a medical man, and he will supply you with a well-fitting truss,
_which will eventually cure him_. If the truss be properly made
(under the direction of an experienced surgeon) by a skillful
surgical-instrument-maker, a beautiful, nicely fitting truss will be
supplied, which will take the proper and exact curve of the lower
part of the infant’s belly, and will thus keep on without using any
under-strap whatever—a great desideratum, as these under-straps are
so constantly wetted and soiled as to endanger the patient
constantly catching cold. But if this under-strap is to be
superseded, the truss must be made exactly to fit the child—to fit
him like a ribbon; which is a difficult thing to accomplish, unless
it be fashioned by a skillful workman. It is only lately that these
trusses have been made without under-straps. Formerly the
under-straps were indispensable necessaries.
These groin ruptures require great attention and supervision, as the
rupture (the bowel) must, before putting on the truss, be cautiously and
thoroughly returned into the belly; and much care should be used to
prevent the chafing and galling of the tender skin of the babe, which an
ill-fitting truss would be sure to occasion. But if care and skill be
bestowed on the case, a perfect cure might in due time be insured. The
truss must not be discontinued until a _perfect_ cure be effected.
Let me strongly urge you to see that my advice is carried out to the
very letter, as a groin rupture can only be _cured_ in infancy and in
childhood. If it be allowed to run on, unattended to, until adult age,
he will be obliged to wear a truss _all his life_, which would be a
great annoyance and a perpetual irritation to him.
CLOTHING.
21. _Is it necessary to have a flannel cap in readiness to put on as
soon as a babe is born?_
Sir Charles Locock considers that a flannel cap is _not_ necessary, and
asserts that all his best nurses have long discarded flannel caps. Sir
Charles states that since the discontinuance of flannel caps infants
have not been more liable to inflammation of the eyes.
Such authority is, in my opinion, conclusive. My advice, therefore, to
you is, by all means discontinue the use of flannel caps.
22. _What kind of belly-band do you recommend—a flannel or a calico
one?_
I prefer flannel, for two reasons—first, on account of its keeping the
child’s bowels comfortably warm; and, secondly, because of its not
chilling him (and thus endangering cold, etc.) when he wets himself. The
belly-band ought to be moderately but not tightly applied, as, if
tightly applied, it would interfere with the necessary movement of the
bowels.
23. _When should the belly-band be discontinued?_
When the child is two or three months old. The best way of leaving it
off is to tear a strip off daily for a few mornings, and then to leave
it off altogether. “Nurses who take charge of an infant when the monthly
nurse leaves are frequently in the habit of at once leaving off the
belly-band, which often leads to ruptures when the child cries or
strains. It is far wiser to retain it too long than too short a time;
and when a child catches hooping-cough while still very young, it is
safer to resume the belly-band.”[140]
24. _Have you any remarks to make on the clothing of an infant?_
A baby’s clothing ought to be light, warm, loose, and free from pins.
(1.) _It should be light_, without being too airy. Many infants’ clothes
are both too long and too cumbersome. It is really painful to see how
some poor little babies are weighed down with a weight of clothes. They
may be said to “bear the burden,” and that a heavy one, from the very
commencement of their lives! How absurd, too, the practice of making
them wear _long_ clothes. Clothes to cover a child’s feet, and even a
little beyond, may be desirable; but for clothes, when the infant is
carried about, to reach to the ground, is foolish and cruel in the
extreme. I have seen a delicate baby almost ready to faint under the
infliction. (2.) _It should be warm_, without being too warm. The parts
that ought to be kept warm are the chest, the bowels, and the feet. If
the infant be delicate, especially if he be subject to inflammation of
the lungs, he ought to wear a fine flannel, instead of his usual shirts,
which should be changed as frequently. (3.) _The dress should be loose_,
so as to prevent any pressure upon the blood-vessels, which would
otherwise impede the circulation, and thus hinder a proper development
of the parts. It ought to be loose about the chest and waist, so that
the lungs and the heart may have free play. It should be loose about the
stomach, so that digestion may not be impeded; it ought to be loose
about the bowels, in order that the spiral motion of the intestines may
not be interfered with; hence the importance of putting on a belly-band
moderately slack; it should be loose about the sleeves, so that the
blood may course, without let or hindrance, through the arteries and
veins; it ought to be loose, then, everywhere, for nature delights in
freedom from restraint, and will resent, sooner or later, any
interference. Oh that a mother would take common sense, and not custom,
as her guide! (4.) _As few pins_ should be used in the dressing of a
baby as possible. Inattention to this advice has caused many a little
sufferer to be thrown into convulsions.
The generality of mothers use no pins in the dressing of their children;
they tack with a needle and thread every part that requires fastening.
They do not even use pins to fasten the baby’s napkins. They make the
diapers with loops and tapes, and thus altogether supersede the use of
pins in the dressing of an infant. The plan is a good one, takes very
little extra time, and deserves to be universally adopted. If pins be
used for the napkins, they ought to be the Patent Safety Pins.
25. _Is there any necessity for a nurse being particular in airing an
infant’s clothes before they are put on? If she were less particular,
would it not make him more hardy?_
A nurse cannot be too particular on this head. A baby’s clothes ought to
be well aired the day before they are put on, as they should _not_ be
put on warm from the fire. It is well, where it can be done, to let him
have clean clothes daily. Where this cannot be afforded, the clothes, as
soon as they are taken off at night, ought to be well aired so as to
free them from the perspiration, and that they may be ready to put on
the following morning. It is truly nonsensical to endeavor to harden a
child, or any one else, by putting on damp clothes!
26. _What is your opinion of caps for an infant?_
The head ought to be kept cool; caps, therefore, are unnecessary. If
caps be used at all, they should only be worn for the first month in
summer, or for the first two or three months in winter. If a babe take
to caps, it requires care in leaving them off, or he will catch cold.
When you are about discontinuing them, put a thinner and a thinner one
on, every time they are changed, until you leave them off altogether.
But remember, my opinion is, that a child is better _without_ caps; they
only heat his head, cause undue perspiration, and thus make him more
liable to catch cold.
If a babe does not wear a cap in the day, it is not at all necessary
that he should wear one at night. He will sleep more comfortably without
one, and it will be better for his health. Moreover, night-caps injure
both the thickness and the beauty of the hair.
27. _Have you any remarks to make on the clothing of an infant, when, in
the winter time, he is sent out for exercise?_
Be sure that he is well wrapped up. He ought to have under his cloak a
knitted worsted spencer, which should button behind; and if the weather
be very cold, a shawl over all; and, provided it be dry above, and the
wind be not in the east or in the northeast, he may then brave the
weather. He will then come from his walk refreshed and strengthened, for
cold air is an invigorating tonic. In a subsequent conversation I will
indicate the proper age at which a child should be first sent out to
take exercise in the open air.
28. _At what age ought an infant “to be shortened?”_
This, of course, will depend upon the season. In the summer, the right
time “for shortening a babe,” as it is called, is at the end of two
months; in the winter, at the end of three months. But if the right time
for “shortening” a child should happen to be in the spring, let it be
deferred until the end of May. The English springs are very trying and
treacherous; and sometimes, in April, the weather is almost as cold, and
the wind as biting, as in winter. It is treacherous, for the sun is hot,
and the wind, which is at this time of the year frequently easterly, is
keen and cutting. I should far prefer “to shorten” a child in the winter
than in the early spring.
DIET.
29. _Are you an advocate for putting a baby to the breast soon after
birth, or for waiting, as many do, until the third day?_
The infant ought to be put to the breast soon after birth; the interest,
both of the mother and of the child, demands it. It will be advisable to
wait three or four hours, that the mother may recover from her fatigue;
and then the babe must be put to the breast. If this be done, he will
generally take the nipple with avidity.
It might be said that at so early a period there is no milk in the
breast; but such is not usually the case. There generally is a _little_
from the very beginning; which acts on the baby’s bowels like a dose of
purgative medicine, and appears to be intended by nature to cleanse the
system. But, provided there be no milk at first, the very act of sucking
not only gives the child a notion, but, at the same time, causes a
draught (as it is usually called) in the breast, and enables the milk to
flow easily.
Of course, if there be _no_ milk in the breast—the babe having been
applied once or twice to determine the fact—then you must wait for a few
hours before applying him again to the nipple, that is to say, until the
milk be secreted.
An infant who, for two or three days, is kept from the breast, and who
is fed upon gruel, generally becomes feeble, and frequently, at the end
of that time, will not take the nipple at all. Besides, there is a thick
cream (similar to the biestings of a cow), which, if not drawn out by
the child, may cause inflammation and gathering of the bosom, and,
consequently, great suffering to the mother. Moreover, placing him
_early_ to the breast moderates the severity of the mother’s after
pains, and lessens the risk of her flooding. A new-born babe must _not_
have gruel given to him; as it disorders the bowels, causes a
disinclination to suck, and thus makes him feeble.
30. _If an infant show any disinclination to suck, or if he appear
unable to apply his tongue to the nipple, what ought to be done?_
Immediately call the attention of the medical man to the fact, in order
that he may ascertain whether he be tongue-tied. If he be, the simple
operation of dividing the bridle of the tongue will remedy the defect,
and will cause him to take the nipple with ease and comfort.
31. _Provided there be no milk_ AT FIRST; _what ought then to be done?_
Wait with patience: the child (if the mother has no milk) will not, for
at least twelve hours, require artificial food. In the generality of
instances, then, artificial food is not at all necessary; but if it
should be needed, one-third of new milk and two-thirds of warm water,
slightly sweetened with loaf sugar (or with brown sugar, if the babe’s
bowels have not been opened), should be given, in small quantities at a
time, every four hours, until the milk be secreted, and then it must be
discontinued. The infant ought to be put to the nipple every four hours,
but not oftener, until he be able to find nourishment.
If, after the application of the child for a few times, he is unable to
find nourishment, then it will be necessary to wait until the milk be
secreted. As soon as it is secreted, he must be applied, with great
regularity, _alternately_ to each breast.
I say _alternately_ to each breast. _This is most important advice._
Sometimes a child, for some inexplicable reason, prefers one breast to
the other, and the mother, to save a little contention, concedes the
point, and allows him to have his own way. And what is frequently the
consequence?—a gathered breast!
We frequently hear of a babe having no notion of sucking. This “no
notion” may generally be traced to bad management, to stuffing him with
food, and thus giving him a disinclination to take the nipple at all.
32. _How often should a mother suckle her infant?_
A mother generally suckles her baby too often, having him almost
constantly at the breast. This practice is injurious both to parent and
to child. The stomach requires repose as much as any other part of the
body; and how can it have it if it be constantly loaded with
breast-milk? For the first month, he ought to be suckled about every
hour and a half; for the second month, every two hours,—gradually
increasing, as he becomes older, the distance of time between, until at
length he has it about every four hours.
If a baby were suckled at stated periods, he would only look for the
bosom at those times, and be satisfied. A mother is frequently in the
habit of giving the child the breast every time he cries, regardless of
the cause. The cause too frequently is, that he has been too often
suckled—his stomach has been overloaded; the little fellow is constantly
in pain, and he gives utterance to it by cries. How absurd is such a
practice! We may as well endeavor to put out a fire by feeding it with
fuel. An infant ought to be accustomed to regularity in every thing—in
times for suckling, for sleeping, etc. No children thrive so well as
those who are thus early taught.
33. _Where the mother is_ MODERATELY _strong, do you advise that the
infant should have any other food than the breast?_
Artificial food must not, for the first three or four months, be given,
if the parent be _moderately_ strong; of course, if she be feeble, a
_little_ food will be necessary. Many delicate women enjoy better health
while suckling than at any other period of their lives.
34. _What food is the best substitute for a mother’s milk?_
The food that suits one infant will not agree with another. (1.) The one
that I have found the most generally useful, is made as follows: Boil
the crumb of bread for two hours in water, taking particular care that
it does not burn; then add only a _little_ lump sugar (or _brown_ sugar,
if the bowels be costive), to make it palatable. When he is five or six
months old, mix a little new milk—the milk of ONE cow—with it,
gradually, as he becomes older, increasing the quantity until it be
nearly all milk, there being only enough water to boil the bread; the
milk should be poured boiling hot on the bread. Sometimes the two
milks—the mother’s and the cow’s milk—do not agree; when such is the
case, let the milk be left out, both in this and in the foods following,
and let the food be made with water instead of with milk and water. In
other respects, until the child is weaned, let it be made as above
directed; when he is weaned, good fresh cow’s milk MUST, as previously
recommended, be used. (2.) Or, cut thin slices of bread into a basin,
cover the bread with _cold_ water, place it in an oven for two hours to
bake; take it out, beat the bread up with a fork, and then slightly
sweeten it. This is an excellent food. (3.) If the above should not
agree with the infant (although, if properly made, they almost
invariably do), “tous-les-mois”[141] may be given. (4.) Or, Robb’s
Biscuit, as it is “among the best bread compounds made out of
wheat-flour, and is almost always readily digested.”—_Routh._
(5.) Another good food is the following: Take about a pound of flour,
put it in a cloth, tie it up tightly, place it in a saucepanful of
water, and let it boil for four or five hours; then take it out, peel
off the outer rind, and the inside will be found quite dry, which grate.
(6.) Another way of preparing an infant’s food, is to bake flour—biscuit
flour—in a slow oven, until it be of a light fawn color. (7.) An
excellent food for a baby, is baked crumbs of bread. The manner of
preparing it is as follows: Crumb some bread on a plate; put it a little
distance from the fire to dry. When dry, rub the crumbs in a mortar, and
reduce them to a fine powder; then pass them through a sieve. Having
done which, put the crumbs of bread into a slow oven, and let them bake
until they be of a light fawn color. A small quantity either of the
boiled, or of the baked flour, or of the baked crumb of bread, ought to
be made into food in the same way as gruel is made, and should then be
slightly sweetened, according to the state of the bowels, either with
lump or with brown sugar.
(8.) Baked flour sometimes produces constipation; when such is the case,
Mr. Appleton of Budleigh Salterton, Devon, wisely recommends a mixture
of baked flour and prepared oatmeal,[142] in the proportion of two of
the former and one of the latter. He says: “To avoid the constipating
effects, I have always had mixed, before baking, one part of prepared
oatmeal with two parts of flour; this compound I have found both
nourishing, and regulating to the bowels. One tablespoonful of it, mixed
with a quarter of a pint of milk, or milk and water, when well boiled,
flavored, and sweetened with white sugar, produces a thick, nourishing,
and delicious food for infants or invalids.” He goes on to remark: “I
know of no food, after repeated trials, that can be so strongly
recommended by the profession to all mothers in the rearing of their
infants, without or with the aid of the breast, at the same time
relieving them of much draining and dragging while nursing with an
insufficiency of milk, as baked flour and oatmeal.”[143]
(9.) A ninth food may be made with “Farinaceous Food for Infants,
prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces
costiveness—as it sometimes does—let it be mixed either with equal parts
or with one-third of Robertson’s Patent Groats. The mixture of the two
together makes a splendid food for a baby. (10.) A tenth, and an
excellent one, may be made with rusks, boiled for an hour in water,
which ought then to be well beaten up by means of a fork, and slightly
sweetened with lump sugar. Great care should be taken to select good
rusks, as few articles vary so much in quality. (11.) An eleventh is—the
top crust of a baker’s loaf, boiled for an hour in water, and then
moderately sweetened with lump sugar. If, at any time, the child’s
bowels should be costive, _raw_ must be substituted for _lump_ sugar.
(12.) Another capital food for an infant, is that made by Lemann’s
Biscuit Powder. (13.) Or, Brown and Polson’s Patent Corn Flour will be
found suitable. The Queen’s cook, in his recent valuable work,[144]
gives the following formula for making it: “To one dessertspoonful of
Brown & Polson, mixed with a wineglassful of cold water, add half a pint
of boiling water; stir over the fire for five minutes; sweeten lightly,
and feed the baby; but if the infant is being brought up by the hand,
this food should then be mixed with milk—not otherwise.”
(14.) The following is a good and nourishing food for a baby: Soak, for
an hour, some _best_ rice in cold water; strain, and add fresh water to
the rice; then let it simmer till it will pulp through a sieve; put the
pulp and the water in a saucepan, with a lump or two of sugar, and again
let it simmer for a quarter of an hour; a portion of this should be
mixed with one-third of fresh milk, so as to make it of the consistence
of good cream.
When the baby is five or six months old, new milk should be added to any
of the above articles of food, in a similar way to that recommended for
boiled bread.
(15.) For a delicate infant, lentil powder, better known as Du Barry’s
“Revalenta Arabica,” is invaluable. It ought to be made into food, with
new milk, in the same way that arrow-root is made, and should be
moderately sweetened with loaf sugar. Whatever food is selected ought to
be given by means of a nursing-bottle.
If a child’s bowels be relaxed and weak, or if the motions be offensive,
the milk _must_ be boiled. The following (16.) is a good food when an
infant’s bowels are weak and relaxed: “Into five large spoonfuls of the
purest water rub smooth one dessertspoonful of fine flour. Set over the
fire five spoonfuls of new milk, and put two bits of sugar into it; the
moment it boils, pour it into the flour and water, and stir it over a
slow fire twenty minutes.”
Where there is much emaciation, I have found (17.) genuine arrow-root a
very valuable article of food for an infant, as it contains a great deal
of starch, which starch helps to form fat and to evolve caloric
(heat)—both of which a poor, emaciated, chilly child stands so much in
need of. It must be made with good fresh milk, and ought to be slightly
sweetened with loaf sugar; a small pinch of table salt should be added
to it.
I have given you a large and well-tried infant’s dietary to choose from,
as it is sometimes difficult to fix on one that will suit; but remember,
if you find one of the above to agree, keep to it, as a baby requires a
simplicity in food—a child a greater variety.
Let me, in this place, insist upon the necessity of great care and
attention being observed in the preparation of any of the above articles
of diet. A babe’s stomach is very delicate, and will revolt at either
ill-made, or lumpy, or burnt food. Great care ought to be observed as to
the cleanliness of the cooking utensils. The above directions require
the strict supervision of the mother.
Broths have been recommended, but, for my own part, I think that, for a
_young_ infant, they are objectionable; they are apt to turn acid on the
stomach, and to cause flatulence and sickness; they sometimes disorder
the bowels and induce griping and purging.
Whatever artificial food is used ought to be given by means of a bottle,
not only as it is a more natural way than any other of feeding a baby,
as it causes him to suck as though he were drawing it from the mother’s
breast, but as the act of sucking causes the salivary glands to press
out their contents, which materially assists digestion. Moreover, it
seems to satisfy and comfort him more than it otherwise would do.
The food ought to be of the consistence of good cream, and should be
made fresh and fresh. It ought to be given milk-warm. Attention must be
paid to the cleanliness of the vessel, and care should be taken that the
milk be that of ONE cow,[145] and that it be new and of good quality;
for if not, it will turn acid and sour, and disorder the stomach, and
will thus cause either flatulence or looseness of the bowels, or perhaps
convulsions.
The only way to be sure of having it from _one_ cow, is (if you have not
a cow of your own) to have the milk from a _respectable_ cow-keeper, and
to have it brought to your house in a can of your own (the London
milk-cans being the best for the purpose). The better plan is to have
two cans, and to have the milk fresh and fresh every night and morning.
The cans, after each time of using, ought to be scalded out; and, once a
week, the can should be filled with _cold_ water, and the water should
be allowed to remain in it until the can be again required.
Very little sugar should be used in the food, as much sugar weakens the
digestion. A small pinch of table salt ought to be added to whatever
food is given, as “the best savor is salt.” Salt is most wholesome—it
strengthens and assists digestion, prevents the formation of worms, and,
in small quantities, may with advantage be given (if artificial food be
used) to the youngest baby.
35. _Where it is found to be absolutely necessary to give an infant
artificial food_ WHILE SUCKLING, _how often ought he to be fed?_
Not oftener than twice during the twenty-four hours, and then only in
_small_ quantities at a time, as the stomach requires rest, and at the
same time can manage to digest a little food better than it can a great
deal.
Let me again urge upon you the importance, if it be at all practicable,
of keeping the child _entirely_ to the breast for the first three or
four months of his existence. Remember there is no _real_ substitute for
a mother’s milk; there is no food so well adapted to his stomach; there
is no diet equal to it in developing muscle, in making bone, or in
producing that beautiful plump rounded contour of the limbs; there is
nothing like a mother’s milk _alone_ in making a child contented and
happy, in laying the foundation of a healthy constitution, in preparing
the body for a long life, in giving him tone to resist disease, or in
causing him to cut his teeth easily and well; in short, _the mother’s
milk is the greatest temporal blessing an infant can possess_.
As a general rule, therefore, when the child and the mother are
tolerably strong, he is better _without artificial_ food until he has
attained the age of three or four months; then, it will usually be
necessary to feed him twice a day, so as gradually to prepare him to be
weaned (if possible) at the end of nine months. The food mentioned in
the foregoing conversation will be the best for him, commencing
_without_ the cow’s milk, but gradually adding it, as less mother’s milk
and more artificial food be given.
36. _When the mother is not able to suckle her infant herself, what
ought to be done?_
It must first be ascertained, _beyond all doubt_, that a mother is not
able to suckle her own child. Many delicate ladies do suckle their
infants with advantage, not only to their offspring, but to themselves.
“I will maintain,” says Steele, “that the mother grows stronger by it,
and will have her health better than she would have otherwise. She will
find it the greatest cure and preservative for the vapors [nervousness]
and future miscarriages, much beyond any other remedy whatsoever. Her
children will be like giants, whereas otherwise they are but living
shadows, and like unripe fruit; and certainly if a woman is strong
enough to bring forth a child, she is beyond all doubt strong enough to
nurse it afterward.”
Many mothers are never so well as when they are nursing; besides,
suckling prevents a lady from becoming pregnant so frequently as she
otherwise would. This, if she be delicate, is an important
consideration, and more especially if she be subject to miscarry. The
effects of a miscarriage are far more weakening than those of suckling.
A hireling, let her be ever so well inclined, can never have the
affection and unceasing assiduity of a mother, and, therefore, cannot
perform the duties of suckling with equal advantage to the baby.
The number of children who die under five years of age is enormous—many
of them from the want of the mother’s milk. There is a regular “parental
baby-slaughter”—“a massacre of the innocents”—constantly going on in
England, in consequence of infants being thus deprived of their proper
nutriment and just dues! The mortality from this cause is frightful,
chiefly occurring among rich people who are either too grand, or, from
luxury, too delicate, to perform such duties: poor married women, as a
rule, nurse their own children, and, in consequence, reap their reward.
If it be ascertained, _past all doubt_, that a mother cannot suckle her
child, then, if the circumstances of the parents will allow—and they
ought to strain a point to accomplish it—a healthy wet-nurse should be
procured, as, of course, the food which nature has supplied is far, very
far superior to any invented by art.
Never bring up a baby, then, if you can possibly avoid it, on
_artificial_ food. Remember, as I proved in a former conversation, there
is in early infancy no _real_ substitute for either a mother’s or a
wet-nurse’s milk. It is impossible to imitate the admirable and subtle
chemistry of nature. The law of nature is, that a baby, for the first
few months of his existence, shall be brought up by the breast; and
nature’s law cannot be broken with impunity.[146] It will be
imperatively necessary, then—
“To give to nature what is nature’s due.”[147]
Again, in case of a severe illness occurring during the first nine
months of a child’s life, what a comfort either the mother’s or the
wet-nurse’s milk is to him! it often determines whether he shall live or
die.
But if a wet-nurse cannot fill the place of a mother, then, asses’ milk
will be found the best substitute, as it approaches nearer, in
composition, than any other animal’s, to human milk; but it is both
difficult and expensive to obtain. The next best substitute is goats’
milk. Either the one or the other ought to be milked fresh and fresh, as
it is wanted, and should be given by means of a feeding-bottle.
Asses’ milk is more suitable for _delicate_ infants, and goats’ milk for
those who are _strong_.
If neither asses’ milk nor goats’ milk can be procured, then the
following from the very commencement should be given:
New milk, the produce of ONE _healthy_ cow,
Warm water, of each, equal parts;
Table salt,[148] a few grains;
Lump sugar, a sufficient quantity to slightly sweeten it.
The milk itself ought not to be heated over the fire,[149] but should,
as above directed, be warmed by the water; it must, morning and evening,
be had fresh and fresh. The milk and water should be of the same
temperature as the mother’s milk, that is to say, at about ninety to
ninety-five degrees Fahrenheit. It ought to be given by means of a
feeding-bottle, and care must be taken to _scald_ the bottle out twice a
day, for if attention be not paid to this point the delicate stomach of
an infant is soon disordered. As he grows older the milk should be
gradually increased, and the water decreased, until nearly all milk be
given.
There will, in many cases, be quite sufficient nourishment in the above;
I have known some robust infants brought up on it alone. But if it
should not agree with the child, or if there should not be sufficient
nourishment in it, then the food recommended in answer to No. 34
question ought to be given, with this only difference—a little new milk
_must_ from the beginning be added, and should be gradually increased,
until nearly all milk be used.
The milk, as a general rule, ought to be _unboiled_; but if it purge
violently, or if it cause offensive motions—which it sometimes does—then
it must be boiled. The moment the milk boils up it should be taken off
the fire.
Food ought, for the first month, to be given about every two hours; for
the second month, about every three hours; lengthening the space of time
as the baby advances in age. A mother must be careful not to over-feed a
child, as over-feeding is a prolific source of disease.
Let it be thoroughly understood, and let there be no mistake about it,
that a babe, during the first nine months of his life, MUST have—it is
absolutely necessary for his very existence—milk of some kind, as the
staple and principal article of his diet, either mother’s, or
wet-nurse’s, or asses’, or goat’s, or cow’s own milk.
37. _How would you choose a wet-nurse?_
I would inquire particularly into the state of her health; whether she
be of a healthy family, of a consumptive habit, or if she or any of her
family have labored under “king’s evil;” ascertaining if there be any
seams or swellings about her neck; any eruptions or blotches upon her
skin; if she has a plentiful breast of milk, and if it be of good
quality[150] (which may readily be ascertained by milking a little into
a glass); if she has good nipples, sufficiently long for the baby to
hold; that they be not sore; and if her own child be of the same or
nearly of the same age as the one you wish her to nurse. Ascertain
whether she menstruates during suckling; if she does, the milk is not so
good and nourishing, and you had better decline taking her.[151] Assure
yourself that her own babe is strong and healthy, and that he is free
from a sore mouth and from a “breaking-out” of the skin. Indeed, if it
be possible to procure such a wet-nurse, she ought to be from the
country, of ruddy complexion, of clear skin, and of between twenty and
five and twenty years of age, as the milk will then be fresh, pure, and
nourishing.
I consider it to be of great importance that the infant of the wet-nurse
should be, as nearly as possible, of the same age as your own, as the
milk varies in quality according to the age of the child. For instance,
during the commencement of suckling, the milk is thick and creamy,
similar to the biestings of a cow, which, if given to a babe of a few
months old, would cause derangement of the stomach and bowels. After the
first few days, the appearance of the milk changes; it becomes of a
bluish-white color, and contains less nourishment. The milk gradually
becomes more and more nourishing as the infant becomes older and
requires more support.
In selecting a wet-nurse for a very small and feeble babe, you must
carefully ascertain that the nipples of the wet-nurse are good and soft,
and yet not very large: if they be very large, the child’s mouth being
very small, he may not be able to hold them. You must note, too, whether
the milk flows readily from the nipple into the child’s mouth; if it
does not, he may not have strength to draw it, and he would soon die of
starvation. The only way of ascertaining whether the infant actually
draws the milk from the nipple, can be done by examining the mouth of
the child _immediately_ after his taking the breast, and seeing for
yourself whether there be actually milk in his mouth.
Very feeble new-born babes sometimes cannot take the bosom, be the
nipples and the breasts ever so good. In such a case, cow’s milk and
water, sugar and salt, as recommended at page 46, must be given in small
quantities at a time—from two to four teaspoonfuls—but frequently; if
the child be awake, every hour or every half hour, both night and day,
until he be able to take the breast. If, then, a puny, feeble babe is
only able to take but little at a time, and that little by teaspoonfuls,
he must have little and often, in order that “many a little might make a
mickle.”
I have known many puny, delicate children who had not strength to hold
the nipple in their mouths, but who could take milk and water (as above
recommended) by teaspoonfuls only at a time, with steady perseverance,
and giving it every half hour or hour (according to the quantity
swallowed), at length be able to take the breast, and eventually become
strong and hearty children; but such cases require unwearied watching,
perseverance, and care. Bear in mind, then, that the smaller the
quantity of the milk and water given at a time, the oftener must it be
administered, as, of course, the babe must have a certain quantity of
food to sustain life.
38. _What ought to be the diet either of a wet-nurse, or of a mother who
is suckling?_
It is a common practice to cram a wet-nurse with food, and to give her
strong ale to drink, to make good nourishment and plentiful milk! This
practice is absurd; for it either, by making the nurse feverish, makes
the milk more sparing than usual, or it causes the milk to be gross and
unwholesome. On the other hand, we must not run into an opposite
extreme. The mother, or the wet-nurse, by using those means most
conducive to her own health, will best advance the interest of her
little charge.
A wet-nurse ought to live somewhat in the following way: Let her for
breakfast have black tea, with one or two slices of cold meat, if her
appetite demand it, but not otherwise. It is customary for a wet-nurse
to make a hearty luncheon; of this I do not approve. If she feel either
faint or low at eleven o’clock, let her have either a tumbler of porter,
or of mild fresh ale, with a piece of dry toast soaked in it. She ought
not to dine later than half past one or two o’clock; she should eat, for
dinner, either mutton or beef, with either mealy potatoes, or asparagus,
or French beans, or secale, or turnips, or brocoli, or cauliflower, and
stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted
meats, greens, and cabbage must one and all be carefully avoided, as
they only tend to disorder the stomach, and thus to deteriorate the
milk.
It is a common remark, that “a mother who is suckling may eat anything.”
I do not agree with this opinion. Can impure or improper food make pure
and proper milk, or can impure or improper milk make good blood for an
infant, and thus good health?
The wet-nurse ought to take with her dinner a moderate quantity of
either sound porter, or of mild (but not old or strong) ale. Tea should
be taken at half past five or six o’clock; supper at nine, which should
consist either of a slice or two of cold meat, or of cheese if she
prefer it, with half a pint of porter or of mild ale; occasionally, a
basin of gruel may with advantage be substituted. Hot and late suppers
are prejudicial to the mother or to the wet-nurse, and, consequently, to
the child. The wet-nurse ought to be in bed every night by ten o’clock.
It might be said that I have been too minute and particular in my rules
for a wet-nurse; but when it is considered of what importance good milk
is to the well-doing of an infant, in making him strong and robust, not
only now, but as he grows up to manhood, I shall, I trust, be excused
for my prolixity.
39. _Have you any more hints to offer with regard to the management of a
wet-nurse?_
A wet-nurse is frequently allowed to remain in bed until a late hour in
the morning, and during the day to continue in the house, as if she were
a fixture! How is it possible that any one, under such treatment, can
continue healthy?
A wet-nurse ought to rise early, and, if the weather and season will
permit, take a walk, which will give her an appetite for breakfast and
will make a good meal for her little charge. This, of course, cannot,
during the winter months, be done; but even then, she ought, some part
of the day, to take every opportunity of walking out; indeed, in the
summer time she should live half the day in the open air.
She ought strictly to avoid crowded rooms; her mind should be kept calm
and unruffled, as nothing disorders the milk so much as passion and
other violent emotions of the mind; a fretful temper is very injurious,
on which account you should, in choosing your wet-nurse, endeavor to
procure one of a mild, calm, and placid disposition.[152]
A wet-nurse ought never to be allowed to dose her little charge either
with Godfrey’s Cordial, or with Dalby’s Carminative, or with Syrup of
White Poppies, or with medicine of any kind whatever. Let her thoroughly
understand this, and let there be no mistake in the matter. Do not, for
one moment, allow your children’s health to be tampered and trifled
with. A baby’s health is too precious to be doctored, to be experimented
upon, and to be ruined by an ignorant person.
40. _Have the goodness to state at what age a child ought to be weaned?_
This, of course, must depend both upon the strength of the child and
upon the health of the parent; on an average, nine months is the proper
time. If the mother be delicate it may be found necessary to wean the
infant at six months; or if he be weak, or laboring under any disease,
it may be well to continue suckling him for twelve months; but after
that time the breast will do him more harm than good, and will,
moreover, injure the mother’s health, and may, if she be so predisposed,
excite consumption.
41. _How would you recommend a mother to act when she weans her child?_
She ought, as the word signifies, do it gradually—that is to say, she
should, by degrees, give him less and less of the breast, and more and
more of artificial food; at length she must only suckle him at night;
and lastly, it would be well for the mother either to send him away, or
to leave him at home, and, for a few days, to go away herself.
A good plan is, for the nurse-maid to have a half-pint bottle of new
milk—which has been previously boiled[153]—in the bed, so as to give a
little to him in lieu of the breast. The warmth of the body will keep
the milk of a proper temperature, and will supersede the use of lamps,
of candle-frames, and other troublesome contrivances.
42. _While a mother is weaning her infant, and after she has weaned him,
what ought to be his diet?_
Any one of the foods recommended in answer to question 34, page 36.
43. _If a child be suffering severely from “wind,” is there any
objection to the addition of a small quantity either of gin or of
peppermint to his food to disperse it?_
It is a murderous practice to add either gin or peppermint of the shops
(which is oil of peppermint dissolved in spirits) to his food. Many
children have, by such a practice, been made puny and delicate, and have
gradually dropped into an untimely grave. An infant who is kept, for the
first three or four months, _entirely_ to the breast—more especially if
the mother be careful in her own diet—seldom suffers from “wind;” those,
on the contrary, who have much or improper food,[154] suffer severely.
Care in feeding, then, is the grand preventive of “wind;” but if,
notwithstanding all your precautions, the child be troubled with
flatulence, the remedies recommended under the head of Flatulence will
generally answer the purpose.
44. _Have you any remarks to make on sugar for sweetening a baby’s
food?_
A _small_ quantity of sugar in an infant’s food is requisite, sugar
being nourishing and fattening, and making cows’ milk to resemble
somewhat in its properties human milk; but, bear in mind, _it must be
used sparingly_. _Much_ sugar cloys the stomach, weakens the digestion,
produces acidity, sour belchings, and wind.
If a baby’s bowels be either regular or relaxed, _lump_ sugar is the
best for the purpose of sweetening his food; if his bowels are inclined
to be costive, _brown_ sugar ought to be substituted for lump sugar, as
_brown_ sugar acts on a young babe as an aperient, and, in the
generality of cases, is far preferable to physicking him with opening
medicine. An infant’s bowels, whenever it be practicable (and it
generally is), ought to be regulated by a judicious dietary rather than
by physic.
VACCINATION.
45. _Are you an advocate for vaccination?_
Certainly. I consider it to be one of the greatest blessings ever
conferred upon mankind. Small-pox, before vaccination was adopted,
ravaged the country like a plague, and carried off thousands annually;
and those who did escape with their lives were frequently made loathsome
and disgusting objects by it. Even inoculation (which is cutting for the
small-pox) was attended with danger—more especially to the
unprotected—as it caused the disease to spread like wildfire, and thus
it carried off immense numbers.
Vaccination is one and an important cause of our increasing population;
small-pox, in olden times, decimated the country.
46. _But vaccination does not always protect a child from small-pox?_
I grant you that it does not _always_ protect him, _neither does
inoculation_; but when he is vaccinated, if he take the infection, he is
seldom pitted, and very rarely dies, and the disease assumes a
comparatively mild form. There are a few, very few fatal cases recorded
after vaccination, and these may be considered as only exceptions to the
general rule; and, possibly some of these may be traced to the arm, when
the child was vaccinated, not having taken proper effect.
If children and adults were _revaccinated_,—say every seven years after
the first vaccination,—depend upon it, even these rare cases would not
occur, and in a short time small-pox would only be known by name.
47. _Do you consider it, then, the imperative duty of a mother in every
case to have, after the lapse of every seven years, her children
revaccinated?_
I decidedly do; it would be an excellent plan for _every_ person, once
every seven years, to be revaccinated, and even oftener, if small-pox be
rife in the neighborhood. Vaccination, however frequently performed, can
never do the slightest harm, and might do inestimable good. Small-pox is
both a pest and a disgrace, and ought to be constantly fought and
battled with until it be banished (which it may readily be) the kingdom.
I say that small-pox is a pest; it is worse than the plague, for if not
kept in subjection it is more general—sparing neither young nor old,
rich nor poor, and commits greater ravages than the plague ever did.
Small-pox is a disgrace; it is a disgrace to any civilized land, as
there is no necessity for its presence: if cow-pox were properly and
frequently performed, small-pox would be unknown. Cow-pox is a weapon to
conquer small-pox, and to drive it ignominiously from the field.
My firm belief then is, that if _every_ person were, _every seven
years_, duly and properly vaccinated, small-pox might be utterly
exterminated; but as long as there are such lax notions on the subject,
and such gross negligence, the disease will always be rampant, for the
poison of small-pox never slumbers nor sleeps, but requires the utmost
diligence to eradicate it. The great Dr. Jenner, the discoverer of cow
pox as a preventative of small-pox, strongly advocated the absolute
necessity of _every_ person being revaccinated once every seven years,
or even oftener, if there was an epidemic of small-pox in the
neighborhood.
48. _Are you not likely to catch not only the cow-pox, but any other
disease that the child has from whom the matter is taken?_
The same objection holds good in cutting for small-pox
(inoculation)—only in a tenfold degree—small-pox being such a disgusting
complaint. Inoculated small-pox frequently produced and left behind
inveterate “breakings-out,” scars, cicatrices, and indentations of the
skin, sore eyes, blindness, loss of eyelashes, scrofula,
deafness—indeed, a long catalogue of loathsome diseases. A medical man,
of course, will be careful to take the cow-pox matter from a healthy
child.
49. _Would it not be well to take the matter direct from the cow?_
If a doctor be careful—which, of course, he will be—to take the matter
from a healthy child, and from a well-formed vesicle, I consider it
better than taking it _direct_ from the cow, for the following reasons:
The cow-pox lymph, taken direct from the cow, produces much more violent
symptoms than after it has passed through several persons; indeed, in
some cases, it has produced effects as severe as cutting for the
small-pox; besides, it has caused, in many cases, violent inflammation
and even sloughing of the arm. There are also several kinds of
_spurious_ cow-pox to which the cow is subject, and which would be
likely to be mistaken for the _real_ lymph. Again, if even the _genuine_
matter were not taken from the cow _exactly_ at the proper time, it
would be deprived of its protecting power.
50. _At what age do you recommend an infant to be first vaccinated?_
When he is two months old, as the sooner he is protected the better.
Moreover, the older he is the greater will be the difficulty in making
him submit to the operation, and in preventing his arm from being
rubbed, thus endangering the breaking of the vesicles, and thereby
interfering with its effects. If small-pox be prevalent in the
neighborhood, he may, with perfect safety, be vaccinated at the month’s
end; indeed, if the small-pox be near at hand, he _must_ be vaccinated,
regardless of his age and regardless of everything else, for small-pox
spares neither the young nor the old, and if a new-born babe should
unfortunately catch the disease, he will most likely die, as at his
tender age he would not have strength to battle with such a formidable
enemy. “A case in the General Lying-in-Hospital, Lambeth, of small-pox
occurred in a woman a few days after her admission and the birth of her
child. Her own child was vaccinated when only four days old, and all the
other infants in the house, varying from one day to a fortnight and
more. All took the vaccination; and the woman’s own child, which suckled
her and slept with her; and all escaped the small-pox.”[155]
51. _Do you consider that the taking of matter from a child’s arm
weakens the effect of vaccination on the system?_
Certainly not, provided it has taken effect in more than one place. The
arm is frequently much inflamed, and vaccinating other children from it
abates the inflammation, and thus affords relief. _It is always well to
leave one vesicle undisturbed._
52. _If the infant has any “breaking-out” upon the skin, ought that to
be a reason for deferring the vaccination?_
It should, as two skin diseases cannot well go on together; hence the
cow-pox might not take, or, if it did, might not have its proper effect
in preventing small-pox. “It is essential that the vaccine bud or germ
have a congenial soil, uncontaminated by another poison, which, like a
weed, might choke its healthy growth.”[156] The moment the skin be free
from the breaking-out, he must be vaccinated. A trifling skin affection,
like red-gum, unless it be severe, ought not, at the proper age, to
prevent vaccination. If small-pox be rife in the neighborhood, the child
_must_ be vaccinated, regardless of _any_ “breaking-out” on the skin.
53. _Does vaccination make a child poorly?_
At about the fifth day after vaccination, and for three or four days, he
is generally a little feverish; the mouth is slightly hot, and he
delights to have the nipple in his mouth. He does not rest so well at
night; he is rather cross and irritable; and, sometimes, has a slight
bowel complaint. The arm, about the ninth or tenth day, is usually much
inflamed—that is to say, it is, for an inch or two or more around the
vesicles, red, hot, and swollen, and continues in this state for a day
or two, at the end of which time the inflammation gradually subsides. It
might be well to state that the above slight symptoms are desirable, as
it proves that the vaccination has had a proper effect on his system,
and that, consequently, he is more likely to be thoroughly protected
from any risk of catching small-pox.
54. _Do you approve, either during or after vaccination, of giving
medicine, more especially if he be a little feverish?_
No; as it would be likely to work off some of its effects, and thus
would rob the cow-pox of its efficacy on the system. I do not like to
interfere with vaccination _in any way whatever_ (except, at the proper
time, to take a little matter from the arm), but to allow the pock to
have full power upon his constitution.
What do you give the medicine for? If the matter that is put into the
arm be healthy, what need is there of physic? And if the matter be not
of good quality, I am quite sure that no physic will make it so! Look,
therefore, at the case in whatever way you like, physic after
vaccination is not necessary; but, on the contrary, hurtful. If the
vaccination produce a slight feverish attack, it will, without the
administration of a particle of medicine, subside in two or three days.
55. _Have you any directions to give respecting the arm_ AFTER
_vaccination?_
The only precaution necessary, is to take care that the arm be not
rubbed; otherwise the vesicles may be prematurely broken, and the
efficacy of the vaccination may be lessened. The sleeve, in vaccination,
ought to be large and soft, and should _not_ be tied up. The tying up of
a sleeve makes it hard, and is much more likely to rub the vesicles than
if it were put on in the usual way.
56. _If the arm_, AFTER _vaccination, be much inflamed, what ought to be
done?_
Smear frequently, by means of a feather or a camel’s-hair brash, a
little cream on the inflamed part. This simple remedy will afford great
relief and comfort.
57. _Have the goodness to describe the proper appearance, after the
falling off of the scab, of the arm?_
It might be well to remark that the scabs ought always to be allowed to
fall off of themselves. They must not, on any account, be picked or
meddled with. With regard to the proper appearance of the arm after the
falling off of the scab, “a perfect vaccine scar should be of small
size, circular, and marked with radiations and indentations.”[157]
DENTITION.
58. _At what time does dentition commence?_
The period at which it commences is uncertain. It may, as a rule, be
said that a babe begins to cut his teeth at seven months old. Some have
cut teeth at three months; indeed, there are instances on record of
infants having been born with teeth. King Richard the Third is said to
have been an example. Shakspeare notices it thus:
“YORK.—Marry, they say my uncle grew so fast
That he could gnaw a crust at two hours old;
’Twas full two years ere I could get a tooth.
Grandam, this would have been a biting jest.”
_Act 2, sc. 5._
When a babe is born with teeth they generally drop out. On the other
hand, teething in some children does not commence until they are a year
and a half or two years old, and, in rare cases, not until they are
three years old. There are cases recorded of adults who have never cut
any teeth. An instance of the kind came under my own observation.
Dentition has been known to occur in old age. A case is recorded by M.
Carre, in the _Gazette Médicale de Paris_ (Sept. 15, 1860), of an old
lady, aged eighty-five, who cut several teeth after attaining that age!
59. _What is the number of the_ FIRST _set of teeth, and in what order
do they generally appear?_
The first or temporary set consists of twenty. The first set of teeth
are usually cut in pairs. “I may say that nearly invariably the order
is—1st, the lower front incisors [cutting-teeth], then the upper front,
then the _upper_ two lateral incisors, and that not uncommonly a double
tooth is cut before the two _lower_ laterals; but at all events the
lower laterals come 7th and 8th, and not 5th and 6th, as nearly all
books on the subject testify”[158]. Then the first grinders in the lower
jaw, afterward the first upper grinders, then the lower corner pointed
or canine teeth, after which the upper corner or eye-teeth, then the
second grinders in the lower jaw, and lastly, the second grinders of the
upper jaw. They do not, of course, always appear in this rotation.
Nothing is more uncertain than the order of teething. A child seldom
cuts his second grinders until after he is two years old. _He is
usually, from the time they first appear, two years in cutting his first
set of teeth._ As a rule, therefore, a child of two years old has
sixteen, and one of two years and a half old, twenty teeth.
60. _If an infant be either feverish or irritable, or otherwise poorly,
and if the gums be hot, swollen, and tender, are you an advocate for
their being lanced?_
Certainly; by doing so he will, in the generality of instances, be
almost instantly relieved.
61. _But it has been stated that lancing the gums hardens them?_
This is a mistake—it has a contrary effect. It is a well-known fact that
a part which has been divided gives way much more readily than one which
has not been cut. Again, the tooth is bound down by a tight membrane,
which, if not released by lancing, frequently brings on convulsions. If
the symptoms be urgent, it may be necessary from time to time to repeat
the lancing.
It would, of course, be the height of folly to lance the gums unless
they be hot and swollen, and unless the tooth or the teeth be near at
hand. It is not to be considered a panacea for every baby’s ill,
although, in those cases where the lancing of the gums is indicated, the
beneficial effect is sometimes almost magical.
62. _How ought the lancing of a child’s gums to be performed?_
The proper person, of course, to lance his gums is a medical man. But,
if perchance you should be miles away and be out of the reach of one, it
would be well for you to know how the operation ought to be performed.
Well, then, let him lie on the nurse’s lap upon his back, and let the
nurse take hold of his hands, in order that he may not interfere with
the operation.
Then, _if it be the upper gum_ that requires lancing, you ought to go to
the head of the child, looking over, as it were, and into his mouth, and
should steady the gum with the index finger of your left hand; then you
should take hold of the gum-lancet with your right hand—holding it as if
it were a table-knife at dinner—and cut firmly along the inflamed and
swollen gum and down to the tooth, until the edge of the gum-lancet
grates on the tooth. Each incision ought to extend along the ridge of
the gum to about the extent of each expected tooth.
_If it be the lower gum_ that requires lancing, you must go to the side
of the child, and should steady the outside of the jaw with the fingers
of the left hand, and the gum with the left thumb, and then you should
perform the operation as before directed.
Although the lancing of the gums, to make it intelligible to a
non-professional person, requires a long description, it is, in point of
fact, a simple affair, is soon performed, and gives but little pain.
63. _If teething cause convulsions, what ought to be done?_
The first thing to be done (after sending for a medical man) is to
freely dash cold water upon the face, and to sponge the head with cold
water, and as soon as warm water can be procured, to put him into a warm
bath[159] of 98 degrees Fahrenheit. If a thermometer be not at
hand,[160] you must plunge your own elbow into the water: a comfortable
heat for your elbow will be the proper heat for the infant. He must
remain in the bath for a quarter of an hour, or until the fit be at an
end. The body must, after coming out of the bath, be wiped with warm and
dry and coarse towels; he ought then to be placed in a warm blanket. The
gums must be lanced, and cold water should be applied to the head. An
enema, composed of table salt, of olive oil, and warm oatmeal gruel—in
the proportion of one tablespoonful of salt, of one of oil, and a
teacupful of gruel—ought then to be administered, and should, until the
bowels have been well opened, be repeated every quarter of an hour; as
soon as he comes to himself a dose of aperient medicine ought to be
given.
64. _A nurse is in the habit of giving a child who is teething either
coral or ivory to bite—do you approve of the plan?_
I think it a bad practice to give him any hard, unyielding substance, as
it tends to harden the gums, and by so doing causes the teeth to come
through with greater difficulty. I have found softer substances, such as
either a piece of wax-taper, or an india-rubber ring, or a piece of the
best bridle-leather, or a crust of bread, of great service. If a piece
of crust be given as a gum-stick, he must, while biting it, be well
watched, or by accident he might loosen a large piece of it, which might
choke him. The pressure of any of these excites a more rapid absorption
of the gum, and thus causes the tooth to come through more easily and
quickly.
65. _Have you any objection to my baby, when he is cutting his teeth,
sucking his thumb?_
Certainly not; the thumb is the best gum-stick in the world—it is
convenient, it is handy (in every sense of the word), it is of the right
size, and of the proper consistence—neither too hard nor too soft; there
is no danger, as of some artificial gum-sticks, of its being swallowed,
and thus of its choking the child. The sucking of the thumb causes the
salivary glands to pour out their contents, and thus not only to moisten
the dry mouth, but assists the digestion; the pressure of the thumb
eases, while the teeth are “breeding,” the pain and irritation of the
gums, and helps, when the teeth are sufficiently advanced, to bring them
through the gums. Sucking of the thumb will often make a cross infant
contented and happy, and will frequently induce a restless babe to fall
into a sweet refreshing sleep. Truly may the thumb be called a baby’s
comfort. By all means, then, let your child suck his thumb whenever he
likes, and as long as he chooses to do so.
There is a charming, bewitching little picture of a babe sucking his
thumb in Kingsley’s _Water Babies_, which I cordially commend to your
favorable notice and study.
66. _But if an infant be allowed to suck his thumb, will it not be
likely to become a habit, and stick to him for years—until, indeed, he
become a big boy?_
After he has cut the whole of his first set of teeth, that is to say,
when he is about two years and a half old, he might, if it be likely to
become a habit, be readily cured by the following method, namely, by
making a paste of aloes and water and smearing it upon his thumb. One or
two dressings will suffice, as after just tasting the bitter aloes he
will take a disgust to his former enjoyment, and the habit will at once
be broken.
Many persons, I know, have an objection to children sucking their
thumbs, as, for instance,—
“Perhaps it’s as well to keep children from plums,
And from pears in the season, and sucking their thumbs.”[161]
My reply is—
P’rhaps ’tis as well to keep children from pears;
The pain they might cause is oft followed by tears;
’Tis certainly well to keep them from plums;
But certainly not from sucking their thumbs!
If a babe suck his thumb
’Tis an ease to his gum;
A comfort; a boon; a calmer of grief;
A friend in his need, affording relief;
A solace; a good; a soother of pain;
A composer to sleep; a charm; and a gain;
’Tis handy at once to his sweet mouth to glide;
When done with, drops gently down by his side;
’Tis fixed like an anchor while the babe sleeps,
And the mother with joy her still vigil keeps.
67. _A child who is teething dribbles, and thereby wets his chest, which
frequently causes him to catch cold; what had better be done?_
Have in readiness to put on several _flannel_ dribbling-bibs, so that
they may be changed as often as they become wet; or, if he dribble _very
much_, the oiled silk dribbling-bibs, instead of the flannel ones, may
be used, and which may be procured at any baby-linen warehouse.
68. _Do you approve of giving a child, during teething, much fruit?_
No; unless it be a few ripe strawberries or raspberries, or a roasted
apple, or the juice of five or six grapes—taking care that he does not
swallow either the seeds or the skin—or the insides of ripe
gooseberries, or an orange. Such fruits, if the bowels be in a costive
state, will be particularly useful.
All stone fruits, _raw_ apples, or pears ought to be carefully avoided,
as they not only disorder the stomach and the bowels—causing
convulsions, gripings, etc.—but they have the effect of weakening the
bowels, and thus of engendering worms.
69. _Is a child, during teething, more subject to disease, and if so, to
what complaints, and in what manner may they be prevented?_
The teeth are a fruitful source of suffering and of disease, and are
with truth styled “our first and our last plagues.” Dentition is the
most important period of a child’s life, and is the exciting cause of
many infantile diseases; during this period, therefore, he requires
constant and careful watching. When we consider how the teeth elongate
and enlarge in his gums, pressing on the nerves and on the surrounding
parts, and thus how frequently they produce pain, irritation, and
inflammation; when we further contemplate what sympathy there is in the
nervous system, and how susceptible the young are to pain, no surprise
can be felt at the immense disturbance and the consequent suffering and
danger frequently experienced by children while cutting their _first_
set of teeth.
The complaints or the diseases induced by dentition are numberless,
affecting almost every organ of the body,—the _brain_, occasioning
convulsions, water on the brain, etc.; the _lungs_, producing
congestion, inflammation, cough, etc.; the _stomach_, exciting sickness,
flatulence, acidity, etc.; the _bowels_, inducing griping, at one time
costiveness, and at another time purging; the _skin_, causing
“breakings-out.”
To prevent these diseases, means ought to be used to invigorate a
child’s constitution by plain, wholesome food, as recommended under the
article of diet; by exercise and fresh air;[162] by allowing him,
weather permitting, to be out of doors a great part of every day; by
lancing the gums when they get red, hot, and swollen; by attention to
the bowels, and if he suffer more than usual, by keeping them rather in
a relaxed state by any simple aperient, such as either castor oil or
magnesia and rhubarb, etc.; and, let me add, by attention to his temper.
Many children are made feverish and ill by petting and spoiling them. On
this subject I cannot do better than refer you to an excellent little
work entitled Abbott’s _Mother at Home_, wherein the author proves the
great importance of _early_ training.
70. _Have the goodness to describe the symptoms and the treatment of
Painful Dentition._
Painful dentition may be divided into two forms—(1.) the Mild; and (2.)
the Severe. In the _mild_ form the child is peevish and fretful, and
puts his fingers, and everything within reach, to his mouth; he likes to
have his gums rubbed, and takes the breast with avidity; indeed, it
seems a greater comfort to him than ever. There is generally a
considerable flow of saliva, and he has frequently a more loose state of
bowels than is his wont.
Now, with regard to the more _severe_ form of painful dentition: The
gums are red, swollen, and hot, and he cannot, without expressing pain,
bear to have them touched; hence, if he be at the breast, he is
constantly loosing the nipple. There is dryness of the mouth, although
before there had been a great flow of saliva. He is feverish, restless,
and starts in his sleep. His face is flushed. His head is heavy and hot.
He is sometimes convulsed.[163] He is frequently violently griped and
purged, and suffers severely from flatulence. He is predisposed to many
and severe diseases.
The _treatment_ of the _mild_ form consists of friction of the gums with
the finger; with a little “soothing syrup,” as recommended by Sir
Charles Locock;[164] a tepid bath of about 92 degrees Fahrenheit, every
night at bedtime; attention to diet and bowels; fresh air and exercise.
For the mild form, the above plan will usually be all that is required.
If he dribble and the bowels be relaxed, so much the better; the flow of
saliva and the increased action of the bowels afford relief, and
therefore must not be interfered with. In the _mild_ form lancing of the
gums is not desirable. The gums ought not to be lanced unless the teeth
be near at hand, and unless the gums be red, hot, and swollen.
In the _severe_ form a medical man should be consulted early, as more
energetic remedies will be demanded; that is to say, the gums will
require to be freely lanced, warm baths to be used, and medicines to be
given, to ward off mischief from the head, from the chest, and from the
stomach.
If you are living in the town and your baby suffers much from teething,
take him into the country. It is wonderful what change of air to the
country will often do, in relieving a child, who is painfully cutting
his teeth. The number of deaths in London from teething is frightful; it
is in the country comparatively trifling.
71. _Should an infant be purged during teething, or indeed, during any
other time, do you approve of either absorbent or astringent medicines
to restrain it?_
Certainly not. I should look upon the relaxation as an effort of nature
to relieve itself. A child is never purged without a cause; that cause,
in the generality of instances, is the presence of either some
undigested food, or acidity, or depraved motions that want a vent.
The better plan is, in such a case, to give a dose of aperient medicine,
such as either castor oil or magnesia and rhubarb, and thus work it off.
IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE
MISCHIEF.[165] If he be purged more than usual, attention should be paid
to the diet—if it be absolutely necessary to give him artificial food
while suckling—and care must be taken not to overload the stomach.
72. _A child is subject to a slight cough during dentition—called by
nurses “tooth-cough”—which a parent would not consider of sufficient
importance to consult a doctor about; pray tell me if there is any
objection to a mother giving her child a small quantity either of syrup
of white poppies or of paregoric to ease it?_
A cough is an effort of nature to bring up any secretion from the lining
membrane of the lungs, or from the bronchial tubes, hence it ought not
to be interfered with. I have known the administration of syrup of white
poppies, or of paregoric, to stop the cough, and thereby to prevent the
expulsion of the phlegm, and thus to produce either inflammation of the
lungs or bronchitis. Moreover, both paregoric and syrup of white poppies
are, for a young child, dangerous medicines (unless administered by a
judicious medical man), and _ought never to be given by a mother_.
In the month of April, 1844, I was sent for in great haste to an infant,
aged seventeen months, who was laboring under convulsions and extreme
drowsiness, from the injudicious administration of paregoric, which had
been given to him to ease a cough. By the prompt administration of an
emetic he was saved.
73. _A child who is teething is subject to a “breaking-out,” more
especially behind the ears—which is most disfiguring, and frequently
very annoying; what would you recommend?_
I would apply no external application to cure it, as I should look upon
it as an effort of the constitution to relieve itself; and should
expect, if the “breaking-out” were repelled, that either convulsions, or
bronchitis, or inflammation of the lungs, or water on the brain would be
the consequence.
The only plan I should adopt would be, to be more careful in his diet:
to give him less meat (if he be old enough to eat animal food), and to
give him, once or twice a week, a few doses of mild aperient medicine;
and, if the irritation from the “breaking-out” be great, to bathe it
occasionally either with a little warm milk and water, or with rose
water.
EXERCISE.
74. _Do you recommend exercise in the open air for a baby? and if so,
how soon after birth?_
I am a great advocate for having exercise in the open air. “The infant
in arms makes known its desire for fresh air by restlessness—it cries,
for it cannot speak its wants; is taken abroad, and is quiet.”
The age at which he ought to commence taking exercise will, of course,
depend upon the season and upon the weather. If it be summer, and the
weather be fine, he should be carried in the open air a week or a
fortnight after birth; but if it be winter, he ought not, on any
account, to be taken out under the month, and not even then, unless the
weather be mild for the season, and it be the middle of the day. At the
end of two months he should breathe the open air more frequently. And
after the expiration of three months he ought to be carried out _every
day_, even if it be wet under foot, provided it be fine above, and the
wind be neither in an easterly nor in a northeasterly direction; by
doing so we shall make him strong and hearty, and give the skin that
mottled appearance which is so characteristic of health. He must, of
course, be well clothed.
I cannot help expressing my disapprobation of the practice of smothering
up an infant’s face with a handkerchief, with a veil, or with any other
covering, when he is taken out into the air. If his face be so muffled
up, he may as well remain at home; as, under such circumstances, it is
impossible for him to receive any benefit from the invigorating effects
of the fresh air.
75. _Can you devise any method to induce a baby himself to take
exercise?_
He must be encouraged to use muscular exertion; and, for this purpose,
he ought to be frequently laid either upon a rug, or carpet, or the
floor: he will then stretch his limbs and kick about with perfect glee.
It is a pretty sight, to see a little fellow kicking and sprawling on
the floor. He crows with delight, and thoroughly enjoys himself: it
strengthens his back; it enables him to stretch his limbs, and to use
his muscles; and is one of the best kinds of exercise a very young child
can take. While going through his performances, his diaper, if he wear
one, should be unfastened, in order that he might go through his
exercises untrammeled. By adopting the above plan, the babe quietly
enjoys himself—his brain is not over-excited by it; this is an important
consideration, for both mothers and nurses are apt to rouse and excite
very young children, to their manifest detriment. A babe requires rest,
and not excitement. How wrong it is, then, for either a mother or a
nurse to be exciting and rousing a new-born babe. It is most injurious
and weakening to his brain. In the early period of his existence his
time ought to be almost entirely spent in sleeping and in sucking!
76. _Do you approve of tossing an infant much about?_
I have seen a child tossed up nearly to the ceiling! Can anything be
more cruel or absurd? Violent tossing of a young babe ought never to be
allowed: it only frightens him, and has been known to bring on
convulsions. He should be gently moved up and down (not tossed): such
exercise causes a proper circulation of the blood, promotes digestion,
and soothes to sleep. He must always be kept quiet immediately after
taking the breast: if he be tossed _directly_ afterward, it interferes
with his digestion, and is likely to produce sickness.
SLEEP.
77. _Ought the infant’s sleeping apartment to be kept warm?_
The lying-in room is generally kept too warm, its heat being, in many
instances, more that of an oven than of a room. Such a place is must
unhealthy, and is fraught with danger both to the mother and the baby.
We are not, of course, to run into an opposite extreme, but are to keep
the chamber at a moderate and comfortable temperature. The door ought
occasionally to be left ajar, in order the more effectually to change
the air and thus to make it more pure and sweet.
A new-born babe, then, ought to be kept comfortably warm, but not very
warm. It is folly in the extreme to attempt to harden a very young child
either by allowing him, in the winter time, to be in a bedroom without a
fire, or by dipping him in _cold_ water, or by keeping him with scant
clothing on his bed. The temperature of a bedroom, in the winter time,
should be, as nearly as possible, at 60° Fahr. Although the room should
be comfortably warm, it ought, from time to time, to be properly
ventilated. An unventilated room soon becomes foul, and, therefore,
unhealthy. How many in this world, both children and adults, are
“poisoned with their own breaths!”
An infant should not be allowed to look at the glare either of a fire or
of a lighted candle, as the glare tends to weaken the sight, and
sometimes brings on an inflammation of the eyes. In speaking to and in
noticing a baby, you ought always to stand _before_ and not _behind_
him, or it might make him squint.
78. _Ought a babe to lie alone from the first?_
Certainly not. At first—say for the first few months—he requires the
warmth of another person’s body, especially in the winter; but care must
be taken not to overlay him, as many infants, from carelessness in this
particular, have lost their lives. After the first few months, he had
better lie alone, on a horse-hair mattress.
79. _Do you approve of rocking an infant to sleep?_
I do not. If the rules of health be observed, he will sleep both soundly
and sweetly without rocking; if they be not, the rocking might cause him
to fall into a feverish, disturbed slumber, but not into a refreshing,
calm sleep. Besides, if you once take to that habit, he will not go to
sleep without it.
80. _Then don’t you approve of a rocking-chair, and of rockers to the
cradle?_
Certainly not: a rocking-chair, or rockers to the cradle, may be useful
to a lazy nurse or mother, and may induce a child to sleep, but that
restlessly, when he does not need sleep, or when he is wet and
uncomfortable, and requires “changing;” but will not cause him to have
that sweet and gentle and exquisite slumber so characteristic of a baby
who has no artificial appliances to make him sleep. No! rockers are
perfectly unnecessary, and the sooner they are banished the nursery the
better will it be for the infant community. I do not know a more
wearisome and monotonous sound than the everlasting rockings to and fro
in some nurseries; they are often accompanied by a dolorous lullaby from
the nurse, which adds much to the misery and depressing influence of the
performance.
81. _While the infant is asleep, do you advise the head of the crib to
be covered with a handkerchief, to shade his eyes from the light, and,
if it be summer time, to keep off the flies?_
If the head of the crib be covered, the baby cannot breathe freely; the
air within the crib becomes contaminated, and thus the lungs cannot
properly perform their functions. If his sleep is to be refreshing, he
must breathe pure air. I do not even approve of a head to a crib. A
child is frequently allowed to sleep on a bed with the curtains drawn
completely close, as though it were dangerous for a breath of air to
blow upon him![166] This practice is most injurious. An infant must have
the full benefit of the air of the room; indeed, the bedroom door ought
to be frequently left ajar, so that the air of the apartment may be
changed—taking care, of course, not to expose him to a draught. If the
flies, while he is asleep, annoy him, let a _net_ veil be thrown over
his face, as he can readily breathe through net, but not through a
handkerchief.
82. _Have you any suggestions to offer as to the way a babe should be
dressed when he is put down to sleep?_
Whenever he be put down to sleep, be more than usually particular that
his dress be loose in every part; be careful that there be neither
strings nor bands to cramp him. Let him, then, during repose, be more
than ordinarily free and unrestrained—
“If, while in cradled rest your infant sleeps,
Your watchful eye unceasing vigils keeps,
Lest cramping bonds his pliant limbs constrain,
And cause defects that manhood may retain.”[167]
83. _Is it a good sign for a young child to sleep much?_
A babe who sleeps a great deal thrives much more than one who does not.
I have known many children who were born[168] small and delicate, but
who slept the greatest part of their time, become strong and healthy. On
the other hand, I have known those who were born large and strong, yet
who slept but little, become weak and unhealthy.
The common practice of a nurse allowing a baby to sleep upon her lap is
a bad one, and ought never to be countenanced. He sleeps cooler, more
comfortably, and soundly in his crib.
The younger an infant is the more he generally sleeps, so that during
the early months he is seldom awake, and then only to take the breast.
84. _How is it that much sleep causes a young child to thrive so well?_
If there be pain in any part of the body, or if any of the functions be
not properly performed, he sleeps but little. On the contrary, if there
be exemption from pain, and if there be a due performance of all the
functions, he sleeps a great deal; and thus the body becomes refreshed
and invigorated.
85. _As much sleep is of such advantage, if an infant sleep but little,
would you advise composing medicine to be given to him?_
Certainly not. The practice of giving composing medicine to a young
child cannot be too strongly reprobated. If he does not sleep enough,
the mother ought to ascertain if the bowels be in a proper state,
whether they be sufficiently opened that the motions be of a good
color—namely, a bright yellow, inclining to orange color—and free from
slime or from bad smell. An occasional dose of rhubarb and magnesia is
frequently the best composing medicine he can take.
86. _We often hear of Coroner’s inquests upon infants who have been
found dead in bed—accidentally overlaid: what is usually the cause?_
Suffocation, produced either by ignorance or by carelessness. From
_ignorance_ in mothers, in their not knowing the common laws of life,
and the vital importance of free and unrestricted respiration, not only
when babies are up and about, but when they are in bed and asleep. From
_carelessness_, in their allowing young and thoughtless servants to have
the charge of infants at night; more especially as young girls are
usually heavy sleepers, and are thus too much overpowered with sleep to
attend to their necessary duties.
A foolish mother sometimes goes to sleep while allowing her child to
continue sucking. The unconscious babe, after a time, looses the nipple,
and buries his head in the bedclothes. She awakes in the morning,
finding, to her horror, a corpse by her side! A mother ought, therefore,
never to go to sleep until her child has finished sucking.
_The following are a few rules to prevent an infant from being
accidentally overlaid_: (1.) Let your baby, while asleep, have plenty of
room in the bed. (2.) Do not allow him to be too near to you; or if he
be unavoidably near you (from the small size of the bed), let his face
be turned to the opposite side. (3.) Let him lie fairly either on his
side or on his back. (4.) Be careful to ascertain that his mouth be not
covered with the bedclothes; and (5.) Do not smother his face with
clothes, as a plentiful supply of pure air is as necessary when he is
awake, or even more so, than when he is asleep. (6.) Never let him lie
low in the bed. (7.) Let there be _no_ pillow near the one his head is
resting on, lest he roll to it, and thus bury his head in it. Remember,
a young child has neither the strength nor the sense to get out of
danger; and, if he unfortunately either turn on his face, or bury his
head in a pillow that is near, the chances are that he will be
suffocated, more especially as these accidents usually occur at night,
when the mother or the nurse is fast asleep. (8.) Never intrust him at
night to a young, giddy, and thoughtless servant.
THE BLADDER AND THE BOWELS OF AN INFANT.
87. _Have you any hints to offer respecting the bowels and the bladder
of an infant during the first three months of his existence?_
A mother ought daily to satisfy herself as to the state of the bladder
and the bowels of her child. She herself should inspect the motions, and
see that they are of a proper color (bright yellow, inclining to orange)
and consistence (that of thick gruel), that they are neither slimy, nor
curdled, nor green; if they should be either the one or the other, it is
a proof that she herself has, in all probability, been imprudent in her
diet, and that it will be necessary for the future that she be more
careful both in what she eats and in what she drinks.
She ought, moreover, to satisfy herself that the urine does not smell
strongly, that it does not stain the napkins, and that he makes a
sufficient quantity.
A frequent cause of a child crying is, he is wet and uncomfortable, and
wants drying and changing, and the only way he has of informing his
mother of the fact is by crying lustily, and thus telling her in most
expressive language of her thoughtlessness and carelessness.
88. _How soon may an infant dispense with napkins?_
A baby of three months and upward, ought to be held out at least a dozen
times during the twenty-four hours; if such a plan were adopted, napkins
might at the end of three months be dispensed with—a great
_desideratum_—and he would be inducted into clean habits—a blessing to
himself, and a comfort to all around, and a great saving of dresses and
of furniture. “Teach your children to be clean. A dirty child is the
mother’s disgrace.”[169] Truer words were never written: A DIRTY CHILD
IS THE MOTHER’S DISGRACE!
AILMENTS, DISEASE, ETC.
89. _A new-born babe frequently has a collection of mucus in the
air-passages, causing him to wheeze: is it a dangerous symptom?_
No, not if it occur _immediately_ after birth; as soon as the bowels
have been opened, it generally leaves him, or even before, if he give a
good cry, which as soon as he is born he usually does. If there be any
mucus either within or about the mouth, impeding breathing, it must with
a soft handkerchief be removed.
90. _Is it advisable, as soon as an infant is born, to give him
medicine?_
It is now proved that the giving of medicine to a babe _immediately_
after birth is unnecessary, nay, that it is hurtful—that is, provided he
be early put to the breast, as the mother’s _first_ milk is generally
sufficient to open the bowels. Sir Charles Locock[170] makes the
following sensible remarks on the subject: “I used to limit any aperient
to a new-born infant to those which had not the first milk, and who had
wet-nurses whose milk was, of course, some weeks old; but for many
years, I have never allowed any aperient at all to any new-born infant,
and I am satisfied it is the safest and the wisest plan.”
This advice of Sir Charles Locock—_to give no aperient to a new-born
infant_—is most valuable, and ought to be strictly followed. By adopting
his recommendation much after-misery might be averted. If a new-born
babe’s bowels be costive, rather than give him an aperient, try the
effect of a little moist sugar dissolved in a little water; that is to
say, dissolve half a teaspoonful of pure unadulterated _raw_ sugar in a
teaspoonful of warm water, and administer it to him; if in four hours it
should not operate, repeat the dose. Butter and raw sugar is a popular
remedy, and is sometimes used by a nurse to open the bowels of a
new-born babe, and where there is costiveness answers the purpose
exceedingly well, and is far superior to castor oil. Try by all means to
do, if possible, without a particle of opening medicine. If you once
begin to give aperients, you will have frequently to repeat them.
Opening physic leads to opening physic, until at length his stomach and
bowels will become a physic shop! Let me, then, emphatically say, avoid,
if possible, giving a new-born babe a drop or a grain of opening
medicine. If from the first you refrain from giving an aperient, he
seldom requires one afterward. It is the _first_ step that is so
important to take in this as in all other things.
If a new-born babe has _not_ for twelve hours made water, the medical
man ought to be informed of it, in order that he may inquire into the
matter and apply the proper remedies. Be particular in attending to
these directions, or evil consequences will inevitably ensue.
91. _Some persons say that new-born female infants have milk in their
bosoms, and that it is necessary to squeeze them, and apply plasters to
disperse the milk._
The idea of there being real milk in a baby’s breast is doubtful, the
squeezing of the bosom is barbarous, and the application of plasters is
useless. “Without actually saying,” says Sir Charles Locock, “there is
milk secreted in the breasts of infants, there is undoubtedly not rarely
considerable swelling of the breasts both in _female_ and _male_
infants, and on squeezing them a serous fluid oozes out. I agree with
you that the nurses should never be allowed to squeeze them, but be
ordered to leave them alone.”[171]
92. _Have the goodness to mention the_ SLIGHT _ailments which are not of
sufficient importance to demand the assistance of a medical man?_
I deem it well to make the distinction between _serious_ and _slight_
ailments; I am addressing a mother. With regard to _serious_ ailments, I
do not think myself justified, except in certain _urgent_ cases, in
instructing a parent to deal with them. It might be well to make a
mother acquainted with the _symptoms_, but not with the _treatment_, in
order that she might lose no time in calling in medical aid. This I hope
to have the pleasure of doing in future conversations.
_Serious_ diseases, _with a few exceptions_, and which I will indicate
in subsequent conversations, ought never to be treated by a parent, not
even in the _early_ stages, for it is in the early stages that the most
good can generally be done. It is utterly impossible for any one who is
not trained to the medical profession to understand a _serious_ disease
in all its bearings, and thereby to treat it satisfactorily.
There are some exceptions to these remarks. It will be seen, in future
conversations, that Sir Charles Locock considers that a mother ought to
be made acquainted with the _treatment_ of _some_ of the more _serious_
diseases, where delay in obtaining _immediate_ medical assistance might
be death. I bow to his superior judgment, and have supplied the
deficiency in subsequent conversations.
The ailments and the diseases of infants, such as may, in the absence of
the doctor, be treated by a parent, are the following: Chafings,
Convulsions, Costiveness, Flatulence, Gripings, Hiccup, Looseness of the
Bowels (Diarrhœa), Dysentery, Nettle-rash, Red-gum, Stuffing of the
Nose, Sickness, Thrush. In all these complaints I will tell you—_What to
do_, and—_What_ NOT _to do_.
93. _What are the causes and the treatment of chafing?_
The want of water: inattention and want of cleanliness are the usual
causes of chafing.
_What to do._—The chafed parts ought to be well and thoroughly sponged
with tepid _rain_ water—allowing the water from a well-filled sponge to
stream over them—and, afterward, they should be thoroughly but tenderly
dried with a soft towel, and then be dusted, either with finely-powdered
starch made of wheaten flour, or with violet powder, or with
finely-powdered native carbonate of zinc, or they should be bathed with
finely-powdered fuller’s-earth and tepid water.
If, in a few days, the parts be not healed, discontinue the above
treatment, and use the following application: Beat up well together the
whites of two eggs, then add, drop by drop, two tablespoonfuls of
brandy. When well mixed put it into a bottle and cork it up. Before
using it let the excoriated parts be gently bathed with lukewarm rain
water, and, with a soft napkin, be tenderly dried; then, by means of a
camel’s-hair brush, apply the above liniment, having first shaken the
bottle.
But bear in mind, after all that can be said and done, _that there is
nothing in these cases like water_—there is nothing like keeping the
parts clean, and the only way of _thoroughly_ effecting this object is
_by putting him every morning_ INTO _his tub_.
_What_ NOT _to do_.—Do not apply white lead, as it is a poison. Do not
be afraid of using _plenty_ of water, as cleanliness is one of the most
important items of the treatment.
94. _What are the causes of convulsions in an infant?_
Stuffing him, in the early months of his existence, _with food_, the
mother having plenty of breast-milk the while; the constant physicking
of a child by his own mother; teething; hooping-cough, when attacking a
very young baby.
I never knew a case of convulsions occur—say for the first four months
(except in very young infants laboring under hooping-cough)—where
children lived on the breast-milk alone, and where they were _not_
frequently quacked by their mothers!
For the treatment of the convulsions from teething, see page 66.
_What to do_ in a case of convulsions which has been caused by feeding
an infant either with too much or with _artificial_ food. Give him,
every ten minutes, a teaspoonful of ipecacuanha wine, until free
vomiting be excited, then put him into a warm bath (see Warm Baths); and
when he comes out of it administer to him a teaspoonful of castor oil,
and repeat it every four hours until the bowels be well opened.
_What_ NOT _to do_.—Do not, for at least a month after the fit, give him
artificial food, but keep him entirely to the breast. Do not apply
leeches to the head.
_What to do in a case of convulsions from hooping-cough._—There is
nothing better than dashing cold water on the face, and immersing him in
a warm bath of 98 degrees Fahr. If he be about his teeth, and they be
plaguing him, let the gums be both freely and frequently lanced. In
convulsions from hooping-cough I have found cod-liver oil a valuable
medicine. Convulsions seldom occur in hooping-cough, unless the child be
either very young or exceedingly delicate. In either case cod-liver oil
is likely to be serviceable, as it helps to sustain and support him in
his extremity.
Convulsions attending an attack of hooping-cough make it a _serious_
complication, and requires the assiduous and skillful attention of a
judicious medical man.
_What_ NOT _to do_ in such a case.—Do not apply leeches; the babe
requires additional strength, and not to be robbed of it; and do not
attempt to treat the case yourself.
95. _What are the best remedies for the costiveness of an infant?_
I strongly object to the frequent administration of opening medicine, as
the repetition of it increases the mischief to a tenfold degree.
_What to do._—If a babe, after the first few months, were held out, and
if, at regular intervals, he were put upon his chair, costiveness would
not so much prevail. It is wonderful how soon the bowels, in the
generality of cases, by this simple plan may be brought into a regular
state.
Besides, it inducts an infant into clean habits. I know many careful
mothers who have accustomed their children, after the first three
months, to do without diapers altogether. It causes at first a little
trouble, but that trouble is amply repaid by the good consequences that
ensue; among which must be named the dispensing with such incumbrances
as diapers. Diapers frequently chafe, irritate, and gall the tender skin
of a baby. But they cannot, of course, at an early age be dispensed
with, unless a mother has great judgment, sense, tact, and perseverance,
to bring her little charge into the habit of having the bowels relieved
and the bladder emptied every time he is either held out or put upon his
chair.
Before giving an infant a particle of aperient medicine, try, if the
bowels are costive, the effect of a little raw sugar and water, either
half a teaspoonful of raw sugar dissolved in a teaspoonful or two of
water, or give him, out of your fingers, half a teaspoonful of raw sugar
to eat. I mean by _raw_ sugar, not the white, but the pure and
unadulterated sugar, and which you can only procure from a respectable
grocer. If you are wise, you will defer as long as you can giving an
aperient. If you once begin, and continue it for awhile, opening
medicine becomes a dire necessity, and then woe-betide the poor
unfortunate child!
It might sometimes be necessary to give opening medicine, but the less
frequently the better. The following, when it becomes absolutely
necessary to give an aperient, are some of the best, simple, and safe
that can be administered by a mother to her baby. I give you several, as
it might be well, from time to time, to vary them: (1.) One or two
teaspoonfuls of fluid magnesia, made palatable by the addition of a
little sugar, may be chosen; or (2.) The popular remedy of syrup of
rhubarb and castor oil:
Take of—Syrup of Rhubarb,
Castor Oil, of each half an ounce:
To make a Mixture. A teaspoonful to be taken early in the morning,
first well shaking the bottle.
It might be well again to state, that the bottle must be _violently_
shaken _just_ before administering the mixture, or the oil will not mix
with the syrup; or (3.) A teaspoonful of syrup of rhubarb, without the
admixture of the castor oil may be given early in the morning
occasionally; or (4.) A teaspoonful of equal parts, say half an ounce of
each, of fluid magnesia and of syrup of rhubarb, may be taken for a
change. Another safe and palatable aperient for an infant is (5.) Syrup
of senna, from a half to a whole teaspoonful being the dose. Castor oil
is another medicine prescribed for a baby’s costiveness, and, being a
safe one, may occasionally be used. Care should be taken to have the
castor oil freshly drawn, and of the best quality. (6.) Syrup of red
roses and castor oil (of each equal parts), being a good, elegant, and
pleasant way of giving it:
Take of—Syrup of Red Roses,
Castor Oil, of each six drachms:
To make a Mixture. A teaspoonful to be taken occasionally, first well
shaking the bottle, and to be repeated every four hours, until the
bowels be relieved.
(7.) An excellent remedy for the costiveness of a baby is a soap
suppository, the application of which will be found a safe, speedy, and
certain method of opening the bowels. It is made by paring a piece of
white curd-soap round; it should be of the size, in circumference, of a
cedar pencil, and it must be in length about two inches. This should be
administered by dipping it in a little warm sweet oil, and should then
be gently introduced up the bowel in the same manner as you would an
enema pipe, allowing about a quarter of an inch to remain in view. It
must then be left alone, and in a minute or two the soap suppository
will be expelled, and instantly the bowels will be comfortably and
effectually relieved. When a child is two or three years old and upwards
a dip-candle suppository is superior to a soap suppository.
If it be _absolutely_ necessary to give opening medicine, it will be
well to alternate the use of them—that is to say, to give at one time
the syrup of senna, at another the fluid magnesia sweetened, and a third
to administer the soap suppository dipped in oil, but waiting at least
two days between, the bowels being costive all the time, before
resorting to an aperient. Bear in mind, and let it make a strong
impression upon you, that the less the bowels of an infant are irritated
by opening medicine, the aperient being ever so simple and
well-selected, the better will it be for him both now and for the
future.
When the infant is five or six months old, either oatmeal milk gruel, or
Robinson’s Patent Groat Gruel made with new milk, occasionally given in
lieu of the usual food, will often open the bowels, and will thus
supersede the necessity of administering an aperient.
Castor oil, or Dr. Merriman’s Purgative Liniment,[172] well rubbed every
morning, for ten minutes at a time, over the region of the bowels, will
frequently prevent costiveness, and thus will do away with the
need—which is a great consideration—of giving an aperient.
_What_ NOT _to do_.—There are two preparations of mercury I wish to warn
you against administering of your own accord, viz.—(1.) Calomel, and a
milder preparation called (2.) gray powder (mercury with chalk). It is a
common practice in this country to give calomel, on account of the
readiness with which it may be administered, it being small in quantity
and nearly tasteless. Gray powder, also, is, with many mothers, a
favorite in the nursery. It is a medicine of immense power—either for
good or for evil; in certain cases it is very valuable; but in others,
and in the great majority, it is very detrimental.
This practice, then, of a mother giving mercury, whether in the form
either of calomel or of gray powder, cannot be too strongly reprobated,
as the frequent administration either of one or of the other weakens the
body, predisposes it to cold, and frequently excites king’s evil—a
disease too common in this country. Calomel and gray powder, then, ought
never to be administered unless ordered by a medical man.
Syrup of buckthorn and jalap are also frequently given, but they are
griping medicines for a baby, and ought to be banished from the nursery.
The frequent repetition of opening medicines, then, in any shape or
form, very much interferes with digestion; they must, therefore, be
given as seldom as possible.
Let me, at the risk of wearying you, again urge the importance of your
avoiding, as much as possible, giving a babe purgative medicines. They
irritate beyond measure the tender bowels of an infant, and only make
him more costive afterward; they interfere with his digestion, and are
liable to give him cold. A mother who is always of her own accord
quacking her child with opening physic, is laying up for her unfortunate
offspring a debilitated constitution—a miserable existence.
96. _Are there any means of preventing the Costiveness of an infant?_
If greater care were paid to the rules of health, such as attention to
diet, exercise in the open air, thorough ablution of the _whole_
body—more especially when he is being washed—causing the water, from a
large and well-filled sponge, to stream over the lower part of his
bowels; the regular habit of causing him, at stated periods, to be held
out, whether he want or not, that he may solicit a stool. If all these
rules were observed, costiveness would not so frequently prevail, and
one of the miseries of the nursery would be done away with.
Some mothers are frequently dosing their poor unfortunate babies either
with magnesia to cool them, or with castor oil to heal the bowels! Oh,
the folly of such practices! The frequent repetition of magnesia,
instead of cooling an infant, makes him feverish and irritable. The
constant administration of castor oil, instead of healing the bowels,
wounds them beyond measure. No! it would be a blessed thing if a baby
could be brought up without giving him a particle of opening medicine;
his bowels would then act naturally and well: but then, as I have just
now remarked, a mother must be particular in attending to Nature’s
medicines—to fresh air, to exercise, to diet, to thorough ablution, etc.
Until that time comes, poor unfortunate babies must be occasionally
dosed with an aperient.
97. _What are the causes of, and remedies for, Flatulence?_
Flatulence most frequently occurs in those infants who live on
_artificial_ food, especially if they are overfed. I therefore beg to
refer you to the precautions I have given, when speaking of the
importance of keeping a child for the first four or five months
_entirely_ to the breast; and, if that be not practicable, of the times
of feeding, and of the _best_ kinds of artificial food, and of those
which are least likely to cause “wind.”
_What to do._—Notwithstanding these precautions, if the babe should
still suffer, “One of the best and safest remedies for flatulence is
sal-volatile,—a teaspoonful of a solution of one drachm to an ounce and
a half of water.”[173] Or, a little dill or aniseed may be added to the
food—half a teaspoonful of dill water. Or, take twelve drops of oil of
dill, and two lumps of sugar; rub them well in a mortar together; then
add, drop by drop, three tablespoonfuls of spring water; let it be
preserved in a bottle for use. A teaspoonful of this, first shaking the
vial, may be added to each quantity of food. Or, three teaspoonfuls of
bruised caraway seeds may be boiled for ten minutes in a teacupful of
water, and then strained. One or two teaspoonfuls of the caraway-tea may
be added to each quantity of his food, or a dose of rhubarb and magnesia
may be occasionally given.
Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at a
time, by means of the warm hand, over the bowels, will frequently give
relief. Turning the child over on his bowels, so that they may press on
the nurse’s lap, will often afford great comfort. A warm bath (where he
is suffering severely) generally gives _immediate_ ease in flatulence;
it acts as a fomentation to the bowels. But after all, a dose of mild
aperient medicine, when the babe is suffering severely, is often the
best remedy for “wind.”
Remember, at all times, prevention, whenever it be—and how frequently it
is—possible, is better than cure.
_What_ NOT _to do_.—“Godfrey’s Cordial,” “Infants’ Preservative,” and
“Dalby’s Carminative” are sometimes given in flatulence; but as most of
these quack medicines contain, in one form or another, either opium or
poppy, and as opium and poppy are both dangerous remedies for children,
ALL quack medicines must be banished the nursery.
Syrup of poppies is another remedy which is often given by a nurse to
afford relief for flatulence; but let me urge upon you the importance of
banishing it from the nursery. It has (when given by unprofessional
persons) caused the untimely end of thousands of children. The medical
journals and the newspapers teem with cases of deaths from mothers
incautiously giving syrup of poppies to ease pain and to procure sleep.
98. _What are the symptoms, the causes, and the treatment of “Gripings”
of an infant?_
_The symptoms._—The child draws up his legs; screams violently; if put
to the nipple to comfort him, he turns away from it and cries bitterly;
he strains, as though he were having a stool; if he have a motion, it
will be slimy, curdled, and perhaps green. If, in addition to the above
symptoms, he pass a large quantity of watery fluid from the bowels, the
case becomes one of _watery gripes_, and requires the immediate
attention of a medical man.
The _causes_ of “gripings” or “gripes” may proceed either from the
infant or from the mother. If from the child, it is generally owing
either to improper food or to over-feeding: if from the mother, it may
be traced to her having taken either greens, or pork, or tart beer, or
sour porter, or pickles, or drastic purgatives.
_What to do._—The _treatment_, of course, must depend upon the cause. If
it arise from over-feeding, I would advise a dose of castor oil to be
given, and warm fomentations to be applied to the bowels, and the mother
or the nurse to be more careful for the future. If it proceed from
improper food, a dose or two of magnesia and rhubarb in a little dill
water, made palatable with simple syrup.[174] If it arise from a
mother’s imprudence in eating trash, or from her taking violent
medicine, a warm bath: a warm bath, indeed, let the cause of “griping”
be what it may, usually affords instant relief.
Another excellent remedy is the following: Soak a piece of new flannel,
folded into two or three thicknesses, in warm water; wring it tolerably
dry, and apply as hot as the child can comfortably bear it to the
bowels, then wrap him in a warm, dry blanket, and keep him, for at least
half an hour, enveloped in it. Under the above treatment, he will
generally soon fall into a sweet sleep, and awake quite refreshed.
_What_ NOT _to do_.—Do not give opiates, astringents, chalk, or any
quack medicine whatever.
If a child suffer from a mother’s folly in her eating improper food, it
will be cruel in the extreme for him a _second_ time to be tormented
from the same cause.
99. _What occasions Hiccough, and what is its treatment?_
Hiccough is of such a trifling nature as hardly to require interference.
It may generally be traced to over-feeding. Should it be severe, four or
five grains of calcined magnesia, with a little syrup and aniseed water,
and attention to feeding, are all that will be necessary.
100. _Will you describe the symptoms of Diarrhœa—“Looseness of the
bowels?”_
It will be well, before doing so, to tell you how many motions a young
infant ought to have a day, their color, consistence, and smell. Well,
then, he should have from three to six motions in the twenty-four hours;
the color ought to be a bright yellow, inclining to orange; the
consistence should be that of thick gruel; indeed, his motion, if
healthy, ought to be somewhat of the color (but a little more
orange-tinted) and of the consistence of mustard made for the table; it
should be nearly, if not quite, devoid of smell; it ought to have a
faint and peculiar, but not a strong disagreeable odor. If it has a
strong and disagreeable smell, the child is not well, and the case
should be investigated, more especially if there be either curds or
lumps in the motions; these latter symptoms denote that the food has not
been properly digested.
Now, suppose a child should have a slight bowel complaint—that is to
say, that he has six or eight motions during the twenty-four hours,—and
that the stools are of a thinner consistence than what I have
described,—provided, at the same time, that he is not griped, that he
has no pain, and has not lost his desire for the breast: What ought to
be done? _Nothing._ A slight looseness of the bowels should _never_ be
interfered with,—it is often an effort of nature to relieve itself of
some vitiated motion that wanted a vent—or to act as a diversion, by
relieving the irritation of the gums. Even if he be not cutting his
teeth, he may be “breeding” them, that is to say, the teeth may be
forming in his gums, and may cause almost as much irritation as though
he were actually cutting them. Hence, you see the immense good a slight
“looseness of the bowels” may cause. I think that I have now proved to
you the danger of interfering in such a case, and that I have shown you
the folly and the mischief of at once giving astringents—such as
Godfrey’s Cordial, Dalby’s Carminative, etc.—to relieve a _slight_
relaxation.
A moderate “looseness of the bowels,” then, is often a safety-valve, and
you may with as much propriety close the safety-valve of a steam engine
as stop a moderate “looseness of the bowels!”
Now, if the infant, instead of having from three to six motions, should
have more than double the latter number; if they be more watery; if they
become slimy and green, or green in part and curdled; if they should
have an unpleasant smell; if he be sick, cross, restless, fidgety, and
poorly; if every time he has a motion he be griped and in pain, we
should then say that he is laboring under diarrhœa; then, it will be
necessary to give a little medicine, which I will indicate in a
subsequent Conversation.
Should there be both blood and slime mixed with the stool, the case
becomes more serious; still, with proper care, relief can generally be
quickly obtained. If the evacuations—instead of being stool—are merely
blood and slime, and the child strain frequently and violently,
endeavoring thus, but in vain, to relieve himself, crying at each
effort, the case assumes the character of dysentery.[175]
If there be a mixture of blood, slime, and stool from the bowels, the
case would be called dysenteric diarrhœa. This latter case requires
great skill and judgment on the part of a medical man, and great
attention and implicit obedience from the mother and the nurse. I merely
mention these diseases in order to warn you of their importance, and of
the necessity of strictly attending to a doctor’s orders.
101. _What are the causes of Diarrhœa—“Looseness of the bowels?”_
Improper food; over-feeding; teething; cold; the mother’s milk from
various causes disagreeing, namely, from her being out of health, from
her eating unsuitable food, from her taking improper and drastic
purgatives, or from her suckling her child when she is pregnant. Of
course, if any of these causes are in operation, they ought, if
possible, to be remedied, or medicine to the babe will be of little
avail.
102. _What is the treatment of Diarrhœa?_
_What to do._—If the case be _slight_, and has lasted two or three days
(do not interfere by giving medicine at first), and if the cause, as it
probably is, be some acidity or vitiated stool that wants a vent, and
thus endeavors to obtain one by purging, the best treatment is to assist
nature by giving either a dose of castor oil or a moderate one of
rhubarb and magnesia,[176] and thus to work off the enemy.
After the enemy has been worked off, either by the castor oil or by the
magnesia and rhubarb, the purging will, in all probability, cease; but
if the relaxation still continue, that is to say, for three or four
days,—then, if medical advice cannot be procured, the following mixture
should be given:
Take of—Compound Powdered Chalk with Opium, ten grains;
Oil of Dill, five drops;
Simple Syrup, three drachms;
Water, nine drachms:
Make a Mixture.[177] Half a teaspoonful to be given to an infant of
six months and under, and one teaspoonful to a child above that age,
every four hours—first shaking the bottle.
The baby ought, for a few days, to be kept _entirely_ to the breast. The
mother should be most particular in her own diet.
_What_ NOT _to do_.—The mother must neither take greens, nor cabbage,
nor raw fruit, nor pastry, nor beer; indeed, while the diarrhœa of her
babe continues, she had better abstain from wine, as well as from
fermented liquors. The child, if at the breast, ought _not_, while the
diarrhœa continues, to have any artificial food. He must neither be
dosed with gray powder (a favorite but highly improper remedy in these
cases), nor with any quack medicines, such as Dalby’s Carminative or
Godfrey’s Cordial.
103. _What are the symptoms of Dysentery?_
Dysentery frequently arises from a neglected diarrhœa. It is more
dangerous than diarrhœa, as it is of an inflammatory character; and as,
unfortunately, it frequently attacks a delicate child, requires skillful
handling: hence the care and experience required in treating a case of
dysentery.
Well, then, what are the symptoms? The infant, in all probability, has
had an attack of diarrhœa—bowel complaint as it is called—for several
days; he having had a dozen or two of motions, many of them slimy and
frothy, like “frog-spawn,” during the twenty-four hours. Suddenly the
character of the motion changes,—from being principally stool, it
becomes almost entirely blood and mucus; he is dreadfully griped, which
causes him to strain violently, as though his inside would come away
every time he has a motion,—screaming and twisting about, evidently
being in the greatest pain, drawing his legs up to his belly and
writhing in agony. Sickness and vomiting are always present, which still
more robs him of his little remaining strength, and prevents the repair
of his system. Now, look at his face! It is the very picture of
distress. Suppose he has been a plump, healthy little fellow, you will
see his face, in a few days, become old-looking, care-worn, haggard, and
pinched. Day and night the enemy tracks him (unless proper remedies be
administered); no sleep, or, if he sleep, he is every few minutes
roused. It is heart-rending to have to attend a bad case of dysentery in
a child,—the writhing, the screaming, the frequent vomiting, the pitiful
look, the rapid wasting and exhaustion, make it more distressing to
witness than almost any other disease a doctor attends.
104. _Can anything be done to relieve such a case?_
Yes. A judicious medical man will do a great deal. But, suppose that you
are not able to procure one, I will tell you _what to do_ and _what_ NOT
_to do_.
_What to do._—If the child be at the breast, keep him to it, and let him
have nothing else, for dysentery is frequently caused by improper
feeding. If your milk be not good, or it be scanty, _instantly_ procure
a healthy wet-nurse. _Lose not a moment_; for in dysentery moments are
precious. But, suppose that you have no milk, and that no wet-nurse can
be procured: what then? Feed him entirely on cow’s milk—the milk of
_one_ healthy cow; let the milk be unboiled, and be fresh from the cow.
Give it in small quantities at a time, and frequently, so that it may be
retained on the stomach. If a tablespoonful of the milk make him sick,
give him a dessertspoonful; if a dessertspoonful cause sickness, let him
only have a teaspoonful at a time, and let it be repeated every quarter
of an hour. But remember, in such a case the breast-milk—the breast milk
alone—is incomparably superior to any other milk or to any other food
whatever.
If he be a year old and weaned, then feed him, as above recommended, on
the cow’s milk. If there be extreme exhaustion and debility, let fifteen
drops of brandy be added to each tablespoonful of new milk, and let it
be given every half hour.
Now with regard to medicine. I approach this part of the treatment with
some degree of reluctance—for dysentery is a case requiring opium, and
opium I never like a mother of her own accord to administer. But suppose
a medical man cannot be procured in time, the mother must then prescribe
or the child will die! _What then is to be done?_ Sir Charles Locock
considers “that in severe dysentery, especially where there is sickness,
there is no remedy equal to pure calomel, in a full dose, without
opium.”[178] Therefore, at the very _onset_ of the disease, let from
three to five grains (according to the age of the patient) of calomel,
mixed with an equal quantity of powdered white sugar, be put dry on the
tongue. In three hours after let the following mixture be administered:
Take of—Compound Ipecacuanha Powder, five grains;
Ipecacuanha Wine, half a drachm;
Simple Syrup, three drachms;
Cinnamon Water, nine drachms:
To make a Mixture.[179] A teaspoonful to be given every three or four
hours, first _well_ shaking the bottle.
Supposing he cannot retain the mixture—the stomach rejecting it as soon
as swallowed—what then? Give the opium, mixed with small doses of
mercury with chalk and sugar, in the form of powder, and put one of the
powders _dry_ on the tongue every three hours:
Take of—Powdered Opium, half a grain;
Mercury with Chalk, nine grains;
Sugar of Milk, twenty-four grains:
Mix well in a mortar, and divide into twelve powders.
Now, suppose the dysentery has for several days persisted, and that,
during that time, nothing but mucus and blood—that no real stool—has
come from the bowels, then a combination of castor oil and opium[180]
ought, instead of the medicine recommended above, to be given.
Take of—Mixture of Acacia, three drachms;
Simple Syrup, three drachms;
Tincture of Opium, ten drops (_not_ minims);
Castor Oil, two drachms;
Cinnamon Water, four drachms:
Make a Mixture. A teaspoonful to be taken every four hours, first
_well_ shaking the bottle.
A warm bath, at the commencement of the disease, is very efficacious;
but it must be given at the _commencement_. If he has had dysentery for
a day or two, he will be too weak to have a warm bath; then, instead of
the bath, try the following: Wrap him in a blanket which has been
previously wrung out of hot water, over which envelop him in a _dry_
blanket. Keep him in this hot, damp blanket for half an hour; then take
him out, put on his night-gown and place him in bed, which has been, if
it be winter time, previously warmed. The above “blanket treatment” will
frequently give great relief, and will sometimes cause him to fall into
a sweet sleep. A flannel bag filled with hot powdered table salt, made
hot in the oven, applied to the bowels, will afford much comfort.
_What_ NOT _to do_.—Do not give aperients, unless it be, as before
advised, the castor oil guarded with the opium; do not stuff him with
artificial food; do not fail to send for a judicious and an experienced
medical man; for, remember, it requires a skillful doctor to treat a
case of dysentery, more especially in a child.
105. _What are the symptoms, the causes, and the treatment of
Nettle-rash?_
Nettle-rash consists of several irregular raised wheals, red at the base
and white on the summit, on different parts of the body; _but it seldom
attacks the face_. It is not contagious, and it may occur at all ages
and many times. It comes and goes, remaining only a short time in a
place. It puts on very much the appearance of the child having been
stung by nettles—hence its name. It produces great heat, itching, and
irritation, sometimes to such a degree as to make him feverish, sick,
and fretful. He is generally worse when he is warm in bed, or when the
surface of his body is suddenly exposed to the air. Rubbing the skin,
too, always aggravates the itching and the tingling, and brings out a
fresh crop.
The _cause_ of nettle-rash may commonly be traced to improper feeding;
although, occasionally, it proceeds from teething.
_What to do._—It is a complaint of no danger, and readily gives way to a
mild aperient, and to attention to diet. There is nothing better to
relieve the irritation of the skin than a warm bath. If it be a severe
attack of nettle-rash, by all means call in a medical man.
_What_ NOT _to do_.—Do not apply cold applications to his skin, and do
not wash him (while the rash is out) in quite _cold_ water. Do not allow
him to be in a draught, but let him be in a well-ventilated room. If he
be old enough to eat meat, keep it from him for a few days, and let him
live on milk and farinaceous diet. Avoid strong purgatives, and calomel,
and gray powder.
106. _What are the symptoms and the treatment of Red-gum?_
Red-gum, tooth-rash, red-gown, is usually owing to irritation from
teething; not always from the cutting, but from the evolution, the
“breeding,” of the teeth. It is also sometimes owing to unhealthy stools
irritating the bowels, and showing itself, by sympathy, on the skin.
Red-gum consists of several small papulæ, or pimples, about the size of
pins’ heads, and may be known from measles—the only disease for which it
is at all likely to be mistaken—by its being unattended by symptoms of
cold, such as sneezing, running, and redness of the eyes, etc., and by
the patches _not_ assuming a crescentic, half-moon shape; red-gum, in
short, may readily be known by the child’s health being unaffected,
unless, indeed, there be a great crop of pimples; then there will be
slight feverishness.
_What to do._—Little need be done. If there be a good deal of
irritation, a mild aperient should be given. The child ought to be kept
moderately but not very warm.
_What_ NOT _to do_.—Draughts of air, or cold, should be carefully
avoided; as, by sending the eruption suddenly in, either convulsions or
disordered bowels might be produced. Do not dose him with gray powder.
107. _How would you prevent “Stuffing of the nose” in a new-born babe?_
Rubbing a little tallow on the bridge of the nose is the old-fashioned
remedy, and answers the purpose. It ought to be applied every evening
just before putting him to bed.
If the “stuffing” be severe, dip a sponge in hot water, as hot as he can
comfortably bear; ascertain that it be not too hot, by previously
applying it to your own face, and then put it for a few minutes to the
bridge of his nose. As soon as the hard mucus is within reach, it should
be carefully removed.
108. _Do you consider sickness injurious to an infant?_
Many thriving babies are, after taking the breast, frequently sick;
still we cannot look upon sickness otherwise than as an index of either
a disordered or of an overloaded stomach. If the child be sick, and yet
be thriving, it is a proof that he overloads his stomach. A mother,
then, must not allow him to suck so much at a time. She should, until he
retains all he takes, lessen the quantity of milk. If he be sick and
does _not_ thrive, the mother should notice if the milk he throws up has
a sour smell; if it has, she must first of all look to her own health;
she ought to ascertain if her own stomach be out of order; for if such
be the case, it is impossible for her to make good milk. She should
observe whether, in the morning, her own tongue be furred and dry;
whether she have a disagreeable taste in her mouth, or pains at her
stomach, or heartburn, or flatulence. If she have all, or any of these
symptoms, the mystery is explained why he is sick and does not thrive.
She ought then to seek advice, and a medical man will soon put her
stomach into good order; and, by so doing, will, at the same time,
benefit the child.
But if the mother be in the enjoyment of good health, she must then look
to the babe herself, and ascertain if he be cutting his teeth; if the
gums require lancing; if the secretions from the bowels be proper both
in quantity and in quality; and, if he have had _artificial_ food—it
being absolutely necessary to give such food—whether it agree with him.
_What to do._—In the first place, if the gums are red, hot, and swollen,
let them be lanced; in the second, if the secretions from the bowels are
either unhealthy or scanty, give him a dose of aperient medicine, such
as castor oil, or the following: Take two or three grains of powdered
Turkey rhubarb, three grains of pure carbonate of magnesia, and one
grain of aromatic powder. Mix. The powder to be taken at bedtime, mixed
in a teaspoonful of sugar and water, and which should, if necessary, be
repeated the following night. In the third place, if the food he be
taking does not agree with him, change it (_vide_ answer to question
33). Give it in smaller quantities at a time, and not so frequently; or,
what will be better still, if it be possible, keep him, for awhile,
entirely to the breast.
_What_ NOT _to do_.—Do not let him overload his stomach either with
breast-milk or _with artificial food_. Let the mother avoid, until his
sickness be relieved, greens, cabbage, and all other green vegetables.
109. _What are the causes, the symptoms, the prevention, and the cure of
Thrush?_
The thrush is a frequent disease of an infant, and is often brought on
either by stuffing him or by giving him improper food. A child brought
up _entirely_, for the first three or four months, on the breast, seldom
suffers from this complaint. The thrush consists of several irregular,
roundish, white specks on the lips, the tongue, the inside and the
angles of the mouth, giving the parts affected the appearance of curds
and whey having been smeared upon them. The mouth is hot and painful,
and he is afraid to suck: the moment the nipple is put into his mouth he
begins to cry. The thrush sometimes, although but rarely, runs through
the whole of the alimentary canal. It should be borne in mind that
nearly every child who is sucking has his or her tongue white or
“frosted” as it is sometimes called. The thrush may be mild or very
severe.
Now with regard to _What to do_.—As the thrush is generally owing to
improper and to artificial feeding, _if the child be at the breast_,
keep him, for a time, entirely to it. Do not let him be always sucking,
as that will not only fret his mouth, but will likewise irritate and
make sore the mother’s nipple.
_If he be not at the breast_, but has been weaned, then keep him for a
few days entirely to a milk diet—to the milk of ONE cow—either boiled,
if it be hot weather, to keep it sweet; or unboiled, in cool
weather—fresh as it comes from the cow.
The best medicine is the old-fashioned one of borax, a combination of
powdered lump sugar and borax being a good one for the purpose: the
powdered lump sugar increases the efficacy and the cleansing properties
of the borax; it tends, moreover, to make it more palatable:
Take of—Biborate of Soda, half a drachm;
Lump sugar, two scruples:
To be well mixed together, and made into twelve powders. One of the
powders to be put dry on the tongue every four hours.
The best _local_ remedy is honey of borax, which ought to be smeared
frequently, by means of the finger, on the parts affected.
Thorough ventilation of the apartment must be observed; and great
cleanliness of the vessels containing the milk should be insisted upon.
In a bad case of thrush, change of air to the country is most desirable;
the effect is sometimes, in such cases, truly magical.
If the thrush be brought on either by too much or by improper food, in
the first case, of course, a mother must lessen the quantity; and, in
the second, she should be more careful in her selection.
_What_ NOT _to do_.—Do not use either a calf’s teat or wash-leather for
the feeding-bottle; fortunately, since the invention of india-rubber
teats, they are now nearly exploded; they were, in olden times, fruitful
causes of thrush. Do not mind the trouble of ascertaining that the
cooking-vessels connected with the baby’s food are perfectly clean and
sweet. Do not leave the purity and the goodness of the cow’s milk (it
being absolutely necessary to feed him on artificial food) to be judged
either by the milkman or by the nurse, but taste and prove it yourself.
Do not keep the milk in a warm place, but either in the dairy or in the
cellar; and, if it be summer time, let the jug holding the milk be put
in a crock containing lumps of ice. Do not use milk that has been milked
longer than twelve hours, but, if practicable, have it milked direct
from the cow, and use it _immediately_—let it be really and truly fresh
and genuine milk.
When the disease is _severe_, it may require more active treatment—such
as a dose of calomel; _which medicine must never be given, unless it be
either under the direction of a medical man, or unless it be in an
extreme case,—such as dysentery_;[181] therefore, the mother had better
seek advice.
In a _severe_ case of thrush, where the complaint has been brought on by
_artificial_ feeding—the babe not having the advantage of the mother’s
milk—it is really surprising how rapidly a wet-nurse—if the case has not
been too long deferred—will effect a cure, where all other means have
been tried and have failed. The effect has been truly magical! In a
severe case of thrush, pure air and thorough ventilation are essential
to recovery.
110. _Is anything to be learned from the cry of an infant?_
There is a language in the cry of an infant which a thoughtful medical
man can well interpret. The cry of hunger, for instance, is very
characteristic,—it is unaccompanied with tears, and is a wailing cry;
the cry of teething, is a fretful cry; the cry of earache is short,
sharp, piercing, and decisive, the head being moved about from side to
side, and the little hand being often put up to the affected side of the
head; the cry of bowelache is also expressive,—the cry is not so
piercing as from earache, and is an interrupted, straining cry,
accompanied with a drawing up of the legs to the belly; the cry of
bronchitis is a gruff and phlegmatic cry; the cry of inflammation of the
lungs is more a moan than a cry; the cry of croup is hoarse, and rough,
and ringing, and is so characteristic that it may truly be called “the
croupy cry,” moreover, he breathes as though he breathed through muslin;
the cry of inflammation of the membranes of the brain is a piercing
shriek—a danger signal—most painful to hear; the cry of a child
recovering from a severe illness is a cross, and wayward, and tearful
cry; he may truly be said to be in a quarrelsome mood; he bursts out
without rhyme or reason into a passionate flood of tears; tears are
always, in a severe illness, to be looked upon as a good omen, as a sign
of amendment: tears, when a child is dangerously ill, are rarely if ever
seen; a cry at night, for light—a frequent cause of a babe crying—is a
restless cry:
“An infant crying in the night:
An infant crying for the light:
And with no language but a cry.”[182]
111. _If an infant be delicate, have you any objection to his having
either veal or mutton broth to strengthen him?_
Broths seldom agree with a babe at the breast. I have known them produce
sickness, disorder the bowels, and create fever. I recommend you,
therefore, not to make the attempt.
Although broth and beef-tea, when taken by the mouth, will seldom agree
with an infant at the breast, yet, when used as an enema, and in small
quantities, so that they may be retained, I have frequently found them
to be of great benefit: they have, in some instances, appeared to have
snatched delicate children from the brink of the grave.
112. _My babe’s ankles are very weak: what do you advise to strengthen
them?_
If his ankles be weak, let them every morning be bathed, after the
completion of his morning’s ablution, for five minutes each time, with
bay salt and water, a small handful of bay salt dissolved in a quart of
rain water (with the chill of the water taken off in the winter, and of
its proper temperature in the summer time); then let them be dried;
after the drying, let the ankles be well rubbed with the following
liniment:
Take of—Oil of Rosemary, three drachms;
Liniment of Camphor, thirteen drachms:
To make a Liniment.
Do not let him be put on his feet early; but allow him to crawl, and
sprawl, and kick about the floor, until his ankles become strong.
Do not, on any account, without having competent advice on the subject,
use iron instruments or mechanical supports of any kind: the ankles are
generally, by such artificial supports, made worse, in consequence of
the pressure causing a further dwindling away and enfeebling of the
ligaments of the ankles, already wasted and weakened.
Let him wear shoes, with straps over the insteps to keep them on, and
not boots: boots will only, by wasting the ligaments, increase the
weakness of the ankles.
113. _Sometimes there is a difficulty in restraining the bleeding of
leech-bites. What is the best method?_
The difficulty in these cases generally arises from the improper method
of performing it. For example—a mother endeavors to stop the hemorrhage
by loading the part with rag; the more the bites discharge, the more rag
she applies. At the same time, the child probably is in a room with a
large fire, with two or three candles, with the doors closed, and with
perhaps a dozen people in the apartment, whom the mother has, in her
fright, sent for. This practice is strongly reprehensible.
If the bleeding cannot be stopped,—in the first place, the fire must be
extinguished, the door and windows should be thrown open, and the room
ought to be cleared of persons, with the exception of one, or, at the
most, two; and every rag should be removed. “Stopping of
leech-bites.—The simplest and most certain way, till the proper
assistance is obtained, is the pressure of the finger, with nothing
intervening. It _cannot_ bleed through that.”[183]
Many babies have lost their lives by excessive loss of blood from
leech-bites, from a mother not knowing how to act, and also from the
medical man either living at a distance, or not being at hand.
Fortunately for the infantile community, leeches are now very seldom
ordered by doctors.
114. _Supposing a baby to be poorly, have you any advice to give to his
mother as to her own management?_
She must endeavor to calm her feelings, or her milk will be disordered,
and she will thus materially increase his illness. If he be laboring
under any inflammatory disorder, she ought to refrain from the taking of
beer, wine, and spirits, and from all stimulating food; otherwise, she
will feed his disease.
Before concluding the first part of my subject—the Management of
Infancy—let me again urge upon you the importance—the paramount
importance—if you wish your babe to be strong and hearty,—of giving him
as little opening physic as possible. The best physic for him is
Nature’s physic—fresh air and exercise and simplicity of living. A
mother who is herself always drugging her child, can only do good to two
persons—the doctor and the druggist!
If an infant from his birth be properly managed,—if he has an abundance
of fresh air for his lungs,—if he has plenty of exercise for his muscles
(by allowing him to kick and sprawl on the floor),—if he has a good
swilling and sousing of water for his skin,—if, during the _early_
months of his life, he has nothing but the mother’s milk for his
stomach,—he will require very little medicine—the less the better! He
does not want his stomach to be made into a doctor’s shop! The grand
thing is not to take every opportunity of administering physic, but of
using every means of withholding it! And if physic be necessary, not to
doctor him yourself, unless it be in extreme and urgent cases (which in
preceding and succeeding Conversations I either have or will indicate),
but to employ an experienced medical man. A babe who is always, without
rhyme or reason, being physicked, is sure to be puny, delicate, and
unhealthy, and is ready, at any moment, to drop into an untimely grave!
CONCLUDING REMARKS ON INFANCY.
115. In concluding the first part of our subject—Infancy—I beg to
remark. There are four things essentially necessary to an infant’s
well-doing, namely, (1) plenty of water for the skin; (2) plenty of milk
for the stomach; (3) plenty of fresh air for the lungs; (4) plenty of
sleep for the brain: these are the four grand essentials for a babe;
without an abundance of each and all of them, perfect health is utterly
impossible!
PART II.
CHILDHOOD.
_Household treasures! household treasures!
Are they jewels rich and rare;
Or gems of rarest workmanship;
Or gold and silver ware?
Ask the mother as she gazes
On her little ones at play:
Household treasures! household treasures!
Happy children—ye are they._
J. E. CARPENTER.
ABLUTION.
116. _At twelve months old, do you still recommend a child to be_ PUT IN
HIS TUB _to be washed?_
Certainly I do, as I have previously recommended at page 16, in order
that his skin may be well and thoroughly cleansed. If it be summer time,
the water should be used cold; if it be winter, a dash of warm must be
added, so that it may be of the temperature of new milk; but do not, on
any account, use _very warm_ water. The head must be washed (but not
dried) before he be placed in his tub; then, putting him in the tub
(containing the necessary quantity of water, and washing him as
previously recommended),[184] a large sponge should be filled with the
water and squeezed over the head, so that the water may stream over the
whole surface of the body. A jugful of cold water should, just before
taking him out of his bath, be poured over and down his loins; all this
ought rapidly to be done, and he must be quickly dried with soft towels,
and then expeditiously dressed. For the washing of your child I would
recommend you to use Castile soap in preference to any other: it is more
pure, and less irritating, and hence does not injure the texture of the
skin. Take care that the soap does not get into his eyes, or it might
produce irritation and smarting.
117. _Some mothers object to a child’s_ STANDING _in the water_.
If the head be wetted before he be placed in the tub, and if he be
washed as above directed, there can be no valid objection to it. He must
not be allowed to remain in the tub more than five minutes.
118. _Does not washing the child’s head, every morning, make him more
liable to catch cold, and does it not tend to weaken his sight?_
It does neither the one nor the other; on the contrary, it prevents
cold, and strengthens the sight; it cleanses the scalp, prevents scurf,
and, by that means, causes a more beautiful head of hair. The head,
after each washing, ought to be well brushed with a soft brush, but
should not be combed. The brushing causes a healthy circulation of the
scalp.
119. _If the head, notwithstanding the washing, be scurfy, what should
be done?_
After the head has been well dried, let a little cocoanut oil be well
rubbed, for five minutes each time, into the roots of the hair, and,
afterward, let the head be well brushed, but not combed. The fine-tooth
comb will cause a greater accumulation of scurf, and will scratch and
injure the scalp.
120. _Do you recommend a child to be washed_ IN HIS TUB _every night and
morning_?
No; once a day is quite sufficient; in the morning in preference to the
evening; unless he be poorly, then, evening instead of morning; as,
immediately after he has been washed and dried, he can be put to bed.
121. _Ought a child to be placed in his tub while he is in a state of
perspiration?_
Not while he is perspiring _violently_, or the perspiration might be
checked suddenly, and ill consequences would ensue; _nor ought he to be
put in his tub when he is cold_, or his blood would be chilled, and
would be sent from the skin to some internal vital part, and thus would
be likely to light up inflammation—probably of the lungs. His skin, when
he is placed in his bath, ought to be moderately and comfortably warm;
neither too hot nor too cold.
122. _When the child is a year old, do you recommend cold or warm water
to be used?_
If it be winter, a little warm water ought to be added, so as to raise
the temperature to that of new milk. As the summer advances, less and
less warm water is required, so that, at length, none is needed.
123. _If a child be delicate, do you recommend anything to be added to
the water which may tend to brace and strengthen him?_
Either a handful of table salt or half a handful of bay salt should be
previously dissolved in a quart jug—of _cold_ water; then, just before
taking the child out of his morning bath, let the above be poured over
and down the back and loins of the child—holding the jug, while pouring
its contents on the back, twelve inches from the child, in order that it
might act as a kind of douche bath.
124. _Do you recommend the child, after he has been dried with the
towel, to be rubbed with the hand?_
I do; as friction encourages the cutaneous circulation, and causes the
skin to perform its functions properly, thus preventing the perspiration
(which is one of the impurities of the body) from being sent inwardly
either to the lungs or to other parts. The back, the chest, the bowels,
and the limbs are the parts that ought to be well rubbed.
CLOTHING.