interfere with our legitimate object.

2474. We have already said that the suckling mother should avoid

stimulants, especially spirituous ones; and though something of this

sort is absolutely necessary to support her strength during the

exhausting process, it should be rather of a _tonic_ than of a

stimulating character; and as all wines contain a large percentage of

brandy, they are on that account less beneficial than the pure juice of

the fermented grape might be. But there is another consideration to be

taken into account on this subject; the mother has not only to think of

herself, but also of her infant. Now wines, especially port wine, very

often--indeed, most frequently--affect the baby's bowels, and what might

have been grateful to the mother becomes thus a source of pain and

irritation to the child afterwards. Sherry is less open to this

objection than other wines, yet still _it_ very frequently does

influence the second participator, or the child whose mother has taken

it.

2475. The nine or twelve months a woman usually suckles must be, to some

extent, to most mothers, a period of privation and penance, and unless

she is deaf to the cries of her baby, and insensible to its kicks and

plunges, and will not see in such muscular evidences the griping pains

that rack her child, she will avoid every article that can remotely

affect the little being who draws its sustenance from her. She will see

that the babe is acutely affected by all that in any way influences her,

and willingly curtail her own enjoyments, rather than see her infant

rendered feverish, irritable, and uncomfortable. As the best tonic,

then, and the most efficacious indirect stimulant that a mother can take

at such times, there is no potation equal to _porter_ and _stout_, or,

what is better still, an equal part of porter and stout. Ale, except for

a few constitutions, is too subtle and too sweet, generally causing

acidity or heartburn, and stout alone is too potent to admit of a full

draught, from its proneness to affect the head; and quantity, as well as

moderate strength, is required to make the draught effectual; the equal

mixture, therefore, of stout and porter yields all the properties

desired or desirable as a medicinal agent for this purpose.

2476. Independently of its invigorating influence on the constitution,

_porter exerts a marked and specific effect on the secretion of milk;

more powerful in exciting an abundant supply of that fluid than any

other article within the range of the physician's art;_ and, in cases of

deficient quantity, is the most certain, speedy, and the healthiest

means that can be employed to insure a quick and abundant flow. In cases

where malt liquor produces flatulency, a few grains of the "carbonate of

soda" may advantageously be added to each glass immediately before

drinking, which will have the effect of neutralizing any acidity that

may be in the porter at the time, and will also prevent its

after-disagreement with the stomach. The quantity to be taken must

depend upon the natural strength of the mother, the age and demand made

by the infant on the parent, and other causes; but the amount should

vary from _one_ to _two_ pints a day, never taking less than half a pint

at a time, which should be repeated three or four times a day.

2477. We have said that the period of suckling is a season of penance to

the mother, but this is not invariably the case; and, as so much must

depend upon the natural strength of the stomach, and its power of

assimilating all kinds of food into healthy _chyle_, it is impossible to

define exceptions. Where a woman feels she can eat any kind of food,

without inconvenience or detriment, she should live during her suckling

as she did before; but, as a general rule, we are bound to advise all

mothers to abstain from such articles as pickles, fruits, cucumbers, and

all acid and slowly digestible foods, unless they wish for restless

nights and crying infants.

2478. As regards exercise and amusement, we would certainly neither

prohibit a mother's dancing, going to a theatre, nor even from attending

an assembly. The first, however, is the best indoor recreation she can

take, and a young mother will do well to often amuse herself in the

nursery with this most excellent means of healthful circulation. The

only precaution necessary is to avoid letting the child suck the milk

that has lain long in the breast, or is heated by excessive action.

2479. Every mother who can, should be provided with a breast-pump, or

glass tube, to draw off the superabundance that has been accumulating in

her absence from the child, or the first gush excited by undue exertion:

the subsequent supply of milk will be secreted under the invigorating

influence of a previous healthy stimulus.

2480. As the first milk that is secreted contains a large amount of the

saline elements, and is thin and innutritious, it is most admirably

adapted for the purpose Nature designed it to fulfil,--that of an

aperient; but which, unfortunately, it is seldom permitted, in our

artificial mode of living, to perform.

2481. So opposed are we to the objectionable plan of physicking new-born

children, that, unless for positive illness, we would much rather advise

that medicine should be administered _through_ the mother for the first

eight or ten weeks of its existence. This practice, which few mothers

will object to, is easily effected by the parent, when such a course is

necessary for the child, taking either a dose of castor-oil, half an

ounce of tasteless salts (the phosphate of soda), one or two

teaspoonfuls of magnesia, a dose of lenitive electuary, manna, or any

mild and simple aperient, which, almost before it can have taken effect

on herself, will exhibit its action on her child.

2482. One of the most common errors that mothers fall into while

suckling their children, is that of fancying they are always hungry, and

consequently overfeeding them; and with this, the great mistake of

applying the child to the breast on every occasion of its crying,

without investigating the cause of its complaint, and, under the belief

that it wants food, putting the nipple into its crying mouth, until the

infant turns in revulsion and petulance from what it should accept with

eagerness and joy. At such times, a few teaspoonfuls of water, slightly

chilled, will often instantly pacify a crying and restless child, who

has turned in loathing from the offered breast; or, after imbibing a few

drops, and finding it not what nature craved, throws back its head in

disgust, and cries more petulantly than before. In such a case as this,

the young mother, grieved at her baby's rejection of the tempting

present, and distressed at its cries, and in terror of some injury, over

and over ransacks its clothes, believing some insecure pin can alone be

the cause of such sharp complaining, an accident that, from her own care

in dressing, however, is seldom or ever the case.

2483. These abrupt cries of the child, if they do not proceed from

thirst, which a little water will relieve, not unfrequently occur from

some unequal pressure, a fold or twist in the "roller," or some

constriction round the tender body. If this is suspected, the mother

must not be content with merely slackening the strings; the child should

be undressed, and the creases and folds of the hot skin, especially

those about the thighs and groins, examined, to see that no powder has

caked, and, becoming hard, irritated the parts. The violet powder should

be dusted freely over all, to cool the skin, and everything put on fresh

and smooth. If such precautions have not afforded relief, and, in

addition to the crying, the child plunges or draws up its legs, the

mother may be assured some cause of irritation exists in the stomach or

bowels,--either acidity in the latter or distension from overfeeding in

the former; but, from whichever cause, the child should be "opened"

before the fire, and a heated napkin applied all over the abdomen, the

infant being occasionally elevated to a sitting position, and while

gently jolted on the knee, the back should be lightly patted with the

hand.

2484. Should the mother have any reason to apprehend that the _cause_ of

inconvenience proceeds from the bladder--a not unfrequent source of

pain,--the napkin is to be dipped in hot water, squeezed out, and

immediately applied over the part, and repeated every eight or ten

minutes, for several times in succession, either till the natural relief

is afforded, or a cessation of pain allows of its discontinuance. The

pain that young infants often suffer, and the crying that results from

it, is, as we have already said, frequently caused by the mother

inconsiderately overfeeding her child, and is produced by the pain of

distension, and the mechanical pressure of a larger quantity of fluid in

the stomach than the gastric juice can convert into cheese and digest.

2485. Some children are stronger in the enduring power of the stomach

than others, and get rid of the excess by vomiting, concluding every

process of suckling by an emission of milk and curd. Such children are

called by nurses "thriving children;" and generally they are so, simply

because their digestion is good, and they have the power of expelling

with impunity that superabundance of aliment which in others is a source

of distension, flatulence, and pain.

2486. The length of time an infant should be suckled must depend much on

the health and strength of the child, and the health of the mother, and

the quantity and quality of her milk; though, when all circumstances are

favourable, it should never be less than _nine_, nor exceed _fifteen_

months; but perhaps the true time will be found in the medium between

both. But of this we may be sure, that Nature never ordained a child to

live on suction after having endowed it with teeth to bite and to grind;

and nothing is more out of place and unseemly than to hear a child, with

a set of twenty teeth, ask for "the breast."

2487. The practice of protracted wet-nursing is hurtful to the mother,

by keeping up an uncalled-for, and, after the proper time, an unhealthy

drain on her system, while the child either derives no benefit from what

it no longer requires, or it produces a positive injury on its

constitution. After the period when Nature has ordained the child shall

live by other means, the secretion of milk becomes thin and

deteriorated, showing in the flabby flesh and puny features of the child

both its loss of nutritious properties and the want of more stimulating

aliment.

2488. Though we have said that twelve months is about the medium time a

baby should be suckled, we by no means wish to imply that a child should

be fed exclusively on milk for its first year; quite the reverse; the

infant can hardly be too soon made independent of the mother. Thus,

should illness assail her, her milk fail, or any domestic cause abruptly

cut off the natural supply, the child having been annealed to an

artificial diet, its life might be safely carried on without seeking for

a wet-nurse, and without the slightest danger to its system.

2489. The advantage to the mother of early accustoming the child to

artificial food is as considerable to herself as beneficial to her

infant; the demand on her physical strength in the first instance will

be less severe and exhausting, the child will sleep longer on a less

rapidly digestible aliment, and yield to both more quiet nights, and the

mother will be more at liberty to go out for business or pleasure,

another means of sustenance being at hand till her return. Besides these

advantages, by a judicious blending of the two systems of feeding, the

infant will acquire greater constitutional strength, so that, if

attacked by sickness or disease, it will have a much greater chance of

resisting its virulence than if dependent alone on the mother, whose

milk, affected by fatigue and the natural anxiety of the parent for her

offspring, is at such a time neither good in its properties nor likely

to be beneficial to the patient.

2490. All that we have further to say on suckling is an advice to

mothers, that if they wish to keep a sound and unchapped nipple, and

possibly avoid what is called a "broken breast," never to put it up with

a wet nipple, but always to have a soft handkerchief in readiness, and

the moment that delicate part is drawn from the child's mouth, to dry it

carefully of the milk and saliva that moisten it; and, further, to make

a practice of suckling from each breast alternately.

Dress and Dressing, Washing, &c.

2491. As respects the dress and dressing of a new-born infant, or of a

child in arms, during any stage of its nursing, there are few women who

will require us to give them guidance or directions for their

instruction; and though a few hints on the subject may not be out of

place here, yet most women intuitively "take to a baby," and, with a

small amount of experience, are able to perform all the little offices

necessary to its comfort and cleanliness with ease and completeness. We

shall, therefore, on this delicate subject hold our peace; and only,

from afar, _hint_ "at what we would," leaving our suggestions to be

approved or rejected, according as they chime with the judgment and the

apprehension of our motherly readers.

2492. In these days of intelligence, there are few ladies who have not,

in all probability, seen the manner in which the Indian squaw, the

aborigines of Polynesia, and even the Lapp and Esquimaux, strap down

their baby on a board, and by means of a loop suspend it to the bough of

a tree, hang it up to the rafters of the hut, or on travel, dangle it on

their backs, outside the domestic implements, which, as the slave of her

master, man, the wronged but uncomplaining woman carries, in order that

her lord may march in unhampered freedom. Cruel and confining as this

system of "backboard" dressing may seem to our modern notions of freedom

and exercise, it is positively less irksome, less confining, and

infinitely less prejudicial to health, than the mummying of children by

our grandmothers a hundred, ay, fifty years ago: for what with

chin-stays, back-stays, body-stays, forehead-cloths, rollers, bandages,

&c., an infant had as many girths and strings, to keep head, limbs, and

body in one exact position, as a ship has halyards.

2493. Much of this--indeed we may say all--has been abolished; but still

the child is far from being dressed loosely enough; and we shall never

be satisfied till the abominable use of the _pin_ is avoided _in toto_

in an infant's dressing, and a texture made for all the under garments

of a child of a cool and elastic material.

2494. The manner in which an infant is encircled in a bandage called the

"roller," as if it had fractured ribs, compressing those organs--that,

living on suction, must be, for the health of the child, to a certain

degree distended, to obtain sufficient aliment from the fluid

imbibed--is perfectly preposterous. Our humanity, as well as our duty,

calls upon us at once to abrogate and discountenance by every means in

our power. Instead of the process of washing and dressing being made, as

with the adult, a refreshment and comfort, it is, by the dawdling manner

in which it is performed, the multiplicity of things used, and the

perpetual change of position of the infant to adjust its complicated

clothing, rendered an operation of positive irritation and annoyance.

We, therefore, entreat all mothers to regard this subject in its true

light, and study to the utmost, simplicity in dress, and dispatch in the

process.

2495. Children do not so much cry from the washing as from the

irritation caused by the frequent change of position in which they are

placed, the number of times they are turned on their face, on their

back, and on their side, by the manipulations demanded by the

multiplicity of articles to be fitted, tacked, and carefully adjusted on

their bodies. What mother ever found her girl of six or seven stand

quiet while she was curling her hair? How many times nightly has she not

to reprove her for not standing still during the process! It is the same

with the unconscious infant, who cannot bear to be moved about, and who

has no sooner grown reconciled to one position than it is forced

reluctantly into another. It is true, in one instance the child has

intelligence to guide it, and in the other not; but the _motitory

nerves_, in both instances, resent coercion, and a child cannot be too

little handled.

2496. On this account alone, and, for the moment, setting health and

comfort out of the question, we beg mothers to simplify their baby's

dress as much as possible; and not only to put on as little as is

absolutely necessary, but to make that as simple in its contrivance and

adjustment as it will admit of; to avoid belly-bands, rollers, girths,

and everything that can impede or confine the natural expansion of the

digestive organs, on the due performance of whose functions the child

lives, thrives, and develops its physical being.

REARING BY HAND.

Articles necessary, and how to use them,--Preparation of Foods.--

Baths.--Advantages of Rearing by Hand.

2497. As we do not for a moment wish to be thought an advocate for an

artificial, in preference to the natural course of rearing children, we

beg our renders to understand us perfectly on this head; all we desire

to prove is the fact that a child _can_ be brought up as well on a spoon

dietary as the best example to be found of those reared on the breast;

having more strength, indeed, from the more nutritious food on which it

lives. It will be thus less liable to infectious diseases, and more

capable of resisting the virulence of any danger that may attack it; and

without in any way depreciating the nutriment of its natural food, we

wish to impress on the mother's mind that there are many cases of

infantine debility which might eventuate in rickets, curvature of the

spine, or mesenteric disease, where the addition to, or total

substitution of, an artificial and more stimulating aliment, would not

only give tone and strength to the constitution, but at the same time

render the employment of mechanical means totally unnecessary. And,

finally, though we would never--where the mother had the strength to

suckle her child--supersede the breast, we would insist on making it a

rule to accustom the child as early as possible to the use of an

artificial diet, not only that it may acquire more vigour to help it

over the ills of childhood, but that, in the absence of the mother, it

might not miss the maternal sustenance; and also for the parent's sake,

that, should the milk, from any cause, become vitiated, or suddenly

cease, the child can be made over to the bottle and the spoon without

the slightest apprehension of hurtful consequences.

2498. To those persons unacquainted with the system, or who may have

been erroneously informed on the matter, the rearing of a child by hand

may seem surrounded by innumerable difficulties, and a large amount of

personal trouble and anxiety to the nurse or mother who undertakes the

duty. This, however, is a fallacy in every respect, except as regards

the fact of preparing the food; but even this extra amount of work, by

adopting the course we shall lay down, may be reduced to a very small

sum of inconvenience; and as respects anxiety, the only thing calling

for care is the display of judgment in the preparation of the food. The

articles required for the purpose of feeding an infant are a night-lamp,

with its pan and lid, to keep the food warm; a nursing-bottle, with a

prepared teat; and a small pap saucepan, for use by day. Of the lamp we

need hardly speak, most mothers being acquainted with its operation: but

to those to whom it is unknown we may observe, that the flame from the

floating rushlight heats the water in the reservoir above, in which the

covered pan that contains the food floats, keeping it at such a heat

that, when thinned by milk, it will be of a temperature suitable for

immediate use. Though many kinds of nursing-bottles have been lately

invented, and some mounted with India-rubber nipples, the common glass

bottle, with the calf's teat, is equal in cleanliness and utility to

any; besides, the nipple put into the child's mouth is so white and

natural in appearance, that no child taken from the breast will refuse

it. The black artificial ones of caoutchouc or gutta-percha are

unnatural. The prepared teats can be obtained at any chemist's, and as

they are kept in spirits, they will require a little soaking in warm

water, and gentle washing, before being tied securely, by means of fine

twine, round the neck of the bottle, just sufficient being left

projecting for the child to grasp freely in its lips; for if left the

full length, or over long, it will be drawn too far into the mouth, and

possibly make the infant heave. When once properly adjusted, the nipple

need never be removed till replaced by a new one, which will hardly be

necessary oftener than once a fortnight, though with care one will last

for several weeks. The nursing-bottle should be thoroughly washed and

cleaned every day, and always rinsed out before and after using it, the

warm water being squeezed through the nipple, to wash out any particles

of food that might lodge in the aperture, and become sour. The teat can

always be kept white and soft by turning the end of the bottle, when not

in use, into a narrow jug containing water, taking care to dry it first,

and then to warm it by drawing the food through before putting it into

the child's mouth.

Food, and its Preparation.

2499. The articles generally employed as food for infants consist of

arrowroot, bread, flour, baked flour, prepared groats, farinaceous food,

biscuit-powder, biscuits, tops-and-bottoms, and semolina, or manna

croup, as it is otherwise called, which, like tapioca, is the prepared

pith of certain vegetable substances. Of this list the least

efficacious, though, perhaps, the most believed in, is arrowroot, which

only as a mere agent, for change, and then only for a very short time,

should ever be employed as a means of diet to infancy or childhood. It

is a thin, flatulent, and innutritious food, and incapable of supporting

infantine life with energy. Bread, though the universal _régime_ with

the labouring poor, where the infant's stomach and digestive powers are

a reflex, in miniature, of the father's, should never be given to an

infant under three months, and, even then, however finely beaten up and

smoothly made, is a very questionable diet. Flour, when well boiled,

though infinitely better than arrowroot, is still only a kind of

fermentative paste, that counteracts its own good by after-acidity and

flatulence.

2500. Baked flour, when cooked into a pale brown mass, and finely

powdered, makes a far superior food to the others, and may be considered

as a very useful diet, especially for a change. Prepared groats may be

classed with arrowroot and raw flour, as being innutritious. The

articles that now follow in our list are all good, and such as we could,

with conscience and safety, trust to for the health and development of

any child whatever.

2501. We may observe in this place, that an occasional change in the

character of the food is highly desirable, both as regards the health

and benefit of the child; and though the interruption should only last

for a day, the change will be advantageous.

2502. The packets sold as farinaceous food are unquestionably the best

aliment that can be given from the first to a baby, and may be

continued, with the exception of an occasional change, without

alteration of the material, till the child is able to take its regular

meals of animal and vegetable food. Some infants are so constituted as

to require a frequent and total change in their system of living,

seeming to thrive for a certain time on any food given to them, but if

persevered in too long, declining in bulk and appearance as rapidly as

they had previously progressed. In such cases the food should be

immediately changed, and when that which appeared to agree best with the

child is resumed, it should be altered in its quality, and perhaps in

its consistency.

2503. For the farinaceous food there are directions with each packet,

containing instructions for the making; but, whatever the food employed

is, enough should be made at once to last the day and night; at first,

about a pint basinful, but, as the child advances, a quart will hardly

be too much. In all cases, let the food boil a sufficient time,

constantly stirring, and taking every precaution that it does not get

burnt, in which case it is on no account to be used.

2504. The food should always be made with water, the whole sweetened at

once, and of such a consistency that, when poured out, and it has had

time to cool, it will cut with the firmness of a pudding or custard. One

or two spoonfuls are to be put into the pap saucepan and stood on the

hob till the heat has softened it, when enough milk is to be added, and

carefully mixed with the food, till the whole has the consistency of

ordinary cream; it is then to be poured into the nursing-bottle, and the

food having been drawn through to warm the nipple, it is to be placed in

the child's mouth. For the first month or more, half a bottleful will be

quite enough to give the infant at one time; but, as the child grows, it

will be necessary not only to increase the quantity given at each time,

but also gradually to make its food more consistent, and, after the

third month, to add an egg to every pint basin of food made. At night

the mother puts the food into the covered pan of her lamp, instead of

the saucepan--that is, enough for one supply, and, having lighted the

rush, she will find, on the waking of her child, the food sufficiently

hot to bear the cooling addition of the milk. But, whether night or day,

the same food should never be heated twice, and what the child leaves

should be thrown away.

2505. The biscuit powder is used in the same manner as the farinaceous

food, and both prepared much after the fashion of making starch. But

when tops-and-bottoms, or the whole biscuit, are employed, they require

soaking in cold water for some time previous to boiling. The biscuit or

biscuits are then to be slowly boiled in as much water as will, when

thoroughly soft, allow of their being beaten by a three-pronged fork

into a fine, smooth, and even pulp, and which, when poured into a basin

and become cold, will cut out like a custard. If two large biscuits have

been so treated, and the child is six or seven months old, beat up two

eggs, sufficient sugar to properly sweeten it, and about a pint of skim

milk. Pour this on the beaten biscuit in the saucepan, stirring

constantly; boil for about five minutes, pour into a basin, and use,

when cold, in the same manner as the other.

2506. This makes an admirable food, at once nutritious and

strengthening. When tops-and-bottoms or rusks are used, the quantity of

the egg may be reduced, or altogether omitted.

2507. Semolina, or manna croup, being in little hard grains, like a fine

millet-seed, must be boiled for some time, and the milk, sugar, and egg

added to it on the fire, and boiled for a few minutes longer, and, when

cold, used as the other preparations.

2508. Many persons entertain a belief that cow's milk is hurtful to

infants, and, consequently, refrain from giving it; but this is a very

great mistake, for both sugar and milk should form a large portion of

every meal an infant takes.

TEETHING AND CONVULSIONS.

Fits, &c., the consequence of Dentition, and how to be treated.--The

number and order of the Teeth, and manner in which they are cut.--First

and Second Set.

2509. About three months after birth, the infant's troubles may be said

to begin; teeth commence forming in the gums, causing pain and

irritation in the mouth, and which, but for the saliva it causes to flow

so abundantly, would be attended with very serious consequences. At the

same time the mother frequently relaxes in the punctuality of the

regimen imposed on her, and, taking some unusual or different food,

excites diarrhoea or irritation in her child's stomach, which not

unfrequently results in a rash on the skin, or slight febrile symptoms,

which, if not subdued in their outset, superinduce some more serious

form of infantine disease. But, as a general rule, the teeth are the

primary cause of much of the child's sufferings, in consequence of the

state of nervous and functional irritation into which the system is

thrown by their formation and progress out of the jaw and through the

gums. We propose beginning this branch of our subject with that most

fertile source of an infant's suffering--

Teething.

2510. That this subject may he better understood by the nurse and

mother, and the reason of the constitutional disturbance that, to a

greater or less degree, is experienced by all infants, may be made

intelligible to those who have the care of children, we shall commence

by giving a brief account of the formation of the teeth, the age at

which they appear in the mouth, and the order in which they pierce the

gums. The organs of mastication in the adult consist of 32 distinct

teeth, 16 in either jaw; being, in fact, a double set. The teeth are

divided into 4 incisors, 2 canine, 4 first and second grinders, and 6

molars; but in childhood the complement or first set consists of only

twenty, and these only make their appearance as the development of the

frame indicates the requirement of a different kind of food for the

support of the system. At birth some of the first-cut teeth are found in

the cavities of the jaw, in a very small and rudimentary form; but this

is by no means universal. About the third month, the jaws, which are

hollow and divided into separate cells, begin to expand, making room for

the slowly developing teeth, which, arranged for beauty and economy of

space lengthwise, gradually turn their tops upwards, piercing the gum by

their edges, which, being sharp, assist in cutting a passage through the

soft parts. There is no particular period at which children cut their

teeth, some being remarkably early, and others equally late. The

earliest age that we have ever ourselves known as a reliable fact was,

_six weeks_. Such peculiarities are generally hereditary, and, as in

this case, common to a whole family. The two extremes are probably

represented by six and sixteen months. Pain and drivelling are the

usual, but by no means the general, indications of teething.

2511. About the sixth month the gums become tense and swollen,

presenting a red, shiny appearance, while the salivary glands pour out

an unusual quantity of saliva. After a time, a white line or round spot

is observed on the top of one part of the gums, and the sharp edge of

the tooth may be felt beneath if the finger is gently pressed on the

part. Through these white spots the teeth burst their way in the

following order:--

2512. Two incisors in the lower jaw are first cut, though, in general,

some weeks elapse between the appearance of the first and the advent of

the second. The next teeth cut are the four incisors of the upper jaw.

The next in order are the remaining two incisors of the bottom, one on

each side, then two top and two bottom on each side, but not joining the

incisors; and lastly, about the eighteenth or twentieth month, the four

eye teeth, filling up the space left between the side teeth and the

incisors; thus completing the infant's set of sixteen. Sometimes at the

same period, but more frequently some months later, four more double

teeth slowly make their appearance, one on each side of each jaw,

completing the entire series of the child's first set of twenty teeth.

It is asserted that a child, while cutting its teeth, should either

dribble excessively, vomit after every meal, or be greatly relaxed.

Though one or other, or all of these at once, may attend a case of

teething, it by no means follows that any one of them should accompany

this process of nature, though there can be no doubt that where the pain

consequent on the unyielding state of the gums, and the firmness of the

skin that covers the tooth, is severe, a copious discharge of saliva

acts beneficially in saving the head, and also in guarding the child

from those dangerous attacks of fits to which many children in their

teething are liable.

2513. _The Symptoms_ that generally indicate the cutting of teeth, in

addition to the inflamed and swollen state of the gums, and increased

flow of saliva, are the restless and peevish state of the child, the

hands being thrust into the mouth, and the evident pleasure imparted by

rubbing the finger or nail gently along the gum; the lips are often

excoriated, and the functions of the stomach or bowels are out of order.

In severe cases, occurring in unhealthy or scrofulous children, there

are, from the first, considerable fever, disturbed sleep, fretfulness,

diarrhoea, rolling of the eyes, convulsive startings, laborious

breathing, coma, or unnatural sleep, ending, unless the head is quickly

relieved, in death.

2514. The _Treatment_ in all cases of painful teething is remarkably

simple, and consists in keeping the body cool by mild aperient

medicines, allaying the irritation in the gums by friction with a rough

ivory ring or a stale crust of broad, and when the head, lungs, or any

organ is overloaded or unduly excited, to use the hot bath, and by

throwing the body into a perspiration, equalize the circulation, and

relieve the system from the danger of a fatal termination.

2515. Besides these, there is another means, but that must be employed

by a medical man; namely, scarifying the gums--an operation always safe,

and which, when judiciously performed, and at a critical opportunity,

will often snatch the child from the grasp of death.

2516. There are few subjects on which mothers have often formed such

strong and mistaken opinions as on that of lancing an infant's gums,

some rather seeing their child go into fits--and by the unrelieved

irritation endangering inflammation of the brain, water on the head,

rickets, and other lingering affections--than permit the surgeon to

afford instant relief by cutting through the hard skin, which, like a

bladder over the stopper of a bottle, effectually confines the tooth to

the socket, and prevents it piercing the soft, spongy substance of the

gum. This prejudice is a great error, as we shall presently show; for,

so far from hurting the child, there is nothing that will so soon

convert an infant's tears into smiles as scarifying the gums in painful

teething; that is, if effectually done, and the skin of the tooth be

divided.

2517. Though teething is a natural function, and to an infant in perfect

health should be unproductive of pain, yet in general it is not only a

fertile cause of suffering, but often a source of alarm and danger; the

former, from irritation in the stomach and bowels, deranging the whole

economy of the system, and the latter, from coma and fits, that may

excite alarm in severe cases; and the danger, that eventuates in some

instances, from organic disease of the head or spinal marrow.

2518. We shall say nothing in this place of "rickets," or "water on the

head," which are frequent results of dental irritation, but proceed to

finish our remarks on the treatment of teething. Though strongly

advocating the lancing of the gums in teething, and when there are any

severe head-symptoms, yet it should never be needlessly done, or before

being satisfied that the tooth is fully formed, and is out of the

socket, and under the gum. When assured on these points, the gum should

be cut lengthwise, and from the top of the gum downwards to the tooth,

in an horizontal direction, thus----, and for about half an inch in

length. The operation is then to be repeated in a transverse direction,

cutting across the gum, in the centre of the first incision, and forming

a cross, thus +. The object of this double incision is to insure a

retraction of the cut parts, and leave an open way for the tooth to

start from--an advantage not to be obtained when only one incision is

made; for unless the tooth immediately follows the lancing, the opening

reunites, and the operation has to be repeated. That this operation is

very little or not at all painful, is evidenced by the suddenness with

which the infant falls asleep after the lancing, and awakes in

apparently perfect health, though immediately before the use of the

gum-lancet, the child may have been shrieking or in convulsions.

Convulsions, or Infantine Fits.

2519. From their birth till after teething, infants are more or less

subject or liable to sudden fits, which often, without any assignable

cause, will attack the child in a moment, and while in the mother's

arms; and which, according to their frequency, and the age and strength

of the infant, are either slight or dangerous.

2520. Whatever may have been the remote cause, the immediate one is some

irritation of the nervous system, causing convulsions, or an effusion to

the head, inducing coma. In the first instance, the infant cries out

with a quick, short scream, rolls up its eyes, arches its body

backwards, its arms become bent and fixed, and the fingers parted; the

lips and eyelids assume a dusky leaden colour, while the face remains

pale, and the eyes open, glassy, or staring. This condition may or may

not be attended with muscular twitchings of the mouth, and convulsive

plunges of the arms. The fit generally lasts from one to three minutes,

when the child recovers with a sigh, and the relaxation of the body. In

the other case, the infant is attacked at once with total insensibility

and relaxation of the limbs, coldness of the body and suppressed

breathing; the eyes, when open, being dilated, and presenting a dim

glistening appearance; the infant appearing, for the moment, to be dead.

2521. _Treatment._-The first step in either case is, to immerse the

child in a hot bath up to the chin; or if sufficient hot water cannot be

procured to cover the body, make a hip-bath of what can be obtained;

and, while the left hand supports the child in a sitting or recumbent

position, with the right scoop up the water, and run it over the chest

of the patient. When sufficient water can be obtained, the spine should

be briskly rubbed while in the bath; when this cannot be done, lay the

child on the knees, and with the fingers dipped in brandy, rub the whole

length of the spine vigorously for two or three minutes, and when

restored to consciousness, give occasionally a teaspoonful of weak

brandy and water or wine and water.

2522. An hour after the bath, it may be necessary to give an aperient

powder, possibly also to repeat the dose for once or twice every three

hours; in which case the following prescription is to be employed. Take

of

Powdered scammony 6 grains.

Grey powder 6 grains.

Antimonial powder 4 grains.

Lump sugar 20 grains.

Mix thoroughly, and divide into three powders, which are to be taken as

advised for an infant one year old; for younger or weakly infants,

divide into four powders, and give as the other. For thirst and febrile

symptoms, give drinks of barley-water, or cold water, and every three

hours put ten to fifteen drops of spirits of sweet nitre in a

dessert-spoonful of either beverage.

THRUSH, AND ITS TREATMENT.

2523. This is a disease to which infants are peculiarly subject, and in

whom alone it may be said to be a disease; for when thrush shows itself

in adult or advanced life, it is not as a disease proper, but only as a

symptom, or accessory, of some other ailment, generally of a chronic

character, and should no more be classed as a separate affection than

the petechae, or dark-coloured spots that appear in malignant measles,

may be considered a distinct affection.

2524. Thrush is a disease of the follicles of the mucous membrane of the

alimentary canal, whereby there are formed small vesicles, or bladders,

filled with a thick mucous secretion, which, bursting, discharge their

contents, and form minute ulcers in the centre of each vessel. To make

this formal but unavoidable description intelligible, we must beg the

reader's patience while we briefly explain terms that may appear to many

so unmeaning, and make the pathology of thrush fully familiar.

2525. The whole digestive canal, of which the stomach and bowels are

only a part, is covered, from the lips, eyes, and ears downwards, with a

thin glairy tissue, like the skin that lines the inside of an egg,

called the mucous membrane; this membrane is dotted all over, in a state

of health, by imperceptible points, called follicles, through which the

saliva, or mucous secreted by the membrane, is poured out.

2526. These follicles, or little glands, then, becoming enlarged, and

filled with a congealed fluid, constitute thrush in its first stage; and

when the child's lips and mouth appear a mass of small pearls, then, as

these break and discharge, the second stage, or that of ulceration, sets

in.

2527. _Symptoms._--Thrush is generally preceded by considerable

irritation, by the child crying and fretting, showing more than ordinary

redness of the lips and nostrils, hot fetid breath, with relaxed bowels,

and dark feculent evacuations; the water is scanty and high-coloured;

whilst considerable difficulty in swallowing, and much thirst, are the

other symptoms, which a careful observation of the little patient makes

manifest.

2528. The situation and character of thrush show at once that the cause

is some irritation of the mucous membrane, and can proceed only from the

nature and quality of the food. Before weaning, this must be looked for

in the mother, and the condition of the milk; after that time, in the

crude and indigestible nature of the food given. In either case, this

exciting cause of the disease must be at once stopped. When it proceeds

from the mother, it is always best to begin by physicking the infant

through the parent; that is to say, let the parent first take the

medicine, which will sufficiently affect the child through the milk:

this plan has the double object of benefiting the patient and, at the

same time, correcting the state of the mother, and improving the

condition of her milk. In the other case, when the child is being fed by

hand, then proceed by totally altering the style of aliment given, and

substituting farinaceous food, custards, blanc-mange, and ground-rice

puddings.

2529. As an aperient medicine for the mother, the best thing she can

take is a dessert-spoonful of carbonate of magnesia once or twice a day,

in a cup of cold water; and every second day, for two or three times, an

aperient pill.

2530. As the thrush extends all over the mouth, throat, stomach, and

bowels, the irritation to the child from such an extent of diseased

surface is proportionately great, and before attempting to act on such a

tender surface by opening medicine, the better plan is to soothe by an

emollient mixture; and, for that purpose, let the following be prepared.

Take of

Castor oil 2 drachms.

Sugar 1 drachm.

Mucilage, or powdered gum Arabic half a drachm.

Triturate till the oil is incorporated, then add slowly--

Mint-water One ounce and a half

Laudanum Ten drops

Half a teaspoonful three times a day, to an infant from one to two years

old; a teaspoonful from two to three years old; and a dessertspoonful at

any age over that time. After two days' use of the mixture, one of the

following powders should be given twice a day, accompanied with one dose

daily of the mixture:--

Grey powder 20 grains.

Powdered rhubarb 15 grains.

Scammony 10 grains. Mix.

Divide into twelve powders, for one year; eight powders, from one to

two; and six powders, from two to six years old. After that age, double

the strength, by giving the quantity of two powders at once.

2531. It is sometimes customary to apply borax and honey to the mouth

for thrush; but it is always better to treat the disease

constitutionally rather than locally. The first steps, therefore, to be

adopted are, to remove or correct the exciting cause--the mother's milk

or food; allay irritation by a warm bath and the castor-oil mixture,

followed by and conjoined with the powders.

2532. To those, however, who wish to try the honey process, the best

preparation to use is the following:-Rub down one ounce of honey with

two drachms of tincture of myrrh, and apply it to the lips and mouth

every four or six hours.

2533. It is a popular belief, and one most devoutly cherished by many

nurses and elderly persons, that everybody must, at some time of their

life, between birth and death, have an attack of thrush, and if not in

infancy, or prime of life, it will surely attack them on their

death-bed, in a form more malignant than if the patient had been

affected with the malady earlier; the black thrush with which they are

then reported to be affected being, in all probability, the petechae or

purple spots that characterize the worst form, and often the last stage,

of typhoid fever.

2534. In general, very little medicine is needed in this disease of the

thrush--an alterative powder, or a little magnesia, given once or twice,

being all, with the warm bath, that, in the great majority of cases, is

needed to restore the mucous membrane to health. As thrush is caused by

an excess of heat, or over-action in the lining membrane of the stomach

and bowels, whatever will counteract this state, by throwing the heat on

the surface, must materially benefit, if not cure, the disease: and that

means every mother has at hand, in the form of a _warm bath_. After the

application of this, a little magnesia to correct the acidity existing

along the surface of the mucous membrane, is often all that is needed to

throw the system into such a state as will effect its own cure. This

favourable state is indicated by an excessive flow of saliva, or what is

called "dribbling," and by a considerable amount of relaxation of the

bowels-a condition that must not be mistaken for diarrhoea, and checked

as if a disease, but rather, for the day or two it continues, encouraged

as a critical evacuant.

2535. Should there be much debility in the convalescence, half a

teaspoonful of stee wine, given twice a day in a little barley-water,

will be found sufficient for all the purposes of a tonic. This, with the

precaution of changing the child's food, or, when it lives on the

mother, of correcting the quality of the milk by changing her own diet,

and, by means of an antacid or aperient, improving the state of the

secretion. Such is all the treatment that this disease in general

requires.

2536. The class of diseases we are now approaching are the most

important, both in their pathological features and in their consequences

on the constitution, of any group or individual disease that assails the

human body; and though more frequently attacking the undeveloped frame

of childhood, are yet by no means confined to that period. These are

called Eruptive Fevers, and embrace chicken-pox, cow-pox, small-pox,

scarlet fever, measles, milary fever, and erysipelas, or St. Anthony's

fire.

2537. The general character of all these is, that they are contagious,

and, as a general rule, attack a person only once in his lifetime; that

their chain of diseased actions always begins with fever, and that,

after an interval of from one to four days, the fever is followed by an

eruption of the skin.

CHICKEN-POX, OR GLASS-POX; AND COW-POX, OR VACCINATION.

2538. CHICKEN-POX, or GLASS-POX, may, in strict propriety, be classed as

a mild variety of small-pox, presenting all the mitigated symptoms of

that formidable disease. Among many physicians it is, indeed, classed as

small-pox, and not a separate disease; but as this is not the place to

discuss such questions, and as we profess to give only facts, the result

of our own practical experience, we shall treat this affection of

glass-pox or chicken-pox, as we ourselves have found it, as a distinct

and separate disease.

2539. Chicken-pox is marked by all the febrile symptoms presented by

small-pox, with this difference, that, in the case of chicken-pox, each

symptom is particularly slight. The heat of body is much less acute, and

the principal symptoms are difficulty of breathing, headache, coated

tongue, and nausea, which sometimes amounts to vomiting. After a term of

general irritability, heat, and restlessness, about the fourth day, or

between the third and fourth, an eruption makes its appearance over the

face, neck, and body, in its first two stages closely resembling

small-pox, with this especial difference, that whereas the pustules in

small-pox have _flat_ and _depressed_ centres--an infallible

characteristic of small-pox--the pustules in chicken-pox remain

_globular_, while the fluid in them changes from a transparent white to

a straw-coloured liquid, which begins to exude and disappear about the

eighth or ninth day, and, in mild cases, by the twelfth desquamates, or

peels off entirely.

2540. There can be no doubt that chicken-pox, like small-pox, is

contagious, and under certain states of the atmosphere becomes endemic.

Parents should, therefore, avoid exposing young children to the danger

of infection by taking them where it is known to exist, as chicken-pox,

in weakly constitutions, or in very young children, may superinduce

small-pox, the one disease either running concurrently with the other,

or discovering itself as the other declines. This, of course, is a

condition that renders the case very hazardous, as the child has to

struggle against two diseases at once, or before it has recruited

strength from the attack of the first.

2541. _Treatment_.--In all ordinary cases of chicken-pox--and it is very

seldom it assumes any complexity--the whole treatment resolves itself

into the use of the warm bath, and a course of gentle aperients. The

bath should be used when the oppression of the lungs renders the

breathing difficult, or the heat and dryness of the skin, with the

undeveloped rash beneath the surface, shows the necessity for its use.

2542. As the pustules in chicken-pox very rarely run to the state of

suppuration, as in the other disease, there is no fear of _pitting_ or

disfigurement, except in very severe forms, which, however, happen so

seldom as not to merit apprehension. When the eruption subsides,

however, the face may be washed with elder-flower water, and the routine

followed which is prescribed in the convalescent state of small-pox.

2543. COW-POX, properly speaking, is an artificial disease, established

in a healthy body as a prophylactic, or preventive agent, against the

more serious attack of small-pox, and is merely that chain of slight

febrile symptoms and local irritation, consequent on the specific action

of the lymph of the vaccination, in its action on the circulating system

of the body. This is not the place to speak of the benefits conferred on

mankind by the discovery of vaccination, not only as the preserver of

the human features from a most loathsome disfigurement, but as a

sanitary agent in the prolongation of life.

2544. Fortunately the State has now made it imperative on all parents to

have their children vaccinated before, or by the end of, the twelfth

week; thus doing away, as far as possible, with the danger to public

health proceeding from the ignorance or prejudice of those parents whose

want of information on the subject makes them object to the employment

of this specific preventive; for though vaccination has been proved

_not_ to be _always_ an infallible guard against small-pox, the attack

is always much lighter, should it occur, and is seldom, if indeed

_ever_, fatal after the precaution of vaccination. The best time to

vaccinate a child is after the sixth and before the twelfth week, if it

is in perfect health, but still earlier if small-pox is prevalent, and

any danger exists of the infant taking the disease. It is customary, and

always advisable, to give the child a mild aperient powder one or two

days before inserting the lymph in the arm; and should measles, scarlet

fever, or any other disease arise during the progress of the pustule,

the child, when recovered, should be _re-vaccinated_, and the lymph

taken from its arm on no account used for vaccinating purposes.

2545. The disease of cow-pox generally takes twenty days to complete its

course; in other words, the maturity and declension of the pustule takes

that time to fulfil its several changes. The mode of vaccination is

either to insert the matter, or lymph, taken from a healthy child, under

the cuticle in several places on both arms, or, which is still better,

to make three slight scratches, or abrasions, with a lancet on one arm

in this manner, ,,",, and work into the irritated parts the lymph,

allowing the arm to dry thoroughly before putting down the infant's

sleeve; by this means absorption is insured, and the unnecessary pain of

several pustules on both arms avoided. No apparent change is observable

by the eye for several days; indeed, not till the fourth, in many cases,

is there any evidence of a vesicle; about the fifth day, however, a pink

areola, or circle, is observed round one or all of the places,

surrounding a small pearly vesicle or bladder. This goes on deepening in

hue till the seventh or eighth day, when the vesicle is about an inch in

diameter, with a depressed centre; on the ninth the edges are elevated,

and the surrounding part hard and inflamed. The disease is now at its

height, and the pustule should be opened, if not for the purpose of

vaccinating other children, to allow the escape of the lymph, and subdue

the inflammatory action. After the twelfth day the centre is covered by

a brown scab, and the colour of the swelling becomes darker, gradually

declining in hardness and colour till the twentieth, when the scab

falls, off, leaving a small pit, or cicatrix, to mark the seat of the

disease, and for life prove a certificate of successful vaccination.

2546. In some children the inflammation and swelling of the arm is

excessive, and extremely painful, and the fever, about the ninth or

tenth day, very high; the pustule, therefore, at that time, should

sometimes be opened, the arm fomented every two hours with a warm bread

poultice, and an aperient powder given to the infant.

MEASLES AND SCARLET FEVER, WITH THE TREATMENT OF BOTH.

Measles.

2547. This much-dreaded disease, which forms the next subject in our

series of infantine diseases, and which entails more evils on the health

of childhood than any other description of physical suffering to which

that age of life is subject, may be considered more an affection of the

venous circulation, tending to general and local congestion, attended

with a diseased condition of the blood, than either as a fever or an

inflammation; and though generally classed before or after scarlet

fever, is, in its pathology and treatment, irrespective of its

after-consequences, as distinct and opposite as one disease can well be

from another.

4548. As we have already observed, measles are always characterized by

the running at the nose and eyes, and great oppression of breathing; so,

in the mode of treatment, two objects are to be held especially in view;

first, to unload the congested state of the lungs,--the cause of the

oppressed breathing; and, secondly, to act vigorously, both during the

disease and afterwards, on the bowels. At the same time it cannot be too

strongly borne in mind, that though the patient in measles should on no

account be kept unduly hot, more care than in most infantine complaints

should be taken to guard the body from _cold_, or any abrupt changes of

temperature. With these special observations, we shall proceed to give a

description of the disease, as recognized by its usual--

2549. _Symptoms_, which commence with cold chills and flushes,

lassitude, heaviness, pain in the head, and drowsiness, cough,

hoarseness, and extreme difficulty of breathing, frequent sneezing,

deduction or running at the eyes and nose, nausea, sometimes vomiting,

thirst, a furred tongue; the pulse throughout is quick, and sometimes

full and soft, at others hard and small, with other indications of an

inflammatory nature.

2550. On the third day, small red points make their appearance, first on

the face and neck, gradually extending over the upper and lower part of

the body. On the fifth day, the vivid red of the eruption changes into a

brownish hue; and, in two or three days more, the rash entirely

disappears, leaving a loose powdery desquamation on the skin, which rubs

off like dandriff. At this stage of the disease a diarrhoea frequently

comes on, which, being what is called "critical," should never be

checked, unless seriously severe. Measles sometimes assume a typhoid or

malignant character, in which form the symptoms are all greatly

exaggerated, and the case from the first becomes both doubtful and

dangerous. In this condition the eruption comes out sooner, and only in

patches; and often, after showing for a few hours, suddenly recedes,

presenting, instead of the usual florid red, a dark purple or blackish

hue; a dark brown fur forms on the gums and mouth, the breathing becomes

laborious, delirium supervenes, and, if unrelieved, is followed by coma;

a fetid diarrhoea takes place, and the patient sinks under the congested

state of the lungs and the oppressed functions of the brain.

2551. The unfavourable symptoms in measles are a high degree of fever,

the excessive heat and dryness of the skin, hurried and short breathing,

and a particularly hard pulse. The sequels, or after-consequences, of

measles are, croup, bronchitis, mesenteric disease, abscesses behind the

ear, ophthalmia, and glandular swellings in other parts of the body.

2552. _Treatment_.--In the first place, the patient should be kept in a

cool room, the temperature of which must be regulated to suit the

child's feelings of comfort, and the diet adapted to the strictest

principles of abstinence. When the inflammatory symptoms are severe,

bleeding, in some form, is often necessary, though, when adopted, it

must be in the _first stage_ of the disease; and, if the lungs are the

apprehended seat of the inflammation, two or more leeches, according to

the age and strength of the patient, must be applied to the upper part

of the chest, followed by a small blister; or the blister may be

substituted for the leeches, the attendant bearing in mind, that the

benefit effected by the blister can always be considerably augmented by

plunging the feet into very hot water about a couple of hours after

applying the blister, and kept in the water for about two minutes. And

let it further be remembered, that this immersion of the feet in hot

water may be adopted at any time or stage of the disease; and that,

whenever the _head_ or _lungs_ are oppressed, relief will _always_

accrue from its sudden and brief employment. When the symptoms commence

with much shivering, and the skin early assumes a hot, dry character,

the appearance of the rash will be facilitated, and all the other

symptoms rendered milder, if the patient is put into a warm bath, and

kept in the water for about three minutes. Or, where that is not

convenient, the following process, which will answer quite as well, can

be substituted:--Stand the child, naked, in a tub, and, having first

prepared several jugs of sufficiently warm water, empty them, in quick

succession, over the patient's shoulders and body; immediately wrap in a

hot blanket, and put the child to bed till it rouses from the sleep that

always follows the effusion or bath. This agent, by lowering the

temperature of the skin, and opening the pores, producing a natural

perspiration, and unloading the congested state of the lungs, in most

cases does away entirely with the necessity both for leeches and a

blister. Whether any of these external means have been employed or not,

the first internal remedies should commence with a series of aperient

powders and a saline mixture, as prescribed in the following

formularies; at the same time, as a beverage to quench the thirst, let a

quantity of barley-water be made, slightly acidulated by the juice of an

orange, and partially sweetened by some sugar-candy; and of which, when

properly made and cold, let the patient drink as often as thirst, or the

dryness of the mouth, renders necessary.

2553. _Aperient Powders_.--Take of scammony and jalap, each 24 grains;

grey powder and powdered antimony, each 18 grains. Mix and divide into

12 powders, if for a child between two and four years of age; into 8

powders, if for a child between four and eight years of ago; and into 6

powders for between eight and twelve years. One powder to be given, in a

little jelly or sugar-and-water, every three or four hours, according to

the severity of the symptoms.

2554. _Saline Mixture_.--Take of mint-water, 6 ounces; powdered nitre,

20 grains; antimonial wine, 3 drachms; spirits of nitre, 2 drachms;

syrup of saffron, 2 drachms. Mix. To children under three years, give a

teaspoonful every two hours; from that age to six, a dessertspoonful at

the same times; and a tablespoonful every three or four hours to

children between six and twelve.

2555. The object of these aperient powders is to keep up a steady but

gentle action on the bowels; but, whenever it seems necessary to

administer a stronger dose, and effect a brisk action on the digestive

organs,--a course particularly imperative towards the close of the

disease,--two of these powders given at once, according to the age, will

be found to produce that effect; that is, two of the twelve for a child

under four years, and two of the eight, and two of the six, according to

the age of the patient.

2556. When the difficulty of breathing becomes oppressive, as it

generally does towards night, a hot bran poultice, laid on the chest,

will be always found highly beneficial. The diet throughout must be

light, and consist of farinaceous food, such as rice and sago puddings,

beef-tea and toast; and not till convalescence sets in should hard or

animal food be given.

2557. When measles assume the malignant form, the advice just given must

be broken through; food of a nutritious and stimulating character should

be at once substituted, and administered in conjunction with wine, and

even spirits, and the disease regarded and treated as a case of typhus.

But, as this form of measles is not frequent, and, if occurring, hardly

likely to be treated without assistance, it is unnecessary to enter on

the minutiae of its practice here. What we have prescribed, in almost

all cases, will be found sufficient to meet every emergency, without

resorting to a multiplicity of agents.

2558. The great point to remember in measles is, not to give up the

treatment with the apparent subsidence of the disease, as the

_after-consequences_ of measles are too often more serious, and to be

more dreaded, than the measles themselves. To guard against this danger,

and thoroughly purify the system, after the subsidence of all the

symptoms of the disease, a corrective course of medicine, and a regimen

of exercise, should be adopted for some weeks after the cure of the

disease. To effect this, an active aperient powder should be given every

three or four clays, with a daily dose of the subjoined tonic mixture,

with as much exercise, by walking, running after a hoop, or other bodily

exertion, as the strength of the child and the state of the atmosphere

will admit, the patient being, wherever possible, removed to a purer air

as soon as convalescence warrants the change.

2559. _Tonic Mixture_.--Take of infusion of rose-leaves, 6 ounces;

quinine, 8 grains; diluted sulphuric acid, 15 drops. Mix. Dose, from

half a teaspoonful up to a dessertspoonful, once a day, according to the

ago of the patient.

Scarlatina, or Scarlet Fever.

2560. Though professional accuracy has divided this disease into several

forms, we shall keep to the one disease most generally mot with, the

common or simple scarlet fever, which, in all cases, is characterized by

an excessive heat on the skin, sore throat, and a peculiar speckled

appearance of the tongue.

2561. _Symptoms_.--Cold chills, shivering, nausea, thirst, hot skin,

quick pulse, with difficulty of swallowing; the tongue is coated,

presenting through its fur innumerable specks, the elevated papillae of

the tongue, which gives it the speckled character, that, if not the

invariable sign of scarlet fever, is only met with in cases closely

analogous to that disease. Between the _second_ and __third_ day, but

most frequently on the _third_, a bright red efflorescence breaks out in

patches on the face, neck, and back, from which it extends over the

trunk and extremities, always showing thicker and deeper in colour

wherever there is any pressure, such as the elbows, back, and hips; when

the eruption is well out, the skin presents the appearance of a boiled

lobster-shell. At first, the skin is smooth, but, as the disease

advances, perceptible roughness is apparent, from the elevation of the

rash, or, more properly, the pores of the skin. On the _fifth_ and

_sixth_ days the eruption begins to decline, and by the _eighth_ has

generally entirely disappeared. During the whole of this period, there

is, more or less, constant sore throat.

2562. The _Treatment_ of scarlet fever is, in general, very simple.

Where the heat is great, and the eruption comes out with difficulty, or

recedes as soon as it appears, the body should be sponged with cold

vinegar-and-water, or tepid water, as in measles, poured over the chest

and body, the patient being, as in that disease, wrapped in a blanket

and put to bed, and the same powders and mixture ordered in measles

administered, with the addition of a constant hot bran poultice round

the throat, which should be continued from the first symptom till a day

or two after the declension of the rash. The same low diet and cooling

drink, with the same general instructions, are to be obeyed in this as

in the former disease.

2563. When the fever runs high in the first stage, and there is much

nausea, before employing the effusions of water, give the patient an

emetic, of equal, parts of ipecacuanha and antimonial wine, in doses of

from a teaspoonful to a tablespoonful, according to age. By these means,

nine out of every ten cases of scarlatina may be safely and

expeditiously cured, especially if the temperature of the patient's room

is kept at an even standard of about sixty degrees.

HOOPING-COUGH, CROUP, AND DIARRHOEA, WITH THEIR MODE OF TREATMENT.

Hooping-Cough.

2564. THIS is purely a spasmodic disease, and is only infectious through

the faculty of imitation, a habit that all children are remarkably apt

to fall into; and even where adults have contracted hooping-cough, it

has been from the same cause, and is as readily accounted for, on the

principle of imitation, as that the gaping of one person will excite or

predispose a whole party to follow the same spasmodic example. If any

one associates for a few days with a person who stammers badly, he will

find, when released from his company, that the sequence of his

articulation and the fluency of his speech are, for a time, gone; and it

will be a matter of constant vigilance, and some difficulty, to overcome

the evil of so short an association. The manner in which a number of

school-girls will, one after another, fall into a fit on beholding one

of their number attacked with epilepsy, must be familiar to many. These

several facts lead us to a juster notion of how to treat this spasmodic

disease. Every effort should, therefore, be directed, mentally and

physically, to break the chain of nervous action, on which the

continuance of the cough depends.

2565. _Symptoms._--Hooping-cough comes on with a slight oppression of

breathing, thirst, quick pulse, hoarseness, and a hard, dry cough. This

state may exist without any change from one to two or three weeks before

the peculiar feature of the disease-the _hoop_-sets in. As the

characteristics of this cough are known to all, it is unnecessary to

enter here, physiologically, on the subject. We shall, therefore, merely

remark that the frequent vomiting and bleeding at the mouth or nose are

favourable signs, and proceed to the

2566. _Treatment_, which should consist in keeping up a state of nausea

and vomiting. For this purpose, give the child doses of ipecacuanha and

antimonial wines, in equal parts, and quantities varying from half to

one and a half teaspoonful once a day, or, when the expectoration is

hard and difficult of expulsion, giving the following cough mixture

every four hours. Take of

Syrup of squills 1/2 ounce.

Antimonial wine 1 ounce.

Laudanum 15 drops.

Syrup of Toulou 2 drachms.

Water 1-1/2 ounce.

Mix. The dose is from half a spoonful to a dessertspoonful. When the

cough is urgent, the warm bath is to be used, and either one or two

leeches applied over the breastbone, or else a small blister laid on the

lower part of the throat.

2567. Such is the medical treatment of hooping-cough; but there is a

moral regimen, based on the nature of the disease, which should never be

omitted. And, on the principle that a sudden start or diversion of the

mind will arrest a person in the act of sneezing or gaping, so the like

means should be adopted with the hooping-cough patient; and, in the

first stage, before the _hooping_ has been added, the parent should

endeavour to break the paroxysm of the cough by abruptly attracting the

patient's attention, and thus, if possible, preventing the cough from

reaching that height when the ingulp of air gives the hoop or crow that

marks the disease; but when once that symptom has set in, it becomes

still more necessary to endeavour, by even measures of intimidation, to

break the spasmodic chain of the cough. Exercise in the open air, when

dry, is also requisite, and charge of scene and air in all cases is of

absolute necessity, and may be adopted at any stage of the disease.

Croup.

2568. This is by far the most formidable and fatal of all the diseases

to which infancy and childhood are liable, and is purely an inflammatory

affection, attacking that portion of the mucous membrane lining the

windpipe and bronchial tubes, and from the effect of which a false or

loose membrane is formed along the windpipe, resembling in appearance

the finger of a glove suspended in the passage, and, consequently,

terminating the life of the patient by suffocation; for, as the lower

end grows together and becomes closed, no air can enter the lungs, and

the child dies choked. All dull, fat, and heavy children are peculiarly

predisposed to this disease, and those with short necks and who make a

wheezing noise in their natural breathing. Croup is always sudden in its

attack, and rapid in its career, usually proving fatal within three

days; most frequently commences in the night, and generally attacking

children between the ages of three and ten years. Mothers should,

therefore, be on their guard who have children predisposed to this

disease, and immediately resort to the means hereafter advised.

2569. _Symptoms_.--Languor and restlessness, hoarseness, wheezing, and

short, dry cough, with occasional rattling in the throat during sleep,

the child often plucking at its throat with its fingers; difficulty of

breathing, which quickly becomes hard and laboured, causing great

anxiety of the countenance, and the veins of the neck to swell and

become knotted; the voice in speaking acquires a sharp, crowing, or

croupy sound, while the inspirations have a harsh, metallic intonation.

After a few hours, a quantity of thick, ropy mucus is thrown out,

hanging about the mouth, and causing suffocating fits of coughing to

expel.

2570. Treatment.--Place the child immediately in a hot bath up to the

throat; and, on removal from the water, give an emetic of the antimonial

or ipecacuanha wine, and, when the vomiting has subsided, lay a long

blister down the front of the throat, and administer one of the

following powders every twenty minutes to a child from three to six

years of age.

2571. Take of calomel, 12 grains; tartar emetic, 2 grains; lump sugar,

30 grains. Mix accurately, and divide into 12 powders. For a child from

six to twelve years, divide into 6 powders, and give one every

half-hour.

2572. Should the symptoms remain unabated after a few hours, apply one

or two leeches to the throat, and put mustard poultices to the foot and

thighs, retaining them about eight minutes; and, in extreme cases, a

mustard poultice to the spine between the shoulders, and at the same

time rub mercurial ointment into the armpits and the angles of the jaws.

2573. Such is a vigorous and reliable system of treatment in severe

cases of croup; but, in the milder and more general form, the following

abridgment will, in all probability, be all that will be

required:--First, the hot bath; second, the emetic; third, a mustard

plaster round the throat for five minutes; fourth, the powders; fifth,

another emetic in six hours, if needed, and the powders continued

without intermission while the urgency of the symptoms continues. When

relief has been obtained, these are to be discontinued, and a dose of

senna tea given to act on the bowels.

Diarrhoea.

2574. The diarrhoea with which children are so frequently affected,

especially in infancy, should demand the nurse's immediate attention,

and when the secretion, from its clayey colour, indicates an absence of

bile, a powder composed of 3 grains of grey powder and 1 grain of

rhubarb, should be given twice, with an interval of four hours between

each dose, to a child from one to two years, and, a day or two

afterwards, an aperient powder containing the same ingredients and

quantities, with the addition of 2 or 3 grains of scammony. For the

relaxation consequent on an overloaded stomach, or acidity in the

bowels, a little magnesia dissolved in milk should be employed two or

three times a day.

2575. When much griping and pain attend the diarrhoea, half a

teaspoonful of Dalby's Carminative (the best of all patent medicines)

should be given, either with or without a small quantity of castor oil

to carry off the exciting cause.

2576. For any form of diarrhoea that, by excessive action, demands a

speedy correction, the most efficacious remedy that can be employed in

all ages and conditions of childhood is the tincture of Kino, of which

from 10 to 30 drops, mixed with a little sugar and water in a spoon, are

to be given every two or three hours till the undue action has been

checked. Often the change of diet to rice, milk, eggs, or the

substitution of animal for vegetable food, or _vice versa_, will correct

an unpleasant and almost chronic state of diarrhoea.

2577. A very excellent carminative powder for flatulent infants may be

kept in the house, and employed with advantage, whenever the child is in

pain or griped, by dropping 5 grains of oil of aniseed and 2 of

peppermint on half an ounce of lump sugar, and rubbing it in a mortar,

with a drachm of magnesia, into a fine powder. A small quantity of this

may be given in a little water at any time, and always with benefit.

THE DOCTOR.