initial commit of ebook 24854HEADmain

214 files changed, 23340 insertions, 0 deletions

diff --git a/.gitattributes b/.gitattributes
new file mode 100644
index 0000000..6833f05
--- /dev/null
+++ b/.gitattributes
@@ -0,0 +1,3 @@
+* text=auto
+*.txt text
+*.md text
diff --git a/24854-8.txt b/24854-8.txt
new file mode 100644
index 0000000..3db0cd5
--- /dev/null
+++ b/24854-8.txt
@@ -0,0 +1,7260 @@
+The Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4),
+by W. Grant Hague
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Eugenic Marriage, Vol 2 (of 4)
+       A Personal Guide to the New Science of Better Living and Better Babies
+
+Author: W. Grant Hague
+
+Release Date: March 16, 2008 [EBook #24854]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+
+
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+
+
+
+
+
+
+[Illustration: _By courtesy of The New York Times_
+
+NEW YORK'S BETTER BABY
+
+Little Hiss Johanna Wiggers, who won the first prize in New York's
+Better Babies Contest by scoring 100 points, is the type of little girl
+that will make the best mothers, and the better race tomorrow. Her score
+card showed; age, 28 months; weight, 33 lbs. 14 ozs.; height, 35-1/2
+inches; circumference of head, 19-1/2 inches: circumference of chest, 20
+inches; lateral diameter of chest, 6 inches; diameter of chest from
+front to back, 4-1/2 inches; length of arm to tip of middle finger,
+14-1/2 inches; length of leg to the sole of the foot, 16-1/2 inches;
+total, 100 points.]
+
+
+
+
+The Eugenic Marriage
+
+A Personal Guide to the New Science of Better Living and Better Babies
+
+By W. GRANT HAGUE, M. D.
+
+_College of Physicians and Surgeons (Columbia University), New York;
+Member of County Medical Society, and of the American Medical
+Association_
+
+In Four Volumes
+
+VOLUME II
+
+New York
+
+THE REVIEW OF REVIEWS COMPANY
+
+1914
+
+     Copyright, 1913, by
+     W. GRANT HAGUE
+
+     Copyright, 1914, by
+     W. GRANT HAGUE
+
+
+
+
+TABLE OF CONTENTS
+
+
+
+SEX HYGIENE FOR THE BOY
+
+CHAPTER XII
+
+BUILDING OUR BOYS
+
+PAGE
+
+A word to parents--Interest in sex hygiene--The "Social Evil"--Ten
+millions suffering with venereal diseases in the United
+States--Immorality not confined to large cities--Venereal diseases
+common in country places--What are the consequences of venereal disease
+to the boy?--Gonorrhea, or clap--Symptoms of gonorrhea in the
+male--Complications of gonorrhea--Syphilis, or the "pox"--How syphilis
+is acquired--Syphilis attacks every organ in the body--Not possible to
+tell when cured--The chancre--Systematic, or constitutional
+symptoms--Mucous patches and ulcers--Syphilis of the blood vessels and
+lymphatic glands--The interior organs--Brain and spinal cord--The nose,
+eye, ear, throat--Hair and nails--What the boy with venereal disease may
+cause in others--The infected wife--A girl's fate when she
+marries--Young wife rendered sterile--Young wife made to miscarry--Is
+the husband to blame--Building the man--Age of puberty--"Internal
+Secretion" ... PAGE 139
+
+
+CHAPTER XIII
+
+THE PARENTS AND THE BOY
+
+Abuse of the procreative function--The continent life--Provide the
+environment necessary to the clean life--The period of procreative
+power--Self-abuse--Masturbation--Treatment of masturbation--Night losses
+or wet dreams--Causes of night emissions--Sexual excesses--Treatment of
+sexual excesses--What parents should know about the so-called "social
+evil" before speaking with authority to the boy--The need of
+enlightenment in sexual matters--"No one told me, I did not know"--Fake
+medical treatment of venereal diseases--Sowing wild oats--Should
+circumcision be advised ... PAGE 153
+
+
+SEX HYGIENE FOR THE GIRL
+
+CHAPTER XIV
+
+A MOTHER'S DUTY TO HER DAUGHTER
+
+What a mother should tell her little girl--Where do babies come
+from--How baby birds and fish come from eggs--How other animals have
+little nests of their own--The duty of mothers to instruct and
+direct--What a mother should tell her daughter--Every mother should
+regard this duty as sacred--Every female child is a possible future
+mother--Motherhood the highest function of the sex--Health the one
+necessary essential--Symptoms of the first, or beginning
+menstruation--The period of puberty in the female--Changes in the
+reproductive organs at puberty--The female generative organs--The
+function of the reproductive organs--The age of puberty in the
+female--The function of the ovary--The function of the womb--Why
+menstruation occurs every twenty-eight days--The male or papa egg--The
+function of the spermatozoa--"Tell the whole story"--"How do these
+spermatozoa get there"--The union of the species--"How can a baby live
+in there for such a long time"--How the baby gets its nourishment in the
+womb--Girls must not become mothers ... PAGE 173
+
+
+CHAPTER XV
+
+PREPARING FOR MOTHERHOOD
+
+Menstruation--Irregular menstruation--Changes in the quantity
+of the flow--How the womb is held in place--Symptoms of
+menstruation--Menstruation should not be accompanied with pain--Don't
+give your daughters patent medicines, or "Female Regulators"--Take your
+daughter to the doctor--Leucorrhea in girls--Bathing when
+menstruating--Constipation and displaced wombs--Dress and
+menstruation--Absence of menstruation, or amenorrhea--Treatment of
+amenorrhea--Painful menstruation, or dysmenorrhea--Causes of
+dysmenorrhea--Treatment of dysmenorrhea--Sterility in the
+female--Conditions which affect the fertility of women--Climate, station
+in life, season of the year, age, the tendency to miscarry--Causes of
+sterility in the female--Displacement of womb--Diseases of womb,
+ovaries, or tubes--Malformations--Lacerations--Tumors--Leucorrhea--Physical
+debility--Obesity--Special poisons--"Knack of miscarrying"--Miscarriage--Cause
+of miscarriage--The course and symptoms of miscarriage--What to do
+when a miscarriage is threatened--Treatment of threatened
+miscarriage--Treatment of inevitable miscarriage--After
+treatment of miscarriage--The tendency to miscarriage ... PAGE 187
+
+
+THE BABY
+
+CHAPTER XVI
+
+HYGIENE AND DEVELOPMENT OF THE BABY
+
+What to prepare for the coming baby--Care of the newly-born baby--The
+first bath--Dressing the cord--Treatment after the cord falls off--A
+pouting navel--Bathing baby--Clothing the baby--Baby's night
+clothes--Care of the eyes--Care of the mouth and first teeth--Care of
+the skin--Care of the genital organs--Amusing baby--Temperature
+in children--The teeth--The permanent teeth--Care of the
+teeth--Dentition--Treatment of teething--How to weigh the baby--Average
+weight of a male baby--Average weight of a female baby--Average height
+of a male child--The rate of growth of a child--Pulse rate in
+children--Infant records, why they should be kept--"Growing
+pains" ... PAGE 209
+
+
+CHAPTER XVII
+
+BABY'S FEEDING HABITS
+
+Overfeeding baby--Intervals of feeding--How long should a baby stay at
+the breast--Vomiting between feedings--Regularity of feeding--Why is
+regularity of feeding important--A baby never vomits--What is the
+significance of so-called vomiting after feedings--Mother's milk that is
+unfit for baby--Fresh air for baby--Air baths for baby ... PAGE 223
+
+
+CHAPTER XVIII
+
+BABY'S GOOD AND BAD HABITS--FOOD FORMULAS
+
+Baby's bed--The proper way to lay baby in bed--Baby should sleep by
+itself--How long should a baby sleep--Why a baby cries--The habitual
+crier--The habit of feeding baby every time it cries--The habit of
+walking the floor with baby every time it cries--Jouncing, or hobbling
+baby--Baby needs water to drink--The evil habit of kissing
+baby--Establishing toilet habits--Baby's comforter--What can be done to
+lessen the evil effects of the comforter habit--Beef juice--Beef juice
+by the cold process--Mutton broth--Mutton broth with cornstarch or
+arrowroot--Chicken, veal, and beef broths--Scraped beef or meat
+pulp--Junket or curds and whey--Whey--Barley water--Barley water gruel
+or barley jelly--Rice, wheat or oat water--Imperial Granum--Albumen
+water--Dried bread--Coddled egg ... PAGE 235
+
+
+ARTIFICIAL FEEDING
+
+CHAPTER XIX
+
+ARTIFICIAL FEEDING
+
+Elementary principles of milk modification--The secret of the efficiency
+of mothers' milk--Two important factors in successful artificial
+feeding--Every child is a problem in itself--Proprietary foods of little
+value as infant foods--Their value is in the milk added to them--The
+credit belongs to the cow--Difference between human and cow's milk--What
+"top-milk" feeding means--Utensils necessary for home modification of
+milk--Artificial feeding from birth to the twelfth month--How to
+measure "top-milk"--Easy bottle-feeding method--Condensed milk
+feeding--Objections to condensed milk feeding ... PAGE 249
+
+
+CHAPTER XX
+
+ARTIFICIAL FEEDING (_continued_)
+
+How to prepare milk mixtures--Sterilizing the food for the day's
+feeding--How to test the temperature of the food for baby--When to
+increase the quality or quantity of food--Food allowable during the
+first year in addition to milk--Beef-juice--White of egg--Orange
+juice--Peptonized milk--The hot or immediate process--The cold
+process--Partially peptonized milk--Completely peptonized milk--Uses of
+peptonized milk--Objections to peptonized milk--What a mother should
+know about baby's feeding bottle and nipple--Should a mother put her
+baby on artificial food if her supply of milk during the first two weeks
+is not quite enough to satisfy it--Certain conditions justify the
+adoption of artificial feeding from the beginning--Mothers' mistakes in
+the preparation of artificial food--Feeding during the second
+year--Sample meals for a child three years of age--The diet of older
+children--Meats, vegetables, cereals, bread, desserts, fruits ... PAGE 259
+
+
+WHAT MOTHERS SHOULD KNOW
+
+CHAPTER XXI
+
+THE EDUCATION OF THE MOTHER
+
+What mothers should know about the care of children during illness--A
+sick child should be in bed--The diet of the sick child--A child is the
+most helpless living thing--The delicate child--How to feed the delicate
+child--How to bathe the delicate child--Airing the delicate
+child--Habits of the delicate child--Indiscriminate feeding--Poor
+appetite--Loss of appetite--Treatment of loss of appetite--Overeating in
+infancy--What correct eating means--Bran as a food--Breakfast for a
+child at school--Lunch for a child at school--Bran muffins for school
+children--Bran muffins in constipation--Hysterical children--What a
+mother should know about cathartics and how to give a dose of castor
+oil--Castor oil--Calomel--Citrate of Magnesium--When to use castor
+oil--When to use calomel--Vaccination--Time for vaccination--Methods of
+vaccination--Symptoms of successful vaccination ... PAGE 277
+
+
+CHAPTER XXII
+
+CONSTIPATION IN INFANTS AND CHILDREN
+
+Constipation--Regularity of bowel function--The function of the
+stomach--Fermentation--Incomplete constipation--Importance of a clean
+bowel--A daily movement of the bowel necessary--Constipation in
+breast-fed infants--Treatment of constipation in breast-fed
+infants--Constipation in bottle-fed infants--Treatment of constipation
+in bottle-fed infants--Constipation in children over two years of
+age--Diet list for constipation in children--Bran muffins in
+constipation--Treatment of obstinate constipation--Oil injections in
+constipation ... PAGE 303
+
+
+CHAPTER XXIII
+
+CONSTIPATION IN WOMEN
+
+Chief cause of constipation in women--Constipation a cause of domestic
+unhappiness--The requirements of good health--The cost of
+constipation--Constipation and social exigencies--One of the important
+duties of mothers--Constipation and diseases of women--Constipation is
+always harmful--Constipation and pregnancy--Explanation of incomplete
+constipation--Causes of constipation--Negligence--Lack of exercise--Lack
+of water--Lack of bulk in the food taken--Abuse of cathartic drugs and
+aperient waters--Overeating--Treatment of constipation in
+women ... PAGE 315
+
+
+
+
+SEX HYGIENE FOR THE BOY
+
+
+
+
+CHAPTER XII
+
+     "The evil that men do lives after them. The good is often
+     interred with them."
+
+     "The pleasure in living is to meet temptation and not yield to
+     it." Elmer Lee, M. D.
+
+BUILDING OUR BOYS
+
+     A Word to Parents--Interest in Sex Hygiene--The "Social
+     Evil"--Ten Millions Suffering with Venereal Diseases in the
+     United States--Immorality not Confined to Large
+     Cities--Venereal Diseases Common in Country Places--What Are
+     the Consequences of Venereal Disease to the Boy?--Gonorrhea, or
+     Clap--Symptoms of Gonorrhea in the Male--Complications of
+     Gonorrhea--Syphilis, or the "Pox"--How Syphilis is
+     Acquired--Syphilis Attacks Every Organ in the Body--Not
+     Possible to Tell When Cured--The Chancre--Systematic or
+     Constitutional Symptoms--Mucous Patches and Ulcers--Syphilis of
+     the Blood Vessels and Lymphatic Glands--The Interior
+     Organs--Brain and Spinal Cord--The Nose, Eye, Ear, Throat--Hair
+     and Nails--What the Boy with Venereal Disease May Cause in
+     Others--The Infected Wife--A Girl's Fate When She
+     Marries--Young Wife Rendered Sterile--Young Wife Made to
+     Miscarry--Is the Husband to Blame?--Building the Man--Age of
+     Puberty--"Internal Secretion."
+
+
+A WORD TO PARENTS.--Within recent times the subject of sex hygiene has
+been freely discussed by members of the medical profession and through
+them the general public has been made more or less acquainted with the
+problem. It has therefore acquired a degree of genuine interest which
+speaks well for the future of the eugenic ideal. Eugenics is based to a
+very large extent upon the principles underlying sex hygiene.
+
+As a result of this widespread interest and investigation, we have
+discovered that the only method that promises actual progress, is to
+talk plainly and to tell the actual truth. The day of the prude has
+passed. To attempt to achieve results in the education of youth in sex
+problems, without giving, facts, is wasted effort. To give facts we must
+explain each problem so that its principles may be clearly understood
+and its meaning grasped. To point out the duty of youth is not
+sufficient. They must be shown why it is to their best interest to live
+the clean life. In every department of education we are beginning to
+appreciate that to achieve results it must be based upon the individual
+equation. This is why we have found it necessary to assert that it is
+the duty of parents to make sex hygiene a personal matter and to
+acquaint their children with the facts relating to this problem. It has
+been discovered, however, that a very large percentage of parents are
+inadequately informed on these subjects, in fact they know practically
+nothing about the actual facts which they are supposed to teach. I shall
+try to tell the story in a way which every parent will understand.
+
+When a boy reaches the age of puberty he is susceptible to sexual
+desire. If he has not been told the story of his growth from boyhood to
+man's estate he will either begin to abuse himself, or he will be later
+enticed to commit himself to intercourse with some unclean female and he
+will acquire a disease as a result.
+
+Inasmuch as it has been asserted that practically every boy has been
+addicted to self-abuse at some time, and that eighty per cent. of all
+males, between the ages of sixteen and thirty years, are victims of
+venereal disease, it would seem justifiable to assume that the boys who
+are informed of the facts in time are the boys who constitute the
+percentage who escape. This, of course, may not be literally true, but
+it is a reasonable assumption.
+
+While self-abuse is a pernicious habit and may be attended with serious
+consequences, it is not a disease and, as will be explained later, it
+can be cured. It is therefore a menace to the individual, not to the
+race, and consequently need not concern us at the present time. On the
+other hand the venereal diseases are not to be considered as individual
+problems since they affect the welfare of the race. The venereal
+diseases which we will consider are gonorrhea and syphilis.
+
+THE SOCIAL EVIL.--It has been estimated that there are more than _ten
+millions_ of people in this country to-day suffering from the effects of
+venereal diseases. In New York city alone, there are _two million_
+victims suffering from the direct or indirect consequences of these
+diseases. It has been authoritatively asserted that, out of every ten
+men between the ages of sixteen and thirty, eight have, or have had, one
+or other of these diseases. When it is remembered that these diseases
+are not merely temporary incidents, but that they may be regarded as
+practically incurable in the vast majority, because of antagonistic
+social conditions and ignorance, and that they are highly infectious, we
+may begin to realize how important they are from the standpoint of race
+regeneration.
+
+Statistics of these conditions are never reliable because much of the
+evil is hidden and lied about. It is quite probable,--if the estimates
+were based upon absolute knowledge--that the extent of the prevalency of
+these diseases would be greatly increased rather than reduced. It is
+however a fact, that the combined ravages of the Great White Plague,
+leprosy, yellow fever, and small-pox, are merely incidents compared to
+the effects which the venereal diseases have had upon mankind. It is
+useless to think that these diseases can be driven out of the land. Any
+hope of this nature is the impression of the dreamer. By a propaganda of
+education, by the spread of the eugenic idea and ideal, we may, however,
+reasonably hope to minimize the evil and, at least, to protect the
+innocent.
+
+THE SOURCES OF IMMORALITY.--It is a fallacious idea to assume that the
+sources of immorality are confined to the large cities. This is far from
+the truth. In smaller towns and country places the diseases are quite
+common and conditions there tend to the spread of the contagion in a
+more intimate and a more harmful way. The individuals who are most
+likely to become affected are those most liable to succumb to temptation
+and whose home ties are of the best. There are many instances on record
+where one or two loose women spread the infection all over the country
+communities, infecting boys and men alike. No one can estimate what the
+final effect of such an epidemic may mean or how many innocent
+individuals may have their lives wrecked as a direct consequence. It is
+because these consequences are the product of ignorance in a very large
+percentage of the cases that there is such urgent need for
+enlightenment. It is at least our plain duty to tell the boy the actual
+facts--to post him with reference to consequences. The more thoroughly
+we instruct him in the elementary facts relative to the venereal
+diseases, the safer he will be from temptation, and if he possesses this
+knowledge and acquires disease, he will be more likely to immediately
+seek competent aid and advice.
+
+
+WHAT ARE THE CONSEQUENCES OF VENEREAL DISEASE TO THE BOY HIMSELF?
+
+GONORRHEA OR "CLAP."--This is the most frequent of the venereal
+diseases. It is also the most serious. It is an unfortunate fact, that
+in the past,--and even to-day--boys have been told that gonorrhea is no
+worse than "a bad cold." This lie has been responsible for much evil and
+a great amount of unnecessary suffering and misery.
+
+Gonorrhea is caused by a germ, obtained, as a rule, during intercourse
+with an infected person. This germ is called gonococcus. It thrives on
+any mucous membrane; it is not, therefore, limited to the sexual organs.
+For this reason it may attack any part of the body where mucous membrane
+is. It is particularly liable to damage, sometimes seriously and
+permanently, the eye. It may be spread from one person to another, or
+from any infected article to a person in numerous ways. The innocent may
+thus suffer as a result of the carelessness of the vicious.
+
+THE SYMPTOMS OF GONORRHEA IN THE MALE are slight itching and burning of
+the mouth of the urethra. This is noticeable at any time from the third
+to the fourteenth day after exposure. These symptoms become more
+pronounced and a slight discharge appears. The patient is compelled to
+urinate frequently and it is painful and difficult. The discharge
+increases, it becomes thicker and looks like ordinary yellow pus. If the
+case is a severe one, the discharge may be blood stained, and if this
+symptom is present urination is more painful and more frequent.
+
+In about ten days the disease reaches its height; it remains stationary
+for a number of weeks and then slowly, seemingly, gets better. The
+discharge grows thinner, less in quantity and lighter in color. It may
+refuse, despite the most careful and efficient treatment, to stop
+altogether; it is then known as "gleet." If the discharge stops
+completely the patient is apparently cured, as far as any external
+manifestation of the disease is concerned. _In seventy-five per cent. of
+the cases, however, this apparent cure is no cure at all, as will be
+seen later._
+
+Certain complications are likely to arise in the course of gonorrhea.
+The infection itself may be of such an acute or virulent type, that it
+invades the deeper structures of its own accord and despite the most
+careful, competent treatment; or if the treatment is not adequate or
+skillful it may be forced backward; or through neglect in not beginning
+the right kind of treatment in times, a simple infection may grow in
+degree into a serious disease, and invade the more important structures.
+In this way are produced disease of the bladder, prostate gland, seminal
+vesicles, testicles, and of the kidneys. Gonorrheal rheumatism may
+follow, and even disease of the lining membrane of the heart, and death.
+
+When disease of the deeper parts occur the patient is frequently
+incapacitated and compelled to go to bed. He may have chills, fever and
+sweats, intense pain and the passage of bloody urine. He may have to be
+operated upon, and his general health may be permanently wrecked. So
+long as the germs are present there is danger despite the most
+scientific treatment. It is not the quality of the treatment that is at
+fault, it is the presence of the germs; and since it is impossible to
+pursue any certain method of eradication, we must continue treatment--as
+long as the germs are present--and hope for favorable results. The
+infection may last for many years. The germs having found entrance into
+the small tubes in the interior organs they can only be dislodged with
+difficulty, if at all. These pockets of germs may be excited to renewed
+activity by sexual intercourse, or by injury to the parts, and may
+reinfect the patient at any times. In a very considerable number of
+these cases where the deeper structures are involved, the patient may
+recover from the acute or painful period of the disease, only to find
+that he is sterile. There are many such cases, and the most vindictive
+individual who may believe that every who sins should be punished will
+admit that sterility, as the price of a moment's forgetfulness, is a
+terrible fee to pay.
+
+SYPHILIS, OR THE "POX," is an infectious, germ blood disease. It is most
+frequently acquired through sexual intercourse.
+
+It may be acquired by direct contact with a diseased person. In order to
+render such contact effective, it is essential that the skin of the
+healthy person be abraded, or the contact may be directly on a mucous
+membrane, as the mouth in the act of kissing.
+
+It may be acquired by using any article which has been used by a
+syphilitic, as a drinking cup, or towel.
+
+It may be acquired through hereditary transmission.
+
+Surgeons frequently contract syphilis while operating on, or examining
+patients who have the disease. Dentists may convey it by means of
+instruments which have not been rendered aseptic, or thoroughly clean.
+Using a towel which has been used by a syphilitic has many times
+conveyed the infection to an innocent party. For this reason the roller
+towel has been done away with, and some states have legislated against
+its use in hotels and other public places. To use dishes, spoons,
+tobacco pipe, beer glasses, etc., which have been used by one having the
+disease is an absolutely certain way of being infected. Cigars which may
+have been made by a syphilitic will infect whoever smokes them with the
+virus of the disease. Syphilis has been known to have been caught from
+using the church communion cup. The public drinking-cup has been a
+prolific source of syphilitic dissemination to innocents. Legislators
+are just waking up to the danger that lurks in this institution and it
+will no doubt be done away with, not only in public places, but on all
+railroad and steamboat lines.
+
+An infected mother can transmit syphilis to her child. If the father is
+affected, but not the wife, the child may escape.
+
+Syphilis attacks every organ in the human body. The actual degree of
+infection has no relation to the size or character of the external
+manifestations. The external evidence may be minute and insignificant,
+while the internal extent and ravages of the disease may be tremendous
+and of large proportions. Many men when asked regarding incidents of the
+long ago, may state, "Oh, yes, I had a chancre twenty-five years ago,
+but it was a very small affair and soon healed up and was cured." Yet
+that same little chancre, that made only a mild impression on the man's
+mind, may, and most probably will, be the direct cause of that man's
+death.
+
+It is not possible to tell with absolute certainty that an individual is
+suffering with syphilis by any known test. The most recent one--the
+Wassermann test--is not absolute by any means.
+
+The first symptoms, or what is known as the initial lesion of syphilis,
+is the chancre.
+
+THE CHANCRE is a small, hard tumor, or it may be a small ulcer with a
+hard base, or it may simply appear as a thin small patch on any mucous
+membrane. It is not painful, it can be moved if taken between the
+fingers, showing it is not attached to the deep structures, and when it
+is so moved it is not tender or sore. Any little lump which ulcerates
+located on the genitals must be regarded with suspicion. Boys and men
+should not be satisfied with any offhand statement that, "it is
+nothing." It may be a chancre, and it may be exceedingly serious if not
+properly diagnosed.
+
+Systemic, or constitutional symptoms, begin to show themselves any time
+from the sixth to the tenth week after the appearance of the chancre.
+
+ERUPTIONS OF THE SKIN characterize every case of syphilis. They occur in
+all degrees from the mild rash to the foul ulcer. The ulcerative process
+is very often extensive and loathsome.
+
+MUCOUS PATCHES AND ULCERS affect the mucous membranes. The mouth and
+throat are favorite locations for these lesions. They occur in the anus
+and rectum, and may be mistaken in that region for other serious
+conditions. Men who drink and smoke suffer as a rule severely from
+mucous patches in the mouth and throat.
+
+Syphilis attacks the blood vessels and the lymphatic glands. These cases
+may have been unrecognized, and may have existed for many years. A man
+may die from a rupture of a blood vessel in the brain during middle life
+as a consequence of a forgotten, supposedly cured case of syphilis many
+years before.
+
+THE INTERIOR ORGANS may be attacked by syphilis. As a result we get
+disease of the liver, heart, stomach, kidneys, lungs, and other parts.
+It has been suggested that many diseases affecting these organs, for
+which treatment proves unsatisfactory, may have had their origin in a
+former syphilis.
+
+THE BRAIN AND SPINAL CORD are quite often the seat of syphilitic
+affections. A tumor, known by the name of "gumma," is the result. The
+blood vessels of the entire nervous system may be affected and, as a
+consequence, we often see cases of paralysis, apoplexy, epilepsy,
+locomotor ataxia and death.
+
+THE NOSE, EYE, EAR, THROAT, are frequently very seriously compromised as
+a result of the syphilitic poison. Deformity, caused by rotting of the
+bones of these parts is not infrequent. Loss of voice, or smell, or
+hearing, or sight, may result.
+
+THE HAIR AND NAILS may fall out. The bones may ulcerate and rot. The
+organs of procreation usually participate in the degenerative process.
+Virility is destroyed, and impotence is quite common after a severe
+attack.
+
+
+WHAT THE BOY WITH VENEREAL DISEASE MAY CAUSE IN OTHERS
+
+GONORRHEA.--When the average boy acquires gonorrhea he frequently does
+not know, for many weeks, that he is the victim of a dangerous,
+infectious disease. He appreciates probably, that it relates to the
+sexual indiscretion he was guilty of, and feels that it is something to
+be ashamed of. He therefore hides his condition, confides in no one, and
+blindly hopes it will get better somehow or at some time. Meantime the
+disease, which may have been mild at the beginning, is gradually gaining
+ground and strength, and his neglect may eventuate in lifelong misery.
+No means are taken to guard against spreading the infection, the
+discharge may lodge on his fingers and he may infect his eyes and may
+lose his sight because he did not know that the discharge is one of the
+most dangerous fluids known. It may get on water-closet seats and infect
+others. Eventually he is compelled to seek aid, and he may, after a long
+period, be freed from the immediate consequences of his folly. At a
+later date he marries, and as previously explained, he infects his wife.
+This is the beginning of much of the domestic infelicity that is so
+prevalent to-day, and, inasmuch as it is a subject that should be
+thoroughly understood by every woman and mother, I shall carefully and
+clearly explain its significance and its consequences.
+
+Let us first, however, briefly consider what may occur to others if the
+boy is unfortunate enough to acquire syphilis. Again the boy fails to
+comprehend the nature of his affliction. There is imminent danger of the
+members of his household becoming infected. He uses the same dishes,
+spoons, towels, and utensils, any one of which may convey the disease to
+his father, mother, sister, or brother. He may use the common drinking
+glass in school, college, or office, and spread the disease in this way.
+He may kiss any member of his family, or a baby, and infect them. He may
+have his hair cut, or be shaved, and the virus may be spread around in
+this way if the barber does not sterilize the article used,--which he
+never does. He may drink at a soda fountain, or at a saloon, and the
+next individual to use the same glass may acquire the disease. He is a
+menace to the individual, to the community, and to the race. Wives often
+acquire syphilis from their husbands.
+
+THE INFECTED WIFE.--It has been previously stated that eight out of
+every ten males between the ages of sixteen and thirty, have had or
+have, gonorrhea or syphilis. Seventy-five per cent. of these cases have
+not been cured. About thirty-five per cent. of these are destined to
+infect wife, or wife and children, and in all probability many others.
+
+If a young wife acquires infection from her husband, she is exactly in
+the same condition as the diseased boy,--she does not know what ails
+her, so she wastes precious time in unprofitable worry. Why should she
+know what the trouble is? She came to the marriage bed pure, and clean,
+and healthy. Her previous education did not include instruction which
+would even help her to guess what the trouble might be. She is simply
+conscious of new distressing conditions which she does not understand.
+She may try to believe that these conditions are incidental to the
+change in her life. Shortly, however, the discharge, which she has had
+for a number of weeks, and which she thought was only a leucorrhea, or
+"the whites," becomes so profuse and nasty that she begins douching.
+This procedure simply blinds her to the true nature of the affection,
+and in the end she is driven, ashamed and reluctant, to consult a
+physician. She may be informed that her condition is bad, and that it
+will be necessary that she submit to a course of treatment. After a time
+the physician may succeed in tiding her over the immediate consequences
+of the gonorrheal infection she innocently acquired. She may soon after
+become pregnant, and she may miscarry as a result of the old trouble, or
+she may carry the child the full period. When the child is born it may
+be blind and this defect is a consequence of the old infection to the
+mother from the father. If the mother is syphilitic the child most
+likely will inherit all the horrible possibilities of transmitted
+blood-poison.
+
+Pregnancy frequently "lights up" any old, gonorrheal infection in the
+female, so this young wife fails to completely recover after the
+confinement. She is able to be about, but her strength refuses to be
+restored. It may be months later when she begins to suffer pain and to
+realize that she is quite sick. She develops a fever and may have a
+chill. The physician discovers that she has pus in her tubes and there
+is danger of peritonitis or general blood poisoning. The old germs have
+been roused and are active. Unfortunately they are located where it is
+impossible to dislodge them without resorting to a serious operation. It
+is now a problem of saving her life. She is taken to the hospital and
+her womb, tubes, and ovaries, are removed--she is unsexed.
+
+Young wives are being operated on every day, in every city in the
+civilized world for just such causes. It is a notorious fact, that, in
+every city in the world, the number of operations that are daily being
+performed on women, is increasing appallingly. Every surgeon knows that
+eighty per cent. of these operations are caused, directly or indirectly,
+by these diseases, and in almost every case in married women, they are
+obtained innocently from their own husbands. It is rare to find a
+married woman who is not suffering from some ovarian or uterine trouble,
+or some obscure nervous condition, which is not amenable to the ordinary
+remedies, and a very large percentage of these cases are primarily
+caused by infection obtained in the same way.
+
+When a girl marries she does not know what fate has in store for her,
+nor is there any possible way of knowing, under the present marriage
+system. If she begets a sickly, puny child,--assuming she herself has
+providentially escaped immediate disease,--she devotes all her mother
+love and devotion to her child, but she is fighting a hopeless fight as
+I previously explained when I stated that one-half of the total effort
+of one-third of the race, is expended in combating conditions against
+which no successful effort is possible. Even her prayers are futile,
+because the wrong is implanted in the constitution of the child and the
+remedy is beyond her power to find. These are the tragedies of life,
+which no words may adequately describe, and compared to which the
+incidental troubles of the world at large are as nothing.
+
+If the conditions are not as bad as those depicted above, the original
+infection may have rendered her sterile. If the germs reached the womb
+and tubes, the inflammatory process may close these tubes, with the
+result that conception is impossible. In these cases the woman has to
+bear the stigma and disgrace of a childless union, though she is not
+the guilty party. Many husbands are sterile, however, as a result of
+venereal disease. It is claimed that eighty per cent. of childless
+marriages are caused by sterility of the male partner. Curiously and
+unfortunately these men never suspect themselves. The wife is the
+delinquent member, in their estimation. She is the victim of jest and
+suspicion, and later of jibes and insults. Many women have had their
+lives rendered miserable and unhappy because of this suspicion. They are
+compelled by their husbands to submit to examination and unpleasant and
+painful treatment and operations with the intention of rectifying a
+defective condition that does not exist. Many conscientious physicians
+refuse to treat women patients against whom the charge of sterility is
+made, before subjecting the husbands to thorough examination, and, since
+eighty per cent. of childless marriages are due to sterility in the
+male, this is a just and reasonable course to pursue.
+
+During the course of all this domestic trouble and tragedy, the young
+wife's health has suffered--she scarcely enjoys one day of good health.
+Her mental condition is even worse. She submits to innuendo and insult
+under the impression that she is the unwitting cause of all the domestic
+wretchedness and often wishes she had never entered the marriage state.
+We must remember that these conditions wreck ideals and homes, and that
+they frequently render inefficient both husband and wife. The economic
+business of marriage becomes a failure, ambition is crushed and hope
+dies in the heart.
+
+If the mother has been inoculated with the virus of syphilis her
+existence is equally wretched; her health is ruined; her efficiency is
+forever mortgaged. If she becomes pregnant she will most likely abort
+and she will go on aborting for years, in the effort to bring children
+into the home, accusing herself meantime and submitting to the
+reflections which are heaped upon her, while the real culprit is the
+husband. He assumes an injured and innocent attitude and behaves as if
+he had been imposed upon by marriage with a woman who cannot carry out
+her marital contract.
+
+If she gives birth to a child or children, they are syphilitic. They
+may be deformed, or they may be feeble-minded or idiots. They may live
+at home for years, always ailing, always sick. They may develop
+epilepsy, St. Vitus' dance, skin disease, or mental vagaries, and they
+may have to be put into institutions for the feeble-minded, or they may
+die by inches at home.
+
+IS THE HUSBAND TO BLAME?--If a boy had gonorrhea a number of years
+before entering the marriage state, was treated for it by a physician,
+until all symptoms had disappeared and had enjoyed apparent good health
+in the interim, and had never been told any of the facts regarding
+probable consequences, is it just to blame him if he infects his wife?
+It is certain no man would willingly subject his bride to the risk of
+infection, with all its horrible consequences. These conditions exist as
+a result of the prudish attitude of society in the past toward all
+questions affecting sex hygiene. We have not told all the truth to the
+boy. Whatever knowledge he may have had was gained from companions, or
+from individuals who knew the garbled facts only. There is of course no
+excuse for the man who acquires disease after marriage and conveys it to
+his wife or children. This is a very different situation and one which
+should merit the severest condemnation and punishment. We are, however,
+only interested in the boy at present and will not take up the reader's
+time with a discussion of the "social evil" from this standpoint.
+
+BUILDING A MAN.--When the boy is about fifteen years of age certain
+changes begin to manifest themselves. He grows more rapidly, a growth in
+which his whole system participates. His bones grow bigger and stronger,
+his muscles increase in size, even his heart, and lungs, and liver, and
+his digestive system accommodate themselves to this transformation; the
+voice changes and hair begins to grow on his face. The mental process
+also keeps pace with the new order of things. He thinks differently and
+he sees from a new viewpoint. Nature is making a man out of a boy.
+
+These changes were not understood in the past, but we are beginning to
+appreciate the reason for this evolutionary process. We have discovered
+that the cause depends upon certain active changes which take place in
+the sex organs. About this time the testicles begin to be active. For
+years these glands have been preparing themselves for this work, so they
+first grow rapidly, increasing in size until they are about eight times
+bigger than they were before this time, then they begin to pour into the
+circulation a secretion which stimulates changes in all other parts of
+the body and is directly responsible for the wonderful change that is
+evident in the stature of the boy's body.
+
+This substance or "internal secretion" must not be confused with the
+semen. The internal secretion is simply the substance which nature
+employs in the developing process and is responsible for the degree of
+growth and quality of manhood which the boy manifests. The semen, on the
+other hand, is the procreative or fertilizing fluid which enables a man
+to beget offspring. When a boy understands this process it aids him in
+appreciating the importance of his sex organs and a little thought
+enables him to understand that if he abuses these organs he will
+seriously interfere with his own development. This process goes on for a
+number of years, until the boy reaches maturity. Any act or habit which
+weakens the quality of this secretion will deplete his powers and render
+him physically and mentally inefficient. To make a man, nature must be
+permitted to work in her own way. You cannot improve on her methods nor
+can you break her laws with impunity.
+
+
+
+
+CHAPTER XIII
+
+THE PARENTS AND THE BOY
+
+     Abuse of the Procreative Function--The Continent Life--Provide
+     the Environment Necessary to the Clean Life--The Period of
+     Procreative Power--Self-abuse--Masturbation--Treatment of
+     Masturbation--Night Losses or Wet Dreams--Causes of Night
+     Emissions--Sexual Excesses--Treatment of Sexual Excesses--What
+     Parents Should Know About the So-called "Social Evil," Before
+     Speaking with Authority to the Boy--The Need of Enlightenment
+     in Sexual Matters--"No One Told Me, I Did Not Know"--Fake
+     Medical Treatment of Venereal Diseases--Sowing Wild
+     Oats--Should Circumcision be Advised?
+
+
+ABUSE OF THE PROCREATIVE FUNCTION.--Breeders of animals have discovered
+that to breed from very young stock is not good. The quality and stamina
+of the progeny is lowered and the vitality of the parent stock is
+reduced. It is not a good economic proposition.
+
+Boys should therefore be taught that any form of sexual indulgence is
+harmful before the period of full growth.
+
+Nature did not intend that the procreative function should be exercised
+by individuals who were not fully developed. The perpetuation of the
+species must not depend upon the license of immaturity. The instinct of
+sex-attraction must not be debased to serve a puerile, rather than a
+holy purpose.
+
+Sexual indulgence in any form, and in any degree, at any age prior to
+full maturity is a perversion of the primal instinct of race
+perpetuation. The practice has a more intimate and a more personal
+association with growing boys, however, than a merely altruistic
+reference. Any indulgence of this character at this time is physically
+and mentally injurious. No boy can hope ever to acquire the full measure
+of his possible development as an efficient working or thinking machine
+if he wastes his vital forces in unnatural liberties. He should be
+taught this truth in an emphatic manner by those responsible for his
+education.
+
+There is a false idea prevalent that a continent life is harmful. So far
+as continence relates to immaturity, it may be strongly and justly
+asserted that it is probably the most important factor in the
+conservation of health and strength. The retention of the procreative
+fluids, at a time when nature is opposed to their loss, enables the
+growing economy to utilize them in the conservation of nervous energy
+and virility. If a boy dissipates these energizing fluids, he deprives
+his body of the richest products which he is capable of manufacturing at
+a time when he needs every aid in the building up of a physically and
+mentally sound and vigorous constitution. There cannot exist a normal
+development if the body is deprived of the essential ingredients
+necessary to growth and mental vigor.
+
+There was a time when young men were actually taught that sexual
+intercourse was necessary to develop full manhood. This was followed by
+a period of silence, which has practically extended to recent times.
+Both of these systems are pernicious. We know that sexual intercourse is
+not necessary to the development of mature normal manhood or womanhood.
+On the contrary, we know that continence, not incontinence, is an
+absolute essential to the growth of full sexual, virile maturity, as
+well as to the growth of efficient and healthy manhood and womanhood.
+
+We must appeal to a boy's reason and show him the personal side of clean
+living. When he understands that to attain success in every department
+of human effort,--on the baseball and football fields, in the ring, in
+gymnastic contents, in examinations, in social intercourse, in trades
+and professions,--a continent life is the only means possible that
+promises success, he will give the appeal consideration.
+
+We must employ all the safety devices possible to guard against the
+inclination of youth to wander. Regular exercise is one of the very best
+institutions in this respect. If we can instill into our boys a love of
+manly sports and encourage every effort in this direction, we will be
+doing much to minimize the growth of any tendency toward incontinence.
+We must provide the environment necessary to right living. The home
+should be attractive and we should permit the boy to have privileges
+even at the expense of the housekeeping decorum. His companions should
+be made welcome if they are the right kind of intimates, and the parents
+should enter into the life of the boy and try to look at "things" from
+his standpoint.
+
+THE PERIOD OF PROCREATIVE POWER.--The procreative ability begins at
+puberty. There is no fixed period at which it may be said to end. From
+puberty until the period of physical maturity, it grows in vigor and it
+remains stationary until middle life, when it gradually declines. The
+standard of virility is unquestionably an individual problem. It depends
+upon the various factors that contribute to good health and longevity.
+It may be stated that the boy who abused his procreative function,
+during the period of immaturity, will not enjoy, during the mature
+period of his sexual life, a normal standard of vigor, nor will he carry
+the ability into old age, to the same relative degree, as he would, and
+as he had the innate promise to do--if he had led a normal continent
+existence. It may also be stated here that there is no effective
+remedial measures known, that will "bring back" the procreative ability
+if it is lost as a result of disobeying natural laws. Drugs and
+treatments by quacks to cure impotence are impositions and fakes. Money
+and time spent in the pursuit of this dream is money and time wasted.
+
+SELF-ABUSE OR MASTURBATION.--By self-abuse is meant the production of
+the venereal orgasm, with or without emission, by any means other than
+the natural union of the sexes.
+
+It is a fact that the large majority of boys acquire the habit of
+self-abuse at some time. This is a very serious reflection upon parent,
+teacher, and physician, because it is through ignorance of the
+elementary principles of sex hygiene that this condition continues to
+exist. If they were warned against the possibility of self-abuse
+arising in innocent ways, as well as in more reprehensible ways, they
+would exert their influence against its acquirement. If however a boy
+discovers accidentally a condition of which he was innocent, and of
+which he does not know the significance, it is human nature that he
+should investigate the phenomenon and in the end suffer as a
+consequence. In the effort to relieve some local irritation he may
+handle himself and be led into a dangerous practice. He does not know
+that the practice may have serious results--in fact he does not know he
+is doing anything wrong. Many boys have practically ruined their
+physical health and become morally irresponsible because no one--neither
+parent, teacher, physician, nor friend--told them of their danger. This
+is unjust, but great strides are being made in this direction and we may
+reasonably hope, that in the not far distant future, every boy will be
+plainly told the true facts about himself.
+
+Most boys acquire this habit from other boys, but as we have intimated
+it is possible to acquire it in what are termed innocent ways. Sometimes
+the sensation which leads to it is discovered by sliding down banisters;
+or it may be that climbing trees or poles first awakens the feeling.
+Very young children are sometimes taught the vice by depraved nurses.
+Local irritation, as has been stated, may necessitate itching and
+handling the parts and in this way the vice is begun. The results are
+the same, no matter how the habit may have originated.
+
+If the habit is persisted in, the muscular system suffers,--the muscles
+become weak and flabby; the patient develops weariness and languor and
+loses his mental and physical vigor. He is no longer forceful or
+energetic, his efficiency is impaired and as a consequence his nervous
+system begins to show signs of depleted strength. He cannot concentrate
+his thoughts, he falls behind in his studies, his mental effort is
+sluggish, he becomes diffident and shy, shuns society, loses confidence
+in himself, is morbid and emotional and may even think of suicide.
+
+It is astonishing how indulgence in this habit may affect the moral
+nature of a boy. First of all, he is no longer frank and open. He
+becomes shifty and suspicious and will not look you squarely in the
+face. A boy cannot become a slave to this habit without it affecting his
+mind. He invites debasing thoughts,--the old pure and clean method of
+thought and living no longer satisfy. His imagination even becomes
+corrupt and his moral nature and moral sense is perverted until he no
+longer seems to be able to tell the difference between right and wrong.
+He has little regard for the truth and if occasion demands it he will
+lie without appreciating the dishonorable part he is playing. In the end
+his will power is lost--even the effort to save himself is too feeble to
+succeed--he is a slave to the habit, his health and strength ruined.
+
+If every boy could realize the possible end of this evil habit he would
+make an effort to rid himself of it before he becomes its victim and its
+slave. It may be easy to abandon the practice in the beginning. The
+longer he continues it, however, the less chance he has of finally
+mastering it, until, if he persists beyond a certain point, it is a
+matter of serious question whether he will ever be able to free himself
+from its grip. If the boy has lost the will power to carry out his
+resolves, no number of good desires or resolutions will avail. And it is
+just this will power that the wasting of the semen saps little by little
+away.
+
+TREATMENT.--What can we do for these boys? Most of them can do much for
+themselves by simply stopping the practice. There are, of course, others
+who need careful management before the habit may be controlled and
+health restored. It is well to always remember to be tactful and patient
+and kind to these boys. Many of them are standing on the brink of
+despair, weak in body and weak in mind. They do not know where to turn
+to look for a friend--the right kind of a friend. It is a terrible
+thought that your own boy may be abjectly miserable in his own home
+because he is harboring a secret that is wrecking his health, and,
+though he may long for sympathy and a helping hand, neither his father
+nor mother have invited his confidence or spoken to him about these
+things. A watchful mother can usually tell when her boy becomes addicted
+to this habit. He will show it in his manner, he will not be free and
+open, he will want to be by himself. Later he will show the effects of
+the abusive treatment he is subjecting himself to in his appearance. He
+will be sunken-eyed, pimply-faced, pasty-skinned, shiftless, sneaking,
+silent, unmanly. No mother can fail to note these signs and she should
+suspect the cause and take steps to tactfully reach him before he has
+ruined his health absolutely.
+
+We would advise regular exercise of a vigorous kind. Tire out the body
+so that sleep may be sound. Cold baths, followed by brisk rub-downs; no
+intoxicants, light meals, plenty of drinking water morning and night.
+The bowels should be regular every day. He should sleep alone on a hard
+bed in a well-aired room with light covering. He should keep busy every
+minute of the day and he should not think of himself at all.
+
+The boy must realize that his salvation rests with himself. After he
+knows the real danger which the habit carries with it, he must be on his
+guard every moment to abstain. If he does not he may rest assured that
+the practice will ruin his health, render him, a business failure and
+deprive him of all happiness during the rest of his life.
+
+NIGHT LOSSES OR "WET-DREAMS."--A so-called wet-dream is an unconscious
+emission of semen during sleep. The discharge may or may not be
+accompanied with an erotic dream.
+
+After a certain age--which may be from the twelfth or fourteenth year--a
+boy may discover that he has discharged some substance during his sleep.
+He finds the discharge on his night clothes and it naturally puzzles him
+greatly. He may be entirely unconscious of the whole proceeding, having
+slept soundly during the night, or he may wake up to find the fluid
+actually discharging.
+
+If a boy has not been told of this phenomenon he may regard it as a form
+of self-abuse of which he may have heard and as a consequence he may
+worry himself sick, as the night emissions continue to occur from time
+to time. Many pure-minded boys have been rendered miserable, and their
+efficiency and health have suffered as a result of just such an
+experience. It is, therefore, proper that they should fully understand
+the true significance of these occurrences.
+
+CAUSES OF NIGHT EMISSIONS.--I have explained how nature makes a man out
+of a boy. During this maturing process the testicles are very active
+organs--their function is to manufacture or secrete the fertilizing
+fluid or semen. This maturing process begins actively, as I stated,
+about the age of fifteen, though in some boys it frequently occurs
+earlier, sometimes as early as the twelfth year. When the testicle
+begins to grow at this time they manufacture more semen than the little
+pockets can hold, so nature adopts the method of permitting the surplus
+to escape during sleep. These night emissions, therefore, are perfectly
+natural losses, and need cause absolutely no distress of mind whatever.
+The frequency with which they may occur depends altogether upon the
+temperament of the boy. If the boy is a strong, active, athletic boy,
+they may not be so frequent in him as they may be in a quiet, studious
+boy. The system of the athletic boy seems to utilize more of this
+surplus than the quieter existence of the studious boy calls for. If the
+discharge does not occur oftener than once every two weeks, it may be
+regarded as normal and natural. Should they become more frequent than
+this, the boy should inform his mother or father and the family
+physician should be consulted. It may be that he is in need of a tonic,
+or special instructions regarding his method of living and his mode of
+exercising. Whatever the cause may be, it can be corrected, and the best
+plan is to give it attention as soon as it is noted that the losses are
+too frequent.
+
+SEXUAL EXCESSES.--It is well known to the medical profession that the
+marital relation is frequently practiced to excess. The same indictment
+may be passed on what may be termed extra-marital relations. No one has
+ever formulated a general sexual standard which could be safely regarded
+as normal. Too many individual conditions of temperament and health
+enter into the proposition to permit of a standard being formulated. It
+must, therefore, be regarded as an individual question to be adjusted,
+if necessary, by the family physician. What may safely be regarded as
+normal and harmless in one, constitutes, for many reasons, excess in
+another. When a man performs hard physical or mental labor, his sexual
+aptitude or capacity is limited, and this limitation cannot be exceeded
+without risk. Such a limitation may not constitute an excess in a man
+whose occupation does not call for a great expenditure of physical or
+mental energy. Any indulgence which produces exhaustion is excessive.
+
+The age of the individual has undoubtedly much to do with his sexual
+endurance. A young, virile adult will tolerate a sexual expenditure
+which would seriously affect the health and vigor of an older man.
+
+Environment and inclination are factors in determining the standard of
+some people. If the marital relations are participated in simply to
+preserve peace and harmony in the home, they are productive of harm even
+if indulged in moderately.
+
+The symptoms of sexual excess are much the same as those of self-abuse.
+To a certain extent, however, they are favorably influenced, because the
+conditions under which the relationship is practiced are natural,
+because the participants are matured physically, and because there is no
+element of worry over the probable effects.
+
+Sexual excess defeats its own purpose, because it engenders a lack of
+desire and consequently it is to a certain extent a self-limiting
+process. We must also remember that excess entails consequences just as
+the breaking of any natural law is followed by retribution of some kind.
+In these cases we find that discomfort follows excess. The parts become
+irritated and congested and disease of the prostate gland always
+follows.
+
+TREATMENT.--Stop the excess by self-control and self-restraint. Employ
+all the aids dictated by an intelligent perusal of the laws of sex
+hygiene. Preserve the general health. It may be necessary to resort to
+local treatment, because, if the parts have been abused by excessive
+indulgence, there is always more or less irritation and congestion
+present. This condition affects the nerves, suggestive reflex sensations
+are produced by a congested prostate and the patient becomes morbid. It
+is essential for such patients to consult a physician whose local
+treatment will stop the sensitiveness in the parts and relieve him so
+that he may carry out his programme of restoration unhampered by
+conditions which are only amenable to local treatment.
+
+WHAT PARENTS SHOULD KNOW ABOUT THE SO-CALLED "SOCIAL EVIL" BEFORE
+SPEAKING WITH AUTHORITY TO "THE BOY."--To be qualified to speak with
+authority, or convincingly, to a boy upon sex hygiene, the parents must
+be familiar with, and well versed in the subject. The facts related in
+the preceding pages must be thoroughly understood. No parent can study
+these facts intelligently without being impressed with the importance of
+the subject; without realizing that it is absolutely essential that the
+fundamental principles of sex hygiene should be taught to the rising
+generation; without acknowledging the tremendous part for evil which
+prudery and ignorance play in the education of youth; and without being
+convinced that most of the evil is the product of ignorance on the part
+of the boy, and that parents are in a large sense to blame if they fail
+to impart the necessary knowledge in time.
+
+The need for enlightenment in sexual matters is a product of existing
+conditions. Civilization and the social environment are developing along
+a plane which subjects the youth to temptations that practically did not
+exist in the past. There is a broader and looser code of ethics.
+Business monopolizes the entire time of the father, and social and
+political unrest and misdirected ambition distracts the mother. The son
+or daughter has a wider latitude and a freer reign than they once had.
+The opportunities for promiscuous intimacies are easier, and the public
+conveniences and utilities lend themselves to the designs of
+evil-intentioned and loose-moraled women. The ease of travel, the laxity
+of laws, the theater, with its unchaste and indecent plays, the moving
+picture snows, the vaudeville resorts, whose highest priced "talent" is
+some voluptuous female, who has cultivated the art of draping nudity
+with suggestiveness and singing immoral songs, all tend to give youth a
+false impression of the reality of life and to make the path of the
+degenerate easy and profitable. The rich are growing richer, and their
+children are pampered and overfed and underrestrained. Time hangs
+heavily on their hands and their only mental effort is to devise new
+methods and new ways of satisfying the lust of liberty and
+overstimulated desire. The poor are growing poorer, and to "keep in the
+ring," to live and dress beyond their means as many do, it is necessary
+to have an unexacting standard of morals. In this way the promiscuous
+libertine is evolved,--the most insidious and dangerous product of
+present day civilization, and the most pernicious factor in the spread
+of immoral impulses and indecent diseases.
+
+Parents must accept these institutions and agencies as necessary
+instruments of evil and adopt measures to nullify their attractiveness.
+Eternal vigilance is the price of success, but the quality of the
+vigilance must be dictated by love, not by suspicion and distrust.
+
+When the parent can convince the boy that the knowledge is imparted, not
+with the intention of depriving him of what he may construe as his
+natural liberties and rights, but with the single intention of adding to
+the sum total of his pleasure and success, he will look more kindly upon
+any proposition that suggests a course of conduct that leads to clean
+living. Sex hygiene will eventually find a natural place in the scheme
+of education. It will be taught to male and female alike. In the
+meantime, however, we must begin by educating the educators--the
+parents. In the beginning, their task will not be easy. There will be
+much to overcome, much ignorance, prudery, false modesty, hypocrisy;
+there will be much vicious teaching and evil example to live down. But
+we cannot hope to achieve results in the noblest cause, save by patient,
+intelligent, and persistent effort and by self-sacrifice and a constant
+enthusiasm. The aim is to tell all,--all the truth,--so that we may
+never be assailed by the cry, "No one told me, I did not know," from the
+loved lips of son or daughter gone astray.
+
+THE FATHER AND THE BOY.--The right kind of father can always find the
+time and the way to awaken in the heart of the boy the spirit of
+companionship. No boy living will resent the fellowship of the right
+kind of father. It depends upon the father! If the spirit of chumminess
+does not exist between you and your boy, you are at fault, you have made
+a mistake, you have missed your opportunity, you "did not go about it in
+the right way and in the right spirit." Try again--it may not be too
+late.
+
+The father who adopts the habit of taking his boys (and his girls too)
+out for long walks, at least every Sunday, and who spends an hour with
+them every evening--is the right kind of father. One who has never
+tested the merit of walks with children cannot possibly appreciate the
+enjoyment and benefit that can accrue from them. It is not only the
+physical good that results, nor the inspiration which one may draw from
+nature, but the concrete advantages that come from the fellowship with
+the children are a new and a real experience--this is what counts. You
+will have opportunities of sewing seeds in their minds that will grow
+into a harvest that will astonish you. Children in the right mood--and
+they are in the right mood when they are happy, and they are happy out
+in the open with an interesting companion--are alert, and responsive,
+and eager to be told "things," and this mood can be put to marvelous use
+by the "right kind of father." The father who wanders forth with the
+fixed purpose of thinking out some business problem during the walk and
+permits the children to find their own amusement is the wrong kind of
+father. He must choose to be a child again, he must desire to please
+them, he must make an effort to be in harmony with them, he must draw on
+his experience to interest them, he must talk to them entertainingly of
+every interesting problem which the walk itself suggests or he must
+formulate a plan and select a subject with a definite educational scheme
+in view. We can, in a most effective way, begin to build their
+characters, and, by the right kind of talk and enthusiasm, he can
+determine their resolves to be honest, truthful, just, clean,
+sympathetic. He can instill into them, in a thousand different ways, the
+determination and inspiration to succeed. It is a wonderful and a
+precious chance, and it will make the "right kind of father" more just,
+more sympathetic, more optimistic, and it will make him young again and
+more successful. Try it.
+
+Implant in the hearts of your children a love of home, make the evening
+meal and hour by the fireside a period of congenial fellowship, when all
+the little irritable ruffles of the day may be ironed out and swept
+away. The secret is to be intimate. Tell them the secret of success from
+your standpoint, how happiness is gained only by being efficient and
+successful, and that, to be efficient, one must be energetic and
+healthy. Drum into their ears the truth that life is a battle, and only
+the brave "win out," and health is the one essential necessity. It is
+astonishing how such talks will impress young minds. They will remind
+you of things you said, that made a lasting impression on them, long
+after you have forgotten the incident.
+
+A father can, in this way, by talking of the future to his boy, convey
+to him the high hopes he entertains of the great success the boy is
+going to achieve--you establish a standard in the boy's mind, and he
+unconsciously hopes to attain that standard. If you have impressed him
+with the necessity of preserving his health and strength, as an
+essential to success, he will be slow to yield to any temptation that
+may interfere with his plans. This reasoning may sound quixotic to some
+people, but it is the truth. Many a boy has been inspired to success by
+the knowledge that his mother or father believed in him, and was
+confident he would be a leader. He strove to justify the pride and
+confidence of those who held him dear, and he won out.
+
+To retain his health, therefore, is the first impulse to be conveyed to
+the boy. When he recognizes this truth, it is an easy task to instill a
+love of exercise, gymnastics, swimming, fresh air, cleanliness and
+temperance in him. If these are attained, you will have tided him over
+the tendency to self-abuse, and you will have rendered him less likely
+to yield to evil suggestion or temptation. His confidence in you will be
+whole-hearted and implicit. You can do anything with him at the
+psychological moment. It is now time to talk of more intimate matters.
+Carefully and tactfully, the father approaches the fundamental truths of
+sex hygiene.
+
+The selection of a subject for a text as a means from which to advance
+toward the real facts is sometimes of importance. It must not appear as
+though the subject was designedly chosen. If it follows in a natural way
+it will more thoroughly interest the boy and he will have swallowed a
+large dose of truth before he is impressed with the personal viewpoint.
+A passing trotting horse has served me a number of times for intimate
+talks with boys on heredity and kindred subjects. I invite the boy to
+watch how the horse uses his legs, and how rhythmically and beautifully
+he places his feet, and how his whole attitude serves the end for which
+he is exerting himself--to gain speed. Tell the boy the story of how
+professional breeders have achieved such marvelous results; how for
+generations the "strain" has been kept clean and pure, how any
+descendant of a great sire, who showed any habit detrimental to the
+development of the highest racing qualities--no matter how trivial the
+disability might be--was cast aside, experience having taught that it
+does not pay to waste effort and time on any horse whose physical or
+mental characteristics are not up to the highest standard. Such a horse
+will not win, and it is only "wins" that count.
+
+Change the subject to human beings. Tell him how the race maintains its
+standard; but show him the difference between the methods employed. How
+the horse has his mate selected because of the female's good qualities,
+so that the offspring may possess like qualities, if not better, and
+that the selection is made by men who know their business, and have had
+long experience in the work. How, on the other hand, a young man with no
+experience is permitted to choose any woman he may fancy irrespective of
+her qualifications. As a consequence, we have all kinds of children,
+good and bad, feeble and strong, honest and dishonest, some degenerates
+from birth, some criminal, and many diseased and inefficient, few of
+them "winners." It is an easy matter to preach a little sermon from this
+text. Show him how essential it is to select the mother of one's
+children wisely, to know if there is disease in the future wife's blood,
+if her family history is good, if her temperament is suited to his, if
+her domestic qualities are satisfactory, if her principles are moral
+and normal, and if she understands and appreciates the true object and
+function of marriage. Show him also the element of justice involved in
+the marriage contract; that he must give what he exacts, that if he
+expects a healthy and normal wife, he must be healthy and normal
+himself; if he expects purity and cleanliness he must give purity and
+cleanliness; if he expects to mate with a fit female he must be an
+efficient and fit male. Remember that every act, deed, thought, and
+aspiration is regulated by laws which one cannot fool with, or disobey,
+without reaping a harvest which will conquer, crush and ruin you, no
+matter how clever or smart you may think yourself.
+
+Show him the wisdom of the breeders' habit of never permitting sexual
+liberties in a too young stallion. For the same reason the boy must
+conserve his strength and virility for the marriage state and for the
+function of procreation.
+
+In a further talk, the father may extend this subject and gradually lead
+up to the "consequences" of the unclean life. The boy will be ready for
+this talk and will evince an interest in it that will be encouraging and
+promising.
+
+The talk about the science of mating the horses he will understand
+readily and thoroughly, and he will not fail to see the point when you
+switch to man and apply the same principles. Then when you show how
+mismating is responsible for poor children quality and how disease
+accounts for feeble-minded and degenerate offspring, he will be fairly
+well posted, and he will be ready to imbibe more details, and you will
+have done much of your duty. His curiosity will be quickened and his
+interest is awakened. It depends upon the father. If your boy is honest
+and clean, open and decent, he will not fall without a fight, and while
+he is fighting he is maturing. If your picture of the consequences of
+the venereal diseases has been effective and vivid, he will grow up with
+a healthy horror of them. If your conduct as a father has been wise and
+exemplary, and if your home has the right kind of environment, and the
+right kind of mother in it, you have done all a father can do to help
+the boy over the rough spots. The proper kind of encouragement and the
+right kind of vigilance, and books which will satisfy the boy's craving
+for more knowledge along this line is all that is needed to help the boy
+to "win out."
+
+FAKE MEDICAL TREATMENT FOR VENEREAL DISEASES.--Parents should in every
+possible way discourage the use of patent medicines and fake medical
+methods of curing these diseases. Untold harm has been done to boys and
+to women by these nostrums.
+
+In every instance the motive underlying the methods of people selling
+these things is to frighten the patients into the belief that their
+condition is more serious than it is in order to justify a long and
+expensive course of treatment.
+
+Their work is carelessly performed, and frequently they are directly
+responsible for the development of complication and dangerous sequelæ.
+The promises of speedy cures are false, and, not infrequently, methods
+of black-mailing have been known to follow an expensive and unsuccessful
+course of treatment.
+
+There is no class of disease in which the help and honesty of the
+legitimate medical profession is needed more than in the treatment of
+the venereal diseases. Parents should see to it that the family
+physician is prescribing any strange medicine that may appear in the
+boy's room, and not some unknown individual who may be an impostor and a
+blackmailer.
+
+SOWING WILD OATS.--Writers of fiction and others of a more serious trend
+of thought have recognized the sowing of wild oats as an institution
+which, if it does not merit the full approval of society's moral code,
+is, at least, tolerated. No serious consequences befall the offender. On
+the contrary, the libertine is the type of hero who receives the
+commendatory quips of erotic dames and the questionable interest of
+hysterical maidens.
+
+Women of easy morals are always willing to espouse the cause of the
+"black sheep," and to further the matrimonial success of the penitent
+_roué_. Many mothers are willing to marry their daughters to the
+polished villain of society, who is known as a rake and debauchee, if
+his family connections are desirable. It has been even held that a
+youth who did not "sow his wild oats" was of doubtful stamina.
+
+That many able men have sown wild oats is indisputable, and that many
+men who are respectful husbands, have also gone "through the mill" is
+also true, but this need not blind us to the fact that thousands upon
+thousands, who could have been successful men of affairs and creditable
+husbands and fathers, have been utterly ruined, as a result of having
+sown wild oats. No man is a better man because of a past record of
+licentious habits. The man who sows and escapes the harvest is lucky.
+The man who reaps, reaps in abundance. Most men regret the lapses of
+youth. Most of these lapses would never have occurred if the impulse
+could have been governed by the reasoning of maturity. These acts are
+the promptings of an impetuosity which may be entirely foreign to the
+individual's innate character, but brought out by promiscuous
+circumstances and the ignorance and license of youth. If we can protect
+youth, by an adequate knowledge of the consequences, we will furnish the
+means to tide over the impressionable period. Until a healthy maturity
+of judgment will assume the task unaided.
+
+The effects of the wild oats' theory are too tragically evident to need
+any argumentative refutation. The statistics of the prevalency of
+venereal diseases alone is sufficient; the results of these diseases are
+more than enough.
+
+Study the records of the jails and prisons, courts and asylums,
+hospitals and health resorts, think of the hundreds of thousands of
+diseased and deformed and mentally inferior children, of the multitude
+of paretics, melancholies, ataxics, maniacs, syphilitics,--all the
+products of "wild oats,"--and ask if the wild oats' theory is
+justifiable.
+
+Think of the ruined homes, the wretched lives of fallen women, the
+hopeless prayers of abandoned wives, the loneliness and misery of
+parents neglected and forgotten, the "bastards" and fatherless children,
+the drunkards and criminals and tramps--all weeds of the wild oats'
+harvest.
+
+Then reflect upon the tragedies, the suicides of the betrayed and of the
+diseased, the bank thief, the broken hearts of deserted and hungry
+children, the army of inefficients--around whose necks hang wild oats'
+medals, the men of big business, who constantly fight the effects of
+early incontinence and abuse, and the thousands who go to early graves,
+and then ask, in all justice, if the sowing of wild oats needs
+justification.
+
+Who supports the thousands of prostitutes? Who made them? Wherever you
+find pauperism, crime, drunkenness, insanity, idleness, immorality, vice
+and disease, you will find that the sower of wild oats has traveled the
+path and left his stain and his footprints there.
+
+SHOULD CIRCUMCISION BE ADVISED?--The answer to the above question is
+"Yes," in every instance. If circumcision is done early,--during the
+first two weeks of life,--the operation is without danger and
+practically without pain. In quite a considerable percentage of all
+males, circumcision is an absolute necessity. For excellent medical
+reasons, about which your family physician can inform you, every boy
+should be circumcised.
+
+
+
+
+CHAPTER XIV
+
+A MOTHER'S DUTY TO HER DAUGHTER
+
+     What a Mother Should Tell Her Little Girl--Where Do Babies Come
+     From--How Baby Birds and Fish Come from Eggs--How Other Animals
+     Have Little Nests of Their Own--The Duty of Mothers to Instruct
+     and Direct--What a Mother Should Tell Her Daughter--Every
+     Mother Should Regard This Duty as Sacred--Every Female Child is
+     a Possible Future Mother--Motherhood the Highest Function of
+     the Sex--Health the One Necessary Essential--Symptoms of the
+     First, or Beginning Menstruation--The Period of Puberty in the
+     Female--Changes in the Reproductive Organs at Puberty--The
+     Female Generative Organs--The Function of the Reproductive
+     Organs--The Age of Puberty in the Female--The Function of the
+     Ovary--The Function of the Womb--Why Menstruation Occurs Every
+     Twenty-eight Days--The Male or Papa Egg--The Function of the
+     Spermatozoa--"Tell the Whole Story"--"How do These Spermatozoa
+     Get There"--The Union of the Species--"How Can a Baby Live in
+     There for Such a Long Time"--How the Baby Gets its Nourishment
+     in the Womb--Girls Must Not Become Mothers.
+
+
+WHAT A MOTHER SHOULD TELL HER LITTLE GIRL.--Every little girl should be
+told the Story of Life by her mother. It should be told in simple
+language, so that the little girl will understand. Very early in life
+the little girl will be prompted to inquire of her mother "Where do
+babies come from?" It is wrong to give an evasive reply to this natural
+inquiry or to postpone telling the story, because they will be told it
+by playmates and will receive very wrong and very crude impressions of
+this wonderful subject.
+
+Every mother knows enough of life to tell her little girl its story in a
+way that will impress her with the sacredness of God's beautiful
+reproductive plan. She should begin by telling her a story about how the
+birds live. How at a certain season of the year they choose a mate and
+go housekeeping. They build a nest, and when it is all nicely finished,
+the mother bird lays her eggs. Then the papa and mamma bird take turns
+and sit on the eggs to keep them warm, and after a time the egg breaks
+and a little bird is born into the world. They feed the little baby
+birds until their feathers grow, and when they are old enough they fly
+away from their home and begin life by themselves.
+
+Many questions will be asked as the mother tells the story in her own
+words, and the correct answers to these questions will fill in all the
+difficult-to-understand points. The story of how the fish lay eggs in
+shallow water so that the sun may keep them warm and hatch them out will
+interest also. Be careful to impress upon them that there is always a
+mamma and a papa, a male and a female bird and fish,--that this is
+necessary because God made it so, and we must obey His wish. When the
+little girl fully understands the story of the egg bird, and egg fish,
+the mother can tell how the Creator thought out a different plan for
+other animals like the dog, horse, lion, elephant, and cow. He knew that
+it would neither be safe nor possible for these animals to stay at home
+long enough to sit on eggs and hatch their babies, so he made a nest for
+them inside of their bodies. There they would be warm and would always
+be with their mammas no matter what they were doing. So we come to the
+answer to their question: "Where do babies come from?"
+
+These interesting stories, according to the intelligence and sincerity
+of the mother, can be taken advantage of, to impress the little girl
+with the importance of many of the lessons of life. For example, her
+attention can be drawn to the fact that man and woman are the highest
+types of living things that God made. No other living thing, animal, or
+fish, or bird, or tree, or flower, can talk, and think, and reason as
+man and woman can. Because of this faculty--to think and reason--the
+human family are always trying to find out what can be done with all the
+other things God made. We try to find out what the different rocks are
+good for; what the different trees are good for, and the different kinds
+of earth, and animals, and birds, and fishes, and everything in the
+world. We study these, and we learn much, and we are made happier and
+more comfortable by what we learn. For example, by studying horses, and
+feeding and breeding them carefully, and training them, and caring for
+them, we can make stronger horses and better and faster horses; by
+studying trees, and planting them in soil best suited to them, and
+giving them plenty of water to drink, we can compel these trees to grow
+better apples and pears and peaches. In the same way we can produce
+better strawberries, and oranges, and grapes, and we can grow flowers
+with sweeter smells and prettier colors. We do all this by training
+these animals and trees to grow a certain way, to eat certain food, to
+drink pure water, and we protect them from the cold and sometimes from
+the sun if it is too hot. Our faculty to think and reason has taught us
+just what is good for them, and we compel them to obey our laws. As a
+result they become strong and more healthy. Now show the little girl how
+important she is; how much more precious she is than a tree, or animal,
+or flower, and how much more necessary it is that we, mammas and papas,
+should use our ability to think and reason in her interest. Show her how
+we have found out all about babies and little girls and how we know just
+what to do to make strong and healthy, and pure, and good, and clean men
+and women of all the little boys and girls in the world. Tell her that
+this is what mother is doing now, training her and compelling her to do
+the things that will make her a strong and a good mother when she grows
+older. Let her distinctly understand that it is the duty of mothers to
+instruct and to correct their little daughters when they do any wrong.
+Mothers know, because they have had experience in these matters, and
+they know just how a little girl must live, and dress, and eat, and
+behave, in order to be strong and pure, and good. So when mother
+reproves and corrects, it is because she knows that what you are doing
+to merit a correction is not for your ultimate good. Show them that all
+young things, and young animals, and young babies, and young girls, must
+be compelled to obey certain rules and laws, otherwise they would not
+grow up to be strong and healthy. Sometimes a rose bush grows up among
+stones and weeds, but it never thrives, it is always more or less sick.
+It does not grow strong, its flowers are poor little sickly things
+compared to the roses on a bush that is planted in proper soil, and
+carefully tended and pruned, and watered. So would the little girl turn
+out if she grew up in bad company and did not have a mother to guard and
+guide her,--to prune her when she was growing careless. Everything in
+this world has a meaning, and when mother tells you that you must not do
+a certain thing you very much want to do, she has a very good reason for
+telling you not to do it. You may not know the reason, but you should
+have confidence in your mother, you should believe that she knows what
+is best, and that she would not inflict pain or cause you suffering
+unless she knew it was for your good. The young horse does not
+understand why a halter is put around its neck and is made to run around
+in a circle until it is tired. It would much rather enjoy itself in its
+own care-free, and happy way. And when finally a full set of harness is
+put on, and it is put into the shafts of a wagon and tied there, and
+made to pull it and its driver many weary miles the horse does not like
+it, and he rebels strenuously. He is, however, compelled to obey in the
+end, and he finally consents to become a useful horse.
+
+It is exactly the same way with every little boy and girl. We are put
+into this world for a certain purpose, and we must all work. Now parents
+know this, and they know just how to prepare little girls and boys for
+this work. They therefore ask them to do many things that are not
+pleasant or agreeable but which must be done in order to prepare them
+for the work ahead.
+
+
+WHAT A MOTHER SHOULD TELL HER DAUGHTER
+
+Your daughter is now about fourteen years of age. She is about to pass
+from girlhood to womanhood and she should know more of life's story. The
+mother will now tell her the complete story in the form of little talks,
+based upon the following facts as texts. Each mother will doubtless add
+to the story as conditions justify and as the education of the mother
+and daughter may dictate. A multitude of little side talks can be wisely
+indulged in to make clear any uncertain or doubtful explanation, and
+every one of these incidental excursions can be made exceedingly
+interesting if wisely and opportunely chosen. Always remember, however,
+to emphasize the sacredness of the story. Do not permit your daughter to
+get the impression that you are telling her something that simply has to
+be told, just as you told her the correct way to boil an egg. Let her
+realize and get the impression that this is the most serious and most
+wonderfully interesting story in existence, the most important story she
+will ever hear. Let her understand that motherhood, for which she is now
+preparing, is the duty God assigned her in this world: that that duty
+must be carried out, and that she must do nothing, nor leave anything
+undone, to interfere with its accomplishment. Do not only impress her
+with the story itself, but let your own explanation be so emphatically
+serious, that she will deeply appreciate its momentous significance--an
+occasion to be remembered all her life.
+
+If she gets the proper impression from you at this time she will never
+treat the subject lightly, or permit it to be promiscuously discussed
+within her hearing.
+
+Begin by telling her that she is about to enter the most important
+period of her life. Explain why this is so in the following way, in your
+own words. If we admit every female child to be a future mother, and
+motherhood the highest function possible to the sex, then the awakening
+of the sex organs and the mother instinct, must be the most important
+developmental episode in the life story of every woman. If this is so,
+then it follows that every girl should enter this period in the very
+best physical health possible, in order to reap the best results
+incident to this evolutionary period. We impress and warn her,
+therefore, that, as her system is about to undergo important changes,
+she must be particularly careful of her health. A little mistake at this
+time may be followed by more serious consequences than if made at any
+other time in her life. If a girl is to become a mother, certain changes
+must occur in her body before the nest, of which we previously wrote,
+can be made ready. God did not overlook anything when He peopled the
+earth; He therefore wisely planned that these changes in the female
+should occur at a time when the girl is strong and healthy.
+
+THE PERIOD OF PUBERTY IN THE FEMALE. SYMPTOMS OF BEGINNING
+MENSTRUATION.--At about the age of fourteen these changes begin to give
+evidence of existence. They affect the girl's whole system and the
+mother must be especially patient and sympathetic. Her disposition may
+change, she may want to be alone, and she may be more or less
+melancholy. She will be dissatisfied with the things that previously
+interested her. She will tire easily, and she may have many spasmodic
+pains from time to time. The wise mother will tactfully see that she
+takes plenty of nourishing food and systematic exercise, and that she
+gets enough sleep in a well-aired room. There are other physical changes
+which are observable at this age. The girl grows taller, the figure
+broadens out, the hips widen, the bust enlarges, and the waist line
+increases in size. These are all part of the great change from girlhood
+to womanhood.
+
+CHANGES IN THE REPRODUCTIVE ORGANS.--The principal change takes place in
+the reproductive organs themselves, and it is very essential that she
+should have a clear mental picture of just what is meant by
+"reproductive" organs and their location in her body. We mean by this
+term the group of organs which are concerned in creating and nourishing
+a child until it is old enough to be born into the world.
+
+THE FEMALE GENERATIVE ORGANS.--These organs are the womb or uterus, two
+ovaries, two fallopian tubes and the vagina. The womb or uterus is the
+"nest." It is about the size of and is shaped like a pear. It is hollow,
+however, though its walls are quite thick. The ovaries are about the
+size of a peach stone and lie at the side of the womb,--one on either
+side. The fallopian tubes connect the ovaries with the womb. The vagina
+connects the womb with the outside world,--it is sometimes known as the
+birth canal. In the very lowest part of the abdomen, or belly, in front,
+is the bladder, which collects the urine until it is necessary to pass
+it out. In the back part of this region is the rectum; it collects all
+the undigested food, etc., from the intestinal canal. Between these
+two,--the bladder and rectum,--we find the reproductive organs, the
+womb, ovaries and vagina, described above.
+
+THE FUNCTION OF THE REPRODUCTIVE ORGANS.--It will be difficult, even for
+mothers, to acquire a clear understanding of the function of the
+reproductive or generative organs. It is an exceedingly interesting
+process, however, and it is well worth a patient, attentive study to
+clearly understand the brief description we give of it. If you acquire a
+distinct mental picture of the problem you will be able to tell your
+daughter a story that will be of intense interest to her, and a tale
+that is interesting is impressive and is productive of thought and
+reflection. That is the condition of mind we want daughters to be in
+when they hear this story.
+
+The human ovaries begin to prepare themselves for their life work when
+the girl is about eight years of age. When they are ripe, or ready to
+perform this duty, the girl menstruates for the first time. This is
+known as the age of "puberty," which implies that she has developed,
+passed from girlhood into womanhood. After having reached the age of
+puberty it is possible to become a mother.
+
+THE AGE OF PUBERTY.--There is no fixed age at which the first
+menstruation takes place. Some girls develop quicker than others,--a
+condition that depends upon the health and type of girl. A strong,
+robust, full-blooded girl will menstruate at an earlier age, than will a
+sickly anemic girl. The average age is fourteen years, though there is
+no reason to worry if a girl does not menstruate for a number of years
+later. In warm climates the age of puberty is from two to four years
+earlier than in more temperate climates.
+
+THE FUNCTION OF THE OVARY.--Just what takes place in each ovary when it
+is ripe is best explained by likening an ovary to an orange,--though of
+course the ovary is very much smaller than an orange, as was previously
+noted. If you make a cut in an orange and squeeze it, you express some
+of its juice and most likely you will also express one or more seeds.
+The seeds of the ovaries are called "ovules," and the process by which
+it expresses them is called "ovulation." Of course there is no actual
+squeezing of the ovary,--the ovules grow in the ovary, and as they ripen
+they come to the surface, and when actually ripe, the part of the
+surface of the ovary to which they come, opens up (like a flower
+unfolding when in bloom), and they fall out. The ovule we may regard as
+the human female egg, and one ripens and falls out every twenty-eight
+days.
+
+When the egg falls out of the ovary it falls into the tube which carries
+it into the womb. This tube you will remember is called the fallopian
+tube. The ovule or egg is now in the cavity of the womb where we will
+leave it for the present.
+
+THE FUNCTION OF THE WOMB.--While these changes are going on in the
+ovary, the womb is also preparing itself for its share of the work. The
+lining or internal surface of the womb is composed of mucous membrane,
+much the same as the interior lining of the mouth and throat. This
+lining becomes congested with blood, and is so intensely swollen at the
+time when the ovule or egg reaches the womb, that it is ready to rupture
+and bleed all over its surface. Just whether it will rupture and bleed,
+depends upon whether the egg is going to grow into a child or not. If it
+is not going to grow into a child, it immediately bleeds freely, and
+continues to bleed, until the whole lining of the womb and egg is passed
+out into the outer world. This takes four or five days and constitutes
+"menstruation." After menstruation is over, the womb begins again to
+prepare itself for the coming of the next ovule or egg, and as this
+occurs every twenty-eight days, menstruation is commonly termed the
+"monthly periods."
+
+WHY MENSTRUATION OCCURS EVERY TWENTY-EIGHT DAYS.--The reason why the
+womb does this every twenty-eight days is because it is impossible to
+tell just when the womb will be called upon to nourish and support a
+child. If it did not get rid of the old blood, it would not be in a
+healthy condition to nourish and take care of a baby, nor would its
+interior be ready to supply new fresh blood for the growth of the
+infant. Hence nature constructs and builds a new "nest" in the interior
+of the womb each month. It very much resembles the new home into which
+the bride and groom, go to begin housekeeping.
+
+When you told your little girl the story of life, you particularly drew
+her attention to the important fact that every living thing is created
+by the union of a male and female principle, and, therefore, has a mamma
+and papa. This applies to trees, flowers, vegetables, fish, animals,
+birds, insects,--every living thing, including human beings. We have
+seen that the ovule from the ovary is the female egg, or principle. It
+is the part the female contributes toward the future child. Before a
+child is possible, however, the ovule must meet the egg from the male.
+
+THE MALE OR PAPA EGG.--The male or papa egg is called a "spermatozoa."
+It reaches the interior of the womb through the lower opening, which you
+will remember opens into the vagina. Emphasize to your daughter that the
+female ovule or egg, and the male egg, or spermatozoa, are minute
+objects, so microscopically small that a hundred million of them could
+comfortably lie upon a ten-cent piece.
+
+THE FUNCTION OF THE SPERMATOZOA.--God gave the male spermatozoa the
+power to move. To watch them under the microscope you would imagine you
+were looking into a bowl of water, in which there were hundreds of
+little fish all squirming around. But the most wonderful thing about
+them is, they can only move in an upward direction,--they seemingly
+cannot move downward, or sideways. If you think for a moment you will
+understand why God gave them this marvelous property. When the male
+semen is deposited in the female vagina, there are thousands of these
+minute, living, moving spermatozoa in it. The womb is above the vagina,
+and the female egg is in the womb, consequently, to reach this egg, the
+spermatozoa must travel upward. To travel in any other direction would
+be fruitless energy. There is only one female egg, but there are
+thousands of male eggs, or spermatozoa; it is easy, therefore, to
+comprehend how one of these spermatozoa should exactly be in line with
+the female egg in its upward path, since there are so many of them. It
+is only necessary that one should meet the female egg in order to
+impregnate it.
+
+The shape of the male principle, or spermatozoa, is exactly like a
+little tadpole, and you no doubt recall that a tadpole has a minute
+tail, the movement of which enables it to swim around. So has the
+spermatozoa, and by the incessant movement of this microscopic tail they
+all move upward as soon as discharged by the male. I told you that God
+gave the male-germ life. It is necessary now to explain the character of
+this life. It is very brief; it is estimated that they are active for
+two hours, and then become inactive, or die. The best way to explain the
+brief activity to your daughter, is to liken the spermatozoa, to a
+mechanical toy, which is wound up to go for a certain time. After it
+runs out it becomes inactive; this is exactly what happens to the little
+human tadpole. If during this brief life none of them has happened to
+reach the female egg, pregnancy does not take place and menstruation
+occurs. On the other hand, if this were not so,--if these spermatozoa
+were active for a longer period, pregnancy would almost be certain to
+take place every time the womb was not already occupied with a
+pregnancy.
+
+TELL THE WHOLE STORY.--When a mother reaches this stage of the wondrous
+tale she will be asked by an innocent girl,--"How do these spermatozoa
+get there?" or, "You have not told me where these tadpoles came from"
+or, "I don't understand how these spermatozoa got into the vagina" or,
+"I don't know why you call these the male egg when they are in mamma."
+It does not matter how it is expressed, the intent is plain enough. I
+have said, that an innocent girl will ask this question, the implication
+being that one who is not innocent will refrain from asking this
+question. A girl who knows the answer will not ask, because, if she is
+familiar with this subject before her mother thinks it wise and proper
+to tell her, she obtained her information from a source which, most
+likely, insinuated a suggestive, or evil, meaning into the explanation,
+consequently she would be afraid, or ashamed, to ask the question. An
+innocent girl, on the other hand, would rightly ask for information
+which is obviously kept back, and which she has a right to know, since
+a complete, and intelligent understanding of the story depends upon the
+elucidation asked. If it is proper to tell part of the story, it is
+essential to tell all of it. Tell it in your own words in this way:
+
+When God conceived the human race He ensured its perpetuation by
+designing a method whereby this would be rendered possible: He did more;
+He wisely decided that the function, involving the very existence of the
+human race, should be attended with a sentient gratification. He further
+instilled into the fundamental economy of mankind, sex attraction, which
+is involuntary, undeniable, and unquenchable. If God conceived the means
+and the method, no human mind in possession of its faculties should see
+evil where it does not exist. It was by Him designed that the male organ
+of reproduction should deposit its germinating fluid in the vagina of
+the female, and this is accomplished by a union of species.
+
+The one set of reproductive organs is a complement of the other, and
+essential to the other. It is by this act that the male spermatozoa is
+enabled to complete the function of fecundation.
+
+If now we assume the male and female element to have met and united,
+menstruation does not take place. The egg or embryo (the future child)
+begins to grow, and it remains in the womb for two hundred and eighty
+days from the day when the male and female egg met. It is quite natural
+for an intelligent girl to ask her mother to explain, "How a baby can
+live in there for such a long time," or "What makes it grow if it does
+not get anything to eat or drink."
+
+HOW THE BABY GETS ITS NOURISHMENT IN THE WOMB.--These questions can be
+answered in this way. While the baby is in its little comfortable home
+it gets everything it needs. You are in your home now. If you wanted a
+drink, what would you do? Wouldn't you go to the water faucet and draw a
+glass of water? The water comes to you through a pipe, right into your
+home, you don't have to go out of the house to get it. And if you wanted
+light when it is dark you would turn on the gas and light it. It, too,
+comes into your home through a pipe. Now baby gets its air; and food,
+and all it needs to drink in just that way. There are two little pipes
+which go into its nest or home, and then into the baby's body at the
+navel, and through these pipes fresh blood runs in and out. When mother
+breathes, her blood sucks up oxygen from the air in her lungs, and the
+blood carries oxygen to every part of her body. In this way, all parts
+are supplied with the proper quantity of air. Now the baby is simply a
+new part of mamma as long as it is in its nest in her body, so it too
+gets air in this way. When mother eats, the food is taken into her
+stomach and it is there changed into liquid and so prepared, that when
+it passes into the intestines, the part of the food that is good for
+her, is sucked up into the blood, and the blood carries it to every part
+of her body. It distributes whatever is needed to all parts, and as the
+baby is a part, it gets its share. The other pipe carries the blood back
+again, out of the baby for new supplies, and as this is going on all the
+time, there is no danger of the baby starving in any way, or at any
+time.
+
+When your daughter understands this, show her how important it is that
+mothers should be in good health, otherwise the baby will not get good
+food, it will not be properly nourished and will be born a poor, little
+sickly child. Little girls, consequently, should try to eat properly,
+exercise regularly, and do everything their mothers tell them, so that
+when they become mothers, they will be able to nourish their babies and
+not bring into the world poor little starved infants.
+
+GIRLS MUST NOT BECOME MOTHERS.--We have previously stated that girls can
+become mothers when they have reached the age of puberty. God did not
+intend, however, that girls at the age of twelve or fourteen should
+become mothers, because their bodies are not strong enough, nor are they
+fully grown, nor have they the experience, to undertake the physical
+task and responsibility of bringing a baby into the world. We know this
+from experience, because we have seen the sickly babies such girls have,
+and we have seen how much these girl mothers suffer, and how they ruin
+their health, by trying to do what God did not intend they should do.
+Even the trees teach us this lesson. An orange tree will bring out buds,
+which would develop into oranges, when it is two years old. The
+experienced farmer, however, will pluck these buds off, and will do so
+every year, till the tree is five years old. If he allowed the tree to
+bear fruit during its young years, the oranges would not be good, or
+sweet, or large; so he waits until the tree has grown and is strong and
+healthy, when its fruit will be large and sweet. An orange tree of this
+type will have better fruit, and will continue to produce this good
+variety for many years. A tree allowed to bear fruit when two years old
+will never have first class oranges, nor will it continue to have, even
+poor oranges, as long as the other.
+
+
+
+
+CHAPTER XV
+
+PREPARING FOR MOTHERHOOD
+
+     Menstruation--Irregular Menstruation--Changes in the Quantity
+     of the Flow--How the Womb is Held in Place--Symptoms of
+     Menstruation--Menstruation Should Not be Accompanied with
+     Pain--Don't Give Your Daughters Patent Medicines or "Female
+     Regulators"--Take Your Daughter to the Doctor--Leucorrhea in
+     Girls--Bathing when Menstruating--Constipation and Displaced
+     Wombs--Dress and Menstruation--Absence of Menstruation, or
+     Amenorrhea--Treatment of Amenorrhea--Painful Menstruation, or
+     Dysmenorrhea--Causes of Dysmenorrhea--Treatment of
+     Dysmenorrhea--Sterility in the Female--Conditions Which Affect
+     the Fertility of Women--Climate--Station in Life--Season of the
+     Year--Age--The Tendency to Miscarry--Causes of Sterility in the
+     Female--Displacement of Womb--Diseases of Womb, Ovaries, or
+     Tubes--Malformations--Lacerations--Tumors--Leucorrhea--Physical
+     Debility--Obesity--Special Poisons--"Knack of
+     Miscarrying"--Miscarriage--Cause of Miscarriage--The Course and
+     Symptoms of Miscarriage--What to do when a Miscarriage is
+     Threatened--Treatment of Threatened Miscarriage--Treatment of
+     Inevitable Miscarriage--After Treatment of Miscarriage--The
+     Tendency to Miscarriage.
+
+
+MENSTRUATION
+
+We have explained in the previous chapter what menstruation is, its
+frequency, its significance and its origin. There are a number of its
+common characteristics with which the mother and daughter should be
+acquainted.
+
+IRREGULAR MENSTRUATION.--Menstruation may occur once (the first time)
+and fail to recur the following month or for a number of months. This
+need cause no alarm as long as the general health remains good. It will
+come again in its own time. Nervousness may cause a suspension of
+menstruation. This is quite common in school girls who are driven too
+hard at school, whose sleep is interfered with, whose appetite is poor
+and who are allowed too many social indiscretions, as parties, dances,
+etc., where late hours are observed, all of which should be put aside
+until school life is over. Sometimes menstruation will temporarily stop
+if the girl goes away from home on a visit.
+
+Sometimes the quantity will be greater than at other times, and a very
+scant flow, after it has been free and regular may cause apprehension.
+Various causes may be responsible for a decrease, catching cold, sitting
+on cold steps or cold ground, wearing damp clothes, nervousness, mental
+worry, physical exhaustion, insufficient food and exercise, and anemia,
+may cause it. For these reasons a girl should be exceedingly careful of
+her health, she should guard against catching cold. Do not change the
+underwear until certain that the weather is far enough advanced in
+season to justify such a change. She should not become exhausted or
+worry. In all cases of suppression, or of increased flow, a physician
+should be consulted at once, and girls should be instructed to tell
+their mothers of any change in the character of the "periods," as soon
+as it occurs. Mothers should instruct their daughters to rest the first
+day of their monthly flow, and all during the menstruation they should
+refrain from any unusual activity. Even play should be moderated and
+abstained from entirely if there is any pain. In order that the girl
+fully appreciates why these rules are laid down, it is advisable to
+explain just how the womb is held in place in her body.
+
+This appears to the writer as being a particular important point. A girl
+must not be expected to give these matters the serious consideration
+they merit unless she thoroughly understands the reasons why. An
+explanation, in the form of even an intelligent talk, will soon be
+forgotten. If, however, a definite, concrete picture, is impressed upon
+her; if she actually sees in her mind the process that is going on, she
+will understand why it is necessary to do as she is told. If the mother
+will therefore assure herself that the daughter actually knows what is
+being accomplished in her womb at the menstrual period, she will carry
+out the instructions more faithfully.
+
+HOW THE WOMB IS HELD IN PLACE.--The human uterus, or womb, is held in
+its proper place in much the same way as a clothes pin sits on a clothes
+line. The heavier part is the upper part, and that part is held in place
+partly by resting on the rectum behind, and the bladder in front. When
+menstruation occurs, the body of the womb becomes much heavier because
+of the increased amount of blood in its interior. This added weight
+increases its liability to tip over, and if any extra strain or effort
+is made at this time it will become tipped, or as the physician calls
+it, displaced. If a womb becomes displaced, every menstruation afterward
+will be painful and prolonged,--sometimes excessively so. A displaced
+womb becomes congested and unhealthy. It causes leucorrhea or a chronic
+discharge, makes a nervous wreck of the woman, results in sterility and
+frequently in a dangerous operation. There are, therefore, ample reasons
+for watchfulness and care on the part of the growing girl.
+
+SYMPTOMS OF MENSTRUATION.--After menstruation is established there
+should be no actual pain at each period. There are, however, certain
+undefined feelings,--premonitory symptoms,--which may be explained in
+the following terms:--A day or two before the date on which the
+menstruation is expected, the girl will appreciate that "her sickness"
+is coming. She will not, or should not, complain of pain, but will state
+that she has a bearing down feeling, is a little more nervous than
+usual, has no desire to go into company, and wants to be more or less
+her own entertainer. The "sick" period usually lasts four or five days.
+The second day is the most important.
+
+MENSTRUATION SHOULD NOT BE ACCOMPANIED WITH PAIN.--If any actual pain
+accompanies menstruation, either before or after it is established, the
+mother should at once take the daughter to the family physician.
+Menstruation is a natural, physiological act and should not be
+accompanied with actual distress or pain. It is astonishing how many
+mothers will allow their daughters to suffer needlessly, for months and
+years, because of the mistaken idea that "since the pain is there, it
+must be," or because she--the mother--suffered, so also must the
+daughter suffer. There is no more unfortunate mistake, and many a girl's
+health and happiness has been blasted because of this misbelief. The
+cause of the pain is, in a vast majority of the cases, a very simple
+one, and can be removed in a very brief time.
+
+Should the menstrual period last too long, be too frequent, or be in any
+way not what it should be, consult your physician. If you are not sure
+of "what it should be," or if you have any doubt, ask your doctor. Don't
+let any false pride or feeling of modesty on your part, or on the part
+of your daughter, dictate your policy under such circumstances. Don't
+take the advice of your friends or neighbors in a matter so vital. It is
+too important, and they are not qualified to "guess" any more than you
+are. Don't, if you have any respect for yourself, or love for your
+child, begin dosing her with the advertised patent medicines and "Female
+Regulators" for which so much is claimed, and which seem to "just suit"
+your daughter's case at this particular time. Take her to the doctor,
+whose advice you value (or you should not have him as a family
+physician), who has no interest at stake except to help you and your
+child, and whose fee is no more than the price of one of these bottles
+of advertised poison. He is the only one qualified to speak with
+authority on such a momentous subject, and you will never spend a dollar
+to better advantage. Warn your daughter not to speak about "her
+sickness" to other girls.
+
+Especial attention should be paid to cleanliness during this period. The
+mistaken idea that bathing of any kind at this time may have disastrous
+consequences is responsible for much of this neglect. If proper care is
+taken warm sponge baths, in a warm room, will not cause any trouble.
+Unpleasant odors can be avoided by sponging the parts with a warm
+solution, into which a mild antiseptic is put, upon changing the cloths.
+
+LEUCORRHEA IN GIRLS.--It has been stated above that a displaced womb may
+cause leucorrhea or a discharge. It must be remembered that leucorrhea,
+or "whites," may occur in girls as well as in married women. It can also
+result from catching cold during the menstrual period. Another mistaken
+idea is that girls should not take douches for fear of injuring the
+hymen. This is erroneous, and while they are entirely unnecessary in a
+vast majority of cases it is sometimes absolutely essential to douche in
+order to cure leucorrhea. When they are given, it is advisable to use
+the small nozzle that comes with every douche bag set.
+
+CONSTIPATION AND DISPLACED WOMBS.--When the picture is fresh in the mind
+of the girl, of how the womb is held upright in her body, the mother
+should speak to her about the serious results that may occur from
+constipation. If the rectum is full of hardened feces the womb will be
+pushed out of place, and if under these circumstances straining is
+necessary to empty the bowel, and if this condition is habitual,
+constipation may be the actual cause of displacement of the womb.
+
+DRESS AND MENSTRUATION.--It is also an opportune time to demonstrate to
+what extent serious results may follow mistakes in dressing. The habit
+of permitting growing girls to constrict the waist, to bind and pull the
+abdomen by too tight garters, or too tight corset, is wrong, and no
+mother should permit it. In another part of the book, this matter is
+taken up more fully, but if it is explained to the girl while she is
+considering the subject of menstruation, she may more quickly and more
+fully appreciate its significance.
+
+ABSENCE OF MENSTRUATION--AMENORRHEA.--The absence of menstruation after
+it has been established, does not, as a rule, indicate any disease of
+the womb or female sexual organs. It is to be regarded merely as a
+symptom and can be, as previously stated, safely ignored if the general
+health is good. If the general condition is poor, and the quantity and
+quality of the blood deficient, it is a provision of nature to suppress
+menstruation in the interest of the general health. For this reason it
+is safe to disregard the amenorrhea and build up the bodily strength.
+This explains why some girls pass the usual age of puberty and show no
+signs of menstruating. They are poorly developed sexually, through
+deficiency of blood. If, on the other hand, a girl should have all the
+symptoms of menstruation every month, but no flow, she should be
+examined by a physician to determine if there is any obstruction to the
+escape of blood. Total absence of any symptoms of menstruation extending
+into adult life, may indicate an absence of the sexual organs. During
+the first year after puberty it is quite natural for menstruation to be
+irregular; after the function is thoroughly established there are many
+causes that may be responsible for its temporary absence.
+
+CAUSES OF AMENORRHEA.--Any condition or circumstance which reduces the
+general health or impoverishes the quality or quantity of the blood and
+weakens the nervous system, will result in a stoppage of the monthly
+periods. Among these are insufficient food and exercise, overwork,
+overstudy, exposure to cold, sitting on cold steps or gold ground,
+wearing damp clothes, bathing in cold water at the beginning of
+menstruation, powerful emotions, as great fright, anger, anxiety; acute
+diseases, such as typhoid fever, cholera, the infectious skin diseases;
+chronic diseases such as Bright's disease, heart disease, consumption;
+anemia and chlorosis are very common causes. Obesity or an overfat
+condition will cause an early suppression of the menses which may result
+in a fruitless marriage. Displacement of the womb and other local
+disorders frequently result in scanty or delayed menstruation. Anxiety
+lest pregnancy may occur in the newly married may cause a delay in the
+periods. A radical change of climate or sometimes a visit to the
+country, or changed circumstances may stop the flow for the time being.
+
+TREATMENT.--The treatment of amenorrhea, or absence of menstruation,
+will depend on the underlying cause. A careful investigation should be
+made into the mode of life and the hygienic surroundings of the patient.
+Her general health and her mental condition should be inquired into. If
+the patient is not in good health, or is not obtaining exercise in the
+open air, or if she is a victim of mental worry or of domestic
+unhappiness, or if any sufficient cause exists for the amenorrhea it
+must be removed before any treatment may be expected to relieve the
+condition. If the patient is a married woman the possibility of
+pregnancy should always be borne in mind, and no radical treatment
+instituted until this has been excluded. If the absence of menstruation
+is dependent upon defective development of the sexual organs we cannot
+expect much from any treatment. The amenorrhea from exhaustive diseases
+will usually correct itself with, or soon after, the establishment of
+convalescence. In diseases which tend to death, as in consumption, heart
+disease, etc., the function is never reestablished. A very common habit
+of most people is to regard the absence of the monthly periods as the
+cause of their ill health. It is not, it is the result of the ill
+health. Get rid of the bad health and the menses will take care of
+themselves. That form of amenorrhea which is the result of change of
+climate or surroundings will regulate itself as soon as the victim
+becomes acclimated or reconciled to the change, or returns home if the
+visit is of brief duration.
+
+As a general routine treatment, good wholesome food, regular hours,
+fresh air, sunlight, and judicious exercise, with such other measures as
+may be suggested by the condition of the blood and nervous system, are
+the indications in the way of treatment. Anemia and chlorosis (poor
+blood) should be treated by the administration of iron in some form.
+Obesity should be reduced by diet, exercise, and such other treatment as
+may be found efficient and not detrimental to health. Overwork, mental
+and physical, should be stopped, and sedentary habits changed to a more
+active out-door life. The acute suppression from exposure to cold,
+wearing of damp clothes, sitting on cold stones or cold or damp ground,
+sea bathing in very cold water, is very often associated with an acute
+inflammation of the womb itself and calls for rest in bed, laxatives to
+open the bowel, hot application to the lower part of the abdomen and a
+teaspoonful of Hayden's Viburnum in a glass of hot water every four
+hours until relieved. The use of the sitz bath is frequently successful
+if taken at night followed by a laxative and a hot drink.
+
+PAINFUL MENSTRUATION--DYSMENORRHEA.--Most, if not all, victims of
+painful menstruation are of a nervous temperament. Dysmenorrhea is
+simply one symptom of the general nervous condition. The nervousness may
+be acquired or it may be the result of heredity. In girls it has been
+found to be an accompaniment of the overwork and worry of school and
+student life. Girls who suffer greatly from it while in school are
+entirely free during vacation from school.
+
+There is a type of painful menstruation known as neuralgic dysmenorrhea.
+This is simply a local expression of a general neuralgic tendency. It
+comes under conditions which favor neuralgias in other parts of the
+body. Girls and women affected with this type of dysmenorrhea are often
+anemic, hysterical, and not infrequently the victims of malaria,
+rheumatism, or other diseases which tend to impoverish the blood and
+reduce nerve vitality. The pain resembles neuralgia elsewhere. It comes
+and goes, it may last a brief time or a long time, it may be very mild
+or very severe. The pain bears no fixed relation to the flow, it may
+proceed, accompany or follow it.
+
+Mechanical dysmenorrhea is that form in which a mechanical impediment
+exists to the escape of the menstrual fluid. The internal canal may be
+too small, displacement, growths, either inside or out of the womb,
+faulty development, or frequently simple congestion will act as an
+obstruction and cause pain from tension. The pain accompanying
+mechanical dysmenorrhea is very different from the neuralgic type. It
+comes on gradually, increases slowly until it is very severe and stops
+suddenly. A gush of blood from the womb announces the fact that the
+obstruction has been overcome and the womb has emptied itself; as soon
+as this occurs the pain ceases.
+
+In the mechanical variety there are frequently clots in the menstrual
+flow. Inasmuch as this type may be caused by imperfect development of
+the womb, it is common to find that pain has characterized the monthly
+periods from the time of the first menstruation. It may, however, as
+stated above, be caused by growths which had their beginning at a later
+period.
+
+TREATMENT.--For the neuralgic variety the treatment should be general.
+The whole object is to build up the general health. Fresh air, sunlight,
+out-door exercise, plain, substantial food, regular hours, pleasant
+surroundings, and such medication as may be indicated, should be the
+course to follow. The bowels should be kept regular and digestion aided
+in every way possible, if necessary by rest from school, or work, or by
+a change of air and scene. If the patient is inclined to malaria she
+must take quinine and live in a locality free from that tendency. If
+rheumatic she should take the remedies advised in that disease and avoid
+colds, wet clothes, or sitting in cold, badly ventilated rooms, churches
+or theatres. If there are no distinct evidences of special tendencies,
+general tonics may be given to advantage. These should consist chiefly
+of iron, arsenic, phosphous, nux vomica, cod liver oil, etc.
+
+The treatment of mechanical dysmenorrhea of course implies removal of
+the cause. As this necessitates operative procedure, or at least an
+examination by a physician, it is best left in his hands.
+
+
+STERILITY
+
+Sterility means the inability to become a parent. A woman who is sterile
+cannot become a mother. She is for some reason unable to have a baby.
+
+A childless union is frequently the cause of much unhappiness. There is
+something lacking in the expression "a childless home." It seems a
+paradox, as home is inherently associated with children and happiness.
+It has been stated that one out of every eight marriages is barren. The
+average time which elapses after marriage and the birth of the first
+child is seventeen months. Physicians agree that if a woman goes over
+three years after marriage without having a baby her chances of having
+one are small. If children are desired, and they usually are by
+childless parents, every effort should be made within the first three
+years to ascertain the cause of the sterility, and if it can be
+rectified. The barrenness may be dependent upon some physical defect
+which will quickly respond to the proper medical treatment. It is well
+to remember, however, that the defect is not always the woman's. In
+every six childless marriages about one is due to sterility in the
+husband. The age of the greatest fertility in women is between twenty
+and twenty-four years. It is rare to find a barren woman between these
+years. Nature evidently intended that the duties of maternity should be
+assumed between the twenty and twenty-fourth year. If married before the
+age of twenty the statistics prove that barrenness exists in one woman
+in every twelve. If married after the twenty-fourth year the chances of
+having children decreases with the age of the woman.
+
+If a mother goes for three consecutive years without becoming pregnant
+the chances are that she will have no more children. Consequently if
+other children are desired it is unsafe to rest upon the assumption that
+a woman will again be a mother simply because she has been one in the
+past. Many conditions could, and may, have occurred since the last
+pregnancy (and may be as a result of that pregnancy) to change her
+natural fertility into a condition of temporary sterility. An
+examination should therefore be made before too long an interval elapses
+and the facts learned. It will usually be found in such cases that a
+displacement or laceration, or at most, some cause easily remedied is
+immediately responsible for the apparent barrenness.
+
+
+CONDITIONS WHICH AFFECT THE FERTILITY OF WOMEN
+
+CLIMATE.--It is a well-known fact that more children are born in
+southern regions than in northern countries. It may be asserted,
+therefore, that climate affects the fertility of the race.
+
+STATION IN LIFE.--Children are more numerous among the poor than among
+those who are wealthy and enjoy the luxury of riches. This condition
+cannot, however, be construed as a true expression of fertile
+efficiency. It is more a comparison of ethics, and when we express it
+thus we are giving it its most charitable name.
+
+SEASON OF THE YEAR.--The spring of the year, being more favorable to
+fecundity, exerts an influence over the increase of population. Nursing
+mothers are as a rule sterile until after weaning time. This is not
+always so however, and the possibility of pregnancy taking place while
+nursing a baby, and before menstruation is reestablished must be
+reckoned with as it occurs quite frequently.
+
+AGE.--Age may be said to affect the fertility of women inasmuch as
+sterility is the natural and proper condition before menstruation is
+established and after menstruation ceases.
+
+THE TENDENCY TO MISCARRY.--Because a woman has never given birth to a
+living child is no proof that she is sterile. Many women have the
+ability to conceive but for some reason they have acquired the
+misfortune, or the "knack," of miscarrying. This is a condition of the
+gravest significance and will be considered at length in its proper
+place.
+
+The influence of a temporary separation has had excellent results in a
+great many historical cases. Where the married couple seem to be lacking
+in some one or other of the emotional or temperamental qualifications,
+it is advisable to suggest a temporary separation. When this period has
+expired and they resume marital relationship the element of novelty,
+acting as a stimulus, quite frequently reestablishes a fertility that
+was seemingly suspended, or awakens it if conception has never
+previously taken place.
+
+There are a great many cases on record where, conditions having remained
+the same, women have become fertile after years of seeming barrenness.
+It is impossible to explain, or to satisfactorily understand these
+cases. It is quite common to note cases in which women have never become
+pregnant until a number of years after marriage, even when the desire to
+have children existed. There is one case on record of a woman married at
+eighteen, but although both herself and her husband enjoyed habitual
+good health, conception did not take place until she was forty-eight
+years of age when she bore a healthy child. Women should not, therefore,
+become easily discouraged in the hope of having a baby, especially when
+they have a clean history, and a healthy body. The conditions may change
+and may become favorable when hope is about to die.
+
+
+CAUSES OF STERILITY IN WOMEN
+
+Inasmuch as it is necessary to consult a competent physician in all
+cases of sterility, it is not necessary to go into detail regarding each
+possible cause, other than to explain how each may produce barrenness.
+It will be observed that a competent physician is specified and advised
+in these cases. This is very important because many advertising, or
+"quack" doctors, particularly solicit these kind of cases. They are not
+competent to be trusted with such cases and will likely effect more harm
+than good. A woman should not hesitate to consult the best available
+medical authority if she is a victim of sterility. There is nothing to
+be ashamed of. It is a perfectly proper medical situation and should
+receive the best medical advice and investigation. The following are the
+more frequent causes of absolute sterility.
+
+(A) Displacement of womb.
+
+(B) Diseases of womb, ovaries or fallopian tubes.
+
+(C) Malformations.
+
+(D) Lacerations or tears of mouth of womb.
+
+(E) Tumor.
+
+(F) Leucorrhea.
+
+(G) Physical debility.
+
+(H) Special blood poisons.
+
+(I) Great obesity.
+
+(J) Anemia.
+
+(K) Self-abuse.
+
+(L) Habitual alcoholism.
+
+(M) Lack of moderation in the marital relations.
+
+(N) Certain diseases may be associated with barrenness: cancer,
+diabetes, consumption, Bright's disease, etc.
+
+(O) Certain temperamental conditions may be associated with barrenness:
+lack of affinity, frigidity.
+
+
+THE KNACK OF MISCARRYING
+
+DISPLACEMENT OF WOMB.--In many instances the primary cause of the
+displaced womb was some energetic, muscular effort, made while the
+victim was yet a girl,--probably before menstruation began. Whatever act
+first caused a slight tilting of the womb, must necessarily have been
+an unusual physical effort, and as girls are getting more and more
+strenuous we may look for more trouble in this direction in the future.
+Inasmuch as a slight tilting of the womb gradually gets worse it is a
+reasonable expectation to believe that sterility is a natural sequence
+to displacement. The girl may have been the victim of painful
+menstruation which was neglected, because not quite painful enough to
+compel medical relief, which is sought for only as a last resource
+unfortunately under the circumstances. Intercourse may also have been
+more or less painful,--a condition which again is mistakenly and
+imprudently borne in silence and left to take care of itself. But when
+persistent sterility faces her, the woman seeks medical assistance and
+her trouble is discovered. As the displacement is found to be the cause
+of her sterility, its correction, which is a comparatively easy medical
+problem, not only cures the barrenness but happily relieves her of the
+menstrual distress and all other pain.
+
+The treatment for displacement consist of placing medicated pieces of
+wool or cotton, called tampons, in the vagina in such a position as to
+hold the womb, _as_ nearly in its proper place as is possible. After a
+time nature will so strengthen the ligaments that they will hold the
+womb and a cure is, therefore, affected. The length of time necessary to
+cure depends upon the length of time the displacement has existed. It
+may take, from two to four months. When the displacement is of long
+standing and is accompanied with more or less inflammation, adhesions
+sometimes grow between the womb and the adjacent organs. It is necessary
+to resort to surgery in such cases, but the result is always good and
+the danger practically nothing.
+
+DISEASE OF THE WOMB, OVARIES OR FALLOPIAN TUBES.--Disease of the womb,
+ovaries, and fallopian tubes, which renders the victim sterile, is as a
+rule the direct result of infection. Such infection is conveyed by the
+husband to the wife. This is quite a common condition. The simple fact
+that such conditions exist leads us to hope that the time is not far
+distant when it will be compulsory for all participants in the marriage
+ceremony to submit to a thorough physical examination. By this means,
+and by this means only, will the innocent be protected. No one can
+conceive, unless he has been identified, as a physician, with one of the
+large metropolitan hospital clinics, of the extent of this class of
+disease, and of the frightful suffering caused, and innocent lives
+ruined, by infection conveyed in this way. It is a tragic corollary to
+the marriage vow "for better or for worse."
+
+If a woman is fortunate enough to fall into the hands of an honorable
+physician, who will tactfully explain to her the serious significance of
+her condition and obtain her consent to treat her until she is cured,
+which in all probability will include a surgical operation, and will do
+so with diligence, without regard to the size of the bill, she will
+indeed be a lucky woman. It is from women who are suffering with such
+diseases,--most of them without the slightest idea of what ails
+them,--that the venders of advertised nostrums reap their fortunes, and
+it is from the same victims that most of the advertised medical "quacks"
+look for their blood-money. The great difficulty, however, lies in the
+failure of the woman to appreciate the seriousness of her condition, and
+as a consequence she fails to understands why it should take so long to
+cure her. She loses confidence in her physician, she buys certain
+"cures" recommended to her by Mrs. Busybody and later tries other
+physicians and ends by losing faith in herself. Meantime she grows worse
+and worse. There are thousands such. It may be here stated without fear
+of contradiction that if the public in general would repose more
+confidence in the medical profession, there would be much less
+suffering, much less sorrow, fewer regrets, fewer irresponsible "isms,"
+and cults, because there would be fewer disappointed individuals to
+support them. If the medical profession would condescend to employ the
+tactics and devices of those questionable, fashionable agencies that
+claim the power to cure human suffering, it could quickly reap the
+profit and the laudation that it now escapes because it keeps the faith.
+
+The way to be cured of any disease, if it is curable, is to engage a
+reputable physician and follow his instructions implicitly. Let him
+understand you expect him to see you through your trouble and let him
+know you have confidence in him. There isn't one physician in a thousand
+who will cheat you under these circumstances.
+
+MALFORMATION.--Under this heading are all those cases of sterility
+resulting from imperfect generative organs. These are products of a
+failure on the part of nature to furnish or develop the structures
+participating in the propagation of the species. The entire generative
+organs are sometimes wanting. The womb may have failed for some reason
+to grow with the rest of the body, it remains (as it is known) as an
+"infantile womb." Occasionally the womb grows together, that is, it is
+solid instead of being a hollow organ. The mouth of the womb may be too
+small, representing what is called "a pin head opening." The natural
+opening is large enough to admit a lead pencil, a "pin head opening"
+would not be larger than the lead in the pencil. The latter condition is
+quite a common cause of sterility and is readily amenable to treatment.
+Most of the malformations which produce sterility are impossible to
+cure.
+
+LACERATIONS OR TEARS IN MOUTH OF WOMB.--This subject is fully discussed
+on another page of this volume.
+
+TUMOR.--A tumor may be so situated as to prevent conception, or it may
+involve the body of the womb constituting a reason in itself for
+sterility.
+
+LEUCORRHEA.--Leucorrhea or "the whites" may be of such an acid character
+as to kill the spermatozoa in the vagina, or it may be of such volume as
+to render impregnation impossible. The treatment of this condition is
+discussed elsewhere.
+
+PHYSICAL DEBILITY.--When the general health is bad, no matter from what
+cause, sterility usually exists. This lack of vitality may be due to
+chronic disease, or it may have been caused by a very severe acute
+illness, such as typhoid fever. One's mode of living, if unhygienic, may
+be responsible for continued bad health and a consequent sterility.
+
+OBESITY.--Very fat women are usually barren. If a woman rapidly
+accumulates fat after marriage she as a rule does not have more than one
+or two children. Women often become stout immediately after the child
+bearing age ceases.
+
+SPECIAL POISONS.--Certain special poisons in the blood cause sterility
+by producing miscarriage.
+
+
+MISCARRIAGE
+
+By the term "miscarriage" we mean that for some reason the progress of
+pregnancy has been interrupted and the fetus is expelled from the womb.
+A miscarriage or abortion (both terms meaning the same--the difference
+between the two terms is a technical one and need not concern us here)
+can occur any time after conception up to approximately the seventh
+month, when, if labor takes place, the child may be born alive. The
+condition would then be termed a premature labor. A miscarriage or
+abortion is an immature labor and implies an immature or dead child.
+
+The condition is a serious one no matter whether it is attended with
+grave symptoms or apparently no symptoms. If it occurs shortly after
+conception, during the first few months of married life it is serious,
+if not in its physical consequences, it is in its significance, because
+it establishes the tendency to miscarry,--a tendency that may result in
+great mental distress because of the worry and fear it engenders, and of
+sorrow and heartache because it may blast the hope of parentage. Such a
+miscarriage may take place at once after conception. If so, the
+following menstruation may be delayed for a week or so and is then a
+little more profuse than is customary. This will be the only indication
+that a life has been sacrificed that the young wife may have, and
+frequently the significance of such an occurrence is never understood,
+yet the tendency to miscarry is nevertheless established, and a seeming
+sterility is apparently the fate of the woman. It is, therefore, of the
+greatest importance that extreme care should be taken to bring the first
+pregnancy to a successful consummation. A young wife should realize that
+she is apt to become pregnant at any time. Her conduct therefore should
+be such at least as not to harm the life principle with which she has
+been entrusted. To this end any excessive sexual activity should be
+strictly avoided.
+
+CAUSES OF MISCARRIAGE.--Any strenuous physical effort must be guarded
+against. Included in such efforts may be the following: dancing,
+running, jumping, surf-bathing, sewing on a machine, sweeping, washing,
+house-cleaning, moving furniture, etc. Sometimes the primary cause of a
+miscarriage is to be found in some hygienic act, such as a hot bath, too
+prolonged or too many hot douches near the menstrual periods. A blow or
+a fall, even a fright or shock may cause a miscarriage. Anything that
+violently shakes or agitates the womb, which may at this time be
+irritable because of its condition, will be sufficient to excite it to
+contract and miscarry. Hence violent coughing or vomiting should be
+avoided if possible; horseback riding, jolting in a carriage,
+convulsions, hysterical crying, may also be the causative factors.
+Displacement of the womb by limiting its tendency to grow when pregnant,
+may cause it to miscarry. Very severe general diseases such as
+small-pox, pneumonia, etc., will cause the womb to empty itself. Disease
+of the fetus or the presence of syphilis in either of the parents will
+also have the same result.
+
+THE COURSE AND SYMPTOMS OF MISCARRIAGE.--The cause of a miscarriage or
+abortion is much the same as an ordinary labor at term. Whatever
+interrupts the pregnancy causes the death of the fetus. The dead fetus
+acts as a foreign body and excites the womb to contract as it does
+during an ordinary confinement. The contractions open up the mouth of
+the womb and the fetus is expelled together with its membranes and
+after-birth. The significant and the most important symptom of a
+miscarriage or abortion is hemorrhage or bleeding from the privates. The
+flow of blood may not amount to much or it may be excessive and
+alarming; it may not be constant, it may come from time to time in the
+form of clots.
+
+The next significant and important symptom of miscarriage or abortion is
+pain. The pain, like the flow of blood, may be only slight or it may be
+very severe, sometimes it is absent in very early miscarriage. As a rule
+the pain is severe when the miscarriage occurs after pregnancy has
+lasted for a number of months.
+
+A miscarriage or abortion is said to be "complete" when the fetus with
+its membranes and after-birth is expelled clean and whole, or in other
+words when the womb empties itself completely. A miscarriage or abortion
+is said to be "incomplete" when some part of the embryo is left in the
+womb.
+
+WHAT TO DO WHEN A MISCARRIAGE IS THREATENED.--When a woman, who is
+pregnant, begins to flow she should at once go to bed and keep perfectly
+quiet and send for a physician. A miscarriage is a treacherous condition
+and is so regarded by all medical men. It may not amount to much or it
+may, on the other hand, develop into a serious situation. The immediate
+danger is from hemorrhage; the ultimate or remote danger is sepsis or
+blood poisoning. The condition is one that can only be taken in charge
+by a qualified physician in whose hands we can safely leave the conduct
+of the case.
+
+As a general rule it is quite safe to assert that a woman will not bleed
+enough at the beginning of a miscarriage to do any permanent harm.
+Consequently there is no occasion for unnecessary alarm. She must,
+however, as stated above, heed the warning and go to bed, keep perfectly
+quiet and send for a physician. If she fails to follow this advice it is
+quite possible that she may have a hemorrhage during the course of the
+miscarriage of a sufficiently serious character to endanger her life or
+from the effects of which she may suffer for the remainder of her life.
+
+There is practically no danger during the course of or after a
+"complete" miscarriage. The danger which may ensue from an "incomplete"
+miscarriage is hemorrhage and a form of poisoning caused by the
+absorption into the system of putrifying products of the part of the
+dead embryo left in the womb.
+
+There are a large number of cases of criminal abortion in which septic
+poisoning occurs caused by the utensils or instruments used in inducing
+the abortion. All of these cases are operative cases which must be
+attended to promptly to save life.
+
+TREATMENT OF THREATENED MISCARRIAGE.--Not all of the cases of beginning
+miscarriage end in miscarriage. If the physician is sent for in time he
+can very frequently give directions that will, if carried out
+faithfully, avert the disaster. Success is more likely to attend those
+cases in which the trouble has been caused by some accidental injury, as
+a fall, or blow, or extra exertion. This is more especially the case if
+the woman has previously borne children, is healthy and in good
+condition and whose womb is known not to be diseased. In these cases
+there is a partial separation of the fetus from the wall of the womb,
+which causes the bleeding. The physician will direct that the woman be
+put to bed, in a quiet, darkened room. He will instruct the nurse to
+sterilize the external genital region: a sterile gauze dressing is then
+left in place. Some form of prescription will be given to diminish the
+patient's nervous fear and to allay any tendency on the part of the womb
+to contract. It is always essential and very important to save
+everything that passes from the womb during the course of a threatened
+miscarriage in order that the physician may know exactly just what the
+condition is. Each cloth, each clot of blood will have to be examined
+before the proper treatment can be pursued in safety.
+
+When the miscarriage cannot be prevented it is called an "Inevitable
+miscarriage."
+
+TREATMENT OF AN INEVITABLE MISCARRIAGE.--In these cases every precaution
+is taken, just as in a normal confinement, to avert blood poisoning. The
+hands, instruments, dressings, etc., are carefully rendered sterile and
+the whole field must be surgically clean. The physician will conduct the
+case as conditions justify and as the situation develops.
+
+AFTER TREATMENT OF A MISCARRIAGE.--It is one of the many thankless tasks
+of a physician's life to insist on each patient staying in bed at least
+ten days after a miscarriage. The average woman and frequently the
+intelligent woman fails to appreciate the absolute necessity for this
+procedure. It is necessary and it is the physician's duty to insist on
+it being done in the interest of the woman. Many of the multitude of
+diseases of women are caused by disregarding advice on such occasions.
+
+THE TENDENCY TO MISCARRY.--If a woman, for any reason, has had a
+miscarriage, her womb will tend to miscarry at the same period during a
+subsequent pregnancy. If the miscarriage should occur during her first
+pregnancy the tendency to miscarry will be greater than if acquired
+after she has had a baby.
+
+This is one of the reasons why young wives often fail to have children.
+They "get rid" of the first one or two, because they are not ready to
+have children, or because they want some enjoyment themselves before
+they are tied down with a family. Having established the habit their
+womb has been educated to abort, and it will keep this habit up, much to
+their astonishment and chagrin.
+
+Young wives should therefore faithfully follow out all the rules of the
+Hygiene of Pregnancy laid down by their physician, and which are given
+in detail in this book.
+
+[Illustration: _Courtesy of New York World_
+
+AT WORK WITH THE CALIPERS
+
+Watching carefully the physical development of the child month by month
+is one of those many little things which may result in disaster if
+neglected.
+
+Abnormal development, or lack of development, should be promptly
+reported to the physician, as it may be a warning of serious trouble.
+
+For the table of standards, mental and physical, adopted by the American
+Medical Society see page 271.]
+
+
+
+
+THE BABY
+
+
+
+
+CHAPTER XVI
+
+HYGIENE AND DEVELOPMENT OF THE BABY
+
+     What to Prepare for the Coming Baby--Care of the Newly-born
+     Baby--The First Bath--Dressing the Cord--Treatment After the
+     Cord Falls off--A Pouting Navel--Bathing Baby--Clothing the
+     Baby--Baby's Night Clothes--Care of the Eyes--Care of the Mouth
+     and First Teeth--Care of the Skin--Care of the Genital
+     Organs--Amusing Baby--Temperature in Children--The Teeth--The
+     Permanent Teeth--Care of the Teeth--Dentition--Treatment of
+     Teething--How to Weigh the Baby--Average Weight of a Male
+     Baby--Average Weight of a Female Baby--Average Height of a Male
+     Child--The Rate of Growth of a Child--Pulse Rate in
+     Children--Infant Records, Why They Should be Kept--"Growing
+     Pains."
+
+
+WHAT TO PREPARE FOR THE COMING BABY.--The physician should instruct the
+young wife just what to provide for the coming baby. The following list
+will be found useful as a general guide.
+
+     An ordinary clothes basket, padded and lined, is quite
+     sufficient for the first month; or, a baby crib, which may be
+     cheap or expensive as the individual taste dictates. The Taylor
+     crib is probably the handiest and best one on the market.
+
+     Pin cushion;
+
+     Puff-box and puff;
+
+     Soap box containing pure castile soap;
+
+     Hair brush and fine comb;
+
+     Two wash cloths;
+
+     Four ounces of crystal boracic acid, a saturated solution of
+     which is used for cleansing baby's eyes and mouth;
+
+     One pound of good absorbent cotton;
+
+     A flexible tube of white vaseline;
+
+     A bath thermometer;
+
+     A package of sterile gauze;
+
+     A half dozen baby towels, good quality;
+
+     A soft, white, good blanket,--one and one-half yards square;
+
+     One pair small blunt pointed scissors;
+
+     A package of the best safety pins;
+
+     Three or four dozen bird's-eye cotton diapers. First size,
+     eighteen inches square. Second size, twenty-five inches square;
+
+     One yard of soft white flannel for belly bands; each band
+     should be five inches wide, by twenty-four inches long.
+
+     Two silk and wool shirts;
+
+     Three flannel shirts (all shirts should be high necked, long
+     sleeved, and open down the front);
+
+     Three Eiderdown wrappers;
+
+     Three Cashmere sacques;
+
+     Three pads for crib;
+
+     Six dresses;
+
+     Six petticoats (they should be thirty-three inches long from
+     neck to hem; they should be turned up at the bottom for about
+     four inches and should button there to keep the feet warm; if
+     it is desired to use pinning blankets for the first two months
+     in place of the petticoats, they should be made of soft white
+     flannel with cotton bands);
+
+     Six night slips;
+
+     Six pair socks;
+
+     Two cloaks;
+
+     Two hoods;
+
+     One dozen bibs.
+
+Simplicity, warmth, and freedom are the essentials in latter-day baby
+clothes. It is cheaper to make the clothes than to buy them. Excellent
+and accurate paper patterns can be obtained, giving the quantity of
+material necessary and suggesting the kind and quality best suited for
+the purpose. These patterns may be obtained from the Butterick
+Publishing Company in New York City.
+
+CARE OF THE NEWLY-BORN BABY.--After the nurse has completed her duties
+with the mother after the confinement, she will prepare to give baby its
+first bath.
+
+The bath should be given in a warm room. This is a matter that should
+receive more consideration than has been given it. Nurses do not as a
+rule attach much importance to this duty, while in reality it is a most
+important one. I have seen trained nurses make ready to give baby its
+first bath in rooms, during the night, that were not heated adequately.
+I am convinced that many babies have been victims of this careless habit
+to the extent of grafting on them the tendency to catarrhal colds and
+bronchitis because of undue exposure at this critical period. If one
+will remember that a baby has just been removed from an environment
+where the temperature was suitable and constant, to one in which it
+needs a large degree of artificial heat until such time as it may become
+accustomed to the change, one may appreciate the risk taken in exposing
+the child for even a short time. The mother should therefore warn the
+nurse not to undertake the baby's first bath until the temperature and
+other conditions are favorable. Many nurses and other individuals have
+the impression, without knowing why, that the baby should be cleansed
+and bathed immediately after birth. This is not at all necessary. If the
+conditions are not favorable, it would be far better to wrap the baby
+snugly in a warm blanket--first having put a diaper on--and place it in
+its crib with a hot water bottle near it and defer the bathing until the
+following forenoon. By that time the baby will be adapted to its new
+surroundings; its lungs will have become accustomed to the air which it
+is breathing for the first time; the mother will have been rendered
+comfortable; in other words, the conditions and the environment will be
+favorable for the baby and for a better performance of the duty.
+
+The next important feature of the first bath is that it should be done
+in the quickest time consistent with efficient service. Only the
+necessary exposure should be indulged in. It is not necessary that the
+baby should be exposed to the admiring inspection of every member of the
+household--there will be plenty of time for that without risking the
+health of the child. A pan of water at a temperature of 100° F. should
+be placed on a stool in front of the nurse. The nurse should have on a
+rubber apron, and on top of this, an ordinary apron and a warm bath
+towel laid over her knees. The child should be gently rubbed with warm
+sweet oil to remove the _vernix caseosa_ (the greasy substance which is
+on all babies when born to a lesser or greater extent). Particular
+attention is to be given to all folds of the skin, as under the arms, in
+the fold of the neck, in the groin, behind the ears, etc., because in
+these parts the substance is thickest and if not carefully removed it
+will cake, and cause painful eruptions and sores, which may bleed and
+render the infant extremely uncomfortable. It is not necessary to
+expose the whole body at one time while applying the oil. The lower half
+may be covered with a warm soft towel while the nurse is oiling the
+upper part, and vice versa. After the body has been thoroughly oiled it
+should be cleansed with water at the proper temperature, in which pure
+castile soap has been dissolved. Absorbent cotton only should be used to
+wash the baby. All the washing is done with the baby on the nurse's
+knee; it is not put into the water.
+
+The baby should be mopped dry with sterile gauze, or with a soft sterile
+towel, the cord dressed and the flannel band adjusted. It should then be
+completely dressed and put to the nipple and later to sleep.
+
+DRESSING THE CORD.--The cord should be covered with powder and sterile
+gauze. The powder to use should be plain subnitrate of bismuth. If there
+is any reason to use another powder the physician will write a
+prescription for it according to indications. The subnitrate of bismuth
+will be found much better than any ordinary talcum or toilet powder,
+many of which do not make good dressing powders.
+
+Very few nurses know how to dress the cord. It seems to be impossible to
+impress them with the need of frequent attention to the cord. Fresh
+powder should be put on every time the diaper is removed, every time the
+infant urinates, and at other times during the day. The cord should be
+kept absolutely dry. Putting on powder twice daily will not keep the
+cord dry and many nurses are too lazy to bother to do it oftener. You
+cannot make a mistake in putting on too much powder, you can make a
+serious mistake by not putting on enough. Every time the cord is
+powdered it should be lifted up, away from the skin of the abdomen, and
+the powder put below it. The cord should be slightly drawn out and the
+powder applied round its base where it meets the skin. Many nurses are
+afraid to touch or handle the cord--they find it easier to neglect it.
+The mother should see that the nurse dresses the cord at least five
+times every day.
+
+APPLYING THE STERILE GAUZE TO THE CORD.--A piece of gauze, six inches
+square is taken, a hole is cut the size of a ten-cent piece out of the
+center, the cord is drawn through the hole, the gauze folded lengthwise
+over the cord and then sidewise, and this is held in place by the
+binder. This piece of gauze will adhere to the cord and will most likely
+be removed with the cord on the fifth day. If it should fall off,
+another piece may be put on in the same way.
+
+If the cord does not fall off until very late it is because it has not
+been attended to rightly or because it was a very thick cord.
+
+TREATMENT AFTER THE CORD FALLS OFF.--The stump of the cord should be
+powdered with the same powder used on the cord; a pad two inches square
+of sterile gauze and quite thick should be held over the stump for a
+number of days by the abdominal binder. This is used to prevent a
+possible rupture. After a week the size of the pad may be reduced, but a
+small pad should be used over the stump of the cord for a month or more.
+
+A POUTING NAVEL.--If the stump of the cord should protrude, a piece of
+strong pasteboard, the size of a fifty-cent piece, should be wrapped in
+soft gauze and placed over the navel, over this a gauze pad, and if
+necessary this should be held in place by a strip of adhesive plaster,
+though the binder is usually sufficient if it is put on carefully. If
+this pad is held properly and worn for a month the tendency to
+protrusion or rupture will have passed away. These pads may of course,
+be removed when the baby is being bathed and put back again before the
+binder is applied.
+
+BATHING BABY.--A baby should not be put into water for a bath until
+after the cord has been off for forty-eight hours.
+
+During the first few months the temperature of the water should be 98°
+F. The temperature of the water should be taken with a bath thermometer;
+it should not be guessed at. A bath thermometer is an inexpensive
+commodity and it will be in daily use in many ways in a home where there
+is a baby--it should therefore be procured wherever possible. The room
+should be warm; there should be no draughts. The mother or nurse should
+cultivate the habit of bathing baby quickly and with system. Everything
+should be ready and at hand. A little salt in the water will tend to
+strengthen the skin; it will also relieve any superficial rashes or
+excoriations which may be on the skin. Four tablespoonfuls to a gallon
+of water will be sufficient. The sea salt sold in the stores may be used
+in lesser quantities.
+
+By the end of the fifth month the temperature of the water may be
+reduced to 95° F., and by the end of the first year to 90° F. After the
+first year the mother should accustom the child to a quick sponge with
+cool water on the chest and spine immediately after the bath. This
+simple means, if kept up, will often prevent the development of colds
+and bronchial troubles so common to children in temperate latitudes.
+
+The best time to give the warm bath is at night. In the morning a cold
+sponge bath is desirable. This should be given as described in the
+chapter on cold sponge or shower baths.
+
+In certain children bathing seems to depress their entire system. They
+do not react well even to a warm bath. They remain blue or pale around
+the mouth and eyes; bathing should therefore be carefully undertaken
+with these children until such time as they acquire strength.
+
+CLOTHING OF BABY.--The baby should wear a woolen shirt, with a high neck
+and long sleeves. The abdominal binder may be worn for the first three
+months. It is not necessary after that time. If worn longer the habit is
+acquired and chronic indigestion may ensue when it is ultimately taken
+off. If the baby is very thin it may be wise to leave it on, simply for
+its warming effect, for a few months longer. If the child is normal and
+healthy the binder should be left off permanently after three months.
+The band for the first four weeks should be made of plain flannel; after
+this period a knitted band with shoulder straps is the better article.
+All petticoats and skirts should be supported from the shoulders.
+Stockinet is a good material for diapers; it is soft, warm, and pliable.
+
+Baby's feet should be warm always. Cold feet are frequently responsible
+for colic and gastro-intestinal troubles. A hot water bottle should be
+placed in the carriage if the weather is cold, but care should be taken
+to see that it does not touch the feet, otherwise it may burn them. The
+same measure may be adopted in the baby's crib if the feet are cold.
+
+During the summer the outer clothing should be made of the thinnest
+quality of material possible, and the underclothing of the finest
+flannel or gauze. Body heat may be maintained during changes of
+temperature by extra outer wraps--not by dressing the baby in clothes
+that keep it too hot and uncomfortable all the time.
+
+The main object to be attained in clothing the baby is to ensure a
+sufficient protection, but the clothing must be light, warm, loose, and
+non-irritating. Don't bundle up the arms and legs so that they cannot be
+moved; don't pin them so tight that the child cannot breathe properly
+and don't put the band on so that the child is in torture all the time
+from inability to move the abdomen.
+
+BABY'S NIGHT CLOTHES.--The night clothing should be the same as that
+worn during the day, but it should be loose and of the lightest flannel
+material. For older children a thin woolen shirt (not the one worn
+during the day) and a suit of union clothing with feet is best.
+
+The mistake must not be made to cover children too warmly at night. They
+can do with relatively less than adults. Too much covering will render
+the sleep restless, will encourage nightmare, and in older children will
+engender bad habits. Delicate children especially must not be
+over-covered at night.
+
+For the first few months children should sleep in a darkened room.
+
+CARE OF THE EYES.--The eyes should be cleansed for the first few days
+with a saturated solution of boracic acid. They should be protected from
+the direct light for two or three weeks after birth.
+
+CARE OF THE MOUTH AND FIRST TEETH.--Boiled cooled water should be used
+to cleanse the mouth every morning after the bath. A soft piece of
+sterile gauze should used for this purpose. The mother must guard
+against using too much force in cleaning the mouth of an infant.
+
+The milk teeth should receive attention. If they are allowed to become
+dirty they will become carious and cause bad breath and neuralgia.
+Teeth of this character are a menace to health because they harbor germs
+and in this way infect the mouth and cause stomach troubles. Teeth that
+are carious should be filled or removed.
+
+CARE OF THE SKIN.--The skin of a baby, because of its delicate
+character, is susceptible to the slightest changes in the weather or to
+the condition of the digestive organs. Babies are frequently subject to
+rashes, intertrigo, excoriations, eczema, and other skin affections. It
+is much easier to prevent these conditions than to cure them.
+Cleanliness, not only in giving a daily efficient bath, but in every
+other respect, is essential. Castile soap only should be used, and no
+rubbing indulged in, simply mopping the parts with gauze well saturated
+with soapy water. All napkins should be removed as soon as soiled. If
+the skin is easily chafed the child should be bathed in salt water or
+water in which bran is mixed as explained in the chapter on bran baths.
+
+The baby should be well powdered with a good quality of toilet powder.
+Ordinary starch, or talcum, or the stearate of zinc is suitable. Fat
+infants should be powdered in all the skin folds; otherwise they are
+sure to chafe.
+
+CARE OF THE GENITAL ORGANS.--The mother should make it a habit to remove
+any dirt from the genitals of the baby during the morning bath. Fecal
+matter sometimes gets into the folds of the female baby; this should be
+removed promptly. In older female children, dirt and dust get into the
+genitals which often has to be removed carefully with a soft piece of
+cloth. An exceedingly chronic form of inflammation is often seen in poor
+children because of neglect of these parts.
+
+In male babies the mother must daily push back the foreskin and clean
+under it. If this is not done the natural secretion will gather there
+and cause much trouble. If the foreskin is long, the child should be
+circumcised; if it is not long it must be pushed back daily for a number
+of weeks; otherwise it will contract and it may be necessary to operate
+on it at a later date. If this is not faithfully attended to the prepuce
+will become adherent, the child becomes nervous and irritable, and it
+may become addicted to self-abuse at a very early date--simply because
+the mother is derelict in the performance of her duty. If you are afraid
+to do your duty, don't neglect it, ask the doctor to show you just what
+has to be done and just how it should be done. You will find it to be a
+simple matter when you know how, as most things are.
+
+AMUSING BABY.--Mothers should understand that it is not necessary to
+amuse a baby under one year of age. Their nervous systems are not ready
+for any such sport. To excite a baby to laughter is to subject it to a
+shock which may injure it. The healthy development of the brain of a
+child demands quiet and restful surroundings. It should sleep, eat, and
+be allowed to amuse itself in a natural way.
+
+TEMPERATURE IN CHILDREN.--The normal temperature in a child varies more
+than it does in an adult. The rectal range may be between 98° and 99.5°
+F. and may be normal to that particular child. A rectal temperature of
+97.5° F. or of 100.5° F. is of no importance unless it continues.
+
+The best place to take the temperature in a child is the rectum and the
+next best place is in the groin. The temperature will always be from a
+half to a full degree higher in the rectum than in the groin. The
+thermometer should be left in the rectum for two minutes, and in the
+groin for five minutes.
+
+The temperature in a child is a very fair guide as to the severity of
+the disease. It must be remembered, however, that a child will develop a
+temperature of two or three degrees from a very slight cause. It is not
+the height of the fever that is significant, but rather the duration of
+the fever that is important. A fever of 102° F. in a child may only mean
+a slight indigestion which will wholly disappear after a laxative is
+given, while the same degree of temperature in an adult usually means
+something much more serious. The degree of the temperature therefore
+should not occasion unnecessary worry; if, however, it continues and if
+the child shows other signs of illness, it may be regarded as indicating
+an abnormal condition which should be immediately found out. A
+temperature of 100° F. to 102° F. usually means a mild illness, and one
+of 104° F. or over, a serious sickness.
+
+It is not advisable that the ordinary mother should possess a clinical
+thermometer. There are many occasions when a child will have a fever
+which should not cause any worry; if the mother gets the thermometer
+habit, she will many times occasion unnecessary calls of the physician
+only to learn that they are false fears.
+
+THE TEETH.--There is no definite time at which the first teeth appear.
+They usually come between the sixth and eighth months. They may not,
+however, come until much later; or they may come earlier than the sixth
+month; and yet the child may be perfectly healthy. They come as a rule
+in the following order:
+
+    1. The two lower middle teeth,                           6 to 8 months.
+    2. The four upper middle teeth,                          8 to 10 months.
+    3. One on each side of two lower middle teeth,           8 to 12 months.
+
+    4. One on each side, above and below, back of
+       above teeth (four in all),                           12 to 15 months.
+
+    5. The next one on each side, above and below, back of
+       those already in (four in all),                      18 to 24 months.
+
+    6. The four back teeth on each side, above and below,   24 to 30 months.
+
+
+    At 1 year a child should have                  6 teeth
+
+    At 1-1-2 years a child should have            12 teeth
+
+    At 2 years a child should have                16 teeth
+
+    At 2-1-2 years a child should have            20 teeth
+
+They may not come in the above regular order even in well children. The
+upper front teeth may come first. If the child is sickly there may be
+marked irregularity in the order in which they appear. Twenty teeth
+comprise the first set.
+
+THE PERMANENT TEETH.--This set consists of thirty-two teeth. They begin
+about the sixth year and they are usually not complete until the
+twentieth year. They appear in the following order:
+
+    First molars                6 years
+    Incisors               7 to 8 years
+    Bicuspids             9 to 10 years
+    Canines              12 to 14 years
+    Second molars        12 to 15 years
+    Third molars         17 to 25 years
+
+CARE OF THE TEETH.--The teeth should be given attention as soon as they
+appear. It is an excellent custom to wash the teeth and gums twice daily
+with a piece of clean absorbent cotton rolled round the finger of the
+mother and dipped in a saturated solution of boracic acid. This should
+be done up to the second year. After the second year a soft brush should
+be used and the teeth thoroughly cleaned morning and night with pure
+castile soap or a powder. The teeth of every child should be examined by
+a dentist every six months. All cavities should be filled with a soft
+filling. The milk teeth should not decay, but should fall out, or be
+forced out by the second set. A child should be taught to gargle early
+and a mouth wash should be used morning and night.
+
+DENTITION.--As a general rule the process of teething is accompanied by
+some symptoms. There may be fever, restlessness, and loss of appetite;
+though in many cases there are absolutely no symptoms. Some children
+seem to teethe hard, others easily. The same child may have some teeth
+without pain, and with others it may suffer severely. The condition of
+the child at the time, its age, and the season of the year undoubtedly
+have an influence. Children who are sickly and puny may have much
+difficulty while teething.
+
+The degree of sickness varies quite considerably. There may only be, as
+stated above, slight fever, restlessness, with loss of appetite; or
+there may be, in addition to these symptoms, a pronounced fermentative
+diarrhea, which may lead to serious intestinal diseases; frequently
+there is a cough. This is more apt to be the case if the child is
+teething during the hot season.
+
+TREATMENT.--When dentition affects the child's disposition it is a good
+plan to reduce the feeding in quantity and quality for the time being.
+If the child is bottle-fed, two ounces can be taken out of each bottle
+and one ounce of boiled water added. If the child is breast-fed, he
+should be given two ounces of warm, boiled water before each feeding,
+and the actual feeding time at the breast shortened.
+
+Rubbing the gum over the erupting tooth with a clean cloth may aid in
+helping it through. If the child is very restless and has lost sleep,
+the cloth may be moistened with brandy and water. Lancing the gum,
+though it is seldom done now-a-days, is justified in a few cases.
+Teething is not the cause of actual disease as was once thought, but it
+must be remembered that a child whose vitality is reduced by fever,
+restlessness, loss of appetite, loss of sleep, and irregular bowels, is
+more susceptible to disease than when enjoying robust health.
+
+Sometimes a child will have a fever for one or two weeks during a hard
+dentition. There is apt to be more or less intestinal indigestion and
+fermentation at this time and as a consequence actual intestinal disease
+may develop. To avoid such a possibility it is an excellent plan to give
+an occasional dose of castor oil to clean thoroughly the whole
+intestinal canal. This should be done irrespective of the condition of
+the bowel, because frequently a diarrhea is caused by retained
+fermenting products.
+
+Mothers must not acquire the habit of attributing all symptoms to the
+teething process simply because the child is teething. It must be
+remembered that a child may get a disease, or an ailment, while
+teething, that has nothing to do with teething. If this is neglected,
+serious consequences may result. Many children have lost their lives by
+a mother's carelessness in this way. Be on the safe side, consult your
+doctor; let him assume the responsibility.
+
+HOW TO WEIGH THE BABY.--The test of weight is one of the most
+satisfactory we possess as an indication of physical progress and
+health. It is not an absolute test, but it may safely be relied upon.
+The fattest baby is not necessarily the healthiest. A gradual and a
+uniform increase is a satisfactory growth. At birth a baby weighs, on an
+average, from seven to eight pounds, though some babies weighing less
+are equally healthy. The normal and customary gain is from four to six
+ounces every week after birth.
+
+The baby should be weighed about the same time of the day each week, and
+before a meal.
+
+The average weight of a male child at different ages is as follows:
+
+    Birth                     7-1/2 lbs.
+    3 weeks                       8 lbs.
+    1 month                   8-1/2 lbs.
+    3 months                     12 lbs.
+    4 months                 13-1/2 lbs.
+    5 months                     15 lbs.
+    6 months                 15-1/2 lbs.
+    7 months                     17 lbs.
+    9 months                     19 lbs.
+    1 year                       21 lbs.
+    1-1/2 years                  23 lbs.
+    2 years                  26-1/2 lbs.
+    3 years                  31-1/2 lbs.
+    4 years                  35-1/2 lbs.
+    5 years                      40 lbs.
+    6 years                      45 lbs.
+    7 years                      49 lbs.
+    8 years                      54 lbs.
+    9 years                      59 lbs.
+    10 years                 65-1/2 lbs.
+
+A female child weighs about one-fifteenth less than a male child, as a
+rule.
+
+Table showing the average height of a male child, at different ages:
+
+    At birth             20-1/2 in.
+    6 months                 26 in.
+    1 year                   29 in.
+    2 years              32-1/2 in.
+    3 years                  35 in.
+    4 years                  38 in.
+    5 years              41-1/2 in.
+    6 years                  44 in.
+    7 years                  46 in.
+    8 years                  48 in.
+    9 years                  50 in.
+    10 years                 52 in.
+
+THE RATE OF GROWTH OF A CHILD.--A child grows most rapidly during its
+first year--six to seven inches; from fourth to sixteenth, about two
+inches annually; thence to twentieth, one inch. Commonly, a child at two
+and a half years has attained half of its ultimate adult stature. The
+diseases of youth always accelerate growth.
+
+PULSE RATE IN CHILDREN AND ADULTS.--Normal Pulse,--of new born, 130 to
+140, per minute; first year, 105 to 115; second year, 106 to 115; third
+year, 95 to 105; fifth to twelfth year, 80 to 90; thirteenth to
+twenty-first year, 75 to 80; twenty-first to sixtieth year, 70 to 75; in
+old age, 75 to 85.
+
+INFANT RECORDS.--A record should be kept by the mother of every child
+which would embrace exact data as to weight, diet, size, development of
+mental power, teeth, ailments, sickness, pains, etc., with dates and any
+information which would aid in recalling exact conditions. Such records
+are of the utmost value in a number of ways. They help in giving
+suggestions as to diet, general health, and mental qualities of the
+child in question, and they aid in furnishing what physicians call "past
+history," which past history has a very valuable significance in
+estimating the character and importance of sickness during later years.
+
+Such a record is also of importance in comparing a child's development
+with what is regarded as standard development, and also with the growth
+and development of other children in or out of the family.
+
+If a child should thus be found to fall seriously below the standard and
+yet not appear actually sick, a very thorough and routine investigation
+should be instituted to discover if possible the cause. Some error might
+thus be detected which might seriously affect the child's future growth
+and well-being.
+
+The date of the closing of the soft spot on the baby's head should be
+noted, and if it is still open, when it should be closed, it might mean
+that the child has a serious brain condition. The soft spot should close
+between the eighteenth and twenty-fourth months. The family physician
+should be notified if the soft spot is open later than the second year,
+as he may want to investigate the cause.
+
+Should the child be unusually backward in walking, and when it does so
+should limp and feel pain in the knees, it should be examined for any
+symptom of hip joint disease, of which these are the earliest signs.
+
+If the child complains of so-called "growing pains," keep in mind that
+these are rheumatic and may need attention. There are no such pains as
+actual "growing pains," that is, pains caused by the child growing.
+
+
+
+
+CHAPTER XVII
+
+BABY'S FEEDING HABITS
+
+     Overfeeding Baby--Intervals of Feeding--How Long Should a Baby
+     Stay at the Breast--Vomiting Between Feedings--Regularity of
+     Feeding--Why is Regularity of Feeding Important--"A Baby Never
+     Vomits"--What is the Significance of So-called Vomiting After
+     Feedings--Mothers Milk That is Unfit for Baby--Fresh Air for
+     Baby--Air Baths for Baby.
+
+
+OVERFEEDING BABY.--Every nursing mother should have printed and hung up,
+so she may read it every time she nurses her child, the following motto:
+"DON'T OVERFEED BABY." Few, if any, babies die of willful starvation:
+many die as a result of overfeeding. Mistaken kindness and lack of
+judgment are responsible for one-half of all the troubles of infancy.
+Babies require much less than is constantly given them. The stomach of a
+baby at birth will not hold more than one ounce, which is two
+tablespoonfuls; and at two months it will not hold more than three
+tablespoonfuls; and at six months, six or seven tablespoonfuls. Read
+these quantities once again carefully and try to realize the
+significance of the smallness of them. A baby is just like a little pig;
+it will go on feeding as long as it is allowed. The baby does not
+reason; it has no judgment; it depends upon its mother's judgment. If
+the mother is false to the trust the baby overloads its stomach. A
+swollen, distended, overloaded stomach causes indigestion. A baby with
+indigestion is a colicky, fretty, sick baby. Overfeeding, therefore, is
+the beginning of lots of trouble to the mother, and needless pain and
+suffering and sickness to the baby. A simple matter, but it is one of
+the most difficult lessons nursing mothers have to learn.
+
+Overfeeding is most apt to occur at night. Many mothers put the child to
+the nipple for its regular feeding and fall asleep; the child keeps on
+nursing at intervals until twice the proper quantity is taken; or she
+gives it the nipple or the bottle if it cries, without regard to whether
+it is the proper feeding time or not. The habit of overfeeding is very
+common in infants who are suffering from indigestion. They cry
+frequently, and are irritable most of the time; nothing seems to satisfy
+them but the nipple. Taking the warm milk into the stomach seems to
+allay the distress for the time being, so mothers get into the habit of
+quieting them in this way. The cry of the drinking man, whom we try to
+sober up, is: "Just one more drink and I'll quit." You give the drink
+and in a little while the demand is repeated. If the mother understood
+the seriousness of this practice of giving the child the nipple or
+bottle at irregular times, she would not do it.
+
+Overfeeding an infant may lay the foundation for a lifelong ailment. The
+excess of food remains in the stomach or bowels undigested. If you
+remember that this mass of undigested matter is confined in a small
+space which is both warm and damp, it will be easily understood that
+putrefaction is the inevitable outcome. As a result of this putrefaction
+there are produced certain ptomaines and leucomaines. These poisons are
+carried through the body, causing "auto-intoxication" which upsets and
+irritates the child's nervous system and may cause very serious
+consequences, as it frequently produces sudden death from apoplexy and
+"heart failure" in the adult. These children are always restless,
+fretful, continually uncomfortable, sleepless and colicky. They lose
+weight, the stomach becomes distended and a gastritis or inflammation of
+the stomach results.
+
+Frequently a mother with such a fretful baby, seeing her child getting
+thinner and thinner, will think that it is not getting enough to eat,
+and will proceed to add to the trouble by giving the child more to eat.
+
+Mothers must therefore learn not to overfeed their infants; not to
+imagine that a failure to gain weight means the need of more food (if
+the quality of the food being given is wrong, will increasing the
+quantity of bad food do any good?); not to feed irregularly, no matter
+how insistent the child may be.
+
+INTERVALS OF FEEDING.--The physician will give instructions regarding
+the feeding of the newly born baby for the first few days. After the
+first few days and up to the beginning of the third month, it should be
+fed every two hours from 7 A. M. until 9 P. M., and twice during the
+night between 9 P. M. and 7 A. M., when the regular two-hours' interval
+again begins for the following day. The two night feedings should be
+about 1 and 4:30 A. M.
+
+After the third month, and up to the sixth month, feed every three hours
+and once during the night. From the sixth month until weaned, every
+three and one-half or four hours, and not at all during the night.
+
+While it has been pointed out that regularity of feeding is absolutely
+essential, the above schedule is not to be regarded as an absolute
+guide. It is a general guide,--approximately it will be found correct in
+a large majority of cases. Each baby is a rule unto itself. The quantity
+of the mother's milk will dictate the interval after the first month and
+for each month as the baby grows. If a mother with no milk to spare, is
+nursing a big, strong, husky baby, the three-hour interval during the
+day may have to be shortened to two and one-half hours. As a rule,
+however, these exceptions are better regulated by attention to the time
+the baby is given at each nursing to fill its stomach.
+
+HOW LONG SHOULD A BABY STAY AT THE BREAST?--Babies differ as to their
+method of feeding; some of them seem to like to nurse a moment or two
+and then look around; others seem to regard nursing as a serious
+business, and resent any effort to take the nipple away until they have
+finished. A baby should be taught to nurse methodically; it should not
+be allowed to play the nipple. Let it fill its stomach and put it down
+as quickly as possible. A mother will very soon know just how long it
+takes the baby to fill its little stomach, and when she finds this out
+she should time it by the clock. When the supply of milk is sufficient,
+and the child is strong, and nurses freely, eight to twelve minutes are
+sufficient. After it is taken away from the breast it must be left quiet
+till the next feeding.
+
+Other babies, according to the ability they evince to nurse, even when
+the milk runs freely, require a longer time,--from twelve to fifteen
+minutes. The rule, however, is never to allow them to nurse so long that
+when they are taken away the milk runs out of the mouth. If this occurs,
+cut down the length of time they are at the breast, and always time the
+length of feeding by the clock,--don't guess at it.
+
+CHILDREN WHO "VOMIT" BETWEEN FEEDINGS.--When a child habitually brings
+up food between feedings it is usually a symptom of gastric indigestion.
+In these cases it is advisable to add lime-water to each feeding, and to
+remove some of the fat in each feeding. If improvement does not follow
+remove more of the fat by removing some of the cream from the top of the
+bottle before shaking it.
+
+Remove from the bottle four ounces of cream and shake before preparing
+the food from what is left. If the child improves after a few days
+remove only three ounces, then in a few days remove two ounces and later
+one ounce. After a time, sufficiently long to permit the stomach to
+become accustomed to the graded amounts of fat, the former diet of whole
+milk can be again resumed.
+
+Never decrease the interval of feeding of a baby who is bringing up
+parts of its meal between feedings; it is frequently advisable to
+increase the interval. If a child is colicky and is bringing up lots of
+gas in addition to some food, one-half grain of benzoate of soda may be
+added to each ounce of food given and continued for a number of weeks if
+necessary. When the gas is located in the intestines and is not brought
+up, it must be made to pass downward. Attention to the bowels is of
+great importance in these cases and it may be necessary to peptonize the
+milk for some time. A reduction of the sugar and starch in the feeding
+frequently cures this condition. (See "Colic.")
+
+There are children who continue to have symptoms of indigestion and who
+do not thrive despite various changes in the quantity and quality of the
+feedings. It may be necessary to obtain a wet nurse for them, as it is
+with "the delicate child." If a wet nurse cannot be obtained, or if the
+age will permit, a substitute may be tried. Borden's Eagle brand of
+condensed milk, canned, is probably the best substitute under these
+circumstances. Condensed milk should never be used as a continuous food;
+as a substitute, however, for a few weeks it is often invaluable. With
+an infant of three or four months it should be used at the beginning in
+the proportion of one ounce of the milk to sixteen ounces of plain
+boiled water or barley water. The proper quantity, whatever the child is
+taking (four or six ounces according to the age) at the time, can be
+taken from the sixteen ounces and fed to the child. As the symptoms
+improve the milk should be diluted less and less, 1 to 14, 1 to 10, and
+so on until the proper strength is reached. After the child has been on
+the condensed milk for a month it should be changed back to cow's milk,
+using of course a diluted formula until the child becomes accustomed to
+the change. Condensed milk, if used as a permanent food, will fatten
+babies, but their vitality is very deficient, the muscles flabby, and
+the resistance to disease exceedingly poor. They are apt to develop
+rickets and sometimes scurvy.
+
+REGULARITY OF FEEDING.--One of the very first, and one of the most
+important factors in contributing to the good health and the comfort of
+a baby is absolute regularity in feeding. A regular interval of feeding
+is particularly essential during the first month of a baby's life.
+
+Despite the explicit way in which young mothers are instructed in this
+respect, it is one of the disappointing incidents of the practice of
+medicine to observe how many of these mothers fail to heed the advice.
+We have personally tried to find an explanation for this astonishing
+carelessness, and have come to the conclusion that it is not due to
+intentional forgetfulness, but rather to an inexplicable failure to
+appreciate that the physician means exactly what he says.
+
+If, for example, specific instructions are given to feed, or nurse, the
+child every two hours (and by "specific instructions" it is meant, that
+the physician takes time to explain in detail the instructions he
+gives--that the instructions are not incidental to the call, but part
+of the call;--that the advice is given not as a choice of what is
+desirable, but as an absolute rule to follow; and carefully explains why
+it is imperative to do as he says; and is satisfied the mother
+understands what he means) it would seem that there could be no possible
+reason why the directions should not be faithfully carried out. Yet such
+is not the case in many instances, and the excuses given by mothers for
+failure are so trivial and annoying that they show a failure to
+appreciate that they are dealing with a serious problem--a problem
+affecting human life. They fail to understand that fatal consequences
+may follow their negligence. They treat the baby problem exactly as they
+would a household incident, and as they do not consider it important
+whether the breakfast dishes are washed at 9 A. M. or at twelve noon,
+neither do they consider it important whether the baby is fed at 9 A. M.
+or an hour later. When mothers learn that the attention they must give
+their babies is essentially different from the attention they give
+ordinary household duties, the problem of raising children with success
+and comfort will be greatly simplified.
+
+If the instructions are to feed the baby at certain intervals, do so at
+all hazards. To offer the foolish excuse that the baby was asleep when
+feeding time came, is no excuse at all; as a matter of fact the baby
+should be asleep at each feeding time, if it is healthy. Wake it and
+feed it, for, as will be shown later, it is the constant regularity that
+counts. It will be more difficult to institute regular feeding intervals
+during the first month, because a healthy baby is very difficult to wake
+up, even to be fed, during the first few weeks of life. It is absolutely
+essential, however, that it should be wakened: otherwise the tendency to
+overfill the stomach at the next feeding will lead to indigestion and
+colic.
+
+WHY IS REGULARITY OF FEEDING IMPORTANT?--Because a baby's stomach holds
+a very small quantity, and experience has taught us that a baby will
+thrive better on small quantities given frequently, rather than large
+quantities at longer intervals. The smaller the baby, the smaller the
+quantity to begin with. Some babies weigh from five to seven pounds at
+birth, while others weigh from nine to twelve pounds. It would be
+unreasonable to expect a very small baby to be able to hold and digest
+as much as a very large baby. Considerable common sense and the exercise
+of some judgment is therefore necessary on the part of the uninstructed
+mother, as to just the right quantity to give. Fortunately, a little
+experience will enable the observant mother quickly to solve this
+important problem. Nature promptly furnishes the symptoms which will
+correctly guide her. Before considering the significance of these
+symptoms let us appreciate certain facts common to all babies, and we
+will more easily interpret the meaning of the special symptoms the baby
+will furnish.
+
+First of all the baby never vomits. The ejection of food, therefore, is
+dependent upon a condition, not a disease. If milk runs out of its mouth
+immediately, or within a few moments, after a feeding, the explanation
+is that it was fed too much; it does not vomit, the stomach simply
+overflows. It is exactly like trying to put more milk into a cup after
+it is full,--it will not hold more, it overflows.
+
+The significance of this symptom, therefore, is that the quantity of the
+feeding is wrong (it is not the baby's stomach that is at fault,--it is
+the mother's judgment). Reduce the quantity of each feeding and you will
+quickly cure it. If the milk does not overflow soon after a feeding, the
+baby will appear satisfied and will go to sleep, and will sleep until it
+is time for the next feeding. It may not do this, however. In half an
+hour, or a little longer, after the feeding, it wakes, it begins to fret
+and cry, and very soon it suddenly belches gas and ejects a mouthful of
+milk, after which it will rest quietly for a few moments, when it will
+begin fretting all over again. It may keep up this performance for an
+hour, or until the next feeding, and if so it is exhausted and unfit to
+carry on the digestive process. It is in these cases where most mothers
+make serious mistakes. This is the beginning of real trouble, and the
+family physician is the only one qualified to give advice under such
+circumstances. Remember the warning given regarding heeding the advice
+of every busybody just at this time. Your baby's health is at stake;
+maybe its life depends upon what you choose to do.
+
+WHAT IS THE SIGNIFICANCE OF "VOMITING" AFTER FEEDINGS IN BABIES?--Let us
+examine the difference between the milk which overflowed immediately
+after the feeding and the milk which the baby ejects one-half hour or so
+later, and which is now being considered.
+
+The first milk looks like ordinary milk (breast milk), or if the baby is
+being fed from the bottle, it looks just like the mixture in the bottle.
+It not only looks like what it took, but it smells just like it. Now
+examine the other; we find it looks like curdled milk, it is lumpy, and
+we immediately can tell that it is sour, because it smells sour and
+looks sour.
+
+The explanation of the first overflow (immediately after the feeding)
+was the too great quantity; the explanation of the second overflow
+(one-half hour or so after the feeding), is the wrong quality of milk.
+The quantity was right because none overflowed right after the feeding,
+but the quality was wrong. Again, it is not the baby's stomach that is
+at fault,--it is the quality of the milk.
+
+How do we know this? Because of what takes place in the baby's stomach
+during the one-half hour between the feeding and the time of the
+overflow of the sour milk. The quantity being right, why should the baby
+have any trouble if the quality is correct? It should not. Therefore by
+changing the quality (not the quantity as in the former case) we cure
+the trouble, thus proving the quality of the milk to be at fault.
+
+What took place in the baby's stomach in the intervening half hour? The
+quality being wrong, the little stomach could not digest the mixture
+quick enough. Fermentation set in, gas was evolved, and as the stomach
+was full before the gas was manufactured (and as more and more gas is
+manufactured when food ferments), the stomach overflowed and out of the
+baby's mouth comes gas, and sour, fermenting, curdled milk. This process
+goes on until fermentation stops, or until the little stomach has just
+enough left to fill it and no more. But think what this is,--a sour mass
+of rotting, indigestible, curdled milk,--and that is what this baby is
+expected to live and thrive on.
+
+Some babies seem to have trouble from the very first day of life. Either
+they will not retain the food, or the food fails to agree with them. If
+the baby is put upon artificial food at once, these troubles are, of
+course, not unexpected (because the right artificial food may not be
+first chosen for the particular baby), but it is not always the
+artificially fed baby that gives us trouble, and it is sometimes
+difficult to find the cause for such trouble in a baby who has had
+nothing but its mother's milk since it was born.
+
+The cause of stomach trouble in a baby a few days old, fed exclusively
+on mother's milk, is invariably to be found in the quality of the milk.
+
+The quality of the mother's milk may be affected in a number of ways
+which will render it unfit for the baby. For example, if the mother for
+any reason becomes sick, and has a high fever shortly after confinement,
+it will affect her milk and render it unfit temporarily.
+
+If the mother worries or becomes highly nervous during the first few
+days of her baby's life, she will so affect her milk as to render it
+unfit for baby. If a baby is fed for a number of days after its birth by
+its mother, and it should prove afterward that she has not enough milk
+to continue feeding it, and has finally to put it on artificial food,
+the baby will most likely have acquired slight stomach ailments that may
+be troublesome for some time, because in this case both the quality and
+the quantity were no doubt wrong. Constipation in the mother will also
+cause trouble. The child will develop colic and extreme irritability
+until the mother's condition is relieved.
+
+Each of these conditions affecting the milk of the nursing mother
+usually demands a change of food for the baby, and the substitution of
+the proper artificial food will invariably immediately correct the
+trouble. In some cases, however, the quality of the mother's milk is not
+dependent upon a temporary temperamental condition, but is caused by
+errors in diet, or conduct, or both. The milk of a physically tired,
+worn-out mother, is not good, no matter whether the exhaustion is caused
+by actual physical labor or by the exactions of a strenuous social
+programme. The milk of a mother who persists in eating irregularly, or
+who willfully caters to an appetite which craves the rich, highly
+seasoned articles of diet, or who attempts to satisfy a legitimate
+hunger by drinking large quantities of stale tea or coffee and eating
+bread, is unfit for her baby.
+
+These cases are amenable to the proper treatment, which of course means,
+that the mother must change her conduct if at fault, and live strictly
+upon the diet prescribed elsewhere for nursing mothers.
+
+If these troubles occur in babies who have been fed exclusively upon
+artificial food, an entire change of food is frequently necessary.
+
+
+FRESH AIR FOR BABY
+
+Baby's first journey out of doors depends upon so many contingencies
+that no specific age can be given when it would be perfectly safe to
+take it.
+
+First, the weather and season of the year should be considered. The baby
+should not be taken out at all when it is wet, or foggy, or very humid;
+nor when it is extremely cold.
+
+Second, the vigor or vitality of the individual child must be
+considered. Some children can safely be taken out if the weather is
+propitious when two weeks old, others cannot be taken out without risk
+until they are two months old, regardless of the weather conditions. If
+a child is robust at birth, and nurses well, and increases in weight
+from the beginning, he can be taken out when he is two weeks old while
+the sun shines during the middle of the day. If a child is small and
+puny when born, and begins to have nursing troubles from the beginning,
+does not increase in weight, is fretting, and crying, and sleeps
+spasmodically, it would be unsafe to take it out before the sixth week
+unless it is at a season of the year which would justify exposure to the
+sunshine.
+
+The question of suitable clothing will be important, and will decide the
+advisability as to when the baby should go out. Every baby should be
+dressed in wool weather is not too distinctly bad. Remember always to
+[Transcriber's note: words missing in text] from neck to ankles. Its
+head should be warmly clad. Dressed thus and well wrapped in blankets, a
+healthy child is ready for an out-door trip at any time, if the
+[Transcriber's note: words missing in text] have plenty of blankets
+below the child as well as above it, if it is in a baby carriage. In
+very cold weather the child should be buried in blankets, and a hot
+water bottle can be wrapped in near his feet. Great care must be taken
+that the water in the bottle is not too hot, and that it does not
+actually touch the skin. No matter how many or how few blankets are
+used, the face should be exposed directly to the fresh air. When the air
+is very gusty, or high, a light veil can be laid over the face, but
+never at any other time.
+
+AIR BATHS FOR BABIES.--Babies necessarily require plenty of exercise and
+plenty of fresh air, as has been pointed out. It is a splendid custom to
+allow the baby to lie naked after his bath for half an hour. If the room
+is comfortably warm, select a spot that is free from draughts, and lay
+the baby on a pillow or two and let him kick and coo. In the sun by the
+window, his head and especially the eyes shaded from the direct rays of
+the sun, is an excellent place in the summer time. The influence of the
+direct sun rays on the little naked body is conducive to good sturdy
+health, good nerves, and sound sleep.
+
+
+
+
+CHAPTER XVIII
+
+BABY'S GOOD AND BAD HABITS. FOOD FORMULAS
+
+     Baby's Bed--The Proper Way to Lay Baby in Bed--Baby Should
+     Sleep by Itself--How Long Should a Baby Sleep--Why a Baby
+     Cries--The Habitual Crier--The Habit of Feeding Baby Every Time
+     it Cries--The Habit of Walking the Floor with Baby Every Time
+     it Cries--Jouncing, or Hobbling Baby--Baby Needs Water to
+     Drink--The Evil Habit of Kissing Baby--Establishing Toilet
+     Habits--Baby's Comforter--What can be Done to Lessen the Evil
+     Effects of the Comforter Habit--Beef Juice--Beef Juice by the
+     Cold Process--Mutton Broth--Mutton Broth with Cornstarch or
+     Arrowroot--Chicken, Veal, and Beef Broths--Scraped Beef or Meat
+     Pulp--Junket or Curds and Whey--Whey--Barley Water--Barley
+     Water Gruel or Barley Jelly--Rice, Wheat or Oat Water--Imperial
+     Granum--Albumen Water--Dried Bread--Coddled Egg.
+
+
+BABY'S BED
+
+THE PROPER WAY TO LAY BABY IN ITS BED.--The baby should be accustomed to
+sleep by itself from the day of its birth. Mothers have been known to
+smother their babies during sleep. The mother may pull the bed-clothing
+over the baby's head during the night and thus deprive it fresh air. A
+mother is much more apt to nurse her baby regularly and to do it more
+efficiently, if she is compelled to get up to do it. If she occupies the
+same bed with baby, she may fall asleep while nursing him; the baby
+consequently nurses too long, fills his stomach too full, and soon
+develops indigestion and colic in addition to acquiring a very bad
+habit.
+
+For the first few weeks an ordinary basket arrangement is all that is
+necessary. As soon as the baby begins to move around it should have a
+regular baby crib, so that possible accidents may be avoided.
+
+When the baby is placed in bed after a feeding, it should be laid upon
+its back, being tilted slightly toward its right side. By placing a
+soft, small pillow, under its left side, the baby will rest more on its
+right side, which is the proper position. The reason of this is because
+the liver of a child grows quicker and larger than any other organ, and
+it is on the right side. By placing the child on this side, it prevents
+the heavy liver from sagging over on the little full stomach. If the
+child were laid on its left side, the liver would crowd the full stomach
+and embarrass the heart, and cause pain and restlessness. Frequently a
+change of position fully to the right side, when a child has been
+restless or crying, and especially if it has been lying on its back,
+will at once relieve it and allow it to go to sleep again. It is the
+knowledge of these little things that count in babyhood.
+
+HOW LONG SHOULD A BABY SLEEP?--A perfectly healthy baby should sleep,
+while very young, eighteen or twenty hours out of the twenty-four. As it
+grows older it will sleep less. It should have, and nothing should
+interfere with its having, two sound naps every day,--one in the
+forenoon after its bath, and the other in the afternoon. When four or
+five months old, it should also sleep from 7 P. M. until 10 P. M., then
+it should be fed and allowed to sleep until morning. It has been aptly
+said, that, "a child might easily overeat, but he practically never
+oversleeps." During the second year a child should sleep twelve hours at
+night, and about two hours during the day. The twelve-hour night rest
+should be continued until the child is six years of age. The practice of
+taking a nap at noon is a very good one, and it should be encouraged as
+long as possible. It can usually be kept up until the child begins
+school life. The strenuous activity of childhood, makes some such rest
+highly desirable, and the result will necessarily be a stronger body, a
+better disposition, and firmer nerves than otherwise. The practice of
+retiring early should be strictly enforced during childhood. Children of
+two years of age, should retire at 6:30 P. M., or at latest at 7 P. M.,
+those from three to five years, may remain up an additional hour. At
+thirteen or fourteen the regular bedtime should be at 8:30 P. M. There
+is no justification for the late hours which growing children are
+allowed to keep, especially in large cities.
+
+Regular sleep is largely a matter of habit, and if the infant is started
+right, with suitable feedings, given at definite times, followed by the
+proper periods of sleep, but little trouble will be experienced with
+sleeplessness. When sleep is disturbed and broken, it means bad habits,
+unsuitable food, minor forms of indigestion, or positive illness of some
+kind. Sleep is absolutely essential in infancy and all through childhood
+for purposes of growth. It is wrong to permit a child to sleep too much
+during the day; it will become a habit, and it will not sleep well
+during the night as a consequence. In order to prevent or break this
+habit, the child should be kept in a well-lighted room and should be
+amused and entertained so as to keep it awake. The nap during the middle
+of the day is an exceedingly important factor in keeping the average
+child in good physical condition. It is a valuable adjunct in
+preventing, and in treating, nervousness in children. Children who are
+anemic should be encouraged to sleep long and freely in well-aired
+rooms.
+
+WHY A BABY CRIES.--As has been stated, every healthy baby should cry for
+half an hour each day. Nature suggests, demands this as an essential
+exercise. Muscular movements involving a greater part of the whole body
+accompany the act of crying and furnish this necessary exercise. It is
+of great importance to an adequate and uniform development of the lungs;
+deep breathing is necessary to lusty crying, hence the lungs are
+expanded and the blood renewed and oxygenated. Crying is also of
+material aid in moving the baby's bowels. Babies in perfect health will,
+however, cry under any of the following circumstances, and doubtless
+under circumstances of lesser importance and frequency when frightened
+or uncomfortable from hunger or position, soiled napkins, inflamed
+buttocks, earache, pain, from heat or cold, unsuitable clothing, and
+during difficult bowel movement, when displeased or angry. Children
+slightly but painfully ill may cry incessantly for an hour or two. Thus,
+with intestinal colic, when the cry is loud and continuous until the
+child is relieved or until he falls asleep from exhaustion.
+
+The healthy, well trained child seldom causes trouble; it is the rule
+for it to be happy and good natured in its own way.
+
+THE HABITUAL CRIER.--If a child becomes a habitual crier, it is because
+it is uncomfortable and unhappy. There are restless, often vigorous,
+crying, whining infants, and the trouble, as a rule, is in the
+intestinal tract. Badly managed, "spoiled babies" cry from inattention,
+and when left alone. If they are taken up and talked to, the crying
+ceases, thus proving that it was not pain or discomfort that was causing
+the crying. In the case of the habitual crier we try to find out the
+cause of the bowel trouble and cure it; the spoiled infant we discipline
+rigidly, or leave it alone if its parents prefer that kind of baby.
+
+THE HABIT OF FEEDING BABY EVERY TIME IT CRIES.--The habit of regular
+feeding will, if persisted in and successfully established, render
+advice on this subject unnecessary. So also will the explanation of the
+evil of overfeeding have its effect on mothers. Apart from these
+reasons, however, the habit of feeding baby every time it cries is a
+pernicious one, and no doubt the mother, who will be striving to
+faithfully follow instructions, will have to overcome the advice of
+meddling friends who will regard it as a cruelty to allow the baby to
+cry. Do not give in to these busy-bodies; insist on attending to your
+own affairs, but be absolutely sure baby is not crying for a just cause.
+A child can only cry; that is its only language, but it cries for many
+things other than the nipple or the bottle. Examine it carefully,--a wet
+diaper a pin, an uncomfortable position, a drink of water, any of these
+may be the cause.
+
+It is just as essential that a child should cry as that it should sleep.
+Every healthy child should cry for twenty or thirty minutes every
+twenty-four hours. Nature calls for this as an exercise in order to
+develop the lungs; therefore, if there is no just cause for the crying
+you must regard it as a necessary evil, even if you look upon it as a
+domestic affliction.
+
+THE HABIT OF WALKING THE FLOOR WITH BABY EVERY TIME IT CRIES.--This is
+another habit that is indulged in to the sorrow and ridicule of the
+race. If you are a victim of this habit, you have yourself to blame. It
+is a matter of education, or habit, pure and simple, and, like all bad
+habits, it is difficult to break away from. In the preceding paragraph,
+you have been told that when baby wants something, or is uncomfortable,
+it employs the language nature gave it,--it cries. No child ever cried
+to be walked up and down the floor in the dead of the night. Begin at
+the beginning, when it first cries, find out why it is crying. Offer it
+a little water if it is not feeding time. Examine its diaper and if
+soiled change it. It may be overdressed and consequently hot,
+perspiring, and uncomfortable; change its position. Find out if any pin
+is open and hurting it; loosen the binder so it can breathe easily. If
+it is a colicky child follow the instructions given in the treatment of
+colic. Be patient the first few nights, and be thorough, because you may
+discover why it cries and each discovery will help you next time. If you
+discover something wrong, some reasonable excuse for the crying, does it
+not prove the folly of walking the floor? If it wants a drink of water,
+or if its diaper is wet, how is walking the floor going to cure it, or
+how can you expect the baby to stop crying when you so unjustly construe
+its reasonable and its only way of asking a favor? If walking the floor
+stops its crying, it stops it by exhausting the child, not by relieving
+it of its little ailment.
+
+JOUNCING OR HOBBLING BABY.--This is another habit that should be frowned
+upon. So many persons are addicted to this form of baby torture, that it
+is astonishing more immediate harm does not result from it. Be
+particularly careful not to indulge in it, or permit anyone else to do
+it immediately after feeding. If you form the habit of putting baby down
+at once after each feeding, as you have been instructed to do, the
+opportunity to jounce it will not exist. A little reasoning will clearly
+convince you that to subject a baby to violent exercise when its stomach
+is full would interrupt digestion and so shake the full stomach hat it
+would distend it and cause indigestion. You would not think of
+exercising yourself after a meal; why exercise a baby?
+
+BABY NEEDS WATER TO DRINK.--Boil a quantity of water each morning, put
+in a clean bottle, and keep in a cool place. Give the baby some, three
+or four times daily between feedings. One teaspoonful is enough to begin
+with, and as it grows older it will take more. It may not always take
+the water but it will take what it wants, and it needs some every day;
+it is therefore your duty, inasmuch as baby cannot ask for it, to offer
+it regularly each day as part of your daily routine.
+
+
+KISSING
+
+A child should never be kissed on the mouth by anyone, not even its own
+parents.
+
+Kissing should not be allowed among children. If any kissing is done it
+should be on the brow, never on the mouth, hands, or fingers.
+
+Many diseases are carried by this pernicious habit, and you cannot
+afford to have baby's health jeopardized by this promiscuous and
+unnecessary liberty.
+
+
+ESTABLISHING TOILET HABITS
+
+When baby reaches the age of three months, a regular systemized effort
+should be made to educate it to "habits of cleanliness." Nothing can be
+done in this direction previous to this age, as a child at that period
+of its life is scarcely conscious of the natural functions of its body.
+Each time a baby, after the third month, is making an effort to move its
+bowels, the nurse or mother should go to it as it lies in its crib, and
+talk to it by making a certain sound or say a certain word--whichever
+word or words you want to educate your child to say, when it wants to
+move its bowels. By constant attention and effort in this direction, a
+child with quick perception and initiative will soon associate the sound
+and the function, and it will begin to make the sound when the function
+is about to be performed. As soon as it begins to make this sound, if
+prior to the act of moving the bowels, the child should be immediately
+taken up and held on a chamber, into which some hot water has been put,
+and encouraged to relieve itself, the nurse or mother still repeating
+the sound, or word, or words.
+
+Having successfully accomplished this programme a number of times, the
+child should be encouraged and petted every time it gives a satisfactory
+warning, and discouraged and reproved every time it wets or soils its
+napkin. A little later, say about six months, the child should be held
+on the chamber at a certain time each morning and evening, thus
+encouraging it to move its bowels regularly twice daily. The careful
+carrying out of a scheme such as the above will establish regular,
+cleanly habits, and will to a very large extent guard against
+constipation in the future.
+
+BABY'S COMFORTER.--The discovery and introduction of the comforter or
+rubber teat was an unfortunate episode in someone's life. By the
+careless, conscienceless nurse, or thoughtless mother, it is regarded as
+a real comfort and blessing. Any temporary comfort, however, which the
+nurse or mother may enjoy as a result of its use, is at the expense of
+the health of the child. Its use is a serious reflection upon the good
+intention and intelligence of the mother who permits her child to use
+one. It is a bad habit from every viewpoint possible. In order that
+mothers, open to conviction and capable of reasoning, may appreciate the
+character of the harm done by the use of the comforter, we will briefly
+record these conditions:
+
+1st. The constant sucking pulls upon the delicate structures of the
+mouth and throat, and so impairs the health tone of these structures
+that they become flaccid and feebly nourished. This to a certain degree
+causes adenoids, enlarged tonsils, loose palate and weak throat, with
+the constant tendency to winter colds and coughs, and to catarrh.
+
+2nd. It causes an excessive flow of saliva. Saliva should only be
+stimulated previous to stomach digestion. By causing an excessive flow
+of saliva into an empty stomach, the digestive powers are interfered
+with, and seriously weakened. Stomach trouble, and consequently
+intestinal disease, may therefore be caused by the seemingly innocent
+comforter.
+
+3rd. A constantly used comforter always causes disease of the mouth.
+Mucous erosions, canker sores, little ulcers, etc., are produced in this
+way.
+
+4th. The use of the comforter makes it impossible to put the child to
+sleep, or even to leave it alone, without first placing it in its mouth.
+
+5th. To stifle a baby's cry, by pushing the comforter into its mouth, is
+as bad as giving it chloroform to mask a serious and dangerous pain. If
+may have a just reason for crying, as is explained elsewhere, and if
+that reason is not searched for and found, it may mean serious trouble
+later.
+
+6th. Actual deformities of the mouth are produced by constant use of the
+comforter. The continuous sucking affects the gums, pushes them out of
+shape and position, and the teeth as a consequence come at wrong angles,
+thus causing unsightly deformities, which last throughout the life of
+the child.
+
+7th. The worst fault of the comforter is to be found in its
+uncleanliness. We are quite satisfied that the use of the comforter will
+be legislated against one of these days. If preventive medicine means
+anything, it must certainly reckon with the comforter in the very near
+future. Have you ever watched your baby suck on its comforter? If you
+have, you must have noted the tireless energy with which it works its
+tiny jaws and tongue. Suddenly the comforter slips from the little mouth
+and baby begins to cry, attracting the attention of the mother, or
+nurse, or little sister, who promptly, recognizing the trouble, pounces
+on the offending comforter, which has fallen to the floor, and with a
+perfunctory wipe replaces it in baby's mouth. It is done just as we have
+written it, many thousand times, and yet the problem of infant mortality
+is represented as a vexatious mystery. The newspapers solicit charitable
+aid, and write eloquent appeals regarding the necessity of sending a few
+babies to the seashore in the summer time or to supply a few with ice
+during the hot spells. A hundred other energetic enthusiasts send forth
+their laudable effort to raise the standard of child hygiene, yet the
+manufacturers of the comforter, and the ignorant mother and nurse who
+use it, do more harm in one day than all the honest effort of these
+combined forces can neutralize in a year.
+
+The rubber comforter is one of the most fertile causes of infection and
+illness in babies because of the peculiar adaptability to collecting
+germs which it possesses.
+
+When the comforter is finally discarded the habit of sucking is so
+firmly established that the child will suck its thumb for many years
+after. This results in further disease and deformity to the growing
+mouth and throat, and also to the thumb.
+
+After a child has used a pacifier or comforter for some time it
+invariably becomes a mouth breather. A mouth-breathing child is very apt
+to catch cold and as a consequence of the habit may become catarrhal or
+tubercular.
+
+WHAT CAN BE DONE TO LESSEN THE EVIL EFFECTS OF THE "COMFORTER"
+HABIT?--It is a most difficult habit to cure when once established. The
+very least that can be done is to keep the comforter scrupulously clean,
+washing it several times daily. To have not one, but two or three, kept
+in a saturated solution of boracic acid, ready to put into the baby's
+mouth should one be required to replace another that has fallen out. We
+should furnish a large shield to prevent it being swallowed. We can try
+the method of weaning the baby from the comforter by tying a ribbon to
+it and to the child's bodice. The system is gradually to shorten the
+ribbon until it becomes too short for the baby to suck in comfort. It
+will then gradually grow away from the habit.
+
+
+FOOD FORMULAS
+
+BEEF JUICE.--Take one pound of round steak and broil it slightly. Press
+the juice out with a lemon squeezer, or, with a meat-press. Season with
+salt and serve hot or cold as desired. If it is heated after it has once
+been cold, it should not be overheated as this will coagulate the
+albumen which will appear as flakes floating on the surface of the
+juice.
+
+BEEF JUICE BY THE COLD PROCESS.--Take one pound of finely chopped round
+steak, six ounces of cold water, a pinch of salt; place in a covered jar
+and stand on ice, or in a cool place, six hours. This mixture should be
+shaken from time to time. Strain and squeeze all the juice out by
+placing the meat in a coarse cloth and twisting it very hard. Season and
+feed as above.
+
+Beef juice made in this way is more nutritious than that made from the
+steak when broiled; it is not, however, quite so palatable.
+
+Beef juice made in either of the above ways is much more nutritious than
+the beef extracts sold ready to use.
+
+MUTTON BROTH.--Take one pound of finely chopped lean mutton, including
+some of the bone, one pint of cold water and a pinch of salt, cook for
+three hours over a slow fire down to half a pint, adding water to make
+up this quantity if necessary; strain through muslin. When it is cold
+remove the fat and add more salt if required. It may be fed warm or cold
+in the form of a jelly.
+
+MUTTON BROTH WITH CORNSTARCH OR ARROWROOT.--Add to the above sufficient
+cornstarch or arrowroot to thicken, cook for ten minutes and then add
+three ounces of milk, or one ounce of thick cream, to a half pint of
+broth. This makes a nutritious and extremely palatable broth.
+
+CHICKEN, VEAL, AND BEEF BROTHS.--These may be made and used in the same
+way as mutton broth.
+
+SCRAPED BEEF OR MEAT PULP.--Take a rare piece of round or sirloin steak,
+cut the outer part away, scrape or shred with a blunt knife. Cutting the
+meat into small pieces is not satisfactory. One teaspoonful to one
+tablespoonful may be given well salted, to a child a year and a half
+old. It is best to begin with a small dose and work up to the larger to
+accustom the digestive apparatus to its use.
+
+JUNKET, OR CURDS AND WHEY.--Take one pint of warm fresh cow's milk, a
+pinch of salt, a teaspoonful of granulated sugar, to which add two
+teaspoonfuls of Fairchild's essence of pepsin and allow the mixture to
+stand until firmly coagulated--this may take about twenty minutes--place
+in the ice box until thoroughly cold. Nutmeg may be added for older
+children and adults.
+
+WHEY.--The coagulated milk prepared as above is broken up with a fork
+and the whey is strained off through cheesecloth. If a stimulant is
+desired, brandy, in the proportion of one teaspoonful to six
+tablespoonfuls of the whey may be added.
+
+BARLEY WATER.--One level tablespoonful of Robinson's barley is rubbed up
+with a little cold water, to this is added one pint of boiled water
+containing a pinch of salt. The mixture should be stirred while the
+water is being added. Cook for thirty minutes in a double boiler and
+strain. Enough boiling water should be added to the mixture to make up
+the full pint if any has boiled away.
+
+BARLEY GRUEL OR BARLEY JELLY.--Repeat the above process, but instead of
+using one tablespoonful of the barley powder, use from two to four
+according to the consistency of the gruel or jelly desired.
+
+Barley water may be made from the grains. A formula for this process
+will be found in the chapter on artificial feeding.
+
+RICE, WHEAT, OR OAT WATER.--These are made from the rice, wheat, or oat
+flour in the same way as barley water described above. They may be made
+from the grains also, using the same proportions as in the making of
+barley water.
+
+IMPERIAL GRANUM.--This is prepared in the same way as the barley flour
+above described.
+
+ALBUMEN WATER.--Take half a pint of cold water, the white of one fresh
+egg, a pinch of salt, and a teaspoonful of brandy, shake and feed from a
+spoon or from a bottle. This is frequently used in cases of vomiting, or
+in irritable stomachs. It is often retained when all other food is
+rejected.
+
+DRIED BREAD.--Cut either stale or fresh bread into thin slices and place
+in the open oven. When it is dried and crisp but not browned it may be
+given to children in preference to crackers.
+
+CODDLED EGG.--A fresh egg with the shell intact is placed in boiling
+water which is immediately removed from the fire. The egg is allowed to
+remain in the water for eight minutes when it is ready for use. The
+white only should be used if the digestion is poor.
+
+
+
+
+ARTIFICIAL FEEDING
+
+
+
+
+CHAPTER XIX
+
+ARTIFICIAL FEEDING
+
+     Elementary Principles of Milk Modification--The Secret of the
+     Efficiency of Mother's Milk--Two Important Factors in
+     Successful Artificial Feeding--Every Child is a Problem in
+     Itself--Proprietary Foods of Little Value as Infant
+     Foods--Their Value is in the Milk Added to Them--The Credit
+     Belongs to the Cow--Difference Between Human and Cow's
+     Milk--What "Top-milk Feeding" Means--Utensils Necessary for
+     Home Modification of Milk--Artificial Feeding from Birth to the
+     Twelfth Month--How to Measure Top-milk--Easy Bottle-feeding
+     Method--Condensed Milk Feeding--Objections to Condensed Milk
+     Feeding.
+
+
+ELEMENTARY PRINCIPLES OF MILK MODIFICATION.--Mothers who have to raise
+their children on artificial food should understand the elementary
+principles of milk modification. They should know, for example, that the
+one object of milk modification is to render it as nearly an exact
+substitute for mother's milk, according to the age of the child, as is
+possible. If we could do this with scientific exactness, artificial
+feeding would be a simple process. We cannot, however; nor has there
+ever been devised a method by which we may hope successfully to
+duplicate mother's milk. It is a comparatively simple matter for the
+efficient chemist to analyze the breast milk of any nursing mother; and
+it is quite possible to duplicate the milk according to the analysis,
+with chemical exactness, but the two fluids will not be the same. There
+is present in the mother's milk something which synthetic chemistry
+cannot discover. This something is nature's secret,--it is akin to the
+life-giving principle which is contained in the germinal fluid, and in
+the hen's egg. We cannot therefore hope to build up an artificial food
+that contains this mysterious life-giving principle which is the secret
+of the efficiency of maternal milk,--we can only hope to approximate
+it. It is possible that we might be successful so far as its nursing
+efficiency is concerned, if all children were alike, if all children
+were of a uniform standard of health. As a matter of fact, no two babies
+are exactly alike. And while the mother of each child undoubtedly
+secretes a milk suitable to the degree of healthfulness of her own
+child, the same milk might not be equally suitable to another child. The
+milk, therefore, that is manufactured to agree with an average mother's
+milk is dependent for its success upon the vitality of the child to
+which it is fed. If that child is not a well child, according to an
+accepted standard, the milk will not agree with it, even though it is
+the best possible substitute for an average breast milk.
+
+We have consequently two factors to consider in successful or efficient
+artificial feeding:
+
+    1. Our inability to duplicate exactly mother's milk.
+    2. The lack of a uniform health standard in children.
+
+It is the lack of a uniform health standard in children that gives to
+artificial feeding all its difficulties. It renders the successful
+artificial feeding of children a personal or individual problem. Some
+children,--those who approximate a standard of health for their age; in
+other words, "well" children,--thrive on a milk modification that
+experience has taught us is suitable for well children of their age.
+Others, and they are in the majority, have to be fed on a modification
+which actual test proves to agree with their digestive capabilities.
+Every artificially fed child therefore must be studied from its own
+individual standpoint. A certain modification of milk may not agree with
+a child fed every two and one-half hours, which will be found to agree
+if fed in the same quantity, to the same child, every three hours. The
+slightest change, a change which would seem to be so insignificant in
+itself as not to justify serious consideration, may mean the difference
+between normal healthfulness and constant ill health. A food that is too
+strong for a child's digestive ability, and which causes vomiting,
+colic, and diarrhea, may be rendered exactly right by the slightest
+modification one of its constituents. To effect such a change quickly
+and successfully, one must be trained to interpret the symptoms
+correctly and to know how to make the change in the modification of the
+milk. Mothers cannot be expected to possess this degree of skill: they
+should therefore refrain from experimenting, because an experiment on a
+baby is not only dangerous, but ethically it is criminal. Call the
+family physician; put the burden on his shoulder.
+
+It is this element of uncertainty in our ability to effect a standard
+modification of milk that has afforded manufacturers the rich
+opportunity of putting on the market various baby foods for which much
+is claimed. These foods are really substitutes for the inefficiency of
+the average mother. There is no real justification for their use. If all
+mothers were clean, faithful, and efficient, there is no reason why each
+one could not be taught to modify cow's milk to suit her child, just as
+satisfactorily, or more so, than a manufacturer who never saw her child.
+The manufacturers, however, do the work, and the naturally ignorant or
+lazy and inefficient mother, is willing to pay for the extra cost of
+labor, to save herself the trouble on the one hand, and to subject her
+child to a series of experiments in order to discover the manufactured
+food that is particularly adapted to her particular baby on the other
+hand. We believe that most mothers have never considered the question
+from this standpoint; that most mothers adopt this method of artificial
+feeding at the direct suggestion of their family physician, and are not,
+therefore, responsible. These foods do not contain the nutritional
+elements necessary to healthy growth; or as they exist in normal breast
+milk; or as they can be approximated in ordinary milk modification at
+home. Proprietary foods are of decidedly poor value in infant nutrition,
+and should not be used. They have a value, however, in certain diseased
+conditions, but within a very small range. As a food for a healthy
+growing infant, they should not be used, and when the average physician
+appreciates this fact, and so instructs the mothers of the country, it
+will be to the distinct advantage of the race in every respect.
+Proprietary foods to which fresh cow's milk is added, are not foods at
+all,--they depend upon the milk so far as any nutritional value is
+concerned; and it would be far safer to modify at home a good milk than
+to buy a proprietary food, the analysis of which cannot be depended
+upon. The credit for the fat, healthy babies we see advertised does not
+belong to the manufacturers, but to the cow whose milk you add to the
+manufacturer's sugar.
+
+The proprietary beef foods are also valueless as infant foods. In
+certain illnesses, when we want a mild stimulant, a teaspoonful or two
+in hot water may have a certain value, but that is all. The beef juice
+of home manufacture is much more valuable.
+
+DIFFERENCE BETWEEN HUMAN AND COW'S MILK.--The composition of cow's milk
+is as follows:
+
+    Fat (represented by cream)        4%
+    Sugar                             4%
+    Proteids (represented by curd)    4%
+
+The composition of an average human breast milk is as follows:
+
+    Fat              4%
+    Sugar            7%
+    Proteids     1-1/2%
+
+It will be observed from a comparison of the above tables that cow's
+milk is much richer in proteids (the substances which form with water
+the curd of sour milk) than is human milk. If one remembers that cow's
+milk is manufactured by nature primarily for the feeding of calves, not
+for babies, and that the stomach of a calf is intended to exist
+exclusively on vegetable products, and that nature is preparing it for
+this purpose, and feeds it a food when young that will enable it to grow
+so as to be adapted for that purpose, one can understand that the
+problem of the modification of cow's milk to suit the stomach of a baby
+is not by any means a simple matter. Since the proteids are so much in
+excess in cow's milk, we must dilute cow's milk with twice its bulk or
+more of water to render it fit food for a new born baby. If we dilute
+cow's milk to this extent to get the proteid percentage right, we
+immediately disarrange the percentage of the cream or fat. We overcome
+this difficulty by taking the cream from the top of the bottle and
+diluting it because it is richer in fat and does not need so much
+dilution. This is the explanation of the so-called "top-milk feeding."
+The percentage of sugar represents another problem. The percentage of
+sugar in cow's milk compared with the sugar in human milk is deficient,
+so we add milk-sugar to the cow's milk to make up the deficient
+percentage.
+
+There is yet another feature which we must rectify; cow's milk is acid,
+while human milk is alkaline. To overcome this difference we add
+lime-water. We must also take into consideration that cow's milk is
+ordinarily full of germs, while human milk is free from them; to
+overcome this danger we resort to heating the milk to a degree which
+experience has taught us will kill all germs. Cooked milk is not as
+wholesome as uncooked milk, and it has a tendency to cause constipation.
+We have to a certain extent overcome the need for cooking all milk for
+babies, as will be noted later, but in summer time, unless the milk is
+known to be pure and free from germs, it is advisable to sterilize it.
+
+
+UTENSILS NECESSARY FOR HOME MODIFICATION OF MILK
+
+    One dozen round, eight-ounce nursing bottles.
+    One dozen black rubber nipples.
+    One eight-ounce measuring glass or graduate.
+    One brush for cleaning bottles.
+    One two-quart glass preserve jar for mixing the various ingredients.
+    One one-ounce Chapin dipper, for removing the top-milk.
+    One glass funnel.
+
+A detailed description of the proper kinds of bottles and nipples will
+be found elsewhere. The measuring glass or graduate should be
+wide-mouthed. It is not safe to spoon the top-milk off, nor is it safe
+to pour it out. Absorbent cotton should be provided to close the nursing
+bottles when filled and left standing in the ice box.
+
+
+ARTIFICIAL FEEDING FROM BIRTH TO THE TWELFTH MONTH
+
+The following formulas for the different ages may be found useful for
+well babies:
+
+
+From the third to the tenth day:
+
+    Milk (top 16 oz.)                3 ounces.
+    Lime-water                     1/2 ounce.
+    Milk-sugar                       1 ounce.
+    Boiled water to make            16 ounces.
+
+Ten feedings in twenty-four hours; 1-1/2 to 2 ounces at each feeding.
+
+
+From the tenth to the twenty-first day:
+
+    Milk (top 16 oz.)           6 ounces.
+    Lime-water              1-1/2 ounces.
+    Milk-sugar              1-1/2 ounces.
+    Water to make              24 ounces.
+
+Nine to ten feedings in twenty-four hours; 1-1/2 to 2 ounces at each
+feeding.
+
+
+From third to the sixth week:
+
+    Milk (top 16 oz.)       10 ounces.
+    Lime-water           2-1/2 ounces.
+    Milk-sugar               2 ounces.
+    Water to make           32 ounces.
+
+Eight to nine feedings in twenty-four hours; 2 or 3 ounces at each
+feeding.
+
+
+From sixth week to the third month:
+
+    Milk (top 16 oz.)    12 ounces.
+    Milk-sugar            2 ounces.
+    Lime-water            3 ounces.
+    Water to make        32 ounces.
+
+Seven to eight feedings in twenty-four hours; 2-1/2 to 4 ounces at each
+feeding.
+
+
+From third to fifth month:
+
+After this age two bottles of milk are required, 16 ounces being taken
+from the top of each bottle and mixed.
+
+    Milk (top 16 oz.)     18 ounces.
+    Milk-sugar             2 ounces.
+    Lime-water             4 ounces.
+    Water to make         40 ounces.
+
+Six feedings in twenty-four hours; 4 to 5 ounces at each feeding.
+
+
+From the fifth to the seventh month:
+
+    Milk (top 16 oz.)      21 ounces.
+    Milk-sugar              2 ounces.
+    Lime-water              5 ounces.
+    Water to make          42 ounces.
+
+Six feedings in twenty-four hours; 5 to 7 ounces at each feeding.
+
+
+From the seventh to the ninth month:
+
+    Milk (top 16 oz.)       27 ounces.
+    Milk-sugar           2-1/2 ounces.
+    Lime-water               6 ounces.
+    Water to make           48 ounces.
+
+Five to seven feedings in twenty-four hours; 6 to 8 ounces at each
+feeding.
+
+
+From the ninth to the twelfth month:
+
+    Milk (top 16 oz.)            35 ounces.
+    Milk-sugar                2-1/2 ounces.
+    Lime-water                    6 ounces.
+    Water to make                56 ounces.
+
+Five to six feedings in twenty-four hours; 7 to 9 ounces at each
+feeding.
+
+It will be observed that 16 ounces of top-milk is used to make the
+various formulas from. This means that the mother will dip off, with a
+Chapin dipper, 16 ounces from the top of a bottle of milk which has
+stood for four or five hours to allow the cream to rise; she will then
+mix this and take from the mixture the number of ounces called for in
+the formula she is using according to the age of the child. The ordinary
+milk that is delivered in New York City may be assumed to have stood the
+four or five hours necessary. This may not be so, however, in the
+country, as it is frequently delivered there as soon as it is milked. In
+such cases the mother will permit it to stand in the ice box until the
+cream has risen.
+
+When the mother is about to make the mixture called for in feeding from
+the third to the fifth month she will observe that 18 ounces of milk is
+called for. Now since she only uses 16 ounces of the top-milk from one
+bottle this will not be enough. She must therefore use 16 ounces from
+two bottles of milk; this she will mix together and from this mixture
+she will take the 18 ounces wanted. Whatever milk is left over may be
+used for ordinary table purposes.
+
+
+EASY BOTTLE-FEEDING METHOD
+
+The following formulas and instructions for bottle-feeding are taken
+from the Rules for the Care of Infants and Young Children which are used
+by Dr. Kerley at the out-patient department of the Babies' Hospital and
+give the simplest and easiest means of bottle-feeding:
+
+     BOTTLE-FEEDING.--The bottle should be thoroughly cleansed with
+     borax and hot water (one teaspoonful of borax to a pint of
+     water) and boil before using. The nipple should be turned
+     inside out, scrubbed with a brush, using hot borax water. The
+     brush should be used for no other purpose. The bottle and
+     nipple should rest in plain boiled water until wanted. Never
+     use grocery milk. Use only bottled milk which is delivered
+     every morning. From May 1st to October 1st the milk should be
+     boiled five minutes immediately after receiving. Children of
+     the same age vary greatly as to the strength and amount of food
+     required. A mixture, when prepared, should be put in a covered
+     glass fruit-jar and kept on the ice. For the average baby the
+     following mixture will be found useful:
+
+     "For a child under six weeks of age: Nine ounces of milk,
+     twenty-seven ounces of barley-water, four teaspoonfuls of
+     granulated sugar. Feed from two to three ounces at two and
+     one-quarter hour intervals, nine feedings in twenty-four hours.
+
+     "Sixth to the twelfth week: Twelve ounces milk, twenty-four
+     ounces barley-water, five teaspoonfuls sugar. Feed from three
+     to four ounces at each feeding.
+
+     "Third to the sixth month: Eighteen ounces of milk, thirty
+     ounces of barley-water, six teaspoonfuls of sugar. Feed four to
+     six ounces at three-hour intervals, seven feedings in
+     twenty-four hours.
+
+     "Sixth to the ninth month: Twenty-four ounces milk, twenty-four
+     ounces barley-water, six teaspoonfuls granulated sugar. Feed
+     six to eight ounces at three-hour intervals, six feedings in
+     twenty-four hours.
+
+     "Ninth to twelfth month: Thirty-eight ounces milk, twelve
+     ounces barley-water, six teaspoonfuls of granulated sugar. Feed
+     seven to nine ounces at three and one-half hour intervals, five
+     feedings in twenty-four hours."
+
+BARLEY-WATER.--The barley-water used in the above formulas may be made
+in the following way: To two teaspoonfuls of pearl barley, add one quart
+of water, and boil continuously for six hours, keeping the quantity up
+to a quart by the addition of water; strain through coarse muslin. The
+barley will be better if it is soaked for a number of hours, or over
+night, before cooking. The water in which it is soaked is not used.
+
+An equally good barley-water may be made in an easier way by using
+Robinson's prepared barley. This may be procured in the drug stores. It
+is only necessary to take one even tablespoonful of this barley to
+twelve ounces of water and cook for twenty minutes.
+
+CONDENSED MILK.--When the mother cannot afford to buy bottled milk from
+the wagon, when she has no ice-chest and cannot afford to buy ice, she
+should not attempt cow's-milk feeding, but may use canned condensed milk
+as a substitute during the hot months only. The can, when opened, should
+be kept in the coolest place in the apartment, carefully wrapped in
+clean white paper or in a clean towel. The feeding hours are the same as
+for fresh cow's milk:
+
+"Under three months of age: Condensed milk one-half to one teaspoonful;
+barley-water, two to four ounces.
+
+"Third to sixth month: Condensed milk, one to two teaspoonfuls;
+barley-water, four to six ounces.
+
+"Sixth to ninth month: Condensed milk, two to three teaspoonfuls;
+barley-water, six to eight ounces.
+
+"Ninth to twelfth month: Condensed milk, three teaspoonfuls;
+barley-water, eight to nine ounces."
+
+OBJECTIONS TO CONDENSED MILK FEEDING.--Condensed milk is not to be
+recommended as a permanent food where good cow's milk can be obtained.
+In most cases it should be used as the sole food for a few weeks only.
+It may be used when the digestion is impaired for some reason. If the
+symptoms are intestinal it will be more apt to agree than if they are
+caused by stomach ailments. The symptoms of intestinal disturbances
+are,--colic, flatulence (gas), curds or specks in the stools,
+constipation or diarrhea. It will not be found suitable if the child is
+simply vomiting.
+
+The objections to condensed milk are: It is very rich in sugar and very
+deficient in proteids and fat. Children fed on condensed milk often gain
+very rapidly in weight but have little strength or resistance. They do
+not fight disease well for this reason; they are apt to develop rickets
+and scurvy.
+
+
+
+
+CHAPTER XX
+
+ARTIFICIAL FEEDING--CONTINUED
+
+     How to Prepare Milk Mixtures--Sterilizing the Food for the
+     Day's Feeding--How to Test the Temperature of the Food for
+     Baby--When to Increase the Quality or Quantity of Food--Food
+     Allowable During the First Year in Addition to Milk--Beef
+     Juice--White of Egg--Orange Juice--Peptonized Milk--The Hot or
+     Immediate Process--The Cold Process--Partially Peptonized
+     Milk--Completely Peptonized Milk--Uses of Peptonized
+     Milk--Objections to Peptonized Milk--What a Mother Should Know
+     About Baby's Feeding Bottle and Nipple--Should a Mother Put Her
+     Baby on Artificial Food if Her Supply of Milk, During the First
+     Two Weeks is not Quite Enough to Satisfy it--Certain Conditions
+     Justify the Adoption of Artificial Feeding from the
+     Beginning--Mothers' Mistakes in the Preparation of Artificial
+     Food--Feeding During the Second Year--Sample Meals for a Child
+     Three Years of Age--The Diet of Older Children--Meats,
+     Vegetables, Cereals, Bread, Desserts--Fruits.
+
+
+HOW TO PREPARE MILK MIXTURES
+
+The mother should always remember, that the secret of success in raising
+a baby efficiently on artificial food is to be cleanly and to be exact.
+The bottles and the nipples must be scrupulously clean; the hands of the
+mother must be clean; the water used must be boiled and each ingredient
+must be measured exactly.
+
+First dissolve the sugar in the boiled water, which must be the exact
+quantity; then remove the top-milk and measure the exact amount wanted
+in the graduate, pour into the jar, add the water and sugar mixture, and
+finally the lime water.
+
+It is always desirable to make the entire quantity for the day at one
+time. After the total quantity has been mixed in the jar, fill each
+bottle with the amount for each feeding, put in a cotton stopper, and
+place the bottles in the ice box.
+
+In measuring the sugar, it should be remembered that two scant
+dipperfuls equal one ounce by weight of the sugar.
+
+When each individual bottle is to be filled, do it with the aid of the
+glass funnel which has been previously sterilized.
+
+STERILIZING THE FOOD FOR THE DAY'S FEEDING.--The simplest method is to
+place the two-quart jar containing the milk mixture for the next
+twenty-four hours' feeding upon a saucer in the bottom of an open pan,
+and then to pour enough tepid water into the pan (outside of the jar)
+until it will come up as high as the milk level. The water in the pan is
+then brought slowly to the boiling point. The pan is then moved to the
+back of the stove and left for half an hour. The jar is then removed and
+rapidly cooled by allowing cool water to flow over the outside; the
+individual bottles filled and put in the ice box.
+
+It is always wise to taste the milk before making up the day's feeding
+to be sure it is not sour. The milk from a herd of good cows is always
+better than the milk from one cow no matter how good that one cow may
+be.
+
+When about to feed the baby, the bottle is taken out of the ice box and
+heated to the desired temperature in a water bath. The temperature of
+the milk can be tested by allowing a few drops to fall on the wrist; it
+should feel warm, not hot; it should not be tasted by putting the bottle
+to the mouth of the nurse, or mother, as it may become infected by doing
+so. A flannel cover, or bag, should be made to fit the bottle and it
+should be put on while the baby is nursing so that the milk may retain
+its heat. The baby must not be disturbed while nursing, nor should he be
+jounced or carried around after nursing. These habits cause vomiting and
+indigestion. He should be put in his crib.
+
+WHEN TO INCREASE THE QUALITY OR QUANTITY OF FOOD.--Children of the same
+age may have different digestive abilities. A strong, robust child may
+be permitted to take a richer quality of milk than a weak, puny infant
+of the same age. If the quality or quantity of each feeding is too weak
+or small for the baby he will be dissatisfied and he will cry after the
+feeding. In such cases, if the bowel discharges are natural and yellow
+without curds or white specks, and if he is not gaining sufficiently in
+weight, the next stronger formula may be tried. If it is decided to put
+him on the stronger mixture, it is wise to cut the quantity down for a
+day or two in order to test out his digestive ability. If the stools
+remain good after three days, the quantity may be slowly increased until
+the amount in the recipe is allowed. It is a much more serious risk to
+overfeed the baby than to underfeed him. If too large a quantity is
+given, he may vomit it at once, or he may develop colic with intestinal
+indigestion. Such babies lose weight, become fretful and irritable, even
+though the appetite may remain good. If too strong a quality is given he
+may vomit sour, buttery-smelling milk, or have colic, and pass curds in
+the stool. If this happens it may be necessary to go back to a weak
+formula and work up from that standard. This is always a tedious and
+anxious experience and may lay the foundation for digestive disturbances
+for a long time. Don't be too anxious to increase the quality, or
+quantity, of your baby's food. It is much better to go slow and have a
+well baby, than to try to force matters and get into all kinds of
+trouble. No science calls for more elementary common sense, than the
+science of infant therapy.
+
+Digestive disturbances incident to this period are fully explained in
+the chapter on Diseases of Children.
+
+
+FOOD ALLOWABLE DURING THE FIRST YEAR, IN ADDITION TO MILK
+
+About the twelfth month the baby should receive plain milk mixtures
+instead of the top-milk heretofore used in making up the food. At first
+the milk may be plain milk from an ordinary bottle shaken up. Of this he
+may take five ounces, to which may be added three ounces of barley
+water. The barley water may be gradually withdrawn, an ounce at a time,
+replacing this amount with milk, until the child is taking eight ounces
+of milk and two ounces of barley water. Later plain mixed milk will be
+suitable for a child about the fourteenth month.
+
+Barley water may be added to the milk at any time after the third month
+in place of the plain boiled water in the preceding formulas. It is
+advisable to do this if there is any trouble with digestion, or if there
+are curds in the stools. Some children take more kindly to barley water
+than plain water at a very early age.
+
+BEEF JUICE.--The juice squeezed from broiled steak may be given a child
+at about the eighth or ninth month, or, in cases of anemia, earlier than
+this. It is given before the milk feeding, diluted with an equal amount
+of water. At first a teaspoonful of the extracted juice should be given
+with the same quantity of water; increase every four days until at the
+end of two or three weeks two tablespoonfuls are given.
+
+WHITE OF EGG.--Place an egg in boiling water and allow the water to cool
+with an egg in it. In ten minutes the white of the egg will be
+coagulated and ready for use. It may be used in place of the beef juice
+if the latter does not agree and may be begun at the sixth month and
+given once daily. One-half of the white of the egg should be tried, then
+at the end of a week, if it agrees with the child, the whole white of
+one egg may be given.
+
+ORANGE JUICE.--This juice has a good effect on the bowels and may be
+given even to very young children who are disposed to be constipated. It
+is also of benefit in counteracting the effect of boiled milk. The juice
+should be extracted from fresh oranges and strained. One teaspoonful may
+be given at first one hour before a feeding. The amount may be increased
+until four teaspoonfuls, or one tablespoonful, are given daily.
+
+PEPTONIZED MILK.--The object of peptonization of milk is partly or
+wholly to digest the casein, or curd, of the milk before feeding.
+
+Fairchild's Peptonizing Powder is used for this purpose. The powder is
+put up in tubes, and instructions are furnished in each box as to its
+use.
+
+There are two methods of using the powders:
+
+THE HOT OR IMMEDIATE PROCESS.--Fifteen minutes before feeding add from
+one-eighth to one-quarter of the contents of a tube to the milk mixture
+in the nursing bottle ready for use. The bottle is then put in water at
+a temperature of from 110° to 120° F., and allowed to remain in the
+water for fifteen minutes. The amount of the powder used and the
+temperature of the water depend upon the amount of milk in the nursing
+bottle.
+
+THE COLD PROCESS.--Four ounces of cold water are put into a clean quart
+bottle and the powder from one of the tubes. Shake the mixture
+thoroughly until the powder is dissolved. Add a pint of cold fresh milk,
+shake the bottle again and place directly on ice. When any of this milk
+is used the bottle should be again shaken and put immediately back on
+ice.
+
+If necessary this process may be modified so that partially or
+completely peptonized milk may be made.
+
+PARTIALLY PEPTONIZED MILK.--Put four ounces of water and a whole tube of
+powder into a clean pan and stir well; add a pint of cold milk and heat
+to the boiling point, stirring the mixture all the time. There should be
+enough heat to bring the milk to the boiling point in ten minutes. Allow
+the mixture to cool somewhat and strain into a clean jar, cork tightly
+and keep in a cool place. Shake the jar before and after using any of
+the contents.
+
+If partially peptonized milk is properly prepared it should not become
+bitter.
+
+COMPLETELY PEPTONIZED MILK.--Put four ounces of cold water and the
+powder contained in one of the tubes into a clean quart bottle and shake
+thoroughly. Add a pint of cold fresh milk and shake again; then place
+the bottle in a pan of warm water about 115° F., or not too hot to place
+the hand in comfortably. Keep the bottle in the water bath for thirty
+minutes; then place the bottle directly on ice.
+
+USES OF PEPTONIZED MILK.--Partially peptonized milk is useful in young
+infants who have difficulty in digesting the curd of milk. Completely
+peptonized milk is frequently used during attacks of indigestion. It is
+used also to tide a delicate infant over a period when for some reason
+the digestive apparatus refuses to digest and assimilate even dilute
+mixtures. It is of value also in acute or chronic illness when the child
+has to be fed through a tube. When it is necessary to feed per rectum
+peptonized foods are often selected in preference to others.
+
+OBJECTIONS TO PEPTONIZED MILK.--Complete peptonization of milk renders
+the milk bitter. For this reason many children will not take it. Very
+young children whose sense of taste is not developed may be induced to
+take it after a few days. It is not wise to continue its use long
+because the function of the stomach will become accustomed to the use of
+predigested food and refuse to work when called upon. If it is used for
+a number of weeks it is wise to stop it gradually in order to permit the
+stomach to resume its function in a normal way.
+
+WHAT A MOTHER SHOULD KNOW ABOUT BABY'S FEEDING BOTTLE AND NIPPLE.--In
+the first place, always buy round bottles,--round everywhere, inside and
+out,--there should be no corners anywhere. The reason for this is, that
+bottles that are round everywhere, are easily cleaned, and can be
+thoroughly cleaned, and having no corners they do not lend themselves to
+collecting dirt and bacteria. When these bottles are first bought they
+should be boiled. After each feeding they should be thoroughly washed
+with soap or washing powder. A long-handled bottle brush should be used
+to help clean the bottle. After the bottle has been thoroughly rinsed a
+number of times with hot water, it should be set aside filled with warm
+water into which one teaspoonful of bicarbonate of soda has been put.
+Before filling them with the freshly prepared food each morning the
+bottles should be boiled. Every mother with a bottle-fed baby should buy
+a dozen bottles, all of the same kind and size to begin with. This is a
+great advantage for a number of important reasons, two or three of which
+I will mention:
+
+1st. Having enough bottles means that each bottle will be used once only
+during the twenty-four hours; there is less chance therefore of a bottle
+being cleaned carelessly.
+
+2nd. Having a fresh bottle for each feeding permits all of the food for
+twenty-four hours being made at one time. This ensures uniformity of
+quality of each feeding.
+
+3rd. By cleaning all the bottles at one time (previous to filling) it is
+more apt to be done thoroughly; and by making all the food for a day at
+one time it is more apt to be correct than if each feeding was made
+separately.
+
+The baby's nipple should be made of plain black rubber. It should not be
+too thick because it is necessary to turn it inside out in order to
+clean it thoroughly. The hole in the nipple should not be too large--if
+the child can empty the bottle in less time than fifteen minutes the
+hole is too large. If the milk drops out but does not run it is about
+right. Don't buy nipples too long or too large. A long nipple tends to
+gag the child and cause vomiting. A large nipple prevents the child from
+sucking properly and usually allows the food to be taken too quickly and
+with air, which causes colic and indigestion. It is well to have always
+half a dozen nipples of the right kind on hand. When new, nipples should
+be boiled before using. After each feeding the nipple should be washed
+in borax and water on both sides, then it should be put in a dish
+containing fresh, cold, borax water and left there until again required.
+A large portion of the success of raising healthy, bottle-fed babies is
+in being everlastingly clean in the details of caring for the bottles
+and nipples which are in daily use.
+
+SHOULD A MOTHER PUT HER BABY ON ARTIFICIAL FOOD IF HER SUPPLY OF MILK,
+DURING THE FIRST TWO WEEKS, IS NOT QUITE ENOUGH TO SATISFY IT?--This is
+a question that cannot be answered by a simple yes or no. A great deal
+depends upon circumstances, and these circumstances must be weighed and
+counterweighed before an answer is given. It is a serious matter, in our
+judgment it is a criminal proceeding for a physician to advise the use
+of an artificial food without exhausting every aid and means to preserve
+and increase the mother's milk. This is a subject in need of earnest
+missionaries in all walks of life, and it should be the duty of every
+woman's club and gathering to voice the conviction of the highest
+womanhood by advocating the use of mother's milk with every child born.
+A woman who can and will not nurse her own child is scarcely deserving
+of the name of mother.
+
+It does not seem quite human to deprive a baby of the milk which
+rightfully belongs to it; yet in certain walks of life this is not an
+uncommon procedure. On the other hand the percentage of women able to
+nurse their children is decreasing. This is especially true as applied
+to cities, though it is also true, in a less degree, in the rural
+districts. One eminent authority states that less than twenty-five per
+cent. of the well-to-do mothers, who have earnestly and intelligently
+attempted to nurse their babies, succeed in doing so for a period longer
+than three months. This authority also says: "An intellectual city
+mother who is able to nurse her child successfully for the entire first
+year is almost a phenomenon." Women nowadays have so many diversified
+interests, that the primal duty of maternal nursing is not at all a
+fashionable function. If, however, the mother is willing, and has
+conscientiously tried to nurse her baby, and after seven or eight days
+it is found that she has not enough milk to satisfy it, and if the
+quality seems to be good, some expedient should be immediately adopted
+to tide the condition over until the mother resumes her customary
+household routine. The safest expedient under these circumstances is to
+alternate the feedings; one feeding from both breasts of the mother, and
+the next an artificial food. Some arrangement of this kind is the just
+and the safest way, because a very large percentage of mothers suffer
+from inactivity while lying in bed after a confinement. This inactivity
+expresses itself in a failure of some of the organs to perform their
+duty properly. This may affect the quantity, and sometimes the quality,
+of the milk, but it is, as a rule, quickly rectified as soon as the
+mother is up and active.
+
+If, however, the milk is still found to be inadequate after she is up
+and has resumed her usual habits, and if her health is good, and she is
+eating well, it is distinctly best to put the child exclusively on an
+artificial diet.
+
+
+CERTAIN CONDITIONS JUSTIFY THE ADOPTION OF ARTIFICIAL FEEDING FROM THE
+BEGINNING
+
+1st. Woman suffering with any wasting disease such a cancer or
+tuberculosis. (One of these days, and very soon we hope, it will be
+legally impossible for a tubercular or cancerous patient to become a
+mother.)
+
+2nd. When a mother is the victim of any of the serious childbed
+complications such as convulsions, kidney disease, extensive loss of
+blood or blood poisoning, or runs a high temperature because of some
+disease occurring at the same time as the confinement, as, for example,
+appendicitis, scarlet fever, typhoid fever, etc.
+
+3rd. Epilepsy, chorea, insanity, are also conditions which render
+artificial feeding necessary.
+
+It is much wiser immediately to put the child on artificial feeding if
+there is a justifiable reason for it than to experiment, because any
+experiment at this time is almost certain not to be in favor of the
+child. Artificial feeding is a comparatively easy and successful
+problem, provided it is begun with healthy digestive organs. If you keep
+the child at the breast of a mother whose milk is inadequate in quantity
+or quality, or both, for two or three days, and then begin artificial
+feeding, the child's stomach is already unable to perform its duty, and
+you have to treat it with the greatest degree of care and attention, and
+probably begin with a weak food, until you regain the lost ground.
+
+MOTHERS' MISTAKES IN THE PREPARATION OF ARTIFICIAL FOOD.--Another
+interesting condition which is quite common, is the tendency on the part
+of the mother to fail to follow instructions correctly,--even though
+written or printed,--regarding the preparation of the baby's food. When
+the baby is not thriving and gaining steadily in weight, or is fretty
+and cries a good deal, and does not rest and sleep peacefully,
+something, of course, is wrong. If, after a careful physical examination
+of the child, nothing is found to justify these symptoms, a physician
+invariably finds, if he questions the mother closely, that she has
+mistaken the instructions and is preparing the food wrongly.
+
+Infinite care in every little detail is the price of success in raising
+babies as well as in every other field of human endeavor. Revise
+carefully your method of preparing baby's food if there is any trouble
+such as is described above. Despite your absolute assurance that you are
+making no mistake, do not be surprised to find that you are not
+following directions to the letter, and because of this unintentional
+mistake, your negligence is responsible for your baby's condition. Go
+over the instructions with your husband, and let him follow your method
+of preparation, as you repeat it. He may detect the mistake if any
+exists,--two heads are always better than one. So important is this
+matter that the following two actual cases will demonstrate how easy it
+is to make a mistake, despite the absolute confidence of the mother, in
+each case, that she was following the printed directions correctly:
+
+I was called to see a baby whose mother informed me that it was having a
+great deal of trouble. It was apparently not thriving; its bowels were
+bad; it constantly cried, and seemed to be suffering from colic and
+indigestion. The mother stated that it lay with its legs constantly
+drawn up and passed enormous quantities of gas. The baby certainly
+looked sick. It had been a small baby at birth; and at three months it
+weighed only six pounds. After a careful examination, I could find
+nothing in the physical condition of the child itself, which
+satisfactorily explained the condition, and had made up my mind that the
+food upon which it was being exclusively fed, and upon which it had been
+fed since birth, was not agreeing with it. Before recommending a change
+of food, I asked the mother to state in detail just how she prepared it.
+
+The directions printed on the can in which the food was bought called
+for so many ounces of a certain quality of "top milk." She thought this
+meant simply so many ounces off the top of a bottle of milk, which, of
+course, meant that she was feeding her baby exclusively a very rich
+cream and absolutely no milk. The result was that the baby--small and
+weak to begin with--could not digest this rich mixture, so it gradually
+lost vitality, as the mother kept increasing the strength of the food,
+according to the age, as directed by the instructions, until it was
+completely knocked out. I pointed out her mistake and suggested a change
+in her methods; she was instructed to use the formula for a child of two
+months, instead of the one for three months, as she was doing. The child
+immediately began to pick up and in the course of six weeks was entirely
+cured, and had gained considerably in weight. This mother was a
+careful, clean, painstaking, attentive nurse, and it was a long time
+before she forgave herself for the mistake. The mistake here was a
+little matter, but the results were big and convincing.
+
+The second case was that of a child of about the same age, but in this
+instance it had been a robust, healthy child when born, and of normal
+weight and size. The mother nursed it for about one month, when her milk
+failed, and it was put upon a well-known, patent barley preparation. The
+food seemed to agree with it for a time, but, as the mother explained,
+the child soon seemed to be dissatisfied at each feeding,--it gave her
+the impression that it was not getting enough to eat, so she increased
+the quantity. Despite this increase of food, it was apparent that the
+baby was getting weaker, and more and more irritable, and sleepless,
+until there was no rest night or day for the mother or baby. About this
+time the child began to "swell up" as if dropsical; it lost its healthy
+color and looked as if made of wax. It was very evident that the child
+was being starved, yet this scarcely seemed probable when the actual
+quantity of food consumed was considered. The directions on the can of
+this food, called for a certain amount of the barley powder to be mixed
+with boiled water; and in an additional paragraph it was directed to mix
+this with a certain amount of milk. When I requested the mother to state
+how she prepared the food, I was astonished to learn that she had
+evidently never read the second paragraph of the directions. She was
+feeding her baby on barley powder and boiled water,--an excellent
+starvation diet. When her attention was called to the grave carelessness
+she had been guilty of, she was the most contrite mother I ever knew. As
+soon as the milk was added to the food the baby immediately began to
+thrive was very soon a robust, healthy infant.
+
+Of course these were errors of bad judgment and gross negligence of
+which few mothers would be guilty, but these types of mistakes come to
+the attention of physicians frequently, and emphasize the need of
+constant vigilance in every detail in the management of babies if we
+wish to achieve success.
+
+
+FEEDING DURING THE SECOND YEAR
+
+At the beginning of the second year the child should be fed at the
+following hours, 6 and 10 A. M., 2, 6, and 10 P. M.
+
+Early in the second year the child should be taught to drink from a cup.
+
+A proper diet for a child of twelve months, of average development,
+would be as follows:
+
+6 A. M. Milk and barley water, or milk and oat gruel, in the proportion
+of seven ounces of milk to three ounces of the diluent.
+
+9 A. M. The juice of an orange (strained).
+
+10 A. M. The same as at 6 A. M.
+
+2 P. M. Chicken broth with rice or stale bread crumbs, six ounces; or a
+light boiled egg mixed with stale bread crumbs; or beef juice, three
+ounces. Milk and gruel same as at 6 A. M., but four ounces only.
+
+6 P. M. Two tablespoonfuls of cereal jelly in eight ounces of milk; a
+piece of stale bread and butter. (The jelly is made by cooking the
+cereal for three hours the day before it is wanted; it should then be
+strained through a colander; oatmeal, barley, or wheat may be used.)
+
+10 P. M. Same as at 6 A. M.
+
+About the fifteenth month the cereals may be given much thicker and fed
+with a spoon. The child can at this time take a number of various fruit
+juices. Orange juice is the best. Carefully strained juice of ripe
+peaches, strawberries, raspberries, may be given in reasonable amounts,
+one or two tablespoonfuls, once daily. Custard, cornstarch, plain rice
+pudding, junket, wheatena, cornmeal, hominy, oatmeal, zwieback, bran
+biscuit, each with butter, may be added in reasonable quantities between
+the eighteenth and twenty-fourth months. When cereals are given they
+should be thoroughly cooked, usually for three hours, and strained. When
+apple sauce is given to a child about the second year it should contain
+very little sugar and baked apples should be fed without cream. Water
+must be given to the child between meals especially during the summer.
+It should be boiled and cooled kept in a cool place. The following
+schedule for a child about the third year constitutes a good average
+diet for a healthy child:
+
+
+TABLE OF STANDARDS
+
+(As Adopted and Copyrighted by the American Medical Society)
+
+PHYSICAL DEVELOPMENT
+
+[Transcriber's Note: The ages were difficult to read and may not all be
+correct.]
+
+Age in Months
+   Weight
+          Height
+                  Circumference of head
+                            Circumference of chest
+                                    Circumference of abdomen
+                                            Lat. Diameter of chest
+                                                   Chest front to back
+                                                          Length of arm
+                                                                  Length of leg
+-------------------------------------------------------------------------------
+   lbs.   in.      in.      in.     in.     in.    in.    in.     in.
+ 6   17    27      17-1/2   17-1/2  17-1/2  5      4-1/2  10      10
+ 9   19    28      18       18      18      5      4-1/2  11      11
+12   20    29      18-1/2   18-1/2  18-1/2  5      4-3/4  12      12-1/2
+16   23    30      18-1/2   18-1/2  18-1/2  5-1/2  5      12-1/2  13-1/2
+21   24    31      18-1/2   19-1/2  19-1/4  6      5      14      15
+24   25    32      19       20      19-1/2  6      5      14-1/2  15-1/2
+28   27    33-1/2  19       20      19-1/2  6      5      14-3/4  15-3/4
+32   29    35      19-1/2   20-1/2  19-1/2  6-1/4  5-1/2  14-3/4  15-3/4
+36   32    36-1/2  20       21      20      6-1/4  5-1/2  15      16-1/2
+===============================================================================
+
+
+MENTAL DEVELOPMENT
+
+     Attention, facial expression, irritability and disposition
+     should be considered.
+
+     Six Months
+
+     Child sits unsupported for a few minutes.... Balances head....
+     Eye follows a bright object.... Looks in direction of an
+     unexpected sound.... Child seizes an object and holds it....
+
+     Twelve Months
+
+     Stands and walks with support.... Makes a few sounds, such as
+     mam-mam, da-da, co-oo.... Plays with toys.... Attempts to use
+     paper and pencil.... Shows interest in pictures.... Clings to
+     mother....
+
+     Eighteen Months
+
+     Child walks and runs alone.... Says a few words, such as Mama,
+     Papa, Baby.... Points to common objects in pictures....
+     Imitates a few simple movements, such as placing hands on head
+     or clapping hands....
+
+     Two Years
+
+     Runs.... Repeats two or three words.... Knows features....
+     Obeys simple commands, such as "Throw me the ball".... Imitates
+     movements....
+
+     Two and One-Half Years
+
+     Talks in short sentences.... Knows names of members of the
+     family.... Roughly copies a circle.... Recognizes self in
+     mirror.... Imitates more complex movements....
+
+     Three Years
+
+     Talks distinctly.... Repeats sentences of six simple words....
+     Repeats up to two numerals--meaning repeats first one numeral
+     and then two numerals.... Enumerates objects in a complex
+     picture and attempts to describe it....
+
+     Four Years
+
+     Knows its sex.... Names familiar objects, such as key, knife,
+     etc..... Repeats three numerals.... Compares two sticks (can
+     select the longer).... Distinguishes the longer of two
+     lines....
+
+     Five Years
+
+     Compares weights and lengths.... Copies a square.... Counts
+     four pennies.... Describes a picture....
+
+Breakfast:--(7 to 8 o'clock) Oatmeal, hominy or cracked wheat (cooked
+three hours), served with milk, a little salt but very little sugar. A
+soft egg, boiled, poached, or coddled. Stale bread and butter. One glass
+of warm milk. At 10 o'clock, the juice of one orange.
+
+Dinner:--(12 o'clock) Strained soup, four ounces. Chop, roast beef,
+steak, chicken, small quantity of any one. Baked potato and cooked rice,
+or spaghetti. A selection of green vegetables may be made from asparagus
+tips, string beans, peas, spinach, cauliflower, carrots; they should be
+cooked until very soft, and mashed or put through a sieve. For dessert,
+plain rice pudding or bread pudding, stewed prunes, baked or stewed
+apple, junket, custard or cornstarch. A glass of milk or water.
+
+Supper:--(6 o'clock) Cereal; farina, arrowroot, cream of wheat, wheatena
+(each cooked two hours), with salt but no sugar. Give two or three
+tablespoonfuls. Drink of milk with stale bread and butter. Twice a week,
+a little plain ice cream, or junket, custard or cornstarch.
+
+Three meals a day at this time are better than more frequent feedings.
+The child has a better appetite and much better digestion. It may be
+found necessary to give delicate children a luncheon at 3 o'clock. A
+glass of milk and a Graham wafer, or a cup of broth and a zwieback, will
+answer the purpose. Children recovering from serious illness will need
+more frequent nourishment. Up to the sixth year the diet may conform to
+the above schedule, increasing the individual quantities as
+circumstances may warrant.
+
+
+THE DIET OF OLDER CHILDREN (FROM SIX TO TEN YEARS)
+
+After the sixth year the diet will conform to the adult diet, with
+certain exceptions. The important exceptions are as follows: All meats
+are to be excluded except roast beef, steak, lamb chops, roast lamb,
+mutton chop; all meats should be cooked rare and either scraped or
+finely divided. They should be broiled or roasted, never fried, and
+never given oftener than once daily, and then only in small quantity.
+Pies, rich puddings, pastries of all kinds, gravies, sauces, all highly
+seasoned dishes; wine, beer, coffee, tea, should never be given to
+children. Ham, bacon, sausage, pork, liver, kidney, game, and all dried
+and salted meats, codfish, mackerel and halibut, are particularly bad.
+
+The following articles are permissible: Broiled chicken, shad, bass. The
+"platter gravy" from a roast is very nourishing if given in small
+amounts. Milk should continue to form an important part of the dietary
+up to the tenth year. It should be clean and fresh but not too rich.
+Sometimes it is found advisable to dilute the milk with water that has
+been boiled and cooled. Some children will take it if a pinch of salt or
+bicarbonate of soda is put into it, and they will digest it easier and
+better. They should never be allowed to take more than one quart daily
+and frequently less will do more good. Cream is not good for children of
+this age. Eggs are valuable; they should never be given fried or in the
+form of omelets, they are best given boiled, poached or coddled and only
+slightly cooked. It is never necessary to give more than one egg at a
+meal. There are children with whom eggs do not agree; these children are
+disposed to "biliousness."
+
+VEGETABLES.--Certain vegetables are objectionable at this age: Raw
+celery, radishes, raw onions, cucumbers, tomatoes, lettuce, corn, lima
+beans, cabbage, egg plant. The following are good: White potatoes (never
+fried), spinach, peas, asparagus tips, string beans, celery, young
+beets, carrots, squash, turnips, boiled onions and cauliflower. It is
+important to remember that all vegetables should be thoroughly cooked;
+they cannot be cooked too much. After boiling for some time the water
+should be drained off and fresh water used to complete cooking.
+Vegetables should be fed in small quantities. From the third to the
+tenth year they form an important and essential part of the diet of all
+children. After the tenth year they can be eaten as served to adults,
+and other vegetables may then be added. As a rule salads of all kinds
+should be omitted until after the twelfth year.
+
+CEREALS.--Children should not be allowed to eat too much cereal at one
+meal,--never more than one small saucerful. Cereals should be properly
+cooked. It is not safe to adhere strictly to the directions on the
+package of any cereal. As a rule they require much longer cooking. They
+are best cooked in a double boiler. They may be served with milk, salt,
+and not more than one teaspoonful of sugar.
+
+BREAD.--Fresh bread is never allowable. Graham wafers, oatmeal crackers,
+Huntley and Palmer breakfast biscuits, bran muffins, rye bread, corn
+bread, stale rolls, are all suitable to growing children.
+
+Hot bread, fresh rolls, buckwheat or griddle cakes, all sweet cakes, are
+objectionable.
+
+DESSERTS.--The only permissible desserts for this age are junket,
+custards, plain rice, or sago; or bread pudding. The only safe rule to
+follow so far as "sweet things" are concerned, is not to give them at
+all. This applies to candy, ice cream, pies, pastries, jam, syrups,
+preserved fruits, nuts and dried fruits. The parent who indulges a child
+to "a taste," is guilty of a bad habit, and it can only lead to trouble.
+
+FRUITS.--These should always be fresh and selected with care. Fruit is
+the most important article of diet to a child of this age. Up to five
+years it is safest to use only cooked fruits and fresh fruit juices: of
+these the juice from sweet oranges, grape fruit, peaches, strawberries,
+and raspberries may be given. Stewed or baked apples, apple sauce, figs,
+prunes, peaches, apricots, pears are excellent because of their effect
+on the bowels. When the bowels are loose, and especially in hot weather,
+great care must be taken when fruit of any kind is used. The pulp of any
+fruit should never be used; cherries, bananas, pineapples, and berries
+are not to be given to children. Milk should never be allowed at the
+same meal when sour fruit is served.
+
+
+
+
+WHAT MOTHERS SHOULD KNOW
+
+
+
+
+CHAPTER XXI
+
+     "Life has taught me that it is the women of a country in whose
+     hands its destiny reposes. No cause that is not great enough to
+     command their devotion and pure enough to deserve their
+     sympathy can ever wholly triumph."
+
+     JOSEPH H. CHOATE.
+
+THE EDUCATION OF THE MOTHER
+
+     What Mothers Should Know About the Care of Children During
+     Illness--A Sick Child Should be in Bed--The Diet of the Sick
+     Child--A Child is the Most Helpless Living Thing--The Delicate
+     Child--How to Feed the Delicate Child--How to Bathe the
+     Delicate Child--Airing the Delicate Child--Habits of the
+     Delicate Child--Indiscriminate Feeding--Poor Appetite--Loss of
+     Appetite--Treatment of Loss of Appetite--Overeating in
+     Infancy--What Correct Eating Means--Bran as a Food--Breakfast
+     for a Child at School--Lunch for a Child at School--Bran
+     Muffins for School Children--Bran Muffins in
+     Constipation--Hysterical Children--What a Mother Should Know
+     About Cathartics and How to Give a Dose of Castor Oil--Castor
+     Oil--Calomel--Citrate of Magnesium--When to Use Castor
+     Oil--When to Use Calomel--Vaccination--Time for
+     Vaccination--Methods of Vaccination.--Symptoms of Successful
+     Vaccination.
+
+
+WHAT MOTHERS SHOULD KNOW ABOUT THE CARE OF CHILDREN DURING ILLNESS
+
+Every child has a certain amount of vitality and resistance. When
+illness comes it should be our duty to maintain the vitality and
+resistance to the highest degree. We should, therefore, irrespective of
+the nature of the illness, surround the child with all the conditions
+that will minister to the preservation of whatever strength and vitality
+the child has. Experience has taught us that there are certain
+requirements that should be carried out in the general management of
+sick children.
+
+A SICK CHILD SHOULD BE IN BED.--In the first place a sick child should
+be in bed. There is no exception to this rule. It is impossible to do
+justice to a child if you allow him to dissipate his strength and
+exhaust himself moving from place to place while he is sick. A mother
+should not forget that it is she who must exercise wisdom and decide
+what is best for her child. The judgment of a sick person is not to be
+relied upon, and it would be wrong to submit to the whims and fancies of
+an ailing child, if these are known to be medically disadvantageous to
+its best interests.
+
+Quiet surroundings are essential in all acute illnesses. The nurse
+should be congenial to the child. If the patient demands the presence of
+the mother she should remain, but she should not try to entertain him or
+interfere with the nurse.
+
+The clothing of the patient should be the ordinary night-dress which is
+worn in health. In no disease is any special kind, or quantity of
+clothing required.
+
+The temperature of the room should be 68° F. Thermometers are cheap and
+an exact knowledge of the degree of heat in a sickroom is an essential
+requisite. Nothing drains the vitality during sickness quicker than
+varying degrees of heat and cold. It uses up nerve force and energy and
+renders the patient irritable and difficult to manage.
+
+The strictest attention should be paid to the ventilation of the
+sickroom. We are learning more and more that fresh air is essential to
+the speedy cure of all diseases and to the general well-being of the
+patient. A direct, continuous communication between the sickroom and
+out-of-doors is imperative. It is a splendid measure to use two rooms
+for the patient and to change him twice daily, and to air thoroughly the
+unused room.
+
+The sickroom itself should be large and in a quiet part of the house. In
+summer time the windows may be wide open, in winter months the degree of
+ventilation can be regulated by the thermometer.
+
+Many mothers fail to appreciate that drinking water is an important
+requisite in all ailments of childhood, should be given freely, but it
+should be known to be absolutely pure. The same rule applies to sponging
+the patient. It must be done every day; sometimes it is necessary to do
+it more often, but if so it will be so directed by the attending
+physician.
+
+THE DIET OF THE SICK CHILD.--Prescribing the diet of the sick child is
+an important undertaking. It should be remembered that during sickness
+the digestive capacity is reduced; consequently the food must be
+lessened in quantity and in strength. If the patient is an infant at
+breast the best way to accomplish our purpose is to give before each
+feeding two ounces of boiled water, cooled to the temperature of the
+body. This dilutes the mother's milk and renders it more easy of
+digestion. If bottle-fed, it is accomplished by replacing one-half of
+the milk with water. In certain diseases milk is totally withdrawn, but
+these cases will be noted when discussing the treatment of the various
+diseases. With older children, we give milk diluted with water, or
+gruels, soups, or cereals, as conditions warrant.
+
+Needless interference with the patient must not be indulged in. Sleep
+and quiet are essential features of nature's reparative process. It is
+seldom necessary to disturb a sick child for the giving of food or
+medicine oftener than every second or third hour. Medicine may always be
+given with food. Meddlesome interference, talkative attendants, or
+excessive noise may exhaust a child and may prolong and render dangerous
+or fatal a condition that would otherwise go on to recovery.
+
+One satisfactory movement of the bowel daily is essential to the comfort
+and progress of a sick person. If this does not take place naturally, it
+should be obtained by an enema.
+
+At the beginning of any illness in childhood it is a safe procedure to
+give a dose of a suitable cathartic as soon as it is discovered that the
+child is sick.
+
+A CHILD IS THE MOST HELPLESS LIVING THING.--Nature endows the young of
+every species--except those of the human family--with certain instincts,
+which, when developed, govern and control their lives absolutely. The
+technical definition of an instinct is an exceedingly complicated word
+picture. It is only essential to an intelligent understanding of our
+subject that the reader should have a definite idea of the difference
+between an act that is the result of a process of reasoning and an act
+that is the result of an instinct. If a man finds his way out of his
+burning home he will stay out as long as there is any danger. The
+crudest kind of reasoning will teach this lesson. A horse, on the other
+hand--and incidentally it may be noted that a horse is regarded as an
+intelligent animal--if led out of a burning stable and let loose, will
+immediately reënter and be burned to death. The horse is the victim of
+instinct; he obeys the unconquerable instinct to return to his stall--he
+cannot reason as the man can that a home that is burning is not a proper
+place to seek safety in. When an ostrich fears danger he buries his head
+in the sand, under the impression that if his head is out of sight he is
+safe from danger. This is his instinctive plan of procedure in the
+presence of danger, and it is the plan of every ostrich, everywhere,
+always. A little reasoning would show them how foolish the idea is--but
+they cannot reason. That is the province of man alone. If the first
+member of a flock of sheep jumps over a fence to get into the next
+field, every member of the flock will follow, each one jumping the
+fence, though there may be an open gate between the two fields a few
+yards away. Instinct dictates the plan to the sheep as they have
+received instructions from their ancestors always to "follow the lead."
+This is their hereditary legacy and they cannot disobey it.
+
+Animals are born with instincts which need only circumstances to bring
+them out. Now a baby is not born with instincts of this character,--it
+has not even the instinct to help itself; it cannot find the breasts
+that were made for it; it is more helpless than the baby cat or dog or
+worm. Therefore a baby in whose brain the potential faculty of reason is
+slumbering must of necessity begin its career wholly dependent upon the
+supervision and love of its mother, until such time as it may be capable
+of reasoning for itself. Motherhood is therefore the supreme privilege
+of womanhood. It cannot be superseded, hence the fundamental factor in
+any system of race culture, or in any system of infant mortality, must
+tend to raise the quality and the intelligence of motherhood as a basic
+necessity. Motherhood at the present time, though the most important and
+sacred profession in the world, is almost exclusively carried on by
+unskilled labor. The maternal instinct is deeply rooted and universal;
+its absence must be regarded as an abnormality, or as a product of
+misdirected education. The requisites for the mothers of the future
+should be absolute physical health and love of children.
+
+If nature endowed a baby with instincts there would be no need for
+reason or education. Education cannot teach a cat how to nurse or wash a
+kitten any better than it does,--its instinct is good enough. The mother
+of a human baby, however, is not born with the instinct which enables
+her to care for her baby equally as well as the cat cares for her
+kitten. She must be educated or taught to care for it. She can then care
+for it better than the cat cares for the kitten, and she can be taught
+to bake, to sew, to read; to play on the piano, which a cat cannot be
+taught. So while a baby may be the most helpless living thing at one
+stage of its career it has in it--in the faculty of reasoning--the
+ability to become the Lord of all the Earth and of all the animals
+therein. To limit the environment of a child by imposing instincts upon
+it, would be to limit its inherent freedom. To be obliged to obey a
+prescribed instinctive law would rob mankind of his creative or
+reasoning faculty, and that would be to lower him to the level of the
+brute creation. Reason is of no use if our acts are already determined
+for us. There are therefore good reasons why the human baby should be,
+at the moment of its birth, the most helpless living thing; and as a
+consequence it is imperative, if the eugenic ideal is worthy of
+attainment, that every baby should have the benefit of trained and
+efficient care and education.
+
+
+THE DELICATE CHILD
+
+There is a certain standard by which we measure the physical and mental
+development of children. This standard we regard as the evidence of
+normal development. Some children exceed these requirements; they are
+bigger and stronger at a given age than the average child at the same
+age. There are other children who cannot be called sick, but who are
+physically and mentally inferior to the average standard, whom we
+designate as "delicate." These children are not as big, or as strong, or
+as heavy, as other children of the same age. They are born with a
+reduced vitality, or through mismanagement in early infancy they have
+acquired a subnormal standard of development. Children born of parents
+who are not of standard vitality are predisposed to be delicate. If the
+parents are of average development, and the delicacy of the child is
+acquired by mismanagement, the proper dietetic and hygienic management
+will, as a rule, promptly result in a satisfactory restoration to normal
+health.
+
+TREATMENT.--When a mother awakes to the knowledge that her child is
+delicate; when she understands that her child's vitality is not what it
+should be, and when she resolves to "do something" in the interest of
+her child, she is on the right road, and we hope to encourage her in the
+good intention. We would however tell her that her effort must be
+thorough, and that she must be patient and persevering. If she does not
+falter in well doing she will succeed beyond her expectation, and the
+satisfaction she will experience in noting the evidences of returning
+health and strength in the appearance and conduct of her child, should
+be ample recompense for the effort made and the time bestowed.
+
+She must begin with a definite knowledge of just what she intends doing;
+she must know, however, what must be done and she must begin at the
+beginning and build from a sure foundation. It is therefore absolutely
+essential to ascertain if there is any actual disease underlying the
+reduced vitality which is responsible for the delicacy of the child;
+this necessitates a thorough examination by a competent physician. If
+you are assured there is no disease present, no tuberculosis, no
+syphilis, no malaria, and that debilitating conditions, such as
+adenoids, sexual abnormalities, the results of self-abuse, skin disease,
+do not exist, then certain fixed rules can be laid down, and definite
+principles followed in the daily management.
+
+WEIGHT, AS A STANDARD OF DEVELOPMENT.--It has been stated elsewhere in
+this book that one of the safest guides to follow, as to whether a child
+is thriving, is its weight. This can be relied upon as a general rule. A
+child should therefore be weighed regularly every week. If it is not
+gaining an average of four ounces weekly it is not thriving up to
+standard. When the average is below four ounces there is something wrong
+with the quality or quantity of the food.
+
+HOW TO FEED THE DELICATE CHILD.--If the child is breast-fed and the
+weight standard, as evidenced by the weekly averages, is persistently
+below normal, we must find a substitute for the mother's milk. If the
+child is bottle-fed and it is demonstrated that it is impossible to
+maintain normal development on cow's milk, a wet-nurse should be
+obtained. After the child is weaned, or put upon a more liberal diet,
+milk should continue to be the chief article of diet. From the first to
+the third year a child should take one quart of milk daily in addition
+to the other food. There are some children, however, who seemingly
+cannot take milk without getting indigestion; they should be put on
+skimmed milk, to which may be added a small quantity of sugar to make up
+for the loss of fat. Mothers must be certain that too much milk is not
+given, or the desire for other necessary food will diminish.
+
+After the first year it is a very good plan to give one teaspoonful of
+scraped beef daily. If this is well borne, two may be given and later
+three. It can be given immediately before the regular feeding of cereal
+and milk. From the twelfth to the sixteenth month eggs may be given: at
+first one-half, and later a whole egg mixed with bread crumbs. Various
+vegetables should also be given cooked in the form of a purée. If at any
+time the child should refuse the food, or act as if it had no appetite,
+leave the milk out of the diet; this may then restore the appetite and
+it will take the other food freely; the milk can be resumed later.
+
+As the child grows older, the distaste for milk may grow, or he may be
+one of those children with whom milk really does not agree; in either
+event, do not hesitate to leave it out of the child's dietary. These
+children should be encouraged to eat plenty of good butter on their
+bread and crackers. Butter will not only agree with them, but it will
+supply any fat deficiency in the general diet. The diet may now consist
+of milk (unless it disagrees), cereals cooked three hours, raw or rare
+meat, poultry, eggs, vegetables, purées, cooked and raw fruit, bread,
+crackers.
+
+HOW TO BATHE THE DELICATE CHILD.--Regular daily baths are particularly
+of benefit to the delicate child, despite the prevailing fear that they
+may catch cold. The salt bath is advised and the time to take it is just
+before retiring. The room should be warm and the temperature of the
+water should be 90° F.: it should not last longer than five minutes, and
+the water should be cooled down to 70° F., before the child is removed
+from the bath. While the cold water is running in, the surface of the
+body should be briskly rubbed with the mother's hands and after removal
+the child should be dried with a fairly coarse bath towel to ensure a
+good reaction. Very delicate children need not have the temperature of
+the water reduced; others may stand water of 80° F., but no lower. In
+the poorly nourished it is frequently advantageous to rub the body,
+after drying, with olive oil or goose oil. This aids nutrition and
+because of the massage it aids circulation. In some older children a
+daily cold spinal douche seems to act particularly well. If the child
+does not promptly react from the effect of the cold water it is best to
+discontinue it.
+
+AIRING THE DELICATE CHILD.--Delicate children should, above all things,
+be assured of the maximum amount of fresh air and sunlight. Many mothers
+entertain the idea that these children are disposed to take cold easily,
+if in the open air,--which is not the case. All children need an
+abundance of fresh air and the delicate need it particularly. The season
+of the year and the character of the weather will, of course, dictate
+just how much open-air exercise they may take.
+
+If the weather is very cold and the air damp, or if there is a very cold
+high wind, it is best to remain indoors; otherwise the child should
+remain out for four or five hours. Indoor airing is obtained by
+dressing the child to go out-doors, putting him in his carriage, and
+leaving him before an open window in a room of good size with all the
+doors closed so as not to create a draught.
+
+HABITS OF THE DELICATE CHILD.--The amount of sleep necessary for a
+delicate child is the same as for a normal child of the same age. The
+room should always be well aired, night and day, and should be devoted
+to the exclusive use of the child.
+
+These children should never be allowed to sit on the floor. It is always
+a difficult matter to avoid this, but it must be religiously guarded
+against; otherwise a cold is the inevitable result.
+
+A change of air is sometimes advisable and essential, especially during
+the hot, humid weather of July and August. Much better results will be
+obtained by sending these children to the mountains than to the
+seashore.
+
+Delicate children should always be clothed warmly, but not too warmly.
+The feet and legs must always be kept comfortable. Moderate exercise,
+short of fatigue, is necessary. A midday nap after the noon meal should
+be taken every day. The child should be undressed and put to bed for two
+hours and left there, whether it sleeps or not. This applies to delicate
+children of all ages.
+
+The education of delicate children should be postponed until the health
+is restored. They should, however, be made to obey and they should be
+taught good habits. When school work begins it should be made light and
+easy. They should not go to school before the eighth year, and then not
+unless physically fit. They should not play at rough games or with rough
+companions, though it is not wise to shield them too much. Their habits
+and peculiarities should be studied and every possible effort made to
+direct them kindly and wisely so that they may contribute to their own
+upbuilding.
+
+A systematic observance of these suggestions will save many lives and
+will aid very considerably in producing stronger men and women. Infinite
+patience, tact and self-sacrifice is necessary, but the results in every
+case justify the measures adopted.
+
+INDISCRIMINATE FEEDING: POOR APPETITE.--In considering many of the
+diseases of childhood the term "indiscriminate feeding" is used. An
+explanation of just what is meant by this will be of decided advantage.
+There are two fundamental essentials in the successful feeding of
+infants and children: regularity and suitable food.
+
+A child whose feeding intervals are not regular and whose food is
+unsuitable is a victim of indiscriminate feeding.
+
+The lack of observance of the regularity rule always leads to loss of
+appetite and indigestion.
+
+Loss of appetite is a serious condition in a growing child and may give
+infinite trouble. Indigestion in a growing child is unnecessary,
+unfortunate, and frequently is the one factor that spoils an entire
+life. It is unnecessary, because it means and is caused by neglect on
+the part of the mother; it is unfortunate, because it always paves the
+way for any serious ailment that is epidemic or "in the air"; and it is
+important, because it very frequently weakens the stomach and renders it
+unfit for normal digestion for a long period, if not for life.
+
+If for some reason a child's appetite becomes poor and it is not
+properly managed until the appetite is restored to normal,
+indiscriminate feeding is always the result.
+
+The reason for the poor appetite may be because the child is kept
+indoors too long, or because it is being fed on unsuitable food, or is
+living in unsanitary surroundings, or many other reasons, sometimes
+trifling reasons, may cause it. When a child will not eat at meal time,
+the mother feels that it should eat sometime, so she encourages it to
+eat between meals, and because of a mistaken kindness she breaks the law
+of regularity,--a law that can never be broken without serious results
+following. A child in this condition becomes a disturber of the peace;
+the parents can do nothing with him; he insists on eating just what he
+likes and when he likes; and he chooses, as a rule, candy, cake,
+pastries, ice cream, tea, coffee. Indigestion follows, the child loses
+weight, is languid and listless and constipated.
+
+When finally the physician is called in he finds it necessary to go back
+to first principles. He lays down the law in a definite, stern way, and
+the mother and the child must obey. Most parents know and admit they are
+doing wrong to give in to a whimsical child, and if they would only make
+up their minds to conquer when conquering is easy they would save
+themselves many heartaches, many regrets, and the child much suffering
+and much possible permanent injury as a consequence. Usually one parent
+is willing to be master but the other lacks the mental equipment to meet
+the issue, and argues, as he or she imagines, in favor of the child. The
+parent whose instinct is correct, whose judgment is true, whose
+interpretation of the situation is just, should not be dissuaded, or
+argued away from his or her duty. If it is the first real problem in
+your domestic experience in which a decided stand must be made, make it
+without fear and without hesitation, and carry it through to the bitter
+end. Results will justify and vindicate you.
+
+The general treatment of these children will be found outlined in the
+following paragraph on Loss of Appetite.
+
+LOSS OF APPETITE.--If a child complains of not being hungry, and will
+not take enough food, and if this condition continues for some time, we
+must regard the matter as being abnormal and find the cause. This is
+necessary because a child must eat in order to maintain a certain
+standard of growth and vitality. These children are not sick; they are
+active and continue to play as usual and they sleep soundly, but they
+have no appetite. One of the most frequent causes of this condition is
+too frequent feedings. Some children are naturally small eaters. They
+thrive and maintain a satisfactory weight; their system seems not to
+demand large quantities or even ordinary quantities of food. Parents
+observe this habit of little eating and begin to coax and bribe the
+child to eat more at meal time, and to eat between meals. In this way
+the child really overeats, the appetite becomes capricious, and the
+stomach rebels. In a very short time the condition of "loss of appetite"
+is established as a consequence. Another cause is the drinking of too
+much milk, and yet another and very common cause is indiscriminate
+eating of candy, cakes crackers, and fruit between meals. Children who
+are fed at the table with adults eat things they should not eat, and
+spoil their digestive organs and loss of appetite is the result. The
+Scotch custom of compelling children to eat at a separate table is an
+excellent one. They are not tempted to ask for things they cannot have.
+Lack of fresh air and exercise frequently results in impaired appetite.
+
+TREATMENT.--The very first thing to do with these children is to stop
+any habit that may be responsible for the loss of appetite. If the child
+has been eating between meals, stop it absolutely. If too much milk has
+been taken, stop milk entirely. If the child has not been getting enough
+fresh air, or if it has been sleeping in a badly ventilated room, or if
+baths have been too infrequent, rectify the fault. If eating at the
+family table and fed indiscriminately, change the programme; feed him
+before the family sits down to meals. Now regulate the time of feeding
+to suit the age of the child and adhere to strict regularity. It is a
+pernicious and absolutely wrong custom to force children to eat, or to
+coax them to eat when they do not want to eat. Loss of appetite will
+never be cured by forced feeding, or by reducing the interval between
+feedings, or by giving the child stronger or more concentrated food
+under the mistaken idea that in this way the loss of appetite can be
+"made up." The interval of feeding should rather be lengthened than
+otherwise in order to give the digestive organs an opportunity to regain
+the normal desire for food. Pay strict attention to the bowels. Be
+certain the child has a daily satisfactory movement and that he drinks
+frequently between meals.
+
+If the child does not promptly respond to the proper hygienic and
+dietary treatment as outlined above there are two things that can be
+done:
+
+1st: Send the child away. A change of scene and climate will sometimes
+work like a charm in these cases, and will, after a reasonable length of
+time, establish a permanently good appetite.
+
+2nd: If this is not possible, as sometimes it may not be with poor
+patients, then we can give the child suitable tonics.
+
+OVEREATING.--The large majority of individuals eat too much. Most of us
+would enjoy better health, better spirits, and greater efficiency if we
+consumed from one-third to one-half less food than we habitually do.
+
+Every living organism requires a certain amount of nourishment according
+to the work performed and to replenish wear and tear; when food is
+supplied in excess, the system cannot utilize it, but it is compelled to
+rid itself of the excess in some way. The work involved in this
+eliminating process is exceedingly detrimental to the various organs and
+to the individual. To overeat is to overwork, and to overwork a machine
+or an animal is not only poor economy but bad judgment. If the digestive
+apparatus is required to work overtime, it is a self-evident assumption
+that the various organs will not digest efficiently the food necessary
+for ordinary existence. If the necessary nourishment is not adequately
+digested, the general health will suffer as a consequence. If the
+general health is below standard the individual will not be competent to
+carry on the requirements of a normal, healthy life.
+
+We must, however, give some thought to the effect which the excess of
+food exerts upon the human machine.
+
+Nature provides and maintains a standard relationship between the
+capacity of the individual and his needs. A child has a digestive
+capacity to digest and assimilate a quantity of food sufficient for his
+growth and proper nourishment; an adult maintains the same standard
+according to his requirements. All the other organs are adjusted to
+harmonize with this scheme. If we overeat, the immediate result is to
+disorganize this relationship between the various organs; hence we have
+a multitude of effects which manifest themselves in various ways as a
+direct result of overeating. The combined general effect expresses
+itself in the form of what is regarded as poor health and a low standard
+of efficiency. When a larger quantity of food is taken into the stomach
+than it can properly digest within a reasonable time, two conditions
+immediately follow. The stomach itself is dilated and the food is not
+thoroughly digested. If the habit is persisted in, indigestion, and
+later chronic gastritis ensues. The direct symptoms of these conditions
+are given in detail in another part of this book. Very few individuals,
+however, appreciate the indirect consequences of overeating and of
+indiscriminate eating on the general health. It is impossible to
+tabulate in so many words the effect which this habit has on efficiency
+and temperament. We read and hear a great deal to-day about efficiency.
+Now, an individual's efficiency is an expression of that individual's
+health standard or capacity. To be 100 per cent. efficient one must
+enjoy good health. It would be absurd to expect a high standard of
+efficiency from an individual with a low standard of health. Poor health
+means poor vitality. Vitality is the mark of the master. Without
+vitality one can never dominate. All the great achievements of the race
+have been consummated by those who conserved their vitality. No single
+factor contributes a larger percentage of inefficients and failures than
+overeating. The man or woman who, from habit or experience, has learned
+the lesson of right eating and living need not be lacking in efficiency,
+nor need they despair of the attainment of success.
+
+SYMPTOMS OF OVEREATING.--Efficiency depends not only upon one's capacity
+to perform, but upon the character of the performance. The spirit must
+be willing to perform. The overeater is heavy, phlegmatic, indifferent,
+lacking in energy, tact and initiative. She is constantly subjecting her
+system to needless overwork; she is depressed, nervous, imaginative and
+she is not ambitious. She is a victim of self-poisoning, of
+constipation, indigestion, headaches, flatulency, neuralgia, vertigo,
+and melancholia. An overeater never enjoys good health, never is
+efficient, and cannot possibly be successful.
+
+To enjoy good health one should know how to select food and how to
+combine and proportion it. It has been said that the American people are
+a race of dyspeptics, and it must be admitted that the assertion is
+more or less true. There are millions of people who suffer from
+indigestion in some degree, and it may justly be said that indigestion
+has its beginning in overeating, in some form. It may not be overeating
+in actual bulk, but it is overeating some article or articles that do
+not agree with the individual, and the fact that certain articles do not
+agree is unquestionably dependent upon the nervous temperament of the
+American people--and the temperament of a people is a product of the
+kind of existence the people subject themselves to. We are, therefore,
+unwittingly, victims of our environment.
+
+Correct eating means simple eating--only a few things at a time. Food
+should be selected according to one's age and occupation, and according
+to the season of the year. To eat habitually large quantities and at the
+same time a large variety is suicide pure and simple. If one dared to
+make the experiment of cutting down one's diet one-half, it is
+absolutely certain the effect would be immediate benefit. The benefit
+would not only be manifest in the physical betterment, but the
+efficiency and general well-being would be greatly enhanced. It is not
+the kind of food that makes a dyspeptic, but the quantity. A well person
+need not consider whether a certain kind of food will or will not agree,
+providing she does not eat too freely of that food, or combine it with
+other food. The combination of which may in itself form too much of one
+kind at a time.
+
+Some people imagine, for example, that oatmeal porridge does not agree
+with them. When the matter is inquired into, however, it is found that
+they habitually eat bread, eggs, and other articles, with coffee at the
+the same meal with the porridge. From this combination they experience
+distress and blame the porridge. If these would take a plate of oatmeal
+porridge with cream and salt, and some stewed fruit for breakfast they
+would not experience any trouble, and this would be an ample meal for
+the ordinary individual. It is not the porridge, but the unsuitable
+combination, that is at fault. The same may be said of milk. Many people
+state that they cannot take milk and they deprive themselves of one of
+the very best articles of diet because of this idea. There are very few
+people in the world who cannot take milk in some way. It is not the milk
+that is at fault; it is the combination of it with other less nutritious
+articles that is the cause of the distress. Even candy is responsible
+for thousands of cases of indigestion. Anyone may safely take a
+reasonable quantity of good candy, but if it is taken at a wrong time,
+or combined with other articles, it may readily produce indigestion.
+
+Indiscriminate eating and overeating are prolific causes of rheumatism,
+kidney disease, heart disease, liver troubles, obesity,
+arteriosclerosis, and apoplexy. These diseases are notoriously on the
+increase and must be construed as a direct consequence of the tendency
+of the American people to overeat and to eat indiscriminately.
+
+BRAN AS A FOOD.--In the chapter on constipation there may be found a
+formula for making bran muffins. These muffins are invaluable to
+children in health, and to the victim of indigestion or constipation,
+whether child or adult. One muffin with each meal will solve the problem
+of constipation in growing children without the use of drugs or other
+aid. They will regulate the bowels of adults in many instances without
+resorting to drugs.
+
+Raw fruit in season, or stewed fruit, or a baked apple, with a light
+boiled egg and one bran muffin, is an ample and a nourishing breakfast
+for a child at school.
+
+For lunch the same child should have a plate of thoroughly done
+vegetable soup, a bran muffin, and more fruit. After school, a glass of
+milk with two or three Graham wafers may be given.
+
+For dinner the child at school may have a mixed meal. This meal should
+not be later than six-thirty o'clock and the child should retire at
+eight-thirty at the latest. A bran muffin should be taken with this meal
+unless the child's bowels are too loose.
+
+Mothers should insist on their children eating these muffins. If a child
+eats only what it likes it will not eat what is good for it. If the
+mother insists in the right way she will win; if she does not the child
+will win. If the child wins, the mother is the wrong kind of mother. I
+do not know of any other single article of diet that is of such value
+to growing children as these bran muffins. Children who eat them
+regularly will have less sickness than other children; they will be
+strong, healthy and full of energy. The bran in itself is not
+responsible for this list of excellent acquirements, but the regular
+eating of the bran is. Most ailments of children are of
+gastro-intestinal origin; bran keeps the entire length of the
+gastro-intestinal tract sweet and clean; if the child eats a bran muffin
+with each meal it will not have much desire or much room for any other
+form of bread or pastry. If white bread or pastry is abstained from the
+child will not have indigestion, or constipation, and hence it will not
+be constantly poisoning itself as most children do whose diet is not
+restricted and whose bowels are more or less constipated.
+
+These muffins should be made of the ordinary unsifted bran. If this is
+not procurable the sifted bran (Johnstone's) may be employed. This bran
+may be bought in any good grocery.
+
+Modern milling methods, modern cookery, and modern methods of forced
+farming, have each contributed their share of rendering food inert and
+frequently deleterious. The miller has extracted the coarse cellulose
+from the various flours in the effort to manufacture a product suitable
+to the super-civilized public demand. This cellulose is absolutely
+essential to gastric and intestinal digestion, and if children are
+deprived of it constipation and indigestion are the natural result.
+Forced farming accomplishes the same effect--the fiber of the vegetable
+is deficient. Bran is rich in mineral salts, iron, protein, and
+phosphates, and gives to growing children the ingredients which ordinary
+food is deficient in. Bran prevents intestinal fermentation and children
+who eat it are free from intestinal gas and putrefaction. It harmonizes
+chemically with all other foods. Children should be made to take it
+every day as a matter of self-preservation and of duty.
+
+HYSTERICAL CHILDREN.--Hysteria is not a disease of infancy or of young
+children. It is seen as a rule after the eight year. Male as well as
+female children may be the victims to an equal degree. It is much more
+frequently seen in the offspring of parents who are themselves nervous,
+or alcoholic, or who suffer from insanity, or have insanity in the
+family history. If these children in addition to the hereditary
+influence suffer from stomach or intestinal disease, or general poor
+health and are overworked at school, they are very apt to become
+hysterical.
+
+They are capricious, indifferent, and excitable. Their disposition is
+irritable; they frequently exhibit fits of great excitability of temper
+and passion. They cry or weep without cause. They often have
+hallucinations and while asleep have attacks resembling night terrors.
+They complain of pains in the joints, and are frequently treated for
+disease that does not exist. Such condition as hysterical cough, spasm
+of the muscles of the face, mouth, eyes, and of the neck exist and are
+difficult to diagnose from real disease. These children complain of
+painful sensations and sensitive areas and exaggerate all symptoms
+unnecessarily.
+
+The possibility of curing these patients is good, providing the
+treatment is faithfully carried out. It is less favorable when marked
+hereditary influences are strong.
+
+TREATMENT.--In all children of distinctly nervous type and especially
+those of nervous parents, the first essential duty is to develop their
+muscular system. Try in every way to make healthy animals of them.
+Attention and treatment should not be directed toward the nervous
+system. If the child is made strong by out-door life, good plain,
+digestible food, early hours, regular sleep in thoroughly aired rooms,
+regular bathing, and if the school work is conducted with moderation and
+judgment, the nerves and the nervous temperament will participate in the
+healthy growth which will follow as a result. Tea and coffee should be
+forbidden. Exciting books and questionable entertainment as given in
+picture shows and theaters must not be allowed. If older members of the
+family, or parents, are excitable and nervous the children should be
+sent away to the country from them.
+
+They should be put in charge of a person who will exercise firm control
+over them. It may be necessary to take these patients away from other
+children, and isolate them under proper control until they are able to
+control themselves. They should be interested in exercise that compels
+them to work; they should live and if convenient sleep out of doors; and
+they should take iron or cod liver oil, or any other indicated tonic. If
+they complain of pain they should receive cold-water douches, or the
+cold pack, or the shower bath; and they should be put to bed and treated
+firmly but kindly. Attention to the bowels is always essential, because
+these children are as a rule the victims of chronic constipation.
+
+WHAT A MOTHER SHOULD KNOW ABOUT CATHARTICS AND HOW TO GIVE A CHILD A
+DOSE OF CASTOR OIL.--Broadly speaking there are three kinds of
+cathartics. I will, in a simple way, explain their action so that a
+mother may know which one to select under certain circumstances.
+Frequently a mother is told by her physician to "keep the bowels of her
+child open." Few mothers know how to keep the bowels open, and as this
+is an important matter, every mother should know the reason why "any"
+laxative or cathartic is not always suitable.
+
+CASTOR OIL.--This is one of the oldest and one of the best cathartics we
+possess for children. It is a mechanical cathartic; it acts in exactly
+the same way as a street-cleaning machine. It cleans the street by
+sweeping or pushing everything before it.
+
+CALOMEL--This is a chemical cathartic. It acts through the blood. When
+it is absorbed by the blood its chemical ingredients act on certain
+nerves as irritants. These nerves excite the liver and bowel to action
+and an evacuation is the result.
+
+CITRATE OF MAGNESIA.--This is a saline laxative. It acts by drawing out
+of the bowel wall enough liquid from the blood to sweep the contents
+out. It may be likened to the street cleaner who flushes and cleans the
+street by means of a hose pipe attached to the water hydrant.
+
+Under what condition should a mother use these remedies? Castor oil is
+ordinarily the best cathartic in childhood; it is not, however, always
+the best. Most ailments of children are of gastro-intestinal
+origin--they have either overeaten or they have eaten the wrong kind of
+food. The stomach and bowel are overloaded: they must be cleaned out. We
+want a mechanical cathartic, one that will push everything ahead of it,
+so we use castor oil. When a child needs a cleaning out, use castor oil.
+By a "cleaning out" we mean, when we know he has eaten too much of a
+questionable variety of food, as pastries, cakes, fruit, ice cream,
+etc., as children do at parties; or when he has eaten unripe fruit, as
+green apples, etc.; or when for some reason he is constipated and
+complains of not feeling well, use castor oil.
+
+If you decide to use castor oil, use enough. A large dose will act
+promptly and with less pain and with more certain results than a small
+dose.
+
+It is always safe and it is always best to decide upon castor oil as the
+proper remedy, if the child has no fever. If he has a fever he will most
+likely vomit castor oil when another kind of cathartic would stay on the
+stomach.
+
+Castor oil works more effectively, more thoroughly, and is less likely
+to be vomited if given on an empty stomach, so we give it two hours
+after eating and we give no food for two hours after it is taken.
+
+Castor oil is distinctly of advantage in many chronic diseases of the
+intestines because of its healing properties. In chronic colitis, for
+example, when the child is suffering with malnutrition, irregular bowel
+action with an odor, and mucous or bloody stools, a combination of
+castor oil and salol, in emulsion, in small doses,--to which a small
+quantity of opium may be added or withheld according to the frequency of
+the movements,--with an occasional colon irrigation, is sometimes
+invaluable.
+
+Mothers must remember that castor oil is not good in the treatment of
+constipation, because its after effect is to constipate, consequently we
+would not use it "to keep the bowels open,"--it is only of use to clean
+the bowel out thoroughly when that is indicated.
+
+HOW TO GIVE A DOSE OF CASTOR OIL--The best way to give a child castor
+oil is as follows: Place the bottle containing the oil on its side on a
+piece of ice in the ice box; chill it thoroughly. Take a tablespoon and
+smear it with butter; pour the ice cold oil into the spoon; it will
+stick together like a piece of chewing gum and it will slide out of the
+buttered spoon in one lump. In this way it will not spread over the
+mouth and teeth and throat, leaving a bad taste, but will go straight
+and surely into the stomach. The child cannot swallow some and retain
+enough in the mouth to sputter it all over itself and only get half a
+dose; it will not nauseate it, because it practically is tasteless if
+given cold, and the stomach will tolerate the cold oil much better than
+when given in the ordinary way.
+
+A baby can be given oil in the same way, but in smaller doses. When the
+teaspoon is put into the mouth of a baby it should be immediately turned
+on its side so that it will keep the mouth open. If the nose is held
+closed and the mouth wide open for a few seconds the baby cannot spit
+the oil out--it must swallow, and if the oil sticks together as cold oil
+will, it gets the whole dose. It usually takes two persons to give a
+baby a dose of oil--one to open the mouth and give the medicine, the
+other to hold the nose and arms.
+
+CALOMEL.--The general indication for calomel is fever. When a child
+develops a disease it immediately gets a temperature, and very
+frequently the fever is quite high because the slightest ailment gives a
+child fever. When fever begins, digestion practically stops, it is
+therefore imperative to clean the whole gastro-intestinal canal;
+otherwise the undigested material will putrefy and poison the entire
+system and render the disease more serious than it need be.
+
+Now we select in such conditions calomel for two reasons:
+
+First, because the presence of fever indicates that infection of the
+blood is taking place; this may come either from the intestinal canal
+itself, or from the germs of the disease with which the child is
+suffering. Since calomel acts chemically through the blood it is the
+cathartic indicated.
+
+Second, because a cathartic like castor oil does not act through the
+blood and it would most likely be vomited by a fevered stomach.
+
+Certain conditions indicate calomel; biliousness and jaundice, for
+example, because it has a specific action on the liver and if the liver
+is at fault calomel is the proper remedy.
+
+Calomel is best given in small divided doses, 1-10 of a grain every half
+hour, for ten doses. It is best given combined with soda; every drug
+store carries tablets of calomel and soda for this reason.
+
+Calomel should never be given in the treatment of constipation, nor
+should it be used indiscriminately by mothers, as much harm may result.
+It has its specific use as indicated above, but it should never be used
+under any other circumstances.
+
+CITRATE OF MAGNESIA.--This is a mild laxative. After the bowels have
+been thoroughly opened with castor oil or calomel, small doses of
+citrate of magnesia may be given for a few days, "to keep the bowels
+open." There is no danger or harm in its use if used for this purpose.
+It must not be used, however, in the treatment of constipation of
+children for the simple reason that you cannot cure constipation by the
+use of drugs of any kind. Laxatives of this type have become a national
+curse. Adults, especially women, use them constantly. All these
+advertised saline laxative waters work by weakening the blood--when a
+dose is taken the chemicals in it draw through the bowel wall blood
+serum, and produce, because of the excess of this watery fluid, large,
+and frequently many, liquid movements.
+
+If this practice is continued, as it often is every day, the quality of
+the blood will suffer seriously, and many individuals are the victims of
+neuralgic pains, headaches, nervousness, insomnia, anemia, and general
+broken health as a direct consequence of this pernicious habit.
+
+Mothers will try to remember, therefore, that drugs and saline waters
+have no place in the treatment of constipation in children or
+themselves. Constipation must be treated by diet, exercise regular
+living and by the observance of hygienic and sanitary common-sense
+rules.
+
+
+VACCINATION
+
+TIME FOR VACCINATION.--The best time to vaccinate a child is during the
+first three months if he is healthy. The reason for selecting so early a
+period is because the constitutional disturbances are much less at this
+time than in later childhood. It should not be done during active
+dentition. If the child is delicate if his nutrition is bad it should be
+deferred until a later time. Children suffering from eczema or from any
+skin disease or those syphilitic should not be vaccinated until it is
+compulsory, or until exposed to small-pox.
+
+METHODS OF VACCINATING.--It is customary in America to vaccinate at one
+point rather than to make a number of inoculations as is the custom in
+some other countries. The leg or the arm is the usual location selected.
+In infants the sore can be protected better on the leg; in children of
+the run-about age, the arm is the better location because it can be kept
+at rest easier.
+
+Before vaccinating the skin should be rendered surgically clean; this
+can be done by washing with soap and water, drying and then rubbing with
+alcohol. The wound should be left uncovered for about twenty minutes to
+dry, it may then be covered with a bandage, or with a vaccine shield.
+The part should not be washed for twenty-four hours.
+
+THE SYMPTOMS OF SUCCESSFUL VACCINATION.--Nothing is noticed until the
+third or fourth day, when a red papule appears. In the course of the
+following day a vesicle appears; this vesicle enlarges until it reaches
+its full development on the ninth day. The size of the vesicle is about
+one-half inch in diameter; it is surrounded with a reddish inflammatory
+area for about two inches. The vesicle begins to dry and is shortly a
+dark crust which remains from one to three weeks and then falls off. It
+leaves a bluish scar which soon turns white and the part is roughened
+and honeycombed. During the period when the vaccination is at its height
+the child suffers from fever and irritability and loss of appetite.
+
+If vaccination does not "take" in an infant it should be done two or
+three times and if then unsuccessful it should be repeated every year
+until it takes. The fact that vaccination does not take does not imply
+that the child would not take small-pox but rather that the vaccine used
+is not suitable. There are some children, however, who seem to be immune
+to vaccination.
+
+Sometimes the symptoms are more severe than those enumerated; this seems
+to depend upon the susceptibility of the child. The vesicle may be much
+larger and the area of inflammation much more dense and angry. The fever
+may be higher and may last longer; there may be a general rash and the
+degree of depression more profound. Vesicles may be produced on other
+parts of the body as a result of scratching. Mothers must always
+remember that vaccination is a surgical wound to begin with and that it
+is capable of infection in the same way as are other wounds, and that
+any result coming from such an infection is not due to the vaccine or to
+the process of vaccination, but to the infection. Many people get unjust
+ideas about vaccination from just such cases. If the mother is not
+cleanly or neglects the vaccinated area and permits it to become
+infected she must not and others should not decry vaccination as a
+consequence. Anyone who doubts the virtue of vaccination is condemning
+himself; he is simply ignorant of the accumulation of evidence in favor
+of it and assumes a position without any possible justification. The
+mortality of vaccination is stated by Voigt from statistics to be 35 in
+2,275,000 cases. In fact, all the deaths are from causes which are
+preventable and no doubt the result of direct carelessness on the part
+of the operator or the mother.
+
+TREATMENT.--The mother must understand in what way she may contribute to
+the successful termination of a case of vaccination. She should see that
+the part upon which the child is to be vaccinated is absolutely clean so
+far as she can make it with soap and water. She should see that the part
+is allowed to dry thoroughly after vaccination. She should not wash the
+part for at least twenty-four hours. If a vaccine shield is put on she
+should not disturb it. If the mother is prepared to do her part
+faithfully a vaccine shield is not necessary from a medical standpoint
+and in some cases it is objectionable. A simple, clean bandage is all
+that is necessary. It is very important that the child be kept from
+scratching the part; most of the troubles of vaccination come from this
+habit. It is desirable that the limb should be kept at rest during the
+stage when the process is at its height. If the vesicle discharges it is
+necessary that the area should be kept clean and dusted with boracic
+acid. If the wound becomes infected it must be treated by a physician.
+The mother must not resort to home remedies in such cases unless she is
+prepared to take the consequences, which may be serious.
+
+
+
+
+CHAPTER XXII
+
+CONSTIPATION IN INFANTS AND CHILDREN
+
+     "It is a greater disgrace to be sick than to be in the
+     penitentiary. When you are arrested it is because you have
+     broken a man-made statute, but when you are ill, it is because
+     you have disobeyed one of God's laws."
+
+     Constipation--Regularity of Bowel Function--The Function of the
+     Stomach--Fermentation--Incomplete Constipation--Importance of a
+     Clean Bowel--A Daily Movement of the Bowel
+     Necessary--Constipation in Breast-Fed Infants--Treatment of
+     Constipation in Breast-Fed Infants--Constipation in Bottle-Fed
+     Infants--Treatment of Constipation in Bottle-Fed
+     Infants--Constipation in Children Over Two Years of Age--Diet
+     List for Constipation in Children--Bran Muffins in
+     Constipation--Treatment of Obstinate Constipation--Oil
+     Injections in Constipation.
+
+
+CONSTIPATION. REGULARITY OF BOWEL FUNCTION
+
+The most frequent cause of ill health and inefficiency in the human race
+is inattention to regulation of the bowel function. Good health depends
+upon many causes of which good blood is an absolutely necessary
+requisite. Good blood depends upon what feeds and sustains it. There are
+other contributing factors, such as the proper kind of exercise, the
+proper amount and quality of fresh air, the method of living, etc., but
+these are all food in a sense. The food we take in is acted upon by the
+various digestive juices until everything is extracted from it that
+contributes to the building up of the body. Whatever is left, whatever
+the body does not want, is immediately, or within a reasonable time,
+passed out in the form of a movement of the bowels.
+
+If any part of the digestive function is deficient, impaired health, or
+mental and physical inefficiency expressed in the form of indigestion,
+is the result. If the bowel is at fault, constipation is the usual
+consequence. A perfectly healthy living machine must maintain a perfect
+digestion and regular bowel movements.
+
+THE FUNCTION OF THE STOMACH is to mix and churn the food, and to add
+certain ingredients to the mixture so that before it is carried into the
+intestines it is (as far as it is the stomach's duty to render it) ready
+to be absorbed into the system. Before it reaches that part of the
+intestine which absorbs, it is acted upon again and certain other
+ingredients are added to it by certain other digestive organs. In time
+it is in shape to be used and it is sent along on its way. As it passes
+onward the little sucking glands in the wall of the bowel suck up all
+the liquid element in the mass of food. The liquid element in the mass
+is the food itself, rendered liquid by the stomach and other digestive
+organs and juices. The remaining solid mass is that part of the food
+which the body cannot use and does not want. By the time the liquid
+element is absorbed, the solid mass (always kept moving by the bowel
+wall) has reached the rectum, ready to be passed out at once, or very
+soon, provided--and upon this provision depends the success of the
+entire process,--it has all been done within a certain time. If the
+stomach takes too long to do its work we have indigestion. If the bowel
+takes too long to do its work we have constipation.
+
+FERMENTATION.--Now let us consider the matter from another standpoint.
+If food stays too long in the stomach it begins to ferment. When
+anything ferments it makes and evolves gas. You, no doubt, have noticed
+many times how the cork pops out of a bottle if its contents are
+"working," or fermenting. If you watch that bottle you will notice that
+it is quietly or actively evolving air bubbles. That is gas,--gas
+manufactured by the process of fermentation. This is exactly the process
+that goes on in the stomach or bowel of a dyspeptic, and it is this
+collection of foul, poisonous gas that causes the distress and bloated
+feeling which every dyspeptic suffers from after eating,--if it is this
+"flatulent" type of indigestion which is present.
+
+THE SIGNIFICANCE OF CONSTIPATION.--If the food takes too long to pass
+through the bowel it causes, as we have stated, constipation. What is
+the real significance of constipation? It means that in passing through
+the bowel the food has given up all its liquid element (which is all its
+nourishing element), but the bowel has been too slow in passing it
+along. Consequently it is not ready to be expelled while it is yet a
+harmless semi-solid mass. It stays in the bowel too long--it begins to
+putrefy, bacteria attack it, and it is soon a semi-liquid, foul, rotting
+mass. The sucking glands in the intestinal wall continue to suck--that
+is their duty. They cannot discriminate between what is good and what is
+bad--they simply go on absorbing whatever is there to absorb. So there
+are absorbed into the system liquid and gaseous products which are
+poison.
+
+This process has been called by a number of names; "self-poisoning"
+explains the condition thoroughly. The other names are, auto-infection,
+auto-intoxication, enteric-infection, enteric-toxemia, intestinal
+indigestion.
+
+The condition is a serious one, because it is absolutely impossible to
+feel well, or to enjoy good health, while it lasts. The feeling of being
+constantly sick, yet not sick enough to stop working or to demand a
+radical cure, affects a woman's efficiency, interferes with her capacity
+to work, her ability to render the home an abode of contentment, to be
+an agreeable companion, or to adequately take care of her children.
+
+The constant absorption of intestinal poisons affects the system
+itself,--the symptoms are headache, neuralgia, loss of appetite,
+nervousness, insomnia, vertigo, inability to concentrate, lassitude,
+indigestion. The condition which we name constipation is therefore one
+of supreme importance. From a medical standpoint, it is the biggest
+problem in the whole realm of disease. It is the most significant
+hygienic function of life, and it is becoming more and more important,
+and more and more a problem. Every modern factor upon which physical
+efficiency seems to depend is an enemy to the systematic regulation of
+this function. Our method of hurried and indiscriminate eating, our
+system of strenuous living, our unsanitary environment, our business
+activity, our method of pursuing pleasure, take no account of, and
+resent the time devoted to cultivating, as a hygienic necessity, this
+toilet requirement. This imperative call of nature is pushed aside by
+the child at play, by the housewife for a duty which could wait, by the
+merchant for an engagement. It is particularly an American disease, and
+it is uniquely an American woman's affliction. It is a curious
+commentary on the intelligence of the American people, who are
+ordinarily alert and analytical, to realize how few of them really know
+how serious a matter constipation is. They don't know because they have
+given the matter absolutely no thought. They have accepted it as a mere
+matter of fact, almost of fate.
+
+INCOMPLETE CONSTIPATION.--There is a type of constipation that is not
+known to the average person and not well understood by those few who
+know of its existence. In this form of constipation there is a daily
+bowel movement but the movement is not complete. The bowel does not
+thoroughly empty itself; it has established this habit because of
+conditions under which it has had to do its work. If a woman
+neglects herself, becomes muscularly inactive, does not take
+proper out-door exercise, grows fat and lazy, eats irregularly and
+indiscriminately,--the bowel suffers with the rest of the system. The
+woman may have a healthy appetite, may eat the wrong things at the wrong
+time, yet the bowel is supposed to go on acting rightly, but it does
+not. It, too, becomes lazy and acquires bad habits, and this form of
+incomplete constipation is the result. These patients look healthy and
+get little sympathy for any pains they may have. They may even gain in
+weight; they get headaches once in a while, and if they go shopping or
+visiting they don't feel quite well afterward. They are suffering from
+the effects of chronic constipation, though their bowels are apparently
+regular. They are marching onward toward apoplexy or Bright's disease of
+the kidney.
+
+IMPORTANCE OF A CLEAN BOWEL.--Every mother, sooner or later, observes
+that a physician always thoroughly cleans out the bowel of a sick child
+at once, no matter what the character of the sickness is. He does this
+for two reasons,--first, because he knows that the great majority of
+children's ailments are of gastro-intestinal origin; second, if the
+origin of the disease is not in the stomach or bowels, experience has
+taught him that if the bowels are clean at the beginning of a disease,
+that disease will run a milder and shorter course than if complicated
+with a condition of self-poisoning. If a child develops fever the
+digestive function stops; whatever food is in the stomach or bowel will
+promptly ferment and putrefy because of the abnormal heat caused by the
+fever and the arrested digestion. If this is not cleaned out at once the
+self-poisoning process begins.
+
+The above is a suggestive admission for a physician to make. It simply
+means that the vast majority of the calls made by a physician on ailing
+children are caused by errors in diet and can be completely cured by a
+dose of castor oil or calomel, or, better still, need never occur.
+
+A mother who neglects, who is guilty of inattention to the conditions of
+her child's bowel, fails in one of the most important duties of
+motherhood. I know as a father and a physician that if a child's bowel
+acts regularly and thoroughly, that child is fortified to the highest
+efficient degree against the multitude of little ailments common to all
+children. A clean bowel means good blood, good digestion, ability to
+exercise properly, to sleep soundly and to think clearly. Such a child
+will resist infection and throw off the minor troubles that pave the way
+for serious sickness. It is a secret worth knowing.
+
+A DAILY MOVEMENT OF THE BOWEL NECESSARY.--In order to preserve good
+health one thorough movement of the bowel is necessary daily. A baby may
+have two or three and enjoy robust health. A larger daily number
+suggests an abnormal condition of the bowel and an investigation should
+be made. If a nursing baby's bowels do not move before bedtime it should
+be given an injection of equal parts of glycerine and hot water,
+one-half cupful; or an enema of soap and water, or a glycerine
+suppository. When a child is six months old, in some sooner, it should
+be put on the stool at a certain time every morning. This will aid in
+the establishment of the habit, as a child soon understands why it is
+made to assume this position and acts accordingly.
+
+The condition referred to above and which we termed incomplete
+constipation may affect the nursing infant. A child's bowels may move
+daily and yet the child will suffer from constipation. If the movements
+are watched it will be observed that certain children strain when at
+stool, and after a time succeed in passing hard, dry lumps or balls of
+fecal matter. Such a movement is a certain indication that the bowel is
+not emptying itself satisfactorily and that a constant toxemia or
+poisoning is going on. Very faithful efforts should be made to remedy
+this condition by the use of articles of diet that are known to be
+laxative, otherwise the condition is one that will "grow" with the child
+and establish an obstinate chronic constipation with all its miseries
+and dangers.
+
+CONSTIPATION IN BREAST-FED INFANTS.--Many nursing infants thrive and
+gain in weight, yet they are constipated. Before you drug your baby be
+sure the fault is not your own. Many mothers are responsible for the
+constipation with which baby suffers. If the mother is constipated, so
+will the child be. Cure the constipation of the mother and the baby's
+bowels will regulate themselves. Nursing mothers who are large
+tea-drinkers have irregular bowels as a rule. A baby whose mother is
+lazy or indolent, who does not take a reasonable amount of exercise,
+whose diet is faulty and whose hours are bad, is a sufferer from
+constipation. The mother's life must be regulated, her diet and habits
+corrected, and the instructions carried out as already recommended. The
+breast milk should be examined and if any cause for constipation exists
+in it, it should be rectified as suggested elsewhere.
+
+If it is thought advisable to resort to drugs for the immediate relief
+of the constipation of infants, the best ones are the aromatic fluid
+extract of cascara sagrada; milk of magnesia with equal parts of the
+aromatic syrup of rhubarb given in doses of one to three teaspoonfuls
+daily.
+
+Irrigations, enemas, and suppositories should not be used continuously.
+The habit is a bad one. The parts become accustomed to their use and
+fail to act. If the child is passing dry and hard stools it is of
+advantage to inject two ounces of warm sweet oil at night, allowing it
+to remain in the bowel until the following morning. See page 312.
+
+CONSTIPATION IN BOTTLE-FED INFANTS.--It is much easier to treat the
+constipation of bottle-fed babies than of those breast-fed, because the
+food can be changed to ensure regular bowel movements. The first change
+to be made in a bottle-fed baby who is habitually constipated is to add
+more cream to the food. The way to do this is to take out of the bottle
+of each feeding one tablespoonful of the food and put in its place one
+tablespoonful pure cream. If this change partly rectifies the bowel
+ailment, add more cream until the bowels are of the proper consistency.
+Milk given constipated babies should be raw, never boiled, as boiled
+milk will always aggravate the trouble.
+
+The use of oatmeal water instead of plain water in making the baby's
+food may cure the bowel trouble. Taking the sugar of milk out of the
+baby's food and putting in its place the same quantity of Mellin's food
+will sometimes cure the constipation.
+
+One or two teaspoonfuls of milk of magnesia put into one feeding daily,
+or fifteen drops to one tablespoonful of the aromatic fluid extract of
+cascara sagrada will move the bowels. Orange juice, strained, two
+teaspoonfuls twice daily, is an excellent remedy and should be tried in
+every case. Sweet oil and pure cod liver oil, in doses of thirty drops
+to two teaspoonfuls three times daily after feedings, if the little
+patient is poorly nourished. If the stools remain hard and dry, an
+injection of two ounces of warm sweet oil at bedtime is an excellent
+method of aiding the bowel. The oil should remain in the bowel all
+night. This lubricates the parts, softens the fecal mass and stimulates
+the gut to perform its own work. See page 312.
+
+CONSTIPATION IN CHILDREN OVER TWO YEARS OF AGE.--Most children when put
+upon a varied diet after the nursing days are over are relieved of any
+constipation which may have existed up to that time. There are a few,
+however, whose condition does not seem to improve. These children need
+attention. We should first insist on regular habits. A child should be
+told that its bowels must move every morning after breakfast. If this
+is absolutely insisted upon the child will soon recognize the
+uselessness of fighting the proposition and submit. If at any time a
+conscientious effort is made to move the bowel without result after
+fifteen minutes it is wise to use a glycerine suppository so that the
+bowel will empty itself.
+
+It has been stated in another part of this book that there are children
+with whom milk does not agree. Experience has taught us that milk,
+especially milk that has been boiled, causes more cases of constipation
+in growing children than all other causes combined. Find out if it is
+milk that is the cause in any individual case. While these children
+cannot take whole milk just as it comes from the dairy without suffering
+in a great many ways, they can take milk and water, or milk and oatmeal
+water, prepared in the following way, without becoming constipated. A
+bottle of fresh milk is allowed to stand in a cool place for five hours,
+when the top ten ounces are skimmed off with a Chapin dipper and mixed
+with twelve ounces of oatmeal gruel or plain water. This can be used as
+a drink.
+
+Parents can select from the following list of articles such combinations
+as may be suitable to constitute the regular meals of a constipated
+child:
+
+    Lamb chops.
+    Rare steak.
+    Rare roast beef.
+    Hashed chicken.
+    Soft boiled eggs.
+    Cracked wheat.
+    Hominy.
+    Cornmeal.
+    Oatmeal, Scotch.
+    Bran biscuits.
+    Oatmeal crackers.
+    Graham wafers.
+    Stewed or baked apple.
+    Apple sauce.
+    Plain vanilla ice cream.
+    Animal broths, purées of peas.
+    Beans, and lentils.
+    Peas.
+    String beans.
+    Spinach.
+    Cauliflower.
+    Asparagus.
+    Stewed tomatoes, strained.
+    Whole wheat bread.
+    Zwieback.
+    Custard.
+    Stewed prunes.
+    Junket.
+    Cornstarch.
+
+Malted milk is agreeable and advisable as a drink.
+
+Orange juice or a scraped raw apple is allowable at this time.
+Constipated children should eat plenty of good butter. Olive oil, two
+or three teaspoonfuls after each meal, is excellent. It can be kept up
+for months to advantage. Older children may eat raw and cooked fruits,
+figs, dates, baked potatoes, poultry, and fish. One or two raw apples or
+a peach or orange may be given daily. A strict observance of the above
+rules and diet will result in normal movements of the bowel if persisted
+in for a reasonable time. It may be necessary occasionally to use a
+suppository or an enema now and again until the habit is established.
+
+In children from five to fifteen years of age the use of bran muffins,
+with fruit, etc., as described above, will effect a cure of constipation
+without having to resort to drugs. I have cured many cases of
+constipation in growing children with these muffins without making any
+other change in their diet or habits.
+
+
+RECIPE FOR BRAN MUFFINS
+
+     Take one pint of best flour, one quart unsifted bran, one
+     teaspoonful bicarbonate of soda (baking soda), a pinch of salt.
+     Mix these thoroughly together, then add: six to eight
+     tablespoonfuls good, New Orleans molasses, one pint of milk.
+     Mix together very thoroughly. Put in muffin rings and bake in
+     oven. About one ounce should be put in each ring as they raise
+     easily. Eat with plenty of good butter. They should be given to
+     children before each meal, when they are hungry, not after
+     their stomachs are full. Put bran in dish first. Sift in flour,
+     soda and salt. Mix these thoroughly together, then add one pint
+     of milk (two cupfuls) and six to eight tablespoonfuls of New
+     Orleans molasses. The quantity of molasses depends upon the
+     individual taste. They are good for any child or adult whether
+     constipation exists or not.
+
+Drugs may be of temporary service in some cases. A pill of cascara
+sagrada is the best for this purpose. It should not be continued for
+more than two weeks. Castor oil, calomel, and other frequently-used
+cathartics should never be used in simple constipation.
+
+
+TREATMENT OF OBSTINATE CONSTIPATION
+
+There are cases that resist treatment of the kind described above. Diet
+and drugs do not succeed in establishing the habit of daily bowel
+movements. In these cases radical treatment is imperative. The diet
+should be the same as that described above, but it will be found
+advisable to cut out milk altogether. Cereals can be taken with sugar
+and butter instead of milk. The oil injection plan of Professor Kerley
+has given me excellent results. I quote his comments upon and method of
+giving it:--
+
+"OIL INJECTIONS."--"For this purpose a soft-bulb syringe of four ounces'
+capacity is ordered. Over the hard rubber tip is place a small sized
+adult rectal tube or a No. 18 American catheter. The catheter or tube is
+cut so that but nine inches remain for use. The cut end is forced over
+the small, hard rubber tip of the syringe. A fountain syringe is
+impracticable for this purpose, as it is soon destroyed by the oil and
+rendered unfit for use. Besides, sufficient pressure is not produced to
+force the oil into the gut even with a high elevation of the bag. The
+child is placed on his back or on his left side. The syringe is filled
+with oil, the tube is lubricated, and passed through the rectum as far
+as it can go. When it has been passed to the full nine inches, as may
+readily be done with a little practice, the syringe is emptied and the
+tube withdrawn. The injection should be given after the child has been
+placed in bed for the night. It is our object to have the oil retained
+during the night. If a passage of the bowels is produced at the time, or
+if the oil leaks out during the night, a small quantity should be used.
+In some of my patients I have been able to use but one ounce. In very
+few, indeed, does it cause an evacuation at the time. If there is a
+tendency to leakage a napkin should be worn to avoid soiling the
+bed-linen. The following morning after breakfast, the child is placed on
+the vessel and kept there until a bowel movement results or until
+fifteen minutes have elapsed. In a great many cases if the constipation
+has been obstinate for months, the bowel will be at once evacuated. When
+this does not occur in fifteen minutes, a glycerine suppository is
+inserted, which invariably produces an evacuation. This use of the
+suppository, according to my observation, can usually be dispensed with
+in a very few days; the use of the oil, however, may have to be
+continued for several weeks. When the child has had the oil nightly and
+an evacuation the next morning without assistance for two weeks, I
+direct that the oil be omitted for a night and the effect noted. If the
+usual passage occurs after breakfast, the oil is given for five nights
+and then omitted. If the case progresses satisfactorily the use of the
+oil is gradually omitted, being given at first every second night, then
+every third, fourth, or fifth night, etc. A considerable number of cases
+have been completely relieved in two months. In the event of no passage
+following the omission of the oil, its use is continued for two weeks
+longer, when it is again omitted for a night." To illustrate this point
+the following case is cited.
+
+"ILLUSTRATIVE CASE.--A boy three years of age had never had a bowel
+evacuation without drugs, soap enemas, or suppositories since birth, and
+finally these were no longer effective. The mother, thoroughly
+frightened, brought the child to me. Eight months of diet and the use of
+the oil were required before he was entirely well. It is now three
+months since the local treatment was discontinued and the bowel function
+remains normal.
+
+"The diet with the absence of milk must be continued for months after
+the patient is apparently well, and he must not be allowed to pass a
+single morning without an evacuation at the usual time. In assuming the
+management of one of these cases I explain to the mother or nurse that
+the treatment is not pleasant for the child or the attendant, and that
+it may have to be persisted in for weeks, and unless she is willing to
+carry it out to the end, it would better not be undertaken. I assure
+her, however, that with her coöperation, which is usually readily given,
+the child will make a complete recovery. Cases that are slow in
+responding to treatment, I usually give the additional advantage of
+abdominal massage from twenty minutes to one-half hour, before the child
+is placed at stool. The massage should practiced by one skilled in the
+work.
+
+"The above local measures apply particularly to children after the
+eighteenth month. They may be used earlier, however, following out the
+diet along the lines laid down for bottle-fed children who suffer from
+constipation. In very young children a smaller amount of oil should be
+used, never more than two ounces, usually one ounce is all that is
+required. When the oil treatment is under way, whatever the age of the
+patient, laxative drugs should not be given."
+
+
+
+
+CHAPTER XXIII
+
+CONSTIPATION IN WOMEN
+
+     Chief Cause of Constipation in Women--Constipation a Cause of
+     Domestic Unhappiness--The Requirements of Good Health--The Cost
+     of Constipation--Constipation and Social Exigencies--One of the
+     Important Duties of Mothers--Constipation and Diseases of
+     Women--Constipation is Always Harmful--Constipation and
+     Pregnancy--Explanation of Incomplete Constipation--Causes of
+     Constipation--Negligence--Lack of Exercise--Lack of Water--Lack
+     of Bulk in the Food Taken--Abuse of Cathartic Drugs and
+     Aperient Waters--Overeating--Treatment of Constipation in
+     Women.
+
+
+It has been stated that constipation is almost universal among the women
+of America. It is a fact that very few American women enjoy, to a
+reasonable degree, a permanently satisfactory bowel condition.
+Constipation is an acquired habit and unquestionably negligence is the
+primary and the chief cause of it. The negligence, no doubt, begins at a
+very early age; it is at least an established habit before any
+intelligent, consecutive effort is made to remedy it. Inasmuch as women
+are the mothers of the race, and as their part in the scheme of life
+_is_ the supreme one; and as constipation has been shown to be a
+serious, far-reaching, significant disease, a very sincere and
+persistent crusade should be made to educate women as to its importance.
+For a less altruistic purpose, tremendous popular movements have been
+carried to success. For a less service rendered to the race names have
+achieved renown. In addition to the symptoms stated in the preceding
+paper, the condition which we now desire to emphasize is the effect of
+the constant self-poisoning on the general health and its effect upon a
+woman's reproductive efficiency.
+
+The poison being constantly absorbed, means general bad health, bad
+health to a degree depending upon the degree of constipation which is
+the cause of the poisoning. It may be simply that the woman does not
+wholly enjoy good health, or that she is completely incapacitated
+because of chronic bad health, or any degree of indifferent health
+between these two extremes.
+
+If the degree of poison is sufficient to cause habitual poor health, its
+effect upon the blood must be bad, and the effect of the bad blood upon
+the nervous system and the other vital organs cannot be good. Now if
+this process has been going on for many years, the condition of the
+woman, who is its victim, as an efficient machine, compared with the
+woman in whom this condition never did exist, must be very different
+indeed. This condition of affairs--inasmuch as constipation is so common
+in women--must have a tremendous significance when estimating the
+vitality and efficiency of the coming generation.
+
+We might go much further and yet be sure of our position, and maintain
+that it is this national autotoxemia, this scourge of womanhood, that is
+to a great extent responsible for the characteristic American "vice of
+neurasthenia," and of the domestic infelicity and unhappiness which are
+so common in the large cities of this country. If we add to the
+intestinal autotoxemia of constipation, the tendency to, or vice of,
+indiscriminate eating and drinking--of which the American people are
+particularly guilty--we would be on firmer ground. In fact we would feel
+that we had pointed out the one underlying cause of most of the domestic
+irritability prevalent to-day, which is of serious importance, and which
+is, fortunately, capable of correction. It is a matter of everlasting
+and continuous education.
+
+THE REQUIREMENTS OF GOOD HEALTH.--There are certain fundamental basic
+requirements which are essential to good health: fresh air, good water,
+a reasonable amount of physical and mental exercise, nutritious food,
+freedom from unnecessary and unreasonable worry, frequent bathing, and a
+daily movement of the bowels. The reason why constipation is of such
+serious importance is because it is the only basic requirement of good
+health that afflicts a large majority of the race at the same time. The
+health of so many is being undermined by this one affliction, that it
+dominates all other factors that have any bearing upon posterity. A
+woman may enjoy all the essential conditions necessary to good health,
+yet she may be constipated, and the presence of this condition will
+undermine, in her constitution, all the benefits she derives from her
+advantageous environments. It will do more; it will be responsible for
+the disposition,--the temperament,--of that woman. The natural
+disposition of that woman may be an amicable one; if it were allowed to
+express itself naturally it would be kind, gentle, considerate,
+affectionate. No woman, however, the victim of chronic constipation, can
+preserve an equable temperament or an amicable disposition. It is
+impossible--with her nerves being constantly poisoned--that she can hold
+the symptoms of that condition in abeyance. She must be irritable and
+nervous and sick of herself and everything and everybody. The home as a
+direct result suffers; its atmosphere is not one of contentment and
+peace and affection. Constipation, therefore, blights the home and the
+influence of one blighted home may have a far-reaching effect on the
+story of the human race. It is responsible also for that woman's mental
+attitude outside the home. Instead of exerting an optimistic influence,
+her whole existence is a message of pessimism and discouragement.
+Multiply these influences and messages to correspond with the prevalence
+of the disease and we have a condition that is tremendously significant,
+a condition that is really a pressing economic issue. A constipated
+woman is an anti-eugenist--a eugenic atrocity.
+
+We have no desire to create a false impression or to build up a foolish
+fear. Are we justified in regarding this as one of the most important,
+if not the most important, disease condition; the most menacing physical
+vice, which the human race has to combat? Let us offer the following
+brief facts in witness of our stand:
+
+THE COST OF CONSTIPATION.--It has been estimated that consumption (the
+great white plague) kills one-tenth of all the human race. Cancer kills
+half as many, or one in every twenty. Constipation, and the diseases
+which are caused directly by it, kills one in every three of all the
+people on the civilized globe.
+
+Constipation has been responsible for the expenditure of millions of
+dollars in advertising in the newspapers alone,--more, probably, than
+has been spent in advertising remedies for all other diseases combined.
+Do you suppose this money was a donation? Do you suppose these keen,
+alert interpreters of the spirit of the times, the up-to-date business
+men, were not and are not aware that constipation is the "universal
+disease"?
+
+Every drug store, in every civilized spot on earth, has its shelves
+loaded down with constipation remedies; dinner pills, liver pills,
+cathartic pills, tablets in all possible coatings and combinations,
+mineral waters from a multitude of springs, aperient drinks by the
+dozen, laxative teas and cordials, cathartic oils and emulsions. If the
+demand for these articles should cease most of the drug stores would
+close up.
+
+Many millions of dollars have been made and are being made by various
+men and concerns, who have devised ingenious mechanical agencies which
+are supposed to cure, and in curing renew the lost health caused by
+constipation. We have in mind in this connection, a man who conceived
+the ingenious plan of putting the opening of an ordinary fountain
+syringe in the middle instead of at the end and made a fortune out of
+it. In this opening he places an upright nozzle, and instead of hanging
+the bag up and allowing the water to run into the bowel, he has the
+patient sit on the bag and thereby the water is forced into the bowel.
+He has written a two-hundred page book on the advantages of this idea,
+and his "literature" contains the names of famous men and women in all
+walks of life who use his device. The name of one of the famous judges
+of the Supreme Court of the United States was there; another was the
+name of a popular operatic beauty who writes for the daily press little
+essays on "How to be beautiful!" and "How to keep well!" He deserves his
+success. He is an emancipator and has doubtless done a great deal of
+good. His success demonstrates, beyond contradiction, the prevalence of
+the malady under discussion, and it must be remembered that he is only
+one of hundreds who garner from the same ample harvest.
+
+If we could estimate in value the economic loss sustained by the race
+because of the inefficiency of the victims of intestinal intoxication,
+due to constipation, the sum would be colossal. Even then it would only
+represent the direct economic deficiency--it would not express, nor
+could any figure adequately represent, the indirect loss sustained by
+the race because of the temperamental characteristics, which are the
+products of intestinal poisoning, and which produce domestic tragedies
+and economic failures.
+
+Has this array of evidence any meaning, or does it just happen to be so?
+We leave it to the reader; if it stimulates thought, or pricks a
+conscience it will have done its duty.
+
+CONSTIPATION AND SOCIAL EXIGENCIES.--The cause of constipation in women,
+whose social station commands every sanitary, hygienic, and dietary
+luxury, is their method of living, the food they eat, and the negligence
+which is almost obligatory because of social exactions. If constipation
+did not so frequently accompany "good" living (which is the modern name
+for overeating and drinking) we would have thousands and thousands of
+healthy, robust, contented women, fit and willing to assume the onerous
+duties concomitant with motherhood. All their enthusiasm, however, is
+expended in the effort to keep "in the ring," to overcome the effects of
+the poison of constipation, to preserve their youth and freshness, to
+undo what neglect has accomplished. It is because of the failure of this
+simple function that my lady seeks the masseur, the facial artist, the
+society doctor, the beauty expert, and the thousand and one agencies,
+which an extravagant and profligate age has made necessary to foster the
+efficiency of its votaries.
+
+I am optimistic, however, regarding the future. I believe the human race
+is improving, despite the disadvantageous surroundings and conditions
+which hamper honest effort and stultify truth. A higher efficiency is
+the goal, and the intention is to obtain this desideratum by fair and by
+just means. There is an awakening, an unrest, a groping for knowledge in
+almost every field of human endeavor, and there is none in which the
+yearning for fact, for truth, for instruction, is stronger and keener,
+than in the world-wide movement in the interest of a better motherhood,
+and in a more serious study of child life. It is an encouraging sign, a
+hopeful promise, of what the future has in store.
+
+ONE OF THE IMPORTANT DUTIES OF MOTHERS.--The immediate lesson to be
+learnt from the facts just recounted is to instruct mothers in their
+duty toward their daughters. If each mother would retain the confidence
+of her daughter sufficient to instruct her in the duties which are
+important, how much needless suffering would be saved. To know as a
+matter of fact whether the daughter's bowels are in good condition will
+appeal to all who read this as being of very great importance. It is not
+only necessary to know if they have a movement every day, it is
+necessary to know the character of the daily movement; whether it is
+hard and dry and necessitates straining,--the evil consequences of
+which, in young girls, is very serious indeed,--or if it is habitually
+loose and suggestive of what has been described as incomplete
+constipation.
+
+If the mothers of America would consecrate themselves to this simple
+task, who could tell in mere words the effect it would have on the race
+yet unborn? There are problems of scientific intent, and of fancy names,
+that engage the attention of philanthropically inclined ladies, and
+which are emblazoned on the society columns of the daily press, of much
+less importance to the human family than the homely duty we ask mothers
+to devote themselves to.
+
+CONSTIPATION AND DISEASES OF WOMEN.--Constipation is present in a very
+large majority of the cases of diseases of women. It may be caused by
+disease of the womb, or it may cause disease of the womb. There is no
+question about the bad effect constipation has upon all diseases of this
+type. In many cases it is absolutely impossible to effect a cure without
+first curing the accompanying constipation.
+
+We seldom appreciate how severe a degree of constipation a growing girl
+will submit to without seeking relief. Some of the worst cases of
+constipation that have been known, have been in girls between the ages
+of sixteen and twenty. The mechanical effects of such a condition can
+well be imagined. The constant, severe straining, necessary to evacuate
+the bowel, has, in very many instances, produced congestion and
+displacement of the womb and ovaries. It is not observed at this time,
+or if observed it is not understood, and thus is laid the foundation for
+years of neurasthenia, helplessness, and disease.
+
+The more we investigate the ramifications of constipation the more we
+learn of its seriousness and of its significance.
+
+CONSTIPATION IS ALWAYS HARMFUL.--There is no period in life when
+constipation can be borne with impunity. Youth, with its virility and
+vitality, will endure its consequences with an apparent negation, so far
+as positive or specific results are concerned, but it is only an
+apparent impunity. There is always a certain amount of strength built
+up, held in reserve as a heritage of youth, which will withstand a
+certain amount of physical license, but if this reserve is assailed by
+an unnecessary imposition, and is successfully undermined, there will be
+infinitely less reserve to call upon in the legitimate battle of life.
+Life is too real, too concentrated, too strenuous, and health is too
+precious to be wilfully wasted in any form of self-abuse.
+
+CONSTIPATION AND PREGNANCY.--Mothers will appreciate from the foregoing
+explanation why constipation is eugenically a crime during pregnancy.
+The evils which result from constipation mechanically, frequently have
+serious consequences by interfering with the circulation of the blood to
+the womb, by forcing the womb to assume wrong positions, by straining at
+stool, and by preventing the kidneys from functionating properly; these
+may render the life of the pregnant woman miserable, and may be the
+direct cause of a painful, prolonged, difficult labor. The evils which
+result from constipation because of the absorption of poisons by the
+bowel are of the gravest importance during pregnancy. These poisons
+affect the general health; the victim is tired, listless, and apathetic,
+and is thereby disinclined to exercise adequately; the appetite is
+poor; there are headaches, neuralgias, insomnia, nervousness,
+melancholia, and general mental and physical inertness. What hope may a
+pregnant woman entertain of having "an easy confinement," or of bringing
+a healthy child into the world under these circumstances? Who is to
+blame? Sometimes it is necessary to tell the unadorned truth,--the woman
+is to blame. No woman has a right to assume the responsibilities of
+maternity who has not had enough respect for herself to discontinue
+habits which caused this failing, or who has not had strength of will
+enough to begin its successful cure. Get busy,--do something,--it is
+never "too late," but do it now.
+
+Before we take up the treatment of constipation in women, it is
+necessary to explain more fully the type of constipation which we
+referred to as "incomplete" constipation. There is a condition of the
+bowel, in which we find its wall coated with hard fecal matter. The size
+of the bowel may be dilated as a consequence. This condition may occupy
+part, or most, of the entire length of the large intestine. In the
+middle of this hard mass there is a small channel through which
+semi-liquid matter passes. When the bowel moves, it is this semi-liquid
+matter that passes out, and this constitutes the daily movement. We have
+consequently a condition in which we have a daily movement but not a
+complete emptying of the bowel. The character of the stools from such a
+bowel must necessarily be more or less of a semi-liquid consistency,
+because the intestine, being coated with a hard dried out layer of old
+fecal substance, is prevented from absorbing the liquid part of the
+fresh fecal mass passing through it. This condition may exist for a
+considerable time, but it will slowly undermine the health and vitality
+of any person in whom it exists. The symptoms which a patient in this
+condition complains of are,--a feeling of being tired and languid, no
+energy or vim, headache, loss of appetite, loss of flesh, neuralgic
+pains, nausea, vertigo (dizziness), insomnia, frequent colds, cold hands
+and feet, biliousness, sallow skin and muddy complexion, liver spots,
+coated tongue and a "bad breath," nervousness, melancholia, various
+abnormal conditions and diseases of the skin, pimples, blackheads,
+eruptions, eczema, piles, appendicitis, diseases of the intestinal wall
+as a result of the constipation, Bright's disease of the kidney, and
+many other morbid conditions. Any physician could name many symptoms,
+which were never properly understood but which are now known to be
+caused by the absorption of poisons resulting from inactivity of the
+bowels. Patients may not necessarily have all of the above symptoms;
+they may have a number of them, or they may have all of them, and they
+may have others not mentioned at all.
+
+TREATMENT OF CONSTIPATION IN WOMEN.--To effect a movement of the bowels
+in a patient who is a victim of constipation is not a cure. We can
+indefinitely cause bowel action by drugs, etc., but the condition will
+remain the same or worse. When habitual constipation exists there is an
+underlying condition affecting the entire system which indicates that
+something is radically wrong. It may be necessary to change the whole
+routine of the patient's life. It will certainly be necessary at the
+very beginning to inquire into the daily diet, exercise, and
+surroundings.
+
+During the past ten years there has been born every few days a new
+medical "ism," a new religious cult. Why? Because human nature is an
+unstable equation. We are never satisfied with the old order of things
+and there will always be a following wherever there is a leader. These
+"isms" and cults do not survive. Some seem to thrive, others die a
+natural death. There is a law, as old as the hills, that you cannot get
+something for nothing in this world. We learn its bitter truth as the
+years pass, and when we get over the day dreams and the sentiment of
+youth we settle down to real work. If we desire to retain good health,
+or regain lost health, we must do something. No one can hand it to us on
+a silver plate, nor can anyone work a miracle in our behalf. We cannot
+buy health, we must deserve it.
+
+This is the secret of the success of all schemes to cure disease. The
+human family will not knuckle down and swallow the truth. The man or
+woman in poor health is looking for Aladdin's lamp everywhere and
+always. A new bait, dressed up in lubricated, oily words, promising
+impossible results, will be accepted as the simple unadorned truth, and
+will be bought and paid for, in the end forgotten. The royal road, the
+easy road, which they are looking for is impossible. There is no way by
+which any one of us may continue to break the laws of nature and retain
+or regain our lost health. Miracles are impossible. Prayers without
+deeds are empty mouthings and a waste of time. Let us see how this works
+out in the treatment of constipation. We must find the cause of the
+constipation. I will name the causes in their order of frequency.
+
+NEGLIGENCE.--This is unquestionably the primary cause of almost all
+cases of bowel inactivity. As has been already noted, the exigencies of
+modern life are of such a strenuous nature that we do not find the time
+to devote to this function the degree of systematic attention which it
+demands in order to preserve a healthy condition of intestinal
+regularity. The bowel is simply a complex muscle controlled by an
+elaborate system of nerves of an involuntary type. In order to preserve
+the highest degree of efficiency of this complicated mechanism, it must
+be permitted to obey the laws nature endowed it with and which it must
+obey. When the fecal mass reaches the rectum the nerve centers, acting
+through the spinal cord, send a message to the rectum something like
+this: "Empty yourself of your contents, we have made all preparations
+and everything is ready." The rectum obeys to the extent of notifying
+you that it wants to be relieved; you feel the desire to evacuate the
+bowels. If you obey, all is well, nature is appeased, you encourage the
+systematic regularity necessary to good health. If you do not obey, you
+upset the delicate mechanism, and frequent negligence of this character
+will result in the complete disarrangement of this complex machinery so
+that it will fail to warn you that a bowel movement is necessary and
+constipation is established. We must therefore retrace our steps and
+re-educate the bowel systematically to empty itself at a certain time
+every day. This can be done in nearly every case without artificial
+assistance. It may take time but it is worth a little methodical
+persistence. The point is, you must do it; no "ism" or esoteric agency
+can do it for you.
+
+Mothers will recognize from this explanation the necessity of
+establishing the habit in children at the earliest possible moment.
+
+LACK OF EXERCISE.--What does the word exercise imply? It implies
+movement, better circulation of the blood, better health and tone to
+every part of the body, more oxygen, and a richer, better quality of
+blood, and because of a better quality of blood, which is the fuel of
+the body machine, we have a better, smoother working machine. Every
+human being requires a certain amount of exercise; otherwise the machine
+will not run smoothly. If this exercise is not obtained, things begin to
+go wrong. One of the very first signs to indicate that the machine is
+not running as it ought to run, is a sluggish condition of the whole
+digestive apparatus and a certain degree of bowel inactivity
+(constipation) follows. There is no substitute for this need. Drugs will
+not help you, mechanical devices will not do the work for you, though
+they may aid you. You must do the work yourself. If you fail or hesitate
+to recognize the truth, if you temporize or procrastinate, you are only
+deferring the issue. The argument that you have not the time, that your
+work will not permit you, is no argument at all. You must do it or reap
+the consequences; you certainly cannot escape them. The wise woman
+accepts the situation, the fool goes to an early grave.
+
+LACK OF WATER.--Constipation may be due to a deficiency of water in the
+system. Women who suffer from this type do not drink enough water. The
+bowel may be willing and able to do its duty, but is handicapped because
+a certain amount of liquid is essential to proper digestion and natural
+bowel activity. At least six glasses of water should be taken by every
+healthy adult human being in each twenty-four hours. The best time to
+take this water is as follows: one glass on arising, two between
+breakfast and lunch, two between lunch and dinner, and one on retiring.
+Between meals means one hour after a meal and at least one-half hour
+before the following meal. No liquid should be taken during a meal, or
+immediately after, or before a meal. All water taken may be hot or cold,
+according to the fancy of the taker. It is of advantage to squeeze the
+juice of half a lemon into the water taken on arising if there is any
+tendency to constipation or if the liver is lazy or torpid. It is also
+good for the complexion.
+
+LACK OF BULK IN THE FOOD TAKEN.--Sometimes the character of the food
+taken is such that there is no body to it. The process of digestion so
+completely liquefies it that the bowel has no solid matter to
+manipulate. To excite the peculiar movements of the intestinal wall
+there must be substance in the contents. The variety of the daily food
+must be so arranged as to provide this. A list of these foods is
+provided elsewhere in this book. Certain other foods stimulate
+intestinal activity, not because of their bulk, but because of the
+chemical elements they contain. All forms of sugar, the sugars of
+fruits, the acids of fruits and vegetables, are excellent natural
+laxatives. Sour milk and buttermilk, oils and fats, are also of distinct
+value in this respect.
+
+On the other hand, soups, gruels, porridges, and purées are constipating
+because the digestive process reduces them to liquids and leaves no bulk
+for the bowel to act upon. New bread, hot biscuits, "noodles," and
+doughy foods are also objectionable, especially to children. Hot baths,
+hot drinks, hot enemas, and sweating are also constipating because they
+extract so much liquid from the bowel leaving the contents excessively
+dry.
+
+ABUSE OF CATHARTIC DRUGS AND APERIENT WATERS.--This is a widespread
+evil; it may justly be regarded as a national curse. The victims of this
+custom do not realize that they are addicted to a habit which must be
+rightly regarded as equally as bad as the drink habit, so far as its
+ultimate effect on the general health and the prospect of longevity is
+concerned. Its popularity is a product of our national vice of
+indiscriminate eating and drinking. It is more common among the class
+who live in restaurants, hotels, and boarding houses, who keep late
+hours, eat late suppers and who do not exercise enough. These
+individuals eat too much and live too high. After a time the liver
+becomes sluggish, the stomach fails to digest properly, the bowels lose
+their tone, and flatulent indigestion or some other more or less serious
+condition follows; to maintain the pace, to feel and keep fit, they
+discover that a glass of some advertised aperient or laxative water
+before breakfast works wonders, tides them over for the time being and
+keeps them "in the ring." They compliment themselves and push the
+specter of age aside.
+
+The thought that they were not "as young as they once were," or that
+they must go slow, was not a very pleasing suggestion, so having found a
+"cure" by adding another bad habit on top of an existence which is
+composed of nothing but bad habits, they start all over again. The
+suggestion that their trouble is a warning that "things are going wrong"
+and that the whole plan of living must be radically and promptly changed
+does not meet with their approval, and so the Department of Health
+statistics heap up the records of deaths due to heart disease, hardening
+of the arteries, Bright's disease of the kidneys and apoplexy. It is not
+a happy tale, but the truth is often tragic.
+
+When a woman finds that her physical efficiency depends upon the
+habitual use of cathartic drugs or laxative waters, she must regard the
+knowledge with respect, she must give it serious consideration, and she
+must adopt means to so change her method of living, that nature will be
+given a chance to work in her interest--not against her. Better to find
+out exactly where the trouble _is_ now, and go after it than to travel
+too far along the wrong road. Many die from the "disease" of
+procrastination.
+
+OVEREATING.--Overeating may be included in this classification because
+it so overworks the digestive apparatus that it is impossible for it
+satisfactorily to complete its function. Any reader desirous of
+understanding the full significance of overeating in this connection
+should carefully read the article on this subject on pages 289 and 290.
+
+There are, of course, a great many other causes for constipation but
+these are the important ones. When we find the cause of any particular
+case it will suggest the remedy and we must employ it faithfully if we
+hope to effect a cure. If it is negligence, we must correct that fault
+and compel our daily routine to accommodate itself to a regular
+observance of this function. If it is lack of exercise, we must get more
+exercise, or if it is lack of bulk in our food, we must change our
+method of living and select with more care the foods we eat. If it is
+lack of water, we can correct the constipation by adding the proper
+amount of water at the proper time.
+
+A patient who has been a victim of chronic constipation for some time
+must live a life somewhat after the following general plan:
+
+She should increase the vegetables, fruits, and fats in her diet and she
+should drink enough water. It is a good plan to sip slowly one-half pint
+of hot or cold water morning and evening. Daily exercise in the open air
+is advisable; exercise of some kind, even if taken indoors, is
+imperative. Walking, riding, bicycling, tennis, golf, swimming, are the
+best forms of exercise for women. Indoor gymnastics can be made a
+satisfactory substitute. After the exercise a hot shower bath and a cold
+sponge bath or cold plunge or a swim should follow.
+
+Women in very moderate circumstances may walk briskly a distance of
+three or four miles, and on returning can take a warm bath followed by a
+brisk rub-off with a coarse towel wrung out of cold water, or they can
+use a hose with a spray nozzle and allow the cold water to run over them
+for a few seconds after the warm dip in the bath tub. After the adoption
+of these measures the bowels may tend to regulate themselves. If so,
+this is the proper time to cultivate the habit of regularity, by
+selecting a certain time each morning or before retiring for this
+function. The patient should go to the toilet at the regular time even
+if the desire is not present. By straining slightly, and by encouraging
+the voluntary desire, the bowel may receive the necessary stimulation
+and an evacuation may result. If there should seem to be no disposition
+on the part of the bowel to become accustomed to this procedure, we must
+aid it for the time being. A glycerine or soap suppository, a glass of
+aperient water, Pluto, Hunyadi, Apenta, or the imported Carlsbad salt in
+warm water, or the effervescent Citrate of Magnesium, will result in a
+prompt emptying of the bowel. There are a great many other cathartic
+drugs and many well-known laxative pills, etc., but these are not
+necessary if a systematic effort is being made to cure the constipation,
+because success will come within a reasonable time if the patient will
+not become unduly discouraged. Many victims are deficient in fat; the
+bowel needs lubrication; we therefore recommend a good quality of olive
+oil, one tablespoonful after each meal. Frequently it is of advantage to
+inject, high up in the bowel, two or three ounces of sweet oil at night,
+as is done in children, and which is fully described in the previous
+chapter.
+
+If the constipation is due to deranged nerves, in which the reflexes of
+the intestinal wall seem to share, we advise massage of the abdomen, and
+an occasional hot or cold rectal injection. The proper quantity to use
+for this purpose is from two to three quarts. The solution to use is the
+normal salt solution. See page 627.
+
+In that form of incomplete constipation in which we stated that there
+was a layer of hard, impacted feces covering the bowel wall, a special
+method of treatment is necessary. In these cases nothing will succeed as
+satisfactorily as very hot, high rectal injections. The object of course
+is to rid the bowel of the old, hard, dry mass, which has collected
+there, before we can hope to get the bowel into condition to perform its
+own work. It is almost incredible that the human bowel can hold so much
+old dried-out, nasty stuff as is stored up in these constipated bowels.
+Hot salt water, as hot as can be tolerated, two or three quarts at a
+time, is the correct way to dislodge this mass. It will not be done at
+once; it frequently takes two or three weeks before the bowel is fairly
+clean. The irrigations should be given every second night until the
+bowel is clean. The method of giving these washings is fully described
+on page 312. While these irrigations are being given the patient should
+take olive oil by the mouth, one tablespoonful after each meal. The
+proper food, open-air exercise, sanitary living, plenty of water, and
+regular attention to the bowel movements will in the end cure the
+affliction.
+
+
+
+
+
+End of the Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4),
+by W. Grant Hague
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+***** This file should be named 24854-8.txt or 24854-8.zip *****
+This and all associated files of various formats will be found in:
+        http://www.gutenberg.org/2/4/8/5/24854/
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+http://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at http://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+http://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at http://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit http://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including checks, online payments and credit card donations.
+To donate, please visit: http://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart is the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     http://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
diff --git a/24854-8.zip b/24854-8.zip
new file mode 100644
index 0000000..fe98862
--- /dev/null
+++ b/24854-8.zip
diff --git a/24854-h.zip b/24854-h.zip
new file mode 100644
index 0000000..97f1a16
--- /dev/null
+++ b/24854-h.zip
diff --git a/24854-h/24854-h.htm b/24854-h/24854-h.htm
new file mode 100644
index 0000000..2f189a9
--- /dev/null
+++ b/24854-h/24854-h.htm
@@ -0,0 +1,8804 @@
+<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
+    "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
+
+<html xmlns="http://www.w3.org/1999/xhtml">
+  <head>
+    <meta http-equiv="Content-Type" content="text/html;charset=iso-8859-1" />
+    <title>
+      The Project Gutenberg eBook of The Eugenic Marriage, Vol. 2, by W. Grant Hague, M. D.
+    </title>
+    <style type="text/css">
+/*<![CDATA[  XML blockout */
+<!--
+    p {  margin-top: .75em;
+         text-align: justify;
+         margin-bottom: .75em;
+         }
+    h1,h2,h3,h4,h5,h6 {
+         text-align: center; /* all headings centered */
+         clear: both;
+         }
+    hr { width: 33%;
+	 margin-top: 2em;
+	 margin-bottom: 2em;
+         margin-left: auto;
+         margin-right: auto;
+         clear: both;
+       }
+
+    table {margin-left: auto; margin-right: auto;}
+
+    body{margin-left: 10%;
+         margin-right: 10%;
+        }
+
+    .pagenum  { /* uncomment the next line for invisible page numbers */
+            /*  visibility: hidden;  */
+                position: absolute;
+                left: 92%;
+                font-size: smaller;
+                text-align: right;
+              } /* page numbers */
+
+    .blockquot{margin-left: 5%; margin-right: 10%;}
+    .right   {text-align: right;}
+    .center   {text-align: center;}
+    .smcap    {font-variant: small-caps;}
+
+    .caption  {font-weight: bold;}
+
+    .figcenter   {margin: auto; text-align: center;}
+
+    .figleft     {float: left; clear: left; margin-left: 0; margin-bottom: 1em; margin-top:
+                 1em; margin-right: 1em; padding: 0; text-align: center;}
+
+    .figright    {float: right; clear: right; margin-left: 1em; margin-bottom: 1em;
+                 margin-top: 1em; margin-right: 0; padding: 0; text-align: center;}
+
+    .footnotes        {border: dashed 1px;}
+    .footnote         {margin-left: 10%; margin-right: 10%; font-size: 0.9em;}
+    .footnote .label  {position: absolute; right: 84%; text-align: right;}
+    .fnanchor         {vertical-align: super; font-size: .8em; text-decoration: none;}
+
+    .poem             {margin-left:10%; margin-right:10%; text-align: left;}
+    .poem br          {display: none;}
+    .poem .stanza     {margin: 1em 0em 1em 0em;}
+    .poem span.i0     {display: block; margin-left: 0em; padding-left: 3em; text-indent: -3em;}
+    .poem span.i2     {display: block; margin-left: 2em; padding-left: 3em; text-indent: -3em;}
+    .poem span.i4     {display: block; margin-left: 4em; padding-left: 3em; text-indent: -3em;}
+    // -->
+    /* XML end  ]]>*/
+    </style>
+  </head>
+<body>
+
+
+<pre>
+
+The Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4),
+by W. Grant Hague
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Eugenic Marriage, Vol 2 (of 4)
+       A Personal Guide to the New Science of Better Living and Better Babies
+
+Author: W. Grant Hague
+
+Release Date: March 16, 2008 [EBook #24854]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+
+
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+
+
+
+
+</pre>
+
+
+<div class="figcenter" style="width: 350px;">
+<img src="images/v2frontis.jpg" width="350" height="500" alt="New York&#39;s Better Baby" title="" />
+<span class="caption"><i>By courtesy of The New York Times</i><br />
+
+New York&#39;s Better Baby</span>
+</div>
+
+<div class="blockquot">Little Hiss Johanna Wiggers, who won the first prize in New York's
+Better Babies Contest by scoring 100 points, is the type of little girl that
+will make the best mothers, and the better race tomorrow. Her score card
+showed; age, 28 months; weight, 33 lbs. 14 ozs.; height, 35-1/2 inches;
+circumference of head, 19-1/2 inches: circumference of chest, 20 inches;
+lateral diameter of chest, 6 inches; diameter of chest from front to back,
+4-1/2 inches; length of arm to tip of middle finger, 14-1/2 inches; length of
+leg to the sole of the foot, 16-1/2 inches; total, 100 points.</div>
+
+
+
+<hr style="width: 65%;" />
+<h1>The Eugenic Marriage</h1>
+
+<h3>A Personal Guide to the
+New Science of Better
+Living and Better Babies</h3>
+
+<h2>By W. GRANT HAGUE, M. D.</h2>
+
+<p class="center"><i>College of Physicians and Surgeons (Columbia
+University), New York; Member of County Medical
+Society, and of the American Medical Association</i></p>
+
+<h3>In Four Volumes</h3>
+
+<h3>VOLUME II</h3>
+
+<p class="center">New York<br /><br />
+
+THE REVIEW OF REVIEWS COMPANY<br /><br />
+
+1914</p>
+
+<p class="center">
+Copyright, 1913, by<br />
+<span class="smcap">W. Grant Hague</span><br />
+<br />
+Copyright, 1914, by<br />
+<span class="smcap">W. Grant Hague</span><br />
+</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_iii" id="Page_iii">[Pg iii]</a></span></p>
+<h2>TABLE OF CONTENTS</h2>
+
+
+
+<h4><span class="smcap">Sex Hygiene for the Boy</span></h4>
+
+<h3>CHAPTER XII</h3>
+
+<h4>BUILDING OUR BOYS</h4>
+
+<p>A word to parents&mdash;Interest in sex hygiene&mdash;The "Social
+Evil"&mdash;Ten millions suffering with venereal diseases in
+the United States&mdash;Immorality not confined to large cities&mdash;Venereal
+diseases common in country places&mdash;What are
+the consequences of venereal disease to the boy?&mdash;Gonorrhea,
+or clap&mdash;Symptoms of gonorrhea in the male&mdash;Complications
+of gonorrhea&mdash;Syphilis, or the "pox"&mdash;How
+syphilis is acquired&mdash;Syphilis attacks every organ in
+the body&mdash;Not possible to tell when cured&mdash;The chancre&mdash;Systematic,
+or constitutional symptoms&mdash;Mucous
+patches and ulcers&mdash;Syphilis of the blood vessels and
+lymphatic glands&mdash;The interior organs&mdash;Brain and spinal
+cord&mdash;The nose, eye, ear, throat&mdash;Hair and nails&mdash;What
+the boy with venereal disease may cause in others&mdash;The
+infected wife&mdash;A girl's fate when she marries&mdash;Young
+wife rendered sterile&mdash;Young wife made to miscarry&mdash;Is
+the husband to blame&mdash;Building the man&mdash;Age of puberty&mdash;"Internal
+Secretion"  Page <a href="#Page_139">139</a></p>
+
+
+<h3>CHAPTER XIII</h3>
+
+<h4>THE PARENTS AND THE BOY</h4>
+
+<p>Abuse of the procreative function&mdash;The continent life&mdash;Provide
+the environment necessary to the clean life&mdash;The
+period of procreative power&mdash;Self-abuse&mdash;Masturbation&mdash;Treatment
+of masturbation&mdash;Night losses or wet
+dreams&mdash;Causes of night emissions&mdash;Sexual excesses&mdash;Treatment
+of sexual excesses&mdash;What parents should
+know about the so-called "social evil" before speaking
+with authority to the boy&mdash;The need of enlightenment in
+sexual matters&mdash;"No one told me, I did not know"&mdash;Fake
+medical treatment of venereal diseases&mdash;Sowing wild oats&mdash;Should
+circumcision be advised Page <a href="#Page_153">153</a></p>
+
+
+<h4><span class="smcap">Sex Hygiene for the Girl</span></h4>
+
+<h3>CHAPTER XIV</h3>
+
+<h4>A MOTHER'S DUTY TO HER DAUGHTER</h4>
+
+<p>What a mother should tell her little girl&mdash;Where do babies
+come from&mdash;How baby birds and fish come from eggs&mdash;How
+other animals have little nests of their own&mdash;The
+duty of mothers to instruct and direct&mdash;What a
+mother should tell her daughter&mdash;Every mother should<span class='pagenum'><a name="Page_iv" id="Page_iv">[Pg iv]</a></span>
+regard this duty as sacred&mdash;Every female child is a possible
+future mother&mdash;Motherhood the highest function of
+the sex&mdash;Health the one necessary essential&mdash;Symptoms
+of the first, or beginning menstruation&mdash;The period of
+puberty in the female&mdash;Changes in the reproductive
+organs at puberty&mdash;The female generative organs&mdash;The
+function of the reproductive organs&mdash;The age of puberty
+in the female&mdash;The function of the ovary&mdash;The function
+of the womb&mdash;Why menstruation occurs every twenty-eight
+days&mdash;The male or papa egg&mdash;The function of the
+spermatozoa&mdash;"Tell the whole story"&mdash;"How do these
+spermatozoa get there"&mdash;The union of the species&mdash;"How
+can a baby live in there for such a long time"&mdash;How the
+baby gets its nourishment in the womb&mdash;Girls must not
+become mothers Page <a href="#Page_173">173</a></p>
+
+
+<h3>CHAPTER XV</h3>
+
+<h4>PREPARING FOR MOTHERHOOD</h4>
+
+<p>Menstruation&mdash;Irregular menstruation&mdash;Changes in the
+quantity of the flow&mdash;How the womb is held in place&mdash;Symptoms
+of menstruation&mdash;Menstruation should not be
+accompanied with pain&mdash;Don't give your daughters
+patent medicines, or "Female Regulators"&mdash;Take your
+daughter to the doctor&mdash;Leucorrhea in girls&mdash;Bathing
+when menstruating&mdash;Constipation and displaced wombs&mdash;Dress
+and menstruation&mdash;Absence of menstruation, or
+amenorrhea&mdash;Treatment of amenorrhea&mdash;Painful menstruation,
+or dysmenorrhea&mdash;Causes of dysmenorrhea&mdash;Treatment
+of dysmenorrhea&mdash;Sterility in the female&mdash;Conditions
+which affect the fertility of women&mdash;Climate,
+station in life, season of the year, age, the tendency
+to miscarry&mdash;Causes of sterility in the female&mdash;Displacement
+of womb&mdash;Diseases of womb, ovaries, or tubes&mdash;Malformations&mdash;Lacerations&mdash;Tumors&mdash;
+Leucorrhea&mdash;Physical
+debility&mdash;Obesity&mdash;Special poisons&mdash;"Knack
+of miscarrying"&mdash;Miscarriage&mdash;Cause of miscarriage&mdash;The
+course and symptoms of miscarriage&mdash;What to do
+when a miscarriage is threatened&mdash;Treatment of
+threatened miscarriage&mdash;Treatment of inevitable miscarriage&mdash;After
+treatment of miscarriage&mdash;The tendency
+to miscarriage Page <a href="#Page_187">187</a></p>
+
+
+<h4><span class="smcap">The Baby</span></h4>
+
+<h3>CHAPTER XVI</h3>
+
+<h4>HYGIENE AND DEVELOPMENT OF THE BABY</h4>
+
+<p>What to prepare for the coming baby&mdash;Care of the newly-born
+baby&mdash;The first bath&mdash;Dressing the cord&mdash;Treatment
+after the cord falls off&mdash;A pouting navel&mdash;Bathing
+baby&mdash;Clothing the baby&mdash;Baby's night clothes&mdash;Care of<span class='pagenum'><a name="Page_v" id="Page_v">[Pg v]</a></span>
+the eyes&mdash;Care of the mouth and first teeth&mdash;Care of the
+skin&mdash;Care of the genital organs&mdash;Amusing baby&mdash;Temperature
+in children&mdash;The teeth&mdash;The permanent teeth&mdash;Care
+of the teeth&mdash;Dentition&mdash;Treatment of teething&mdash;How
+to weigh the baby&mdash;Average weight of a male baby&mdash;Average
+weight of a female baby&mdash;Average height of a
+male child&mdash;The rate of growth of a child&mdash;Pulse rate in
+children&mdash;Infant records, why they should be kept&mdash;"Growing
+pains" Page <a href="#Page_209">209</a></p>
+
+
+<h3>CHAPTER XVII</h3>
+
+<h4>BABY'S FEEDING HABITS</h4>
+
+<p>Overfeeding baby&mdash;Intervals of feeding&mdash;How long should a
+baby stay at the breast&mdash;Vomiting between feedings&mdash;Regularity
+of feeding&mdash;Why is regularity of feeding important&mdash;A
+baby never vomits&mdash;What is the significance
+of so-called vomiting after feedings&mdash;Mother's milk that
+is unfit for baby&mdash;Fresh air for baby&mdash;Air baths for baby Page <a href="#Page_223">223</a></p>
+
+
+<h3>CHAPTER XVIII</h3>
+
+<h4>BABY'S GOOD AND BAD HABITS&mdash;FOOD FORMULAS</h4>
+
+<p>Baby's bed&mdash;The proper way to lay baby in bed&mdash;Baby should
+sleep by itself&mdash;How long should a baby sleep&mdash;Why
+a baby cries&mdash;The habitual crier&mdash;The habit of feeding
+baby every time it cries&mdash;The habit of walking the floor
+with baby every time it cries&mdash;Jouncing, or hobbling baby&mdash;Baby
+needs water to drink&mdash;The evil habit of kissing
+baby&mdash;Establishing toilet habits&mdash;Baby's comforter&mdash;What
+can be done to lessen the evil effects of the comforter
+habit&mdash;Beef juice&mdash;Beef juice by the cold process&mdash;Mutton
+broth&mdash;Mutton broth with cornstarch or arrowroot&mdash;Chicken,
+veal, and beef broths&mdash;Scraped beef or
+meat pulp&mdash;Junket or curds and whey&mdash;Whey&mdash;Barley
+water&mdash;Barley water gruel or barley jelly&mdash;Rice, wheat
+or oat water&mdash;Imperial Granum&mdash;Albumen water&mdash;Dried
+bread&mdash;Coddled egg Page <a href="#Page_235">235</a></p>
+
+
+<h4><span class="smcap">Artificial Feeding</span></h4>
+
+<h3>CHAPTER XIX</h3>
+
+<h3>ARTIFICIAL FEEDING</h3>
+
+<p>Elementary principles of milk modification&mdash;The secret of the
+efficiency of mothers' milk&mdash;Two important factors in
+successful artificial feeding&mdash;Every child is a problem in
+itself&mdash;Proprietary foods of little value as infant foods&mdash;Their<span class='pagenum'><a name="Page_vi" id="Page_vi">[Pg vi]</a></span>
+value is in the milk added to them&mdash;The credit belongs
+to the cow&mdash;Difference between human and cow's
+milk&mdash;What "top-milk" feeding means&mdash;Utensils necessary
+for home modification of milk&mdash;Artificial feeding
+from birth to the twelfth month&mdash;How to measure "top-milk"&mdash;Easy
+bottle-feeding method&mdash;Condensed milk
+feeding&mdash;Objections to condensed milk feeding Page <a href="#Page_249">249</a></p>
+
+
+<h3>CHAPTER XX</h3>
+
+<h4>ARTIFICIAL FEEDING (<i>continued</i>)</h4>
+
+<p>How to prepare milk mixtures&mdash;Sterilizing the food for the
+day's feeding&mdash;How to test the temperature of the food
+for baby&mdash;When to increase the quality or quantity of
+food&mdash;Food allowable during the first year in addition to
+milk&mdash;Beef-juice&mdash;White of egg&mdash;Orange juice&mdash;Peptonized
+milk&mdash;The hot or immediate process&mdash;The cold
+process&mdash;Partially peptonized milk&mdash;Completely peptonized
+milk&mdash;Uses of peptonized milk&mdash;Objections to
+peptonized milk&mdash;What a mother should know about
+baby's feeding bottle and nipple&mdash;Should a mother put
+her baby on artificial food if her supply of milk during
+the first two weeks is not quite enough to satisfy it&mdash;Certain
+conditions justify the adoption of artificial feeding
+from the beginning&mdash;Mothers' mistakes in the
+preparation of artificial food&mdash;Feeding during the second
+year&mdash;Sample meals for a child three years of age&mdash;The
+diet of older children&mdash;Meats, vegetables, cereals, bread,
+desserts, fruits Page <a href="#Page_259">259</a></p>
+
+
+<h4><span class="smcap">What Mothers Should Know</span></h4>
+
+<h3>CHAPTER XXI</h3>
+
+<h4>THE EDUCATION OF THE MOTHER</h4>
+
+<p>What mothers should know about the care of children during
+illness&mdash;A sick child should be in bed&mdash;The diet of the
+sick child&mdash;A child is the most helpless living thing&mdash;The
+delicate child&mdash;How to feed the delicate child&mdash;How
+to bathe the delicate child&mdash;Airing the delicate child&mdash;Habits
+of the delicate child&mdash;Indiscriminate feeding&mdash;Poor
+appetite&mdash;Loss of appetite&mdash;Treatment of loss of
+appetite&mdash;Overeating in infancy&mdash;What correct eating
+means&mdash;Bran as a food&mdash;Breakfast for a child at school&mdash;Lunch
+for a child at school&mdash;Bran muffins for school
+children&mdash;Bran muffins in constipation&mdash;Hysterical children&mdash;What
+a mother should know about cathartics and<span class='pagenum'><a name="Page_vii" id="Page_vii">[Pg vii]</a></span>
+how to give a dose of castor oil&mdash;Castor oil&mdash;Calomel&mdash;Citrate
+of Magnesium&mdash;When to use castor oil&mdash;When
+to use calomel&mdash;Vaccination&mdash;Time for vaccination&mdash;Methods
+of vaccination&mdash;Symptoms of successful vaccination Page <a href="#Page_277">277</a></p>
+
+
+<h3>CHAPTER XXII</h3>
+
+<h4>CONSTIPATION IN INFANTS AND CHILDREN</h4>
+
+<p>Constipation&mdash;Regularity of bowel function&mdash;The function of
+the stomach&mdash;Fermentation&mdash;Incomplete constipation&mdash;Importance
+of a clean bowel&mdash;A daily movement of the
+bowel necessary&mdash;Constipation in breast-fed infants&mdash;Treatment
+of constipation in breast-fed infants&mdash;Constipation
+in bottle-fed infants&mdash;Treatment of constipation
+in bottle-fed infants&mdash;Constipation in children over two
+years of age&mdash;Diet list for constipation in children&mdash;Bran
+muffins in constipation&mdash;Treatment of obstinate constipation&mdash;Oil
+injections in constipation Page <a href="#Page_303">303</a></p>
+
+
+<h3>CHAPTER XXIII</h3>
+
+<h4>CONSTIPATION IN WOMEN</h4>
+
+<p>Chief cause of constipation in women&mdash;Constipation a cause
+of domestic unhappiness&mdash;The requirements of good
+health&mdash;The cost of constipation&mdash;Constipation and social
+exigencies&mdash;One of the important duties of mothers&mdash;Constipation
+and diseases of women&mdash;Constipation is always
+harmful&mdash;Constipation and pregnancy&mdash;Explanation
+of incomplete constipation&mdash;Causes of constipation&mdash;Negligence&mdash;Lack
+of exercise&mdash;Lack of water&mdash;Lack of
+bulk in the food taken&mdash;Abuse of cathartic drugs and
+aperient waters&mdash;Overeating&mdash;Treatment of constipation
+in women Page <a href="#Page_315">315</a></p>
+
+
+
+<hr style="width: 65%;" />
+<h2>SEX HYGIENE FOR THE BOY</h2>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_139" id="Page_139">[Pg 139]</a></span></p>
+<h2>CHAPTER XII</h2>
+
+<div class="blockquot"><p>"The evil that men do lives after them. The good is often
+interred with them."</p>
+
+<p>"The pleasure in living is to meet temptation and not yield
+to it." Elmer Lee, M. D.</p></div>
+
+<h3>BUILDING OUR BOYS</h3>
+
+<div class="blockquot"><p>A Word to Parents&mdash;Interest in Sex Hygiene&mdash;The "Social
+Evil"&mdash;Ten Millions Suffering with Venereal Diseases in
+the United States&mdash;Immorality not Confined to Large
+Cities&mdash;Venereal Diseases Common in Country Places&mdash;What
+Are the Consequences of Venereal Disease to the
+Boy?&mdash;Gonorrhea, or Clap&mdash;Symptoms of Gonorrhea in
+the Male&mdash;Complications of Gonorrhea&mdash;Syphilis, or the
+"Pox"&mdash;How Syphilis is Acquired&mdash;Syphilis Attacks
+Every Organ in the Body&mdash;Not Possible to Tell When
+Cured&mdash;The Chancre&mdash;Systematic or Constitutional
+Symptoms&mdash;Mucous Patches and Ulcers&mdash;Syphilis of
+the Blood Vessels and Lymphatic Glands&mdash;The Interior
+Organs&mdash;Brain and Spinal Cord&mdash;The Nose, Eye, Ear,
+Throat&mdash;Hair and Nails&mdash;What the Boy with Venereal
+Disease May Cause in Others&mdash;The Infected Wife&mdash;A
+Girl's Fate When She Marries&mdash;Young Wife Rendered
+Sterile&mdash;Young Wife Made to Miscarry&mdash;Is the Husband
+to Blame?&mdash;Building the Man&mdash;Age of Puberty&mdash;"Internal
+Secretion."</p></div>
+
+
+<p><b>A Word to Parents.</b>&mdash;Within recent times the subject
+of sex hygiene has been freely discussed by members of
+the medical profession and through them the general
+public has been made more or less acquainted with the
+problem. It has therefore acquired a degree of genuine
+interest which speaks well for the future of the eugenic
+ideal. Eugenics is based to a very large extent upon the
+principles underlying sex hygiene.</p>
+
+<p>As a result of this widespread interest and investigation,
+we have discovered that the only method that promises
+actual progress, is to talk plainly and to tell the
+actual truth. The day of the prude has passed. To
+attempt to achieve results in the education of youth in<span class='pagenum'><a name="Page_140" id="Page_140">[Pg 140]</a></span>
+sex problems, without giving, facts, is wasted effort.
+To give facts we must explain each problem so that its
+principles may be clearly understood and its meaning
+grasped. To point out the duty of youth is not sufficient.
+They must be shown why it is to their best interest to
+live the clean life. In every department of education we
+are beginning to appreciate that to achieve results it
+must be based upon the individual equation. This is
+why we have found it necessary to assert that it is the
+duty of parents to make sex hygiene a personal matter
+and to acquaint their children with the facts relating to
+this problem. It has been discovered, however, that a
+very large percentage of parents are inadequately informed
+on these subjects, in fact they know practically
+nothing about the actual facts which they are supposed
+to teach. I shall try to tell the story in a way which
+every parent will understand.</p>
+
+<p>When a boy reaches the age of puberty he is susceptible
+to sexual desire. If he has not been told the story
+of his growth from boyhood to man's estate he will
+either begin to abuse himself, or he will be later enticed
+to commit himself to intercourse with some unclean
+female and he will acquire a disease as a result.</p>
+
+<p>Inasmuch as it has been asserted that practically every
+boy has been addicted to self-abuse at some time, and
+that eighty per cent. of all males, between the ages of
+sixteen and thirty years, are victims of venereal disease,
+it would seem justifiable to assume that the boys who
+are informed of the facts in time are the boys who constitute
+the percentage who escape. This, of course, may
+not be literally true, but it is a reasonable assumption.</p>
+
+<p>While self-abuse is a pernicious habit and may be attended
+with serious consequences, it is not a disease and,
+as will be explained later, it can be cured. It is therefore
+a menace to the individual, not to the race, and
+consequently need not concern us at the present time.
+On the other hand the venereal diseases are not to be
+considered as individual problems since they affect the
+welfare of the race. The venereal diseases which we
+will consider are gonorrhea and syphilis.</p>
+
+<p><b>The Social Evil.</b>&mdash;It has been estimated that there are<span class='pagenum'><a name="Page_141" id="Page_141">[Pg 141]</a></span>
+more than <i>ten millions</i> of people in this country to-day
+suffering from the effects of venereal diseases. In New
+York city alone, there are <i>two million</i> victims suffering
+from the direct or indirect consequences of these diseases.
+It has been authoritatively asserted that, out of every
+ten men between the ages of sixteen and thirty, eight
+have, or have had, one or other of these diseases. When
+it is remembered that these diseases are not merely temporary
+incidents, but that they may be regarded as
+practically incurable in the vast majority, because of
+antagonistic social conditions and ignorance, and that
+they are highly infectious, we may begin to realize how
+important they are from the standpoint of race regeneration.</p>
+
+<p>Statistics of these conditions are never reliable because
+much of the evil is hidden and lied about. It is quite
+probable,&mdash;if the estimates were based upon absolute
+knowledge&mdash;that the extent of the prevalency of these
+diseases would be greatly increased rather than reduced.
+It is however a fact, that the combined ravages of the
+Great White Plague, leprosy, yellow fever, and small-pox,
+are merely incidents compared to the effects which the
+venereal diseases have had upon mankind. It is useless
+to think that these diseases can be driven out of the land.
+Any hope of this nature is the impression of the dreamer.
+By a propaganda of education, by the spread of the
+eugenic idea and ideal, we may, however, reasonably hope
+to minimize the evil and, at least, to protect the innocent.</p>
+
+<p><b>The Sources of Immorality.</b>&mdash;It is a fallacious idea to
+assume that the sources of immorality are confined to
+the large cities. This is far from the truth. In smaller
+towns and country places the diseases are quite common
+and conditions there tend to the spread of the contagion
+in a more intimate and a more harmful way. The individuals
+who are most likely to become affected are those
+most liable to succumb to temptation and whose home
+ties are of the best. There are many instances on record
+where one or two loose women spread the infection
+all over the country communities, infecting boys and
+men alike. No one can estimate what the final effect
+of such an epidemic may mean or how many innocent<span class='pagenum'><a name="Page_142" id="Page_142">[Pg 142]</a></span>
+individuals may have their lives wrecked as a direct consequence.
+It is because these consequences are the product
+of ignorance in a very large percentage of the cases
+that there is such urgent need for enlightenment. It is
+at least our plain duty to tell the boy the actual facts&mdash;to
+post him with reference to consequences. The more
+thoroughly we instruct him in the elementary facts relative
+to the venereal diseases, the safer he will be from
+temptation, and if he possesses this knowledge and acquires
+disease, he will be more likely to immediately seek
+competent aid and advice.</p>
+
+
+<h3>WHAT ARE THE CONSEQUENCES OF VENEREAL
+DISEASE TO THE BOY HIMSELF?</h3>
+
+<p><b>Gonorrhea or "Clap."</b>&mdash;This is the most frequent of
+the venereal diseases. It is also the most serious. It is
+an unfortunate fact, that in the past,&mdash;and even to-day&mdash;boys
+have been told that gonorrhea is no worse than
+"a bad cold." This lie has been responsible for much
+evil and a great amount of unnecessary suffering and
+misery.</p>
+
+<p>Gonorrhea is caused by a germ, obtained, as a rule,
+during intercourse with an infected person. This germ
+is called gonococcus. It thrives on any mucous membrane;
+it is not, therefore, limited to the sexual organs.
+For this reason it may attack any part of the body where
+mucous membrane is. It is particularly liable to damage,
+sometimes seriously and permanently, the eye. It
+may be spread from one person to another, or from any
+infected article to a person in numerous ways. The innocent
+may thus suffer as a result of the carelessness of
+the vicious.</p>
+
+<p><b>The Symptoms of Gonorrhea in the Male</b> are slight
+itching and burning of the mouth of the urethra. This
+is noticeable at any time from the third to the fourteenth
+day after exposure. These symptoms become
+more pronounced and a slight discharge appears. The
+patient is compelled to urinate frequently and it is painful
+and difficult. The discharge increases, it becomes
+thicker and looks like ordinary yellow pus. If the case
+is a severe one, the discharge may be blood stained, and<span class='pagenum'><a name="Page_143" id="Page_143">[Pg 143]</a></span>
+if this symptom is present urination is more painful and
+more frequent.</p>
+
+<p>In about ten days the disease reaches its height; it
+remains stationary for a number of weeks and then
+slowly, seemingly, gets better. The discharge grows
+thinner, less in quantity and lighter in color. It may
+refuse, despite the most careful and efficient treatment,
+to stop altogether; it is then known as "gleet." If the
+discharge stops completely the patient is apparently cured,
+as far as any external manifestation of the disease is
+concerned. <i>In seventy-five per cent. of the cases, however,
+this apparent cure is no cure at all, as will be seen
+later.</i></p>
+
+<p>Certain complications are likely to arise in the course
+of gonorrhea. The infection itself may be of such an
+acute or virulent type, that it invades the deeper structures
+of its own accord and despite the most careful, competent
+treatment; or if the treatment is not adequate
+or skillful it may be forced backward; or through neglect
+in not beginning the right kind of treatment in
+times, a simple infection may grow in degree into a
+serious disease, and invade the more important structures.
+In this way are produced disease of the bladder, prostate
+gland, seminal vesicles, testicles, and of the kidneys.
+Gonorrheal rheumatism may follow, and even disease
+of the lining membrane of the heart, and death.</p>
+
+<p>When disease of the deeper parts occur the patient
+is frequently incapacitated and compelled to go to bed.
+He may have chills, fever and sweats, intense pain and
+the passage of bloody urine. He may have to be operated
+upon, and his general health may be permanently wrecked.
+So long as the germs are present there is danger despite
+the most scientific treatment. It is not the quality of
+the treatment that is at fault, it is the presence of the
+germs; and since it is impossible to pursue any certain
+method of eradication, we must continue treatment&mdash;as
+long as the germs are present&mdash;and hope for favorable
+results. The infection may last for many years. The
+germs having found entrance into the small tubes in
+the interior organs they can only be dislodged with
+difficulty, if at all. These pockets of germs may be excited<span class='pagenum'><a name="Page_144" id="Page_144">[Pg 144]</a></span>
+to renewed activity by sexual intercourse, or by
+injury to the parts, and may reinfect the patient at any
+times. In a very considerable number of these cases
+where the deeper structures are involved, the patient
+may recover from the acute or painful period of the
+disease, only to find that he is sterile. There are many
+such cases, and the most vindictive individual who may
+believe that every who sins should be punished will
+admit that sterility, as the price of a moment's forgetfulness,
+is a terrible fee to pay.</p>
+
+<p><b>Syphilis, or the "Pox,"</b> is an infectious, germ blood
+disease. It is most frequently acquired through sexual
+intercourse.</p>
+
+<p>It may be acquired by direct contact with a diseased
+person. In order to render such contact effective, it is
+essential that the skin of the healthy person be abraded,
+or the contact may be directly on a mucous membrane,
+as the mouth in the act of kissing.</p>
+
+<p>It may be acquired by using any article which has been
+used by a syphilitic, as a drinking cup, or towel.</p>
+
+<p>It may be acquired through hereditary transmission.</p>
+
+<p>Surgeons frequently contract syphilis while operating
+on, or examining patients who have the disease. Dentists
+may convey it by means of instruments which have
+not been rendered aseptic, or thoroughly clean. Using
+a towel which has been used by a syphilitic has many
+times conveyed the infection to an innocent party. For
+this reason the roller towel has been done away with,
+and some states have legislated against its use in
+hotels and other public places. To use dishes, spoons,
+tobacco pipe, beer glasses, etc., which have been used
+by one having the disease is an absolutely certain way
+of being infected. Cigars which may have been made
+by a syphilitic will infect whoever smokes them with the
+virus of the disease. Syphilis has been known to have
+been caught from using the church communion cup. The
+public drinking-cup has been a prolific source of syphilitic
+dissemination to innocents. Legislators are just waking
+up to the danger that lurks in this institution and it
+will no doubt be done away with, not only in public places,
+but on all railroad and steamboat lines.<span class='pagenum'><a name="Page_145" id="Page_145">[Pg 145]</a></span></p>
+
+<p>An infected mother can transmit syphilis to her child.
+If the father is affected, but not the wife, the child may
+escape.</p>
+
+<p>Syphilis attacks every organ in the human body. The
+actual degree of infection has no relation to the size or
+character of the external manifestations. The external
+evidence may be minute and insignificant, while the
+internal extent and ravages of the disease may be tremendous
+and of large proportions. Many men when
+asked regarding incidents of the long ago, may state,
+"Oh, yes, I had a chancre twenty-five years ago, but it
+was a very small affair and soon healed up and was
+cured." Yet that same little chancre, that made only
+a mild impression on the man's mind, may, and most
+probably will, be the direct cause of that man's death.</p>
+
+<p>It is not possible to tell with absolute certainty that an
+individual is suffering with syphilis by any known test.
+The most recent one&mdash;the Wassermann test&mdash;is not absolute
+by any means.</p>
+
+<p>The first symptoms, or what is known as the initial
+lesion of syphilis, is the chancre.</p>
+
+<p><b>The Chancre</b> is a small, hard tumor, or it may be a
+small ulcer with a hard base, or it may simply appear
+as a thin small patch on any mucous membrane. It is
+not painful, it can be moved if taken between the fingers,
+showing it is not attached to the deep structures,
+and when it is so moved it is not tender or sore. Any
+little lump which ulcerates located on the genitals must
+be regarded with suspicion. Boys and men should not
+be satisfied with any offhand statement that, "it is nothing."
+It may be a chancre, and it may be exceedingly
+serious if not properly diagnosed.</p>
+
+<p>Systemic, or constitutional symptoms, begin to show
+themselves any time from the sixth to the tenth week
+after the appearance of the chancre.</p>
+
+<p><b>Eruptions of the Skin</b> characterize every case of
+syphilis. They occur in all degrees from the mild rash
+to the foul ulcer. The ulcerative process is very often
+extensive and loathsome.</p>
+
+<p><b>Mucous Patches and Ulcers</b> affect the mucous membranes.
+The mouth and throat are favorite locations<span class='pagenum'><a name="Page_146" id="Page_146">[Pg 146]</a></span>
+for these lesions. They occur in the anus and rectum,
+and may be mistaken in that region for other serious
+conditions. Men who drink and smoke suffer as a
+rule severely from mucous patches in the mouth and
+throat.</p>
+
+<p>Syphilis attacks the blood vessels and the lymphatic
+glands. These cases may have been unrecognized, and
+may have existed for many years. A man may die
+from a rupture of a blood vessel in the brain during
+middle life as a consequence of a forgotten, supposedly
+cured case of syphilis many years before.</p>
+
+<p><b>The Interior Organs</b> may be attacked by syphilis.
+As a result we get disease of the liver, heart, stomach,
+kidneys, lungs, and other parts. It has been suggested
+that many diseases affecting these organs, for which
+treatment proves unsatisfactory, may have had their
+origin in a former syphilis.</p>
+
+<p><b>The Brain and Spinal Cord</b> are quite often the seat
+of syphilitic affections. A tumor, known by the name
+of "gumma," is the result. The blood vessels of the entire
+nervous system may be affected and, as a consequence,
+we often see cases of paralysis, apoplexy, epilepsy,
+locomotor ataxia and death.</p>
+
+<p><b>The Nose, Eye, Ear, Throat</b>, are frequently very seriously
+compromised as a result of the syphilitic poison.
+Deformity, caused by rotting of the bones of these parts
+is not infrequent. Loss of voice, or smell, or hearing,
+or sight, may result.</p>
+
+<p><b>The Hair and Nails</b> may fall out. The bones may
+ulcerate and rot. The organs of procreation usually
+participate in the degenerative process. Virility is destroyed,
+and impotence is quite common after a severe
+attack.</p>
+
+
+<h3>WHAT THE BOY WITH VENEREAL DISEASE MAY
+CAUSE IN OTHERS</h3>
+
+<p><b>Gonorrhea.</b>&mdash;When the average boy acquires gonorrhea
+he frequently does not know, for many weeks, that
+he is the victim of a dangerous, infectious disease. He
+appreciates probably, that it relates to the sexual indiscretion<span class='pagenum'><a name="Page_147" id="Page_147">[Pg 147]</a></span>
+he was guilty of, and feels that it is something
+to be ashamed of. He therefore hides his condition, confides
+in no one, and blindly hopes it will get better somehow
+or at some time. Meantime the disease, which may
+have been mild at the beginning, is gradually gaining
+ground and strength, and his neglect may eventuate in
+lifelong misery. No means are taken to guard against
+spreading the infection, the discharge may lodge on his
+fingers and he may infect his eyes and may lose his sight
+because he did not know that the discharge is one of
+the most dangerous fluids known. It may get on water-closet
+seats and infect others. Eventually he is compelled
+to seek aid, and he may, after a long period, be freed
+from the immediate consequences of his folly. At a
+later date he marries, and as previously explained, he
+infects his wife. This is the beginning of much of the
+domestic infelicity that is so prevalent to-day, and, inasmuch
+as it is a subject that should be thoroughly understood
+by every woman and mother, I shall carefully and
+clearly explain its significance and its consequences.</p>
+
+<p>Let us first, however, briefly consider what may occur
+to others if the boy is unfortunate enough to acquire
+syphilis. Again the boy fails to comprehend the nature
+of his affliction. There is imminent danger of the members
+of his household becoming infected. He uses the
+same dishes, spoons, towels, and utensils, any one of
+which may convey the disease to his father, mother, sister,
+or brother. He may use the common drinking glass
+in school, college, or office, and spread the disease in
+this way. He may kiss any member of his family, or
+a baby, and infect them. He may have his hair cut,
+or be shaved, and the virus may be spread around in this
+way if the barber does not sterilize the article used,&mdash;which
+he never does. He may drink at a soda fountain,
+or at a saloon, and the next individual to use the same
+glass may acquire the disease. He is a menace to the
+individual, to the community, and to the race. Wives
+often acquire syphilis from their husbands.</p>
+
+<p><b>The Infected Wife.</b>&mdash;It has been previously stated that
+eight out of every ten males between the ages of sixteen
+and thirty, have had or have, gonorrhea or syphilis.<span class='pagenum'><a name="Page_148" id="Page_148">[Pg 148]</a></span>
+Seventy-five per cent. of these cases have not been cured.
+About thirty-five per cent. of these are destined to infect
+wife, or wife and children, and in all probability
+many others.</p>
+
+<p>If a young wife acquires infection from her husband,
+she is exactly in the same condition as the diseased boy,&mdash;she
+does not know what ails her, so she wastes precious
+time in unprofitable worry. Why should she know what
+the trouble is? She came to the marriage bed pure, and
+clean, and healthy. Her previous education did not include
+instruction which would even help her to guess
+what the trouble might be. She is simply conscious of
+new distressing conditions which she does not understand.
+She may try to believe that these conditions are
+incidental to the change in her life. Shortly, however,
+the discharge, which she has had for a number of weeks,
+and which she thought was only a leucorrhea, or "the
+whites," becomes so profuse and nasty that she begins
+douching. This procedure simply blinds her to the true
+nature of the affection, and in the end she is driven,
+ashamed and reluctant, to consult a physician. She may
+be informed that her condition is bad, and that it will
+be necessary that she submit to a course of treatment.
+After a time the physician may succeed in tiding her over
+the immediate consequences of the gonorrheal infection
+she innocently acquired. She may soon after become
+pregnant, and she may miscarry as a result of the old
+trouble, or she may carry the child the full period. When
+the child is born it may be blind and this defect is a
+consequence of the old infection to the mother from
+the father. If the mother is syphilitic the child most
+likely will inherit all the horrible possibilities of transmitted
+blood-poison.</p>
+
+<p>Pregnancy frequently "lights up" any old, gonorrheal
+infection in the female, so this young wife fails to completely
+recover after the confinement. She is able to
+be about, but her strength refuses to be restored. It
+may be months later when she begins to suffer pain
+and to realize that she is quite sick. She develops a
+fever and may have a chill. The physician discovers that
+she has pus in her tubes and there is danger of peritonitis<span class='pagenum'><a name="Page_149" id="Page_149">[Pg 149]</a></span>
+or general blood poisoning. The old germs have
+been roused and are active. Unfortunately they are located
+where it is impossible to dislodge them without
+resorting to a serious operation. It is now a problem of
+saving her life. She is taken to the hospital and her
+womb, tubes, and ovaries, are removed&mdash;she is unsexed.</p>
+
+<p>Young wives are being operated on every day, in every
+city in the civilized world for just such causes. It is a
+notorious fact, that, in every city in the world, the number
+of operations that are daily being performed on
+women, is increasing appallingly. Every surgeon knows
+that eighty per cent. of these operations are caused, directly
+or indirectly, by these diseases, and in almost every
+case in married women, they are obtained innocently from
+their own husbands. It is rare to find a married woman
+who is not suffering from some ovarian or uterine trouble,
+or some obscure nervous condition, which is not amenable
+to the ordinary remedies, and a very large percentage of
+these cases are primarily caused by infection obtained
+in the same way.</p>
+
+<p>When a girl marries she does not know what fate has
+in store for her, nor is there any possible way of knowing,
+under the present marriage system. If she begets a
+sickly, puny child,&mdash;assuming she herself has providentially
+escaped immediate disease,&mdash;she devotes all her
+mother love and devotion to her child, but she is fighting
+a hopeless fight as I previously explained when I stated
+that one-half of the total effort of one-third of the race,
+is expended in combating conditions against which no
+successful effort is possible. Even her prayers are futile,
+because the wrong is implanted in the constitution of the
+child and the remedy is beyond her power to find. These
+are the tragedies of life, which no words may adequately
+describe, and compared to which the incidental troubles
+of the world at large are as nothing.</p>
+
+<p>If the conditions are not as bad as those depicted above,
+the original infection may have rendered her sterile. If
+the germs reached the womb and tubes, the inflammatory
+process may close these tubes, with the result that conception
+is impossible. In these cases the woman has to
+bear the stigma and disgrace of a childless union, though<span class='pagenum'><a name="Page_150" id="Page_150">[Pg 150]</a></span>
+she is not the guilty party. Many husbands are sterile,
+however, as a result of venereal disease. It is claimed
+that eighty per cent. of childless marriages are caused
+by sterility of the male partner. Curiously and unfortunately
+these men never suspect themselves. The
+wife is the delinquent member, in their estimation. She
+is the victim of jest and suspicion, and later of jibes and
+insults. Many women have had their lives rendered
+miserable and unhappy because of this suspicion. They
+are compelled by their husbands to submit to examination
+and unpleasant and painful treatment and operations with
+the intention of rectifying a defective condition that does
+not exist. Many conscientious physicians refuse to treat
+women patients against whom the charge of sterility is
+made, before subjecting the husbands to thorough examination, and,
+since eighty per cent. of childless marriages
+are due to sterility in the male, this is a just and
+reasonable course to pursue.</p>
+
+<p>During the course of all this domestic trouble and
+tragedy, the young wife's health has suffered&mdash;she scarcely
+enjoys one day of good health. Her mental condition
+is even worse. She submits to innuendo and insult under
+the impression that she is the unwitting cause of all the
+domestic wretchedness and often wishes she had never
+entered the marriage state. We must remember that
+these conditions wreck ideals and homes, and that they
+frequently render inefficient both husband and wife. The
+economic business of marriage becomes a failure, ambition
+is crushed and hope dies in the heart.</p>
+
+<p>If the mother has been inoculated with the virus of
+syphilis her existence is equally wretched; her health is
+ruined; her efficiency is forever mortgaged. If she becomes
+pregnant she will most likely abort and she will go
+on aborting for years, in the effort to bring children into
+the home, accusing herself meantime and submitting to
+the reflections which are heaped upon her, while the real
+culprit is the husband. He assumes an injured and innocent
+attitude and behaves as if he had been imposed
+upon by marriage with a woman who cannot carry out
+her marital contract.</p>
+
+<p>If she gives birth to a child or children, they are<span class='pagenum'><a name="Page_151" id="Page_151">[Pg 151]</a></span>
+syphilitic. They may be deformed, or they may be feeble-minded
+or idiots. They may live at home for years,
+always ailing, always sick. They may develop epilepsy,
+St. Vitus' dance, skin disease, or mental vagaries, and
+they may have to be put into institutions for the feeble-minded,
+or they may die by inches at home.</p>
+
+<p><b>Is the Husband to Blame?</b>&mdash;If a boy had gonorrhea
+a number of years before entering the marriage state,
+was treated for it by a physician, until all symptoms had
+disappeared and had enjoyed apparent good health in the
+interim, and had never been told any of the facts regarding
+probable consequences, is it just to blame him if he
+infects his wife? It is certain no man would willingly
+subject his bride to the risk of infection, with all its horrible
+consequences. These conditions exist as a result of
+the prudish attitude of society in the past toward all
+questions affecting sex hygiene. We have not told all
+the truth to the boy. Whatever knowledge he may have
+had was gained from companions, or from individuals
+who knew the garbled facts only. There is of course
+no excuse for the man who acquires disease after marriage
+and conveys it to his wife or children. This is a
+very different situation and one which should merit the
+severest condemnation and punishment. We are, however,
+only interested in the boy at present and will not
+take up the reader's time with a discussion of the "social
+evil" from this standpoint.</p>
+
+<p><b>Building a Man.</b>&mdash;When the boy is about fifteen years
+of age certain changes begin to manifest themselves. He
+grows more rapidly, a growth in which his whole system
+participates. His bones grow bigger and stronger, his
+muscles increase in size, even his heart, and lungs, and
+liver, and his digestive system accommodate themselves
+to this transformation; the voice changes and hair begins
+to grow on his face. The mental process also keeps pace
+with the new order of things. He thinks differently and
+he sees from a new viewpoint. Nature is making a man
+out of a boy.</p>
+
+<p>These changes were not understood in the past, but we
+are beginning to appreciate the reason for this evolutionary
+process. We have discovered that the cause depends<span class='pagenum'><a name="Page_152" id="Page_152">[Pg 152]</a></span>
+upon certain active changes which take place in the
+sex organs. About this time the testicles begin to be
+active. For years these glands have been preparing themselves
+for this work, so they first grow rapidly, increasing
+in size until they are about eight times bigger than they
+were before this time, then they begin to pour into the
+circulation a secretion which stimulates changes in all
+other parts of the body and is directly responsible for the
+wonderful change that is evident in the stature of the
+boy's body.</p>
+
+<p>This substance or "internal secretion" must not be
+confused with the semen. The internal secretion is simply
+the substance which nature employs in the developing
+process and is responsible for the degree of growth and
+quality of manhood which the boy manifests. The semen,
+on the other hand, is the procreative or fertilizing fluid
+which enables a man to beget offspring. When a boy
+understands this process it aids him in appreciating the
+importance of his sex organs and a little thought enables
+him to understand that if he abuses these organs he will
+seriously interfere with his own development. This
+process goes on for a number of years, until the boy
+reaches maturity. Any act or habit which weakens the
+quality of this secretion will deplete his powers and
+render him physically and mentally inefficient. To make
+a man, nature must be permitted to work in her own way.
+You cannot improve on her methods nor can you break
+her laws with impunity.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_153" id="Page_153">[Pg 153]</a></span></p>
+<h2>CHAPTER XIII</h2>
+
+<h3>THE PARENTS AND THE BOY</h3>
+
+<div class="blockquot"><p>Abuse of the Procreative Function&mdash;The Continent Life&mdash;Provide
+the Environment Necessary to the Clean Life&mdash;The
+Period of Procreative Power&mdash;Self-abuse&mdash;Masturbation&mdash;Treatment
+of Masturbation&mdash;Night Losses or
+Wet Dreams&mdash;Causes of Night Emissions&mdash;Sexual Excesses&mdash;Treatment
+of Sexual Excesses&mdash;What Parents
+Should Know About the So-called "Social Evil," Before
+Speaking with Authority to the Boy&mdash;The Need of Enlightenment
+in Sexual Matters&mdash;"No One Told Me, I Did
+Not Know"&mdash;Fake Medical Treatment of Venereal Diseases&mdash;Sowing
+Wild Oats&mdash;Should Circumcision be
+Advised?</p></div>
+
+
+<p><b>Abuse of the Procreative Function.</b>&mdash;Breeders of animals
+have discovered that to breed from very young stock
+is not good. The quality and stamina of the progeny is
+lowered and the vitality of the parent stock is reduced.
+It is not a good economic proposition.</p>
+
+<p>Boys should therefore be taught that any form of
+sexual indulgence is harmful before the period of full
+growth.</p>
+
+<p>Nature did not intend that the procreative function
+should be exercised by individuals who were not fully developed.
+The perpetuation of the species must not depend
+upon the license of immaturity. The instinct of sex-attraction
+must not be debased to serve a puerile, rather
+than a holy purpose.</p>
+
+<p>Sexual indulgence in any form, and in any degree, at
+any age prior to full maturity is a perversion of the primal
+instinct of race perpetuation. The practice has a more
+intimate and a more personal association with growing
+boys, however, than a merely altruistic reference. Any
+indulgence of this character at this time is physically
+and mentally injurious. No boy can hope ever to acquire
+the full measure of his possible development as an efficient
+working or thinking machine if he wastes his vital<span class='pagenum'><a name="Page_154" id="Page_154">[Pg 154]</a></span>
+forces in unnatural liberties. He should be taught this
+truth in an emphatic manner by those responsible for his
+education.</p>
+
+<p>There is a false idea prevalent that a continent life is
+harmful. So far as continence relates to immaturity, it
+may be strongly and justly asserted that it is probably
+the most important factor in the conservation of health
+and strength. The retention of the procreative fluids, at
+a time when nature is opposed to their loss, enables the
+growing economy to utilize them in the conservation of
+nervous energy and virility. If a boy dissipates these
+energizing fluids, he deprives his body of the richest
+products which he is capable of manufacturing at a time
+when he needs every aid in the building up of a physically
+and mentally sound and vigorous constitution. There
+cannot exist a normal development if the body is deprived
+of the essential ingredients necessary to growth and
+mental vigor.</p>
+
+<p>There was a time when young men were actually
+taught that sexual intercourse was necessary to develop
+full manhood. This was followed by a period of silence,
+which has practically extended to recent times. Both of
+these systems are pernicious. We know that sexual intercourse
+is not necessary to the development of mature
+normal manhood or womanhood. On the contrary, we
+know that continence, not incontinence, is an absolute
+essential to the growth of full sexual, virile maturity, as
+well as to the growth of efficient and healthy manhood
+and womanhood.</p>
+
+<p>We must appeal to a boy's reason and show him the
+personal side of clean living. When he understands that
+to attain success in every department of human effort,&mdash;on
+the baseball and football fields, in the ring, in
+gymnastic contents, in examinations, in social intercourse,
+in trades and professions,&mdash;a continent life is the only
+means possible that promises success, he will give the
+appeal consideration.</p>
+
+<p>We must employ all the safety devices possible to
+guard against the inclination of youth to wander. Regular
+exercise is one of the very best institutions in this
+respect. If we can instill into our boys a love of manly<span class='pagenum'><a name="Page_155" id="Page_155">[Pg 155]</a></span>
+sports and encourage every effort in this direction, we
+will be doing much to minimize the growth of any tendency
+toward incontinence. We must provide the environment
+necessary to right living. The home should
+be attractive and we should permit the boy to have
+privileges even at the expense of the housekeeping decorum.
+His companions should be made welcome if they
+are the right kind of intimates, and the parents should
+enter into the life of the boy and try to look at "things"
+from his standpoint.</p>
+
+<p><b>The Period of Procreative Power.</b>&mdash;The procreative
+ability begins at puberty. There is no fixed period at
+which it may be said to end. From puberty until the
+period of physical maturity, it grows in vigor and it remains
+stationary until middle life, when it gradually
+declines. The standard of virility is unquestionably an
+individual problem. It depends upon the various factors
+that contribute to good health and longevity. It may be
+stated that the boy who abused his procreative function,
+during the period of immaturity, will not enjoy, during
+the mature period of his sexual life, a normal standard
+of vigor, nor will he carry the ability into old age, to the
+same relative degree, as he would, and as he had the
+innate promise to do&mdash;if he had led a normal continent
+existence. It may also be stated here that there is no
+effective remedial measures known, that will "bring
+back" the procreative ability if it is lost as a result of
+disobeying natural laws. Drugs and treatments by quacks
+to cure impotence are impositions and fakes. Money
+and time spent in the pursuit of this dream is money and
+time wasted.</p>
+
+<p><b>Self-Abuse or Masturbation.</b>&mdash;By self-abuse is meant
+the production of the venereal orgasm, with or without
+emission, by any means other than the natural union
+of the sexes.</p>
+
+<p>It is a fact that the large majority of boys acquire
+the habit of self-abuse at some time. This is a very
+serious reflection upon parent, teacher, and physician,
+because it is through ignorance of the elementary principles
+of sex hygiene that this condition continues to
+exist. If they were warned against the possibility of<span class='pagenum'><a name="Page_156" id="Page_156">[Pg 156]</a></span>
+self-abuse arising in innocent ways, as well as in more
+reprehensible ways, they would exert their influence
+against its acquirement. If however a boy discovers
+accidentally a condition of which he was innocent, and
+of which he does not know the significance, it is human
+nature that he should investigate the phenomenon and
+in the end suffer as a consequence. In the effort to
+relieve some local irritation he may handle himself and
+be led into a dangerous practice. He does not know that
+the practice may have serious results&mdash;in fact he does
+not know he is doing anything wrong. Many boys have
+practically ruined their physical health and become
+morally irresponsible because no one&mdash;neither parent,
+teacher, physician, nor friend&mdash;told them of their danger.
+This is unjust, but great strides are being made in this
+direction and we may reasonably hope, that in the not
+far distant future, every boy will be plainly told the
+true facts about himself.</p>
+
+<p>Most boys acquire this habit from other boys, but as
+we have intimated it is possible to acquire it in what
+are termed innocent ways. Sometimes the sensation
+which leads to it is discovered by sliding down banisters;
+or it may be that climbing trees or poles first awakens
+the feeling. Very young children are sometimes taught
+the vice by depraved nurses. Local irritation, as has
+been stated, may necessitate itching and handling the
+parts and in this way the vice is begun. The results are
+the same, no matter how the habit may have originated.</p>
+
+<p>If the habit is persisted in, the muscular system suffers,&mdash;the
+muscles become weak and flabby; the patient develops
+weariness and languor and loses his mental and
+physical vigor. He is no longer forceful or energetic,
+his efficiency is impaired and as a consequence his nervous
+system begins to show signs of depleted strength. He
+cannot concentrate his thoughts, he falls behind in his
+studies, his mental effort is sluggish, he becomes diffident
+and shy, shuns society, loses confidence in himself, is
+morbid and emotional and may even think of suicide.</p>
+
+<p>It is astonishing how indulgence in this habit may
+affect the moral nature of a boy. First of all, he is
+no longer frank and open. He becomes shifty and<span class='pagenum'><a name="Page_157" id="Page_157">[Pg 157]</a></span>
+suspicious and will not look you squarely in the face.
+A boy cannot become a slave to this habit without it
+affecting his mind. He invites debasing thoughts,&mdash;the
+old pure and clean method of thought and living no
+longer satisfy. His imagination even becomes corrupt
+and his moral nature and moral sense is perverted until
+he no longer seems to be able to tell the difference between
+right and wrong. He has little regard for the
+truth and if occasion demands it he will lie without appreciating
+the dishonorable part he is playing. In the
+end his will power is lost&mdash;even the effort to save himself
+is too feeble to succeed&mdash;he is a slave to the habit,
+his health and strength ruined.</p>
+
+<p>If every boy could realize the possible end of this evil
+habit he would make an effort to rid himself of it before
+he becomes its victim and its slave. It may be
+easy to abandon the practice in the beginning. The
+longer he continues it, however, the less chance he has
+of finally mastering it, until, if he persists beyond a
+certain point, it is a matter of serious question whether
+he will ever be able to free himself from its grip. If the
+boy has lost the will power to carry out his resolves, no
+number of good desires or resolutions will avail. And
+it is just this will power that the wasting of the semen
+saps little by little away.</p>
+
+<p><b>Treatment.</b>&mdash;What can we do for these boys? Most
+of them can do much for themselves by simply stopping
+the practice. There are, of course, others who need
+careful management before the habit may be controlled
+and health restored. It is well to always remember to
+be tactful and patient and kind to these boys. Many
+of them are standing on the brink of despair, weak in
+body and weak in mind. They do not know where to
+turn to look for a friend&mdash;the right kind of a friend.
+It is a terrible thought that your own boy may be abjectly
+miserable in his own home because he is harboring
+a secret that is wrecking his health, and, though he
+may long for sympathy and a helping hand, neither his
+father nor mother have invited his confidence or spoken
+to him about these things. A watchful mother can
+usually tell when her boy becomes addicted to this habit.<span class='pagenum'><a name="Page_158" id="Page_158">[Pg 158]</a></span>
+He will show it in his manner, he will not be free and
+open, he will want to be by himself. Later he will show
+the effects of the abusive treatment he is subjecting himself
+to in his appearance. He will be sunken-eyed,
+pimply-faced, pasty-skinned, shiftless, sneaking, silent,
+unmanly. No mother can fail to note these signs and
+she should suspect the cause and take steps to tactfully
+reach him before he has ruined his health absolutely.</p>
+
+<p>We would advise regular exercise of a vigorous kind.
+Tire out the body so that sleep may be sound. Cold
+baths, followed by brisk rub-downs; no intoxicants, light
+meals, plenty of drinking water morning and night. The
+bowels should be regular every day. He should sleep
+alone on a hard bed in a well-aired room with light covering.
+He should keep busy every minute of the day and
+he should not think of himself at all.</p>
+
+<p>The boy must realize that his salvation rests with himself.
+After he knows the real danger which the habit
+carries with it, he must be on his guard every moment
+to abstain. If he does not he may rest assured that
+the practice will ruin his health, render him, a business
+failure and deprive him of all happiness during the rest
+of his life.</p>
+
+<p><b>Night Losses or "Wet-Dreams."</b>&mdash;A so-called wet-dream
+is an unconscious emission of semen during sleep.
+The discharge may or may not be accompanied with an
+erotic dream.</p>
+
+<p>After a certain age&mdash;which may be from the twelfth
+or fourteenth year&mdash;a boy may discover that he has discharged
+some substance during his sleep. He finds the
+discharge on his night clothes and it naturally puzzles
+him greatly. He may be entirely unconscious of the
+whole proceeding, having slept soundly during the night,
+or he may wake up to find the fluid actually discharging.</p>
+
+<p>If a boy has not been told of this phenomenon he may
+regard it as a form of self-abuse of which he may have
+heard and as a consequence he may worry himself sick,
+as the night emissions continue to occur from time to
+time. Many pure-minded boys have been rendered miserable,
+and their efficiency and health have suffered as<span class='pagenum'><a name="Page_159" id="Page_159">[Pg 159]</a></span>
+a result of just such an experience. It is, therefore,
+proper that they should fully understand the true significance
+of these occurrences.</p>
+
+<p><b>Causes of Night Emissions.</b>&mdash;I have explained how
+nature makes a man out of a boy. During this maturing
+process the testicles are very active organs&mdash;their function
+is to manufacture or secrete the fertilizing fluid or
+semen. This maturing process begins actively, as I
+stated, about the age of fifteen, though in some boys it
+frequently occurs earlier, sometimes as early as the
+twelfth year. When the testicle begins to grow at this
+time they manufacture more semen than the little pockets
+can hold, so nature adopts the method of permitting the
+surplus to escape during sleep. These night emissions,
+therefore, are perfectly natural losses, and need cause
+absolutely no distress of mind whatever. The frequency
+with which they may occur depends altogether upon the
+temperament of the boy. If the boy is a strong, active,
+athletic boy, they may not be so frequent in him as they
+may be in a quiet, studious boy. The system of the
+athletic boy seems to utilize more of this surplus than
+the quieter existence of the studious boy calls for. If
+the discharge does not occur oftener than once every
+two weeks, it may be regarded as normal and natural.
+Should they become more frequent than this, the boy
+should inform his mother or father and the family physician
+should be consulted. It may be that he is in need
+of a tonic, or special instructions regarding his method
+of living and his mode of exercising. Whatever the
+cause may be, it can be corrected, and the best plan is
+to give it attention as soon as it is noted that the losses
+are too frequent.</p>
+
+<p><b>Sexual Excesses.</b>&mdash;It is well known to the medical
+profession that the marital relation is frequently practiced
+to excess. The same indictment may be passed on
+what may be termed extra-marital relations. No one
+has ever formulated a general sexual standard which
+could be safely regarded as normal. Too many individual
+conditions of temperament and health enter into
+the proposition to permit of a standard being formulated.
+It must, therefore, be regarded as an individual question<span class='pagenum'><a name="Page_160" id="Page_160">[Pg 160]</a></span>
+to be adjusted, if necessary, by the family physician.
+What may safely be regarded as normal and harmless
+in one, constitutes, for many reasons, excess in another.
+When a man performs hard physical or mental labor, his
+sexual aptitude or capacity is limited, and this limitation
+cannot be exceeded without risk. Such a limitation may
+not constitute an excess in a man whose occupation does
+not call for a great expenditure of physical or mental
+energy. Any indulgence which produces exhaustion is
+excessive.</p>
+
+<p>The age of the individual has undoubtedly much to
+do with his sexual endurance. A young, virile adult
+will tolerate a sexual expenditure which would seriously
+affect the health and vigor of an older man.</p>
+
+<p>Environment and inclination are factors in determining
+the standard of some people. If the marital relations
+are participated in simply to preserve peace and harmony
+in the home, they are productive of harm even if indulged
+in moderately.</p>
+
+<p>The symptoms of sexual excess are much the same as
+those of self-abuse. To a certain extent, however, they
+are favorably influenced, because the conditions under
+which the relationship is practiced are natural, because
+the participants are matured physically, and because there
+is no element of worry over the probable effects.</p>
+
+<p>Sexual excess defeats its own purpose, because it engenders
+a lack of desire and consequently it is to a certain
+extent a self-limiting process. We must also remember
+that excess entails consequences just as the breaking
+of any natural law is followed by retribution of some
+kind. In these cases we find that discomfort follows
+excess. The parts become irritated and congested and
+disease of the prostate gland always follows.</p>
+
+<p><b>Treatment.</b>&mdash;Stop the excess by self-control and self-restraint.
+Employ all the aids dictated by an intelligent
+perusal of the laws of sex hygiene. Preserve the general
+health. It may be necessary to resort to local treatment,
+because, if the parts have been abused by excessive indulgence,
+there is always more or less irritation and congestion
+present. This condition affects the nerves, suggestive
+reflex sensations are produced by a congested<span class='pagenum'><a name="Page_161" id="Page_161">[Pg 161]</a></span>
+prostate and the patient becomes morbid. It is essential
+for such patients to consult a physician whose local treatment
+will stop the sensitiveness in the parts and relieve
+him so that he may carry out his programme of restoration
+unhampered by conditions which are only amenable
+to local treatment.</p>
+
+<p><b>What Parents Should Know About the So-Called
+"Social Evil" Before Speaking With Authority to
+"The Boy."</b>&mdash;To be qualified to speak with authority, or
+convincingly, to a boy upon sex hygiene, the parents must
+be familiar with, and well versed in the subject. The
+facts related in the preceding pages must be thoroughly
+understood. No parent can study these facts intelligently
+without being impressed with the importance of the subject;
+without realizing that it is absolutely essential that
+the fundamental principles of sex hygiene should be
+taught to the rising generation; without acknowledging
+the tremendous part for evil which prudery and ignorance
+play in the education of youth; and without being convinced
+that most of the evil is the product of ignorance
+on the part of the boy, and that parents are in a large
+sense to blame if they fail to impart the necessary knowledge
+in time.</p>
+
+<p>The need for enlightenment in sexual matters is a
+product of existing conditions. Civilization and the social
+environment are developing along a plane which subjects
+the youth to temptations that practically did not exist in
+the past. There is a broader and looser code of ethics.
+Business monopolizes the entire time of the father, and
+social and political unrest and misdirected ambition distracts
+the mother. The son or daughter has a wider
+latitude and a freer reign than they once had. The opportunities
+for promiscuous intimacies are easier, and the
+public conveniences and utilities lend themselves to the
+designs of evil-intentioned and loose-moraled women.
+The ease of travel, the laxity of laws, the theater, with
+its unchaste and indecent plays, the moving picture
+snows, the vaudeville resorts, whose highest priced
+"talent" is some voluptuous female, who has cultivated
+the art of draping nudity with suggestiveness and singing
+immoral songs, all tend to give youth a false impression<span class='pagenum'><a name="Page_162" id="Page_162">[Pg 162]</a></span>
+of the reality of life and to make the path of the degenerate
+easy and profitable. The rich are growing
+richer, and their children are pampered and overfed and
+underrestrained. Time hangs heavily on their hands and
+their only mental effort is to devise new methods and new
+ways of satisfying the lust of liberty and overstimulated
+desire. The poor are growing poorer, and to "keep in the
+ring," to live and dress beyond their means as many do,
+it is necessary to have an unexacting standard of morals.
+In this way the promiscuous libertine is evolved,&mdash;the
+most insidious and dangerous product of present day
+civilization, and the most pernicious factor in the spread
+of immoral impulses and indecent diseases.</p>
+
+<p>Parents must accept these institutions and agencies as
+necessary instruments of evil and adopt measures to nullify
+their attractiveness. Eternal vigilance is the price of
+success, but the quality of the vigilance must be dictated
+by love, not by suspicion and distrust.</p>
+
+<p>When the parent can convince the boy that the knowledge
+is imparted, not with the intention of depriving him
+of what he may construe as his natural liberties and
+rights, but with the single intention of adding to the sum
+total of his pleasure and success, he will look more kindly
+upon any proposition that suggests a course of conduct
+that leads to clean living. Sex hygiene will eventually
+find a natural place in the scheme of education. It will
+be taught to male and female alike. In the meantime,
+however, we must begin by educating the educators&mdash;the
+parents. In the beginning, their task will not be easy.
+There will be much to overcome, much ignorance,
+prudery, false modesty, hypocrisy; there will be much
+vicious teaching and evil example to live down. But we
+cannot hope to achieve results in the noblest cause, save
+by patient, intelligent, and persistent effort and by self-sacrifice
+and a constant enthusiasm. The aim is to tell
+all,&mdash;all the truth,&mdash;so that we may never be assailed by
+the cry, "No one told me, I did not know," from the loved
+lips of son or daughter gone astray.</p>
+
+<p><b>The Father and the Boy.</b>&mdash;The right kind of father
+can always find the time and the way to awaken in the
+heart of the boy the spirit of companionship. No boy<span class='pagenum'><a name="Page_163" id="Page_163">[Pg 163]</a></span>
+living will resent the fellowship of the right kind of
+father. It depends upon the father! If the spirit of
+chumminess does not exist between you and your boy, you
+are at fault, you have made a mistake, you have missed
+your opportunity, you "did not go about it in the right
+way and in the right spirit." Try again&mdash;it may not be
+too late.</p>
+
+<p>The father who adopts the habit of taking his boys
+(and his girls too) out for long walks, at least every Sunday,
+and who spends an hour with them every evening&mdash;is
+the right kind of father. One who has never tested the
+merit of walks with children cannot possibly appreciate
+the enjoyment and benefit that can accrue from them.
+It is not only the physical good that results, nor the inspiration
+which one may draw from nature, but the concrete
+advantages that come from the fellowship with the
+children are a new and a real experience&mdash;this is what
+counts. You will have opportunities of sewing seeds in
+their minds that will grow into a harvest that will
+astonish you. Children in the right mood&mdash;and they
+are in the right mood when they are happy, and they are
+happy out in the open with an interesting companion&mdash;are
+alert, and responsive, and eager to be told "things,"
+and this mood can be put to marvelous use by the "right
+kind of father." The father who wanders forth with the
+fixed purpose of thinking out some business problem during
+the walk and permits the children to find their own
+amusement is the wrong kind of father. He must choose
+to be a child again, he must desire to please them, he must
+make an effort to be in harmony with them, he must draw
+on his experience to interest them, he must talk to them
+entertainingly of every interesting problem which the
+walk itself suggests or he must formulate a plan and
+select a subject with a definite educational scheme in view.
+We can, in a most effective way, begin to build their
+characters, and, by the right kind of talk and enthusiasm,
+he can determine their resolves to be honest, truthful, just,
+clean, sympathetic. He can instill into them, in a
+thousand different ways, the determination and inspiration
+to succeed. It is a wonderful and a precious chance,
+and it will make the "right kind of father" more just,<span class='pagenum'><a name="Page_164" id="Page_164">[Pg 164]</a></span>
+more sympathetic, more optimistic, and it will make him
+young again and more successful. Try it.</p>
+
+<p>Implant in the hearts of your children a love of home,
+make the evening meal and hour by the fireside a period
+of congenial fellowship, when all the little irritable ruffles
+of the day may be ironed out and swept away. The secret
+is to be intimate. Tell them the secret of success from
+your standpoint, how happiness is gained only by being
+efficient and successful, and that, to be efficient, one must
+be energetic and healthy. Drum into their ears the truth
+that life is a battle, and only the brave "win out," and
+health is the one essential necessity. It is astonishing how
+such talks will impress young minds. They will remind
+you of things you said, that made a lasting impression on
+them, long after you have forgotten the incident.</p>
+
+<p>A father can, in this way, by talking of the future to his
+boy, convey to him the high hopes he entertains of the
+great success the boy is going to achieve&mdash;you establish
+a standard in the boy's mind, and he unconsciously hopes
+to attain that standard. If you have impressed him with
+the necessity of preserving his health and strength, as an
+essential to success, he will be slow to yield to any temptation
+that may interfere with his plans. This reasoning
+may sound quixotic to some people, but it is the truth.
+Many a boy has been inspired to success by the knowledge
+that his mother or father believed in him, and was
+confident he would be a leader. He strove to justify the
+pride and confidence of those who held him dear, and
+he won out.</p>
+
+<p>To retain his health, therefore, is the first impulse to be
+conveyed to the boy. When he recognizes this truth, it is
+an easy task to instill a love of exercise, gymnastics,
+swimming, fresh air, cleanliness and temperance in him.
+If these are attained, you will have tided him over the
+tendency to self-abuse, and you will have rendered him
+less likely to yield to evil suggestion or temptation. His
+confidence in you will be whole-hearted and implicit.
+You can do anything with him at the psychological
+moment. It is now time to talk of more intimate matters.
+Carefully and tactfully, the father approaches the fundamental
+truths of sex hygiene.<span class='pagenum'><a name="Page_165" id="Page_165">[Pg 165]</a></span></p>
+
+<p>The selection of a subject for a text as a means from
+which to advance toward the real facts is sometimes of
+importance. It must not appear as though the subject
+was designedly chosen. If it follows in a natural way
+it will more thoroughly interest the boy and he will have
+swallowed a large dose of truth before he is impressed
+with the personal viewpoint. A passing trotting horse
+has served me a number of times for intimate talks with
+boys on heredity and kindred subjects. I invite the boy
+to watch how the horse uses his legs, and how rhythmically
+and beautifully he places his feet, and how his whole attitude
+serves the end for which he is exerting himself&mdash;to
+gain speed. Tell the boy the story of how professional
+breeders have achieved such marvelous results; how for
+generations the "strain" has been kept clean and pure,
+how any descendant of a great sire, who showed any
+habit detrimental to the development of the highest racing
+qualities&mdash;no matter how trivial the disability might be&mdash;was
+cast aside, experience having taught that it does not
+pay to waste effort and time on any horse whose physical
+or mental characteristics are not up to the highest
+standard. Such a horse will not win, and it is only
+"wins" that count.</p>
+
+<p>Change the subject to human beings. Tell him how
+the race maintains its standard; but show him the difference
+between the methods employed. How the horse
+has his mate selected because of the female's good qualities,
+so that the offspring may possess like qualities, if
+not better, and that the selection is made by men who
+know their business, and have had long experience in the
+work. How, on the other hand, a young man with no experience
+is permitted to choose any woman he may fancy
+irrespective of her qualifications. As a consequence, we
+have all kinds of children, good and bad, feeble and
+strong, honest and dishonest, some degenerates from
+birth, some criminal, and many diseased and inefficient,
+few of them "winners." It is an easy matter to preach
+a little sermon from this text. Show him how essential
+it is to select the mother of one's children wisely, to know
+if there is disease in the future wife's blood, if her family
+history is good, if her temperament is suited to his, if her<span class='pagenum'><a name="Page_166" id="Page_166">[Pg 166]</a></span>
+domestic qualities are satisfactory, if her principles are
+moral and normal, and if she understands and appreciates
+the true object and function of marriage. Show him also
+the element of justice involved in the marriage contract;
+that he must give what he exacts, that if he expects a
+healthy and normal wife, he must be healthy and normal
+himself; if he expects purity and cleanliness he must give
+purity and cleanliness; if he expects to mate with a fit
+female he must be an efficient and fit male. Remember
+that every act, deed, thought, and aspiration is regulated
+by laws which one cannot fool with, or disobey, without
+reaping a harvest which will conquer, crush and ruin
+you, no matter how clever or smart you may think yourself.</p>
+
+<p>Show him the wisdom of the breeders' habit of never
+permitting sexual liberties in a too young stallion. For
+the same reason the boy must conserve his strength and
+virility for the marriage state and for the function of
+procreation.</p>
+
+<p>In a further talk, the father may extend this subject
+and gradually lead up to the "consequences" of the unclean
+life. The boy will be ready for this talk and will
+evince an interest in it that will be encouraging and
+promising.</p>
+
+<p>The talk about the science of mating the horses he will
+understand readily and thoroughly, and he will not fail
+to see the point when you switch to man and apply the
+same principles. Then when you show how mismating is
+responsible for poor children quality and how disease
+accounts for feeble-minded and degenerate offspring, he
+will be fairly well posted, and he will be ready to imbibe
+more details, and you will have done much of your duty.
+His curiosity will be quickened and his interest is
+awakened. It depends upon the father. If your boy is
+honest and clean, open and decent, he will not fall without
+a fight, and while he is fighting he is maturing. If your
+picture of the consequences of the venereal diseases has
+been effective and vivid, he will grow up with a healthy
+horror of them. If your conduct as a father has been
+wise and exemplary, and if your home has the right kind
+of environment, and the right kind of mother in it, you<span class='pagenum'><a name="Page_167" id="Page_167">[Pg 167]</a></span>
+have done all a father can do to help the boy over the
+rough spots. The proper kind of encouragement and the
+right kind of vigilance, and books which will satisfy the
+boy's craving for more knowledge along this line is all
+that is needed to help the boy to "win out."</p>
+
+<p><b>Fake Medical Treatment for Venereal Diseases.</b>&mdash;Parents
+should in every possible way discourage the use
+of patent medicines and fake medical methods of curing
+these diseases. Untold harm has been done to boys and to
+women by these nostrums.</p>
+
+<p>In every instance the motive underlying the methods of
+people selling these things is to frighten the patients into
+the belief that their condition is more serious than it is in
+order to justify a long and expensive course of treatment.</p>
+
+<p>Their work is carelessly performed, and frequently
+they are directly responsible for the development of complication
+and dangerous sequel&aelig;. The promises of
+speedy cures are false, and, not infrequently, methods of
+black-mailing have been known to follow an expensive
+and unsuccessful course of treatment.</p>
+
+<p>There is no class of disease in which the help and
+honesty of the legitimate medical profession is needed
+more than in the treatment of the venereal diseases.
+Parents should see to it that the family physician is
+prescribing any strange medicine that may appear in the
+boy's room, and not some unknown individual who may
+be an impostor and a blackmailer.</p>
+
+<p><b>Sowing Wild Oats.</b>&mdash;Writers of fiction and others of
+a more serious trend of thought have recognized the sowing
+of wild oats as an institution which, if it does not
+merit the full approval of society's moral code, is, at
+least, tolerated. No serious consequences befall the offender.
+On the contrary, the libertine is the type of hero
+who receives the commendatory quips of erotic dames
+and the questionable interest of hysterical maidens.</p>
+
+<p>Women of easy morals are always willing to espouse
+the cause of the "black sheep," and to further the
+matrimonial success of the penitent <i>rou&eacute;</i>. Many mothers
+are willing to marry their daughters to the polished villain
+of society, who is known as a rake and debauchee, if his<span class='pagenum'><a name="Page_168" id="Page_168">[Pg 168]</a></span>
+family connections are desirable. It has been even held
+that a youth who did not "sow his wild oats" was of
+doubtful stamina.</p>
+
+<p>That many able men have sown wild oats is indisputable,
+and that many men who are respectful husbands,
+have also gone "through the mill" is also true, but this
+need not blind us to the fact that thousands upon
+thousands, who could have been successful men of affairs
+and creditable husbands and fathers, have been utterly
+ruined, as a result of having sown wild oats. No man
+is a better man because of a past record of licentious
+habits. The man who sows and escapes the harvest is
+lucky. The man who reaps, reaps in abundance. Most
+men regret the lapses of youth. Most of these lapses
+would never have occurred if the impulse could have been
+governed by the reasoning of maturity. These acts are
+the promptings of an impetuosity which may be entirely
+foreign to the individual's innate character, but brought
+out by promiscuous circumstances and the ignorance and
+license of youth. If we can protect youth, by an adequate
+knowledge of the consequences, we will furnish
+the means to tide over the impressionable period. Until
+a healthy maturity of judgment will assume the task unaided.</p>
+
+<p>The effects of the wild oats' theory are too tragically
+evident to need any argumentative refutation. The
+statistics of the prevalency of venereal diseases alone is
+sufficient; the results of these diseases are more than
+enough.</p>
+
+<p>Study the records of the jails and prisons, courts and
+asylums, hospitals and health resorts, think of the
+hundreds of thousands of diseased and deformed and
+mentally inferior children, of the multitude of paretics,
+melancholies, ataxics, maniacs, syphilitics,&mdash;all the
+products of "wild oats,"&mdash;and ask if the wild oats' theory
+is justifiable.</p>
+
+<p>Think of the ruined homes, the wretched lives of fallen
+women, the hopeless prayers of abandoned wives, the
+loneliness and misery of parents neglected and forgotten,
+the "bastards" and fatherless children, the drunkards and
+criminals and tramps&mdash;all weeds of the wild oats' harvest.<span class='pagenum'><a name="Page_169" id="Page_169">[Pg 169]</a></span></p>
+
+<p>Then reflect upon the tragedies, the suicides of the betrayed
+and of the diseased, the bank thief, the broken
+hearts of deserted and hungry children, the army of
+inefficients&mdash;around whose necks hang wild oats' medals,
+the men of big business, who constantly fight the effects
+of early incontinence and abuse, and the thousands who
+go to early graves, and then ask, in all justice, if the sowing
+of wild oats needs justification.</p>
+
+<p>Who supports the thousands of prostitutes? Who
+made them? Wherever you find pauperism, crime,
+drunkenness, insanity, idleness, immorality, vice and
+disease, you will find that the sower of wild oats has
+traveled the path and left his stain and his footprints
+there.</p>
+
+<p><b>Should Circumcision be Advised?</b>&mdash;The answer to the
+above question is "Yes," in every instance. If circumcision
+is done early,&mdash;during the first two weeks of life,&mdash;the
+operation is without danger and practically without
+pain. In quite a considerable percentage of all males,
+circumcision is an absolute necessity. For excellent
+medical reasons, about which your family physician can
+inform you, every boy should be circumcised.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_173" id="Page_173">[Pg 173]</a></span></p>
+<h2>CHAPTER XIV</h2>
+
+<h3>A MOTHER'S DUTY TO HER DAUGHTER</h3>
+
+<div class="blockquot"><p>What a Mother Should Tell Her Little Girl&mdash;Where Do
+Babies Come From&mdash;How Baby Birds and Fish Come
+from Eggs&mdash;How Other Animals Have Little Nests of
+Their Own&mdash;The Duty of Mothers to Instruct and Direct&mdash;What
+a Mother Should Tell Her Daughter&mdash;Every
+Mother Should Regard This Duty as Sacred&mdash;Every Female
+Child is a Possible Future Mother&mdash;Motherhood the
+Highest Function of the Sex&mdash;Health the One Necessary
+Essential&mdash;Symptoms of the First, or Beginning Menstruation&mdash;The
+Period of Puberty in the Female&mdash;Changes in
+the Reproductive Organs at Puberty&mdash;The Female Generative
+Organs&mdash;The Function of the Reproductive Organs&mdash;The
+Age of Puberty in the Female&mdash;The Function
+of the Ovary&mdash;The Function of the Womb&mdash;Why Menstruation
+Occurs Every Twenty-eight Days&mdash;The Male or
+Papa Egg&mdash;The Function of the Spermatozoa&mdash;"Tell the
+Whole Story"&mdash;"How do These Spermatozoa Get There"&mdash;The
+Union of the Species&mdash;"How Can a Baby Live in
+There for Such a Long Time"&mdash;How the Baby Gets its
+Nourishment in the Womb&mdash;Girls Must Not Become
+Mothers.</p></div>
+
+
+<p><b>What a Mother Should Tell Her Little Girl.</b>&mdash;Every
+little girl should be told the Story of Life by her mother.
+It should be told in simple language, so that the little girl
+will understand. Very early in life the little girl will be
+prompted to inquire of her mother "Where do babies
+come from?" It is wrong to give an evasive reply to
+this natural inquiry or to postpone telling the story, because
+they will be told it by playmates and will receive
+very wrong and very crude impressions of this wonderful
+subject.</p>
+
+<p>Every mother knows enough of life to tell her little girl
+its story in a way that will impress her with the sacredness
+of God's beautiful reproductive plan. She should
+begin by telling her a story about how the birds live.
+How at a certain season of the year they choose a mate<span class='pagenum'><a name="Page_174" id="Page_174">[Pg 174]</a></span>
+and go housekeeping. They build a nest, and when it is
+all nicely finished, the mother bird lays her eggs. Then
+the papa and mamma bird take turns and sit on the eggs
+to keep them warm, and after a time the egg breaks and
+a little bird is born into the world. They feed the little
+baby birds until their feathers grow, and when they are
+old enough they fly away from their home and begin life
+by themselves.</p>
+
+<p>Many questions will be asked as the mother tells the
+story in her own words, and the correct answers to these
+questions will fill in all the difficult-to-understand points.
+The story of how the fish lay eggs in shallow water so
+that the sun may keep them warm and hatch them out will
+interest also. Be careful to impress upon them that
+there is always a mamma and a papa, a male and a female
+bird and fish,&mdash;that this is necessary because God made
+it so, and we must obey His wish. When the little girl
+fully understands the story of the egg bird, and egg fish,
+the mother can tell how the Creator thought out a different
+plan for other animals like the dog, horse, lion,
+elephant, and cow. He knew that it would neither be safe
+nor possible for these animals to stay at home long
+enough to sit on eggs and hatch their babies, so he made
+a nest for them inside of their bodies. There they would
+be warm and would always be with their mammas no
+matter what they were doing. So we come to the answer
+to their question: "Where do babies come from?"</p>
+
+<p>These interesting stories, according to the intelligence
+and sincerity of the mother, can be taken advantage of,
+to impress the little girl with the importance of many of
+the lessons of life. For example, her attention can be
+drawn to the fact that man and woman are the highest
+types of living things that God made. No other living
+thing, animal, or fish, or bird, or tree, or flower, can talk,
+and think, and reason as man and woman can. Because
+of this faculty&mdash;to think and reason&mdash;the human family
+are always trying to find out what can be done with all
+the other things God made. We try to find out what the
+different rocks are good for; what the different trees are
+good for, and the different kinds of earth, and animals,
+and birds, and fishes, and everything in the world. We<span class='pagenum'><a name="Page_175" id="Page_175">[Pg 175]</a></span>
+study these, and we learn much, and we are made happier
+and more comfortable by what we learn. For example,
+by studying horses, and feeding and breeding them carefully,
+and training them, and caring for them, we can
+make stronger horses and better and faster horses; by
+studying trees, and planting them in soil best suited to
+them, and giving them plenty of water to drink, we can
+compel these trees to grow better apples and pears and
+peaches. In the same way we can produce better strawberries,
+and oranges, and grapes, and we can grow flowers
+with sweeter smells and prettier colors. We do all
+this by training these animals and trees to grow a certain
+way, to eat certain food, to drink pure water, and we
+protect them from the cold and sometimes from the sun
+if it is too hot. Our faculty to think and reason has
+taught us just what is good for them, and we compel them
+to obey our laws. As a result they become strong and
+more healthy. Now show the little girl how important
+she is; how much more precious she is than a tree, or
+animal, or flower, and how much more necessary it is that
+we, mammas and papas, should use our ability to think
+and reason in her interest. Show her how we have found
+out all about babies and little girls and how we know
+just what to do to make strong and healthy, and pure,
+and good, and clean men and women of all the little boys
+and girls in the world. Tell her that this is what mother
+is doing now, training her and compelling her to do the
+things that will make her a strong and a good mother
+when she grows older. Let her distinctly understand that
+it is the duty of mothers to instruct and to correct their
+little daughters when they do any wrong. Mothers know,
+because they have had experience in these matters, and
+they know just how a little girl must live, and dress,
+and eat, and behave, in order to be strong and pure, and
+good. So when mother reproves and corrects, it is because
+she knows that what you are doing to merit a correction
+is not for your ultimate good. Show them that
+all young things, and young animals, and young babies,
+and young girls, must be compelled to obey certain rules
+and laws, otherwise they would not grow up to be strong
+and healthy. Sometimes a rose bush grows up among<span class='pagenum'><a name="Page_176" id="Page_176">[Pg 176]</a></span>
+stones and weeds, but it never thrives, it is always more
+or less sick. It does not grow strong, its flowers are poor
+little sickly things compared to the roses on a bush that is
+planted in proper soil, and carefully tended and pruned,
+and watered. So would the little girl turn out if she grew
+up in bad company and did not have a mother to guard
+and guide her,&mdash;to prune her when she was growing careless.
+Everything in this world has a meaning, and when
+mother tells you that you must not do a certain thing you
+very much want to do, she has a very good reason for
+telling you not to do it. You may not know the reason,
+but you should have confidence in your mother, you
+should believe that she knows what is best, and that she
+would not inflict pain or cause you suffering unless she
+knew it was for your good. The young horse does not
+understand why a halter is put around its neck and is
+made to run around in a circle until it is tired. It would
+much rather enjoy itself in its own care-free, and happy
+way. And when finally a full set of harness is put on, and
+it is put into the shafts of a wagon and tied there, and
+made to pull it and its driver many weary miles the horse
+does not like it, and he rebels strenuously. He is, however,
+compelled to obey in the end, and he finally consents
+to become a useful horse.</p>
+
+<p>It is exactly the same way with every little boy and
+girl. We are put into this world for a certain purpose,
+and we must all work. Now parents know this, and they
+know just how to prepare little girls and boys for this
+work. They therefore ask them to do many things that
+are not pleasant or agreeable but which must be done in
+order to prepare them for the work ahead.</p>
+
+
+<h3>WHAT A MOTHER SHOULD TELL HER DAUGHTER</h3>
+
+<p>Your daughter is now about fourteen years of age.
+She is about to pass from girlhood to womanhood and
+she should know more of life's story. The mother will
+now tell her the complete story in the form of little talks,
+based upon the following facts as texts. Each mother
+will doubtless add to the story as conditions justify and
+as the education of the mother and daughter may dictate.
+A multitude of little side talks can be wisely indulged in<span class='pagenum'><a name="Page_177" id="Page_177">[Pg 177]</a></span>
+to make clear any uncertain or doubtful explanation, and
+every one of these incidental excursions can be made exceedingly
+interesting if wisely and opportunely chosen.
+Always remember, however, to emphasize the sacredness
+of the story. Do not permit your daughter to get the impression
+that you are telling her something that simply
+has to be told, just as you told her the correct way to
+boil an egg. Let her realize and get the impression that
+this is the most serious and most wonderfully interesting
+story in existence, the most important story she will ever
+hear. Let her understand that motherhood, for which she
+is now preparing, is the duty God assigned her in this
+world: that that duty must be carried out, and that she
+must do nothing, nor leave anything undone, to interfere
+with its accomplishment. Do not only impress her with
+the story itself, but let your own explanation be so emphatically
+serious, that she will deeply appreciate its
+momentous significance&mdash;an occasion to be remembered
+all her life.</p>
+
+<p>If she gets the proper impression from you at this time
+she will never treat the subject lightly, or permit it to be
+promiscuously discussed within her hearing.</p>
+
+<p>Begin by telling her that she is about to enter the most
+important period of her life. Explain why this is so in the
+following way, in your own words. If we admit every
+female child to be a future mother, and motherhood the
+highest function possible to the sex, then the awakening
+of the sex organs and the mother instinct, must be the
+most important developmental episode in the life story of
+every woman. If this is so, then it follows that every girl
+should enter this period in the very best physical health
+possible, in order to reap the best results incident to this
+evolutionary period. We impress and warn her, therefore,
+that, as her system is about to undergo important
+changes, she must be particularly careful of her health.
+A little mistake at this time may be followed by more
+serious consequences than if made at any other time in
+her life. If a girl is to become a mother, certain changes
+must occur in her body before the nest, of which we
+previously wrote, can be made ready. God did not overlook
+anything when He peopled the earth; He therefore<span class='pagenum'><a name="Page_178" id="Page_178">[Pg 178]</a></span>
+wisely planned that these changes in the female should
+occur at a time when the girl is strong and healthy.</p>
+
+<p><b>The Period of Puberty in the Female. Symptoms of
+Beginning Menstruation.</b>&mdash;At about the age of fourteen
+these changes begin to give evidence of existence. They
+affect the girl's whole system and the mother must be
+especially patient and sympathetic. Her disposition may
+change, she may want to be alone, and she may be more
+or less melancholy. She will be dissatisfied with the
+things that previously interested her. She will tire easily,
+and she may have many spasmodic pains from time to
+time. The wise mother will tactfully see that she takes
+plenty of nourishing food and systematic exercise, and
+that she gets enough sleep in a well-aired room. There
+are other physical changes which are observable at this
+age. The girl grows taller, the figure broadens out, the
+hips widen, the bust enlarges, and the waist line increases
+in size. These are all part of the great change from girlhood
+to womanhood.</p>
+
+<p><b>Changes in the Reproductive Organs.</b>&mdash;The principal
+change takes place in the reproductive organs themselves,
+and it is very essential that she should have a clear mental
+picture of just what is meant by "reproductive" organs
+and their location in her body. We mean by this
+term the group of organs which are concerned in creating
+and nourishing a child until it is old enough to be born
+into the world.</p>
+
+<p><b>The Female Generative Organs.</b>&mdash;These organs are
+the womb or uterus, two ovaries, two fallopian tubes
+and the vagina. The womb or uterus is the "nest."
+It is about the size of and is shaped like a pear. It is
+hollow, however, though its walls are quite thick. The
+ovaries are about the size of a peach stone and lie at the
+side of the womb,&mdash;one on either side. The fallopian
+tubes connect the ovaries with the womb. The vagina
+connects the womb with the outside world,&mdash;it is sometimes
+known as the birth canal. In the very lowest part
+of the abdomen, or belly, in front, is the bladder, which
+collects the urine until it is necessary to pass it out.
+In the back part of this region is the rectum; it collects
+all the undigested food, etc., from the intestinal canal.<span class='pagenum'><a name="Page_179" id="Page_179">[Pg 179]</a></span>
+Between these two,&mdash;the bladder and rectum,&mdash;we find
+the reproductive organs, the womb, ovaries and vagina,
+described above.</p>
+
+<p><b>The Function of the Reproductive Organs.</b>&mdash;It will
+be difficult, even for mothers, to acquire a clear understanding
+of the function of the reproductive or generative
+organs. It is an exceedingly interesting process,
+however, and it is well worth a patient, attentive study to
+clearly understand the brief description we give of it.
+If you acquire a distinct mental picture of the problem
+you will be able to tell your daughter a story that will be
+of intense interest to her, and a tale that is interesting
+is impressive and is productive of thought and reflection.
+That is the condition of mind we want daughters
+to be in when they hear this story.</p>
+
+<p>The human ovaries begin to prepare themselves for
+their life work when the girl is about eight years of
+age. When they are ripe, or ready to perform this duty,
+the girl menstruates for the first time. This is known
+as the age of "puberty," which implies that she has developed,
+passed from girlhood into womanhood. After
+having reached the age of puberty it is possible to become
+a mother.</p>
+
+<p><b>The Age of Puberty.</b>&mdash;There is no fixed age at which
+the first menstruation takes place. Some girls develop
+quicker than others,&mdash;a condition that depends upon
+the health and type of girl. A strong, robust, full-blooded
+girl will menstruate at an earlier age, than will
+a sickly anemic girl. The average age is fourteen years,
+though there is no reason to worry if a girl does not
+menstruate for a number of years later. In warm climates
+the age of puberty is from two to four years earlier
+than in more temperate climates.</p>
+
+<p><b>The Function of the Ovary.</b>&mdash;Just what takes place
+in each ovary when it is ripe is best explained by likening
+an ovary to an orange,&mdash;though of course the ovary
+is very much smaller than an orange, as was previously
+noted. If you make a cut in an orange and squeeze it,
+you express some of its juice and most likely you will
+also express one or more seeds. The seeds of the ovaries
+are called "ovules," and the process by which it expresses<span class='pagenum'><a name="Page_180" id="Page_180">[Pg 180]</a></span>
+them is called "ovulation." Of course there
+is no actual squeezing of the ovary,&mdash;the ovules grow
+in the ovary, and as they ripen they come to the surface,
+and when actually ripe, the part of the surface of the
+ovary to which they come, opens up (like a flower unfolding
+when in bloom), and they fall out. The ovule
+we may regard as the human female egg, and one ripens
+and falls out every twenty-eight days.</p>
+
+<p>When the egg falls out of the ovary it falls into the
+tube which carries it into the womb. This tube you
+will remember is called the fallopian tube. The ovule
+or egg is now in the cavity of the womb where we will
+leave it for the present.</p>
+
+<p><b>The Function of the Womb.</b>&mdash;While these changes
+are going on in the ovary, the womb is also preparing
+itself for its share of the work. The lining or internal
+surface of the womb is composed of mucous membrane,
+much the same as the interior lining of the mouth and
+throat. This lining becomes congested with blood, and
+is so intensely swollen at the time when the ovule or
+egg reaches the womb, that it is ready to rupture and
+bleed all over its surface. Just whether it will rupture
+and bleed, depends upon whether the egg is going
+to grow into a child or not. If it is not going to grow
+into a child, it immediately bleeds freely, and continues
+to bleed, until the whole lining of the womb and egg
+is passed out into the outer world. This takes four or
+five days and constitutes "menstruation." After menstruation
+is over, the womb begins again to prepare itself
+for the coming of the next ovule or egg, and as this
+occurs every twenty-eight days, menstruation is commonly
+termed the "monthly periods."</p>
+
+<p><b>Why Menstruation Occurs Every Twenty-Eight
+Days.</b>&mdash;The reason why the womb does this every twenty-eight
+days is because it is impossible to tell just when
+the womb will be called upon to nourish and support
+a child. If it did not get rid of the old blood, it would
+not be in a healthy condition to nourish and take care
+of a baby, nor would its interior be ready to supply
+new fresh blood for the growth of the infant. Hence
+nature constructs and builds a new "nest" in the interior<span class='pagenum'><a name="Page_181" id="Page_181">[Pg 181]</a></span>
+of the womb each month. It very much resembles
+the new home into which the bride and groom, go to
+begin housekeeping.</p>
+
+<p>When you told your little girl the story of life, you particularly
+drew her attention to the important fact that
+every living thing is created by the union of a male
+and female principle, and, therefore, has a mamma and
+papa. This applies to trees, flowers, vegetables, fish,
+animals, birds, insects,&mdash;every living thing, including
+human beings. We have seen that the ovule from the
+ovary is the female egg, or principle. It is the part
+the female contributes toward the future child. Before
+a child is possible, however, the ovule must meet the
+egg from the male.</p>
+
+<p><b>The Male or Papa Egg.</b>&mdash;The male or papa egg is
+called a "spermatozoa." It reaches the interior of the
+womb through the lower opening, which you will remember
+opens into the vagina. Emphasize to your daughter
+that the female ovule or egg, and the male egg, or
+spermatozoa, are minute objects, so microscopically
+small that a hundred million of them could comfortably
+lie upon a ten-cent piece.</p>
+
+<p><b>The Function of the Spermatozoa.</b>&mdash;God gave the
+male spermatozoa the power to move. To watch them
+under the microscope you would imagine you were looking
+into a bowl of water, in which there were hundreds
+of little fish all squirming around. But the most wonderful
+thing about them is, they can only move in an upward
+direction,&mdash;they seemingly cannot move downward, or
+sideways. If you think for a moment you will understand
+why God gave them this marvelous property.
+When the male semen is deposited in the female vagina,
+there are thousands of these minute, living, moving
+spermatozoa in it. The womb is above the vagina, and
+the female egg is in the womb, consequently, to reach
+this egg, the spermatozoa must travel upward. To travel
+in any other direction would be fruitless energy. There
+is only one female egg, but there are thousands of male
+eggs, or spermatozoa; it is easy, therefore, to comprehend
+how one of these spermatozoa should exactly be in line
+with the female egg in its upward path, since there are so<span class='pagenum'><a name="Page_182" id="Page_182">[Pg 182]</a></span>
+many of them. It is only necessary that one should meet
+the female egg in order to impregnate it.</p>
+
+<p>The shape of the male principle, or spermatozoa, is
+exactly like a little tadpole, and you no doubt recall that
+a tadpole has a minute tail, the movement of which
+enables it to swim around. So has the spermatozoa, and
+by the incessant movement of this microscopic tail they
+all move upward as soon as discharged by the male. I
+told you that God gave the male-germ life. It is necessary
+now to explain the character of this life. It is very
+brief; it is estimated that they are active for two hours,
+and then become inactive, or die. The best way to explain
+the brief activity to your daughter, is to liken the
+spermatozoa, to a mechanical toy, which is wound up
+to go for a certain time. After it runs out it becomes
+inactive; this is exactly what happens to the little human
+tadpole. If during this brief life none of them has
+happened to reach the female egg, pregnancy does not
+take place and menstruation occurs. On the other hand,
+if this were not so,&mdash;if these spermatozoa were active
+for a longer period, pregnancy would almost be certain
+to take place every time the womb was not already occupied
+with a pregnancy.</p>
+
+<p><b>Tell the Whole Story.</b>&mdash;When a mother reaches this
+stage of the wondrous tale she will be asked by an innocent
+girl,&mdash;"How do these spermatozoa get there?" or,
+"You have not told me where these tadpoles came from"
+or, "I don't understand how these spermatozoa got into
+the vagina" or, "I don't know why you call these the
+male egg when they are in mamma." It does not matter
+how it is expressed, the intent is plain enough. I have
+said, that an innocent girl will ask this question, the
+implication being that one who is not innocent will
+refrain from asking this question. A girl who knows the
+answer will not ask, because, if she is familiar with this
+subject before her mother thinks it wise and proper to
+tell her, she obtained her information from a source
+which, most likely, insinuated a suggestive, or evil, meaning
+into the explanation, consequently she would be afraid,
+or ashamed, to ask the question. An innocent girl, on
+the other hand, would rightly ask for information which<span class='pagenum'><a name="Page_183" id="Page_183">[Pg 183]</a></span>
+is obviously kept back, and which she has a right to
+know, since a complete, and intelligent understanding of
+the story depends upon the elucidation asked. If it is
+proper to tell part of the story, it is essential to tell all
+of it. Tell it in your own words in this way:</p>
+
+<p>When God conceived the human race He ensured its
+perpetuation by designing a method whereby this would
+be rendered possible: He did more; He wisely decided
+that the function, involving the very existence of the
+human race, should be attended with a sentient gratification.
+He further instilled into the fundamental economy
+of mankind, sex attraction, which is involuntary, undeniable,
+and unquenchable. If God conceived the means
+and the method, no human mind in possession of its
+faculties should see evil where it does not exist. It was
+by Him designed that the male organ of reproduction
+should deposit its germinating fluid in the vagina of the
+female, and this is accomplished by a union of species.</p>
+
+<p>The one set of reproductive organs is a complement of
+the other, and essential to the other. It is by this act that
+the male spermatozoa is enabled to complete the function
+of fecundation.</p>
+
+<p>If now we assume the male and female element to
+have met and united, menstruation does not take place.
+The egg or embryo (the future child) begins to grow,
+and it remains in the womb for two hundred and eighty
+days from the day when the male and female egg met.
+It is quite natural for an intelligent girl to ask her mother
+to explain, "How a baby can live in there for such a long
+time," or "What makes it grow if it does not get anything
+to eat or drink."</p>
+
+<p><b>How the Baby Gets its Nourishment in the
+Womb.</b>&mdash;These questions can be answered in this way.
+While the baby is in its little comfortable home it gets
+everything it needs. You are in your home now. If
+you wanted a drink, what would you do? Wouldn't you
+go to the water faucet and draw a glass of water? The
+water comes to you through a pipe, right into your home,
+you don't have to go out of the house to get it. And if
+you wanted light when it is dark you would turn on the
+gas and light it. It, too, comes into your home through<span class='pagenum'><a name="Page_184" id="Page_184">[Pg 184]</a></span>
+a pipe. Now baby gets its air; and food, and all it needs
+to drink in just that way. There are two little pipes
+which go into its nest or home, and then into the baby's
+body at the navel, and through these pipes fresh blood
+runs in and out. When mother breathes, her blood sucks
+up oxygen from the air in her lungs, and the blood carries
+oxygen to every part of her body. In this way, all
+parts are supplied with the proper quantity of air. Now
+the baby is simply a new part of mamma as long as it is
+in its nest in her body, so it too gets air in this way.
+When mother eats, the food is taken into her stomach and
+it is there changed into liquid and so prepared, that when
+it passes into the intestines, the part of the food that is
+good for her, is sucked up into the blood, and the blood
+carries it to every part of her body. It distributes whatever
+is needed to all parts, and as the baby is a part, it
+gets its share. The other pipe carries the blood back
+again, out of the baby for new supplies, and as this is
+going on all the time, there is no danger of the baby
+starving in any way, or at any time.</p>
+
+<p>When your daughter understands this, show her how
+important it is that mothers should be in good health,
+otherwise the baby will not get good food, it will not be
+properly nourished and will be born a poor, little sickly
+child. Little girls, consequently, should try to eat properly,
+exercise regularly, and do everything their mothers
+tell them, so that when they become mothers, they will be
+able to nourish their babies and not bring into the world
+poor little starved infants.</p>
+
+<p><b>Girls Must not Become Mothers.</b>&mdash;We have previously
+stated that girls can become mothers when they
+have reached the age of puberty. God did not intend,
+however, that girls at the age of twelve or fourteen
+should become mothers, because their bodies are not
+strong enough, nor are they fully grown, nor have they
+the experience, to undertake the physical task and
+responsibility of bringing a baby into the world. We
+know this from experience, because we have seen the
+sickly babies such girls have, and we have seen how much
+these girl mothers suffer, and how they ruin their health,
+by trying to do what God did not intend they should do.<span class='pagenum'><a name="Page_185" id="Page_185">[Pg 185]</a></span>
+Even the trees teach us this lesson. An orange tree will
+bring out buds, which would develop into oranges, when
+it is two years old. The experienced farmer, however,
+will pluck these buds off, and will do so every year, till
+the tree is five years old. If he allowed the tree to bear
+fruit during its young years, the oranges would not be
+good, or sweet, or large; so he waits until the tree has
+grown and is strong and healthy, when its fruit will be
+large and sweet. An orange tree of this type will have
+better fruit, and will continue to produce this good
+variety for many years. A tree allowed to bear fruit
+when two years old will never have first class oranges,
+nor will it continue to have, even poor oranges, as long
+as the other.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_187" id="Page_187">[Pg 187]</a></span></p>
+<h2>CHAPTER XV</h2>
+
+<h3>PREPARING FOR MOTHERHOOD</h3>
+
+<div class="blockquot"><p>Menstruation&mdash;Irregular Menstruation&mdash;Changes in the Quantity
+of the Flow&mdash;How the Womb is Held in Place&mdash;Symptoms
+of Menstruation&mdash;Menstruation Should Not
+be Accompanied with Pain&mdash;Don't Give Your Daughters
+Patent Medicines or "Female Regulators"&mdash;Take Your
+Daughter to the Doctor&mdash;Leucorrhea in Girls&mdash;Bathing
+when Menstruating&mdash;Constipation and Displaced Wombs&mdash;Dress
+and Menstruation&mdash;Absence of Menstruation, or
+Amenorrhea&mdash;Treatment of Amenorrhea&mdash;Painful Menstruation,
+or Dysmenorrhea&mdash;Causes of Dysmenorrhea&mdash;Treatment
+of Dysmenorrhea&mdash;Sterility in the Female&mdash;Conditions
+Which Affect the Fertility of Women&mdash;Climate&mdash;Station
+in Life&mdash;Season of the Year&mdash;Age&mdash;The
+Tendency to Miscarry&mdash;Causes of Sterility in the Female&mdash;Displacement
+of Womb&mdash;Diseases of Womb, Ovaries,
+or Tubes&mdash;Malformations&mdash;Lacerations&mdash;Tumors&mdash;Leucorrhea&mdash;Physical
+Debility&mdash;Obesity&mdash;Special Poisons&mdash;"Knack
+of Miscarrying"&mdash;Miscarriage&mdash;Cause of Miscarriage&mdash;The
+Course and Symptoms of Miscarriage&mdash;What
+to do when a Miscarriage is Threatened&mdash;Treatment of
+Threatened Miscarriage&mdash;Treatment of Inevitable Miscarriage&mdash;After
+Treatment of Miscarriage&mdash;The Tendency
+to Miscarriage.</p></div>
+
+
+<h3>MENSTRUATION</h3>
+
+<p>We have explained in the previous chapter what
+menstruation is, its frequency, its significance and its
+origin. There are a number of its common characteristics
+with which the mother and daughter should be acquainted.</p>
+
+<p><b>Irregular Menstruation.</b>&mdash;Menstruation may occur
+once (the first time) and fail to recur the following
+month or for a number of months. This need cause no
+alarm as long as the general health remains good. It
+will come again in its own time. Nervousness may cause
+a suspension of menstruation. This is quite common in
+school girls who are driven too hard at school, whose<span class='pagenum'><a name="Page_188" id="Page_188">[Pg 188]</a></span>
+sleep is interfered with, whose appetite is poor and who
+are allowed too many social indiscretions, as parties,
+dances, etc., where late hours are observed, all of which
+should be put aside until school life is over. Sometimes
+menstruation will temporarily stop if the girl goes away
+from home on a visit.</p>
+
+<p>Sometimes the quantity will be greater than at other
+times, and a very scant flow, after it has been free and
+regular may cause apprehension. Various causes may be
+responsible for a decrease, catching cold, sitting on cold
+steps or cold ground, wearing damp clothes, nervousness,
+mental worry, physical exhaustion, insufficient food and
+exercise, and anemia, may cause it. For these reasons a
+girl should be exceedingly careful of her health, she
+should guard against catching cold. Do not change the
+underwear until certain that the weather is far enough
+advanced in season to justify such a change. She should
+not become exhausted or worry. In all cases of suppression,
+or of increased flow, a physician should be
+consulted at once, and girls should be instructed to tell
+their mothers of any change in the character of the
+"periods," as soon as it occurs. Mothers should instruct
+their daughters to rest the first day of their monthly flow,
+and all during the menstruation they should refrain from
+any unusual activity. Even play should be moderated and
+abstained from entirely if there is any pain. In order
+that the girl fully appreciates why these rules are laid
+down, it is advisable to explain just how the womb is held
+in place in her body.</p>
+
+<p>This appears to the writer as being a particular important
+point. A girl must not be expected to give these
+matters the serious consideration they merit unless she
+thoroughly understands the reasons why. An explanation,
+in the form of even an intelligent talk, will soon be
+forgotten. If, however, a definite, concrete picture, is
+impressed upon her; if she actually sees in her mind the
+process that is going on, she will understand why it is
+necessary to do as she is told. If the mother will therefore
+assure herself that the daughter actually knows what
+is being accomplished in her womb at the menstrual
+period, she will carry out the instructions more faithfully.<span class='pagenum'><a name="Page_189" id="Page_189">[Pg 189]</a></span></p>
+
+<p><b>How the Womb is Held in Place.</b>&mdash;The human
+uterus, or womb, is held in its proper place in much the
+same way as a clothes pin sits on a clothes line. The
+heavier part is the upper part, and that part is held in
+place partly by resting on the rectum behind, and the
+bladder in front. When menstruation occurs, the body
+of the womb becomes much heavier because of the increased
+amount of blood in its interior. This added
+weight increases its liability to tip over, and if any extra
+strain or effort is made at this time it will become tipped,
+or as the physician calls it, displaced. If a womb becomes
+displaced, every menstruation afterward will be painful
+and prolonged,&mdash;sometimes excessively so. A displaced
+womb becomes congested and unhealthy. It causes
+leucorrhea or a chronic discharge, makes a nervous wreck
+of the woman, results in sterility and frequently in a
+dangerous operation. There are, therefore, ample reasons
+for watchfulness and care on the part of the growing
+girl.</p>
+
+<p><b>Symptoms of Menstruation.</b>&mdash;After menstruation is
+established there should be no actual pain at each period.
+There are, however, certain undefined feelings,&mdash;premonitory
+symptoms,&mdash;which may be explained in the
+following terms:&mdash;A day or two before the date on which
+the menstruation is expected, the girl will appreciate that
+"her sickness" is coming. She will not, or should not,
+complain of pain, but will state that she has a bearing
+down feeling, is a little more nervous than usual, has no
+desire to go into company, and wants to be more or less
+her own entertainer. The "sick" period usually lasts four
+or five days. The second day is the most important.</p>
+
+<p><b>Menstruation Should Not be Accompanied With
+Pain.</b>&mdash;If any actual pain accompanies menstruation, either
+before or after it is established, the mother should
+at once take the daughter to the family physician. Menstruation
+is a natural, physiological act and should not be
+accompanied with actual distress or pain. It is astonishing
+how many mothers will allow their daughters to
+suffer needlessly, for months and years, because of the
+mistaken idea that "since the pain is there, it must be,"
+or because she&mdash;the mother&mdash;suffered, so also must the<span class='pagenum'><a name="Page_190" id="Page_190">[Pg 190]</a></span>
+daughter suffer. There is no more unfortunate mistake,
+and many a girl's health and happiness has been blasted
+because of this misbelief. The cause of the pain is, in
+a vast majority of the cases, a very simple one, and can
+be removed in a very brief time.</p>
+
+<p>Should the menstrual period last too long, be too frequent,
+or be in any way not what it should be, consult
+your physician. If you are not sure of "what it should
+be," or if you have any doubt, ask your doctor. Don't let
+any false pride or feeling of modesty on your part, or on
+the part of your daughter, dictate your policy under such
+circumstances. Don't take the advice of your friends or
+neighbors in a matter so vital. It is too important, and
+they are not qualified to "guess" any more than you are.
+Don't, if you have any respect for yourself, or love for
+your child, begin dosing her with the advertised patent
+medicines and "Female Regulators" for which so much
+is claimed, and which seem to "just suit" your daughter's
+case at this particular time. Take her to the doctor,
+whose advice you value (or you should not have him as a
+family physician), who has no interest at stake except to
+help you and your child, and whose fee is no more than
+the price of one of these bottles of advertised poison. He
+is the only one qualified to speak with authority on such
+a momentous subject, and you will never spend a dollar
+to better advantage. Warn your daughter not to speak
+about "her sickness" to other girls.</p>
+
+<p>Especial attention should be paid to cleanliness during
+this period. The mistaken idea that bathing of any kind
+at this time may have disastrous consequences is responsible
+for much of this neglect. If proper care is taken
+warm sponge baths, in a warm room, will not cause any
+trouble. Unpleasant odors can be avoided by sponging
+the parts with a warm solution, into which a mild antiseptic
+is put, upon changing the cloths.</p>
+
+<p><b>Leucorrhea in Girls.</b>&mdash;It has been stated above that a
+displaced womb may cause leucorrhea or a discharge. It
+must be remembered that leucorrhea, or "whites," may
+occur in girls as well as in married women. It can also
+result from catching cold during the menstrual period.
+Another mistaken idea is that girls should not take<span class='pagenum'><a name="Page_191" id="Page_191">[Pg 191]</a></span>
+douches for fear of injuring the hymen. This is erroneous,
+and while they are entirely unnecessary in a
+vast majority of cases it is sometimes absolutely essential
+to douche in order to cure leucorrhea. When they are
+given, it is advisable to use the small nozzle that comes
+with every douche bag set.</p>
+
+<p><b>Constipation and Displaced Wombs.</b>&mdash;When the picture
+is fresh in the mind of the girl, of how the womb
+is held upright in her body, the mother should speak to
+her about the serious results that may occur from constipation.
+If the rectum is full of hardened feces the
+womb will be pushed out of place, and if under these
+circumstances straining is necessary to empty the bowel,
+and if this condition is habitual, constipation may be the
+actual cause of displacement of the womb.</p>
+
+<p><b>Dress and Menstruation.</b>&mdash;It is also an opportune time
+to demonstrate to what extent serious results may follow
+mistakes in dressing. The habit of permitting growing
+girls to constrict the waist, to bind and pull the abdomen
+by too tight garters, or too tight corset, is wrong, and no
+mother should permit it. In another part of the book,
+this matter is taken up more fully, but if it is explained
+to the girl while she is considering the subject of menstruation,
+she may more quickly and more fully appreciate
+its significance.</p>
+
+<p><b>Absence of Menstruation&mdash;Amenorrhea.</b>&mdash;The absence
+of menstruation after it has been established, does
+not, as a rule, indicate any disease of the womb or female
+sexual organs. It is to be regarded merely as a symptom
+and can be, as previously stated, safely ignored if the
+general health is good. If the general condition is poor,
+and the quantity and quality of the blood deficient, it is a
+provision of nature to suppress menstruation in the interest
+of the general health. For this reason it is safe to
+disregard the amenorrhea and build up the bodily strength.
+This explains why some girls pass the usual age of
+puberty and show no signs of menstruating. They are
+poorly developed sexually, through deficiency of blood.
+If, on the other hand, a girl should have all the symptoms
+of menstruation every month, but no flow, she should be
+examined by a physician to determine if there is any<span class='pagenum'><a name="Page_192" id="Page_192">[Pg 192]</a></span>
+obstruction to the escape of blood. Total absence of any
+symptoms of menstruation extending into adult life, may
+indicate an absence of the sexual organs. During the
+first year after puberty it is quite natural for menstruation
+to be irregular; after the function is thoroughly established
+there are many causes that may be responsible for
+its temporary absence.</p>
+
+<p><b>Causes of Amenorrhea.</b>&mdash;Any condition or circumstance
+which reduces the general health or impoverishes
+the quality or quantity of the blood and weakens the
+nervous system, will result in a stoppage of the monthly
+periods. Among these are insufficient food and exercise,
+overwork, overstudy, exposure to cold, sitting on cold
+steps or gold ground, wearing damp clothes, bathing in
+cold water at the beginning of menstruation, powerful
+emotions, as great fright, anger, anxiety; acute diseases,
+such as typhoid fever, cholera, the infectious skin diseases;
+chronic diseases such as Bright's disease, heart disease,
+consumption; anemia and chlorosis are very common
+causes. Obesity or an overfat condition will cause an
+early suppression of the menses which may result in a
+fruitless marriage. Displacement of the womb and other
+local disorders frequently result in scanty or delayed
+menstruation. Anxiety lest pregnancy may occur in
+the newly married may cause a delay in the periods. A
+radical change of climate or sometimes a visit to the
+country, or changed circumstances may stop the flow for
+the time being.</p>
+
+<p><b>Treatment.</b>&mdash;The treatment of amenorrhea, or absence
+of menstruation, will depend on the underlying
+cause. A careful investigation should be made into the
+mode of life and the hygienic surroundings of the patient.
+Her general health and her mental condition should be
+inquired into. If the patient is not in good health, or is
+not obtaining exercise in the open air, or if she is a
+victim of mental worry or of domestic unhappiness, or
+if any sufficient cause exists for the amenorrhea it must
+be removed before any treatment may be expected to relieve
+the condition. If the patient is a married woman
+the possibility of pregnancy should always be borne in
+mind, and no radical treatment instituted until this has<span class='pagenum'><a name="Page_193" id="Page_193">[Pg 193]</a></span>
+been excluded. If the absence of menstruation is dependent
+upon defective development of the sexual organs
+we cannot expect much from any treatment. The amenorrhea
+from exhaustive diseases will usually correct itself
+with, or soon after, the establishment of convalescence.
+In diseases which tend to death, as in consumption, heart
+disease, etc., the function is never reestablished. A very
+common habit of most people is to regard the absence of
+the monthly periods as the cause of their ill health. It
+is not, it is the result of the ill health. Get rid of the bad
+health and the menses will take care of themselves. That
+form of amenorrhea which is the result of change of
+climate or surroundings will regulate itself as soon as the
+victim becomes acclimated or reconciled to the change, or
+returns home if the visit is of brief duration.</p>
+
+<p>As a general routine treatment, good wholesome food,
+regular hours, fresh air, sunlight, and judicious exercise,
+with such other measures as may be suggested by the
+condition of the blood and nervous system, are the indications
+in the way of treatment. Anemia and chlorosis
+(poor blood) should be treated by the administration of
+iron in some form. Obesity should be reduced by diet,
+exercise, and such other treatment as may be found efficient
+and not detrimental to health. Overwork, mental
+and physical, should be stopped, and sedentary habits
+changed to a more active out-door life. The acute suppression
+from exposure to cold, wearing of damp clothes,
+sitting on cold stones or cold or damp ground, sea bathing
+in very cold water, is very often associated with an acute
+inflammation of the womb itself and calls for rest in bed,
+laxatives to open the bowel, hot application to the lower
+part of the abdomen and a teaspoonful of Hayden's
+Viburnum in a glass of hot water every four hours until
+relieved. The use of the sitz bath is frequently successful
+if taken at night followed by a laxative and a hot drink.</p>
+
+<p><b>Painful Menstruation&mdash;Dysmenorrhea.</b>&mdash;Most, if not
+all, victims of painful menstruation are of a nervous
+temperament. Dysmenorrhea is simply one symptom of
+the general nervous condition. The nervousness may be
+acquired or it may be the result of heredity. In girls it
+has been found to be an accompaniment of the overwork<span class='pagenum'><a name="Page_194" id="Page_194">[Pg 194]</a></span>
+and worry of school and student life. Girls who suffer
+greatly from it while in school are entirely free during
+vacation from school.</p>
+
+<p>There is a type of painful menstruation known as
+neuralgic dysmenorrhea. This is simply a local expression
+of a general neuralgic tendency. It comes under
+conditions which favor neuralgias in other parts of the
+body. Girls and women affected with this type of dysmenorrhea
+are often anemic, hysterical, and not infrequently
+the victims of malaria, rheumatism, or other
+diseases which tend to impoverish the blood and reduce
+nerve vitality. The pain resembles neuralgia elsewhere.
+It comes and goes, it may last a brief time or a long time,
+it may be very mild or very severe. The pain bears no
+fixed relation to the flow, it may proceed, accompany or
+follow it.</p>
+
+<p>Mechanical dysmenorrhea is that form in which a
+mechanical impediment exists to the escape of the menstrual
+fluid. The internal canal may be too small, displacement,
+growths, either inside or out of the womb,
+faulty development, or frequently simple congestion will
+act as an obstruction and cause pain from tension. The
+pain accompanying mechanical dysmenorrhea is very different
+from the neuralgic type. It comes on gradually,
+increases slowly until it is very severe and stops suddenly.
+A gush of blood from the womb announces the
+fact that the obstruction has been overcome and the
+womb has emptied itself; as soon as this occurs the pain
+ceases.</p>
+
+<p>In the mechanical variety there are frequently clots
+in the menstrual flow. Inasmuch as this type may be
+caused by imperfect development of the womb, it is
+common to find that pain has characterized the monthly
+periods from the time of the first menstruation. It may,
+however, as stated above, be caused by growths which
+had their beginning at a later period.</p>
+
+<p><b>Treatment.</b>&mdash;For the neuralgic variety the treatment
+should be general. The whole object is to build up the
+general health. Fresh air, sunlight, out-door exercise,
+plain, substantial food, regular hours, pleasant surroundings,
+and such medication as may be indicated, should be<span class='pagenum'><a name="Page_195" id="Page_195">[Pg 195]</a></span>
+the course to follow. The bowels should be kept regular
+and digestion aided in every way possible, if necessary
+by rest from school, or work, or by a change of air and
+scene. If the patient is inclined to malaria she must
+take quinine and live in a locality free from that tendency.
+If rheumatic she should take the remedies advised
+in that disease and avoid colds, wet clothes, or sitting
+in cold, badly ventilated rooms, churches or theatres.
+If there are no distinct evidences of special tendencies,
+general tonics may be given to advantage. These should
+consist chiefly of iron, arsenic, phosphous, nux vomica,
+cod liver oil, etc.</p>
+
+<p>The treatment of mechanical dysmenorrhea of course
+implies removal of the cause. As this necessitates operative
+procedure, or at least an examination by a physician,
+it is best left in his hands.</p>
+
+
+<h3>STERILITY</h3>
+
+<p>Sterility means the inability to become a parent. A
+woman who is sterile cannot become a mother. She is
+for some reason unable to have a baby.</p>
+
+<p>A childless union is frequently the cause of much unhappiness.
+There is something lacking in the expression
+"a childless home." It seems a paradox, as home is inherently
+associated with children and happiness. It has
+been stated that one out of every eight marriages is barren.
+The average time which elapses after marriage and
+the birth of the first child is seventeen months. Physicians
+agree that if a woman goes over three years after marriage
+without having a baby her chances of having one
+are small. If children are desired, and they usually are
+by childless parents, every effort should be made within
+the first three years to ascertain the cause of the sterility,
+and if it can be rectified. The barrenness may be dependent
+upon some physical defect which will quickly
+respond to the proper medical treatment. It is well to
+remember, however, that the defect is not always the
+woman's. In every six childless marriages about one
+is due to sterility in the husband. The age of the greatest
+fertility in women is between twenty and twenty-four<span class='pagenum'><a name="Page_196" id="Page_196">[Pg 196]</a></span>
+years. It is rare to find a barren woman between these
+years. Nature evidently intended that the duties of maternity
+should be assumed between the twenty and twenty-fourth
+year. If married before the age of twenty the
+statistics prove that barrenness exists in one woman in
+every twelve. If married after the twenty-fourth year
+the chances of having children decreases with the age
+of the woman.</p>
+
+<p>If a mother goes for three consecutive years without
+becoming pregnant the chances are that she will have
+no more children. Consequently if other children are
+desired it is unsafe to rest upon the assumption that a
+woman will again be a mother simply because she has
+been one in the past. Many conditions could, and may,
+have occurred since the last pregnancy (and may be as
+a result of that pregnancy) to change her natural fertility
+into a condition of temporary sterility. An examination
+should therefore be made before too long an
+interval elapses and the facts learned. It will usually
+be found in such cases that a displacement or laceration,
+or at most, some cause easily remedied is immediately
+responsible for the apparent barrenness.</p>
+
+
+<h3>CONDITIONS WHICH AFFECT THE FERTILITY OF
+WOMEN</h3>
+
+<p><b>Climate.</b>&mdash;It is a well-known fact that more children
+are born in southern regions than in northern countries.
+It may be asserted, therefore, that climate affects the
+fertility of the race.</p>
+
+<p><b>Station in Life.</b>&mdash;Children are more numerous among
+the poor than among those who are wealthy and enjoy
+the luxury of riches. This condition cannot, however,
+be construed as a true expression of fertile efficiency.
+It is more a comparison of ethics, and when we express
+it thus we are giving it its most charitable name.</p>
+
+<p><b>Season of the Year.</b>&mdash;The spring of the year, being
+more favorable to fecundity, exerts an influence over the
+increase of population. Nursing mothers are as a rule
+sterile until after weaning time. This is not always so
+however, and the possibility of pregnancy taking place<span class='pagenum'><a name="Page_197" id="Page_197">[Pg 197]</a></span>
+while nursing a baby, and before menstruation is reestablished
+must be reckoned with as it occurs quite
+frequently.</p>
+
+<p><b>Age.</b>&mdash;Age may be said to affect the fertility of women
+inasmuch as sterility is the natural and proper condition
+before menstruation is established and after menstruation
+ceases.</p>
+
+<p><b>The Tendency to Miscarry.</b>&mdash;Because a woman has
+never given birth to a living child is no proof that she
+is sterile. Many women have the ability to conceive but
+for some reason they have acquired the misfortune, or the
+"knack," of miscarrying. This is a condition of the
+gravest significance and will be considered at length in
+its proper place.</p>
+
+<p>The influence of a temporary separation has had excellent
+results in a great many historical cases. Where
+the married couple seem to be lacking in some one or
+other of the emotional or temperamental qualifications,
+it is advisable to suggest a temporary separation. When
+this period has expired and they resume marital relationship
+the element of novelty, acting as a stimulus, quite
+frequently reestablishes a fertility that was seemingly suspended,
+or awakens it if conception has never previously
+taken place.</p>
+
+<p>There are a great many cases on record where, conditions
+having remained the same, women have become
+fertile after years of seeming barrenness. It is impossible
+to explain, or to satisfactorily understand these
+cases. It is quite common to note cases in which women
+have never become pregnant until a number of years
+after marriage, even when the desire to have children
+existed. There is one case on record of a woman married
+at eighteen, but although both herself and her husband
+enjoyed habitual good health, conception did not
+take place until she was forty-eight years of age when
+she bore a healthy child. Women should not, therefore,
+become easily discouraged in the hope of having a baby,
+especially when they have a clean history, and a healthy
+body. The conditions may change and may become
+favorable when hope is about to die.<span class='pagenum'><a name="Page_198" id="Page_198">[Pg 198]</a></span></p>
+
+
+<h3>CAUSES OF STERILITY IN WOMEN</h3>
+
+<p>Inasmuch as it is necessary to consult a competent
+physician in all cases of sterility, it is not necessary to
+go into detail regarding each possible cause, other than
+to explain how each may produce barrenness. It will
+be observed that a competent physician is specified and
+advised in these cases. This is very important because
+many advertising, or "quack" doctors, particularly solicit
+these kind of cases. They are not competent to be trusted
+with such cases and will likely effect more harm than
+good. A woman should not hesitate to consult the best
+available medical authority if she is a victim of sterility.
+There is nothing to be ashamed of. It is a perfectly
+proper medical situation and should receive the best
+medical advice and investigation. The following are the
+more frequent causes of absolute sterility.</p>
+
+<p>(A) Displacement of womb.</p>
+
+<p>(B) Diseases of womb, ovaries or fallopian tubes.</p>
+
+<p>(C) Malformations.</p>
+
+<p>(D) Lacerations or tears of mouth of womb.</p>
+
+<p>(E) Tumor.</p>
+
+<p>(F) Leucorrhea.</p>
+
+<p>(G) Physical debility.</p>
+
+<p>(H) Special blood poisons.</p>
+
+<p>(I) Great obesity.</p>
+
+<p>(J) Anemia.</p>
+
+<p>(K) Self-abuse.</p>
+
+<p>(L) Habitual alcoholism.</p>
+
+<p>(M) Lack of moderation in the marital relations.</p>
+
+<p>(N) Certain diseases may be associated with barrenness:
+cancer, diabetes, consumption, Bright's disease, etc.</p>
+
+<p>(O) Certain temperamental conditions may be associated
+with barrenness: lack of affinity, frigidity.</p>
+
+
+<h3>THE KNACK OF MISCARRYING</h3>
+
+<p><b>Displacement of Womb.</b>&mdash;In many instances the primary
+cause of the displaced womb was some energetic,
+muscular effort, made while the victim was yet a girl,&mdash;probably
+before menstruation began. Whatever act first<span class='pagenum'><a name="Page_199" id="Page_199">[Pg 199]</a></span>
+caused a slight tilting of the womb, must necessarily have
+been an unusual physical effort, and as girls are getting
+more and more strenuous we may look for more trouble
+in this direction in the future. Inasmuch as a slight tilting
+of the womb gradually gets worse it is a reasonable
+expectation to believe that sterility is a natural sequence
+to displacement. The girl may have been the victim of
+painful menstruation which was neglected, because not
+quite painful enough to compel medical relief, which is
+sought for only as a last resource unfortunately under
+the circumstances. Intercourse may also have been more
+or less painful,&mdash;a condition which again is mistakenly
+and imprudently borne in silence and left to take care
+of itself. But when persistent sterility faces her, the
+woman seeks medical assistance and her trouble is discovered.
+As the displacement is found to be the cause
+of her sterility, its correction, which is a comparatively
+easy medical problem, not only cures the barrenness but
+happily relieves her of the menstrual distress and all
+other pain.</p>
+
+<p>The treatment for displacement consist of placing
+medicated pieces of wool or cotton, called tampons, in the
+vagina in such a position as to hold the womb, <i>as</i> nearly
+in its proper place as is possible. After a time nature will
+so strengthen the ligaments that they will hold the womb
+and a cure is, therefore, affected. The length of time
+necessary to cure depends upon the length of time the
+displacement has existed. It may take, from two to
+four months. When the displacement is of long standing
+and is accompanied with more or less inflammation,
+adhesions sometimes grow between the womb and the
+adjacent organs. It is necessary to resort to surgery
+in such cases, but the result is always good and the danger
+practically nothing.</p>
+
+<p><b>Disease of the Womb, Ovaries or Fallopian Tubes.</b>&mdash;Disease
+of the womb, ovaries, and fallopian tubes, which
+renders the victim sterile, is as a rule the direct result of
+infection. Such infection is conveyed by the husband to
+the wife. This is quite a common condition. The simple
+fact that such conditions exist leads us to hope
+that the time is not far distant when it will be compulsory<span class='pagenum'><a name="Page_200" id="Page_200">[Pg 200]</a></span>
+for all participants in the marriage ceremony to
+submit to a thorough physical examination. By this
+means, and by this means only, will the innocent be
+protected. No one can conceive, unless he has been identified,
+as a physician, with one of the large metropolitan
+hospital clinics, of the extent of this class of disease,
+and of the frightful suffering caused, and innocent lives
+ruined, by infection conveyed in this way. It is a tragic
+corollary to the marriage vow "for better or for worse."</p>
+
+<p>If a woman is fortunate enough to fall into the hands
+of an honorable physician, who will tactfully explain
+to her the serious significance of her condition and obtain
+her consent to treat her until she is cured, which
+in all probability will include a surgical operation, and
+will do so with diligence, without regard to the size of the
+bill, she will indeed be a lucky woman. It is from
+women who are suffering with such diseases,&mdash;most of
+them without the slightest idea of what ails them,&mdash;that
+the venders of advertised nostrums reap their fortunes,
+and it is from the same victims that most of the
+advertised medical "quacks" look for their blood-money.
+The great difficulty, however, lies in the failure of the
+woman to appreciate the seriousness of her condition, and
+as a consequence she fails to understands why it should
+take so long to cure her. She loses confidence in her
+physician, she buys certain "cures" recommended to her
+by Mrs. Busybody and later tries other physicians and
+ends by losing faith in herself. Meantime she grows
+worse and worse. There are thousands such. It may
+be here stated without fear of contradiction that if the
+public in general would repose more confidence in the
+medical profession, there would be much less suffering,
+much less sorrow, fewer regrets, fewer irresponsible
+"isms," and cults, because there would be fewer disappointed
+individuals to support them. If the medical
+profession would condescend to employ the tactics and
+devices of those questionable, fashionable agencies that
+claim the power to cure human suffering, it could quickly
+reap the profit and the laudation that it now escapes
+because it keeps the faith.</p>
+
+<p>The way to be cured of any disease, if it is curable,<span class='pagenum'><a name="Page_201" id="Page_201">[Pg 201]</a></span>
+is to engage a reputable physician and follow his instructions
+implicitly. Let him understand you expect
+him to see you through your trouble and let him know
+you have confidence in him. There isn't one physician
+in a thousand who will cheat you under these circumstances.</p>
+
+<p><b>Malformation.</b>&mdash;Under this heading are all those cases
+of sterility resulting from imperfect generative organs.
+These are products of a failure on the part of nature
+to furnish or develop the structures participating in the
+propagation of the species. The entire generative organs
+are sometimes wanting. The womb may have failed
+for some reason to grow with the rest of the body, it
+remains (as it is known) as an "infantile womb." Occasionally
+the womb grows together, that is, it is solid
+instead of being a hollow organ. The mouth of the womb
+may be too small, representing what is called "a pin head
+opening." The natural opening is large enough to admit
+a lead pencil, a "pin head opening" would not be
+larger than the lead in the pencil. The latter condition
+is quite a common cause of sterility and is readily amenable
+to treatment. Most of the malformations which
+produce sterility are impossible to cure.</p>
+
+<p><b>Lacerations or Tears in Mouth of Womb.</b>&mdash;This subject
+is fully discussed on another page of this volume.</p>
+
+<p><b>Tumor.</b>&mdash;A tumor may be so situated as to prevent
+conception, or it may involve the body of the womb
+constituting a reason in itself for sterility.</p>
+
+<p><b>Leucorrhea.</b>&mdash;Leucorrhea or "the whites" may be of
+such an acid character as to kill the spermatozoa in the
+vagina, or it may be of such volume as to render impregnation
+impossible. The treatment of this condition
+is discussed elsewhere.</p>
+
+<p><b>Physical Debility.</b>&mdash;When the general health is bad,
+no matter from what cause, sterility usually exists. This
+lack of vitality may be due to chronic disease, or it may
+have been caused by a very severe acute illness, such
+as typhoid fever. One's mode of living, if unhygienic,
+may be responsible for continued bad health and a consequent
+sterility.</p>
+
+<p><b>Obesity.</b>&mdash;Very fat women are usually barren. If a<span class='pagenum'><a name="Page_202" id="Page_202">[Pg 202]</a></span>
+woman rapidly accumulates fat after marriage she as a
+rule does not have more than one or two children.
+Women often become stout immediately after the child
+bearing age ceases.</p>
+
+<p><b>Special Poisons.</b>&mdash;Certain special poisons in the blood
+cause sterility by producing miscarriage.</p>
+
+
+<h3>MISCARRIAGE</h3>
+
+<p>By the term "miscarriage" we mean that for some
+reason the progress of pregnancy has been interrupted
+and the fetus is expelled from the womb. A miscarriage
+or abortion (both terms meaning the same&mdash;the difference
+between the two terms is a technical one and need not
+concern us here) can occur any time after conception
+up to approximately the seventh month, when, if labor
+takes place, the child may be born alive. The condition
+would then be termed a premature labor. A miscarriage
+or abortion is an immature labor and implies an immature
+or dead child.</p>
+
+<p>The condition is a serious one no matter whether it
+is attended with grave symptoms or apparently no symptoms.
+If it occurs shortly after conception, during the
+first few months of married life it is serious, if not in its
+physical consequences, it is in its significance, because it
+establishes the tendency to miscarry,&mdash;a tendency that
+may result in great mental distress because of the worry
+and fear it engenders, and of sorrow and heartache because
+it may blast the hope of parentage. Such a miscarriage
+may take place at once after conception. If so,
+the following menstruation may be delayed for a week
+or so and is then a little more profuse than is customary.
+This will be the only indication that a life has been
+sacrificed that the young wife may have, and frequently
+the significance of such an occurrence is never understood,
+yet the tendency to miscarry is nevertheless established,
+and a seeming sterility is apparently the fate of
+the woman. It is, therefore, of the greatest importance
+that extreme care should be taken to bring the first
+pregnancy to a successful consummation. A young wife
+should realize that she is apt to become pregnant at<span class='pagenum'><a name="Page_203" id="Page_203">[Pg 203]</a></span>
+any time. Her conduct therefore should be such at
+least as not to harm the life principle with which she has
+been entrusted. To this end any excessive sexual activity
+should be strictly avoided.</p>
+
+<p><b>Causes of Miscarriage.</b>&mdash;Any strenuous physical effort
+must be guarded against. Included in such efforts
+may be the following: dancing, running, jumping, surf-bathing,
+sewing on a machine, sweeping, washing, house-cleaning,
+moving furniture, etc. Sometimes the primary
+cause of a miscarriage is to be found in some hygienic
+act, such as a hot bath, too prolonged or too many hot
+douches near the menstrual periods. A blow or a fall,
+even a fright or shock may cause a miscarriage. Anything
+that violently shakes or agitates the womb, which
+may at this time be irritable because of its condition,
+will be sufficient to excite it to contract and miscarry.
+Hence violent coughing or vomiting should be avoided
+if possible; horseback riding, jolting in a carriage, convulsions,
+hysterical crying, may also be the causative
+factors. Displacement of the womb by limiting its tendency
+to grow when pregnant, may cause it to miscarry.
+Very severe general diseases such as small-pox, pneumonia,
+etc., will cause the womb to empty itself. Disease
+of the fetus or the presence of syphilis in either of
+the parents will also have the same result.</p>
+
+<p><b>The Course and Symptoms of Miscarriage.</b>&mdash;The
+cause of a miscarriage or abortion is much the same as
+an ordinary labor at term. Whatever interrupts the pregnancy
+causes the death of the fetus. The dead fetus
+acts as a foreign body and excites the womb to contract
+as it does during an ordinary confinement. The contractions
+open up the mouth of the womb and the fetus
+is expelled together with its membranes and after-birth.
+The significant and the most important symptom of a
+miscarriage or abortion is hemorrhage or bleeding from
+the privates. The flow of blood may not amount to
+much or it may be excessive and alarming; it may not
+be constant, it may come from time to time in the form
+of clots.</p>
+
+<p>The next significant and important symptom of miscarriage
+or abortion is pain. The pain, like the flow of<span class='pagenum'><a name="Page_204" id="Page_204">[Pg 204]</a></span>
+blood, may be only slight or it may be very severe, sometimes
+it is absent in very early miscarriage. As a rule
+the pain is severe when the miscarriage occurs after
+pregnancy has lasted for a number of months.</p>
+
+<p>A miscarriage or abortion is said to be "complete"
+when the fetus with its membranes and after-birth is
+expelled clean and whole, or in other words when the
+womb empties itself completely. A miscarriage or abortion
+is said to be "incomplete" when some part of the
+embryo is left in the womb.</p>
+
+<p><b>What to Do When a Miscarriage is Threatened.</b>&mdash;When
+a woman, who is pregnant, begins to flow she
+should at once go to bed and keep perfectly quiet and
+send for a physician. A miscarriage is a treacherous
+condition and is so regarded by all medical men. It
+may not amount to much or it may, on the other hand,
+develop into a serious situation. The immediate danger
+is from hemorrhage; the ultimate or remote danger is
+sepsis or blood poisoning. The condition is one that
+can only be taken in charge by a qualified physician in
+whose hands we can safely leave the conduct of the
+case.</p>
+
+<p>As a general rule it is quite safe to assert that a
+woman will not bleed enough at the beginning of a miscarriage
+to do any permanent harm. Consequently there
+is no occasion for unnecessary alarm. She must, however,
+as stated above, heed the warning and go to bed,
+keep perfectly quiet and send for a physician. If she
+fails to follow this advice it is quite possible that she may
+have a hemorrhage during the course of the miscarriage
+of a sufficiently serious character to endanger her life
+or from the effects of which she may suffer for the
+remainder of her life.</p>
+
+<p>There is practically no danger during the course of
+or after a "complete" miscarriage. The danger which
+may ensue from an "incomplete" miscarriage is hemorrhage
+and a form of poisoning caused by the absorption
+into the system of putrifying products of the part of the
+dead embryo left in the womb.</p>
+
+<p>There are a large number of cases of criminal abortion
+in which septic poisoning occurs caused by the<span class='pagenum'><a name="Page_205" id="Page_205">[Pg 205]</a></span>
+utensils or instruments used in inducing the abortion.
+All of these cases are operative cases which must be
+attended to promptly to save life.</p>
+
+<p><b>Treatment of Threatened Miscarriage.</b>&mdash;Not all of
+the cases of beginning miscarriage end in miscarriage.
+If the physician is sent for in time he can very frequently
+give directions that will, if carried out faithfully, avert
+the disaster. Success is more likely to attend those cases
+in which the trouble has been caused by some accidental
+injury, as a fall, or blow, or extra exertion. This is
+more especially the case if the woman has previously
+borne children, is healthy and in good condition and
+whose womb is known not to be diseased. In these cases
+there is a partial separation of the fetus from the wall
+of the womb, which causes the bleeding. The physician
+will direct that the woman be put to bed, in a quiet,
+darkened room. He will instruct the nurse to sterilize the
+external genital region: a sterile gauze dressing is then
+left in place. Some form of prescription will be given to
+diminish the patient's nervous fear and to allay any tendency
+on the part of the womb to contract. It is always
+essential and very important to save everything that
+passes from the womb during the course of a threatened
+miscarriage in order that the physician may know
+exactly just what the condition is. Each cloth, each
+clot of blood will have to be examined before the proper
+treatment can be pursued in safety.</p>
+
+<p>When the miscarriage cannot be prevented it is called
+an "Inevitable miscarriage."</p>
+
+<p><b>Treatment of an Inevitable Miscarriage.</b>&mdash;In these
+cases every precaution is taken, just as in a normal confinement,
+to avert blood poisoning. The hands, instruments,
+dressings, etc., are carefully rendered sterile and
+the whole field must be surgically clean. The physician
+will conduct the case as conditions justify and as the
+situation develops.</p>
+
+<p><b>After Treatment of a Miscarriage.</b>&mdash;It is one of the
+many thankless tasks of a physician's life to insist on
+each patient staying in bed at least ten days after a miscarriage.
+The average woman and frequently the intelligent
+woman fails to appreciate the absolute necessity<span class='pagenum'><a name="Page_206" id="Page_206">[Pg 206]</a></span>
+for this procedure. It is necessary and it is the
+physician's duty to insist on it being done in the interest
+of the woman. Many of the multitude of diseases of
+women are caused by disregarding advice on such occasions.</p>
+
+<p><b>The Tendency to Miscarry.</b>&mdash;If a woman, for any
+reason, has had a miscarriage, her womb will tend to
+miscarry at the same period during a subsequent pregnancy.
+If the miscarriage should occur during her first
+pregnancy the tendency to miscarry will be greater than
+if acquired after she has had a baby.</p>
+
+<p>This is one of the reasons why young wives often
+fail to have children. They "get rid" of the first one or
+two, because they are not ready to have children, or
+because they want some enjoyment themselves before
+they are tied down with a family. Having established
+the habit their womb has been educated to abort, and it
+will keep this habit up, much to their astonishment and
+chagrin.</p>
+
+<p>Young wives should therefore faithfully follow out all
+the rules of the Hygiene of Pregnancy laid down by their
+physician, and which are given in detail in this book.<span class='pagenum'><a name="Page_207" id="Page_207">[Pg 207]</a></span></p>
+
+<div class="figcenter" style="width: 450px;">
+<img src="images/v2pg207.jpg" width="450" height="459" alt="Courtesy of New York World
+
+At Work with the Calipers" title="" />
+<span class="caption">Courtesy of New York World
+
+At Work with the Calipers</span>
+</div>
+
+<div class="blockquot"><p>Watching carefully the physical development of the child
+month by month is one of those many little things which may
+result in disaster if neglected.</p>
+
+<p>Abnormal development, or lack of development, should be
+promptly reported to the physician, as it may be a warning of
+serious trouble.</p>
+
+<p>For the table of standards, mental and physical, adopted by
+the American Medical Society see page 271.</p></div>
+
+<p><span class='pagenum'><a name="Page_208" id="Page_208">[Pg 208]</a></span></p>
+
+
+
+<hr style="width: 65%;" />
+<h2>THE BABY</h2>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_209" id="Page_209">[Pg 209]</a></span></p>
+<h2>CHAPTER XVI</h2>
+
+<h3>HYGIENE AND DEVELOPMENT OF THE
+BABY</h3>
+
+<div class="blockquot"><p>What to Prepare for the Coming Baby&mdash;Care of the Newly-born
+Baby&mdash;The First Bath&mdash;Dressing the Cord&mdash;Treatment
+After the Cord Falls off&mdash;A Pouting Navel&mdash;Bathing
+Baby&mdash;Clothing the Baby&mdash;Baby's Night Clothes&mdash;Care
+of the Eyes&mdash;Care of the Mouth and First Teeth&mdash;Care
+of the Skin&mdash;Care of the Genital Organs&mdash;Amusing
+Baby&mdash;Temperature in Children&mdash;The Teeth&mdash;The Permanent
+Teeth&mdash;Care of the Teeth&mdash;Dentition&mdash;Treatment
+of Teething&mdash;How to Weigh the Baby&mdash;Average
+Weight of a Male Baby&mdash;Average Weight of a Female
+Baby&mdash;Average Height of a Male Child&mdash;The Rate of
+Growth of a Child&mdash;Pulse Rate in Children&mdash;Infant Records,
+Why They Should be Kept&mdash;"Growing Pains."</p></div>
+
+
+<p><b>What to Prepare For the Coming Baby.</b>&mdash;The
+physician should instruct the young wife just what to
+provide for the coming baby. The following list will
+be found useful as a general guide.</p>
+
+<div class="blockquot"><p>An ordinary clothes basket, padded and lined, is quite sufficient
+for the first month; or, a baby crib, which may be
+cheap or expensive as the individual taste dictates. The
+Taylor crib is probably the handiest and best one on the
+market.</p>
+
+<p>Pin cushion;</p>
+
+<p>Puff-box and puff;</p>
+
+<p>Soap box containing pure castile soap;</p>
+
+<p>Hair brush and fine comb;</p>
+
+<p>Two wash cloths;</p>
+
+<p>Four ounces of crystal boracic acid, a saturated solution of
+which is used for cleansing baby's eyes and mouth;</p>
+
+<p>One pound of good absorbent cotton;</p>
+
+<p>A flexible tube of white vaseline;</p>
+
+<p>A bath thermometer;</p>
+
+<p>A package of sterile gauze;</p>
+
+<p>A half dozen baby towels, good quality;</p>
+
+<p>A soft, white, good blanket,&mdash;one and one-half yards square;</p>
+
+<p>One pair small blunt pointed scissors;<span class='pagenum'><a name="Page_210" id="Page_210">[Pg 210]</a></span></p>
+
+<p>A package of the best safety pins;</p>
+
+<p>Three or four dozen bird's-eye cotton diapers. First size,
+eighteen inches square. Second size, twenty-five inches square;</p>
+
+<p>One yard of soft white flannel for belly bands; each band
+should be five inches wide, by twenty-four inches long.</p>
+
+<p>Two silk and wool shirts;</p>
+
+<p>Three flannel shirts (all shirts should be high necked, long
+sleeved, and open down the front);</p>
+
+<p>Three Eiderdown wrappers;</p>
+
+<p>Three Cashmere sacques;</p>
+
+<p>Three pads for crib;</p>
+
+<p>Six dresses;</p>
+
+<p>Six petticoats (they should be thirty-three inches long from
+neck to hem; they should be turned up at the bottom for about
+four inches and should button there to keep the feet warm; if
+it is desired to use pinning blankets for the first two months in
+place of the petticoats, they should be made of soft white flannel
+with cotton bands);</p>
+
+<p>Six night slips;</p>
+
+<p>Six pair socks;</p>
+
+<p>Two cloaks;</p>
+
+<p>Two hoods;</p>
+
+<p>One dozen bibs.</p></div>
+
+<p>Simplicity, warmth, and freedom are the essentials in
+latter-day baby clothes. It is cheaper to make the clothes
+than to buy them. Excellent and accurate paper patterns
+can be obtained, giving the quantity of material necessary
+and suggesting the kind and quality best suited for
+the purpose. These patterns may be obtained from the
+Butterick Publishing Company in New York City.</p>
+
+<p><b>Care of the Newly-Born Baby.</b>&mdash;After the nurse has
+completed her duties with the mother after the confinement,
+she will prepare to give baby its first bath.</p>
+
+<p>The bath should be given in a warm room. This is
+a matter that should receive more consideration than
+has been given it. Nurses do not as a rule attach much
+importance to this duty, while in reality it is a most important
+one. I have seen trained nurses make ready to
+give baby its first bath in rooms, during the night, that
+were not heated adequately. I am convinced that many
+babies have been victims of this careless habit to the extent
+of grafting on them the tendency to catarrhal colds
+and bronchitis because of undue exposure at this critical
+period. If one will remember that a baby has just been<span class='pagenum'><a name="Page_211" id="Page_211">[Pg 211]</a></span>
+removed from an environment where the temperature
+was suitable and constant, to one in which it needs a large
+degree of artificial heat until such time as it may become
+accustomed to the change, one may appreciate the risk
+taken in exposing the child for even a short time. The
+mother should therefore warn the nurse not to undertake
+the baby's first bath until the temperature and other conditions
+are favorable. Many nurses and other individuals
+have the impression, without knowing why, that the
+baby should be cleansed and bathed immediately after
+birth. This is not at all necessary. If the conditions are
+not favorable, it would be far better to wrap the baby
+snugly in a warm blanket&mdash;first having put a diaper on&mdash;and
+place it in its crib with a hot water bottle near it and
+defer the bathing until the following forenoon. By that
+time the baby will be adapted to its new surroundings;
+its lungs will have become accustomed to the air which
+it is breathing for the first time; the mother will have
+been rendered comfortable; in other words, the conditions
+and the environment will be favorable for the baby
+and for a better performance of the duty.</p>
+
+<p>The next important feature of the first bath is that it
+should be done in the quickest time consistent with
+efficient service. Only the necessary exposure should be
+indulged in. It is not necessary that the baby should be
+exposed to the admiring inspection of every member of
+the household&mdash;there will be plenty of time for that without
+risking the health of the child. A pan of water at a
+temperature of 100&deg; F. should be placed on a stool in
+front of the nurse. The nurse should have on a rubber
+apron, and on top of this, an ordinary apron and a warm
+bath towel laid over her knees. The child should be
+gently rubbed with warm sweet oil to remove the <i>vernix
+caseosa</i> (the greasy substance which is on all babies when
+born to a lesser or greater extent). Particular attention
+is to be given to all folds of the skin, as under the arms,
+in the fold of the neck, in the groin, behind the ears,
+etc., because in these parts the substance is thickest and
+if not carefully removed it will cake, and cause painful
+eruptions and sores, which may bleed and render the infant
+extremely uncomfortable. It is not necessary to<span class='pagenum'><a name="Page_212" id="Page_212">[Pg 212]</a></span>
+expose the whole body at one time while applying the
+oil. The lower half may be covered with a warm soft
+towel while the nurse is oiling the upper part, and vice
+versa. After the body has been thoroughly oiled it should
+be cleansed with water at the proper temperature, in
+which pure castile soap has been dissolved. Absorbent
+cotton only should be used to wash the baby. All the
+washing is done with the baby on the nurse's knee; it is
+not put into the water.</p>
+
+<p>The baby should be mopped dry with sterile gauze,
+or with a soft sterile towel, the cord dressed and the
+flannel band adjusted. It should then be completely
+dressed and put to the nipple and later to sleep.</p>
+
+<p><b>Dressing the Cord.</b>&mdash;The cord should be covered with
+powder and sterile gauze. The powder to use should
+be plain subnitrate of bismuth. If there is any reason
+to use another powder the physician will write a prescription
+for it according to indications. The subnitrate
+of bismuth will be found much better than any ordinary
+talcum or toilet powder, many of which do not make good
+dressing powders.</p>
+
+<p>Very few nurses know how to dress the cord. It seems
+to be impossible to impress them with the need of frequent
+attention to the cord. Fresh powder should be
+put on every time the diaper is removed, every time the
+infant urinates, and at other times during the day. The
+cord should be kept absolutely dry. Putting on powder
+twice daily will not keep the cord dry and many nurses
+are too lazy to bother to do it oftener. You cannot make
+a mistake in putting on too much powder, you can make
+a serious mistake by not putting on enough. Every time
+the cord is powdered it should be lifted up, away from
+the skin of the abdomen, and the powder put below it.
+The cord should be slightly drawn out and the powder
+applied round its base where it meets the skin. Many
+nurses are afraid to touch or handle the cord&mdash;they find
+it easier to neglect it. The mother should see that the
+nurse dresses the cord at least five times every day.</p>
+
+<p><b>Applying the Sterile Gauze to the Cord.</b>&mdash;A piece of
+gauze, six inches square is taken, a hole is cut the size of
+a ten-cent piece out of the center, the cord is drawn<span class='pagenum'><a name="Page_213" id="Page_213">[Pg 213]</a></span>
+through the hole, the gauze folded lengthwise over the
+cord and then sidewise, and this is held in place by the
+binder. This piece of gauze will adhere to the cord and
+will most likely be removed with the cord on the fifth
+day. If it should fall off, another piece may be put on
+in the same way.</p>
+
+<p>If the cord does not fall off until very late it is because
+it has not been attended to rightly or because it was a
+very thick cord.</p>
+
+<p><b>Treatment After the Cord Falls Off.</b>&mdash;The stump of
+the cord should be powdered with the same powder used
+on the cord; a pad two inches square of sterile gauze
+and quite thick should be held over the stump for a number
+of days by the abdominal binder. This is used to
+prevent a possible rupture. After a week the size of the
+pad may be reduced, but a small pad should be used over
+the stump of the cord for a month or more.</p>
+
+<p><b>A Pouting Navel.</b>&mdash;If the stump of the cord should
+protrude, a piece of strong pasteboard, the size of a fifty-cent
+piece, should be wrapped in soft gauze and placed
+over the navel, over this a gauze pad, and if necessary
+this should be held in place by a strip of adhesive plaster,
+though the binder is usually sufficient if it is put on carefully.
+If this pad is held properly and worn for a month
+the tendency to protrusion or rupture will have passed
+away. These pads may of course, be removed when the
+baby is being bathed and put back again before the binder
+is applied.</p>
+
+<p><b>Bathing Baby.</b>&mdash;A baby should not be put into water
+for a bath until after the cord has been off for forty-eight
+hours.</p>
+
+<p>During the first few months the temperature of the
+water should be 98&deg; F. The temperature of the water
+should be taken with a bath thermometer; it should not
+be guessed at. A bath thermometer is an inexpensive
+commodity and it will be in daily use in many ways in a
+home where there is a baby&mdash;it should therefore be procured
+wherever possible. The room should be warm;
+there should be no draughts. The mother or nurse should
+cultivate the habit of bathing baby quickly and with system.
+Everything should be ready and at hand. A little<span class='pagenum'><a name="Page_214" id="Page_214">[Pg 214]</a></span>
+salt in the water will tend to strengthen the skin; it will
+also relieve any superficial rashes or excoriations which
+may be on the skin. Four tablespoonfuls to a gallon of
+water will be sufficient. The sea salt sold in the stores
+may be used in lesser quantities.</p>
+
+<p>By the end of the fifth month the temperature of the
+water may be reduced to 95&deg; F., and by the end of the
+first year to 90&deg; F. After the first year the mother should
+accustom the child to a quick sponge with cool water on
+the chest and spine immediately after the bath. This
+simple means, if kept up, will often prevent the development
+of colds and bronchial troubles so common to children
+in temperate latitudes.</p>
+
+<p>The best time to give the warm bath is at night. In
+the morning a cold sponge bath is desirable. This should
+be given as described in the chapter on cold sponge or
+shower baths.</p>
+
+<p>In certain children bathing seems to depress their entire
+system. They do not react well even to a warm bath.
+They remain blue or pale around the mouth and eyes;
+bathing should therefore be carefully undertaken with
+these children until such time as they acquire strength.</p>
+
+<p><b>Clothing of Baby.</b>&mdash;The baby should wear a woolen
+shirt, with a high neck and long sleeves. The abdominal
+binder may be worn for the first three months. It is not
+necessary after that time. If worn longer the habit is
+acquired and chronic indigestion may ensue when it is
+ultimately taken off. If the baby is very thin it may be
+wise to leave it on, simply for its warming effect, for a
+few months longer. If the child is normal and healthy
+the binder should be left off permanently after three
+months. The band for the first four weeks should be
+made of plain flannel; after this period a knitted band
+with shoulder straps is the better article. All petticoats
+and skirts should be supported from the shoulders.
+Stockinet is a good material for diapers; it is soft, warm,
+and pliable.</p>
+
+<p>Baby's feet should be warm always. Cold feet are
+frequently responsible for colic and gastro-intestinal
+troubles. A hot water bottle should be placed in the
+carriage if the weather is cold, but care should be taken<span class='pagenum'><a name="Page_215" id="Page_215">[Pg 215]</a></span>
+to see that it does not touch the feet, otherwise it may
+burn them. The same measure may be adopted in the
+baby's crib if the feet are cold.</p>
+
+<p>During the summer the outer clothing should be made
+of the thinnest quality of material possible, and the underclothing
+of the finest flannel or gauze. Body heat may
+be maintained during changes of temperature by extra
+outer wraps&mdash;not by dressing the baby in clothes that
+keep it too hot and uncomfortable all the time.</p>
+
+<p>The main object to be attained in clothing the baby
+is to ensure a sufficient protection, but the clothing must
+be light, warm, loose, and non-irritating. Don't bundle
+up the arms and legs so that they cannot be moved; don't
+pin them so tight that the child cannot breathe properly
+and don't put the band on so that the child is in torture
+all the time from inability to move the abdomen.</p>
+
+<p><b>Baby's Night Clothes.</b>&mdash;The night clothing should be
+the same as that worn during the day, but it should be
+loose and of the lightest flannel material. For older
+children a thin woolen shirt (not the one worn during
+the day) and a suit of union clothing with feet is best.</p>
+
+<p>The mistake must not be made to cover children too
+warmly at night. They can do with relatively less than
+adults. Too much covering will render the sleep restless,
+will encourage nightmare, and in older children
+will engender bad habits. Delicate children especially
+must not be over-covered at night.</p>
+
+<p>For the first few months children should sleep in a
+darkened room.</p>
+
+<p><b>Care of the Eyes.</b>&mdash;The eyes should be cleansed for
+the first few days with a saturated solution of boracic
+acid. They should be protected from the direct light for
+two or three weeks after birth.</p>
+
+<p><b>Care of the Mouth and First Teeth.</b>&mdash;Boiled cooled
+water should be used to cleanse the mouth every morning
+after the bath. A soft piece of sterile gauze should
+used for this purpose. The mother must guard
+against using too much force in cleaning the mouth of
+an infant.</p>
+
+<p>The milk teeth should receive attention. If they are
+allowed to become dirty they will become carious and<span class='pagenum'><a name="Page_216" id="Page_216">[Pg 216]</a></span>
+cause bad breath and neuralgia. Teeth of this character
+are a menace to health because they harbor germs and
+in this way infect the mouth and cause stomach troubles.
+Teeth that are carious should be filled or removed.</p>
+
+<p><b>Care of the Skin.</b>&mdash;The skin of a baby, because of its
+delicate character, is susceptible to the slightest changes
+in the weather or to the condition of the digestive organs.
+Babies are frequently subject to rashes, intertrigo, excoriations,
+eczema, and other skin affections. It is much
+easier to prevent these conditions than to cure them.
+Cleanliness, not only in giving a daily efficient bath, but
+in every other respect, is essential. Castile soap only
+should be used, and no rubbing indulged in, simply mopping
+the parts with gauze well saturated with soapy
+water. All napkins should be removed as soon as soiled.
+If the skin is easily chafed the child should be bathed in
+salt water or water in which bran is mixed as explained
+in the chapter on bran baths.</p>
+
+<p>The baby should be well powdered with a good quality
+of toilet powder. Ordinary starch, or talcum, or the
+stearate of zinc is suitable. Fat infants should be powdered
+in all the skin folds; otherwise they are sure to
+chafe.</p>
+
+<p><b>Care of the Genital Organs.</b>&mdash;The mother should make
+it a habit to remove any dirt from the genitals of the
+baby during the morning bath. Fecal matter sometimes
+gets into the folds of the female baby; this should be
+removed promptly. In older female children, dirt and
+dust get into the genitals which often has to be removed
+carefully with a soft piece of cloth. An exceedingly
+chronic form of inflammation is often seen in poor children
+because of neglect of these parts.</p>
+
+<p>In male babies the mother must daily push back the
+foreskin and clean under it. If this is not done the
+natural secretion will gather there and cause much
+trouble. If the foreskin is long, the child should be circumcised;
+if it is not long it must be pushed back daily
+for a number of weeks; otherwise it will contract and it
+may be necessary to operate on it at a later date. If this
+is not faithfully attended to the prepuce will become adherent,
+the child becomes nervous and irritable, and it<span class='pagenum'><a name="Page_217" id="Page_217">[Pg 217]</a></span>
+may become addicted to self-abuse at a very early date&mdash;simply
+because the mother is derelict in the performance
+of her duty. If you are afraid to do your duty, don't
+neglect it, ask the doctor to show you just what has to be
+done and just how it should be done. You will find it to
+be a simple matter when you know how, as most things
+are.</p>
+
+<p><b>Amusing Baby.</b>&mdash;Mothers should understand that it is
+not necessary to amuse a baby under one year of age.
+Their nervous systems are not ready for any such sport.
+To excite a baby to laughter is to subject it to a shock
+which may injure it. The healthy development of the
+brain of a child demands quiet and restful surroundings.
+It should sleep, eat, and be allowed to amuse itself in a
+natural way.</p>
+
+<p><b>Temperature in Children.</b>&mdash;The normal temperature
+in a child varies more than it does in an adult. The rectal
+range may be between 98&deg; and 99.5&deg; F. and may be normal
+to that particular child. A rectal temperature of
+97.5&deg; F. or of 100.5&deg; F. is of no importance unless it
+continues.</p>
+
+<p>The best place to take the temperature in a child is the
+rectum and the next best place is in the groin. The
+temperature will always be from a half to a full degree
+higher in the rectum than in the groin. The thermometer
+should be left in the rectum for two minutes, and in the
+groin for five minutes.</p>
+
+<p>The temperature in a child is a very fair guide as to
+the severity of the disease. It must be remembered, however,
+that a child will develop a temperature of two or
+three degrees from a very slight cause. It is not the
+height of the fever that is significant, but rather the duration
+of the fever that is important. A fever of 102&deg; F.
+in a child may only mean a slight indigestion which will
+wholly disappear after a laxative is given, while the same
+degree of temperature in an adult usually means something
+much more serious. The degree of the temperature
+therefore should not occasion unnecessary worry; if, however,
+it continues and if the child shows other signs of
+illness, it may be regarded as indicating an abnormal condition
+which should be immediately found out. A temperature<span class='pagenum'><a name="Page_218" id="Page_218">[Pg 218]</a></span>
+of 100&deg; F. to 102&deg; F. usually means a mild illness,
+and one of 104&deg; F. or over, a serious sickness.</p>
+
+<p>It is not advisable that the ordinary mother should
+possess a clinical thermometer. There are many occasions
+when a child will have a fever which should not
+cause any worry; if the mother gets the thermometer
+habit, she will many times occasion unnecessary calls of
+the physician only to learn that they are false fears.</p>
+
+<p><b>The Teeth.</b>&mdash;There is no definite time at which the
+first teeth appear. They usually come between the sixth
+and eighth months. They may not, however, come until
+much later; or they may come earlier than the sixth
+month; and yet the child may be perfectly healthy. They
+come as a rule in the following order:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>1. The two lower middle teeth,</td><td align='right'>6 to 8 months.</td></tr>
+<tr><td align='left'>2. The four upper middle teeth,</td><td align='right'>8 to 10 months.</td></tr>
+<tr><td align='left'>3. One on each side of two lower middle teeth,</td><td align='right'>8 to 12 months.</td></tr>
+<tr><td align='left'>4. One on each side, above and below, back of above teeth (four in all),</td><td align='right'>12 to 15 months.</td></tr>
+<tr><td align='left'>5. The next one on each side, above and below, back of those already in (four in all),</td><td align='right'>18 to 24 months.</td></tr>
+<tr><td align='left'>6. The four back teeth on each side, above and below,</td><td align='right'>24 to 30 months.</td></tr>
+</table></div>
+
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>At 1 year a child should have</td><td align='right'>6 teeth</td></tr>
+<tr><td align='left'>At 1-1-2 years a child should have</td><td align='right'>12 teeth</td></tr>
+<tr><td align='left'>At 2 years a child should have</td><td align='right'>16 teeth</td></tr>
+<tr><td align='left'>At 2-1-2 years a child should have</td><td align='right'>20 teeth</td></tr>
+</table></div>
+
+<p>They may not come in the above regular order even in
+well children. The upper front teeth may come first.
+If the child is sickly there may be marked irregularity
+in the order in which they appear. Twenty teeth comprise
+the first set.</p>
+
+<p><b>The Permanent Teeth.</b>&mdash;This set consists of thirty-two
+teeth. They begin about the sixth year and they are
+usually not complete until the twentieth year. They appear
+in the following order:<span class='pagenum'><a name="Page_219" id="Page_219">[Pg 219]</a></span></p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>First molars</td><td align='right'>6 years</td></tr>
+<tr><td align='left'>Incisors</td><td align='right'>7 to 8 years</td></tr>
+<tr><td align='left'>Bicuspids</td><td align='right'>9 to 10 years</td></tr>
+<tr><td align='left'>Canines</td><td align='right'>12 to 14 years</td></tr>
+<tr><td align='left'>Second molars</td><td align='right'>12 to 15 years</td></tr>
+<tr><td align='left'>Third molars</td><td align='right'>17 to 25 years</td></tr>
+</table></div>
+
+<p><b>Care of the Teeth.</b>&mdash;The teeth should be given attention
+as soon as they appear. It is an excellent custom
+to wash the teeth and gums twice daily with a piece of
+clean absorbent cotton rolled round the finger of the
+mother and dipped in a saturated solution of boracic
+acid. This should be done up to the second year. After
+the second year a soft brush should be used and the teeth
+thoroughly cleaned morning and night with pure castile
+soap or a powder. The teeth of every child should be
+examined by a dentist every six months. All cavities
+should be filled with a soft filling. The milk teeth should
+not decay, but should fall out, or be forced out by the
+second set. A child should be taught to gargle early and
+a mouth wash should be used morning and night.</p>
+
+<p><b>Dentition.</b>&mdash;As a general rule the process of teething
+is accompanied by some symptoms. There may be fever,
+restlessness, and loss of appetite; though in many cases
+there are absolutely no symptoms. Some children seem
+to teethe hard, others easily. The same child may have
+some teeth without pain, and with others it may suffer
+severely. The condition of the child at the time, its age,
+and the season of the year undoubtedly have an influence.
+Children who are sickly and puny may have much difficulty
+while teething.</p>
+
+<p>The degree of sickness varies quite considerably. There
+may only be, as stated above, slight fever, restlessness,
+with loss of appetite; or there may be, in addition to
+these symptoms, a pronounced fermentative diarrhea,
+which may lead to serious intestinal diseases; frequently
+there is a cough. This is more apt to be the case if the
+child is teething during the hot season.</p>
+
+<p><b>Treatment.</b>&mdash;When dentition affects the child's disposition
+it is a good plan to reduce the feeding in quantity
+and quality for the time being. If the child is bottle-fed,<span class='pagenum'><a name="Page_220" id="Page_220">[Pg 220]</a></span>
+two ounces can be taken out of each bottle and one
+ounce of boiled water added. If the child is breast-fed,
+he should be given two ounces of warm, boiled water
+before each feeding, and the actual feeding time at the
+breast shortened.</p>
+
+<p>Rubbing the gum over the erupting tooth with a clean
+cloth may aid in helping it through. If the child is very
+restless and has lost sleep, the cloth may be moistened
+with brandy and water. Lancing the gum, though it is
+seldom done now-a-days, is justified in a few cases.
+Teething is not the cause of actual disease as was once
+thought, but it must be remembered that a child whose
+vitality is reduced by fever, restlessness, loss of appetite,
+loss of sleep, and irregular bowels, is more susceptible
+to disease than when enjoying robust health.</p>
+
+<p>Sometimes a child will have a fever for one or two
+weeks during a hard dentition. There is apt to be more
+or less intestinal indigestion and fermentation at this time
+and as a consequence actual intestinal disease may develop.
+To avoid such a possibility it is an excellent plan
+to give an occasional dose of castor oil to clean thoroughly
+the whole intestinal canal. This should be done
+irrespective of the condition of the bowel, because frequently
+a diarrhea is caused by retained fermenting
+products.</p>
+
+<p>Mothers must not acquire the habit of attributing all
+symptoms to the teething process simply because the
+child is teething. It must be remembered that a child
+may get a disease, or an ailment, while teething, that
+has nothing to do with teething. If this is neglected,
+serious consequences may result. Many children have
+lost their lives by a mother's carelessness in this way.
+Be on the safe side, consult your doctor; let him assume
+the responsibility.</p>
+
+<p><b>How to Weigh the Baby.</b>&mdash;The test of weight is one
+of the most satisfactory we possess as an indication of
+physical progress and health. It is not an absolute test,
+but it may safely be relied upon. The fattest baby is not
+necessarily the healthiest. A gradual and a uniform increase
+is a satisfactory growth. At birth a baby weighs,
+on an average, from seven to eight pounds, though some<span class='pagenum'><a name="Page_221" id="Page_221">[Pg 221]</a></span>
+babies weighing less are equally healthy. The normal
+and customary gain is from four to six ounces every
+week after birth.</p>
+
+<p>The baby should be weighed about the same time of
+the day each week, and before a meal.</p>
+
+<p>The average weight of a male child at different ages
+is as follows:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Birth</td><td align='right'>7-1/2 lbs.</td></tr>
+<tr><td align='left'>3 weeks</td><td align='right'>8 lbs.</td></tr>
+<tr><td align='left'>1 month</td><td align='right'>8-1/2 lbs.</td></tr>
+<tr><td align='left'>3 months</td><td align='right'>12 lbs.</td></tr>
+<tr><td align='left'>4 months</td><td align='right'>13-1/2 lbs.</td></tr>
+<tr><td align='left'>5 months</td><td align='right'>15 lbs.</td></tr>
+<tr><td align='left'>6 months</td><td align='right'>15-1/2 lbs.</td></tr>
+<tr><td align='left'>7 months</td><td align='right'>17 lbs.</td></tr>
+<tr><td align='left'>9 months</td><td align='right'>19 lbs.</td></tr>
+<tr><td align='left'>1 year</td><td align='right'>21 lbs.</td></tr>
+<tr><td align='left'>1-1/2 years</td><td align='right'>23 lbs.</td></tr>
+<tr><td align='left'>2 years</td><td align='right'>26-1/2 lbs.</td></tr>
+<tr><td align='left'>3 years</td><td align='right'>31-1/2 lbs.</td></tr>
+<tr><td align='left'>4 years</td><td align='right'>35-1/2 lbs.</td></tr>
+<tr><td align='left'>5 years</td><td align='right'>40 lbs.</td></tr>
+<tr><td align='left'>6 years</td><td align='right'>45 lbs.</td></tr>
+<tr><td align='left'>7 years</td><td align='right'>49 lbs.</td></tr>
+<tr><td align='left'>8 years</td><td align='right'>54 lbs.</td></tr>
+<tr><td align='left'>9 years</td><td align='right'>59 lbs.</td></tr>
+<tr><td align='left'>10 years</td><td align='right'>65-1/2 lbs.</td></tr>
+</table></div>
+<p>A female child weighs about one-fifteenth less than a
+male child, as a rule.</p>
+
+<p>Table showing the average height of a male child, at
+different ages:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>At birth</td><td align='right'>20-1/2 in.</td></tr>
+<tr><td align='left'>6 months</td><td align='right'>26 in.</td></tr>
+<tr><td align='left'>1 year</td><td align='right'>29 in.</td></tr>
+<tr><td align='left'>2 years</td><td align='right'>32-1/2 in.</td></tr>
+<tr><td align='left'>3 years</td><td align='right'>35 in.</td></tr>
+<tr><td align='left'>4 years</td><td align='right'>38 in.</td></tr>
+<tr><td align='left'>5 years</td><td align='right'>41-1/2 in.</td></tr>
+<tr><td align='left'>6 years</td><td align='right'>44 in.</td></tr>
+<tr><td align='left'>7 years</td><td align='right'>46 in.</td></tr>
+<tr><td align='left'>8 years</td><td align='right'>48 in.</td></tr>
+<tr><td align='left'>9 years</td><td align='right'>50 in.</td></tr>
+<tr><td align='left'>10 years</td><td align='right'>52 in.</td></tr>
+</table></div>
+
+<p><b>The Rate of Growth of a Child.</b>&mdash;A child grows most
+rapidly during its first year&mdash;six to seven inches; from
+fourth to sixteenth, about two inches annually; thence to
+twentieth, one inch. Commonly, a child at two and a
+half years has attained half of its ultimate adult stature.
+The diseases of youth always accelerate growth.</p>
+
+<p><b>Pulse Rate in Children and Adults.</b>&mdash;Normal Pulse,&mdash;of
+new born, 130 to 140, per minute; first year, 105 to
+115; second year, 106 to 115; third year, 95 to 105; fifth<span class='pagenum'><a name="Page_222" id="Page_222">[Pg 222]</a></span>
+to twelfth year, 80 to 90; thirteenth to twenty-first year,
+75 to 80; twenty-first to sixtieth year, 70 to 75; in old
+age, 75 to 85.</p>
+
+<p><b>Infant Records.</b>&mdash;A record should be kept by the
+mother of every child which would embrace exact data
+as to weight, diet, size, development of mental power,
+teeth, ailments, sickness, pains, etc., with dates and any
+information which would aid in recalling exact conditions.
+Such records are of the utmost value in a number
+of ways. They help in giving suggestions as to diet, general
+health, and mental qualities of the child in question,
+and they aid in furnishing what physicians call "past
+history," which past history has a very valuable significance
+in estimating the character and importance of
+sickness during later years.</p>
+
+<p>Such a record is also of importance in comparing a
+child's development with what is regarded as standard
+development, and also with the growth and development
+of other children in or out of the family.</p>
+
+<p>If a child should thus be found to fall seriously below
+the standard and yet not appear actually sick, a very
+thorough and routine investigation should be instituted
+to discover if possible the cause. Some error might thus
+be detected which might seriously affect the child's future
+growth and well-being.</p>
+
+<p>The date of the closing of the soft spot on the baby's
+head should be noted, and if it is still open, when it should
+be closed, it might mean that the child has a serious brain
+condition. The soft spot should close between the eighteenth
+and twenty-fourth months. The family physician
+should be notified if the soft spot is open later than the
+second year, as he may want to investigate the cause.</p>
+
+<p>Should the child be unusually backward in walking,
+and when it does so should limp and feel pain in the
+knees, it should be examined for any symptom of hip
+joint disease, of which these are the earliest signs.</p>
+
+<p>If the child complains of so-called "growing pains,"
+keep in mind that these are rheumatic and may need attention.
+There are no such pains as actual "growing
+pains," that is, pains caused by the child growing.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_223" id="Page_223">[Pg 223]</a></span></p>
+<h2>CHAPTER XVII</h2>
+
+<h3>BABY'S FEEDING HABITS</h3>
+
+<div class="blockquot"><p>Overfeeding Baby&mdash;Intervals of Feeding&mdash;How Long Should
+a Baby Stay at the Breast&mdash;Vomiting Between Feedings&mdash;Regularity
+of Feeding&mdash;Why is Regularity of Feeding
+Important&mdash;"A Baby Never Vomits"&mdash;What is the Significance
+of So-called Vomiting After Feedings&mdash;Mothers
+Milk That is Unfit for Baby&mdash;Fresh Air for Baby&mdash;Air
+Baths for Baby.</p></div>
+
+
+<p><b>Overfeeding Baby.</b>&mdash;Every nursing mother should
+have printed and hung up, so she may read it every time
+she nurses her child, the following motto: "DON'T
+OVERFEED BABY." Few, if any, babies die of willful
+starvation: many die as a result of overfeeding. Mistaken
+kindness and lack of judgment are responsible
+for one-half of all the troubles of infancy. Babies require
+much less than is constantly given them. The
+stomach of a baby at birth will not hold more than one
+ounce, which is two tablespoonfuls; and at two months it
+will not hold more than three tablespoonfuls; and at six
+months, six or seven tablespoonfuls. Read these quantities
+once again carefully and try to realize the significance of
+the smallness of them. A baby is just like a little pig;
+it will go on feeding as long as it is allowed. The
+baby does not reason; it has no judgment; it depends
+upon its mother's judgment. If the mother is false
+to the trust the baby overloads its stomach. A swollen,
+distended, overloaded stomach causes indigestion. A
+baby with indigestion is a colicky, fretty, sick baby.
+Overfeeding, therefore, is the beginning of lots of trouble
+to the mother, and needless pain and suffering and sickness
+to the baby. A simple matter, but it is one of the
+most difficult lessons nursing mothers have to learn.</p>
+
+<p>Overfeeding is most apt to occur at night. Many
+mothers put the child to the nipple for its regular feeding
+and fall asleep; the child keeps on nursing at intervals<span class='pagenum'><a name="Page_224" id="Page_224">[Pg 224]</a></span>
+until twice the proper quantity is taken; or she
+gives it the nipple or the bottle if it cries, without regard
+to whether it is the proper feeding time or not.
+The habit of overfeeding is very common in infants
+who are suffering from indigestion. They cry frequently,
+and are irritable most of the time; nothing
+seems to satisfy them but the nipple. Taking the warm
+milk into the stomach seems to allay the distress for
+the time being, so mothers get into the habit of quieting
+them in this way. The cry of the drinking man, whom
+we try to sober up, is: "Just one more drink and I'll
+quit." You give the drink and in a little while the
+demand is repeated. If the mother understood the seriousness
+of this practice of giving the child the nipple
+or bottle at irregular times, she would not do it.</p>
+
+<p>Overfeeding an infant may lay the foundation for a
+lifelong ailment. The excess of food remains in the
+stomach or bowels undigested. If you remember that
+this mass of undigested matter is confined in a small
+space which is both warm and damp, it will be easily
+understood that putrefaction is the inevitable outcome.
+As a result of this putrefaction there are produced certain
+ptomaines and leucomaines. These poisons are carried
+through the body, causing "auto-intoxication" which
+upsets and irritates the child's nervous system and may
+cause very serious consequences, as it frequently produces
+sudden death from apoplexy and "heart failure"
+in the adult. These children are always restless, fretful,
+continually uncomfortable, sleepless and colicky. They
+lose weight, the stomach becomes distended and a gastritis
+or inflammation of the stomach results.</p>
+
+<p>Frequently a mother with such a fretful baby, seeing
+her child getting thinner and thinner, will think
+that it is not getting enough to eat, and will proceed
+to add to the trouble by giving the child more to eat.</p>
+
+<p>Mothers must therefore learn not to overfeed their
+infants; not to imagine that a failure to gain weight
+means the need of more food (if the quality of the
+food being given is wrong, will increasing the quantity
+of bad food do any good?); not to feed irregularly,
+no matter how insistent the child may be.<span class='pagenum'><a name="Page_225" id="Page_225">[Pg 225]</a></span></p>
+
+<p><b>Intervals of Feeding.</b>&mdash;The physician will give instructions
+regarding the feeding of the newly born baby for
+the first few days. After the first few days and up to
+the beginning of the third month, it should be fed every
+two hours from 7 <span class="smcap">a. m.</span> until 9 <span class="smcap">p. m.</span>, and twice during
+the night between 9 <span class="smcap">p. m.</span> and 7 <span class="smcap">a. m.</span>, when the regular
+two-hours' interval again begins for the following day.
+The two night feedings should be about 1 and 4:30 <span class="smcap">a. m.</span></p>
+
+<p>After the third month, and up to the sixth month, feed
+every three hours and once during the night. From the
+sixth month until weaned, every three and one-half or
+four hours, and not at all during the night.</p>
+
+<p>While it has been pointed out that regularity of feeding
+is absolutely essential, the above schedule is not to
+be regarded as an absolute guide. It is a general guide,&mdash;approximately
+it will be found correct in a large majority
+of cases. Each baby is a rule unto itself. The quantity
+of the mother's milk will dictate the interval after the
+first month and for each month as the baby grows. If a
+mother with no milk to spare, is nursing a big, strong,
+husky baby, the three-hour interval during the day may
+have to be shortened to two and one-half hours. As
+a rule, however, these exceptions are better regulated
+by attention to the time the baby is given at each nursing
+to fill its stomach.</p>
+
+<p><b>How Long Should a Baby Stay at the Breast?</b>&mdash;Babies
+differ as to their method of feeding; some of
+them seem to like to nurse a moment or two and then
+look around; others seem to regard nursing as a serious
+business, and resent any effort to take the nipple away
+until they have finished. A baby should be taught to
+nurse methodically; it should not be allowed to play
+the nipple. Let it fill its stomach and put it
+down as quickly as possible. A mother will very soon
+know just how long it takes the baby to fill its little
+stomach, and when she finds this out she should time
+it by the clock. When the supply of milk is sufficient,
+and the child is strong, and nurses freely, eight to twelve
+minutes are sufficient. After it is taken away from the
+breast it must be left quiet till the next feeding.</p>
+
+<p>Other babies, according to the ability they evince to<span class='pagenum'><a name="Page_226" id="Page_226">[Pg 226]</a></span>
+nurse, even when the milk runs freely, require a longer
+time,&mdash;from twelve to fifteen minutes. The rule, however,
+is never to allow them to nurse so long that when
+they are taken away the milk runs out of the mouth.
+If this occurs, cut down the length of time they are
+at the breast, and always time the length of feeding by
+the clock,&mdash;don't guess at it.</p>
+
+<p><b>Children Who "Vomit" Between Feedings.</b>&mdash;When
+a child habitually brings up food between feedings it is
+usually a symptom of gastric indigestion. In these cases
+it is advisable to add lime-water to each feeding, and
+to remove some of the fat in each feeding. If improvement
+does not follow remove more of the fat by removing
+some of the cream from the top of the bottle
+before shaking it.</p>
+
+<p>Remove from the bottle four ounces of cream and
+shake before preparing the food from what is left. If
+the child improves after a few days remove only three
+ounces, then in a few days remove two ounces and later
+one ounce. After a time, sufficiently long to permit the
+stomach to become accustomed to the graded amounts
+of fat, the former diet of whole milk can be again resumed.</p>
+
+<p>Never decrease the interval of feeding of a baby who
+is bringing up parts of its meal between feedings;
+it is frequently advisable to increase the interval. If
+a child is colicky and is bringing up lots of gas in
+addition to some food, one-half grain of benzoate of
+soda may be added to each ounce of food given and
+continued for a number of weeks if necessary. When
+the gas is located in the intestines and is not brought
+up, it must be made to pass downward. Attention to
+the bowels is of great importance in these cases and it
+may be necessary to peptonize the milk for some time. A
+reduction of the sugar and starch in the feeding frequently
+cures this condition. (See "Colic.")</p>
+
+<p>There are children who continue to have symptoms of
+indigestion and who do not thrive despite various changes
+in the quantity and quality of the feedings. It may be
+necessary to obtain a wet nurse for them, as it is with
+"the delicate child." If a wet nurse cannot be obtained,<span class='pagenum'><a name="Page_227" id="Page_227">[Pg 227]</a></span>
+or if the age will permit, a substitute may be tried.
+Borden's Eagle brand of condensed milk, canned, is probably
+the best substitute under these circumstances. Condensed
+milk should never be used as a continuous food;
+as a substitute, however, for a few weeks it is often
+invaluable. With an infant of three or four months
+it should be used at the beginning in the proportion of
+one ounce of the milk to sixteen ounces of plain boiled
+water or barley water. The proper quantity, whatever the
+child is taking (four or six ounces according to the
+age) at the time, can be taken from the sixteen ounces
+and fed to the child. As the symptoms improve the
+milk should be diluted less and less, 1 to 14, 1 to 10,
+and so on until the proper strength is reached. After
+the child has been on the condensed milk for a month
+it should be changed back to cow's milk, using of course
+a diluted formula until the child becomes accustomed
+to the change. Condensed milk, if used as a permanent
+food, will fatten babies, but their vitality is very deficient,
+the muscles flabby, and the resistance to disease exceedingly
+poor. They are apt to develop rickets and
+sometimes scurvy.</p>
+
+<p><b>Regularity of Feeding.</b>&mdash;One of the very first, and
+one of the most important factors in contributing to
+the good health and the comfort of a baby is absolute
+regularity in feeding. A regular interval of feeding is
+particularly essential during the first month of a baby's
+life.</p>
+
+<p>Despite the explicit way in which young mothers are
+instructed in this respect, it is one of the disappointing
+incidents of the practice of medicine to observe how
+many of these mothers fail to heed the advice. We have
+personally tried to find an explanation for this astonishing
+carelessness, and have come to the conclusion that
+it is not due to intentional forgetfulness, but rather to
+an inexplicable failure to appreciate that the physician
+means exactly what he says.</p>
+
+<p>If, for example, specific instructions are given to feed,
+or nurse, the child every two hours (and by "specific
+instructions" it is meant, that the physician takes time
+to explain in detail the instructions he gives&mdash;that the<span class='pagenum'><a name="Page_228" id="Page_228">[Pg 228]</a></span>
+instructions are not incidental to the call, but part of
+the call;&mdash;that the advice is given not as a choice of
+what is desirable, but as an absolute rule to follow; and
+carefully explains why it is imperative to do as he says;
+and is satisfied the mother understands what he means)
+it would seem that there could be no possible reason
+why the directions should not be faithfully carried out.
+Yet such is not the case in many instances, and the excuses
+given by mothers for failure are so trivial and
+annoying that they show a failure to appreciate that
+they are dealing with a serious problem&mdash;a problem
+affecting human life. They fail to understand that fatal
+consequences may follow their negligence. They treat
+the baby problem exactly as they would a household
+incident, and as they do not consider it important whether
+the breakfast dishes are washed at 9 <span class="smcap">a. m.</span> or at twelve
+noon, neither do they consider it important whether the
+baby is fed at 9 <span class="smcap">a. m.</span> or an hour later. When mothers
+learn that the attention they must give their babies is
+essentially different from the attention they give ordinary
+household duties, the problem of raising children with
+success and comfort will be greatly simplified.</p>
+
+<p>If the instructions are to feed the baby at certain intervals,
+do so at all hazards. To offer the foolish excuse
+that the baby was asleep when feeding time came, is no
+excuse at all; as a matter of fact the baby should be
+asleep at each feeding time, if it is healthy. Wake it
+and feed it, for, as will be shown later, it is the constant
+regularity that counts. It will be more difficult to institute
+regular feeding intervals during the first month,
+because a healthy baby is very difficult to wake up, even
+to be fed, during the first few weeks of life. It is absolutely
+essential, however, that it should be wakened:
+otherwise the tendency to overfill the stomach at the next
+feeding will lead to indigestion and colic.</p>
+
+<p><b>Why is Regularity of Feeding Important?</b>&mdash;Because
+a baby's stomach holds a very small quantity, and experience
+has taught us that a baby will thrive better on
+small quantities given frequently, rather than large quantities
+at longer intervals. The smaller the baby, the smaller
+the quantity to begin with. Some babies weigh from<span class='pagenum'><a name="Page_229" id="Page_229">[Pg 229]</a></span>
+five to seven pounds at birth, while others weigh from
+nine to twelve pounds. It would be unreasonable to expect
+a very small baby to be able to hold and digest as
+much as a very large baby. Considerable common sense
+and the exercise of some judgment is therefore necessary
+on the part of the uninstructed mother, as to just the right
+quantity to give. Fortunately, a little experience will
+enable the observant mother quickly to solve this important
+problem. Nature promptly furnishes the
+symptoms which will correctly guide her. Before considering
+the significance of these symptoms let us appreciate
+certain facts common to all babies, and we will
+more easily interpret the meaning of the special symptoms
+the baby will furnish.</p>
+
+<p>First of all the baby never vomits. The ejection of
+food, therefore, is dependent upon a condition, not a
+disease. If milk runs out of its mouth immediately, or
+within a few moments, after a feeding, the explanation is
+that it was fed too much; it does not vomit, the stomach
+simply overflows. It is exactly like trying to put more
+milk into a cup after it is full,&mdash;it will not hold more, it
+overflows.</p>
+
+<p>The significance of this symptom, therefore, is that the
+quantity of the feeding is wrong (it is not the baby's
+stomach that is at fault,&mdash;it is the mother's judgment).
+Reduce the quantity of each feeding and you will quickly
+cure it. If the milk does not overflow soon after a feeding,
+the baby will appear satisfied and will go to sleep,
+and will sleep until it is time for the next feeding. It
+may not do this, however. In half an hour, or a little
+longer, after the feeding, it wakes, it begins to fret and
+cry, and very soon it suddenly belches gas and ejects a
+mouthful of milk, after which it will rest quietly for a
+few moments, when it will begin fretting all over again.
+It may keep up this performance for an hour, or until
+the next feeding, and if so it is exhausted and unfit to
+carry on the digestive process. It is in these cases where
+most mothers make serious mistakes. This is the beginning
+of real trouble, and the family physician is the
+only one qualified to give advice under such circumstances.
+Remember the warning given regarding heeding the advice<span class='pagenum'><a name="Page_230" id="Page_230">[Pg 230]</a></span>
+of every busybody just at this time. Your baby's
+health is at stake; maybe its life depends upon what you
+choose to do.</p>
+
+<p><b>What is the Significance of "Vomiting" After Feedings
+in Babies?</b>&mdash;Let us examine the difference between
+the milk which overflowed immediately after the feeding
+and the milk which the baby ejects one-half hour or so
+later, and which is now being considered.</p>
+
+<p>The first milk looks like ordinary milk (breast milk), or
+if the baby is being fed from the bottle, it looks just like
+the mixture in the bottle. It not only looks like what it
+took, but it smells just like it. Now examine the other;
+we find it looks like curdled milk, it is lumpy, and we immediately
+can tell that it is sour, because it smells sour
+and looks sour.</p>
+
+<p>The explanation of the first overflow (immediately
+after the feeding) was the too great quantity; the explanation
+of the second overflow (one-half hour or so after the
+feeding), is the wrong quality of milk. The quantity was
+right because none overflowed right after the feeding,
+but the quality was wrong. Again, it is not the baby's
+stomach that is at fault,&mdash;it is the quality of the milk.</p>
+
+<p>How do we know this? Because of what takes place
+in the baby's stomach during the one-half hour between
+the feeding and the time of the overflow of the sour milk.
+The quantity being right, why should the baby have any
+trouble if the quality is correct? It should not. Therefore
+by changing the quality (not the quantity as in the
+former case) we cure the trouble, thus proving the quality
+of the milk to be at fault.</p>
+
+<p>What took place in the baby's stomach in the intervening
+half hour? The quality being wrong, the little
+stomach could not digest the mixture quick enough.
+Fermentation set in, gas was evolved, and as the stomach
+was full before the gas was manufactured (and as more
+and more gas is manufactured when food ferments), the
+stomach overflowed and out of the baby's mouth comes
+gas, and sour, fermenting, curdled milk. This process
+goes on until fermentation stops, or until the little
+stomach has just enough left to fill it and no more. But
+think what this is,&mdash;a sour mass of rotting, indigestible,<span class='pagenum'><a name="Page_231" id="Page_231">[Pg 231]</a></span>
+curdled milk,&mdash;and that is what this baby is expected to
+live and thrive on.</p>
+
+<p>Some babies seem to have trouble from the very first
+day of life. Either they will not retain the food, or the
+food fails to agree with them. If the baby is put upon
+artificial food at once, these troubles are, of course, not
+unexpected (because the right artificial food may not be
+first chosen for the particular baby), but it is not always
+the artificially fed baby that gives us trouble, and it is
+sometimes difficult to find the cause for such trouble in
+a baby who has had nothing but its mother's milk since
+it was born.</p>
+
+<p>The cause of stomach trouble in a baby a few days old,
+fed exclusively on mother's milk, is invariably to be found
+in the quality of the milk.</p>
+
+<p>The quality of the mother's milk may be affected in a
+number of ways which will render it unfit for the baby.
+For example, if the mother for any reason becomes sick,
+and has a high fever shortly after confinement, it will
+affect her milk and render it unfit temporarily.</p>
+
+<p>If the mother worries or becomes highly nervous during
+the first few days of her baby's life, she will so affect
+her milk as to render it unfit for baby. If a baby is fed
+for a number of days after its birth by its mother, and it
+should prove afterward that she has not enough milk to
+continue feeding it, and has finally to put it on artificial
+food, the baby will most likely have acquired slight
+stomach ailments that may be troublesome for some time,
+because in this case both the quality and the quantity were
+no doubt wrong. Constipation in the mother will also
+cause trouble. The child will develop colic and extreme
+irritability until the mother's condition is relieved.</p>
+
+<p>Each of these conditions affecting the milk of the
+nursing mother usually demands a change of food for the
+baby, and the substitution of the proper artificial food
+will invariably immediately correct the trouble. In some
+cases, however, the quality of the mother's milk is not
+dependent upon a temporary temperamental condition,
+but is caused by errors in diet, or conduct, or both. The
+milk of a physically tired, worn-out mother, is not good,
+no matter whether the exhaustion is caused by actual<span class='pagenum'><a name="Page_232" id="Page_232">[Pg 232]</a></span>
+physical labor or by the exactions of a strenuous social
+programme. The milk of a mother who persists in eating
+irregularly, or who willfully caters to an appetite
+which craves the rich, highly seasoned articles of diet,
+or who attempts to satisfy a legitimate hunger by drinking
+large quantities of stale tea or coffee and eating
+bread, is unfit for her baby.</p>
+
+<p>These cases are amenable to the proper treatment,
+which of course means, that the mother must change her
+conduct if at fault, and live strictly upon the diet prescribed
+elsewhere for nursing mothers.</p>
+
+<p>If these troubles occur in babies who have been fed exclusively
+upon artificial food, an entire change of food
+is frequently necessary.</p>
+
+
+<h3>FRESH AIR FOR BABY</h3>
+
+<p>Baby's first journey out of doors depends upon so many
+contingencies that no specific age can be given when it
+would be perfectly safe to take it.</p>
+
+<p>First, the weather and season of the year should be
+considered. The baby should not be taken out at all
+when it is wet, or foggy, or very humid; nor when it is
+extremely cold.</p>
+
+<p>Second, the vigor or vitality of the individual child
+must be considered. Some children can safely be taken
+out if the weather is propitious when two weeks old,
+others cannot be taken out without risk until they are two
+months old, regardless of the weather conditions. If a
+child is robust at birth, and nurses well, and increases in
+weight from the beginning, he can be taken out when he
+is two weeks old while the sun shines during the middle
+of the day. If a child is small and puny when born, and
+begins to have nursing troubles from the beginning, does
+not increase in weight, is fretting, and crying, and sleeps
+spasmodically, it would be unsafe to take it out before the
+sixth week unless it is at a season of the year which
+would justify exposure to the sunshine.</p>
+
+<p>The question of suitable clothing will be important,
+and will decide the advisability as to when the baby
+should go out. Every baby should be dressed in wool<span class='pagenum'><a name="Page_233" id="Page_233">[Pg 233]</a></span>
+weather is not too distinctly bad. Remember always to [Transcriber's note: words missing
+in text]
+from neck to ankles. Its head should be warmly clad.
+Dressed thus and well wrapped in blankets, a healthy
+child is ready for an out-door trip at any time, if the [Transcriber's note: words
+missing in text]
+have plenty of blankets below the child as well as above it,
+if it is in a baby carriage. In very cold weather the child
+should be buried in blankets, and a hot water bottle can
+be wrapped in near his feet. Great care must be taken
+that the water in the bottle is not too hot, and that it
+does not actually touch the skin. No matter how many or
+how few blankets are used, the face should be exposed
+directly to the fresh air. When the air is very gusty, or
+high, a light veil can be laid over the face, but never at
+any other time.</p>
+
+<p><b>Air Baths for Babies.</b>&mdash;Babies necessarily require
+plenty of exercise and plenty of fresh air, as has been
+pointed out. It is a splendid custom to allow the baby to
+lie naked after his bath for half an hour. If the room is
+comfortably warm, select a spot that is free from
+draughts, and lay the baby on a pillow or two and let him
+kick and coo. In the sun by the window, his head and
+especially the eyes shaded from the direct rays of the
+sun, is an excellent place in the summer time. The influence
+of the direct sun rays on the little naked body is
+conducive to good sturdy health, good nerves, and sound
+sleep.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_235" id="Page_235">[Pg 235]</a></span></p>
+<h2>CHAPTER XVIII</h2>
+
+<h3>BABY'S GOOD AND BAD HABITS. FOOD
+FORMULAS</h3>
+
+<div class="blockquot"><p>Baby's Bed&mdash;The Proper Way to Lay Baby in Bed&mdash;Baby
+Should Sleep by Itself&mdash;How Long Should a Baby Sleep&mdash;Why
+a Baby Cries&mdash;The Habitual Crier&mdash;The Habit of
+Feeding Baby Every Time it Cries&mdash;The Habit of Walking
+the Floor with Baby Every Time it Cries&mdash;Jouncing,
+or Hobbling Baby&mdash;Baby Needs Water to Drink&mdash;The
+Evil Habit of Kissing Baby&mdash;Establishing Toilet Habits&mdash;Baby's
+Comforter&mdash;What can be Done to Lessen the
+Evil Effects of the Comforter Habit&mdash;Beef Juice&mdash;Beef
+Juice by the Cold Process&mdash;Mutton Broth&mdash;Mutton Broth
+with Cornstarch or Arrowroot&mdash;Chicken, Veal, and Beef
+Broths&mdash;Scraped Beef or Meat Pulp&mdash;Junket or Curds
+and Whey&mdash;Whey&mdash;Barley Water&mdash;Barley Water Gruel
+or Barley Jelly&mdash;Rice, Wheat or Oat Water&mdash;Imperial
+Granum&mdash;Albumen Water&mdash;Dried Bread&mdash;Coddled Egg.</p></div>
+
+
+<h3>BABY'S BED</h3>
+
+<p><b>The Proper Way to Lay Baby in Its Bed.</b>&mdash;The baby
+should be accustomed to sleep by itself from the day of its
+birth. Mothers have been known to smother their babies
+during sleep. The mother may pull the bed-clothing over
+the baby's head during the night and thus deprive it fresh
+air. A mother is much more apt to nurse her baby regularly
+and to do it more efficiently, if she is compelled to
+get up to do it. If she occupies the same bed with baby,
+she may fall asleep while nursing him; the baby consequently
+nurses too long, fills his stomach too full, and
+soon develops indigestion and colic in addition to acquiring
+a very bad habit.</p>
+
+<p>For the first few weeks an ordinary basket arrangement
+is all that is necessary. As soon as the baby begins
+to move around it should have a regular baby crib, so
+that possible accidents may be avoided.</p>
+
+<p>When the baby is placed in bed after a feeding, it
+should be laid upon its back, being tilted slightly toward
+its right side. By placing a soft, small pillow, under its<span class='pagenum'><a name="Page_236" id="Page_236">[Pg 236]</a></span>
+left side, the baby will rest more on its right side, which
+is the proper position. The reason of this is because
+the liver of a child grows quicker and larger than any
+other organ, and it is on the right side. By placing the
+child on this side, it prevents the heavy liver from
+sagging over on the little full stomach. If the child were
+laid on its left side, the liver would crowd the full stomach
+and embarrass the heart, and cause pain and restlessness.
+Frequently a change of position fully to the right side,
+when a child has been restless or crying, and especially
+if it has been lying on its back, will at once relieve it and
+allow it to go to sleep again. It is the knowledge of
+these little things that count in babyhood.</p>
+
+<p><b>How Long Should a Baby Sleep?</b>&mdash;A perfectly
+healthy baby should sleep, while very young, eighteen or
+twenty hours out of the twenty-four. As it grows older
+it will sleep less. It should have, and nothing should
+interfere with its having, two sound naps every day,&mdash;one
+in the forenoon after its bath, and the other in the
+afternoon. When four or five months old, it should also
+sleep from 7 <span class="smcap">p. m.</span> until 10 <span class="smcap">p. m.</span>, then it should be
+fed and allowed to sleep until morning. It has been
+aptly said, that, "a child might easily overeat, but he
+practically never oversleeps." During the second year a
+child should sleep twelve hours at night, and about two
+hours during the day. The twelve-hour night rest should
+be continued until the child is six years of age. The
+practice of taking a nap at noon is a very good one, and
+it should be encouraged as long as possible. It can
+usually be kept up until the child begins school life. The
+strenuous activity of childhood, makes some such rest
+highly desirable, and the result will necessarily be a
+stronger body, a better disposition, and firmer nerves
+than otherwise. The practice of retiring early should be
+strictly enforced during childhood. Children of two
+years of age, should retire at 6:30 <span class="smcap">p. m.</span>, or at latest
+at 7 <span class="smcap">p. m.</span>, those from three to five years, may remain
+up an additional hour. At thirteen or fourteen the regular
+bedtime should be at 8:30 <span class="smcap">p. m.</span> There is no
+justification for the late hours which growing children
+are allowed to keep, especially in large cities.<span class='pagenum'><a name="Page_237" id="Page_237">[Pg 237]</a></span></p>
+
+<p>Regular sleep is largely a matter of habit, and if the
+infant is started right, with suitable feedings, given at
+definite times, followed by the proper periods of sleep,
+but little trouble will be experienced with sleeplessness.
+When sleep is disturbed and broken, it means bad habits,
+unsuitable food, minor forms of indigestion, or positive
+illness of some kind. Sleep is absolutely essential in infancy
+and all through childhood for purposes of growth.
+It is wrong to permit a child to sleep too much during
+the day; it will become a habit, and it will not sleep well
+during the night as a consequence. In order to prevent
+or break this habit, the child should be kept in a well-lighted
+room and should be amused and entertained so
+as to keep it awake. The nap during the middle of the
+day is an exceedingly important factor in keeping the
+average child in good physical condition. It is a valuable
+adjunct in preventing, and in treating, nervousness in
+children. Children who are anemic should be encouraged
+to sleep long and freely in well-aired rooms.</p>
+
+<p><b>Why a Baby Cries.</b>&mdash;As has been stated, every healthy
+baby should cry for half an hour each day. Nature suggests,
+demands this as an essential exercise. Muscular
+movements involving a greater part of the whole body
+accompany the act of crying and furnish this necessary
+exercise. It is of great importance to an adequate and
+uniform development of the lungs; deep breathing is
+necessary to lusty crying, hence the lungs are expanded
+and the blood renewed and oxygenated. Crying is also
+of material aid in moving the baby's bowels. Babies in
+perfect health will, however, cry under any of the following
+circumstances, and doubtless under circumstances
+of lesser importance and frequency when frightened or
+uncomfortable from hunger or position, soiled napkins,
+inflamed buttocks, earache, pain, from heat or cold, unsuitable
+clothing, and during difficult bowel movement,
+when displeased or angry. Children slightly but painfully
+ill may cry incessantly for an hour or two. Thus,
+with intestinal colic, when the cry is loud and continuous
+until the child is relieved or until he falls asleep from
+exhaustion.</p>
+
+<p>The healthy, well trained child seldom causes trouble;<span class='pagenum'><a name="Page_238" id="Page_238">[Pg 238]</a></span>
+it is the rule for it to be happy and good natured in its
+own way.</p>
+
+<p><b>The Habitual Crier.</b>&mdash;If a child becomes a habitual
+crier, it is because it is uncomfortable and unhappy.
+There are restless, often vigorous, crying, whining infants,
+and the trouble, as a rule, is in the intestinal tract.
+Badly managed, "spoiled babies" cry from inattention,
+and when left alone. If they are taken up and talked to,
+the crying ceases, thus proving that it was not pain or
+discomfort that was causing the crying. In the case of
+the habitual crier we try to find out the cause of the
+bowel trouble and cure it; the spoiled infant we discipline
+rigidly, or leave it alone if its parents prefer that kind of
+baby.</p>
+
+<p><b>The Habit of Feeding Baby Every Time It Cries.</b>&mdash;The
+habit of regular feeding will, if persisted in and
+successfully established, render advice on this subject unnecessary.
+So also will the explanation of the evil of
+overfeeding have its effect on mothers. Apart from
+these reasons, however, the habit of feeding baby every
+time it cries is a pernicious one, and no doubt the mother,
+who will be striving to faithfully follow instructions, will
+have to overcome the advice of meddling friends who
+will regard it as a cruelty to allow the baby to cry. Do
+not give in to these busy-bodies; insist on attending to
+your own affairs, but be absolutely sure baby is not crying
+for a just cause. A child can only cry; that is its only
+language, but it cries for many things other than the
+nipple or the bottle. Examine it carefully,&mdash;a wet diaper
+a pin, an uncomfortable position, a drink of water, any
+of these may be the cause.</p>
+
+<p>It is just as essential that a child should cry as that
+it should sleep. Every healthy child should cry for
+twenty or thirty minutes every twenty-four hours. Nature
+calls for this as an exercise in order to develop the
+lungs; therefore, if there is no just cause for the crying
+you must regard it as a necessary evil, even if you
+look upon it as a domestic affliction.</p>
+
+<p><b>The Habit of Walking the Floor With Baby Every
+Time It Cries.</b>&mdash;This is another habit that is indulged
+in to the sorrow and ridicule of the race. If you are a<span class='pagenum'><a name="Page_239" id="Page_239">[Pg 239]</a></span>
+victim of this habit, you have yourself to blame. It is a
+matter of education, or habit, pure and simple, and, like
+all bad habits, it is difficult to break away from. In the
+preceding paragraph, you have been told that when baby
+wants something, or is uncomfortable, it employs the
+language nature gave it,&mdash;it cries. No child ever cried
+to be walked up and down the floor in the dead of the
+night. Begin at the beginning, when it first cries, find
+out why it is crying. Offer it a little water if it is not
+feeding time. Examine its diaper and if soiled change
+it. It may be overdressed and consequently hot, perspiring,
+and uncomfortable; change its position. Find out
+if any pin is open and hurting it; loosen the binder so it
+can breathe easily. If it is a colicky child follow the
+instructions given in the treatment of colic. Be patient
+the first few nights, and be thorough, because you may
+discover why it cries and each discovery will help you
+next time. If you discover something wrong, some
+reasonable excuse for the crying, does it not prove the
+folly of walking the floor? If it wants a drink of water,
+or if its diaper is wet, how is walking the floor going to
+cure it, or how can you expect the baby to stop crying
+when you so unjustly construe its reasonable and its only
+way of asking a favor? If walking the floor stops its
+crying, it stops it by exhausting the child, not by relieving
+it of its little ailment.</p>
+
+<p><b>Jouncing or Hobbling Baby.</b>&mdash;This is another habit
+that should be frowned upon. So many persons are addicted
+to this form of baby torture, that it is astonishing
+more immediate harm does not result from it. Be particularly
+careful not to indulge in it, or permit anyone else
+to do it immediately after feeding. If you form the
+habit of putting baby down at once after each feeding, as
+you have been instructed to do, the opportunity to jounce
+it will not exist. A little reasoning will clearly convince
+you that to subject a baby to violent exercise when its
+stomach is full would interrupt digestion and so shake
+the full stomach hat it would distend it and cause indigestion.
+You would not think of exercising yourself
+after a meal; why exercise a baby?</p>
+
+<p><b>Baby Needs Water to Drink.</b>&mdash;Boil a quantity of<span class='pagenum'><a name="Page_240" id="Page_240">[Pg 240]</a></span>
+water each morning, put in a clean bottle, and keep in
+a cool place. Give the baby some, three or four times
+daily between feedings. One teaspoonful is enough to
+begin with, and as it grows older it will take more. It
+may not always take the water but it will take what it
+wants, and it needs some every day; it is therefore your
+duty, inasmuch as baby cannot ask for it, to offer it
+regularly each day as part of your daily routine.</p>
+
+
+<h3>KISSING</h3>
+
+<p>A child should never be kissed on the mouth by anyone,
+not even its own parents.</p>
+
+<p>Kissing should not be allowed among children. If any
+kissing is done it should be on the brow, never on the
+mouth, hands, or fingers.</p>
+
+<p>Many diseases are carried by this pernicious habit, and
+you cannot afford to have baby's health jeopardized by
+this promiscuous and unnecessary liberty.</p>
+
+
+<h3>ESTABLISHING TOILET HABITS</h3>
+
+<p>When baby reaches the age of three months, a regular
+systemized effort should be made to educate it to "habits
+of cleanliness." Nothing can be done in this direction
+previous to this age, as a child at that period of its life
+is scarcely conscious of the natural functions of its body.
+Each time a baby, after the third month, is making an
+effort to move its bowels, the nurse or mother should go
+to it as it lies in its crib, and talk to it by making a certain
+sound or say a certain word&mdash;whichever word or words
+you want to educate your child to say, when it wants to
+move its bowels. By constant attention and effort in
+this direction, a child with quick perception and initiative
+will soon associate the sound and the function, and it will
+begin to make the sound when the function is about to be
+performed. As soon as it begins to make this sound, if
+prior to the act of moving the bowels, the child should
+be immediately taken up and held on a chamber, into
+which some hot water has been put, and encouraged to<span class='pagenum'><a name="Page_241" id="Page_241">[Pg 241]</a></span>
+relieve itself, the nurse or mother still repeating the
+sound, or word, or words.</p>
+
+<p>Having successfully accomplished this programme a
+number of times, the child should be encouraged and
+petted every time it gives a satisfactory warning, and
+discouraged and reproved every time it wets or soils its
+napkin. A little later, say about six months, the child
+should be held on the chamber at a certain time each
+morning and evening, thus encouraging it to move its
+bowels regularly twice daily. The careful carrying out
+of a scheme such as the above will establish regular,
+cleanly habits, and will to a very large extent guard
+against constipation in the future.</p>
+
+<p><b>Baby's Comforter.</b>&mdash;The discovery and introduction of
+the comforter or rubber teat was an unfortunate episode
+in someone's life. By the careless, conscienceless nurse,
+or thoughtless mother, it is regarded as a real comfort
+and blessing. Any temporary comfort, however, which
+the nurse or mother may enjoy as a result of its use, is
+at the expense of the health of the child. Its use is a
+serious reflection upon the good intention and intelligence
+of the mother who permits her child to use one. It is a
+bad habit from every viewpoint possible. In order that
+mothers, open to conviction and capable of reasoning,
+may appreciate the character of the harm done by the
+use of the comforter, we will briefly record these conditions:</p>
+
+<p>1st. The constant sucking pulls upon the delicate structures
+of the mouth and throat, and so impairs the health
+tone of these structures that they become flaccid and
+feebly nourished. This to a certain degree causes
+adenoids, enlarged tonsils, loose palate and weak throat,
+with the constant tendency to winter colds and coughs,
+and to catarrh.</p>
+
+<p>2nd. It causes an excessive flow of saliva. Saliva
+should only be stimulated previous to stomach digestion.
+By causing an excessive flow of saliva into an empty
+stomach, the digestive powers are interfered with, and
+seriously weakened. Stomach trouble, and consequently
+intestinal disease, may therefore be caused by the seemingly
+innocent comforter.<span class='pagenum'><a name="Page_242" id="Page_242">[Pg 242]</a></span></p>
+
+<p>3rd. A constantly used comforter always causes disease
+of the mouth. Mucous erosions, canker sores, little ulcers,
+etc., are produced in this way.</p>
+
+<p>4th. The use of the comforter makes it impossible to
+put the child to sleep, or even to leave it alone, without
+first placing it in its mouth.</p>
+
+<p>5th. To stifle a baby's cry, by pushing the comforter
+into its mouth, is as bad as giving it chloroform to mask
+a serious and dangerous pain. If may have a just reason
+for crying, as is explained elsewhere, and if that reason
+is not searched for and found, it may mean serious
+trouble later.</p>
+
+<p>6th. Actual deformities of the mouth are produced by
+constant use of the comforter. The continuous sucking
+affects the gums, pushes them out of shape and position,
+and the teeth as a consequence come at wrong angles,
+thus causing unsightly deformities, which last throughout
+the life of the child.</p>
+
+<p>7th. The worst fault of the comforter is to be found
+in its uncleanliness. We are quite satisfied that the use
+of the comforter will be legislated against one of these
+days. If preventive medicine means anything, it must
+certainly reckon with the comforter in the very near
+future. Have you ever watched your baby suck on its
+comforter? If you have, you must have noted the tireless
+energy with which it works its tiny jaws and tongue.
+Suddenly the comforter slips from the little mouth and
+baby begins to cry, attracting the attention of the mother,
+or nurse, or little sister, who promptly, recognizing the
+trouble, pounces on the offending comforter, which has
+fallen to the floor, and with a perfunctory wipe replaces
+it in baby's mouth. It is done just as we have written it,
+many thousand times, and yet the problem of infant
+mortality is represented as a vexatious mystery. The
+newspapers solicit charitable aid, and write eloquent appeals
+regarding the necessity of sending a few babies
+to the seashore in the summer time or to supply a few
+with ice during the hot spells. A hundred other energetic
+enthusiasts send forth their laudable effort to raise the
+standard of child hygiene, yet the manufacturers of the
+comforter, and the ignorant mother and nurse who use it,<span class='pagenum'><a name="Page_243" id="Page_243">[Pg 243]</a></span>
+do more harm in one day than all the honest effort of
+these combined forces can neutralize in a year.</p>
+
+<p>The rubber comforter is one of the most fertile causes
+of infection and illness in babies because of the peculiar
+adaptability to collecting germs which it possesses.</p>
+
+<p>When the comforter is finally discarded the habit of
+sucking is so firmly established that the child will suck
+its thumb for many years after. This results in further
+disease and deformity to the growing mouth and throat,
+and also to the thumb.</p>
+
+<p>After a child has used a pacifier or comforter for some
+time it invariably becomes a mouth breather. A mouth-breathing
+child is very apt to catch cold and as a consequence
+of the habit may become catarrhal or tubercular.</p>
+
+<p><b>What Can be Done to Lessen the Evil Effects of the
+"Comforter" Habit?</b>&mdash;It is a most difficult habit to cure
+when once established. The very least that can be done
+is to keep the comforter scrupulously clean, washing it
+several times daily. To have not one, but two or three,
+kept in a saturated solution of boracic acid, ready to put
+into the baby's mouth should one be required to replace
+another that has fallen out. We should furnish a large
+shield to prevent it being swallowed. We can try the
+method of weaning the baby from the comforter by tying
+a ribbon to it and to the child's bodice. The system is
+gradually to shorten the ribbon until it becomes too short
+for the baby to suck in comfort. It will then gradually
+grow away from the habit.</p>
+
+
+<h3>FOOD FORMULAS</h3>
+
+<p><b>Beef Juice.</b>&mdash;Take one pound of round steak and broil it
+slightly. Press the juice out with a lemon squeezer, or, with
+a meat-press. Season with salt and serve hot or cold as desired.
+If it is heated after it has once been cold, it should not
+be overheated as this will coagulate the albumen which will appear
+as flakes floating on the surface of the juice.</p>
+
+<p><b>Beef Juice by the Cold Process.</b>&mdash;Take one pound of finely
+chopped round steak, six ounces of cold water, a pinch of salt;
+place in a covered jar and stand on ice, or in a cool place, six
+hours. This mixture should be shaken from time to time.
+Strain and squeeze all the juice out by placing the meat in a
+coarse cloth and twisting it very hard. Season and feed as
+above.<span class='pagenum'><a name="Page_244" id="Page_244">[Pg 244]</a></span></p>
+
+<p>Beef juice made in this way is more nutritious than that made
+from the steak when broiled; it is not, however, quite so palatable.</p>
+
+<p>Beef juice made in either of the above ways is much more
+nutritious than the beef extracts sold ready to use.</p>
+
+<p><b>Mutton Broth.</b>&mdash;Take one pound of finely chopped lean
+mutton, including some of the bone, one pint of cold water and
+a pinch of salt, cook for three hours over a slow fire down to
+half a pint, adding water to make up this quantity if necessary;
+strain through muslin. When it is cold remove the fat and
+add more salt if required. It may be fed warm or cold in the
+form of a jelly.</p>
+
+<p><b>Mutton Broth With Cornstarch or Arrowroot.</b>&mdash;Add to the
+above sufficient cornstarch or arrowroot to thicken, cook for
+ten minutes and then add three ounces of milk, or one ounce
+of thick cream, to a half pint of broth. This makes a nutritious
+and extremely palatable broth.</p>
+
+<p><b>Chicken, Veal, and Beef Broths.</b>&mdash;These may be made and
+used in the same way as mutton broth.</p>
+
+<p><b>Scraped Beef or Meat Pulp.</b>&mdash;Take a rare piece of round
+or sirloin steak, cut the outer part away, scrape or shred with
+a blunt knife. Cutting the meat into small pieces is not satisfactory.
+One teaspoonful to one tablespoonful may be given
+well salted, to a child a year and a half old. It is best to begin
+with a small dose and work up to the larger to accustom the
+digestive apparatus to its use.</p>
+
+<p><b>Junket, or Curds and Whey.</b>&mdash;Take one pint of warm fresh
+cow's milk, a pinch of salt, a teaspoonful of granulated sugar,
+to which add two teaspoonfuls of Fairchild's essence of pepsin
+and allow the mixture to stand until firmly coagulated&mdash;this may
+take about twenty minutes&mdash;place in the ice box until thoroughly
+cold. Nutmeg may be added for older children and adults.</p>
+
+<p><b>Whey.</b>&mdash;The coagulated milk prepared as above is broken
+up with a fork and the whey is strained off through cheesecloth.
+If a stimulant is desired, brandy, in the proportion of one teaspoonful
+to six tablespoonfuls of the whey may be added.</p>
+
+<p><b>Barley Water.</b>&mdash;One level tablespoonful of Robinson's barley
+is rubbed up with a little cold water, to this is added one
+pint of boiled water containing a pinch of salt. The mixture
+should be stirred while the water is being added. Cook for
+thirty minutes in a double boiler and strain. Enough boiling
+water should be added to the mixture to make up the full pint
+if any has boiled away.</p>
+
+<p><b>Barley Gruel or Barley Jelly.</b>&mdash;Repeat the above process,
+but instead of using one tablespoonful of the barley powder,
+use from two to four according to the consistency of the gruel
+or jelly desired.</p>
+
+<p>Barley water may be made from the grains. A formula for
+this process will be found in the chapter on artificial feeding.</p>
+
+<p><b>Rice, Wheat, or Oat Water.</b>&mdash;These are made from the rice,<span class='pagenum'><a name="Page_245" id="Page_245">[Pg 245]</a></span>
+wheat, or oat flour in the same way as barley water described
+above. They may be made from the grains also, using the same
+proportions as in the making of barley water.</p>
+
+<p><b>Imperial Granum.</b>&mdash;This is prepared in the same way as the
+barley flour above described.</p>
+
+<p><b>Albumen Water.</b>&mdash;Take half a pint of cold water, the white
+of one fresh egg, a pinch of salt, and a teaspoonful of brandy,
+shake and feed from a spoon or from a bottle. This is frequently
+used in cases of vomiting, or in irritable stomachs. It is
+often retained when all other food is rejected.</p>
+
+<p><b>Dried Bread.</b>&mdash;Cut either stale or fresh bread into thin
+slices and place in the open oven. When it is dried and crisp
+but not browned it may be given to children in preference to
+crackers.</p>
+
+<p><b>Coddled Egg.</b>&mdash;A fresh egg with the shell intact is placed in
+boiling water which is immediately removed from the fire. The
+egg is allowed to remain in the water for eight minutes when it
+is ready for use. The white only should be used if the digestion
+is poor.</p>
+
+
+
+<hr style="width: 65%;" />
+
+<h2>ARTIFICIAL FEEDING</h2>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_249" id="Page_249">[Pg 249]</a></span></p>
+<h2>CHAPTER XIX</h2>
+
+<h3>ARTIFICIAL FEEDING</h3>
+
+<div class="blockquot"><p>Elementary Principles of Milk Modification&mdash;The Secret of
+the Efficiency of Mother's Milk&mdash;Two Important Factors
+in Successful Artificial Feeding&mdash;Every Child is a Problem
+in Itself&mdash;Proprietary Foods of Little Value as Infant
+Foods&mdash;Their Value is in the Milk Added to Them&mdash;The
+Credit Belongs to the Cow&mdash;Difference Between Human
+and Cow's Milk&mdash;What "Top-milk Feeding" Means&mdash;Utensils
+Necessary for Home Modification of Milk&mdash;Artificial
+Feeding from Birth to the Twelfth Month&mdash;How
+to Measure Top-milk&mdash;Easy Bottle-feeding Method&mdash;Condensed
+Milk Feeding&mdash;Objections to Condensed
+Milk Feeding.</p></div>
+
+
+<p><b>Elementary Principles of Milk Modification.</b>&mdash;Mothers
+who have to raise their children on artificial food
+should understand the elementary principles of milk
+modification. They should know, for example, that the
+one object of milk modification is to render it as nearly
+an exact substitute for mother's milk, according to the
+age of the child, as is possible. If we could do this
+with scientific exactness, artificial feeding would be a
+simple process. We cannot, however; nor has there
+ever been devised a method by which we may hope successfully
+to duplicate mother's milk. It is a comparatively
+simple matter for the efficient chemist to analyze
+the breast milk of any nursing mother; and it is quite
+possible to duplicate the milk according to the analysis,
+with chemical exactness, but the two fluids will not be
+the same. There is present in the mother's milk something
+which synthetic chemistry cannot discover. This
+something is nature's secret,&mdash;it is akin to the life-giving
+principle which is contained in the germinal fluid, and
+in the hen's egg. We cannot therefore hope to build
+up an artificial food that contains this mysterious life-giving
+principle which is the secret of the efficiency of
+maternal milk,&mdash;we can only hope to approximate it.<span class='pagenum'><a name="Page_250" id="Page_250">[Pg 250]</a></span>
+It is possible that we might be successful so far as its
+nursing efficiency is concerned, if all children were alike,
+if all children were of a uniform standard of health.
+As a matter of fact, no two babies are exactly alike.
+And while the mother of each child undoubtedly secretes
+a milk suitable to the degree of healthfulness of her
+own child, the same milk might not be equally suitable
+to another child. The milk, therefore, that is manufactured
+to agree with an average mother's milk is dependent
+for its success upon the vitality of the child to
+which it is fed. If that child is not a well child, according
+to an accepted standard, the milk will not agree with
+it, even though it is the best possible substitute for an
+average breast milk.</p>
+
+<p>We have consequently two factors to consider in successful
+or efficient artificial feeding:</p>
+
+<div class="poem"><div class="stanza">
+<span class="i0">1. Our inability to duplicate exactly mother's milk.<br /></span>
+<span class="i0">2. The lack of a uniform health standard in children.<br /></span>
+</div></div>
+
+<p>It is the lack of a uniform health standard in children
+that gives to artificial feeding all its difficulties.
+It renders the successful artificial feeding of children a
+personal or individual problem. Some children,&mdash;those
+who approximate a standard of health for their age;
+in other words, "well" children,&mdash;thrive on a milk modification
+that experience has taught us is suitable for
+well children of their age. Others, and they are in the
+majority, have to be fed on a modification which actual
+test proves to agree with their digestive capabilities.
+Every artificially fed child therefore must be studied
+from its own individual standpoint. A certain modification
+of milk may not agree with a child fed every two
+and one-half hours, which will be found to agree if fed
+in the same quantity, to the same child, every
+three hours. The slightest change, a change which
+would seem to be so insignificant in itself as not to
+justify serious consideration, may mean the difference
+between normal healthfulness and constant ill health.
+A food that is too strong for a child's digestive ability,
+and which causes vomiting, colic, and diarrhea, may be
+rendered exactly right by the slightest modification
+one of its constituents. To effect such a change quickly<span class='pagenum'><a name="Page_251" id="Page_251">[Pg 251]</a></span>
+and successfully, one must be trained to interpret the
+symptoms correctly and to know how to make the change
+in the modification of the milk. Mothers cannot be expected
+to possess this degree of skill: they should therefore
+refrain from experimenting, because an experiment
+on a baby is not only dangerous, but ethically it
+is criminal. Call the family physician; put the burden
+on his shoulder.</p>
+
+<p>It is this element of uncertainty in our ability to effect
+a standard modification of milk that has afforded manufacturers
+the rich opportunity of putting on the market
+various baby foods for which much is claimed. These
+foods are really substitutes for the inefficiency of the
+average mother. There is no real justification for their
+use. If all mothers were clean, faithful, and efficient,
+there is no reason why each one could not be taught
+to modify cow's milk to suit her child, just as satisfactorily,
+or more so, than a manufacturer who never saw
+her child. The manufacturers, however, do the work,
+and the naturally ignorant or lazy and inefficient mother,
+is willing to pay for the extra cost of labor, to save
+herself the trouble on the one hand, and to subject her
+child to a series of experiments in order to discover the
+manufactured food that is particularly adapted to her
+particular baby on the other hand. We believe that
+most mothers have never considered the question from
+this standpoint; that most mothers adopt this method
+of artificial feeding at the direct suggestion of their
+family physician, and are not, therefore, responsible.
+These foods do not contain the nutritional elements
+necessary to healthy growth; or as they exist in normal
+breast milk; or as they can be approximated in
+ordinary milk modification at home. Proprietary foods
+are of decidedly poor value in infant nutrition, and
+should not be used. They have a value, however,
+in certain diseased conditions, but within a very small
+range. As a food for a healthy growing infant, they
+should not be used, and when the average physician
+appreciates this fact, and so instructs the mothers of
+the country, it will be to the distinct advantage of the
+race in every respect. Proprietary foods to which fresh<span class='pagenum'><a name="Page_252" id="Page_252">[Pg 252]</a></span>
+cow's milk is added, are not foods at all,&mdash;they depend
+upon the milk so far as any nutritional value is concerned;
+and it would be far safer to modify at home a
+good milk than to buy a proprietary food, the analysis
+of which cannot be depended upon. The credit for the fat,
+healthy babies we see advertised does not belong to
+the manufacturers, but to the cow whose milk you add
+to the manufacturer's sugar.</p>
+
+<p>The proprietary beef foods are also valueless as infant
+foods. In certain illnesses, when we want a mild
+stimulant, a teaspoonful or two in hot water may have
+a certain value, but that is all. The beef juice of home
+manufacture is much more valuable.</p>
+
+<p><b>Difference Between Human and Cow's Milk.</b>&mdash;The
+composition of cow's milk is as follows:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Fat (represented by cream)</td><td align='right'>4%</td></tr>
+<tr><td align='left'>Sugar</td><td align='right'>4%</td></tr>
+<tr><td align='left'>Proteids (represented by curd)</td><td align='right'>4%</td></tr>
+</table></div>
+
+<p>The composition of an average human breast milk
+is as follows:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Fat</td><td align='right'>4%</td></tr>
+<tr><td align='left'>Sugar</td><td align='right'>7%</td></tr>
+<tr><td align='left'>Proteids</td><td align='right'>1-1/2%</td></tr>
+</table></div>
+
+<p>It will be observed from a comparison of the above
+tables that cow's milk is much richer in proteids (the
+substances which form with water the curd of sour milk)
+than is human milk. If one remembers that cow's milk is
+manufactured by nature primarily for the feeding of
+calves, not for babies, and that the stomach of a calf
+is intended to exist exclusively on vegetable products,
+and that nature is preparing it for this purpose, and
+feeds it a food when young that will enable it to grow
+so as to be adapted for that purpose, one can understand
+that the problem of the modification of cow's milk to
+suit the stomach of a baby is not by any means a simple
+matter. Since the proteids are so much in excess in
+cow's milk, we must dilute cow's milk with twice its
+bulk or more of water to render it fit food for a new
+born baby. If we dilute cow's milk to this extent to get
+the proteid percentage right, we immediately disarrange<span class='pagenum'><a name="Page_253" id="Page_253">[Pg 253]</a></span>
+the percentage of the cream or fat. We overcome this
+difficulty by taking the cream from the top of the bottle
+and diluting it because it is richer in fat and does not
+need so much dilution. This is the explanation of the
+so-called "top-milk feeding." The percentage of sugar
+represents another problem. The percentage of sugar
+in cow's milk compared with the sugar in human milk
+is deficient, so we add milk-sugar to the cow's milk
+to make up the deficient percentage.</p>
+
+<p>There is yet another feature which we must rectify;
+cow's milk is acid, while human milk is alkaline. To overcome
+this difference we add lime-water. We must also
+take into consideration that cow's milk is ordinarily full of
+germs, while human milk is free from them; to overcome
+this danger we resort to heating the milk to a degree
+which experience has taught us will kill all germs.
+Cooked milk is not as wholesome as uncooked milk, and
+it has a tendency to cause constipation. We have to a
+certain extent overcome the need for cooking all milk
+for babies, as will be noted later, but in summer time,
+unless the milk is known to be pure and free from germs,
+it is advisable to sterilize it.</p>
+
+
+<h4>UTENSILS NECESSARY FOR HOME MODIFICATION
+OF MILK</h4>
+
+<div class="poem"><div class="stanza">
+<span class="i0">One dozen round, eight-ounce nursing bottles.<br /></span>
+<span class="i0">One dozen black rubber nipples.<br /></span>
+<span class="i0">One eight-ounce measuring glass or graduate.<br /></span>
+<span class="i0">One brush for cleaning bottles.<br /></span>
+<span class="i0">One two-quart glass preserve jar for mixing the various ingredients.<br /></span>
+<span class="i0">One one-ounce Chapin dipper, for removing the top-milk.<br /></span>
+<span class="i0">One glass funnel.<br /></span>
+</div></div>
+
+<p>A detailed description of the proper kinds of bottles
+and nipples will be found elsewhere. The measuring
+glass or graduate should be wide-mouthed. It is not
+safe to spoon the top-milk off, nor is it safe to pour it
+out. Absorbent cotton should be provided to close the
+nursing bottles when filled and left standing in the ice
+box.<span class='pagenum'><a name="Page_254" id="Page_254">[Pg 254]</a></span></p>
+
+
+<h4>ARTIFICIAL FEEDING FROM BIRTH TO THE
+TWELFTH MONTH</h4>
+
+<p>The following formulas for the different ages may be
+found useful for well babies:</p>
+
+
+<p>From the third to the tenth day:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>3 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>1/2 ounce.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>1 ounce.</td></tr>
+<tr><td align='left'>Boiled water to make</td><td align='right'>16 ounces.</td></tr>
+</table></div>
+
+<p>Ten feedings in twenty-four hours; 1-1/2 to 2 ounces at each
+feeding.</p>
+
+
+<p>From the tenth to the twenty-first day:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>6 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>1-1/2 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>1-1/2 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>24 ounces.</td></tr>
+</table></div>
+
+<p>Nine to ten feedings in twenty-four hours; 1-1/2 to 2 ounces
+at each feeding.</p>
+
+
+<p>From third to the sixth week:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>10 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>2-1/2 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>32 ounces.</td></tr>
+</table></div>
+
+<p>Eight to nine feedings in twenty-four hours; 2 or 3 ounces at
+each feeding.</p>
+
+
+<p>From sixth week to the third month:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>12 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>3 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>32 ounces.</td></tr>
+</table></div>
+
+<p>Seven to eight feedings in twenty-four hours; 2-1/2 to 4 ounces
+at each feeding.</p>
+
+
+<p>From third to fifth month:</p>
+
+<p>After this age two bottles of milk are required, 16 ounces
+being taken from the top of each bottle and mixed.</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>18 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>4 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>40 ounces.</td></tr>
+</table></div>
+
+<p>Six feedings in twenty-four hours; 4 to 5 ounces at each
+feeding.</p>
+
+
+<p>From the fifth to the seventh month:</p>
+
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>21 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2 ounces.</td></tr>
+<tr><td align='left'><span class='pagenum'><a name="Page_255" id="Page_255">[Pg 255]</a></span></td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>5 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>42 ounces.</td></tr>
+</table></div>
+
+<p>Six feedings in twenty-four hours; 5 to 7 ounces at each feeding.</p>
+
+
+<p>From the seventh to the ninth month:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>27 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2-1/2 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>6 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>48 ounces.</td></tr>
+</table></div>
+<p>Five to seven feedings in twenty-four hours; 6 to 8 ounces at
+each feeding.</p>
+
+
+<p>From the ninth to the twelfth month:</p>
+
+
+<div class='center'>
+<table border="0" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Milk (top 16 oz.)</td><td align='right'>35 ounces.</td></tr>
+<tr><td align='left'>Milk-sugar</td><td align='right'>2-1/2 ounces.</td></tr>
+<tr><td align='left'>Lime-water</td><td align='right'>6 ounces.</td></tr>
+<tr><td align='left'>Water to make</td><td align='right'>56 ounces.</td></tr>
+</table></div>
+
+<p>Five to six feedings in twenty-four hours; 7 to 9 ounces at
+each feeding.</p>
+
+<p>It will be observed that 16 ounces of top-milk is used
+to make the various formulas from. This means that
+the mother will dip off, with a Chapin dipper, 16 ounces
+from the top of a bottle of milk which has stood for
+four or five hours to allow the cream to rise; she
+will then mix this and take from the mixture the number
+of ounces called for in the formula she is using according
+to the age of the child. The ordinary milk that is delivered
+in New York City may be assumed to have stood
+the four or five hours necessary. This may not be so,
+however, in the country, as it is frequently delivered
+there as soon as it is milked. In such cases the mother
+will permit it to stand in the ice box until the cream
+has risen.</p>
+
+<p>When the mother is about to make the mixture called
+for in feeding from the third to the fifth month she
+will observe that 18 ounces of milk is called for. Now
+since she only uses 16 ounces of the top-milk from one
+bottle this will not be enough. She must therefore use
+16 ounces from two bottles of milk; this she will mix
+together and from this mixture she will take the 18
+ounces wanted. Whatever milk is left over may be
+used for ordinary table purposes.<span class='pagenum'><a name="Page_256" id="Page_256">[Pg 256]</a></span></p>
+
+
+<h4>EASY BOTTLE-FEEDING METHOD</h4>
+
+<p>The following formulas and instructions for bottle-feeding
+are taken from the Rules for the Care of Infants
+and Young Children which are used by Dr. Kerley at
+the out-patient department of the Babies' Hospital and
+give the simplest and easiest means of bottle-feeding:</p>
+
+<div class="blockquot"><p><b>Bottle-Feeding.</b>&mdash;The bottle should be thoroughly cleansed
+with borax and hot water (one teaspoonful of borax to a pint
+of water) and boil before using. The nipple should be turned
+inside out, scrubbed with a brush, using hot borax water. The
+brush should be used for no other purpose. The bottle and nipple
+should rest in plain boiled water until wanted. Never use
+grocery milk. Use only bottled milk which is delivered every
+morning. From May 1st to October 1st the milk should be
+boiled five minutes immediately after receiving. Children of the
+same age vary greatly as to the strength and amount of food
+required. A mixture, when prepared, should be put in a covered
+glass fruit-jar and kept on the ice. For the average baby the
+following mixture will be found useful:</p>
+
+<p>"For a child under six weeks of age: Nine ounces of milk,
+twenty-seven ounces of barley-water, four teaspoonfuls of granulated
+sugar. Feed from two to three ounces at two and one-quarter
+hour intervals, nine feedings in twenty-four hours.</p>
+
+<p>"Sixth to the twelfth week: Twelve ounces milk, twenty-four
+ounces barley-water, five teaspoonfuls sugar. Feed from three
+to four ounces at each feeding.</p>
+
+<p>"Third to the sixth month: Eighteen ounces of milk, thirty
+ounces of barley-water, six teaspoonfuls of sugar. Feed four
+to six ounces at three-hour intervals, seven feedings in twenty-four
+hours.</p>
+
+<p>"Sixth to the ninth month: Twenty-four ounces milk, twenty-four
+ounces barley-water, six teaspoonfuls granulated sugar.
+Feed six to eight ounces at three-hour intervals, six feedings in
+twenty-four hours.</p>
+
+<p>"Ninth to twelfth month: Thirty-eight ounces milk, twelve
+ounces barley-water, six teaspoonfuls of granulated sugar. Feed
+seven to nine ounces at three and one-half hour intervals, five
+feedings in twenty-four hours."</p></div>
+
+<p><b>Barley-Water.</b>&mdash;The barley-water used in the above
+formulas may be made in the following way: To two
+teaspoonfuls of pearl barley, add one quart of water,
+and boil continuously for six hours, keeping the quantity
+up to a quart by the addition of water; strain through
+coarse muslin. The barley will be better if it is soaked<span class='pagenum'><a name="Page_257" id="Page_257">[Pg 257]</a></span>
+for a number of hours, or over night, before cooking.
+The water in which it is soaked is not used.</p>
+
+<p>An equally good barley-water may be made in an
+easier way by using Robinson's prepared barley. This
+may be procured in the drug stores. It is only necessary
+to take one even tablespoonful of this barley to twelve
+ounces of water and cook for twenty minutes.</p>
+
+<p><b>Condensed Milk.</b>&mdash;When the mother cannot afford to
+buy bottled milk from the wagon, when she has no ice-chest
+and cannot afford to buy ice, she should not attempt
+cow's-milk feeding, but may use canned condensed
+milk as a substitute during the hot months only. The can,
+when opened, should be kept in the coolest place in the
+apartment, carefully wrapped in clean white paper or in a
+clean towel. The feeding hours are the same as for fresh
+cow's milk:</p>
+
+<p>"Under three months of age: Condensed milk one-half
+to one teaspoonful; barley-water, two to four ounces.</p>
+
+<p>"Third to sixth month: Condensed milk, one to two
+teaspoonfuls; barley-water, four to six ounces.</p>
+
+<p>"Sixth to ninth month: Condensed milk, two to three
+teaspoonfuls; barley-water, six to eight ounces.</p>
+
+<p>"Ninth to twelfth month: Condensed milk, three teaspoonfuls;
+barley-water, eight to nine ounces."</p>
+
+<p><b>Objections to Condensed Milk Feeding.</b>&mdash;Condensed
+milk is not to be recommended as a permanent food
+where good cow's milk can be obtained. In most cases
+it should be used as the sole food for a few weeks only.
+It may be used when the digestion is impaired for some
+reason. If the symptoms are intestinal it will be more
+apt to agree than if they are caused by stomach ailments.
+The symptoms of intestinal disturbances are,&mdash;colic, flatulence
+(gas), curds or specks in the stools, constipation
+or diarrhea. It will not be found suitable if the child is
+simply vomiting.</p>
+
+<p>The objections to condensed milk are: It is very rich
+in sugar and very deficient in proteids and fat. Children
+fed on condensed milk often gain very rapidly in weight
+but have little strength or resistance. They do not fight
+disease well for this reason; they are apt to develop
+rickets and scurvy.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_259" id="Page_259">[Pg 259]</a></span></p>
+<h2>CHAPTER XX</h2>
+
+<h3>ARTIFICIAL FEEDING&mdash;CONTINUED</h3>
+
+<div class="blockquot"><p>How to Prepare Milk Mixtures&mdash;Sterilizing the Food for the
+Day's Feeding&mdash;How to Test the Temperature of the
+Food for Baby&mdash;When to Increase the Quality or Quantity
+of Food&mdash;Food Allowable During the First Year in
+Addition to Milk&mdash;Beef Juice&mdash;White of Egg&mdash;Orange
+Juice&mdash;Peptonized Milk&mdash;The Hot or Immediate Process&mdash;The
+Cold Process&mdash;Partially Peptonized Milk&mdash;Completely
+Peptonized Milk&mdash;Uses of Peptonized Milk&mdash;Objections
+to Peptonized Milk&mdash;What a Mother Should
+Know About Baby's Feeding Bottle and Nipple&mdash;Should
+a Mother Put Her Baby on Artificial Food if Her Supply
+of Milk, During the First Two Weeks is not Quite
+Enough to Satisfy it&mdash;Certain Conditions Justify the
+Adoption of Artificial Feeding from the Beginning&mdash;Mothers'
+Mistakes in the Preparation of Artificial Food&mdash;Feeding
+During the Second Year&mdash;Sample Meals for a
+Child Three Years of Age&mdash;The Diet of Older Children&mdash;Meats,
+Vegetables, Cereals, Bread, Desserts&mdash;Fruits.</p></div>
+
+
+<h4>HOW TO PREPARE MILK MIXTURES</h4>
+
+<p>The mother should always remember, that the secret
+of success in raising a baby efficiently on artificial food
+is to be cleanly and to be exact. The bottles and the
+nipples must be scrupulously clean; the hands of the
+mother must be clean; the water used must be boiled and
+each ingredient must be measured exactly.</p>
+
+<p>First dissolve the sugar in the boiled water, which
+must be the exact quantity; then remove the top-milk and
+measure the exact amount wanted in the graduate, pour
+into the jar, add the water and sugar mixture, and finally
+the lime water.</p>
+
+<p>It is always desirable to make the entire quantity for
+the day at one time. After the total quantity has been
+mixed in the jar, fill each bottle with the amount for each
+feeding, put in a cotton stopper, and place the bottles in
+the ice box.</p>
+
+<p>In measuring the sugar, it should be remembered that<span class='pagenum'><a name="Page_260" id="Page_260">[Pg 260]</a></span>
+two scant dipperfuls equal one ounce by weight of the
+sugar.</p>
+
+<p>When each individual bottle is to be filled, do it with
+the aid of the glass funnel which has been previously
+sterilized.</p>
+
+<p><b>Sterilizing the Food For the Day's Feeding.</b>&mdash;The
+simplest method is to place the two-quart jar containing
+the milk mixture for the next twenty-four hours' feeding
+upon a saucer in the bottom of an open pan, and then to
+pour enough tepid water into the pan (outside of the
+jar) until it will come up as high as the milk level. The
+water in the pan is then brought slowly to the boiling
+point. The pan is then moved to the back of the stove
+and left for half an hour. The jar is then removed and
+rapidly cooled by allowing cool water to flow over the
+outside; the individual bottles filled and put in the ice
+box.</p>
+
+<p>It is always wise to taste the milk before making up
+the day's feeding to be sure it is not sour. The milk
+from a herd of good cows is always better than the milk
+from one cow no matter how good that one cow may
+be.</p>
+
+<p>When about to feed the baby, the bottle is taken out
+of the ice box and heated to the desired temperature in
+a water bath. The temperature of the milk can be tested
+by allowing a few drops to fall on the wrist; it should
+feel warm, not hot; it should not be tasted by putting the
+bottle to the mouth of the nurse, or mother, as it may
+become infected by doing so. A flannel cover, or bag,
+should be made to fit the bottle and it should be put on
+while the baby is nursing so that the milk may retain its
+heat. The baby must not be disturbed while nursing, nor
+should he be jounced or carried around after nursing.
+These habits cause vomiting and indigestion. He should
+be put in his crib.</p>
+
+<p><b>When to Increase the Quality or Quantity of Food.</b>&mdash;Children
+of the same age may have different digestive
+abilities. A strong, robust child may be permitted to
+take a richer quality of milk than a weak, puny infant
+of the same age. If the quality or quantity of each feeding
+is too weak or small for the baby he will be dissatisfied<span class='pagenum'><a name="Page_261" id="Page_261">[Pg 261]</a></span>
+and he will cry after the feeding. In such cases, if
+the bowel discharges are natural and yellow without
+curds or white specks, and if he is not gaining sufficiently
+in weight, the next stronger formula may be tried. If it
+is decided to put him on the stronger mixture, it is wise
+to cut the quantity down for a day or two in order to
+test out his digestive ability. If the stools remain good
+after three days, the quantity may be slowly increased
+until the amount in the recipe is allowed. It is a much
+more serious risk to overfeed the baby than to underfeed
+him. If too large a quantity is given, he may vomit it at
+once, or he may develop colic with intestinal indigestion.
+Such babies lose weight, become fretful and irritable,
+even though the appetite may remain good. If too strong
+a quality is given he may vomit sour, buttery-smelling
+milk, or have colic, and pass curds in the stool. If this
+happens it may be necessary to go back to a weak formula
+and work up from that standard. This is always a
+tedious and anxious experience and may lay the foundation
+for digestive disturbances for a long time. Don't
+be too anxious to increase the quality, or quantity, of
+your baby's food. It is much better to go slow and have
+a well baby, than to try to force matters and get into all
+kinds of trouble. No science calls for more elementary
+common sense, than the science of infant therapy.</p>
+
+<p>Digestive disturbances incident to this period are fully
+explained in the chapter on Diseases of Children.</p>
+
+
+<h4>FOOD ALLOWABLE DURING THE FIRST YEAR, IN
+ADDITION TO MILK</h4>
+
+<p>About the twelfth month the baby should receive plain
+milk mixtures instead of the top-milk heretofore used in
+making up the food. At first the milk may be plain milk
+from an ordinary bottle shaken up. Of this he may take
+five ounces, to which may be added three ounces of barley
+water. The barley water may be gradually withdrawn,
+an ounce at a time, replacing this amount with milk, until
+the child is taking eight ounces of milk and two ounces
+of barley water. Later plain mixed milk will be suitable
+for a child about the fourteenth month.</p>
+
+<p>Barley water may be added to the milk at any time<span class='pagenum'><a name="Page_262" id="Page_262">[Pg 262]</a></span>
+after the third month in place of the plain boiled water
+in the preceding formulas. It is advisable to do this if
+there is any trouble with digestion, or if there are curds
+in the stools. Some children take more kindly to barley
+water than plain water at a very early age.</p>
+
+<p><b>Beef Juice.</b>&mdash;The juice squeezed from broiled steak
+may be given a child at about the eighth or ninth month,
+or, in cases of anemia, earlier than this. It is given
+before the milk feeding, diluted with an equal amount
+of water. At first a teaspoonful of the extracted juice
+should be given with the same quantity of water; increase
+every four days until at the end of two or three
+weeks two tablespoonfuls are given.</p>
+
+<p><b>White of Egg.</b>&mdash;Place an egg in boiling water and
+allow the water to cool with an egg in it. In ten minutes
+the white of the egg will be coagulated and ready for use.
+It may be used in place of the beef juice if the latter does
+not agree and may be begun at the sixth month and given
+once daily. One-half of the white of the egg should be
+tried, then at the end of a week, if it agrees with the
+child, the whole white of one egg may be given.</p>
+
+<p><b>Orange Juice.</b>&mdash;This juice has a good effect on the
+bowels and may be given even to very young children
+who are disposed to be constipated. It is also of benefit
+in counteracting the effect of boiled milk. The juice
+should be extracted from fresh oranges and strained.
+One teaspoonful may be given at first one hour before a
+feeding. The amount may be increased until four teaspoonfuls,
+or one tablespoonful, are given daily.</p>
+
+<p><b>Peptonized Milk.</b>&mdash;The object of peptonization of milk
+is partly or wholly to digest the casein, or curd, of the
+milk before feeding.</p>
+
+<p>Fairchild's Peptonizing Powder is used for this
+purpose. The powder is put up in tubes, and instructions
+are furnished in each box as to its use.</p>
+
+<p>There are two methods of using the powders:</p>
+
+<p><b>The Hot or Immediate Process.</b>&mdash;Fifteen minutes before
+feeding add from one-eighth to one-quarter of the
+contents of a tube to the milk mixture in the nursing
+bottle ready for use. The bottle is then put in water at a
+temperature of from 110&deg; to 120&deg; F., and allowed to<span class='pagenum'><a name="Page_263" id="Page_263">[Pg 263]</a></span>
+remain in the water for fifteen minutes. The amount
+of the powder used and the temperature of the water
+depend upon the amount of milk in the nursing bottle.</p>
+
+<p><b>The Cold Process.</b>&mdash;Four ounces of cold water are
+put into a clean quart bottle and the powder from one of
+the tubes. Shake the mixture thoroughly until the
+powder is dissolved. Add a pint of cold fresh milk, shake
+the bottle again and place directly on ice. When any of
+this milk is used the bottle should be again shaken and
+put immediately back on ice.</p>
+
+<p>If necessary this process may be modified so that
+partially or completely peptonized milk may be made.</p>
+
+<p><b>Partially Peptonized Milk.</b>&mdash;Put four ounces of water
+and a whole tube of powder into a clean pan and stir well;
+add a pint of cold milk and heat to the boiling point,
+stirring the mixture all the time. There should be
+enough heat to bring the milk to the boiling point in ten
+minutes. Allow the mixture to cool somewhat and strain
+into a clean jar, cork tightly and keep in a cool place.
+Shake the jar before and after using any of the contents.</p>
+
+<p>If partially peptonized milk is properly prepared it
+should not become bitter.</p>
+
+<p><b>Completely Peptonized Milk.</b>&mdash;Put four ounces of
+cold water and the powder contained in one of the tubes
+into a clean quart bottle and shake thoroughly. Add a
+pint of cold fresh milk and shake again; then place the
+bottle in a pan of warm water about 115&deg; F., or not too
+hot to place the hand in comfortably. Keep the bottle
+in the water bath for thirty minutes; then place the bottle
+directly on ice.</p>
+
+<p><b>Uses of Peptonized Milk.</b>&mdash;Partially peptonized milk
+is useful in young infants who have difficulty in digesting
+the curd of milk. Completely peptonized milk is frequently
+used during attacks of indigestion. It is used
+also to tide a delicate infant over a period when for some
+reason the digestive apparatus refuses to digest and assimilate
+even dilute mixtures. It is of value also in acute
+or chronic illness when the child has to be fed through a
+tube. When it is necessary to feed per rectum peptonized
+foods are often selected in preference to others.<span class='pagenum'><a name="Page_264" id="Page_264">[Pg 264]</a></span></p>
+
+<p><b>Objections to Peptonized Milk.</b>&mdash;Complete peptonization
+of milk renders the milk bitter. For this reason
+many children will not take it. Very young children
+whose sense of taste is not developed may be induced to
+take it after a few days. It is not wise to continue its
+use long because the function of the stomach will become
+accustomed to the use of predigested food and refuse to
+work when called upon. If it is used for a number of
+weeks it is wise to stop it gradually in order to permit the
+stomach to resume its function in a normal way.</p>
+
+<p><b>What a Mother Should Know About Baby's Feeding
+Bottle and Nipple.</b>&mdash;In the first place, always buy
+round bottles,&mdash;round everywhere, inside and out,&mdash;there
+should be no corners anywhere. The reason for this is,
+that bottles that are round everywhere, are easily cleaned,
+and can be thoroughly cleaned, and having no corners
+they do not lend themselves to collecting dirt and
+bacteria. When these bottles are first bought they should
+be boiled. After each feeding they should be thoroughly
+washed with soap or washing powder. A long-handled
+bottle brush should be used to help clean the bottle.
+After the bottle has been thoroughly rinsed a number
+of times with hot water, it should be set aside filled with
+warm water into which one teaspoonful of bicarbonate
+of soda has been put. Before filling them with the freshly
+prepared food each morning the bottles should be boiled.
+Every mother with a bottle-fed baby should buy a dozen
+bottles, all of the same kind and size to begin with. This
+is a great advantage for a number of important reasons,
+two or three of which I will mention:</p>
+
+<p>1st. Having enough bottles means that each bottle will
+be used once only during the twenty-four hours; there
+is less chance therefore of a bottle being cleaned carelessly.</p>
+
+<p>2nd. Having a fresh bottle for each feeding permits all
+of the food for twenty-four hours being made at one
+time. This ensures uniformity of quality of each feeding.</p>
+
+<p>3rd. By cleaning all the bottles at one time (previous to
+filling) it is more apt to be done thoroughly; and by
+making all the food for a day at one time it is more<span class='pagenum'><a name="Page_265" id="Page_265">[Pg 265]</a></span>
+apt to be correct than if each feeding was made separately.</p>
+
+<p>The baby's nipple should be made of plain black rubber.
+It should not be too thick because it is necessary to turn
+it inside out in order to clean it thoroughly. The hole
+in the nipple should not be too large&mdash;if the child can
+empty the bottle in less time than fifteen minutes the
+hole is too large. If the milk drops out but does not
+run it is about right. Don't buy nipples too long or
+too large. A long nipple tends to gag the child and cause
+vomiting. A large nipple prevents the child from sucking
+properly and usually allows the food to be taken too
+quickly and with air, which causes colic and indigestion.
+It is well to have always half a dozen nipples of the right
+kind on hand. When new, nipples should be boiled before
+using. After each feeding the nipple should be
+washed in borax and water on both sides, then it should
+be put in a dish containing fresh, cold, borax water and
+left there until again required. A large portion of the
+success of raising healthy, bottle-fed babies is in being
+everlastingly clean in the details of caring for the bottles
+and nipples which are in daily use.</p>
+
+<p><b>Should a Mother Put Her Baby on Artificial Food
+if Her Supply of Milk, During the First Two Weeks,
+is Not Quite Enough to Satisfy It?</b>&mdash;This is a question
+that cannot be answered by a simple yes or no. A great
+deal depends upon circumstances, and these circumstances
+must be weighed and counterweighed before an answer
+is given. It is a serious matter, in our judgment it is a
+criminal proceeding for a physician to advise the use of
+an artificial food without exhausting every aid and
+means to preserve and increase the mother's milk. This
+is a subject in need of earnest missionaries in all walks
+of life, and it should be the duty of every woman's club
+and gathering to voice the conviction of the highest
+womanhood by advocating the use of mother's milk with
+every child born. A woman who can and will not nurse
+her own child is scarcely deserving of the name of
+mother.</p>
+
+<p>It does not seem quite human to deprive a baby of the
+milk which rightfully belongs to it; yet in certain walks
+of life this is not an uncommon procedure. On the other<span class='pagenum'><a name="Page_266" id="Page_266">[Pg 266]</a></span>
+hand the percentage of women able to nurse their children
+is decreasing. This is especially true as applied to
+cities, though it is also true, in a less degree, in the rural
+districts. One eminent authority states that less than
+twenty-five per cent. of the well-to-do mothers, who have
+earnestly and intelligently attempted to nurse their babies,
+succeed in doing so for a period longer than three months.
+This authority also says: "An intellectual city mother
+who is able to nurse her child successfully for the entire
+first year is almost a phenomenon." Women nowadays
+have so many diversified interests, that the primal duty of
+maternal nursing is not at all a fashionable function. If,
+however, the mother is willing, and has conscientiously
+tried to nurse her baby, and after seven or eight days it is
+found that she has not enough milk to satisfy it, and if the
+quality seems to be good, some expedient should be immediately
+adopted to tide the condition over until the
+mother resumes her customary household routine. The
+safest expedient under these circumstances is to alternate
+the feedings; one feeding from both breasts of the
+mother, and the next an artificial food. Some arrangement
+of this kind is the just and the safest way, because a
+very large percentage of mothers suffer from inactivity
+while lying in bed after a confinement. This inactivity
+expresses itself in a failure of some of the organs to
+perform their duty properly. This may affect the quantity,
+and sometimes the quality, of the milk, but it is, as a
+rule, quickly rectified as soon as the mother is up and
+active.</p>
+
+<p>If, however, the milk is still found to be inadequate
+after she is up and has resumed her usual habits, and if
+her health is good, and she is eating well, it is distinctly
+best to put the child exclusively on an artificial diet.</p>
+
+
+<h4>CERTAIN CONDITIONS JUSTIFY THE ADOPTION
+OF ARTIFICIAL FEEDING FROM
+THE BEGINNING</h4>
+
+<p>1st. Woman suffering with any wasting disease such a
+cancer or tuberculosis. (One of these days, and very
+soon we hope, it will be legally impossible for a tubercular
+or cancerous patient to become a mother.)<span class='pagenum'><a name="Page_267" id="Page_267">[Pg 267]</a></span></p>
+
+<p>2nd. When a mother is the victim of any of the serious
+childbed complications such as convulsions, kidney
+disease, extensive loss of blood or blood poisoning, or
+runs a high temperature because of some disease occurring
+at the same time as the confinement, as, for example,
+appendicitis, scarlet fever, typhoid fever, etc.</p>
+
+<p>3rd. Epilepsy, chorea, insanity, are also conditions
+which render artificial feeding necessary.</p>
+
+<p>It is much wiser immediately to put the child on
+artificial feeding if there is a justifiable reason for it than
+to experiment, because any experiment at this time is
+almost certain not to be in favor of the child. Artificial
+feeding is a comparatively easy and successful problem,
+provided it is begun with healthy digestive organs. If
+you keep the child at the breast of a mother whose milk
+is inadequate in quantity or quality, or both, for two or
+three days, and then begin artificial feeding, the child's
+stomach is already unable to perform its duty, and you
+have to treat it with the greatest degree of care and attention,
+and probably begin with a weak food, until you
+regain the lost ground.</p>
+
+<p><b>Mothers' Mistakes in the Preparation of Artificial
+Food.</b>&mdash;Another interesting condition which is quite common,
+is the tendency on the part of the mother to fail to
+follow instructions correctly,&mdash;even though written or
+printed,&mdash;regarding the preparation of the baby's food.
+When the baby is not thriving and gaining steadily in
+weight, or is fretty and cries a good deal, and does not
+rest and sleep peacefully, something, of course, is wrong.
+If, after a careful physical examination of the child,
+nothing is found to justify these symptoms, a physician
+invariably finds, if he questions the mother closely, that
+she has mistaken the instructions and is preparing the
+food wrongly.</p>
+
+<p>Infinite care in every little detail is the price of success
+in raising babies as well as in every other field of human
+endeavor. Revise carefully your method of preparing
+baby's food if there is any trouble such as is described
+above. Despite your absolute assurance that you are
+making no mistake, do not be surprised to find that you
+are not following directions to the letter, and because of<span class='pagenum'><a name="Page_268" id="Page_268">[Pg 268]</a></span>
+this unintentional mistake, your negligence is responsible
+for your baby's condition. Go over the instructions with
+your husband, and let him follow your method of preparation,
+as you repeat it. He may detect the mistake if any
+exists,&mdash;two heads are always better than one. So important
+is this matter that the following two actual cases
+will demonstrate how easy it is to make a mistake, despite
+the absolute confidence of the mother, in each case, that
+she was following the printed directions correctly:</p>
+
+<p>I was called to see a baby whose mother informed me
+that it was having a great deal of trouble. It was apparently
+not thriving; its bowels were bad; it constantly
+cried, and seemed to be suffering from colic and indigestion.
+The mother stated that it lay with its legs
+constantly drawn up and passed enormous quantities of
+gas. The baby certainly looked sick. It had been a small
+baby at birth; and at three months it weighed only six
+pounds. After a careful examination, I could find nothing
+in the physical condition of the child itself, which
+satisfactorily explained the condition, and had made up
+my mind that the food upon which it was being exclusively
+fed, and upon which it had been fed since birth,
+was not agreeing with it. Before recommending a change
+of food, I asked the mother to state in detail just how
+she prepared it.</p>
+
+<p>The directions printed on the can in which the food
+was bought called for so many ounces of a certain quality
+of "top milk." She thought this meant simply so many
+ounces off the top of a bottle of milk, which, of course,
+meant that she was feeding her baby exclusively a very
+rich cream and absolutely no milk. The result was that
+the baby&mdash;small and weak to begin with&mdash;could not
+digest this rich mixture, so it gradually lost vitality, as
+the mother kept increasing the strength of the food, according
+to the age, as directed by the instructions, until
+it was completely knocked out. I pointed out her mistake
+and suggested a change in her methods; she was instructed
+to use the formula for a child of two months,
+instead of the one for three months, as she was doing.
+The child immediately began to pick up and in the course
+of six weeks was entirely cured, and had gained considerably<span class='pagenum'><a name="Page_269" id="Page_269">[Pg 269]</a></span>
+in weight. This mother was a careful, clean,
+painstaking, attentive nurse, and it was a long time before
+she forgave herself for the mistake. The mistake here was
+a little matter, but the results were big and convincing.</p>
+
+<p>The second case was that of a child of about the same
+age, but in this instance it had been a robust, healthy
+child when born, and of normal weight and size. The
+mother nursed it for about one month, when her milk
+failed, and it was put upon a well-known, patent barley
+preparation. The food seemed to agree with it for a
+time, but, as the mother explained, the child soon seemed
+to be dissatisfied at each feeding,&mdash;it gave her the impression
+that it was not getting enough to eat, so she
+increased the quantity. Despite this increase of food, it
+was apparent that the baby was getting weaker, and
+more and more irritable, and sleepless, until there was
+no rest night or day for the mother or baby. About this
+time the child began to "swell up" as if dropsical; it lost
+its healthy color and looked as if made of wax. It was
+very evident that the child was being starved, yet this
+scarcely seemed probable when the actual quantity of
+food consumed was considered. The directions on the
+can of this food, called for a certain amount of the barley
+powder to be mixed with boiled water; and in an additional
+paragraph it was directed to mix this with a
+certain amount of milk. When I requested the mother to
+state how she prepared the food, I was astonished to
+learn that she had evidently never read the second
+paragraph of the directions. She was feeding her baby
+on barley powder and boiled water,&mdash;an excellent starvation
+diet. When her attention was called to the grave
+carelessness she had been guilty of, she was the most
+contrite mother I ever knew. As soon as the milk was
+added to the food the baby immediately began to thrive
+was very soon a robust, healthy infant.</p>
+
+<p>Of course these were errors of bad judgment and
+gross negligence of which few mothers would be guilty,
+but these types of mistakes come to the attention of
+physicians frequently, and emphasize the need of constant
+vigilance in every detail in the management of babies if
+we wish to achieve success.<span class='pagenum'><a name="Page_270" id="Page_270">[Pg 270]</a></span></p>
+
+
+<h4>FEEDING DURING THE SECOND YEAR</h4>
+
+<p>At the beginning of the second year the child should
+be fed at the following hours, 6 and 10 <span class="smcap">a. m.</span>, 2, 6, and
+10 <span class="smcap">p. m.</span></p>
+
+<p>Early in the second year the child should be taught
+to drink from a cup.</p>
+
+<p>A proper diet for a child of twelve months, of average
+development, would be as follows:</p>
+
+<p>6 <span class="smcap">a. m.</span> Milk and barley water, or milk and oat gruel,
+in the proportion of seven ounces of milk to three ounces
+of the diluent.</p>
+
+<p>9 <span class="smcap">a. m.</span> The juice of an orange (strained).</p>
+
+<p>10 <span class="smcap">a. m.</span> The same as at 6 <span class="smcap">a. m.</span></p>
+
+<p>2 <span class="smcap">p. m.</span> Chicken broth with rice or stale bread crumbs,
+six ounces; or a light boiled egg mixed with stale bread
+crumbs; or beef juice, three ounces. Milk and gruel
+same as at 6 <span class="smcap">a. m.</span>, but four ounces only.</p>
+
+<p>6 <span class="smcap">p. m.</span> Two tablespoonfuls of cereal jelly in eight
+ounces of milk; a piece of stale bread and butter. (The
+jelly is made by cooking the cereal for three hours the
+day before it is wanted; it should then be strained through
+a colander; oatmeal, barley, or wheat may be used.)</p>
+
+<p>10 <span class="smcap">p. m.</span> Same as at 6 <span class="smcap">a. m.</span></p>
+
+<p>About the fifteenth month the cereals may be given
+much thicker and fed with a spoon. The child can at
+this time take a number of various fruit juices. Orange
+juice is the best. Carefully strained juice of ripe peaches,
+strawberries, raspberries, may be given in reasonable
+amounts, one or two tablespoonfuls, once daily. Custard,
+cornstarch, plain rice pudding, junket, wheatena, cornmeal,
+hominy, oatmeal, zwieback, bran biscuit, each with
+butter, may be added in reasonable quantities between
+the eighteenth and twenty-fourth months. When cereals
+are given they should be thoroughly cooked, usually for
+three hours, and strained. When apple sauce is given to
+a child about the second year it should contain very little
+sugar and baked apples should be fed without cream.
+Water must be given to the child between meals especially
+during the summer. It should be boiled and cooled
+kept in a cool place. The following schedule for a child
+about the third year constitutes a good average diet for
+a healthy child:</p>
+
+
+<h3>TABLE OF STANDARDS</h3>
+
+<h4>(As Adopted and Copyrighted by the American Medical Society)</h4>
+
+<h3>PHYSICAL DEVELOPMENT</h3>
+
+<h5>[Transcriber's Note: The ages were difficult to read and may not all be correct.]</h5>
+
+<div class='center'>
+<table border="1" cellpadding="4" cellspacing="0" summary="">
+<tr><td align='left'>Age in Months</td><td align='left'>Weight</td><td align='left'>Height</td><td align='left'>Circumference of head</td><td align='left'>Circumference of chest</td><td align='left'>Circumference of abdomen</td><td align='left'>Lat. Diameter of chest</td><td align='left'>Chest front to back</td><td align='left'>Length of arm</td><td align='left'>Length of leg</td></tr>
+<tr><td align='left'>&nbsp;</td><td align='left'>lbs.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td><td align='left'>in.</td></tr>
+<tr><td align='left'>6</td><td align='left'>17</td><td align='left'>27</td><td align='left'>17-1/2</td><td align='left'>17-1/2</td><td align='left'>17-1/2</td><td align='left'>5</td><td align='left'>4-1/2</td><td align='left'>10</td><td align='left'>10</td></tr>
+<tr><td align='left'>9</td><td align='left'>19</td><td align='left'>28</td><td align='left'>18</td><td align='left'>18</td><td align='left'>18</td><td align='left'>5</td><td align='left'>4-1/2</td><td align='left'>11</td><td align='left'>11</td></tr>
+<tr><td align='left'>12</td><td align='left'>20</td><td align='left'>29</td><td align='left'>18-1/2</td><td align='left'>18-1/2</td><td align='left'>18-1/2</td><td align='left'>5</td><td align='left'>4-3/4</td><td align='left'>12</td><td align='left'>12-1/2</td></tr>
+<tr><td align='left'>16</td><td align='left'>23</td><td align='left'>30</td><td align='left'>18-1/2</td><td align='left'>18-1/2</td><td align='left'>18-1/2</td><td align='left'>5-1/2</td><td align='left'>5</td><td align='left'>12-1/2</td><td align='left'>13-1/2</td></tr>
+<tr><td align='left'>21</td><td align='left'>24</td><td align='left'>31</td><td align='left'>18-1/2</td><td align='left'>19-1/2</td><td align='left'>19-1/4</td><td align='left'>6</td><td align='left'>5</td><td align='left'>14</td><td align='left'>15</td></tr>
+<tr><td align='left'>24</td><td align='left'>25</td><td align='left'>32</td><td align='left'>19</td><td align='left'>20</td><td align='left'>19-1/2</td><td align='left'>6</td><td align='left'>5</td><td align='left'>14-1/2</td><td align='left'>15-1/2</td></tr>
+<tr><td align='left'>28</td><td align='left'>27</td><td align='left'>33-1/2</td><td align='left'>19</td><td align='left'>20</td><td align='left'>19-1/2</td><td align='left'>6</td><td align='left'>5</td><td align='left'>14-3/4</td><td align='left'>15-3/4</td></tr>
+<tr><td align='left'>32</td><td align='left'>29</td><td align='left'>35</td><td align='left'>19-1/2</td><td align='left'>20-1/2</td><td align='left'>19-1/2</td><td align='left'>6-1/4</td><td align='left'>5-1/2</td><td align='left'>14-3/4</td><td align='left'>15-3/4</td></tr>
+<tr><td align='left'>36</td><td align='left'>32</td><td align='left'>36-1/2</td><td align='left'>20</td><td align='left'>21</td><td align='left'>20</td><td align='left'>6-1/4</td><td align='left'>5-1/2</td><td align='left'>15</td><td align='left'>16-1/2</td></tr>
+</table></div>
+
+<h4>MENTAL DEVELOPMENT</h4>
+
+<div class="blockquot"><p>Attention, facial expression, irritability and disposition should be considered.</p>
+
+<h5>Six Months</h5>
+
+<p>Child sits unsupported for a few minutes.... Balances head.... Eye
+follows a bright object.... Looks in direction of an unexpected sound....
+Child seizes an object and holds it....</p>
+
+<h5>Twelve Months</h5>
+
+<p>Stands and walks with support.... Makes a few sounds, such as
+mam-mam, da-da, co-oo.... Plays with toys.... Attempts to use paper and
+pencil.... Shows interest in pictures.... Clings to mother....</p>
+
+<h5>Eighteen Months</h5>
+
+<p>Child walks and runs alone.... Says a few words, such as Mama,
+Papa, Baby.... Points to common objects in pictures.... Imitates a few
+simple movements, such as placing hands on head or clapping hands....</p>
+
+<h5>Two Years</h5>
+
+<p>Runs.... Repeats two or three words.... Knows features.... Obeys
+simple commands, such as "Throw me the ball".... Imitates movements....</p>
+
+<h5>Two and One-Half Years</h5>
+
+<p>Talks in short sentences.... Knows names of members of the family....
+Roughly copies a circle.... Recognizes self in mirror.... Imitates more
+complex movements....</p>
+
+<h5>Three Years</h5>
+
+<p>Talks distinctly.... Repeats sentences of six simple words.... Repeats
+up to two numerals&mdash;meaning repeats first one numeral and then two
+numerals.... Enumerates objects in a complex picture and attempts to
+describe it....</p>
+
+<h5>Four Years</h5>
+
+<p>Knows its sex.... Names familiar objects, such as key, knife, etc.....
+Repeats three numerals.... Compares two sticks (can select the longer)....
+Distinguishes the longer of two lines....</p>
+
+<h5>Five Years</h5>
+
+<p>Compares weights and lengths.... Copies a square.... Counts four
+pennies.... Describes a picture....</p></div><p><span class='pagenum'><a name="Page_271" id="Page_271">[Pg 271]</a></span></p>
+
+<p>Breakfast:&mdash;(7 to 8 o'clock) Oatmeal, hominy or
+cracked wheat (cooked three hours), served with milk,
+a little salt but very little sugar. A soft egg, boiled,
+poached, or coddled. Stale bread and butter. One glass
+of warm milk. At 10 o'clock, the juice of one orange.</p>
+
+<p>Dinner:&mdash;(12 o'clock) Strained soup, four ounces.
+Chop, roast beef, steak, chicken, small quantity of any
+one. Baked potato and cooked rice, or spaghetti. A
+selection of green vegetables may be made from asparagus
+tips, string beans, peas, spinach, cauliflower, carrots;
+they should be cooked until very soft, and mashed or put
+through a sieve. For dessert, plain rice pudding or bread
+pudding, stewed prunes, baked or stewed apple, junket,
+custard or cornstarch. A glass of milk or water.</p>
+
+<p>Supper:&mdash;(6 o'clock) Cereal; farina, arrowroot, cream
+of wheat, wheatena (each cooked two hours), with salt
+but no sugar. Give two or three tablespoonfuls. Drink
+of milk with stale bread and butter. Twice a week,
+a little plain ice cream, or junket, custard or cornstarch.</p>
+
+<p>Three meals a day at this time are better than more
+frequent feedings. The child has a better appetite and
+much better digestion. It may be found necessary to
+give delicate children a luncheon at 3 o'clock. A glass
+of milk and a Graham wafer, or a cup of broth and a
+zwieback, will answer the purpose. Children recovering
+from serious illness will need more frequent nourishment.
+Up to the sixth year the diet may conform to the above
+schedule, increasing the individual quantities as circumstances
+may warrant.</p>
+
+
+<h4>THE DIET OF OLDER CHILDREN (FROM SIX TO
+TEN YEARS)</h4>
+
+<p>After the sixth year the diet will conform to the adult
+diet, with certain exceptions. The important exceptions
+are as follows: All meats are to be excluded except roast
+beef, steak, lamb chops, roast lamb, mutton chop; all
+meats should be cooked rare and either scraped or finely<span class='pagenum'><a name="Page_272" id="Page_272">[Pg 272]</a></span>
+divided. They should be broiled or roasted, never fried,
+and never given oftener than once daily, and then only in
+small quantity. Pies, rich puddings, pastries of all kinds,
+gravies, sauces, all highly seasoned dishes; wine, beer,
+coffee, tea, should never be given to children. Ham,
+bacon, sausage, pork, liver, kidney, game, and all dried
+and salted meats, codfish, mackerel and halibut, are
+particularly bad.</p>
+
+<p>The following articles are permissible: Broiled
+chicken, shad, bass. The "platter gravy" from a roast
+is very nourishing if given in small amounts. Milk
+should continue to form an important part of the dietary
+up to the tenth year. It should be clean and fresh but
+not too rich. Sometimes it is found advisable to dilute
+the milk with water that has been boiled and cooled.
+Some children will take it if a pinch of salt or bicarbonate
+of soda is put into it, and they will digest it
+easier and better. They should never be allowed to take
+more than one quart daily and frequently less will do
+more good. Cream is not good for children of this
+age. Eggs are valuable; they should never be given
+fried or in the form of omelets, they are best given
+boiled, poached or coddled and only slightly cooked. It
+is never necessary to give more than one egg at a meal.
+There are children with whom eggs do not agree; these
+children are disposed to "biliousness."</p>
+
+<p><b>Vegetables.</b>&mdash;Certain vegetables are objectionable at
+this age: Raw celery, radishes, raw onions, cucumbers,
+tomatoes, lettuce, corn, lima beans, cabbage, egg plant.
+The following are good: White potatoes (never fried),
+spinach, peas, asparagus tips, string beans,
+celery, young beets, carrots, squash, turnips, boiled
+onions and cauliflower. It is important to remember
+that all vegetables should be thoroughly cooked; they
+cannot be cooked too much. After boiling for some
+time the water should be drained off and fresh water
+used to complete cooking. Vegetables should be fed
+in small quantities. From the third to the tenth year
+they form an important and essential part of the diet
+of all children. After the tenth year they can be eaten
+as served to adults, and other vegetables may then be<span class='pagenum'><a name="Page_273" id="Page_273">[Pg 273]</a></span>
+added. As a rule salads of all kinds should be omitted
+until after the twelfth year.</p>
+
+<p><b>Cereals.</b>&mdash;Children should not be allowed to eat too
+much cereal at one meal,&mdash;never more than one small
+saucerful. Cereals should be properly cooked. It is
+not safe to adhere strictly to the directions on the package
+of any cereal. As a rule they require much longer
+cooking. They are best cooked in a double boiler. They
+may be served with milk, salt, and not more than one
+teaspoonful of sugar.</p>
+
+<p><b>Bread.</b>&mdash;Fresh bread is never allowable. Graham
+wafers, oatmeal crackers, Huntley and Palmer breakfast
+biscuits, bran muffins, rye bread, corn bread, stale
+rolls, are all suitable to growing children.</p>
+
+<p>Hot bread, fresh rolls, buckwheat or griddle cakes,
+all sweet cakes, are objectionable.</p>
+
+<p><b>Desserts.</b>&mdash;The only permissible desserts for this age
+are junket, custards, plain rice, or sago; or bread pudding.
+The only safe rule to follow so far as "sweet
+things" are concerned, is not to give them at all. This
+applies to candy, ice cream, pies, pastries, jam, syrups,
+preserved fruits, nuts and dried fruits. The parent who
+indulges a child to "a taste," is guilty of a bad habit,
+and it can only lead to trouble.</p>
+
+<p><b>Fruits.</b>&mdash;These should always be fresh and selected
+with care. Fruit is the most important article of diet
+to a child of this age. Up to five years it is safest to
+use only cooked fruits and fresh fruit juices: of these
+the juice from sweet oranges, grape fruit, peaches, strawberries,
+and raspberries may be given. Stewed or baked
+apples, apple sauce, figs, prunes, peaches, apricots, pears
+are excellent because of their effect on the bowels. When
+the bowels are loose, and especially in hot weather, great
+care must be taken when fruit of any kind is used. The
+pulp of any fruit should never be used; cherries, bananas,
+pineapples, and berries are not to be given to children.
+Milk should never be allowed at the same meal when sour
+fruit is served.</p>
+
+
+
+<hr style="width: 65%;" />
+<h2>WHAT MOTHERS SHOULD KNOW</h2>
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_277" id="Page_277">[Pg 277]</a></span></p>
+<h2>CHAPTER XXI</h2>
+
+<div class="blockquot"><p>"Life has taught me that it is the women of a country in
+whose hands its destiny reposes. No cause that is not great
+enough to command their devotion and pure enough to deserve
+their sympathy can ever wholly triumph."</p></div>
+
+<p class="right">
+<span class="smcap">Joseph H. Choate</span>.<br />
+</p>
+
+<h3>THE EDUCATION OF THE MOTHER</h3>
+
+<div class="blockquot"><p>What Mothers Should Know About the Care of Children
+During Illness&mdash;A Sick Child Should be in Bed&mdash;The
+Diet of the Sick Child&mdash;A Child is the Most Helpless
+Living Thing&mdash;The Delicate Child&mdash;How to Feed the
+Delicate Child&mdash;How to Bathe the Delicate Child&mdash;Airing
+the Delicate Child&mdash;Habits of the Delicate Child&mdash;Indiscriminate
+Feeding&mdash;Poor Appetite&mdash;Loss of Appetite&mdash;Treatment
+of Loss of Appetite&mdash;Overeating in Infancy&mdash;What
+Correct Eating Means&mdash;Bran as a Food&mdash;Breakfast
+for a Child at School&mdash;Lunch for a Child at School&mdash;Bran
+Muffins for School Children&mdash;Bran Muffins in Constipation&mdash;Hysterical
+Children&mdash;What a Mother Should
+Know About Cathartics and How to Give a Dose of
+Castor Oil&mdash;Castor Oil&mdash;Calomel&mdash;Citrate of Magnesium&mdash;When
+to Use Castor Oil&mdash;When to Use Calomel&mdash;Vaccination&mdash;Time
+for Vaccination&mdash;Methods of Vaccination.&mdash;Symptoms
+of Successful Vaccination.</p></div>
+
+
+<h4>WHAT MOTHERS SHOULD KNOW ABOUT THE
+CARE OF CHILDREN DURING ILLNESS</h4>
+
+<p>Every child has a certain amount of vitality and resistance.
+When illness comes it should be our duty to
+maintain the vitality and resistance to the highest degree.
+We should, therefore, irrespective of the nature of the
+illness, surround the child with all the conditions that
+will minister to the preservation of whatever strength and
+vitality the child has. Experience has taught us that there
+are certain requirements that should be carried out in
+the general management of sick children.</p>
+
+<p><b>A Sick Child Should be in Bed.</b>&mdash;In the first place a
+sick child should be in bed. There is no exception to<span class='pagenum'><a name="Page_278" id="Page_278">[Pg 278]</a></span>
+this rule. It is impossible to do justice to a child if
+you allow him to dissipate his strength and exhaust himself
+moving from place to place while he is sick. A
+mother should not forget that it is she who must exercise
+wisdom and decide what is best for her child. The
+judgment of a sick person is not to be relied upon, and
+it would be wrong to submit to the whims and fancies
+of an ailing child, if these are known to be medically
+disadvantageous to its best interests.</p>
+
+<p>Quiet surroundings are essential in all acute illnesses.
+The nurse should be congenial to the child. If the
+patient demands the presence of the mother she should
+remain, but she should not try to entertain him or interfere
+with the nurse.</p>
+
+<p>The clothing of the patient should be the ordinary
+night-dress which is worn in health. In no disease is
+any special kind, or quantity of clothing required.</p>
+
+<p>The temperature of the room should be 68&deg; F. Thermometers
+are cheap and an exact knowledge of the degree
+of heat in a sickroom is an essential requisite. Nothing
+drains the vitality during sickness quicker than varying
+degrees of heat and cold. It uses up nerve force and
+energy and renders the patient irritable and difficult to
+manage.</p>
+
+<p>The strictest attention should be paid to the ventilation
+of the sickroom. We are learning more and more
+that fresh air is essential to the speedy cure of all diseases
+and to the general well-being of the patient. A direct,
+continuous communication between the sickroom and out-of-doors
+is imperative. It is a splendid measure to use
+two rooms for the patient and to change him twice daily,
+and to air thoroughly the unused room.</p>
+
+<p>The sickroom itself should be large and in a quiet
+part of the house. In summer time the windows may
+be wide open, in winter months the degree of ventilation
+can be regulated by the thermometer.</p>
+
+<p>Many mothers fail to appreciate that drinking water
+is an important requisite in all ailments of childhood,
+should be given freely, but it should be known to be
+absolutely pure. The same rule applies to sponging the
+patient. It must be done every day; sometimes it is<span class='pagenum'><a name="Page_279" id="Page_279">[Pg 279]</a></span>
+necessary to do it more often, but if so it will be so
+directed by the attending physician.</p>
+
+<p><b>The Diet of the Sick Child.</b>&mdash;Prescribing the diet of
+the sick child is an important undertaking. It should
+be remembered that during sickness the digestive capacity
+is reduced; consequently the food must be lessened
+in quantity and in strength. If the patient is an
+infant at breast the best way to accomplish our purpose
+is to give before each feeding two ounces of boiled water,
+cooled to the temperature of the body. This dilutes the
+mother's milk and renders it more easy of digestion. If
+bottle-fed, it is accomplished by replacing one-half of
+the milk with water. In certain diseases milk is totally
+withdrawn, but these cases will be noted when discussing
+the treatment of the various diseases. With older children,
+we give milk diluted with water, or gruels, soups,
+or cereals, as conditions warrant.</p>
+
+<p>Needless interference with the patient must not be indulged
+in. Sleep and quiet are essential features of
+nature's reparative process. It is seldom necessary to
+disturb a sick child for the giving of food or medicine
+oftener than every second or third hour. Medicine may
+always be given with food. Meddlesome interference,
+talkative attendants, or excessive noise may exhaust a
+child and may prolong and render dangerous or fatal
+a condition that would otherwise go on to recovery.</p>
+
+<p>One satisfactory movement of the bowel daily is essential
+to the comfort and progress of a sick person. If this
+does not take place naturally, it should be obtained by
+an enema.</p>
+
+<p>At the beginning of any illness in childhood it is a
+safe procedure to give a dose of a suitable cathartic as
+soon as it is discovered that the child is sick.</p>
+
+<p><b>A Child is the Most Helpless Living Thing.</b>&mdash;Nature
+endows the young of every species&mdash;except those
+of the human family&mdash;with certain instincts, which, when
+developed, govern and control their lives absolutely. The
+technical definition of an instinct is an exceedingly complicated
+word picture. It is only essential to an intelligent
+understanding of our subject that the reader should
+have a definite idea of the difference between an act that<span class='pagenum'><a name="Page_280" id="Page_280">[Pg 280]</a></span>
+is the result of a process of reasoning and an act that is
+the result of an instinct. If a man finds his way out
+of his burning home he will stay out as long as there
+is any danger. The crudest kind of reasoning will teach
+this lesson. A horse, on the other hand&mdash;and incidentally
+it may be noted that a horse is regarded as an intelligent
+animal&mdash;if led out of a burning stable and let loose,
+will immediately re&euml;nter and be burned to death. The
+horse is the victim of instinct; he obeys the unconquerable
+instinct to return to his stall&mdash;he cannot reason
+as the man can that a home that is burning is not a
+proper place to seek safety in. When an ostrich fears
+danger he buries his head in the sand, under the impression
+that if his head is out of sight he is safe from
+danger. This is his instinctive plan of procedure in the
+presence of danger, and it is the plan of every ostrich,
+everywhere, always. A little reasoning would show them
+how foolish the idea is&mdash;but they cannot reason. That
+is the province of man alone. If the first member of a
+flock of sheep jumps over a fence to get into the next
+field, every member of the flock will follow, each one
+jumping the fence, though there may be an open gate
+between the two fields a few yards away. Instinct dictates
+the plan to the sheep as they have received instructions
+from their ancestors always to "follow the lead."
+This is their hereditary legacy and they cannot disobey
+it.</p>
+
+<p>Animals are born with instincts which need only circumstances
+to bring them out. Now a baby is not born
+with instincts of this character,&mdash;it has not even the instinct
+to help itself; it cannot find the breasts that were
+made for it; it is more helpless than the baby cat or dog
+or worm. Therefore a baby in whose brain the potential
+faculty of reason is slumbering must of necessity begin
+its career wholly dependent upon the supervision and
+love of its mother, until such time as it may be capable
+of reasoning for itself. Motherhood is therefore the
+supreme privilege of womanhood. It cannot be superseded,
+hence the fundamental factor in any system of race
+culture, or in any system of infant mortality, must tend
+to raise the quality and the intelligence of motherhood<span class='pagenum'><a name="Page_281" id="Page_281">[Pg 281]</a></span>
+as a basic necessity. Motherhood at the present time,
+though the most important and sacred profession in
+the world, is almost exclusively carried on by unskilled
+labor. The maternal instinct is deeply rooted and universal;
+its absence must be regarded as an abnormality,
+or as a product of misdirected education. The requisites
+for the mothers of the future should be absolute physical
+health and love of children.</p>
+
+<p>If nature endowed a baby with instincts there would
+be no need for reason or education. Education cannot
+teach a cat how to nurse or wash a kitten any better
+than it does,&mdash;its instinct is good enough. The mother
+of a human baby, however, is not born with the instinct
+which enables her to care for her baby equally as well
+as the cat cares for her kitten. She must be educated
+or taught to care for it. She can then care for it better
+than the cat cares for the kitten, and she can be taught
+to bake, to sew, to read; to play on the piano, which a cat
+cannot be taught. So while a baby may be the most
+helpless living thing at one stage of its career it has in
+it&mdash;in the faculty of reasoning&mdash;the ability to become the
+Lord of all the Earth and of all the animals therein.
+To limit the environment of a child by imposing instincts
+upon it, would be to limit its inherent freedom.
+To be obliged to obey a prescribed instinctive law would
+rob mankind of his creative or reasoning faculty, and
+that would be to lower him to the level of the brute creation.
+Reason is of no use if our acts are already determined
+for us. There are therefore good reasons why
+the human baby should be, at the moment of its birth,
+the most helpless living thing; and as a consequence
+it is imperative, if the eugenic ideal is worthy of attainment,
+that every baby should have the benefit of
+trained and efficient care and education.</p>
+
+
+<h4>THE DELICATE CHILD</h4>
+
+<p>There is a certain standard by which we measure the
+physical and mental development of children. This standard
+we regard as the evidence of normal development.
+Some children exceed these requirements; they<span class='pagenum'><a name="Page_282" id="Page_282">[Pg 282]</a></span>
+are bigger and stronger at a given age than the average
+child at the same age. There are other children who
+cannot be called sick, but who are physically and mentally
+inferior to the average standard, whom we designate
+as "delicate." These children are not as big, or
+as strong, or as heavy, as other children of the same
+age. They are born with a reduced vitality, or through
+mismanagement in early infancy they have acquired a
+subnormal standard of development. Children born of
+parents who are not of standard vitality are predisposed
+to be delicate. If the parents are of average development,
+and the delicacy of the child is acquired by mismanagement,
+the proper dietetic and hygienic management
+will, as a rule, promptly result in a satisfactory
+restoration to normal health.</p>
+
+<p><b>Treatment.</b>&mdash;When a mother awakes to the knowledge
+that her child is delicate; when she understands that
+her child's vitality is not what it should be, and when
+she resolves to "do something" in the interest of her
+child, she is on the right road, and we hope to encourage
+her in the good intention. We would however
+tell her that her effort must be thorough, and that she
+must be patient and persevering. If she does not falter
+in well doing she will succeed beyond her expectation,
+and the satisfaction she will experience in noting the
+evidences of returning health and strength in the appearance
+and conduct of her child, should be ample recompense
+for the effort made and the time bestowed.</p>
+
+<p>She must begin with a definite knowledge of just what
+she intends doing; she must know, however, what must
+be done and she must begin at the beginning and build
+from a sure foundation. It is therefore absolutely essential
+to ascertain if there is any actual disease underlying
+the reduced vitality which is responsible for the delicacy
+of the child; this necessitates a thorough examination by
+a competent physician. If you are assured there is no
+disease present, no tuberculosis, no syphilis, no malaria,
+and that debilitating conditions, such as adenoids, sexual
+abnormalities, the results of self-abuse, skin disease, do
+not exist, then certain fixed rules can be laid down, and
+definite principles followed in the daily management.<span class='pagenum'><a name="Page_283" id="Page_283">[Pg 283]</a></span></p>
+
+<p><b>Weight, as a Standard of Development.</b>&mdash;It has been
+stated elsewhere in this book that one of the safest
+guides to follow, as to whether a child is thriving, is
+its weight. This can be relied upon as a general rule.
+A child should therefore be weighed regularly every
+week. If it is not gaining an average of four ounces
+weekly it is not thriving up to standard. When the
+average is below four ounces there is something wrong
+with the quality or quantity of the food.</p>
+
+<p><b>How to Feed the Delicate Child.</b>&mdash;If the child is
+breast-fed and the weight standard, as evidenced by the
+weekly averages, is persistently below normal, we must
+find a substitute for the mother's milk. If the child is
+bottle-fed and it is demonstrated that it is impossible to
+maintain normal development on cow's milk, a wet-nurse
+should be obtained. After the child is weaned, or put
+upon a more liberal diet, milk should continue to be the
+chief article of diet. From the first to the third year a
+child should take one quart of milk daily in addition to
+the other food. There are some children, however, who
+seemingly cannot take milk without getting indigestion;
+they should be put on skimmed milk, to which may be
+added a small quantity of sugar to make up for the loss
+of fat. Mothers must be certain that too much milk is
+not given, or the desire for other necessary food will
+diminish.</p>
+
+<p>After the first year it is a very good plan to give one
+teaspoonful of scraped beef daily. If this is well borne,
+two may be given and later three. It can be given immediately
+before the regular feeding of cereal and milk.
+From the twelfth to the sixteenth month eggs may be
+given: at first one-half, and later a whole egg mixed
+with bread crumbs. Various vegetables should also be
+given cooked in the form of a pur&eacute;e. If at any time the
+child should refuse the food, or act as if it had no appetite,
+leave the milk out of the diet; this may then restore
+the appetite and it will take the other food freely; the
+milk can be resumed later.</p>
+
+<p>As the child grows older, the distaste for milk may
+grow, or he may be one of those children with whom
+milk really does not agree; in either event, do not hesitate<span class='pagenum'><a name="Page_284" id="Page_284">[Pg 284]</a></span>
+to leave it out of the child's dietary. These children
+should be encouraged to eat plenty of good butter on their
+bread and crackers. Butter will not only agree with
+them, but it will supply any fat deficiency in the general
+diet. The diet may now consist of milk (unless it disagrees),
+cereals cooked three hours, raw or rare meat,
+poultry, eggs, vegetables, pur&eacute;es, cooked and raw fruit,
+bread, crackers.</p>
+
+<p><b>How to Bathe the Delicate Child.</b>&mdash;Regular daily
+baths are particularly of benefit to the delicate child,
+despite the prevailing fear that they may catch cold.
+The salt bath is advised and the time to take it is just
+before retiring. The room should be warm and the temperature
+of the water should be 90&deg; F.: it should not
+last longer than five minutes, and the water should be
+cooled down to 70&deg; F., before the child is removed from
+the bath. While the cold water is running in, the surface
+of the body should be briskly rubbed with the
+mother's hands and after removal the child should be
+dried with a fairly coarse bath towel to ensure a good
+reaction. Very delicate children need not have the temperature
+of the water reduced; others may stand water
+of 80&deg; F., but no lower. In the poorly nourished it is
+frequently advantageous to rub the body, after drying,
+with olive oil or goose oil. This aids nutrition and because
+of the massage it aids circulation. In some older
+children a daily cold spinal douche seems to act particularly
+well. If the child does not promptly react from
+the effect of the cold water it is best to discontinue it.</p>
+
+<p><b>Airing the Delicate Child.</b>&mdash;Delicate children should,
+above all things, be assured of the maximum amount
+of fresh air and sunlight. Many mothers entertain the
+idea that these children are disposed to take cold easily,
+if in the open air,&mdash;which is not the case. All children
+need an abundance of fresh air and the delicate need it
+particularly. The season of the year and the character
+of the weather will, of course, dictate just how much
+open-air exercise they may take.</p>
+
+<p>If the weather is very cold and the air damp, or if
+there is a very cold high wind, it is best to remain indoors;
+otherwise the child should remain out for four<span class='pagenum'><a name="Page_285" id="Page_285">[Pg 285]</a></span>
+or five hours. Indoor airing is obtained by dressing
+the child to go out-doors, putting him in his carriage,
+and leaving him before an open window in a room of
+good size with all the doors closed so as not to create a
+draught.</p>
+
+<p><b>Habits of the Delicate Child.</b>&mdash;The amount of sleep
+necessary for a delicate child is the same as for a normal
+child of the same age. The room should always be well
+aired, night and day, and should be devoted to the exclusive
+use of the child.</p>
+
+<p>These children should never be allowed to sit on the
+floor. It is always a difficult matter to avoid this, but
+it must be religiously guarded against; otherwise a cold
+is the inevitable result.</p>
+
+<p>A change of air is sometimes advisable and essential,
+especially during the hot, humid weather of July and
+August. Much better results will be obtained by sending
+these children to the mountains than to the seashore.</p>
+
+<p>Delicate children should always be clothed warmly,
+but not too warmly. The feet and legs must always be
+kept comfortable. Moderate exercise, short of fatigue,
+is necessary. A midday nap after the noon meal should
+be taken every day. The child should be undressed and
+put to bed for two hours and left there, whether it sleeps
+or not. This applies to delicate children of all ages.</p>
+
+<p>The education of delicate children should be postponed
+until the health is restored. They should, however, be
+made to obey and they should be taught good habits.
+When school work begins it should be made light and
+easy. They should not go to school before the eighth
+year, and then not unless physically fit. They should
+not play at rough games or with rough companions,
+though it is not wise to shield them too much. Their
+habits and peculiarities should be studied and every possible
+effort made to direct them kindly and wisely so
+that they may contribute to their own upbuilding.</p>
+
+<p>A systematic observance of these suggestions will save
+many lives and will aid very considerably in producing
+stronger men and women. Infinite patience, tact and
+self-sacrifice is necessary, but the results in every case
+justify the measures adopted.<span class='pagenum'><a name="Page_286" id="Page_286">[Pg 286]</a></span></p>
+
+<p><b>Indiscriminate Feeding: Poor Appetite.</b>&mdash;In considering
+many of the diseases of childhood the term "indiscriminate
+feeding" is used. An explanation of just what
+is meant by this will be of decided advantage. There
+are two fundamental essentials in the successful feeding
+of infants and children: regularity and suitable food.</p>
+
+<p>A child whose feeding intervals are not regular and
+whose food is unsuitable is a victim of indiscriminate
+feeding.</p>
+
+<p>The lack of observance of the regularity rule always
+leads to loss of appetite and indigestion.</p>
+
+<p>Loss of appetite is a serious condition in a growing
+child and may give infinite trouble. Indigestion in a
+growing child is unnecessary, unfortunate, and frequently
+is the one factor that spoils an entire life. It
+is unnecessary, because it means and is caused by neglect
+on the part of the mother; it is unfortunate, because it
+always paves the way for any serious ailment that is
+epidemic or "in the air"; and it is important, because it
+very frequently weakens the stomach and renders it
+unfit for normal digestion for a long period, if not for
+life.</p>
+
+<p>If for some reason a child's appetite becomes poor
+and it is not properly managed until the appetite is restored
+to normal, indiscriminate feeding is always the
+result.</p>
+
+<p>The reason for the poor appetite may be because the
+child is kept indoors too long, or because it is being
+fed on unsuitable food, or is living in unsanitary surroundings,
+or many other reasons, sometimes trifling
+reasons, may cause it. When a child will not eat at
+meal time, the mother feels that it should eat sometime,
+so she encourages it to eat between meals, and because
+of a mistaken kindness she breaks the law of regularity,&mdash;a
+law that can never be broken without serious results
+following. A child in this condition becomes a disturber
+of the peace; the parents can do nothing with him;
+he insists on eating just what he likes and when he
+likes; and he chooses, as a rule, candy, cake, pastries,
+ice cream, tea, coffee. Indigestion follows, the child loses
+weight, is languid and listless and constipated.<span class='pagenum'><a name="Page_287" id="Page_287">[Pg 287]</a></span></p>
+
+<p>When finally the physician is called in he finds it
+necessary to go back to first principles. He lays down
+the law in a definite, stern way, and the mother and the
+child must obey. Most parents know and admit they
+are doing wrong to give in to a whimsical child, and
+if they would only make up their minds to conquer when
+conquering is easy they would save themselves many
+heartaches, many regrets, and the child much suffering
+and much possible permanent injury as a consequence.
+Usually one parent is willing to be master but the other
+lacks the mental equipment to meet the issue, and argues,
+as he or she imagines, in favor of the child. The parent
+whose instinct is correct, whose judgment is true, whose
+interpretation of the situation is just, should not be dissuaded,
+or argued away from his or her duty. If it is
+the first real problem in your domestic experience in
+which a decided stand must be made, make it without
+fear and without hesitation, and carry it through to the
+bitter end. Results will justify and vindicate you.</p>
+
+<p>The general treatment of these children will be found
+outlined in the following paragraph on Loss of Appetite.</p>
+
+<p><b>Loss of Appetite.</b>&mdash;If a child complains of not being
+hungry, and will not take enough food, and if this condition
+continues for some time, we must regard the
+matter as being abnormal and find the cause. This is
+necessary because a child must eat in order to maintain
+a certain standard of growth and vitality. These children
+are not sick; they are active and continue to play
+as usual and they sleep soundly, but they have no appetite.
+One of the most frequent causes of this condition
+is too frequent feedings. Some children are naturally
+small eaters. They thrive and maintain a satisfactory
+weight; their system seems not to demand large quantities
+or even ordinary quantities of food. Parents observe
+this habit of little eating and begin to coax and
+bribe the child to eat more at meal time, and to eat
+between meals. In this way the child really overeats,
+the appetite becomes capricious, and the stomach rebels.
+In a very short time the condition of "loss of appetite"
+is established as a consequence. Another cause is the<span class='pagenum'><a name="Page_288" id="Page_288">[Pg 288]</a></span>
+drinking of too much milk, and yet another and very
+common cause is indiscriminate eating of candy, cakes
+crackers, and fruit between meals. Children who are
+fed at the table with adults eat things they should not
+eat, and spoil their digestive organs and loss of appetite
+is the result. The Scotch custom of compelling children
+to eat at a separate table is an excellent one. They
+are not tempted to ask for things they cannot have. Lack
+of fresh air and exercise frequently results in impaired
+appetite.</p>
+
+<p><b>Treatment.</b>&mdash;The very first thing to do with these children
+is to stop any habit that may be responsible for
+the loss of appetite. If the child has been eating between
+meals, stop it absolutely. If too much milk has
+been taken, stop milk entirely. If the child has not
+been getting enough fresh air, or if it has been sleeping
+in a badly ventilated room, or if baths have been too infrequent,
+rectify the fault. If eating at the family table
+and fed indiscriminately, change the programme; feed
+him before the family sits down to meals. Now regulate
+the time of feeding to suit the age of the child and
+adhere to strict regularity. It is a pernicious and absolutely
+wrong custom to force children to eat, or to
+coax them to eat when they do not want to eat. Loss
+of appetite will never be cured by forced feeding, or
+by reducing the interval between feedings, or by giving
+the child stronger or more concentrated food under
+the mistaken idea that in this way the loss of appetite
+can be "made up." The interval of feeding should rather
+be lengthened than otherwise in order to give the digestive
+organs an opportunity to regain the normal desire
+for food. Pay strict attention to the bowels. Be certain
+the child has a daily satisfactory movement and that he
+drinks frequently between meals.</p>
+
+<p>If the child does not promptly respond to the proper
+hygienic and dietary treatment as outlined above there
+are two things that can be done:</p>
+
+<p>1st: Send the child away. A change of scene and
+climate will sometimes work like a charm in these cases,
+and will, after a reasonable length of time, establish a
+permanently good appetite.<span class='pagenum'><a name="Page_289" id="Page_289">[Pg 289]</a></span></p>
+
+<p>2nd: If this is not possible, as sometimes it may not
+be with poor patients, then we can give the child suitable
+tonics.</p>
+
+<p><b>Overeating.</b>&mdash;The large majority of individuals eat
+too much. Most of us would enjoy better health, better
+spirits, and greater efficiency if we consumed from one-third
+to one-half less food than we habitually do.</p>
+
+<p>Every living organism requires a certain amount of
+nourishment according to the work performed and to
+replenish wear and tear; when food is supplied in excess,
+the system cannot utilize it, but it is compelled to rid
+itself of the excess in some way. The work involved
+in this eliminating process is exceedingly detrimental to
+the various organs and to the individual. To overeat
+is to overwork, and to overwork a machine or an animal
+is not only poor economy but bad judgment. If the
+digestive apparatus is required to work overtime, it is
+a self-evident assumption that the various organs will
+not digest efficiently the food necessary for ordinary existence.
+If the necessary nourishment is not adequately
+digested, the general health will suffer as a consequence.
+If the general health is below standard the individual will
+not be competent to carry on the requirements of a normal,
+healthy life.</p>
+
+<p>We must, however, give some thought to the effect
+which the excess of food exerts upon the human machine.</p>
+
+<p>Nature provides and maintains a standard relationship
+between the capacity of the individual and his needs.
+A child has a digestive capacity to digest and assimilate
+a quantity of food sufficient for his growth and proper
+nourishment; an adult maintains the same standard according
+to his requirements. All the other organs are
+adjusted to harmonize with this scheme. If we overeat,
+the immediate result is to disorganize this relationship
+between the various organs; hence we have a multitude
+of effects which manifest themselves in various ways
+as a direct result of overeating. The combined general
+effect expresses itself in the form of what is regarded
+as poor health and a low standard of efficiency. When a
+larger quantity of food is taken into the stomach than<span class='pagenum'><a name="Page_290" id="Page_290">[Pg 290]</a></span>
+it can properly digest within a reasonable time, two
+conditions immediately follow. The stomach itself is
+dilated and the food is not thoroughly digested. If the
+habit is persisted in, indigestion, and later chronic gastritis
+ensues. The direct symptoms of these conditions
+are given in detail in another part of this book. Very
+few individuals, however, appreciate the indirect consequences
+of overeating and of indiscriminate eating on
+the general health. It is impossible to tabulate in so
+many words the effect which this habit has on efficiency
+and temperament. We read and hear a great deal to-day
+about efficiency. Now, an individual's efficiency
+is an expression of that individual's health standard or
+capacity. To be 100 per cent. efficient one must enjoy
+good health. It would be absurd to expect a high standard
+of efficiency from an individual with a low standard
+of health. Poor health means poor vitality. Vitality
+is the mark of the master. Without vitality one can
+never dominate. All the great achievements of the race
+have been consummated by those who conserved their
+vitality. No single factor contributes a larger percentage
+of inefficients and failures than overeating. The man
+or woman who, from habit or experience, has learned the
+lesson of right eating and living need not be lacking in
+efficiency, nor need they despair of the attainment of
+success.</p>
+
+<p><b>Symptoms of Overeating.</b>&mdash;Efficiency depends not
+only upon one's capacity to perform, but upon the character
+of the performance. The spirit must be willing
+to perform. The overeater is heavy, phlegmatic, indifferent,
+lacking in energy, tact and initiative. She is constantly
+subjecting her system to needless overwork;
+she is depressed, nervous, imaginative and she is not
+ambitious. She is a victim of self-poisoning, of constipation,
+indigestion, headaches, flatulency, neuralgia, vertigo,
+and melancholia. An overeater never enjoys good
+health, never is efficient, and cannot possibly be successful.</p>
+
+<p>To enjoy good health one should know how to select
+food and how to combine and proportion it. It has been
+said that the American people are a race of dyspeptics,<span class='pagenum'><a name="Page_291" id="Page_291">[Pg 291]</a></span>
+and it must be admitted that the assertion is more or less
+true. There are millions of people who suffer from
+indigestion in some degree, and it may justly be said
+that indigestion has its beginning in overeating, in some
+form. It may not be overeating in actual bulk, but it
+is overeating some article or articles that do not agree
+with the individual, and the fact that certain articles
+do not agree is unquestionably dependent upon the
+nervous temperament of the American people&mdash;and the
+temperament of a people is a product of the kind of
+existence the people subject themselves to. We are,
+therefore, unwittingly, victims of our environment.</p>
+
+<p>Correct eating means simple eating&mdash;only a few things
+at a time. Food should be selected according to one's
+age and occupation, and according to the season of the
+year. To eat habitually large quantities and at the same
+time a large variety is suicide pure and simple. If one
+dared to make the experiment of cutting down one's diet
+one-half, it is absolutely certain the effect would be immediate
+benefit. The benefit would not only be manifest
+in the physical betterment, but the efficiency and general
+well-being would be greatly enhanced. It is not
+the kind of food that makes a dyspeptic, but the quantity.
+A well person need not consider whether a certain kind
+of food will or will not agree, providing she does not
+eat too freely of that food, or combine it with other food.
+The combination of which may in itself form too much
+of one kind at a time.</p>
+
+<p>Some people imagine, for example, that oatmeal porridge
+does not agree with them. When the matter is
+inquired into, however, it is found that they habitually
+eat bread, eggs, and other articles, with coffee at the
+the same meal with the porridge. From this combination
+they experience distress and blame the porridge. If these
+would take a plate of oatmeal porridge with
+cream and salt, and some stewed fruit for breakfast
+they would not experience any trouble, and this would
+be an ample meal for the ordinary individual. It is not
+the porridge, but the unsuitable combination, that is at
+fault. The same may be said of milk. Many people state
+that they cannot take milk and they deprive themselves<span class='pagenum'><a name="Page_292" id="Page_292">[Pg 292]</a></span>
+of one of the very best articles of diet because of this
+idea. There are very few people in the world who cannot
+take milk in some way. It is not the milk that is
+at fault; it is the combination of it with other less nutritious
+articles that is the cause of the distress. Even
+candy is responsible for thousands of cases of indigestion.
+Anyone may safely take a reasonable quantity of good
+candy, but if it is taken at a wrong time, or combined
+with other articles, it may readily produce indigestion.</p>
+
+<p>Indiscriminate eating and overeating are prolific causes
+of rheumatism, kidney disease, heart disease, liver
+troubles, obesity, arteriosclerosis, and apoplexy. These
+diseases are notoriously on the increase and must be
+construed as a direct consequence of the tendency of the
+American people to overeat and to eat indiscriminately.</p>
+
+<p><b>Bran as a Food.</b>&mdash;In the chapter on constipation there
+may be found a formula for making bran muffins. These
+muffins are invaluable to children in health, and to the
+victim of indigestion or constipation, whether child or
+adult. One muffin with each meal will solve the problem
+of constipation in growing children without the use
+of drugs or other aid. They will regulate the bowels
+of adults in many instances without resorting to drugs.</p>
+
+<p>Raw fruit in season, or stewed fruit, or a baked apple,
+with a light boiled egg and one bran muffin, is an ample
+and a nourishing breakfast for a child at school.</p>
+
+<p>For lunch the same child should have a plate of thoroughly
+done vegetable soup, a bran muffin, and more
+fruit. After school, a glass of milk with two or three
+Graham wafers may be given.</p>
+
+<p>For dinner the child at school may have a mixed meal.
+This meal should not be later than six-thirty o'clock
+and the child should retire at eight-thirty at the latest.
+A bran muffin should be taken with this meal unless the
+child's bowels are too loose.</p>
+
+<p>Mothers should insist on their children eating these
+muffins. If a child eats only what it likes it will not
+eat what is good for it. If the mother insists in the right
+way she will win; if she does not the child will win.
+If the child wins, the mother is the wrong kind of mother.
+I do not know of any other single article of diet that<span class='pagenum'><a name="Page_293" id="Page_293">[Pg 293]</a></span>
+is of such value to growing children as these bran muffins.
+Children who eat them regularly will have less sickness
+than other children; they will be strong, healthy and full
+of energy. The bran in itself is not responsible for this
+list of excellent acquirements, but the regular eating of
+the bran is. Most ailments of children are of gastro-intestinal
+origin; bran keeps the entire length of the
+gastro-intestinal tract sweet and clean; if the child eats
+a bran muffin with each meal it will not have much desire
+or much room for any other form of bread or pastry.
+If white bread or pastry is abstained from the child
+will not have indigestion, or constipation, and hence it
+will not be constantly poisoning itself as most children
+do whose diet is not restricted and whose bowels are
+more or less constipated.</p>
+
+<p>These muffins should be made of the ordinary unsifted
+bran. If this is not procurable the sifted bran (Johnstone's)
+may be employed. This bran may be bought in
+any good grocery.</p>
+
+<p>Modern milling methods, modern cookery, and modern
+methods of forced farming, have each contributed their
+share of rendering food inert and frequently deleterious.
+The miller has extracted the coarse cellulose from the
+various flours in the effort to manufacture a product
+suitable to the super-civilized public demand. This cellulose
+is absolutely essential to gastric and intestinal
+digestion, and if children are deprived of it constipation
+and indigestion are the natural result. Forced farming
+accomplishes the same effect&mdash;the fiber of the vegetable
+is deficient. Bran is rich in mineral salts, iron, protein,
+and phosphates, and gives to growing children the ingredients
+which ordinary food is deficient in. Bran
+prevents intestinal fermentation and children who eat
+it are free from intestinal gas and putrefaction. It harmonizes
+chemically with all other foods. Children
+should be made to take it every day as a matter of self-preservation
+and of duty.</p>
+
+<p><b>Hysterical Children.</b>&mdash;Hysteria is not a disease of infancy
+or of young children. It is seen as a rule after
+the eight year. Male as well as female children may
+be the victims to an equal degree. It is much more<span class='pagenum'><a name="Page_294" id="Page_294">[Pg 294]</a></span>
+frequently seen in the offspring of parents who are
+themselves nervous, or alcoholic, or who suffer from
+insanity, or have insanity in the family history. If these
+children in addition to the hereditary influence suffer
+from stomach or intestinal disease, or general poor health
+and are overworked at school, they are very apt to become
+hysterical.</p>
+
+<p>They are capricious, indifferent, and excitable. Their
+disposition is irritable; they frequently exhibit fits of
+great excitability of temper and passion. They cry or
+weep without cause. They often have hallucinations and
+while asleep have attacks resembling night terrors. They
+complain of pains in the joints, and are frequently treated
+for disease that does not exist. Such condition as hysterical
+cough, spasm of the muscles of the face, mouth,
+eyes, and of the neck exist and are difficult to diagnose
+from real disease. These children complain of painful
+sensations and sensitive areas and exaggerate all symptoms
+unnecessarily.</p>
+
+<p>The possibility of curing these patients is good, providing
+the treatment is faithfully carried out. It is less
+favorable when marked hereditary influences are strong.</p>
+
+<p><b>Treatment.</b>&mdash;In all children of distinctly nervous type
+and especially those of nervous parents, the first essential
+duty is to develop their muscular system. Try in
+every way to make healthy animals of them. Attention
+and treatment should not be directed toward the nervous
+system. If the child is made strong by out-door life,
+good plain, digestible food, early hours, regular sleep
+in thoroughly aired rooms, regular bathing, and if the
+school work is conducted with moderation and judgment,
+the nerves and the nervous temperament will participate
+in the healthy growth which will follow as a
+result. Tea and coffee should be forbidden. Exciting
+books and questionable entertainment as given in picture
+shows and theaters must not be allowed. If older members
+of the family, or parents, are excitable and nervous
+the children should be sent away to the country from
+them.</p>
+
+<p>They should be put in charge of a person who will
+exercise firm control over them. It may be necessary<span class='pagenum'><a name="Page_295" id="Page_295">[Pg 295]</a></span>
+to take these patients away from other children, and isolate
+them under proper control until they are able to
+control themselves. They should be interested in exercise
+that compels them to work; they should live and if convenient
+sleep out of doors; and they should take iron or
+cod liver oil, or any other indicated tonic. If they complain
+of pain they should receive cold-water douches, or
+the cold pack, or the shower bath; and they should be
+put to bed and treated firmly but kindly. Attention to
+the bowels is always essential, because these children
+are as a rule the victims of chronic constipation.</p>
+
+<p><b>What a Mother Should Know About Cathartics and
+How to Give a Child a Dose of Castor Oil.</b>&mdash;Broadly
+speaking there are three kinds of cathartics. I
+will, in a simple way, explain their action so that a
+mother may know which one to select under certain circumstances.
+Frequently a mother is told by her physician
+to "keep the bowels of her child open." Few
+mothers know how to keep the bowels open, and as this
+is an important matter, every mother should know the
+reason why "any" laxative or cathartic is not always
+suitable.</p>
+
+<p><b>Castor Oil.</b>&mdash;This is one of the oldest and one of the
+best cathartics we possess for children. It is a mechanical
+cathartic; it acts in exactly the same way as a street-cleaning
+machine. It cleans the street by sweeping or
+pushing everything before it.</p>
+
+<p><b>Calomel</b>&mdash;This is a chemical cathartic. It acts through
+the blood. When it is absorbed by the blood its chemical
+ingredients act on certain nerves as irritants. These
+nerves excite the liver and bowel to action and an evacuation
+is the result.</p>
+
+<p><b>Citrate of Magnesia.</b>&mdash;This is a saline laxative. It
+acts by drawing out of the bowel wall enough liquid
+from the blood to sweep the contents out. It may be
+likened to the street cleaner who flushes and cleans the
+street by means of a hose pipe attached to the water
+hydrant.</p>
+
+<p>Under what condition should a mother use these remedies?
+Castor oil is ordinarily the best cathartic in childhood;
+it is not, however, always the best. Most ailments<span class='pagenum'><a name="Page_296" id="Page_296">[Pg 296]</a></span>
+of children are of gastro-intestinal origin&mdash;they have
+either overeaten or they have eaten the wrong kind of
+food. The stomach and bowel are overloaded: they must
+be cleaned out. We want a mechanical cathartic, one
+that will push everything ahead of it, so we use castor
+oil. When a child needs a cleaning out, use castor oil.
+By a "cleaning out" we mean, when we know he has
+eaten too much of a questionable variety of food, as pastries,
+cakes, fruit, ice cream, etc., as children do at parties;
+or when he has eaten unripe fruit, as green apples, etc.;
+or when for some reason he is constipated and complains
+of not feeling well, use castor oil.</p>
+
+<p>If you decide to use castor oil, use enough. A large
+dose will act promptly and with less pain and with more
+certain results than a small dose.</p>
+
+<p>It is always safe and it is always best to decide upon
+castor oil as the proper remedy, if the child has no fever.
+If he has a fever he will most likely vomit castor oil
+when another kind of cathartic would stay on the stomach.</p>
+
+<p>Castor oil works more effectively, more thoroughly,
+and is less likely to be vomited if given on an empty
+stomach, so we give it two hours after eating and we
+give no food for two hours after it is taken.</p>
+
+<p>Castor oil is distinctly of advantage in many chronic
+diseases of the intestines because of its healing properties.
+In chronic colitis, for example, when the child is suffering
+with malnutrition, irregular bowel action with an
+odor, and mucous or bloody stools, a combination of
+castor oil and salol, in emulsion, in small doses,&mdash;to which
+a small quantity of opium may be added or withheld
+according to the frequency of the movements,&mdash;with an
+occasional colon irrigation, is sometimes invaluable.</p>
+
+<p>Mothers must remember that castor oil is not good
+in the treatment of constipation, because its after effect
+is to constipate, consequently we would not use it "to
+keep the bowels open,"&mdash;it is only of use to clean the
+bowel out thoroughly when that is indicated.</p>
+
+<p><b>How to Give a Dose of Castor Oil</b>&mdash;The best way to
+give a child castor oil is as follows: Place the bottle
+containing the oil on its side on a piece of ice in the ice
+box; chill it thoroughly. Take a tablespoon and smear<span class='pagenum'><a name="Page_297" id="Page_297">[Pg 297]</a></span>
+it with butter; pour the ice cold oil into the spoon; it
+will stick together like a piece of chewing gum and
+it will slide out of the buttered spoon in one lump.
+In this way it will not spread over the mouth and teeth
+and throat, leaving a bad taste, but will go straight and
+surely into the stomach. The child cannot swallow some
+and retain enough in the mouth to sputter it all over itself
+and only get half a dose; it will not nauseate it, because it
+practically is tasteless if given cold, and the stomach will
+tolerate the cold oil much better than when given in the
+ordinary way.</p>
+
+<p>A baby can be given oil in the same way, but in smaller
+doses. When the teaspoon is put into the mouth of a baby
+it should be immediately turned on its side so that it will
+keep the mouth open. If the nose is held closed and the
+mouth wide open for a few seconds the baby cannot spit
+the oil out&mdash;it must swallow, and if the oil sticks together
+as cold oil will, it gets the whole dose. It usually takes
+two persons to give a baby a dose of oil&mdash;one to open the
+mouth and give the medicine, the other to hold the nose
+and arms.</p>
+
+<p><b>Calomel.</b>&mdash;The general indication for calomel is fever.
+When a child develops a disease it immediately gets a
+temperature, and very frequently the fever is quite high
+because the slightest ailment gives a child fever. When
+fever begins, digestion practically stops, it is therefore
+imperative to clean the whole gastro-intestinal canal;
+otherwise the undigested material will putrefy and poison
+the entire system and render the disease more serious
+than it need be.</p>
+
+<p>Now we select in such conditions calomel for two
+reasons:</p>
+
+<p>First, because the presence of fever indicates that infection
+of the blood is taking place; this may come either
+from the intestinal canal itself, or from the germs of the
+disease with which the child is suffering. Since calomel
+acts chemically through the blood it is the cathartic
+indicated.</p>
+
+<p>Second, because a cathartic like castor oil does not
+act through the blood and it would most likely be vomited
+by a fevered stomach.<span class='pagenum'><a name="Page_298" id="Page_298">[Pg 298]</a></span></p>
+
+<p>Certain conditions indicate calomel; biliousness and
+jaundice, for example, because it has a specific action
+on the liver and if the liver is at fault calomel is the
+proper remedy.</p>
+
+<p>Calomel is best given in small divided doses, 1-10 of
+a grain every half hour, for ten doses. It is best given
+combined with soda; every drug store carries tablets of
+calomel and soda for this reason.</p>
+
+<p>Calomel should never be given in the treatment of
+constipation, nor should it be used indiscriminately by
+mothers, as much harm may result. It has its specific
+use as indicated above, but it should never be used
+under any other circumstances.</p>
+
+<p><b>Citrate of Magnesia.</b>&mdash;This is a mild laxative. After
+the bowels have been thoroughly opened with castor oil
+or calomel, small doses of citrate of magnesia may be
+given for a few days, "to keep the bowels open." There
+is no danger or harm in its use if used for this purpose.
+It must not be used, however, in the treatment of constipation
+of children for the simple reason that you cannot
+cure constipation by the use of drugs of any kind.
+Laxatives of this type have become a national curse.
+Adults, especially women, use them constantly. All
+these advertised saline laxative waters work by weakening
+the blood&mdash;when a dose is taken the chemicals in it
+draw through the bowel wall blood serum, and produce,
+because of the excess of this watery fluid, large, and
+frequently many, liquid movements.</p>
+
+<p>If this practice is continued, as it often is every day,
+the quality of the blood will suffer seriously, and many
+individuals are the victims of neuralgic pains, headaches,
+nervousness, insomnia, anemia, and general broken health
+as a direct consequence of this pernicious habit.</p>
+
+<p>Mothers will try to remember, therefore, that drugs
+and saline waters have no place in the treatment of
+constipation in children or themselves. Constipation must
+be treated by diet, exercise regular living and by the
+observance of hygienic and sanitary common-sense
+rules.<span class='pagenum'><a name="Page_299" id="Page_299">[Pg 299]</a></span></p>
+
+
+<h4>VACCINATION</h4>
+
+<p><b>Time for Vaccination.</b>&mdash;The best time to vaccinate a
+child is during the first three months if he is healthy.
+The reason for selecting so early a period is because
+the constitutional disturbances are much less at this time
+than in later childhood. It should not be done during
+active dentition. If the child is delicate if his nutrition
+is bad it should be deferred until a later time. Children
+suffering from eczema or from any skin disease or those
+syphilitic should not be vaccinated until it is compulsory,
+or until exposed to small-pox.</p>
+
+<p><b>Methods of Vaccinating.</b>&mdash;It is customary in America
+to vaccinate at one point rather than to make a number
+of inoculations as is the custom in some other countries.
+The leg or the arm is the usual location selected. In
+infants the sore can be protected better on the leg; in
+children of the run-about age, the arm is the better location
+because it can be kept at rest easier.</p>
+
+<p>Before vaccinating the skin should be rendered surgically
+clean; this can be done by washing with soap and
+water, drying and then rubbing with alcohol. The wound
+should be left uncovered for about twenty minutes to
+dry, it may then be covered with a bandage, or with a
+vaccine shield. The part should not be washed for
+twenty-four hours.</p>
+
+<p><b>The Symptoms of Successful Vaccination.</b>&mdash;Nothing
+is noticed until the third or fourth day, when a red
+papule appears. In the course of the following day a
+vesicle appears; this vesicle enlarges until it reaches its
+full development on the ninth day. The size of the vesicle
+is about one-half inch in diameter; it is surrounded with
+a reddish inflammatory area for about two inches. The
+vesicle begins to dry and is shortly a dark crust which
+remains from one to three weeks and then falls off.
+It leaves a bluish scar which soon turns white and the
+part is roughened and honeycombed. During the period
+when the vaccination is at its height the child suffers
+from fever and irritability and loss of appetite.</p>
+
+<p>If vaccination does not "take" in an infant it should
+be done two or three times and if then unsuccessful it<span class='pagenum'><a name="Page_300" id="Page_300">[Pg 300]</a></span>
+should be repeated every year until it takes. The fact
+that vaccination does not take does not imply that the
+child would not take small-pox but rather that the vaccine
+used is not suitable. There are some children, however,
+who seem to be immune to vaccination.</p>
+
+<p>Sometimes the symptoms are more severe than those
+enumerated; this seems to depend upon the susceptibility
+of the child. The vesicle may be much larger and the
+area of inflammation much more dense and angry. The
+fever may be higher and may last longer; there may be
+a general rash and the degree of depression more profound.
+Vesicles may be produced on other parts of the
+body as a result of scratching. Mothers must always
+remember that vaccination is a surgical wound to begin
+with and that it is capable of infection in the same way
+as are other wounds, and that any result coming from
+such an infection is not due to the vaccine or to the
+process of vaccination, but to the infection. Many people
+get unjust ideas about vaccination from just such cases.
+If the mother is not cleanly or neglects the vaccinated
+area and permits it to become infected she must not
+and others should not decry vaccination as a consequence.
+Anyone who doubts the virtue of vaccination is condemning
+himself; he is simply ignorant of the accumulation
+of evidence in favor of it and assumes a position
+without any possible justification. The mortality of vaccination
+is stated by Voigt from statistics to be 35 in
+2,275,000 cases. In fact, all the deaths are from causes
+which are preventable and no doubt the result of direct
+carelessness on the part of the operator or the mother.</p>
+
+<p><b>Treatment.</b>&mdash;The mother must understand in what
+way she may contribute to the successful termination of
+a case of vaccination. She should see that the part upon
+which the child is to be vaccinated is absolutely clean
+so far as she can make it with soap and water. She
+should see that the part is allowed to dry thoroughly
+after vaccination. She should not wash the part for at
+least twenty-four hours. If a vaccine shield is put on
+she should not disturb it. If the mother is prepared
+to do her part faithfully a vaccine shield is not necessary
+from a medical standpoint and in some cases it is<span class='pagenum'><a name="Page_301" id="Page_301">[Pg 301]</a></span>
+objectionable. A simple, clean bandage is all that is necessary.
+It is very important that the child be kept from
+scratching the part; most of the troubles of vaccination
+come from this habit. It is desirable that the limb
+should be kept at rest during the stage when the process
+is at its height. If the vesicle discharges it is necessary
+that the area should be kept clean and dusted with boracic
+acid. If the wound becomes infected it must be treated
+by a physician. The mother must not resort to home
+remedies in such cases unless she is prepared to take the
+consequences, which may be serious.</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_303" id="Page_303">[Pg 303]</a></span></p>
+<h2>CHAPTER XXII</h2>
+
+<h3>CONSTIPATION IN INFANTS AND CHILDREN</h3>
+
+<div class="blockquot"><p>"It is a greater disgrace to be sick than to be in the penitentiary.
+When you are arrested it is because you have
+broken a man-made statute, but when you are ill, it is because
+you have disobeyed one of God's laws."</p></div>
+
+<div class="blockquot"><p>Constipation&mdash;Regularity of Bowel Function&mdash;The Function
+of the Stomach&mdash;Fermentation&mdash;Incomplete Constipation&mdash;Importance
+of a Clean Bowel&mdash;A Daily Movement
+of the Bowel Necessary&mdash;Constipation in Breast-Fed Infants&mdash;Treatment
+of Constipation in Breast-Fed Infants&mdash;Constipation
+in Bottle-Fed Infants&mdash;Treatment of Constipation
+in Bottle-Fed Infants&mdash;Constipation in Children
+Over Two Years of Age&mdash;Diet List for Constipation
+in Children&mdash;Bran Muffins in Constipation&mdash;Treatment
+of Obstinate Constipation&mdash;Oil Injections in Constipation.</p></div>
+
+
+<h4>CONSTIPATION. REGULARITY OF BOWEL
+FUNCTION</h4>
+
+<p>The most frequent cause of ill health and inefficiency
+in the human race is inattention to regulation of the bowel
+function. Good health depends upon many causes of
+which good blood is an absolutely necessary requisite.
+Good blood depends upon what feeds and sustains it.
+There are other contributing factors, such as the proper
+kind of exercise, the proper amount and quality of fresh
+air, the method of living, etc., but these are all food
+in a sense. The food we take in is acted upon by the
+various digestive juices until everything is extracted from
+it that contributes to the building up of the body. Whatever
+is left, whatever the body does not want, is immediately,
+or within a reasonable time, passed out in the
+form of a movement of the bowels.</p>
+
+<p>If any part of the digestive function is deficient, impaired
+health, or mental and physical inefficiency expressed
+in the form of indigestion, is the result. If<span class='pagenum'><a name="Page_304" id="Page_304">[Pg 304]</a></span>
+the bowel is at fault, constipation is the usual consequence.
+A perfectly healthy living machine must maintain
+a perfect digestion and regular bowel movements.</p>
+
+<p><b>The Function of the Stomach</b> is to mix and churn
+the food, and to add certain ingredients to the mixture
+so that before it is carried into the intestines it is (as
+far as it is the stomach's duty to render it) ready to be
+absorbed into the system. Before it reaches that part
+of the intestine which absorbs, it is acted upon again and
+certain other ingredients are added to it by certain other
+digestive organs. In time it is in shape to be used and
+it is sent along on its way. As it passes onward the little
+sucking glands in the wall of the bowel suck up all the
+liquid element in the mass of food. The liquid element in
+the mass is the food itself, rendered liquid by the stomach
+and other digestive organs and juices. The remaining
+solid mass is that part of the food which the body cannot
+use and does not want. By the time the liquid element
+is absorbed, the solid mass (always kept moving
+by the bowel wall) has reached the rectum, ready to be
+passed out at once, or very soon, provided&mdash;and upon
+this provision depends the success of the entire process,&mdash;it
+has all been done within a certain time. If the stomach
+takes too long to do its work we have indigestion. If
+the bowel takes too long to do its work we have constipation.</p>
+
+<p><b>Fermentation.</b>&mdash;Now let us consider the matter from
+another standpoint. If food stays too long in the stomach
+it begins to ferment. When anything ferments it makes
+and evolves gas. You, no doubt, have noticed many
+times how the cork pops out of a bottle if its contents
+are "working," or fermenting. If you watch that bottle
+you will notice that it is quietly or actively evolving air
+bubbles. That is gas,&mdash;gas manufactured by the process
+of fermentation. This is exactly the process that goes on
+in the stomach or bowel of a dyspeptic, and it is this collection
+of foul, poisonous gas that causes the distress and
+bloated feeling which every dyspeptic suffers from after
+eating,&mdash;if it is this "flatulent" type of indigestion which
+is present.</p>
+
+<p><b>The Significance of Constipation.</b>&mdash;If the food takes<span class='pagenum'><a name="Page_305" id="Page_305">[Pg 305]</a></span>
+too long to pass through the bowel it causes, as we have
+stated, constipation. What is the real significance of
+constipation? It means that in passing through the bowel
+the food has given up all its liquid element (which is all
+its nourishing element), but the bowel has been too slow
+in passing it along. Consequently it is not ready to be
+expelled while it is yet a harmless semi-solid mass. It
+stays in the bowel too long&mdash;it begins to putrefy, bacteria
+attack it, and it is soon a semi-liquid, foul, rotting mass.
+The sucking glands in the intestinal wall continue to
+suck&mdash;that is their duty. They cannot discriminate between
+what is good and what is bad&mdash;they simply go on
+absorbing whatever is there to absorb. So there are
+absorbed into the system liquid and gaseous products
+which are poison.</p>
+
+<p>This process has been called by a number of names;
+"self-poisoning" explains the condition thoroughly. The
+other names are, auto-infection, auto-intoxication, enteric-infection,
+enteric-toxemia, intestinal indigestion.</p>
+
+<p>The condition is a serious one, because it is absolutely
+impossible to feel well, or to enjoy good health, while it
+lasts. The feeling of being constantly sick, yet not sick
+enough to stop working or to demand a radical cure, affects
+a woman's efficiency, interferes with her capacity
+to work, her ability to render the home an abode of contentment,
+to be an agreeable companion, or to adequately
+take care of her children.</p>
+
+<p>The constant absorption of intestinal poisons affects
+the system itself,&mdash;the symptoms are headache, neuralgia,
+loss of appetite, nervousness, insomnia, vertigo, inability
+to concentrate, lassitude, indigestion. The condition
+which we name constipation is therefore one of supreme
+importance. From a medical standpoint, it is the biggest
+problem in the whole realm of disease. It is the most
+significant hygienic function of life, and it is becoming
+more and more important, and more and more a problem.
+Every modern factor upon which physical efficiency seems
+to depend is an enemy to the systematic regulation of
+this function. Our method of hurried and indiscriminate
+eating, our system of strenuous living, our unsanitary environment,
+our business activity, our method of pursuing<span class='pagenum'><a name="Page_306" id="Page_306">[Pg 306]</a></span>
+pleasure, take no account of, and resent the time devoted
+to cultivating, as a hygienic necessity, this toilet requirement.
+This imperative call of nature is pushed aside by
+the child at play, by the housewife for a duty which could
+wait, by the merchant for an engagement. It is particularly
+an American disease, and it is uniquely an American
+woman's affliction. It is a curious commentary on the
+intelligence of the American people, who are ordinarily
+alert and analytical, to realize how few of them really
+know how serious a matter constipation is. They don't
+know because they have given the matter absolutely no
+thought. They have accepted it as a mere matter of
+fact, almost of fate.</p>
+
+<p><b>Incomplete Constipation.</b>&mdash;There is a type of constipation
+that is not known to the average person and not
+well understood by those few who know of its existence.
+In this form of constipation there is a daily bowel movement
+but the movement is not complete. The bowel does
+not thoroughly empty itself; it has established this habit
+because of conditions under which it has had to do its
+work. If a woman neglects herself, becomes muscularly
+inactive, does not take proper out-door exercise, grows fat
+and lazy, eats irregularly and indiscriminately,&mdash;the bowel
+suffers with the rest of the system. The woman may
+have a healthy appetite, may eat the wrong things at
+the wrong time, yet the bowel is supposed to go on acting
+rightly, but it does not. It, too, becomes lazy and acquires
+bad habits, and this form of incomplete constipation
+is the result. These patients look healthy and get
+little sympathy for any pains they may have. They may
+even gain in weight; they get headaches once in a while,
+and if they go shopping or visiting they don't feel quite
+well afterward. They are suffering from the effects of
+chronic constipation, though their bowels are apparently
+regular. They are marching onward toward apoplexy
+or Bright's disease of the kidney.</p>
+
+<p><b>Importance of a Clean Bowel.</b>&mdash;Every mother, sooner
+or later, observes that a physician always thoroughly
+cleans out the bowel of a sick child at once, no matter
+what the character of the sickness is. He does this for
+two reasons,&mdash;first, because he knows that the great<span class='pagenum'><a name="Page_307" id="Page_307">[Pg 307]</a></span>
+majority of children's ailments are of gastro-intestinal
+origin; second, if the origin of the disease is not in the
+stomach or bowels, experience has taught him that if
+the bowels are clean at the beginning of a disease, that
+disease will run a milder and shorter course than if
+complicated with a condition of self-poisoning. If a
+child develops fever the digestive function stops; whatever
+food is in the stomach or bowel will promptly
+ferment and putrefy because of the abnormal heat caused
+by the fever and the arrested digestion. If this is not
+cleaned out at once the self-poisoning process begins.</p>
+
+<p>The above is a suggestive admission for a physician
+to make. It simply means that the vast majority of the
+calls made by a physician on ailing children are caused
+by errors in diet and can be completely cured by a dose of
+castor oil or calomel, or, better still, need never occur.</p>
+
+<p>A mother who neglects, who is guilty of inattention to
+the conditions of her child's bowel, fails in one of the
+most important duties of motherhood. I know as a father
+and a physician that if a child's bowel acts regularly and
+thoroughly, that child is fortified to the highest efficient
+degree against the multitude of little ailments common
+to all children. A clean bowel means good blood, good
+digestion, ability to exercise properly, to sleep soundly
+and to think clearly. Such a child will resist infection
+and throw off the minor troubles that pave the way for
+serious sickness. It is a secret worth knowing.</p>
+
+<p><b>A Daily Movement of the Bowel Necessary.</b>&mdash;In
+order to preserve good health one thorough movement of
+the bowel is necessary daily. A baby may have two or
+three and enjoy robust health. A larger daily number
+suggests an abnormal condition of the bowel and an investigation
+should be made. If a nursing baby's bowels
+do not move before bedtime it should be given an injection
+of equal parts of glycerine and hot water, one-half
+cupful; or an enema of soap and water, or a glycerine
+suppository. When a child is six months old, in some
+sooner, it should be put on the stool at a certain time
+every morning. This will aid in the establishment of the
+habit, as a child soon understands why it is made to assume
+this position and acts accordingly.<span class='pagenum'><a name="Page_308" id="Page_308">[Pg 308]</a></span></p>
+
+<p>The condition referred to above and which we termed
+incomplete constipation may affect the nursing infant.
+A child's bowels may move daily and yet the child will
+suffer from constipation. If the movements are watched
+it will be observed that certain children strain when at
+stool, and after a time succeed in passing hard, dry lumps
+or balls of fecal matter. Such a movement is a certain
+indication that the bowel is not emptying itself satisfactorily
+and that a constant toxemia or poisoning is
+going on. Very faithful efforts should be made to
+remedy this condition by the use of articles of diet that
+are known to be laxative, otherwise the condition is one
+that will "grow" with the child and establish an obstinate
+chronic constipation with all its miseries and dangers.</p>
+
+<p><b>Constipation in Breast-Fed Infants.</b>&mdash;Many nursing
+infants thrive and gain in weight, yet they are constipated.
+Before you drug your baby be sure the fault is not your
+own. Many mothers are responsible for the constipation
+with which baby suffers. If the mother is constipated,
+so will the child be. Cure the constipation of the mother
+and the baby's bowels will regulate themselves. Nursing
+mothers who are large tea-drinkers have irregular bowels
+as a rule. A baby whose mother is lazy or indolent, who
+does not take a reasonable amount of exercise, whose diet
+is faulty and whose hours are bad, is a sufferer from
+constipation. The mother's life must be regulated, her
+diet and habits corrected, and the instructions carried out
+as already recommended. The breast milk should
+be examined and if any cause for constipation exists in
+it, it should be rectified as suggested elsewhere.</p>
+
+<p>If it is thought advisable to resort to drugs for the
+immediate relief of the constipation of infants, the best
+ones are the aromatic fluid extract of cascara sagrada;
+milk of magnesia with equal parts of the aromatic syrup
+of rhubarb given in doses of one to three teaspoonfuls
+daily.</p>
+
+<p>Irrigations, enemas, and suppositories should not be
+used continuously. The habit is a bad one. The parts
+become accustomed to their use and fail to act. If
+the child is passing dry and hard stools it is of advantage
+to inject two ounces of warm sweet oil at night, allowing<span class='pagenum'><a name="Page_309" id="Page_309">[Pg 309]</a></span>
+it to remain in the bowel until the following morning.
+See page 312.</p>
+
+<p><b>Constipation in Bottle-Fed Infants.</b>&mdash;It is much
+easier to treat the constipation of bottle-fed babies than
+of those breast-fed, because the food can be changed to
+ensure regular bowel movements. The first change to
+be made in a bottle-fed baby who is habitually constipated
+is to add more cream to the food. The way to do
+this is to take out of the bottle of each feeding one tablespoonful
+of the food and put in its place one tablespoonful
+pure cream. If this change partly rectifies the bowel
+ailment, add more cream until the bowels are of the
+proper consistency. Milk given constipated babies should
+be raw, never boiled, as boiled milk will always aggravate
+the trouble.</p>
+
+<p>The use of oatmeal water instead of plain water in
+making the baby's food may cure the bowel trouble.
+Taking the sugar of milk out of the baby's food and
+putting in its place the same quantity of Mellin's food
+will sometimes cure the constipation.</p>
+
+<p>One or two teaspoonfuls of milk of magnesia put into
+one feeding daily, or fifteen drops to one tablespoonful
+of the aromatic fluid extract of cascara sagrada will move
+the bowels. Orange juice, strained, two teaspoonfuls
+twice daily, is an excellent remedy and should be tried
+in every case. Sweet oil and pure cod liver oil, in doses
+of thirty drops to two teaspoonfuls three times daily
+after feedings, if the little patient is poorly nourished.
+If the stools remain hard and dry, an injection of two
+ounces of warm sweet oil at bedtime is an excellent
+method of aiding the bowel. The oil should remain in
+the bowel all night. This lubricates the parts, softens
+the fecal mass and stimulates the gut to perform its own
+work. See page 312.</p>
+
+<p><b>Constipation in Children Over Two Years of Age.</b>&mdash;Most
+children when put upon a varied diet after the
+nursing days are over are relieved of any constipation
+which may have existed up to that time. There are a
+few, however, whose condition does not seem to improve.
+These children need attention. We should first insist
+on regular habits. A child should be told that its<span class='pagenum'><a name="Page_310" id="Page_310">[Pg 310]</a></span>
+bowels must move every morning after breakfast. If
+this is absolutely insisted upon the child will soon recognize
+the uselessness of fighting the proposition and
+submit. If at any time a conscientious effort is made
+to move the bowel without result after fifteen minutes
+it is wise to use a glycerine suppository so that the bowel
+will empty itself.</p>
+
+<p>It has been stated in another part of this book that
+there are children with whom milk does not agree. Experience
+has taught us that milk, especially milk that
+has been boiled, causes more cases of constipation in
+growing children than all other causes combined. Find
+out if it is milk that is the cause in any individual case.
+While these children cannot take whole milk just as
+it comes from the dairy without suffering in a great
+many ways, they can take milk and water, or milk and
+oatmeal water, prepared in the following way, without
+becoming constipated. A bottle of fresh milk is allowed
+to stand in a cool place for five hours, when the
+top ten ounces are skimmed off with a Chapin dipper
+and mixed with twelve ounces of oatmeal gruel or plain
+water. This can be used as a drink.</p>
+
+<p>Parents can select from the following list of articles
+such combinations as may be suitable to constitute the
+regular meals of a constipated child:</p>
+
+<div class="poem"><div class="stanza">
+<span class="i0">Lamb chops.<br /></span>
+<span class="i0">Rare steak.<br /></span>
+<span class="i0">Rare roast beef.<br /></span>
+<span class="i0">Hashed chicken.<br /></span>
+<span class="i0">Soft boiled eggs.<br /></span>
+<span class="i0">Cracked wheat.<br /></span>
+<span class="i0">Hominy.<br /></span>
+<span class="i0">Cornmeal.<br /></span>
+<span class="i0">Oatmeal, Scotch.<br /></span>
+<span class="i0">Bran biscuits.<br /></span>
+<span class="i0">Oatmeal crackers.<br /></span>
+<span class="i0">Graham wafers.<br /></span>
+<span class="i0">Stewed or baked apple.<br /></span>
+<span class="i0">Apple sauce.<br /></span>
+<span class="i0">Plain vanilla ice cream.<br /></span>
+<span class="i0">Animal broths, pur&eacute;es of peas.<br /></span>
+<span class="i0">Beans, and lentils.<br /></span>
+<span class="i0">Peas.<br /></span>
+<span class="i0">String beans.<br /></span>
+<span class="i0">Spinach.<br /></span>
+<span class="i0">Cauliflower.<br /></span>
+<span class="i0">Asparagus.<br /></span>
+<span class="i0">Stewed tomatoes, strained.<br /></span>
+<span class="i0">Whole wheat bread.<br /></span>
+<span class="i0">Zwieback.<br /></span>
+<span class="i0">Custard.<br /></span>
+<span class="i0">Stewed prunes.<br /></span>
+<span class="i0">Junket.<br /></span>
+<span class="i0">Cornstarch.<br /></span>
+</div></div>
+
+<p>Malted milk is agreeable and advisable as a drink.</p>
+
+<p>Orange juice or a scraped raw apple is allowable
+at this time. Constipated children should eat plenty<span class='pagenum'><a name="Page_311" id="Page_311">[Pg 311]</a></span>
+of good butter. Olive oil, two or three teaspoonfuls
+after each meal, is excellent. It can be kept up for
+months to advantage. Older children may eat raw and
+cooked fruits, figs, dates, baked potatoes, poultry, and
+fish. One or two raw apples or a peach or orange may
+be given daily. A strict observance of the above rules
+and diet will result in normal movements of the bowel
+if persisted in for a reasonable time. It may be necessary
+occasionally to use a suppository or an enema now
+and again until the habit is established.</p>
+
+<p>In children from five to fifteen years of age the use
+of bran muffins, with fruit, etc., as described above, will
+effect a cure of constipation without having to resort
+to drugs. I have cured many cases of constipation in
+growing children with these muffins without making
+any other change in their diet or habits.</p>
+
+
+<h4>RECIPE FOR BRAN MUFFINS</h4>
+
+<div class="blockquot"><p>Take one pint of best flour, one quart unsifted bran, one
+teaspoonful bicarbonate of soda (baking soda), a pinch of salt.
+Mix these thoroughly together, then add: six to eight tablespoonfuls
+good, New Orleans molasses, one pint of milk.
+Mix together very thoroughly. Put in muffin rings and bake
+in oven. About one ounce should be put in each ring as they
+raise easily. Eat with plenty of good butter. They should
+be given to children before each meal, when they are hungry,
+not after their stomachs are full. Put bran in dish first. Sift
+in flour, soda and salt. Mix these thoroughly together, then
+add one pint of milk (two cupfuls) and six to eight tablespoonfuls
+of New Orleans molasses. The quantity of molasses
+depends upon the individual taste. They are good
+for any child or adult whether constipation exists or not.</p></div>
+
+<p>Drugs may be of temporary service in some cases.
+A pill of cascara sagrada is the best for this purpose.
+It should not be continued for more than two weeks.
+Castor oil, calomel, and other frequently-used cathartics
+should never be used in simple constipation.</p>
+
+
+<h4>TREATMENT OF OBSTINATE CONSTIPATION</h4>
+
+<p>There are cases that resist treatment of the kind described
+above. Diet and drugs do not succeed in establishing<span class='pagenum'><a name="Page_312" id="Page_312">[Pg 312]</a></span>
+the habit of daily bowel movements. In these
+cases radical treatment is imperative. The diet should
+be the same as that described above, but it will be found
+advisable to cut out milk altogether. Cereals can be
+taken with sugar and butter instead of milk. The oil
+injection plan of Professor Kerley has given me excellent
+results. I quote his comments upon and method
+of giving it:&mdash;</p>
+
+<p><b>"Oil Injections."</b>&mdash;"For this purpose a soft-bulb
+syringe of four ounces' capacity is ordered. Over the
+hard rubber tip is place a small sized adult rectal tube
+or a No. 18 American catheter. The catheter or tube
+is cut so that but nine inches remain for use. The cut
+end is forced over the small, hard rubber tip of the
+syringe. A fountain syringe is impracticable for this
+purpose, as it is soon destroyed by the oil and rendered
+unfit for use. Besides, sufficient pressure is not produced
+to force the oil into the gut even with a high
+elevation of the bag. The child is placed on his back
+or on his left side. The syringe is filled with oil, the
+tube is lubricated, and passed through the rectum as
+far as it can go. When it has been passed to the full
+nine inches, as may readily be done with a little practice,
+the syringe is emptied and the tube withdrawn.
+The injection should be given after the child has been
+placed in bed for the night. It is our object to have
+the oil retained during the night. If a passage of the
+bowels is produced at the time, or if the oil leaks out during
+the night, a small quantity should be used. In some
+of my patients I have been able to use but one ounce.
+In very few, indeed, does it cause an evacuation at the
+time. If there is a tendency to leakage a napkin should
+be worn to avoid soiling the bed-linen. The following
+morning after breakfast, the child is placed on the vessel
+and kept there until a bowel movement results or until
+fifteen minutes have elapsed. In a great many cases
+if the constipation has been obstinate for months, the
+bowel will be at once evacuated. When this does not
+occur in fifteen minutes, a glycerine suppository is inserted,
+which invariably produces an evacuation. This
+use of the suppository, according to my observation,<span class='pagenum'><a name="Page_313" id="Page_313">[Pg 313]</a></span>
+can usually be dispensed with in a very few days; the
+use of the oil, however, may have to be continued for
+several weeks. When the child has had the oil nightly
+and an evacuation the next morning without assistance
+for two weeks, I direct that the oil be omitted for a
+night and the effect noted. If the usual passage occurs
+after breakfast, the oil is given for five nights and then
+omitted. If the case progresses satisfactorily the use
+of the oil is gradually omitted, being given at first every
+second night, then every third, fourth, or fifth night, etc.
+A considerable number of cases have been completely
+relieved in two months. In the event of no passage
+following the omission of the oil, its use is continued
+for two weeks longer, when it is again omitted for a
+night." To illustrate this point the following case is
+cited.</p>
+
+<p><b>"Illustrative Case.</b>&mdash;A boy three years of age had
+never had a bowel evacuation without drugs, soap enemas,
+or suppositories since birth, and finally these were no
+longer effective. The mother, thoroughly frightened,
+brought the child to me. Eight months of diet and the
+use of the oil were required before he was entirely well.
+It is now three months since the local treatment was
+discontinued and the bowel function remains normal.</p>
+
+<p>"The diet with the absence of milk must be continued
+for months after the patient is apparently well, and
+he must not be allowed to pass a single morning without
+an evacuation at the usual time. In assuming the
+management of one of these cases I explain to the
+mother or nurse that the treatment is not pleasant for
+the child or the attendant, and that it may have to be
+persisted in for weeks, and unless she is willing to carry
+it out to the end, it would better not be undertaken.
+I assure her, however, that with her co&ouml;peration, which
+is usually readily given, the child will make a complete
+recovery. Cases that are slow in responding to treatment,
+I usually give the additional advantage of abdominal
+massage from twenty minutes to one-half hour,
+before the child is placed at stool. The massage should
+practiced by one skilled in the work.</p>
+
+<p>"The above local measures apply particularly to children<span class='pagenum'><a name="Page_314" id="Page_314">[Pg 314]</a></span>
+after the eighteenth month. They may be used
+earlier, however, following out the diet along the lines
+laid down for bottle-fed children who suffer from constipation.
+In very young children a smaller amount of
+oil should be used, never more than two ounces, usually
+one ounce is all that is required. When the oil treatment
+is under way, whatever the age of the patient,
+laxative drugs should not be given."</p>
+
+
+
+<hr style="width: 65%;" />
+<p><span class='pagenum'><a name="Page_315" id="Page_315">[Pg 315]</a></span></p>
+<h2>CHAPTER XXIII</h2>
+
+<h3>CONSTIPATION IN WOMEN</h3>
+
+<div class="blockquot"><p>Chief Cause of Constipation in Women&mdash;Constipation a Cause
+of Domestic Unhappiness&mdash;The Requirements of Good
+Health&mdash;The Cost of Constipation&mdash;Constipation and
+Social Exigencies&mdash;One of the Important Duties of
+Mothers&mdash;Constipation and Diseases of Women&mdash;Constipation
+is Always Harmful&mdash;Constipation and Pregnancy&mdash;Explanation
+of Incomplete Constipation&mdash;Causes
+of Constipation&mdash;Negligence&mdash;Lack of Exercise&mdash;Lack of
+Water&mdash;Lack of Bulk in the Food Taken&mdash;Abuse of
+Cathartic Drugs and Aperient Waters&mdash;Overeating&mdash;Treatment
+of Constipation in Women.</p></div>
+
+
+<p>It has been stated that constipation is almost universal
+among the women of America. It is a fact that very
+few American women enjoy, to a reasonable degree, a
+permanently satisfactory bowel condition. Constipation
+is an acquired habit and unquestionably negligence is
+the primary and the chief cause of it. The negligence,
+no doubt, begins at a very early age; it is at least an
+established habit before any intelligent, consecutive effort
+is made to remedy it. Inasmuch as women are the mothers
+of the race, and as their part in the scheme of life <i>is</i>
+the supreme one; and as constipation has been shown to
+be a serious, far-reaching, significant disease, a very sincere
+and persistent crusade should be made to educate
+women as to its importance. For a less altruistic purpose,
+tremendous popular movements have been carried
+to success. For a less service rendered to the race names
+have achieved renown. In addition to the symptoms
+stated in the preceding paper, the condition which we
+now desire to emphasize is the effect of the constant
+self-poisoning on the general health and its effect upon a
+woman's reproductive efficiency.</p>
+
+<p>The poison being constantly absorbed, means general
+bad health, bad health to a degree depending upon the
+degree of constipation which is the cause of the poisoning.
+It may be simply that the woman does not wholly
+enjoy good health, or that she is completely incapacitated<span class='pagenum'><a name="Page_316" id="Page_316">[Pg 316]</a></span>
+because of chronic bad health, or any degree of indifferent
+health between these two extremes.</p>
+
+<p>If the degree of poison is sufficient to cause habitual
+poor health, its effect upon the blood must be bad, and
+the effect of the bad blood upon the nervous system and
+the other vital organs cannot be good. Now if this
+process has been going on for many years, the condition
+of the woman, who is its victim, as an efficient machine,
+compared with the woman in whom this condition never
+did exist, must be very different indeed. This condition
+of affairs&mdash;inasmuch as constipation is so common in
+women&mdash;must have a tremendous significance when estimating
+the vitality and efficiency of the coming generation.</p>
+
+<p>We might go much further and yet be sure of our
+position, and maintain that it is this national autotoxemia,
+this scourge of womanhood, that is to a great extent responsible
+for the characteristic American "vice of neurasthenia,"
+and of the domestic infelicity and unhappiness
+which are so common in the large cities of this country.
+If we add to the intestinal autotoxemia of constipation,
+the tendency to, or vice of, indiscriminate eating and
+drinking&mdash;of which the American people are particularly
+guilty&mdash;we would be on firmer ground. In fact we
+would feel that we had pointed out the one underlying
+cause of most of the domestic irritability prevalent to-day,
+which is of serious importance, and which is, fortunately,
+capable of correction. It is a matter of everlasting
+and continuous education.</p>
+
+<p><b>The Requirements of Good Health.</b>&mdash;There are certain
+fundamental basic requirements which are essential
+to good health: fresh air, good water, a reasonable amount
+of physical and mental exercise, nutritious food, freedom
+from unnecessary and unreasonable worry, frequent bathing,
+and a daily movement of the bowels. The reason
+why constipation is of such serious importance is because
+it is the only basic requirement of good health that
+afflicts a large majority of the race at the same time.
+The health of so many is being undermined by this one
+affliction, that it dominates all other factors that have
+any bearing upon posterity. A woman may enjoy all<span class='pagenum'><a name="Page_317" id="Page_317">[Pg 317]</a></span>
+the essential conditions necessary to good health, yet
+she may be constipated, and the presence of this condition
+will undermine, in her constitution, all the benefits
+she derives from her advantageous environments. It
+will do more; it will be responsible for the disposition,&mdash;the
+temperament,&mdash;of that woman. The natural disposition
+of that woman may be an amicable one; if it were
+allowed to express itself naturally it would be kind,
+gentle, considerate, affectionate. No woman, however,
+the victim of chronic constipation, can preserve an equable
+temperament or an amicable disposition. It is impossible&mdash;with
+her nerves being constantly poisoned&mdash;that she
+can hold the symptoms of that condition in abeyance.
+She must be irritable and nervous and sick of herself
+and everything and everybody. The home as a direct
+result suffers; its atmosphere is not one of contentment
+and peace and affection. Constipation, therefore, blights
+the home and the influence of one blighted home may
+have a far-reaching effect on the story of the human race.
+It is responsible also for that woman's mental attitude
+outside the home. Instead of exerting an optimistic influence,
+her whole existence is a message of pessimism
+and discouragement. Multiply these influences and messages
+to correspond with the prevalence of the disease
+and we have a condition that is tremendously significant,
+a condition that is really a pressing economic issue. A
+constipated woman is an anti-eugenist&mdash;a eugenic
+atrocity.</p>
+
+<p>We have no desire to create a false impression or to
+build up a foolish fear. Are we justified in regarding
+this as one of the most important, if not the most important,
+disease condition; the most menacing physical
+vice, which the human race has to combat? Let us
+offer the following brief facts in witness of our stand:</p>
+
+<p><b>The Cost of Constipation.</b>&mdash;It has been estimated that
+consumption (the great white plague) kills one-tenth
+of all the human race. Cancer kills half as many, or
+one in every twenty. Constipation, and the diseases
+which are caused directly by it, kills one in every three
+of all the people on the civilized globe.</p>
+
+<p>Constipation has been responsible for the expenditure<span class='pagenum'><a name="Page_318" id="Page_318">[Pg 318]</a></span>
+of millions of dollars in advertising in the newspapers
+alone,&mdash;more, probably, than has been spent in advertising
+remedies for all other diseases combined. Do
+you suppose this money was a donation? Do you suppose
+these keen, alert interpreters of the spirit of the
+times, the up-to-date business men, were not and are
+not aware that constipation is the "universal disease"?</p>
+
+<p>Every drug store, in every civilized spot on earth, has
+its shelves loaded down with constipation remedies; dinner
+pills, liver pills, cathartic pills, tablets in all possible
+coatings and combinations, mineral waters from a multitude
+of springs, aperient drinks by the dozen, laxative
+teas and cordials, cathartic oils and emulsions. If the
+demand for these articles should cease most of the drug
+stores would close up.</p>
+
+<p>Many millions of dollars have been made and are
+being made by various men and concerns, who have
+devised ingenious mechanical agencies which are supposed
+to cure, and in curing renew the lost health caused
+by constipation. We have in mind in this connection,
+a man who conceived the ingenious plan of putting the
+opening of an ordinary fountain syringe in the middle
+instead of at the end and made a fortune out of it.
+In this opening he places an upright nozzle, and instead
+of hanging the bag up and allowing the water to run
+into the bowel, he has the patient sit on the bag and
+thereby the water is forced into the bowel. He has written
+a two-hundred page book on the advantages of
+this idea, and his "literature" contains the names of
+famous men and women in all walks of life who use
+his device. The name of one of the famous judges of
+the Supreme Court of the United States was there;
+another was the name of a popular operatic beauty who
+writes for the daily press little essays on "How to be
+beautiful!" and "How to keep well!" He deserves his
+success. He is an emancipator and has doubtless done
+a great deal of good. His success demonstrates, beyond
+contradiction, the prevalence of the malady under discussion,
+and it must be remembered that he is only
+one of hundreds who garner from the same ample
+harvest.<span class='pagenum'><a name="Page_319" id="Page_319">[Pg 319]</a></span></p>
+
+<p>If we could estimate in value the economic loss sustained
+by the race because of the inefficiency of the
+victims of intestinal intoxication, due to constipation,
+the sum would be colossal. Even then it would only
+represent the direct economic deficiency&mdash;it would not
+express, nor could any figure adequately represent, the
+indirect loss sustained by the race because of the temperamental
+characteristics, which are the products of
+intestinal poisoning, and which produce domestic tragedies
+and economic failures.</p>
+
+<p>Has this array of evidence any meaning, or does it
+just happen to be so? We leave it to the reader; if it
+stimulates thought, or pricks a conscience it will have
+done its duty.</p>
+
+<p><b>Constipation and Social Exigencies.</b>&mdash;The cause of
+constipation in women, whose social station commands
+every sanitary, hygienic, and dietary luxury, is their
+method of living, the food they eat, and the negligence
+which is almost obligatory because of social exactions.
+If constipation did not so frequently accompany "good"
+living (which is the modern name for overeating and
+drinking) we would have thousands and thousands of
+healthy, robust, contented women, fit and willing to assume
+the onerous duties concomitant with motherhood.
+All their enthusiasm, however, is expended in the effort
+to keep "in the ring," to overcome the effects of the
+poison of constipation, to preserve their youth and freshness,
+to undo what neglect has accomplished. It is because
+of the failure of this simple function that my lady
+seeks the masseur, the facial artist, the society doctor,
+the beauty expert, and the thousand and one agencies,
+which an extravagant and profligate age has made necessary
+to foster the efficiency of its votaries.</p>
+
+<p>I am optimistic, however, regarding the future. I believe
+the human race is improving, despite the disadvantageous
+surroundings and conditions which hamper
+honest effort and stultify truth. A higher efficiency is
+the goal, and the intention is to obtain this desideratum
+by fair and by just means. There is an awakening, an
+unrest, a groping for knowledge in almost every field of
+human endeavor, and there is none in which the yearning<span class='pagenum'><a name="Page_320" id="Page_320">[Pg 320]</a></span>
+for fact, for truth, for instruction, is stronger and keener,
+than in the world-wide movement in the interest of a
+better motherhood, and in a more serious study of child
+life. It is an encouraging sign, a hopeful promise, of
+what the future has in store.</p>
+
+<p><b>One of the Important Duties of Mothers.</b>&mdash;The immediate
+lesson to be learnt from the facts just recounted
+is to instruct mothers in their duty toward their daughters.
+If each mother would retain the confidence of her
+daughter sufficient to instruct her in the duties which
+are important, how much needless suffering would be
+saved. To know as a matter of fact whether the
+daughter's bowels are in good condition will appeal to all
+who read this as being of very great importance. It is
+not only necessary to know if they have a movement
+every day, it is necessary to know the character of the
+daily movement; whether it is hard and dry and necessitates
+straining,&mdash;the evil consequences of which, in
+young girls, is very serious indeed,&mdash;or if it is habitually
+loose and suggestive of what has been described as incomplete
+constipation.</p>
+
+<p>If the mothers of America would consecrate themselves
+to this simple task, who could tell in mere words
+the effect it would have on the race yet unborn? There
+are problems of scientific intent, and of fancy names,
+that engage the attention of philanthropically inclined
+ladies, and which are emblazoned on the society columns
+of the daily press, of much less importance to the human
+family than the homely duty we ask mothers to devote
+themselves to.</p>
+
+<p><b>Constipation and Diseases of Women.</b>&mdash;Constipation
+is present in a very large majority of the cases of diseases
+of women. It may be caused by disease of the womb,
+or it may cause disease of the womb. There is no
+question about the bad effect constipation has upon all
+diseases of this type. In many cases it is absolutely impossible
+to effect a cure without first curing the accompanying
+constipation.</p>
+
+<p>We seldom appreciate how severe a degree of constipation
+a growing girl will submit to without seeking relief.
+Some of the worst cases of constipation that have been<span class='pagenum'><a name="Page_321" id="Page_321">[Pg 321]</a></span>
+known, have been in girls between the ages of sixteen
+and twenty. The mechanical effects of such a condition
+can well be imagined. The constant, severe straining,
+necessary to evacuate the bowel, has, in very many instances,
+produced congestion and displacement of the
+womb and ovaries. It is not observed at this time, or
+if observed it is not understood, and thus is laid the
+foundation for years of neurasthenia, helplessness, and
+disease.</p>
+
+<p>The more we investigate the ramifications of constipation
+the more we learn of its seriousness and of its significance.</p>
+
+<p><b>Constipation is Always Harmful.</b>&mdash;There is no period
+in life when constipation can be borne with impunity.
+Youth, with its virility and vitality, will endure its consequences
+with an apparent negation, so far as positive or
+specific results are concerned, but it is only an apparent
+impunity. There is always a certain amount of strength
+built up, held in reserve as a heritage of youth, which
+will withstand a certain amount of physical license, but
+if this reserve is assailed by an unnecessary imposition,
+and is successfully undermined, there will be infinitely
+less reserve to call upon in the legitimate battle of life.
+Life is too real, too concentrated, too strenuous, and
+health is too precious to be wilfully wasted in any form
+of self-abuse.</p>
+
+<p><b>Constipation and Pregnancy.</b>&mdash;Mothers will appreciate
+from the foregoing explanation why constipation
+is eugenically a crime during pregnancy. The evils
+which result from constipation mechanically, frequently
+have serious consequences by interfering with the circulation
+of the blood to the womb, by forcing the womb to
+assume wrong positions, by straining at stool, and by
+preventing the kidneys from functionating properly;
+these may render the life of the pregnant woman miserable,
+and may be the direct cause of a painful, prolonged,
+difficult labor. The evils which result from constipation
+because of the absorption of poisons by the bowel are of
+the gravest importance during pregnancy. These poisons
+affect the general health; the victim is tired, listless, and
+apathetic, and is thereby disinclined to exercise adequately;<span class='pagenum'><a name="Page_322" id="Page_322">[Pg 322]</a></span>
+the appetite is poor; there are headaches,
+neuralgias, insomnia, nervousness, melancholia, and
+general mental and physical inertness. What hope may
+a pregnant woman entertain of having "an easy confinement,"
+or of bringing a healthy child into the world
+under these circumstances? Who is to blame? Sometimes
+it is necessary to tell the unadorned truth,&mdash;the
+woman is to blame. No woman has a right to assume
+the responsibilities of maternity who has not had enough
+respect for herself to discontinue habits which caused this
+failing, or who has not had strength of will enough to
+begin its successful cure. Get busy,&mdash;do something,&mdash;it
+is never "too late," but do it now.</p>
+
+<p>Before we take up the treatment of constipation in
+women, it is necessary to explain more fully the type
+of constipation which we referred to as "incomplete"
+constipation. There is a condition of the bowel, in which
+we find its wall coated with hard fecal matter. The size
+of the bowel may be dilated as a consequence. This
+condition may occupy part, or most, of the entire length
+of the large intestine. In the middle of this hard mass
+there is a small channel through which semi-liquid matter
+passes. When the bowel moves, it is this semi-liquid
+matter that passes out, and this constitutes the daily
+movement. We have consequently a condition in which
+we have a daily movement but not a complete emptying
+of the bowel. The character of the stools from such a
+bowel must necessarily be more or less of a semi-liquid
+consistency, because the intestine, being coated with a
+hard dried out layer of old fecal substance, is prevented
+from absorbing the liquid part of the fresh fecal mass
+passing through it. This condition may exist for a considerable
+time, but it will slowly undermine the health and
+vitality of any person in whom it exists. The symptoms
+which a patient in this condition complains of are,&mdash;a
+feeling of being tired and languid, no energy or vim,
+headache, loss of appetite, loss of flesh, neuralgic pains,
+nausea, vertigo (dizziness), insomnia, frequent colds,
+cold hands and feet, biliousness, sallow skin and muddy
+complexion, liver spots, coated tongue and a "bad breath,"
+nervousness, melancholia, various abnormal conditions<span class='pagenum'><a name="Page_323" id="Page_323">[Pg 323]</a></span>
+and diseases of the skin, pimples, blackheads, eruptions,
+eczema, piles, appendicitis, diseases of the intestinal wall
+as a result of the constipation, Bright's disease of the
+kidney, and many other morbid conditions. Any physician
+could name many symptoms, which were never
+properly understood but which are now known to be
+caused by the absorption of poisons resulting from inactivity
+of the bowels. Patients may not necessarily have
+all of the above symptoms; they may have a number of
+them, or they may have all of them, and they may have
+others not mentioned at all.</p>
+
+<p><b>Treatment of Constipation in Women.</b>&mdash;To effect a
+movement of the bowels in a patient who is a victim of
+constipation is not a cure. We can indefinitely cause
+bowel action by drugs, etc., but the condition will remain
+the same or worse. When habitual constipation exists
+there is an underlying condition affecting the entire
+system which indicates that something is radically wrong.
+It may be necessary to change the whole routine of the
+patient's life. It will certainly be necessary at the very
+beginning to inquire into the daily diet, exercise, and
+surroundings.</p>
+
+<p>During the past ten years there has been born every
+few days a new medical "ism," a new religious cult.
+Why? Because human nature is an unstable equation.
+We are never satisfied with the old order of things and
+there will always be a following wherever there is a
+leader. These "isms" and cults do not survive. Some
+seem to thrive, others die a natural death. There is a
+law, as old as the hills, that you cannot get something for
+nothing in this world. We learn its bitter truth as the
+years pass, and when we get over the day dreams and the
+sentiment of youth we settle down to real work. If we
+desire to retain good health, or regain lost health, we must
+do something. No one can hand it to us on a silver plate,
+nor can anyone work a miracle in our behalf. We cannot
+buy health, we must deserve it.</p>
+
+<p>This is the secret of the success of all schemes to cure
+disease. The human family will not knuckle down and
+swallow the truth. The man or woman in poor health is
+looking for Aladdin's lamp everywhere and always. A<span class='pagenum'><a name="Page_324" id="Page_324">[Pg 324]</a></span>
+new bait, dressed up in lubricated, oily words, promising
+impossible results, will be accepted as the simple unadorned
+truth, and will be bought and paid for, in the
+end forgotten. The royal road, the easy road, which they
+are looking for is impossible. There is no way by which
+any one of us may continue to break the laws of nature
+and retain or regain our lost health. Miracles are impossible.
+Prayers without deeds are empty mouthings
+and a waste of time. Let us see how this works out in
+the treatment of constipation. We must find the cause of
+the constipation. I will name the causes in their order
+of frequency.</p>
+
+<p><b>Negligence.</b>&mdash;This is unquestionably the primary
+cause of almost all cases of bowel inactivity. As has
+been already noted, the exigencies of modern life are of
+such a strenuous nature that we do not find the time to
+devote to this function the degree of systematic attention
+which it demands in order to preserve a healthy condition
+of intestinal regularity. The bowel is simply a
+complex muscle controlled by an elaborate system of
+nerves of an involuntary type. In order to preserve the
+highest degree of efficiency of this complicated mechanism,
+it must be permitted to obey the laws nature endowed
+it with and which it must obey. When the fecal
+mass reaches the rectum the nerve centers, acting through
+the spinal cord, send a message to the rectum something
+like this: "Empty yourself of your contents, we have
+made all preparations and everything is ready." The
+rectum obeys to the extent of notifying you that it wants
+to be relieved; you feel the desire to evacuate the bowels.
+If you obey, all is well, nature is appeased, you encourage
+the systematic regularity necessary to good health. If
+you do not obey, you upset the delicate mechanism, and
+frequent negligence of this character will result in the
+complete disarrangement of this complex machinery so
+that it will fail to warn you that a bowel movement is
+necessary and constipation is established. We must
+therefore retrace our steps and re-educate the bowel
+systematically to empty itself at a certain time every
+day. This can be done in nearly every case without
+artificial assistance. It may take time but it is worth<span class='pagenum'><a name="Page_325" id="Page_325">[Pg 325]</a></span>
+a little methodical persistence. The point is, you must
+do it; no "ism" or esoteric agency can do it for you.</p>
+
+<p>Mothers will recognize from this explanation the necessity
+of establishing the habit in children at the earliest
+possible moment.</p>
+
+<p><b>Lack of Exercise.</b>&mdash;What does the word exercise imply?
+It implies movement, better circulation of the blood,
+better health and tone to every part of the body, more
+oxygen, and a richer, better quality of blood, and because
+of a better quality of blood, which is the fuel of the body
+machine, we have a better, smoother working machine.
+Every human being requires a certain amount of exercise;
+otherwise the machine will not run smoothly. If
+this exercise is not obtained, things begin to go wrong.
+One of the very first signs to indicate that the machine is
+not running as it ought to run, is a sluggish condition
+of the whole digestive apparatus and a certain degree of
+bowel inactivity (constipation) follows. There is no substitute
+for this need. Drugs will not help you, mechanical
+devices will not do the work for you, though they may
+aid you. You must do the work yourself. If you fail
+or hesitate to recognize the truth, if you temporize or
+procrastinate, you are only deferring the issue. The
+argument that you have not the time, that your work
+will not permit you, is no argument at all. You must do
+it or reap the consequences; you certainly cannot escape
+them. The wise woman accepts the situation, the fool
+goes to an early grave.</p>
+
+<p><b>Lack of Water.</b>&mdash;Constipation may be due to a deficiency
+of water in the system. Women who suffer from
+this type do not drink enough water. The bowel may be
+willing and able to do its duty, but is handicapped because
+a certain amount of liquid is essential to proper
+digestion and natural bowel activity. At least six glasses
+of water should be taken by every healthy adult human
+being in each twenty-four hours. The best time to take
+this water is as follows: one glass on arising, two between
+breakfast and lunch, two between lunch and dinner,
+and one on retiring. Between meals means one hour
+after a meal and at least one-half hour before the following
+meal. No liquid should be taken during a meal, or<span class='pagenum'><a name="Page_326" id="Page_326">[Pg 326]</a></span>
+immediately after, or before a meal. All water taken may
+be hot or cold, according to the fancy of the taker. It
+is of advantage to squeeze the juice of half a lemon into
+the water taken on arising if there is any tendency to
+constipation or if the liver is lazy or torpid. It is also
+good for the complexion.</p>
+
+<p><b>Lack of Bulk in the Food Taken.</b>&mdash;Sometimes the
+character of the food taken is such that there is no body
+to it. The process of digestion so completely liquefies
+it that the bowel has no solid matter to manipulate. To
+excite the peculiar movements of the intestinal wall there
+must be substance in the contents. The variety of the
+daily food must be so arranged as to provide this. A
+list of these foods is provided elsewhere in this book.
+Certain other foods stimulate intestinal activity, not because
+of their bulk, but because of the chemical elements
+they contain. All forms of sugar, the sugars of fruits,
+the acids of fruits and vegetables, are excellent natural
+laxatives. Sour milk and buttermilk, oils and fats, are
+also of distinct value in this respect.</p>
+
+<p>On the other hand, soups, gruels, porridges, and pur&eacute;es
+are constipating because the digestive process reduces
+them to liquids and leaves no bulk for the bowel to act
+upon. New bread, hot biscuits, "noodles," and doughy
+foods are also objectionable, especially to children. Hot
+baths, hot drinks, hot enemas, and sweating are also
+constipating because they extract so much liquid from
+the bowel leaving the contents excessively dry.</p>
+
+<p><b>Abuse of Cathartic Drugs and Aperient Waters.</b>&mdash;This
+is a widespread evil; it may justly be regarded as
+a national curse. The victims of this custom do not
+realize that they are addicted to a habit which must be
+rightly regarded as equally as bad as the drink habit, so
+far as its ultimate effect on the general health and the
+prospect of longevity is concerned. Its popularity is a
+product of our national vice of indiscriminate eating and
+drinking. It is more common among the class who live
+in restaurants, hotels, and boarding houses, who keep late
+hours, eat late suppers and who do not exercise enough.
+These individuals eat too much and live too high. After
+a time the liver becomes sluggish, the stomach fails to<span class='pagenum'><a name="Page_327" id="Page_327">[Pg 327]</a></span>
+digest properly, the bowels lose their tone, and flatulent
+indigestion or some other more or less serious condition
+follows; to maintain the pace, to feel and keep fit, they
+discover that a glass of some advertised aperient or laxative
+water before breakfast works wonders, tides them
+over for the time being and keeps them "in the ring."
+They compliment themselves and push the specter of
+age aside.</p>
+
+<p>The thought that they were not "as young as they once
+were," or that they must go slow, was not a very pleasing
+suggestion, so having found a "cure" by adding another
+bad habit on top of an existence which is composed of
+nothing but bad habits, they start all over again. The
+suggestion that their trouble is a warning that "things
+are going wrong" and that the whole plan of living must
+be radically and promptly changed does not meet with
+their approval, and so the Department of Health statistics
+heap up the records of deaths due to heart disease,
+hardening of the arteries, Bright's disease of the kidneys
+and apoplexy. It is not a happy tale, but the truth is
+often tragic.</p>
+
+<p>When a woman finds that her physical efficiency depends
+upon the habitual use of cathartic drugs or laxative
+waters, she must regard the knowledge with respect, she
+must give it serious consideration, and she must adopt
+means to so change her method of living, that nature will
+be given a chance to work in her interest&mdash;not against
+her. Better to find out exactly where the trouble <i>is</i> now,
+and go after it than to travel too far along the wrong
+road. Many die from the "disease" of procrastination.</p>
+
+<p><b>Overeating.</b>&mdash;Overeating may be included in this
+classification because it so overworks the digestive apparatus
+that it is impossible for it satisfactorily to complete
+its function. Any reader desirous of understanding
+the full significance of overeating in this connection
+should carefully read the article on this subject on pages
+289 and 290.</p>
+
+<p>There are, of course, a great many other causes for
+constipation but these are the important ones. When we
+find the cause of any particular case it will suggest the
+remedy and we must employ it faithfully if we hope to<span class='pagenum'><a name="Page_328" id="Page_328">[Pg 328]</a></span>
+effect a cure. If it is negligence, we must correct that
+fault and compel our daily routine to accommodate itself
+to a regular observance of this function. If it is lack of
+exercise, we must get more exercise, or if it is lack of
+bulk in our food, we must change our method of living
+and select with more care the foods we eat. If it is lack
+of water, we can correct the constipation by adding the
+proper amount of water at the proper time.</p>
+
+<p>A patient who has been a victim of chronic constipation
+for some time must live a life somewhat after the following
+general plan:</p>
+
+<p>She should increase the vegetables, fruits, and fats in
+her diet and she should drink enough water. It is a good
+plan to sip slowly one-half pint of hot or cold water
+morning and evening. Daily exercise in the open air is
+advisable; exercise of some kind, even if taken indoors,
+is imperative. Walking, riding, bicycling, tennis, golf,
+swimming, are the best forms of exercise for women.
+Indoor gymnastics can be made a satisfactory substitute.
+After the exercise a hot shower bath and a cold sponge
+bath or cold plunge or a swim should follow.</p>
+
+<p>Women in very moderate circumstances may walk
+briskly a distance of three or four miles, and on returning
+can take a warm bath followed by a brisk rub-off with a
+coarse towel wrung out of cold water, or they can use a
+hose with a spray nozzle and allow the cold water to run
+over them for a few seconds after the warm dip in the
+bath tub. After the adoption of these measures the
+bowels may tend to regulate themselves. If so, this is the
+proper time to cultivate the habit of regularity, by selecting
+a certain time each morning or before retiring for
+this function. The patient should go to the toilet at the
+regular time even if the desire is not present. By straining
+slightly, and by encouraging the voluntary desire, the
+bowel may receive the necessary stimulation and an
+evacuation may result. If there should seem to be no
+disposition on the part of the bowel to become accustomed
+to this procedure, we must aid it for the time being. A
+glycerine or soap suppository, a glass of aperient water,
+Pluto, Hunyadi, Apenta, or the imported Carlsbad salt
+in warm water, or the effervescent Citrate of Magnesium,<span class='pagenum'><a name="Page_329" id="Page_329">[Pg 329]</a></span>
+will result in a prompt emptying of the bowel. There are
+a great many other cathartic drugs and many well-known
+laxative pills, etc., but these are not necessary if a
+systematic effort is being made to cure the constipation,
+because success will come within a reasonable time if the
+patient will not become unduly discouraged. Many
+victims are deficient in fat; the bowel needs lubrication;
+we therefore recommend a good quality of olive oil, one
+tablespoonful after each meal. Frequently it is of advantage
+to inject, high up in the bowel, two or three
+ounces of sweet oil at night, as is done in children, and
+which is fully described in the previous chapter.</p>
+
+<p>If the constipation is due to deranged nerves, in which
+the reflexes of the intestinal wall seem to share, we advise
+massage of the abdomen, and an occasional hot or
+cold rectal injection. The proper quantity to use for this
+purpose is from two to three quarts. The solution to
+use is the normal salt solution. See page 627.</p>
+
+<p>In that form of incomplete constipation in which we
+stated that there was a layer of hard, impacted feces
+covering the bowel wall, a special method of treatment
+is necessary. In these cases nothing will succeed as
+satisfactorily as very hot, high rectal injections. The
+object of course is to rid the bowel of the old, hard, dry
+mass, which has collected there, before we can hope to
+get the bowel into condition to perform its own work. It
+is almost incredible that the human bowel can hold so
+much old dried-out, nasty stuff as is stored up in these
+constipated bowels. Hot salt water, as hot as can be
+tolerated, two or three quarts at a time, is the correct
+way to dislodge this mass. It will not be done at once; it
+frequently takes two or three weeks before the bowel
+is fairly clean. The irrigations should be given every
+second night until the bowel is clean. The method of
+giving these washings is fully described on page 312.
+While these irrigations are being given the patient should
+take olive oil by the mouth, one tablespoonful after each
+meal. The proper food, open-air exercise, sanitary living,
+plenty of water, and regular attention to the bowel
+movements will in the end cure the affliction.</p>
+
+
+
+
+
+
+
+
+<pre>
+
+
+
+
+
+End of the Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4), 
+by W. Grant Hague
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+***** This file should be named 24854-h.htm or 24854-h.zip *****
+This and all associated files of various formats will be found in:
+        http://www.gutenberg.org/2/4/8/5/24854/
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+http://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at http://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+http://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at http://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit http://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including checks, online payments and credit card donations.
+To donate, please visit: http://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart is the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     http://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
+
+
+</pre>
+
+</body>
+</html>
diff --git a/24854-h/images/v2frontis.jpg b/24854-h/images/v2frontis.jpg
new file mode 100644
index 0000000..ac410ea
--- /dev/null
+++ b/24854-h/images/v2frontis.jpg
diff --git a/24854-h/images/v2pg207.jpg b/24854-h/images/v2pg207.jpg
new file mode 100644
index 0000000..3d09b4a
--- /dev/null
+++ b/24854-h/images/v2pg207.jpg
diff --git a/24854-page-images/f001.jpg b/24854-page-images/f001.jpg
new file mode 100644
index 0000000..8260108
--- /dev/null
+++ b/24854-page-images/f001.jpg
diff --git a/24854-page-images/f002.png b/24854-page-images/f002.png
new file mode 100644
index 0000000..0395759
--- /dev/null
+++ b/24854-page-images/f002.png
diff --git a/24854-page-images/f003.png b/24854-page-images/f003.png
new file mode 100644
index 0000000..b6f6879
--- /dev/null
+++ b/24854-page-images/f003.png
diff --git a/24854-page-images/f004.png b/24854-page-images/f004.png
new file mode 100644
index 0000000..ac4963a
--- /dev/null
+++ b/24854-page-images/f004.png
diff --git a/24854-page-images/f005.png b/24854-page-images/f005.png
new file mode 100644
index 0000000..237e4a6
--- /dev/null
+++ b/24854-page-images/f005.png
diff --git a/24854-page-images/f006.png b/24854-page-images/f006.png
new file mode 100644
index 0000000..1ecb3fe
--- /dev/null
+++ b/24854-page-images/f006.png
diff --git a/24854-page-images/f007.png b/24854-page-images/f007.png
new file mode 100644
index 0000000..07d9ed8
--- /dev/null
+++ b/24854-page-images/f007.png
diff --git a/24854-page-images/f008.png b/24854-page-images/f008.png
new file mode 100644
index 0000000..efb5aa9
--- /dev/null
+++ b/24854-page-images/f008.png
diff --git a/24854-page-images/f009.png b/24854-page-images/f009.png
new file mode 100644
index 0000000..0629d44
--- /dev/null
+++ b/24854-page-images/f009.png
diff --git a/24854-page-images/f010.png b/24854-page-images/f010.png
new file mode 100644
index 0000000..85e73aa
--- /dev/null
+++ b/24854-page-images/f010.png
diff --git a/24854-page-images/f011.png b/24854-page-images/f011.png
new file mode 100644
index 0000000..b7e49c6
--- /dev/null
+++ b/24854-page-images/f011.png
diff --git a/24854-page-images/p139.png b/24854-page-images/p139.png
new file mode 100644
index 0000000..1951293
--- /dev/null
+++ b/24854-page-images/p139.png
diff --git a/24854-page-images/p140.png b/24854-page-images/p140.png
new file mode 100644
index 0000000..2d74deb
--- /dev/null
+++ b/24854-page-images/p140.png
diff --git a/24854-page-images/p141.png b/24854-page-images/p141.png
new file mode 100644
index 0000000..3b324ac
--- /dev/null
+++ b/24854-page-images/p141.png
diff --git a/24854-page-images/p142.png b/24854-page-images/p142.png
new file mode 100644
index 0000000..50d92ac
--- /dev/null
+++ b/24854-page-images/p142.png
diff --git a/24854-page-images/p143.png b/24854-page-images/p143.png
new file mode 100644
index 0000000..81a9f61
--- /dev/null
+++ b/24854-page-images/p143.png
diff --git a/24854-page-images/p144.png b/24854-page-images/p144.png
new file mode 100644
index 0000000..295fa6d
--- /dev/null
+++ b/24854-page-images/p144.png
diff --git a/24854-page-images/p145.png b/24854-page-images/p145.png
new file mode 100644
index 0000000..ca9fd21
--- /dev/null
+++ b/24854-page-images/p145.png
diff --git a/24854-page-images/p146.png b/24854-page-images/p146.png
new file mode 100644
index 0000000..22a35ea
--- /dev/null
+++ b/24854-page-images/p146.png
diff --git a/24854-page-images/p147.png b/24854-page-images/p147.png
new file mode 100644
index 0000000..71de2c9
--- /dev/null
+++ b/24854-page-images/p147.png
diff --git a/24854-page-images/p148.png b/24854-page-images/p148.png
new file mode 100644
index 0000000..59c3f5b
--- /dev/null
+++ b/24854-page-images/p148.png
diff --git a/24854-page-images/p149.png b/24854-page-images/p149.png
new file mode 100644
index 0000000..f82dba7
--- /dev/null
+++ b/24854-page-images/p149.png
diff --git a/24854-page-images/p150.png b/24854-page-images/p150.png
new file mode 100644
index 0000000..0b87378
--- /dev/null
+++ b/24854-page-images/p150.png
diff --git a/24854-page-images/p151.png b/24854-page-images/p151.png
new file mode 100644
index 0000000..2311e1d
--- /dev/null
+++ b/24854-page-images/p151.png
diff --git a/24854-page-images/p152.png b/24854-page-images/p152.png
new file mode 100644
index 0000000..c8ad47f
--- /dev/null
+++ b/24854-page-images/p152.png
diff --git a/24854-page-images/p153.png b/24854-page-images/p153.png
new file mode 100644
index 0000000..ec6a360
--- /dev/null
+++ b/24854-page-images/p153.png
diff --git a/24854-page-images/p154.png b/24854-page-images/p154.png
new file mode 100644
index 0000000..8234774
--- /dev/null
+++ b/24854-page-images/p154.png
diff --git a/24854-page-images/p155.png b/24854-page-images/p155.png
new file mode 100644
index 0000000..584faba
--- /dev/null
+++ b/24854-page-images/p155.png
diff --git a/24854-page-images/p156.png b/24854-page-images/p156.png
new file mode 100644
index 0000000..d0dc4f6
--- /dev/null
+++ b/24854-page-images/p156.png
diff --git a/24854-page-images/p157.png b/24854-page-images/p157.png
new file mode 100644
index 0000000..cc9901a
--- /dev/null
+++ b/24854-page-images/p157.png
diff --git a/24854-page-images/p158.png b/24854-page-images/p158.png
new file mode 100644
index 0000000..57fa6d6
--- /dev/null
+++ b/24854-page-images/p158.png
diff --git a/24854-page-images/p159.png b/24854-page-images/p159.png
new file mode 100644
index 0000000..9d5c6d4
--- /dev/null
+++ b/24854-page-images/p159.png
diff --git a/24854-page-images/p160.png b/24854-page-images/p160.png
new file mode 100644
index 0000000..4b95ac1
--- /dev/null
+++ b/24854-page-images/p160.png
diff --git a/24854-page-images/p161.png b/24854-page-images/p161.png
new file mode 100644
index 0000000..d9f3387
--- /dev/null
+++ b/24854-page-images/p161.png
diff --git a/24854-page-images/p162.png b/24854-page-images/p162.png
new file mode 100644
index 0000000..06402a4
--- /dev/null
+++ b/24854-page-images/p162.png
diff --git a/24854-page-images/p163.png b/24854-page-images/p163.png
new file mode 100644
index 0000000..2ea4dfe
--- /dev/null
+++ b/24854-page-images/p163.png
diff --git a/24854-page-images/p164.png b/24854-page-images/p164.png
new file mode 100644
index 0000000..ea81953
--- /dev/null
+++ b/24854-page-images/p164.png
diff --git a/24854-page-images/p165.png b/24854-page-images/p165.png
new file mode 100644
index 0000000..1dbd510
--- /dev/null
+++ b/24854-page-images/p165.png
diff --git a/24854-page-images/p166.png b/24854-page-images/p166.png
new file mode 100644
index 0000000..b025a26
--- /dev/null
+++ b/24854-page-images/p166.png
diff --git a/24854-page-images/p167.png b/24854-page-images/p167.png
new file mode 100644
index 0000000..fec7dae
--- /dev/null
+++ b/24854-page-images/p167.png
diff --git a/24854-page-images/p168.png b/24854-page-images/p168.png
new file mode 100644
index 0000000..31f9cc3
--- /dev/null
+++ b/24854-page-images/p168.png
diff --git a/24854-page-images/p169.png b/24854-page-images/p169.png
new file mode 100644
index 0000000..017807b
--- /dev/null
+++ b/24854-page-images/p169.png
diff --git a/24854-page-images/p170.png b/24854-page-images/p170.png
new file mode 100644
index 0000000..6ea8d82
--- /dev/null
+++ b/24854-page-images/p170.png
diff --git a/24854-page-images/p171.png b/24854-page-images/p171.png
new file mode 100644
index 0000000..9bf2f97
--- /dev/null
+++ b/24854-page-images/p171.png
diff --git a/24854-page-images/p172.png b/24854-page-images/p172.png
new file mode 100644
index 0000000..9bf08a0
--- /dev/null
+++ b/24854-page-images/p172.png
diff --git a/24854-page-images/p173.png b/24854-page-images/p173.png
new file mode 100644
index 0000000..656d43f
--- /dev/null
+++ b/24854-page-images/p173.png
diff --git a/24854-page-images/p174.png b/24854-page-images/p174.png
new file mode 100644
index 0000000..9c26c2f
--- /dev/null
+++ b/24854-page-images/p174.png
diff --git a/24854-page-images/p175.png b/24854-page-images/p175.png
new file mode 100644
index 0000000..0ef72aa
--- /dev/null
+++ b/24854-page-images/p175.png
diff --git a/24854-page-images/p176.png b/24854-page-images/p176.png
new file mode 100644
index 0000000..43f7bba
--- /dev/null
+++ b/24854-page-images/p176.png
diff --git a/24854-page-images/p177.png b/24854-page-images/p177.png
new file mode 100644
index 0000000..c430dd5
--- /dev/null
+++ b/24854-page-images/p177.png
diff --git a/24854-page-images/p178.png b/24854-page-images/p178.png
new file mode 100644
index 0000000..d42ce10
--- /dev/null
+++ b/24854-page-images/p178.png
diff --git a/24854-page-images/p179.png b/24854-page-images/p179.png
new file mode 100644
index 0000000..e49898c
--- /dev/null
+++ b/24854-page-images/p179.png
diff --git a/24854-page-images/p180.png b/24854-page-images/p180.png
new file mode 100644
index 0000000..74ef8bb
--- /dev/null
+++ b/24854-page-images/p180.png
diff --git a/24854-page-images/p181.png b/24854-page-images/p181.png
new file mode 100644
index 0000000..7e0df75
--- /dev/null
+++ b/24854-page-images/p181.png
diff --git a/24854-page-images/p182.png b/24854-page-images/p182.png
new file mode 100644
index 0000000..e0560fe
--- /dev/null
+++ b/24854-page-images/p182.png
diff --git a/24854-page-images/p183.png b/24854-page-images/p183.png
new file mode 100644
index 0000000..0fd5d91
--- /dev/null
+++ b/24854-page-images/p183.png
diff --git a/24854-page-images/p184.png b/24854-page-images/p184.png
new file mode 100644
index 0000000..3cc7600
--- /dev/null
+++ b/24854-page-images/p184.png
diff --git a/24854-page-images/p185.png b/24854-page-images/p185.png
new file mode 100644
index 0000000..2aacbde
--- /dev/null
+++ b/24854-page-images/p185.png
diff --git a/24854-page-images/p186.png b/24854-page-images/p186.png
new file mode 100644
index 0000000..63bb188
--- /dev/null
+++ b/24854-page-images/p186.png
diff --git a/24854-page-images/p187.png b/24854-page-images/p187.png
new file mode 100644
index 0000000..7bda0b0
--- /dev/null
+++ b/24854-page-images/p187.png
diff --git a/24854-page-images/p188.png b/24854-page-images/p188.png
new file mode 100644
index 0000000..c762a3d
--- /dev/null
+++ b/24854-page-images/p188.png
diff --git a/24854-page-images/p189.png b/24854-page-images/p189.png
new file mode 100644
index 0000000..532a25b
--- /dev/null
+++ b/24854-page-images/p189.png
diff --git a/24854-page-images/p190.png b/24854-page-images/p190.png
new file mode 100644
index 0000000..c99ef82
--- /dev/null
+++ b/24854-page-images/p190.png
diff --git a/24854-page-images/p191.png b/24854-page-images/p191.png
new file mode 100644
index 0000000..1891660
--- /dev/null
+++ b/24854-page-images/p191.png
diff --git a/24854-page-images/p192.png b/24854-page-images/p192.png
new file mode 100644
index 0000000..de79261
--- /dev/null
+++ b/24854-page-images/p192.png
diff --git a/24854-page-images/p193.png b/24854-page-images/p193.png
new file mode 100644
index 0000000..51ab312
--- /dev/null
+++ b/24854-page-images/p193.png
diff --git a/24854-page-images/p194.png b/24854-page-images/p194.png
new file mode 100644
index 0000000..7386747
--- /dev/null
+++ b/24854-page-images/p194.png
diff --git a/24854-page-images/p195.png b/24854-page-images/p195.png
new file mode 100644
index 0000000..e8f6cd5
--- /dev/null
+++ b/24854-page-images/p195.png
diff --git a/24854-page-images/p196.png b/24854-page-images/p196.png
new file mode 100644
index 0000000..1082e6e
--- /dev/null
+++ b/24854-page-images/p196.png
diff --git a/24854-page-images/p197.png b/24854-page-images/p197.png
new file mode 100644
index 0000000..58636bb
--- /dev/null
+++ b/24854-page-images/p197.png
diff --git a/24854-page-images/p198.png b/24854-page-images/p198.png
new file mode 100644
index 0000000..1ce91e9
--- /dev/null
+++ b/24854-page-images/p198.png
diff --git a/24854-page-images/p199.png b/24854-page-images/p199.png
new file mode 100644
index 0000000..020f815
--- /dev/null
+++ b/24854-page-images/p199.png
diff --git a/24854-page-images/p200.png b/24854-page-images/p200.png
new file mode 100644
index 0000000..c52b5bd
--- /dev/null
+++ b/24854-page-images/p200.png
diff --git a/24854-page-images/p201.png b/24854-page-images/p201.png
new file mode 100644
index 0000000..bddea41
--- /dev/null
+++ b/24854-page-images/p201.png
diff --git a/24854-page-images/p202.png b/24854-page-images/p202.png
new file mode 100644
index 0000000..7745944
--- /dev/null
+++ b/24854-page-images/p202.png
diff --git a/24854-page-images/p203.png b/24854-page-images/p203.png
new file mode 100644
index 0000000..f594ad1
--- /dev/null
+++ b/24854-page-images/p203.png
diff --git a/24854-page-images/p204.png b/24854-page-images/p204.png
new file mode 100644
index 0000000..2a6c13f
--- /dev/null
+++ b/24854-page-images/p204.png
diff --git a/24854-page-images/p205.jpg b/24854-page-images/p205.jpg
new file mode 100644
index 0000000..59f078f
--- /dev/null
+++ b/24854-page-images/p205.jpg
diff --git a/24854-page-images/p206.png b/24854-page-images/p206.png
new file mode 100644
index 0000000..6ab87a1
--- /dev/null
+++ b/24854-page-images/p206.png
diff --git a/24854-page-images/p207.png b/24854-page-images/p207.png
new file mode 100644
index 0000000..63fc5ae
--- /dev/null
+++ b/24854-page-images/p207.png
diff --git a/24854-page-images/p208.png b/24854-page-images/p208.png
new file mode 100644
index 0000000..ce7733b
--- /dev/null
+++ b/24854-page-images/p208.png
diff --git a/24854-page-images/p209.png b/24854-page-images/p209.png
new file mode 100644
index 0000000..e401c94
--- /dev/null
+++ b/24854-page-images/p209.png
diff --git a/24854-page-images/p210.png b/24854-page-images/p210.png
new file mode 100644
index 0000000..35135c9
--- /dev/null
+++ b/24854-page-images/p210.png
diff --git a/24854-page-images/p211.png b/24854-page-images/p211.png
new file mode 100644
index 0000000..1e49347
--- /dev/null
+++ b/24854-page-images/p211.png
diff --git a/24854-page-images/p212.png b/24854-page-images/p212.png
new file mode 100644
index 0000000..6b96882
--- /dev/null
+++ b/24854-page-images/p212.png
diff --git a/24854-page-images/p213.png b/24854-page-images/p213.png
new file mode 100644
index 0000000..24ac7a1
--- /dev/null
+++ b/24854-page-images/p213.png
diff --git a/24854-page-images/p214.png b/24854-page-images/p214.png
new file mode 100644
index 0000000..a2e6392
--- /dev/null
+++ b/24854-page-images/p214.png
diff --git a/24854-page-images/p215.png b/24854-page-images/p215.png
new file mode 100644
index 0000000..9743fa2
--- /dev/null
+++ b/24854-page-images/p215.png
diff --git a/24854-page-images/p216.png b/24854-page-images/p216.png
new file mode 100644
index 0000000..b61336f
--- /dev/null
+++ b/24854-page-images/p216.png
diff --git a/24854-page-images/p217.png b/24854-page-images/p217.png
new file mode 100644
index 0000000..68e05e7
--- /dev/null
+++ b/24854-page-images/p217.png
diff --git a/24854-page-images/p218.png b/24854-page-images/p218.png
new file mode 100644
index 0000000..e473d03
--- /dev/null
+++ b/24854-page-images/p218.png
diff --git a/24854-page-images/p219.png b/24854-page-images/p219.png
new file mode 100644
index 0000000..9c2bf79
--- /dev/null
+++ b/24854-page-images/p219.png
diff --git a/24854-page-images/p220.png b/24854-page-images/p220.png
new file mode 100644
index 0000000..a19be10
--- /dev/null
+++ b/24854-page-images/p220.png
diff --git a/24854-page-images/p221.png b/24854-page-images/p221.png
new file mode 100644
index 0000000..f9cda41
--- /dev/null
+++ b/24854-page-images/p221.png
diff --git a/24854-page-images/p222.png b/24854-page-images/p222.png
new file mode 100644
index 0000000..3b7f5a1
--- /dev/null
+++ b/24854-page-images/p222.png
diff --git a/24854-page-images/p223.png b/24854-page-images/p223.png
new file mode 100644
index 0000000..c533549
--- /dev/null
+++ b/24854-page-images/p223.png
diff --git a/24854-page-images/p224.png b/24854-page-images/p224.png
new file mode 100644
index 0000000..d667f33
--- /dev/null
+++ b/24854-page-images/p224.png
diff --git a/24854-page-images/p225.png b/24854-page-images/p225.png
new file mode 100644
index 0000000..10d8fca
--- /dev/null
+++ b/24854-page-images/p225.png
diff --git a/24854-page-images/p226.png b/24854-page-images/p226.png
new file mode 100644
index 0000000..5c4f836
--- /dev/null
+++ b/24854-page-images/p226.png
diff --git a/24854-page-images/p227.png b/24854-page-images/p227.png
new file mode 100644
index 0000000..ec8e057
--- /dev/null
+++ b/24854-page-images/p227.png
diff --git a/24854-page-images/p228.png b/24854-page-images/p228.png
new file mode 100644
index 0000000..5c37f5c
--- /dev/null
+++ b/24854-page-images/p228.png
diff --git a/24854-page-images/p229.png b/24854-page-images/p229.png
new file mode 100644
index 0000000..780cc70
--- /dev/null
+++ b/24854-page-images/p229.png
diff --git a/24854-page-images/p230.png b/24854-page-images/p230.png
new file mode 100644
index 0000000..51ad260
--- /dev/null
+++ b/24854-page-images/p230.png
diff --git a/24854-page-images/p231.png b/24854-page-images/p231.png
new file mode 100644
index 0000000..78075d4
--- /dev/null
+++ b/24854-page-images/p231.png
diff --git a/24854-page-images/p232.png b/24854-page-images/p232.png
new file mode 100644
index 0000000..b42127b
--- /dev/null
+++ b/24854-page-images/p232.png
diff --git a/24854-page-images/p233.png b/24854-page-images/p233.png
new file mode 100644
index 0000000..334c978
--- /dev/null
+++ b/24854-page-images/p233.png
diff --git a/24854-page-images/p234.png b/24854-page-images/p234.png
new file mode 100644
index 0000000..c772ac6
--- /dev/null
+++ b/24854-page-images/p234.png
diff --git a/24854-page-images/p235.png b/24854-page-images/p235.png
new file mode 100644
index 0000000..fb5d5f5
--- /dev/null
+++ b/24854-page-images/p235.png
diff --git a/24854-page-images/p236.png b/24854-page-images/p236.png
new file mode 100644
index 0000000..5f8fddd
--- /dev/null
+++ b/24854-page-images/p236.png
diff --git a/24854-page-images/p237.png b/24854-page-images/p237.png
new file mode 100644
index 0000000..2297737
--- /dev/null
+++ b/24854-page-images/p237.png
diff --git a/24854-page-images/p238.png b/24854-page-images/p238.png
new file mode 100644
index 0000000..272e0a8
--- /dev/null
+++ b/24854-page-images/p238.png
diff --git a/24854-page-images/p239.png b/24854-page-images/p239.png
new file mode 100644
index 0000000..f126922
--- /dev/null
+++ b/24854-page-images/p239.png
diff --git a/24854-page-images/p240.png b/24854-page-images/p240.png
new file mode 100644
index 0000000..421d417
--- /dev/null
+++ b/24854-page-images/p240.png
diff --git a/24854-page-images/p241.png b/24854-page-images/p241.png
new file mode 100644
index 0000000..fdf92a9
--- /dev/null
+++ b/24854-page-images/p241.png
diff --git a/24854-page-images/p242.png b/24854-page-images/p242.png
new file mode 100644
index 0000000..dadb116
--- /dev/null
+++ b/24854-page-images/p242.png
diff --git a/24854-page-images/p243.png b/24854-page-images/p243.png
new file mode 100644
index 0000000..0a7bf05
--- /dev/null
+++ b/24854-page-images/p243.png
diff --git a/24854-page-images/p244.png b/24854-page-images/p244.png
new file mode 100644
index 0000000..36b798c
--- /dev/null
+++ b/24854-page-images/p244.png
diff --git a/24854-page-images/p245.png b/24854-page-images/p245.png
new file mode 100644
index 0000000..35c1d2b
--- /dev/null
+++ b/24854-page-images/p245.png
diff --git a/24854-page-images/p246.png b/24854-page-images/p246.png
new file mode 100644
index 0000000..31e854d
--- /dev/null
+++ b/24854-page-images/p246.png
diff --git a/24854-page-images/p247.png b/24854-page-images/p247.png
new file mode 100644
index 0000000..9dac910
--- /dev/null
+++ b/24854-page-images/p247.png
diff --git a/24854-page-images/p248.png b/24854-page-images/p248.png
new file mode 100644
index 0000000..272e9c1
--- /dev/null
+++ b/24854-page-images/p248.png
diff --git a/24854-page-images/p249.png b/24854-page-images/p249.png
new file mode 100644
index 0000000..ae3b2f5
--- /dev/null
+++ b/24854-page-images/p249.png
diff --git a/24854-page-images/p250.png b/24854-page-images/p250.png
new file mode 100644
index 0000000..ac716c1
--- /dev/null
+++ b/24854-page-images/p250.png
diff --git a/24854-page-images/p251.png b/24854-page-images/p251.png
new file mode 100644
index 0000000..c89100a
--- /dev/null
+++ b/24854-page-images/p251.png
diff --git a/24854-page-images/p252.png b/24854-page-images/p252.png
new file mode 100644
index 0000000..127ab43
--- /dev/null
+++ b/24854-page-images/p252.png
diff --git a/24854-page-images/p253.png b/24854-page-images/p253.png
new file mode 100644
index 0000000..c754fae
--- /dev/null
+++ b/24854-page-images/p253.png
diff --git a/24854-page-images/p254.png b/24854-page-images/p254.png
new file mode 100644
index 0000000..fe0fbfb
--- /dev/null
+++ b/24854-page-images/p254.png
diff --git a/24854-page-images/p255.png b/24854-page-images/p255.png
new file mode 100644
index 0000000..028dcb9
--- /dev/null
+++ b/24854-page-images/p255.png
diff --git a/24854-page-images/p256.png b/24854-page-images/p256.png
new file mode 100644
index 0000000..9c81e5f
--- /dev/null
+++ b/24854-page-images/p256.png
diff --git a/24854-page-images/p257.png b/24854-page-images/p257.png
new file mode 100644
index 0000000..b9da4b6
--- /dev/null
+++ b/24854-page-images/p257.png
diff --git a/24854-page-images/p258.png b/24854-page-images/p258.png
new file mode 100644
index 0000000..4deb4ee
--- /dev/null
+++ b/24854-page-images/p258.png
diff --git a/24854-page-images/p259.png b/24854-page-images/p259.png
new file mode 100644
index 0000000..6bc15c7
--- /dev/null
+++ b/24854-page-images/p259.png
diff --git a/24854-page-images/p260.png b/24854-page-images/p260.png
new file mode 100644
index 0000000..0d80760
--- /dev/null
+++ b/24854-page-images/p260.png
diff --git a/24854-page-images/p261.png b/24854-page-images/p261.png
new file mode 100644
index 0000000..f273b06
--- /dev/null
+++ b/24854-page-images/p261.png
diff --git a/24854-page-images/p262.png b/24854-page-images/p262.png
new file mode 100644
index 0000000..1b9ad2b
--- /dev/null
+++ b/24854-page-images/p262.png
diff --git a/24854-page-images/p263.png b/24854-page-images/p263.png
new file mode 100644
index 0000000..76b0d8d
--- /dev/null
+++ b/24854-page-images/p263.png
diff --git a/24854-page-images/p264.png b/24854-page-images/p264.png
new file mode 100644
index 0000000..297d5ff
--- /dev/null
+++ b/24854-page-images/p264.png
diff --git a/24854-page-images/p265.png b/24854-page-images/p265.png
new file mode 100644
index 0000000..5511f13
--- /dev/null
+++ b/24854-page-images/p265.png
diff --git a/24854-page-images/p266.png b/24854-page-images/p266.png
new file mode 100644
index 0000000..de8080f
--- /dev/null
+++ b/24854-page-images/p266.png
diff --git a/24854-page-images/p267.png b/24854-page-images/p267.png
new file mode 100644
index 0000000..29efaf4
--- /dev/null
+++ b/24854-page-images/p267.png
diff --git a/24854-page-images/p268.png b/24854-page-images/p268.png
new file mode 100644
index 0000000..0f01f2c
--- /dev/null
+++ b/24854-page-images/p268.png
diff --git a/24854-page-images/p269.png b/24854-page-images/p269.png
new file mode 100644
index 0000000..5fc8eeb
--- /dev/null
+++ b/24854-page-images/p269.png
diff --git a/24854-page-images/p270.png b/24854-page-images/p270.png
new file mode 100644
index 0000000..bd8ead8
--- /dev/null
+++ b/24854-page-images/p270.png
diff --git a/24854-page-images/p270a.png b/24854-page-images/p270a.png
new file mode 100644
index 0000000..ad2abb9
--- /dev/null
+++ b/24854-page-images/p270a.png
diff --git a/24854-page-images/p271.png b/24854-page-images/p271.png
new file mode 100644
index 0000000..3a38a56
--- /dev/null
+++ b/24854-page-images/p271.png
diff --git a/24854-page-images/p272.png b/24854-page-images/p272.png
new file mode 100644
index 0000000..77806eb
--- /dev/null
+++ b/24854-page-images/p272.png
diff --git a/24854-page-images/p273.png b/24854-page-images/p273.png
new file mode 100644
index 0000000..72c9f0d
--- /dev/null
+++ b/24854-page-images/p273.png
diff --git a/24854-page-images/p274.png b/24854-page-images/p274.png
new file mode 100644
index 0000000..925a3c0
--- /dev/null
+++ b/24854-page-images/p274.png
diff --git a/24854-page-images/p275.png b/24854-page-images/p275.png
new file mode 100644
index 0000000..9c60df1
--- /dev/null
+++ b/24854-page-images/p275.png
diff --git a/24854-page-images/p276.png b/24854-page-images/p276.png
new file mode 100644
index 0000000..99805ce
--- /dev/null
+++ b/24854-page-images/p276.png
diff --git a/24854-page-images/p277.png b/24854-page-images/p277.png
new file mode 100644
index 0000000..f691a19
--- /dev/null
+++ b/24854-page-images/p277.png
diff --git a/24854-page-images/p278.png b/24854-page-images/p278.png
new file mode 100644
index 0000000..bff83ed
--- /dev/null
+++ b/24854-page-images/p278.png
diff --git a/24854-page-images/p279.png b/24854-page-images/p279.png
new file mode 100644
index 0000000..ed642e9
--- /dev/null
+++ b/24854-page-images/p279.png
diff --git a/24854-page-images/p280.png b/24854-page-images/p280.png
new file mode 100644
index 0000000..3ff89da
--- /dev/null
+++ b/24854-page-images/p280.png
diff --git a/24854-page-images/p281.png b/24854-page-images/p281.png
new file mode 100644
index 0000000..663d5a9
--- /dev/null
+++ b/24854-page-images/p281.png
diff --git a/24854-page-images/p282.png b/24854-page-images/p282.png
new file mode 100644
index 0000000..7db45ec
--- /dev/null
+++ b/24854-page-images/p282.png
diff --git a/24854-page-images/p283.png b/24854-page-images/p283.png
new file mode 100644
index 0000000..967372d
--- /dev/null
+++ b/24854-page-images/p283.png
diff --git a/24854-page-images/p284.png b/24854-page-images/p284.png
new file mode 100644
index 0000000..58537e9
--- /dev/null
+++ b/24854-page-images/p284.png
diff --git a/24854-page-images/p285.png b/24854-page-images/p285.png
new file mode 100644
index 0000000..4073409
--- /dev/null
+++ b/24854-page-images/p285.png
diff --git a/24854-page-images/p286.png b/24854-page-images/p286.png
new file mode 100644
index 0000000..7cefce3
--- /dev/null
+++ b/24854-page-images/p286.png
diff --git a/24854-page-images/p287.png b/24854-page-images/p287.png
new file mode 100644
index 0000000..cf44ccc
--- /dev/null
+++ b/24854-page-images/p287.png
diff --git a/24854-page-images/p288.png b/24854-page-images/p288.png
new file mode 100644
index 0000000..0a3fd52
--- /dev/null
+++ b/24854-page-images/p288.png
diff --git a/24854-page-images/p289.png b/24854-page-images/p289.png
new file mode 100644
index 0000000..0cc60d1
--- /dev/null
+++ b/24854-page-images/p289.png
diff --git a/24854-page-images/p290.png b/24854-page-images/p290.png
new file mode 100644
index 0000000..4434a9f
--- /dev/null
+++ b/24854-page-images/p290.png
diff --git a/24854-page-images/p291.png b/24854-page-images/p291.png
new file mode 100644
index 0000000..307a00e
--- /dev/null
+++ b/24854-page-images/p291.png
diff --git a/24854-page-images/p292.png b/24854-page-images/p292.png
new file mode 100644
index 0000000..9a29490
--- /dev/null
+++ b/24854-page-images/p292.png
diff --git a/24854-page-images/p293.png b/24854-page-images/p293.png
new file mode 100644
index 0000000..8370d65
--- /dev/null
+++ b/24854-page-images/p293.png
diff --git a/24854-page-images/p294.png b/24854-page-images/p294.png
new file mode 100644
index 0000000..b66cbe6
--- /dev/null
+++ b/24854-page-images/p294.png
diff --git a/24854-page-images/p295.png b/24854-page-images/p295.png
new file mode 100644
index 0000000..411cf8c
--- /dev/null
+++ b/24854-page-images/p295.png
diff --git a/24854-page-images/p296.png b/24854-page-images/p296.png
new file mode 100644
index 0000000..1dbb5b2
--- /dev/null
+++ b/24854-page-images/p296.png
diff --git a/24854-page-images/p297.png b/24854-page-images/p297.png
new file mode 100644
index 0000000..f2325b3
--- /dev/null
+++ b/24854-page-images/p297.png
diff --git a/24854-page-images/p298.png b/24854-page-images/p298.png
new file mode 100644
index 0000000..fd55641
--- /dev/null
+++ b/24854-page-images/p298.png
diff --git a/24854-page-images/p299.png b/24854-page-images/p299.png
new file mode 100644
index 0000000..96f87d6
--- /dev/null
+++ b/24854-page-images/p299.png
diff --git a/24854-page-images/p300.png b/24854-page-images/p300.png
new file mode 100644
index 0000000..9262bb4
--- /dev/null
+++ b/24854-page-images/p300.png
diff --git a/24854-page-images/p301.png b/24854-page-images/p301.png
new file mode 100644
index 0000000..69a5d5c
--- /dev/null
+++ b/24854-page-images/p301.png
diff --git a/24854-page-images/p302.png b/24854-page-images/p302.png
new file mode 100644
index 0000000..0ad1419
--- /dev/null
+++ b/24854-page-images/p302.png
diff --git a/24854-page-images/p303.png b/24854-page-images/p303.png
new file mode 100644
index 0000000..54631c4
--- /dev/null
+++ b/24854-page-images/p303.png
diff --git a/24854-page-images/p304.png b/24854-page-images/p304.png
new file mode 100644
index 0000000..ae14f93
--- /dev/null
+++ b/24854-page-images/p304.png
diff --git a/24854-page-images/p305.png b/24854-page-images/p305.png
new file mode 100644
index 0000000..5dde197
--- /dev/null
+++ b/24854-page-images/p305.png
diff --git a/24854-page-images/p306.png b/24854-page-images/p306.png
new file mode 100644
index 0000000..77d4a26
--- /dev/null
+++ b/24854-page-images/p306.png
diff --git a/24854-page-images/p307.png b/24854-page-images/p307.png
new file mode 100644
index 0000000..865f957
--- /dev/null
+++ b/24854-page-images/p307.png
diff --git a/24854-page-images/p308.png b/24854-page-images/p308.png
new file mode 100644
index 0000000..5de0448
--- /dev/null
+++ b/24854-page-images/p308.png
diff --git a/24854-page-images/p309.png b/24854-page-images/p309.png
new file mode 100644
index 0000000..39843f4
--- /dev/null
+++ b/24854-page-images/p309.png
diff --git a/24854-page-images/p310.png b/24854-page-images/p310.png
new file mode 100644
index 0000000..f64be8c
--- /dev/null
+++ b/24854-page-images/p310.png
diff --git a/24854-page-images/p311.png b/24854-page-images/p311.png
new file mode 100644
index 0000000..7a34039
--- /dev/null
+++ b/24854-page-images/p311.png
diff --git a/24854-page-images/p312.png b/24854-page-images/p312.png
new file mode 100644
index 0000000..798a03d
--- /dev/null
+++ b/24854-page-images/p312.png
diff --git a/24854-page-images/p313.png b/24854-page-images/p313.png
new file mode 100644
index 0000000..c4c986c
--- /dev/null
+++ b/24854-page-images/p313.png
diff --git a/24854-page-images/p314.png b/24854-page-images/p314.png
new file mode 100644
index 0000000..b0aaca9
--- /dev/null
+++ b/24854-page-images/p314.png
diff --git a/24854-page-images/p315.png b/24854-page-images/p315.png
new file mode 100644
index 0000000..2e10c6b
--- /dev/null
+++ b/24854-page-images/p315.png
diff --git a/24854-page-images/p316.png b/24854-page-images/p316.png
new file mode 100644
index 0000000..9d13686
--- /dev/null
+++ b/24854-page-images/p316.png
diff --git a/24854-page-images/p317.png b/24854-page-images/p317.png
new file mode 100644
index 0000000..b05a783
--- /dev/null
+++ b/24854-page-images/p317.png
diff --git a/24854-page-images/p318.png b/24854-page-images/p318.png
new file mode 100644
index 0000000..37f68f6
--- /dev/null
+++ b/24854-page-images/p318.png
diff --git a/24854-page-images/p319.png b/24854-page-images/p319.png
new file mode 100644
index 0000000..1382aa7
--- /dev/null
+++ b/24854-page-images/p319.png
diff --git a/24854-page-images/p320.png b/24854-page-images/p320.png
new file mode 100644
index 0000000..92bbacf
--- /dev/null
+++ b/24854-page-images/p320.png
diff --git a/24854-page-images/p321.png b/24854-page-images/p321.png
new file mode 100644
index 0000000..e105190
--- /dev/null
+++ b/24854-page-images/p321.png
diff --git a/24854-page-images/p322.png b/24854-page-images/p322.png
new file mode 100644
index 0000000..143dedc
--- /dev/null
+++ b/24854-page-images/p322.png
diff --git a/24854-page-images/p323.png b/24854-page-images/p323.png
new file mode 100644
index 0000000..c6b0767
--- /dev/null
+++ b/24854-page-images/p323.png
diff --git a/24854-page-images/p324.png b/24854-page-images/p324.png
new file mode 100644
index 0000000..3283223
--- /dev/null
+++ b/24854-page-images/p324.png
diff --git a/24854-page-images/p325.png b/24854-page-images/p325.png
new file mode 100644
index 0000000..f037f57
--- /dev/null
+++ b/24854-page-images/p325.png
diff --git a/24854-page-images/p326.png b/24854-page-images/p326.png
new file mode 100644
index 0000000..b5a38e7
--- /dev/null
+++ b/24854-page-images/p326.png
diff --git a/24854-page-images/p327.png b/24854-page-images/p327.png
new file mode 100644
index 0000000..165ca1f
--- /dev/null
+++ b/24854-page-images/p327.png
diff --git a/24854-page-images/p328.png b/24854-page-images/p328.png
new file mode 100644
index 0000000..6d3f7dc
--- /dev/null
+++ b/24854-page-images/p328.png
diff --git a/24854-page-images/p329.png b/24854-page-images/p329.png
new file mode 100644
index 0000000..42f9e90
--- /dev/null
+++ b/24854-page-images/p329.png
diff --git a/24854.txt b/24854.txt
new file mode 100644
index 0000000..dbc367c
--- /dev/null
+++ b/24854.txt
@@ -0,0 +1,7260 @@
+The Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4),
+by W. Grant Hague
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: The Eugenic Marriage, Vol 2 (of 4)
+       A Personal Guide to the New Science of Better Living and Better Babies
+
+Author: W. Grant Hague
+
+Release Date: March 16, 2008 [EBook #24854]
+
+Language: English
+
+Character set encoding: ASCII
+
+*** START OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+
+
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+
+
+
+
+
+
+[Illustration: _By courtesy of The New York Times_
+
+NEW YORK'S BETTER BABY
+
+Little Hiss Johanna Wiggers, who won the first prize in New York's
+Better Babies Contest by scoring 100 points, is the type of little girl
+that will make the best mothers, and the better race tomorrow. Her score
+card showed; age, 28 months; weight, 33 lbs. 14 ozs.; height, 35-1/2
+inches; circumference of head, 19-1/2 inches: circumference of chest, 20
+inches; lateral diameter of chest, 6 inches; diameter of chest from
+front to back, 4-1/2 inches; length of arm to tip of middle finger,
+14-1/2 inches; length of leg to the sole of the foot, 16-1/2 inches;
+total, 100 points.]
+
+
+
+
+The Eugenic Marriage
+
+A Personal Guide to the New Science of Better Living and Better Babies
+
+By W. GRANT HAGUE, M. D.
+
+_College of Physicians and Surgeons (Columbia University), New York;
+Member of County Medical Society, and of the American Medical
+Association_
+
+In Four Volumes
+
+VOLUME II
+
+New York
+
+THE REVIEW OF REVIEWS COMPANY
+
+1914
+
+     Copyright, 1913, by
+     W. GRANT HAGUE
+
+     Copyright, 1914, by
+     W. GRANT HAGUE
+
+
+
+
+TABLE OF CONTENTS
+
+
+
+SEX HYGIENE FOR THE BOY
+
+CHAPTER XII
+
+BUILDING OUR BOYS
+
+PAGE
+
+A word to parents--Interest in sex hygiene--The "Social Evil"--Ten
+millions suffering with venereal diseases in the United
+States--Immorality not confined to large cities--Venereal diseases
+common in country places--What are the consequences of venereal disease
+to the boy?--Gonorrhea, or clap--Symptoms of gonorrhea in the
+male--Complications of gonorrhea--Syphilis, or the "pox"--How syphilis
+is acquired--Syphilis attacks every organ in the body--Not possible to
+tell when cured--The chancre--Systematic, or constitutional
+symptoms--Mucous patches and ulcers--Syphilis of the blood vessels and
+lymphatic glands--The interior organs--Brain and spinal cord--The nose,
+eye, ear, throat--Hair and nails--What the boy with venereal disease may
+cause in others--The infected wife--A girl's fate when she
+marries--Young wife rendered sterile--Young wife made to miscarry--Is
+the husband to blame--Building the man--Age of puberty--"Internal
+Secretion" ... PAGE 139
+
+
+CHAPTER XIII
+
+THE PARENTS AND THE BOY
+
+Abuse of the procreative function--The continent life--Provide the
+environment necessary to the clean life--The period of procreative
+power--Self-abuse--Masturbation--Treatment of masturbation--Night losses
+or wet dreams--Causes of night emissions--Sexual excesses--Treatment of
+sexual excesses--What parents should know about the so-called "social
+evil" before speaking with authority to the boy--The need of
+enlightenment in sexual matters--"No one told me, I did not know"--Fake
+medical treatment of venereal diseases--Sowing wild oats--Should
+circumcision be advised ... PAGE 153
+
+
+SEX HYGIENE FOR THE GIRL
+
+CHAPTER XIV
+
+A MOTHER'S DUTY TO HER DAUGHTER
+
+What a mother should tell her little girl--Where do babies come
+from--How baby birds and fish come from eggs--How other animals have
+little nests of their own--The duty of mothers to instruct and
+direct--What a mother should tell her daughter--Every mother should
+regard this duty as sacred--Every female child is a possible future
+mother--Motherhood the highest function of the sex--Health the one
+necessary essential--Symptoms of the first, or beginning
+menstruation--The period of puberty in the female--Changes in the
+reproductive organs at puberty--The female generative organs--The
+function of the reproductive organs--The age of puberty in the
+female--The function of the ovary--The function of the womb--Why
+menstruation occurs every twenty-eight days--The male or papa egg--The
+function of the spermatozoa--"Tell the whole story"--"How do these
+spermatozoa get there"--The union of the species--"How can a baby live
+in there for such a long time"--How the baby gets its nourishment in the
+womb--Girls must not become mothers ... PAGE 173
+
+
+CHAPTER XV
+
+PREPARING FOR MOTHERHOOD
+
+Menstruation--Irregular menstruation--Changes in the quantity
+of the flow--How the womb is held in place--Symptoms of
+menstruation--Menstruation should not be accompanied with pain--Don't
+give your daughters patent medicines, or "Female Regulators"--Take your
+daughter to the doctor--Leucorrhea in girls--Bathing when
+menstruating--Constipation and displaced wombs--Dress and
+menstruation--Absence of menstruation, or amenorrhea--Treatment of
+amenorrhea--Painful menstruation, or dysmenorrhea--Causes of
+dysmenorrhea--Treatment of dysmenorrhea--Sterility in the
+female--Conditions which affect the fertility of women--Climate, station
+in life, season of the year, age, the tendency to miscarry--Causes of
+sterility in the female--Displacement of womb--Diseases of womb,
+ovaries, or tubes--Malformations--Lacerations--Tumors--Leucorrhea--Physical
+debility--Obesity--Special poisons--"Knack of miscarrying"--Miscarriage--Cause
+of miscarriage--The course and symptoms of miscarriage--What to do
+when a miscarriage is threatened--Treatment of threatened
+miscarriage--Treatment of inevitable miscarriage--After
+treatment of miscarriage--The tendency to miscarriage ... PAGE 187
+
+
+THE BABY
+
+CHAPTER XVI
+
+HYGIENE AND DEVELOPMENT OF THE BABY
+
+What to prepare for the coming baby--Care of the newly-born baby--The
+first bath--Dressing the cord--Treatment after the cord falls off--A
+pouting navel--Bathing baby--Clothing the baby--Baby's night
+clothes--Care of the eyes--Care of the mouth and first teeth--Care of
+the skin--Care of the genital organs--Amusing baby--Temperature
+in children--The teeth--The permanent teeth--Care of the
+teeth--Dentition--Treatment of teething--How to weigh the baby--Average
+weight of a male baby--Average weight of a female baby--Average height
+of a male child--The rate of growth of a child--Pulse rate in
+children--Infant records, why they should be kept--"Growing
+pains" ... PAGE 209
+
+
+CHAPTER XVII
+
+BABY'S FEEDING HABITS
+
+Overfeeding baby--Intervals of feeding--How long should a baby stay at
+the breast--Vomiting between feedings--Regularity of feeding--Why is
+regularity of feeding important--A baby never vomits--What is the
+significance of so-called vomiting after feedings--Mother's milk that is
+unfit for baby--Fresh air for baby--Air baths for baby ... PAGE 223
+
+
+CHAPTER XVIII
+
+BABY'S GOOD AND BAD HABITS--FOOD FORMULAS
+
+Baby's bed--The proper way to lay baby in bed--Baby should sleep by
+itself--How long should a baby sleep--Why a baby cries--The habitual
+crier--The habit of feeding baby every time it cries--The habit of
+walking the floor with baby every time it cries--Jouncing, or hobbling
+baby--Baby needs water to drink--The evil habit of kissing
+baby--Establishing toilet habits--Baby's comforter--What can be done to
+lessen the evil effects of the comforter habit--Beef juice--Beef juice
+by the cold process--Mutton broth--Mutton broth with cornstarch or
+arrowroot--Chicken, veal, and beef broths--Scraped beef or meat
+pulp--Junket or curds and whey--Whey--Barley water--Barley water gruel
+or barley jelly--Rice, wheat or oat water--Imperial Granum--Albumen
+water--Dried bread--Coddled egg ... PAGE 235
+
+
+ARTIFICIAL FEEDING
+
+CHAPTER XIX
+
+ARTIFICIAL FEEDING
+
+Elementary principles of milk modification--The secret of the efficiency
+of mothers' milk--Two important factors in successful artificial
+feeding--Every child is a problem in itself--Proprietary foods of little
+value as infant foods--Their value is in the milk added to them--The
+credit belongs to the cow--Difference between human and cow's milk--What
+"top-milk" feeding means--Utensils necessary for home modification of
+milk--Artificial feeding from birth to the twelfth month--How to
+measure "top-milk"--Easy bottle-feeding method--Condensed milk
+feeding--Objections to condensed milk feeding ... PAGE 249
+
+
+CHAPTER XX
+
+ARTIFICIAL FEEDING (_continued_)
+
+How to prepare milk mixtures--Sterilizing the food for the day's
+feeding--How to test the temperature of the food for baby--When to
+increase the quality or quantity of food--Food allowable during the
+first year in addition to milk--Beef-juice--White of egg--Orange
+juice--Peptonized milk--The hot or immediate process--The cold
+process--Partially peptonized milk--Completely peptonized milk--Uses of
+peptonized milk--Objections to peptonized milk--What a mother should
+know about baby's feeding bottle and nipple--Should a mother put her
+baby on artificial food if her supply of milk during the first two weeks
+is not quite enough to satisfy it--Certain conditions justify the
+adoption of artificial feeding from the beginning--Mothers' mistakes in
+the preparation of artificial food--Feeding during the second
+year--Sample meals for a child three years of age--The diet of older
+children--Meats, vegetables, cereals, bread, desserts, fruits ... PAGE 259
+
+
+WHAT MOTHERS SHOULD KNOW
+
+CHAPTER XXI
+
+THE EDUCATION OF THE MOTHER
+
+What mothers should know about the care of children during illness--A
+sick child should be in bed--The diet of the sick child--A child is the
+most helpless living thing--The delicate child--How to feed the delicate
+child--How to bathe the delicate child--Airing the delicate
+child--Habits of the delicate child--Indiscriminate feeding--Poor
+appetite--Loss of appetite--Treatment of loss of appetite--Overeating in
+infancy--What correct eating means--Bran as a food--Breakfast for a
+child at school--Lunch for a child at school--Bran muffins for school
+children--Bran muffins in constipation--Hysterical children--What a
+mother should know about cathartics and how to give a dose of castor
+oil--Castor oil--Calomel--Citrate of Magnesium--When to use castor
+oil--When to use calomel--Vaccination--Time for vaccination--Methods of
+vaccination--Symptoms of successful vaccination ... PAGE 277
+
+
+CHAPTER XXII
+
+CONSTIPATION IN INFANTS AND CHILDREN
+
+Constipation--Regularity of bowel function--The function of the
+stomach--Fermentation--Incomplete constipation--Importance of a clean
+bowel--A daily movement of the bowel necessary--Constipation in
+breast-fed infants--Treatment of constipation in breast-fed
+infants--Constipation in bottle-fed infants--Treatment of constipation
+in bottle-fed infants--Constipation in children over two years of
+age--Diet list for constipation in children--Bran muffins in
+constipation--Treatment of obstinate constipation--Oil injections in
+constipation ... PAGE 303
+
+
+CHAPTER XXIII
+
+CONSTIPATION IN WOMEN
+
+Chief cause of constipation in women--Constipation a cause of domestic
+unhappiness--The requirements of good health--The cost of
+constipation--Constipation and social exigencies--One of the important
+duties of mothers--Constipation and diseases of women--Constipation is
+always harmful--Constipation and pregnancy--Explanation of incomplete
+constipation--Causes of constipation--Negligence--Lack of exercise--Lack
+of water--Lack of bulk in the food taken--Abuse of cathartic drugs and
+aperient waters--Overeating--Treatment of constipation in
+women ... PAGE 315
+
+
+
+
+SEX HYGIENE FOR THE BOY
+
+
+
+
+CHAPTER XII
+
+     "The evil that men do lives after them. The good is often
+     interred with them."
+
+     "The pleasure in living is to meet temptation and not yield to
+     it." Elmer Lee, M. D.
+
+BUILDING OUR BOYS
+
+     A Word to Parents--Interest in Sex Hygiene--The "Social
+     Evil"--Ten Millions Suffering with Venereal Diseases in the
+     United States--Immorality not Confined to Large
+     Cities--Venereal Diseases Common in Country Places--What Are
+     the Consequences of Venereal Disease to the Boy?--Gonorrhea, or
+     Clap--Symptoms of Gonorrhea in the Male--Complications of
+     Gonorrhea--Syphilis, or the "Pox"--How Syphilis is
+     Acquired--Syphilis Attacks Every Organ in the Body--Not
+     Possible to Tell When Cured--The Chancre--Systematic or
+     Constitutional Symptoms--Mucous Patches and Ulcers--Syphilis of
+     the Blood Vessels and Lymphatic Glands--The Interior
+     Organs--Brain and Spinal Cord--The Nose, Eye, Ear, Throat--Hair
+     and Nails--What the Boy with Venereal Disease May Cause in
+     Others--The Infected Wife--A Girl's Fate When She
+     Marries--Young Wife Rendered Sterile--Young Wife Made to
+     Miscarry--Is the Husband to Blame?--Building the Man--Age of
+     Puberty--"Internal Secretion."
+
+
+A WORD TO PARENTS.--Within recent times the subject of sex hygiene has
+been freely discussed by members of the medical profession and through
+them the general public has been made more or less acquainted with the
+problem. It has therefore acquired a degree of genuine interest which
+speaks well for the future of the eugenic ideal. Eugenics is based to a
+very large extent upon the principles underlying sex hygiene.
+
+As a result of this widespread interest and investigation, we have
+discovered that the only method that promises actual progress, is to
+talk plainly and to tell the actual truth. The day of the prude has
+passed. To attempt to achieve results in the education of youth in sex
+problems, without giving, facts, is wasted effort. To give facts we must
+explain each problem so that its principles may be clearly understood
+and its meaning grasped. To point out the duty of youth is not
+sufficient. They must be shown why it is to their best interest to live
+the clean life. In every department of education we are beginning to
+appreciate that to achieve results it must be based upon the individual
+equation. This is why we have found it necessary to assert that it is
+the duty of parents to make sex hygiene a personal matter and to
+acquaint their children with the facts relating to this problem. It has
+been discovered, however, that a very large percentage of parents are
+inadequately informed on these subjects, in fact they know practically
+nothing about the actual facts which they are supposed to teach. I shall
+try to tell the story in a way which every parent will understand.
+
+When a boy reaches the age of puberty he is susceptible to sexual
+desire. If he has not been told the story of his growth from boyhood to
+man's estate he will either begin to abuse himself, or he will be later
+enticed to commit himself to intercourse with some unclean female and he
+will acquire a disease as a result.
+
+Inasmuch as it has been asserted that practically every boy has been
+addicted to self-abuse at some time, and that eighty per cent. of all
+males, between the ages of sixteen and thirty years, are victims of
+venereal disease, it would seem justifiable to assume that the boys who
+are informed of the facts in time are the boys who constitute the
+percentage who escape. This, of course, may not be literally true, but
+it is a reasonable assumption.
+
+While self-abuse is a pernicious habit and may be attended with serious
+consequences, it is not a disease and, as will be explained later, it
+can be cured. It is therefore a menace to the individual, not to the
+race, and consequently need not concern us at the present time. On the
+other hand the venereal diseases are not to be considered as individual
+problems since they affect the welfare of the race. The venereal
+diseases which we will consider are gonorrhea and syphilis.
+
+THE SOCIAL EVIL.--It has been estimated that there are more than _ten
+millions_ of people in this country to-day suffering from the effects of
+venereal diseases. In New York city alone, there are _two million_
+victims suffering from the direct or indirect consequences of these
+diseases. It has been authoritatively asserted that, out of every ten
+men between the ages of sixteen and thirty, eight have, or have had, one
+or other of these diseases. When it is remembered that these diseases
+are not merely temporary incidents, but that they may be regarded as
+practically incurable in the vast majority, because of antagonistic
+social conditions and ignorance, and that they are highly infectious, we
+may begin to realize how important they are from the standpoint of race
+regeneration.
+
+Statistics of these conditions are never reliable because much of the
+evil is hidden and lied about. It is quite probable,--if the estimates
+were based upon absolute knowledge--that the extent of the prevalency of
+these diseases would be greatly increased rather than reduced. It is
+however a fact, that the combined ravages of the Great White Plague,
+leprosy, yellow fever, and small-pox, are merely incidents compared to
+the effects which the venereal diseases have had upon mankind. It is
+useless to think that these diseases can be driven out of the land. Any
+hope of this nature is the impression of the dreamer. By a propaganda of
+education, by the spread of the eugenic idea and ideal, we may, however,
+reasonably hope to minimize the evil and, at least, to protect the
+innocent.
+
+THE SOURCES OF IMMORALITY.--It is a fallacious idea to assume that the
+sources of immorality are confined to the large cities. This is far from
+the truth. In smaller towns and country places the diseases are quite
+common and conditions there tend to the spread of the contagion in a
+more intimate and a more harmful way. The individuals who are most
+likely to become affected are those most liable to succumb to temptation
+and whose home ties are of the best. There are many instances on record
+where one or two loose women spread the infection all over the country
+communities, infecting boys and men alike. No one can estimate what the
+final effect of such an epidemic may mean or how many innocent
+individuals may have their lives wrecked as a direct consequence. It is
+because these consequences are the product of ignorance in a very large
+percentage of the cases that there is such urgent need for
+enlightenment. It is at least our plain duty to tell the boy the actual
+facts--to post him with reference to consequences. The more thoroughly
+we instruct him in the elementary facts relative to the venereal
+diseases, the safer he will be from temptation, and if he possesses this
+knowledge and acquires disease, he will be more likely to immediately
+seek competent aid and advice.
+
+
+WHAT ARE THE CONSEQUENCES OF VENEREAL DISEASE TO THE BOY HIMSELF?
+
+GONORRHEA OR "CLAP."--This is the most frequent of the venereal
+diseases. It is also the most serious. It is an unfortunate fact, that
+in the past,--and even to-day--boys have been told that gonorrhea is no
+worse than "a bad cold." This lie has been responsible for much evil and
+a great amount of unnecessary suffering and misery.
+
+Gonorrhea is caused by a germ, obtained, as a rule, during intercourse
+with an infected person. This germ is called gonococcus. It thrives on
+any mucous membrane; it is not, therefore, limited to the sexual organs.
+For this reason it may attack any part of the body where mucous membrane
+is. It is particularly liable to damage, sometimes seriously and
+permanently, the eye. It may be spread from one person to another, or
+from any infected article to a person in numerous ways. The innocent may
+thus suffer as a result of the carelessness of the vicious.
+
+THE SYMPTOMS OF GONORRHEA IN THE MALE are slight itching and burning of
+the mouth of the urethra. This is noticeable at any time from the third
+to the fourteenth day after exposure. These symptoms become more
+pronounced and a slight discharge appears. The patient is compelled to
+urinate frequently and it is painful and difficult. The discharge
+increases, it becomes thicker and looks like ordinary yellow pus. If the
+case is a severe one, the discharge may be blood stained, and if this
+symptom is present urination is more painful and more frequent.
+
+In about ten days the disease reaches its height; it remains stationary
+for a number of weeks and then slowly, seemingly, gets better. The
+discharge grows thinner, less in quantity and lighter in color. It may
+refuse, despite the most careful and efficient treatment, to stop
+altogether; it is then known as "gleet." If the discharge stops
+completely the patient is apparently cured, as far as any external
+manifestation of the disease is concerned. _In seventy-five per cent. of
+the cases, however, this apparent cure is no cure at all, as will be
+seen later._
+
+Certain complications are likely to arise in the course of gonorrhea.
+The infection itself may be of such an acute or virulent type, that it
+invades the deeper structures of its own accord and despite the most
+careful, competent treatment; or if the treatment is not adequate or
+skillful it may be forced backward; or through neglect in not beginning
+the right kind of treatment in times, a simple infection may grow in
+degree into a serious disease, and invade the more important structures.
+In this way are produced disease of the bladder, prostate gland, seminal
+vesicles, testicles, and of the kidneys. Gonorrheal rheumatism may
+follow, and even disease of the lining membrane of the heart, and death.
+
+When disease of the deeper parts occur the patient is frequently
+incapacitated and compelled to go to bed. He may have chills, fever and
+sweats, intense pain and the passage of bloody urine. He may have to be
+operated upon, and his general health may be permanently wrecked. So
+long as the germs are present there is danger despite the most
+scientific treatment. It is not the quality of the treatment that is at
+fault, it is the presence of the germs; and since it is impossible to
+pursue any certain method of eradication, we must continue treatment--as
+long as the germs are present--and hope for favorable results. The
+infection may last for many years. The germs having found entrance into
+the small tubes in the interior organs they can only be dislodged with
+difficulty, if at all. These pockets of germs may be excited to renewed
+activity by sexual intercourse, or by injury to the parts, and may
+reinfect the patient at any times. In a very considerable number of
+these cases where the deeper structures are involved, the patient may
+recover from the acute or painful period of the disease, only to find
+that he is sterile. There are many such cases, and the most vindictive
+individual who may believe that every who sins should be punished will
+admit that sterility, as the price of a moment's forgetfulness, is a
+terrible fee to pay.
+
+SYPHILIS, OR THE "POX," is an infectious, germ blood disease. It is most
+frequently acquired through sexual intercourse.
+
+It may be acquired by direct contact with a diseased person. In order to
+render such contact effective, it is essential that the skin of the
+healthy person be abraded, or the contact may be directly on a mucous
+membrane, as the mouth in the act of kissing.
+
+It may be acquired by using any article which has been used by a
+syphilitic, as a drinking cup, or towel.
+
+It may be acquired through hereditary transmission.
+
+Surgeons frequently contract syphilis while operating on, or examining
+patients who have the disease. Dentists may convey it by means of
+instruments which have not been rendered aseptic, or thoroughly clean.
+Using a towel which has been used by a syphilitic has many times
+conveyed the infection to an innocent party. For this reason the roller
+towel has been done away with, and some states have legislated against
+its use in hotels and other public places. To use dishes, spoons,
+tobacco pipe, beer glasses, etc., which have been used by one having the
+disease is an absolutely certain way of being infected. Cigars which may
+have been made by a syphilitic will infect whoever smokes them with the
+virus of the disease. Syphilis has been known to have been caught from
+using the church communion cup. The public drinking-cup has been a
+prolific source of syphilitic dissemination to innocents. Legislators
+are just waking up to the danger that lurks in this institution and it
+will no doubt be done away with, not only in public places, but on all
+railroad and steamboat lines.
+
+An infected mother can transmit syphilis to her child. If the father is
+affected, but not the wife, the child may escape.
+
+Syphilis attacks every organ in the human body. The actual degree of
+infection has no relation to the size or character of the external
+manifestations. The external evidence may be minute and insignificant,
+while the internal extent and ravages of the disease may be tremendous
+and of large proportions. Many men when asked regarding incidents of the
+long ago, may state, "Oh, yes, I had a chancre twenty-five years ago,
+but it was a very small affair and soon healed up and was cured." Yet
+that same little chancre, that made only a mild impression on the man's
+mind, may, and most probably will, be the direct cause of that man's
+death.
+
+It is not possible to tell with absolute certainty that an individual is
+suffering with syphilis by any known test. The most recent one--the
+Wassermann test--is not absolute by any means.
+
+The first symptoms, or what is known as the initial lesion of syphilis,
+is the chancre.
+
+THE CHANCRE is a small, hard tumor, or it may be a small ulcer with a
+hard base, or it may simply appear as a thin small patch on any mucous
+membrane. It is not painful, it can be moved if taken between the
+fingers, showing it is not attached to the deep structures, and when it
+is so moved it is not tender or sore. Any little lump which ulcerates
+located on the genitals must be regarded with suspicion. Boys and men
+should not be satisfied with any offhand statement that, "it is
+nothing." It may be a chancre, and it may be exceedingly serious if not
+properly diagnosed.
+
+Systemic, or constitutional symptoms, begin to show themselves any time
+from the sixth to the tenth week after the appearance of the chancre.
+
+ERUPTIONS OF THE SKIN characterize every case of syphilis. They occur in
+all degrees from the mild rash to the foul ulcer. The ulcerative process
+is very often extensive and loathsome.
+
+MUCOUS PATCHES AND ULCERS affect the mucous membranes. The mouth and
+throat are favorite locations for these lesions. They occur in the anus
+and rectum, and may be mistaken in that region for other serious
+conditions. Men who drink and smoke suffer as a rule severely from
+mucous patches in the mouth and throat.
+
+Syphilis attacks the blood vessels and the lymphatic glands. These cases
+may have been unrecognized, and may have existed for many years. A man
+may die from a rupture of a blood vessel in the brain during middle life
+as a consequence of a forgotten, supposedly cured case of syphilis many
+years before.
+
+THE INTERIOR ORGANS may be attacked by syphilis. As a result we get
+disease of the liver, heart, stomach, kidneys, lungs, and other parts.
+It has been suggested that many diseases affecting these organs, for
+which treatment proves unsatisfactory, may have had their origin in a
+former syphilis.
+
+THE BRAIN AND SPINAL CORD are quite often the seat of syphilitic
+affections. A tumor, known by the name of "gumma," is the result. The
+blood vessels of the entire nervous system may be affected and, as a
+consequence, we often see cases of paralysis, apoplexy, epilepsy,
+locomotor ataxia and death.
+
+THE NOSE, EYE, EAR, THROAT, are frequently very seriously compromised as
+a result of the syphilitic poison. Deformity, caused by rotting of the
+bones of these parts is not infrequent. Loss of voice, or smell, or
+hearing, or sight, may result.
+
+THE HAIR AND NAILS may fall out. The bones may ulcerate and rot. The
+organs of procreation usually participate in the degenerative process.
+Virility is destroyed, and impotence is quite common after a severe
+attack.
+
+
+WHAT THE BOY WITH VENEREAL DISEASE MAY CAUSE IN OTHERS
+
+GONORRHEA.--When the average boy acquires gonorrhea he frequently does
+not know, for many weeks, that he is the victim of a dangerous,
+infectious disease. He appreciates probably, that it relates to the
+sexual indiscretion he was guilty of, and feels that it is something to
+be ashamed of. He therefore hides his condition, confides in no one, and
+blindly hopes it will get better somehow or at some time. Meantime the
+disease, which may have been mild at the beginning, is gradually gaining
+ground and strength, and his neglect may eventuate in lifelong misery.
+No means are taken to guard against spreading the infection, the
+discharge may lodge on his fingers and he may infect his eyes and may
+lose his sight because he did not know that the discharge is one of the
+most dangerous fluids known. It may get on water-closet seats and infect
+others. Eventually he is compelled to seek aid, and he may, after a long
+period, be freed from the immediate consequences of his folly. At a
+later date he marries, and as previously explained, he infects his wife.
+This is the beginning of much of the domestic infelicity that is so
+prevalent to-day, and, inasmuch as it is a subject that should be
+thoroughly understood by every woman and mother, I shall carefully and
+clearly explain its significance and its consequences.
+
+Let us first, however, briefly consider what may occur to others if the
+boy is unfortunate enough to acquire syphilis. Again the boy fails to
+comprehend the nature of his affliction. There is imminent danger of the
+members of his household becoming infected. He uses the same dishes,
+spoons, towels, and utensils, any one of which may convey the disease to
+his father, mother, sister, or brother. He may use the common drinking
+glass in school, college, or office, and spread the disease in this way.
+He may kiss any member of his family, or a baby, and infect them. He may
+have his hair cut, or be shaved, and the virus may be spread around in
+this way if the barber does not sterilize the article used,--which he
+never does. He may drink at a soda fountain, or at a saloon, and the
+next individual to use the same glass may acquire the disease. He is a
+menace to the individual, to the community, and to the race. Wives often
+acquire syphilis from their husbands.
+
+THE INFECTED WIFE.--It has been previously stated that eight out of
+every ten males between the ages of sixteen and thirty, have had or
+have, gonorrhea or syphilis. Seventy-five per cent. of these cases have
+not been cured. About thirty-five per cent. of these are destined to
+infect wife, or wife and children, and in all probability many others.
+
+If a young wife acquires infection from her husband, she is exactly in
+the same condition as the diseased boy,--she does not know what ails
+her, so she wastes precious time in unprofitable worry. Why should she
+know what the trouble is? She came to the marriage bed pure, and clean,
+and healthy. Her previous education did not include instruction which
+would even help her to guess what the trouble might be. She is simply
+conscious of new distressing conditions which she does not understand.
+She may try to believe that these conditions are incidental to the
+change in her life. Shortly, however, the discharge, which she has had
+for a number of weeks, and which she thought was only a leucorrhea, or
+"the whites," becomes so profuse and nasty that she begins douching.
+This procedure simply blinds her to the true nature of the affection,
+and in the end she is driven, ashamed and reluctant, to consult a
+physician. She may be informed that her condition is bad, and that it
+will be necessary that she submit to a course of treatment. After a time
+the physician may succeed in tiding her over the immediate consequences
+of the gonorrheal infection she innocently acquired. She may soon after
+become pregnant, and she may miscarry as a result of the old trouble, or
+she may carry the child the full period. When the child is born it may
+be blind and this defect is a consequence of the old infection to the
+mother from the father. If the mother is syphilitic the child most
+likely will inherit all the horrible possibilities of transmitted
+blood-poison.
+
+Pregnancy frequently "lights up" any old, gonorrheal infection in the
+female, so this young wife fails to completely recover after the
+confinement. She is able to be about, but her strength refuses to be
+restored. It may be months later when she begins to suffer pain and to
+realize that she is quite sick. She develops a fever and may have a
+chill. The physician discovers that she has pus in her tubes and there
+is danger of peritonitis or general blood poisoning. The old germs have
+been roused and are active. Unfortunately they are located where it is
+impossible to dislodge them without resorting to a serious operation. It
+is now a problem of saving her life. She is taken to the hospital and
+her womb, tubes, and ovaries, are removed--she is unsexed.
+
+Young wives are being operated on every day, in every city in the
+civilized world for just such causes. It is a notorious fact, that, in
+every city in the world, the number of operations that are daily being
+performed on women, is increasing appallingly. Every surgeon knows that
+eighty per cent. of these operations are caused, directly or indirectly,
+by these diseases, and in almost every case in married women, they are
+obtained innocently from their own husbands. It is rare to find a
+married woman who is not suffering from some ovarian or uterine trouble,
+or some obscure nervous condition, which is not amenable to the ordinary
+remedies, and a very large percentage of these cases are primarily
+caused by infection obtained in the same way.
+
+When a girl marries she does not know what fate has in store for her,
+nor is there any possible way of knowing, under the present marriage
+system. If she begets a sickly, puny child,--assuming she herself has
+providentially escaped immediate disease,--she devotes all her mother
+love and devotion to her child, but she is fighting a hopeless fight as
+I previously explained when I stated that one-half of the total effort
+of one-third of the race, is expended in combating conditions against
+which no successful effort is possible. Even her prayers are futile,
+because the wrong is implanted in the constitution of the child and the
+remedy is beyond her power to find. These are the tragedies of life,
+which no words may adequately describe, and compared to which the
+incidental troubles of the world at large are as nothing.
+
+If the conditions are not as bad as those depicted above, the original
+infection may have rendered her sterile. If the germs reached the womb
+and tubes, the inflammatory process may close these tubes, with the
+result that conception is impossible. In these cases the woman has to
+bear the stigma and disgrace of a childless union, though she is not
+the guilty party. Many husbands are sterile, however, as a result of
+venereal disease. It is claimed that eighty per cent. of childless
+marriages are caused by sterility of the male partner. Curiously and
+unfortunately these men never suspect themselves. The wife is the
+delinquent member, in their estimation. She is the victim of jest and
+suspicion, and later of jibes and insults. Many women have had their
+lives rendered miserable and unhappy because of this suspicion. They are
+compelled by their husbands to submit to examination and unpleasant and
+painful treatment and operations with the intention of rectifying a
+defective condition that does not exist. Many conscientious physicians
+refuse to treat women patients against whom the charge of sterility is
+made, before subjecting the husbands to thorough examination, and, since
+eighty per cent. of childless marriages are due to sterility in the
+male, this is a just and reasonable course to pursue.
+
+During the course of all this domestic trouble and tragedy, the young
+wife's health has suffered--she scarcely enjoys one day of good health.
+Her mental condition is even worse. She submits to innuendo and insult
+under the impression that she is the unwitting cause of all the domestic
+wretchedness and often wishes she had never entered the marriage state.
+We must remember that these conditions wreck ideals and homes, and that
+they frequently render inefficient both husband and wife. The economic
+business of marriage becomes a failure, ambition is crushed and hope
+dies in the heart.
+
+If the mother has been inoculated with the virus of syphilis her
+existence is equally wretched; her health is ruined; her efficiency is
+forever mortgaged. If she becomes pregnant she will most likely abort
+and she will go on aborting for years, in the effort to bring children
+into the home, accusing herself meantime and submitting to the
+reflections which are heaped upon her, while the real culprit is the
+husband. He assumes an injured and innocent attitude and behaves as if
+he had been imposed upon by marriage with a woman who cannot carry out
+her marital contract.
+
+If she gives birth to a child or children, they are syphilitic. They
+may be deformed, or they may be feeble-minded or idiots. They may live
+at home for years, always ailing, always sick. They may develop
+epilepsy, St. Vitus' dance, skin disease, or mental vagaries, and they
+may have to be put into institutions for the feeble-minded, or they may
+die by inches at home.
+
+IS THE HUSBAND TO BLAME?--If a boy had gonorrhea a number of years
+before entering the marriage state, was treated for it by a physician,
+until all symptoms had disappeared and had enjoyed apparent good health
+in the interim, and had never been told any of the facts regarding
+probable consequences, is it just to blame him if he infects his wife?
+It is certain no man would willingly subject his bride to the risk of
+infection, with all its horrible consequences. These conditions exist as
+a result of the prudish attitude of society in the past toward all
+questions affecting sex hygiene. We have not told all the truth to the
+boy. Whatever knowledge he may have had was gained from companions, or
+from individuals who knew the garbled facts only. There is of course no
+excuse for the man who acquires disease after marriage and conveys it to
+his wife or children. This is a very different situation and one which
+should merit the severest condemnation and punishment. We are, however,
+only interested in the boy at present and will not take up the reader's
+time with a discussion of the "social evil" from this standpoint.
+
+BUILDING A MAN.--When the boy is about fifteen years of age certain
+changes begin to manifest themselves. He grows more rapidly, a growth in
+which his whole system participates. His bones grow bigger and stronger,
+his muscles increase in size, even his heart, and lungs, and liver, and
+his digestive system accommodate themselves to this transformation; the
+voice changes and hair begins to grow on his face. The mental process
+also keeps pace with the new order of things. He thinks differently and
+he sees from a new viewpoint. Nature is making a man out of a boy.
+
+These changes were not understood in the past, but we are beginning to
+appreciate the reason for this evolutionary process. We have discovered
+that the cause depends upon certain active changes which take place in
+the sex organs. About this time the testicles begin to be active. For
+years these glands have been preparing themselves for this work, so they
+first grow rapidly, increasing in size until they are about eight times
+bigger than they were before this time, then they begin to pour into the
+circulation a secretion which stimulates changes in all other parts of
+the body and is directly responsible for the wonderful change that is
+evident in the stature of the boy's body.
+
+This substance or "internal secretion" must not be confused with the
+semen. The internal secretion is simply the substance which nature
+employs in the developing process and is responsible for the degree of
+growth and quality of manhood which the boy manifests. The semen, on the
+other hand, is the procreative or fertilizing fluid which enables a man
+to beget offspring. When a boy understands this process it aids him in
+appreciating the importance of his sex organs and a little thought
+enables him to understand that if he abuses these organs he will
+seriously interfere with his own development. This process goes on for a
+number of years, until the boy reaches maturity. Any act or habit which
+weakens the quality of this secretion will deplete his powers and render
+him physically and mentally inefficient. To make a man, nature must be
+permitted to work in her own way. You cannot improve on her methods nor
+can you break her laws with impunity.
+
+
+
+
+CHAPTER XIII
+
+THE PARENTS AND THE BOY
+
+     Abuse of the Procreative Function--The Continent Life--Provide
+     the Environment Necessary to the Clean Life--The Period of
+     Procreative Power--Self-abuse--Masturbation--Treatment of
+     Masturbation--Night Losses or Wet Dreams--Causes of Night
+     Emissions--Sexual Excesses--Treatment of Sexual Excesses--What
+     Parents Should Know About the So-called "Social Evil," Before
+     Speaking with Authority to the Boy--The Need of Enlightenment
+     in Sexual Matters--"No One Told Me, I Did Not Know"--Fake
+     Medical Treatment of Venereal Diseases--Sowing Wild
+     Oats--Should Circumcision be Advised?
+
+
+ABUSE OF THE PROCREATIVE FUNCTION.--Breeders of animals have discovered
+that to breed from very young stock is not good. The quality and stamina
+of the progeny is lowered and the vitality of the parent stock is
+reduced. It is not a good economic proposition.
+
+Boys should therefore be taught that any form of sexual indulgence is
+harmful before the period of full growth.
+
+Nature did not intend that the procreative function should be exercised
+by individuals who were not fully developed. The perpetuation of the
+species must not depend upon the license of immaturity. The instinct of
+sex-attraction must not be debased to serve a puerile, rather than a
+holy purpose.
+
+Sexual indulgence in any form, and in any degree, at any age prior to
+full maturity is a perversion of the primal instinct of race
+perpetuation. The practice has a more intimate and a more personal
+association with growing boys, however, than a merely altruistic
+reference. Any indulgence of this character at this time is physically
+and mentally injurious. No boy can hope ever to acquire the full measure
+of his possible development as an efficient working or thinking machine
+if he wastes his vital forces in unnatural liberties. He should be
+taught this truth in an emphatic manner by those responsible for his
+education.
+
+There is a false idea prevalent that a continent life is harmful. So far
+as continence relates to immaturity, it may be strongly and justly
+asserted that it is probably the most important factor in the
+conservation of health and strength. The retention of the procreative
+fluids, at a time when nature is opposed to their loss, enables the
+growing economy to utilize them in the conservation of nervous energy
+and virility. If a boy dissipates these energizing fluids, he deprives
+his body of the richest products which he is capable of manufacturing at
+a time when he needs every aid in the building up of a physically and
+mentally sound and vigorous constitution. There cannot exist a normal
+development if the body is deprived of the essential ingredients
+necessary to growth and mental vigor.
+
+There was a time when young men were actually taught that sexual
+intercourse was necessary to develop full manhood. This was followed by
+a period of silence, which has practically extended to recent times.
+Both of these systems are pernicious. We know that sexual intercourse is
+not necessary to the development of mature normal manhood or womanhood.
+On the contrary, we know that continence, not incontinence, is an
+absolute essential to the growth of full sexual, virile maturity, as
+well as to the growth of efficient and healthy manhood and womanhood.
+
+We must appeal to a boy's reason and show him the personal side of clean
+living. When he understands that to attain success in every department
+of human effort,--on the baseball and football fields, in the ring, in
+gymnastic contents, in examinations, in social intercourse, in trades
+and professions,--a continent life is the only means possible that
+promises success, he will give the appeal consideration.
+
+We must employ all the safety devices possible to guard against the
+inclination of youth to wander. Regular exercise is one of the very best
+institutions in this respect. If we can instill into our boys a love of
+manly sports and encourage every effort in this direction, we will be
+doing much to minimize the growth of any tendency toward incontinence.
+We must provide the environment necessary to right living. The home
+should be attractive and we should permit the boy to have privileges
+even at the expense of the housekeeping decorum. His companions should
+be made welcome if they are the right kind of intimates, and the parents
+should enter into the life of the boy and try to look at "things" from
+his standpoint.
+
+THE PERIOD OF PROCREATIVE POWER.--The procreative ability begins at
+puberty. There is no fixed period at which it may be said to end. From
+puberty until the period of physical maturity, it grows in vigor and it
+remains stationary until middle life, when it gradually declines. The
+standard of virility is unquestionably an individual problem. It depends
+upon the various factors that contribute to good health and longevity.
+It may be stated that the boy who abused his procreative function,
+during the period of immaturity, will not enjoy, during the mature
+period of his sexual life, a normal standard of vigor, nor will he carry
+the ability into old age, to the same relative degree, as he would, and
+as he had the innate promise to do--if he had led a normal continent
+existence. It may also be stated here that there is no effective
+remedial measures known, that will "bring back" the procreative ability
+if it is lost as a result of disobeying natural laws. Drugs and
+treatments by quacks to cure impotence are impositions and fakes. Money
+and time spent in the pursuit of this dream is money and time wasted.
+
+SELF-ABUSE OR MASTURBATION.--By self-abuse is meant the production of
+the venereal orgasm, with or without emission, by any means other than
+the natural union of the sexes.
+
+It is a fact that the large majority of boys acquire the habit of
+self-abuse at some time. This is a very serious reflection upon parent,
+teacher, and physician, because it is through ignorance of the
+elementary principles of sex hygiene that this condition continues to
+exist. If they were warned against the possibility of self-abuse
+arising in innocent ways, as well as in more reprehensible ways, they
+would exert their influence against its acquirement. If however a boy
+discovers accidentally a condition of which he was innocent, and of
+which he does not know the significance, it is human nature that he
+should investigate the phenomenon and in the end suffer as a
+consequence. In the effort to relieve some local irritation he may
+handle himself and be led into a dangerous practice. He does not know
+that the practice may have serious results--in fact he does not know he
+is doing anything wrong. Many boys have practically ruined their
+physical health and become morally irresponsible because no one--neither
+parent, teacher, physician, nor friend--told them of their danger. This
+is unjust, but great strides are being made in this direction and we may
+reasonably hope, that in the not far distant future, every boy will be
+plainly told the true facts about himself.
+
+Most boys acquire this habit from other boys, but as we have intimated
+it is possible to acquire it in what are termed innocent ways. Sometimes
+the sensation which leads to it is discovered by sliding down banisters;
+or it may be that climbing trees or poles first awakens the feeling.
+Very young children are sometimes taught the vice by depraved nurses.
+Local irritation, as has been stated, may necessitate itching and
+handling the parts and in this way the vice is begun. The results are
+the same, no matter how the habit may have originated.
+
+If the habit is persisted in, the muscular system suffers,--the muscles
+become weak and flabby; the patient develops weariness and languor and
+loses his mental and physical vigor. He is no longer forceful or
+energetic, his efficiency is impaired and as a consequence his nervous
+system begins to show signs of depleted strength. He cannot concentrate
+his thoughts, he falls behind in his studies, his mental effort is
+sluggish, he becomes diffident and shy, shuns society, loses confidence
+in himself, is morbid and emotional and may even think of suicide.
+
+It is astonishing how indulgence in this habit may affect the moral
+nature of a boy. First of all, he is no longer frank and open. He
+becomes shifty and suspicious and will not look you squarely in the
+face. A boy cannot become a slave to this habit without it affecting his
+mind. He invites debasing thoughts,--the old pure and clean method of
+thought and living no longer satisfy. His imagination even becomes
+corrupt and his moral nature and moral sense is perverted until he no
+longer seems to be able to tell the difference between right and wrong.
+He has little regard for the truth and if occasion demands it he will
+lie without appreciating the dishonorable part he is playing. In the end
+his will power is lost--even the effort to save himself is too feeble to
+succeed--he is a slave to the habit, his health and strength ruined.
+
+If every boy could realize the possible end of this evil habit he would
+make an effort to rid himself of it before he becomes its victim and its
+slave. It may be easy to abandon the practice in the beginning. The
+longer he continues it, however, the less chance he has of finally
+mastering it, until, if he persists beyond a certain point, it is a
+matter of serious question whether he will ever be able to free himself
+from its grip. If the boy has lost the will power to carry out his
+resolves, no number of good desires or resolutions will avail. And it is
+just this will power that the wasting of the semen saps little by little
+away.
+
+TREATMENT.--What can we do for these boys? Most of them can do much for
+themselves by simply stopping the practice. There are, of course, others
+who need careful management before the habit may be controlled and
+health restored. It is well to always remember to be tactful and patient
+and kind to these boys. Many of them are standing on the brink of
+despair, weak in body and weak in mind. They do not know where to turn
+to look for a friend--the right kind of a friend. It is a terrible
+thought that your own boy may be abjectly miserable in his own home
+because he is harboring a secret that is wrecking his health, and,
+though he may long for sympathy and a helping hand, neither his father
+nor mother have invited his confidence or spoken to him about these
+things. A watchful mother can usually tell when her boy becomes addicted
+to this habit. He will show it in his manner, he will not be free and
+open, he will want to be by himself. Later he will show the effects of
+the abusive treatment he is subjecting himself to in his appearance. He
+will be sunken-eyed, pimply-faced, pasty-skinned, shiftless, sneaking,
+silent, unmanly. No mother can fail to note these signs and she should
+suspect the cause and take steps to tactfully reach him before he has
+ruined his health absolutely.
+
+We would advise regular exercise of a vigorous kind. Tire out the body
+so that sleep may be sound. Cold baths, followed by brisk rub-downs; no
+intoxicants, light meals, plenty of drinking water morning and night.
+The bowels should be regular every day. He should sleep alone on a hard
+bed in a well-aired room with light covering. He should keep busy every
+minute of the day and he should not think of himself at all.
+
+The boy must realize that his salvation rests with himself. After he
+knows the real danger which the habit carries with it, he must be on his
+guard every moment to abstain. If he does not he may rest assured that
+the practice will ruin his health, render him, a business failure and
+deprive him of all happiness during the rest of his life.
+
+NIGHT LOSSES OR "WET-DREAMS."--A so-called wet-dream is an unconscious
+emission of semen during sleep. The discharge may or may not be
+accompanied with an erotic dream.
+
+After a certain age--which may be from the twelfth or fourteenth year--a
+boy may discover that he has discharged some substance during his sleep.
+He finds the discharge on his night clothes and it naturally puzzles him
+greatly. He may be entirely unconscious of the whole proceeding, having
+slept soundly during the night, or he may wake up to find the fluid
+actually discharging.
+
+If a boy has not been told of this phenomenon he may regard it as a form
+of self-abuse of which he may have heard and as a consequence he may
+worry himself sick, as the night emissions continue to occur from time
+to time. Many pure-minded boys have been rendered miserable, and their
+efficiency and health have suffered as a result of just such an
+experience. It is, therefore, proper that they should fully understand
+the true significance of these occurrences.
+
+CAUSES OF NIGHT EMISSIONS.--I have explained how nature makes a man out
+of a boy. During this maturing process the testicles are very active
+organs--their function is to manufacture or secrete the fertilizing
+fluid or semen. This maturing process begins actively, as I stated,
+about the age of fifteen, though in some boys it frequently occurs
+earlier, sometimes as early as the twelfth year. When the testicle
+begins to grow at this time they manufacture more semen than the little
+pockets can hold, so nature adopts the method of permitting the surplus
+to escape during sleep. These night emissions, therefore, are perfectly
+natural losses, and need cause absolutely no distress of mind whatever.
+The frequency with which they may occur depends altogether upon the
+temperament of the boy. If the boy is a strong, active, athletic boy,
+they may not be so frequent in him as they may be in a quiet, studious
+boy. The system of the athletic boy seems to utilize more of this
+surplus than the quieter existence of the studious boy calls for. If the
+discharge does not occur oftener than once every two weeks, it may be
+regarded as normal and natural. Should they become more frequent than
+this, the boy should inform his mother or father and the family
+physician should be consulted. It may be that he is in need of a tonic,
+or special instructions regarding his method of living and his mode of
+exercising. Whatever the cause may be, it can be corrected, and the best
+plan is to give it attention as soon as it is noted that the losses are
+too frequent.
+
+SEXUAL EXCESSES.--It is well known to the medical profession that the
+marital relation is frequently practiced to excess. The same indictment
+may be passed on what may be termed extra-marital relations. No one has
+ever formulated a general sexual standard which could be safely regarded
+as normal. Too many individual conditions of temperament and health
+enter into the proposition to permit of a standard being formulated. It
+must, therefore, be regarded as an individual question to be adjusted,
+if necessary, by the family physician. What may safely be regarded as
+normal and harmless in one, constitutes, for many reasons, excess in
+another. When a man performs hard physical or mental labor, his sexual
+aptitude or capacity is limited, and this limitation cannot be exceeded
+without risk. Such a limitation may not constitute an excess in a man
+whose occupation does not call for a great expenditure of physical or
+mental energy. Any indulgence which produces exhaustion is excessive.
+
+The age of the individual has undoubtedly much to do with his sexual
+endurance. A young, virile adult will tolerate a sexual expenditure
+which would seriously affect the health and vigor of an older man.
+
+Environment and inclination are factors in determining the standard of
+some people. If the marital relations are participated in simply to
+preserve peace and harmony in the home, they are productive of harm even
+if indulged in moderately.
+
+The symptoms of sexual excess are much the same as those of self-abuse.
+To a certain extent, however, they are favorably influenced, because the
+conditions under which the relationship is practiced are natural,
+because the participants are matured physically, and because there is no
+element of worry over the probable effects.
+
+Sexual excess defeats its own purpose, because it engenders a lack of
+desire and consequently it is to a certain extent a self-limiting
+process. We must also remember that excess entails consequences just as
+the breaking of any natural law is followed by retribution of some kind.
+In these cases we find that discomfort follows excess. The parts become
+irritated and congested and disease of the prostate gland always
+follows.
+
+TREATMENT.--Stop the excess by self-control and self-restraint. Employ
+all the aids dictated by an intelligent perusal of the laws of sex
+hygiene. Preserve the general health. It may be necessary to resort to
+local treatment, because, if the parts have been abused by excessive
+indulgence, there is always more or less irritation and congestion
+present. This condition affects the nerves, suggestive reflex sensations
+are produced by a congested prostate and the patient becomes morbid. It
+is essential for such patients to consult a physician whose local
+treatment will stop the sensitiveness in the parts and relieve him so
+that he may carry out his programme of restoration unhampered by
+conditions which are only amenable to local treatment.
+
+WHAT PARENTS SHOULD KNOW ABOUT THE SO-CALLED "SOCIAL EVIL" BEFORE
+SPEAKING WITH AUTHORITY TO "THE BOY."--To be qualified to speak with
+authority, or convincingly, to a boy upon sex hygiene, the parents must
+be familiar with, and well versed in the subject. The facts related in
+the preceding pages must be thoroughly understood. No parent can study
+these facts intelligently without being impressed with the importance of
+the subject; without realizing that it is absolutely essential that the
+fundamental principles of sex hygiene should be taught to the rising
+generation; without acknowledging the tremendous part for evil which
+prudery and ignorance play in the education of youth; and without being
+convinced that most of the evil is the product of ignorance on the part
+of the boy, and that parents are in a large sense to blame if they fail
+to impart the necessary knowledge in time.
+
+The need for enlightenment in sexual matters is a product of existing
+conditions. Civilization and the social environment are developing along
+a plane which subjects the youth to temptations that practically did not
+exist in the past. There is a broader and looser code of ethics.
+Business monopolizes the entire time of the father, and social and
+political unrest and misdirected ambition distracts the mother. The son
+or daughter has a wider latitude and a freer reign than they once had.
+The opportunities for promiscuous intimacies are easier, and the public
+conveniences and utilities lend themselves to the designs of
+evil-intentioned and loose-moraled women. The ease of travel, the laxity
+of laws, the theater, with its unchaste and indecent plays, the moving
+picture snows, the vaudeville resorts, whose highest priced "talent" is
+some voluptuous female, who has cultivated the art of draping nudity
+with suggestiveness and singing immoral songs, all tend to give youth a
+false impression of the reality of life and to make the path of the
+degenerate easy and profitable. The rich are growing richer, and their
+children are pampered and overfed and underrestrained. Time hangs
+heavily on their hands and their only mental effort is to devise new
+methods and new ways of satisfying the lust of liberty and
+overstimulated desire. The poor are growing poorer, and to "keep in the
+ring," to live and dress beyond their means as many do, it is necessary
+to have an unexacting standard of morals. In this way the promiscuous
+libertine is evolved,--the most insidious and dangerous product of
+present day civilization, and the most pernicious factor in the spread
+of immoral impulses and indecent diseases.
+
+Parents must accept these institutions and agencies as necessary
+instruments of evil and adopt measures to nullify their attractiveness.
+Eternal vigilance is the price of success, but the quality of the
+vigilance must be dictated by love, not by suspicion and distrust.
+
+When the parent can convince the boy that the knowledge is imparted, not
+with the intention of depriving him of what he may construe as his
+natural liberties and rights, but with the single intention of adding to
+the sum total of his pleasure and success, he will look more kindly upon
+any proposition that suggests a course of conduct that leads to clean
+living. Sex hygiene will eventually find a natural place in the scheme
+of education. It will be taught to male and female alike. In the
+meantime, however, we must begin by educating the educators--the
+parents. In the beginning, their task will not be easy. There will be
+much to overcome, much ignorance, prudery, false modesty, hypocrisy;
+there will be much vicious teaching and evil example to live down. But
+we cannot hope to achieve results in the noblest cause, save by patient,
+intelligent, and persistent effort and by self-sacrifice and a constant
+enthusiasm. The aim is to tell all,--all the truth,--so that we may
+never be assailed by the cry, "No one told me, I did not know," from the
+loved lips of son or daughter gone astray.
+
+THE FATHER AND THE BOY.--The right kind of father can always find the
+time and the way to awaken in the heart of the boy the spirit of
+companionship. No boy living will resent the fellowship of the right
+kind of father. It depends upon the father! If the spirit of chumminess
+does not exist between you and your boy, you are at fault, you have made
+a mistake, you have missed your opportunity, you "did not go about it in
+the right way and in the right spirit." Try again--it may not be too
+late.
+
+The father who adopts the habit of taking his boys (and his girls too)
+out for long walks, at least every Sunday, and who spends an hour with
+them every evening--is the right kind of father. One who has never
+tested the merit of walks with children cannot possibly appreciate the
+enjoyment and benefit that can accrue from them. It is not only the
+physical good that results, nor the inspiration which one may draw from
+nature, but the concrete advantages that come from the fellowship with
+the children are a new and a real experience--this is what counts. You
+will have opportunities of sewing seeds in their minds that will grow
+into a harvest that will astonish you. Children in the right mood--and
+they are in the right mood when they are happy, and they are happy out
+in the open with an interesting companion--are alert, and responsive,
+and eager to be told "things," and this mood can be put to marvelous use
+by the "right kind of father." The father who wanders forth with the
+fixed purpose of thinking out some business problem during the walk and
+permits the children to find their own amusement is the wrong kind of
+father. He must choose to be a child again, he must desire to please
+them, he must make an effort to be in harmony with them, he must draw on
+his experience to interest them, he must talk to them entertainingly of
+every interesting problem which the walk itself suggests or he must
+formulate a plan and select a subject with a definite educational scheme
+in view. We can, in a most effective way, begin to build their
+characters, and, by the right kind of talk and enthusiasm, he can
+determine their resolves to be honest, truthful, just, clean,
+sympathetic. He can instill into them, in a thousand different ways, the
+determination and inspiration to succeed. It is a wonderful and a
+precious chance, and it will make the "right kind of father" more just,
+more sympathetic, more optimistic, and it will make him young again and
+more successful. Try it.
+
+Implant in the hearts of your children a love of home, make the evening
+meal and hour by the fireside a period of congenial fellowship, when all
+the little irritable ruffles of the day may be ironed out and swept
+away. The secret is to be intimate. Tell them the secret of success from
+your standpoint, how happiness is gained only by being efficient and
+successful, and that, to be efficient, one must be energetic and
+healthy. Drum into their ears the truth that life is a battle, and only
+the brave "win out," and health is the one essential necessity. It is
+astonishing how such talks will impress young minds. They will remind
+you of things you said, that made a lasting impression on them, long
+after you have forgotten the incident.
+
+A father can, in this way, by talking of the future to his boy, convey
+to him the high hopes he entertains of the great success the boy is
+going to achieve--you establish a standard in the boy's mind, and he
+unconsciously hopes to attain that standard. If you have impressed him
+with the necessity of preserving his health and strength, as an
+essential to success, he will be slow to yield to any temptation that
+may interfere with his plans. This reasoning may sound quixotic to some
+people, but it is the truth. Many a boy has been inspired to success by
+the knowledge that his mother or father believed in him, and was
+confident he would be a leader. He strove to justify the pride and
+confidence of those who held him dear, and he won out.
+
+To retain his health, therefore, is the first impulse to be conveyed to
+the boy. When he recognizes this truth, it is an easy task to instill a
+love of exercise, gymnastics, swimming, fresh air, cleanliness and
+temperance in him. If these are attained, you will have tided him over
+the tendency to self-abuse, and you will have rendered him less likely
+to yield to evil suggestion or temptation. His confidence in you will be
+whole-hearted and implicit. You can do anything with him at the
+psychological moment. It is now time to talk of more intimate matters.
+Carefully and tactfully, the father approaches the fundamental truths of
+sex hygiene.
+
+The selection of a subject for a text as a means from which to advance
+toward the real facts is sometimes of importance. It must not appear as
+though the subject was designedly chosen. If it follows in a natural way
+it will more thoroughly interest the boy and he will have swallowed a
+large dose of truth before he is impressed with the personal viewpoint.
+A passing trotting horse has served me a number of times for intimate
+talks with boys on heredity and kindred subjects. I invite the boy to
+watch how the horse uses his legs, and how rhythmically and beautifully
+he places his feet, and how his whole attitude serves the end for which
+he is exerting himself--to gain speed. Tell the boy the story of how
+professional breeders have achieved such marvelous results; how for
+generations the "strain" has been kept clean and pure, how any
+descendant of a great sire, who showed any habit detrimental to the
+development of the highest racing qualities--no matter how trivial the
+disability might be--was cast aside, experience having taught that it
+does not pay to waste effort and time on any horse whose physical or
+mental characteristics are not up to the highest standard. Such a horse
+will not win, and it is only "wins" that count.
+
+Change the subject to human beings. Tell him how the race maintains its
+standard; but show him the difference between the methods employed. How
+the horse has his mate selected because of the female's good qualities,
+so that the offspring may possess like qualities, if not better, and
+that the selection is made by men who know their business, and have had
+long experience in the work. How, on the other hand, a young man with no
+experience is permitted to choose any woman he may fancy irrespective of
+her qualifications. As a consequence, we have all kinds of children,
+good and bad, feeble and strong, honest and dishonest, some degenerates
+from birth, some criminal, and many diseased and inefficient, few of
+them "winners." It is an easy matter to preach a little sermon from this
+text. Show him how essential it is to select the mother of one's
+children wisely, to know if there is disease in the future wife's blood,
+if her family history is good, if her temperament is suited to his, if
+her domestic qualities are satisfactory, if her principles are moral
+and normal, and if she understands and appreciates the true object and
+function of marriage. Show him also the element of justice involved in
+the marriage contract; that he must give what he exacts, that if he
+expects a healthy and normal wife, he must be healthy and normal
+himself; if he expects purity and cleanliness he must give purity and
+cleanliness; if he expects to mate with a fit female he must be an
+efficient and fit male. Remember that every act, deed, thought, and
+aspiration is regulated by laws which one cannot fool with, or disobey,
+without reaping a harvest which will conquer, crush and ruin you, no
+matter how clever or smart you may think yourself.
+
+Show him the wisdom of the breeders' habit of never permitting sexual
+liberties in a too young stallion. For the same reason the boy must
+conserve his strength and virility for the marriage state and for the
+function of procreation.
+
+In a further talk, the father may extend this subject and gradually lead
+up to the "consequences" of the unclean life. The boy will be ready for
+this talk and will evince an interest in it that will be encouraging and
+promising.
+
+The talk about the science of mating the horses he will understand
+readily and thoroughly, and he will not fail to see the point when you
+switch to man and apply the same principles. Then when you show how
+mismating is responsible for poor children quality and how disease
+accounts for feeble-minded and degenerate offspring, he will be fairly
+well posted, and he will be ready to imbibe more details, and you will
+have done much of your duty. His curiosity will be quickened and his
+interest is awakened. It depends upon the father. If your boy is honest
+and clean, open and decent, he will not fall without a fight, and while
+he is fighting he is maturing. If your picture of the consequences of
+the venereal diseases has been effective and vivid, he will grow up with
+a healthy horror of them. If your conduct as a father has been wise and
+exemplary, and if your home has the right kind of environment, and the
+right kind of mother in it, you have done all a father can do to help
+the boy over the rough spots. The proper kind of encouragement and the
+right kind of vigilance, and books which will satisfy the boy's craving
+for more knowledge along this line is all that is needed to help the boy
+to "win out."
+
+FAKE MEDICAL TREATMENT FOR VENEREAL DISEASES.--Parents should in every
+possible way discourage the use of patent medicines and fake medical
+methods of curing these diseases. Untold harm has been done to boys and
+to women by these nostrums.
+
+In every instance the motive underlying the methods of people selling
+these things is to frighten the patients into the belief that their
+condition is more serious than it is in order to justify a long and
+expensive course of treatment.
+
+Their work is carelessly performed, and frequently they are directly
+responsible for the development of complication and dangerous sequelae.
+The promises of speedy cures are false, and, not infrequently, methods
+of black-mailing have been known to follow an expensive and unsuccessful
+course of treatment.
+
+There is no class of disease in which the help and honesty of the
+legitimate medical profession is needed more than in the treatment of
+the venereal diseases. Parents should see to it that the family
+physician is prescribing any strange medicine that may appear in the
+boy's room, and not some unknown individual who may be an impostor and a
+blackmailer.
+
+SOWING WILD OATS.--Writers of fiction and others of a more serious trend
+of thought have recognized the sowing of wild oats as an institution
+which, if it does not merit the full approval of society's moral code,
+is, at least, tolerated. No serious consequences befall the offender. On
+the contrary, the libertine is the type of hero who receives the
+commendatory quips of erotic dames and the questionable interest of
+hysterical maidens.
+
+Women of easy morals are always willing to espouse the cause of the
+"black sheep," and to further the matrimonial success of the penitent
+_roue_. Many mothers are willing to marry their daughters to the
+polished villain of society, who is known as a rake and debauchee, if
+his family connections are desirable. It has been even held that a
+youth who did not "sow his wild oats" was of doubtful stamina.
+
+That many able men have sown wild oats is indisputable, and that many
+men who are respectful husbands, have also gone "through the mill" is
+also true, but this need not blind us to the fact that thousands upon
+thousands, who could have been successful men of affairs and creditable
+husbands and fathers, have been utterly ruined, as a result of having
+sown wild oats. No man is a better man because of a past record of
+licentious habits. The man who sows and escapes the harvest is lucky.
+The man who reaps, reaps in abundance. Most men regret the lapses of
+youth. Most of these lapses would never have occurred if the impulse
+could have been governed by the reasoning of maturity. These acts are
+the promptings of an impetuosity which may be entirely foreign to the
+individual's innate character, but brought out by promiscuous
+circumstances and the ignorance and license of youth. If we can protect
+youth, by an adequate knowledge of the consequences, we will furnish the
+means to tide over the impressionable period. Until a healthy maturity
+of judgment will assume the task unaided.
+
+The effects of the wild oats' theory are too tragically evident to need
+any argumentative refutation. The statistics of the prevalency of
+venereal diseases alone is sufficient; the results of these diseases are
+more than enough.
+
+Study the records of the jails and prisons, courts and asylums,
+hospitals and health resorts, think of the hundreds of thousands of
+diseased and deformed and mentally inferior children, of the multitude
+of paretics, melancholies, ataxics, maniacs, syphilitics,--all the
+products of "wild oats,"--and ask if the wild oats' theory is
+justifiable.
+
+Think of the ruined homes, the wretched lives of fallen women, the
+hopeless prayers of abandoned wives, the loneliness and misery of
+parents neglected and forgotten, the "bastards" and fatherless children,
+the drunkards and criminals and tramps--all weeds of the wild oats'
+harvest.
+
+Then reflect upon the tragedies, the suicides of the betrayed and of the
+diseased, the bank thief, the broken hearts of deserted and hungry
+children, the army of inefficients--around whose necks hang wild oats'
+medals, the men of big business, who constantly fight the effects of
+early incontinence and abuse, and the thousands who go to early graves,
+and then ask, in all justice, if the sowing of wild oats needs
+justification.
+
+Who supports the thousands of prostitutes? Who made them? Wherever you
+find pauperism, crime, drunkenness, insanity, idleness, immorality, vice
+and disease, you will find that the sower of wild oats has traveled the
+path and left his stain and his footprints there.
+
+SHOULD CIRCUMCISION BE ADVISED?--The answer to the above question is
+"Yes," in every instance. If circumcision is done early,--during the
+first two weeks of life,--the operation is without danger and
+practically without pain. In quite a considerable percentage of all
+males, circumcision is an absolute necessity. For excellent medical
+reasons, about which your family physician can inform you, every boy
+should be circumcised.
+
+
+
+
+CHAPTER XIV
+
+A MOTHER'S DUTY TO HER DAUGHTER
+
+     What a Mother Should Tell Her Little Girl--Where Do Babies Come
+     From--How Baby Birds and Fish Come from Eggs--How Other Animals
+     Have Little Nests of Their Own--The Duty of Mothers to Instruct
+     and Direct--What a Mother Should Tell Her Daughter--Every
+     Mother Should Regard This Duty as Sacred--Every Female Child is
+     a Possible Future Mother--Motherhood the Highest Function of
+     the Sex--Health the One Necessary Essential--Symptoms of the
+     First, or Beginning Menstruation--The Period of Puberty in the
+     Female--Changes in the Reproductive Organs at Puberty--The
+     Female Generative Organs--The Function of the Reproductive
+     Organs--The Age of Puberty in the Female--The Function of the
+     Ovary--The Function of the Womb--Why Menstruation Occurs Every
+     Twenty-eight Days--The Male or Papa Egg--The Function of the
+     Spermatozoa--"Tell the Whole Story"--"How do These Spermatozoa
+     Get There"--The Union of the Species--"How Can a Baby Live in
+     There for Such a Long Time"--How the Baby Gets its Nourishment
+     in the Womb--Girls Must Not Become Mothers.
+
+
+WHAT A MOTHER SHOULD TELL HER LITTLE GIRL.--Every little girl should be
+told the Story of Life by her mother. It should be told in simple
+language, so that the little girl will understand. Very early in life
+the little girl will be prompted to inquire of her mother "Where do
+babies come from?" It is wrong to give an evasive reply to this natural
+inquiry or to postpone telling the story, because they will be told it
+by playmates and will receive very wrong and very crude impressions of
+this wonderful subject.
+
+Every mother knows enough of life to tell her little girl its story in a
+way that will impress her with the sacredness of God's beautiful
+reproductive plan. She should begin by telling her a story about how the
+birds live. How at a certain season of the year they choose a mate and
+go housekeeping. They build a nest, and when it is all nicely finished,
+the mother bird lays her eggs. Then the papa and mamma bird take turns
+and sit on the eggs to keep them warm, and after a time the egg breaks
+and a little bird is born into the world. They feed the little baby
+birds until their feathers grow, and when they are old enough they fly
+away from their home and begin life by themselves.
+
+Many questions will be asked as the mother tells the story in her own
+words, and the correct answers to these questions will fill in all the
+difficult-to-understand points. The story of how the fish lay eggs in
+shallow water so that the sun may keep them warm and hatch them out will
+interest also. Be careful to impress upon them that there is always a
+mamma and a papa, a male and a female bird and fish,--that this is
+necessary because God made it so, and we must obey His wish. When the
+little girl fully understands the story of the egg bird, and egg fish,
+the mother can tell how the Creator thought out a different plan for
+other animals like the dog, horse, lion, elephant, and cow. He knew that
+it would neither be safe nor possible for these animals to stay at home
+long enough to sit on eggs and hatch their babies, so he made a nest for
+them inside of their bodies. There they would be warm and would always
+be with their mammas no matter what they were doing. So we come to the
+answer to their question: "Where do babies come from?"
+
+These interesting stories, according to the intelligence and sincerity
+of the mother, can be taken advantage of, to impress the little girl
+with the importance of many of the lessons of life. For example, her
+attention can be drawn to the fact that man and woman are the highest
+types of living things that God made. No other living thing, animal, or
+fish, or bird, or tree, or flower, can talk, and think, and reason as
+man and woman can. Because of this faculty--to think and reason--the
+human family are always trying to find out what can be done with all the
+other things God made. We try to find out what the different rocks are
+good for; what the different trees are good for, and the different kinds
+of earth, and animals, and birds, and fishes, and everything in the
+world. We study these, and we learn much, and we are made happier and
+more comfortable by what we learn. For example, by studying horses, and
+feeding and breeding them carefully, and training them, and caring for
+them, we can make stronger horses and better and faster horses; by
+studying trees, and planting them in soil best suited to them, and
+giving them plenty of water to drink, we can compel these trees to grow
+better apples and pears and peaches. In the same way we can produce
+better strawberries, and oranges, and grapes, and we can grow flowers
+with sweeter smells and prettier colors. We do all this by training
+these animals and trees to grow a certain way, to eat certain food, to
+drink pure water, and we protect them from the cold and sometimes from
+the sun if it is too hot. Our faculty to think and reason has taught us
+just what is good for them, and we compel them to obey our laws. As a
+result they become strong and more healthy. Now show the little girl how
+important she is; how much more precious she is than a tree, or animal,
+or flower, and how much more necessary it is that we, mammas and papas,
+should use our ability to think and reason in her interest. Show her how
+we have found out all about babies and little girls and how we know just
+what to do to make strong and healthy, and pure, and good, and clean men
+and women of all the little boys and girls in the world. Tell her that
+this is what mother is doing now, training her and compelling her to do
+the things that will make her a strong and a good mother when she grows
+older. Let her distinctly understand that it is the duty of mothers to
+instruct and to correct their little daughters when they do any wrong.
+Mothers know, because they have had experience in these matters, and
+they know just how a little girl must live, and dress, and eat, and
+behave, in order to be strong and pure, and good. So when mother
+reproves and corrects, it is because she knows that what you are doing
+to merit a correction is not for your ultimate good. Show them that all
+young things, and young animals, and young babies, and young girls, must
+be compelled to obey certain rules and laws, otherwise they would not
+grow up to be strong and healthy. Sometimes a rose bush grows up among
+stones and weeds, but it never thrives, it is always more or less sick.
+It does not grow strong, its flowers are poor little sickly things
+compared to the roses on a bush that is planted in proper soil, and
+carefully tended and pruned, and watered. So would the little girl turn
+out if she grew up in bad company and did not have a mother to guard and
+guide her,--to prune her when she was growing careless. Everything in
+this world has a meaning, and when mother tells you that you must not do
+a certain thing you very much want to do, she has a very good reason for
+telling you not to do it. You may not know the reason, but you should
+have confidence in your mother, you should believe that she knows what
+is best, and that she would not inflict pain or cause you suffering
+unless she knew it was for your good. The young horse does not
+understand why a halter is put around its neck and is made to run around
+in a circle until it is tired. It would much rather enjoy itself in its
+own care-free, and happy way. And when finally a full set of harness is
+put on, and it is put into the shafts of a wagon and tied there, and
+made to pull it and its driver many weary miles the horse does not like
+it, and he rebels strenuously. He is, however, compelled to obey in the
+end, and he finally consents to become a useful horse.
+
+It is exactly the same way with every little boy and girl. We are put
+into this world for a certain purpose, and we must all work. Now parents
+know this, and they know just how to prepare little girls and boys for
+this work. They therefore ask them to do many things that are not
+pleasant or agreeable but which must be done in order to prepare them
+for the work ahead.
+
+
+WHAT A MOTHER SHOULD TELL HER DAUGHTER
+
+Your daughter is now about fourteen years of age. She is about to pass
+from girlhood to womanhood and she should know more of life's story. The
+mother will now tell her the complete story in the form of little talks,
+based upon the following facts as texts. Each mother will doubtless add
+to the story as conditions justify and as the education of the mother
+and daughter may dictate. A multitude of little side talks can be wisely
+indulged in to make clear any uncertain or doubtful explanation, and
+every one of these incidental excursions can be made exceedingly
+interesting if wisely and opportunely chosen. Always remember, however,
+to emphasize the sacredness of the story. Do not permit your daughter to
+get the impression that you are telling her something that simply has to
+be told, just as you told her the correct way to boil an egg. Let her
+realize and get the impression that this is the most serious and most
+wonderfully interesting story in existence, the most important story she
+will ever hear. Let her understand that motherhood, for which she is now
+preparing, is the duty God assigned her in this world: that that duty
+must be carried out, and that she must do nothing, nor leave anything
+undone, to interfere with its accomplishment. Do not only impress her
+with the story itself, but let your own explanation be so emphatically
+serious, that she will deeply appreciate its momentous significance--an
+occasion to be remembered all her life.
+
+If she gets the proper impression from you at this time she will never
+treat the subject lightly, or permit it to be promiscuously discussed
+within her hearing.
+
+Begin by telling her that she is about to enter the most important
+period of her life. Explain why this is so in the following way, in your
+own words. If we admit every female child to be a future mother, and
+motherhood the highest function possible to the sex, then the awakening
+of the sex organs and the mother instinct, must be the most important
+developmental episode in the life story of every woman. If this is so,
+then it follows that every girl should enter this period in the very
+best physical health possible, in order to reap the best results
+incident to this evolutionary period. We impress and warn her,
+therefore, that, as her system is about to undergo important changes,
+she must be particularly careful of her health. A little mistake at this
+time may be followed by more serious consequences than if made at any
+other time in her life. If a girl is to become a mother, certain changes
+must occur in her body before the nest, of which we previously wrote,
+can be made ready. God did not overlook anything when He peopled the
+earth; He therefore wisely planned that these changes in the female
+should occur at a time when the girl is strong and healthy.
+
+THE PERIOD OF PUBERTY IN THE FEMALE. SYMPTOMS OF BEGINNING
+MENSTRUATION.--At about the age of fourteen these changes begin to give
+evidence of existence. They affect the girl's whole system and the
+mother must be especially patient and sympathetic. Her disposition may
+change, she may want to be alone, and she may be more or less
+melancholy. She will be dissatisfied with the things that previously
+interested her. She will tire easily, and she may have many spasmodic
+pains from time to time. The wise mother will tactfully see that she
+takes plenty of nourishing food and systematic exercise, and that she
+gets enough sleep in a well-aired room. There are other physical changes
+which are observable at this age. The girl grows taller, the figure
+broadens out, the hips widen, the bust enlarges, and the waist line
+increases in size. These are all part of the great change from girlhood
+to womanhood.
+
+CHANGES IN THE REPRODUCTIVE ORGANS.--The principal change takes place in
+the reproductive organs themselves, and it is very essential that she
+should have a clear mental picture of just what is meant by
+"reproductive" organs and their location in her body. We mean by this
+term the group of organs which are concerned in creating and nourishing
+a child until it is old enough to be born into the world.
+
+THE FEMALE GENERATIVE ORGANS.--These organs are the womb or uterus, two
+ovaries, two fallopian tubes and the vagina. The womb or uterus is the
+"nest." It is about the size of and is shaped like a pear. It is hollow,
+however, though its walls are quite thick. The ovaries are about the
+size of a peach stone and lie at the side of the womb,--one on either
+side. The fallopian tubes connect the ovaries with the womb. The vagina
+connects the womb with the outside world,--it is sometimes known as the
+birth canal. In the very lowest part of the abdomen, or belly, in front,
+is the bladder, which collects the urine until it is necessary to pass
+it out. In the back part of this region is the rectum; it collects all
+the undigested food, etc., from the intestinal canal. Between these
+two,--the bladder and rectum,--we find the reproductive organs, the
+womb, ovaries and vagina, described above.
+
+THE FUNCTION OF THE REPRODUCTIVE ORGANS.--It will be difficult, even for
+mothers, to acquire a clear understanding of the function of the
+reproductive or generative organs. It is an exceedingly interesting
+process, however, and it is well worth a patient, attentive study to
+clearly understand the brief description we give of it. If you acquire a
+distinct mental picture of the problem you will be able to tell your
+daughter a story that will be of intense interest to her, and a tale
+that is interesting is impressive and is productive of thought and
+reflection. That is the condition of mind we want daughters to be in
+when they hear this story.
+
+The human ovaries begin to prepare themselves for their life work when
+the girl is about eight years of age. When they are ripe, or ready to
+perform this duty, the girl menstruates for the first time. This is
+known as the age of "puberty," which implies that she has developed,
+passed from girlhood into womanhood. After having reached the age of
+puberty it is possible to become a mother.
+
+THE AGE OF PUBERTY.--There is no fixed age at which the first
+menstruation takes place. Some girls develop quicker than others,--a
+condition that depends upon the health and type of girl. A strong,
+robust, full-blooded girl will menstruate at an earlier age, than will a
+sickly anemic girl. The average age is fourteen years, though there is
+no reason to worry if a girl does not menstruate for a number of years
+later. In warm climates the age of puberty is from two to four years
+earlier than in more temperate climates.
+
+THE FUNCTION OF THE OVARY.--Just what takes place in each ovary when it
+is ripe is best explained by likening an ovary to an orange,--though of
+course the ovary is very much smaller than an orange, as was previously
+noted. If you make a cut in an orange and squeeze it, you express some
+of its juice and most likely you will also express one or more seeds.
+The seeds of the ovaries are called "ovules," and the process by which
+it expresses them is called "ovulation." Of course there is no actual
+squeezing of the ovary,--the ovules grow in the ovary, and as they ripen
+they come to the surface, and when actually ripe, the part of the
+surface of the ovary to which they come, opens up (like a flower
+unfolding when in bloom), and they fall out. The ovule we may regard as
+the human female egg, and one ripens and falls out every twenty-eight
+days.
+
+When the egg falls out of the ovary it falls into the tube which carries
+it into the womb. This tube you will remember is called the fallopian
+tube. The ovule or egg is now in the cavity of the womb where we will
+leave it for the present.
+
+THE FUNCTION OF THE WOMB.--While these changes are going on in the
+ovary, the womb is also preparing itself for its share of the work. The
+lining or internal surface of the womb is composed of mucous membrane,
+much the same as the interior lining of the mouth and throat. This
+lining becomes congested with blood, and is so intensely swollen at the
+time when the ovule or egg reaches the womb, that it is ready to rupture
+and bleed all over its surface. Just whether it will rupture and bleed,
+depends upon whether the egg is going to grow into a child or not. If it
+is not going to grow into a child, it immediately bleeds freely, and
+continues to bleed, until the whole lining of the womb and egg is passed
+out into the outer world. This takes four or five days and constitutes
+"menstruation." After menstruation is over, the womb begins again to
+prepare itself for the coming of the next ovule or egg, and as this
+occurs every twenty-eight days, menstruation is commonly termed the
+"monthly periods."
+
+WHY MENSTRUATION OCCURS EVERY TWENTY-EIGHT DAYS.--The reason why the
+womb does this every twenty-eight days is because it is impossible to
+tell just when the womb will be called upon to nourish and support a
+child. If it did not get rid of the old blood, it would not be in a
+healthy condition to nourish and take care of a baby, nor would its
+interior be ready to supply new fresh blood for the growth of the
+infant. Hence nature constructs and builds a new "nest" in the interior
+of the womb each month. It very much resembles the new home into which
+the bride and groom, go to begin housekeeping.
+
+When you told your little girl the story of life, you particularly drew
+her attention to the important fact that every living thing is created
+by the union of a male and female principle, and, therefore, has a mamma
+and papa. This applies to trees, flowers, vegetables, fish, animals,
+birds, insects,--every living thing, including human beings. We have
+seen that the ovule from the ovary is the female egg, or principle. It
+is the part the female contributes toward the future child. Before a
+child is possible, however, the ovule must meet the egg from the male.
+
+THE MALE OR PAPA EGG.--The male or papa egg is called a "spermatozoa."
+It reaches the interior of the womb through the lower opening, which you
+will remember opens into the vagina. Emphasize to your daughter that the
+female ovule or egg, and the male egg, or spermatozoa, are minute
+objects, so microscopically small that a hundred million of them could
+comfortably lie upon a ten-cent piece.
+
+THE FUNCTION OF THE SPERMATOZOA.--God gave the male spermatozoa the
+power to move. To watch them under the microscope you would imagine you
+were looking into a bowl of water, in which there were hundreds of
+little fish all squirming around. But the most wonderful thing about
+them is, they can only move in an upward direction,--they seemingly
+cannot move downward, or sideways. If you think for a moment you will
+understand why God gave them this marvelous property. When the male
+semen is deposited in the female vagina, there are thousands of these
+minute, living, moving spermatozoa in it. The womb is above the vagina,
+and the female egg is in the womb, consequently, to reach this egg, the
+spermatozoa must travel upward. To travel in any other direction would
+be fruitless energy. There is only one female egg, but there are
+thousands of male eggs, or spermatozoa; it is easy, therefore, to
+comprehend how one of these spermatozoa should exactly be in line with
+the female egg in its upward path, since there are so many of them. It
+is only necessary that one should meet the female egg in order to
+impregnate it.
+
+The shape of the male principle, or spermatozoa, is exactly like a
+little tadpole, and you no doubt recall that a tadpole has a minute
+tail, the movement of which enables it to swim around. So has the
+spermatozoa, and by the incessant movement of this microscopic tail they
+all move upward as soon as discharged by the male. I told you that God
+gave the male-germ life. It is necessary now to explain the character of
+this life. It is very brief; it is estimated that they are active for
+two hours, and then become inactive, or die. The best way to explain the
+brief activity to your daughter, is to liken the spermatozoa, to a
+mechanical toy, which is wound up to go for a certain time. After it
+runs out it becomes inactive; this is exactly what happens to the little
+human tadpole. If during this brief life none of them has happened to
+reach the female egg, pregnancy does not take place and menstruation
+occurs. On the other hand, if this were not so,--if these spermatozoa
+were active for a longer period, pregnancy would almost be certain to
+take place every time the womb was not already occupied with a
+pregnancy.
+
+TELL THE WHOLE STORY.--When a mother reaches this stage of the wondrous
+tale she will be asked by an innocent girl,--"How do these spermatozoa
+get there?" or, "You have not told me where these tadpoles came from"
+or, "I don't understand how these spermatozoa got into the vagina" or,
+"I don't know why you call these the male egg when they are in mamma."
+It does not matter how it is expressed, the intent is plain enough. I
+have said, that an innocent girl will ask this question, the implication
+being that one who is not innocent will refrain from asking this
+question. A girl who knows the answer will not ask, because, if she is
+familiar with this subject before her mother thinks it wise and proper
+to tell her, she obtained her information from a source which, most
+likely, insinuated a suggestive, or evil, meaning into the explanation,
+consequently she would be afraid, or ashamed, to ask the question. An
+innocent girl, on the other hand, would rightly ask for information
+which is obviously kept back, and which she has a right to know, since
+a complete, and intelligent understanding of the story depends upon the
+elucidation asked. If it is proper to tell part of the story, it is
+essential to tell all of it. Tell it in your own words in this way:
+
+When God conceived the human race He ensured its perpetuation by
+designing a method whereby this would be rendered possible: He did more;
+He wisely decided that the function, involving the very existence of the
+human race, should be attended with a sentient gratification. He further
+instilled into the fundamental economy of mankind, sex attraction, which
+is involuntary, undeniable, and unquenchable. If God conceived the means
+and the method, no human mind in possession of its faculties should see
+evil where it does not exist. It was by Him designed that the male organ
+of reproduction should deposit its germinating fluid in the vagina of
+the female, and this is accomplished by a union of species.
+
+The one set of reproductive organs is a complement of the other, and
+essential to the other. It is by this act that the male spermatozoa is
+enabled to complete the function of fecundation.
+
+If now we assume the male and female element to have met and united,
+menstruation does not take place. The egg or embryo (the future child)
+begins to grow, and it remains in the womb for two hundred and eighty
+days from the day when the male and female egg met. It is quite natural
+for an intelligent girl to ask her mother to explain, "How a baby can
+live in there for such a long time," or "What makes it grow if it does
+not get anything to eat or drink."
+
+HOW THE BABY GETS ITS NOURISHMENT IN THE WOMB.--These questions can be
+answered in this way. While the baby is in its little comfortable home
+it gets everything it needs. You are in your home now. If you wanted a
+drink, what would you do? Wouldn't you go to the water faucet and draw a
+glass of water? The water comes to you through a pipe, right into your
+home, you don't have to go out of the house to get it. And if you wanted
+light when it is dark you would turn on the gas and light it. It, too,
+comes into your home through a pipe. Now baby gets its air; and food,
+and all it needs to drink in just that way. There are two little pipes
+which go into its nest or home, and then into the baby's body at the
+navel, and through these pipes fresh blood runs in and out. When mother
+breathes, her blood sucks up oxygen from the air in her lungs, and the
+blood carries oxygen to every part of her body. In this way, all parts
+are supplied with the proper quantity of air. Now the baby is simply a
+new part of mamma as long as it is in its nest in her body, so it too
+gets air in this way. When mother eats, the food is taken into her
+stomach and it is there changed into liquid and so prepared, that when
+it passes into the intestines, the part of the food that is good for
+her, is sucked up into the blood, and the blood carries it to every part
+of her body. It distributes whatever is needed to all parts, and as the
+baby is a part, it gets its share. The other pipe carries the blood back
+again, out of the baby for new supplies, and as this is going on all the
+time, there is no danger of the baby starving in any way, or at any
+time.
+
+When your daughter understands this, show her how important it is that
+mothers should be in good health, otherwise the baby will not get good
+food, it will not be properly nourished and will be born a poor, little
+sickly child. Little girls, consequently, should try to eat properly,
+exercise regularly, and do everything their mothers tell them, so that
+when they become mothers, they will be able to nourish their babies and
+not bring into the world poor little starved infants.
+
+GIRLS MUST NOT BECOME MOTHERS.--We have previously stated that girls can
+become mothers when they have reached the age of puberty. God did not
+intend, however, that girls at the age of twelve or fourteen should
+become mothers, because their bodies are not strong enough, nor are they
+fully grown, nor have they the experience, to undertake the physical
+task and responsibility of bringing a baby into the world. We know this
+from experience, because we have seen the sickly babies such girls have,
+and we have seen how much these girl mothers suffer, and how they ruin
+their health, by trying to do what God did not intend they should do.
+Even the trees teach us this lesson. An orange tree will bring out buds,
+which would develop into oranges, when it is two years old. The
+experienced farmer, however, will pluck these buds off, and will do so
+every year, till the tree is five years old. If he allowed the tree to
+bear fruit during its young years, the oranges would not be good, or
+sweet, or large; so he waits until the tree has grown and is strong and
+healthy, when its fruit will be large and sweet. An orange tree of this
+type will have better fruit, and will continue to produce this good
+variety for many years. A tree allowed to bear fruit when two years old
+will never have first class oranges, nor will it continue to have, even
+poor oranges, as long as the other.
+
+
+
+
+CHAPTER XV
+
+PREPARING FOR MOTHERHOOD
+
+     Menstruation--Irregular Menstruation--Changes in the Quantity
+     of the Flow--How the Womb is Held in Place--Symptoms of
+     Menstruation--Menstruation Should Not be Accompanied with
+     Pain--Don't Give Your Daughters Patent Medicines or "Female
+     Regulators"--Take Your Daughter to the Doctor--Leucorrhea in
+     Girls--Bathing when Menstruating--Constipation and Displaced
+     Wombs--Dress and Menstruation--Absence of Menstruation, or
+     Amenorrhea--Treatment of Amenorrhea--Painful Menstruation, or
+     Dysmenorrhea--Causes of Dysmenorrhea--Treatment of
+     Dysmenorrhea--Sterility in the Female--Conditions Which Affect
+     the Fertility of Women--Climate--Station in Life--Season of the
+     Year--Age--The Tendency to Miscarry--Causes of Sterility in the
+     Female--Displacement of Womb--Diseases of Womb, Ovaries, or
+     Tubes--Malformations--Lacerations--Tumors--Leucorrhea--Physical
+     Debility--Obesity--Special Poisons--"Knack of
+     Miscarrying"--Miscarriage--Cause of Miscarriage--The Course and
+     Symptoms of Miscarriage--What to do when a Miscarriage is
+     Threatened--Treatment of Threatened Miscarriage--Treatment of
+     Inevitable Miscarriage--After Treatment of Miscarriage--The
+     Tendency to Miscarriage.
+
+
+MENSTRUATION
+
+We have explained in the previous chapter what menstruation is, its
+frequency, its significance and its origin. There are a number of its
+common characteristics with which the mother and daughter should be
+acquainted.
+
+IRREGULAR MENSTRUATION.--Menstruation may occur once (the first time)
+and fail to recur the following month or for a number of months. This
+need cause no alarm as long as the general health remains good. It will
+come again in its own time. Nervousness may cause a suspension of
+menstruation. This is quite common in school girls who are driven too
+hard at school, whose sleep is interfered with, whose appetite is poor
+and who are allowed too many social indiscretions, as parties, dances,
+etc., where late hours are observed, all of which should be put aside
+until school life is over. Sometimes menstruation will temporarily stop
+if the girl goes away from home on a visit.
+
+Sometimes the quantity will be greater than at other times, and a very
+scant flow, after it has been free and regular may cause apprehension.
+Various causes may be responsible for a decrease, catching cold, sitting
+on cold steps or cold ground, wearing damp clothes, nervousness, mental
+worry, physical exhaustion, insufficient food and exercise, and anemia,
+may cause it. For these reasons a girl should be exceedingly careful of
+her health, she should guard against catching cold. Do not change the
+underwear until certain that the weather is far enough advanced in
+season to justify such a change. She should not become exhausted or
+worry. In all cases of suppression, or of increased flow, a physician
+should be consulted at once, and girls should be instructed to tell
+their mothers of any change in the character of the "periods," as soon
+as it occurs. Mothers should instruct their daughters to rest the first
+day of their monthly flow, and all during the menstruation they should
+refrain from any unusual activity. Even play should be moderated and
+abstained from entirely if there is any pain. In order that the girl
+fully appreciates why these rules are laid down, it is advisable to
+explain just how the womb is held in place in her body.
+
+This appears to the writer as being a particular important point. A girl
+must not be expected to give these matters the serious consideration
+they merit unless she thoroughly understands the reasons why. An
+explanation, in the form of even an intelligent talk, will soon be
+forgotten. If, however, a definite, concrete picture, is impressed upon
+her; if she actually sees in her mind the process that is going on, she
+will understand why it is necessary to do as she is told. If the mother
+will therefore assure herself that the daughter actually knows what is
+being accomplished in her womb at the menstrual period, she will carry
+out the instructions more faithfully.
+
+HOW THE WOMB IS HELD IN PLACE.--The human uterus, or womb, is held in
+its proper place in much the same way as a clothes pin sits on a clothes
+line. The heavier part is the upper part, and that part is held in place
+partly by resting on the rectum behind, and the bladder in front. When
+menstruation occurs, the body of the womb becomes much heavier because
+of the increased amount of blood in its interior. This added weight
+increases its liability to tip over, and if any extra strain or effort
+is made at this time it will become tipped, or as the physician calls
+it, displaced. If a womb becomes displaced, every menstruation afterward
+will be painful and prolonged,--sometimes excessively so. A displaced
+womb becomes congested and unhealthy. It causes leucorrhea or a chronic
+discharge, makes a nervous wreck of the woman, results in sterility and
+frequently in a dangerous operation. There are, therefore, ample reasons
+for watchfulness and care on the part of the growing girl.
+
+SYMPTOMS OF MENSTRUATION.--After menstruation is established there
+should be no actual pain at each period. There are, however, certain
+undefined feelings,--premonitory symptoms,--which may be explained in
+the following terms:--A day or two before the date on which the
+menstruation is expected, the girl will appreciate that "her sickness"
+is coming. She will not, or should not, complain of pain, but will state
+that she has a bearing down feeling, is a little more nervous than
+usual, has no desire to go into company, and wants to be more or less
+her own entertainer. The "sick" period usually lasts four or five days.
+The second day is the most important.
+
+MENSTRUATION SHOULD NOT BE ACCOMPANIED WITH PAIN.--If any actual pain
+accompanies menstruation, either before or after it is established, the
+mother should at once take the daughter to the family physician.
+Menstruation is a natural, physiological act and should not be
+accompanied with actual distress or pain. It is astonishing how many
+mothers will allow their daughters to suffer needlessly, for months and
+years, because of the mistaken idea that "since the pain is there, it
+must be," or because she--the mother--suffered, so also must the
+daughter suffer. There is no more unfortunate mistake, and many a girl's
+health and happiness has been blasted because of this misbelief. The
+cause of the pain is, in a vast majority of the cases, a very simple
+one, and can be removed in a very brief time.
+
+Should the menstrual period last too long, be too frequent, or be in any
+way not what it should be, consult your physician. If you are not sure
+of "what it should be," or if you have any doubt, ask your doctor. Don't
+let any false pride or feeling of modesty on your part, or on the part
+of your daughter, dictate your policy under such circumstances. Don't
+take the advice of your friends or neighbors in a matter so vital. It is
+too important, and they are not qualified to "guess" any more than you
+are. Don't, if you have any respect for yourself, or love for your
+child, begin dosing her with the advertised patent medicines and "Female
+Regulators" for which so much is claimed, and which seem to "just suit"
+your daughter's case at this particular time. Take her to the doctor,
+whose advice you value (or you should not have him as a family
+physician), who has no interest at stake except to help you and your
+child, and whose fee is no more than the price of one of these bottles
+of advertised poison. He is the only one qualified to speak with
+authority on such a momentous subject, and you will never spend a dollar
+to better advantage. Warn your daughter not to speak about "her
+sickness" to other girls.
+
+Especial attention should be paid to cleanliness during this period. The
+mistaken idea that bathing of any kind at this time may have disastrous
+consequences is responsible for much of this neglect. If proper care is
+taken warm sponge baths, in a warm room, will not cause any trouble.
+Unpleasant odors can be avoided by sponging the parts with a warm
+solution, into which a mild antiseptic is put, upon changing the cloths.
+
+LEUCORRHEA IN GIRLS.--It has been stated above that a displaced womb may
+cause leucorrhea or a discharge. It must be remembered that leucorrhea,
+or "whites," may occur in girls as well as in married women. It can also
+result from catching cold during the menstrual period. Another mistaken
+idea is that girls should not take douches for fear of injuring the
+hymen. This is erroneous, and while they are entirely unnecessary in a
+vast majority of cases it is sometimes absolutely essential to douche in
+order to cure leucorrhea. When they are given, it is advisable to use
+the small nozzle that comes with every douche bag set.
+
+CONSTIPATION AND DISPLACED WOMBS.--When the picture is fresh in the mind
+of the girl, of how the womb is held upright in her body, the mother
+should speak to her about the serious results that may occur from
+constipation. If the rectum is full of hardened feces the womb will be
+pushed out of place, and if under these circumstances straining is
+necessary to empty the bowel, and if this condition is habitual,
+constipation may be the actual cause of displacement of the womb.
+
+DRESS AND MENSTRUATION.--It is also an opportune time to demonstrate to
+what extent serious results may follow mistakes in dressing. The habit
+of permitting growing girls to constrict the waist, to bind and pull the
+abdomen by too tight garters, or too tight corset, is wrong, and no
+mother should permit it. In another part of the book, this matter is
+taken up more fully, but if it is explained to the girl while she is
+considering the subject of menstruation, she may more quickly and more
+fully appreciate its significance.
+
+ABSENCE OF MENSTRUATION--AMENORRHEA.--The absence of menstruation after
+it has been established, does not, as a rule, indicate any disease of
+the womb or female sexual organs. It is to be regarded merely as a
+symptom and can be, as previously stated, safely ignored if the general
+health is good. If the general condition is poor, and the quantity and
+quality of the blood deficient, it is a provision of nature to suppress
+menstruation in the interest of the general health. For this reason it
+is safe to disregard the amenorrhea and build up the bodily strength.
+This explains why some girls pass the usual age of puberty and show no
+signs of menstruating. They are poorly developed sexually, through
+deficiency of blood. If, on the other hand, a girl should have all the
+symptoms of menstruation every month, but no flow, she should be
+examined by a physician to determine if there is any obstruction to the
+escape of blood. Total absence of any symptoms of menstruation extending
+into adult life, may indicate an absence of the sexual organs. During
+the first year after puberty it is quite natural for menstruation to be
+irregular; after the function is thoroughly established there are many
+causes that may be responsible for its temporary absence.
+
+CAUSES OF AMENORRHEA.--Any condition or circumstance which reduces the
+general health or impoverishes the quality or quantity of the blood and
+weakens the nervous system, will result in a stoppage of the monthly
+periods. Among these are insufficient food and exercise, overwork,
+overstudy, exposure to cold, sitting on cold steps or gold ground,
+wearing damp clothes, bathing in cold water at the beginning of
+menstruation, powerful emotions, as great fright, anger, anxiety; acute
+diseases, such as typhoid fever, cholera, the infectious skin diseases;
+chronic diseases such as Bright's disease, heart disease, consumption;
+anemia and chlorosis are very common causes. Obesity or an overfat
+condition will cause an early suppression of the menses which may result
+in a fruitless marriage. Displacement of the womb and other local
+disorders frequently result in scanty or delayed menstruation. Anxiety
+lest pregnancy may occur in the newly married may cause a delay in the
+periods. A radical change of climate or sometimes a visit to the
+country, or changed circumstances may stop the flow for the time being.
+
+TREATMENT.--The treatment of amenorrhea, or absence of menstruation,
+will depend on the underlying cause. A careful investigation should be
+made into the mode of life and the hygienic surroundings of the patient.
+Her general health and her mental condition should be inquired into. If
+the patient is not in good health, or is not obtaining exercise in the
+open air, or if she is a victim of mental worry or of domestic
+unhappiness, or if any sufficient cause exists for the amenorrhea it
+must be removed before any treatment may be expected to relieve the
+condition. If the patient is a married woman the possibility of
+pregnancy should always be borne in mind, and no radical treatment
+instituted until this has been excluded. If the absence of menstruation
+is dependent upon defective development of the sexual organs we cannot
+expect much from any treatment. The amenorrhea from exhaustive diseases
+will usually correct itself with, or soon after, the establishment of
+convalescence. In diseases which tend to death, as in consumption, heart
+disease, etc., the function is never reestablished. A very common habit
+of most people is to regard the absence of the monthly periods as the
+cause of their ill health. It is not, it is the result of the ill
+health. Get rid of the bad health and the menses will take care of
+themselves. That form of amenorrhea which is the result of change of
+climate or surroundings will regulate itself as soon as the victim
+becomes acclimated or reconciled to the change, or returns home if the
+visit is of brief duration.
+
+As a general routine treatment, good wholesome food, regular hours,
+fresh air, sunlight, and judicious exercise, with such other measures as
+may be suggested by the condition of the blood and nervous system, are
+the indications in the way of treatment. Anemia and chlorosis (poor
+blood) should be treated by the administration of iron in some form.
+Obesity should be reduced by diet, exercise, and such other treatment as
+may be found efficient and not detrimental to health. Overwork, mental
+and physical, should be stopped, and sedentary habits changed to a more
+active out-door life. The acute suppression from exposure to cold,
+wearing of damp clothes, sitting on cold stones or cold or damp ground,
+sea bathing in very cold water, is very often associated with an acute
+inflammation of the womb itself and calls for rest in bed, laxatives to
+open the bowel, hot application to the lower part of the abdomen and a
+teaspoonful of Hayden's Viburnum in a glass of hot water every four
+hours until relieved. The use of the sitz bath is frequently successful
+if taken at night followed by a laxative and a hot drink.
+
+PAINFUL MENSTRUATION--DYSMENORRHEA.--Most, if not all, victims of
+painful menstruation are of a nervous temperament. Dysmenorrhea is
+simply one symptom of the general nervous condition. The nervousness may
+be acquired or it may be the result of heredity. In girls it has been
+found to be an accompaniment of the overwork and worry of school and
+student life. Girls who suffer greatly from it while in school are
+entirely free during vacation from school.
+
+There is a type of painful menstruation known as neuralgic dysmenorrhea.
+This is simply a local expression of a general neuralgic tendency. It
+comes under conditions which favor neuralgias in other parts of the
+body. Girls and women affected with this type of dysmenorrhea are often
+anemic, hysterical, and not infrequently the victims of malaria,
+rheumatism, or other diseases which tend to impoverish the blood and
+reduce nerve vitality. The pain resembles neuralgia elsewhere. It comes
+and goes, it may last a brief time or a long time, it may be very mild
+or very severe. The pain bears no fixed relation to the flow, it may
+proceed, accompany or follow it.
+
+Mechanical dysmenorrhea is that form in which a mechanical impediment
+exists to the escape of the menstrual fluid. The internal canal may be
+too small, displacement, growths, either inside or out of the womb,
+faulty development, or frequently simple congestion will act as an
+obstruction and cause pain from tension. The pain accompanying
+mechanical dysmenorrhea is very different from the neuralgic type. It
+comes on gradually, increases slowly until it is very severe and stops
+suddenly. A gush of blood from the womb announces the fact that the
+obstruction has been overcome and the womb has emptied itself; as soon
+as this occurs the pain ceases.
+
+In the mechanical variety there are frequently clots in the menstrual
+flow. Inasmuch as this type may be caused by imperfect development of
+the womb, it is common to find that pain has characterized the monthly
+periods from the time of the first menstruation. It may, however, as
+stated above, be caused by growths which had their beginning at a later
+period.
+
+TREATMENT.--For the neuralgic variety the treatment should be general.
+The whole object is to build up the general health. Fresh air, sunlight,
+out-door exercise, plain, substantial food, regular hours, pleasant
+surroundings, and such medication as may be indicated, should be the
+course to follow. The bowels should be kept regular and digestion aided
+in every way possible, if necessary by rest from school, or work, or by
+a change of air and scene. If the patient is inclined to malaria she
+must take quinine and live in a locality free from that tendency. If
+rheumatic she should take the remedies advised in that disease and avoid
+colds, wet clothes, or sitting in cold, badly ventilated rooms, churches
+or theatres. If there are no distinct evidences of special tendencies,
+general tonics may be given to advantage. These should consist chiefly
+of iron, arsenic, phosphous, nux vomica, cod liver oil, etc.
+
+The treatment of mechanical dysmenorrhea of course implies removal of
+the cause. As this necessitates operative procedure, or at least an
+examination by a physician, it is best left in his hands.
+
+
+STERILITY
+
+Sterility means the inability to become a parent. A woman who is sterile
+cannot become a mother. She is for some reason unable to have a baby.
+
+A childless union is frequently the cause of much unhappiness. There is
+something lacking in the expression "a childless home." It seems a
+paradox, as home is inherently associated with children and happiness.
+It has been stated that one out of every eight marriages is barren. The
+average time which elapses after marriage and the birth of the first
+child is seventeen months. Physicians agree that if a woman goes over
+three years after marriage without having a baby her chances of having
+one are small. If children are desired, and they usually are by
+childless parents, every effort should be made within the first three
+years to ascertain the cause of the sterility, and if it can be
+rectified. The barrenness may be dependent upon some physical defect
+which will quickly respond to the proper medical treatment. It is well
+to remember, however, that the defect is not always the woman's. In
+every six childless marriages about one is due to sterility in the
+husband. The age of the greatest fertility in women is between twenty
+and twenty-four years. It is rare to find a barren woman between these
+years. Nature evidently intended that the duties of maternity should be
+assumed between the twenty and twenty-fourth year. If married before the
+age of twenty the statistics prove that barrenness exists in one woman
+in every twelve. If married after the twenty-fourth year the chances of
+having children decreases with the age of the woman.
+
+If a mother goes for three consecutive years without becoming pregnant
+the chances are that she will have no more children. Consequently if
+other children are desired it is unsafe to rest upon the assumption that
+a woman will again be a mother simply because she has been one in the
+past. Many conditions could, and may, have occurred since the last
+pregnancy (and may be as a result of that pregnancy) to change her
+natural fertility into a condition of temporary sterility. An
+examination should therefore be made before too long an interval elapses
+and the facts learned. It will usually be found in such cases that a
+displacement or laceration, or at most, some cause easily remedied is
+immediately responsible for the apparent barrenness.
+
+
+CONDITIONS WHICH AFFECT THE FERTILITY OF WOMEN
+
+CLIMATE.--It is a well-known fact that more children are born in
+southern regions than in northern countries. It may be asserted,
+therefore, that climate affects the fertility of the race.
+
+STATION IN LIFE.--Children are more numerous among the poor than among
+those who are wealthy and enjoy the luxury of riches. This condition
+cannot, however, be construed as a true expression of fertile
+efficiency. It is more a comparison of ethics, and when we express it
+thus we are giving it its most charitable name.
+
+SEASON OF THE YEAR.--The spring of the year, being more favorable to
+fecundity, exerts an influence over the increase of population. Nursing
+mothers are as a rule sterile until after weaning time. This is not
+always so however, and the possibility of pregnancy taking place while
+nursing a baby, and before menstruation is reestablished must be
+reckoned with as it occurs quite frequently.
+
+AGE.--Age may be said to affect the fertility of women inasmuch as
+sterility is the natural and proper condition before menstruation is
+established and after menstruation ceases.
+
+THE TENDENCY TO MISCARRY.--Because a woman has never given birth to a
+living child is no proof that she is sterile. Many women have the
+ability to conceive but for some reason they have acquired the
+misfortune, or the "knack," of miscarrying. This is a condition of the
+gravest significance and will be considered at length in its proper
+place.
+
+The influence of a temporary separation has had excellent results in a
+great many historical cases. Where the married couple seem to be lacking
+in some one or other of the emotional or temperamental qualifications,
+it is advisable to suggest a temporary separation. When this period has
+expired and they resume marital relationship the element of novelty,
+acting as a stimulus, quite frequently reestablishes a fertility that
+was seemingly suspended, or awakens it if conception has never
+previously taken place.
+
+There are a great many cases on record where, conditions having remained
+the same, women have become fertile after years of seeming barrenness.
+It is impossible to explain, or to satisfactorily understand these
+cases. It is quite common to note cases in which women have never become
+pregnant until a number of years after marriage, even when the desire to
+have children existed. There is one case on record of a woman married at
+eighteen, but although both herself and her husband enjoyed habitual
+good health, conception did not take place until she was forty-eight
+years of age when she bore a healthy child. Women should not, therefore,
+become easily discouraged in the hope of having a baby, especially when
+they have a clean history, and a healthy body. The conditions may change
+and may become favorable when hope is about to die.
+
+
+CAUSES OF STERILITY IN WOMEN
+
+Inasmuch as it is necessary to consult a competent physician in all
+cases of sterility, it is not necessary to go into detail regarding each
+possible cause, other than to explain how each may produce barrenness.
+It will be observed that a competent physician is specified and advised
+in these cases. This is very important because many advertising, or
+"quack" doctors, particularly solicit these kind of cases. They are not
+competent to be trusted with such cases and will likely effect more harm
+than good. A woman should not hesitate to consult the best available
+medical authority if she is a victim of sterility. There is nothing to
+be ashamed of. It is a perfectly proper medical situation and should
+receive the best medical advice and investigation. The following are the
+more frequent causes of absolute sterility.
+
+(A) Displacement of womb.
+
+(B) Diseases of womb, ovaries or fallopian tubes.
+
+(C) Malformations.
+
+(D) Lacerations or tears of mouth of womb.
+
+(E) Tumor.
+
+(F) Leucorrhea.
+
+(G) Physical debility.
+
+(H) Special blood poisons.
+
+(I) Great obesity.
+
+(J) Anemia.
+
+(K) Self-abuse.
+
+(L) Habitual alcoholism.
+
+(M) Lack of moderation in the marital relations.
+
+(N) Certain diseases may be associated with barrenness: cancer,
+diabetes, consumption, Bright's disease, etc.
+
+(O) Certain temperamental conditions may be associated with barrenness:
+lack of affinity, frigidity.
+
+
+THE KNACK OF MISCARRYING
+
+DISPLACEMENT OF WOMB.--In many instances the primary cause of the
+displaced womb was some energetic, muscular effort, made while the
+victim was yet a girl,--probably before menstruation began. Whatever act
+first caused a slight tilting of the womb, must necessarily have been
+an unusual physical effort, and as girls are getting more and more
+strenuous we may look for more trouble in this direction in the future.
+Inasmuch as a slight tilting of the womb gradually gets worse it is a
+reasonable expectation to believe that sterility is a natural sequence
+to displacement. The girl may have been the victim of painful
+menstruation which was neglected, because not quite painful enough to
+compel medical relief, which is sought for only as a last resource
+unfortunately under the circumstances. Intercourse may also have been
+more or less painful,--a condition which again is mistakenly and
+imprudently borne in silence and left to take care of itself. But when
+persistent sterility faces her, the woman seeks medical assistance and
+her trouble is discovered. As the displacement is found to be the cause
+of her sterility, its correction, which is a comparatively easy medical
+problem, not only cures the barrenness but happily relieves her of the
+menstrual distress and all other pain.
+
+The treatment for displacement consist of placing medicated pieces of
+wool or cotton, called tampons, in the vagina in such a position as to
+hold the womb, _as_ nearly in its proper place as is possible. After a
+time nature will so strengthen the ligaments that they will hold the
+womb and a cure is, therefore, affected. The length of time necessary to
+cure depends upon the length of time the displacement has existed. It
+may take, from two to four months. When the displacement is of long
+standing and is accompanied with more or less inflammation, adhesions
+sometimes grow between the womb and the adjacent organs. It is necessary
+to resort to surgery in such cases, but the result is always good and
+the danger practically nothing.
+
+DISEASE OF THE WOMB, OVARIES OR FALLOPIAN TUBES.--Disease of the womb,
+ovaries, and fallopian tubes, which renders the victim sterile, is as a
+rule the direct result of infection. Such infection is conveyed by the
+husband to the wife. This is quite a common condition. The simple fact
+that such conditions exist leads us to hope that the time is not far
+distant when it will be compulsory for all participants in the marriage
+ceremony to submit to a thorough physical examination. By this means,
+and by this means only, will the innocent be protected. No one can
+conceive, unless he has been identified, as a physician, with one of the
+large metropolitan hospital clinics, of the extent of this class of
+disease, and of the frightful suffering caused, and innocent lives
+ruined, by infection conveyed in this way. It is a tragic corollary to
+the marriage vow "for better or for worse."
+
+If a woman is fortunate enough to fall into the hands of an honorable
+physician, who will tactfully explain to her the serious significance of
+her condition and obtain her consent to treat her until she is cured,
+which in all probability will include a surgical operation, and will do
+so with diligence, without regard to the size of the bill, she will
+indeed be a lucky woman. It is from women who are suffering with such
+diseases,--most of them without the slightest idea of what ails
+them,--that the venders of advertised nostrums reap their fortunes, and
+it is from the same victims that most of the advertised medical "quacks"
+look for their blood-money. The great difficulty, however, lies in the
+failure of the woman to appreciate the seriousness of her condition, and
+as a consequence she fails to understands why it should take so long to
+cure her. She loses confidence in her physician, she buys certain
+"cures" recommended to her by Mrs. Busybody and later tries other
+physicians and ends by losing faith in herself. Meantime she grows worse
+and worse. There are thousands such. It may be here stated without fear
+of contradiction that if the public in general would repose more
+confidence in the medical profession, there would be much less
+suffering, much less sorrow, fewer regrets, fewer irresponsible "isms,"
+and cults, because there would be fewer disappointed individuals to
+support them. If the medical profession would condescend to employ the
+tactics and devices of those questionable, fashionable agencies that
+claim the power to cure human suffering, it could quickly reap the
+profit and the laudation that it now escapes because it keeps the faith.
+
+The way to be cured of any disease, if it is curable, is to engage a
+reputable physician and follow his instructions implicitly. Let him
+understand you expect him to see you through your trouble and let him
+know you have confidence in him. There isn't one physician in a thousand
+who will cheat you under these circumstances.
+
+MALFORMATION.--Under this heading are all those cases of sterility
+resulting from imperfect generative organs. These are products of a
+failure on the part of nature to furnish or develop the structures
+participating in the propagation of the species. The entire generative
+organs are sometimes wanting. The womb may have failed for some reason
+to grow with the rest of the body, it remains (as it is known) as an
+"infantile womb." Occasionally the womb grows together, that is, it is
+solid instead of being a hollow organ. The mouth of the womb may be too
+small, representing what is called "a pin head opening." The natural
+opening is large enough to admit a lead pencil, a "pin head opening"
+would not be larger than the lead in the pencil. The latter condition is
+quite a common cause of sterility and is readily amenable to treatment.
+Most of the malformations which produce sterility are impossible to
+cure.
+
+LACERATIONS OR TEARS IN MOUTH OF WOMB.--This subject is fully discussed
+on another page of this volume.
+
+TUMOR.--A tumor may be so situated as to prevent conception, or it may
+involve the body of the womb constituting a reason in itself for
+sterility.
+
+LEUCORRHEA.--Leucorrhea or "the whites" may be of such an acid character
+as to kill the spermatozoa in the vagina, or it may be of such volume as
+to render impregnation impossible. The treatment of this condition is
+discussed elsewhere.
+
+PHYSICAL DEBILITY.--When the general health is bad, no matter from what
+cause, sterility usually exists. This lack of vitality may be due to
+chronic disease, or it may have been caused by a very severe acute
+illness, such as typhoid fever. One's mode of living, if unhygienic, may
+be responsible for continued bad health and a consequent sterility.
+
+OBESITY.--Very fat women are usually barren. If a woman rapidly
+accumulates fat after marriage she as a rule does not have more than one
+or two children. Women often become stout immediately after the child
+bearing age ceases.
+
+SPECIAL POISONS.--Certain special poisons in the blood cause sterility
+by producing miscarriage.
+
+
+MISCARRIAGE
+
+By the term "miscarriage" we mean that for some reason the progress of
+pregnancy has been interrupted and the fetus is expelled from the womb.
+A miscarriage or abortion (both terms meaning the same--the difference
+between the two terms is a technical one and need not concern us here)
+can occur any time after conception up to approximately the seventh
+month, when, if labor takes place, the child may be born alive. The
+condition would then be termed a premature labor. A miscarriage or
+abortion is an immature labor and implies an immature or dead child.
+
+The condition is a serious one no matter whether it is attended with
+grave symptoms or apparently no symptoms. If it occurs shortly after
+conception, during the first few months of married life it is serious,
+if not in its physical consequences, it is in its significance, because
+it establishes the tendency to miscarry,--a tendency that may result in
+great mental distress because of the worry and fear it engenders, and of
+sorrow and heartache because it may blast the hope of parentage. Such a
+miscarriage may take place at once after conception. If so, the
+following menstruation may be delayed for a week or so and is then a
+little more profuse than is customary. This will be the only indication
+that a life has been sacrificed that the young wife may have, and
+frequently the significance of such an occurrence is never understood,
+yet the tendency to miscarry is nevertheless established, and a seeming
+sterility is apparently the fate of the woman. It is, therefore, of the
+greatest importance that extreme care should be taken to bring the first
+pregnancy to a successful consummation. A young wife should realize that
+she is apt to become pregnant at any time. Her conduct therefore should
+be such at least as not to harm the life principle with which she has
+been entrusted. To this end any excessive sexual activity should be
+strictly avoided.
+
+CAUSES OF MISCARRIAGE.--Any strenuous physical effort must be guarded
+against. Included in such efforts may be the following: dancing,
+running, jumping, surf-bathing, sewing on a machine, sweeping, washing,
+house-cleaning, moving furniture, etc. Sometimes the primary cause of a
+miscarriage is to be found in some hygienic act, such as a hot bath, too
+prolonged or too many hot douches near the menstrual periods. A blow or
+a fall, even a fright or shock may cause a miscarriage. Anything that
+violently shakes or agitates the womb, which may at this time be
+irritable because of its condition, will be sufficient to excite it to
+contract and miscarry. Hence violent coughing or vomiting should be
+avoided if possible; horseback riding, jolting in a carriage,
+convulsions, hysterical crying, may also be the causative factors.
+Displacement of the womb by limiting its tendency to grow when pregnant,
+may cause it to miscarry. Very severe general diseases such as
+small-pox, pneumonia, etc., will cause the womb to empty itself. Disease
+of the fetus or the presence of syphilis in either of the parents will
+also have the same result.
+
+THE COURSE AND SYMPTOMS OF MISCARRIAGE.--The cause of a miscarriage or
+abortion is much the same as an ordinary labor at term. Whatever
+interrupts the pregnancy causes the death of the fetus. The dead fetus
+acts as a foreign body and excites the womb to contract as it does
+during an ordinary confinement. The contractions open up the mouth of
+the womb and the fetus is expelled together with its membranes and
+after-birth. The significant and the most important symptom of a
+miscarriage or abortion is hemorrhage or bleeding from the privates. The
+flow of blood may not amount to much or it may be excessive and
+alarming; it may not be constant, it may come from time to time in the
+form of clots.
+
+The next significant and important symptom of miscarriage or abortion is
+pain. The pain, like the flow of blood, may be only slight or it may be
+very severe, sometimes it is absent in very early miscarriage. As a rule
+the pain is severe when the miscarriage occurs after pregnancy has
+lasted for a number of months.
+
+A miscarriage or abortion is said to be "complete" when the fetus with
+its membranes and after-birth is expelled clean and whole, or in other
+words when the womb empties itself completely. A miscarriage or abortion
+is said to be "incomplete" when some part of the embryo is left in the
+womb.
+
+WHAT TO DO WHEN A MISCARRIAGE IS THREATENED.--When a woman, who is
+pregnant, begins to flow she should at once go to bed and keep perfectly
+quiet and send for a physician. A miscarriage is a treacherous condition
+and is so regarded by all medical men. It may not amount to much or it
+may, on the other hand, develop into a serious situation. The immediate
+danger is from hemorrhage; the ultimate or remote danger is sepsis or
+blood poisoning. The condition is one that can only be taken in charge
+by a qualified physician in whose hands we can safely leave the conduct
+of the case.
+
+As a general rule it is quite safe to assert that a woman will not bleed
+enough at the beginning of a miscarriage to do any permanent harm.
+Consequently there is no occasion for unnecessary alarm. She must,
+however, as stated above, heed the warning and go to bed, keep perfectly
+quiet and send for a physician. If she fails to follow this advice it is
+quite possible that she may have a hemorrhage during the course of the
+miscarriage of a sufficiently serious character to endanger her life or
+from the effects of which she may suffer for the remainder of her life.
+
+There is practically no danger during the course of or after a
+"complete" miscarriage. The danger which may ensue from an "incomplete"
+miscarriage is hemorrhage and a form of poisoning caused by the
+absorption into the system of putrifying products of the part of the
+dead embryo left in the womb.
+
+There are a large number of cases of criminal abortion in which septic
+poisoning occurs caused by the utensils or instruments used in inducing
+the abortion. All of these cases are operative cases which must be
+attended to promptly to save life.
+
+TREATMENT OF THREATENED MISCARRIAGE.--Not all of the cases of beginning
+miscarriage end in miscarriage. If the physician is sent for in time he
+can very frequently give directions that will, if carried out
+faithfully, avert the disaster. Success is more likely to attend those
+cases in which the trouble has been caused by some accidental injury, as
+a fall, or blow, or extra exertion. This is more especially the case if
+the woman has previously borne children, is healthy and in good
+condition and whose womb is known not to be diseased. In these cases
+there is a partial separation of the fetus from the wall of the womb,
+which causes the bleeding. The physician will direct that the woman be
+put to bed, in a quiet, darkened room. He will instruct the nurse to
+sterilize the external genital region: a sterile gauze dressing is then
+left in place. Some form of prescription will be given to diminish the
+patient's nervous fear and to allay any tendency on the part of the womb
+to contract. It is always essential and very important to save
+everything that passes from the womb during the course of a threatened
+miscarriage in order that the physician may know exactly just what the
+condition is. Each cloth, each clot of blood will have to be examined
+before the proper treatment can be pursued in safety.
+
+When the miscarriage cannot be prevented it is called an "Inevitable
+miscarriage."
+
+TREATMENT OF AN INEVITABLE MISCARRIAGE.--In these cases every precaution
+is taken, just as in a normal confinement, to avert blood poisoning. The
+hands, instruments, dressings, etc., are carefully rendered sterile and
+the whole field must be surgically clean. The physician will conduct the
+case as conditions justify and as the situation develops.
+
+AFTER TREATMENT OF A MISCARRIAGE.--It is one of the many thankless tasks
+of a physician's life to insist on each patient staying in bed at least
+ten days after a miscarriage. The average woman and frequently the
+intelligent woman fails to appreciate the absolute necessity for this
+procedure. It is necessary and it is the physician's duty to insist on
+it being done in the interest of the woman. Many of the multitude of
+diseases of women are caused by disregarding advice on such occasions.
+
+THE TENDENCY TO MISCARRY.--If a woman, for any reason, has had a
+miscarriage, her womb will tend to miscarry at the same period during a
+subsequent pregnancy. If the miscarriage should occur during her first
+pregnancy the tendency to miscarry will be greater than if acquired
+after she has had a baby.
+
+This is one of the reasons why young wives often fail to have children.
+They "get rid" of the first one or two, because they are not ready to
+have children, or because they want some enjoyment themselves before
+they are tied down with a family. Having established the habit their
+womb has been educated to abort, and it will keep this habit up, much to
+their astonishment and chagrin.
+
+Young wives should therefore faithfully follow out all the rules of the
+Hygiene of Pregnancy laid down by their physician, and which are given
+in detail in this book.
+
+[Illustration: _Courtesy of New York World_
+
+AT WORK WITH THE CALIPERS
+
+Watching carefully the physical development of the child month by month
+is one of those many little things which may result in disaster if
+neglected.
+
+Abnormal development, or lack of development, should be promptly
+reported to the physician, as it may be a warning of serious trouble.
+
+For the table of standards, mental and physical, adopted by the American
+Medical Society see page 271.]
+
+
+
+
+THE BABY
+
+
+
+
+CHAPTER XVI
+
+HYGIENE AND DEVELOPMENT OF THE BABY
+
+     What to Prepare for the Coming Baby--Care of the Newly-born
+     Baby--The First Bath--Dressing the Cord--Treatment After the
+     Cord Falls off--A Pouting Navel--Bathing Baby--Clothing the
+     Baby--Baby's Night Clothes--Care of the Eyes--Care of the Mouth
+     and First Teeth--Care of the Skin--Care of the Genital
+     Organs--Amusing Baby--Temperature in Children--The Teeth--The
+     Permanent Teeth--Care of the Teeth--Dentition--Treatment of
+     Teething--How to Weigh the Baby--Average Weight of a Male
+     Baby--Average Weight of a Female Baby--Average Height of a Male
+     Child--The Rate of Growth of a Child--Pulse Rate in
+     Children--Infant Records, Why They Should be Kept--"Growing
+     Pains."
+
+
+WHAT TO PREPARE FOR THE COMING BABY.--The physician should instruct the
+young wife just what to provide for the coming baby. The following list
+will be found useful as a general guide.
+
+     An ordinary clothes basket, padded and lined, is quite
+     sufficient for the first month; or, a baby crib, which may be
+     cheap or expensive as the individual taste dictates. The Taylor
+     crib is probably the handiest and best one on the market.
+
+     Pin cushion;
+
+     Puff-box and puff;
+
+     Soap box containing pure castile soap;
+
+     Hair brush and fine comb;
+
+     Two wash cloths;
+
+     Four ounces of crystal boracic acid, a saturated solution of
+     which is used for cleansing baby's eyes and mouth;
+
+     One pound of good absorbent cotton;
+
+     A flexible tube of white vaseline;
+
+     A bath thermometer;
+
+     A package of sterile gauze;
+
+     A half dozen baby towels, good quality;
+
+     A soft, white, good blanket,--one and one-half yards square;
+
+     One pair small blunt pointed scissors;
+
+     A package of the best safety pins;
+
+     Three or four dozen bird's-eye cotton diapers. First size,
+     eighteen inches square. Second size, twenty-five inches square;
+
+     One yard of soft white flannel for belly bands; each band
+     should be five inches wide, by twenty-four inches long.
+
+     Two silk and wool shirts;
+
+     Three flannel shirts (all shirts should be high necked, long
+     sleeved, and open down the front);
+
+     Three Eiderdown wrappers;
+
+     Three Cashmere sacques;
+
+     Three pads for crib;
+
+     Six dresses;
+
+     Six petticoats (they should be thirty-three inches long from
+     neck to hem; they should be turned up at the bottom for about
+     four inches and should button there to keep the feet warm; if
+     it is desired to use pinning blankets for the first two months
+     in place of the petticoats, they should be made of soft white
+     flannel with cotton bands);
+
+     Six night slips;
+
+     Six pair socks;
+
+     Two cloaks;
+
+     Two hoods;
+
+     One dozen bibs.
+
+Simplicity, warmth, and freedom are the essentials in latter-day baby
+clothes. It is cheaper to make the clothes than to buy them. Excellent
+and accurate paper patterns can be obtained, giving the quantity of
+material necessary and suggesting the kind and quality best suited for
+the purpose. These patterns may be obtained from the Butterick
+Publishing Company in New York City.
+
+CARE OF THE NEWLY-BORN BABY.--After the nurse has completed her duties
+with the mother after the confinement, she will prepare to give baby its
+first bath.
+
+The bath should be given in a warm room. This is a matter that should
+receive more consideration than has been given it. Nurses do not as a
+rule attach much importance to this duty, while in reality it is a most
+important one. I have seen trained nurses make ready to give baby its
+first bath in rooms, during the night, that were not heated adequately.
+I am convinced that many babies have been victims of this careless habit
+to the extent of grafting on them the tendency to catarrhal colds and
+bronchitis because of undue exposure at this critical period. If one
+will remember that a baby has just been removed from an environment
+where the temperature was suitable and constant, to one in which it
+needs a large degree of artificial heat until such time as it may become
+accustomed to the change, one may appreciate the risk taken in exposing
+the child for even a short time. The mother should therefore warn the
+nurse not to undertake the baby's first bath until the temperature and
+other conditions are favorable. Many nurses and other individuals have
+the impression, without knowing why, that the baby should be cleansed
+and bathed immediately after birth. This is not at all necessary. If the
+conditions are not favorable, it would be far better to wrap the baby
+snugly in a warm blanket--first having put a diaper on--and place it in
+its crib with a hot water bottle near it and defer the bathing until the
+following forenoon. By that time the baby will be adapted to its new
+surroundings; its lungs will have become accustomed to the air which it
+is breathing for the first time; the mother will have been rendered
+comfortable; in other words, the conditions and the environment will be
+favorable for the baby and for a better performance of the duty.
+
+The next important feature of the first bath is that it should be done
+in the quickest time consistent with efficient service. Only the
+necessary exposure should be indulged in. It is not necessary that the
+baby should be exposed to the admiring inspection of every member of the
+household--there will be plenty of time for that without risking the
+health of the child. A pan of water at a temperature of 100 deg. F. should
+be placed on a stool in front of the nurse. The nurse should have on a
+rubber apron, and on top of this, an ordinary apron and a warm bath
+towel laid over her knees. The child should be gently rubbed with warm
+sweet oil to remove the _vernix caseosa_ (the greasy substance which is
+on all babies when born to a lesser or greater extent). Particular
+attention is to be given to all folds of the skin, as under the arms, in
+the fold of the neck, in the groin, behind the ears, etc., because in
+these parts the substance is thickest and if not carefully removed it
+will cake, and cause painful eruptions and sores, which may bleed and
+render the infant extremely uncomfortable. It is not necessary to
+expose the whole body at one time while applying the oil. The lower half
+may be covered with a warm soft towel while the nurse is oiling the
+upper part, and vice versa. After the body has been thoroughly oiled it
+should be cleansed with water at the proper temperature, in which pure
+castile soap has been dissolved. Absorbent cotton only should be used to
+wash the baby. All the washing is done with the baby on the nurse's
+knee; it is not put into the water.
+
+The baby should be mopped dry with sterile gauze, or with a soft sterile
+towel, the cord dressed and the flannel band adjusted. It should then be
+completely dressed and put to the nipple and later to sleep.
+
+DRESSING THE CORD.--The cord should be covered with powder and sterile
+gauze. The powder to use should be plain subnitrate of bismuth. If there
+is any reason to use another powder the physician will write a
+prescription for it according to indications. The subnitrate of bismuth
+will be found much better than any ordinary talcum or toilet powder,
+many of which do not make good dressing powders.
+
+Very few nurses know how to dress the cord. It seems to be impossible to
+impress them with the need of frequent attention to the cord. Fresh
+powder should be put on every time the diaper is removed, every time the
+infant urinates, and at other times during the day. The cord should be
+kept absolutely dry. Putting on powder twice daily will not keep the
+cord dry and many nurses are too lazy to bother to do it oftener. You
+cannot make a mistake in putting on too much powder, you can make a
+serious mistake by not putting on enough. Every time the cord is
+powdered it should be lifted up, away from the skin of the abdomen, and
+the powder put below it. The cord should be slightly drawn out and the
+powder applied round its base where it meets the skin. Many nurses are
+afraid to touch or handle the cord--they find it easier to neglect it.
+The mother should see that the nurse dresses the cord at least five
+times every day.
+
+APPLYING THE STERILE GAUZE TO THE CORD.--A piece of gauze, six inches
+square is taken, a hole is cut the size of a ten-cent piece out of the
+center, the cord is drawn through the hole, the gauze folded lengthwise
+over the cord and then sidewise, and this is held in place by the
+binder. This piece of gauze will adhere to the cord and will most likely
+be removed with the cord on the fifth day. If it should fall off,
+another piece may be put on in the same way.
+
+If the cord does not fall off until very late it is because it has not
+been attended to rightly or because it was a very thick cord.
+
+TREATMENT AFTER THE CORD FALLS OFF.--The stump of the cord should be
+powdered with the same powder used on the cord; a pad two inches square
+of sterile gauze and quite thick should be held over the stump for a
+number of days by the abdominal binder. This is used to prevent a
+possible rupture. After a week the size of the pad may be reduced, but a
+small pad should be used over the stump of the cord for a month or more.
+
+A POUTING NAVEL.--If the stump of the cord should protrude, a piece of
+strong pasteboard, the size of a fifty-cent piece, should be wrapped in
+soft gauze and placed over the navel, over this a gauze pad, and if
+necessary this should be held in place by a strip of adhesive plaster,
+though the binder is usually sufficient if it is put on carefully. If
+this pad is held properly and worn for a month the tendency to
+protrusion or rupture will have passed away. These pads may of course,
+be removed when the baby is being bathed and put back again before the
+binder is applied.
+
+BATHING BABY.--A baby should not be put into water for a bath until
+after the cord has been off for forty-eight hours.
+
+During the first few months the temperature of the water should be 98 deg.
+F. The temperature of the water should be taken with a bath thermometer;
+it should not be guessed at. A bath thermometer is an inexpensive
+commodity and it will be in daily use in many ways in a home where there
+is a baby--it should therefore be procured wherever possible. The room
+should be warm; there should be no draughts. The mother or nurse should
+cultivate the habit of bathing baby quickly and with system. Everything
+should be ready and at hand. A little salt in the water will tend to
+strengthen the skin; it will also relieve any superficial rashes or
+excoriations which may be on the skin. Four tablespoonfuls to a gallon
+of water will be sufficient. The sea salt sold in the stores may be used
+in lesser quantities.
+
+By the end of the fifth month the temperature of the water may be
+reduced to 95 deg. F., and by the end of the first year to 90 deg. F. After the
+first year the mother should accustom the child to a quick sponge with
+cool water on the chest and spine immediately after the bath. This
+simple means, if kept up, will often prevent the development of colds
+and bronchial troubles so common to children in temperate latitudes.
+
+The best time to give the warm bath is at night. In the morning a cold
+sponge bath is desirable. This should be given as described in the
+chapter on cold sponge or shower baths.
+
+In certain children bathing seems to depress their entire system. They
+do not react well even to a warm bath. They remain blue or pale around
+the mouth and eyes; bathing should therefore be carefully undertaken
+with these children until such time as they acquire strength.
+
+CLOTHING OF BABY.--The baby should wear a woolen shirt, with a high neck
+and long sleeves. The abdominal binder may be worn for the first three
+months. It is not necessary after that time. If worn longer the habit is
+acquired and chronic indigestion may ensue when it is ultimately taken
+off. If the baby is very thin it may be wise to leave it on, simply for
+its warming effect, for a few months longer. If the child is normal and
+healthy the binder should be left off permanently after three months.
+The band for the first four weeks should be made of plain flannel; after
+this period a knitted band with shoulder straps is the better article.
+All petticoats and skirts should be supported from the shoulders.
+Stockinet is a good material for diapers; it is soft, warm, and pliable.
+
+Baby's feet should be warm always. Cold feet are frequently responsible
+for colic and gastro-intestinal troubles. A hot water bottle should be
+placed in the carriage if the weather is cold, but care should be taken
+to see that it does not touch the feet, otherwise it may burn them. The
+same measure may be adopted in the baby's crib if the feet are cold.
+
+During the summer the outer clothing should be made of the thinnest
+quality of material possible, and the underclothing of the finest
+flannel or gauze. Body heat may be maintained during changes of
+temperature by extra outer wraps--not by dressing the baby in clothes
+that keep it too hot and uncomfortable all the time.
+
+The main object to be attained in clothing the baby is to ensure a
+sufficient protection, but the clothing must be light, warm, loose, and
+non-irritating. Don't bundle up the arms and legs so that they cannot be
+moved; don't pin them so tight that the child cannot breathe properly
+and don't put the band on so that the child is in torture all the time
+from inability to move the abdomen.
+
+BABY'S NIGHT CLOTHES.--The night clothing should be the same as that
+worn during the day, but it should be loose and of the lightest flannel
+material. For older children a thin woolen shirt (not the one worn
+during the day) and a suit of union clothing with feet is best.
+
+The mistake must not be made to cover children too warmly at night. They
+can do with relatively less than adults. Too much covering will render
+the sleep restless, will encourage nightmare, and in older children will
+engender bad habits. Delicate children especially must not be
+over-covered at night.
+
+For the first few months children should sleep in a darkened room.
+
+CARE OF THE EYES.--The eyes should be cleansed for the first few days
+with a saturated solution of boracic acid. They should be protected from
+the direct light for two or three weeks after birth.
+
+CARE OF THE MOUTH AND FIRST TEETH.--Boiled cooled water should be used
+to cleanse the mouth every morning after the bath. A soft piece of
+sterile gauze should used for this purpose. The mother must guard
+against using too much force in cleaning the mouth of an infant.
+
+The milk teeth should receive attention. If they are allowed to become
+dirty they will become carious and cause bad breath and neuralgia.
+Teeth of this character are a menace to health because they harbor germs
+and in this way infect the mouth and cause stomach troubles. Teeth that
+are carious should be filled or removed.
+
+CARE OF THE SKIN.--The skin of a baby, because of its delicate
+character, is susceptible to the slightest changes in the weather or to
+the condition of the digestive organs. Babies are frequently subject to
+rashes, intertrigo, excoriations, eczema, and other skin affections. It
+is much easier to prevent these conditions than to cure them.
+Cleanliness, not only in giving a daily efficient bath, but in every
+other respect, is essential. Castile soap only should be used, and no
+rubbing indulged in, simply mopping the parts with gauze well saturated
+with soapy water. All napkins should be removed as soon as soiled. If
+the skin is easily chafed the child should be bathed in salt water or
+water in which bran is mixed as explained in the chapter on bran baths.
+
+The baby should be well powdered with a good quality of toilet powder.
+Ordinary starch, or talcum, or the stearate of zinc is suitable. Fat
+infants should be powdered in all the skin folds; otherwise they are
+sure to chafe.
+
+CARE OF THE GENITAL ORGANS.--The mother should make it a habit to remove
+any dirt from the genitals of the baby during the morning bath. Fecal
+matter sometimes gets into the folds of the female baby; this should be
+removed promptly. In older female children, dirt and dust get into the
+genitals which often has to be removed carefully with a soft piece of
+cloth. An exceedingly chronic form of inflammation is often seen in poor
+children because of neglect of these parts.
+
+In male babies the mother must daily push back the foreskin and clean
+under it. If this is not done the natural secretion will gather there
+and cause much trouble. If the foreskin is long, the child should be
+circumcised; if it is not long it must be pushed back daily for a number
+of weeks; otherwise it will contract and it may be necessary to operate
+on it at a later date. If this is not faithfully attended to the prepuce
+will become adherent, the child becomes nervous and irritable, and it
+may become addicted to self-abuse at a very early date--simply because
+the mother is derelict in the performance of her duty. If you are afraid
+to do your duty, don't neglect it, ask the doctor to show you just what
+has to be done and just how it should be done. You will find it to be a
+simple matter when you know how, as most things are.
+
+AMUSING BABY.--Mothers should understand that it is not necessary to
+amuse a baby under one year of age. Their nervous systems are not ready
+for any such sport. To excite a baby to laughter is to subject it to a
+shock which may injure it. The healthy development of the brain of a
+child demands quiet and restful surroundings. It should sleep, eat, and
+be allowed to amuse itself in a natural way.
+
+TEMPERATURE IN CHILDREN.--The normal temperature in a child varies more
+than it does in an adult. The rectal range may be between 98 deg. and 99.5 deg.
+F. and may be normal to that particular child. A rectal temperature of
+97.5 deg. F. or of 100.5 deg. F. is of no importance unless it continues.
+
+The best place to take the temperature in a child is the rectum and the
+next best place is in the groin. The temperature will always be from a
+half to a full degree higher in the rectum than in the groin. The
+thermometer should be left in the rectum for two minutes, and in the
+groin for five minutes.
+
+The temperature in a child is a very fair guide as to the severity of
+the disease. It must be remembered, however, that a child will develop a
+temperature of two or three degrees from a very slight cause. It is not
+the height of the fever that is significant, but rather the duration of
+the fever that is important. A fever of 102 deg. F. in a child may only mean
+a slight indigestion which will wholly disappear after a laxative is
+given, while the same degree of temperature in an adult usually means
+something much more serious. The degree of the temperature therefore
+should not occasion unnecessary worry; if, however, it continues and if
+the child shows other signs of illness, it may be regarded as indicating
+an abnormal condition which should be immediately found out. A
+temperature of 100 deg. F. to 102 deg. F. usually means a mild illness, and one
+of 104 deg. F. or over, a serious sickness.
+
+It is not advisable that the ordinary mother should possess a clinical
+thermometer. There are many occasions when a child will have a fever
+which should not cause any worry; if the mother gets the thermometer
+habit, she will many times occasion unnecessary calls of the physician
+only to learn that they are false fears.
+
+THE TEETH.--There is no definite time at which the first teeth appear.
+They usually come between the sixth and eighth months. They may not,
+however, come until much later; or they may come earlier than the sixth
+month; and yet the child may be perfectly healthy. They come as a rule
+in the following order:
+
+    1. The two lower middle teeth,                           6 to 8 months.
+    2. The four upper middle teeth,                          8 to 10 months.
+    3. One on each side of two lower middle teeth,           8 to 12 months.
+
+    4. One on each side, above and below, back of
+       above teeth (four in all),                           12 to 15 months.
+
+    5. The next one on each side, above and below, back of
+       those already in (four in all),                      18 to 24 months.
+
+    6. The four back teeth on each side, above and below,   24 to 30 months.
+
+
+    At 1 year a child should have                  6 teeth
+
+    At 1-1-2 years a child should have            12 teeth
+
+    At 2 years a child should have                16 teeth
+
+    At 2-1-2 years a child should have            20 teeth
+
+They may not come in the above regular order even in well children. The
+upper front teeth may come first. If the child is sickly there may be
+marked irregularity in the order in which they appear. Twenty teeth
+comprise the first set.
+
+THE PERMANENT TEETH.--This set consists of thirty-two teeth. They begin
+about the sixth year and they are usually not complete until the
+twentieth year. They appear in the following order:
+
+    First molars                6 years
+    Incisors               7 to 8 years
+    Bicuspids             9 to 10 years
+    Canines              12 to 14 years
+    Second molars        12 to 15 years
+    Third molars         17 to 25 years
+
+CARE OF THE TEETH.--The teeth should be given attention as soon as they
+appear. It is an excellent custom to wash the teeth and gums twice daily
+with a piece of clean absorbent cotton rolled round the finger of the
+mother and dipped in a saturated solution of boracic acid. This should
+be done up to the second year. After the second year a soft brush should
+be used and the teeth thoroughly cleaned morning and night with pure
+castile soap or a powder. The teeth of every child should be examined by
+a dentist every six months. All cavities should be filled with a soft
+filling. The milk teeth should not decay, but should fall out, or be
+forced out by the second set. A child should be taught to gargle early
+and a mouth wash should be used morning and night.
+
+DENTITION.--As a general rule the process of teething is accompanied by
+some symptoms. There may be fever, restlessness, and loss of appetite;
+though in many cases there are absolutely no symptoms. Some children
+seem to teethe hard, others easily. The same child may have some teeth
+without pain, and with others it may suffer severely. The condition of
+the child at the time, its age, and the season of the year undoubtedly
+have an influence. Children who are sickly and puny may have much
+difficulty while teething.
+
+The degree of sickness varies quite considerably. There may only be, as
+stated above, slight fever, restlessness, with loss of appetite; or
+there may be, in addition to these symptoms, a pronounced fermentative
+diarrhea, which may lead to serious intestinal diseases; frequently
+there is a cough. This is more apt to be the case if the child is
+teething during the hot season.
+
+TREATMENT.--When dentition affects the child's disposition it is a good
+plan to reduce the feeding in quantity and quality for the time being.
+If the child is bottle-fed, two ounces can be taken out of each bottle
+and one ounce of boiled water added. If the child is breast-fed, he
+should be given two ounces of warm, boiled water before each feeding,
+and the actual feeding time at the breast shortened.
+
+Rubbing the gum over the erupting tooth with a clean cloth may aid in
+helping it through. If the child is very restless and has lost sleep,
+the cloth may be moistened with brandy and water. Lancing the gum,
+though it is seldom done now-a-days, is justified in a few cases.
+Teething is not the cause of actual disease as was once thought, but it
+must be remembered that a child whose vitality is reduced by fever,
+restlessness, loss of appetite, loss of sleep, and irregular bowels, is
+more susceptible to disease than when enjoying robust health.
+
+Sometimes a child will have a fever for one or two weeks during a hard
+dentition. There is apt to be more or less intestinal indigestion and
+fermentation at this time and as a consequence actual intestinal disease
+may develop. To avoid such a possibility it is an excellent plan to give
+an occasional dose of castor oil to clean thoroughly the whole
+intestinal canal. This should be done irrespective of the condition of
+the bowel, because frequently a diarrhea is caused by retained
+fermenting products.
+
+Mothers must not acquire the habit of attributing all symptoms to the
+teething process simply because the child is teething. It must be
+remembered that a child may get a disease, or an ailment, while
+teething, that has nothing to do with teething. If this is neglected,
+serious consequences may result. Many children have lost their lives by
+a mother's carelessness in this way. Be on the safe side, consult your
+doctor; let him assume the responsibility.
+
+HOW TO WEIGH THE BABY.--The test of weight is one of the most
+satisfactory we possess as an indication of physical progress and
+health. It is not an absolute test, but it may safely be relied upon.
+The fattest baby is not necessarily the healthiest. A gradual and a
+uniform increase is a satisfactory growth. At birth a baby weighs, on an
+average, from seven to eight pounds, though some babies weighing less
+are equally healthy. The normal and customary gain is from four to six
+ounces every week after birth.
+
+The baby should be weighed about the same time of the day each week, and
+before a meal.
+
+The average weight of a male child at different ages is as follows:
+
+    Birth                     7-1/2 lbs.
+    3 weeks                       8 lbs.
+    1 month                   8-1/2 lbs.
+    3 months                     12 lbs.
+    4 months                 13-1/2 lbs.
+    5 months                     15 lbs.
+    6 months                 15-1/2 lbs.
+    7 months                     17 lbs.
+    9 months                     19 lbs.
+    1 year                       21 lbs.
+    1-1/2 years                  23 lbs.
+    2 years                  26-1/2 lbs.
+    3 years                  31-1/2 lbs.
+    4 years                  35-1/2 lbs.
+    5 years                      40 lbs.
+    6 years                      45 lbs.
+    7 years                      49 lbs.
+    8 years                      54 lbs.
+    9 years                      59 lbs.
+    10 years                 65-1/2 lbs.
+
+A female child weighs about one-fifteenth less than a male child, as a
+rule.
+
+Table showing the average height of a male child, at different ages:
+
+    At birth             20-1/2 in.
+    6 months                 26 in.
+    1 year                   29 in.
+    2 years              32-1/2 in.
+    3 years                  35 in.
+    4 years                  38 in.
+    5 years              41-1/2 in.
+    6 years                  44 in.
+    7 years                  46 in.
+    8 years                  48 in.
+    9 years                  50 in.
+    10 years                 52 in.
+
+THE RATE OF GROWTH OF A CHILD.--A child grows most rapidly during its
+first year--six to seven inches; from fourth to sixteenth, about two
+inches annually; thence to twentieth, one inch. Commonly, a child at two
+and a half years has attained half of its ultimate adult stature. The
+diseases of youth always accelerate growth.
+
+PULSE RATE IN CHILDREN AND ADULTS.--Normal Pulse,--of new born, 130 to
+140, per minute; first year, 105 to 115; second year, 106 to 115; third
+year, 95 to 105; fifth to twelfth year, 80 to 90; thirteenth to
+twenty-first year, 75 to 80; twenty-first to sixtieth year, 70 to 75; in
+old age, 75 to 85.
+
+INFANT RECORDS.--A record should be kept by the mother of every child
+which would embrace exact data as to weight, diet, size, development of
+mental power, teeth, ailments, sickness, pains, etc., with dates and any
+information which would aid in recalling exact conditions. Such records
+are of the utmost value in a number of ways. They help in giving
+suggestions as to diet, general health, and mental qualities of the
+child in question, and they aid in furnishing what physicians call "past
+history," which past history has a very valuable significance in
+estimating the character and importance of sickness during later years.
+
+Such a record is also of importance in comparing a child's development
+with what is regarded as standard development, and also with the growth
+and development of other children in or out of the family.
+
+If a child should thus be found to fall seriously below the standard and
+yet not appear actually sick, a very thorough and routine investigation
+should be instituted to discover if possible the cause. Some error might
+thus be detected which might seriously affect the child's future growth
+and well-being.
+
+The date of the closing of the soft spot on the baby's head should be
+noted, and if it is still open, when it should be closed, it might mean
+that the child has a serious brain condition. The soft spot should close
+between the eighteenth and twenty-fourth months. The family physician
+should be notified if the soft spot is open later than the second year,
+as he may want to investigate the cause.
+
+Should the child be unusually backward in walking, and when it does so
+should limp and feel pain in the knees, it should be examined for any
+symptom of hip joint disease, of which these are the earliest signs.
+
+If the child complains of so-called "growing pains," keep in mind that
+these are rheumatic and may need attention. There are no such pains as
+actual "growing pains," that is, pains caused by the child growing.
+
+
+
+
+CHAPTER XVII
+
+BABY'S FEEDING HABITS
+
+     Overfeeding Baby--Intervals of Feeding--How Long Should a Baby
+     Stay at the Breast--Vomiting Between Feedings--Regularity of
+     Feeding--Why is Regularity of Feeding Important--"A Baby Never
+     Vomits"--What is the Significance of So-called Vomiting After
+     Feedings--Mothers Milk That is Unfit for Baby--Fresh Air for
+     Baby--Air Baths for Baby.
+
+
+OVERFEEDING BABY.--Every nursing mother should have printed and hung up,
+so she may read it every time she nurses her child, the following motto:
+"DON'T OVERFEED BABY." Few, if any, babies die of willful starvation:
+many die as a result of overfeeding. Mistaken kindness and lack of
+judgment are responsible for one-half of all the troubles of infancy.
+Babies require much less than is constantly given them. The stomach of a
+baby at birth will not hold more than one ounce, which is two
+tablespoonfuls; and at two months it will not hold more than three
+tablespoonfuls; and at six months, six or seven tablespoonfuls. Read
+these quantities once again carefully and try to realize the
+significance of the smallness of them. A baby is just like a little pig;
+it will go on feeding as long as it is allowed. The baby does not
+reason; it has no judgment; it depends upon its mother's judgment. If
+the mother is false to the trust the baby overloads its stomach. A
+swollen, distended, overloaded stomach causes indigestion. A baby with
+indigestion is a colicky, fretty, sick baby. Overfeeding, therefore, is
+the beginning of lots of trouble to the mother, and needless pain and
+suffering and sickness to the baby. A simple matter, but it is one of
+the most difficult lessons nursing mothers have to learn.
+
+Overfeeding is most apt to occur at night. Many mothers put the child to
+the nipple for its regular feeding and fall asleep; the child keeps on
+nursing at intervals until twice the proper quantity is taken; or she
+gives it the nipple or the bottle if it cries, without regard to whether
+it is the proper feeding time or not. The habit of overfeeding is very
+common in infants who are suffering from indigestion. They cry
+frequently, and are irritable most of the time; nothing seems to satisfy
+them but the nipple. Taking the warm milk into the stomach seems to
+allay the distress for the time being, so mothers get into the habit of
+quieting them in this way. The cry of the drinking man, whom we try to
+sober up, is: "Just one more drink and I'll quit." You give the drink
+and in a little while the demand is repeated. If the mother understood
+the seriousness of this practice of giving the child the nipple or
+bottle at irregular times, she would not do it.
+
+Overfeeding an infant may lay the foundation for a lifelong ailment. The
+excess of food remains in the stomach or bowels undigested. If you
+remember that this mass of undigested matter is confined in a small
+space which is both warm and damp, it will be easily understood that
+putrefaction is the inevitable outcome. As a result of this putrefaction
+there are produced certain ptomaines and leucomaines. These poisons are
+carried through the body, causing "auto-intoxication" which upsets and
+irritates the child's nervous system and may cause very serious
+consequences, as it frequently produces sudden death from apoplexy and
+"heart failure" in the adult. These children are always restless,
+fretful, continually uncomfortable, sleepless and colicky. They lose
+weight, the stomach becomes distended and a gastritis or inflammation of
+the stomach results.
+
+Frequently a mother with such a fretful baby, seeing her child getting
+thinner and thinner, will think that it is not getting enough to eat,
+and will proceed to add to the trouble by giving the child more to eat.
+
+Mothers must therefore learn not to overfeed their infants; not to
+imagine that a failure to gain weight means the need of more food (if
+the quality of the food being given is wrong, will increasing the
+quantity of bad food do any good?); not to feed irregularly, no matter
+how insistent the child may be.
+
+INTERVALS OF FEEDING.--The physician will give instructions regarding
+the feeding of the newly born baby for the first few days. After the
+first few days and up to the beginning of the third month, it should be
+fed every two hours from 7 A. M. until 9 P. M., and twice during the
+night between 9 P. M. and 7 A. M., when the regular two-hours' interval
+again begins for the following day. The two night feedings should be
+about 1 and 4:30 A. M.
+
+After the third month, and up to the sixth month, feed every three hours
+and once during the night. From the sixth month until weaned, every
+three and one-half or four hours, and not at all during the night.
+
+While it has been pointed out that regularity of feeding is absolutely
+essential, the above schedule is not to be regarded as an absolute
+guide. It is a general guide,--approximately it will be found correct in
+a large majority of cases. Each baby is a rule unto itself. The quantity
+of the mother's milk will dictate the interval after the first month and
+for each month as the baby grows. If a mother with no milk to spare, is
+nursing a big, strong, husky baby, the three-hour interval during the
+day may have to be shortened to two and one-half hours. As a rule,
+however, these exceptions are better regulated by attention to the time
+the baby is given at each nursing to fill its stomach.
+
+HOW LONG SHOULD A BABY STAY AT THE BREAST?--Babies differ as to their
+method of feeding; some of them seem to like to nurse a moment or two
+and then look around; others seem to regard nursing as a serious
+business, and resent any effort to take the nipple away until they have
+finished. A baby should be taught to nurse methodically; it should not
+be allowed to play the nipple. Let it fill its stomach and put it down
+as quickly as possible. A mother will very soon know just how long it
+takes the baby to fill its little stomach, and when she finds this out
+she should time it by the clock. When the supply of milk is sufficient,
+and the child is strong, and nurses freely, eight to twelve minutes are
+sufficient. After it is taken away from the breast it must be left quiet
+till the next feeding.
+
+Other babies, according to the ability they evince to nurse, even when
+the milk runs freely, require a longer time,--from twelve to fifteen
+minutes. The rule, however, is never to allow them to nurse so long that
+when they are taken away the milk runs out of the mouth. If this occurs,
+cut down the length of time they are at the breast, and always time the
+length of feeding by the clock,--don't guess at it.
+
+CHILDREN WHO "VOMIT" BETWEEN FEEDINGS.--When a child habitually brings
+up food between feedings it is usually a symptom of gastric indigestion.
+In these cases it is advisable to add lime-water to each feeding, and to
+remove some of the fat in each feeding. If improvement does not follow
+remove more of the fat by removing some of the cream from the top of the
+bottle before shaking it.
+
+Remove from the bottle four ounces of cream and shake before preparing
+the food from what is left. If the child improves after a few days
+remove only three ounces, then in a few days remove two ounces and later
+one ounce. After a time, sufficiently long to permit the stomach to
+become accustomed to the graded amounts of fat, the former diet of whole
+milk can be again resumed.
+
+Never decrease the interval of feeding of a baby who is bringing up
+parts of its meal between feedings; it is frequently advisable to
+increase the interval. If a child is colicky and is bringing up lots of
+gas in addition to some food, one-half grain of benzoate of soda may be
+added to each ounce of food given and continued for a number of weeks if
+necessary. When the gas is located in the intestines and is not brought
+up, it must be made to pass downward. Attention to the bowels is of
+great importance in these cases and it may be necessary to peptonize the
+milk for some time. A reduction of the sugar and starch in the feeding
+frequently cures this condition. (See "Colic.")
+
+There are children who continue to have symptoms of indigestion and who
+do not thrive despite various changes in the quantity and quality of the
+feedings. It may be necessary to obtain a wet nurse for them, as it is
+with "the delicate child." If a wet nurse cannot be obtained, or if the
+age will permit, a substitute may be tried. Borden's Eagle brand of
+condensed milk, canned, is probably the best substitute under these
+circumstances. Condensed milk should never be used as a continuous food;
+as a substitute, however, for a few weeks it is often invaluable. With
+an infant of three or four months it should be used at the beginning in
+the proportion of one ounce of the milk to sixteen ounces of plain
+boiled water or barley water. The proper quantity, whatever the child is
+taking (four or six ounces according to the age) at the time, can be
+taken from the sixteen ounces and fed to the child. As the symptoms
+improve the milk should be diluted less and less, 1 to 14, 1 to 10, and
+so on until the proper strength is reached. After the child has been on
+the condensed milk for a month it should be changed back to cow's milk,
+using of course a diluted formula until the child becomes accustomed to
+the change. Condensed milk, if used as a permanent food, will fatten
+babies, but their vitality is very deficient, the muscles flabby, and
+the resistance to disease exceedingly poor. They are apt to develop
+rickets and sometimes scurvy.
+
+REGULARITY OF FEEDING.--One of the very first, and one of the most
+important factors in contributing to the good health and the comfort of
+a baby is absolute regularity in feeding. A regular interval of feeding
+is particularly essential during the first month of a baby's life.
+
+Despite the explicit way in which young mothers are instructed in this
+respect, it is one of the disappointing incidents of the practice of
+medicine to observe how many of these mothers fail to heed the advice.
+We have personally tried to find an explanation for this astonishing
+carelessness, and have come to the conclusion that it is not due to
+intentional forgetfulness, but rather to an inexplicable failure to
+appreciate that the physician means exactly what he says.
+
+If, for example, specific instructions are given to feed, or nurse, the
+child every two hours (and by "specific instructions" it is meant, that
+the physician takes time to explain in detail the instructions he
+gives--that the instructions are not incidental to the call, but part
+of the call;--that the advice is given not as a choice of what is
+desirable, but as an absolute rule to follow; and carefully explains why
+it is imperative to do as he says; and is satisfied the mother
+understands what he means) it would seem that there could be no possible
+reason why the directions should not be faithfully carried out. Yet such
+is not the case in many instances, and the excuses given by mothers for
+failure are so trivial and annoying that they show a failure to
+appreciate that they are dealing with a serious problem--a problem
+affecting human life. They fail to understand that fatal consequences
+may follow their negligence. They treat the baby problem exactly as they
+would a household incident, and as they do not consider it important
+whether the breakfast dishes are washed at 9 A. M. or at twelve noon,
+neither do they consider it important whether the baby is fed at 9 A. M.
+or an hour later. When mothers learn that the attention they must give
+their babies is essentially different from the attention they give
+ordinary household duties, the problem of raising children with success
+and comfort will be greatly simplified.
+
+If the instructions are to feed the baby at certain intervals, do so at
+all hazards. To offer the foolish excuse that the baby was asleep when
+feeding time came, is no excuse at all; as a matter of fact the baby
+should be asleep at each feeding time, if it is healthy. Wake it and
+feed it, for, as will be shown later, it is the constant regularity that
+counts. It will be more difficult to institute regular feeding intervals
+during the first month, because a healthy baby is very difficult to wake
+up, even to be fed, during the first few weeks of life. It is absolutely
+essential, however, that it should be wakened: otherwise the tendency to
+overfill the stomach at the next feeding will lead to indigestion and
+colic.
+
+WHY IS REGULARITY OF FEEDING IMPORTANT?--Because a baby's stomach holds
+a very small quantity, and experience has taught us that a baby will
+thrive better on small quantities given frequently, rather than large
+quantities at longer intervals. The smaller the baby, the smaller the
+quantity to begin with. Some babies weigh from five to seven pounds at
+birth, while others weigh from nine to twelve pounds. It would be
+unreasonable to expect a very small baby to be able to hold and digest
+as much as a very large baby. Considerable common sense and the exercise
+of some judgment is therefore necessary on the part of the uninstructed
+mother, as to just the right quantity to give. Fortunately, a little
+experience will enable the observant mother quickly to solve this
+important problem. Nature promptly furnishes the symptoms which will
+correctly guide her. Before considering the significance of these
+symptoms let us appreciate certain facts common to all babies, and we
+will more easily interpret the meaning of the special symptoms the baby
+will furnish.
+
+First of all the baby never vomits. The ejection of food, therefore, is
+dependent upon a condition, not a disease. If milk runs out of its mouth
+immediately, or within a few moments, after a feeding, the explanation
+is that it was fed too much; it does not vomit, the stomach simply
+overflows. It is exactly like trying to put more milk into a cup after
+it is full,--it will not hold more, it overflows.
+
+The significance of this symptom, therefore, is that the quantity of the
+feeding is wrong (it is not the baby's stomach that is at fault,--it is
+the mother's judgment). Reduce the quantity of each feeding and you will
+quickly cure it. If the milk does not overflow soon after a feeding, the
+baby will appear satisfied and will go to sleep, and will sleep until it
+is time for the next feeding. It may not do this, however. In half an
+hour, or a little longer, after the feeding, it wakes, it begins to fret
+and cry, and very soon it suddenly belches gas and ejects a mouthful of
+milk, after which it will rest quietly for a few moments, when it will
+begin fretting all over again. It may keep up this performance for an
+hour, or until the next feeding, and if so it is exhausted and unfit to
+carry on the digestive process. It is in these cases where most mothers
+make serious mistakes. This is the beginning of real trouble, and the
+family physician is the only one qualified to give advice under such
+circumstances. Remember the warning given regarding heeding the advice
+of every busybody just at this time. Your baby's health is at stake;
+maybe its life depends upon what you choose to do.
+
+WHAT IS THE SIGNIFICANCE OF "VOMITING" AFTER FEEDINGS IN BABIES?--Let us
+examine the difference between the milk which overflowed immediately
+after the feeding and the milk which the baby ejects one-half hour or so
+later, and which is now being considered.
+
+The first milk looks like ordinary milk (breast milk), or if the baby is
+being fed from the bottle, it looks just like the mixture in the bottle.
+It not only looks like what it took, but it smells just like it. Now
+examine the other; we find it looks like curdled milk, it is lumpy, and
+we immediately can tell that it is sour, because it smells sour and
+looks sour.
+
+The explanation of the first overflow (immediately after the feeding)
+was the too great quantity; the explanation of the second overflow
+(one-half hour or so after the feeding), is the wrong quality of milk.
+The quantity was right because none overflowed right after the feeding,
+but the quality was wrong. Again, it is not the baby's stomach that is
+at fault,--it is the quality of the milk.
+
+How do we know this? Because of what takes place in the baby's stomach
+during the one-half hour between the feeding and the time of the
+overflow of the sour milk. The quantity being right, why should the baby
+have any trouble if the quality is correct? It should not. Therefore by
+changing the quality (not the quantity as in the former case) we cure
+the trouble, thus proving the quality of the milk to be at fault.
+
+What took place in the baby's stomach in the intervening half hour? The
+quality being wrong, the little stomach could not digest the mixture
+quick enough. Fermentation set in, gas was evolved, and as the stomach
+was full before the gas was manufactured (and as more and more gas is
+manufactured when food ferments), the stomach overflowed and out of the
+baby's mouth comes gas, and sour, fermenting, curdled milk. This process
+goes on until fermentation stops, or until the little stomach has just
+enough left to fill it and no more. But think what this is,--a sour mass
+of rotting, indigestible, curdled milk,--and that is what this baby is
+expected to live and thrive on.
+
+Some babies seem to have trouble from the very first day of life. Either
+they will not retain the food, or the food fails to agree with them. If
+the baby is put upon artificial food at once, these troubles are, of
+course, not unexpected (because the right artificial food may not be
+first chosen for the particular baby), but it is not always the
+artificially fed baby that gives us trouble, and it is sometimes
+difficult to find the cause for such trouble in a baby who has had
+nothing but its mother's milk since it was born.
+
+The cause of stomach trouble in a baby a few days old, fed exclusively
+on mother's milk, is invariably to be found in the quality of the milk.
+
+The quality of the mother's milk may be affected in a number of ways
+which will render it unfit for the baby. For example, if the mother for
+any reason becomes sick, and has a high fever shortly after confinement,
+it will affect her milk and render it unfit temporarily.
+
+If the mother worries or becomes highly nervous during the first few
+days of her baby's life, she will so affect her milk as to render it
+unfit for baby. If a baby is fed for a number of days after its birth by
+its mother, and it should prove afterward that she has not enough milk
+to continue feeding it, and has finally to put it on artificial food,
+the baby will most likely have acquired slight stomach ailments that may
+be troublesome for some time, because in this case both the quality and
+the quantity were no doubt wrong. Constipation in the mother will also
+cause trouble. The child will develop colic and extreme irritability
+until the mother's condition is relieved.
+
+Each of these conditions affecting the milk of the nursing mother
+usually demands a change of food for the baby, and the substitution of
+the proper artificial food will invariably immediately correct the
+trouble. In some cases, however, the quality of the mother's milk is not
+dependent upon a temporary temperamental condition, but is caused by
+errors in diet, or conduct, or both. The milk of a physically tired,
+worn-out mother, is not good, no matter whether the exhaustion is caused
+by actual physical labor or by the exactions of a strenuous social
+programme. The milk of a mother who persists in eating irregularly, or
+who willfully caters to an appetite which craves the rich, highly
+seasoned articles of diet, or who attempts to satisfy a legitimate
+hunger by drinking large quantities of stale tea or coffee and eating
+bread, is unfit for her baby.
+
+These cases are amenable to the proper treatment, which of course means,
+that the mother must change her conduct if at fault, and live strictly
+upon the diet prescribed elsewhere for nursing mothers.
+
+If these troubles occur in babies who have been fed exclusively upon
+artificial food, an entire change of food is frequently necessary.
+
+
+FRESH AIR FOR BABY
+
+Baby's first journey out of doors depends upon so many contingencies
+that no specific age can be given when it would be perfectly safe to
+take it.
+
+First, the weather and season of the year should be considered. The baby
+should not be taken out at all when it is wet, or foggy, or very humid;
+nor when it is extremely cold.
+
+Second, the vigor or vitality of the individual child must be
+considered. Some children can safely be taken out if the weather is
+propitious when two weeks old, others cannot be taken out without risk
+until they are two months old, regardless of the weather conditions. If
+a child is robust at birth, and nurses well, and increases in weight
+from the beginning, he can be taken out when he is two weeks old while
+the sun shines during the middle of the day. If a child is small and
+puny when born, and begins to have nursing troubles from the beginning,
+does not increase in weight, is fretting, and crying, and sleeps
+spasmodically, it would be unsafe to take it out before the sixth week
+unless it is at a season of the year which would justify exposure to the
+sunshine.
+
+The question of suitable clothing will be important, and will decide the
+advisability as to when the baby should go out. Every baby should be
+dressed in wool weather is not too distinctly bad. Remember always to
+[Transcriber's note: words missing in text] from neck to ankles. Its
+head should be warmly clad. Dressed thus and well wrapped in blankets, a
+healthy child is ready for an out-door trip at any time, if the
+[Transcriber's note: words missing in text] have plenty of blankets
+below the child as well as above it, if it is in a baby carriage. In
+very cold weather the child should be buried in blankets, and a hot
+water bottle can be wrapped in near his feet. Great care must be taken
+that the water in the bottle is not too hot, and that it does not
+actually touch the skin. No matter how many or how few blankets are
+used, the face should be exposed directly to the fresh air. When the air
+is very gusty, or high, a light veil can be laid over the face, but
+never at any other time.
+
+AIR BATHS FOR BABIES.--Babies necessarily require plenty of exercise and
+plenty of fresh air, as has been pointed out. It is a splendid custom to
+allow the baby to lie naked after his bath for half an hour. If the room
+is comfortably warm, select a spot that is free from draughts, and lay
+the baby on a pillow or two and let him kick and coo. In the sun by the
+window, his head and especially the eyes shaded from the direct rays of
+the sun, is an excellent place in the summer time. The influence of the
+direct sun rays on the little naked body is conducive to good sturdy
+health, good nerves, and sound sleep.
+
+
+
+
+CHAPTER XVIII
+
+BABY'S GOOD AND BAD HABITS. FOOD FORMULAS
+
+     Baby's Bed--The Proper Way to Lay Baby in Bed--Baby Should
+     Sleep by Itself--How Long Should a Baby Sleep--Why a Baby
+     Cries--The Habitual Crier--The Habit of Feeding Baby Every Time
+     it Cries--The Habit of Walking the Floor with Baby Every Time
+     it Cries--Jouncing, or Hobbling Baby--Baby Needs Water to
+     Drink--The Evil Habit of Kissing Baby--Establishing Toilet
+     Habits--Baby's Comforter--What can be Done to Lessen the Evil
+     Effects of the Comforter Habit--Beef Juice--Beef Juice by the
+     Cold Process--Mutton Broth--Mutton Broth with Cornstarch or
+     Arrowroot--Chicken, Veal, and Beef Broths--Scraped Beef or Meat
+     Pulp--Junket or Curds and Whey--Whey--Barley Water--Barley
+     Water Gruel or Barley Jelly--Rice, Wheat or Oat Water--Imperial
+     Granum--Albumen Water--Dried Bread--Coddled Egg.
+
+
+BABY'S BED
+
+THE PROPER WAY TO LAY BABY IN ITS BED.--The baby should be accustomed to
+sleep by itself from the day of its birth. Mothers have been known to
+smother their babies during sleep. The mother may pull the bed-clothing
+over the baby's head during the night and thus deprive it fresh air. A
+mother is much more apt to nurse her baby regularly and to do it more
+efficiently, if she is compelled to get up to do it. If she occupies the
+same bed with baby, she may fall asleep while nursing him; the baby
+consequently nurses too long, fills his stomach too full, and soon
+develops indigestion and colic in addition to acquiring a very bad
+habit.
+
+For the first few weeks an ordinary basket arrangement is all that is
+necessary. As soon as the baby begins to move around it should have a
+regular baby crib, so that possible accidents may be avoided.
+
+When the baby is placed in bed after a feeding, it should be laid upon
+its back, being tilted slightly toward its right side. By placing a
+soft, small pillow, under its left side, the baby will rest more on its
+right side, which is the proper position. The reason of this is because
+the liver of a child grows quicker and larger than any other organ, and
+it is on the right side. By placing the child on this side, it prevents
+the heavy liver from sagging over on the little full stomach. If the
+child were laid on its left side, the liver would crowd the full stomach
+and embarrass the heart, and cause pain and restlessness. Frequently a
+change of position fully to the right side, when a child has been
+restless or crying, and especially if it has been lying on its back,
+will at once relieve it and allow it to go to sleep again. It is the
+knowledge of these little things that count in babyhood.
+
+HOW LONG SHOULD A BABY SLEEP?--A perfectly healthy baby should sleep,
+while very young, eighteen or twenty hours out of the twenty-four. As it
+grows older it will sleep less. It should have, and nothing should
+interfere with its having, two sound naps every day,--one in the
+forenoon after its bath, and the other in the afternoon. When four or
+five months old, it should also sleep from 7 P. M. until 10 P. M., then
+it should be fed and allowed to sleep until morning. It has been aptly
+said, that, "a child might easily overeat, but he practically never
+oversleeps." During the second year a child should sleep twelve hours at
+night, and about two hours during the day. The twelve-hour night rest
+should be continued until the child is six years of age. The practice of
+taking a nap at noon is a very good one, and it should be encouraged as
+long as possible. It can usually be kept up until the child begins
+school life. The strenuous activity of childhood, makes some such rest
+highly desirable, and the result will necessarily be a stronger body, a
+better disposition, and firmer nerves than otherwise. The practice of
+retiring early should be strictly enforced during childhood. Children of
+two years of age, should retire at 6:30 P. M., or at latest at 7 P. M.,
+those from three to five years, may remain up an additional hour. At
+thirteen or fourteen the regular bedtime should be at 8:30 P. M. There
+is no justification for the late hours which growing children are
+allowed to keep, especially in large cities.
+
+Regular sleep is largely a matter of habit, and if the infant is started
+right, with suitable feedings, given at definite times, followed by the
+proper periods of sleep, but little trouble will be experienced with
+sleeplessness. When sleep is disturbed and broken, it means bad habits,
+unsuitable food, minor forms of indigestion, or positive illness of some
+kind. Sleep is absolutely essential in infancy and all through childhood
+for purposes of growth. It is wrong to permit a child to sleep too much
+during the day; it will become a habit, and it will not sleep well
+during the night as a consequence. In order to prevent or break this
+habit, the child should be kept in a well-lighted room and should be
+amused and entertained so as to keep it awake. The nap during the middle
+of the day is an exceedingly important factor in keeping the average
+child in good physical condition. It is a valuable adjunct in
+preventing, and in treating, nervousness in children. Children who are
+anemic should be encouraged to sleep long and freely in well-aired
+rooms.
+
+WHY A BABY CRIES.--As has been stated, every healthy baby should cry for
+half an hour each day. Nature suggests, demands this as an essential
+exercise. Muscular movements involving a greater part of the whole body
+accompany the act of crying and furnish this necessary exercise. It is
+of great importance to an adequate and uniform development of the lungs;
+deep breathing is necessary to lusty crying, hence the lungs are
+expanded and the blood renewed and oxygenated. Crying is also of
+material aid in moving the baby's bowels. Babies in perfect health will,
+however, cry under any of the following circumstances, and doubtless
+under circumstances of lesser importance and frequency when frightened
+or uncomfortable from hunger or position, soiled napkins, inflamed
+buttocks, earache, pain, from heat or cold, unsuitable clothing, and
+during difficult bowel movement, when displeased or angry. Children
+slightly but painfully ill may cry incessantly for an hour or two. Thus,
+with intestinal colic, when the cry is loud and continuous until the
+child is relieved or until he falls asleep from exhaustion.
+
+The healthy, well trained child seldom causes trouble; it is the rule
+for it to be happy and good natured in its own way.
+
+THE HABITUAL CRIER.--If a child becomes a habitual crier, it is because
+it is uncomfortable and unhappy. There are restless, often vigorous,
+crying, whining infants, and the trouble, as a rule, is in the
+intestinal tract. Badly managed, "spoiled babies" cry from inattention,
+and when left alone. If they are taken up and talked to, the crying
+ceases, thus proving that it was not pain or discomfort that was causing
+the crying. In the case of the habitual crier we try to find out the
+cause of the bowel trouble and cure it; the spoiled infant we discipline
+rigidly, or leave it alone if its parents prefer that kind of baby.
+
+THE HABIT OF FEEDING BABY EVERY TIME IT CRIES.--The habit of regular
+feeding will, if persisted in and successfully established, render
+advice on this subject unnecessary. So also will the explanation of the
+evil of overfeeding have its effect on mothers. Apart from these
+reasons, however, the habit of feeding baby every time it cries is a
+pernicious one, and no doubt the mother, who will be striving to
+faithfully follow instructions, will have to overcome the advice of
+meddling friends who will regard it as a cruelty to allow the baby to
+cry. Do not give in to these busy-bodies; insist on attending to your
+own affairs, but be absolutely sure baby is not crying for a just cause.
+A child can only cry; that is its only language, but it cries for many
+things other than the nipple or the bottle. Examine it carefully,--a wet
+diaper a pin, an uncomfortable position, a drink of water, any of these
+may be the cause.
+
+It is just as essential that a child should cry as that it should sleep.
+Every healthy child should cry for twenty or thirty minutes every
+twenty-four hours. Nature calls for this as an exercise in order to
+develop the lungs; therefore, if there is no just cause for the crying
+you must regard it as a necessary evil, even if you look upon it as a
+domestic affliction.
+
+THE HABIT OF WALKING THE FLOOR WITH BABY EVERY TIME IT CRIES.--This is
+another habit that is indulged in to the sorrow and ridicule of the
+race. If you are a victim of this habit, you have yourself to blame. It
+is a matter of education, or habit, pure and simple, and, like all bad
+habits, it is difficult to break away from. In the preceding paragraph,
+you have been told that when baby wants something, or is uncomfortable,
+it employs the language nature gave it,--it cries. No child ever cried
+to be walked up and down the floor in the dead of the night. Begin at
+the beginning, when it first cries, find out why it is crying. Offer it
+a little water if it is not feeding time. Examine its diaper and if
+soiled change it. It may be overdressed and consequently hot,
+perspiring, and uncomfortable; change its position. Find out if any pin
+is open and hurting it; loosen the binder so it can breathe easily. If
+it is a colicky child follow the instructions given in the treatment of
+colic. Be patient the first few nights, and be thorough, because you may
+discover why it cries and each discovery will help you next time. If you
+discover something wrong, some reasonable excuse for the crying, does it
+not prove the folly of walking the floor? If it wants a drink of water,
+or if its diaper is wet, how is walking the floor going to cure it, or
+how can you expect the baby to stop crying when you so unjustly construe
+its reasonable and its only way of asking a favor? If walking the floor
+stops its crying, it stops it by exhausting the child, not by relieving
+it of its little ailment.
+
+JOUNCING OR HOBBLING BABY.--This is another habit that should be frowned
+upon. So many persons are addicted to this form of baby torture, that it
+is astonishing more immediate harm does not result from it. Be
+particularly careful not to indulge in it, or permit anyone else to do
+it immediately after feeding. If you form the habit of putting baby down
+at once after each feeding, as you have been instructed to do, the
+opportunity to jounce it will not exist. A little reasoning will clearly
+convince you that to subject a baby to violent exercise when its stomach
+is full would interrupt digestion and so shake the full stomach hat it
+would distend it and cause indigestion. You would not think of
+exercising yourself after a meal; why exercise a baby?
+
+BABY NEEDS WATER TO DRINK.--Boil a quantity of water each morning, put
+in a clean bottle, and keep in a cool place. Give the baby some, three
+or four times daily between feedings. One teaspoonful is enough to begin
+with, and as it grows older it will take more. It may not always take
+the water but it will take what it wants, and it needs some every day;
+it is therefore your duty, inasmuch as baby cannot ask for it, to offer
+it regularly each day as part of your daily routine.
+
+
+KISSING
+
+A child should never be kissed on the mouth by anyone, not even its own
+parents.
+
+Kissing should not be allowed among children. If any kissing is done it
+should be on the brow, never on the mouth, hands, or fingers.
+
+Many diseases are carried by this pernicious habit, and you cannot
+afford to have baby's health jeopardized by this promiscuous and
+unnecessary liberty.
+
+
+ESTABLISHING TOILET HABITS
+
+When baby reaches the age of three months, a regular systemized effort
+should be made to educate it to "habits of cleanliness." Nothing can be
+done in this direction previous to this age, as a child at that period
+of its life is scarcely conscious of the natural functions of its body.
+Each time a baby, after the third month, is making an effort to move its
+bowels, the nurse or mother should go to it as it lies in its crib, and
+talk to it by making a certain sound or say a certain word--whichever
+word or words you want to educate your child to say, when it wants to
+move its bowels. By constant attention and effort in this direction, a
+child with quick perception and initiative will soon associate the sound
+and the function, and it will begin to make the sound when the function
+is about to be performed. As soon as it begins to make this sound, if
+prior to the act of moving the bowels, the child should be immediately
+taken up and held on a chamber, into which some hot water has been put,
+and encouraged to relieve itself, the nurse or mother still repeating
+the sound, or word, or words.
+
+Having successfully accomplished this programme a number of times, the
+child should be encouraged and petted every time it gives a satisfactory
+warning, and discouraged and reproved every time it wets or soils its
+napkin. A little later, say about six months, the child should be held
+on the chamber at a certain time each morning and evening, thus
+encouraging it to move its bowels regularly twice daily. The careful
+carrying out of a scheme such as the above will establish regular,
+cleanly habits, and will to a very large extent guard against
+constipation in the future.
+
+BABY'S COMFORTER.--The discovery and introduction of the comforter or
+rubber teat was an unfortunate episode in someone's life. By the
+careless, conscienceless nurse, or thoughtless mother, it is regarded as
+a real comfort and blessing. Any temporary comfort, however, which the
+nurse or mother may enjoy as a result of its use, is at the expense of
+the health of the child. Its use is a serious reflection upon the good
+intention and intelligence of the mother who permits her child to use
+one. It is a bad habit from every viewpoint possible. In order that
+mothers, open to conviction and capable of reasoning, may appreciate the
+character of the harm done by the use of the comforter, we will briefly
+record these conditions:
+
+1st. The constant sucking pulls upon the delicate structures of the
+mouth and throat, and so impairs the health tone of these structures
+that they become flaccid and feebly nourished. This to a certain degree
+causes adenoids, enlarged tonsils, loose palate and weak throat, with
+the constant tendency to winter colds and coughs, and to catarrh.
+
+2nd. It causes an excessive flow of saliva. Saliva should only be
+stimulated previous to stomach digestion. By causing an excessive flow
+of saliva into an empty stomach, the digestive powers are interfered
+with, and seriously weakened. Stomach trouble, and consequently
+intestinal disease, may therefore be caused by the seemingly innocent
+comforter.
+
+3rd. A constantly used comforter always causes disease of the mouth.
+Mucous erosions, canker sores, little ulcers, etc., are produced in this
+way.
+
+4th. The use of the comforter makes it impossible to put the child to
+sleep, or even to leave it alone, without first placing it in its mouth.
+
+5th. To stifle a baby's cry, by pushing the comforter into its mouth, is
+as bad as giving it chloroform to mask a serious and dangerous pain. If
+may have a just reason for crying, as is explained elsewhere, and if
+that reason is not searched for and found, it may mean serious trouble
+later.
+
+6th. Actual deformities of the mouth are produced by constant use of the
+comforter. The continuous sucking affects the gums, pushes them out of
+shape and position, and the teeth as a consequence come at wrong angles,
+thus causing unsightly deformities, which last throughout the life of
+the child.
+
+7th. The worst fault of the comforter is to be found in its
+uncleanliness. We are quite satisfied that the use of the comforter will
+be legislated against one of these days. If preventive medicine means
+anything, it must certainly reckon with the comforter in the very near
+future. Have you ever watched your baby suck on its comforter? If you
+have, you must have noted the tireless energy with which it works its
+tiny jaws and tongue. Suddenly the comforter slips from the little mouth
+and baby begins to cry, attracting the attention of the mother, or
+nurse, or little sister, who promptly, recognizing the trouble, pounces
+on the offending comforter, which has fallen to the floor, and with a
+perfunctory wipe replaces it in baby's mouth. It is done just as we have
+written it, many thousand times, and yet the problem of infant mortality
+is represented as a vexatious mystery. The newspapers solicit charitable
+aid, and write eloquent appeals regarding the necessity of sending a few
+babies to the seashore in the summer time or to supply a few with ice
+during the hot spells. A hundred other energetic enthusiasts send forth
+their laudable effort to raise the standard of child hygiene, yet the
+manufacturers of the comforter, and the ignorant mother and nurse who
+use it, do more harm in one day than all the honest effort of these
+combined forces can neutralize in a year.
+
+The rubber comforter is one of the most fertile causes of infection and
+illness in babies because of the peculiar adaptability to collecting
+germs which it possesses.
+
+When the comforter is finally discarded the habit of sucking is so
+firmly established that the child will suck its thumb for many years
+after. This results in further disease and deformity to the growing
+mouth and throat, and also to the thumb.
+
+After a child has used a pacifier or comforter for some time it
+invariably becomes a mouth breather. A mouth-breathing child is very apt
+to catch cold and as a consequence of the habit may become catarrhal or
+tubercular.
+
+WHAT CAN BE DONE TO LESSEN THE EVIL EFFECTS OF THE "COMFORTER"
+HABIT?--It is a most difficult habit to cure when once established. The
+very least that can be done is to keep the comforter scrupulously clean,
+washing it several times daily. To have not one, but two or three, kept
+in a saturated solution of boracic acid, ready to put into the baby's
+mouth should one be required to replace another that has fallen out. We
+should furnish a large shield to prevent it being swallowed. We can try
+the method of weaning the baby from the comforter by tying a ribbon to
+it and to the child's bodice. The system is gradually to shorten the
+ribbon until it becomes too short for the baby to suck in comfort. It
+will then gradually grow away from the habit.
+
+
+FOOD FORMULAS
+
+BEEF JUICE.--Take one pound of round steak and broil it slightly. Press
+the juice out with a lemon squeezer, or, with a meat-press. Season with
+salt and serve hot or cold as desired. If it is heated after it has once
+been cold, it should not be overheated as this will coagulate the
+albumen which will appear as flakes floating on the surface of the
+juice.
+
+BEEF JUICE BY THE COLD PROCESS.--Take one pound of finely chopped round
+steak, six ounces of cold water, a pinch of salt; place in a covered jar
+and stand on ice, or in a cool place, six hours. This mixture should be
+shaken from time to time. Strain and squeeze all the juice out by
+placing the meat in a coarse cloth and twisting it very hard. Season and
+feed as above.
+
+Beef juice made in this way is more nutritious than that made from the
+steak when broiled; it is not, however, quite so palatable.
+
+Beef juice made in either of the above ways is much more nutritious than
+the beef extracts sold ready to use.
+
+MUTTON BROTH.--Take one pound of finely chopped lean mutton, including
+some of the bone, one pint of cold water and a pinch of salt, cook for
+three hours over a slow fire down to half a pint, adding water to make
+up this quantity if necessary; strain through muslin. When it is cold
+remove the fat and add more salt if required. It may be fed warm or cold
+in the form of a jelly.
+
+MUTTON BROTH WITH CORNSTARCH OR ARROWROOT.--Add to the above sufficient
+cornstarch or arrowroot to thicken, cook for ten minutes and then add
+three ounces of milk, or one ounce of thick cream, to a half pint of
+broth. This makes a nutritious and extremely palatable broth.
+
+CHICKEN, VEAL, AND BEEF BROTHS.--These may be made and used in the same
+way as mutton broth.
+
+SCRAPED BEEF OR MEAT PULP.--Take a rare piece of round or sirloin steak,
+cut the outer part away, scrape or shred with a blunt knife. Cutting the
+meat into small pieces is not satisfactory. One teaspoonful to one
+tablespoonful may be given well salted, to a child a year and a half
+old. It is best to begin with a small dose and work up to the larger to
+accustom the digestive apparatus to its use.
+
+JUNKET, OR CURDS AND WHEY.--Take one pint of warm fresh cow's milk, a
+pinch of salt, a teaspoonful of granulated sugar, to which add two
+teaspoonfuls of Fairchild's essence of pepsin and allow the mixture to
+stand until firmly coagulated--this may take about twenty minutes--place
+in the ice box until thoroughly cold. Nutmeg may be added for older
+children and adults.
+
+WHEY.--The coagulated milk prepared as above is broken up with a fork
+and the whey is strained off through cheesecloth. If a stimulant is
+desired, brandy, in the proportion of one teaspoonful to six
+tablespoonfuls of the whey may be added.
+
+BARLEY WATER.--One level tablespoonful of Robinson's barley is rubbed up
+with a little cold water, to this is added one pint of boiled water
+containing a pinch of salt. The mixture should be stirred while the
+water is being added. Cook for thirty minutes in a double boiler and
+strain. Enough boiling water should be added to the mixture to make up
+the full pint if any has boiled away.
+
+BARLEY GRUEL OR BARLEY JELLY.--Repeat the above process, but instead of
+using one tablespoonful of the barley powder, use from two to four
+according to the consistency of the gruel or jelly desired.
+
+Barley water may be made from the grains. A formula for this process
+will be found in the chapter on artificial feeding.
+
+RICE, WHEAT, OR OAT WATER.--These are made from the rice, wheat, or oat
+flour in the same way as barley water described above. They may be made
+from the grains also, using the same proportions as in the making of
+barley water.
+
+IMPERIAL GRANUM.--This is prepared in the same way as the barley flour
+above described.
+
+ALBUMEN WATER.--Take half a pint of cold water, the white of one fresh
+egg, a pinch of salt, and a teaspoonful of brandy, shake and feed from a
+spoon or from a bottle. This is frequently used in cases of vomiting, or
+in irritable stomachs. It is often retained when all other food is
+rejected.
+
+DRIED BREAD.--Cut either stale or fresh bread into thin slices and place
+in the open oven. When it is dried and crisp but not browned it may be
+given to children in preference to crackers.
+
+CODDLED EGG.--A fresh egg with the shell intact is placed in boiling
+water which is immediately removed from the fire. The egg is allowed to
+remain in the water for eight minutes when it is ready for use. The
+white only should be used if the digestion is poor.
+
+
+
+
+ARTIFICIAL FEEDING
+
+
+
+
+CHAPTER XIX
+
+ARTIFICIAL FEEDING
+
+     Elementary Principles of Milk Modification--The Secret of the
+     Efficiency of Mother's Milk--Two Important Factors in
+     Successful Artificial Feeding--Every Child is a Problem in
+     Itself--Proprietary Foods of Little Value as Infant
+     Foods--Their Value is in the Milk Added to Them--The Credit
+     Belongs to the Cow--Difference Between Human and Cow's
+     Milk--What "Top-milk Feeding" Means--Utensils Necessary for
+     Home Modification of Milk--Artificial Feeding from Birth to the
+     Twelfth Month--How to Measure Top-milk--Easy Bottle-feeding
+     Method--Condensed Milk Feeding--Objections to Condensed Milk
+     Feeding.
+
+
+ELEMENTARY PRINCIPLES OF MILK MODIFICATION.--Mothers who have to raise
+their children on artificial food should understand the elementary
+principles of milk modification. They should know, for example, that the
+one object of milk modification is to render it as nearly an exact
+substitute for mother's milk, according to the age of the child, as is
+possible. If we could do this with scientific exactness, artificial
+feeding would be a simple process. We cannot, however; nor has there
+ever been devised a method by which we may hope successfully to
+duplicate mother's milk. It is a comparatively simple matter for the
+efficient chemist to analyze the breast milk of any nursing mother; and
+it is quite possible to duplicate the milk according to the analysis,
+with chemical exactness, but the two fluids will not be the same. There
+is present in the mother's milk something which synthetic chemistry
+cannot discover. This something is nature's secret,--it is akin to the
+life-giving principle which is contained in the germinal fluid, and in
+the hen's egg. We cannot therefore hope to build up an artificial food
+that contains this mysterious life-giving principle which is the secret
+of the efficiency of maternal milk,--we can only hope to approximate
+it. It is possible that we might be successful so far as its nursing
+efficiency is concerned, if all children were alike, if all children
+were of a uniform standard of health. As a matter of fact, no two babies
+are exactly alike. And while the mother of each child undoubtedly
+secretes a milk suitable to the degree of healthfulness of her own
+child, the same milk might not be equally suitable to another child. The
+milk, therefore, that is manufactured to agree with an average mother's
+milk is dependent for its success upon the vitality of the child to
+which it is fed. If that child is not a well child, according to an
+accepted standard, the milk will not agree with it, even though it is
+the best possible substitute for an average breast milk.
+
+We have consequently two factors to consider in successful or efficient
+artificial feeding:
+
+    1. Our inability to duplicate exactly mother's milk.
+    2. The lack of a uniform health standard in children.
+
+It is the lack of a uniform health standard in children that gives to
+artificial feeding all its difficulties. It renders the successful
+artificial feeding of children a personal or individual problem. Some
+children,--those who approximate a standard of health for their age; in
+other words, "well" children,--thrive on a milk modification that
+experience has taught us is suitable for well children of their age.
+Others, and they are in the majority, have to be fed on a modification
+which actual test proves to agree with their digestive capabilities.
+Every artificially fed child therefore must be studied from its own
+individual standpoint. A certain modification of milk may not agree with
+a child fed every two and one-half hours, which will be found to agree
+if fed in the same quantity, to the same child, every three hours. The
+slightest change, a change which would seem to be so insignificant in
+itself as not to justify serious consideration, may mean the difference
+between normal healthfulness and constant ill health. A food that is too
+strong for a child's digestive ability, and which causes vomiting,
+colic, and diarrhea, may be rendered exactly right by the slightest
+modification one of its constituents. To effect such a change quickly
+and successfully, one must be trained to interpret the symptoms
+correctly and to know how to make the change in the modification of the
+milk. Mothers cannot be expected to possess this degree of skill: they
+should therefore refrain from experimenting, because an experiment on a
+baby is not only dangerous, but ethically it is criminal. Call the
+family physician; put the burden on his shoulder.
+
+It is this element of uncertainty in our ability to effect a standard
+modification of milk that has afforded manufacturers the rich
+opportunity of putting on the market various baby foods for which much
+is claimed. These foods are really substitutes for the inefficiency of
+the average mother. There is no real justification for their use. If all
+mothers were clean, faithful, and efficient, there is no reason why each
+one could not be taught to modify cow's milk to suit her child, just as
+satisfactorily, or more so, than a manufacturer who never saw her child.
+The manufacturers, however, do the work, and the naturally ignorant or
+lazy and inefficient mother, is willing to pay for the extra cost of
+labor, to save herself the trouble on the one hand, and to subject her
+child to a series of experiments in order to discover the manufactured
+food that is particularly adapted to her particular baby on the other
+hand. We believe that most mothers have never considered the question
+from this standpoint; that most mothers adopt this method of artificial
+feeding at the direct suggestion of their family physician, and are not,
+therefore, responsible. These foods do not contain the nutritional
+elements necessary to healthy growth; or as they exist in normal breast
+milk; or as they can be approximated in ordinary milk modification at
+home. Proprietary foods are of decidedly poor value in infant nutrition,
+and should not be used. They have a value, however, in certain diseased
+conditions, but within a very small range. As a food for a healthy
+growing infant, they should not be used, and when the average physician
+appreciates this fact, and so instructs the mothers of the country, it
+will be to the distinct advantage of the race in every respect.
+Proprietary foods to which fresh cow's milk is added, are not foods at
+all,--they depend upon the milk so far as any nutritional value is
+concerned; and it would be far safer to modify at home a good milk than
+to buy a proprietary food, the analysis of which cannot be depended
+upon. The credit for the fat, healthy babies we see advertised does not
+belong to the manufacturers, but to the cow whose milk you add to the
+manufacturer's sugar.
+
+The proprietary beef foods are also valueless as infant foods. In
+certain illnesses, when we want a mild stimulant, a teaspoonful or two
+in hot water may have a certain value, but that is all. The beef juice
+of home manufacture is much more valuable.
+
+DIFFERENCE BETWEEN HUMAN AND COW'S MILK.--The composition of cow's milk
+is as follows:
+
+    Fat (represented by cream)        4%
+    Sugar                             4%
+    Proteids (represented by curd)    4%
+
+The composition of an average human breast milk is as follows:
+
+    Fat              4%
+    Sugar            7%
+    Proteids     1-1/2%
+
+It will be observed from a comparison of the above tables that cow's
+milk is much richer in proteids (the substances which form with water
+the curd of sour milk) than is human milk. If one remembers that cow's
+milk is manufactured by nature primarily for the feeding of calves, not
+for babies, and that the stomach of a calf is intended to exist
+exclusively on vegetable products, and that nature is preparing it for
+this purpose, and feeds it a food when young that will enable it to grow
+so as to be adapted for that purpose, one can understand that the
+problem of the modification of cow's milk to suit the stomach of a baby
+is not by any means a simple matter. Since the proteids are so much in
+excess in cow's milk, we must dilute cow's milk with twice its bulk or
+more of water to render it fit food for a new born baby. If we dilute
+cow's milk to this extent to get the proteid percentage right, we
+immediately disarrange the percentage of the cream or fat. We overcome
+this difficulty by taking the cream from the top of the bottle and
+diluting it because it is richer in fat and does not need so much
+dilution. This is the explanation of the so-called "top-milk feeding."
+The percentage of sugar represents another problem. The percentage of
+sugar in cow's milk compared with the sugar in human milk is deficient,
+so we add milk-sugar to the cow's milk to make up the deficient
+percentage.
+
+There is yet another feature which we must rectify; cow's milk is acid,
+while human milk is alkaline. To overcome this difference we add
+lime-water. We must also take into consideration that cow's milk is
+ordinarily full of germs, while human milk is free from them; to
+overcome this danger we resort to heating the milk to a degree which
+experience has taught us will kill all germs. Cooked milk is not as
+wholesome as uncooked milk, and it has a tendency to cause constipation.
+We have to a certain extent overcome the need for cooking all milk for
+babies, as will be noted later, but in summer time, unless the milk is
+known to be pure and free from germs, it is advisable to sterilize it.
+
+
+UTENSILS NECESSARY FOR HOME MODIFICATION OF MILK
+
+    One dozen round, eight-ounce nursing bottles.
+    One dozen black rubber nipples.
+    One eight-ounce measuring glass or graduate.
+    One brush for cleaning bottles.
+    One two-quart glass preserve jar for mixing the various ingredients.
+    One one-ounce Chapin dipper, for removing the top-milk.
+    One glass funnel.
+
+A detailed description of the proper kinds of bottles and nipples will
+be found elsewhere. The measuring glass or graduate should be
+wide-mouthed. It is not safe to spoon the top-milk off, nor is it safe
+to pour it out. Absorbent cotton should be provided to close the nursing
+bottles when filled and left standing in the ice box.
+
+
+ARTIFICIAL FEEDING FROM BIRTH TO THE TWELFTH MONTH
+
+The following formulas for the different ages may be found useful for
+well babies:
+
+
+From the third to the tenth day:
+
+    Milk (top 16 oz.)                3 ounces.
+    Lime-water                     1/2 ounce.
+    Milk-sugar                       1 ounce.
+    Boiled water to make            16 ounces.
+
+Ten feedings in twenty-four hours; 1-1/2 to 2 ounces at each feeding.
+
+
+From the tenth to the twenty-first day:
+
+    Milk (top 16 oz.)           6 ounces.
+    Lime-water              1-1/2 ounces.
+    Milk-sugar              1-1/2 ounces.
+    Water to make              24 ounces.
+
+Nine to ten feedings in twenty-four hours; 1-1/2 to 2 ounces at each
+feeding.
+
+
+From third to the sixth week:
+
+    Milk (top 16 oz.)       10 ounces.
+    Lime-water           2-1/2 ounces.
+    Milk-sugar               2 ounces.
+    Water to make           32 ounces.
+
+Eight to nine feedings in twenty-four hours; 2 or 3 ounces at each
+feeding.
+
+
+From sixth week to the third month:
+
+    Milk (top 16 oz.)    12 ounces.
+    Milk-sugar            2 ounces.
+    Lime-water            3 ounces.
+    Water to make        32 ounces.
+
+Seven to eight feedings in twenty-four hours; 2-1/2 to 4 ounces at each
+feeding.
+
+
+From third to fifth month:
+
+After this age two bottles of milk are required, 16 ounces being taken
+from the top of each bottle and mixed.
+
+    Milk (top 16 oz.)     18 ounces.
+    Milk-sugar             2 ounces.
+    Lime-water             4 ounces.
+    Water to make         40 ounces.
+
+Six feedings in twenty-four hours; 4 to 5 ounces at each feeding.
+
+
+From the fifth to the seventh month:
+
+    Milk (top 16 oz.)      21 ounces.
+    Milk-sugar              2 ounces.
+    Lime-water              5 ounces.
+    Water to make          42 ounces.
+
+Six feedings in twenty-four hours; 5 to 7 ounces at each feeding.
+
+
+From the seventh to the ninth month:
+
+    Milk (top 16 oz.)       27 ounces.
+    Milk-sugar           2-1/2 ounces.
+    Lime-water               6 ounces.
+    Water to make           48 ounces.
+
+Five to seven feedings in twenty-four hours; 6 to 8 ounces at each
+feeding.
+
+
+From the ninth to the twelfth month:
+
+    Milk (top 16 oz.)            35 ounces.
+    Milk-sugar                2-1/2 ounces.
+    Lime-water                    6 ounces.
+    Water to make                56 ounces.
+
+Five to six feedings in twenty-four hours; 7 to 9 ounces at each
+feeding.
+
+It will be observed that 16 ounces of top-milk is used to make the
+various formulas from. This means that the mother will dip off, with a
+Chapin dipper, 16 ounces from the top of a bottle of milk which has
+stood for four or five hours to allow the cream to rise; she will then
+mix this and take from the mixture the number of ounces called for in
+the formula she is using according to the age of the child. The ordinary
+milk that is delivered in New York City may be assumed to have stood the
+four or five hours necessary. This may not be so, however, in the
+country, as it is frequently delivered there as soon as it is milked. In
+such cases the mother will permit it to stand in the ice box until the
+cream has risen.
+
+When the mother is about to make the mixture called for in feeding from
+the third to the fifth month she will observe that 18 ounces of milk is
+called for. Now since she only uses 16 ounces of the top-milk from one
+bottle this will not be enough. She must therefore use 16 ounces from
+two bottles of milk; this she will mix together and from this mixture
+she will take the 18 ounces wanted. Whatever milk is left over may be
+used for ordinary table purposes.
+
+
+EASY BOTTLE-FEEDING METHOD
+
+The following formulas and instructions for bottle-feeding are taken
+from the Rules for the Care of Infants and Young Children which are used
+by Dr. Kerley at the out-patient department of the Babies' Hospital and
+give the simplest and easiest means of bottle-feeding:
+
+     BOTTLE-FEEDING.--The bottle should be thoroughly cleansed with
+     borax and hot water (one teaspoonful of borax to a pint of
+     water) and boil before using. The nipple should be turned
+     inside out, scrubbed with a brush, using hot borax water. The
+     brush should be used for no other purpose. The bottle and
+     nipple should rest in plain boiled water until wanted. Never
+     use grocery milk. Use only bottled milk which is delivered
+     every morning. From May 1st to October 1st the milk should be
+     boiled five minutes immediately after receiving. Children of
+     the same age vary greatly as to the strength and amount of food
+     required. A mixture, when prepared, should be put in a covered
+     glass fruit-jar and kept on the ice. For the average baby the
+     following mixture will be found useful:
+
+     "For a child under six weeks of age: Nine ounces of milk,
+     twenty-seven ounces of barley-water, four teaspoonfuls of
+     granulated sugar. Feed from two to three ounces at two and
+     one-quarter hour intervals, nine feedings in twenty-four hours.
+
+     "Sixth to the twelfth week: Twelve ounces milk, twenty-four
+     ounces barley-water, five teaspoonfuls sugar. Feed from three
+     to four ounces at each feeding.
+
+     "Third to the sixth month: Eighteen ounces of milk, thirty
+     ounces of barley-water, six teaspoonfuls of sugar. Feed four to
+     six ounces at three-hour intervals, seven feedings in
+     twenty-four hours.
+
+     "Sixth to the ninth month: Twenty-four ounces milk, twenty-four
+     ounces barley-water, six teaspoonfuls granulated sugar. Feed
+     six to eight ounces at three-hour intervals, six feedings in
+     twenty-four hours.
+
+     "Ninth to twelfth month: Thirty-eight ounces milk, twelve
+     ounces barley-water, six teaspoonfuls of granulated sugar. Feed
+     seven to nine ounces at three and one-half hour intervals, five
+     feedings in twenty-four hours."
+
+BARLEY-WATER.--The barley-water used in the above formulas may be made
+in the following way: To two teaspoonfuls of pearl barley, add one quart
+of water, and boil continuously for six hours, keeping the quantity up
+to a quart by the addition of water; strain through coarse muslin. The
+barley will be better if it is soaked for a number of hours, or over
+night, before cooking. The water in which it is soaked is not used.
+
+An equally good barley-water may be made in an easier way by using
+Robinson's prepared barley. This may be procured in the drug stores. It
+is only necessary to take one even tablespoonful of this barley to
+twelve ounces of water and cook for twenty minutes.
+
+CONDENSED MILK.--When the mother cannot afford to buy bottled milk from
+the wagon, when she has no ice-chest and cannot afford to buy ice, she
+should not attempt cow's-milk feeding, but may use canned condensed milk
+as a substitute during the hot months only. The can, when opened, should
+be kept in the coolest place in the apartment, carefully wrapped in
+clean white paper or in a clean towel. The feeding hours are the same as
+for fresh cow's milk:
+
+"Under three months of age: Condensed milk one-half to one teaspoonful;
+barley-water, two to four ounces.
+
+"Third to sixth month: Condensed milk, one to two teaspoonfuls;
+barley-water, four to six ounces.
+
+"Sixth to ninth month: Condensed milk, two to three teaspoonfuls;
+barley-water, six to eight ounces.
+
+"Ninth to twelfth month: Condensed milk, three teaspoonfuls;
+barley-water, eight to nine ounces."
+
+OBJECTIONS TO CONDENSED MILK FEEDING.--Condensed milk is not to be
+recommended as a permanent food where good cow's milk can be obtained.
+In most cases it should be used as the sole food for a few weeks only.
+It may be used when the digestion is impaired for some reason. If the
+symptoms are intestinal it will be more apt to agree than if they are
+caused by stomach ailments. The symptoms of intestinal disturbances
+are,--colic, flatulence (gas), curds or specks in the stools,
+constipation or diarrhea. It will not be found suitable if the child is
+simply vomiting.
+
+The objections to condensed milk are: It is very rich in sugar and very
+deficient in proteids and fat. Children fed on condensed milk often gain
+very rapidly in weight but have little strength or resistance. They do
+not fight disease well for this reason; they are apt to develop rickets
+and scurvy.
+
+
+
+
+CHAPTER XX
+
+ARTIFICIAL FEEDING--CONTINUED
+
+     How to Prepare Milk Mixtures--Sterilizing the Food for the
+     Day's Feeding--How to Test the Temperature of the Food for
+     Baby--When to Increase the Quality or Quantity of Food--Food
+     Allowable During the First Year in Addition to Milk--Beef
+     Juice--White of Egg--Orange Juice--Peptonized Milk--The Hot or
+     Immediate Process--The Cold Process--Partially Peptonized
+     Milk--Completely Peptonized Milk--Uses of Peptonized
+     Milk--Objections to Peptonized Milk--What a Mother Should Know
+     About Baby's Feeding Bottle and Nipple--Should a Mother Put Her
+     Baby on Artificial Food if Her Supply of Milk, During the First
+     Two Weeks is not Quite Enough to Satisfy it--Certain Conditions
+     Justify the Adoption of Artificial Feeding from the
+     Beginning--Mothers' Mistakes in the Preparation of Artificial
+     Food--Feeding During the Second Year--Sample Meals for a Child
+     Three Years of Age--The Diet of Older Children--Meats,
+     Vegetables, Cereals, Bread, Desserts--Fruits.
+
+
+HOW TO PREPARE MILK MIXTURES
+
+The mother should always remember, that the secret of success in raising
+a baby efficiently on artificial food is to be cleanly and to be exact.
+The bottles and the nipples must be scrupulously clean; the hands of the
+mother must be clean; the water used must be boiled and each ingredient
+must be measured exactly.
+
+First dissolve the sugar in the boiled water, which must be the exact
+quantity; then remove the top-milk and measure the exact amount wanted
+in the graduate, pour into the jar, add the water and sugar mixture, and
+finally the lime water.
+
+It is always desirable to make the entire quantity for the day at one
+time. After the total quantity has been mixed in the jar, fill each
+bottle with the amount for each feeding, put in a cotton stopper, and
+place the bottles in the ice box.
+
+In measuring the sugar, it should be remembered that two scant
+dipperfuls equal one ounce by weight of the sugar.
+
+When each individual bottle is to be filled, do it with the aid of the
+glass funnel which has been previously sterilized.
+
+STERILIZING THE FOOD FOR THE DAY'S FEEDING.--The simplest method is to
+place the two-quart jar containing the milk mixture for the next
+twenty-four hours' feeding upon a saucer in the bottom of an open pan,
+and then to pour enough tepid water into the pan (outside of the jar)
+until it will come up as high as the milk level. The water in the pan is
+then brought slowly to the boiling point. The pan is then moved to the
+back of the stove and left for half an hour. The jar is then removed and
+rapidly cooled by allowing cool water to flow over the outside; the
+individual bottles filled and put in the ice box.
+
+It is always wise to taste the milk before making up the day's feeding
+to be sure it is not sour. The milk from a herd of good cows is always
+better than the milk from one cow no matter how good that one cow may
+be.
+
+When about to feed the baby, the bottle is taken out of the ice box and
+heated to the desired temperature in a water bath. The temperature of
+the milk can be tested by allowing a few drops to fall on the wrist; it
+should feel warm, not hot; it should not be tasted by putting the bottle
+to the mouth of the nurse, or mother, as it may become infected by doing
+so. A flannel cover, or bag, should be made to fit the bottle and it
+should be put on while the baby is nursing so that the milk may retain
+its heat. The baby must not be disturbed while nursing, nor should he be
+jounced or carried around after nursing. These habits cause vomiting and
+indigestion. He should be put in his crib.
+
+WHEN TO INCREASE THE QUALITY OR QUANTITY OF FOOD.--Children of the same
+age may have different digestive abilities. A strong, robust child may
+be permitted to take a richer quality of milk than a weak, puny infant
+of the same age. If the quality or quantity of each feeding is too weak
+or small for the baby he will be dissatisfied and he will cry after the
+feeding. In such cases, if the bowel discharges are natural and yellow
+without curds or white specks, and if he is not gaining sufficiently in
+weight, the next stronger formula may be tried. If it is decided to put
+him on the stronger mixture, it is wise to cut the quantity down for a
+day or two in order to test out his digestive ability. If the stools
+remain good after three days, the quantity may be slowly increased until
+the amount in the recipe is allowed. It is a much more serious risk to
+overfeed the baby than to underfeed him. If too large a quantity is
+given, he may vomit it at once, or he may develop colic with intestinal
+indigestion. Such babies lose weight, become fretful and irritable, even
+though the appetite may remain good. If too strong a quality is given he
+may vomit sour, buttery-smelling milk, or have colic, and pass curds in
+the stool. If this happens it may be necessary to go back to a weak
+formula and work up from that standard. This is always a tedious and
+anxious experience and may lay the foundation for digestive disturbances
+for a long time. Don't be too anxious to increase the quality, or
+quantity, of your baby's food. It is much better to go slow and have a
+well baby, than to try to force matters and get into all kinds of
+trouble. No science calls for more elementary common sense, than the
+science of infant therapy.
+
+Digestive disturbances incident to this period are fully explained in
+the chapter on Diseases of Children.
+
+
+FOOD ALLOWABLE DURING THE FIRST YEAR, IN ADDITION TO MILK
+
+About the twelfth month the baby should receive plain milk mixtures
+instead of the top-milk heretofore used in making up the food. At first
+the milk may be plain milk from an ordinary bottle shaken up. Of this he
+may take five ounces, to which may be added three ounces of barley
+water. The barley water may be gradually withdrawn, an ounce at a time,
+replacing this amount with milk, until the child is taking eight ounces
+of milk and two ounces of barley water. Later plain mixed milk will be
+suitable for a child about the fourteenth month.
+
+Barley water may be added to the milk at any time after the third month
+in place of the plain boiled water in the preceding formulas. It is
+advisable to do this if there is any trouble with digestion, or if there
+are curds in the stools. Some children take more kindly to barley water
+than plain water at a very early age.
+
+BEEF JUICE.--The juice squeezed from broiled steak may be given a child
+at about the eighth or ninth month, or, in cases of anemia, earlier than
+this. It is given before the milk feeding, diluted with an equal amount
+of water. At first a teaspoonful of the extracted juice should be given
+with the same quantity of water; increase every four days until at the
+end of two or three weeks two tablespoonfuls are given.
+
+WHITE OF EGG.--Place an egg in boiling water and allow the water to cool
+with an egg in it. In ten minutes the white of the egg will be
+coagulated and ready for use. It may be used in place of the beef juice
+if the latter does not agree and may be begun at the sixth month and
+given once daily. One-half of the white of the egg should be tried, then
+at the end of a week, if it agrees with the child, the whole white of
+one egg may be given.
+
+ORANGE JUICE.--This juice has a good effect on the bowels and may be
+given even to very young children who are disposed to be constipated. It
+is also of benefit in counteracting the effect of boiled milk. The juice
+should be extracted from fresh oranges and strained. One teaspoonful may
+be given at first one hour before a feeding. The amount may be increased
+until four teaspoonfuls, or one tablespoonful, are given daily.
+
+PEPTONIZED MILK.--The object of peptonization of milk is partly or
+wholly to digest the casein, or curd, of the milk before feeding.
+
+Fairchild's Peptonizing Powder is used for this purpose. The powder is
+put up in tubes, and instructions are furnished in each box as to its
+use.
+
+There are two methods of using the powders:
+
+THE HOT OR IMMEDIATE PROCESS.--Fifteen minutes before feeding add from
+one-eighth to one-quarter of the contents of a tube to the milk mixture
+in the nursing bottle ready for use. The bottle is then put in water at
+a temperature of from 110 deg. to 120 deg. F., and allowed to remain in the
+water for fifteen minutes. The amount of the powder used and the
+temperature of the water depend upon the amount of milk in the nursing
+bottle.
+
+THE COLD PROCESS.--Four ounces of cold water are put into a clean quart
+bottle and the powder from one of the tubes. Shake the mixture
+thoroughly until the powder is dissolved. Add a pint of cold fresh milk,
+shake the bottle again and place directly on ice. When any of this milk
+is used the bottle should be again shaken and put immediately back on
+ice.
+
+If necessary this process may be modified so that partially or
+completely peptonized milk may be made.
+
+PARTIALLY PEPTONIZED MILK.--Put four ounces of water and a whole tube of
+powder into a clean pan and stir well; add a pint of cold milk and heat
+to the boiling point, stirring the mixture all the time. There should be
+enough heat to bring the milk to the boiling point in ten minutes. Allow
+the mixture to cool somewhat and strain into a clean jar, cork tightly
+and keep in a cool place. Shake the jar before and after using any of
+the contents.
+
+If partially peptonized milk is properly prepared it should not become
+bitter.
+
+COMPLETELY PEPTONIZED MILK.--Put four ounces of cold water and the
+powder contained in one of the tubes into a clean quart bottle and shake
+thoroughly. Add a pint of cold fresh milk and shake again; then place
+the bottle in a pan of warm water about 115 deg. F., or not too hot to place
+the hand in comfortably. Keep the bottle in the water bath for thirty
+minutes; then place the bottle directly on ice.
+
+USES OF PEPTONIZED MILK.--Partially peptonized milk is useful in young
+infants who have difficulty in digesting the curd of milk. Completely
+peptonized milk is frequently used during attacks of indigestion. It is
+used also to tide a delicate infant over a period when for some reason
+the digestive apparatus refuses to digest and assimilate even dilute
+mixtures. It is of value also in acute or chronic illness when the child
+has to be fed through a tube. When it is necessary to feed per rectum
+peptonized foods are often selected in preference to others.
+
+OBJECTIONS TO PEPTONIZED MILK.--Complete peptonization of milk renders
+the milk bitter. For this reason many children will not take it. Very
+young children whose sense of taste is not developed may be induced to
+take it after a few days. It is not wise to continue its use long
+because the function of the stomach will become accustomed to the use of
+predigested food and refuse to work when called upon. If it is used for
+a number of weeks it is wise to stop it gradually in order to permit the
+stomach to resume its function in a normal way.
+
+WHAT A MOTHER SHOULD KNOW ABOUT BABY'S FEEDING BOTTLE AND NIPPLE.--In
+the first place, always buy round bottles,--round everywhere, inside and
+out,--there should be no corners anywhere. The reason for this is, that
+bottles that are round everywhere, are easily cleaned, and can be
+thoroughly cleaned, and having no corners they do not lend themselves to
+collecting dirt and bacteria. When these bottles are first bought they
+should be boiled. After each feeding they should be thoroughly washed
+with soap or washing powder. A long-handled bottle brush should be used
+to help clean the bottle. After the bottle has been thoroughly rinsed a
+number of times with hot water, it should be set aside filled with warm
+water into which one teaspoonful of bicarbonate of soda has been put.
+Before filling them with the freshly prepared food each morning the
+bottles should be boiled. Every mother with a bottle-fed baby should buy
+a dozen bottles, all of the same kind and size to begin with. This is a
+great advantage for a number of important reasons, two or three of which
+I will mention:
+
+1st. Having enough bottles means that each bottle will be used once only
+during the twenty-four hours; there is less chance therefore of a bottle
+being cleaned carelessly.
+
+2nd. Having a fresh bottle for each feeding permits all of the food for
+twenty-four hours being made at one time. This ensures uniformity of
+quality of each feeding.
+
+3rd. By cleaning all the bottles at one time (previous to filling) it is
+more apt to be done thoroughly; and by making all the food for a day at
+one time it is more apt to be correct than if each feeding was made
+separately.
+
+The baby's nipple should be made of plain black rubber. It should not be
+too thick because it is necessary to turn it inside out in order to
+clean it thoroughly. The hole in the nipple should not be too large--if
+the child can empty the bottle in less time than fifteen minutes the
+hole is too large. If the milk drops out but does not run it is about
+right. Don't buy nipples too long or too large. A long nipple tends to
+gag the child and cause vomiting. A large nipple prevents the child from
+sucking properly and usually allows the food to be taken too quickly and
+with air, which causes colic and indigestion. It is well to have always
+half a dozen nipples of the right kind on hand. When new, nipples should
+be boiled before using. After each feeding the nipple should be washed
+in borax and water on both sides, then it should be put in a dish
+containing fresh, cold, borax water and left there until again required.
+A large portion of the success of raising healthy, bottle-fed babies is
+in being everlastingly clean in the details of caring for the bottles
+and nipples which are in daily use.
+
+SHOULD A MOTHER PUT HER BABY ON ARTIFICIAL FOOD IF HER SUPPLY OF MILK,
+DURING THE FIRST TWO WEEKS, IS NOT QUITE ENOUGH TO SATISFY IT?--This is
+a question that cannot be answered by a simple yes or no. A great deal
+depends upon circumstances, and these circumstances must be weighed and
+counterweighed before an answer is given. It is a serious matter, in our
+judgment it is a criminal proceeding for a physician to advise the use
+of an artificial food without exhausting every aid and means to preserve
+and increase the mother's milk. This is a subject in need of earnest
+missionaries in all walks of life, and it should be the duty of every
+woman's club and gathering to voice the conviction of the highest
+womanhood by advocating the use of mother's milk with every child born.
+A woman who can and will not nurse her own child is scarcely deserving
+of the name of mother.
+
+It does not seem quite human to deprive a baby of the milk which
+rightfully belongs to it; yet in certain walks of life this is not an
+uncommon procedure. On the other hand the percentage of women able to
+nurse their children is decreasing. This is especially true as applied
+to cities, though it is also true, in a less degree, in the rural
+districts. One eminent authority states that less than twenty-five per
+cent. of the well-to-do mothers, who have earnestly and intelligently
+attempted to nurse their babies, succeed in doing so for a period longer
+than three months. This authority also says: "An intellectual city
+mother who is able to nurse her child successfully for the entire first
+year is almost a phenomenon." Women nowadays have so many diversified
+interests, that the primal duty of maternal nursing is not at all a
+fashionable function. If, however, the mother is willing, and has
+conscientiously tried to nurse her baby, and after seven or eight days
+it is found that she has not enough milk to satisfy it, and if the
+quality seems to be good, some expedient should be immediately adopted
+to tide the condition over until the mother resumes her customary
+household routine. The safest expedient under these circumstances is to
+alternate the feedings; one feeding from both breasts of the mother, and
+the next an artificial food. Some arrangement of this kind is the just
+and the safest way, because a very large percentage of mothers suffer
+from inactivity while lying in bed after a confinement. This inactivity
+expresses itself in a failure of some of the organs to perform their
+duty properly. This may affect the quantity, and sometimes the quality,
+of the milk, but it is, as a rule, quickly rectified as soon as the
+mother is up and active.
+
+If, however, the milk is still found to be inadequate after she is up
+and has resumed her usual habits, and if her health is good, and she is
+eating well, it is distinctly best to put the child exclusively on an
+artificial diet.
+
+
+CERTAIN CONDITIONS JUSTIFY THE ADOPTION OF ARTIFICIAL FEEDING FROM THE
+BEGINNING
+
+1st. Woman suffering with any wasting disease such a cancer or
+tuberculosis. (One of these days, and very soon we hope, it will be
+legally impossible for a tubercular or cancerous patient to become a
+mother.)
+
+2nd. When a mother is the victim of any of the serious childbed
+complications such as convulsions, kidney disease, extensive loss of
+blood or blood poisoning, or runs a high temperature because of some
+disease occurring at the same time as the confinement, as, for example,
+appendicitis, scarlet fever, typhoid fever, etc.
+
+3rd. Epilepsy, chorea, insanity, are also conditions which render
+artificial feeding necessary.
+
+It is much wiser immediately to put the child on artificial feeding if
+there is a justifiable reason for it than to experiment, because any
+experiment at this time is almost certain not to be in favor of the
+child. Artificial feeding is a comparatively easy and successful
+problem, provided it is begun with healthy digestive organs. If you keep
+the child at the breast of a mother whose milk is inadequate in quantity
+or quality, or both, for two or three days, and then begin artificial
+feeding, the child's stomach is already unable to perform its duty, and
+you have to treat it with the greatest degree of care and attention, and
+probably begin with a weak food, until you regain the lost ground.
+
+MOTHERS' MISTAKES IN THE PREPARATION OF ARTIFICIAL FOOD.--Another
+interesting condition which is quite common, is the tendency on the part
+of the mother to fail to follow instructions correctly,--even though
+written or printed,--regarding the preparation of the baby's food. When
+the baby is not thriving and gaining steadily in weight, or is fretty
+and cries a good deal, and does not rest and sleep peacefully,
+something, of course, is wrong. If, after a careful physical examination
+of the child, nothing is found to justify these symptoms, a physician
+invariably finds, if he questions the mother closely, that she has
+mistaken the instructions and is preparing the food wrongly.
+
+Infinite care in every little detail is the price of success in raising
+babies as well as in every other field of human endeavor. Revise
+carefully your method of preparing baby's food if there is any trouble
+such as is described above. Despite your absolute assurance that you are
+making no mistake, do not be surprised to find that you are not
+following directions to the letter, and because of this unintentional
+mistake, your negligence is responsible for your baby's condition. Go
+over the instructions with your husband, and let him follow your method
+of preparation, as you repeat it. He may detect the mistake if any
+exists,--two heads are always better than one. So important is this
+matter that the following two actual cases will demonstrate how easy it
+is to make a mistake, despite the absolute confidence of the mother, in
+each case, that she was following the printed directions correctly:
+
+I was called to see a baby whose mother informed me that it was having a
+great deal of trouble. It was apparently not thriving; its bowels were
+bad; it constantly cried, and seemed to be suffering from colic and
+indigestion. The mother stated that it lay with its legs constantly
+drawn up and passed enormous quantities of gas. The baby certainly
+looked sick. It had been a small baby at birth; and at three months it
+weighed only six pounds. After a careful examination, I could find
+nothing in the physical condition of the child itself, which
+satisfactorily explained the condition, and had made up my mind that the
+food upon which it was being exclusively fed, and upon which it had been
+fed since birth, was not agreeing with it. Before recommending a change
+of food, I asked the mother to state in detail just how she prepared it.
+
+The directions printed on the can in which the food was bought called
+for so many ounces of a certain quality of "top milk." She thought this
+meant simply so many ounces off the top of a bottle of milk, which, of
+course, meant that she was feeding her baby exclusively a very rich
+cream and absolutely no milk. The result was that the baby--small and
+weak to begin with--could not digest this rich mixture, so it gradually
+lost vitality, as the mother kept increasing the strength of the food,
+according to the age, as directed by the instructions, until it was
+completely knocked out. I pointed out her mistake and suggested a change
+in her methods; she was instructed to use the formula for a child of two
+months, instead of the one for three months, as she was doing. The child
+immediately began to pick up and in the course of six weeks was entirely
+cured, and had gained considerably in weight. This mother was a
+careful, clean, painstaking, attentive nurse, and it was a long time
+before she forgave herself for the mistake. The mistake here was a
+little matter, but the results were big and convincing.
+
+The second case was that of a child of about the same age, but in this
+instance it had been a robust, healthy child when born, and of normal
+weight and size. The mother nursed it for about one month, when her milk
+failed, and it was put upon a well-known, patent barley preparation. The
+food seemed to agree with it for a time, but, as the mother explained,
+the child soon seemed to be dissatisfied at each feeding,--it gave her
+the impression that it was not getting enough to eat, so she increased
+the quantity. Despite this increase of food, it was apparent that the
+baby was getting weaker, and more and more irritable, and sleepless,
+until there was no rest night or day for the mother or baby. About this
+time the child began to "swell up" as if dropsical; it lost its healthy
+color and looked as if made of wax. It was very evident that the child
+was being starved, yet this scarcely seemed probable when the actual
+quantity of food consumed was considered. The directions on the can of
+this food, called for a certain amount of the barley powder to be mixed
+with boiled water; and in an additional paragraph it was directed to mix
+this with a certain amount of milk. When I requested the mother to state
+how she prepared the food, I was astonished to learn that she had
+evidently never read the second paragraph of the directions. She was
+feeding her baby on barley powder and boiled water,--an excellent
+starvation diet. When her attention was called to the grave carelessness
+she had been guilty of, she was the most contrite mother I ever knew. As
+soon as the milk was added to the food the baby immediately began to
+thrive was very soon a robust, healthy infant.
+
+Of course these were errors of bad judgment and gross negligence of
+which few mothers would be guilty, but these types of mistakes come to
+the attention of physicians frequently, and emphasize the need of
+constant vigilance in every detail in the management of babies if we
+wish to achieve success.
+
+
+FEEDING DURING THE SECOND YEAR
+
+At the beginning of the second year the child should be fed at the
+following hours, 6 and 10 A. M., 2, 6, and 10 P. M.
+
+Early in the second year the child should be taught to drink from a cup.
+
+A proper diet for a child of twelve months, of average development,
+would be as follows:
+
+6 A. M. Milk and barley water, or milk and oat gruel, in the proportion
+of seven ounces of milk to three ounces of the diluent.
+
+9 A. M. The juice of an orange (strained).
+
+10 A. M. The same as at 6 A. M.
+
+2 P. M. Chicken broth with rice or stale bread crumbs, six ounces; or a
+light boiled egg mixed with stale bread crumbs; or beef juice, three
+ounces. Milk and gruel same as at 6 A. M., but four ounces only.
+
+6 P. M. Two tablespoonfuls of cereal jelly in eight ounces of milk; a
+piece of stale bread and butter. (The jelly is made by cooking the
+cereal for three hours the day before it is wanted; it should then be
+strained through a colander; oatmeal, barley, or wheat may be used.)
+
+10 P. M. Same as at 6 A. M.
+
+About the fifteenth month the cereals may be given much thicker and fed
+with a spoon. The child can at this time take a number of various fruit
+juices. Orange juice is the best. Carefully strained juice of ripe
+peaches, strawberries, raspberries, may be given in reasonable amounts,
+one or two tablespoonfuls, once daily. Custard, cornstarch, plain rice
+pudding, junket, wheatena, cornmeal, hominy, oatmeal, zwieback, bran
+biscuit, each with butter, may be added in reasonable quantities between
+the eighteenth and twenty-fourth months. When cereals are given they
+should be thoroughly cooked, usually for three hours, and strained. When
+apple sauce is given to a child about the second year it should contain
+very little sugar and baked apples should be fed without cream. Water
+must be given to the child between meals especially during the summer.
+It should be boiled and cooled kept in a cool place. The following
+schedule for a child about the third year constitutes a good average
+diet for a healthy child:
+
+
+TABLE OF STANDARDS
+
+(As Adopted and Copyrighted by the American Medical Society)
+
+PHYSICAL DEVELOPMENT
+
+[Transcriber's Note: The ages were difficult to read and may not all be
+correct.]
+
+Age in Months
+   Weight
+          Height
+                  Circumference of head
+                            Circumference of chest
+                                    Circumference of abdomen
+                                            Lat. Diameter of chest
+                                                   Chest front to back
+                                                          Length of arm
+                                                                  Length of leg
+-------------------------------------------------------------------------------
+   lbs.   in.      in.      in.     in.     in.    in.    in.     in.
+ 6   17    27      17-1/2   17-1/2  17-1/2  5      4-1/2  10      10
+ 9   19    28      18       18      18      5      4-1/2  11      11
+12   20    29      18-1/2   18-1/2  18-1/2  5      4-3/4  12      12-1/2
+16   23    30      18-1/2   18-1/2  18-1/2  5-1/2  5      12-1/2  13-1/2
+21   24    31      18-1/2   19-1/2  19-1/4  6      5      14      15
+24   25    32      19       20      19-1/2  6      5      14-1/2  15-1/2
+28   27    33-1/2  19       20      19-1/2  6      5      14-3/4  15-3/4
+32   29    35      19-1/2   20-1/2  19-1/2  6-1/4  5-1/2  14-3/4  15-3/4
+36   32    36-1/2  20       21      20      6-1/4  5-1/2  15      16-1/2
+===============================================================================
+
+
+MENTAL DEVELOPMENT
+
+     Attention, facial expression, irritability and disposition
+     should be considered.
+
+     Six Months
+
+     Child sits unsupported for a few minutes.... Balances head....
+     Eye follows a bright object.... Looks in direction of an
+     unexpected sound.... Child seizes an object and holds it....
+
+     Twelve Months
+
+     Stands and walks with support.... Makes a few sounds, such as
+     mam-mam, da-da, co-oo.... Plays with toys.... Attempts to use
+     paper and pencil.... Shows interest in pictures.... Clings to
+     mother....
+
+     Eighteen Months
+
+     Child walks and runs alone.... Says a few words, such as Mama,
+     Papa, Baby.... Points to common objects in pictures....
+     Imitates a few simple movements, such as placing hands on head
+     or clapping hands....
+
+     Two Years
+
+     Runs.... Repeats two or three words.... Knows features....
+     Obeys simple commands, such as "Throw me the ball".... Imitates
+     movements....
+
+     Two and One-Half Years
+
+     Talks in short sentences.... Knows names of members of the
+     family.... Roughly copies a circle.... Recognizes self in
+     mirror.... Imitates more complex movements....
+
+     Three Years
+
+     Talks distinctly.... Repeats sentences of six simple words....
+     Repeats up to two numerals--meaning repeats first one numeral
+     and then two numerals.... Enumerates objects in a complex
+     picture and attempts to describe it....
+
+     Four Years
+
+     Knows its sex.... Names familiar objects, such as key, knife,
+     etc..... Repeats three numerals.... Compares two sticks (can
+     select the longer).... Distinguishes the longer of two
+     lines....
+
+     Five Years
+
+     Compares weights and lengths.... Copies a square.... Counts
+     four pennies.... Describes a picture....
+
+Breakfast:--(7 to 8 o'clock) Oatmeal, hominy or cracked wheat (cooked
+three hours), served with milk, a little salt but very little sugar. A
+soft egg, boiled, poached, or coddled. Stale bread and butter. One glass
+of warm milk. At 10 o'clock, the juice of one orange.
+
+Dinner:--(12 o'clock) Strained soup, four ounces. Chop, roast beef,
+steak, chicken, small quantity of any one. Baked potato and cooked rice,
+or spaghetti. A selection of green vegetables may be made from asparagus
+tips, string beans, peas, spinach, cauliflower, carrots; they should be
+cooked until very soft, and mashed or put through a sieve. For dessert,
+plain rice pudding or bread pudding, stewed prunes, baked or stewed
+apple, junket, custard or cornstarch. A glass of milk or water.
+
+Supper:--(6 o'clock) Cereal; farina, arrowroot, cream of wheat, wheatena
+(each cooked two hours), with salt but no sugar. Give two or three
+tablespoonfuls. Drink of milk with stale bread and butter. Twice a week,
+a little plain ice cream, or junket, custard or cornstarch.
+
+Three meals a day at this time are better than more frequent feedings.
+The child has a better appetite and much better digestion. It may be
+found necessary to give delicate children a luncheon at 3 o'clock. A
+glass of milk and a Graham wafer, or a cup of broth and a zwieback, will
+answer the purpose. Children recovering from serious illness will need
+more frequent nourishment. Up to the sixth year the diet may conform to
+the above schedule, increasing the individual quantities as
+circumstances may warrant.
+
+
+THE DIET OF OLDER CHILDREN (FROM SIX TO TEN YEARS)
+
+After the sixth year the diet will conform to the adult diet, with
+certain exceptions. The important exceptions are as follows: All meats
+are to be excluded except roast beef, steak, lamb chops, roast lamb,
+mutton chop; all meats should be cooked rare and either scraped or
+finely divided. They should be broiled or roasted, never fried, and
+never given oftener than once daily, and then only in small quantity.
+Pies, rich puddings, pastries of all kinds, gravies, sauces, all highly
+seasoned dishes; wine, beer, coffee, tea, should never be given to
+children. Ham, bacon, sausage, pork, liver, kidney, game, and all dried
+and salted meats, codfish, mackerel and halibut, are particularly bad.
+
+The following articles are permissible: Broiled chicken, shad, bass. The
+"platter gravy" from a roast is very nourishing if given in small
+amounts. Milk should continue to form an important part of the dietary
+up to the tenth year. It should be clean and fresh but not too rich.
+Sometimes it is found advisable to dilute the milk with water that has
+been boiled and cooled. Some children will take it if a pinch of salt or
+bicarbonate of soda is put into it, and they will digest it easier and
+better. They should never be allowed to take more than one quart daily
+and frequently less will do more good. Cream is not good for children of
+this age. Eggs are valuable; they should never be given fried or in the
+form of omelets, they are best given boiled, poached or coddled and only
+slightly cooked. It is never necessary to give more than one egg at a
+meal. There are children with whom eggs do not agree; these children are
+disposed to "biliousness."
+
+VEGETABLES.--Certain vegetables are objectionable at this age: Raw
+celery, radishes, raw onions, cucumbers, tomatoes, lettuce, corn, lima
+beans, cabbage, egg plant. The following are good: White potatoes (never
+fried), spinach, peas, asparagus tips, string beans, celery, young
+beets, carrots, squash, turnips, boiled onions and cauliflower. It is
+important to remember that all vegetables should be thoroughly cooked;
+they cannot be cooked too much. After boiling for some time the water
+should be drained off and fresh water used to complete cooking.
+Vegetables should be fed in small quantities. From the third to the
+tenth year they form an important and essential part of the diet of all
+children. After the tenth year they can be eaten as served to adults,
+and other vegetables may then be added. As a rule salads of all kinds
+should be omitted until after the twelfth year.
+
+CEREALS.--Children should not be allowed to eat too much cereal at one
+meal,--never more than one small saucerful. Cereals should be properly
+cooked. It is not safe to adhere strictly to the directions on the
+package of any cereal. As a rule they require much longer cooking. They
+are best cooked in a double boiler. They may be served with milk, salt,
+and not more than one teaspoonful of sugar.
+
+BREAD.--Fresh bread is never allowable. Graham wafers, oatmeal crackers,
+Huntley and Palmer breakfast biscuits, bran muffins, rye bread, corn
+bread, stale rolls, are all suitable to growing children.
+
+Hot bread, fresh rolls, buckwheat or griddle cakes, all sweet cakes, are
+objectionable.
+
+DESSERTS.--The only permissible desserts for this age are junket,
+custards, plain rice, or sago; or bread pudding. The only safe rule to
+follow so far as "sweet things" are concerned, is not to give them at
+all. This applies to candy, ice cream, pies, pastries, jam, syrups,
+preserved fruits, nuts and dried fruits. The parent who indulges a child
+to "a taste," is guilty of a bad habit, and it can only lead to trouble.
+
+FRUITS.--These should always be fresh and selected with care. Fruit is
+the most important article of diet to a child of this age. Up to five
+years it is safest to use only cooked fruits and fresh fruit juices: of
+these the juice from sweet oranges, grape fruit, peaches, strawberries,
+and raspberries may be given. Stewed or baked apples, apple sauce, figs,
+prunes, peaches, apricots, pears are excellent because of their effect
+on the bowels. When the bowels are loose, and especially in hot weather,
+great care must be taken when fruit of any kind is used. The pulp of any
+fruit should never be used; cherries, bananas, pineapples, and berries
+are not to be given to children. Milk should never be allowed at the
+same meal when sour fruit is served.
+
+
+
+
+WHAT MOTHERS SHOULD KNOW
+
+
+
+
+CHAPTER XXI
+
+     "Life has taught me that it is the women of a country in whose
+     hands its destiny reposes. No cause that is not great enough to
+     command their devotion and pure enough to deserve their
+     sympathy can ever wholly triumph."
+
+     JOSEPH H. CHOATE.
+
+THE EDUCATION OF THE MOTHER
+
+     What Mothers Should Know About the Care of Children During
+     Illness--A Sick Child Should be in Bed--The Diet of the Sick
+     Child--A Child is the Most Helpless Living Thing--The Delicate
+     Child--How to Feed the Delicate Child--How to Bathe the
+     Delicate Child--Airing the Delicate Child--Habits of the
+     Delicate Child--Indiscriminate Feeding--Poor Appetite--Loss of
+     Appetite--Treatment of Loss of Appetite--Overeating in
+     Infancy--What Correct Eating Means--Bran as a Food--Breakfast
+     for a Child at School--Lunch for a Child at School--Bran
+     Muffins for School Children--Bran Muffins in
+     Constipation--Hysterical Children--What a Mother Should Know
+     About Cathartics and How to Give a Dose of Castor Oil--Castor
+     Oil--Calomel--Citrate of Magnesium--When to Use Castor
+     Oil--When to Use Calomel--Vaccination--Time for
+     Vaccination--Methods of Vaccination.--Symptoms of Successful
+     Vaccination.
+
+
+WHAT MOTHERS SHOULD KNOW ABOUT THE CARE OF CHILDREN DURING ILLNESS
+
+Every child has a certain amount of vitality and resistance. When
+illness comes it should be our duty to maintain the vitality and
+resistance to the highest degree. We should, therefore, irrespective of
+the nature of the illness, surround the child with all the conditions
+that will minister to the preservation of whatever strength and vitality
+the child has. Experience has taught us that there are certain
+requirements that should be carried out in the general management of
+sick children.
+
+A SICK CHILD SHOULD BE IN BED.--In the first place a sick child should
+be in bed. There is no exception to this rule. It is impossible to do
+justice to a child if you allow him to dissipate his strength and
+exhaust himself moving from place to place while he is sick. A mother
+should not forget that it is she who must exercise wisdom and decide
+what is best for her child. The judgment of a sick person is not to be
+relied upon, and it would be wrong to submit to the whims and fancies of
+an ailing child, if these are known to be medically disadvantageous to
+its best interests.
+
+Quiet surroundings are essential in all acute illnesses. The nurse
+should be congenial to the child. If the patient demands the presence of
+the mother she should remain, but she should not try to entertain him or
+interfere with the nurse.
+
+The clothing of the patient should be the ordinary night-dress which is
+worn in health. In no disease is any special kind, or quantity of
+clothing required.
+
+The temperature of the room should be 68 deg. F. Thermometers are cheap and
+an exact knowledge of the degree of heat in a sickroom is an essential
+requisite. Nothing drains the vitality during sickness quicker than
+varying degrees of heat and cold. It uses up nerve force and energy and
+renders the patient irritable and difficult to manage.
+
+The strictest attention should be paid to the ventilation of the
+sickroom. We are learning more and more that fresh air is essential to
+the speedy cure of all diseases and to the general well-being of the
+patient. A direct, continuous communication between the sickroom and
+out-of-doors is imperative. It is a splendid measure to use two rooms
+for the patient and to change him twice daily, and to air thoroughly the
+unused room.
+
+The sickroom itself should be large and in a quiet part of the house. In
+summer time the windows may be wide open, in winter months the degree of
+ventilation can be regulated by the thermometer.
+
+Many mothers fail to appreciate that drinking water is an important
+requisite in all ailments of childhood, should be given freely, but it
+should be known to be absolutely pure. The same rule applies to sponging
+the patient. It must be done every day; sometimes it is necessary to do
+it more often, but if so it will be so directed by the attending
+physician.
+
+THE DIET OF THE SICK CHILD.--Prescribing the diet of the sick child is
+an important undertaking. It should be remembered that during sickness
+the digestive capacity is reduced; consequently the food must be
+lessened in quantity and in strength. If the patient is an infant at
+breast the best way to accomplish our purpose is to give before each
+feeding two ounces of boiled water, cooled to the temperature of the
+body. This dilutes the mother's milk and renders it more easy of
+digestion. If bottle-fed, it is accomplished by replacing one-half of
+the milk with water. In certain diseases milk is totally withdrawn, but
+these cases will be noted when discussing the treatment of the various
+diseases. With older children, we give milk diluted with water, or
+gruels, soups, or cereals, as conditions warrant.
+
+Needless interference with the patient must not be indulged in. Sleep
+and quiet are essential features of nature's reparative process. It is
+seldom necessary to disturb a sick child for the giving of food or
+medicine oftener than every second or third hour. Medicine may always be
+given with food. Meddlesome interference, talkative attendants, or
+excessive noise may exhaust a child and may prolong and render dangerous
+or fatal a condition that would otherwise go on to recovery.
+
+One satisfactory movement of the bowel daily is essential to the comfort
+and progress of a sick person. If this does not take place naturally, it
+should be obtained by an enema.
+
+At the beginning of any illness in childhood it is a safe procedure to
+give a dose of a suitable cathartic as soon as it is discovered that the
+child is sick.
+
+A CHILD IS THE MOST HELPLESS LIVING THING.--Nature endows the young of
+every species--except those of the human family--with certain instincts,
+which, when developed, govern and control their lives absolutely. The
+technical definition of an instinct is an exceedingly complicated word
+picture. It is only essential to an intelligent understanding of our
+subject that the reader should have a definite idea of the difference
+between an act that is the result of a process of reasoning and an act
+that is the result of an instinct. If a man finds his way out of his
+burning home he will stay out as long as there is any danger. The
+crudest kind of reasoning will teach this lesson. A horse, on the other
+hand--and incidentally it may be noted that a horse is regarded as an
+intelligent animal--if led out of a burning stable and let loose, will
+immediately reenter and be burned to death. The horse is the victim of
+instinct; he obeys the unconquerable instinct to return to his stall--he
+cannot reason as the man can that a home that is burning is not a proper
+place to seek safety in. When an ostrich fears danger he buries his head
+in the sand, under the impression that if his head is out of sight he is
+safe from danger. This is his instinctive plan of procedure in the
+presence of danger, and it is the plan of every ostrich, everywhere,
+always. A little reasoning would show them how foolish the idea is--but
+they cannot reason. That is the province of man alone. If the first
+member of a flock of sheep jumps over a fence to get into the next
+field, every member of the flock will follow, each one jumping the
+fence, though there may be an open gate between the two fields a few
+yards away. Instinct dictates the plan to the sheep as they have
+received instructions from their ancestors always to "follow the lead."
+This is their hereditary legacy and they cannot disobey it.
+
+Animals are born with instincts which need only circumstances to bring
+them out. Now a baby is not born with instincts of this character,--it
+has not even the instinct to help itself; it cannot find the breasts
+that were made for it; it is more helpless than the baby cat or dog or
+worm. Therefore a baby in whose brain the potential faculty of reason is
+slumbering must of necessity begin its career wholly dependent upon the
+supervision and love of its mother, until such time as it may be capable
+of reasoning for itself. Motherhood is therefore the supreme privilege
+of womanhood. It cannot be superseded, hence the fundamental factor in
+any system of race culture, or in any system of infant mortality, must
+tend to raise the quality and the intelligence of motherhood as a basic
+necessity. Motherhood at the present time, though the most important and
+sacred profession in the world, is almost exclusively carried on by
+unskilled labor. The maternal instinct is deeply rooted and universal;
+its absence must be regarded as an abnormality, or as a product of
+misdirected education. The requisites for the mothers of the future
+should be absolute physical health and love of children.
+
+If nature endowed a baby with instincts there would be no need for
+reason or education. Education cannot teach a cat how to nurse or wash a
+kitten any better than it does,--its instinct is good enough. The mother
+of a human baby, however, is not born with the instinct which enables
+her to care for her baby equally as well as the cat cares for her
+kitten. She must be educated or taught to care for it. She can then care
+for it better than the cat cares for the kitten, and she can be taught
+to bake, to sew, to read; to play on the piano, which a cat cannot be
+taught. So while a baby may be the most helpless living thing at one
+stage of its career it has in it--in the faculty of reasoning--the
+ability to become the Lord of all the Earth and of all the animals
+therein. To limit the environment of a child by imposing instincts upon
+it, would be to limit its inherent freedom. To be obliged to obey a
+prescribed instinctive law would rob mankind of his creative or
+reasoning faculty, and that would be to lower him to the level of the
+brute creation. Reason is of no use if our acts are already determined
+for us. There are therefore good reasons why the human baby should be,
+at the moment of its birth, the most helpless living thing; and as a
+consequence it is imperative, if the eugenic ideal is worthy of
+attainment, that every baby should have the benefit of trained and
+efficient care and education.
+
+
+THE DELICATE CHILD
+
+There is a certain standard by which we measure the physical and mental
+development of children. This standard we regard as the evidence of
+normal development. Some children exceed these requirements; they are
+bigger and stronger at a given age than the average child at the same
+age. There are other children who cannot be called sick, but who are
+physically and mentally inferior to the average standard, whom we
+designate as "delicate." These children are not as big, or as strong, or
+as heavy, as other children of the same age. They are born with a
+reduced vitality, or through mismanagement in early infancy they have
+acquired a subnormal standard of development. Children born of parents
+who are not of standard vitality are predisposed to be delicate. If the
+parents are of average development, and the delicacy of the child is
+acquired by mismanagement, the proper dietetic and hygienic management
+will, as a rule, promptly result in a satisfactory restoration to normal
+health.
+
+TREATMENT.--When a mother awakes to the knowledge that her child is
+delicate; when she understands that her child's vitality is not what it
+should be, and when she resolves to "do something" in the interest of
+her child, she is on the right road, and we hope to encourage her in the
+good intention. We would however tell her that her effort must be
+thorough, and that she must be patient and persevering. If she does not
+falter in well doing she will succeed beyond her expectation, and the
+satisfaction she will experience in noting the evidences of returning
+health and strength in the appearance and conduct of her child, should
+be ample recompense for the effort made and the time bestowed.
+
+She must begin with a definite knowledge of just what she intends doing;
+she must know, however, what must be done and she must begin at the
+beginning and build from a sure foundation. It is therefore absolutely
+essential to ascertain if there is any actual disease underlying the
+reduced vitality which is responsible for the delicacy of the child;
+this necessitates a thorough examination by a competent physician. If
+you are assured there is no disease present, no tuberculosis, no
+syphilis, no malaria, and that debilitating conditions, such as
+adenoids, sexual abnormalities, the results of self-abuse, skin disease,
+do not exist, then certain fixed rules can be laid down, and definite
+principles followed in the daily management.
+
+WEIGHT, AS A STANDARD OF DEVELOPMENT.--It has been stated elsewhere in
+this book that one of the safest guides to follow, as to whether a child
+is thriving, is its weight. This can be relied upon as a general rule. A
+child should therefore be weighed regularly every week. If it is not
+gaining an average of four ounces weekly it is not thriving up to
+standard. When the average is below four ounces there is something wrong
+with the quality or quantity of the food.
+
+HOW TO FEED THE DELICATE CHILD.--If the child is breast-fed and the
+weight standard, as evidenced by the weekly averages, is persistently
+below normal, we must find a substitute for the mother's milk. If the
+child is bottle-fed and it is demonstrated that it is impossible to
+maintain normal development on cow's milk, a wet-nurse should be
+obtained. After the child is weaned, or put upon a more liberal diet,
+milk should continue to be the chief article of diet. From the first to
+the third year a child should take one quart of milk daily in addition
+to the other food. There are some children, however, who seemingly
+cannot take milk without getting indigestion; they should be put on
+skimmed milk, to which may be added a small quantity of sugar to make up
+for the loss of fat. Mothers must be certain that too much milk is not
+given, or the desire for other necessary food will diminish.
+
+After the first year it is a very good plan to give one teaspoonful of
+scraped beef daily. If this is well borne, two may be given and later
+three. It can be given immediately before the regular feeding of cereal
+and milk. From the twelfth to the sixteenth month eggs may be given: at
+first one-half, and later a whole egg mixed with bread crumbs. Various
+vegetables should also be given cooked in the form of a puree. If at any
+time the child should refuse the food, or act as if it had no appetite,
+leave the milk out of the diet; this may then restore the appetite and
+it will take the other food freely; the milk can be resumed later.
+
+As the child grows older, the distaste for milk may grow, or he may be
+one of those children with whom milk really does not agree; in either
+event, do not hesitate to leave it out of the child's dietary. These
+children should be encouraged to eat plenty of good butter on their
+bread and crackers. Butter will not only agree with them, but it will
+supply any fat deficiency in the general diet. The diet may now consist
+of milk (unless it disagrees), cereals cooked three hours, raw or rare
+meat, poultry, eggs, vegetables, purees, cooked and raw fruit, bread,
+crackers.
+
+HOW TO BATHE THE DELICATE CHILD.--Regular daily baths are particularly
+of benefit to the delicate child, despite the prevailing fear that they
+may catch cold. The salt bath is advised and the time to take it is just
+before retiring. The room should be warm and the temperature of the
+water should be 90 deg. F.: it should not last longer than five minutes, and
+the water should be cooled down to 70 deg. F., before the child is removed
+from the bath. While the cold water is running in, the surface of the
+body should be briskly rubbed with the mother's hands and after removal
+the child should be dried with a fairly coarse bath towel to ensure a
+good reaction. Very delicate children need not have the temperature of
+the water reduced; others may stand water of 80 deg. F., but no lower. In
+the poorly nourished it is frequently advantageous to rub the body,
+after drying, with olive oil or goose oil. This aids nutrition and
+because of the massage it aids circulation. In some older children a
+daily cold spinal douche seems to act particularly well. If the child
+does not promptly react from the effect of the cold water it is best to
+discontinue it.
+
+AIRING THE DELICATE CHILD.--Delicate children should, above all things,
+be assured of the maximum amount of fresh air and sunlight. Many mothers
+entertain the idea that these children are disposed to take cold easily,
+if in the open air,--which is not the case. All children need an
+abundance of fresh air and the delicate need it particularly. The season
+of the year and the character of the weather will, of course, dictate
+just how much open-air exercise they may take.
+
+If the weather is very cold and the air damp, or if there is a very cold
+high wind, it is best to remain indoors; otherwise the child should
+remain out for four or five hours. Indoor airing is obtained by
+dressing the child to go out-doors, putting him in his carriage, and
+leaving him before an open window in a room of good size with all the
+doors closed so as not to create a draught.
+
+HABITS OF THE DELICATE CHILD.--The amount of sleep necessary for a
+delicate child is the same as for a normal child of the same age. The
+room should always be well aired, night and day, and should be devoted
+to the exclusive use of the child.
+
+These children should never be allowed to sit on the floor. It is always
+a difficult matter to avoid this, but it must be religiously guarded
+against; otherwise a cold is the inevitable result.
+
+A change of air is sometimes advisable and essential, especially during
+the hot, humid weather of July and August. Much better results will be
+obtained by sending these children to the mountains than to the
+seashore.
+
+Delicate children should always be clothed warmly, but not too warmly.
+The feet and legs must always be kept comfortable. Moderate exercise,
+short of fatigue, is necessary. A midday nap after the noon meal should
+be taken every day. The child should be undressed and put to bed for two
+hours and left there, whether it sleeps or not. This applies to delicate
+children of all ages.
+
+The education of delicate children should be postponed until the health
+is restored. They should, however, be made to obey and they should be
+taught good habits. When school work begins it should be made light and
+easy. They should not go to school before the eighth year, and then not
+unless physically fit. They should not play at rough games or with rough
+companions, though it is not wise to shield them too much. Their habits
+and peculiarities should be studied and every possible effort made to
+direct them kindly and wisely so that they may contribute to their own
+upbuilding.
+
+A systematic observance of these suggestions will save many lives and
+will aid very considerably in producing stronger men and women. Infinite
+patience, tact and self-sacrifice is necessary, but the results in every
+case justify the measures adopted.
+
+INDISCRIMINATE FEEDING: POOR APPETITE.--In considering many of the
+diseases of childhood the term "indiscriminate feeding" is used. An
+explanation of just what is meant by this will be of decided advantage.
+There are two fundamental essentials in the successful feeding of
+infants and children: regularity and suitable food.
+
+A child whose feeding intervals are not regular and whose food is
+unsuitable is a victim of indiscriminate feeding.
+
+The lack of observance of the regularity rule always leads to loss of
+appetite and indigestion.
+
+Loss of appetite is a serious condition in a growing child and may give
+infinite trouble. Indigestion in a growing child is unnecessary,
+unfortunate, and frequently is the one factor that spoils an entire
+life. It is unnecessary, because it means and is caused by neglect on
+the part of the mother; it is unfortunate, because it always paves the
+way for any serious ailment that is epidemic or "in the air"; and it is
+important, because it very frequently weakens the stomach and renders it
+unfit for normal digestion for a long period, if not for life.
+
+If for some reason a child's appetite becomes poor and it is not
+properly managed until the appetite is restored to normal,
+indiscriminate feeding is always the result.
+
+The reason for the poor appetite may be because the child is kept
+indoors too long, or because it is being fed on unsuitable food, or is
+living in unsanitary surroundings, or many other reasons, sometimes
+trifling reasons, may cause it. When a child will not eat at meal time,
+the mother feels that it should eat sometime, so she encourages it to
+eat between meals, and because of a mistaken kindness she breaks the law
+of regularity,--a law that can never be broken without serious results
+following. A child in this condition becomes a disturber of the peace;
+the parents can do nothing with him; he insists on eating just what he
+likes and when he likes; and he chooses, as a rule, candy, cake,
+pastries, ice cream, tea, coffee. Indigestion follows, the child loses
+weight, is languid and listless and constipated.
+
+When finally the physician is called in he finds it necessary to go back
+to first principles. He lays down the law in a definite, stern way, and
+the mother and the child must obey. Most parents know and admit they are
+doing wrong to give in to a whimsical child, and if they would only make
+up their minds to conquer when conquering is easy they would save
+themselves many heartaches, many regrets, and the child much suffering
+and much possible permanent injury as a consequence. Usually one parent
+is willing to be master but the other lacks the mental equipment to meet
+the issue, and argues, as he or she imagines, in favor of the child. The
+parent whose instinct is correct, whose judgment is true, whose
+interpretation of the situation is just, should not be dissuaded, or
+argued away from his or her duty. If it is the first real problem in
+your domestic experience in which a decided stand must be made, make it
+without fear and without hesitation, and carry it through to the bitter
+end. Results will justify and vindicate you.
+
+The general treatment of these children will be found outlined in the
+following paragraph on Loss of Appetite.
+
+LOSS OF APPETITE.--If a child complains of not being hungry, and will
+not take enough food, and if this condition continues for some time, we
+must regard the matter as being abnormal and find the cause. This is
+necessary because a child must eat in order to maintain a certain
+standard of growth and vitality. These children are not sick; they are
+active and continue to play as usual and they sleep soundly, but they
+have no appetite. One of the most frequent causes of this condition is
+too frequent feedings. Some children are naturally small eaters. They
+thrive and maintain a satisfactory weight; their system seems not to
+demand large quantities or even ordinary quantities of food. Parents
+observe this habit of little eating and begin to coax and bribe the
+child to eat more at meal time, and to eat between meals. In this way
+the child really overeats, the appetite becomes capricious, and the
+stomach rebels. In a very short time the condition of "loss of appetite"
+is established as a consequence. Another cause is the drinking of too
+much milk, and yet another and very common cause is indiscriminate
+eating of candy, cakes crackers, and fruit between meals. Children who
+are fed at the table with adults eat things they should not eat, and
+spoil their digestive organs and loss of appetite is the result. The
+Scotch custom of compelling children to eat at a separate table is an
+excellent one. They are not tempted to ask for things they cannot have.
+Lack of fresh air and exercise frequently results in impaired appetite.
+
+TREATMENT.--The very first thing to do with these children is to stop
+any habit that may be responsible for the loss of appetite. If the child
+has been eating between meals, stop it absolutely. If too much milk has
+been taken, stop milk entirely. If the child has not been getting enough
+fresh air, or if it has been sleeping in a badly ventilated room, or if
+baths have been too infrequent, rectify the fault. If eating at the
+family table and fed indiscriminately, change the programme; feed him
+before the family sits down to meals. Now regulate the time of feeding
+to suit the age of the child and adhere to strict regularity. It is a
+pernicious and absolutely wrong custom to force children to eat, or to
+coax them to eat when they do not want to eat. Loss of appetite will
+never be cured by forced feeding, or by reducing the interval between
+feedings, or by giving the child stronger or more concentrated food
+under the mistaken idea that in this way the loss of appetite can be
+"made up." The interval of feeding should rather be lengthened than
+otherwise in order to give the digestive organs an opportunity to regain
+the normal desire for food. Pay strict attention to the bowels. Be
+certain the child has a daily satisfactory movement and that he drinks
+frequently between meals.
+
+If the child does not promptly respond to the proper hygienic and
+dietary treatment as outlined above there are two things that can be
+done:
+
+1st: Send the child away. A change of scene and climate will sometimes
+work like a charm in these cases, and will, after a reasonable length of
+time, establish a permanently good appetite.
+
+2nd: If this is not possible, as sometimes it may not be with poor
+patients, then we can give the child suitable tonics.
+
+OVEREATING.--The large majority of individuals eat too much. Most of us
+would enjoy better health, better spirits, and greater efficiency if we
+consumed from one-third to one-half less food than we habitually do.
+
+Every living organism requires a certain amount of nourishment according
+to the work performed and to replenish wear and tear; when food is
+supplied in excess, the system cannot utilize it, but it is compelled to
+rid itself of the excess in some way. The work involved in this
+eliminating process is exceedingly detrimental to the various organs and
+to the individual. To overeat is to overwork, and to overwork a machine
+or an animal is not only poor economy but bad judgment. If the digestive
+apparatus is required to work overtime, it is a self-evident assumption
+that the various organs will not digest efficiently the food necessary
+for ordinary existence. If the necessary nourishment is not adequately
+digested, the general health will suffer as a consequence. If the
+general health is below standard the individual will not be competent to
+carry on the requirements of a normal, healthy life.
+
+We must, however, give some thought to the effect which the excess of
+food exerts upon the human machine.
+
+Nature provides and maintains a standard relationship between the
+capacity of the individual and his needs. A child has a digestive
+capacity to digest and assimilate a quantity of food sufficient for his
+growth and proper nourishment; an adult maintains the same standard
+according to his requirements. All the other organs are adjusted to
+harmonize with this scheme. If we overeat, the immediate result is to
+disorganize this relationship between the various organs; hence we have
+a multitude of effects which manifest themselves in various ways as a
+direct result of overeating. The combined general effect expresses
+itself in the form of what is regarded as poor health and a low standard
+of efficiency. When a larger quantity of food is taken into the stomach
+than it can properly digest within a reasonable time, two conditions
+immediately follow. The stomach itself is dilated and the food is not
+thoroughly digested. If the habit is persisted in, indigestion, and
+later chronic gastritis ensues. The direct symptoms of these conditions
+are given in detail in another part of this book. Very few individuals,
+however, appreciate the indirect consequences of overeating and of
+indiscriminate eating on the general health. It is impossible to
+tabulate in so many words the effect which this habit has on efficiency
+and temperament. We read and hear a great deal to-day about efficiency.
+Now, an individual's efficiency is an expression of that individual's
+health standard or capacity. To be 100 per cent. efficient one must
+enjoy good health. It would be absurd to expect a high standard of
+efficiency from an individual with a low standard of health. Poor health
+means poor vitality. Vitality is the mark of the master. Without
+vitality one can never dominate. All the great achievements of the race
+have been consummated by those who conserved their vitality. No single
+factor contributes a larger percentage of inefficients and failures than
+overeating. The man or woman who, from habit or experience, has learned
+the lesson of right eating and living need not be lacking in efficiency,
+nor need they despair of the attainment of success.
+
+SYMPTOMS OF OVEREATING.--Efficiency depends not only upon one's capacity
+to perform, but upon the character of the performance. The spirit must
+be willing to perform. The overeater is heavy, phlegmatic, indifferent,
+lacking in energy, tact and initiative. She is constantly subjecting her
+system to needless overwork; she is depressed, nervous, imaginative and
+she is not ambitious. She is a victim of self-poisoning, of
+constipation, indigestion, headaches, flatulency, neuralgia, vertigo,
+and melancholia. An overeater never enjoys good health, never is
+efficient, and cannot possibly be successful.
+
+To enjoy good health one should know how to select food and how to
+combine and proportion it. It has been said that the American people are
+a race of dyspeptics, and it must be admitted that the assertion is
+more or less true. There are millions of people who suffer from
+indigestion in some degree, and it may justly be said that indigestion
+has its beginning in overeating, in some form. It may not be overeating
+in actual bulk, but it is overeating some article or articles that do
+not agree with the individual, and the fact that certain articles do not
+agree is unquestionably dependent upon the nervous temperament of the
+American people--and the temperament of a people is a product of the
+kind of existence the people subject themselves to. We are, therefore,
+unwittingly, victims of our environment.
+
+Correct eating means simple eating--only a few things at a time. Food
+should be selected according to one's age and occupation, and according
+to the season of the year. To eat habitually large quantities and at the
+same time a large variety is suicide pure and simple. If one dared to
+make the experiment of cutting down one's diet one-half, it is
+absolutely certain the effect would be immediate benefit. The benefit
+would not only be manifest in the physical betterment, but the
+efficiency and general well-being would be greatly enhanced. It is not
+the kind of food that makes a dyspeptic, but the quantity. A well person
+need not consider whether a certain kind of food will or will not agree,
+providing she does not eat too freely of that food, or combine it with
+other food. The combination of which may in itself form too much of one
+kind at a time.
+
+Some people imagine, for example, that oatmeal porridge does not agree
+with them. When the matter is inquired into, however, it is found that
+they habitually eat bread, eggs, and other articles, with coffee at the
+the same meal with the porridge. From this combination they experience
+distress and blame the porridge. If these would take a plate of oatmeal
+porridge with cream and salt, and some stewed fruit for breakfast they
+would not experience any trouble, and this would be an ample meal for
+the ordinary individual. It is not the porridge, but the unsuitable
+combination, that is at fault. The same may be said of milk. Many people
+state that they cannot take milk and they deprive themselves of one of
+the very best articles of diet because of this idea. There are very few
+people in the world who cannot take milk in some way. It is not the milk
+that is at fault; it is the combination of it with other less nutritious
+articles that is the cause of the distress. Even candy is responsible
+for thousands of cases of indigestion. Anyone may safely take a
+reasonable quantity of good candy, but if it is taken at a wrong time,
+or combined with other articles, it may readily produce indigestion.
+
+Indiscriminate eating and overeating are prolific causes of rheumatism,
+kidney disease, heart disease, liver troubles, obesity,
+arteriosclerosis, and apoplexy. These diseases are notoriously on the
+increase and must be construed as a direct consequence of the tendency
+of the American people to overeat and to eat indiscriminately.
+
+BRAN AS A FOOD.--In the chapter on constipation there may be found a
+formula for making bran muffins. These muffins are invaluable to
+children in health, and to the victim of indigestion or constipation,
+whether child or adult. One muffin with each meal will solve the problem
+of constipation in growing children without the use of drugs or other
+aid. They will regulate the bowels of adults in many instances without
+resorting to drugs.
+
+Raw fruit in season, or stewed fruit, or a baked apple, with a light
+boiled egg and one bran muffin, is an ample and a nourishing breakfast
+for a child at school.
+
+For lunch the same child should have a plate of thoroughly done
+vegetable soup, a bran muffin, and more fruit. After school, a glass of
+milk with two or three Graham wafers may be given.
+
+For dinner the child at school may have a mixed meal. This meal should
+not be later than six-thirty o'clock and the child should retire at
+eight-thirty at the latest. A bran muffin should be taken with this meal
+unless the child's bowels are too loose.
+
+Mothers should insist on their children eating these muffins. If a child
+eats only what it likes it will not eat what is good for it. If the
+mother insists in the right way she will win; if she does not the child
+will win. If the child wins, the mother is the wrong kind of mother. I
+do not know of any other single article of diet that is of such value
+to growing children as these bran muffins. Children who eat them
+regularly will have less sickness than other children; they will be
+strong, healthy and full of energy. The bran in itself is not
+responsible for this list of excellent acquirements, but the regular
+eating of the bran is. Most ailments of children are of
+gastro-intestinal origin; bran keeps the entire length of the
+gastro-intestinal tract sweet and clean; if the child eats a bran muffin
+with each meal it will not have much desire or much room for any other
+form of bread or pastry. If white bread or pastry is abstained from the
+child will not have indigestion, or constipation, and hence it will not
+be constantly poisoning itself as most children do whose diet is not
+restricted and whose bowels are more or less constipated.
+
+These muffins should be made of the ordinary unsifted bran. If this is
+not procurable the sifted bran (Johnstone's) may be employed. This bran
+may be bought in any good grocery.
+
+Modern milling methods, modern cookery, and modern methods of forced
+farming, have each contributed their share of rendering food inert and
+frequently deleterious. The miller has extracted the coarse cellulose
+from the various flours in the effort to manufacture a product suitable
+to the super-civilized public demand. This cellulose is absolutely
+essential to gastric and intestinal digestion, and if children are
+deprived of it constipation and indigestion are the natural result.
+Forced farming accomplishes the same effect--the fiber of the vegetable
+is deficient. Bran is rich in mineral salts, iron, protein, and
+phosphates, and gives to growing children the ingredients which ordinary
+food is deficient in. Bran prevents intestinal fermentation and children
+who eat it are free from intestinal gas and putrefaction. It harmonizes
+chemically with all other foods. Children should be made to take it
+every day as a matter of self-preservation and of duty.
+
+HYSTERICAL CHILDREN.--Hysteria is not a disease of infancy or of young
+children. It is seen as a rule after the eight year. Male as well as
+female children may be the victims to an equal degree. It is much more
+frequently seen in the offspring of parents who are themselves nervous,
+or alcoholic, or who suffer from insanity, or have insanity in the
+family history. If these children in addition to the hereditary
+influence suffer from stomach or intestinal disease, or general poor
+health and are overworked at school, they are very apt to become
+hysterical.
+
+They are capricious, indifferent, and excitable. Their disposition is
+irritable; they frequently exhibit fits of great excitability of temper
+and passion. They cry or weep without cause. They often have
+hallucinations and while asleep have attacks resembling night terrors.
+They complain of pains in the joints, and are frequently treated for
+disease that does not exist. Such condition as hysterical cough, spasm
+of the muscles of the face, mouth, eyes, and of the neck exist and are
+difficult to diagnose from real disease. These children complain of
+painful sensations and sensitive areas and exaggerate all symptoms
+unnecessarily.
+
+The possibility of curing these patients is good, providing the
+treatment is faithfully carried out. It is less favorable when marked
+hereditary influences are strong.
+
+TREATMENT.--In all children of distinctly nervous type and especially
+those of nervous parents, the first essential duty is to develop their
+muscular system. Try in every way to make healthy animals of them.
+Attention and treatment should not be directed toward the nervous
+system. If the child is made strong by out-door life, good plain,
+digestible food, early hours, regular sleep in thoroughly aired rooms,
+regular bathing, and if the school work is conducted with moderation and
+judgment, the nerves and the nervous temperament will participate in the
+healthy growth which will follow as a result. Tea and coffee should be
+forbidden. Exciting books and questionable entertainment as given in
+picture shows and theaters must not be allowed. If older members of the
+family, or parents, are excitable and nervous the children should be
+sent away to the country from them.
+
+They should be put in charge of a person who will exercise firm control
+over them. It may be necessary to take these patients away from other
+children, and isolate them under proper control until they are able to
+control themselves. They should be interested in exercise that compels
+them to work; they should live and if convenient sleep out of doors; and
+they should take iron or cod liver oil, or any other indicated tonic. If
+they complain of pain they should receive cold-water douches, or the
+cold pack, or the shower bath; and they should be put to bed and treated
+firmly but kindly. Attention to the bowels is always essential, because
+these children are as a rule the victims of chronic constipation.
+
+WHAT A MOTHER SHOULD KNOW ABOUT CATHARTICS AND HOW TO GIVE A CHILD A
+DOSE OF CASTOR OIL.--Broadly speaking there are three kinds of
+cathartics. I will, in a simple way, explain their action so that a
+mother may know which one to select under certain circumstances.
+Frequently a mother is told by her physician to "keep the bowels of her
+child open." Few mothers know how to keep the bowels open, and as this
+is an important matter, every mother should know the reason why "any"
+laxative or cathartic is not always suitable.
+
+CASTOR OIL.--This is one of the oldest and one of the best cathartics we
+possess for children. It is a mechanical cathartic; it acts in exactly
+the same way as a street-cleaning machine. It cleans the street by
+sweeping or pushing everything before it.
+
+CALOMEL--This is a chemical cathartic. It acts through the blood. When
+it is absorbed by the blood its chemical ingredients act on certain
+nerves as irritants. These nerves excite the liver and bowel to action
+and an evacuation is the result.
+
+CITRATE OF MAGNESIA.--This is a saline laxative. It acts by drawing out
+of the bowel wall enough liquid from the blood to sweep the contents
+out. It may be likened to the street cleaner who flushes and cleans the
+street by means of a hose pipe attached to the water hydrant.
+
+Under what condition should a mother use these remedies? Castor oil is
+ordinarily the best cathartic in childhood; it is not, however, always
+the best. Most ailments of children are of gastro-intestinal
+origin--they have either overeaten or they have eaten the wrong kind of
+food. The stomach and bowel are overloaded: they must be cleaned out. We
+want a mechanical cathartic, one that will push everything ahead of it,
+so we use castor oil. When a child needs a cleaning out, use castor oil.
+By a "cleaning out" we mean, when we know he has eaten too much of a
+questionable variety of food, as pastries, cakes, fruit, ice cream,
+etc., as children do at parties; or when he has eaten unripe fruit, as
+green apples, etc.; or when for some reason he is constipated and
+complains of not feeling well, use castor oil.
+
+If you decide to use castor oil, use enough. A large dose will act
+promptly and with less pain and with more certain results than a small
+dose.
+
+It is always safe and it is always best to decide upon castor oil as the
+proper remedy, if the child has no fever. If he has a fever he will most
+likely vomit castor oil when another kind of cathartic would stay on the
+stomach.
+
+Castor oil works more effectively, more thoroughly, and is less likely
+to be vomited if given on an empty stomach, so we give it two hours
+after eating and we give no food for two hours after it is taken.
+
+Castor oil is distinctly of advantage in many chronic diseases of the
+intestines because of its healing properties. In chronic colitis, for
+example, when the child is suffering with malnutrition, irregular bowel
+action with an odor, and mucous or bloody stools, a combination of
+castor oil and salol, in emulsion, in small doses,--to which a small
+quantity of opium may be added or withheld according to the frequency of
+the movements,--with an occasional colon irrigation, is sometimes
+invaluable.
+
+Mothers must remember that castor oil is not good in the treatment of
+constipation, because its after effect is to constipate, consequently we
+would not use it "to keep the bowels open,"--it is only of use to clean
+the bowel out thoroughly when that is indicated.
+
+HOW TO GIVE A DOSE OF CASTOR OIL--The best way to give a child castor
+oil is as follows: Place the bottle containing the oil on its side on a
+piece of ice in the ice box; chill it thoroughly. Take a tablespoon and
+smear it with butter; pour the ice cold oil into the spoon; it will
+stick together like a piece of chewing gum and it will slide out of the
+buttered spoon in one lump. In this way it will not spread over the
+mouth and teeth and throat, leaving a bad taste, but will go straight
+and surely into the stomach. The child cannot swallow some and retain
+enough in the mouth to sputter it all over itself and only get half a
+dose; it will not nauseate it, because it practically is tasteless if
+given cold, and the stomach will tolerate the cold oil much better than
+when given in the ordinary way.
+
+A baby can be given oil in the same way, but in smaller doses. When the
+teaspoon is put into the mouth of a baby it should be immediately turned
+on its side so that it will keep the mouth open. If the nose is held
+closed and the mouth wide open for a few seconds the baby cannot spit
+the oil out--it must swallow, and if the oil sticks together as cold oil
+will, it gets the whole dose. It usually takes two persons to give a
+baby a dose of oil--one to open the mouth and give the medicine, the
+other to hold the nose and arms.
+
+CALOMEL.--The general indication for calomel is fever. When a child
+develops a disease it immediately gets a temperature, and very
+frequently the fever is quite high because the slightest ailment gives a
+child fever. When fever begins, digestion practically stops, it is
+therefore imperative to clean the whole gastro-intestinal canal;
+otherwise the undigested material will putrefy and poison the entire
+system and render the disease more serious than it need be.
+
+Now we select in such conditions calomel for two reasons:
+
+First, because the presence of fever indicates that infection of the
+blood is taking place; this may come either from the intestinal canal
+itself, or from the germs of the disease with which the child is
+suffering. Since calomel acts chemically through the blood it is the
+cathartic indicated.
+
+Second, because a cathartic like castor oil does not act through the
+blood and it would most likely be vomited by a fevered stomach.
+
+Certain conditions indicate calomel; biliousness and jaundice, for
+example, because it has a specific action on the liver and if the liver
+is at fault calomel is the proper remedy.
+
+Calomel is best given in small divided doses, 1-10 of a grain every half
+hour, for ten doses. It is best given combined with soda; every drug
+store carries tablets of calomel and soda for this reason.
+
+Calomel should never be given in the treatment of constipation, nor
+should it be used indiscriminately by mothers, as much harm may result.
+It has its specific use as indicated above, but it should never be used
+under any other circumstances.
+
+CITRATE OF MAGNESIA.--This is a mild laxative. After the bowels have
+been thoroughly opened with castor oil or calomel, small doses of
+citrate of magnesia may be given for a few days, "to keep the bowels
+open." There is no danger or harm in its use if used for this purpose.
+It must not be used, however, in the treatment of constipation of
+children for the simple reason that you cannot cure constipation by the
+use of drugs of any kind. Laxatives of this type have become a national
+curse. Adults, especially women, use them constantly. All these
+advertised saline laxative waters work by weakening the blood--when a
+dose is taken the chemicals in it draw through the bowel wall blood
+serum, and produce, because of the excess of this watery fluid, large,
+and frequently many, liquid movements.
+
+If this practice is continued, as it often is every day, the quality of
+the blood will suffer seriously, and many individuals are the victims of
+neuralgic pains, headaches, nervousness, insomnia, anemia, and general
+broken health as a direct consequence of this pernicious habit.
+
+Mothers will try to remember, therefore, that drugs and saline waters
+have no place in the treatment of constipation in children or
+themselves. Constipation must be treated by diet, exercise regular
+living and by the observance of hygienic and sanitary common-sense
+rules.
+
+
+VACCINATION
+
+TIME FOR VACCINATION.--The best time to vaccinate a child is during the
+first three months if he is healthy. The reason for selecting so early a
+period is because the constitutional disturbances are much less at this
+time than in later childhood. It should not be done during active
+dentition. If the child is delicate if his nutrition is bad it should be
+deferred until a later time. Children suffering from eczema or from any
+skin disease or those syphilitic should not be vaccinated until it is
+compulsory, or until exposed to small-pox.
+
+METHODS OF VACCINATING.--It is customary in America to vaccinate at one
+point rather than to make a number of inoculations as is the custom in
+some other countries. The leg or the arm is the usual location selected.
+In infants the sore can be protected better on the leg; in children of
+the run-about age, the arm is the better location because it can be kept
+at rest easier.
+
+Before vaccinating the skin should be rendered surgically clean; this
+can be done by washing with soap and water, drying and then rubbing with
+alcohol. The wound should be left uncovered for about twenty minutes to
+dry, it may then be covered with a bandage, or with a vaccine shield.
+The part should not be washed for twenty-four hours.
+
+THE SYMPTOMS OF SUCCESSFUL VACCINATION.--Nothing is noticed until the
+third or fourth day, when a red papule appears. In the course of the
+following day a vesicle appears; this vesicle enlarges until it reaches
+its full development on the ninth day. The size of the vesicle is about
+one-half inch in diameter; it is surrounded with a reddish inflammatory
+area for about two inches. The vesicle begins to dry and is shortly a
+dark crust which remains from one to three weeks and then falls off. It
+leaves a bluish scar which soon turns white and the part is roughened
+and honeycombed. During the period when the vaccination is at its height
+the child suffers from fever and irritability and loss of appetite.
+
+If vaccination does not "take" in an infant it should be done two or
+three times and if then unsuccessful it should be repeated every year
+until it takes. The fact that vaccination does not take does not imply
+that the child would not take small-pox but rather that the vaccine used
+is not suitable. There are some children, however, who seem to be immune
+to vaccination.
+
+Sometimes the symptoms are more severe than those enumerated; this seems
+to depend upon the susceptibility of the child. The vesicle may be much
+larger and the area of inflammation much more dense and angry. The fever
+may be higher and may last longer; there may be a general rash and the
+degree of depression more profound. Vesicles may be produced on other
+parts of the body as a result of scratching. Mothers must always
+remember that vaccination is a surgical wound to begin with and that it
+is capable of infection in the same way as are other wounds, and that
+any result coming from such an infection is not due to the vaccine or to
+the process of vaccination, but to the infection. Many people get unjust
+ideas about vaccination from just such cases. If the mother is not
+cleanly or neglects the vaccinated area and permits it to become
+infected she must not and others should not decry vaccination as a
+consequence. Anyone who doubts the virtue of vaccination is condemning
+himself; he is simply ignorant of the accumulation of evidence in favor
+of it and assumes a position without any possible justification. The
+mortality of vaccination is stated by Voigt from statistics to be 35 in
+2,275,000 cases. In fact, all the deaths are from causes which are
+preventable and no doubt the result of direct carelessness on the part
+of the operator or the mother.
+
+TREATMENT.--The mother must understand in what way she may contribute to
+the successful termination of a case of vaccination. She should see that
+the part upon which the child is to be vaccinated is absolutely clean so
+far as she can make it with soap and water. She should see that the part
+is allowed to dry thoroughly after vaccination. She should not wash the
+part for at least twenty-four hours. If a vaccine shield is put on she
+should not disturb it. If the mother is prepared to do her part
+faithfully a vaccine shield is not necessary from a medical standpoint
+and in some cases it is objectionable. A simple, clean bandage is all
+that is necessary. It is very important that the child be kept from
+scratching the part; most of the troubles of vaccination come from this
+habit. It is desirable that the limb should be kept at rest during the
+stage when the process is at its height. If the vesicle discharges it is
+necessary that the area should be kept clean and dusted with boracic
+acid. If the wound becomes infected it must be treated by a physician.
+The mother must not resort to home remedies in such cases unless she is
+prepared to take the consequences, which may be serious.
+
+
+
+
+CHAPTER XXII
+
+CONSTIPATION IN INFANTS AND CHILDREN
+
+     "It is a greater disgrace to be sick than to be in the
+     penitentiary. When you are arrested it is because you have
+     broken a man-made statute, but when you are ill, it is because
+     you have disobeyed one of God's laws."
+
+     Constipation--Regularity of Bowel Function--The Function of the
+     Stomach--Fermentation--Incomplete Constipation--Importance of a
+     Clean Bowel--A Daily Movement of the Bowel
+     Necessary--Constipation in Breast-Fed Infants--Treatment of
+     Constipation in Breast-Fed Infants--Constipation in Bottle-Fed
+     Infants--Treatment of Constipation in Bottle-Fed
+     Infants--Constipation in Children Over Two Years of Age--Diet
+     List for Constipation in Children--Bran Muffins in
+     Constipation--Treatment of Obstinate Constipation--Oil
+     Injections in Constipation.
+
+
+CONSTIPATION. REGULARITY OF BOWEL FUNCTION
+
+The most frequent cause of ill health and inefficiency in the human race
+is inattention to regulation of the bowel function. Good health depends
+upon many causes of which good blood is an absolutely necessary
+requisite. Good blood depends upon what feeds and sustains it. There are
+other contributing factors, such as the proper kind of exercise, the
+proper amount and quality of fresh air, the method of living, etc., but
+these are all food in a sense. The food we take in is acted upon by the
+various digestive juices until everything is extracted from it that
+contributes to the building up of the body. Whatever is left, whatever
+the body does not want, is immediately, or within a reasonable time,
+passed out in the form of a movement of the bowels.
+
+If any part of the digestive function is deficient, impaired health, or
+mental and physical inefficiency expressed in the form of indigestion,
+is the result. If the bowel is at fault, constipation is the usual
+consequence. A perfectly healthy living machine must maintain a perfect
+digestion and regular bowel movements.
+
+THE FUNCTION OF THE STOMACH is to mix and churn the food, and to add
+certain ingredients to the mixture so that before it is carried into the
+intestines it is (as far as it is the stomach's duty to render it) ready
+to be absorbed into the system. Before it reaches that part of the
+intestine which absorbs, it is acted upon again and certain other
+ingredients are added to it by certain other digestive organs. In time
+it is in shape to be used and it is sent along on its way. As it passes
+onward the little sucking glands in the wall of the bowel suck up all
+the liquid element in the mass of food. The liquid element in the mass
+is the food itself, rendered liquid by the stomach and other digestive
+organs and juices. The remaining solid mass is that part of the food
+which the body cannot use and does not want. By the time the liquid
+element is absorbed, the solid mass (always kept moving by the bowel
+wall) has reached the rectum, ready to be passed out at once, or very
+soon, provided--and upon this provision depends the success of the
+entire process,--it has all been done within a certain time. If the
+stomach takes too long to do its work we have indigestion. If the bowel
+takes too long to do its work we have constipation.
+
+FERMENTATION.--Now let us consider the matter from another standpoint.
+If food stays too long in the stomach it begins to ferment. When
+anything ferments it makes and evolves gas. You, no doubt, have noticed
+many times how the cork pops out of a bottle if its contents are
+"working," or fermenting. If you watch that bottle you will notice that
+it is quietly or actively evolving air bubbles. That is gas,--gas
+manufactured by the process of fermentation. This is exactly the process
+that goes on in the stomach or bowel of a dyspeptic, and it is this
+collection of foul, poisonous gas that causes the distress and bloated
+feeling which every dyspeptic suffers from after eating,--if it is this
+"flatulent" type of indigestion which is present.
+
+THE SIGNIFICANCE OF CONSTIPATION.--If the food takes too long to pass
+through the bowel it causes, as we have stated, constipation. What is
+the real significance of constipation? It means that in passing through
+the bowel the food has given up all its liquid element (which is all its
+nourishing element), but the bowel has been too slow in passing it
+along. Consequently it is not ready to be expelled while it is yet a
+harmless semi-solid mass. It stays in the bowel too long--it begins to
+putrefy, bacteria attack it, and it is soon a semi-liquid, foul, rotting
+mass. The sucking glands in the intestinal wall continue to suck--that
+is their duty. They cannot discriminate between what is good and what is
+bad--they simply go on absorbing whatever is there to absorb. So there
+are absorbed into the system liquid and gaseous products which are
+poison.
+
+This process has been called by a number of names; "self-poisoning"
+explains the condition thoroughly. The other names are, auto-infection,
+auto-intoxication, enteric-infection, enteric-toxemia, intestinal
+indigestion.
+
+The condition is a serious one, because it is absolutely impossible to
+feel well, or to enjoy good health, while it lasts. The feeling of being
+constantly sick, yet not sick enough to stop working or to demand a
+radical cure, affects a woman's efficiency, interferes with her capacity
+to work, her ability to render the home an abode of contentment, to be
+an agreeable companion, or to adequately take care of her children.
+
+The constant absorption of intestinal poisons affects the system
+itself,--the symptoms are headache, neuralgia, loss of appetite,
+nervousness, insomnia, vertigo, inability to concentrate, lassitude,
+indigestion. The condition which we name constipation is therefore one
+of supreme importance. From a medical standpoint, it is the biggest
+problem in the whole realm of disease. It is the most significant
+hygienic function of life, and it is becoming more and more important,
+and more and more a problem. Every modern factor upon which physical
+efficiency seems to depend is an enemy to the systematic regulation of
+this function. Our method of hurried and indiscriminate eating, our
+system of strenuous living, our unsanitary environment, our business
+activity, our method of pursuing pleasure, take no account of, and
+resent the time devoted to cultivating, as a hygienic necessity, this
+toilet requirement. This imperative call of nature is pushed aside by
+the child at play, by the housewife for a duty which could wait, by the
+merchant for an engagement. It is particularly an American disease, and
+it is uniquely an American woman's affliction. It is a curious
+commentary on the intelligence of the American people, who are
+ordinarily alert and analytical, to realize how few of them really know
+how serious a matter constipation is. They don't know because they have
+given the matter absolutely no thought. They have accepted it as a mere
+matter of fact, almost of fate.
+
+INCOMPLETE CONSTIPATION.--There is a type of constipation that is not
+known to the average person and not well understood by those few who
+know of its existence. In this form of constipation there is a daily
+bowel movement but the movement is not complete. The bowel does not
+thoroughly empty itself; it has established this habit because of
+conditions under which it has had to do its work. If a woman
+neglects herself, becomes muscularly inactive, does not take
+proper out-door exercise, grows fat and lazy, eats irregularly and
+indiscriminately,--the bowel suffers with the rest of the system. The
+woman may have a healthy appetite, may eat the wrong things at the wrong
+time, yet the bowel is supposed to go on acting rightly, but it does
+not. It, too, becomes lazy and acquires bad habits, and this form of
+incomplete constipation is the result. These patients look healthy and
+get little sympathy for any pains they may have. They may even gain in
+weight; they get headaches once in a while, and if they go shopping or
+visiting they don't feel quite well afterward. They are suffering from
+the effects of chronic constipation, though their bowels are apparently
+regular. They are marching onward toward apoplexy or Bright's disease of
+the kidney.
+
+IMPORTANCE OF A CLEAN BOWEL.--Every mother, sooner or later, observes
+that a physician always thoroughly cleans out the bowel of a sick child
+at once, no matter what the character of the sickness is. He does this
+for two reasons,--first, because he knows that the great majority of
+children's ailments are of gastro-intestinal origin; second, if the
+origin of the disease is not in the stomach or bowels, experience has
+taught him that if the bowels are clean at the beginning of a disease,
+that disease will run a milder and shorter course than if complicated
+with a condition of self-poisoning. If a child develops fever the
+digestive function stops; whatever food is in the stomach or bowel will
+promptly ferment and putrefy because of the abnormal heat caused by the
+fever and the arrested digestion. If this is not cleaned out at once the
+self-poisoning process begins.
+
+The above is a suggestive admission for a physician to make. It simply
+means that the vast majority of the calls made by a physician on ailing
+children are caused by errors in diet and can be completely cured by a
+dose of castor oil or calomel, or, better still, need never occur.
+
+A mother who neglects, who is guilty of inattention to the conditions of
+her child's bowel, fails in one of the most important duties of
+motherhood. I know as a father and a physician that if a child's bowel
+acts regularly and thoroughly, that child is fortified to the highest
+efficient degree against the multitude of little ailments common to all
+children. A clean bowel means good blood, good digestion, ability to
+exercise properly, to sleep soundly and to think clearly. Such a child
+will resist infection and throw off the minor troubles that pave the way
+for serious sickness. It is a secret worth knowing.
+
+A DAILY MOVEMENT OF THE BOWEL NECESSARY.--In order to preserve good
+health one thorough movement of the bowel is necessary daily. A baby may
+have two or three and enjoy robust health. A larger daily number
+suggests an abnormal condition of the bowel and an investigation should
+be made. If a nursing baby's bowels do not move before bedtime it should
+be given an injection of equal parts of glycerine and hot water,
+one-half cupful; or an enema of soap and water, or a glycerine
+suppository. When a child is six months old, in some sooner, it should
+be put on the stool at a certain time every morning. This will aid in
+the establishment of the habit, as a child soon understands why it is
+made to assume this position and acts accordingly.
+
+The condition referred to above and which we termed incomplete
+constipation may affect the nursing infant. A child's bowels may move
+daily and yet the child will suffer from constipation. If the movements
+are watched it will be observed that certain children strain when at
+stool, and after a time succeed in passing hard, dry lumps or balls of
+fecal matter. Such a movement is a certain indication that the bowel is
+not emptying itself satisfactorily and that a constant toxemia or
+poisoning is going on. Very faithful efforts should be made to remedy
+this condition by the use of articles of diet that are known to be
+laxative, otherwise the condition is one that will "grow" with the child
+and establish an obstinate chronic constipation with all its miseries
+and dangers.
+
+CONSTIPATION IN BREAST-FED INFANTS.--Many nursing infants thrive and
+gain in weight, yet they are constipated. Before you drug your baby be
+sure the fault is not your own. Many mothers are responsible for the
+constipation with which baby suffers. If the mother is constipated, so
+will the child be. Cure the constipation of the mother and the baby's
+bowels will regulate themselves. Nursing mothers who are large
+tea-drinkers have irregular bowels as a rule. A baby whose mother is
+lazy or indolent, who does not take a reasonable amount of exercise,
+whose diet is faulty and whose hours are bad, is a sufferer from
+constipation. The mother's life must be regulated, her diet and habits
+corrected, and the instructions carried out as already recommended. The
+breast milk should be examined and if any cause for constipation exists
+in it, it should be rectified as suggested elsewhere.
+
+If it is thought advisable to resort to drugs for the immediate relief
+of the constipation of infants, the best ones are the aromatic fluid
+extract of cascara sagrada; milk of magnesia with equal parts of the
+aromatic syrup of rhubarb given in doses of one to three teaspoonfuls
+daily.
+
+Irrigations, enemas, and suppositories should not be used continuously.
+The habit is a bad one. The parts become accustomed to their use and
+fail to act. If the child is passing dry and hard stools it is of
+advantage to inject two ounces of warm sweet oil at night, allowing it
+to remain in the bowel until the following morning. See page 312.
+
+CONSTIPATION IN BOTTLE-FED INFANTS.--It is much easier to treat the
+constipation of bottle-fed babies than of those breast-fed, because the
+food can be changed to ensure regular bowel movements. The first change
+to be made in a bottle-fed baby who is habitually constipated is to add
+more cream to the food. The way to do this is to take out of the bottle
+of each feeding one tablespoonful of the food and put in its place one
+tablespoonful pure cream. If this change partly rectifies the bowel
+ailment, add more cream until the bowels are of the proper consistency.
+Milk given constipated babies should be raw, never boiled, as boiled
+milk will always aggravate the trouble.
+
+The use of oatmeal water instead of plain water in making the baby's
+food may cure the bowel trouble. Taking the sugar of milk out of the
+baby's food and putting in its place the same quantity of Mellin's food
+will sometimes cure the constipation.
+
+One or two teaspoonfuls of milk of magnesia put into one feeding daily,
+or fifteen drops to one tablespoonful of the aromatic fluid extract of
+cascara sagrada will move the bowels. Orange juice, strained, two
+teaspoonfuls twice daily, is an excellent remedy and should be tried in
+every case. Sweet oil and pure cod liver oil, in doses of thirty drops
+to two teaspoonfuls three times daily after feedings, if the little
+patient is poorly nourished. If the stools remain hard and dry, an
+injection of two ounces of warm sweet oil at bedtime is an excellent
+method of aiding the bowel. The oil should remain in the bowel all
+night. This lubricates the parts, softens the fecal mass and stimulates
+the gut to perform its own work. See page 312.
+
+CONSTIPATION IN CHILDREN OVER TWO YEARS OF AGE.--Most children when put
+upon a varied diet after the nursing days are over are relieved of any
+constipation which may have existed up to that time. There are a few,
+however, whose condition does not seem to improve. These children need
+attention. We should first insist on regular habits. A child should be
+told that its bowels must move every morning after breakfast. If this
+is absolutely insisted upon the child will soon recognize the
+uselessness of fighting the proposition and submit. If at any time a
+conscientious effort is made to move the bowel without result after
+fifteen minutes it is wise to use a glycerine suppository so that the
+bowel will empty itself.
+
+It has been stated in another part of this book that there are children
+with whom milk does not agree. Experience has taught us that milk,
+especially milk that has been boiled, causes more cases of constipation
+in growing children than all other causes combined. Find out if it is
+milk that is the cause in any individual case. While these children
+cannot take whole milk just as it comes from the dairy without suffering
+in a great many ways, they can take milk and water, or milk and oatmeal
+water, prepared in the following way, without becoming constipated. A
+bottle of fresh milk is allowed to stand in a cool place for five hours,
+when the top ten ounces are skimmed off with a Chapin dipper and mixed
+with twelve ounces of oatmeal gruel or plain water. This can be used as
+a drink.
+
+Parents can select from the following list of articles such combinations
+as may be suitable to constitute the regular meals of a constipated
+child:
+
+    Lamb chops.
+    Rare steak.
+    Rare roast beef.
+    Hashed chicken.
+    Soft boiled eggs.
+    Cracked wheat.
+    Hominy.
+    Cornmeal.
+    Oatmeal, Scotch.
+    Bran biscuits.
+    Oatmeal crackers.
+    Graham wafers.
+    Stewed or baked apple.
+    Apple sauce.
+    Plain vanilla ice cream.
+    Animal broths, purees of peas.
+    Beans, and lentils.
+    Peas.
+    String beans.
+    Spinach.
+    Cauliflower.
+    Asparagus.
+    Stewed tomatoes, strained.
+    Whole wheat bread.
+    Zwieback.
+    Custard.
+    Stewed prunes.
+    Junket.
+    Cornstarch.
+
+Malted milk is agreeable and advisable as a drink.
+
+Orange juice or a scraped raw apple is allowable at this time.
+Constipated children should eat plenty of good butter. Olive oil, two
+or three teaspoonfuls after each meal, is excellent. It can be kept up
+for months to advantage. Older children may eat raw and cooked fruits,
+figs, dates, baked potatoes, poultry, and fish. One or two raw apples or
+a peach or orange may be given daily. A strict observance of the above
+rules and diet will result in normal movements of the bowel if persisted
+in for a reasonable time. It may be necessary occasionally to use a
+suppository or an enema now and again until the habit is established.
+
+In children from five to fifteen years of age the use of bran muffins,
+with fruit, etc., as described above, will effect a cure of constipation
+without having to resort to drugs. I have cured many cases of
+constipation in growing children with these muffins without making any
+other change in their diet or habits.
+
+
+RECIPE FOR BRAN MUFFINS
+
+     Take one pint of best flour, one quart unsifted bran, one
+     teaspoonful bicarbonate of soda (baking soda), a pinch of salt.
+     Mix these thoroughly together, then add: six to eight
+     tablespoonfuls good, New Orleans molasses, one pint of milk.
+     Mix together very thoroughly. Put in muffin rings and bake in
+     oven. About one ounce should be put in each ring as they raise
+     easily. Eat with plenty of good butter. They should be given to
+     children before each meal, when they are hungry, not after
+     their stomachs are full. Put bran in dish first. Sift in flour,
+     soda and salt. Mix these thoroughly together, then add one pint
+     of milk (two cupfuls) and six to eight tablespoonfuls of New
+     Orleans molasses. The quantity of molasses depends upon the
+     individual taste. They are good for any child or adult whether
+     constipation exists or not.
+
+Drugs may be of temporary service in some cases. A pill of cascara
+sagrada is the best for this purpose. It should not be continued for
+more than two weeks. Castor oil, calomel, and other frequently-used
+cathartics should never be used in simple constipation.
+
+
+TREATMENT OF OBSTINATE CONSTIPATION
+
+There are cases that resist treatment of the kind described above. Diet
+and drugs do not succeed in establishing the habit of daily bowel
+movements. In these cases radical treatment is imperative. The diet
+should be the same as that described above, but it will be found
+advisable to cut out milk altogether. Cereals can be taken with sugar
+and butter instead of milk. The oil injection plan of Professor Kerley
+has given me excellent results. I quote his comments upon and method of
+giving it:--
+
+"OIL INJECTIONS."--"For this purpose a soft-bulb syringe of four ounces'
+capacity is ordered. Over the hard rubber tip is place a small sized
+adult rectal tube or a No. 18 American catheter. The catheter or tube is
+cut so that but nine inches remain for use. The cut end is forced over
+the small, hard rubber tip of the syringe. A fountain syringe is
+impracticable for this purpose, as it is soon destroyed by the oil and
+rendered unfit for use. Besides, sufficient pressure is not produced to
+force the oil into the gut even with a high elevation of the bag. The
+child is placed on his back or on his left side. The syringe is filled
+with oil, the tube is lubricated, and passed through the rectum as far
+as it can go. When it has been passed to the full nine inches, as may
+readily be done with a little practice, the syringe is emptied and the
+tube withdrawn. The injection should be given after the child has been
+placed in bed for the night. It is our object to have the oil retained
+during the night. If a passage of the bowels is produced at the time, or
+if the oil leaks out during the night, a small quantity should be used.
+In some of my patients I have been able to use but one ounce. In very
+few, indeed, does it cause an evacuation at the time. If there is a
+tendency to leakage a napkin should be worn to avoid soiling the
+bed-linen. The following morning after breakfast, the child is placed on
+the vessel and kept there until a bowel movement results or until
+fifteen minutes have elapsed. In a great many cases if the constipation
+has been obstinate for months, the bowel will be at once evacuated. When
+this does not occur in fifteen minutes, a glycerine suppository is
+inserted, which invariably produces an evacuation. This use of the
+suppository, according to my observation, can usually be dispensed with
+in a very few days; the use of the oil, however, may have to be
+continued for several weeks. When the child has had the oil nightly and
+an evacuation the next morning without assistance for two weeks, I
+direct that the oil be omitted for a night and the effect noted. If the
+usual passage occurs after breakfast, the oil is given for five nights
+and then omitted. If the case progresses satisfactorily the use of the
+oil is gradually omitted, being given at first every second night, then
+every third, fourth, or fifth night, etc. A considerable number of cases
+have been completely relieved in two months. In the event of no passage
+following the omission of the oil, its use is continued for two weeks
+longer, when it is again omitted for a night." To illustrate this point
+the following case is cited.
+
+"ILLUSTRATIVE CASE.--A boy three years of age had never had a bowel
+evacuation without drugs, soap enemas, or suppositories since birth, and
+finally these were no longer effective. The mother, thoroughly
+frightened, brought the child to me. Eight months of diet and the use of
+the oil were required before he was entirely well. It is now three
+months since the local treatment was discontinued and the bowel function
+remains normal.
+
+"The diet with the absence of milk must be continued for months after
+the patient is apparently well, and he must not be allowed to pass a
+single morning without an evacuation at the usual time. In assuming the
+management of one of these cases I explain to the mother or nurse that
+the treatment is not pleasant for the child or the attendant, and that
+it may have to be persisted in for weeks, and unless she is willing to
+carry it out to the end, it would better not be undertaken. I assure
+her, however, that with her cooeperation, which is usually readily given,
+the child will make a complete recovery. Cases that are slow in
+responding to treatment, I usually give the additional advantage of
+abdominal massage from twenty minutes to one-half hour, before the child
+is placed at stool. The massage should practiced by one skilled in the
+work.
+
+"The above local measures apply particularly to children after the
+eighteenth month. They may be used earlier, however, following out the
+diet along the lines laid down for bottle-fed children who suffer from
+constipation. In very young children a smaller amount of oil should be
+used, never more than two ounces, usually one ounce is all that is
+required. When the oil treatment is under way, whatever the age of the
+patient, laxative drugs should not be given."
+
+
+
+
+CHAPTER XXIII
+
+CONSTIPATION IN WOMEN
+
+     Chief Cause of Constipation in Women--Constipation a Cause of
+     Domestic Unhappiness--The Requirements of Good Health--The Cost
+     of Constipation--Constipation and Social Exigencies--One of the
+     Important Duties of Mothers--Constipation and Diseases of
+     Women--Constipation is Always Harmful--Constipation and
+     Pregnancy--Explanation of Incomplete Constipation--Causes of
+     Constipation--Negligence--Lack of Exercise--Lack of Water--Lack
+     of Bulk in the Food Taken--Abuse of Cathartic Drugs and
+     Aperient Waters--Overeating--Treatment of Constipation in
+     Women.
+
+
+It has been stated that constipation is almost universal among the women
+of America. It is a fact that very few American women enjoy, to a
+reasonable degree, a permanently satisfactory bowel condition.
+Constipation is an acquired habit and unquestionably negligence is the
+primary and the chief cause of it. The negligence, no doubt, begins at a
+very early age; it is at least an established habit before any
+intelligent, consecutive effort is made to remedy it. Inasmuch as women
+are the mothers of the race, and as their part in the scheme of life
+_is_ the supreme one; and as constipation has been shown to be a
+serious, far-reaching, significant disease, a very sincere and
+persistent crusade should be made to educate women as to its importance.
+For a less altruistic purpose, tremendous popular movements have been
+carried to success. For a less service rendered to the race names have
+achieved renown. In addition to the symptoms stated in the preceding
+paper, the condition which we now desire to emphasize is the effect of
+the constant self-poisoning on the general health and its effect upon a
+woman's reproductive efficiency.
+
+The poison being constantly absorbed, means general bad health, bad
+health to a degree depending upon the degree of constipation which is
+the cause of the poisoning. It may be simply that the woman does not
+wholly enjoy good health, or that she is completely incapacitated
+because of chronic bad health, or any degree of indifferent health
+between these two extremes.
+
+If the degree of poison is sufficient to cause habitual poor health, its
+effect upon the blood must be bad, and the effect of the bad blood upon
+the nervous system and the other vital organs cannot be good. Now if
+this process has been going on for many years, the condition of the
+woman, who is its victim, as an efficient machine, compared with the
+woman in whom this condition never did exist, must be very different
+indeed. This condition of affairs--inasmuch as constipation is so common
+in women--must have a tremendous significance when estimating the
+vitality and efficiency of the coming generation.
+
+We might go much further and yet be sure of our position, and maintain
+that it is this national autotoxemia, this scourge of womanhood, that is
+to a great extent responsible for the characteristic American "vice of
+neurasthenia," and of the domestic infelicity and unhappiness which are
+so common in the large cities of this country. If we add to the
+intestinal autotoxemia of constipation, the tendency to, or vice of,
+indiscriminate eating and drinking--of which the American people are
+particularly guilty--we would be on firmer ground. In fact we would feel
+that we had pointed out the one underlying cause of most of the domestic
+irritability prevalent to-day, which is of serious importance, and which
+is, fortunately, capable of correction. It is a matter of everlasting
+and continuous education.
+
+THE REQUIREMENTS OF GOOD HEALTH.--There are certain fundamental basic
+requirements which are essential to good health: fresh air, good water,
+a reasonable amount of physical and mental exercise, nutritious food,
+freedom from unnecessary and unreasonable worry, frequent bathing, and a
+daily movement of the bowels. The reason why constipation is of such
+serious importance is because it is the only basic requirement of good
+health that afflicts a large majority of the race at the same time. The
+health of so many is being undermined by this one affliction, that it
+dominates all other factors that have any bearing upon posterity. A
+woman may enjoy all the essential conditions necessary to good health,
+yet she may be constipated, and the presence of this condition will
+undermine, in her constitution, all the benefits she derives from her
+advantageous environments. It will do more; it will be responsible for
+the disposition,--the temperament,--of that woman. The natural
+disposition of that woman may be an amicable one; if it were allowed to
+express itself naturally it would be kind, gentle, considerate,
+affectionate. No woman, however, the victim of chronic constipation, can
+preserve an equable temperament or an amicable disposition. It is
+impossible--with her nerves being constantly poisoned--that she can hold
+the symptoms of that condition in abeyance. She must be irritable and
+nervous and sick of herself and everything and everybody. The home as a
+direct result suffers; its atmosphere is not one of contentment and
+peace and affection. Constipation, therefore, blights the home and the
+influence of one blighted home may have a far-reaching effect on the
+story of the human race. It is responsible also for that woman's mental
+attitude outside the home. Instead of exerting an optimistic influence,
+her whole existence is a message of pessimism and discouragement.
+Multiply these influences and messages to correspond with the prevalence
+of the disease and we have a condition that is tremendously significant,
+a condition that is really a pressing economic issue. A constipated
+woman is an anti-eugenist--a eugenic atrocity.
+
+We have no desire to create a false impression or to build up a foolish
+fear. Are we justified in regarding this as one of the most important,
+if not the most important, disease condition; the most menacing physical
+vice, which the human race has to combat? Let us offer the following
+brief facts in witness of our stand:
+
+THE COST OF CONSTIPATION.--It has been estimated that consumption (the
+great white plague) kills one-tenth of all the human race. Cancer kills
+half as many, or one in every twenty. Constipation, and the diseases
+which are caused directly by it, kills one in every three of all the
+people on the civilized globe.
+
+Constipation has been responsible for the expenditure of millions of
+dollars in advertising in the newspapers alone,--more, probably, than
+has been spent in advertising remedies for all other diseases combined.
+Do you suppose this money was a donation? Do you suppose these keen,
+alert interpreters of the spirit of the times, the up-to-date business
+men, were not and are not aware that constipation is the "universal
+disease"?
+
+Every drug store, in every civilized spot on earth, has its shelves
+loaded down with constipation remedies; dinner pills, liver pills,
+cathartic pills, tablets in all possible coatings and combinations,
+mineral waters from a multitude of springs, aperient drinks by the
+dozen, laxative teas and cordials, cathartic oils and emulsions. If the
+demand for these articles should cease most of the drug stores would
+close up.
+
+Many millions of dollars have been made and are being made by various
+men and concerns, who have devised ingenious mechanical agencies which
+are supposed to cure, and in curing renew the lost health caused by
+constipation. We have in mind in this connection, a man who conceived
+the ingenious plan of putting the opening of an ordinary fountain
+syringe in the middle instead of at the end and made a fortune out of
+it. In this opening he places an upright nozzle, and instead of hanging
+the bag up and allowing the water to run into the bowel, he has the
+patient sit on the bag and thereby the water is forced into the bowel.
+He has written a two-hundred page book on the advantages of this idea,
+and his "literature" contains the names of famous men and women in all
+walks of life who use his device. The name of one of the famous judges
+of the Supreme Court of the United States was there; another was the
+name of a popular operatic beauty who writes for the daily press little
+essays on "How to be beautiful!" and "How to keep well!" He deserves his
+success. He is an emancipator and has doubtless done a great deal of
+good. His success demonstrates, beyond contradiction, the prevalence of
+the malady under discussion, and it must be remembered that he is only
+one of hundreds who garner from the same ample harvest.
+
+If we could estimate in value the economic loss sustained by the race
+because of the inefficiency of the victims of intestinal intoxication,
+due to constipation, the sum would be colossal. Even then it would only
+represent the direct economic deficiency--it would not express, nor
+could any figure adequately represent, the indirect loss sustained by
+the race because of the temperamental characteristics, which are the
+products of intestinal poisoning, and which produce domestic tragedies
+and economic failures.
+
+Has this array of evidence any meaning, or does it just happen to be so?
+We leave it to the reader; if it stimulates thought, or pricks a
+conscience it will have done its duty.
+
+CONSTIPATION AND SOCIAL EXIGENCIES.--The cause of constipation in women,
+whose social station commands every sanitary, hygienic, and dietary
+luxury, is their method of living, the food they eat, and the negligence
+which is almost obligatory because of social exactions. If constipation
+did not so frequently accompany "good" living (which is the modern name
+for overeating and drinking) we would have thousands and thousands of
+healthy, robust, contented women, fit and willing to assume the onerous
+duties concomitant with motherhood. All their enthusiasm, however, is
+expended in the effort to keep "in the ring," to overcome the effects of
+the poison of constipation, to preserve their youth and freshness, to
+undo what neglect has accomplished. It is because of the failure of this
+simple function that my lady seeks the masseur, the facial artist, the
+society doctor, the beauty expert, and the thousand and one agencies,
+which an extravagant and profligate age has made necessary to foster the
+efficiency of its votaries.
+
+I am optimistic, however, regarding the future. I believe the human race
+is improving, despite the disadvantageous surroundings and conditions
+which hamper honest effort and stultify truth. A higher efficiency is
+the goal, and the intention is to obtain this desideratum by fair and by
+just means. There is an awakening, an unrest, a groping for knowledge in
+almost every field of human endeavor, and there is none in which the
+yearning for fact, for truth, for instruction, is stronger and keener,
+than in the world-wide movement in the interest of a better motherhood,
+and in a more serious study of child life. It is an encouraging sign, a
+hopeful promise, of what the future has in store.
+
+ONE OF THE IMPORTANT DUTIES OF MOTHERS.--The immediate lesson to be
+learnt from the facts just recounted is to instruct mothers in their
+duty toward their daughters. If each mother would retain the confidence
+of her daughter sufficient to instruct her in the duties which are
+important, how much needless suffering would be saved. To know as a
+matter of fact whether the daughter's bowels are in good condition will
+appeal to all who read this as being of very great importance. It is not
+only necessary to know if they have a movement every day, it is
+necessary to know the character of the daily movement; whether it is
+hard and dry and necessitates straining,--the evil consequences of
+which, in young girls, is very serious indeed,--or if it is habitually
+loose and suggestive of what has been described as incomplete
+constipation.
+
+If the mothers of America would consecrate themselves to this simple
+task, who could tell in mere words the effect it would have on the race
+yet unborn? There are problems of scientific intent, and of fancy names,
+that engage the attention of philanthropically inclined ladies, and
+which are emblazoned on the society columns of the daily press, of much
+less importance to the human family than the homely duty we ask mothers
+to devote themselves to.
+
+CONSTIPATION AND DISEASES OF WOMEN.--Constipation is present in a very
+large majority of the cases of diseases of women. It may be caused by
+disease of the womb, or it may cause disease of the womb. There is no
+question about the bad effect constipation has upon all diseases of this
+type. In many cases it is absolutely impossible to effect a cure without
+first curing the accompanying constipation.
+
+We seldom appreciate how severe a degree of constipation a growing girl
+will submit to without seeking relief. Some of the worst cases of
+constipation that have been known, have been in girls between the ages
+of sixteen and twenty. The mechanical effects of such a condition can
+well be imagined. The constant, severe straining, necessary to evacuate
+the bowel, has, in very many instances, produced congestion and
+displacement of the womb and ovaries. It is not observed at this time,
+or if observed it is not understood, and thus is laid the foundation for
+years of neurasthenia, helplessness, and disease.
+
+The more we investigate the ramifications of constipation the more we
+learn of its seriousness and of its significance.
+
+CONSTIPATION IS ALWAYS HARMFUL.--There is no period in life when
+constipation can be borne with impunity. Youth, with its virility and
+vitality, will endure its consequences with an apparent negation, so far
+as positive or specific results are concerned, but it is only an
+apparent impunity. There is always a certain amount of strength built
+up, held in reserve as a heritage of youth, which will withstand a
+certain amount of physical license, but if this reserve is assailed by
+an unnecessary imposition, and is successfully undermined, there will be
+infinitely less reserve to call upon in the legitimate battle of life.
+Life is too real, too concentrated, too strenuous, and health is too
+precious to be wilfully wasted in any form of self-abuse.
+
+CONSTIPATION AND PREGNANCY.--Mothers will appreciate from the foregoing
+explanation why constipation is eugenically a crime during pregnancy.
+The evils which result from constipation mechanically, frequently have
+serious consequences by interfering with the circulation of the blood to
+the womb, by forcing the womb to assume wrong positions, by straining at
+stool, and by preventing the kidneys from functionating properly; these
+may render the life of the pregnant woman miserable, and may be the
+direct cause of a painful, prolonged, difficult labor. The evils which
+result from constipation because of the absorption of poisons by the
+bowel are of the gravest importance during pregnancy. These poisons
+affect the general health; the victim is tired, listless, and apathetic,
+and is thereby disinclined to exercise adequately; the appetite is
+poor; there are headaches, neuralgias, insomnia, nervousness,
+melancholia, and general mental and physical inertness. What hope may a
+pregnant woman entertain of having "an easy confinement," or of bringing
+a healthy child into the world under these circumstances? Who is to
+blame? Sometimes it is necessary to tell the unadorned truth,--the woman
+is to blame. No woman has a right to assume the responsibilities of
+maternity who has not had enough respect for herself to discontinue
+habits which caused this failing, or who has not had strength of will
+enough to begin its successful cure. Get busy,--do something,--it is
+never "too late," but do it now.
+
+Before we take up the treatment of constipation in women, it is
+necessary to explain more fully the type of constipation which we
+referred to as "incomplete" constipation. There is a condition of the
+bowel, in which we find its wall coated with hard fecal matter. The size
+of the bowel may be dilated as a consequence. This condition may occupy
+part, or most, of the entire length of the large intestine. In the
+middle of this hard mass there is a small channel through which
+semi-liquid matter passes. When the bowel moves, it is this semi-liquid
+matter that passes out, and this constitutes the daily movement. We have
+consequently a condition in which we have a daily movement but not a
+complete emptying of the bowel. The character of the stools from such a
+bowel must necessarily be more or less of a semi-liquid consistency,
+because the intestine, being coated with a hard dried out layer of old
+fecal substance, is prevented from absorbing the liquid part of the
+fresh fecal mass passing through it. This condition may exist for a
+considerable time, but it will slowly undermine the health and vitality
+of any person in whom it exists. The symptoms which a patient in this
+condition complains of are,--a feeling of being tired and languid, no
+energy or vim, headache, loss of appetite, loss of flesh, neuralgic
+pains, nausea, vertigo (dizziness), insomnia, frequent colds, cold hands
+and feet, biliousness, sallow skin and muddy complexion, liver spots,
+coated tongue and a "bad breath," nervousness, melancholia, various
+abnormal conditions and diseases of the skin, pimples, blackheads,
+eruptions, eczema, piles, appendicitis, diseases of the intestinal wall
+as a result of the constipation, Bright's disease of the kidney, and
+many other morbid conditions. Any physician could name many symptoms,
+which were never properly understood but which are now known to be
+caused by the absorption of poisons resulting from inactivity of the
+bowels. Patients may not necessarily have all of the above symptoms;
+they may have a number of them, or they may have all of them, and they
+may have others not mentioned at all.
+
+TREATMENT OF CONSTIPATION IN WOMEN.--To effect a movement of the bowels
+in a patient who is a victim of constipation is not a cure. We can
+indefinitely cause bowel action by drugs, etc., but the condition will
+remain the same or worse. When habitual constipation exists there is an
+underlying condition affecting the entire system which indicates that
+something is radically wrong. It may be necessary to change the whole
+routine of the patient's life. It will certainly be necessary at the
+very beginning to inquire into the daily diet, exercise, and
+surroundings.
+
+During the past ten years there has been born every few days a new
+medical "ism," a new religious cult. Why? Because human nature is an
+unstable equation. We are never satisfied with the old order of things
+and there will always be a following wherever there is a leader. These
+"isms" and cults do not survive. Some seem to thrive, others die a
+natural death. There is a law, as old as the hills, that you cannot get
+something for nothing in this world. We learn its bitter truth as the
+years pass, and when we get over the day dreams and the sentiment of
+youth we settle down to real work. If we desire to retain good health,
+or regain lost health, we must do something. No one can hand it to us on
+a silver plate, nor can anyone work a miracle in our behalf. We cannot
+buy health, we must deserve it.
+
+This is the secret of the success of all schemes to cure disease. The
+human family will not knuckle down and swallow the truth. The man or
+woman in poor health is looking for Aladdin's lamp everywhere and
+always. A new bait, dressed up in lubricated, oily words, promising
+impossible results, will be accepted as the simple unadorned truth, and
+will be bought and paid for, in the end forgotten. The royal road, the
+easy road, which they are looking for is impossible. There is no way by
+which any one of us may continue to break the laws of nature and retain
+or regain our lost health. Miracles are impossible. Prayers without
+deeds are empty mouthings and a waste of time. Let us see how this works
+out in the treatment of constipation. We must find the cause of the
+constipation. I will name the causes in their order of frequency.
+
+NEGLIGENCE.--This is unquestionably the primary cause of almost all
+cases of bowel inactivity. As has been already noted, the exigencies of
+modern life are of such a strenuous nature that we do not find the time
+to devote to this function the degree of systematic attention which it
+demands in order to preserve a healthy condition of intestinal
+regularity. The bowel is simply a complex muscle controlled by an
+elaborate system of nerves of an involuntary type. In order to preserve
+the highest degree of efficiency of this complicated mechanism, it must
+be permitted to obey the laws nature endowed it with and which it must
+obey. When the fecal mass reaches the rectum the nerve centers, acting
+through the spinal cord, send a message to the rectum something like
+this: "Empty yourself of your contents, we have made all preparations
+and everything is ready." The rectum obeys to the extent of notifying
+you that it wants to be relieved; you feel the desire to evacuate the
+bowels. If you obey, all is well, nature is appeased, you encourage the
+systematic regularity necessary to good health. If you do not obey, you
+upset the delicate mechanism, and frequent negligence of this character
+will result in the complete disarrangement of this complex machinery so
+that it will fail to warn you that a bowel movement is necessary and
+constipation is established. We must therefore retrace our steps and
+re-educate the bowel systematically to empty itself at a certain time
+every day. This can be done in nearly every case without artificial
+assistance. It may take time but it is worth a little methodical
+persistence. The point is, you must do it; no "ism" or esoteric agency
+can do it for you.
+
+Mothers will recognize from this explanation the necessity of
+establishing the habit in children at the earliest possible moment.
+
+LACK OF EXERCISE.--What does the word exercise imply? It implies
+movement, better circulation of the blood, better health and tone to
+every part of the body, more oxygen, and a richer, better quality of
+blood, and because of a better quality of blood, which is the fuel of
+the body machine, we have a better, smoother working machine. Every
+human being requires a certain amount of exercise; otherwise the machine
+will not run smoothly. If this exercise is not obtained, things begin to
+go wrong. One of the very first signs to indicate that the machine is
+not running as it ought to run, is a sluggish condition of the whole
+digestive apparatus and a certain degree of bowel inactivity
+(constipation) follows. There is no substitute for this need. Drugs will
+not help you, mechanical devices will not do the work for you, though
+they may aid you. You must do the work yourself. If you fail or hesitate
+to recognize the truth, if you temporize or procrastinate, you are only
+deferring the issue. The argument that you have not the time, that your
+work will not permit you, is no argument at all. You must do it or reap
+the consequences; you certainly cannot escape them. The wise woman
+accepts the situation, the fool goes to an early grave.
+
+LACK OF WATER.--Constipation may be due to a deficiency of water in the
+system. Women who suffer from this type do not drink enough water. The
+bowel may be willing and able to do its duty, but is handicapped because
+a certain amount of liquid is essential to proper digestion and natural
+bowel activity. At least six glasses of water should be taken by every
+healthy adult human being in each twenty-four hours. The best time to
+take this water is as follows: one glass on arising, two between
+breakfast and lunch, two between lunch and dinner, and one on retiring.
+Between meals means one hour after a meal and at least one-half hour
+before the following meal. No liquid should be taken during a meal, or
+immediately after, or before a meal. All water taken may be hot or cold,
+according to the fancy of the taker. It is of advantage to squeeze the
+juice of half a lemon into the water taken on arising if there is any
+tendency to constipation or if the liver is lazy or torpid. It is also
+good for the complexion.
+
+LACK OF BULK IN THE FOOD TAKEN.--Sometimes the character of the food
+taken is such that there is no body to it. The process of digestion so
+completely liquefies it that the bowel has no solid matter to
+manipulate. To excite the peculiar movements of the intestinal wall
+there must be substance in the contents. The variety of the daily food
+must be so arranged as to provide this. A list of these foods is
+provided elsewhere in this book. Certain other foods stimulate
+intestinal activity, not because of their bulk, but because of the
+chemical elements they contain. All forms of sugar, the sugars of
+fruits, the acids of fruits and vegetables, are excellent natural
+laxatives. Sour milk and buttermilk, oils and fats, are also of distinct
+value in this respect.
+
+On the other hand, soups, gruels, porridges, and purees are constipating
+because the digestive process reduces them to liquids and leaves no bulk
+for the bowel to act upon. New bread, hot biscuits, "noodles," and
+doughy foods are also objectionable, especially to children. Hot baths,
+hot drinks, hot enemas, and sweating are also constipating because they
+extract so much liquid from the bowel leaving the contents excessively
+dry.
+
+ABUSE OF CATHARTIC DRUGS AND APERIENT WATERS.--This is a widespread
+evil; it may justly be regarded as a national curse. The victims of this
+custom do not realize that they are addicted to a habit which must be
+rightly regarded as equally as bad as the drink habit, so far as its
+ultimate effect on the general health and the prospect of longevity is
+concerned. Its popularity is a product of our national vice of
+indiscriminate eating and drinking. It is more common among the class
+who live in restaurants, hotels, and boarding houses, who keep late
+hours, eat late suppers and who do not exercise enough. These
+individuals eat too much and live too high. After a time the liver
+becomes sluggish, the stomach fails to digest properly, the bowels lose
+their tone, and flatulent indigestion or some other more or less serious
+condition follows; to maintain the pace, to feel and keep fit, they
+discover that a glass of some advertised aperient or laxative water
+before breakfast works wonders, tides them over for the time being and
+keeps them "in the ring." They compliment themselves and push the
+specter of age aside.
+
+The thought that they were not "as young as they once were," or that
+they must go slow, was not a very pleasing suggestion, so having found a
+"cure" by adding another bad habit on top of an existence which is
+composed of nothing but bad habits, they start all over again. The
+suggestion that their trouble is a warning that "things are going wrong"
+and that the whole plan of living must be radically and promptly changed
+does not meet with their approval, and so the Department of Health
+statistics heap up the records of deaths due to heart disease, hardening
+of the arteries, Bright's disease of the kidneys and apoplexy. It is not
+a happy tale, but the truth is often tragic.
+
+When a woman finds that her physical efficiency depends upon the
+habitual use of cathartic drugs or laxative waters, she must regard the
+knowledge with respect, she must give it serious consideration, and she
+must adopt means to so change her method of living, that nature will be
+given a chance to work in her interest--not against her. Better to find
+out exactly where the trouble _is_ now, and go after it than to travel
+too far along the wrong road. Many die from the "disease" of
+procrastination.
+
+OVEREATING.--Overeating may be included in this classification because
+it so overworks the digestive apparatus that it is impossible for it
+satisfactorily to complete its function. Any reader desirous of
+understanding the full significance of overeating in this connection
+should carefully read the article on this subject on pages 289 and 290.
+
+There are, of course, a great many other causes for constipation but
+these are the important ones. When we find the cause of any particular
+case it will suggest the remedy and we must employ it faithfully if we
+hope to effect a cure. If it is negligence, we must correct that fault
+and compel our daily routine to accommodate itself to a regular
+observance of this function. If it is lack of exercise, we must get more
+exercise, or if it is lack of bulk in our food, we must change our
+method of living and select with more care the foods we eat. If it is
+lack of water, we can correct the constipation by adding the proper
+amount of water at the proper time.
+
+A patient who has been a victim of chronic constipation for some time
+must live a life somewhat after the following general plan:
+
+She should increase the vegetables, fruits, and fats in her diet and she
+should drink enough water. It is a good plan to sip slowly one-half pint
+of hot or cold water morning and evening. Daily exercise in the open air
+is advisable; exercise of some kind, even if taken indoors, is
+imperative. Walking, riding, bicycling, tennis, golf, swimming, are the
+best forms of exercise for women. Indoor gymnastics can be made a
+satisfactory substitute. After the exercise a hot shower bath and a cold
+sponge bath or cold plunge or a swim should follow.
+
+Women in very moderate circumstances may walk briskly a distance of
+three or four miles, and on returning can take a warm bath followed by a
+brisk rub-off with a coarse towel wrung out of cold water, or they can
+use a hose with a spray nozzle and allow the cold water to run over them
+for a few seconds after the warm dip in the bath tub. After the adoption
+of these measures the bowels may tend to regulate themselves. If so,
+this is the proper time to cultivate the habit of regularity, by
+selecting a certain time each morning or before retiring for this
+function. The patient should go to the toilet at the regular time even
+if the desire is not present. By straining slightly, and by encouraging
+the voluntary desire, the bowel may receive the necessary stimulation
+and an evacuation may result. If there should seem to be no disposition
+on the part of the bowel to become accustomed to this procedure, we must
+aid it for the time being. A glycerine or soap suppository, a glass of
+aperient water, Pluto, Hunyadi, Apenta, or the imported Carlsbad salt in
+warm water, or the effervescent Citrate of Magnesium, will result in a
+prompt emptying of the bowel. There are a great many other cathartic
+drugs and many well-known laxative pills, etc., but these are not
+necessary if a systematic effort is being made to cure the constipation,
+because success will come within a reasonable time if the patient will
+not become unduly discouraged. Many victims are deficient in fat; the
+bowel needs lubrication; we therefore recommend a good quality of olive
+oil, one tablespoonful after each meal. Frequently it is of advantage to
+inject, high up in the bowel, two or three ounces of sweet oil at night,
+as is done in children, and which is fully described in the previous
+chapter.
+
+If the constipation is due to deranged nerves, in which the reflexes of
+the intestinal wall seem to share, we advise massage of the abdomen, and
+an occasional hot or cold rectal injection. The proper quantity to use
+for this purpose is from two to three quarts. The solution to use is the
+normal salt solution. See page 627.
+
+In that form of incomplete constipation in which we stated that there
+was a layer of hard, impacted feces covering the bowel wall, a special
+method of treatment is necessary. In these cases nothing will succeed as
+satisfactorily as very hot, high rectal injections. The object of course
+is to rid the bowel of the old, hard, dry mass, which has collected
+there, before we can hope to get the bowel into condition to perform its
+own work. It is almost incredible that the human bowel can hold so much
+old dried-out, nasty stuff as is stored up in these constipated bowels.
+Hot salt water, as hot as can be tolerated, two or three quarts at a
+time, is the correct way to dislodge this mass. It will not be done at
+once; it frequently takes two or three weeks before the bowel is fairly
+clean. The irrigations should be given every second night until the
+bowel is clean. The method of giving these washings is fully described
+on page 312. While these irrigations are being given the patient should
+take olive oil by the mouth, one tablespoonful after each meal. The
+proper food, open-air exercise, sanitary living, plenty of water, and
+regular attention to the bowel movements will in the end cure the
+affliction.
+
+
+
+
+
+End of the Project Gutenberg EBook of The Eugenic Marriage, Vol 2 (of 4),
+by W. Grant Hague
+
+*** END OF THIS PROJECT GUTENBERG EBOOK THE EUGENIC MARRIAGE ***
+
+***** This file should be named 24854.txt or 24854.zip *****
+This and all associated files of various formats will be found in:
+        http://www.gutenberg.org/2/4/8/5/24854/
+
+Produced by K.D. Thornton, Jason Isbell, Josephine Paolucci
+and the Online Distributed Proofreading Team at
+http://www.pgdp.net
+
+
+Updated editions will replace the previous one--the old editions
+will be renamed.
+
+Creating the works from public domain print editions means that no
+one owns a United States copyright in these works, so the Foundation
+(and you!) can copy and distribute it in the United States without
+permission and without paying copyright royalties.  Special rules,
+set forth in the General Terms of Use part of this license, apply to
+copying and distributing Project Gutenberg-tm electronic works to
+protect the PROJECT GUTENBERG-tm concept and trademark.  Project
+Gutenberg is a registered trademark, and may not be used if you
+charge for the eBooks, unless you receive specific permission.  If you
+do not charge anything for copies of this eBook, complying with the
+rules is very easy.  You may use this eBook for nearly any purpose
+such as creation of derivative works, reports, performances and
+research.  They may be modified and printed and given away--you may do
+practically ANYTHING with public domain eBooks.  Redistribution is
+subject to the trademark license, especially commercial
+redistribution.
+
+
+
+*** START: FULL LICENSE ***
+
+THE FULL PROJECT GUTENBERG LICENSE
+PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK
+
+To protect the Project Gutenberg-tm mission of promoting the free
+distribution of electronic works, by using or distributing this work
+(or any other work associated in any way with the phrase "Project
+Gutenberg"), you agree to comply with all the terms of the Full Project
+Gutenberg-tm License (available with this file or online at
+http://gutenberg.org/license).
+
+
+Section 1.  General Terms of Use and Redistributing Project Gutenberg-tm
+electronic works
+
+1.A.  By reading or using any part of this Project Gutenberg-tm
+electronic work, you indicate that you have read, understand, agree to
+and accept all the terms of this license and intellectual property
+(trademark/copyright) agreement.  If you do not agree to abide by all
+the terms of this agreement, you must cease using and return or destroy
+all copies of Project Gutenberg-tm electronic works in your possession.
+If you paid a fee for obtaining a copy of or access to a Project
+Gutenberg-tm electronic work and you do not agree to be bound by the
+terms of this agreement, you may obtain a refund from the person or
+entity to whom you paid the fee as set forth in paragraph 1.E.8.
+
+1.B.  "Project Gutenberg" is a registered trademark.  It may only be
+used on or associated in any way with an electronic work by people who
+agree to be bound by the terms of this agreement.  There are a few
+things that you can do with most Project Gutenberg-tm electronic works
+even without complying with the full terms of this agreement.  See
+paragraph 1.C below.  There are a lot of things you can do with Project
+Gutenberg-tm electronic works if you follow the terms of this agreement
+and help preserve free future access to Project Gutenberg-tm electronic
+works.  See paragraph 1.E below.
+
+1.C.  The Project Gutenberg Literary Archive Foundation ("the Foundation"
+or PGLAF), owns a compilation copyright in the collection of Project
+Gutenberg-tm electronic works.  Nearly all the individual works in the
+collection are in the public domain in the United States.  If an
+individual work is in the public domain in the United States and you are
+located in the United States, we do not claim a right to prevent you from
+copying, distributing, performing, displaying or creating derivative
+works based on the work as long as all references to Project Gutenberg
+are removed.  Of course, we hope that you will support the Project
+Gutenberg-tm mission of promoting free access to electronic works by
+freely sharing Project Gutenberg-tm works in compliance with the terms of
+this agreement for keeping the Project Gutenberg-tm name associated with
+the work.  You can easily comply with the terms of this agreement by
+keeping this work in the same format with its attached full Project
+Gutenberg-tm License when you share it without charge with others.
+
+1.D.  The copyright laws of the place where you are located also govern
+what you can do with this work.  Copyright laws in most countries are in
+a constant state of change.  If you are outside the United States, check
+the laws of your country in addition to the terms of this agreement
+before downloading, copying, displaying, performing, distributing or
+creating derivative works based on this work or any other Project
+Gutenberg-tm work.  The Foundation makes no representations concerning
+the copyright status of any work in any country outside the United
+States.
+
+1.E.  Unless you have removed all references to Project Gutenberg:
+
+1.E.1.  The following sentence, with active links to, or other immediate
+access to, the full Project Gutenberg-tm License must appear prominently
+whenever any copy of a Project Gutenberg-tm work (any work on which the
+phrase "Project Gutenberg" appears, or with which the phrase "Project
+Gutenberg" is associated) is accessed, displayed, performed, viewed,
+copied or distributed:
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+1.E.2.  If an individual Project Gutenberg-tm electronic work is derived
+from the public domain (does not contain a notice indicating that it is
+posted with permission of the copyright holder), the work can be copied
+and distributed to anyone in the United States without paying any fees
+or charges.  If you are redistributing or providing access to a work
+with the phrase "Project Gutenberg" associated with or appearing on the
+work, you must comply either with the requirements of paragraphs 1.E.1
+through 1.E.7 or obtain permission for the use of the work and the
+Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or
+1.E.9.
+
+1.E.3.  If an individual Project Gutenberg-tm electronic work is posted
+with the permission of the copyright holder, your use and distribution
+must comply with both paragraphs 1.E.1 through 1.E.7 and any additional
+terms imposed by the copyright holder.  Additional terms will be linked
+to the Project Gutenberg-tm License for all works posted with the
+permission of the copyright holder found at the beginning of this work.
+
+1.E.4.  Do not unlink or detach or remove the full Project Gutenberg-tm
+License terms from this work, or any files containing a part of this
+work or any other work associated with Project Gutenberg-tm.
+
+1.E.5.  Do not copy, display, perform, distribute or redistribute this
+electronic work, or any part of this electronic work, without
+prominently displaying the sentence set forth in paragraph 1.E.1 with
+active links or immediate access to the full terms of the Project
+Gutenberg-tm License.
+
+1.E.6.  You may convert to and distribute this work in any binary,
+compressed, marked up, nonproprietary or proprietary form, including any
+word processing or hypertext form.  However, if you provide access to or
+distribute copies of a Project Gutenberg-tm work in a format other than
+"Plain Vanilla ASCII" or other format used in the official version
+posted on the official Project Gutenberg-tm web site (www.gutenberg.org),
+you must, at no additional cost, fee or expense to the user, provide a
+copy, a means of exporting a copy, or a means of obtaining a copy upon
+request, of the work in its original "Plain Vanilla ASCII" or other
+form.  Any alternate format must include the full Project Gutenberg-tm
+License as specified in paragraph 1.E.1.
+
+1.E.7.  Do not charge a fee for access to, viewing, displaying,
+performing, copying or distributing any Project Gutenberg-tm works
+unless you comply with paragraph 1.E.8 or 1.E.9.
+
+1.E.8.  You may charge a reasonable fee for copies of or providing
+access to or distributing Project Gutenberg-tm electronic works provided
+that
+
+- You pay a royalty fee of 20% of the gross profits you derive from
+     the use of Project Gutenberg-tm works calculated using the method
+     you already use to calculate your applicable taxes.  The fee is
+     owed to the owner of the Project Gutenberg-tm trademark, but he
+     has agreed to donate royalties under this paragraph to the
+     Project Gutenberg Literary Archive Foundation.  Royalty payments
+     must be paid within 60 days following each date on which you
+     prepare (or are legally required to prepare) your periodic tax
+     returns.  Royalty payments should be clearly marked as such and
+     sent to the Project Gutenberg Literary Archive Foundation at the
+     address specified in Section 4, "Information about donations to
+     the Project Gutenberg Literary Archive Foundation."
+
+- You provide a full refund of any money paid by a user who notifies
+     you in writing (or by e-mail) within 30 days of receipt that s/he
+     does not agree to the terms of the full Project Gutenberg-tm
+     License.  You must require such a user to return or
+     destroy all copies of the works possessed in a physical medium
+     and discontinue all use of and all access to other copies of
+     Project Gutenberg-tm works.
+
+- You provide, in accordance with paragraph 1.F.3, a full refund of any
+     money paid for a work or a replacement copy, if a defect in the
+     electronic work is discovered and reported to you within 90 days
+     of receipt of the work.
+
+- You comply with all other terms of this agreement for free
+     distribution of Project Gutenberg-tm works.
+
+1.E.9.  If you wish to charge a fee or distribute a Project Gutenberg-tm
+electronic work or group of works on different terms than are set
+forth in this agreement, you must obtain permission in writing from
+both the Project Gutenberg Literary Archive Foundation and Michael
+Hart, the owner of the Project Gutenberg-tm trademark.  Contact the
+Foundation as set forth in Section 3 below.
+
+1.F.
+
+1.F.1.  Project Gutenberg volunteers and employees expend considerable
+effort to identify, do copyright research on, transcribe and proofread
+public domain works in creating the Project Gutenberg-tm
+collection.  Despite these efforts, Project Gutenberg-tm electronic
+works, and the medium on which they may be stored, may contain
+"Defects," such as, but not limited to, incomplete, inaccurate or
+corrupt data, transcription errors, a copyright or other intellectual
+property infringement, a defective or damaged disk or other medium, a
+computer virus, or computer codes that damage or cannot be read by
+your equipment.
+
+1.F.2.  LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right
+of Replacement or Refund" described in paragraph 1.F.3, the Project
+Gutenberg Literary Archive Foundation, the owner of the Project
+Gutenberg-tm trademark, and any other party distributing a Project
+Gutenberg-tm electronic work under this agreement, disclaim all
+liability to you for damages, costs and expenses, including legal
+fees.  YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
+LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
+PROVIDED IN PARAGRAPH F3.  YOU AGREE THAT THE FOUNDATION, THE
+TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
+LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
+INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
+DAMAGE.
+
+1.F.3.  LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
+defect in this electronic work within 90 days of receiving it, you can
+receive a refund of the money (if any) you paid for it by sending a
+written explanation to the person you received the work from.  If you
+received the work on a physical medium, you must return the medium with
+your written explanation.  The person or entity that provided you with
+the defective work may elect to provide a replacement copy in lieu of a
+refund.  If you received the work electronically, the person or entity
+providing it to you may choose to give you a second opportunity to
+receive the work electronically in lieu of a refund.  If the second copy
+is also defective, you may demand a refund in writing without further
+opportunities to fix the problem.
+
+1.F.4.  Except for the limited right of replacement or refund set forth
+in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER
+WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO
+WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE.
+
+1.F.5.  Some states do not allow disclaimers of certain implied
+warranties or the exclusion or limitation of certain types of damages.
+If any disclaimer or limitation set forth in this agreement violates the
+law of the state applicable to this agreement, the agreement shall be
+interpreted to make the maximum disclaimer or limitation permitted by
+the applicable state law.  The invalidity or unenforceability of any
+provision of this agreement shall not void the remaining provisions.
+
+1.F.6.  INDEMNITY - You agree to indemnify and hold the Foundation, the
+trademark owner, any agent or employee of the Foundation, anyone
+providing copies of Project Gutenberg-tm electronic works in accordance
+with this agreement, and any volunteers associated with the production,
+promotion and distribution of Project Gutenberg-tm electronic works,
+harmless from all liability, costs and expenses, including legal fees,
+that arise directly or indirectly from any of the following which you do
+or cause to occur: (a) distribution of this or any Project Gutenberg-tm
+work, (b) alteration, modification, or additions or deletions to any
+Project Gutenberg-tm work, and (c) any Defect you cause.
+
+
+Section  2.  Information about the Mission of Project Gutenberg-tm
+
+Project Gutenberg-tm is synonymous with the free distribution of
+electronic works in formats readable by the widest variety of computers
+including obsolete, old, middle-aged and new computers.  It exists
+because of the efforts of hundreds of volunteers and donations from
+people in all walks of life.
+
+Volunteers and financial support to provide volunteers with the
+assistance they need, is critical to reaching Project Gutenberg-tm's
+goals and ensuring that the Project Gutenberg-tm collection will
+remain freely available for generations to come.  In 2001, the Project
+Gutenberg Literary Archive Foundation was created to provide a secure
+and permanent future for Project Gutenberg-tm and future generations.
+To learn more about the Project Gutenberg Literary Archive Foundation
+and how your efforts and donations can help, see Sections 3 and 4
+and the Foundation web page at http://www.pglaf.org.
+
+
+Section 3.  Information about the Project Gutenberg Literary Archive
+Foundation
+
+The Project Gutenberg Literary Archive Foundation is a non profit
+501(c)(3) educational corporation organized under the laws of the
+state of Mississippi and granted tax exempt status by the Internal
+Revenue Service.  The Foundation's EIN or federal tax identification
+number is 64-6221541.  Its 501(c)(3) letter is posted at
+http://pglaf.org/fundraising.  Contributions to the Project Gutenberg
+Literary Archive Foundation are tax deductible to the full extent
+permitted by U.S. federal laws and your state's laws.
+
+The Foundation's principal office is located at 4557 Melan Dr. S.
+Fairbanks, AK, 99712., but its volunteers and employees are scattered
+throughout numerous locations.  Its business office is located at
+809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email
+business@pglaf.org.  Email contact links and up to date contact
+information can be found at the Foundation's web site and official
+page at http://pglaf.org
+
+For additional contact information:
+     Dr. Gregory B. Newby
+     Chief Executive and Director
+     gbnewby@pglaf.org
+
+
+Section 4.  Information about Donations to the Project Gutenberg
+Literary Archive Foundation
+
+Project Gutenberg-tm depends upon and cannot survive without wide
+spread public support and donations to carry out its mission of
+increasing the number of public domain and licensed works that can be
+freely distributed in machine readable form accessible by the widest
+array of equipment including outdated equipment.  Many small donations
+($1 to $5,000) are particularly important to maintaining tax exempt
+status with the IRS.
+
+The Foundation is committed to complying with the laws regulating
+charities and charitable donations in all 50 states of the United
+States.  Compliance requirements are not uniform and it takes a
+considerable effort, much paperwork and many fees to meet and keep up
+with these requirements.  We do not solicit donations in locations
+where we have not received written confirmation of compliance.  To
+SEND DONATIONS or determine the status of compliance for any
+particular state visit http://pglaf.org
+
+While we cannot and do not solicit contributions from states where we
+have not met the solicitation requirements, we know of no prohibition
+against accepting unsolicited donations from donors in such states who
+approach us with offers to donate.
+
+International donations are gratefully accepted, but we cannot make
+any statements concerning tax treatment of donations received from
+outside the United States.  U.S. laws alone swamp our small staff.
+
+Please check the Project Gutenberg Web pages for current donation
+methods and addresses.  Donations are accepted in a number of other
+ways including checks, online payments and credit card donations.
+To donate, please visit: http://pglaf.org/donate
+
+
+Section 5.  General Information About Project Gutenberg-tm electronic
+works.
+
+Professor Michael S. Hart is the originator of the Project Gutenberg-tm
+concept of a library of electronic works that could be freely shared
+with anyone.  For thirty years, he produced and distributed Project
+Gutenberg-tm eBooks with only a loose network of volunteer support.
+
+
+Project Gutenberg-tm eBooks are often created from several printed
+editions, all of which are confirmed as Public Domain in the U.S.
+unless a copyright notice is included.  Thus, we do not necessarily
+keep eBooks in compliance with any particular paper edition.
+
+
+Most people start at our Web site which has the main PG search facility:
+
+     http://www.gutenberg.org
+
+This Web site includes information about Project Gutenberg-tm,
+including how to make donations to the Project Gutenberg Literary
+Archive Foundation, how to help produce our new eBooks, and how to
+subscribe to our email newsletter to hear about new eBooks.
diff --git a/24854.zip b/24854.zip
new file mode 100644
index 0000000..94ca306
--- /dev/null
+++ b/24854.zip
diff --git a/LICENSE.txt b/LICENSE.txt
new file mode 100644
index 0000000..6312041
--- /dev/null
+++ b/LICENSE.txt
@@ -0,0 +1,11 @@
+This eBook, including all associated images, markup, improvements,
+metadata, and any other content or labor, has been confirmed to be
+in the PUBLIC DOMAIN IN THE UNITED STATES.
+
+Procedures for determining public domain status are described in
+the "Copyright How-To" at https://www.gutenberg.org.
+
+No investigation has been made concerning possible copyrights in
+jurisdictions other than the United States. Anyone seeking to utilize
+this eBook outside of the United States should confirm copyright
+status under the laws that apply to them.
diff --git a/README.md b/README.md
new file mode 100644
index 0000000..0e9427a
--- /dev/null
+++ b/README.md
@@ -0,0 +1,2 @@
+Project Gutenberg (https://www.gutenberg.org) public repository for
+eBook #24854 (https://www.gutenberg.org/ebooks/24854)