instantly to be removed to a distance. I say _children_, for it is
emphatically a disease of childhood. When adults have it, it is the
exception, and not the rule. “Thus it will be seen, in the account given
of the Boulogne epidemic, that of 366 deaths from this cause, 341
occurred among children under ten years of age. In the Lincolnshire
epidemic, in the autumn of 1858, all the deaths at Horncastle, 25 in
number, occurred among children under twelve years of age.”[225]
208. _What are the causes of Diphtheria?_
Bad and imperfect drainage;[226] want of ventilation; overflowing
privies; low neighborhoods in the vicinity of rivers; stagnant waters;
indeed, everything that vitiates the air and thus depresses the system,
more especially if the weather be close and muggy; poor and improper
food; and last, though not least, contagion. Bear in mind, too, that a
delicate child is much more predisposed to the disease than a strong
one.
209. _What is the treatment of Diphtheria?_
_What to do._—Examine well into the ventilation, for as diphtheria is
frequently caused by deficient ventilation, the best remedy is thorough
ventilation. Look well both to the drains and to the privies, and see
that the drains from the water-closets and from the privies do not in
any way contaminate the pump-water. If the drains be defective or the
privies be full, the disease in your child will be generated, fed, and
fostered. Not only so, but the disease will spread in your family and
all around you.
Keep the child to his bedroom and to his bed. For the first two or three
days, while the fever runs high, put him on a low diet, such as milk,
tea, arrow-root, etc.
Apply to his throat every four hours a warm barm and oatmeal poultice.
If he be old enough to have the knowledge to use a gargle, the following
will be found serviceable:
Take of—Powdered Alum, one drachm;
Simple Syrup, one ounce;
Water, seven ounces:
To make a Gargle.
The best medicine for the first few days of the attack, is one of the
following mixtures:
Take of—Chlorate of Potash, two drachms;
Boiling Water, seven ounces and a half;
Syrup of Red Poppy, half an ounce:
To make a Mixture. A tablespoonful to be taken every four hours.
Or,
Take of—Diluted Sulphuric Acid, one drachm;
Simple Syrup, one ounce and a half;
Infusion of Roses,[227] four ounces and a half;
To make a Mixture. A tablespoonful to be given every four hours.
As soon as the skin has lost its preternatural heat, beef-tea and
chicken broth ought to be given. Or if great prostration should
supervene, in addition to the beef-tea, port wine, a tablespoonful every
four hours, should be administered. If the child be cold, and there be
great sinking of the vital powers, brandy and water should be
substituted for the port wine. Remember, in ordinary cases, port wine
and brandy are not necessary, _but in cases of extreme exhaustion_ they
are most valuable.
As soon as the great heat of the skin has abated and the debility has
set in, one of the following mixtures will be found useful:
Take of—Wine of Iron, one ounce and a half;
Simple Syrup, one ounce;
Water, three ounces and a half:
To make a Mixture. A tablespoonful to be taken every four hours.
Or,
Take of—Muriated Tincture of Iron, half a drachm;
Simple Syrup, one ounce;
Water, three ounces:
To make a Mixture. A tablespoonful to be taken three times a day.
If the disease should travel downward, it will cause all the symptoms of
croup, then it must be treated as croup; with this only difference, that
a blister (_tela vesicatoria_) must _not_ be applied, or the blistered
surface may be attacked by the membrane of diphtheria, which may either
cause death or hasten that catastrophe. In every other respect treat the
case as croup, by giving an emetic, a teaspoonful of ipecacuanha wine
every five minutes, until free vomiting be excited, and then administer
smaller doses of ipecacuanha wine every two or three hours, as I
recommended when conversing with you on the treatment of croup.
_What_ NOT _to do_.—Do not, on any account, apply either leeches or a
blister. If the latter be applied, it is almost sure to be covered with
the membrane of diphtheria, similar to that inside of the mouth and of
the throat, which would be a serious complication. Do not give either
calomel or emetic tartar. Do not depress the system by aperients, for
diphtheria is an awfully depressing complaint of itself; the patient, in
point of fact, is laboring under the depressing effects of poison, for
the blood has been poisoned either by the drinking water being
contaminated by fecal matter from either a privy or from a water-closet;
by some horrid drain; by proximity to a pig-sty; by an overflowing
privy, especially if vegetable matter be rotting at the same time in it;
by bad ventilation, or by contagion. Diphtheria may generally be traced
either to the one or to the other of the above causes; therefore let me
urgently entreat you to look well into all these matters, and thus to
stay the pestilence! Diphtheria might long remain in a neighborhood if
active measures be not used to exterminate it.
210. _Have the goodness to describe the symptoms of Measles?_
Measles commences with symptoms of a common cold; the patient is at
first chilly, then hot and feverish; he has a running at the nose,
sneezing, watering and redness of the eyes, headache, drowsiness, a
hoarse and peculiar ringing cough, which nurses call “measle-cough,” and
difficulty of breathing. These symptoms usually last three days before
the eruption appears; on the fourth it (the eruption) generally makes
its appearance, and continues for four days and then disappears, lasting
altogether, from the commencement of the symptoms of cold to the decline
of the eruption, seven days. It is important to bear in mind that the
eruption consists of _crescent-shaped—half-moon-shaped—patches_; that
they usually appear first about the face and the neck, in which places
they are the best marked; then on the body and on the arms; and, lastly,
on the legs, and that they are slightly raised above the surface of the
skin. The face is swollen, more especially the eyelids, which are
sometimes for a few days closed.
Well, then, remember, _the running at the nose, the sneezing, the
peculiar hoarse cough, and the half-moon-shaped patches_, are the
leading features of the disease, and point out for a certainty that it
is measles.
211. _What constitutes the principal danger in Measles?_
The affection of the chest. The mucous or lining membrane of the
bronchial tubes is always more or less inflamed, and the lungs
themselves are sometimes affected.
212. _Do you recommend “surfeit water” and saffron tea to throw out the
eruption in Measles?_
Certainly not. The only way to throw out the eruption, as it is called,
is to keep the body comfortably warm, and to give the beverages ordered
by the medical man, with the chill off. “Surfeit water,” saffron tea,
and remedies of that class, are hot and stimulating. The only effect
they can have, will be to increase the fever and the inflammation—to add
fuel to the fire.
213. _What is the treatment of Measles?_
_What to do._—The child ought to be confined both to his room and to his
bed, the room being kept comfortably warm; therefore, if it be winter
time, there should be a small fire in the grate; in the summer time, a
fire would be improper. The child must not be exposed to draughts;
notwithstanding, from time to time, the door ought to be left a little
ajar in order to change the air of the apartment; for proper
ventilation, let the disease be what it may, is absolutely necessary.
Let the child, for the first few days, be kept on a low diet, such as on
milk and water, arrow-root, bread and butter, etc.
If the attack be mild, that is to say, if the breathing be not much
affected (for in measles it always is more or less affected), and if
there be not much wheezing, the acidulated infusion of roses’
mixture[228] will be all that is necessary.
But suppose that the breathing is short, and that there is a great
wheezing, then, instead of giving him the mixture just advised, give him
a teaspoonful of a mixture composed of ipecacuanha wine, syrup, and
water,[229] every four hours. And if, on the following day, the
breathing and the wheezing be not relieved, in addition to the
ipecacuanha mixture, apply a tela vesicatoria, as advised under the head
of inflammation of the lungs.
When the child is convalescing, batter puddings, rice, and sago
puddings, in addition to the milk, bread and butter, etc., should be
given; and, a few days later, chicken, mutton-chops, etc.
The child ought not, even in a mild case of measles, and in favorable
weather, to be allowed to leave the house under a fortnight, or it might
bring on an attack of bronchitis.
_What_ NOT _to do_.—Do not give either “surfeit water” or wine. Do not
apply leeches to the chest. Do not expose the child to the cold air. Do
not keep the bedroom very hot, but comfortably warm. Do not let the
child leave the house, even under favorable circumstances, under a
fortnight. Do not, while the eruption is out, give aperients. Do not,
“to ease the cough,” administer either emetic tartar or paregoric—the
former drug is awfully depressing; the latter will stop the cough, and
will thus prevent the expulsion of the phlegm.
214. _What is the difference between Scarlatina and Scarlet Fever?_
They are, indeed, one and the same disease, scarlatina being the Latin
for scarlet fever. But, in a _popular_ sense, when the disease is mild,
it is usually called scarlatina. The latter term does not sound so
formidable to the ears either of patients or of parents.
215. _Will you describe the symptoms of Scarlet Fever?_
The patient is generally chilly, languid, drowsy, feverish, and poorly
for two days before the eruption appears. At the end of the second day,
the characteristic, bright scarlet efflorescence, somewhat similar to
the color of a boiled lobster, usually first shows itself. The scarlet
appearance is not confined to the skin; but the tongue, the throat, and
the whites of the eyes put on the same appearance; with this only
difference, that on the tongue and on the throat the scarlet is much
darker; and, as Dr. Elliotson accurately describes it,—“the tongue looks
as if it had been slightly sprinkled with Cayenne pepper.” The eruption
usually declines on the fifth, and is generally indistinct on the sixth
day; on the seventh it has completely faded away. There is usually,
after the first few days, great itching on the surface of the body. The
skin, at the end of the week, begins to peel and to dust off, making it
look as though meal had been sprinkled upon it.
There are three forms of scarlet fever,—the one where the throat is
_little_, if at all affected, and this is a mild form of the disease;
the second, which is generally, especially at night, attended with
delirium, where the throat is _much_ affected, being often greatly
inflamed and ulcerated; and the third (which is, except in certain
unhealthy districts, comparatively rare, and which is VERY dangerous),
the malignant form.
216. _Would it be well to give a little cooling, opening physic as soon
as a child begins to sicken for Scarlet Fever?_
_On no account whatever._ Aperient medicines are, in my opinion, highly
improper and dangerous both before and during the period of the
eruption. It is my firm conviction that the administration of opening
medicine, at such times, is one of the principal causes of scarlet fever
being so frequently fatal. This is, of course, more applicable to the
poor, and to those who are unable to procure a skillful medical man.
217. _What constitutes the principal danger in Scarlet Fever?_
The affection of the throat, the administration of opening medicine
during the first ten days, and a peculiar disease of the kidneys ending
in _anasarca_ (dropsy), on which account, the medical man ought, when
practicable, to be sent for at the onset, that no time may be lost in
applying _proper_ remedies.
218. _How would you distinguish between Scarlet Fever and Measles?_
Measles commences with symptoms of a common cold; scarlet fever does
not. Measles has a _peculiar hoarse_ cough; scarlet fever has not. The
eruption of measles is in patches of a half-moon shape, and is slightly
raised above the skin; the eruption of scarlet fever is _not_ raised
above the skin at all, and is one continued mass. The color of the
eruption is much more vivid in scarlet fever than in measles. The chest
is the part principally affected in measles, and the throat in scarlet
fever.
There is an excellent method of determining, for a certainty, whether
the eruption be that of scarlatina or otherwise. I myself have, in
several instances, ascertained the truth of it: “For several years M.
Bouchut has remarked in the eruption of scarlatina a curious phenomenon,
which serves to distinguish this eruption from that of measles,
erythema, erysipelas, etc., a phenomenon essentially vital, and which is
connected with the excessive contractability of the capillaries. The
phenomenon in question is a _white line_, which can be produced at
pleasure by drawing the back of the nail along the skin where the
eruption is situated. On drawing the nail, or the extremity of a hard
body (such as a pen-holder), along the eruption, the skin is observed to
grow pale, and to present a white trace, which remains for one or two
minutes, or longer, and then disappears. In this way the diagnosis of
the disease may be very distinctly written on the skin; the word
‘Scarlatina’ disappears as the eruption regains its uniform tint.”[230]
219. _Is it of so much importance, then, to distinguish between Scarlet
Fever and Measles?_
It is of great importance, as in measles the patient ought to be kept
_moderately_ warm, and the drinks should be given with the chill off;
while in scarlet fever the patient ought to be kept cool—indeed, for the
first few days, _cold_; and the beverages, such as spring water, toast
and water, etc., should be administered quite cold.
220. _What is the treatment of Scarlet Fever?_[231]
_What to do._—Pray pay particular attention to my rules, and carry out
my directions to the very letter—as I can then promise you _that if the
scarlet fever be not malignant_, the plan I am about to recommend will,
with God’s blessing, be generally successful.
What is the first thing to be done? Send the child to bed; throw open
the windows, be it winter or summer, and have a thorough ventilation;
for the bedroom must be kept cool, I may say cold. Do not be afraid of
fresh air, for fresh air, for the first few days, is essential to
recovery. _Fresh air, and plenty of it, in scarlet fever, is the best
doctor_ a child can have: let these words be written legibly on your
mind.[232]
Take down the curtains of the bed; remove the valances. If it be summer
time, let the child be only covered with a sheet: if it be winter time,
in addition to the sheet, he should have one blanket over him.
Now for the throat.—The best _external_ application is a barm and
oatmeal poultice. How ought it to be made, and how applied? Put half a
teacupful of barm into a saucepan, put it on the fire to boil; as soon
as it boils take it off the fire, and stir oatmeal into it, until it is
of the consistence of a nice soft poultice; then place it on a rag, and
apply it to the throat; carefully fasten it on with bandage, two or
three turns of the bandage going round the throat, and two or three over
the crown of the head, so as nicely to apply the poultice where it is
wanted—that is to say, to cover the tonsils. Tack the bandage: do not
pin it. Let the poultice be changed three times a day. The best medicine
is the acidulated infusion of roses, sweetened with syrup.[233] It is
grateful and refreshing, it is pleasant to take, it abates fever and
thirst, it cleans the throat and tongue of mucus, and is peculiarly
efficacious in scarlet fever; as soon as the fever is abated it gives an
appetite. My belief is that the sulphuric acid in the mixture is a
specific in scarlet fever, as much as quinine is in ague, and sulphur in
itch. I have reason to say so, for, in numerous cases, I have seen its
immense value.
Now, with regard to food.—If the child be at the breast, keep him
entirely to it. If he be weaned, and under two years old, give him milk
and water, and cold water to drink. If he be older, give him toast and
water, and plain water from the pump, as much as he chooses; let it be
quite cold—the colder the better. Weak black tea, or thin gruel, may be
given, but not caring, unless he be an infant at the breast, if he take
nothing but _cold_ water. If the child be two years old and upwards,
roasted apples with sugar, and grapes will be very refreshing, and will
tend to cleanse both the mouth and the throat. Avoid broths and
stimulants of every kind.
When the appetite returns, you may consider the patient to be safe. The
diet ought now to be gradually improved. Bread and butter, milk and
water, and arrow-root made with equal parts of new milk and water,
should for the first two or three days be given. Then a light batter or
rice pudding may be added, and in a few days afterward, either a little
chicken or a mutton-chop.
The essential remedies, then, in scarlet fever, are, for the first few
days—(1) plenty of fresh air and ventilation, (2) plenty of cold water
to drink, (3) barm poultices to the throat, and (4) the acidulated
infusion of roses’ mixture as a medicine.
Now, then, comes very important advice. After the first few days,
probably five or six, sometimes as early as the fourth day, _watch
carefully and warily, and note the time, the skin will suddenly become
cool_, the child will say that he feels chilly; then is the time you
must now change your tactics—_instantly close the windows, and put extra
clothing_, a blanket or two, on his bed. A flannel night-gown should,
until the dead skin has peeled off, be now worn next to the skin, when
the flannel night-gown should be discontinued. The patient ought ever
after to wear, in the daytime, a flannel waistcoat.[234] His drinks must
now be given with the chill off; he ought to have a warm cup of tea, and
gradually his diet should, as I have previously recommended be improved.
There is one important caution I wish to impress upon you,—_do not give
opening medicine during the time the eruption is out_. In all
probability the bowels will be opened: if so, all well and good; but do
not, on any account, for the first ten days, use artificial means to
open them. It is my firm conviction that the administration of
purgatives in scarlet fever is a fruitful source of dropsy, of disease,
and death. When we take into consideration the sympathy there is between
the skin and the mucous membrane, I think that we should pause before
giving irritating medicines, such as purgatives. The irritation of
aperients on the mucous membrane may cause the poison of the skin
disease (for scarlet fever is a blood poison) to be driven internally to
the kidneys, to the throat, to the pericardium (bag of the heart), or to
the brain. You may say, Do you not purge if the bowels be not open for a
week? I say emphatically, No!
I consider my great success in the treatment of scarlet fever to be
partly owing to my avoidance of aperients during the first ten days of
the child’s illness.
If the bowels, after the ten days, are not properly opened, a dose or
two of the following mixture should be given:
Take of—Simple Syrup, three drachms;
Essence of Senna, nine drachms:
To make a Mixture. Two teaspoonfuls to be given early in the morning
occasionally, and to be repeated in four hours, if the first dose
should not operate.
In a subsequent Conversation, I shall strongly urge you not to allow
your child, when convalescent, to leave the house under at least a month
from the commencement of the illness; I therefore beg to refer you to
that Conversation, and hope that you will give it your best and earnest
consideration! During the last seventeen years I have never had dropsy
from scarlet fever, and I attribute it entirely to the plan I have just
recommended, and in not allowing my patients to leave the house under
the month—until, in fact, the skin that has peeled off has been renewed.
Let us now sum up the plan I adopt:
1. Thorough ventilation, a cool room, and scant clothes on the bed, for
the first five or six days.
2. A change of temperature of the skin to be carefully regarded. As soon
as the skin is cool, closing the windows, and putting additional
clothing on the bed.
3. The acidulated infusion of roses with syrup is _the_ medicine for
scarlet fever.
4. Purgatives to be religiously avoided for the first ten days at least,
and even afterward, unless there be absolute necessity.
5. Leeches, blisters, emetics, cold and tepid spongings, and painting
the tonsils with caustic, inadmissible in scarlet fever.
6. A strict antiphlogistic (low) diet for the first few days, during
which time cold water to be given _ad libitum_.
7. The patient _not_ to leave the house in the summer under the month;
in the winter, under six weeks.
_What_ NOT _to do_.—Do not, then, apply either leeches or blisters to
the throat; do not paint the tonsils with caustic; do not give
aperients; do not, on any account, give either calomel or emetic tartar;
do not, for the first few days of the illness, be afraid of _cold air_
to the skin, and of cold water as a beverage; do not, emphatically let
me say, _do not_ let the child leave the house for at least a month from
the commencement of the illness.
My firm conviction is, that purgatives, emetics, and blisters, by
depressing the patient, sometimes cause ordinary scarlet fever to
degenerate into malignant scarlet fever.
I am aware that some of our first authorities advocate a different plan
to mine. They recommend purgatives, which I may say, in scarlet fever,
are my dread and abhorrence. They advise cold and tepid spongings—a plan
which I think dangerous, as it will probably drive the disease
internally. Blisters, too, have been prescribed; these I consider
weakening, injurious, and barbarous, and likely still more to inflame
the already inflamed skin. They recommend leeches to the throat, which I
am convinced, by depressing the patient, will lessen the chance of his
battling against the disease, and will increase the ulceration of the
tonsils. Again, the patient has not too much blood; the blood is only
poisoned. I look upon scarlet fever as a specific poison of the blood,
and one which will be eliminated from the system, _not_ by bleeding,
_not_ by purgatives, _not_ by emetics, but by a constant supply of fresh
and cool air, by the acid treatment, by cold water as a beverage, and
for the first few days by a strict antiphlogistic (low) diet.
Sydenham says that scarlet fever is oftentimes “fatal through the
officiousness of the doctor.” I conscientiously believe that a truer
remark was never made; and that under a different system to the usual
one adopted, scarlet fever would not be so much dreaded.[235]
221. _How soon ought a child to be allowed to leave the house after an
attack of Scarlet Fever?_
He must _not_ be allowed to go out for at least a month from the
commencement of the attack, in the summer, and six weeks in the winter;
and not even then with out the express permission of a medical man. It
might be said that this is an unreasonable recommendation but when it is
considered that the whole of the skin generally desquamates, or peels
off, and consequently leaves the surface of the body exposed to cold,
which cold flies to the kidneys, producing a peculiar and serious
disease in them, ending in dropsy, this warning will not be deemed
unreasonable.
Scarlet fever dropsy, which is really a _formidable disease, generally
arises from the carelessness, the ignorance, and the thoughtlessness of
parents in allowing a child to leave the house before the new skin is
properly formed and hardened_. Prevention is always better than cure.
Thus far with regard to the danger to the child himself. Now, if you
please, let me show you the risk of contagion that you inflict upon
families, in allowing your child to mix with others before a month at
least has elapsed. Bear in mind, a case is quite as contagious, if not
more so, while the skin is peeling off, as it was before. Thus, in ten
days or a fortnight, there is as much risk of contagion as at the
_beginning_ of the disease, and when the fever is at its height. At the
conclusion of the month the old skin has generally all peeled off, and
the new skin has taken its place; consequently there will then be less
fear of contagion to others. But the contagion of scarlet fever is so
subtle and so uncertain in its duration, that it is impossible to fix
the exact time when it ceases.
Let me most earnestly implore you to ponder well on the above important
facts. If these remarks should be the means of saving only one child
from death, or from broken health, my labor will not have been in vain.
222. _What means do you advise to purify a house from the contagion of
Scarlet Fever?_
Let every room be _lime-washed_ and then be white washed;[236] if the
contagion has been virulent, let every bedroom be freshly papered (the
walls having been previously stripped of the old paper and then
lime-washed); let the bed, the bolsters, the pillows, and the mattresses
be cleansed and purified; let the blankets and coverlids be thoroughly
washed, and then let them be exposed to the open air—if taken into a
field so much the better; let the rooms be well scoured; let the
windows, top and bottom, be thrown wide open; let the drains be
carefully examined; let the pump-water be scrutinized, to see that it be
not contaminated by fecal matter, either from the water-closet or from
the privy; let privies be emptied of their contents—_remember this is
most important advice_—then put into the empty places lime and powdered
charcoal, for it is a well-ascertained fact that it is frequently
impossible to rid a house of the infection of scarlet fever without
adopting such a course. “In St. George’s, Southwark, the medical officer
reports that scarlatina ‘has raged fatally, almost exclusively where
privy or drain smells are to be perceived in the houses.’”[237] Let the
children who have not had, or who do not appear to be sickening for
scarlet fever, be sent away from home—if to a farm-house so much the
better. Indeed, leave no stone unturned, no means untried, to
exterminate the disease from the house and from the neighborhood.
223. _Will you describe the symptoms of Chicken-pox?_
It is occasionally, but not always, ushered in with a slight shivering
fit; the eruption shows itself in about twenty-four hours from the child
first appearing poorly. It is a vesicular[238] disease. The eruption
comes out in the form of small pimples, and principally attacks the
scalp, the neck, the back, the chest, and the shoulders, but rarely the
face; while in small-pox the face is generally the part most affected.
The next day these pimples fill with water, and thus become vesicles; on
the third day they are at maturity. The vesicles are quite separate and
distinct from each other. There is a slight redness around each of them.
Fresh ones, while the others are dying away, make their appearance.
Chicken-pox is usually attended with a slight itching of the skin; when
the vesicles are scratched the fluid escapes, and leaves hard pearl-like
substances, which, in a few days, disappear. Chicken-pox never leaves
pit-marks behind. It is a child’s complaint; adults scarcely, if ever,
have it.
224. _Is there any danger in Chicken-pox; and what treatment do you
advise?_
It is not at all a dangerous, but, on the contrary, a trivial complaint.
It lasts only a few days, and requires but little medicine. The patient
ought, for three or four days, to keep the house, and should abstain
from animal food. On the sixth day, but not until then, a dose or two of
a mild aperient is all that will be required.
225. _Is Chicken-pox infectious?_
There is a diversity of opinion on this head, but one thing is
certain—it cannot be communicated by inoculation.
226. _What are the symptoms of Modified Small-pox?_
The modified small-pox—that is to say, small-pox that has been robbed of
its virulence by the patient having been either already vaccinated, or
by his having had a previous attack of small-pox—is ushered in with
severe symptoms, with symptoms almost as severe as though the patient
had not been already somewhat protected either by vaccination or by the
previous attack of small-pox—that is to say, he has a shivering fit,
great depression of spirits and debility, _malaise_, sickness, headache,
and occasionally delirium. After the above symptoms have lasted about
three days, the eruption shows itself. The immense value of the previous
vaccination, or the previous attack of small-pox, now comes into play.
In a case of _unprotected_ small-pox, the appearance of the eruption
_aggravates_ all the above symptoms, and the danger begins; while in the
_modified_ small-pox, the moment the eruption shows itself, the patient
feels better, and, as a rule, rapidly recovers. The eruption of
_modified_ small-pox varies materially from the eruption of the
_unprotected_ small-pox. The former eruption assumes a varied character,
and is composed, first of vesicles (containing water), and secondly of
pustules (containing matter), each of which pustules has a depression in
the center, and thirdly of several red pimples without either water or
matter in them, and which sometimes assume a livid appearance. These
“breakings-out” generally show themselves more upon the wrist, and
sometimes up one or both of the nostrils. While in the latter
disease—the _unprotected_ small-pox—the “breaking-out” is composed
entirely of pustules containing matter, and which pustules are more on
the face than on any other part of the body. There is generally a
peculiar smell in both diseases—an odor once smelt never to be
forgotten.
Now, there is one most important remark I have to make,—_the modified
small-pox is contagious_. This ought to be borne in mind, as a person
laboring under the disease must, if there be children in the house,
either be sent away himself, or else the children ought to be banished
both the house and the neighborhood. Another important piece of advice
is, let _all_ in the house—children and adults, one and all—be
vaccinated, even if any or all have been previously vaccinated.
_Treatment._—Let the patient keep his room, and if he be very ill, his
bed. Let the chamber be well ventilated. If it be winter time, a small
fire in the grate will encourage ventilation. If it be summer, a fire is
out of the question; indeed, in such a case, the window-sash ought to be
opened, as thorough ventilation is an important requisite of cure, both
in small-pox and in _modified_ small-pox. While the eruption is out, do
not on any account give aperient medicine. In ten days from the
commencement of the illness a mild aperient may be given. The best
medicine in these cases is, the sweetened acidulated infusion of
roses,[239] which ought to be given from the commencement of the
disease, and should be continued until the fever be abated. For the
first few days, as long as the fever lasts, the patient ought not to be
allowed either meat or broth, but should be kept on a low diet, such as
on gruel, arrow-root, milk puddings, etc. As soon as the fever is abated
he ought gradually to resume his usual diet. When he is convalescent, it
is well, where practicable, that he should have change of air for a
month.
227. _How would you distinguish between Modified Small-pox and
Chicken-pox?_
Modified small-pox may readily be distinguished from chicken-pox, by the
former disease being, notwithstanding its modification, much more severe
and the fever much more intense _before_ the eruption shows itself than
chicken-pox; indeed, in chicken-pox there is little or no fever either
before or after the eruption; by the former disease, the modified
small-pox, consisting _partly_ of pustules (containing matter), each
pustule having a depression in the center, and the favorite localities
of the pustules being the wrists and the inside of the nostrils: while,
in the chicken-pox, the eruption consists of vesicles (containing
water), and _not_ pustules (containing matter), and the vesicles having
neither a depression in the center, nor having any particular partiality
to attack either the wrists or the wings of the nose. In modified
small-pox each pustule is, as in unprotected small-pox, inflamed at the
base; while in chicken-pox there is only very slight redness around each
vesicle. The vesicles, too, in chicken-pox are small—much smaller than
the pustules are in modified small-pox.
228. _Is Hooping-cough an inflammatory disease?_
Hooping-cough in itself is not inflammatory, it is purely spasmodic; but
it is generally accompanied with more or less of bronchitis—inflammation
of the mucous membrane of the bronchial tubes—on which account it is
necessary, _in all cases_ of hooping-cough, to consult a medical man,
that he may watch the progress of the disease and nip inflammation in
the bud.
229. _Will you have the goodness to give the symptoms, and a brief
history, of Hooping-cough?_
Hooping-cough is emphatically a disease of the young; it is rare for
adults to have it; if they do, they usually suffer more severely than
children. A child seldom has it but once in his life. It is highly
contagious, and therefore frequently runs through a whole family of
children, giving much annoyance, anxiety, and trouble to the mother and
the nurses; hence hooping-cough is much dreaded by them. It is amenable
to treatment. Spring and summer are the best seasons of the year for the
disease to occur. This complaint usually lasts from six to twelve
weeks—sometimes for a much longer period, more especially if proper
means are not employed to relieve it.
Hooping-cough commences as a common cold and cough. The cough, for ten
days or a fortnight, increases in intensity; at about which time it puts
on the characteristic “hoop.” The attack of cough comes on in paroxysms.
In a paroxysm the child coughs so long and so violently, and _expires_
so much air from the lungs without _inspiring_ any, that at times he
appears nearly suffocated and exhausted; the veins of his neck swell;
his face is nearly purple; his eyes, with the tremendous exertion, seem
almost to start from their sockets; at length there is a sudden
_inspiration_ of air through the contracted chink of the upper part of
the windpipe—the glottis—causing the peculiar “hoop; and, after a little
more coughing, he brings up some glairy mucus from the chest; and
sometimes, by vomiting, food from the stomach; he is at once relieved
until the next paroxysm occurs, when the same process is repeated, the
child during the intervals, in a favorable case, appearing quite well,
and after the cough is over, instantly returning either to his play or
to his food. Generally, after a paroxysm he is hungry, unless, indeed,
there be severe inflammation either of the chest or of the lungs.
Sickness, as I before remarked, frequently accompanies hooping-cough;
when it does, it might be looked upon as a good sign. The child usually
knows when an attack is coming on; he dreads it, and therefore tries to
prevent it; he sometimes partially succeeds; but if he does, it only
makes the attack, when it does come, more severe. All causes of
irritation and excitement ought, as much as possible, to be avoided, as
passion is apt to bring on a severe paroxysm.
A new-born babe, an infant of one or two months old, commonly escapes
the infection; but if at that tender age he unfortunately catch
hooping-cough, it is likely to fare harder with him than if he were
older—the younger the child the greater the risk. But still, in such a
case, do not despair, as I have known numerous instances of new-born
infants, with judicious care, recover perfectly from the attack, and
thrive after it as though nothing of the kind had ever happened.
A new-born babe laboring under hooping-cough is liable to convulsions,
which is, in this disease, one, indeed the great, source of danger. A
child, too, who is teething, and laboring under the disease, is also
liable to convulsions. When the patient is convalescing, care ought to
be taken that he does not catch cold, or the “hoop” might return.
Hooping-cough may either precede, attend, or follow an attack of
measles.
230. _What is the treatment of Hooping-cough?_
We will divide the hooping-cough into three stages, and treat each stage
separately.
_What to do._—_In the first stage_, the commencement of hooping-cough:
For the first ten days give the ipecacuanha wine mixture,[240] a
teaspoonful three times a day. If the child be not weaned, keep him
entirely to the breast; if he be weaned, to a milk and farinaceous diet.
Confine him for the first ten days to the house, more especially if the
hooping-cough be attended, as it usually is, with more or less of
bronchitis. But take care that the rooms be well ventilated, for good
air is essential to the cure. If the bronchitis attending the
hooping-cough be severe, confine him to his bed, and treat him as though
it were simply a case of bronchitis.[241]
_In the second stage_, discontinue the ipecacuanha mixture, and give Dr.
Gibb’s remedy—namely, nitric acid—which I have found to be an
efficacious and valuable one in hooping-cough:
Take of—Diluted Nitric Acid, two drachms;
Compound Tincture of Cardamoms, half a drachm;
Simple Syrup, three ounces;
Water, two ounces and a half:
Make a Mixture. One or two teaspoonfuls, or a tablespoonful, according
to the age of the child—one teaspoonful for an infant of six months,
and two teaspoonfuls for a child of twelve months, and one
tablespoonful for a child of two years, every four hours, first
shaking the bottle.
Let the spine and the chest be well rubbed every night and morning
either with Roche’s Embrocation, or with the following stimulating
liniment (first shaking the bottle):
Take of—Oil of Cloves, one drachm;
Oil of Amber, two drachms;
Camphorated Oil, nine drachms:
Make a Liniment.
Let him wear a broad band of new flannel, which should extend round from
his chest to his back, and which ought to be changed every night and
morning, in order that it may be dried before putting on again. To keep
it in its place it should be fastened by means of tapes and with
shoulder-straps.
The diet ought now to be improved—he should gradually return to his
usual food; and, weather permitting, should almost live in the open
air—fresh air being, in such a case, one of the finest medicines.
_In the third stage_, that is to say, when the complaint has lasted a
month, if by that time the child is not well, there is nothing like
change of air to a high, dry, healthy, country place. Continue the
nitric acid mixture, and either the embrocation or the liniment to the
back and the chest, and let him continue to almost live in the open air,
and be sure that he does not discontinue wearing the flannel until he be
quite cured, and then let it be left off by degrees.
If the hooping-cough have caused debility, give him cod-liver oil, a
teaspoonful twice or three times a day, giving it him on a full stomach
after his meals.
But, remember, after the first three or four weeks, change of air, and
plenty of it, is for hooping-cough the grand remedy.
_What_ NOT _to do_.—Do not apply leeches to the chest, for I would
rather put blood into a child laboring under hooping-cough than take it
out of him—hooping-cough is quite weakening enough to the system of
itself without robbing him of his life’s blood; do not, on any account
whatever, administer either emetic tartar or antimonial wine; do not
give either paregoric or syrup of white poppies; do not drug him either
with calomel or with gray powder; do not dose him with quack medicine;
do not give him stimulants, but rather give him plenty of nourishment,
such as milk and farinaceous food, but _no_ stimulants; do not be
afraid, after the first week or two, of his having fresh air, and plenty
of it—for fresh, pure air is the grand remedy, after all that can be
said and done, in hooping-cough. Although occasionally we find that if
the child be laboring under hooping-cough and is breathing a pure
country air, and is not getting well so rapidly as we could wish, change
of air to a smoky, gas-laden town will sometimes quickly effect a cure;
indeed, some persons go so far as to say that the _best_ remedy for an
_obstinate_ case of hooping-cough is for the child to live the great
part of every day in gas-works!
231. _What is to be done during a paroxysm of Hooping-cough?_
If the child be old enough, let him stand up; but if he be either too
young or too feeble, raise his head, and bend his body a little forward;
then support his back with one hand, and the forehead with the other.
Let the mucus, the moment it is within reach, be wiped with a soft
handkerchief out of his mouth.
232. _In an obstinate case of Hooping-cough, what is the best remedy?_
Change of air, provided there be no active inflammation, to any healthy
spot. A farm-house, in a high, dry, and salubrious neighborhood, is as
good a place as can be chosen. If, in a short time, he be not quite
well, take him to the sea-side: the sea breezes will often, as if by
magic, drive away the disease.
233. _Suppose my child should have a shivering fit, is it to be looked
upon as an important symptom?_
Certainly. Nearly all _serious_ illnesses commence with a shivering fit:
severe colds, influenza, inflammations of different organs, scarlet
fever, measles, small-pox, and very many other diseases, begin in this
way. If, therefore, your child should ever have a shivering fit,
_instantly_ send for a medical man, as delay might be dangerous. A few
hours of judicious treatment, at the commencement of an illness, is
frequently of more avail than days and weeks, nay months, of treatment,
when disease has gained a firm footing. A _serious_ disease often steals
on insidiously, and we have, perhaps, only the shivering fit, which
might be but a _slight_ one, to tell us of its approach.
A _trifling_ ailment, too, by neglecting the premonitory symptom, which,
at first, might only be indicated by a _slight_ shivering fit, will
sometimes become a _mortal_ disorder:
“The little rift within the lute,
That by-and-by will make the music mute,
And ever widening slowly silence all.”[242]
234. _In case of a shivering fit, perhaps you will tell me what to do?_
_Instantly_ have the bed warmed, and put the child to bed. Apply either
a hot bottle or a hot brick, wrapped in flannel, to the soles of his
feet. Put an extra blanket on his bed, and give him a hot cup of tea.
As soon as the shivering fit is over, and he has become hot, gradually
lessen the _extra_ quantity of clothes on his bed, and take away the hot
bottle or the hot brick from his feet.
_What_ NOT _to do_.—Do not give either brandy or wine, as inflammation
of some organ might be about taking place. Do not administer opening
medicine, as there might be some “breaking-out” coming out on the skin,
and an aperient might check it.
235. _My child, apparently otherwise healthy, screams out in the night
violently in his sleep, and nothing for a time will pacify him: what is
likely to be the cause, and what is the treatment?_
The causes of these violent screamings in the night are various. At one
time, they proceed from teething; at another, from worms; sometimes,
from night-mare; occasionally, from either disordered stomach or bowels.
Each of the above causes will, of course, require a different plan of
procedure; it will, therefore, be necessary to consult a medical man on
the subject, who will soon, with appropriate treatment, be able to
relieve him.
236. _Have the goodness to describe the complaint of children called
Mumps._
The mumps, inflammation of the “parotid” gland, is commonly ushered in
with a slight feverish attack. After a short time, a swelling, of stony
hardness, is noticed before and under the ear, which swelling extends
along the neck toward the chin. This lump is exceedingly painful, and
continues painful and swollen for four or five days. At the end of which
time it gradually disappears, leaving not a trace behind. The swelling
of mumps never gathers. It may affect one or both sides of the face. It
seldom occurs but once in a lifetime. It is contagious, and has been
known to run through a whole family or school; but it is not dangerous,
unless, which is rarely the case, it leaves the “parotid” gland, and
migrates either to the head, to the breast, or to the testicle.
237. _What is the treatment of Mumps?_
Foment the swelling, four or five times a day, with a flannel wrung out
of hot chamomile and poppy-head decoction;[243] and apply, every night,
a barm and oatmeal poultice to the swollen gland or glands. Debar, for a
few days, the little patient from taking meat and broth, and let him
live on bread and milk, light puddings, and arrow-root. Keep him in a
well-ventilated room, and shut him out from the company of his brothers,
his sisters, and young companions. Give him a little mild, aperient
medicine. Of course, if there be the slightest symptom of migration to
any other part or parts, instantly call in a medical man.
238. _What is the treatment of a Boil?_
One of the best applications is a Burgundy pitch plaster spread on a
soft piece of wash-leather. Let a chemist spread a plaster, about the
size of the hand; and, from this piece, cut small plasters, the size of
a shilling or a florin (according to the dimensions of the boil), which
snip around and apply to the part. Put a fresh one on daily. This
plaster will soon cause the boil to break; when it does break, squeeze
out the contents, the core, and the matter, and then apply one of the
plasters as before, which, until the boil be well, renew every day.
The old-fashioned remedy for a boil—namely, common yellow soap and brown
sugar, is a capital one for the purposes; it should be made into a
paste, and spread on a piece of coarse linen, the size either of a
shilling or of a florin (according to the size of the boil); it eases
the pain and causes the boil soon to break, and draws it when it is
broken; it should be renewed daily.
_If the boils should arise from the child being in a delicate state of
health_, give him cod-liver oil, meat once a day, and an abundance of
milk and farinaceous food. Let him have plenty of fresh air, exercise,
and play.
_If the boils should arise from gross and improper feeding_, then keep
him for a time from meat, and let him live principally on a milk and
farinaceous diet.
_If the child be fat and gross_, cod-liver oil would be improper; a mild
aperient, such as rhubarb and magnesia, would then be the best medicine.
239. _What are the symptoms of Earache?_
A young child screaming shrilly, violently, and continuously, is
oftentimes owing to earache; carefully, therefore, examine each ear, and
ascertain if there be any discharge; if there be, the mystery is
explained.
Screaming from earache may be distinguished from the screaming from
bowelache by the former (earache) being more continuous—indeed, being
one continued scream, and from the child putting his hand to his head;
while, in the latter (bowelache), the pain is more of a coming and of a
going character, and he draws up his legs to his bowels. Again, in the
former (earache), the secretions from the bowels are natural; while, in
the latter (bowelache), the secretions from the bowels are usually
depraved, and probably offensive. But a careful examination of the ear
will generally at once decide the nature of the case.
240. _What is the best remedy for Earache?_
Apply to the ear a small flannel bag, filled with hot salt—as hot as can
be comfortably borne, or foment the ear with a flannel wrung out of hot
chamomile and poppy-head decoction. A roasted onion, inclosed in muslin,
applied to the ear, is an old-fashioned and favorite remedy, and may, if
the bag of hot salt, or if the hot fomentation do not relieve, be tried.
Put into the ear, but not very far, a small piece of cotton wool,
moistened with warm olive oil. Taking care that the wool is always
removed before a fresh piece be substituted, as if it be allowed to
remain in any length of time, it may produce a discharge from the ear.
Avoid all _cold_ applications. If the earache be severe, keep the little
fellow at home, in a room of equal temperature, but well ventilated, and
give him, for a day or two, no meat.
If a discharge from the ear should either accompany or follow the
earache, _more especially if the discharge be offensive_, instantly call
in a medical man, or deafness for life may be the result.
A knitted or crocheted hat, with woolen rosettes over the ears, is, in
the winter time, an excellent hat for a child subject to earache. The
hat may be procured at any baby-linen warehouse.
241. _What are the causes and the treatment of discharges from the Ear?_
Cold, measles, scarlet fever, healing up of “breakings-out” behind the
ear; pellets of cotton wool, which had been put in the ear, and had been
forgotten to be removed, are the usual causes of discharges from the
ear. It generally commences with earache.
The _treatment_ consists in keeping the parts clean, by syringing the
ear every morning with warm water, by attention to food, keeping the
child principally upon a milk and a farinaceous diet, and by change of
air, more especially to the coast. If change of air be not practicable,
great attention ought to be paid to ventilation. As I have before
advised, in all cases of discharge from the ear, call in a medical man,
as a little judicious medicine is advisable—indeed, essential; and it
may be necessary to syringe the ear with lotions, instead of with warm
water; and, of course, it is only a doctor who has actually seen the
patient who can decide these matters, and what is best to be done in
each individual case.
242. _What is the treatment of a “sty” in the eyelid?_
Bathe the eye frequently with warm milk and water, and apply, every
night at bedtime, a warm white-bread poultice.
No medicine is required; but if the child be gross, keep him for a few
days from meat, and let him live on bread and milk and farinaceous
puddings.
243. _If a child have large bowels, what would you recommend as likely
to reduce their size?_
It ought to be borne in mind that the bowels of a child are larger in
proportion than those of an adult. But, if they be actually larger than
they ought to be, let them be well rubbed for a quarter of an hour at a
time night and morning, with soap liniment, and then apply a broad
flannel belt. “A broad flannel belt worn night and day, firm but not
tight, is very serviceable.”[244] The child ought to be prevented from
drinking as much as he has been in the habit of doing; let him be
encouraged to exercise himself well in the open air; and let strict
regard be paid to his diet.
244. _What are the best aperients for a child?_
If it be _actually_ necessary to give him opening medicine, one or two
teaspoonfuls of syrup of senna, repeated if necessary, in four hours,
will generally answer the purpose; or, for a change, one or two
teaspoonfuls of castor oil may be substituted. Lenitive electuary
(compound confection of senna) is another excellent aperient for the
young, it being mild in its operation, and pleasant to take; a child
fancying it is nothing more than jam, and which it much resembles both
in appearance and in taste. The dose is half or one teaspoonful early in
the morning occasionally. Senna is an admirable aperient for a child,
and is a safe one, which is more than can be said of many others. It is
worthy of note that “the taste of senna may be concealed by sweetening
the infusion,[245] adding milk, and drinking as ordinary tea, which,
when thus prepared, it much resembles.”[246] Honey, too, is a nice
aperient for a child—a teaspoonful ought to be given either by itself,
or spread on a slice of bread.
Some mothers are in the habit of giving their children jalap
gingerbread. I do not approve of it, as jalap is a drastic griping
purgative; besides, jalap is very nasty to take—nothing will make it
palatable.
Fluid magnesia—solution of the bicarbonate of magnesia—is a good
aperient for a child; and, as it has very little taste, is readily
given, more especially if made palatable by the addition either of a
little syrup or of brown sugar. The advantages which it has over the old
solid form are, that it is colorless and nearly tasteless, and never
forms concretions in the bowels, as the _solid_ magnesia, if persevered
in for any length of time, sometimes does. A child two or three years
old may take one or two tablespoonfuls of the fluid, either by itself or
in his food, repeating it every four hours until the bowels be opened.
When the child is old enough to drink the draught off _immediately_, the
addition of one or two teaspoonfuls of lemon-juice, to each dose of the
fluid magnesia, makes a pleasant effervescing draught, and increases its
efficacy as an aperient.
Bran-bread[247] and _treacle_ will frequently open the bowels; and as
treacle is wholesome, it may be substituted for butter when the bowels
are inclined to be costive. A roasted apple, eaten with _raw_ sugar, is
another excellent mild aperient for a child. Milk gruel—that is to say,
milk thickened with oatmeal—forms an excellent food for him, and often
keeps his bowels regular, and thus (_which is a very important
consideration_) supersedes the necessity of giving him an aperient. An
orange (taking care he does not eat the peel or the pulp), or a fig
after dinner, or a few Muscatel raisins, will frequently regulate the
bowels.
Stewed prunes is another admirable remedy for the costiveness of a
child. The manner of stewing them is as follows: Put a pound of prunes
in a brown jar, add two tablespoonfuls of _raw_ sugar, then cover the
prunes and the sugar with cold water; place them in the oven, and let
them stew for four hours. A child should every morning eat half a dozen
or a dozen of them, until the bowels be relieved, taking care that he
does not swallow the stones.
A suppository is a mild and ready way of opening the bowels of a child.
When he is two or three years old and upwards, a _candle_ suppository is
better than a _soap_ suppository. The way of preparing it is as follows:
Cut a piece of dip-tallow candle—the length of three inches—and insert
it as you would a clyster pipe, about two inches up the fundament,
allowing the remaining inch to be in sight, and there let the
suppository remain until the bowels be opened.
245. _What are the most frequent causes of Protrusion of the lower
bowel?_
The too common and reprehensible practice of a parent administering
frequent aperients, especially calomel and jalap, to her child. Another
cause, is allowing him to remain for a quarter of an hour or more at a
time on his chair; this induces him to strain, and to force the gut
down.
246. _What are the remedies?_
If the protrusion of the bowel have been brought on by the abuse of
aperients, abstain for the future from giving them; but if medicine be
absolutely required, give the mildest—such as either syrup of senna or
castor oil—_and the less of those the better_.
If the _external_ application of a purgative will have the desired
effect, it will, in such cases, be better than the _internal_
administration of aperients. Dr. Merriman’s Purgative Liniment[248] is a
good one for the purpose. Let the bowels be well rubbed every night and
morning, for five minutes at a time, with the liniment.
A wet compress to the bowels will frequently open them, and will thus do
away with the necessity of giving an aperient—_a most important
consideration_. Fold a napkin in six thicknesses, soak it in _cold_
water, and apply it to the bowels, over which put either a thin covering
or sheet of gutta-percha, or a piece of oiled silk; keep it in its place
with a broad flannel roller, and let it remain on the bowels for three
or four hours, or until they be opened.
Try what diet will do, as opening the bowels by a regulated diet is far
preferable to the giving of aperients. Let him have either bran-bread,
Robinson’s Patent Groats made into gruel with new milk, or Du Barry’s
Arabica Revalenta, or a slice of Huntley and Palmer’s lump gingerbread.
Let him eat stewed prunes, stewed rhubarb, roasted apples, strawberries,
raspberries, the inside of grapes and gooseberries, figs, etc. Give him
early every morning a draught of _cold_ water.
Let me, again, urge you _not_ to give aperients in these cases, or in
any case, unless you are absolutely compelled. By following my advice
you will save yourself an immense deal of trouble, and your child a long
catalogue of misery. Again, I say, look well into the matter, and
whenever it be practicable, avoid purgatives.
Now, with regard to the best manner of returning the bowel, lay the
child upon the bed on his face and bowels, with his hips a little
raised; then smear lard on the forefinger of your right hand (taking
care that the nail be cut close) and gently with your forefinger press
the bowel into its proper place.
Remember, if the above methods be observed, you cannot do the slightest
injury to the bowel, and the sooner it be returned the better it will be
for the child; for, if the bowel be allowed to remain long down, it may
slough or mortify, and death may ensue. The nurse, every time he has a
motion, must see that the bowel does not come down, and if it does, she
ought instantly to return it. Moreover, the nurse should be careful
_not_ to allow the child to remain on his chair more than two or three
minutes at a time.
Another excellent remedy for the protrusion of the lower bowel is to use
every morning a cold salt and water sitz-bath. There need not be more
than a depth of three inches of water in the bath; a small handful of
table salt should be dissolved in the water; a dash of warm water in the
winter time must be added to take off the extreme chill, and the child
ought not to be allowed to sit in the bath for more than one minute, or
while the mother can count a hundred, taking care the while to throw
either a square of flannel or a small shawl over his shoulders. The
sitz-bath ought to be continued for months, or until the complaint be
removed. I cannot speak in too high praise of these baths.
247. _Do you advise me, every spring and fall, to give my child
brimstone to purify and sweeten his blood, and as a preventive
medicine?_
Certainly not: if you wish to take away his appetite and to weaken and
depress him, give him brimstone! Brimstone is not a remedy fit for a
child’s stomach. The principal use and value of brimstone is as an
external application in itch, and as an internal remedy, mixed with
other laxatives, in piles—piles being a complaint of adults. In olden
times poor unfortunate children were dosed every spring and fall with
brimstone and treacle, to sweeten their blood! Fortunately for the
present race, there is not so much of that folly practiced, but still
there is room for improvement.
To dose a _healthy_ child with physic is the grossest absurdity. No, the
less physic a delicate child has the better it will be for him, but
physic to a healthy child is downright poison!—and brimstone of all
medicines! It is both weakening and depressing to the system, and by
opening the pores of the skin and by relaxing the bowels, is likely to
give cold, and thus to make a healthy a sickly child. Sweeten his blood!
It is more likely to weaken his blood, and thus to make his blood
impure! Blood is not made pure by drugs, but by Nature’s medicine: by
exercise, by pure air, by wholesome diet, by sleep in a well-ventilated
apartment, by regular and thorough ablution. Brimstone a preventive
medicine? Preventive medicine—and brimstone especially in the guise of a
preventive medicine—is “a mockery, a delusion, and a snare.”
248. _When a child is delicate, and his body, without any assignable
cause is gradually wasting away, and the stomach rejects all food that
is taken, what plan can be adopted likely to support his strength, and
thus, probably, be the means of saving his life?_
I have seen, in such a case, great benefit to arise from half a
teacupful of either strong mutton broth, or of strong beef-tea, used as
an enema, every four hours.[249]
It should be administered slowly, in order that it may remain in the
bowel. If the child be sinking, either a dessertspoonful of brandy, or
half a wineglassful of port wine ought to be added to each enema.
The above plan ought only to be adopted if there be _no_ diarrhœa. If
there be diarrhœa, an enema must _not_ be used. Then, provided there be
great wasting away, and extreme exhaustion, and other remedies having
failed, it would be advisable to give, by the mouth, _raw_ beef of the
finest quality, which ought to be taken from the hip-bone, and should be
shredded very fine. All fat and skin must be carefully removed. One or
two teaspoonfuls (according to the age of the child) ought to be given
every four hours. The giving of _raw_ meat to children in exhaustive
diseases, such as excessive long-standing diarrhœa, was introduced into
practice by a Russian physician, a Professor Weisse, of St. Petersburg.
It certainly is, in these cases, a most valuable remedy, and has
frequently been the means of snatching such patients from the jaws of
death. Children usually take raw meat with avidity and with a relish.
249. _If a child be naturally delicate, what plan would you recommend to
strengthen him?_
I should advise strict attention to the rules above mentioned, and
_change of air_—more especially, if it be possible, to the coast. Change
of air, sometimes, upon a delicate child, acts like magic, and may
restore him to health when all other means have failed. If a girl be
delicate, “carry her off to the farm, there to undergo the discipline of
new milk, brown bread, early hours, no lessons, and romps in the
hay-field.”[250] This advice is, of course, equally applicable for a
delicate boy, as delicate boys and delicate girls ought to be treated
alike. Unfortunately, in these very enlightened days! there is too great
a distinction made in the respective management and treatment of boys
and girls.
The best medicines for a delicate child will be the wine of iron and
cod-liver oil. Give them combined in the manner I shall advise when
speaking of the treatment of Rickets.
In diseases of long standing, and that resist the usual remedies, there
is nothing like _change of air_. Hippocrates, the father of medicine,
says:
“In longis morbis solum mutare.”
(In tedious diseases to change the place of residence.)
A child who, in the winter, is always catching cold, whose life during
half of the year is one continued catarrh, who is in consequence likely,
if he grow up at all, to grow up a confirmed invalid, ought, during the
winter months, to seek another clime; and if the parents can afford the
expense, they should, at the beginning of October, cause him to bend his
steps to the south of Europe—Mentone being as good a place as they could
probably fix upon.
250. _Do you approve of sea bathing for a delicate young child?_
No: he is frequently so frightened by it that the alarm would do him
more harm than the bathing would do him good. The better plan would be
to have him every morning well sponged, especially his back and loins,
with sea water; and to have him as much as possible carried on the
beach, in order that he may inhale the sea breezes.
When he be older, and is not frightened at being dipped, sea bathing
will be very beneficial to him. If bathing is to do good, either to an
adult or to a child, it must be anticipated with pleasure, and neither
with dread nor with distaste.
251. _What is the best method of administering medicine to a child?_
If he be old enough, appeal to his reason; for, if a mother endeavor to
deceive her child, and he detect her, he will for the future suspect
her.
If he be too young to be reasoned with, then, if he will not take his
medicine, he must be compelled. Lay him across your knees, let both his
hands and his nose be tightly held, and then, by means of the patent
medicine-spoon, or, if that be not at hand, by either a tea or a
dessertspoon, pour the medicine down his throat, and he will be obliged
to swallow it.
It may be said that this is a cruel procedure; but it is the only way to
compel an unruly child to take physic, and is much less cruel than
running the risk of his dying from the medicine not having been
administered.[251]
252. _Ought a sick child to be roused from his sleep to give him physic,
when it is time for him to take it?_
On no account, as sleep, being a natural restorative, must not be
interfered with. A mother cannot be too particular in administering the
medicine, at stated periods, while he is awake.
253. _Have you any remarks to make on the management of a sick-room, and
have you any directions to give on the nursing of a sick child?_
In sickness select a large and lofty room; if in the town, the back of
the house will be preferable—in order to keep the patient free from
noise and bustle—as a sick-chamber cannot be kept too quiet. Be sure
that there be a chimney in the room—as there ought to be in _every_ room
in the house—and that it be not stopped, as it will help to carry off
the impure air of the apartment. Keep the chamber _well ventilated_, by,
from time to time, opening the window. The air of the apartment cannot
be too pure; therefore, let the evacuations from the bowels be instantly
removed, either to a distant part of the house, or to an out-house, or
to the cellar, as it might be necessary to keep them for the medical
man’s inspection.
Let there be a frequent change of linen, as in sickness it is even more
necessary than in health, more especially if the complaint be fever. In
an attack of fever clean sheets ought, every other day, to be put on the
bed; clean body-linen every day. A frequent change of linen in sickness
is most refreshing.
If the complaint be fever, a fire in the grate will not be necessary.
Should it be a case either of inflammation of the lungs or of the chest,
a small fire in the winter time is desirable, keeping the temperature of
the room as nearly as possible at 60° Fahrenheit. Bear in mind that a
large fire in a sick-room cannot be too strongly condemned; for if there
be fever—and there are scarcely any complaints without—a large fire only
increases it. Small fires, in cases either of inflammation of the lungs
or of the chest, in the winter time, encourage ventilation of the
apartment, and thus carry off impure air. If it be summer time of course
fires would be improper. A thermometer is an indispensable requisite in
a sick-room.
In fever, free and thorough ventilation is of vital importance, more
especially in scarlet fever; then a patient cannot have too much air; in
scarlet fever, for the first few days the windows, be it winter or
summer, must to the widest extent be opened. The fear of the patient
catching cold by doing so is one of the numerous prejudices and baseless
fears that haunt the nursery, and the sooner it is exploded the better
it will be for human life. The valances and bed-curtains ought to be
removed, and there should be as little furniture in the room as
possible.
If it be a case of measles, it will be necessary to adopt a different
course; then the windows ought not to be opened, but the door must from
time to time be left ajar. In a case of measles, if it be winter time, a
_small_ fire in the room will be necessary. In inflammation of the lungs
or of the chest, the windows should not be opened, but the door ought
occasionally to be left unfastened, in order to change the air and to
make it pure. Remember, then, that ventilation, either by open window or
by open door, is most necessary in all diseases. Ventilation is one of
the best friends a doctor has.
In fever, do not load the bed with clothes; in the summer a sheet is
sufficient, in the winter a sheet and a blanket.
In fever, do not be afraid of allowing the patient plenty either of cold
water or of cold toast and water; Nature will tell him when he has had
enough. In measles, let the chill be taken off the toast and water.
In _croup_, have always ready a plentiful supply of hot water, in case a
warm bath might be required.
In _child-crowing_, have always in the sick-room a supply of cold water,
ready at a moments notice to dash upon the face.
In fever, do not let the little patient lie on the lap; he will rest
more comfortably on a horse-hair mattress in his crib or cot. If he have
pain in the bowels, the lap is most agreeable to him: the warmth of the
body, either of the mother or of the nurse, soothes him; besides, if he
be on the lap, he can be turned on his stomach and on his bowels, which
often affords him great relief and comfort. If he be much emaciated,
when he is nursed, place a pillow upon the lap and let him lie upon it.
In _head affections_, darken the room with a _green_ calico blind; keep
the chamber more than usually quiet; let what little talking is
necessary be carried on in whispers, but the less of that the better;
and in _head affections_, never allow smelling-salts to be applied to
the nose, as they only increase the flow of blood to the head, and
consequently do harm.
It is often a good sign when a child, who is seriously ill, suddenly
becomes cross. It is then he begins to feel his weakness, and to give
vent to his feelings. “Children are almost always cross when recovering
from an illness, however patient they may have been during its severest
moments, and the phenomenon is not by any means confined to
children.”[252]
A sick child must _not_ be stuffed with _much_ food at a time. He will
take either a tablespoonful of new milk or a tablespoonful of
chicken-broth every half hour, with greater advantage than a teacupful
of either the one or the other every four hours, which large quantity
would very probably be rejected from his stomach, and may cause the
unfortunately treated child to die of starvation!
If a sick child be peevish, attract his attention either by a toy or by
an ornament; if he be cross, win him over to good humor by love,
affection, and caresses, but let it be done gently and without noise. Do
not let visitors see him; they will only excite, distract, and irritate
him, and help to consume the oxygen of the atmosphere, and thus rob the
air of its exhilarating health-giving qualities and purity; a sick-room,
therefore, is not a proper place either for visitors or for gossips.
In selecting a sick-nurse, let her be gentle, patient, cheerful, quiet,
and kind, but firm withal; she ought to be neither old nor young; if she
be old, she is often garrulous and prejudiced, and thinks too much of
her trouble; if she be young, she is frequently thoughtless and noisy;
therefore choose a middle-aged woman. Do not let there be in the
sick-room more than, besides the mother, one efficient nurse; a great
number can be of no service—they will only be in each other’s way, and
will distract the patient.
Let stillness, especially if the head be the part affected, reign in a
sick-room. Creaking shoes[253] and rustling silk dresses ought not to be
worn in sick-chambers—they are quite out of place there. If the child be
asleep, or if he be dozing, perfect stillness must be enjoined—not even
a whisper should be heard:
“In the sick-room be calm,
Move gently and with care,
Lest any jar or sudden noise
Come sharply unaware.
You cannot tell the harm,
The mischief it may bring,
To wake the sick one suddenly,
Besides the suffering.
The broken sleep excites
Fresh pain, increased distress;
The quiet slumber undisturb’d
Soothes pain and restlessness.
Sleep is the gift of God:
Oh! bear these words at heart,—
‘He giveth his beloved sleep,’
And gently do thy part.”[254]
If there be other children, let them be removed to a distant part of the
house; or, if the disease be of an infectious nature, let them be sent
away from home altogether.
In all illnesses—and bear in mind the following is most important
advice—a child must be encouraged to try and make water, whether he ask
or not, at least four times during the twenty-four hours; and at any
other time, if be expresses the slightest inclination to do so. I have
known a little fellow to hold his water, to his great detriment, for
twelve hours, because either the mother had in her trouble forgotten to
inquire, or the child himself was either too ill or too indolent to make
the attempt.
See that the medical man’s directions are, to the very letter, carried
out. Do not fancy that you know better than he does, otherwise you have
no business to employ him. Let him, then, have your implicit confidence
and your exact obedience. What _you_ may consider to be a trifling
matter, may frequently be of the utmost importance, and may sometimes
decide whether the case shall either end in life or death!
_Lice._—It is not very poetical, as many of the grim facts of everyday
life are not, but, unlike a great deal of poetry, it is unfortunately
too true that after a severe and dangerous illness, especially after a
bad attack of fever, a child’s head frequently becomes infested with
vermin—with lice! It therefore behooves a mother herself to thoroughly
examine, by means of a fine-tooth comb,[255] her child’s head, in order
to satisfy her mind that there be no vermin there. As soon as he be well
enough, he ought to resume his regular ablutions—that is to say, that he
must go again regularly into his tub, and have his head every morning
thoroughly washed with soap and water. A mother ought to be particular
in seeing that the nurse washes the hairbrush at least once every week;
if she does not do so, the dirty brush which had, during the illness,
been used, might contain the “nits,”—the eggs of the lice,—and would
thus propagate the vermin, as they will, when on the head of the child,
soon hatch. If there be already lice on the head, in addition to the
regular washing every morning with the soap and water, and after the
head has been thoroughly dried, let the hair be well and plentifully
dressed with camphorated oil—the oil being allowed to remain on until
the next washing on the following morning. Lice cannot live in oil (more
especially if, as in camphorated oil, camphor be dissolved in it), and
as the camphorated oil will not, in the slightest degree, injure the
hair, it is the best application that can be used. But as soon as the
vermin have disappeared, let the oil be discontinued, as the _natural_
oil of the hair is, at other times, the only oil that is required on the
head.
The “nit”—the egg of the louse—might be distinguished from scurf
(although to the _naked_ eye it is very much like it in appearance) by
the former fastening firmly on one of the hairs as a barnacle would on a
rock, and by it not being readily brushed off as scurf would, which
latter (scurf) is always loose.
254. _My child, in the summer time, is much tormented with fleas: what
are the best remedies?_
A small muslin bag, filled with camphor, placed in the cot or bed, will
drive fleas away. Each flea-bite should, from time to time, be dressed
by means of a camel’s-hair brush, with a drop or two of spirit of
camphor, an ounce bottle of which ought, for the purpose, to be procured
from a chemist. Camphor is also an excellent remedy to prevent bugs from
biting. Bugs and fleas have a horror of camphor; and well they might,
for it is death to them!
There is a famous remedy for the destruction of fleas manufactured in
France, entitled “_La Poudre Insecticide_,” which, although perfectly
harmless to the human economy, is utterly destructive to fleas. Bugs are
best destroyed by oil of turpentine; the places they do love to
congregate in should be well saturated, by means of a brush, with the
oil of turpentine. A few dressings will effectually destroy both them
and their young ones.
255. _Suppose a child to have had an attack either of inflammation of
the lungs or of bronchitis, and to be much predisposed to a return: what
precautions would you take to prevent either the one or the other for
the future?_
I would recommend him to wear fine flannel instead of lawn shirts; to
wear good lamb’s-wool stockings _above the knees_, and good, strong, dry
shoes to his feet; to live, weather permitting, a great part of every
day in the open air; to strengthen his system by good nourishing food—by
an abundance of both milk and meat (the former especially); to send him,
in the autumn, for a couple of months, to the sea-side; to administer to
him, from time to time, cod-liver oil; in short, to think only of his
health, and to let learning, until he be stronger, be left alone.
I also advise either table salt or bay salt to be added to the water in
which the child is washed with in the morning, in a similar manner as
recommended in answer to the 123d question.
256. _Then do you not advise such a child to be confined within doors?_
If any inflammation be present, or if he have but just recovered from
one, it would be improper to send him into the open air, but not
otherwise, as the fresh air would be a likely means of strengthening the
lungs, and thereby of preventing an attack of inflammation for the
future. Besides, the more a child is coddled within doors, the more
likely will he be to catch cold, and to renew the inflammation. If the
weather be cold, yet neither wet nor damp, he ought to be sent out, but
let him be well clothed; and the nurse should have strict injunctions
_not_ to stand about entries, or in any draughts—indeed, not to stand
about at all, but to keep walking about all the time she is in the open
air. Unless you have a trustworthy nurse, it will be well for you either
to accompany her in her walk with your child, or merely to allow her to
walk with him in the garden, as you can then keep your eye upon both of
them.
257. _If a child be either chicken-breasted, or if he be narrow-chested,
are there any means of expanding and of strengthening his chest?_
Learning ought to be put out of the question; attention must be paid to
his health alone, or consumption will probably mark him as its own! Let
him live as much as possible in the open air; if it be country, so much
the better. Let him rise early in the morning, and let him go to bed
betimes; and if he be old enough to use the dumb-bells, or, what is
better, an india-rubber chest expander, he should do so daily. He ought
also to be encouraged to use two short sticks, similar to, but heavier
than, a policeman’s staff, and to go, every morning, through regular
exercises with them. As soon as he be old enough, let him have lessons
from a drill-sergeant and from a dancing-master. Let him be made both to
walk and to sit upright, and let him be kept as much as possible upon a
milk diet,[256] and give him as much as he can eat of fresh meat every
day. Cod-liver oil, a teaspoonful or a dessertspoonful, according to his
age, twice a day, is serviceable in these cases. Stimulants ought to be
carefully avoided. In short, let every means be used to nourish, to
strengthen, and invigorate the system, without at the same time creating
fever. Such a child should be a child of nature; he ought almost to live
in the open air, and throw his books to the winds. Of what use is
learning without health? In such a case as this you cannot have both.
258. _If a child be round-shouldered, or if either of his
shoulder-blades have “grown out,” what had better be done?_
Many children have either round shoulders, or have their shoulder-blades
grown out, or have their spines twisted, from growing too fast, from
being allowed to slouch in their gait, and from not having sufficient
nourishing food, such as meat and milk, to support them while the rapid
growth of childhood is going on.
If your child be affected as above described, nourish him well on milk
and on farinaceous food, and on meat once a day, but let milk be his
staple diet; he ought, during the twenty-four hours, to take two or
three pints of new milk. He should almost live in the open air, and must
have plenty of play. If you can so contrive it, let him live in the
country. When tired, let him lie, for half an hour, two or three times
daily, flat on his back on the carpet. Let him rest at night on a
horse-hair mattress, and not on a feather bed.
Let him have every morning, if it be summer, a thorough cold water
ablution; if it be winter, let the water be made tepid. Let either two
handfuls of table salt or a handful of bay salt be dissolved in the
water. Let the salt and water stream well over his shoulders and down
his back and loins. Let him be well dried with a moderately coarse
towel, and then let his back be well rubbed, and his shoulders be thrown
back—exercising them, much in the same manner as in skipping, for five
or ten minutes at a time. Skipping, by-the-by, is of great use in these
cases, whether the child be either a boy or a girl—using, of course, the
rope backward, and not forward.
Let books be utterly discarded until his shoulders have become strong,
and thus no longer round, and his shoulder-blades have become straight.
It is a painful sight to see a child stoop like an old man.
Let him have twice daily a teaspoonful or a dessertspoonful (according
to his age) of cod-liver oil.
When he is old enough, let the drill-sergeant give him regular lessons,
and let the dancing-master be put in requisition. Let him go through
regular gymnastic exercises, provided they are not of a violent
character.
But, bear in mind, let there be in these cases no mechanical
restraints—no shoulder-straps, no abominable stays. Make him straight by
natural means—by making him strong. Mechanical means would only, by
weakening and wasting the muscles, increase the mischief, and thus the
deformity. In this world of ours there is too much reliance placed on
artificial, and too little on natural means of cure.
259. _What are the causes of Bow Legs in a child; and what is the
treatment?_
Weakness of constitution, poor and insufficient nourishment, and putting
a child, more especially a fat and heavy one, on his legs too early.
_Treatment._—Nourishing food, such as an abundance of milk, and, if he
be old enough, of meat; iron medicines; cod-liver oil; thorough
ablution, every morning, of the whole body; an abundance of exercise
either on pony, or on donkey, or in carriage, but not, until his legs be
stronger, on foot. If they are much bowed, it will be necessary to
consult an experienced surgeon.
260. _If a child, while asleep, “wet his bed,” is there any method of
preventing him from doing so?_
Let him be held out just before he himself goes to bed, and again when
the family retires to rest. If, at the time, he be asleep, he will
become so accustomed to it that he will, without awaking, make water. He
ought to be made to lie on his side; for, if he be put on his back, the
urine will rest upon an irritable part of the bladder, and, if he be
inclined to wet his bed, he will not be able to avoid doing so. He must
not be allowed to drink much with his meals, especially with his supper.
Wetting the bed is an infirmity with some children—they cannot help it.
It is, therefore, cruel to scold and chastise them for it. Occasionally,
however, wetting the bed arises from idleness, in which case, of course,
a little wholesome correction might be necessary.
A waterproof cloth,[257] or bed-sheeting, as it is sometimes called—one
yard by three-quarters of a yard—will effectually preserve the bed from
being wetted, and ought always, on these occasions, to be used.
A mother ought, every morning, to ascertain for herself whether her
child have wet his bed; if he have, and if unfortunately the waterproof
cloth have not been used, the mattress, sheets, and blankets must be
instantly taken to the kitchen fire and be properly dried. Inattention
to the above has frequently caused a child to suffer, either from a
cold, from a fever, or from an inflammation; not only so, but if they be
not dried, he is wallowing in filth and in an offensive effluvium. If
both mother and nurse were more attentive to their duties—in frequently
holding a child out, whether he asks or not—a child wetting his bed
would be the exception, and not, as it frequently is, the rule. If a
child be dirty, you may depend upon it the right persons to blame are
the mother and the nurse, and not the child!
261. _If a child should catch Small-pox, what are the best means to
prevent pitting?_
He ought to be desired neither to pick nor to rub the pustules. If he be
too young to attend to these directions, his hands must be secured in
bags (just large enough to hold them), which bags should be fastened
round the wrists. The nails must be cut very close.
Cream smeared by means of a feather, frequently in the day, on the
pustules, affords great comfort and benefit. Tripe-liquor has, for the
same purpose, been strongly recommended. I, myself, in several cases
have tried it, and with the happiest results. It is most soothing,
comforting, and healing to the skin.
262. _Can you tell me of any plan to prevent Chilblains, or, if a child
be suffering from them, to cure them?_
_First, then, the way to prevent them._—Let a child, who is subject to
them, wear, in the winter time, a square piece of wash-leather over the
toes, a pair of warm lamb’s-wool stockings, and good shoes; but, above
all, let him be encouraged to run about the house as much as possible,
especially before going to bed; and on no account allow him either to
warm his feet before the fire, or to bathe them in _hot_ water. If the
feet be cold, and the child be too young to take exercise, then let them
be well rubbed with the warm hand. If adults suffer from chilblains, I
have found friction, night and morning, with horse-hair flesh-gloves,
the best means of preventing them.
_Secondly, the way to cure them._—_If they be unbroken_, let them be
well rubbed, every night and morning, with spirits of turpentine and
camphorated oil,[258] first shaking the bottle, and then let them be
covered with a piece of lint, over which a piece of wash-leather should
be placed. “An excellent chilblain remedy is made by shaking well
together, in a bottle, spirits of turpentine, white vinegar, and the
contents of an egg, in equal proportion. With this the chilblains should
be rubbed gently whenever they are in a state of irritation, and until
the swelling and redness are dissipated.”[259]
_If they be broken_, let a piece of lint be spread with spermaceti
cerate, and be applied, every morning, to the part, and let a
white-bread poultice be used every night.
263. _During the winter time my child’s hands, legs, etc. chap very
much: what ought I to do?_
Let a teacupful of bran be tied up in a muslin bag, and be put, over
night, into either a large water-can or jug of _rain_ water;[260] and
let this water from the can or jug be the water he is to be washed with
on the following morning, and every morning until the chaps be cured. As
often as water is withdrawn, either from the water-can or from the jug,
let fresh rain water take its place, in order that the bran may be
constantly soaking in it. The bran in the bag should be renewed about
twice a week.
Take particular care to dry the skin well every time he be washed; then,
after each ablution, as well as every night at bedtime, rub a piece of
deer’s suet over the parts affected: a few dressings will perform a
cure. The deer’s suet may be bought at any of the shops where venison is
sold. Another excellent remedy is glycerin,[261] which should be
smeared, by means of the finger or by a camel’s-hair brush, on the parts
affected, two or three times a day. If the child be very young, it might
be necessary to dilute the glycerin with rosewater: fill a small bottle
one-third with glycerin, and fill up the remaining two-thirds of the
bottle with rosewater—shaking the bottle every time just before using
it. The best soap to use for chapped hands is the glycerin soap: no
other being required.
264. _What is the best remedy for Chapped Lips?_
Cold-cream (which may be procured of any respectable chemist) is an
excellent application for _chapped lips_. It ought, by means of the
finger, to be frequently smeared on the parts affected.
265. _Have the goodness to inform me of the different varieties of Worms
that infest a child’s bowels?_
Principally three—1, The tape-worm; 2, the long round-worm; and 3, the
most frequent of all, the common thread or maw-worm. The tape-worm
infests the whole course of the bowels, both small and large: the long
round-worm, principally the small bowels, occasionally the stomach; it
sometimes crawls out of the child’s mouth, causing alarm to the mother;
there is, of course, no danger in its doing so: the common thread-worm
or maw-worm infests the rectum or fundament.
266. _What are the causes of Worms?_
The causes of worms are—weak bowels; bad and improper food, such as
unripe, unsound, or uncooked fruit, and much green vegetables; pork,
especially underdone pork;[262] an abundance of sweets; the neglecting
of giving salt in the food.
267. _What are the symptoms and the treatment of Worms?_
_The symptoms_ of worms are—emaciation; itching and picking of the nose;
a dark mark under the eyes; grating, during sleep, of the teeth;
starting in the sleep; foul breath; furred tongue; uncertain
appetite—sometimes voracious, at other times bad, the little patient
sitting down very hungry to his dinner, and before scarcely tasting a
mouthful, the appetite vanishing; large bowels; colicky pains of the
bowels; slimy motions; itching of the fundament. Tape-worm and
round-worm, more especially the former, are apt, in children, to produce
convulsions. Tape-worm is very weakening to the constitution, and
usually causes great emaciation and general ill health; the sooner
therefore it is expelled from the bowels the better it will be for the
patient.
Many of the obscure diseases of children arise from worms. In all
doubtful cases, therefore, this fact should be borne in mind, in order
that a thorough investigation may be instituted.
With regard to _treatment_, a medical man ought, of course, to be
consulted. He will soon use means both to dislodge them, and to prevent
a future recurrence of them.
Let me caution a mother never to give her child patent medicines for the
destruction of worms. There is one favorite quack powder, which is
composed principally of large doses of calomel, and which is quite as
likely to destroy the patient as the worms! No, if your child have
worms, put him under the care of a judicious medical man, who will soon
expel them, without, at the same time, injuring health and constitution!
268. _How may Worms be prevented from infesting a child’s bowels?_
Worms generally infest _weak_ bowels; hence, the moment a child becomes
strong worms cease to exist. The reason why a child is so subject to
them is owing to the improper food which is usually given to him. When
he be stuffed with unsound and with unripe fruits, with much sweets,
with rich puddings, and with pastry, and when he is oftentimes allowed
to eat his meat _without_ salt, and to _bolt_ his food without chewing
it, is there any wonder that he should suffer from worms? The way to
prevent them is to avoid such things, and, at the same time, to give him
plenty of salt to his _fresh_ and well-cooked meat. Salt strengthens and
assists digestion, and is absolutely necessary to the human economy.
Salt is emphatically a worm-destroyer. The truth of this statement may
be readily tested by sprinkling a little salt on the common earthworm.
“What a comfort and real requisite to human life is salt! It enters into
the constituents of the human blood, and to do without it is wholly
impossible.”[263] To do without it is wholly impossible! These are true
words. Look well to it, therefore, ye mothers, and beware of the
consequences of neglecting such advice, and see for yourselves that your
children regularly eat salt with their food. If they neglect eating salt
with their food, _they must, of necessity, have worms_, and worms that
will eventually injure them and make them miserable.
269. _You have a great objection to the frequent administration of
aperient medicines to a child: can you devise any method to prevent
their use?_
Although we can scarcely call constipation a disease, yet it sometimes
leads to disease. The frequent giving of aperients only adds to the
stubbornness of the bowels.
I have generally found a draught, early every morning, of _cold_
pump-water, the eating either of loaf gingerbread or of oatmeal
gingerbread, a variety of animal and vegetable food, ripe sound fruit,
Muscatel raisins, a fig, or an orange after dinner, and, when he be old
enough, _coffee_ and milk instead of _tea_ and milk, to have the desired
effect, more especially if, for a time, aperients be studiously avoided.
270. _Have you any remarks to make on Rickets?_
Rickets is owing to a want of a sufficient quantity of earthy matter in
the bones; hence the bones bend and twist, and lose their shape, causing
deformity. Rickets generally begins to show itself between the first and
second years of a child’s life. Such children are generally late in
cutting their teeth, and when the teeth do come, they are bad, deficient
of enamel, discolored, and readily decay. A rickety child is generally
stunted in stature; he has a large head, with overhanging forehead, or
what nurses call a watery-head-shaped forehead. The fontanelles, or
openings of the head as they are called, are a long time in closing. A
rickety child is usually talented; his brain seems to thrive at the
expense of his general health. His breast-bone projects out, and the
sides of his chest are flattened—hence he becomes what is called
chicken-breasted or pigeon-breasted; his spine is usually twisted, so
that he is quite awry, and, in a bad case, he is hump-backed; the ribs,
from the twisted spine, on one side bulge out; he is round-shouldered;
the long bones of his body, being soft, bend; he is bow-legged,
knock-kneed, and weak ankled.
Rickets are of various degrees of intensity, the hump-backed being among
the worst. There are many mild forms of rickets; weak ankles,
knocked-knees, bowed-legs, chicken-breasts, being among the latter
number. Many a child, who is not exactly hump-backed, is very
round-shouldered, which latter is also a mild species of rickets.
Show me a child that is rickety, and I can generally prove that it is
owing to poor living, more especially to poor milk. If milk were always
genuine, and if a child had an abundance of it, my belief is that
rickets would be a very rare disease. The importance of genuine milk is
of national importance. We cannot have a race of strong men and women
unless, as children, they have had a good and plentiful supply of milk.
It is utterly impossible. Milk might well be considered one of the
necessaries of a child’s existence.
Genuine fresh milk, then, is one of the grand preventives, as well as
one of the best remedies, for rickets. Many a child would not now have
to swallow quantities of cod-liver oil if previously he had imbibed
quantities of good genuine milk. An insufficient and a poor supply of
milk in childhood sows the seeds of many diseases, and death often
gathers the fruit. Can it be wondered at, when there is so much poor and
nasty milk in England, that rickets in one shape or another is so
prevalent?
When will mothers arouse from their slumbers, rub their eyes, and see
clearly the importance of the subject? When will they know that all the
symptoms of rickets I have just enumerated _usually_ proceed from the
want of nourishment, more especially from the want of genuine and of an
abundance of milk? There are, of course, other means of warding off
rickets besides an abundance of nourishing food, such as thorough
ablution, plenty of air, exercise, play, and sunshine; but of all these
splendid remedies, nourishment stands at the top of the list.
I do not mean to say that rickets _always_ proceeds from poorness of
living—from poor milk. It sometimes arises from scrofula, and is an
inheritance of one or of both the parents.
Rickety children, if not both carefully watched and managed, frequently,
when they become youths, die of consumption. A mother, who has for some
time neglected the advice I have just given, will often find, to her
grievous cost, that the mischief has, past remedy, been done, and that
it is now “too late!—too late!”
271. _How may a child be prevented from becoming Rickety? or, if he be
Rickety, how ought he to be treated?_
If a child be predisposed to be rickety, or if he be actually rickety,
attend to the following rules:
Let him live well, on good nourishing diet, such as on tender
rump-steaks, cut very fine, and mixed with mashed potatoes, crumb of
bread, and with the gravy of the meat. Let him have, as I have before
advised, an abundance of good new milk—a quart or three pints during
every twenty-four hours. Let him have milk in every form—as milk gruel,
Du Barry’s Arabica revalenta made with milk, batter and rice puddings,
suet-pudding, bread and milk, etc.
_To harden the bones_, let lime-water be added to the milk (a
tablespoonful to each teacupful of milk).
Let him have a good supply of fresh, pure, dry air. He must almost live
in the open air—the country, if practicable, in preference to the town,
and the coast in summer and autumn. Sea bathing and sea breezes are
often, in these cases, of inestimable value.
He ought not, at an early age, to be allowed to bear his weight upon his
legs. He must sleep on a horse-hair mattress, and not on a feather bed.
He should use, every morning, cold baths in the summer, and tepid baths
in the winter, with bay salt (a handful) dissolved in the water.
Friction with the hand must, for half an hour at a time, every night and
morning, be sedulously applied to the back and to the limbs. It is
wonderful how much good in these cases friction does.
Strict attention ought to be paid to the rules of health as laid down in
these Conversations. Whatever is conducive to the general health is
preventive and curative of rickets.
Books, if he be old enough to read them, should be thrown aside; health,
and health alone, must be the one grand object.
The best medicines in these cases are a combination of cod-liver oil and
the wine of iron, given in the following manner: Put a teaspoonful of
wine of iron into a wineglass, half fill the glass with water, sweeten
it with a lump or two of sugar, then let a teaspoonful of cod-liver oil
swim on the top; let the child drink it all down together, twice or
three times a day. An hour after a meal is the _best_ time to give the
medicine, as both iron and cod-liver oil sit better on a _full_ than on
an _empty_ stomach. The child in a short time will become fond of the
above medicine, and will be sorry when it is discontinued.
A case of rickets requires great patience and steady perseverance; let,
therefore, the above plan have a fair and long-continued trial, and I
can then promise that there will be every probability that great benefit
will be derived from it.
272. _If a child be subject to a scabby eruption about the mouth, what
is the best local application?_
Leave it to Nature. Do not, on any account, apply any local application
to heal it; if you do, you may produce injury; you may either bring on
an attack of inflammation, or you may throw him into convulsions. No!
This “breaking-out” is frequently a safety-valve, and must not therefore
be needlessly interfered with. Should the eruption be severe, reduce the
child’s diet; keep him from butter, from gravy, and from fat meat, or,
indeed, for a few days from meat altogether; and give him mild aperient
medicine; but, above all things, do not quack him either with calomel or
with gray powder.
273. _Will you have the goodness to describe the eruption on the face
and on the head of a young child, called Milk-Crust or Running Scall?_
Milk-crust is a complaint of very young children—of those who are
cutting their teeth—and as it is a nasty-looking complaint, and
frequently gives a mother a great deal of trouble, of anxiety, and
annoyance, it will be well that you should know its symptoms, its
causes, and its probable duration.
_Symptoms._—When a child is about nine months or a year old, small
pimples are apt to break out around the ears, on the forehead, and on
the head. These pimples at length become vesicles (that is to say, they
contain water), which run into one large one, break, and form a nasty
dirty-looking yellowish, and sometimes greenish scab, which scab is
moist, indeed, sometimes quite wet, and gives out a disagreeable odor,
and which is sometimes so large on the head as actually to form a
skull-cap, and so extensive on the face as to form a mask! These, I am
happy to say, are rare cases. The child’s beauty is, of course, for a
time completely destroyed, and not only his beauty, but his good temper;
for as the eruption causes great irritation and itching, he is
constantly clawing himself, and crying with annoyance a great part of
the day, and sometimes also of the night, the eruption preventing him
from sleeping. It is not contagious, and soon after he has cut the whole
of his _first_ set of teeth, it will get well, provided it has not been
improperly interfered with.
_Causes._—Irritation from teething; stuffing him with overmuch meat,
thus producing a humor, which Nature tries to get rid of by throwing it
out on the surface of the body, the safest place she could fix on for
the purpose, hence the folly and danger of giving medicines and applying
_external_ applications to drive the eruption in. “Diseased nature
oftentimes breaks forth in strange eruptions,”[264] and cures herself in
this way, if she be not too much interfered with, and if the eruption be
not driven in by injudicious treatment. I have known in such cases
disastrous consequences to follow over-officiousness and meddlesomeness.
Nature is trying all she can to drive the humor out, while some
wiseacres are doing all they can to drive the humor in.
_Duration._—As milk-crust is a tedious affair, and will require a
variety of treatment, it will be necessary to consult an experienced
medical man; and although he will be able to afford great relief, the
child will not, in all probability, be quite free from the eruption
until he has cut the whole of his first set of teeth—until he be upwards
of two years and a half old—when, with judicious and careful treatment,
it will gradually disappear, and eventually leave not a trace behind.
It will be far better to leave the case alone—to get well of itself
rather than to try to cure the complaint either by outward applications
or by strong internal medicines; “the remedy is often worse than the
disease,” of this I am quite convinced.
274. _Have you any advice to give me as to my conduct toward my medical
man?_
Give him your entire confidence. Be truthful and be candid with him.
Tell him the truth, the whole truth, and nothing but the truth. Have no
reservations; give him, as near as you can, a plain, unvarnished
statement of the symptoms of the disease. Do not magnify, and do not
make too light of any of them. Be prepared to state the exact time the
child first showed symptoms of illness. If he have had a shivering fit,
however slight, do not fail to tell your medical man of it. Note the
state of the skin; if there be a “breaking-out,” be it ever so trifling,
let it be pointed out to him. Make yourself acquainted with the quantity
and with the appearance of the urine, taking care to have a little of it
saved, in case the doctor may wish to see and examine it. Take notice of
the state of the motions—their number during the twenty-four hours,
their color, their smell, and their consistence, keeping one for his
inspection. Never leave any of these questions to be answered by a
servant; a mother is the proper person to give the necessary and
truthful answers, which answers frequently decide the fate of the
patient. Bear in mind, then, a mother’s untiring care and love,
attention and truthfulness, frequently decide whether, in a serious
illness, the little fellow shall live or die! Fearful responsibility!
A medical man has arduous duties to perform; smooth, therefore, his path
as much as you can, and you will be amply repaid by the increased good
he will be able to do your child. Strictly obey a doctor’s orders—in
diet, in medicine, in everything. Never throw obstacles in his way.
Never omit any of his suggestions; for depend upon it, that if he be a
sensible man, directions, however slight, ought never to be neglected;
bear in mind, with a judicious medical man,—
“That nothing walks with aimless feet.”[265]
If the case be severe, requiring a second opinion, never of your own
accord call in a physician without first consulting and advising with
your own medical man. It would be an act of great discourtesy to do so.
Inattention to the foregoing advice has frequently caused injury to the
patient, and heart-burnings and ill will among doctors.
Speak, in the presence of your child, with respect and kindness of your
medical man, so that the former may look upon the latter as a friend—as
one who will strive, with God’s blessing, to relieve his pain and
suffering. Remember the increased power of doing good the doctor will
have if the child be induced to like, instead of dislike, him. Not only
be careful that you yourself speak before your child respectfully and
kindly of the medical man, but see that your domestics do so likewise;
and take care that they are never allowed to frighten your child, as
many silly servants do, by saying that they will send for the doctor,
who will either give him nasty medicine, or will perform some cruel
operation upon him. A nurse-maid should, then, never for one moment be
permitted to make a doctor an object of terror or of dislike to a child.
Send, whenever it be practicable, for your doctor _early_ in the
morning, as he will then make his arrangements accordingly, and can by
daylight better ascertain the nature of the complaint, more especially
if it be a skin disease. It is utterly impossible for him to form a
correct opinion of the nature of a “breaking-out” either by gas or by
candle-light. If the illness come on at night, particularly if it be
ushered in either with a severe shivering, or with any other urgent
symptom, no time should be lost, be it night or day, in sending for him.
WARM BATHS.
275. _Have the goodness to mention the complaints of a child for which
warm baths are useful?_
1. Convulsions; 2. Pains in the bowels, known by the child drawing up
his legs, screaming violently, etc.; 3. Restlessness from teething; 4.
Flatulence. The warm bath acts as a fomentation to the stomach and the
bowels, and gives ease where the usual remedies do not rapidly relieve.
276. _Will you mention the precautions and the rules to be observed in
putting a child into a warm bath?_
Carefully ascertain before he be immersed in the bath that the water be
neither too hot nor too cold. Carelessness, or over-anxiety to put him
in the water as quickly as possible, has frequently, from his being
immersed in the bath when the water was too hot, caused him great pain
and suffering. From 96 to 98 degrees of Fahrenheit is the proper
temperature of a warm bath. If it be necessary to add fresh warm water,
let him be either removed the while, or let it not be put in when very
hot; for if boiling water be added to increase the heat of the bath, it
naturally ascends, and may scald him. Again, let the fresh water be put
in at as great a distance from him as possible. The usual time for him
to remain in a bath is a quarter of an hour or twenty minutes. Let the
chest and the bowels be rubbed with the hand while he is in the bath.
Let him be immersed in the bath as high up as the neck, taking care that
he be the while supported under the armpits, and that his head be also
rested. As soon as he comes out of the bath he ought to be carefully but
quickly rubbed dry; and, if it be necessary to keep up the action on the
skin, he should be put to bed, between the blankets; or, if the desired
relief has been obtained, between the sheets, which ought to have been
previously warmed, where, most likely, he will fall into a sweet
refreshing sleep.
WARM EXTERNAL APPLICATIONS.
277. _In case of a child suffering pain either in his stomach or in his
bowels, or in case he has a feverish cold, can you tell me of the best
way of applying heat to them?_
In pain, either of the stomach or of the bowels, there is nothing
usually affords greater or speedier relief than the _external_
application of heat. The following are four different methods of
applying heat: 1. A bag of hot salt—that is to say, powdered table
salt—put either into the oven or into a frying-pan, and thus made hot,
and placed in a flannel bag, and then applied, as the case may be,
either to the stomach or to the bowels. Hot salt is an excellent remedy
for these pains. 2. An india-rubber hot water bottle,[266] half filled
with hot water—it need not be boiling—applied to the stomach or to the
bowels will afford great comfort. 3. Another, and an excellent remedy
for these cases, is a hot bran poultice. The way to make it is as
follows: Stir bran into a vessel containing either a pint or a quart
(according to size of poultice required) of boiling water, until it be
of the consistence of a nice soft poultice, then put it into a flannel
bag and apply it to the part affected. When cool, dip it from time to
time in _hot_ water. 4. In case a child has a feverish cold, especially
if it be attended, as it sometimes is, with pains in the bowels, the
following is a good external application: Take a yard of flannel, fold
it three widths, then dip it in very hot water, wring it out tolerably
dry, and apply it evenly and neatly round and round the bowels; over
this, and to keep it in its place and to keep in the moisture, put on a
_dry_ flannel bandage, four yards long and four inches wide. If it be
put on at bedtime, it ought to remain on all night. Where there are
children, it is desirable to have the yard of flannel and the flannel
bandage in readiness, and then a mother will be prepared for
emergencies. Either the one or the other, then, of the above
applications will usually, in pains of the stomach and bowels, afford
great relief. There is one great advantage of the _external_ application
of heat—it can never do harm; if there be inflammation, it will do good;
if there be either cramps or spasms of the stomach, it will be
serviceable; if there be colic, it will be one of the best remedies that
can be used; if it be a feverish cold, by throwing the child into a
perspiration, it will be useful.
It is well for a mother to know how to make a white-bread poultice; and
as the celebrated Abernethy was noted for his poultices, I will give you
his directions, and in his very words: “Scald out a basin, for you can
never make a good poultice unless you have perfectly boiling water,
then, having put in some hot water, throw in coarsely crumbled bread,
and cover it with a plate. When the bread has soaked up as much water as
it will imbibe, drain off the remaining water, and there will be left a
light pulp. Spread it a third of an inch thick on folded linen, and
apply it when of the temperature of a warm bath. It may be said that
this poultice will be very inconvenient if there be no lard in it, for
it will soon get dry; but this is the very thing you want, and it can
easily be moistened by dropping warm water on it, while a greasy
poultice will be moist, but not wet.”[267]
ACCIDENTS.
278. _Supposing a child to cut his finger, what is the best
application?_
There is nothing better than tying it up with rag in its blood, as
nothing is more healing than blood. Do not wash the blood away, but
apply the rag at once, taking care that no foreign substance be left in
the wound. If there be either glass or dirt in it, it will, of course,
be necessary to bathe the cut in warm water, to get rid of it before the
rag be applied. Some mothers use either salt, or Fryar’s Balsam, or
turpentine to a fresh wound; these plans are cruel and unnecessary, and
frequently make the cut difficult to heal. If it bleed immoderately,
sponge the wound freely with cold water. If it be a severe cut, surgical
aid, of course, will be required.
279. _If a child receive a blow, causing a bruise, what had better be
done?_
Immediately smear a small lump of _fresh_ butter on the part affected,
and renew it every few minutes for two or three hours; this is an
old-fashioned, but a very good remedy. Olive oil may—if _fresh_ butter
be not at hand—be used, or soak a piece of brown paper in one-third of
French brandy, and two-thirds of water, and immediately apply it to the
part; when dry renew it. Either of these simple plans—the butter plan is
the best—will generally prevent both swelling and disfiguration.
_A “Black Eye.”_—If a child, or indeed any one else, receive a blow over
the eye, which is likely to cause a “black eye,” there is no remedy
superior to, nor more likely to prevent one, than well buttering the
parts for two or three inches around the eye with fresh butter, renewing
it every few minutes for the space of an hour or two; if such be well
and perseveringly done, the disagreeable appearance of a “black eye”
will in all probability be prevented. A capital remedy for a “black eye”
is the arnica lotion:
Take of—Tincture of Arnica, one ounce;
Water, seven ounces:
To make a Lotion. The eye to be bathed, by means of a soft piece of
linen rag, with this lotion frequently; and, between times, let a
piece of linen rag, wetted in the lotion, be applied to the eye, and
be fastened in its place by means of a bandage.
The white lily leaf, soaked in brandy, is another excellent remedy for
the bruises of a child. Gather the white lily blossoms when in full
bloom, and pot them in a wide-mouthed bottle of brandy, cork the bottle,
and it will then always be ready for use. Apply a leaf to the part
affected, and bind it on either with a bandage or with a handkerchief.
The white lily root sliced is another valuable external application for
bruises.
280. _If a child fall upon his head and be stunned, what ought to be
done?_
If he fall upon his head and be stunned, he will look deadly pale, very
much as if he had fainted. He will in a few minutes, in all probability,
regain his consciousness. Sickness frequently supervenes, which makes
the case more serious, it being a proof that injury, more or less
severe, has been done to the brain; send, therefore, instantly, for a
medical man.
In the mean time, loosen both his collar and neckerchief, lay him flat
on his back, sprinkle cold water upon his face, open the windows so as
to admit plenty of fresh air, and do not let people crowd around him,
nor shout at him, as some do, to make him speak.
While he is in an unconscious state, do not on any account whatever
allow a drop of blood to be taken from him, either by leeches or by
bleeding; if you do, he will probably never rally, but will most likely
sleep “the sleep that knows no waking.”
281. _A nurse sometimes drops an infant and injures his back; what ought
to be done?_
Instantly send for a surgeon; omitting to have proper advice in such a
case has frequently made a child a cripple for life. A nurse frequently,
when she has dropped her little charge, is afraid to tell her mistress;
the consequences might then be deplorable. If ever a child scream
violently without any assignable cause, and the mother is not able for
some time to pacify him, the safer plan is that she send for a doctor,
in order that he might strip and carefully examine him; much
after-misery might often be averted if this plan were more frequently
followed.
282. _Have you any remarks to make and directions to give on accidental
poisoning by lotions, by liniments, etc.?_
It is a culpable practice of either a mother or nurse to leave
_external_ applications within the reach of a child. It is also highly
improper to put a mixture and an _external_ application (such as a
lotion or a liniment) on the same tray or on the same mantle-piece. Many
liniments contain large quantities of opium, a teaspoonful of which
would be likely to cause the death of a child. “Hartshorn and oil,” too,
has frequently been swallowed by children, and in several instances has
caused death. Many lotions contain sugar of lead, which is also
poisonous. There is not, fortunately, generally sufficient lead in the
lotion to cause death; but if there be not enough to cause death, there
may be more than enough to make the child very poorly. All these
accidents occur from disgraceful carelessness.
A mother or a nurse ought _always_, before administering a dose of
medicine to a child, to read the label on the bottle; by adopting this
simple plan many serious accidents and much after-misery might be
averted. Again, I say let every lotion, every liniment, and indeed
everything for _external_ use, be either locked up or be put out of the
way, and far away from all medicine that is given by the mouth. _This
advice admits of no exception._
If your child has swallowed a portion of a liniment containing opium,
instantly send for a medical man. In the mean time, force a strong
mustard emetic (composed of two teaspoonfuls of flour of mustard, mixed
in half a teacupful of warm water) down his throat. Encourage the
vomiting by afterward forcing him to swallow warm water. Tickle the
throat either with your finger or with a feather. Souse him alternately
in a hot and then in a cold bath. Dash cold water on his head and face.
Throw open the windows. Walk him about in the open air. Rouse him by
slapping him, by pinching him, and by shouting to him; rouse him,
indeed, by every means in your power, for if you allow him to go to
sleep, it will, in all probability, be the sleep that knows no waking!
If a child has swallowed “hartshorn and oil,” force him to drink vinegar
and water, lemon-juice and water, barley-water, and thin gruel.
If he have swallowed a lead lotion, give him a mustard emetic, and then
vinegar and water, sweetened either with honey or with sugar, to drink.
283. _Are not Lucifer Matches poisonous?_
Certainly, they are very poisonous; it is therefore desirable that they
should be put out of the reach of children. A mother ought to be very
strict with servants on this head. Moreover, lucifer matches are not
only poisonous but dangerous, as a child might set himself on fire with
them. A case bearing on the subject has just come under my own
observation. A little boy, three years old, was left alone for two or
three minutes, during which time he obtained possession of a lucifer
match, and struck a light by striking the match against the wall.
Instantly there was a blaze. Fortunately for him, in his fright, he
threw the match on the floor. His mother, at this moment, entered the
room. If his clothes had taken fire, which they might have done, had he
not thrown the match away, or if his mother had not been so near at
hand, he would, in all probability, have either been severely burned, or
have been burned to death.
284. _If a child’s clothes take fire, what ought to be done to
extinguish them?_
Lay him on the floor, then roll him either in the rug or in the carpet,
or in the door-mat, or in any thick article of dress you may either have
on, or have at hand—if it be woolen, so much the better; or throw him
down, and roll him over and over on the floor, as by excluding the
atmospheric air, the flame will go out: hence, the importance of a
mother cultivating presence of mind. If parents were better prepared for
such emergencies, such horrid disfigurations and frightful deaths would
be less frequent.
You ought to have a proper fire-guard before the nursery grate, and
should be strict in not allowing your child to play with fire. If he
still persevere in playing with it when he has been repeatedly cautioned
not to do so, he should be punished for his temerity. If anything would
justify corporal chastisement, it would surely be such an act of
disobedience. There are only two acts of disobedience that I would flog
a child for—namely, the playing with fire and the telling of a lie! If
after various warnings and wholesome corrections he still persists, it
would be well to let him slightly taste the pain of his doing so, either
by holding his hand for a moment very near the fire, or by allowing him
to slightly touch either the hot bar of the grate or the flame of the
candle. Take my word for it, the above plan will effectually cure him—he
will never do it again! It would be well for the children of the poor to
have pinafores made either of woolen or of stuff materials. The dreadful
deaths from burning, which so often occur in winter, too frequently
arise from _cotton_ pinafores first taking fire.[268]
If all dresses, after being washed, and just before being dried, were,
for a short time, soaked in a solution of tungstate of soda, such
clothes, when dried, would be perfectly fire-proof.
Tungstate of soda may be used either with or without starch; but full
directions for the using of it will, at the time of purchase, be given
by the chemist.
285. _Is a burn more dangerous than a scald?_
A burn is generally more serious than a scald. Burns and scalds are more
dangerous on the body, especially on the chest, than either on the face
or on the extremities. The younger the child, of course, the greater is
the danger.
Scalds, both of the mouth and of the throat, from a child drinking
boiling water from the spout of a tea-kettle, are most dangerous. A poor
person’s child is, from the unavoidable absence of the mother, sometimes
shut up in the kitchen by himself, and being very thirsty, and no other
water being at hand, he is tempted in his ignorance to drink from the
tea-kettle: if the water be unfortunately boiling, it will most likely
prove to him to be a fatal draught!
286. _What are the best immediate applications to a scald or to a burn?_
There is nothing more efficacious than flour. It ought to be thickly
applied, over the part affected, and should be kept in its place either
with a rag and a bandage, or with strips of old linen. If this be done,
almost instantaneous relief will be experienced, and the burn or the
scald, if superficial, will soon be well. The advantage of flour as a
remedy is this, that it is always at hand. I have seen some extensive
burns and scalds cured by the above simple plan. Another excellent
remedy is cotton wool. The burn or the scald ought to be enveloped in
it; layer after layer should be applied until it be several inches
thick. The cotton wool must not be removed for several days.[269] These
two remedies, flour and cotton wool, may be used in conjunction; that is
to say, the flour may be thickly applied to the scald or to the burn,
and the cotton wool over all.
Prepared lard—that is to say, lard without salt[270]—is an admirable
remedy for burns and for scalds. The advantages of lard are: (1) It is
almost always at hand; (2) It is very cooling, soothing, and
unirritating to the part, and it gives almost immediate freedom from
pain; (3) It effectually protects and sheathes the burn or the scald
from the air; (4) It is readily and easily applied: all that has to be
done is to spread the lard either on pieces of old linen rag, or on
lint, and then to apply them smoothly to the parts affected, keeping
them in their places by means of bandages—which bandages may be readily
made from either old linen or calico shirts. Dr. John Packard, of
Philadelphia, was the first to bring this remedy for burns and scalds
before the public—he having tried it in numerous instances, and with the
happiest results. I myself have, for many years, been in the habit of
prescribing lard as a dressing for blisters, and with the best effects.
I generally advise equal parts of prepared lard and of spermaceti cerate
to be blended together to make an ointment. The spermaceti cerate gives
a little more consistence to the lard, which, in warm weather,
especially, is a great advantage.
Another valuable remedy for burns is, “carron oil;” which is made by
mixing equal parts of linseed oil and lime-water together in a bottle,
and shaking it up before using it.
Cold applications, such as cold water, cold vinegar and water, and cold
lotions, are most injurious, and, in many cases, even dangerous.
Scraped potatoes, sliced cucumber, salt, and spirits of turpentine, have
all been recommended; but, in my practice, nothing has been so
efficacious as the remedies above enumerated.
Do not wash the wound, and do not dress it more frequently than every
_other_ day. If there be much discharge, let it be gently sopped up with
soft old linen rag; but do not, _on any_ account, let the burn be rubbed
or roughly handled. I am convinced that, in the majority of cases,
wounds are too frequently dressed, and that the washing of wounds
prevents the healing of them. “It is a great mistake,” said Ambrose
Paré, “to dress ulcers too often, and to wipe their surfaces clean, for
thereby we not only remove the useless excrement, which is the mud or
sanies of ulcers, but also the matter which forms the flesh.
Consequently, for these reasons, ulcers should not be dressed too
often.”
The burn or the scald may, after the first two days, if severe, require
different dressings; but, if it be severe, the child ought of course to
be immediately placed under the care of a surgeon.
If the scald be either on the leg or on the foot, a common practice is
to take the shoe and the stocking off; in this operation, the skin is
also at the same time very apt to be removed. Now, both the shoe and the
stocking ought to be slit up, and thus be taken off, so that neither
unnecessary pain nor mischief may be caused.
287. _If a bit of quicklime should accidentally enter the eye of my
child, what ought to be done?_
Instantly, but tenderly remove, either by means of a camel’s-hair brush
or by a small spill of paper, any bit of lime that may adhere to the
ball of the eye, or that may be within the eye or on the eyelashes; then
well bathe the eye (allowing a portion to enter it) with vinegar and
water—one part of vinegar to three parts of water, that is to say, a
quarter fill a clean half-pint medicine bottle with vinegar and then
fill it up with spring water, and it will be ready for use. Let the eye
be bathed for at least a quarter of an hour with it. The vinegar will
neutralize the lime, and will rob it of its burning properties.
Having bathed the eye with the vinegar and water for a quarter of an
hour, bathe it for another quarter of an hour simply with a little warm
water; after which, drop into the eye two or three drops of the best
sweet oil, put on an eye-shade made of three thicknesses of linen rag,
covered with green silk, and then do nothing more until the doctor
arrives.
If the above rules be not _promptly_ and _properly_ followed out, the
child may irreparably lose his eyesight; hence the necessity of a
_popular_ work of this kind, to tell a mother, provided _immediate_
assistance cannot be obtained, what ought _instantly_ to be done; for
moments, in such a case, are precious.
While doing all that I have just recommended, let a surgeon be sent for,
as a smart attack of inflammation of the eye is very apt to follow the
burn of lime; but which inflammation will, provided the _previous_
directions have been _promptly_ and _efficiently_ followed out, with
appropriate treatment, soon subside.
The above accident is apt to occur to a child who is standing near a
building when the slacking of quicklime is going on, and where portions
of lime, in the form of powder, are flying about the air. It would be
well not to allow a child to stand about such places, as prevention is
always better than cure. _Quicklime_ is sometimes called _caustic lime_:
it well deserves its name, for it is a _burning lime_, and if proper
means be not promptly used, will soon burn away the sight.
288. “_What is to be done in the case of Choking?_”
Instantly put your finger into the throat and feel if the substance be
within reach; if it be food, force it down, and thus liberate the
breathing; should it be a hard substance, endeavor to hook it out; if
you cannot reach it, give a good smart blow or two with the flat of the
hand on the back; or, as recommended by a contributor to the _Lancet_,
on the chest, taking care to “seize the little patient, and place him
between your knees side ways, and in this or some other manner to
_compress the abdomen_ [the belly], otherwise the power of the blow will
be lost by the yielding of the abdominal parietes [walls of the belly],
and the respiratory effort will not be produced.” If that does not have
the desired effect, tickle the throat with your finger, so as to insure
immediate vomiting, and the consequent ejection of the offending
substance.[271]
289. _Should my child be bitten by a dog supposed to be mad, what ought
to be done?_
Instantly well rub for the space of five of ten seconds—_seconds_, _not_
minutes—a stick of nitrate of silver (lunar caustic) into the wound. The
stick of lunar caustic should be pointed, like a cedar-pencil for
writing, in order the more thoroughly to enter the wound.[272] This, if
properly done directly after the bite, will effectually prevent
hydrophobia. The nitrate of silver acts not only as a caustic to the
part, but it appears effectually to neutralize the poison, and thus by
making the virus perfectly innocuous is a complete antidote. If it be
either the lip, or the parts near the eye, or the wrist, that have been
bitten, it is far preferable to apply the caustic than to cut the part
out; as the former is neither so formidable, nor so dangerous, nor so
disfiguring as the latter, and yet it is equally as efficacious. I am
indebted to the late Mr. Youatt, the celebrated veterinary surgeon, for
this valuable antidote or remedy for the _prevention_ of the most
horrible, heart-rending, and incurable disease known. Mr. Youatt had an
immense practice among dogs as well as among horses. He was a keen
observer of disease, and a dear lover of his profession, and he had paid
great attention to rabies—dog madness. He and his assistants had been
repeatedly bitten by rabid dogs; but knowing that he was in possession
of an infallible preventive remedy, he never dreaded the wounds
inflicted either upon himself or upon his assistants. Mr. Youatt never
knew lunar caustic, if properly and _immediately_ applied, to fail. It
is, of course, only a preventive. If hydrophobia be once developed in
the human system, no antidote has ever yet, for this fell and
intractable disease, been found.
While walking the London Hospitals, upwards of thirty-five years ago, I
received an invitation from Mr. Youatt to attend a lecture on rabies—dog
madness. He had, during the lecture, a dog present laboring under
_incipient_ madness. In a day or two after the lecture, he requested me
and other students to call at his infirmary and see the dog, as the
disease was at that time fully developed. We did so, and found the poor
animal raving mad—frothing at the mouth, and snapping at the iron bars
of his prison. I was particularly struck with a peculiar brilliancy and
wildness of the dog’s eyes. He seemed as though, with affright and
consternation, he beheld objects unseen by all around. It was pitiful to
witness his frightened and anxious countenance. Death soon closed the
scene!
I have thought it my duty to bring the value of lunar caustic as a
preventive of hydrophobia prominently before your notice, and to pay a
tribute of respect to the memory of Mr. Youatt—a man of talent and
genius.
Never kill a dog supposed to be mad who has bitten either a child, or
any one else, until it has, past all doubt, been ascertained whether he
be really mad or not. He ought, of course, to be tied up, and be
carefully watched, and be prevented the while from biting any one else.
The dog, by all means, should be allowed to live at least for some
weeks, as the fact of his remaining will be the best guarantee that
there is no fear of the bitten child having caught hydrophobia.
There is a foolish prejudice abroad, that a dog, be he mad or not, who
has bitten a person ought to be _immediately_ destroyed; that although
the dog be not at the time mad, but should at a future period become so,
the person who had been bitten when the dog was _not_ mad, would, when
the dog became mad, have hydrophobia! It seems almost absurd to bring
the subject forward; but the opinion is so very general and deep rooted,
that I think it well to declare that there is not the slightest
foundation of truth in it, but that it is a ridiculous fallacy!
A cat sometimes goes mad, and its bite may cause hydrophobia; indeed,
the bite of a mad cat is more dangerous than the bite of a mad dog. A
bite from a mad cat ought to be treated precisely in the same
manner—namely, with the lunar caustic—as for a mad dog.
A bite either from a dog or from a cat _who is not mad_, from a cat
especially, is often venomous and difficult to heal. The best
application is _immediately_ to apply a large hot white-bread poultice
to the part, and to renew it every four hours; and, if there be much
pain in the wound, to well foment the part, every time before applying
the poultice, with a hot chamomile and poppy-head fomentation.
Scratches of a cat are best treated by smearing, and that freely and
continuously for an hour, and then afterward at longer intervals, fresh
butter on the part affected. If fresh butter be not at hand, fresh
lard—that is to say, lard _without_ salt—will answer the purpose. If the
pain of the scratch be very intense, foment the part affected with hot
water, and then apply a hot white-bread poultice, which should be
frequently renewed.
290. _What is the best application in case of a sting either from a bee
or from a wasp?_
Extract the sting, if it have been left behind, either by means of a
pair of dressing forceps, or by the pressure of the hollow of a small
key—a watch-key will answer the purpose; then, a little blue (which is
used in washing) moistened with water, should be immediately applied to
the part; or, apply a few drops of solution of potash,[273] or “apply
moist snuff or tobacco, rubbing it well in,”[274] and renew from time to
time either of them: if either of these be not at hand, either honey, or
treacle, or fresh butter, will answer the purpose. Should there be much
swelling or inflammation, apply a hot white-bread poultice, and renew it
frequently. In eating apricots, or peaches, or other fruit, they ought
to, beforehand, be carefully examined, in order to ascertain that no
wasp is lurking in them; otherwise, it may sting the throat, and serious
consequences will ensue.
291. _If a child receive a fall, causing the skin to be grazed, can you
tell me of a good application?_
You will find gummed paper an excellent remedy; the way of preparing it
is as follows: Apply evenly, by means of a small brush, thick mucilage
of gum arabic to cap paper; hang it up to dry, and keep it ready for
use. When wanted, cut a portion as large as may be requisite, then
moisten it with your tongue, in the same manner you would a postage
stamp, and apply it to the grazed part. It may be removed when necessary
by simply wetting it with water. The part in two or three days will be
well. There is usually a margin of gummed paper sold with postage
stamps; this will answer the purpose equally well. If the gummed paper
be not at hand, then frequently, for the space of an hour or two, smear
the part affected with fresh butter.
292. _In case of a child swallowing by mistake either laudanum, or
paregoric, or Godfrey’s Cordial, or any other preparation of opium, what
ought to be done?_
Give, _as quickly as possible_, a strong mustard emetic; that is to say,
mix two teaspoonfuls of flour of mustard in half a teacupful of water,
and force it down his throat. If free vomiting be not induced, tickle
the upper part of the swallow with a feather; drench the little
patient’s stomach with large quantities of warm water. As soon as it can
be obtained from a druggist, give him the following emetic draught:
Take of—Sulphate of Zinc, one scruple;
Simple Syrup, one drachm;
Distilled Water, seven drachms:
To make a Draught.
Smack his buttocks and his back; walk him, or lead him, or carry him
about in the fresh air; shake him by the shoulders; pull his hair;
tickle his nostrils; shout and holla in his ears; plunge him into a warm
bath and then into a cold bath alternately; well sponge his head and
face with cold water; dash cold water on his head, face, and neck; and
do not, on any account, until the effects of the opiate are gone off,
allow him to go to sleep; if you do, he will never wake again! While
doing all these things, of course, you ought to lose no time in sending
for a medical man.
293. _Have you any observations to make on parents allowing the Deadly
Nightshade—the Atropa Belladonna—to grow in their gardens?_
I wish to caution you _not_ on any account to allow the Belladonna—the
Deadly Nightshade—to grow in your garden. The whole plant—root, leaves,
and berries—is poisonous; and the berries, being attractive to the eye,
are very alluring to children.
294. _What is the treatment of poisoning by Belladonna?_
Instantly send for a medical man; but, in the mean time, give an
emetic—a mustard emetic;—mix two teaspoonfuls of flour of mustard in
half a teacupful of warm water, and force it down the child’s throat;
then drench him with warm water, and tickle the upper part of his
swallow either with a feather or with the finger, to make him sick; as
the grand remedy is an emetic to bring up the offending cause. If the
emetic have not acted sufficiently, the medical man when he arrives may
deem it necessary to use the stomach-pump; but remember not a moment
must be lost, for moments are precious in a case of belladonna
poisoning, in giving a mustard emetic, and repeating it again and again
until the enemy be dislodged. Dash cold water upon his head and face;
the best way of doing which is by means of a large sponge, holding his
head and his face over a wash-hand basin, half filled with cold water,
and filling the sponge from the basin, and squeezing it over his head
and face, allowing the water to continuously stream over them for an
hour or two, or until the effects of the poison have passed away. This
sponging of the head and face is very useful in poisoning by opium, as
well as in poisoning by belladonna; indeed, the treatment of poisoning
by the one is very similar to the treatment of poisoning by the other.
I, therefore, for the further treatment of poisoning by belladonna, beg
to refer you to a previous Conversation on the treatment of poisoning by
opium.
295. _Should a child put either a pea or a bead, or any other foreign
substance, up the nose, what ought to be done?_
Do not attempt to extract it yourself, or you might push it farther in,
but send instantly for a surgeon, who will readily remove it, either
with a pair of forceps, or by means of a bent probe, or with a director.
If it be a pea, and it be allowed for any length of time to remain in,
it will swell, and will thus become difficult to extract, and may
produce great irritation and inflammation. A child ought not to be
allowed to play with peas or with beads (unless the beads are on a
string), as he is apt, for amusement, to push them up his nose.
296. _If a child have put either a pea, a bean, a bead, a cherry-stone,
or any other smooth substance, into his ear, what ought to be done to
remove it?_
Turn his head on one side, in order to let the ear with the pea or bead
in it be undermost, then give with the flat of your hand two or three
sharp, sudden slaps or boxes on the other, or _upper_most ear, and most
likely the offending substance will drop out. Poking at the ear will, in
the majority of cases, only send the substance farther in, and will make
it more difficult (if the above simple plan does not succeed) for the
medical man to remove. The surgeon will, in all probability, syringe the
ear; therefore, have a supply of warm water in readiness for him, in
order that no time may be lost.
297. _If an earwig, or any other living thing, should get into the ear
of a child, what ought to be done?_
Lay the child on his side, the affected ear being uppermost, and fill
the ear, from a teaspoon, with either water or sweet oil. The water or
oil will carry the living thing, whatever it be, out of the ear, and the
child is at once relieved.
298. _If a child swallow a piece of broken glass, what ought to be
done?_
Avoid purgatives, as the free action on the bowels would be likely to
force the spiculæ of glass into the mucous membrane of the bowels, and
thus would wound them, and might cause ulceration, and even death. “The
object of treatment will be to allow them to pass through the intestines
well enveloped by the other contents of the tube; and for this purpose a
solid farinaceous diet should be ordered, and purgatives scrupulously
avoided.”[275]
299. _If a child swallow a pin, what should be done?_
Treat him as for broken glass. Give him no aperients, or it might, in
action, force the pin into the bowel. I have known more than one
instance where a child, after swallowing a pin, to have voided it in his
motion.
300. _If a child swallow a coin of any kind, is danger likely to ensue,
and what ought to be done?_
There is, as a rule, no danger. A dose or two of castor oil will be all
that is usually necessary. The evacuations ought to be carefully
examined until the coin be discovered. I once knew a child swallow a
penny-piece, and pass it in his motions.
301. _If a child, while playing with a small coin (such as either a
threepenny or a fourpenny piece), or any other substance, should toss it
into his mouth, and inadvertently allow it to enter the windpipe, what
ought to be done?_