diff options
Diffstat (limited to '6595.txt')
| -rw-r--r-- | 6595.txt | 13959 |
1 files changed, 13959 insertions, 0 deletions
diff --git a/6595.txt b/6595.txt new file mode 100644 index 0000000..3346c81 --- /dev/null +++ b/6595.txt @@ -0,0 +1,13959 @@ +The Project Gutenberg EBook of Advice to a Mother on the Management of her +Children, by Pye Henry Chavasse + +Copyright laws are changing all over the world. Be sure to check the +copyright laws for your country before downloading or redistributing +this or any other Project Gutenberg eBook. + +This header should be the first thing seen when viewing this Project +Gutenberg file. Please do not remove it. Do not change or edit the +header without written permission. + +Please read the "legal small print," and other information about the +eBook and Project Gutenberg at the bottom of this file. Included is +important information about your specific rights and restrictions in +how the file may be used. You can also find out about how to make a +donation to Project Gutenberg, and how to get involved. + + +**Welcome To The World of Free Plain Vanilla Electronic Texts** + +**eBooks Readable By Both Humans and By Computers, Since 1971** + +*****These eBooks Were Prepared By Thousands of Volunteers!***** + + +Title: Advice to a Mother on the Management of her Children + +Author: Pye Henry Chavasse + +Release Date: September, 2004 [EBook #6595] +[Yes, we are more than one year ahead of schedule] +[This file was first posted on December 30, 2002] + +Edition: 10 + +Language: English + +Character set encoding: ASCII + +*** START OF THE PROJECT GUTENBERG EBOOK ADVICE TO A MOTHER *** + + + + +Produced by Charles Aldarondo, Charles Franks, Arno Peters +and the Online Distributed Proofreading Team. + +This file was produced from images generously made available by the +Canadian Institute for Historical Microreproductions. + + + + + +ADVICE TO A MOTHER + +ON THE +MANAGEMENT OF HER CHILDREN +AND ON THE +TREATMENT ON THE MOMENT +OF SOME OF THEIR MORE PRESSING ILLNESSES +AND ACCIDENTS + + +BY + +PYE HENRY CHAVASSE, + +FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, FELLOW OF THE +OBSTETRICAL SOCIETY OF LONDON, FORMERLY PRESIDENT OF QUEEN'S COLLEGE +MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM. + + +"Lo, children and the fruit of the womb are an heritage and gift that +cometh of the Lord." + + + + +PREFACE. + +This Book has been translated into French, into German, into Polish, +and into Tamil (one of the languages of India); it has been +extensively published in America; and is well-known wherever the +English language is spoken. + +The Twelfth Edition--consisting of twenty thousand copies--being +exhausted in less than three years, the THIRTEENTH EDITION is now +published. + +One or two fresh questions have been asked and answered, and two or +three new paragraphs have I been added. + +PYE HENRY CHAVASSE. + +214, HAGLEY ROAD, EDGBASTON, +BIRMINGHAM, _June_, 1878. + + + + +CONTENTS. + + +PART I--INFANCY. + +PRELIMINARY CONVERSATION +ABLUTION +MANAGEMENT OF THE NAVEL +NAVEL RUPTURE--GROIN RUPTURE +CLOTHING +DIET +VACCINATION AND RE-VACCINATION +DENTITION +EXERCISE +SLEEP +THE BLADDER AND THE BOWELS +AILMENTS, DISEASE, ETC. +CONCLUDING REMARKS ON INFANCY + + +PART II--CHILDHOOD + +ABLUTION +CLOTHING +DIET +THE NURSERY +EXERCISE +AMUSEMENTS +EDUCATION +SLEEP +SECOND DENTITION +DISEASE, ETC. +WARM BATHS +WARM EXTERNAL APPLICATIONS +ACCIDENTS + + +PART III--BOYHOOD AND GIRLHOOD + +ABLUTION, ETC. +MANAGEMENT OF THE HAIR +CLOTHING +DIET +AIR AND EXERCISE +AMUSEMENTS +EDUCATION +HOUSEHOLD WORK FOR GIRLS +CHOICE OF PROFESSION OR TRADE +SLEEP +ON THE TEETH AND GUMS +PREVENTION OF DISEASE, ETC. +CONCLUDING REMARKS +INDEX + + + + +ADVICE TO A MOTHER. + + + +PART I.--INFANCY + + + _Infant and suckling._--I. SAMUEL + _A rose with all its sweetest leaves yet folded._--BYRON. + _Man's breathing Miniature!_--COLERIDGE. + + + +PRELIMINARY CONVERSATION + + +1. _I wish to consult you on many subjects appertaining to the +management and the care of children; will you favour me with your +advice and counsel_? + +I shall be happy to accede to your request, and to give you the fruits +of my experience in the clearest manner I am able, and in the simplest +language I can command--freed from all technicalities. I will +endeavour to guide you in the management of the health of your +offspring;--I will describe to you the _symptoms_ of the diseases of +children;--I will warn you of approaching danger, in order that you +may promptly apply for medical assistance before disease has gained +too firm a footing;--I will give you the _treatment_ on the moment; of +some of their more pressing illnesses--when medical aid cannot at once +be procured, and where delay may be death;--I will instruct you, in +case of accidents, on the _immediate_ employment of remedies--where +procrastination may be dangerous;--I will tell you how a sick child +should be nursed, and how a sick-room ought to be managed;--I I will +use my best energy to banish injurious practices from the nursery;--I +will treat of the means to prevent disease where it be possible;--I +will show you the way to preserve the health of the healthy,--and how +to strengthen the delicate;--and will strive to make a medical man's +task more agreeable to himself,--and more beneficial to his +patient,--by dispelling errors and prejudices, and by proving the +importance of your _strictly_ adhering to his rules. If I can +accomplish any of these objects, I shall be amply repaid by the +pleasing satisfaction that I have been of some little service to the +rising generation. + +2. _Then you consider it important that I should be made acquainted +with, and be well informed upon, the subjects you have just named_? + +Certainly! I deem it to be your imperative duty to _study_ the +subjects well. The proper management of children is a vital +question,--a mother's question,--and the most important that can be +brought under the consideration of a parent; and, strange to say, it +is one that has been more neglected than any other. How many mothers +undertake--the responsible management of children without previous +instruction, or without forethought; they undertake it, as though it +may be learned either by intuition or by instinct, or by +affection. The consequence is, that frequently they are in a sea of +trouble and uncertainty, tossing about without either rule or compass; +until, too often, their hopes and treasures are shipwrecked and lost. + +The care and management, and consequently the health and future +well-doing of the child, principally devolve upon the mother, "for it +is the mother after all that has most to do with the making or marring +of the man." [Footnote: _Good Words_, Dr W. Lindsay Alexander, March +1861.] Dr Guthrie justly remarks that--"Moses might have never been +the man he was unless he had been nursed by his own mother. How many +celebrated men have owed their greatness and their goodness to a +mother's training!" Napoleon owed much to his mother. "'The fate of a +child,' said Napoleon, 'is always the work of his mother;' and this +extraordinary man took pleasure in repeating, that to his mother he +owed his elevation. All history confirms this opinion..." The +character of the mother influences the children more than that of the +father, because it is more exposed to their daily, hourly +observation.--_Woman's Mission_. + +I am not overstating the importance of the subject in hand when I say, +that a child is the most valuable treasure in the world, that "he is +the precious gift of God," that he is the source of a mother's +greatest and purest enjoyment, that he is the strongest bond of +affection between her and her husband, and that + + "A babe in a house is a well-spring of pleasure, + A messenger of peace and love."--_Tupper_, + +I have, in the writing of the following pages, had one object +constantly in view--namely, health-- + + "That salt of life, which does to all a relish give, + Its standing pleasure, and intrinsic wealth, + The body's virtue, and the soul's good fortune--health." + +If the following pages insist on the importance of one of a mother's +duties more than another it is this,--_that the mother herself look +well into everything appertaining to the management of her own child_. + +Blessed is that mother among mothers of whom it can be said, that "she +hath done what she could" for her child--for his welfare, for his +happiness, for his health! + +For if a mother hath not "done what she could for her +child"--mentally, morally, and physically--woe betide the unfortunate +little creature;--better had it been for him had he never been born! + + + +ABLUTION + + +3. _Is a new-born infant, for the first time, to be washed in warm +or in cold water_? + +It is not an uncommon plan to use _cold_ water from the first, under +the impression of its strengthening the child. This appears to be a +cruel and barbarous practice, and is likely to have a contrary +tendency. Moreover, it frequently produces either inflammation of the +eyes, or stuffing of the nose, or inflammation of the lungs, or +looseness of the bowels. Although I do not approve of _cold_ water, we +ought not to run into an opposite extreme, as _hot_ water would weaken +and enervate the babe, and thus would predispose him to disease. Luke +warm _rain_ water will be the best to wash him with. This, if it be +summer, should have its temperature gradually lowered, until it be +quite cold, if it be winter, a _dash_ of warm water ought still to be +added, to take oft the chill [Footnote: A nursery basin (Wedgwoode +make is considered the best), holding either six or eight quarts of +water, and which will be sufficiently large to hold the whole body of +the child. The baton is generally fitted into a wooden frame which +will raise it to a convenient height for the washing of the baby.] (By +thermometer = 90 to 92 degrees.) + +It will be necessary to use soap--Castile soap being the best for the +purpose--it being less irritating to the skin than the ordinary +soap. Care should be taken that it does not get into the eyes, as it +may produce either inflammation or smarting of those organs. + +If the skin be delicate, or if there be any excoriation or +"breaking-out" on the skin, then glycerine soap, instead of the +Castile soap, ought to be used. + +4. _At what age do you recommend a mother to commence washing her +infant either in the tub, or in the nursery basin_? + +As soon as the navel string comes away [Footnote: Sir Charles Locock +strongly recommends that an infant should be washed _in a tub_ from +the very commencement. He says,--"All those that I superintend _begin_ +with a tub."--_Letter to the Author_.] Do not be afraid of water,--and +that in plenty,--as it is one of the best strengtheners to a child's +constitution. How many infants suffer, for the want of water from +excoriation! + +5. _Which do you prefer--flannel or sponge--to wash a child with_? + +A piece of flannel is, for the first part of the washing very +useful--that is to say, to use with the soap, and to loosen the dirt +and the perspiration; but for the finishing-up process, a sponge--a +large sponge--is superior to flannel, to wash all away, and to +complete the bathing. A sponge cleanses and gets into all the nooks, +corners, and crevices of the skin. Besides, sponge, to finish up with, +is softer and more agreeable to the tender skin of a babe than +flannel. Moreover, a sponge holds more water than flannel, and thus +enables you to stream the water more effectually over him. A large +sponge will act Like a miniature shower bath, and will thus brace and +strengthen him. + +6. _To prevent a new-born babe from catching cold, is it necessary to +wash his head with brandy_? + +It is _not necessary_. The idea that it will prevent cold is +erroneous, as the rapid evaporation of heat which the brandy causes is +more likely to give than to prevent cold. + +7. _Ought that tenacious, paste like substance, adhering to the skin +of a new-born babe, to be washed off at the first dressing_? + +It should, provided it be done with a soft sponge and with care. If +there be any difficulty in removing the substance, gently rub it, by +means of a flannel, [Footnote: Mrs Baines (who has written so much and +so well on the Management of Children), in a _Letter_ to the Author, +recommends flannel to be used in the _first_ washing of an infant, +which flannel ought afterwards to be burned; and that the sponge +should be only used to complete the process, to clear off what the +flannel had already loosened. She also recommends that every child +should have his own sponge, each of which should have a particular +distinguishing mark upon it, as she considers the promiscuous use of +the same sponge to be a frequent cause of _ophthalmia_ (inflammation +of the eyes). The sponges cannot be kept too clean.] either with a +little lard, or fresh butter, or sweet-oil. After the parts have been +well smeared and gently rubbed with the lard, or oil, or butter, let +all be washed off together, and be thoroughly cleansed away, by means +of a sponge and soap and warm water, and then, to complete the +process, gently put him in for a minute or two in his tub. If this +paste like substance be allowed to remain on the skin, it might +produce either an excoriation, or a "breaking-out" Besides, it is +impossible, if that tenacious substance be allowed to remain on it, +for the skin to perform its proper functions. + +8. _Have you any general observations to make on the washing of a +new-born infant_? + +A babe ought, every morning of his life, to be thoroughly washed from +head to foot, and this can only be properly done by putting him bodily +either into a tub or into a bath, or into a large nursery basin, half +filled with water. The head, before placing him in the bath, should be +first wetted (but not dried), then immediately put him into the water, +and, with a piece of flannel well soaked, cleanse his whole body, +particularly his arm pits, between his thighs, his groins, and his +hams, then take a large sponge in hand, and allow the water from it, +well filled, to stream all over the body, particularly over his back +and loins. Let this advice be well observed, and you will find the +plan most strengthening to your child. The skin must, after every +bath, be thoroughly but quickly dried with warm, dry, soft towels, +first enveloping the child in one, and then gently absorbing the +moisture with the towel, not roughly scrubbing and rubbing his tender +skin as though a horse were being rubbed down. + +The ears must, after each ablution, be carefully and well dried with a +soft dry napkin, inattention to this advice has sometimes caused a +gathering in the ear--a painful and distressing complaint, and at +other times it has produced deafness. + +Directly after the infant is dried, all the parts that are at all +likely to be chafed ought to be well powdered. After he is well dried +and powdered, the chest, the back, the bowels, and the limbs should be +gently rubbed, taking care not to expose him unnecessarily during such +friction. + +He ought to be partially washed every evening, indeed it may be +necessary to use a sponge and a little warm water frequently during +the day, namely, each time after the bowels have been relieved. +_Cleanliness is one of the grand incentives to health_, and therefore +cannot be too strongly insisted upon. If more attention were paid to +this subject, children would be more exempt from chafings, +"breakings-out," and consequent suffering, than they at present +are. After the second month, if the babe be delicate, the addition of +two handfuls of table-salt to the water he is washed with in the +morning will tend to brace and strengthen him. + +With regard to the best powder to dust an infant with, there is +nothing better for general use than starch--the old fashioned starch +_made of wheaten flour_--reduced by means of a pestle and mortar to a +fine powder, or Violet Powder, which is nothing more than finely +powdered starch scented, and which may be procured of any respectable +chemist. Some others are in the habit of using white lead, but as +this is a poison, it ought _on no account_ to be resorted to. + +9. _If the parts about the groin and fundament be excoriated, what is +then the best application_? + +After sponging the parts with tepid _rain water_, holding him over his +tub, and allowing the water from a well filled sponge to stream over +the parts, and then drying them with a soft napkin (not rubbing, but +gently dabbing with the napkin), there is nothing better than dusting +the parts frequently with finely powdered Native Carbonate of +Zinc-Calamine Powder. The best way of using this powder is, tying up a +little of it in a piece of muslin, and then gently dabbing the parts +with it. + +Remember excoriations are generally owing to the want of water,--to +the want of an abundance of water. An infant who is every morning well +soused and well swilled with water seldom suffers either from +excoriations, or from any other of the numerous skin diseases. +Cleanliness, then, is the grand preventative of, and the best remedy +for excoriations. Naaman the Syrian was ordered "to wash and be +clean," and he was healed, "and his flesh came again like unto the +flesh of a little child and he was clean." This was, of course, a +miracle; but how often does water, without any special intervention, +act miraculously both in preventing and in curing skin diseases! + +An infant's clothes, napkins especially, ought never to be washed with +soda; the washing of napkins with soda is apt to produce excoriations +and breakings-out. "As washerwomen often deny that they use soda, it +can be easily detected by simply soaking a clean white napkin in fresh +water and then tasting the water; if it be brackish and salt, soda has +been employed." [Footnote: Communicated by Sir Charles Locock to the +Author.] + +10. _Who is the proper person to wash and dress the babe_? + +The monthly nurse, as long as she is in attendance; but afterwards the +mother, unless she should happen to have an experienced, sensible, +thoughtful nurse, which, unfortunately, is seldom the case. [Footnote: +"The Princess of Wales might have been seen on Thursday taking an +airing in a brougham in Hyde Park with her baby--the future King of +England--on her lap, without a nurse, and accompanied only by Mrs +Brace. The Princess seems a very pattern of mothers, and it is +whispered among the ladies of the Court that every evening the mother +of this young gentleman may be seen in a flannel dress, in order that +she may properly wash and put on baby's night clothes, and see him +safely in bed. It is a pretty subject for a picture."--_Pall Mall +Gazette_.] + +11. _What is the best kind of apron for a mother, or for a nurse, to +wear, while washing the infant_? + +Flannel--a good, thick, soft flannel, usually called +bathcoating--apron, made long and full, and which of course ought to +be well dried every time before it is used. + +12. _Perhaps you will kindly recapitulate, and give me further advice +on the subject of the ablution of my babe_. + +Let him by all means, then, as soon as the navel-string has separated +from the body, be bathed either in his tub, or in his bath, or in his +large nursery-basin, for if he is to be strong and hearty, in the +water every morning he must go. The water ought to be slightly warmer +than new milk. It us dangerous for him to remain for a long period in +his bath, this, of course, holds good in a ten fold degree if the +child have either a cold or pain in his bowels. Take care that, +immediately after he comes out of his tub, he is well dried with warm +towels. It is well to let him have his bath the first thing in the +morning, and before he has been put to the breast, let him be washed +before he has his breakfast, it will refresh him and give him an +appetite. Besides, he ought to have his morning ablution on an empty +stomach, or it may interfere with digestion, and might produce +sickness and pain. In putting him in his tub, let his head be the +first part washed. We all know, that in bathing in the sea, now much +better we can bear the water if we first wet our head, if we do not do +so, we feel shivering and starved and miserable. Let there be no +dawdling in the washing, let it be quickly over. When he is thoroughly +dried with warm _dry_ towels, let him be well rubbed with the warm +hand of the mother or of the nurse. As I previously recommended, while +drying him and while rubbing him, let him repose and kick and stretch +either on the warm flannel apron, or else on a small blanket placed on +the lap. One bathing in the tub, and that in the morning, is +sufficient, and better than night and morning. During the day, as I +before observed, he may, after the action either of his bowels or of +his bladder, require several spongings of lukewarm water, _for +cleanliness is a grand incentive to health and comeliness_. + +Remember it is absolutely necessary to every child from his earliest +babyhood to have a bath, to be immersed every morning of his life in +the water. This advice, unless in cases of severe illness, admits of +no exception. Water to the body--to the whole body--is a necessity of +life, of health, and of happiness, it wards off disease, it brace? the +nerves, it hardens the frame, it is the finest tonic in the world. Oh, +if every mother would follow to the very letter this counsel how much +misery, how much ill-health might then be averted! + + +MANAGEMENT OF THE NAVEL. + +13. _Should the navel-string be wrapped in SINGED rag_? + +There is nothing better than a piece of fine old linen rag, +_unsinged_; when singed, it frequently irritates the infant's skin. + +14. _How ought the navel-string to be wrapped in the rag_? + +Take a piece of soft linen rag, about three inches wide and four +inches long, and wrap it neatly round the navel string, in the same +manner you would around a cut finger, and then, to keep on the rag, +tie it with a few rounds of whity-brown thread. The navel-string thus +covered should, pointing upwards, be placed on the belly of the child, +and must be secured in its place by means of a flannel belly-band. + +15. _If after the navel-string has been secured, bleeding should (in +the absence of the medical man) occur, how must it be restrained_? + +The nurse or the attendant ought immediately to take off the rag, and +tightly, with a ligature composed of four or five whity-brown threads, +retie the navel-string; and to make assurance doubly sure, after once +tying it, she should pass the threads a second time around the +navel-string, and tie it again; and after carefully ascertaining that +it no longer bleeds, fasten it up in the rag as before. Bleeding of +the navel-string rarely occurs, yet, if it should do so--the medical +man not being at hand--the child's after-health, or even his life, +may, if the above directions be not adopted, be endangered. + +16. _When does the navel-string separate from the child_? + +From five days to a week after birth; in some cases not until ten days +or a fortnight, or even, in rare cases, not until three weeks. + +17. _If the navel-string does not at the end of a week came away, +ought any means to be used to cause the separation_? + +Certainly not, it ought always to be allowed to drop off, which, when +in a fit state, it will readily do. Meddling with the navel string +has frequently cost the babe a great deal of suffering, and in some +cases even his life. + +18. _The navel is sometimes a little sore, after the navel-string +comes away, what ought then to be done_? + +A little simple cerate should be spread on lint, and be applied every +morning to the part affected, and a white-bread poultice, every night, +until it is quite healed. + + +NAVEL RUPTURE--GROIN RUPTURE. + +19. _What are the causes of a rupture of the navel? What ought to be +done? Can it be cured_? + +(1) A rupture of the navel is sometimes occasioned by a meddlesome +nurse. She is very anxious to cause the navel-string to separate from +the infant's body, more especially when it is longer in coming away +than usual. She, therefore, before it is in a fit state to drop off, +forces it away. (2) The rapture, at another time, is occasioned by the +child incessantly crying. A mother, then, should always bear in mind, +that a rupture of the navel is often caused by much crying, and that +it occasions much crying, indeed, it is a frequent cause of incessant +crying. A child, therefore, who, without any assignable cause, is +constantly crying, should have his navel carefully examined. + +A rupture of the navel ought always to be treated early--the earlier +the better. Ruptures of the navel can only be _cured_ in infancy and +in childhood. If it be allowed to run on until adult age, a _cure_ is +impossible. Palliative means can then only be adopted. + +The best treatment is a Burgundy pitch plaster, spread on a soft piece +of wash leather, about the size of the top of a tumbler, with a +properly-adjusted pad (made from the plaster) fastened on the centre +of the plaster, which will effectually keep up the rupture, and in a +few weeks will cure it. It will be necessary, from time to time, to +renew the plaster until the cure be effected. These plasters will be +found both more efficacious and pleasant than either truss or bandage; +which latter appliances sometimes gall, and do more harm than they do +good. + +20. _If an infant have a groin-rupture (an inguinal rupture), can that +also be cured_? + +Certainly, if, soon after birth, it be properly attended to. Consult a +medical man, and he will supply you with a well-fitting truss, _which +will eventually cure him_. If the truss be properly made (under the +direction of an experienced surgeon) by a skilful surgical-instrument +maker, a beautiful, nicely-fitting truss will be supplied, which will +take the proper and exact curve of the lower part of the infant's +belly, and will thus keep on without using any under-strap whatever--a +great desideratum, as these under-straps are so constantly wetted and +soiled as to endanger the patient constantly catching cold. But if +this under-strap is to be superseded, the truss must be made exactly +to fit the child--to fit him like a ribbon; which is a difficult thing +to accomplish unless it be fashioned by a skilful workman. It is only +lately that these trusses have been made without under-straps. +Formerly the under-straps were indispensable necessaries. + +These groin-ruptures require great attention and supervision, as the +rupture (the bowel) must, before putting on the truss be cautiously +and thoroughly returned into the belly; and much care should be used +to prevent the chafing and galling of the tender skin of the babe, +which an ill-fitting truss would be sure to occasion. But if care and +skill be bestowed on the case, a perfect cure might in due time be +ensured. The truss must not be discontinued, until a _perfect_ cure be +effected. + +Let me strongly urge you to see that my advice is carried out to the +very letter, as a groin-rupture can only be _cured_ in infancy and in +childhood. If it be allowed to ran on, unattended to, until adult age, +he will be obliged to wear a truss _all his life_, which would be a +great annoyance and a perpetual irritation to him. + + +CLOTHING. + +21. _Is it necessary to have a flannel cap in readiness to put on as +soon as the babe is born_? + +Sir Charles Locock considers that a flannel cap is _not_ necessary, +and asserts that all his best nurses have long discarded flannel +caps. Sir Charles states that since the discontinuance of flannel caps +infants have not been more liable to inflammation of the eyes. Such +authority is, in my opinion, conclusive. My advice, therefore, to you +is, discontinue by all means the use of flannel caps. + +22. _What kind of a belly-band do you recommend--a flannel or a calico +one_? + +I prefer flannel, for two reasons--first, on account of its keeping +the child's bowels comfortably warm; and secondly, because of its not +chilling him (and thus endangering cold, &c.) when he wets +himself. The belly-band ought to be moderately, but not tightly +applied, as, if tightly applied, it would interfere with the necessary +movement of the bowels. + +23. _When should the belly-band be discontinued_? + +When the child is two or three months old. The best way of leaving it +off is to tear a strip off daily for a few mornings, and then to leave +it off altogether. "Nurses who take charge of an infant when the +monthly nurse leaves, are frequently in the habit of at once leaving +off the belly-band, which often leads to ruptures when the child cries +or strains. It is far wiser to retain it too long than too short a +time; and when a child catches whooping-cough, whilst still very +young, it is safer to resume the belly-band." [Footnote: Communicated +by Sir Charles Locock to the Author.] + +24. _Have you any remarks to make on the clothing of on infant_? + +A babe's clothing ought to be light, warm, loose, and free from +pins. (1.) _It should be light_, without being too airy. Many infant's +clothes are both too long and too cumbersome. It is really painful to +see how some poor little babies are weighed down with a weight of +clothes. They may be said to "bear the burden," and that a heavy one, +from the very commencement of their lives! How absurd, too, the +practice of making them wear _long_ clothes. Clothes to cover a +child's feet, and even a little beyond, may be desirable; but for +clothes, when the infant is carried about, to reach to the ground, is +foolish and cruel in the extreme. I have seen a delicate baby almost +ready to faint under the infliction. (2.) _It should be warm_, +without being too warm. The parts that ought to be kept warm are the +chest, the bowels, and the feet. If the infant be delicate, especially +if he be subject to inflammation of the lungs, he ought to wear a fine +flannel, instead of his usual shirts, which should be changed as +frequently. (3.) _The dress should be loose_, so as to prevent any +pressure upon the blood-vessels, which would otherwise impede the +circulation, and thus hinder a proper development of the parts. It +ought to be loose about the chest and waist, so that the lungs and the +heart may have free play. It should be loose about the stomach, so +that digestion may not be impeded; it ought to be loose about the +bowels, in order that the spiral motion of the intestines may not be +interfered with--hence the importance of putting on a belly-band +moderately slack; it should be loose about the sleeves, so that the +blood may course, without let or hindrance, through the arteries and +veins; it ought to be loose, then, everywhere, for nature delights in +freedom from restraint, and will resent, sooner or later, any +interference. Oh, that a mother would take common sense, and not +custom, as her guide! (4.) _As few pins_ should be used in the +dressing of a baby as possible. Inattention to this advice has caused +many a little sufferer to be thrown into convulsions. + +The generality of mothers use no pins in the dressing of their +children; they tack every part that requires fastening with a needle +and thread. They do not even use pins to fasten the baby's +diapers. They make the diapers with loops and tapes, and thus +altogether supersede the use of pins in the dressing of an infant. +The plan is a good one, takes very little extra time, and deserves to +be universally adopted. If pins be used for the diapers, they ought to +be the Patent Safety Pins. + +25. _Is there any necessity for a nurse being particular in airing an +infant's clothes before they are put on? If she were less particular, +would it not make him more hardy_? + +A nurse cannot be too particular on this head. A babe's clothes ought +to be well aired the day before they are put on, as they should _not_ +be put on warm from the fire. It is well, where it can be done, to let +him have clean clothes daily. Where this cannot be afforded, the +clothes, as soon as they are taken off at night, ought to be well +aired, so as to free them from the perspiration, and that they may be +ready to put on the following morning. It is truly nonsensical to +endeavour to harden a child, or any one else, by putting on damp +clothes! + +26. _What is your opinion of caps for an infant_? + +The head ought to be kept cool; caps, therefore, are unnecessary. If +caps be used at all, they should only be worn for the first month in +summer, or for the first two or three months in winter. If a babe take +to caps, it requires care in leaving them off, or he will catch cold. +When you are about discontinuing them, put a thinner and a thinner one +on, every time they are changed, until you leave them off altogether. + +But remember, my opinion is, that a child is better _without_ caps; +they only heat his head, cause undue perspiration, and thus make him +more liable to catch cold. + +If a babe does not wear a cap in the day, it is not at all necessary +that he should wear one at night. He will sleep more comfortably +without one, and it will be better for his health. Moreover, +night-caps injure both the thickness and beauty of the hair. + +27. _Have you any remarks to make on the clothing of an infant, when, +in the winter time, he is sent out for exercise_? + +Be sure that he is well wrapped up. He ought to have under his cloak a +knitted worsted spencer, which should button behind, and if the +weather be very cold, a shawl over all, and, provided it be dry above, +and the wind be not in the east or in the north-east, he may then +brave the weather. He will then come from his walk refreshed and +strengthened, for cold air is an invigorating tonic. In a subsequent +Conversation I will indicate the proper age at which a child should be +first sent out to take exercise in the open air. + +28. _At what age ought an infant "to be shortened?"_ + +This, of course, will depend upon the season. In the summer, the right +time "for shortening a babe," as it is called, is at the end of two +months, in the winter, at the end of three months. But if the right +time for "shortening" a child should happen to be in the spring, let +it be deferred until the end of May. The English springs are very +trying and treacherous, and sometimes, in April the weather is almost +as cold, and the wind as biting as in winter. It is treacherous, for +the sun is hot, and the wind, which is at this time of the year +frequently easterly, is keen and cutting I should far prefer "to +shorten" a child in the winter than in the early spring. + + +DIET + +29. _Are you an advocate for putting a baby to the breast soon after +birth, or for waiting, as many do, until the third day_? + +The infant ought to be put to the bosom soon after birth, the +interest, both of the mother and of the child demands it. It will be +advisable to wait three or four hours, that the mother may recover +from her fatigue, and, then, the babe must be put to the breast. If +this be done, he will generally take the nipple with avidity. + +It might be said, at so early a period that there is no milk in the +bosom; but such is not usually the case. There generally is a +_little_ from the very beginning, which acts on the baby's bowels like +a dose of purgative medicine, and appears to be intended by nature to +cleanse the system. But, provided there be no milk at first, the very +act of sucking not only gives the child a notion, but, at the same +time, causes a draught (as it is usually called) in the breast, and +enables the milk to flow easily. + +Of course, if there be no milk in the bosom--the babe having been +applied once or twice to determine the fact--then you must wait for a +few hours before applying him again to the nipple, that is to say, +until the milk be secreted. + +An infant, who, for two or three days, is kept from the breast, and +who is fed upon gruel, generally becomes feeble, and frequently, at +the end of that time, will not take the nipple at all. Besides, there +is a thick cream (similar to the biestings of a cow), which, if not +drawn out by the child, may cause inflammation and gathering of the +bosom, and, consequently, great suffering to the mother. Moreover, +placing him _early_ to the breast, moderates the severity of the +mother's after pains, and lessens the risk of her flooding. A new-born +babe must _not_ have gruel given to him, as it disorders the bowels, +causes a disinclination to suck, and thus makes him feeble. + +30. _If an infant show any disinclination to suck, or if he appear +unable to apply his tongue to the nipple, what ought to be done_? + +Immediately call the attention of the medical man to the fact, in +order that he may ascertain whether he be tongue-tied. If he be, the +simple operation of dividing the bridle of the tongue will remedy the +defect, and will cause him to take the nipple with ease and comfort. + +31. _Provided there be not milk AT FIRST, what ought then to be done_? + +Wait with patience; the child (if the mother have no milk) will not, +for at least twelve hours, require artificial food. In the generality +of instances, then, artificial food is not at all necessary; but if it +should be needed, one-third of new milk and two-thirds of warm water, +slightly sweetened with loaf sugar (or with brown sugar, if the babe's +bowels have not been opened), should be given, in small quantities at +a time, every four hours, until the milk be secreted, and then it must +be discontinued. The infant ought to be put to the nipple every four +hours, but not oftener, until he be able to find nourishment. + +If after the application of the child for a few times, he is unable to +find nourishment, then it will be necessary to wait until the milk be +secreted. As soon as it is secreted, he must be applied with great +regularity, _alternately_ to each breast. + +I say _alternately_ to each breast. _This is most important +advice_. Sometimes a child, for some inexplicable reason, prefers one +breast to the other, and the mother, to save a little contention, +concedes the point, and allows him to have his own way. And what is +frequently the consequence?--a gathered breast! + +We frequently hear of a babe having no notion of sucking. This "no +notion" may generally be traced to bad management, to stuffing him +with food, and thus giving him a disinclination to take the nipple at +all. + +32. _How often should a mother suckle her infant_? + +A mother generally suckles her baby too often, having him almost +constantly at the breast. This practice is injurious both to parent +and to child. The stomach requires repose as much as any other part of +the body; and how can it have if it be constantly loaded with +breast-milk? For the first month, he ought to be suckled, about every +hour and a half; for the second month, every two hours,--gradually +increasing, as he becomes older, the distance of time between, until +at length he has it about every four hours. + +If a baby were suckled at stated periods, he would only look for the +bosom at those times, and be satisfied. A mother is frequently in the +habit of giving the child the breast every time he cries, regardless +of the cause. The cause too frequently is that he has been too often +suckled--his stomach has been overloaded, the little fellow is +consequently in pain, and he gives utterance to it by cries. How +absurd is such a practice! We may as well endeavour to put out a fire +by feeding it with fuel. An infant ought to be accustomed to +regularity in everything, in times for sucking, for sleeping, &c. No +children thrive so well as those who are thus early taught. + +33. _Where the mother is MODERATELY strong, do you advise that the +infant should have any other food than the breast_? + +Artificial food must not, for the first five or six months, be given, +if the parent be _moderately_ strong, of course, if she be feeble, a +_little_ food will be necessary. Many delicate women enjoy better +health whilst ambling than at any other period of their lives. + +It may be well, where artificial food, in addition to the mother's own +milk, is needed, and before giving any farinaceous food whatever (for +farinaceous food until a child is six or seven months old is +injurious), to give, through a feeding bottle, every night and +morning, in addition to the mother's breast of milk, the following +_Milk-Water-and Sugar-of Milk Food_-- + + Fresh milk, from ONE cow, + Warm water, of each a quarter of a pint, + Sugar of milk one tea spoonful + +The sugar of milk should first be dissolved in the warm water, and +then the fresh milk _unboiled_ should be mixed with it. The sweetening +of the above food with sugar-of-milk, instead of with lump sugar, +makes the food more to resemble the mother's own milk. The infant will +not, probably, at first take more than half of the above quantity at a +time, even if he does so much as that but still the above are the +proper proportions, and as he grows older, he will require the whole +of it at a meal. + +34. _What food, when a babe is six or seven months old, is the best +substitute for a mother's milk?_ + +The food that suits one infant will not agree with another. (1) The +one that I have found the most generally useful, is made as +follows--Boil the crumb of bread for two hours in water, taking +particular care that it does not burn, then add only a _little_ +lump-sugar (or _brown_ sugar, if the bowels be costive), to make it +palatable. When he is six or seven months old, mix a little new +milk--the milk of ONE cow--with it gradually as he becomes older, +increasing the quantity until it be nearly all milk, there being only +enough water to boil the bread, the milk should be poured boiling hot +on the bread. Sometimes the two milks--the mother's and the cow's +milk--do not agree, when such is the case, let the milk be left out, +both in this and in the foods following, and let the food be made with +water, instead of with milk and water. In other respects, until the +child is weaned, let it be made as above directed, when he is weaned, +good fresh cow's milk MUST, as previously recommended, be used. (2) Or +cut thin slices of bread into a basin, cover the bread with _cold_ +water, place it in an oven for two hours to bake, take it out, beat +the bread up with a fork, and then slightly sweeten it. This is an +excellent food. (3) If the above should not agree with the infant +(although, if properly made, they almost invariably do), "tous +les-mois" may be given. [Footnote: "Tous les mois" is the starch +obtained from the tuberous roots of various species of _canna_, and is +imported from the West Indies. It is very similar to arrow root. I +suppose it is called "tous les-mois," as it is good to be eaten all +the year round.](4) Or Robb's Biscuits, as it is "among the best bread +compounds made out of wheat-flour, and is almost always readily +digested."--_Routh_. + +(5) Another good food is the following--Take about a pound of flour +put it in a cloth, tie it up tightly, place it a saucepanful of water, +and let it boil for four or five hours, then take it out, peel off the +outer rind, and the inside will be found quite dry, which grate. (6) +Another way of preparing an infant's food, is to bake flour--biscuit +flour--in a slow oven, until it be of a light fawn colour. Baked flour +ought after it is baked, to be reduced, by means of a rolling pin, to +a fine powder, and should then be kept in a covered tin, ready for +use. (7) An excellent food for a baby is baked crumbs of bread. The +manner of preparing it is as follows--Crumb some bread on a plate, put +it a little distance from the fire to dry. When dry, rub the crumbs in +a mortar, and reduce them to a fine powder, then pass them through a +sieve. Having done which, put the crumbs of bread into a slow oven, +and let them bake until they be of a light fawn colour. A small +quantity either of the boiled, or of the baked flour, or of the baked +crumb of bread, ought to be made into food, in the same way as gruel +is made, and should then be slightly sweetened, according to the state +of the bowels, either with lump or with brown sugar. + +(8) Baked flour sometimes produces constipation, when such is the +case, Mr. Appleton, of Budleigh Salterton, Devon, wisely recommends a +mixture of baked flour, and prepared oatmeal, [Footnote: If there is +any difficulty in obtaining _prepared_ oatmeal, Robinson's Scotch +Oatmeal will answer equally as well.] in the proportion of two of the +former and one of the latter. He says--"To avoid the constipating +effects, I have always had mixed, before baking, one part of prepared +oatmeal with two parts of flour, this compound I have found both +nourishing, and regulating to the bowels. One table-spoonful of it, +mixed with a quarter of a pint of milk, or milk and water, when well +boiled, flavoured and sweetened with white sugar, produces a thick, +nourishing, and delicious food for infants or invalids." He goes on to +remark--"I know of no food, after repeated trials, that can be so +strongly recommended by the profession to all mothers in the rearing +of their infants, without or with the aid of the breasts, at the same +time relieving them of much draining and dragging whilst nursing with +an insufficiency of milk, as baked flour and oatmeal." [Footnote: +_British Medical Journal_, Dec 18, 1858] + +(9) A ninth food may be made with "Farinaceous Food for Infants, +prepared by Hards of Dartford". If Hard's Farinaceous food produces +costiveness--as it sometimes does--let it be mixed either with equal +parts or with one third of Robinson's Scotch Oatmeal. The mixture of +the two together makes a splendid food for a baby. (10) A tenth, and +an excellent one, may be made with rusks, boiled for an hour in water, +which ought then to be well beaten up, by means of a fork, and +slightly sweetened with lump sugar. Great care should be taken to +select good rusks, as few articles vary so much in quality. (11) An +eleventh is--the top crust of a baker's loaf, boiled for an hour in +water, and then moderately sweetened with lump sugar. If, at any time, +the child's bowels should be costive, _raw_ must be substituted for +_lump_ sugar. (12) Another capital food for an infant is that made by +Lemann's Biscuit Powder. [Footnote: Lemann's Biscuit Powder cannot be +too strongly recommended--It is of the finest quality, and may be +obtained of Lemann, Threadneedle Street, London. An extended and an +extensive experience confirms me still more in the good opinion I have +of this food.] (13) Or, Brown and Polson's Patent Corn Flour will be +found suitable. Francatelli, the Queen's cook, in his recent valuable +work, gives the following formula for making it--"To one +dessert-spoonful of Brown and Polson, mixed with a wineglassful of +cold water, add half a pint of boiling water, stir over the fire for +five minutes, sweeten lightly, and feed the baby, but if the infant is +being brought up by the hand, this food should then be mixed with +milk--not otherwise." (14) A fourteenth is Neaves' Farinaceous Food for +Infants, which is a really good article of diet for a babe, it is not +so binding to the bowels as many of the farinaceous foods are, which +is a great recommendation. + +(15) The following is a good and nourishing food for a baby:--Soak for +an hour, some _best_ rice in cold water; strain, and add fresh water +to the rice; then let it simmer till it will pulp through a sieve; put +the pulp and the water in a saucepan, with a lump or two of sugar, and +again let it simmer for a quarter of an hour; a portion of this should +be mixed with one-third of fresh milk, so as to make it of the +consistence of good cream. This is an excellent food for weak bowels. + +When the baby is six or seven months old, new milk should be added to +any of the above articles of food, in a similar way to that +recommended for boiled bread. + +(16.) For a delicate infant, lentil powder, better known as Du Barry's +"Ravalenta Arabica," is invaluable. It ought to be made into food, +with new milk, in the same way that arrow-root is made, and should be +moderately sweetened with loaf-sugar. Whatever food is selected ought +to be given by means of a nursing bottle. + +If a child's bowels be relaxed and weak, or if the motions be +offensive, the milk _must_ be boiled, but not otherwise. The following +(17) is a good food when an infant's bowels are weak and +relaxed:--"Into five large spoonfuls of the purest water, rub smooth +one dessert-spoonful of fine flour. Set over the fire five spoonfuls +of new milk, and put two bits of sugar into it; the moment it boils, +pour it into the flour and water, and stir it over a slow fire twenty +minutes." + +Where there is much emaciation, I have found (18) genuine arrow-root +[Footnote: Genuine arrow-root, of first-rate quality, and at a +reasonable price, may be obtained of H. M. Plumbe, arrow-root +merchant, 8 Alie Place. Great Alie Street. Aldgate, London, E.] a very +valuable article of food for an infant, as it contains a great deal of +starch, which starch helps to form fat and to evolve caloric +(heat)--both of which a poor emaciated chilly child stands so much in +need of. It must be made with equal parts of water and of good fresh +milk, and ought to be slightly sweetened with loaf sugar; a small +pinch of table salt should be added to it. + +Arrow-root will not, as milk will, give bone and muscle; but it will +give--what is very needful to a delicate child--fat and +warmth. Arrow-root, as it is principally composed of starch, comes +under the same category as cream, butter, sugar, oil, and +fat. Arrowroot, then, should always be given with new milk (mixed with +one-half of water); it will then fulfil, to perfection, the exigencies +of nourishing, of warming, and fattening the child's body. + +New milk, composed in due proportions as it is, of cream and of skim +milk--the very acme of perfection--is the only food, _which of itself +alone,_ will nourish and warm and fatten. It is, for a child, _par +excellence,_ the food of foods! + +Arrow-root, and all other farinaceous foods are, for a child, only +supplemental to milk--new milk being, for the young, the staple food +of all other kinds of foods whatever. + +But bear in mind, _and let there be no mistake about it,_ that +farinaceous food, be it what it may, until the child be six or seven +months old, until, indeed, he _begin_ to cut his teeth, is not +suitable for a child; until then, _The Milk-water-salt-and-sugar Food_ +(see page 29) is usually, if he be a dry-nursed child, the best +artificial food for him. + +I have given you a large and well-tried infant's dietary to chose +from, as it is sometimes difficult to fix on one that will suit; but, +remember, if you find one of the above to agree, keep to it, as a babe +requires a simplicity in food--a child a greater variety. + +Let me, in this place, insist upon the necessity of great care and +attention being observed in the preparation of any of the above +articles of diet. A babe's stomach is very delicate, and will revolt +at either ill-made, or lumpy, or burnt food. Great care ought to be +observed as to the cleanliness of the cooking utensils. The above +directions require the strict supervision of the mother. + +Broths have been recommended, but, for my own part, I think that, for +a _young_ infant, they are objectionable; they are apt to turn acid on +the stomach, and to cause flatulence and sickness, they, sometimes, +disorder the bowels and induce griping and purging. + +Whatever artificial food is used ought to be given by means of a +bottle, not only as it is a more natural way than any other of feeding +a baby, as it causes him to suck as though he were drawing it from the +mother's breasts, but as the act of sucking causes the salivary glands +to press out their contents, which materially assist digestion. +Moreover, it seems to satisfy and comfort him more than it otherwise +would do. + +One of the best, if not _the best_ feeding bottle I have yet seen, is +that made by Morgan Brothers, 21 Bow Lane, London. It is called "The +Anglo-French Feeding Bottle" S Maw, of 11 Aldersgate Street, London, +has also brought out an excellent one--"The Fountain Infant's Feeding +Bottle" Another good one is "Mather's Infant's Feeding Bottle" Either +of these three will answer the purpose admirably. I cannot speak in +terms too highly of these valuable inventions. + +The food ought to be of the consistence of good cream, and should be +made fresh and fresh. It ought to be given milk warm. Attention must +be paid to the cleanliness of the vessel, and care should be taken +that the milk be that of ONE cow, [Footnote: I consider it to be of +immense importance to the infant, that the milk be had from ONE cow. A +writer in the _Medical Times and Gazette_ speaking on this subject, +makes the following sensible remarks--"I do not know if a practice +common among French ladies when they do not nurse, has obtained the +attention among ourselves which it seems to me to deserve. When the +infant is to be fed with cow milk that from various cows is submitted +to examination by the medical man and if possible, tried on some +child, and when the milk of any cow has been chosen, no other milk is +ever suffered to enter the child's lips for a French lady would as +soon offer to her infant's mouth the breasts of half a dozen +wet-nurses in the day, as mix together the milk of various cows, which +must differ, even as the animals themselves, in its constituent +qualities. Great attention is also paid to the pasture, or other food +of the cow thus appropriated."] and that it be new and of good +quality, for if not it will turn acid and sour, and disorder the +stomach, and will thus cause either flatulence or looseness of the +bowels, or perhaps convulsions. The only way to be sure of having it +from _one_ cow, is (if you have not a cow of your own), to have the +milk from a _respectable_ cow keeper, and to have it brought to your +house in a can of your own (the London milk cans being the best for +the purpose). The better plan is to have two cans, and to have the +milk fresh and fresh every night and morning. The cans, after each +time of using, ought to be scalded out, and, once a week the can +should be filled with _cold_ water, and the water should be allowed to +remain in it until the can be again required. + +Very little sugar should be used in the food, as much sugar weakens +the digestion. A small pinch of table-salt ought to be added to +whatever food is given, as "the best savour is salt." Salt is most +wholesome--it strengthens and assists digestion, prevents the +formation of worms, and, in small quantities, may with advantage be +given (if artificial food be used) to the youngest baby. + +35. _Where it is found to be absolutely necessary to give an infant +artificial food_ WHILST SUCKLING, _how often ought he to be fed_? + +Not oftener than twice during the twenty four hours, and then only in +_small_ quantities at a time, as the stomach requires rest, and at the +same time, can manage to digest a little food better than it can a +great deal. Let me again urge upon you the importance, if it be at +all practicable, of keeping the child _entirely_ to the breast for the +first five or six months of his existence. Remember there is no +_real_ substitute for a mother's milk, there is no food so well +adapted to his stomach, there is no diet equal to it in developing +muscle, in making bone, or in producing that beautiful plump rounded +contour of the limbs, there is nothing like a mother's milk _alone_ in +making a child contented and happy, in laying the foundation of a +healthy constitution, in preparing the body for a long life, in giving +him tone to resist disease, or in causing him to cut his teeth easily +and well, in short, _the mothers milk is the greatest temporal +blessing an infant can possess_. + +As a general rule, therefore, when the child and the mother are +tolerably strong, he is better _without artificial_ food until he have +attained the age of three or four months, then, it will usually be +necessary to feed him with _The Milk-water-and-sugar-of milk Food_ +(see p 19) twice a day, so as gradually to prepare him to be weaned +(if possible) at the end of nine months. The food mentioned in the +foregoing Conversation will, when he is six or seven months old, be +the best for him. + +36. _When the mother is not able to suckle her infant herself, what +ought to be done_? + +It must first be ascertained, _beyond all doubt_, that a mother is not +able to suckle her own child Many delicate ladies do suckle their +infants with advantage, not only to their offspring, but to +themselves. "I will maintain," says Steele, "that the mother grows +stronger by it, and will have her health better than she would have +otherwise She will find it the greatest cure, and preservative for the +vapours [nervousness] and future miscarriages, much beyond any other +remedy whatsoever Her children will be like giants, whereas otherwise +they are but living shadows, and like unripe fruit, and certainly if a +woman is strong enough to bring forth a child, she is beyond all doubt +strong enough to nurse it afterwards." + +Many mothers are never so well as when they are nursing, besides, +suckling prevents a lady from becoming pregnant so frequently as she +otherwise would. This, if she be delicate, is an important +consideration, and more especially if she be subject to miscarry. The +effects of miscarriage are far more weakening than those of suckling. + +A hireling, let her be ever so well inclined, can never have the +affection and unceasing assiduity of a mother, and, therefore, cannot +perform the duties of suckling with equal advantage to the baby. + +The number of children who die under five years of age is +enormous--many of them from the want of the mother's milk. There is a +regular "parental baby-slaughter"--"a massacre of the innocents"-- +constantly going on in England, in consequence of infants being thus +deprived of their proper nutriment and just dues! The mortality from +this cause is frightful, chiefly occurring among rich people who are +either too grand, or, from luxury, too delicate to perform such +duties; poor married women, as a rule, nurse their own children, and, +in consequence reap their reward. + +If it be ascertained, _past all doubt_, that a mother cannot suckle +her child, then, if the circumstances of the parents will allow--and +they ought to strain a point to accomplish it--a healthy wet-nurse +should be procured, as, of course, the food which nature has supplied +is far, very far superior to any invented by art. Never bring up a +baby, then, if you can possibly avoid it, on _artificial_ +food. Remember, as I proved in a former Conversation, there is in +early infancy no _real_ substitute for either a mother's or a +wet-nurse's milk. It is impossible to imitate the admirable and subtle +chemistry of nature. The law of nature is, that a baby, for the first +few months of his existence, shall be brought up by the breast, and +nature's law cannot be broken with impunity. [Footnote: For further +reasons why artificial food is not desirable, at an early period of +infancy, see answer to 35th question, page 26.] It will be +imperatively necessary then-- + + "To give to nature what is nature's due." + +Again, in case of a severe illness occurring during the first nine +months of a child's life, what a comfort either the mother's or the +wet-nurse's milk is to him! It often determines whether he shall live +or die. But if a wet-nurse cannot fill the place of a mother, then +asses' milk will be found the best substitute, as it approaches +nearer, in composition, than any other animal's, to human milk; but it +is both difficult and expensive to obtain. The next best substitute is +goats' milk. Either the one or the other ought to be milked fresh and +fresh, when wanted, and should be given by means of a feeding-bottle. +Asses' milk is more suitable for a _delicate_ infant, and goats' milk +for a _strong_ one. + +If neither asses' milk nor goats' milk can be procured, then the +following _Milk-water-salt-and-sugar Food_, from the very +commencement, should be given; and as I was the author of the formula, +[Footnote: It first appeared in print in the 4th edition of _Advice to +a Mother_, 1852.] I beg to designate it as--_Rye Chavasse's Milk +Food_:-- + + New milk, the produce of ONE _healthy_ cow; + Warm water, of each, equal parts; + Table salt, a few grains--a small pinch; + Lump sugar, a sufficient quantity, to slightly sweeten it. + +The milk itself ought not to be heated over the fire, [Footnote: It +now and then happens that if the milk be not boiled, the motions of an +infant are offensive; _when such is the case_, let the milk be boiled, +but not otherwise.] but should, as above directed, be warmed by the +water; it must, morning and evening, be had fresh and fresh. The milk +and water should be of the same temperature as the mother's milk, that +is to say, at about ninety degrees Fahrenheit. It ought to be given by +means of either Morgan's, or Maw's, or Mather's feeding-bottle, +[Footnote: See answer to Question 24, page 24.] and care must be +taken to _scald_ the bottle out twice a day, for if attention be not +paid to this point, the delicate stomach of an infant is soon +disordered. The milk should, as he grows older, be gradually increased +and the water decreased, until two-thirds of milk and one-third of +water be used; but remember, that either _much_ or _little_ water must +_always_ be given with the milk. + +The above is my old form, and which I have for many years used with +great success. Where the above food does not agree (and no food except +a healthy mother's own milk does _invariably_ agree) I occasionally +substitute sugar-of milt for the lump sugar, in the proportion of a +tea spoonful of sugar-of milk to every half pint of food. + +If your child bring up his food, and if the ejected matter be +sour-smelling, I should advise you to leave out the sugar-of milk +altogether, and simply to let the child live, for a few days, on milk +and water alone, the milk being of _one_ cow, and in the proportion of +two-thirds to one-third of _warm_ water--not _hot_ water, the milk +should not be scalded with _hot_ water, as it injures its properties, +besides, it is only necessary to give the child his food with the +chill just off. The above food, where the stomach is disordered, is an +admirable one, and will often set the child to rights without giving +him any medicine whatever. Moreover, there is plenty of nourishment in +it to make the babe thrive, for after all it is the milk that is the +important ingredient in all the foods of infants, they can live on it, +and on it alone, and thrive amazingly. + +Mothers sometimes say to me, that farinaceous food makes their babes +flatulent, and that my food (_Pye Chavasse's Milk Food_) has not that +effect. + +The reason of farinaceous food making babes, until they have +_commenced_ cutting their teeth, "windy" is, that the starch of the +farinaceous food (and all farinaceous foods contain more or less of +starch) is not digested, and is not, as it ought to be, converted by +the saliva into sugar [Footnote: See Pye Chavasse's _Counsel to a +Mother_, 3d edition.] hence "wind" is generated, and pain and +convulsions often follow in the train. + +The great desideratum, in devising an infant's formula for food, is to +make it, until he be nine months old, to resemble as much as possible, +a mother's own milk, and which my formula, as nearly as is +practicable, does resemble hence its success and popularity. + +As soon as a child begins to cut his teeth the case is altered, and +_farinaceous food, with milk and with water_, becomes an absolute +necessity. + +I wish, then, to call your especial attention to the following-facts, +for they are facts--Farinaceous foods, _of all kinds_, before a child +_commences_ cutting his teeth (which is when he is about six or seven +months old) are worse than useless--they are, positively, injurious, +they are, during the early period of infant life, perfectly +indigestible, and may bring on--which they frequently do-- +convulsions. A babe fed on farinaceous food alone would certainly die +of starvation, for, "up to six or seven months of age, infants have +not the power of digesting farinaceous or fibrinous substances"--Dr +Letheby on _Food_. + +A babe's salivary glands, until he be six or seven months old, does +not secrete its proper fluid--namely, ptyalin, and consequently the +starch of the farinaceous food--and all farinaceous food contains +starch--is not converted into dextrine and grape-sugar, and is, +therefore, perfectly indigestible and useless--nay, injurious to an +infant, and may bring on pain and convulsions, and even death, hence, +the giving of farinaceous food, until a child be six or seven months +old, is one and the principal cause of the frightful infant mortality +at the present time existing in England, and which is a disgrace to +any civilized land! + +In passing, allow me to urge you never to stuff a babe--never to +overload his little stomach with food, it is far more desirable to +give him a little not enough, than to give him a little too much. Many +a poor child has been, like a young bird, killed with stuffing. If a +child be at the breast, and at the breast alone, there is no fear of +his taking too much, but if he be brought up on artificial food, there +is great fear of his over loading his stomach. Stuffing a child brings +on vomiting and bowel-complaints, and a host of other diseases which +now it would be tedious to enumerate. Let me, then, urge you on no +account, to over load the stomach of a little child. + +There will, then, in many cases, be quite sufficient nourishment in +the above. I have known some robust infants brought up on it, and on +it along, without a particle of farinaceous food, or of any other +food, in any shape or form whatever. But if it should not agree with +the child, or if there should not be sufficient nourishment in it, +then the food recommended in answer to No. 34 question ought to be +given, with this only difference--a little new milk must from the +beginning be added, and should be gradually increased, until nearly +all milk be used. + +The milk, as a general rule, ought to be _unboiled_; but if it purge +violently, or if it cause offensive motions--which it sometimes +does--then it must be boiled. The moment the milk boils up, it should +be taken off the fire. + +Food ought for the first month to be given about every two hours; for +the second month, about every three hours; lengthening the space of +time as the baby advances in age. A mother must be careful not to +over-feed a child, as over-feeding is a prolific source of disease. + +Let it be thoroughly understood, and let there be no mistake about it, +that a babe during the first nine months of his life, MUST have--it is +absolutely necessary for his very existence--milk of some kind, as the +staple and principal article of his diet, either mother's, +wet-nurse's, or asses', or goats', or cow's milk. + +37. _How would you choose a wet-nurse_? + +I would inquire particularly into the state of her health; whether she +be of a healthy family, of a consumptive habit, or if she or any of +her family have laboured under "king's evil;" ascertaining if there be +any seams or swellings about her neck; any eruptions or blotches upon +her skin; if she has a plentiful breast of milk, and if it be of good +quality [Footnote: "It should be thin, and of a bluish-white colour, +sweet to the taste, and when allowed to stand, should throw up a +considerable quantity of cream,"--_Maxell and Evenson on the Diseases +of Children_.] (which may readily be ascertained by milking a little +into a glass); if she has good nipples, sufficiently long for the baby +to hold; that they be not sore; and if her own child be of the same, +or nearly of the same age, as the one you wish her to nurse. +Ascertain, whether she menstruate during suckling; if she does, the +milk is not so good and nourishing, and you had better decline taking +her. [Footnote: Sir Charles Locock considers that a woman who +menstruates during lactation is objectionable as a wet-nurse, and +"that as a mother with her first child is more liable to that +objection, that a second or third child's mother is more eligible than +a first"--_Letter to the Author_.] Assure yourself that her own babe +is strong and healthy that he be free from a sore mouth, and from a +"breaking-out" of the skin. Indeed, if it be possible to procure such +a wet-nurse, she ought to be from the country, of ruddy complexion, of +clear skin, and of between twenty and five-and-twenty years of age, an +the milk will then be fresh, pure, and nourishing. + +I consider it to be of great importance that the infant of the +wet-nurse should be, as nearly as possible, of the same age as your +own, as the milk varies in quality according to the age of the +child. For instance, during the commencement of suckling, the milk is +thick and creamy, similar to the biestings of a cow, which, if given +to a babe of a few months old, would cause derangement of the stomach +and bowels. After the first few days, the appearance of the milk +changes; it becomes of a bluish-white colour, and contains less +nourishment. The milk gradually becomes more and more nourishing as +the infant becomes older and requires more support. + +In selecting a wet-nurse for a very small and feeble babe, you must +carefully ascertain that the nipples of the wet-nurse are good and +soft, and yet not very large. If they be very large, the child's mouth +being very small, he may not be able to hold them. You must note, too, +whether the milk flows readily from the nipple into the child's mouth; +if it does not, he may not have strength to draw it, and he would soon +die of starvation. The only way of ascertaining whether the infant +really draws the milk from the nipple, can be done by examining the +mouth of the child _immediately_ after his taking the breast, and +seeing for yourself whether there be actually milk, or not, in his +mouth. + +Very feeble new-born babes sometimes cannot take the bosom, be the +nipples and the breasts ever so good, and although Maw's nipple-shield +and glass tube had been tried. In such a case, cow's +milk-water-sugar-and-salt, as recommended at page 29, must be given in +small quantities at a time--from two to four tea-spoonfuls--but +frequently; if the child be awake, every hour, or every half hour, +both night and day, until he be able to take the breast. If, then, a +puny, feeble babe is only able to take but little at a time, and that +little by tea-spoonfuls, he must have little and often, in order that +"many a little might make a mickle." + +I have known many puny, delicate children who had not strength to hold +the nipple in their mouths, but who could take milk and water (as +above recommended) by tea-spoonfuls only at a time, with steady +perseverance, and giving it every half hour or hour (according to the +quantity swallowed), at length be able to take the breast, and +eventually become strong and hearty children; but such cases require +unwearied watching, perseverance, and care. Bear in mind, then, that +the smaller the quantity of the milk and water given at a time, the +oftener must it be administered, as, of course, the babe must have a +certain quantity of food to sustain life. + +38. _What ought to be the diet either of a wet-nurse, or of a mother, +who is suckling_? + +It is a common practice to cram a wet-nurse with food, and to give her +strong ale to drink, to make good nourishment and plentiful milk! This +practice is absurd; for it either, by making the nurse feverish, makes +the milk more sparing than usual, or it causes the milk to be gross +and unwholesome. On the other hand, we must not run into an opposite +extreme. The mother, or the wet-nurse, by using those means most +conducive to her own health, will best advance the interest of her +little charge. + +A wet-nurse, ought to live somewhat in the following way:--Let her for +breakfast have black tea, with one or two slices of cold meat, if her +appetite demand it, but not otherwise. It is customary for a wet-nurse +to make a hearty luncheon; of this I do not approve. If she feel +either faint or low at eleven o'clock, let her have either a tumbler +of porter, or of mild fresh ale, with a piece of dry toast soaked in +it. She ought not to dine later than half-past one or two o'clock; she +should eat, for dinner, either mutton or beef, with either mealy +potatoes, or asparagus, or French beans, or secale, or turnips, or +broccoli, or cauliflower, and stale bread. Rich pastry, soups, +gravies, high-seasoned dishes, salted meats, greens, and cabbage, must +one and all be carefully avoided; as they only tend to disorder the +stomach, and thus to deteriorate the milk. + +It is a common remark, that "a mother who is suckling may eat +anything." I do not agree with this opinion. Can impure or improper +food make pure and proper milk, or can impure and improper milk make +good blood for an infant, and thus good health? + +The wet-nurse ought to take with her dinner a moderate quantity of +either sound porter, or of mild (but not old or strong) ale. Tea +should be taken at half past five or six o'clock; supper at nine, +which should consist either of a slice or two of cold meat, or of +cheese if she prefer it, with half a pint of porter or of mild ale; +occasionally a basin of gruel may with advantage be substituted. Hot +and late suppers are prejudicial to the mother, or to the wet-nurse, +and, consequently, to the child. The wet-nurse ought to be in bed +every night by ten o'clock. + +It might be said, that I have been too minute and particular in my +rules for a wet-nurse; but when it is considered of what importance +good milk is to the well-doing of an infant, in making him strong and +robust, not only now, but as he grows up to manhood, I shall, I trust, +be excused for my prolixity. + +39. _Have you any more hints to offer with regard to the management of +a wet-nurse_? + +A wet-nurse is frequently allowed to remain in bed until a late hour +in the morning, and during the day to continue in the house, as if she +were a fixture! How is it possible that any one, under such +treatment, can continue healthy! A wet nurse ought to rise early, and, +if the weather and season will permit, take a walk, which will give +her an appetite for breakfast, and will make a good meal for her +little charge. This, of course, cannot, during the winter mouths, be +done; but even then, she ought, some part of the day, to take every +opportunity of walking out; indeed, in the summer time she should live +half the day in the open air. + +She ought strictly to avoid crowded rooms; her mind should be kept +calm and unruffled, as nothing disorders the milk so much as passion, +and other violent emotions of the mind; a fretful temper is very +injurious, on which account you should, in choosing your wet-nurse, +endeavour to procure one of a mild, calm, and placid disposition. +[Footnote: "'The child is poisoned.' + +'Poisoned! by whom?' + +'By you. You have been fretting.' + +'Nay, indeed, mother. How can I help fretting!' + +'Don't tell me, Margaret. A nursing mother has no business to +fret. She must turn her mind away from her grief to the comfort that +lies in her lap. Know you not that the child pines if the mother vexes +herself?'"--_The Cloister and the Hearth_. By Charles Reade.] + +A wet-nurse ought never to be allowed to dose her little charge either +with Godfrey's Cordial, or with Dalby's Carminative, or with Syrup of +White Poppies, or with medicine of any kind whatever. Let her +thoroughly understand this, and let there be no mistake in the +matter. Do not for one moment allow your children's health to be +tampered and trifled with. A baby's health is too precious to be +doctored, to be experimented upon, and to be ruined by an ignorant +person. + +40. _Have the goodness to state at what age a child ought to be +weaned_? + +This, of course, must depend both upon the strength of the child, and +upon the health of the parent; on an average, nine months is the +proper time. If the mother be delicate, it may be found necessary to +wean the infant at six months; or if he be weak, or labouring under +any disease, it may be well to continue suckling him for twelve +months; but after that time, the breast will do him more harm than +good, and will, moreover, injure the mother's health, and may, if she +be so predisposed, excite consumption. + +41. _How would you recommend a mother to act when, she weans her +child_? + +She ought, as the word signifies, do it gradually--that is to say, she +should, by degrees, give him less and less of the breast, and more and +more of artificial food; at length, she must only suckle him at night; +and lastly, it would be well for the mother either to send him away, +or to leave him at home, and, for a few days, to go away herself. + +A good plan is, for the nurse-maid to have a half-pint bottle of new +milk--which has been previously boiled [Footnote: The previous boiling +of the milk will prevent the warmth of the bed turning the milk sour, +which it otherwise would do.]--in the bed, so as to give a little to +him in lieu of the breast. The warmth of the body will keep the milk +of a proper temperature, and will supersede the use of lamps, of +candle-frames, and of other troublesome contrivances. + +42. _While a mother is weaning her infant, and after she have weaned +him, what ought to be his diet_? + +Any one of the foods recommended in answer to question 34. + +43. _If a child be suffering severely from "wind," is there any +objection to the addition of a small quantity either of gin or of +peppermint to his food to disperse it_? + +It is a murderous practice to add either gin or peppermint of the +shops (which is oil of peppermint dissolved in spirits) to his +food. Many children have, by such a practice, been made puny and +delicate, and have gradually dropped into an untimely grave. An infant +who is kept, for the first five or six months, _entirely_ to the +breast--more especially if the mother be careful in her own +diet--seldom suffers from "wind;" those, on the contrary, who have +much or improper food, [Footnote: For the first five or six months +never, if you can possibly avoid it, give artificial food to an infant +who is sucking. There is nothing, in the generality of cases, that +agrees, for the first few months, like the mother's milk _alone_.] +suffer severely. + +Care in feeding, then, is the grand preventative of "wind;" but if, +notwithstanding all your precautions, the child be troubled with +flatulence, the remedies recommended under the head of Flatulence will +generally answer the purpose. + +44. _Have you any remarks to make on sugar for sweetening a baby's +food_? + +A _small_ quantity of sugar in an infant's food is requisite, sugar +being nourishing and fattening, and making cow's milk to resemble +somewhat, in its properties human milk; but, bear in mind, _it must be +used sparingly._ _Much_ sugar cloys the stomach, weakens the +digestion, produces acidity, sour belchings, and wind:-- + + "Things sweet to taste, prove in digestion sour." + + _Shakspeare._ + +If a babe's bowels be either regular or relaxed, _lump_ sugar is the +best for the purpose of sweetening his food; if his bowels are +inclined to be costive, _raw_ sugar ought to be substituted for lump +sugar, as _raw_ sugar acts on a young babe as an aperient, and, in the +generality of cases, is far preferable to physicking him with opening +medicine. An infant's bowels, whenever it be practicable (and it +generally is), ought to be regulated by a judicious dietary rather +than by physic. + + +VACCINATION AND RE-VACCINATION. + +45. _Are you an advocate for vaccination_? + +Certainly. I consider it to be one of the greatest blessings ever +conferred upon mankind. Small-pox, before vaccination was adopted, +ravaged the country like a plague, and carried off thousands annually; +and those who did escape with their lives were frequently made +loathsome and disgusting objects by it. Even inoculation (which is +cutting for the small-pox) was attended with danger, more especially +to the unprotected--as it caused the disease to spread like wildfire, +and thus it carried off immense numbers. + +Vaccination is one, and an important cause of our increasing +population; small-pox, in olden times, decimated the country. + +46. _But vaccination does not always protect a child from, small-pox_? + +I grant you that it does not _always_ protect him, _neither does +inoculation_; but when he is vaccinated, if he take the infection, he +is seldom pitted, and very rarely dies, and the disease assumes a +comparatively mild form. There are a few, very few fatal cases +recorded after vaccination, and these may be considered as only +exceptions to the general rule; and, possibly, some of these may be +traced to the arm, when the child was vaccinated, not having taken +proper effect. + +If children, and adults were _re-vaccinated_,--say every seven years +after the first vaccination,--depend upon it, even these rare cases +would not occur, and in a short time small-pox would be known only by +name. + +47. _Do you consider it, then, the imperative duty of a mother, in +every case, to have, after the lapse of every seven years, her +children re-vaccinated_? + +I decidedly do: it would be an excellent plan for _every_ person, once +every seven years to be re-vaccinated, and even oftener, if small-pox +be rife in the neighbourhood. Vaccination, however frequently +performed, can never do the slightest harm, and might do inestimable +good. Small-pox is both a pest and a disgrace, and ought to be +constantly fought and battled with, until it be banished (which it may +readily be) the kingdom. + +I say that small-pox is a pest; it is worse than the plague, for if +not kept in subjection, it is more general--sparing neither young nor +old, rich nor poor, and commits greater ravages than the plague ever +did. Small-pox is a disgrace: it is a disgrace to any civilised land, +as there is no necessity for its presence, if cow-pox were properly +and frequently performed, small-pox would be unknown. Cow-pox is a +weapon to conquer small-pox and to drive it ignominiously from the +field. + +My firm belief, then, is, that if _every_ person were, _every seven +years_, duly and properly vaccinated, small-pox might be utterly +exterminated; but as long as there are such lax notions on the +subject, and such gross negligence, the disease will always be +rampant, for the poison of small-pox never slumbers nor sleeps, but +requires the utmost diligence to eradicate it. The great Dr Jenner, +the discoverer of cow-pox as a preventative of small-pox, strongly +advocated the absolute necessity of _every_ person being re-vaccinated +once every seven years, or even, oftener, if there was an epidemic of +small-pox in the neighbourhood. + +48. _Are you not likely to catch not only the cow-pox, but any other +disease that the child has from whom the matter is taken_? + +The same objection holds good in cutting for small pox +(inoculation)--only in a ten-fold degree--small-pox being such a +disgusting complaint. Inoculated small-pox frequently produced and +left behind inveterate "breakings-out," scars, cicatrices, and +indentations of the skin, sore eyes, blindness, loss of eyelashes, +scrofula, deafness--indeed, a long catalogue of loathsome diseases. A +medical man, of course, will be careful to take the cow-pox matter +from a healthy child. + +49. _Would it not be well to take the matter direct from the cow_? + +If a doctor be careful--which, of course, he will be--to take the +matter from a healthy child, and from a well-formed vesicle, I +consider it better than taking it _direct_ from the cow, for the +following reasons:--The cow-pox lymph, taken direct from the cow, +produces much more violent symptoms than after it has passed through +several persons; indeed, in some cases, it has produced effects as +severe as cutting for the small-pox, besides, it has caused, in many +cases, violent inflammation and even sloughing of the arm. There are +also several kinds of _spurious_ cow-pox to which the cow is subject, +and which would be likely to be mistaken for the _real_ lymph. Again, +if even the _genuine_ matter were not taken from the cow _exactly_ at +the proper time, it would he deprived of its protecting power. + +50. _At what age do you recommend an infant to be first vaccinated_? + +When he is two months old, as the sooner he is protected the +better. Moreover, the older he is the greater will be the difficulty +in making him submit to the operation, and in preventing his arm from +being rubbed, thus endangering the breaking of the vesicles, and +thereby interfering with its effects. If small-pox be prevalent in the +neighbourhood, he may, with perfect safety, be vaccinated at the +month's end; indeed if the small-pox be near at hand, he _must_ be +vaccinated, regardless of his age, and regardless of everything else, +for small-pox spares neither the young nor the old, and if a new-born +babe should unfortunately catch the disease, he will most likely die, +as at his tender age he would not have strength to battle with such a +formidable enemy. "A case, in the General Lying-in-Hospital, Lambeth, +of small-pox occurred in a woman a few days after her admission, and +the birth of her child. Her own child was vaccinated when only four +days old, and all the other infants in the house varying from one day +to a fortnight and more. All took the vaccination; and the woman's own +child, which suckled her and slept with her; and all escaped the small +pox." [Footnote: Communicated by Sir Charles Locock to the Author.] + +51. _Do you consider that taking of matter from a child's arm weakens +the effect of vaccination on the system_? + +Certainly not, provided it has taken effect in more than one +place. The arm is frequently much inflamed, and vaccinating other +children from it abates the inflammation, and thus affords relief. _It +is always well to leave one vesicle undisturbed_. + +52. _If the infant have any "breaking out" upon the skin, ought that +to be a reason for deferring the vaccination_? + +It should, as two skin diseases cannot well go on together; hence the +cow-pox might not take, or, if it did, might not have its proper +effect in preventing small-pox. "It is essential that the vaccine bud +or germ have a congenial soil, uncontaminated by another poison, +which, like a weed, might choke its healthy growth."--_Dendy_. The +moment the skin be free from the breaking-out, he must be +vaccinated. A trifling skin affection, like red gum, unless it be +severe, ought not, at the proper age to prevent vaccination. If +small-pox be rife in the neighbourhood, the child _must_ be +vaccinated, regardless of any "breaking-out" on the skin. + +53. _Does vaccination make a child poorly_? + +At about the fifth day after vaccination, and for three or four days, +he is generally a little feverish; the mouth is slightly hot, and he +delights to have the nipple in his mouth. He does not rest so well at +night; he is rather cross and irritable; and, sometimes, has a slight +bowel-complaint. The arm, about the ninth or tenth day, is usually +much inflamed--that is to say it is, for an inch or two or more around +the vesicles, red, hot, swollen, and continues in this state for a day +or two, at the end of which time the inflammation gradually +subsides. It might be well to state that the above slight symptoms are +desirable, as it proves that the vaccination has had a proper effect +on his system, and that, consequently, he is more likely to be +thoroughly protected from any risk of catching small-pox. + +54. _Do you approve, either during or after vaccination, of giving +medicine, more especially if he be a little feverish_? + +No, as it would be likely to work off some of its effects, and thus +would rob the cow-pox of its efficacy on the system. I do not like to +interfere with vaccination _in any way whatever_ (except, at the +proper time, to take a little matter from the arm), but to allow the +pock to have full power upon his constitution. + +What do you give the medicine for? If the matter that is put into the +arm be healthy, what need is there of physic! And if the matter be not +of good quality, I am quite sure that no physic will make it so! Look, +therefore, at the case in whatever way you like, physic after +vaccination is _not_ necessary; but, on the contrary, hurtful. If the +vaccination produce slight feverish attack, it will, without the +administration of a particle of medicine, subside in two or three +days. + +55. _Have you any directions to give respecting the arm AFTER +vaccination_? + +The only precaution necessary is to take care that the arm be not +rubbed; otherwise the vesicles may be prematurely broken, and the +efficacy of the vaccination may be lessened. The sleeve, in +vaccination, ought to be large and soft, and should not be tied +up. The tying up of a sleeve makes it hard, and is much more likely to +rub the vesicles than if it were put on the usual way. + +56. _If the arm, AFTER vaccination, be much inflamed, what ought to be +done_? + +Smear frequently, by means of a feather or a camel's hair brush, a +little cream on the inflamed part. This simple remedy will afford +great comfort and relief. + +57. _Have the goodness to describe the proper appearance, after the +falling-off of the scab of the arm_? + +It might be well to remark, that the scabs ought always to be allowed +to fall off of themselves. They must not, on any account, be picked or +meddled with. With regard to the proper appearance of the arm, after +the falling-off of the scab, "a perfect vaccine scar should be of +small size, circular, and marked with radiations and indentations."-- +_Gregory_. + + +DENTITION + +58. _At what time does dentition commence_? + +The period at which it commences is uncertain. It may, as a rule, be +said that a babe begins to cut his teeth at seven months old. Some +have cut teeth at three months; indeed, there are instances on record +of infants having been born with teeth. King Richard the Third is said +to have been an example. Shakspeare notices it thus:-- + + "YORK.--Marry, they say my uncle grew so fast, + That he could gnaw a crust at two hours old. + 'Twas full two years ere I could get a tooth, + Grandam, this would have been a biting jest." + +When a babe is born with teeth, they generally drop out. On the other +hand, teething, in some children does not commence until they are a +year and a half or two years old, and, in rare cases, not until they +are three years old. There are cases recorded of adults who have never +cut any teeth. An instance of the kind came under my own observation. + +Dentition has been known to occur in old age. A case is recorded by +M. Carre, in the _Gazette Medicale de Paris_ (Sept 15, 1860), of an +old lady, aged eighty-five, who cut several teeth after attaining that +age! + +59. _What is the number of the FIRST set of teeth, and in what order +do they generally appear_? + +The first or temporary set consists of twenty. The first set of teeth +are usually cut in pairs. "I may say that nearly invariably the order +is--1st, the lower front incissors [cutting teeth], then the upper +front, then the _upper_ two lateral incissors, and that not uncommonly +a double tooth is cut before the two _lower_ laterals; but at all +events the lower laterals come 7th and 8th, and, not 5th and 6th, as +nearly all books on the subject testify." [Footnote: Sir Charles +Locock in a _Letter_ to the Author.] Then the first grinders, in the +lower jaw, afterwards the first upper grinders, then the lower +corner-pointed or canine teeth, after which the upper corner or +eye-teeth, then the second grinders in the lower jaw, and lastly, the +second grinders of the upper jaw. They do not, of course, always +appear in this rotation. Nothing is more uncertain than the order of +teething. A child seldom cuts his second grinders until after he is +two years old. _He is, usually, from the time they first appear, two +years in cutting the first set of teeth_. As a rule, therefore, a +child of two years old has sixteen, and one of two years and a half +old, twenty teeth. + +60. _If an infant be feverish or irritable, or otherwise poorly, and +if the gums be hot, swollen, and tender, are you an advocate for their +being lanced_? + +Certainly; by doing so he will, in the generality of instances, be +almost instantly relieved. + +61. _But it has been stated that lancing the gums hardens them_? + +This is a mistake--it has a contrary effect. It is a well-known fact, +that a part which has been divided gives way much more readily than +one which has not been cut. Again, the tooth is bound down by a tight +membrane, which, if not released by lancing, frequently brings on +convulsions. If the symptoms be urgent, it may be necessary from time +to time to repeat the lancing. It would, of course, be the height of +folly to lance the gums unless they be hot and swollen, and unless the +tooth, or the teeth, be near at hand. It is not to be considered a +panacea for every baby's ill, although, in those cases where the +lancing of the gums is indicated, the beneficial effect is sometimes +almost magical. + +62. _How ought the lancing of a child's gums to be performed_? + +The proper person, of course, to lance his gums is a medical man. But +if, perchance, you should be miles away and be out of the reach of +one, it would be well for you to know how the operation ought to be +performed. Well, then, let him lie on the nurse's lap upon his back, +and let the nurse take hold of his hands in order that he may not +interfere with the operation. + +Then, _if it be the upper gum_ that requires lancing, you ought to go +to the head of the child, looking over, as it were, and into his +mouth, and should steady the gum with the index finger of your left +hand; then, you should take hold of the gum-lancet with your right +hand--holding as if it were a table-knife at dinner--and cut firmly +along the inflamed and swollen gum and down to the tooth, until the +edge of the gum-lancet grates on the tooth. Each incision ought to +extend along the ridge of the gum to about the extent of each expected +tooth. + +_If it be the lower gum_ that requires lancing, you must go to the +side of the child, and should steady the outside of the jaw with the +fingers of the left hand, and the gum with the left thumb, and then +you should perform the operation as before directed. + +Although the lancing of the gums, to make it intelligible to a +non-professional person, requires a long description, it is, in point +of fact, a simple affair, is soon performed, and gives but little +pain. + +63. _If teething cause convulsions, what ought to be done_? + +The first thing to be done (after sending for a medical man) is to +freely dash water upon the face, and to sponge the head with cold +water, and as soon as warm water can be procured, to put him into a +warm bath [Footnote: For the precautions to be used in putting a child +into a warm bath, see the answer to question on "Warm Baths."] of 98 +degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No +family, where there are young children, should be without Fahrenheit's +thermometer.] you must plunge your own elbow into the water: a +comfortable heat for your elbow will be the proper heat for the +infant. He must remain in the bath for a quarter of an hour, or until +the fit be at an end. The body must, after coming out of the bath, be +wiped with warm and dry and coarse towels; he ought then to be placed +in a warm blanket. The gums must be lanced, and cold water should be +applied to the head. An enema, composed of table salt, of olive oil, +and warm oatmeal gruel--in the proportion of one table-spoonful of +salt, of one of oil, and a tea-cupful of gruel--ought then to be +administered, and should, until the bowels have been well opened, be +repeated every quarter of an hour; as soon as he comes to himself a +dose of aperient medicine ought to be given. + +It may be well, for the comfort of a mother, to state that a child in +convulsions is perfectly insensible to all pain whatever; indeed, a +return to consciousness speedily puts convulsions to the rout. + +64. _A nurse is in the habit of giving a child, who is teething, +either coral, or ivory, to bite: do you approve of the plan_? + +I think it a bad practice to give him any hard, unyielding substance, +as it tends to harden the gums, and, by so doing, causes the teeth to +come through with greater difficulty. I have found softer substances, +such as either a piece of wax taper, or an India-rubber ring, or a +piece of the best bridle leather, or a crust of bread, of great +service. If a piece of crust be given as a gum-stick, he must, while +biting it, be well watched, or by accident he might loosen a large +piece of it, which might choke him. The pressure of any of these +excites a more rapid absorption of the gum, and thus causes the tooth +to come through more easily and quickly. + +65. _Have you any objection to my baby, when he is cutting his teeth, +sucking his thumb_? + +Certainly not: the thumb is the best gum-stick in the world:--it is +convenient; it is handy (in every sense of the word): it is of the +right size, and of the proper consistence, neither too hard nor too +soft; there is no danger, as of some artificial gum-sticks, of its +being swallowed, and thus of its choking the child. The sucking of the +thumb causes the salivary glands to pour out their contents, and thus +not only to moisten the dry mouth, but assist the digestion; the +pressure of the thumb eases, while the teeth are "breeding," the pain +and irritation of the gums, and helps, when the teeth are sufficiently +advanced, to bring them through the gums. Sucking of the thumb will +often make a cross infant contended and happy, and will frequently +induce a restless babe to fall into a sweet refreshing sleep. Truly +may the thumb be called a baby's comfort. By all means, then, let your +child suck his thumb whenever he likes, and as long as he chooses to +do so. + +There is a charming, bewitching little picture of a babe sucking his +thumb in Kingsley's _Water Babies_, which I heartily commend to your +favourable notice and study. + +66. _But if an infant be allowed to suck his thumb, will it not be +likely to become a habit, and stick to him for years--until, indeed, +he become a big boy_? + +After he have cut the whole of his first set of teeth, that is to say, +when he is about two years and a half old, he might, if it be likely +to become a habit, be readily cured by the following method, namely, +by making a paste of aloes and water, and smearing it upon his +thumb. One or two dressings will suffice as after just tasting the +bitter aloes he will take a disgust to his former enjoyment, and the +habit will at once be broken. + +Many persons I know have an objection to children sucking their +thumbs, as for instance,-- + + "Perhaps it's as well to keep children from plums, + And from pears in the season, and sucking their thumbs." [Footnote: + _Ingoldsby Legends_.] + +My reply is,-- + + P'rhaps 'tis as well to keep children from pears; + The pain they might cause, is oft follow'd by tears; + 'Tis certainly well to keep them from plums; + But certainly not from sucking their thumbs! + If a babe suck his thumb + 'Tis an ease to his gum; + A comfort; a boon; a calmer of grief; + A friend in his need--affording relief; + A solace; a good; a soother of pain; + A composer to sleep; a charm; and a gain. + + 'Tis handy, at once, to his sweet mouth to glide; + When done with, drops gently down by his side; + 'Tis fix'd, like an anchor, while the babe sleeps. + And the mother, with joy, her still vigil keeps. + +67. _A child who is teething dribbles, and thereby wets his chest, +which frequently causes him to catch cold; what had better be done_? + +Have in readiness to put on several _flannel_ dribbling bibs, so that +they may be changed as often as they become wet; or, if he dribble +_very much_, the oiled silk dribbling-bibs, instead of the flannel +ones, may be used, and which may be procured at any baby-linen ware +house. + +68. _Do you approve of giving a child, during teething, much fruit_? + +No; unless it be a few ripe strawberries or raspberries, or a roasted +apple, or the juice of five or six grapes--taking care that he does +not swallow either the seeds or the skin--or the insides of ripe +gooseberries, or an orange. Such fruits, if the bowels be in a costive +state, will be particularly useful. + +All stone fruit, _raw_ apples or pears, ought to be carefully avoided, +as they not only disorder the stomach and the bowels,--causing +convulsions, gripings, &c.,--but they have the effect of weakening the +bowels, and thus of engendering worms. + +69. _Is a child, during teething, more subject to disease, and, if so, +to what complaints, and in what manner may they be prevented_? + +The teeth are a fruitful source of suffering and of disease; and are, +with truth, styled "our first and our last plagues." Dentition is the +most important period of a child's life, and is the exciting cause of +many infantile diseases; during this period, therefore, he requires +constant and careful watching. When we consider how the teeth elongate +and enlarge in his gums, pressing on the nerves and on the surrounding +parts, and thus how frequently they produce pain, irritation, and +inflammation; when we further contemplate what sympathy there is in +the nervous system, and how susceptible the young are to pain, no +surprise can be felt, at the immense disturbance, and the consequent +suffering and danger frequently experienced by children while cutting +their _first_ set of teeth. The complaints or the diseases induced by +dentition are numberless, affecting almost every organ of the +body,--the _brain_, occasioning convulsions, water on the brain, &c.; +the _lungs_, producing congestion, inflammation, cough, &c.; the +_stomach_, exciting sickness, flatulence, acidity, &c,; the _bowels_, +inducing griping, at one time costiveness, and at another time +purging; the _skin_, causing "breakings-out." + +To prevent these diseases, means ought to be used to invigorate a +child's constitution by plain, wholesome food, as recommended under +the article of diet; by exercise and fresh air; [Footnote: The young +of animals seldom suffer from cutting their teeth--and what is the +reason? Because they live in the open air, and take plenty of +exercise; while children are frequently cooped up in close rooms, and +are not allowed the free use of their limbs. The value of fresh air +is well exemplified in the Registrar-General's Report for 1843; he +says that in 1,000,000 deaths, from all diseases, 616 occur in the +town from teething while 120 only take place in the country from the +same cause.] by allowing him, weather permitting, to be out of doors a +great part of every day; by lancing the gums when they get red, hot, +and swollen; by attention to the bowels, and if he suffer more than +usual, by keeping them rather in a relaxed state by any simple +aperient, such as either castor oil, or magnesia and rhubarb, &c.; +and, let me add, by attention to his temper: many children are made +feverish and ill by petting and spoiling them. On this subject I +cannot do better than refer you to an excellent little work entitled +Abbot's _Mother of Home_, wherein the author proves the great +importance of _early_ training. + +70. _Have the goodness to describe the symptoms and the treatment of +Painful Dentition_? + +Painful dentition may be divided into two forms--(1) the Mild; and (2) +the Severe. In the _mild_ form the child is peevish and fretful, and +puts his fingers, and everything within reach, to his mouth, he likes +to have his gums rubbed, and takes the breast with avidity, indeed it +seems a greater comfort to him than ever. There is generally a +considerable flow of saliva, and he has frequently a more loose state +of bowels than is his wont. + +Now, with regard to the more _severe_ form of painful dentition--The +gums are red, swollen, and hot, and he cannot without expressing pain +bear to have them touched, hence, if he be at the breast, he is +constantly loosing the nipple. There is dryness of the mouth, although +before there had been a great flow of saliva. He is feverish, +restless, and starts in his sleep. His face is flashed. His head is +heavy and hot. He is sometimes convulsed. [Footnote: See answer to +Question 63.] He is frequently violently griped and purged, and +suffers severely from flatulence. He is predisposed to many and +severe diseases. + +The _treatment,_ of the _mild_ form, consists of friction, of the gum +with the finger, with a little "soothing syrup," as recommended by Sir +Charles Locock, [Footnote: Soothing syrup--Some of them probably +contain opiates, but a perfectly safe and useful one is a little +Nitrate of Potass in syrup of Roses--one scruple to half an +ounce.--_Communicated by Sir Charles Locock to the Author._ This +'soothing syrup' is not intended to be given us a mixture but to be +used as an application to rub the gums with. It may be well to state +that it is a perfectly harmless remedy even if a little of it were +swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, +every night at bed time, attention to diet and to bowels, fresh air +and exercise. For the mild form, the above plan will usually be all +that is required. If he dribble, and the bowels be relaxed, so much +the better. The flow of saliva and the increased action of the bowels +afford relief, and therefore must not be interfered with. In the +_mild_ form, lancing of the gums is not desirable. The gums ought not +to be lanced, unless the teeth be near at hand, and unless the gums be +red, hot, and swollen. + +In the _severe_ form a medical man should be consulted early, as more +energetic remedies will be demanded; that is to say, the gums will +require to be freely lanced, warm baths to be used, and medicines to +be given, to ward off mischief from the head, from the chest, and from +the stomach. + +If you are living in the town, and your baby suffers much from +teething, take him into the country. It is wonderful what change of +air to the country will often do, in relieving a child who is +painfully cutting his teeth. The number of deaths in London, from +teething, is frightful; it is in the country comparatively trifling. + +71. _Should an infant be purged during teething or indeed, during any +other time, do you approve of either absorbent or astringent medicines +to restrain it_? + +Certainly not. I should look upon, the relaxation as an effort of +nature to relieve itself. A child is never purged without a cause; +that cause, in the generality of instances, is the presence of either +some undigested food, or acidity, or depraved motions, that want a +vent. + +The better plan is, in such a case, to give a dose of aperient +medicine, such as either castor oil, or magnesia and rhubarb; and thus +work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS +PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so +important and is often mistaken.--C. Locock.] If he be purged more +than usual, attention should be paid to the diet--if it be absolutely +necessary to give him artificial food while suckling--and care must be +taken not to overload the stomach. + +72. _A child is subject to a slight cough during dentition--called by +nurses "tooth-cough"--which a parent would not consider of sufficient +importance to consult a doctor about: pray tell me, is there any +objection to a mother giving her child a small quantity either of +syrup of white poppies, or of paregoric, to ease it_? + +A cough is an effort of nature to bring up any secretion from the +lining membrane of the lungs, or from the bronchial tubes, hence it +ought not to be interfered with. I have known the administration of +syrup of white poppies, or of paregoric, to stop the cough, and +thereby to prevent the expulsion of the phlegm, and thus to produce +either inflammation of the lungs, or bronchitis. Moreover, both +paregoric and syrup of white poppies are, for a young child, dangerous +medicines (unless administered by a judicious medical man), and _ought +never to be given by a mother_. + +In the month of April 1844, I was sent for, in great haste, to an +infant, aged seventeen months, who was labouring under convulsions and +extreme drowsiness, from the injudicious administration of paregoric, +which had been given to him to ease a cough. By the prompt +administration of an emetic he was saved. + +73. _A child, who is teething, is subject to a "breaking-out," more +especially behind the ears--which is most disfiguring, and frequently +very annoying what would you recommend_? + +I would apply no external application to cure it, as I should look +upon it as an effort of the constitution to relieve itself, and should +expect, if the "breaking-out" were repelled, that either convulsions, +or bronchitis, or inflammation of the lungs, or water on the brain, +would be the consequence. The only plan I should adopt would be, to be +more careful in his diet, to give him less meat (if he be old enough +to eat animal food), and to give him, once or twice a week, a few +doses of mild aperient medicine, and, if the irritation from the +"breaking-out" be great, to bathe it, occasionally, either with a +little warm milk and water, or with rose water. + + +EXERCISE. + +74. _Do you recommend exercise in the open air for a baby? and if so, +how soon after birth_? + +I am a great advocate for his having exercise in the open air. "The +infant in arms makes known its desire for fresh air, by restlessness, +it cries, for it cannot speak its wants, is taken abroad and is +quiet." + +The age at which he ought to commence taking exercise will, of course, +depend upon the season and upon the weather. If it be summer, and the +weather be fine, he should he carried in the open air, a week or a +fortnight after birth, but if it be winter, he ought not on any +account to be taken out under the month, and not even then, unless the +weather be mild for the season, and it be the middle of the day. At +the end of two months he should breathe the open air more +frequently. And after the expiration of three months, he ought to be +carried out _every day_, even if it be wet under foot, provided it be +fine above, and the wind be neither in an easterly nor in a +north-easterly direction. By doing so we shall make him strong and +hearty, and give the skin that mottled appearance which is so +characteristic of health. He must, of course, be well clothed. + +I cannot help expressing my disapprobation of the practice of +smothering up an infant's face with a handkerchief, with a veil or +with any other covering, when he is taken out into the air. If his +face be so muffled up, he may as well remain at home, as under such +circumstances, it is impossible for him to receive any benefit from +the invigorating effects of the fresh air. + +75. _Can you devise any method to induce a babe himself to take +exercise_? + +He must be encouraged to use muscular exertion, and, for this purpose, +he ought to be frequently laid either upon a rug, or carpet, or the +floor. He will then stretch his limbs and kick about with perfect +glee. It is a pretty sight, to see a little fellow kicking and +sprawling on the floor. He crows with delight and thoroughly enjoys +himself. It strengthens his back, it enables him to stretch his limbs, +and to use his muscles, and is one of the best kinds of exercise a +very young child can take. While going through his performances his +diaper, if he wear one, should be unfastened, in order that he might +go through his exercises untrammelled. By adopting the above plan, the +babe quietly enjoys himself--his brain is not over excited by it; this +is an important consideration, for both mothers and nurses are apt to +rouse, and excite very young children to their manifest detriment. A +babe requires rest, and not excitement. How wrong it is, then, for +either a mother or a nurse to be exciting and rousing a new born +babe. It is most injurious and weakening to his brain. In the early +period of his existence his time ought to be almost entirely spent in +sleeping and in sucking! + +76. _Do you approve of tossing an infant much about_? + +I have seen, a child tossed nearly to the ceiling! Can anything be +more cruel or absurd! Violent tossing of a young babe ought never to +be allowed, it only frightens him, and has been known to bring on +convulsions. He should be gently moved up and down (not tossed), such +exercises causes a proper circulation of the blood, promotes +digestion, and soothes to sleep. He must always be kept quiet +immediately after taking the breast, if he be tossed _directly_ +afterwards, it interferes with his digestion, and is likely to produce +sickness. + + +SLEEP + +77. _Ought the infant's sleeping apartment to be kept warm_? + +The lying-in room is generally kept too warm, its heat being, in many +instances, more that of an oven than of a room. Such a place is most +unhealthy, and is fraught with danger both to the mother and the +baby. We are not, of course, to run into an opposite extreme, but are +to keep the chamber at a moderate and comfortable temperature. The +door ought occasionally to be left ajar, in order the more effectually +to change the air and thus to make it more pure and sweet. + +A new born babe, then, ought to be kept comfortably warm, but not very +warm. It is folly in the extreme to attempt to harden a very young +child either by allowing him, in the winter time, to be in a bedroom +without a fire, or by dipping him in _cold_ water, or by keeping him +with scant clothing on his bed. The temperature of a bedroom, in the +winter time, should be, as nearly as possible, at 60 deg. Fahr. Although +the room should be comfortably warm, it ought from time to time to be +properly ventilated. An unventilated room soon becomes foul, and, +therefore, unhealthy. How many in this world, both children and +adults, are "poisoned with their own breaths!" + +An infant should not be allowed to look at the glare either of a fire +or of a lighted candle, as the glare tends to weaken the sight, and +sometimes brings on an inflammation of the eyes. In speaking to, and +in noticing a baby, you ought always to stand _before_, and not +_behind_ him, or it might make him squint. + +78. _Ought a babe to lie alone from the first_? + +Certainly not: at first--say, for the first few months--he requires +the warmth of another person's body, especially in the winter; but +care must be taken not to overlay him, as many infants, from +carelessness in this particular, have lost their lives. After the +first few months he had better lie alone, on a horse-hair mattress. + +79. _Do you approve of rocking an infant to sleep_? + +I do not. If the rules of health be observed, he will sleep both +soundly and sweetly without rocking; if they be not, the rocking might +cause him to fall into a feverish, disturbed slumber, but not into a +refreshing, calm sleep. Besides, if you once take to that habit, he +will not go to sleep without it. + +80. _Then don't you approve of a rocking-chair, and of rockers to the +cradle_? + +Certainly not: a rocking-chair, or rockers to the cradle, may be +useful to a lazy nurse or mother, and may induce a child to sleep, but +that restlessly, when he does not need sleep, or when he is wet and +uncomfortable, and requires "changing;" but will not cause him to have +that sweet and gentle and exquisite slumber so characteristic of a +baby who has no artificial appliances to make him sleep. No! rockers +are perfectly unnecessary, and the sooner they are banished the +nursery the better will it be for the infant community. I do not know +a more wearisome and monotonous sound than the everlasting rockings to +and fro in some nurseries, they are often accompanied by a dolorous +lullaby from the nurse, which adds much to the misery and depressing +influence of the performance. + +81. _While the infant is asleep, do you advise the head of the crib to +be covered with a handkerchief, to shade his eyes from the light, and, +if it be summer time, to keep off the flies_? + +If the head of the crib be covered, the babe cannot breathe freely, +the air within the crib becomes contaminated, and thus the lungs +cannot properly perform their functions. If his sleep is to be +refreshing, he must breathe pure air. I do not even approve of a head +to a crib. A child is frequently allowed to sleep on a bed with the +curtains drawn completely close, as though it were dangerous for a +breath of air to blow upon him [Footnote: I have somewhere read that +if a cage containing a canary, be suspended at night within a bed +where a person is sleeping, and the curtains be drawn closely around, +that the bird will, in the morning, in all probability, be found +dead!] This practice is most injurious. An infant must have the full +benefit of the air of the room, indeed, the bed room door ought to be +frequently left ajar, so that the air of the apartment may be changed, +taking care, of course, not to expose him to a draught. If the flies, +while he is asleep, annoy him, let a net veil be thrown over his face, +as he can readily breathe through net, but not through a handkerchief. + +82. _Have you any suggestions to offer as to the way a babe should be +dressed when he is put down to sleep_? + +Whenever he be put down to sleep, be more than usually particular that +his dress be loose in every part, be careful that there be neither +strings nor bands, to cramp him. Let him, then, during repose, be more +than ordinarily free and unrestrained-- + + "If, whilst in cradled rest your infant sleeps. + Your watchful eyes unceasing vigil keeps + Lest cramping bonds his pliant limbs constrain, + And cause defects that manhood may retain." + +83. _Is it a good sign for a young child to sleep much_? + +A babe who sleeps a great deal thrives much more than one who does +not. I have known many children, who were born [Footnote: It may be +interesting to a mother to know the average weight of new born +infants. There is a paper on the subject in the _Medical Circular_ +(April 10, 1861) and which has been abridged in _Braithwaite's +Retrospect of Medicine_ (July and December 1861). The following are +extracts--"Dr. E. von Siebold presents a table of the weights of 3000 +infants (1586 male and 1414 female) weighed immediately after +birth. From this table (for which we have not space) it results that +by far the greater number of the children, 2215 weighed between 6 and +8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to +8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight +to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at +9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11 +lbs. The author has never but once met with a child weighing 11 +lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It +is a remarkable fact, that until the weight of 7 lbs the female +infants exceeded the males in number, the latter thenceforward +predominating. + +From these statements, and those of various other authors here quoted, +the conclusion may be drawn that the normal weight of a mature new +born infant is not less than six nor more than 8 lbs., the average +weight being 6 1/2 or 7 lbs., the smaller number referring to female and +the higher to male infants."] small and delicate, but who slept the +greatest part of their time, become strong and healthy. On the other +hand, I have known those who were born large and strong, yet who slept +but little, become weak and unhealthy. + +The common practice of a nurse allowing a baby to sleep upon her lap +is a bad one, and ought never to be countenanced. He sleeps cooler, +more comfortably, and soundly in his crib. + +The younger an infant is the more he generally sleeps, so that during +the early months he is seldom awake, and then only to take the breast. + +84. _How is it that much sleep causes a young child to thrive so +well_? + +If there be pain in any part of the body, or if any of the functions +be not properly performed, he sleeps but little. On the contrary, if +there be exemption from pain, and if there be a due performance of all +the functions, he sleeps a great deal, and thus the body becomes +refreshed and invigorated. + +85. _As much sleep is of such advantage, if an infant sleep but +little, would you advise composing medicine to be given to him_? + +Certainly not. The practice of giving composing medicine to a young +child cannot he too strongly reprobated. If he does not sleep enough, +the mother ought to ascertain if the bowels be in a proper state, +whether they be sufficiently opened, that the motions be of a good +colour--namely, a bright yellow, inclining to orange colour--and free +from slime or from bad smell. An occasional dose of rhubarb and +magnesia is frequently the best composing medicine he can take. + +86. _We often hear of coroner's inquests upon infants who have been +found dead in bed--accidentally overlaid what is usually the cause_? + +Suffocation, produced either by ignorance, or by carelessness. From +_ignorance_ in mothers, in their not knowing the common laws of life, +and the vital importance of free and unrestricted respiration, not +only when babies are up and about, but when they are in bed and +asleep. From _carelessness_, in their allowing young and thoughtless +servants to have the charge of infants at night, more especially as +young girls are usually heavy sleepers, and are thus too much +overpowered with sleep to attend to their necessary duties. + +A foolish mother sometimes goes to sleep while allowing her child to +continue sucking. The unconscious babe, after a tune, looses the +nipple, and buries his head in the bed-clothes. She awakes in the +morning, finding, to her horror, a corpse by her side, with his nose +flattened, and a frothy fluid, tinged with, blood, exuding from his +lips. A mother ought, therefore, never to go to sleep until her child +have finished sucking. + +_The following are a few rules to prevent an infant from being +accidentally overlaid_--(1.) Let your baby while asleep have plenty of +room in the bed. (2.) Do not allow him to be too near to you; or if he +he unavoidably near you (from the small size of the bed), let his face +be turned to the opposite side. (3.) Let him lie fairly either on his +side, or on his back. (4.) Be careful to ascertain that his mouth be +not covered with the bed-clothes; and, (5.) Do not smother his face +with clothes, as a plentiful supply of pure air is as necessary when +he is awake, or even more so, than when he is asleep. (6.) Never let +him lie low in the bed. (7.) Let there be _no_ pillow near the one +his head is resting on, lest he roll to it, and thus bury his head in +it Remember, a young child has neither the strength nor the sense to +get out of danger; and, if he unfortunately either turn on his face, +or bury his head in a pillow that is near, the chances are that he +will be suffocated, more especially as these accidents usually occur +at night, when the mother, or the nurse, is fast asleep. (8.) Never +intrust him at night to a young and thoughtless servant. + + +THE BLADDER AND THE BOWELS OF AN INFANT. + +87. _Have you any hints to offer respecting the bowels and the bladder +of an infant during the first three months of his existence_? + +A mother ought daily to satisfy herself as to the state of the bladder +and the bowels of her child. She herself should inspect the motions, +and see that they are of a proper colour (bright-yellow, inclining to +orange), and consistence (that of thick gruel), that they are neither +slimy, nor curdled, nor green; if they should be either the one or the +other, it is a proof that she herself has, in all probability, been +imprudent in her diet, and that it will be necessary for the future +that she be more careful both in what she eats and in what she drinks. + +She ought, moreover, to satisfy herself that the urine does not smell +strongly, that it does not stain the diapers, and that he makes a +sufficient quantity. + +A frequent cause of a child crying is, he is wet, and uncomfortable, +and wants drying and changing, and the only way he has of informing +his mother of the fact is by crying lustily, and thus telling her in +most expressive language of her thoughtlessness and carelessness. + +88. _How soon may an infant dispense with diapers_? + +A babe of three months and upwards, ought to be held out, at least, a +dozen times during the twenty-four hours; if such a plan were adopted, +diapers might at the end of three months be dispensed with--a great +_desideratum_-and he would be inducted into clean habits--a blessing +to himself, and a comfort to all around, and a great saving of dresses +and of furniture. "Teach your children to be clean. A dirty child is +the mother's disgrace," [Footnote: Hints on Household Management, By +Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS +THE MOTHER'S DISGRACE. + + +AILMENTS, DISEASE, ETC. + +89. _A new born babe frequently has a collection of mucus in the air +passages, causing him to wheeze: is it a dangerous symptom_? + +No, not if it occur _immediately_ after birth; as soon as the bowels +have been opened, it generally leaves him, or even before, if he give +a good cry, which as soon as he is born he usually does. If there be +any mucus either within or about the mouth, impeding breathing, it +must with a soft handkerchief be removed. + +90. _Is it advisable, as soon as an infant is born, to give him +medicine_? + +It is now proved that the giving of medicine to a babe _immediately_ +after birth is unnecessary, nay, that it is hurtful--that is, provided +he be early put to the breast, as the mother's _first_ milk is +generally sufficient to open the bowels. Sir Charles Locock [Footnote: +In a _Letter_ to the Author.] makes the following sensible remarks on +this subject:--"I used to limit any aperient to a new-born infant to +those which had not the first milk, and who had wet nurses, whose milk +was, of course, some weeks old, but for many years I have never +allowed any aperient at all to any new born infant, and I am satisfied +it is the safest and the wisest plan." + +The advice of Sir Charles Locock--_to give no aperient to a new-born +infant_--is most valuable, and ought to be strictly followed. By +adopting his recommendation, much after misery might be averted. If a +new born babe's bowels be costive, rather than give him an aperient, +try the effect of a little moist sugar, dissolved in a little water, +that is to say, dissolve half a tea-spoonful of pure unadulterated +_raw_ sugar in a tea-spoonful of warm water and administer it to him, +if in four hours it should not operate, repeat the dose. Butter and +raw sugar is a popular remedy, and is sometimes used by a nurse to +open the bowels of a new born babe, and where there is costiveness, +answers the purpose exceedingly well, and is far superior to castor +oil. Try by all means to do, if possible, without a particle of +opening medicine. If you once begin to give aperients, you will have +frequently to repeat them. Opening physic leads to opening physic, +until at length his stomach and bowels will become a physic shop! Let +me, then, emphatically say, avoid, if possible, giving a new born babe +a drop or a gram of opening medicine. If from the first you refrain +from giving an aperient, he seldom requires one afterwards. It is the +_first_ step, in this as in all other things, that is so important to +take. + +If a new-born babe have _not_ for twelve hours made water, the medical +man ought to be informed of it, in order that he may inquire into the +matter, and apply the proper remedies. Be particular in attending to +these directions, or evil consequences will inevitably ensue. + +91. _Some persons say, that new-born female infants have milk in their +bosoms, and that it is necessary to squeeze them, and apply plasters +to disperse the milk_. + +The idea of there being real milk in a baby's breast is doubtful, the +squeezing of the bosom is barbarous, and the application of plasters +is useless. "Without actually saying," says Sir Charles Locock, "there +is milk secreted in the breasts of infants, there is undoubtedly not +rarely considerable swelling of the breasts both in _female_ and +_male_ infants, and on squeezing them a serous fluid oozes out. I +agree with you that the nurses should never be allowed to squeeze +them, but be ordered to leave them alone." [Footnote: _Letter_ to the +Author.] + +92. _Have the goodness to mention the SLIGHT ailments which are not of +sufficient importance to demand the assistance of a medical man_? + +I deem it well to make the distinction between _serious_ and _slight_ +ailments, I am addressing a mother. With regard to serious ailments, I +do not think myself justified, except in certain _urgent_ cases, in +instructing a parent to deal with them. It might be well to make a +mother acquainted with the _symptoms_, but not with the _treatment_, +in order that she might lose no time in calling in medical aid. This I +hope to have the pleasure of doing in future Conversations. + +_Serious diseases, with a few exceptions_, and which I will indicate +in subsequent Conversations, ought never to be treated by a parent, +not even in the _early_ stages, for it is in the early stages that the +most good can generally be done. It is utterly impossible for any one +who is not trained to the medical profession to understand a _serious_ +disease in all its bearings, and thereby to treat it satisfactorily. + +There are some exceptions to these remarks. It will be seen in future +Conversations that Sir CHARLES LOCOCK considers that a mother ought to +be made acquainted with the _treatment_ of _some_ of the more +_serious_ diseases, where delay in obtaining _immediate_ medical +assistance might be death. I bow to his superior judgment, and have +supplied the deficiency in subsequent Conversations. + +The ailments and the diseases of infants, such as may, in the absence +of the doctor, be treated by a parent, are the following:--Chafings, +Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of +the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of +the Nose, Sickness, Thrush. In all these complaints I will tell +you--_What to do_, and--_What NOT to do_. + +93. _What are the causes and the treatment of Chafing_? + +The want of water: inattention and want of cleanliness are the usual +causes of chafing. + +_What to do._--The chafed parts ought to be well and thoroughly +sponged with tepid _rain_ water--allowing the water from a well-filled +sponge to stream over them,--and, afterwards, they should be +thoroughly, but tenderly, dried with a soft towel, and then be dusted, +either with finely-powdered starch, made of wheaten flour, or with +Violet Powder, or with finely-powdered Native Carbonate of Zinc, or +they should be bathed with finely-powdered Fuller's-earth and tepid +water. + +If, in a few days, the parts be not healed discontinue the above +treatment, and use the following application:--Beat up well together +the whites of two eggs, then add, drop by drop, two table-spoonfuls of +brandy. When well mixed, put it into a bottle and cork it up. Before +using it let the excoriated parts be gently bathed with luke-warm rain +water, and, with a soft napkin, be tenderly dried; then, by means of a +camel's hair brush, apply the above liniment, having first shaken the +bottle. But bear in mind, after all that can be said and done, _that +there is nothing in these cases like water_--there is nothing like +keeping the parts clean, and the only way of thoroughly effecting this +object is _by putting him every morning INTO his tub_. + +_What NOT to do_.--Do not apply white lead, as it is a poison. Do not +be afraid of using _plenty_ of water, as cleanliness is one of the +most important items of the treatment. + +94. _What are the causes of Convulsions of an infant_? + +Stuffing him, in the early months of his existence, _with food_, the +mother having plenty of breast milk the while, the constant physicking +of child by his own mother, teething, hooping-cough, when attacking a +very young baby. + +I never knew a case of convulsions occur--say for the first four +months--(except in very young infants labouring under hooping-cough), +where children lived on the breast-milk alone, and where they were +_not_ frequently quacked by their mothers. + +For the treatment of the convulsions from teething, see page 46. + +_What to do_ in a case of convulsions which has been caused by feeding +an infant either with too much or with _artificial_ food. Give him, +every ten minutes, a tea-spoonful of ipecacuanha wine, until free +vomiting be excited then put him into a warm bath (see Warm Baths), +and when he comes out of it administer to him a tea-spoonful of castor +oil, and repeat it every four hours, until the bowels be well opened. + +_What NOT to do_--Do not for at least a month after the fit, give him +artificial food, but keep him entirely to the breast. Do not apply +leeches to the head. + +_What to do in a case of convulsions from hooping cough_--There is +nothing better than dashing cold water on the face, and immersing him +in a warm bath of 98 degrees Fahr. If he be about his teeth, and they +be plaguing him, let the gums be both freely and frequently +lanced. Convulsions seldom occur in hooping-cough, unless the child be +either very young or exceedingly delicate. Convulsions attending an +attack of hooping-cough make it a _serious_ complication, and requires +the assiduous and skilful attention of a judicious medical man. + +_What NOT to do in such a case_--Do not apply leeches, the babe +requires additional strength, and not to be robbed of it, and do not +attempt to treat the case yourself. + +95. _What are the best remedies for the Costiveness of an infant_? + +I strongly object to the frequent administration of opening medicine, +as the repetition of it increases the mischief to a tenfold degree. + +_What to do_.--If a babe, after the first few months, were held out, +and if, at regular intervals, he were put upon his chair, costiveness +would not so much prevail. It is wonderful how soon the bowels, in +the generality of cases, by this simple plan, may be brought into a +regular state. Besides, it inducts an infant into clean habits, I know +many careful mothers who have accustomed their children, after the +first three months, to do without diapers altogether. It causes at +first a little trouble, but that trouble is amply repaid by the good +consequences that ensue; among which must be named the dispensing with +such encumbrances as diapers. Diapers frequently chafe, irritate, and +gall the tender skin of a baby. But they cannot of course, at an early +age be dispensed with, unless a mother have great judgment, sense, +tact, and perseverance, to bring her little charge into the habit of +having his bowels relieved and his bladder emptied every time he is +either held out or put upon his chair. + +Before giving an infant a particle of aperient medicine, try, if the +bowels are costive, the effect of a little _raw_ sugar and water, +either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or +two of water, or give him, out of your fingers, half a tea-spoonful of +raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure +and unadulterated sugar, and which you can only procure from a +respectable grocer. If you are wise, you will defer as long as you can +giving an aperient. If you once begin, and continue it for a while, +opening medicine becomes a dire necessity, and then woe betide the +poor unfortunate child. Or, give a third of a tea-spoonful of honey, +early in the morning, occasionally. Or administer a warm water +enema--a tablespoonful, or more, by means of a 2 oz. India Rubber +Enema Bottle. + +_What NOT to do_.--There are two preparations of mercury I wish to +warn you against administering of your own accord, viz.--(1) Calomel, +and a milder preparation called (2) Grey-powder (mercury with +chalk). It is a common practice in this country to give calomel, on +account of the readiness with which it can be administered it being +small in quantity, and nearly tasteless. Grey powder also, is, with +many mothers, a favourite in the nursery. It is a medicine of immense +power--either for good or for evil, in certain cases it is very +valuable, but in others, and in the great majority, it is very +detrimental. This practice, then, of a mother giving mercury, whether +in the form either of calomel or of grey powder, cannot be too +strongly reprobated, as the frequent administration either of the one +or of the other weakens the body, predisposes it to cold, and +frequently excites king's-evil--a disease too common in this +country. Calomel and grey-powder, then, ought never to be administered +unless ordered by a medical man. + +Syrup of buckthorn and jalap are also frequently given, but they are +griping medicines for a baby, and ought to be banished from the +nursery. + +The frequent repetition of opening medicines, then, in any shape or +form, very much interferes with digestion, they must, therefore, be +given as seldom as possible. + +Let me, at the risk of wearying you, again urge the importance of your +avoiding, as much as possible, giving a babe purgative medicines. They +irritate beyond measure the tender bowels of an infant, and only make +him more costive afterwards, they interfere with his digestion, and +are liable to give him cold. A mother who is always, of her own +accord, quacking her child with opening physic, is laying up for her +unfortunate offspring a debilitated constitution--a miserable +existence. + +For further information on this important subject see the 3d edition +of _Counsel to a Mother (being the companion volume of Advice to a +Mother)_, on the great importance of desisting from irritating, from +injuring, and from making still more costive, the obstinate bowels of +a costive child,--by the administration of opening medicine,--however +gentle and well-selected the aperients might be. Oh, that the above +advice could be heard, and be acted upon, through the length and the +breadth of the land, how much misery and mischief would then be +averted! + +96. _Are there any means of preventing the Costiveness of an infant_? + +If greater care were paid to the rules of health, such as attention to +diet, exercise in the open air, thorough ablution of the _whole_ +body--more especially when he is being washed--causing the water, from +a large and well-filled sponge, to stream over the lower part of his +bowels; the regular habit of causing him, at stated periods, to be +held out, whether he want or not, that he may solicit a stool. If all +these rules were observed, costiveness would not so frequently +prevail, and one of the miseries of the nursery would be done away +with. + +Some mothers are frequently dosing their poor unfortunate babes either +with magnesia to cool them, or with castor oil to heal their bowels! +Oh, the folly of such practices! The frequent repetition of magnesia, +instead of cooling an infant, makes him feverish and irritable. The +constant administration of castor oil, instead of healing the bowels, +wounds them beyond measure. No! it would be a blessed thing if a babe +could be brought up without giving ham a particle of opening medicine; +his bowels would then act naturally and well: but then, as I have just +now remarked, a mother, must be particular in attending to Nature's +medicines--to fresh air, to exercise, to diet, to thorough ablution, +&c. Until that time comes, poor unfortunate babies must be, +occasionally, dosed with an aperient. + +97. _What are the causes of, and remedies for, Flatulence_? + +Flatulence most frequently occurs in those infants who live on +_artificial_ food, especially if they be over-fed. I therefore beg to +refer you to the precautions I have given, when speaking of the +importance of keeping a child for the first five or six months +_entirely_ to the breast; and, if that be not practicable, of the +times of feeding, and of the _best_ kinds of artificial food, and of +those which are least likely to cause "wind." + +_What to do._--Notwithstanding these precautions, if the babe should +still suffer, "One of the best and safest remedies for flatulence is +Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce +and a half of water" [Footnote: Sir Charles Locock, in a _Letter_ to +the Author Since Sir Charles did me the honour of sending me, for +publication, the above prescription for flatulence, a new "British +Pharmacopoeia" has been published in which the sal volatile is much +increased in strength it is therefore necessary to lessen the sal +volatile in the above prescription one half--that is to say, a tea +spoonful of the solution of _half_ a drachm to an ounce and a half of +water.] Or, a little dill or aniseed may be added to the food--half a +tea-spoonful of dill water Or, take twelve drops of oil of dill, and +two lumps of sugar, rub them well in a mortar together, then add, drop +by drop, three table-spoonfuls of spring water, let it be preserved in +a bottle for use. A tea-spoonful of this, first shaking the vial, may +be added to each quantity of food. Or, three tea-spoonfuls of bruised +caraway-seeds may be boiled for ten minutes in a tea-cupful of water, +and then strained. One or two tea-spoonfuls of the caraway tea may be +added to each quantity of his food, or a dose of rhubarb and magnesia +may occasionally be given. + +Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at +a time, by means of the warm hand, over the bowels, will frequently +give relief. Turning the child over on his bowels, so that they may +press on the nurses' lap, will often afford great comfort. A warm +bath (where he is suffering severely) generally gives _immediate_ ease +in flatulence, it acts as a fomentation to the bowels. But after all, +a dose of mild aperient medicine, when the babe is suffering severely, +is often the best remedy for "wind." + +Remember, at all times, prevention, whenever it be--and how frequently +it is--possible, is better than cure. + +_What NOT to do_--"Godfrey's Cordial," "Infants' Preservative," and +"Dalby's Carminative," are sometimes given in flatulence, but as most +of these quack medicines contain, in one form or another, either opium +or poppy, and as opium and poppy are both dangerous remedies for +children, ALL quack medicines must be banished the nursery. + +Syrup of poppies is another remedy which is often given by a nurse to +afford relief for flatulence; but let me urge upon you the importance +for banishing it from the nursery. It has (when given by +unprofessional persons) caused the untimely end of thousands of +children. The medical journals and the newspapers teem with cases of +deaths from mothers incautiously giving syrup of poppies to ease pain +and to procure sleep. + +98. _What are the symptoms, the causes, and the treatment of +"Gripings" of an infant_? + +_The symptoms._--The child draws up his legs; screams violently; if +put to the nipple to comfort him, he turns away from it and cries +bitterly; he strains, as though he were having a stool; if he have a +motion, it will be slimy, curdled, and perhaps green. If, in addition +to the above symptoms, he pass a large quantity of watery fluid from +his bowels, the case becomes one of _watery gripes_, and requires the +immediate attention of a doctor. + +The _causes_ of "gripings" or "gripes" may proceed either from the +infant or from the mother. If from the child, it is generally owing +either to improper food or to over-feeding; if from the mother, it may +be traced to her having taken either greens, or port, or tart beer, or +sour porter, or pickles, or drastic purgatives. + +_What to do._--The _treatment_, of course, must depend upon the +cause. If it arise from over-feeding, I would advise a dose of castor +oil to be given, and warm fomentations to be applied to the bowels, +and the mother, or the nurse, to be more careful for the future. If it +proceed from improper food, a dose or two of magnesia and rhubarb in a +little dill water, made palatable with simple syrup. [Footnote: + + Take of--Powdered Turkey Rhubarb, half a scruple; + Carbonate of Magnesia, one scruple; + Simple Syrup, three drachms; + Dill Water, eight drachms; + +Make a Mixture, One or two tea-spoonfuls (according to the age of the +child) to be taken every four boors, until relief be obtained--first +shaking the bottle.) If it arise from a mother's imprudence in eating +trash, or from her taking violent medicine, a warm bath, a warm bath, +indeed, let the cause of "griping" be what it may, usually affords +instant relief. + +Another excellent remedy is the following--Soak a piece of new +flannel, folded into two or three thicknesses, in warm water, wring it +tolerably dry, and apply as hot as the child can comfortably bear it +to the bowels, then wrap him in a warm, dry blanket, and keep him, for +at least half an hour, enveloped in it. Under the above treatment, he +will generally soon fall into a sweet sleep, and awake quite +refreshed. + +_What NOT to do_--Do not give opiates, astringents, chalk, or any +quack medicine whatever. + +If a child suffer from a mother's folly in her eating improper food, +it will be cruel in the extreme for him a _second_ time to be +tormented from the same cause. + +99. _What occasions Hiccup, and what is its treatment_? + +Hiccup is of such a trifling nature as hardly to require +interference. It may generally be traced to over feeding. Should it be +severe, four or five grains of calcined magnesia, with a little syrup +and aniseed water, and attention to feeding are all that will be +necessary. + +100. _Will you describe the symptoms of Infantile Diarrhoea_? + +Infantile diarrhoea, or _cholera infantum_, is one of the most +frequent and serious of infantile diseases, and carries off, during +the year, more children than any other complaint whatever a knowledge +of the symptoms, therefore, is quite necessary for a mother to know, +in order that she may, at the proper tune, call in efficient medical +aid. + +It will be well, before describing the symptoms, to tell you how many +motions a young infant ought to have a day, their colour, consistence, +and smell. Well, then, he should have from three to six motions in +the twenty four hours, the colour ought to be a bright yellow, +inclining to orange, the consistence should be that of thick gruel; +indeed, his motion, if healthy, ought to be somewhat of the colour +(but a little more orange-tinted) and of the consistence of mustard +made for the table; it should be nearly, if not quite, devoid of +smell; it ought to have a faint and peculiar, but not a strong +disagreeable odour. If it have a strong and disagreeable smell, the +child is not well, and the case should be investigated, more +especially if there be either curds or lumps in the motions; these +latter symptoms denote that the food has not been properly digested. + +Now, suppose a child should have a slight bowel complaint--that is to +say, that he has six or eight motions during the twenty-four +hours,--and that the stools are of a thinner consistence than what I +have described,--provided, at the same time, that he be not griped, +that he have no pain, and have not lost his desire for the +breast:--What ought to be done?_Nothing_. A slight looseness of the +bowels should _never_ be interfered with,--it is often an effort of +nature to relieve itself of some vitiated motion that wanted a +vent--or to act as a diversion, by relieving the irritation of the +gums. Even if he be not cutting his teeth, he may be "breeding" +them--that is to say, the teeth may be forming in his gums, and may +cause almost as much, irritation as though he were actually cutting +them. Hence, you see the immense good a slight "looseness of the +bowels" may cause. I think that I have now proved to you the danger of +interfering in such a case, and that I have shown you, the folly and +the mischief of at once giving astringents--such as Godfrey's Cordial, +Dalby's Carminative, &c.--to relieve a _slight_ relaxation. + +A moderate "looseness of the bowels," then, is often a safety-valve, +and you may, with as much propriety, close the safety-valve of a steam +engine, as stop a moderate "looseness of the bowels!" + +Now, if the infant, instead of having from three to six motions, +should have more than double the latter number; if they be more +watery; if they become slimy and green, or green in part and curdled; +if they should have an unpleasant smell; if he be sick, cross, +restless, fidgety, and poorly; if every time he have a motion he be +griped and in pain, we should then say that he is labouring under +Diarrhoea; then, it will be necessary to give a little medicine, which +I will indicate in a subsequent Conversation. + +Should there be both blood and slime mixed with the stool, the case +becomes more serious; still, with proper care, relief can generally be +quickly obtained. If the evacuations--instead of being stool--are +merely blood and slime, and the child strain frequently and violently, +endeavouring thus, but in vain, to relieve himself, crying at each +effort, the case assumes the character of Dysentery. [Footnote: See +Symptoms and Treatment of Dysentery.] + +If there be a mixture of blood, slime, and stool from the bowels, the +case would be called Dysenteric-diarrhoea. The latter case requires +great skill and judgment on the part of a medical men, and great +attention and implicit obedience from the mother and the nurse. I +merely mention these diseases in order to warn you of their +importance, and of the necessity of strictly attending to a doctor's +orders. + +101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_ + +Improper food; overfeeding; teething; cold; the mother's milk from +various causes disagreeing, namely, from her being out of health, from +her eating unsuitable food, from her taking improper and drastic +purgatives, or from her suckling her child when she is pregnant. Of +course, if any of these causes are in operation, they ought, if +possible, to be remedied, or medicine to the babe will be of little +avail. + +102. _What is the treatment of Diarrhoea_? + +_What to do._--If the case be _slight_, and has lasted two or three +days (do not interfere by giving medicine at first), and if the cause, +as it probably is, be some acidity or vitiated stool that wants a +vent, and thus endeavours to obtain one by purging, the best treatment +is, to assist nature by giving either a dose of castor oil, or a +moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and +magnesia mixture prescription, see page 71 (_note_).] and thus to work +off the enemy. After the enemy has been worked off, either by the +castor oil, or by the magnesia and rhubarb, the purging will, in all +probability, cease; but if the relaxation still continue, that is to +say, for three or four days--then, if medical advice cannot be +procured, the following mixture should be given:-- + + Take of--Aromatic Powder of Chalk and Opium, ten grains; + Oil of Dill, five drops; + Simple Syrup, three drachms; + Water, nine drachms; + +Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half +a tea-spoonful to be given to an infant of six months and under, and +one tea-spoonful to a child above that age, every four hours--first +shaking the bottle. + +If the babe be at the breast, he ought, for a few days, to be kept +_entirely_ to it. The mother should be most particular in her own +diet. + +_What NOT to do._--The mother must neither take greens, nor cabbage, +nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of +her babe continues, she had better abstain from wine, as well as from +fermented liquors. The child, if at the breast, ought _not_, while +the diarrhoea continues, to have any artificial food. He must neither +be dosed with grey-powder (a favourite, but highly improper Remedy, in +these cases), nor with any quack medicines, such as Dalby's +Carminative or Godfrey's Cordial. + +103. _What are the symptoms of Dysentery_? + +Dysentery frequently arises from a neglected diarrhoea. It is more +dangerous than diarrhoea, as it is of an inflammatory character; and +as, unfortunately, it frequently attacks a delicate child, requires +skilful handling; hence the care and experience required in treating a +case of dysentery. + +Well, then, what are the symptoms? The infant, in all probability, has +had an attack of diarrhoea--bowel complaint as it is called--for +several days; he having had a dozen or two of motions, many of them +slimy and frothy, like "frog-spawn," during the twenty-four hours. +Suddenly the character of the motion changes,--from being principally +stool, it becomes almost entirely blood and mucus; he is dreadfully +griped, which causes him to strain violently, as though his inside +would come away every time he has a motion,--screaming and twisting +about, evidently being in the greatest pain, drawing his legs up to +his belly and writhing in agony. Sickness and vomiting are always +present, which still more robs him of his little remaining strength, +and prevents the repair of his system. Now, look at his face! It is +the very picture of distress. Suppose he has been a plump, healthy +little fellow, you will see his face, in a few days, become +old-looking, care-worn, haggard, and pinched. Day and night the enemy +tracks him (unless proper remedies be administered); no sleep, or if +he sleep, he is, every few minutes, roused. It is heart-rending to +have to attend a bad case of dysentery in a child,--the writhing, the +screaming, the frequent vomiting, the pitiful look, the rapid wasting +and exhaustion, make it more distressing to witness than almost any +other disease a doctor attends. + +104. _Can anything be done to relieve such a case_? + +Yes. A judicious medical man will do a great deal. But, suppose that +yon are not able to procure one, I will tell you _what to do_ and +_what NOT to do_. + +_What to do_.--If the child be at the breast, keep him to it, and let +him have nothing else for dysentery is frequently caused by improper +feeding. If your milk be not good, or it be scanty, _instantly_ +procure a healthy wet-nurse. _Lose not a moment;_ for in dysentery, +moments are precious. But, suppose that you have no milk, and that no +wet-nurse can be procured: what then? Feed him entirely on cow's +milk--the milk of _one_ healthy cow; let the milk be unboiled, and be +fresh from the cow. Give it in small quantities at a time, and +frequently, so that it may be retained on the stomach. If a +table-spoonful of the milk make him sick, give him a dessert-spoonful; +if a dessert-spoonful cause sickness, let him only have a tea-spoonful +at a time, and let it be repeated every quarter of an hour. But, +remember, in such a case the breast milk--the breast milk alone--is +incomparably superior to any other milk or to any other food whatever. + +If he be a year old, and weaned, then feed him, as above recommended, +on the cow's milk. If there be extreme exhaustion and debility, let +fifteen drops of brandy be added to each table-spoonful of new milk, +and let it be given every half hour. + +Now with regard to medicine. I approach this part of the treatment +with some degree of reluctance,--for dysentery is a case requiring +opium--and opium I never like a mother of her own accord to +administer. But suppose a medical man cannot be procured in time, the +mother must then prescribe, or the child will die! _What then is to +be done?_ Sir Charles Locock considers "that, in severe dysentery, +especially where there is sickness, there is no remedy equal to pure +Calomel, in a full dose without opium." [Footnote: Communicated by Sir +Charles Locock to the Author.] Therefore, at the very _onset_ of the +disease, let from three to five grains (according to the age of the +patient) of Calomel, mixed with an equal quantity of powdered white +sugar, be put dry on the tongue. In three hours after let the +following mixture be administered:-- + + Take of--Compound Powder of Ipecacuanha, five grains; + Ipecacuanha Wine, one drachm; + Simple Syrup, three drachms; + Cinnamon Water, nine drachms; + +To make a Mixture, A tea-spoonful to be given every three or four +hours, first _well_ shaking the bottle. + +Supposing he cannot retain the mixture--the stomach rejecting it as +soon as swallowed--what then? Give the opium, mixed with small doses +of mercury with chalk and sugar, in the form of powder, and put one of +the powders _dry_ on the tongue, every three hours:-- + + Take of--Powdered Opium, half a grain; + Mercury with chalk, nine grains; + Sugar of Milk, twenty-four grains; + +Mix well in a mortar, and divide into twelve powders. + +Now, suppose the dysentery has for several days persisted, and that, +during that time, nothing but mucus and blood--that no real stool--has +come from the bowels, then a combination of castor oil and opium +[Footnote: My friend, the late Dr Baly, who had made dysentery his +particular study, considered the combination of opium and castor oil +very valuable in dysentery.] ought, instead of the medicine +recommended above, to be given:-- + + Take of--Mucilage of Gum Acacia, three drachms; + Simple Syrup, three drachms; + Tincture of Opium, ten drops (_not_ minims); + Castor Oil, two drachms; + Cinnamon water, four drachms: + +Make a Mixture. A tea spoonful to be taken every four hours, first +_well_ shaking the bottle. + +A warm bath, at the commencement of the disease, is very efficacious; +but it must be given at the _commencement_. If he has had dysentery +for a day or two, he will be too weak to have a warm bath; then, +instead of the bath, try the following:--Wrap him in a blanket, which +has been previously wrung out of hot water; over which envelope him in +a _dry_ blanket. Keep him in this hot, damp blanket for half an hour; +then take him out, put on his nightgown and place him in bed, which +has been, if it be winter time, previously warmed. The above "blanket +treatment" will frequently give great relief, and will sometimes cause +him to fall into a sweet sleep. A flannel bag, filled with hot +powdered table salt, made hot in the oven, applied to the bowels, will +afford much comfort. + +_What NOT to do_.--Do not give aperients unless it be, as before +advised, the castor oil guarded with the opium; do not stuff him with +artificial food; do not fail to send for a judicious and an +experienced medical man; for, remember, it requires a skilful doctor +to treat a case of dysentery, more especially in a child. + +105. _What are the symptoms, the causes and the treatment of +Nettle-rash_? + +Nettle-rash consists of several irregular, raised wheals, red at the +base, and white on the summit, on different parts of the body; _but it +seldom attacks the face_. It is not contagious, and it may occur at +all ages and many times. It comes and goes, remaining only a short +time in a place. It puts on very much the appearance of the child +having been stung by nettles--hence its name. It produces great heat, +itching, and irritation, sometimes to such a degree as to make him +feverish, sick, and fretful. He is generally worse when he is warm in +bed, or when the surface of his body is suddenly exposed to the air. +Rubbing the skin, too, always aggravates the itching and the tingling, +and brings out a fresh crop. + +The _cause_ of nettle-rash may commonly be traced to improper feeding; +although, occasionally, it proceeds from teething. + +_What to do_.--It is a complaint of no danger, and readily gives way +to a mild aperient, and to attention to diet. There is nothing better +to relieve the irritation of the skin than a warm bath. If it be a +severe attack of nettle-rash, by all means call in a medical man. + +_What NOT to do_.--Do not apply cold applications to his skin, and do +not wash him (while the rash is out) in quite _cold_ water. Do not +allow him to be in a draught, but let him be in a well-ventilated +room. If he be old enough to eat meat, keep it from him for a few +days, and let him live on milk and farinaceous diet. Avoid strong +purgatives, and calomel, and grey-powder. + +106. _What are the symptoms and the treatment of Red-gum_? + +Red-gum, tooth-rash, red-gown, is usually owing to irritation from +teething; not always from the cutting but from the evolution--the +"breeding," of the teeth. It is also sometimes owing to unhealthy +stools irritating the bowels, and showing itself, by sympathy, on the +skin. Red-gum consists of several small papulae, or pimples, about the +size of pins' heads, and may be known from measles--the only disease +for which it is at all likely to be mistaken--by its being unattended +by symptoms of cold, such as sneezing, running, and redness of the +eyes, &c., and by the patches _not_ assuming a crescentic--half-moon +shape; red-gum, in short, may readily he known by the child's health +being unaffected, unless, indeed, there be a great crop of pimples; +then there will be slight feverishness. + +_What to do_.--Little need be done. If there be a good deal of +irritation, a mild aperient should be given. The child ought to be +kept moderately, but not very warm. + +_What NOT to do_.--Draughts of air, or cold should be carefully +avoided; as, by sending the eruption suddenly in, either convulsions +or disordered bowels might be produced. Do not dose him with +grey-powder. + +107. _How would you prevent "Stuffing of the nose" in a new-born +babe_? + +Rubbing a little tallow on the bridge of the nose is the old-fashioned +remedy, and answers the purpose. It ought to be applied every evening +just before putting him to bed. If the "stuffing" be severe, dip a +sponge in hot water, as hot as he can comfortably bear; ascertain that +it be not too hot, by previously applying it to your own face, and +then put it for a few minutes to the bridge of his nose. As soon as +the hard mucus is within reach, it should be carefully removed. + +108. _Do you consider sickness injurious to an infant_? + +Many thriving babies are, after taking the breast, frequently sick; +still we cannot look upon sickness otherwise than as an index of +either a disordered or of an overloaded stomach. If the child be sick, +and yet be thriving, it is a proof that he overloads his stomach. A +mother, then, must not allow him to suck so much, at a time. She +should, until he retain all he takes, lessen the quantity of milk. If +he be sick and does _not_ thrive, the mother should notice if the milk +he throws up has a sour smell; if it have, she must first of all look +to her own health; she ought to ascertain if her own stomach be out of +order; for if such be the case, it is impossible for her to make good +milk. She should observe whether in the morning her own tongue be +furred and dry; whether she have a disagreeable taste in her mouth, or +pains at her stomach, or heart-burn, or flatulence. If she have all, +or any of these symptoms, the mystery is explained why he is sick and +does not thrive. She ought then to seek advice, and a medical man will +soon put her stomach into good order; and, by so doing, will, at the +same time, benefit her child. + +But if the mother be in the enjoyment of good health, she must then +look to the babe himself, and ascertain if he be cutting his teeth; if +the gums require lancing; if the secretions from the bowels be proper +both in quantity and in quality; and, if he have had _artificial_ +food--it being absolutely necessary to give such food--whether it +agree with him. + +_What to do_.--In the first place, if the gums be red, hot, and +swollen, let them be lanced; in the second, if the secretion from the +bowels be either unhealthy or scanty, give him a dose of aperient +medicine, such as caster oil, or the following:--Take two or three +grains of powdered Turkey rhubarb, three grains of pure carbonate of +magnesia, and one grain of aromatic powder--Mix. The powder to be +taken at bed-time, mixed in a tea-spoonful of sugar and water, and +which should, if necessary, be repeated the following night. In the +third place, if the food he be taking does not agree with him, change +it (_vide_ answer to question 33). Give it in smaller quantities at a +time, and not so frequently; or what will be better still, if it be +possible, keep him, for a while, entirely to the breast. + +_What NOT to do_.--Do not let him overload his stomach either with +breast milk, or with _artificial food_. Let the mother avoid, until +his sickness be relieved, greens, cabbage, and all other green +vegetables. + +109. _What are the causes, the symptoms, the prevention, and the cure +of Thrush_? + +The thrush is a frequent disease of an infant, and is often brought on +either by stuffing or by giving him improper food. A child brought up +_entirely_, for the first three or four months, on the breast, seldom +suffers from this complaint. The thrush consists of several irregular, +roundish, white specks on the lips, the tongue, the inside and the +angles of the mouth, giving the parts affected the appearance of curds +and whey having been smeared upon them. The mouth is hot and painful, +and he is afraid to suck; the moment the nipple is put to his mouth he +begins to cry. The thrush, sometimes, although but rarely, runs +through the whole of the alimentary canal. It should be borne in mind +that nearly every child, who is sucking, has his or her tongue white +or "frosted," as it is sometimes called. The thrush may be mild or +very severe. + +Now with regard to what to do.--As the thrush is generally owing to +improper and to artificial feeding, _if the child be at the breast_, +keep him, for a time, entirely to it. Do not let him be always +sucking, as that will not only fret his month, but will likewise +irritate and make sore the mother's nipple. + +_If he be not at the breast_, but has been weaned, then keep him for a +few days entirely to a milk diet--to the milk of ONE cow--either +boiled, if it be hot weather, to keep it sweet; or unboiled, in cool +weather--fresh as it comes from the cow, mixed with warm water. + +The best medicine is the old-fashioned one of Borax, a combination of +powdered lump-sugar and borax being a good one for the purpose: the +powdered lump-sugar increases the efficacy, and the cleansing +properties of the borax; it tends, moreover, to make it more +palatable.-- + + Take of--Borax, half a drachm; + Lump Sugar, two scruples; + +To be well mixed together, and made into twelve powders. One of the +powders to be put dry on the tongue every four hours. + +The best _local_ remedy is Honey of Borax, which ought to be smeared +frequently, by means of the finger, on the parts affected. + +Thorough ventilation of the apartment must be observed; and great +cleanliness of the vessels containing the milk should be insisted +upon. + +In a bad case of thrush, change of air to the country is most +desirable; the effect is sometimes, in such cases, truly magical. + +If the thrush be brought on either by too much or by improper food; in +the first case of course, a mother must lessen the quantity; and, in +the second, she should be more careful in her selection. + +_What NOT to do_.--Do not use either a calf's teat or wash leather for +the feeding-bottle; fortunately, since the invention of India-rubber +teats, they are now nearly exploded; they were, in olden times, +fruitful causes of thrush. Do not mind the trouble of ascertaining +that the cooking-vessels connected with the baby's food are perfectly +clean and sweet. Do not leave the purity and the goodness of the cow's +milk (it being absolutely necessary to feed him on artificial food) to +be judged either by the milk-man, or by the nurse, but taste and prove +it yourself. Do not keep the milk in a warm place, but either in the +dairy or in the cellar; and, if it be summer time, let the jug holding +the milk be put in a crock containing lumps of ice. Do not use milk +that has been milked longer than twelve hours, but if practicable, +have it milked direct from the cow, and use it _immediately_--let it +be really and truly fresh and genuine milk. + +When the disease is _severe_, it may require more active +treatment--such as a dose of calomel; _which medicine must never be +given unless it be either under the direction of a medical man, or +unless it be in an extreme case,--such as dysentery_; [Footnote: See +the Treatment of Dysentery.] therefore, the mother had better seek +advice. + +In a _severe_ case of thrush, where the complaint has been brought on +by _artificial_ feeding--the babe not having the advantage of the +mother's milk--it is really surprising how rapidly a wet-nurse--if the +case has not been too long deferred--will effect a cure, where all +other means have been tried and have failed. The effect has been truly +magical! In a severe case of thrush pure air and thorough ventilation +are essential to recovery. + +110. _Is anything to be learned from the cry of an infant_? + +A babe can only express his wants and his necessities by a cry; he can +only tell his aches and his pains by a cry; it is the only language of +babyhood; it is the most ancient of all languages; it is the language +known by our earliest progenitors; it is, if listened to aright, a +very expressive language, although it is only but the language of a +cry-- + + "Soft infancy, that nothing canst but cry."--_Shakspeare_. + +There is, then, a language in the cry of an infant, which to a mother +is the most interesting of all languages, and which a thoughtful +medical man can well interpret. The cry of a child, to an experienced +doctor, is, each and all, a distract sound, and is as expressive as +the notes of the gamut. The cry of passion, for instance, is a furious +cry; the cry of sleepiness is a drowsy cry; the cry of grief is a +sobbing cry; the cry of an infant when roused from sleep is a shrill +cry; the cry of hunger is very characteristic,--it is unaccompanied +with tears, and is a wailing cry; the cry of teething is a fretful +cry; the cry of pain tells to the practised ear the part of pain; the +cry of ear-ache is short, sharp, piercing, and decisive, the head +being moved about from side to side, and the little hand being often +put up to the affected side of the head; the cry of bowel-ache is also +expressive,--the cry is not so piercing as from ear-ache, and is an +interrupted, straining cry, accompanied with a drawing-up of the legs +to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the +cry of inflammation of the lungs is more a moan than a cry; the cry of +croup is hoarse, and rough, and ringing, and is so characteristic that +it may truly be called "the croupy cry;" the cry of inflammation of +the membranes of the brain is a piercing shriek--a danger signal--most +painful to hear; the cry of a child recovering from a severe illness +is a cross, and wayward, and tearful cry; he may truly be said to be +in a quarrelsome mood; he bursts out, without rhyme or reason, into a +passionate flood of tears--into "a tempest of tears:" tears are +always, in a severe illness, to be looked upon as a good omen, as a + + "The tears that heal and bless"--_H. Bonar_. + +Tears, when a child is dangerously ill, are rarely, if ever, seen; a +cry, at night, for light--a frequent cause of a babe crying--is a +restless cry:-- + + "An infant--crying in the night; + An infant crying for the light: + And with no language hat a cry."--_Tennyson_. + +111. _If an infant be delicate, have you any objection to his having +either veal or mutton broth, to strengthen him_? + +Broths seldom agree with a babe at the breast I have known them +produce sickness, disorder the bowels, and create fever. I recommend +you, therefore, not to make the attempt. + +Although broth and beef-tea, when taken by the mouth, will seldom +agree with an infant at the breast, yet, when used as an enema, and in +small quantities, so that they may be retained, I have frequently +found them to be of great benefit, they have in some instances +appeared to have snatched delicate children from the brink of the +grave. + +112. _My baby's ankles are very weak: what do you advise to strengthen +them_? + +If his ankles be weak, let them every morning be bathed, after the +completion of his morning's ablution, for fire minutes each time, with +bay-salt and water, a small handful of bay-salt dissolved in a quart +of rain water (with the chill of the water off in the winter, and of +its proper temperature in the summer time); then let them be dried; +after the drying, let the ankles he well rubbed with the following +liniment:-- + + Take of--Oil of Rosemary, three drachms; + Liniment of Camphor, thirteen drachms: + +To make a Liniment + +Do not let him be put on his feet early; but allow him to crawl, and +sprawl, and kick about the floor, until his body and his ankles become +strong. + +Do not, on any account, without having competent advice on the +subject, use iron instruments, or mechanical supports of any kind: the +ankles are generally, by such artificial supports, made worse, in +consequence of the pressure causing a further dwindling away and +enfeebling of the ligaments of the ankles, already wasted and +weakened. + +Let him wear shoes with straps over the insteps to keep them on, and +not boots: boots will only, by wasting the ligaments, increase the +weakness of the ankles. + +113. _Sometimes there is a difficulty in restraining the bleeding of +leech bites. What is the best method_? + +The difficulty in these cases generally arises from the improper +method of performing it. For example--a mother endeavours to stop the +haemorrhage by loading the part with rag; the more the bites discharge, +the more rag she applies. At the same time, the child probably is in a +room with a, large fire, with two or three candles, with the doors +closed, and with perhaps a dozen people in the apartment, whom the +mother has, in her fright, sent for. This practice is strongly +reprehensible. + +If the bleeding cannot be stopped,--in the first place, the fire most +be extinguished, the door and windows should be thrown open, and the +room ought to be cleared of persons, with the exception of one, or, at +the most, two; and every rag should be removed. "Stopping of leech +bites.--The simplest and most certain way, till the proper assistance +is obtained, is the pressure of the finger, with nothing +intervening. It _cannot_ bleed through that." [Footnote: Sir Charles +Locock, in a _Letter_ to the Author.] + +Many babies, by excessive loss of blood from leech bites, have lost +their lives from a mother not knowing how to act, and also from the +medical man either living at a distance, or not being at +hand. Fortunately for the infantile community, leeches are now very +seldom ordered by doctors. + +114. _Supposing a baby to be poorly, have you any advice to give to +his mother as to her own management_? + +She must endeavour to calm her feelings or her milk will be +disordered, and she will thus materially increase his illness. If he +be labouring under any inflammatory disorder, she ought to refrain +from the taking of beer, wine, and spirits, and from all stimulating +food; otherwise, she will feed his disease. + +Before concluding the first part of my subject--the Management of +Infancy--let me again urge upon you the importance--the paramount +importance--if you wish your babe to be strong and hearty,--of giving +him as little opening physic as possible. The best physic for him is +Nature's physic--fresh air, and exercise, and simplicity of living. A +mother who is herself always drugging her child, can only do good to +two persons--the doctor and the druggist! + +If an infant from his birth be properly managed,--if he have an +abundance of fresh air for his lungs,--if he have plenty of exercise +for his muscles (by allowing him to kick and sprawl on the floor),--if +he have a good swilling and sousing of water for his skin,--if, during +the _early_ months of his life, he have nothing but the mother's milk +for his stomach,--he will require very little medicine--the less the +better! He does not want his stomach to be made into a doctor's shop! +The grand thing is not to take every opportunity of administering +physic, but of using every means of with-holding it! And if physic be +necessary, not to doctor him yourself, unless it be in extreme and +urgent cases (which in preceding and succeeding Conversations I either +have or will indicate), but to employ an experienced medical man. A +babe who is always, without rhyme or reason, being physicked, is sure +to be puny, delicate, and unhealthy, and is ready at any moment to +drop into an untimely grave! + +I will maintain that a healthy child _never_ requires drugging with +opening physic, and that costiveness is brought on by bad +management. Aperient medicines to a healthy child are so much poison! +_Let me impress the above remarks on every mother's mind;_ for it is a +subject of vital importance. Never, then, give a purgative to a +healthy child; for, if he be properly managed, he will never require +one. If you once begin to give aperients, you will find a difficulty +discontinuing them. Finally, I will only say with _Punch_,--"Don't" + + +CONCLUDING REMARKS ON INFANCY. + +115. In concluding the first part of our subject--Infancy--I beg to +remark: there are four things essentially necessary to a babe's +well-doing, namely, (1) plenty of water for his skin; (2) plenty of +fresh genuine milk mixed with water for his stomach (of course, giving +him ONLY his mother's milk during the first six, eight, or nine +months of his existence); (3) plenty of pure air for his lungs; (4) +plenty of sleep for his brain: these are the four grand essentials for +an infant; without an abundance of one and all of them, perfect health +is utterly impossible! Perfect health! the greatest earthly blessing, +and more to be coveted than ought else beside! There is not a more +charming sight in the universe than the beaming face of a perfectly +healthy babe,-- + + "His are the joys of nature, his the smile, + The cherub smile, of innocence and health."--_Knox._ + + + + +PART II. + +CHILDHOOD. + + + _The child is father of the man_.--WORDSWORTH. + _Bairns are blessings_--SHAKESPEARE. + _These are MY jewels!_--CORNELLA. + + +ABLUTION. + +116. _At twelve months old, do you still recommend a child to be_ PUT +IN HIS TUB _to be washed_? + +Certainly I do, as I have previously recommended at page 6, in order +that his skin may be well and thoroughly cleansed. If it be summer +time, the water should be used cold; if it be winter, a dash of warm +must be added, so that it may be of the temperature of new milk: but +do not, on any account use _very warm_ water. The head must be washed +(but not dried) before he be placed in a tub, then, putting him in the +tub (containing the necessary quantity of water, and washing him as +previously recommended), [Footnote: See Infancy-Ablution, page 6.] a +large sponge should be filled with the water and squeezed over his +head, so that the water may stream over the whole surface of his +body. A jugful of water should, just before taking him out of his +bath, be poured over and down his loins; all this ought rapidly to be +done, and he must be quickly dried with soft towels, and then +expeditiously dressed. For the washing of your child I would recommend +you to use Castile soap in preference to any other; it is more pure, +and less irritating, and hence does not injure the texture of the +skin. Take care that the soap does not get into his eyes, or it might +produce irritation and smarting. + +117. _Some mothers object to a child's STANDING in the water._ + +If the head be wetted before he be placed in the tub, and if he be +washed as above directed, there can be no valid objection to it. He +must not be allowed to remain in his tab more than five minutes. + +118. _Does not washing the child's head, every morning, make him more +liable to catch cold, and does it not tend to weaken his sight_? + +It does neither the one nor the other; on the contrary, it prevents +cold, and strengthens his sight; it cleanses his scalp, prevents +scurf, and, by that means, causes a more beautiful bead of hair. The +head, after each washing, ought, with a soft brush, to be well +brushed, but should not be combed. The brushing causes a healthy +circulation of the scalp; but combing the hair makes the head scurfy, +and pulls out the hair by the roots. + +119. _If the head, notwithstanding the washing, be scurfy, what should +be done_? + +After the head has been well dried, let a little cocoa-nut oil be well +rubbed, for five minutes each time, into the roots of the hair, and, +afterwards, let the head be well brushed, but not combed. The +fine-tooth comb will cause a greater accumulation of scurf, and will +scratch and injure the scalp. + +120. _Do you recommend a child to be washed_ IN HIS TUB _every night +and morning_? + +No; once a day is quite sufficient; in the morning in preference to +the evening; unless he be poorly, then, evening instead of morning; +as, immediately after he has been washed and dried, he can be put to +bed. + +121. _Ought a child to be placed in his tub whilst he is in a state of +perspiration_? + +Not whilst he is perspiring _violently,_ or the perspiration might he +checked suddenly, and ill consequences would ensue; _nor ought he to +be put in his tub when he is cold,_ or his blood would be chilled, and +would be sent from the skin to some internal vital part, and thus +would be likely to light up inflammation--probably of the lungs. His +skin, when he is placed in his bath, ought to be moderately and +comfortably warm; neither too hot nor too cold. + +122. _When the child is a year old, do you recommend cold or warm +water to be used_? + +If it be winter, a little warm water ought to be added, so as to raise +the temperature to that of new milk. As the summer advances, less and +less warm water is required, so that, at length, none is needed. + +123. _If a child be delicate, do you recommend anything to be added to +the water which may tend to brace and strengthen him_? + +Either a handful of table-salt, or half a handful of bay-salt, or of +Tidman's sea-salt, should be previously dissolved in a quart jug of +_cold_ water; then, just before taking the child out of his morning +bath, let the above be poured over and down the back and loins of the +child--holding the jug, while pouring its contents on the back, a foot +distant from the child, in order that it might act as a kind of douche +bath. + +124. _Do you recommend the child, after he has been dried with the +towel, to be rubbed with the hand_? + +I do; as friction encourages the cutaneous circulation, and causes the +skin to perform its functions properly, thus preventing the +perspiration (which is one of the impurities of the body) from being +sent inwardly either to the lungs or to other parts. The back, the +chest, the bowels, and the limbs are the parts that ought to be well +rubbed. + + +CLOTHING + +125. _Have you any remarks to make on the clothing of a child_? + +Children, boys and girls, especially if they be delicate, ought always +to wear high dresses up to their necks. The exposure of the upper +part of the chest (if the child be weakly) is dangerous. It is in the +_upper_ part of the lungs, in the region of the collar bones, that +consumption first shows itself. The clothing of a child, more +especially about the chest, should be large and full in every part, +and be free from tight strings, so that the circulation of the blood +may not be impeded, and that there may be plenty of room for the fall +development of the rapidly-growing body. + +His frock, or tonic, ought to be of woollen material--warm, light, and +porous, in order that the perspiration may rapidly evaporate. The +practice of some mothers in allowing their children to wear tight +bands round their waists, and tight clothes, is truly reprehensible. + +_Tight_ bands or _tight_ belts around the waist of a child are very +injurious to health; they crib in the chest, and thus interfere with +the rising and the falling of the ribs--so essential to +breathing. _Tight_ hats ought never to be worn; by interfering with +the circulation they cause headaches. Nature delights in freedom, and +resents interference! + +126. _What parts of the body in particular ought to be kept warm_? + +The chest, the bowels, and the feet, should be kept comfortably +warm. We must guard against an opposite extreme, and not keep them too +hot. The head alone should be kept cool, on which account I do not +approve either of night or of day caps. + +127. _What are the best kinds of hat for a child_? + +The best covering for the head, when he is out and about, is a +loose-fitting straw hat, which will allow the perspiration to +escape. It should have a broad rim, to screen the eyes. A sun-shade, +that is to say, a sea-side hat--a hat made of cotton--with a wide brim +to keep off the sun, is also an excellent hat for a child; it is very +light, and allows a free escape of the perspiration. It can be +bought, ready made, at a baby-linen warehouse. + +A knitted or crocheted woollen hat, with woollen rosettes to keep the +ears warm, and which may be procured at any baby-linen warehouse, +makes a nice and comfortable winter's hat for a child. It is also a +good hat for him to wear while performing a long journey. The colour +chosen is generally scarlet and white, which, in cold weather, gives +it a warm and comfortable appearance. + +It is an abominable practice to cover a child's head with beaver or +with felt, or with any thick impervious material It is a +well-ascertained fact, that beaver and silk hats cause men to suffer +from headache, and to lose their hair--the reason being, that the +perspiration cannot possibly escape through them. Now, if the +perspiration cannot escape, dangerous, or at all events injurious, +consequences must ensue, as it is well known that the skin is a +breathing apparatus, and that it will not with impunity bear +interference. + +Neither a child nor any one else should be permitted to be in the +glare of the son without his hat. If he be allowed, he is likely to +have a sun-stroke, which might either at once kill him, or might make +him an idiot for the remainder of his life; which latter would be the +worse alternative of the two. + +128. _Have you, any remarks to make on keeping a child's hands and +legs warm when in the winter time he it carried out_? + +When a child either walks or is carried out in wintry weather, be sure +and see that both his hands and legs are well protected from the +cold. There is nothing for this purpose like woollen gloves, and +woollen stockings coming up over the knees. + +129. _Do you approve of a child wearing a flannel nightgown_? + +He frequently throws the clothes off him, and has occasion to be taken +up in the night, and if he have not a flannel gown on, is likely to +catch cold; on which account I recommend it to be worn. The usual +calico night-gown should be worn _under_ it. + +130. _Do you advise a child to be LIGHTLY clad, in order that he may +be hardened thereby_? + +I should fear that such a plan, instead of hardening, would be likely +to produce a contrary effect. It is an ascertained fact that more +children of the poor, who are thus lightly clad, die, than of those +who are properly defended from the cold. Again, what holds good with a +young plant is equally applicable to a young child; and we all know +that it is ridiculous to think of unnecessarily exposing a tender +plant to harden it. If it were thus exposed, it would wither and die. + +131. _If a child be delicate, if he have a cold body, or a languid +circulation, or if he be predisposed to inflammation of the lungs, do +you approve of his wearing flannel instead of linen shirts_? + +I do; as flannel tends to keep the body at an equal temperature, thus +obviating the effects of the sudden changes of the weather, and +promotes by gentle friction the cutaneous circulation, thus warming +the cold body, and giving an impetus to the languid circulation, and +preventing an undue quantity of blood from being sent to the lungs, +either to light up or to feed inflammation _Fine_ flannel, of course, +ought to be worn, which should be changed as frequently as the usual +shirts. + +If a child have had an attack either of bronchitis or of inflammation +of the lungs, or if he have just recovered from scarlet fever, by all +means, if he have not previously worn flannel, _instantly_ let him +begin to do so, and let him, _next_ to the skin, wear a flannel +waistcoat. _This is important advice, and ought not to be +disregarded_. + +_Scarlet_ flannel is now much used instead of _white_ flannel; and as +scarlet flannel has a more comfortable appearance, and does not shrink +so much in washing, it may be substituted for the white. + +132. _Have you any remarks to make on the shoes and stockings of a +child? and on the right way of cutting the toe-nails_? + +He ought, daring the winter, to wear lamb's wool stockings that will +reach _above_ the knees, and _thick_ calico drawers that will reach a +few inches _below_ the knees; as it is of the utmost importance to +keep the lower extremities comfortably warm. It is really painful to +see how many mothers expose the bare legs of their little ones to the +frosty air, even in the depths of winter. + +Be sure and see that the boots and shoes of your child be sound and +whole; for if they be not so, they will let in the damp, and if the +damp, disease and perhaps death. "If the poor would take better care +of their children's feet half the infantile mortality would +disappear. It only costs twopence to put a piece of thick felt or cork +into the bottom of a boot or shoe, and the difference is often between +that and a doctors bill, with, perhaps, the undertaker's +besides."--_Daily Telegraph_, + +Garters ought not to be worn, as they impede the circulation, waste +the muscles, and interfere with walking. The stocking may be secured +in its place by means of a loop and tape, which should be fastened to +a part of the dress. + +Let me urge upon you the importance of not allowing your child to wear +_tight_ shoes; they cripple the feet, causing the joints of the toes, +which ought to have free play, and which should assist in walking, to +be, in a manner, useless; they produce corns and bunions, and +interfere with the proper circulation of the foot. A shoe ought to be +made according to the shape of the foot--rights and lefts are +therefore desirable. The toe-part of the shoe must be made broad, so +as to allow plenty of room for the toes to expand, and that one toe +cannot overlap another. Be sure, then, that there be no pinching and +no pressure. In the article of shoes you ought to be particular and +liberal; pay attention to having nicely fitting ones, and let them be +made of soft leather, and throw them on one side the moment they are +too small. It is poor economy, indeed, because a pair of shoes be not +worn out, to run the risk of incurring the above evil consequences. + +_Shoes are far preferable to boots:_ boots weaken instead of +strengthen the ankle. The ankle and instep require free play, and +ought not to be hampered by boots. Moreover, boots, by undue +pressure, decidedly waste away the ligaments of the ankle. Boots act +on the ankles in a similar way that stays do on the waist--they do +mischief by pressure. Boots waste away the ligaments of the ankle; +stays waste away the muscles of the back and chest; and thus, in both +cases, do irreparable mischief. + +A shoe for a child ought to be made with a narrow strap over the +instep, and with button and button-hole; if it be not made in this +way, the shoe will not keep on the foot. + +It is a grievous state of things, that in the nineteenth century there +are but few shoemakers who know how to make a shoe! The shoe is made +not to fit a real foot, but a fashionable imaginary one! The poor +unfortunate toes are in consequence screwed up as in a vice! + +Let me strongly urge you to be particular that the sock, or stocking, +fits nicely--that it is neither too small nor too large; if it be too +small, it binds up the toes unmercifully, and makes one toe to ride +over the other, and thus renders the toes perfectly useless in +walking; if it be too large, it is necessary to lap a portion of the +sock, or stocking, either under or over the toes, which thus presses +unduly upon them, and gives pain and annoyance. It should be borne in +mind, that if the toes have full play, they, as it were, grasp the +ground, and greatly assist in locomotion--which, of course, if they +are cramped up, they cannot possibly do. Be careful, too, that the +toe-part of the sock, or stocking, be not pointed; let it be made +square in order to give room to the toes. "At this helpless period of +life, the delicately feeble, outspreading toes are wedged into a +narrow-toed stocking, often so short as to double in the toes, +diminishing the length of the rapidly growing foot! It is next, +perhaps, tightly laced into a boot of less interior dimensions than +itself; when the poor little creature is left to sprawl about with a +limping, stumping gait, thus learning to walk as it best can, under +circumstances the most cruel and torturing imaginable." [Footnote: +_The Foot and its Covering_, second edition. By James Dowie. London: +1872. I beg to call a mother's especial attention to this valuable +little book: it is written by an earnest intelligent man, by one who +has studied the subject in all its bearings, and by one who is himself +a shoemaker.] + +It is impossible for either a stocking, or a shoe, to fit nicely +unless the toe-nails be kept in proper order. Now, in cutting the +toe-nails, there is, as in everything else, a right and a wrong +way. The _right_ way of cutting a toe-nail is to cut it straight--in a +straight line. The _wrong_ way is to cut the corners of the nail--to +round the nail as it is called. This cutting the corners of the nails +often makes work for the surgeon, as I myself can testify; it +frequently produces "growing-in" of the nail, which sometimes +necessitates the removal of either the nail, or a portion of it. + +133. _At what time of the year should a child leave off his winter +clothing_? + +A mother ought not to leave off her children's winter clothing until +the spring be far advanced: it is far better to be on the safe side, +and to allow the winter clothes to be worn until the end of May. The +old adage is very good, and should be borne in mind:-- + + "Button to chin + Till May be in; + Ne'er cast a clout + Till May be out." + +134. _Have you any general remarks to make on the present fashion of +dressing children_? + +The present fashion is absurd. Children are frequently dressed like +mountebanks, with feathers and furbelows and finery; the boys go +bare-legged; the little girls are dressed like women, with their +stuck-out petticoats, crinolines, and low dresses! Their poor little +waists are drawn in tight, so that they can scarcely breathe; their +dresses are very low and short, the consequence is, that a great part +of the chest is exposed to our variable climate; their legs are bare +down to their thin socks, or if they be clothed, they are only covered +with gossamer drawers; while their feet are encased in tight shoes of +paper thickness! Dress! dress! dress! is made with them, at a tender +age, and when first impressions are the strongest, a most important +consideration. They are thus rendered vain and frivolous, and are +taught to consider dress "as the one thing needful" And if they live +to be women--which the present fashion is likely frequently to +prevent--what are they? Silly, simpering, delicate, lack-a-daisical +nonentities; dress being their amusement, their occupation, their +conversation, their everything, their thoughts by day and their dreams +by night! Truly they are melancholy objects to behold! Let children be +dressed as children, not as men and women. Let them be taught that +dress is quite a secondary consideration. Let health, and not +fashion, be the first, and we shall then have, with God's blessing, +blooming children, who will, in time, be the pride and strength of +dear old England! + + +DIET. + +135. _At TWELVE months old, have you any objection to a child having +any other food besides that you mentioned in answer to the 34th +question_? + +There is no objection to his _occasionally_ having, for dinner, either +a mealy, _mashed_ potato and gravy, or a few crumbs of bread and +gravy. Rice-pudding or batter-pudding may, for a change, be given; but +remember, the food recommended in a former Conversation is what, until +he be eighteen months old, must be principally taken. During the early +months of infancy--say, for the first six or seven--if artificial food +be given at all, it should be administered by means of a +feeding-bottle. After that time, either a spoon, or a nursing boat, +will be preferable. The food as he becomes older, ought to be made +more solid. + +136. _At_ EIGHTEEN _months old, have you any objection to a child +having meat_? + +He ought not to have meat until he have several teeth to chew it +with. If he has most of his teeth--which he very likely at this age +will have--there is no objection to his taking a small slice either of +mutton, or occasionally of roast beef, which should be well cut into +very small pieces, and mixed with a mealy _mashed_ potato, and a few +crumbs of bread and gravy; either _every_ day, if he be delicate, or +every _other_ day, if he be a gross or a fast-feeding child. It may be +well, in the generality of cases, for the first few months to give him +meat _every other_ day, and either potato or gravy, or rice or +suet-pudding or batter-pudding on the alternate days; indeed, I think +so highly of rice, of suet, and of batter-puddings, and of other +farinaceous puddings, that I should advise you to let him have either +the one or the other even on those days that he has meat--giving it +him _after_ his meat. But remember, if he have meat _and_ pudding, the +meat ought to be given sparingly. If he be gorged with food, it makes +him irritable, cross, and stupid; at one time, clogging up his bowels, +and producing constipation; at another, disordering his liver, and +causing either clay-coloured stools--denoting a _deficiency_ of bile, +or dark and offensive motions--telling of _vitiated_ bile; while, in a +third case, cramming him with food might bring on convulsions. + +137. _As you are to partial to puddings for a child, which do you +consider the best for him_? + +He ought, every day, to have a pudding for his dinner--either rice, +arrow-root, sago, tapioca, suet-pudding, batter-pudding, or +Yorkshire-pudding, mixed with crumbs of bread and gravy--free from +grease. A well boiled suet-pudding, with plenty of suet in it, is one +of the best puddings he can have; it is, in point of fact, meat and +farinaceous food combined, and is equal to, and will oftentimes +prevent the giving of, cod-liver oil; before cod-liver oil came into +vogue, suet boiled in milk was _the_ remedy for a delicate child. He +may, occasionally, have fruit-pudding, provided the pastry be both +plain and light. + +The objection to fruit pies and puddings is, that the pastry is often +too rich for the delicate stomach of a child; there is so objection, +certainly not, to the fruit--cooked fruit being, for a child, most +wholesome; if, therefore, fruit puddings and pies be eaten, the pastry +part ought to be quite plain. There is, in "Murray's Modern Cookery +Book," an excellent suggestion, which I will take the liberty of +quoting, and of strongly urging my fair reader to carry into +practice:--"_To prepare fruit for children, a far more wholesome way +than in pies and puddings_, is to put apples sliced, or plums, +currants, gooseberries, &c., into a stone jar; and sprinkle among them +as much Lisbon sugar as necessary. Set the jar on an oven or on a +hearth, with a tea-cupful of water to prevent the fruit from burning; +or put the jar into a saucepan of water, till its contents be +perfectly done. Slices of bread or some rice may be put into the jar, +to eat with the fruit." + +_Jam_--such as strawberry, raspberry, gooseberry--_is most wholesome +for a child_, and ought occasionally to be given, in lieu of sugar, +with the rice, with the batter, and with the other puddings. +Marmalade, too, is very wholesome. + +Puddings ought to be given _after_ and not _before_ his meat and +vegetables; if you give him pudding before his meat, he might refuse +to eat meat altogether. By adopting the plan of giving puddings +_every_ day, your child will require _less_ animal food; _much_ meat +is injurious to a young child. But do not run into an opposite +extreme: a _little_ meat ought, every day, to be given, _provided he +has cut the whole of his first set of teeth_; until then, meat every +_other_ day will be often enough. + +138. _As soon as a child has cut the whole of his first set of teeth, +what ought to be his diet?--What should be his breakfast_? + +He can, then, have nothing better, where it agrees, than scalding hot +new milk poured on sliced bread, with a slice or two of bread and +butter to eat with it. Butter, in moderation, is nourishing, +fattening, and wholesome. Moreover, butter tends to keep the bowels +regular. These facts should be borne in mind, as some mothers +foolishly keep their children from butter, declaring it to be too rich +for their children's stomachs! New milk should be used in preference +either to cream or to skim-milk. Cream, as a rule, is too rich for +the delicate stomach of a child, and skim-milk is too poor when robbed +of the butter which the cream contains. But give cream and water, +where new milk (as is _occasionally_ the case) does not agree; but +never give skim-milk. _Skim_-milk (among other evils) produces +costiveness, and necessitates the frequent administration of +aperients. Cream, on the other hand, regulates and tends to open the +bowels. + +Although I am not, as a rule, so partial to cream as I am to good +genuine fresh milk, yet I have found, in cases of great debility, more +especially where a child is much exhausted by some inflammatory +disease, such as inflammation of the lungs, the following food most +serviceable:--Beat up, by means of a fork, the yolk of an egg, then +mix, little by little, half a tea-cupful of very weak _black_ tea, +sweeten with one lump of sugar, and add a table-spoonful of cream. Let +the above, by tea-spoonfuls at a time be frequently given. The above +food is only to be administered until the exhaustion be removed, and +is not to supersede the milk diet, which must, at stated periods, be +given, as I have recommended in answers to previous and subsequent +questions. + +When a child has costive bowels, there is nothing better for his +breakfast than well-made and well-boiled oatmeal stir-about, which +ought to be eaten with milk fresh from the cow. Scotch children +scarcely take anything else, and a finer race is not in existence; +and, as for physic, many of them do not even know either the taste or +the smell of it! You win find Robinson's Pure Scotch Oatmeal (sold in +packets) to be very pure, and sweet, and good. Stir-about is truly +said to be-- + + "The halesome parritch, chief of Scotia's food."--_Burns._ + +Cadbury's Cocoa Essence, made with equal parts of boiling water and +fresh milk, slightly sweetened with lump sugar, is an admirable food +for a delicate child. Bread and butter should be eaten with it. + +139. _Have you any remarks to make on cow's milk as an article of +food_? + +Cow's milk is a valuable, indeed, an indispensable article of diet, +for the young; it is most nourishing, wholesome, and digestible. The +finest and the healthiest children are those who, for the first four +or five years of their lives, are fed _principally_ upon it. Milk +ought then to be their staple food. No child, as a rule, can live, or, +if he live, can be healthy, unless milk be the staple article of his +diet. There is no substitute for milk. To prove the fattening and +strengthening qualities of milk, look only at a young calf who lives +on milk, and on milk alone! He is a Samson in strength, and is "as fat +as butter;" and all young things if they are in health are fat! + +Milk, then, contains every ingredient to build up the body, which is +more than can be said of any other known substance besides. A child +may live entirely, and grow, and become both healthy and strong, on +milk and on milk alone, as it contains every constituent of the human +body. A child cannot "live by bread alone," but he might on milk +alone! Milk is animal and vegetable--it is meat and bread--it is food +and drink--it is a fluid, but as soon as it reaches the stomach it +becomes a solid [Footnote: How is milk in the making of cheese, +converted into curds? By rennet. What is rennet? The juice of a +calf's maw or stomach. The moment the milk enters the human maw or +stomach, the juice of the stomach converts it into curds--into solid +food, just as readily as when it enters a calfs maw or stomach, and +much more readily than by rennet, as the _fresh_ juice is stronger +than the _stale_. An ignorant mother often complains that because, +when her child is sick, the milk curdles, that it is a proof that it +does not agree with him! If, at those times, it did _not_ curdle, it +would, indeed, prove that his stomach was in a wretchedly weak state; +she would then have abundant cause to be anxious.]--solid food; it is +the most important and valuable article of diet for a child in +existence. It is a glorious food for the young, and must never, on any +account whatever, in any case be dispensed with. "Considering that +milk contains in itself most of the constituents of a perfect diet, +and is capable of maintaining life in infancy without the aid of any +other substance, it is marvellous that the consumption of it is +practically limited to so small a class; and not only so, but that in +sick-rooms, where the patient is surrounded with every luxury, +arrow-root, and other compounds containing much less nutriment, should +so often be preferred to it."--_The Times._ + +Do not let me be misunderstood. I do not mean to say, but that the +mixing of farinaceous food--such as Lemann's Biscuit Powder, Robb's +Biscuit, Hard's Farinaceous Food, Brown and Polson's Corn Flour, and +the like, with the milk, is an improvement, in some cases--a great +improvement; but still I maintain that a child might live and thrive, +and that for a lengthened period, on milk--and on milk alone! + +A dog will live and fatten for six weeks on milk alone; while he will +starve and die in a shorter period on strong beef-tea alone! + +It is a grievous sin for a milkman to adulterate milk. How many a +poor infant has fallen a victim to that crime!--for crime it may be +truly called. + +It is folly in the extreme for a mother to bate a milkman down in the +price of his milk; if she does, the milk is sure to be either of +inferior quality, or adulterated, or diluted with water; and woe +betide the poor unfortunate child if it be either the one or the +other! The only way to insure good milk is, to go to a respectable +cow-keeper, and let him be made to thoroughly understand the +importance of your child having _genuine_ milk, and that you are then +willing to pay a fair remunerative price for it. Rest assured, that if +you have to pay one penny or even twopence a quart more for _genuine_ +milk, it is one of the best investments that you ever have made, or +that you are ever likely to make in this world! Cheap and inferior +milk might well be called cheap and nasty; for inferior or adulterated +milk is the very essence, the conglomeration of nastiness; and, +moreover, is very poisonous to a child's stomach. One and the +principal reason why so many children are rickety and scrofulous, is +the horrid stuff called milk that is usually given to them. It is a +crying evil, and demands a thorough investigation and reformation, and +the individual interference of every parent. Limited Liability +Companies are the order of the day; it would really be not a bad +speculation if one were formed in every large town, in order to insure +good, genuine, and undiluted milk. + +_Young_ children, as a rule, are allowed to eat too much meat. It is a +mistaken notion of a mother that they require so much animal food. If +more milk were given and less meat, they would he healthier, and would +not be so predisposed to disease, especially to diseases of debility, +and to skin-disease. + +I should strongly recommend you, then, to be extravagant in your milk +score. Each child ought, in the twenty-four hours, to take at least a +quart of good, fresh, new milk. It should, of course, be given in +various ways,--as bread and milk, rice-puddings, milk and differents +kinds of farinaceous food, stir-about, plain milk, cold milk, hot +milk, any way, and every way, that will please his palate, and that +will induce him to take an abundant supply of it. The "advice" I have +just given you is of paramount importance, and demands your most +earnest attention. There would be very few rickety children in the +world if my "counsel" were followed out to the very letter. + +140. _But suppose my child will not take milk, he having an aversion +to it, what ought then to be done_? + +Boil the milk, and sweeten it to suit his palate. After he has been +accustomed to it for a while, he will then, probably, like +milk. Gradually reduce the sugar, until at length it be dispensed +with. A child will often take milk this way, whereas he will not +otherwise touch it. + +If a child will not drink milk, he _must_ eat meat; it is absolutely +necessary that he should have either the one or the other; and, if he +have cut nearly all his teeth, he ought to have both meat and +milk--the former in moderation, the latter in abundance. + +141. _Supposing milk should not agree with my child, what must then be +done_? + +Milk, either boiled or unboiled, almost always agrees with a child. If +it does not, it must be looked upon as the exception, and not as the +rule. I would, in such a case, advise one-eighth of lime water to be +added to seven-eighths of new milk--that is to say, two +table-spoonfuls of lime water should be mixed with half a pint of new +milk. + +142. _Can you tell me of a way to prevent milk, in hot weather, from +turning sour_? + +Let the jug of milk be put into a crock, containing ice--Wenham Lake +is the best--either in the dairy or in the cellar. The ice may at any +time, be procured of a respectable fishmonger, and should be kept, +wrapped either in flannel or in blanket, in a cool place, until it be +wanted. + +143. _Can you tell me why the children of the rich suffer so much more +from costiveness than do the children of the poor_? + +The principal reason is that the children of the rich drink milk +without water, while the children of the poor drink water without, or +with very little, milk--milk being binding, and water opening to the +bowels. Be sure then, and bear in mind, _as this is most important +advice_, to see that water is mixed with all the milk that is given to +your child. The combination of milk and water for a child is a +glorious compound--strengthening, fattening, refreshing, and +regulating to the bowels, and thus doing away with that disgraceful +proceeding so common in nurseries, of everlastingly physicking, +irritating and irreparably injuring the tender bowels of a child. + +My opinion is, that aperients, as a rule, are quite unnecessary, and +should only be given in severe illness, and under the direction of a +judicious medical man. How much misery, and injury, might be averted +if milk were always given to a child in combination with water! + +Aperients, by repetition, unlike water, increase the mischief tenfold, +and cork them up most effectually; so that the bowels, in time, will +not act without them! + +A mother before she gives an aperient to her child should ponder well +upon what I have said upon the subject, it being a vital question, +affecting, as it does, the well-being and the well-doing of her child. + +144. _But, if a child's bowels be very costive, what is to be done to +relieve them_? + +Do not give him a grain or a drop of opening medicine, but in lieu +thereof, administer, by means of a 6 oz. India-rubber Enema Bottle, +half a tea-cup or a tea-cupful, according to the age of the child, +[Footnote: For a babe, from birth until he be two years old, one, two, +or three table-spoonfuls of warm water will be sufficient, and a 2 +oz. Enema Bottle will be the proper size for the purpose of +administering it.] of warm water; now this will effectually open the +bowels, without confining them afterwards, which opening physic would +most assuredly do! + +145. _Is it necessary to give a child luncheon_? + +If he want anything to eat between breakfast and dinner let him have a +piece of dry bread; and if he have eaten very heartily at dinner, and, +like Oliver Twist, "asks for more!" give him, to satisfy his craving, +a piece of _dry_ bread. He will never eat more of that than will do +him good, and yet he will take sufficient to satisfy his hunger, which +is very important. + +146. _What ought now to be his dinner_? + +He should now have meat, either mutton or beef, daily, which must be +cut up very small, and should be mixed with mealy, _mashed_ potato and +gravy. He ought _always_ to be accustomed to eat salt with his +dinner. Let a mother see that this advice is followed, or evil +consequences will inevitably ensue. Let him be closely watched, to +ascertain that he well masticates his food, and that he does not eat +too quickly; for young children are apt to bolt their food. + +147. _Have you any objection to pork for a change_? + +I have a great objection to it for the young. It is a rich, gross, and +therefore unwholesome food for the delicate stomach of a child. I have +known it, in several instances, produce violent pain, sickness, +purging, and convulsions. If a child be fed much, upon such meat, it +will be likely to produce "breakings-out" on the skin. In fine, his +blood will put on the same character as the food he is fed +with. Moreover, pork might be considered a _strong meat_, and +"_strong_ meat and _strong_ drink can only be taken by _strong_ men." + +148. _Do you approve of veal for a child_? + +My objection to pork was, that it was rich and gross; this does not +apply to veal; but the objection to it is, that it is more difficult +of digestion that either mutton or beef; indeed, all young meats are +harder of digestion than meats of maturity; thus mutton is more +digestible than lamb, and beef than veal. + +149. _Do you disapprove of salted and boiled beef for a child_? + +If beef be _much_ salted it is hard of digestion, and therefore ought +not to be given to him; but if it have been but _slightly_ salted, +then for a change there will be no objection to a little. There is no +necessity in the _winter_ time to _salt_ meat intended for boiling; +then boiled _unsalted_ meat makes a nice change for a child's dinner. +Salt, of course, _must_ with the unsalted meat be eaten. + +150. _But suppose there is nothing on the table that a child may with +impunity eat_? + +He should then have either a grilled mutton chop, or a lightly-boiled +egg; indeed, the latter, at any time, makes an excellent change. There +is great nourishment in an egg; it will not only strengthen the frame, +but it will give animal heat as well: these two qualities of an egg +are most valuable; indeed, essential for the due performance of +health: many articles of food contain the one qualification, but not +the other: hence the egg is admirably suitable for a child's +_occasional_ dinner. + +151. _Are potatoes an unwholesome food for a child_? + +New ones are; but old potatoes well cooked and mealy, are the best +vegetable he can have. They ought to be _well mashed_, as I have known +lumps of potatoes cause convulsions. + +152. _Do you approve of any other vegetables for a child_? + +Occasionally: either asparagus or broccoli, or cauliflower, or +turnips, or French beans, which latter should be cut up fine, may with +advantage be given. Green peas may occasionally be given, provided +they be thoroughly well boiled, and mashed with the knife on the +plate. Underdone and unmashed peas are not fit for a child's stomach: +there is nothing more difficult of digestion than underdone peas. It +is important, too, to mash them, even if they be well done, as a child +generally bolts peas whole; and they pass through the alimentary canal +without being in the least digested. + +153. _Might not a mother be too particular in dieting her child_? + +Certainly not. If blood can be too pure and too good she might! When +we take into account that the food we eat is converted into blood; +that if the food be good the blood is good; and that if the food be +improper or impure, the blood is impure likewise; and, moreover, when +we know that every part of the body is built up by the blood, we +cannot be considered to be too particular in making our selection of +food. Besides if indigestible or improper food be taken into the +stomach, the blood will not only be made impure, but the stomach and +the bowels will be disordered. Do not let me be misunderstood: I am no +advocate for a child having the same food one day as another-- +certainly not. Let there be variety, but let it be _wholesome_ +variety. Variety in a child's (not in infant's) food is necessary. If +he were fed, day after day, on mutton, his stomach would, at length be +brought into that state, that in time it would not properly digest any +other meat, and a miserable existence would be the result. + +154. _What ought a child to drink with his dinner_? + +Toast and water, or, if he prefer it, plain spring water. Let him +have as much as he likes. If you give him water to drink, there is no +fear of his taking too much; Nature will tell him when he has had +enough. Be careful of the quality of the water, and the source from +which you procure it. If the water be _hard_--provided it be free from +organic matter--so much the better. [Footnote: See the _third_ edition +of _Counsel to a Mother_, under the head of "Hard or soft water as a +beverage!"] Spring water from a moderately deep well is the best. If +it come from a land spring, it is apt, indeed, is almost sure to be +contaminated by drains, &c.; which is a frequent cause of fevers, of +diphtheria, of Asiatic cholera, and of other blood poisons. + +Guard against the drinking water being contaminated with lead; never, +therefore, allow the water to be collected in leaden cisterns, as it +sometimes is if the water be obtained from Water-works companies. Lead +pumps, for the same reason, ought never to be used for drinking +purposes. Paralysis, constipation, lead colic, dropping of the wrist, +wasting of the ball of the thumb, loss of memory, and broken and +ruined health, might result from neglect of this advice. + +The drinking fountains are a great boon to poor children, as water and +plenty of it, is one of the chief necessaries of their existence; and, +unfortunately, at their own homes they are not, oftentimes, able to +obtain a sufficient supply. Moreover, drinking fountains are the best +advocates for Temperance. + +Some parents are in the habit of giving their children beer with their +dinners--making them live as they live themselves! This practice is +truly absurd, and fraught with great danger! not only so, but it is +inducing a child to be fond of that which in after life might be his +bane and curse! No good end can be obtained by it; it will _not_ +strengthen so young a child; it will on the contrary, create fever, +and will thereby weaken him; it will act injuriously upon his +delicate, nervous, and vascular systems, and by means of producing +inflammation either of the brain or of its membranes, might thus cause +water on the brain (a disease to which young children are subject), or +it might induce inflammation of the lungs. + +155. _What ought a child who has cut his teeth to have for his +supper_? + +The same that he has for breakfast. He should sup at six o'clock. + +156. _Have you any general remarks to make on a child's meals_? + +I recommended a great sameness in an _infant's_ diet; but a _child's_ +meals, his dinners especially, ought to be much varied. For instance, +do not let him have day after day mutton; but ring the changes on +mutton, beef, poultry, game, and even occasionally fish--sole or cod. + +Not only let there be a change of meat, but let there be a change in +the manner of cooking it; let the meat sometimes be roasted; let it at +other times be boiled. I have known a mother who has prided herself as +being experienced in these matters, feed her child, day after day, on +mutton chops! Such a proceeding is most injurious to him, as after a +while his unfortunate stomach will digest nothing but mutton chops, +and, in time, not even those! + +With regard to vegetables, potatoes--_mashed_ potatoes--ought to be +his staple vegetable; but, every now and then, cauliflower, asparagus, +turnips, and French beans, should be given. + +With respect to puddings, vary them; rice, one day; suet, another; +batter, a third; tapioca, a fourth; or, even occasionally, he might +have either apple or gooseberry or rhubarb pudding--provided the +pastry be plain and light. + +It is an excellent plan, as I have before remarked, to let her child +eat jam--such as strawberry, raspberry, or gooseberry--and that +without stint, either with rice or with batter puddings. + +_Variety of diet_, then, is _good for a child:_ it will give him +muscle, bone, and sinew; and, what is very important, it will tend to +regulate his bowels, and it will thus prevent the necessity of giving +him aperients. + +But do not stuff a child--do not press him, as is the wont of some +mothers, to eat more than he feels inclined. On the contrary, if you +think that he is eating too much--that he is overloading his +stomach--and if he should ask for more, then, instead of giving him +either more meat or more pudding, give him a piece of dry bread. By +doing so, you may rest assured that he will not eat more than is +absolutely good for him. + +157. _If a child be delicate, is there any objection to a little wine, +such as cowslip or tent, to strengthen him_? + +Wine ought not to be given to a child unless it be ordered by a +medical man; it is even more injurious than beer. Wine, beer, and +spirits, principally owe their strength to the alcohol they contain; +indeed, nearly _all_ wines are _fortified_ (as it is called) with +brandy. Brandy contains a large quantity of alcohol, more than any +other liquor, namely 55.3 per cent. If, therefore, you give wine, it +is, in point of fact, giving diluted brandy--diluted alcohol; and +alcohol acts, unless it be used as a medicine, and under skilful +medical advice, as a poison to a child. + +158. _Suppose a child suddenly to lose his appetite? is any notice to +be taken of it_? + +If he cannot eat well, depend upon it, there is something wrong about +the system. If he be teething, let a mother look well to his gums, and +satisfy herself that they do not require lancing. If they be red, hot, +and swollen, send for a medical man, that he may scarify them. If his +gums be not inflamed, and no tooth appears near, let her look well to +the state of his bowels; let her ascertain that they be sufficiently +opened, and that the stools be of a proper consistence, colour, and +smell. If they be neither the one nor the other, give a dose of +aperient medicine, which will generally put all to rights. If the gums +be cool, and the bowels be right, and his appetite continue bad, call +in medical aid. + +A child asking for something to eat, is frequently, in a severe +illness, the first favourable symptom; we may generally then +prognosticate that all will soon be well again. + +If a child refuse his food, neither coax nor tempt him to eat: as food +without an appetite will do him more harm than it will do him good; it +may produce either sickness, bowel-complaint, or fever. Depend upon +it, there is always a cause for a want of appetite;--perhaps his +stomach has been over-worked, and requires repose; or his bowels are +loaded, and Nature wishes to take time to use up the old +material;--there might be fever lurking in his system; Nature stops +the supplies, and thus endeavours, by not giving it food to work with, +to nip it in the bud;--there might be inflammation; food would then be +improper, as it would only add fuel to the fire; let, therefore, the +cause be either an overworked stomach, over-loaded bowels, fever, or +inflammation, food would be injurious. Kind Nature if we will but +listen to her voice, will tell us when to eat, and when to refrain. + +159. _When a child is four or five years old, have you any objection +to his drinking tea_? + +Some parents are in the habit of giving their children strong (and +frequently green) tea. This practice is most hurtful. It acts +injuriously upon their delicate, nervous system, and thus weakens +their whole frame. If milk does not agree, a cup of very weak tea, +that is to say, water with a dash of _black_ tea in it, with a +table-spoonful of cream, may be substituted for milk; but a mother +must never give tea where milk agrees. + +160. _Have you any objection to a child occasionally having either +cakes or sweetmeats_? + +I consider them as so much slow poison. Such things both cloy and +weaken the stomach, and thereby take away the appetite, and thus +debilitate the frame. Moreover "sweetmeats are coloured with poisonous +pigments." A mother, surely, is not aware, that when she is giving +her child Sugar Confectionery she is, in many cases, administering a +deadly poison to him? "We beg to direct the attention of our readers +to the Report of the Analytical Sanitary Commission, contained in the +_Lancet_ of the present week (Dec. 18, 1858), on the pigments employed +in colouring articles of Sugar Confectionery. From this report it +appears that metallic pigments of a highly dangerous and even +poisonous character, containing chromic acid, lead, copper, mercury, +and arsenic, are commonly used in the colouring of such articles." + +If a child be never allowed to eat cakes and sweetmeats, he will +consider a piece of dry bread a luxury, and will eat it with the +greatest relish. + +161. _Is bakers' or is home-made bread the most wholesome for a +child_? + +Bakers' bread is certainly the lightest; and, if we could depend upon +its being unadulterated, would, from its lightness, be the most +wholesome; but as we cannot always depend upon bakers' bread, +home-made bread, as a rule should be preferred. If it be at all heavy, +a child must not be allowed to partake of it; a baker's loaf ought +then to be sent for, and continued to be eaten until light home-made +bread can be procured. Heavy bread is most indigestible. He must not +be allowed to eat bread until it be two or three days old. If it be a +week old, in cold weather, it will be the more wholesome. + +162. _Do you approve either of caraway seeds or of currants in bread +or in cakes--the former to disperse wind, the latter to open the +bowels_? + +There is nothing better than plain bread: the caraway-seeds generally +pass through the bowels undigested, and thus might irritate, and might +produce, instead of disperse wind. [Footnote: Although caraway seeds +_whole_ are unwholesome, yet caraway tea, made as recommended in a +previous Conversation, is an excellent remedy to disperse wind.] Some +mothers put currants in cakes, with a view of opening the bowels of +their children; but they only open them by disordering them. + +163. _My child has an antipathy to certain articles of diet: what +would you advise to be done_? + +A child's antipathy to certain articles of diet should be respected: +it is a sin and a shame to force him to eat what he has a great +dislike to: a child, for instance, sometimes dislikes the fat of meat, +underdone meat, the skin off boiled milk and off rice-pudding. Why +should he not have his likes and dislikes as well as "children of a +larger growth?" Besides, there is an idiosyncrasy--a peculiarity of +the constitution in some children--and Nature oftentimes especially +points out what is good and what is bad for them individually, and we +are not to fly in the face of Nature. "What is one man's meat is +another man's poison." If a child be forced to eat what he dislikes, +it will most likely not only make him sick, but will disorder his +stomach and bowels; food, if it is really to do him good, must be +eaten by him with a relish, and not with disgust and aversion. Some +mothers, who are strict disciplinarians, pride themselves on +compelling their children to eat whatever they choose to give them! +Such children are to be pitied! + +164. _When ought a child to commence to dine with his parents_? + +As soon as he be old enough to sit up at the table, provided the +father and mother either dine or lunch in the middle of the day. "I +always prefer having children about me at meal tines. I think it makes +them little gentlemen and gentlewomen in a manner that nothing else +will."--_Christian's Mistake_. + + +THE NURSERY. + +165. _Save you any remarks to make on the selection, the ventilation, +the warming, the temperature, and the arrangements of a nursery? and +have you any further observations to offer conducive to the well-doing +of my child_? + +The nursery ought to be the largest and the most airy room in the +house. In the town, if it be in the topmost story (provided the +apartment be large and airy) so much the better, as the air will then +be purer. The architect, in the building of a house, ought to be +particularly directed to pay attention to the space, the loftiness, +the ventilation, the light, the warming, and the conveniences of a +nursery. A bath-room attached to it will be of great importance and +benefit to the health of a child. + +It will be advantageous to have a water-closet near at hand, which +should be well supplied with water, be well drained, and be well +ventilated. If this be not practicable, the evacuations ought to be +removed as soon as they are passed. It is a filthy and an idle habit +of a nurse-maid to allow a motion to remain for any length of time in +the room. + +The VENTILATION of a nursery is of paramount importance. There ought +to be a constant supply of fresh pure air in the apartment. But how +few nurseries have fresh, pure air! Many nurseries are nearly +hermetically sealed--the windows are seldom, if ever, opened; the +doors are religiously closed; and, in summer time, the chimneys are +carefully stuffed up, so that a breath of air is not allowed to enter! +The consequences are, the poor unfortunate children "are poisoned by +their own breaths," and are made so delicate that they are constantly +catching cold; indeed, it might be said that they are labouring under +chronic catarrhs, all arising from Nature's laws being set at +defiance. + +The windows ought to be large, and should be made to freely open both +top and bottom. Whenever the child is out of the nursery, the windows +ought to be thrown wide open; indeed, when he is in it, if the weather +be fine, the upper sash should be a little lowered. A child should be +encouraged to change the room, frequently, in order that it may be +freely ventilated; for good air is as necessary to his health as +wholesome food, and air cannot be good if it be not frequently +changed. If you wish to have a strong and healthy child, ponder over +and follow this advice. + +I have to enter my protest against the use of a stove in a nursery. I +consider a gas stove _without a chimney_ to be an abomination, most +destructive to human life. There is nothing like the old-fashioned +open fire-place with a good-sized chimney, so that it may not only +carry off the smoke, but also the impure air of the room. + +Be strict in not allowing your child either to touch or to play with +fire; frightful accidents have occurred from mothers and nurses being +on these points lax. The nursery ought to have a large fire-guard, to +go all round the hearth, and which should be sufficiently high to +prevent a child from climbing over. Not only must the nursery have a +guard, but every room where he is allowed to go should he furnished +with one on the bars. + +Moreover, it will be advisable to have a guard in every room where a +fire is burning, to prevent ladies from being burned. Fortunately for +them, preposterous crinolines are out of fashion: when they were in +fashion, death from burning was of every-day occurrence; indeed, +lady-burning was then to be considered one of the institutions of our +land! + +A nursery is usually kept too hot; the temperature in the winter time +ought _not to exceed_ 60 degrees Fahrenheit A _good_ thermometer +should be considered an indispensable requisite to a nursery. A child +in a hot, close nursery is bathed in perspiration; if he leave the +room to go to one of lower temperature, the pores of his skin are +suddenly closed, and either a severe cold or an inflammation of the +lungs, or an attack of bronchitis, is likely to ensue. Moreover, the +child is both weakened and enervated by the heat, and thus readily +falls a prey to disease. + +A child ought never to be permitted to sit with his back to the fire; +if he be allowed, it weakens the spine, and thus his whole frame; it +causes a rash of blood to the head and face, and predisposes him to +catch cold. + +Let a nurse make a point of opening the nursery window every time that +she and her little charge leave the nursery, if her absence be only +for half an hour. The mother herself ought to see that this advice is +followed, pure air is so essential to the well-being of a child. Pure +air and pure water, and let me add, pure milk, are for a child the +grand and principal requirements of health. + +Look well to the DRAINAGE of your house and neighbourhood. A child is +very susceptible to the influence of bad drainage. Bad drains are +fruitful sources of scarlet fever, of diphtheria, of diarrhoea, +&c. "It is sad to be reminded that, whatever evils threaten the health +of population, whether from pollutions of water or of air,--whether +from bad drainage or overcrowding, they fall heaviest upon the most +innocent victims--upon children of tender years. Their delicate frames +are infinitely more sensitive than the hardened constitutions of +adults, and the breath of poison, or the chill of hardships, easily +blights their tender life."--_The Times._ + +A nursery floor ought not to be _washed_ oftener than once a week; and +then the child or children should, until it be dry, be sent into +another room. During the drying of the floor, the windows must, of +course, be thrown _wide_ open. + +The constant _wetting_ of a nursery is a frequent source of illness +among children. The floor ought, of course, to be kept clean; but this +may be done by the servant thoroughly sweeping the room out every +morning before her little charge makes his appearance. + +Do not have your nursery wall covered with green paper-hangings. Green +paper-hangings contain large quantities of arsenic--arsenite of copper +(Scheele's green)--which, I need scarcely say, is a virulent poison, +and which flies about the room in the form of powder. There is +frequently enough poison on the walls of a room to destroy a whole +neigbourhood. + +There is another great objection to having your nursery walls covered +with _green_ paper-hangings; if any of the paper should become loose +from the walls, a little child is very apt to play with it, and to put +it, as he does every thing else, to his mouth. This is not an +imaginary state of things, as four children in one family have just +lost their lives from sucking green paper-hangings. + +Green dresses, as they are coloured with a preparation of arsenic, are +equally as dangerous as green paper-hangings; a child ought, +therefore, never to wear a green dress. "It may be interesting to some +of our readers," says _Land and Water_, "to know that the new green, +so fashionable for ladies' dresses, is just as dangerous in its nature +as the green wall-paper, about which so much was written some time +since. It is prepared with a large quantity of arsenic; and we have +been assured by several of the leading dressmakers, that the workwomen +employed in making up dresses of this colour are seriously affected +with all the symptoms of arsenical poisoning. Let our lady friends +take care." + +Children's toys are frequently painted of a green colour with arsenite +of copper, and are consequently, highly dangerous for him to play +with. The best toy for a child is a box of _unpainted_ wooden bricks, +which is a constant source of amusement to him. + +If you have your nursery walls hung with paintings and engravings, let +them be of good quality. The horrid daubs and bad engravings that +usually disfigure nursery walls, are enough to ruin the taste of a +child, and to make him take a disgust to drawing, which would be a +misfortune. A fine engraving and a good painting expand and elevate +his mind. We all know that first impressions are the most vivid and +the most lasting. A taste in early life for everything refined and +beautiful purifies his mind, cultivates his intellect, keeps him from +low company, and makes him grow up a gentleman! + +Lucifer matches, in case of sudden illness, should, both in the +nursery and in the bedroom, be always in readiness; but they must be +carefully placed out of the reach of children, as lucifer matches are +a deadly poison. Many inquests have been held on children who have, +from having sucked them, been poisoned by them. + +166. _Have you any observation to make on the LIGHT of a nursery_? + +Let the window, or what is better, the windows, of a nursery be very +large, so as to thoroughly light up every nook and corner of the room, +as there is nothing more conducive to the health of a child than an +abundance of light in the dwelling. A room cannot, then, be too light. +The windows of a nursery are generally too small. A child requires as +much light as a plant. Gardeners are well aware of the great +importance of light in the construction of their greenhouses, and yet +a child, who requires it as much, and is of much greater importance, +is cooped up in dark rooms! + +The windows of a nursery ought not only to be frequently opened to let +in fresh air, but should be _frequently cleaned_, to let in plenty of +light and of sunshine, as nothing is so cheering and beneficial to a +child as an abundance of light and sunshine! + +_With regard to the best artificial light for a nursery._--The air of +a nursery cannot be too pure; I therefore do not advise you to have +gas in it, as gas in burning gives off quantities of carbonic acid and +sulphuretted hydrogen, which vitiate the air. The paraffine lamp, too, +makes a room very hot and close. There is no better light for a +nursery than either Price's patent candles or the old-fashioned +tallow-candle. + +Let a child's _home_ he the happiest _house_ to him in the world; and +to be happy he must be merry, and all around him should be merry and +cheerful; and he ought to have an abundance of playthings, to help on +the merriment. If he have a dismal nurse, and a dismal home, he may +as well be incarcerated in a prison, and be attended by a gaoler. It +is sad enough to see dismal, doleful men and women, but it is a truly +lamentable and unnatural sight to see a doleful child! The young ought +to be as playful and as full of innocent mischief as a kitten. There +will be quite time enough in after years for sorrow and for sadness. + +Bright colours, plenty of light, _clean_ windows (mind this, if you +please), an abundance of _good_-coloured prints, and toys without +number, are the proper furnishings of a nursery. Nursery! why, the +very name tells you what it ought to be--the home of childhood--the +most important room in the house,--a room that will greatly tend to +stamp the character of your child for the remainder of his life. + +167. _Have you any more hints to offer conducive to the well-doing of +my child_? + +You cannot be too particular in the choice of those who are in +constant attendance upon him. You yourself, of course, must be his +_head-nurse_--you only require some one to take the drudgery off your +hands! You ought to be particularly careful in the selection of his +nurse. She should be steady, lively, truthful, and good tempered; and +must be free from any natural imperfection, such as squinting, +stammering, &c., for a child is such an imitative creature that he is +likely to acquire that defect, which in the nurse is natural. +"Children, like babies, are quick at 'taking notice.' What they see +they mark, and what they mark they are very prone to copy."--_The +Times_. + +She ought not to be very young, or she may be thoughtless, careless, +and giggling. You have no right to set a child to mind a child; it +would be like the blind leading the blind. No! a child is too precious +a treasure to be entrusted to the care and keeping of a young girl. +Many a child has been ruined for life by a careless young nurse +dropping him and injuring his spine. + +A nurse ought to be both strong and active, in order that her little +charge may have plenty of good nursing; for it requires great strength +in the arms to carry a heavy child for the space of an hour or two at +a stretch, in the open air; and such is absolutely necessary, and is +the only way to make him strong, and to cause him to cut his teeth +easily, and at the same time to regulate his bowels; a noise, +therefore, most be strong and active, and not mind hard, work, for +hard work it is; but, after she is accustomed to it, pleasant +notwithstanding. + +Never should a nurse be allowed to wear a mask, nor to dress up and +paint herself as a ghost, or as any other frightful object. A child is +naturally timid and full of fears, and what would not make the +slightest impression upon a grown-up person might throw a child into +fits-- + + "The sleeping, and the dead, + Are but as pictures: 'tis the age of childhood + That fears a painted devil."--_Shakspeare_. + +Never should she be permitted to tell her little charge frightful +stories of ghosts and hobgoblins; if this be allowed, the child's +disposition will become timid and wavering, and may continue so for +the remainder of his life. + +If a little fellow were not terrified by such stories, the darkness +would not frighten him more than the light. Moreover, the mind thus +filled with fear, acts upon the body, and injures the health. A child +must never be placed in a dark cellar, nor frightened by tales of +rats, &c. Instances are related of fear thus induced impairing the +intellect for life; and there are numerous examples of sudden fright +causing a dangerous and even a fatal illness. + +_Night-terrors_.--This frightening of a child by a silly nurse +frequently brings on night-terrors. He wakes up suddenly, soon after +going to sleep, frightened and terrified; screaming violently, and +declaring that he has seen either some ghost, or thief, or some object +that the silly nurse had been previously in the day describing, who is +come for him to take him away. The little fellow is the very picture +of terror and alarm; he hides his face in his mother's bosom, the +perspiration streams down him, and it is some time before he can be +pacified--when, at length, he falls into a troubled feverish slumber, +to awake in the morning unrefreshed. Night after night these terrors +harass him, until his health materially suffers, and his young life +becomes miserable looking forward with dread to the approach of +darkness. + +_Treatment of night terrors_.--If they have been brought on by the +folly of the nurse, discharge her at once, and be careful to select a +more discreet one. When the child retires to rest, leave a candle +burning, and let it burn all night, sit with him until he be asleep, +and take care, in case he should rouse up in one of his night-terrors, +that either yourself or some kind person be near at hand. Do not scold +him for being frightened--he cannot help it, but soothe him, calm him, +fondle him, take him into your arms and let him feel that he has some +one to rest upon, to defend and to protect him. It is frequently in +these cases necessary before he can be cared to let him have change of +air and change of scene. Let him live, in the day time, a great part +of the day in the open air. + +A nurse maid should never, on any account whatever, be allowed to whip +a child. "Does ever any man or woman remember the feeling of being +'whipped' as a child, the fierce anger, the insupportable ignominy, +the longing for revenge, which blotted out all thought of contrition +for the fault or rebellion against the punishment? With this +recollection on their own parts, I can hardly suppose any parents +venturing to inflict it, much less allowing its infliction by another +under any circumstances whatever. A nurse-maid or domestic of any +sort, once discovered to have lifted up her hand against a child, +ought to meet instant severe rebuke, and on a repetition of the +offence instant dismissal." [Footnote: _A Woman's Thoughts about +Women_.] + +I have seen in the winter tune a lazy nurse sit before the fire with a +child on her lap, rubbing his cold feet just before putting him to his +bed. Now, this is not the way to warm his feet. The right method is to +let him romp and run either about the room, or the landing, or the +hall--this will effectually warm them, but, of course, it will entail +a little extra trouble on the nurse, as she will have to use a little +exertion to induce him to do so, and this extra trouble a lazy nurse +will not relish. Warming the feet before the fire will give the +little fellow chilblains, and will make him when he is in bed more +chilly. The only way for him to have a good romp before he goes to +bed, is for the mother to join in the game. She may rest assured, that +if she does so, her child will not be the only one to benefit by +it. She herself will find it of marvellous benefit to her own health; +it will warm her own feet, it will be almost sure to insure her a good +night, and will make her feel so light and buoyant as almost to fancy +that she is a girl again! Well, then, let every child, before going to +bed, hold a high court of revelry, let him have an hour--the +Children's Hour--devoted to romp, to dance, to shout, to sing, to +riot, and to play, and let him be the master of the revels-- + + + "Between the dark and the daylight, + When the night is beginning to lower, + Comes a pause in the day's occupation, + Which is known as the Children's Hour." + + _Longfellow_. + +Let a child be employed--take an interest in his employment, let him +fancy that he is useful--_and he is useful_, he is laying in a stock +of health. He is much more usefully employed than many other grown-up +children are! + +A child should be happy; he must, in every way, be made happy; +everything ought to be done to conduce to his happiness, to give him +joy, gladness, and pleasure. Happy he should be, as happy as the day +is long. Kindness should be lavished upon him. Make a child +understand that you love him; prove it in your actions--these are +better than words; look after his little pleasures--join in his little +sports; let him never hear a morose word--it would rankle in his +breast, take deep root, and in due time bring forth bitter +fruit. Love! let love be his pole-star; let it be the guide and the +rule of all you do and all you say unto him. Let your face, as well as +your tongue speak love. Let your hands be ever ready to minister to +his pleasures and to his play. "Blessed be the hand that prepares a +pleasure for a child, for there is no saying when and where it may +again bloom forth. Does not almost everybody remember some +kind-hearted man who showed him a kindness in the dulcet days of +childhood? The writer of this recollects himself, at this moment, a +bare-footed lad, standing at the wooden fence of a poor little garden +in his native village, while, with longing eyes, he gazed on the +flowers which were blooming there quietly in the brightness of the +Sabbath morning. The possessor came from his little cottage. He was a +wood-cutter by trade, and spent the whole week at work in the +woods. He had come into the garden to gather flowers to stick in his +coat when he went to church. He saw the boy, and breaking off the most +beautiful of his carnations (it was streaked with red and white), he +gave it to him. Neither the giver nor the receiver spoke a word, and +with bounding steps the hoy ran home. And now, here, at a vast +distance from that home, after so many events of so many years, the +feeling of gratitude which agitated the breast of the boy, expressed +itself on paper. The carnation has long since faded, but it now +bloometh afresh."--_Douglas Jerrold_. + +The hearty ringing laugh of a child is sweet music to the ear. There +are three most joyous sounds in nature--the hum of a bee, the purr of +a cat, and the laugh of a child. They tell of peace, of happiness, and +of contentment, and make one for a while forget that there is so much +misery in the world. + +A man who dislikes children is unnatural, he has no "milk of human +kindness" in him; he should be shunned. Give me, for a friend, a man-- + + "Who takes the children on his knee, + And winds their curls, about his hand."--_Tennyson_. + +168. _If a child be peevish, and apparently in good health, have you +any plan to propose to allay his irritability_? + +A child's troubles are soon over--his tears are soon dried; "nothing +dries sooner than a tear"--if not prolonged by improper management-- + + "The tear down childhood's check that flows + Is like the dew-drop on the rose; + When next the summer breeze comes by, + And waves the bush, the flower is dry."--_Scott_. + +Never allow a child to be teased; it spoils his temper. If he be in a +cross humour take no notice of it, but divert his attention to some +pleasing object. This may be done without spoiling him. Do not combat +bad temper with bad temper--noise with noise. Be firm, be kind, be +gentle, [Footnote: "But we were gentle among you, even as a women +cherisheth her children."--1 Thess. ii. 7.] be loving, speak quietly, +smile tenderly, and embrace him fondly, but _insist upon implicit +obedience_, and you will have, with God's blessing, a happy child-- + + "When a little child is weak + From fever passing by, + Or wearied out with restlessness + Don't scold him if he cry. + + Tell him some pretty story-- + Don't read it from a book; + He likes to watch you while you speak, + And take in every look. + + Or sometimes singing gently-- + A little song may please, + With quiet and amusing words, + And tune that flows with ease. + + Or if he is impatient, + Perhaps from time to time + A simple hymn may suit the best, + In short and easy rhyme. + + The measured verses flowing + In accents clear and mild, + May blend into his troubled thought, + And soothe the little child. + + But let the words be simple, + And suited to his mind, + And loving, that his weary heart + A resting-place may find."--_Household Verses_. + +Speak, _gently_ to a child; speak _gently_ to all; but more especially +speak _gently_ to a child. "A gentle voice is an excellent thing in a +woman," and is a jewel of great price, and is one of the concomitants +of _perfect_ lady. Let the hinges of your disposition be well +oiled. "'I have a dear friend. He was one of those well-oiled +dispositions which turn upon the hinges of the world without +creaking.' Would to heaven there were more of them! How many there are +who never turn upon the hinges of this world without a grinding that +sets the teeth of a whole household on edge! And somehow or other it +has been the evil fate of many of the best spirits to be so +circumstanced; both men and women, to whom life is 'sweet habitude of +being,' which has gone far to reconcile them to solitude as far less +intolerable! To these especially the creakings of those said rough +hinges of the world is one continued torture, for they are all too +finely strung; and the oft-recurring grind jars the whole sentient +frame, mars the beautiful lyre, and makes cruel discord in a soul of +music. How much of sadness there is in such thoughts! Seems there not +a Past in some lives, to which it is impossible ever to become +reconciled!"--_Life's Problems_. + +Pleasant words ought always to be spoken to a child; there must be +neither snarling, nor snapping, nor snubbing, nor loud contention +towards him. If there be it will ruin his temper and disposition, and +will make him hard and harsh, morose and disagreeable. + +Do not always be telling your child how wicked he is; what a naughty +boy he is; that God will never love him, and all the rest of such +twaddle and blatant inanity! Do not, in point of fact, bully him, as +many poor little fellows are bullied! It will ruin him if you do; it +will make him in after years either a coward or a tyrant. Such +conversations, like constant droppings of water, will make an +impression, and will cause him to feel that it is of no use to try to +be good--that he is hopelessly wicked! Instead of such language, give +him confidence in himself; rather find out his good points and dwell +upon them; praise him where and whenever you can; and make him feel +that, by perseverance and God's blessing, he will make a good +man. Speak truthfully to your child; if you once deceive him, he will +not believe you for the future. Not only so, but if you are truthful +yourself you are likely to make him truthful--like begets like. There +is something beautiful in truth! A lying child is an abomination! Sir +Walter Scott says "that he taught his son to ride, to shoot, and to +tell the truth" Archdeacon Hare asserts "that Purity is the feminine, +Truth the masculine of Honour." + +As soon as a child can speak he should be made to lisp the noble words +of truth, and to love it, and to abhor a lie! What a beautiful +character he will then make! Blessed is the child that can say,-- + + "Parental cares watched o'er my growing youth, + And early stamped it with the love of truth." + + _Leadbeater Papers._ + +Have no favourites, show no partiality; for the young are very +jealous, sharp-sighted, and quick-witted, and take a dislike to the +petted one. Do not rouse the old Adam in them. Let children be taught +to be "kindly affectioned one to another with brotherly love;" let +them be encouraged to share each other's toys and playthings, and to +banish selfishness. + +Attend to a child's _little_ pleasures. It is the _little_ pleasures +of a child that constitute his happiness. Great pleasures to him and +to us all (as a favourite author remarks) come but seldom, and are the +exceptions, and not the rule. + +Let a child he nurtured in love. "It will be seen," says the author of +_John Halifax_, "that I hold this law of kindness as the Alpha and +Omega of education. I once asked one, in his own house, a father in +everything but the name, his authority unquestioned, his least word +held in reverence, his smallest wish obeyed--'How did you ever manage +to bring up these children?' He said: '_By love_.'" + +Let every word and action prove that you love your children. Enter +into all their little pursuits and pleasures. Join them in their play, +and be a "child again!" If they are curious, do not check their +curiosity; but rather encourage it; for they have a great deal--as we +all have--to learn, and how can they know if they are not taught? You +may depend upon it the knowledge they obtain from observation is far +superior to that obtained from books. Let all you teach them, let all +you do, and let all you say bear the stamp of love. "Endeavour, from +first to last, in your intercourse with your children, to let it bear +the impress of _love_. It is not enough that you _feel_ affection +towards your children--that you are devoted to their interests; you +must show in your manner the fondness of your hearts towards +them. Young minds cannot appreciate great sacrifices made for them; +they judge their parents by the words and deeds of every-day +life. They are won by _little_ kindnesses, and alienated by _little_ +acts of neglect or impatience. One complaint unnoticed, one appeal +unheeded, one lawful request arbitrarily refused, will be remembered +by your little ones more than a thousand acts of the most devoted +affection."--_The Protoplast_. + +A placid, well-regulated temper is very conducive to health. A +disordered, or an over-loaded stomach, is a frequent cause of +peevishness. Appropriate treatment in such a case will, of course, be +necessary. + +169. _My child stammers: can you tell me the cause, and can you +suggest a remedy_? + +A child who stammers is generally "nervous," quick, and impulsive. His +ideas flow too rapidly for speech. He is "nervous;" hence, when he is +alone, and with those he loves, he oftentimes speaks fluently and +well; he stammers more both when he is tired and when he is out of +health--when the nerves are either weak or exhausted. He is +emotional: when he is either in a passion or in excitement, either of +joy or of grief, he can scarcely speak--"he stammers all over." He is +impulsive: he often stammers in consequence. He is in too great a +hurry to bring out his words; they do not flow in proper sequence: +hence his words are broken and disjointed. + +Stammering, of course, might be owing either to some organic defect, +such as from defective palate, or from defective brain, then nothing +will cure him; or it might be owing to "nervous" causes--to "irregular +nervous action," then a cure might, with care and perseverance, be +usually effected. + +In all cases of stammering of a child, let both the palate of his +mouth and the bridle of his tongue be carefully examined, to see that +neither the palate be defective, nor the bridle of the tongue be too +short--that he be not tongue-tied. + +_Now, with regard to Treatment._--Make him speak slowly and +deliberately: let him form each word, without clipping or chopping; +let him be made, when you are alone with him, to exercise himself in +elocution. If he speak quickly, stop him in his mid-career, and make +him, quietly and deliberately, go through the sentence again and +again, until he has mastered the difficulty; teach him to collect his +thoughts, and to weigh each word ere he give it utterance; practise +him in singing little hymns and songs for children; this you will find +a valuable help in the cure. A stammerer seldom stutters when he +sings. When he sings, he has a full knowledge of the words, and is +obliged to keep in time--to sing neither too fast nor too +slow. Besides, he sings in a different key to his speaking voice. Many +professors for the treatment of stammering cure their patients by +practising lessons of a sing-song character. + +Never jeer him for stammering, nor turn him to ridicule; if you do, it +will make him ten times worse; but be patient and gentle with him, and +endeavour to give him confidence, and encourage him to speak to you as +quietly, as gently, and deliberately as you speak to him; tell him not +to speak, until he has arranged his thoughts and chosen his words; let +him do nothing in a hurry. + +Demosthenes was said, in his youth, to have stammered fearfully, and +to have cured himself by his own prescription, namely, by putting a +pebble in his mouth, and declaiming, frequently, slowly quietly, and +deliberately, on the sea-shore--the fishes alone being his audience,-- +until at length he cured himself, and charmed the world with his +eloquence and with his elocution. He is held up, to this very day, as +the personification and as the model of an orator. His patience, +perseverance, and practice ought, by all who either are, or are, +interested in a stammerer, to be borne in mind and followed. + +170. _Do you approve of a carpet in a nursery_? + +No, unless it be a small piece for a child to roll upon. A carpet +harbours dirt and dust, which dust is constantly floating about the +atmosphere, and thus making it impure for him to breathe. The truth of +this may be easily ascertained by entering a darkened room, where a +ray of sunshine is struggling through a crevice in the shutters. If +the floor of a nursery must be covered, let drugget be laid down, and +this may every morning be taken up and shaken. The less furniture a +nursery contains the better, for much furniture obstructs the free +circulation of the air, and, moreover, prevents a child from taking +proper play and exercise in the room--an abundance of which are +absolutely necessary for his health. + +171. _Supposing there is not a fire in the nursery grate, ought the +chimney to be stopped to prevent a draught in the room_? + +Certainly not. I consider the use of a chimney to be two-fold--first, +to carry off the smoke, and secondly (which is of quite as much +importance), to ventilate the room, by carrying off the impure air, +loaded as it is with carbonic acid gas--the refuse of respiration. The +chimney, therefore, should never, either winter or summer, be allowed +for one moment to be stopped. This is important advice, and requires +the strict supervision of every mother, as servants will, if they have +the chance, stop all chimneys that have no fires in the grates. + + +EXERCISE. + +172. _Do you approve, during the summer months, of sending a child out +BEFORE breakfast_? + +I do, when the weather will permit, and provided the wind be neither +in an easterly nor in a north-easterly direction; indeed, _he can +scarcely be too much in the open air_. He must not be allowed to stand +about draughts or about entries, and the only way to prevent him doing +so is for the mother herself to accompany the nurse. She will then +kill two birds with one stone, as she will, by doing so, benefit her +own as well as her child's health. + +173. _Ought a child to be early put on his feet to walk_? + +No: let him learn to walk himself. He ought to be put upon a carpet; +and it will be found that when he is strong enough, he will hold by a +chair, and will stand alone: when he can do so, and attempts to walk, +he should then be supported. You must, on first putting him upon his +feet, be guided by his own wishes. He will, as soon as he is strong +enough to walk, have the inclination to do so. When he has the +inclination and the strength it will be folly to restrain him; if he +have neither the inclination nor the strength, it will be absurd to +urge him on. Rely, therefore, to a certain extent, upon the +inclination of the child himself. Self-reliance cannot be too early +taught him, and, indeed, every one else. In the generality of +instances, however, a child is put on his feet too soon, and the +bones, at that tender age, being very flexible, bend, causing bowed +and bandy-legs; and the knees, being weak, approximate too closely +together, and thus they become knock-kneed. This advice of _not_ +putting a child _early_ on his feet, I must strongly insist on, as +many mothers are so ridiculously ambitious that their young ones +should walk early--that they should walk before other children of +their acquaintance have attempted--that they have frequently caused +the above lamentable deformities; which is a standing reproach to them +during the rest of their lives. + +174. _Do you approve of perambulators_? + +I do not, for two reasons:--first, because when a child is strong +enough, he had better walk as much as he will; and, secondly, the +motion is not so good, and the muscles are not so much put into +action, and consequently cannot be so well developed, as when he is +earned. A perambulator is very apt to make a child stoop, and to make +him both crooked and round-shouldered. He is cramped by being so long +in one position. It is painful to notice a babe of a few months old in +one of these newfangled carriages. His little head is bobbing about +first on one side and then on the other--at one moment it is dropping +on his chest, the next it is forcibly jolted behind: he looks, and +doubtless feels, wretched and uncomfortable. Again, these +perambulators are dangerous in crowded thoroughfares. They are a +public nuisance, inasmuch as they are wheeled against and between +people's legs, and are a fruitful source of the breaking of shins, of +the spraining of ankles, of the crushing of corns, and of the ruffling +of the tempers of the foot-passengers who unfortunately come within +their reach; while, in all probability, the gaping nurses are staring +another way, and every way indeed but the right, more especially if +there be a redcoat in the path! + +Besides, in very cold weather, or in a very young infant, the warmth +of the nurse's body, while he is being carried, helps to keep him +warm, he himself being naturally cold. In point of fact, the child, +while being borne in the nurse's arms, reposes on the nurse, warm and +supported, as though he were in a nest! While, on the other hand, if +he be in a perambulator, he is cold and unsupported, looking the very +picture of misery, seeking everywhere for test and comfort, and +finding none! + +A nurse's arm, then, is the only proper carriage for a _young_ child +to take exercise on. She ought to change about, first carrying frim on +the one arm, and then on the other. Nursing him on one arm only might +give his body a twist on one side, and thus might cause deformity. + +When he is old enough to walk, and is able properly to support the +weight of his own neck and back, then there will be no objection, +provided it be not in a crowded thoroughfare, to his riding +occasionally in a perambulator; but when he is older still, and can +sit either a donkey or a pony, such exercise will be far more +beneficial, and will afford him much greater pleasure. + +175. _Supposing it to be wet under foot, but dry above, do you then +approve of sending a child out_? + +If the wind be neither in the east nor the north-east, and if the air +be not damp, let him be well wrapped up and be sent out. If he be +labouring under an inflammation of the lungs, however slight, or if he +be just recovering from one, it would, of coarse, be highly improper. +In the management of a child, we must take care neither to coddle nor +to expose him unnecessarily, as both are dangerous. + +Never send a child out to walk in a fog; he will, if you do, be almost +sure to catch cold. It would be much safer to send him out in rain +than in fog, though neither the one nor the other would be desirable. + +176. _How many times a day in fine weather ought a child to be sent +out_? + +Let him be sent out as often as it be possible. If a child lived more +in the open air than he is wont to do, he would neither be so +susceptible of disease, nor would he suffer so much from teething, nor +from catching cold. + +177. _Supposing the day to be wet, what exercise would you then +recommend_? + +The child ought to run either about a large room, or about the hall; +and if it does not rain violently, you should put on his hat and throw +up the window, taking care while the window is open that he does not +stand still. A wet day is the day for him to hold his high court of +revelry, and "to make him as happy as the day is long." + +Do not on any account allow him to sit any length of time at a table, +amusing himself with books, &c.; let him be active and stirring, that +his blood may freely circulate as it ought to do, and that his muscles +may be well developed. I would rather see him actively engaged in +mischief than sitting still, doing nothing! He ought to be put on the +carpet, and should then be tumbled and rolled about, to make the blood +bound merrily through, the, vessels, to stir up the liver, to promote +digestion, and to open the bowels. The misfortune of it is, the +present race of nurses are so encumbered with long dresses, and so +screwed in with tight stays (aping their betters), that they are not +able to stoop properly, and thus to have a good game of romps with +their little charges. "Doing nothing is doing ill" is as true a saying +as was ever spoken. + +178. _Supposing it to be winter, and the weather to be very cold, +would you still send a child out_? + +Decidedly, provided he be well wrapped up. The cold will brace and +strengthen him. Cold weather is the finest tonic in the world. + +In frosty weather, the roads being slippery, when you send him out to +walk, put a pair of large old woollen stockings over his boots or +shoes. This will not only keep his feet and his legs warm, but it will +prevent him from falling down and hurting himself. While thus +equipped, he may even walk on a slide of ice without falling down! + +A child, in the winter time, requires, to keep him warm, plenty of +flannel and plenty of food, plenty of fresh and genuine milk, and +plenty of water in his tub to wash and bathe him in a morning, plenty +of exercise and plenty of play, and then he may brave the frosty air. +It is the coddled, the half-washed, and the half-starved child +(half-washed and half-starved from either the mother's ignorance or +from the mother's timidity), that is the chilly starveling,--catching +cold at every breath of wind, and every time he either walks or is +carried out,--a puny, skinny, scraggy, scare-crow, more dead than +alive, and more fit for his grave than for the rough world he will +have to struggle in! If the above advice be strictly followed, a child +may be sent out in the coldest weather, even-- + + "When icicles hang by the wall, + And Dick, the shepherd, blows his nail; + And Tom bears logs into the hall, + And milk comes frozen home in pail." + + _Shakspeare_. + + +AMUSEMENTS. + +179. _Have you any remarks to make on the amusements of a child_? + +Let the amusements of a child be as much as possible out of doors; let +him spend the greater part of every day in the open air; let him exert +himself as much as he please, his feelings will tell him when to rest +and when to begin again; let him be what Nature intended Mm to be--a +happy, laughing, joyous child. Do not let him be always poring over +books:-- + + "Books! 'tis a dull and endless strife, + Come, hear the woodland linnet! + How sweet his music! On my life, + There's more of wisdom in it. + + And hark! how blithe the throstle sings! + He, too, is no mean preacher: + Come forth into the light of things,-- + Let Nature be your teacher. + + She has a world of ready wealth, + Our minds and hearts to bless,-- + Spontaneous wisdom breathed by health, + Truth breathed by cheerfulness. + + One impulse from a vernal wood + May teach you more of man, + Of moral evil and of good, + Than, all the sagea can."--_Wordsworth._ + +He ought to be encouraged to engage in those sports wherein the +greatest number of muscles are brought into play. For instance, to +play at ball, or hoop, or football, to play at horses, to run to +certain distances and back; and, if a girl, to amuse herself with a +skipping rope, such, being excellent exercise-- + + "By sports like these are all their cares beguiled, + The sports of children satisfy the child."--_Goldsmith._ + +Every child, where it be practicable, should have a small plot of +ground to cultivate, that he may dig and delve in, and make dirt-pies +if he choose. Children now-a-days, unfortunately, are not allowed to +soil their hands and their fine clothes. For my own part, I dislike +such model children; let a child be natural--let him, as far as is +possible, choose his own sports. Do not be always interfering with his +pursuits, and be finding fault with him. Remember, what may be amusing +to you may be distasteful to him. I do not, of course, mean but that +you should constantly have a watchful eye over him; yet do not let him +see that he is under restraint or surveillance; if you do, you will +never discover his true character and inclinations. Not only so, but +do not dim the bright sunshine of his early life by constantly +checking and thwarting him, Tupper beautifully says-- + + "And check not a child in his merriment,-- + Should not his morning be sunny?" + +When, therefore, he is either in the nursery or in the play-ground, +let him shout and riot and romp about as much as he please. His lungs +and his muscles want developing, and his nerves require strengthening; +and how can such be accomplished unless you allow them to be developed +and strengthened by natural means? + +The nursery is a child's own domain; it is his castle, and he should +be Lord Paramount therein. If he choose to blow a whistle, or to +spring a rattle, or to make any other hideous noise, which to him is +sweet music, he should be allowed, without let or hindrance, to do +so. If any members of the family have weak nerves, let them keep at a +respectful distance. + +A child who never gets into mischief must be either sly, or delicate, +or idiotic; indeed, the system of many persons, in bringing up +children, is likely to make them either the one or the other. The +present plan of training children is nearly all work (books), and very +little play. Play, and plenty of it, is necessary to the very +existence of a child. + +A boy not partial to mischief, innocent mischief, and play, is +unnatural; he is a man before his time, he is a nuisance, he is +disagreeable to himself and to every one around. He is generally a +sneak, and a little humbug. + +Girls, at the present time, are made clever simpletons; their brains +are worked with useless knowledge, which totally unfits them for +every-day duties. Their muscles are allowed to be idle, which makes +them limp and flabby. The want of proper exercise ruins the +complexion, and their faces become of the colour of a tallow candle! +And precious wives and mothers they make when they do grow up! Grow +up, did I say? They grow all manner of ways, and are as crooked as +crooked sticks! + +What an unnatural thing it is to confine a child several hours a day +to his lessons; why, you might as well put a colt in harness, and make +him work for his living! A child is made for play; his roguish little +eye, his lithe figure, his antics, and his drollery, all point out +that he is cut out for play--that it is as necessary to his existence +as the food he eats, and as the air he breathes! + +A child ought not to be allowed to have playthings with which he can +injure either himself or others, such as toy-swords, toy-cannons, +toy-paint-boxes, knives, bows and arrows, hammers, chisels, saws, +&c. He will not only be likely to injure himself and others, but will +make sad havoc on furniture, house, and other property. Fun, frolic, +and play ought, in all innocent ways, to be encouraged; but wilful +mischief and dangerous games ought, by every means, to be +discountenanced. This advice is frequently much needed, as children +prefer to have and delight in dangerous toys, and often coax and +persuade weak and indulgent mothers to gratify their wishes. + +_Painted_ toys are, many of them, highly dangerous, those painted +_green_ especially, as the colour generally consists of Scheele's +green--arsenite of copper. + +Children's paint-boxes are very dangerous toys for a child to play +with; many of the paints are poisonous, containing arsenic, lead, +gamboge, &c, and a child, when painting, is apt to put the brush into +his mouth, to absorb the superabundant fluid. Of all the colours, the +_green_ paint is the most dangerous, as it is frequently composed of +arsenite of copper--arsenic and copper--two deadly poisons. + +There are some paint-boxes warranted not to contain a particle of +poison of any kind these ought, for a child, to be chosen by a mother. + +But, remember, although he ought not to be allowed to have poison +paint-boxes and poison painted toys, _he must have an abundance of +toys,_ such as the white wood toys--brewers' drays, millers' waggons, +boxes of wooden bricks, &c. The Noah's Ark is one of the most amusing +and instructive toys for a child. "Those fashioned out of brown, +unpainted pine-wood by the clever carvers of Nuremberg or the Black +Forest are the best, I think, not only because they are the most +spirited, but because they will survive a good deal of knocking about +and can be sucked with impunity From the first dawn of recollection, +children are thus familiarised with the forms of natural objects, and +may be well up in natural history before they have mastered the ABC" +[Footnote: From an excellent article _About Toys,_ by J Hamilton Fyfe +in _Good Words_ for December 1862.] + +Parents often make Sunday a day of gloom; to this I much object. Of +all the days in the week, Sunday should be the most cheerful and +pleasant. It is considered by our Church a festival, and a glorious +festival it ought to be made, and one on which our Heavenly Father +wishes to see all His children happy and full of innocent joy. Let +Sunday, then, be made a cheerful, joyous, innocently happy day, and +not, as it frequently is, the most miserable and dismal in the +week. It is my firm conviction that many men have been made +irreligious by the ridiculously strict and dismal way they were +compelled, as children, to spend their Sundays. You can no more make +a child religious by gloomy asceticism, than yon can make people good +by Act of Parliament. + +One of the great follies of the present age is, children's parties, +where they are allowed to be dressed up like grown-up women, stuck out +in petticoats, and encouraged to eat rich cake and pastry, and to +drink wine, and to sit up late at night! There is something disgusting +and demoralising in all this. Their pure minds are blighted by it. Do +not let me be misunderstood: there is not the least objection, but, on +the contrary, great advantage, for friends' children to meet friends' +children; but then let them be treated as children, and not as men and +women! + +180. _Do you approve of public play-grounds for children_? + +It would be well, in every village, and in the outskirts of every +town, if a large plot of ground were set apart for children to play +in, and to go through regular gymnastic exercises. Play is absolutely +necessary to a child's very existence, as much as food and sleep; but +in many parts of England where is he to have it? Playgrounds and play +are the best schools we have; they teach a great deal not taught +elsewhere; they give lessons in health, which is the grandest wealth +that can be bestowed--"for health is wealth;" they prepare the soil +for the future schoolmaster; they clear the brain, and thus the +intellect, they strengthen the muscles; they make the blood course +merrily through the arteries; they bestow healthy food for the lungs; +they give an appetite; they make a child, in due time, become every +inch a man! Play-grounds and play are one of the finest institutions +we possess. What would our large public schools be without their play +and cricket grounds? They would be shorn of half their splendour and +their usefulness! + +There is so much talk now-a-days about _useful_ knowledge, that the +importance of play and play-grounds is likely to be forgotten. I +cannot help thinking however, that a better state of things is +dawning. "It seems to be found out that in our zeal for useful +knowledge, that knowledge is found to be not the least useful which +treat boys as active, stirring, aspiring, and ready." [Footnote: _The +Saturday Review_, December 13, 1862.] + +181. _Do you approve of infant schools_? + +I do, if the arrangements be such that health is preferred before +learning. [Footnote: "According to Aristotle, more care should be +taken of the body than of the mind for the first seven years; strict +attention to diet be enforced, &c. . . . . . The eye and ear of the +child should be most watchfully and severely guarded against +contamination of every kind, and unrestrained communication with +servants be strictly prevented. Even his amusements should be under +due regulation, and rendered as interesting and intellectual as +possible."--The Rev John Williams, in his _Life and Actions of +Alexander the Great_] Let children be only confined for three or four +hours a day, and let what little they learn be taught as an amusement +rather than as a labour. A play-ground ought to be attached to an +infant school; where, in fine weather, for every half-hour they spend +in-doors, they should spend one in the open air; and, in wet weather, +they ought to have, in lieu of the play-ground, a large room to romp, +and shout, and riot in. To develop the different organs, muscles, and +other parts of the body, children require fresh air, a free use of +their lungs, active exercise, and their bodies to be thrown into all +manner of attitudes. Let a child mope in a corner, and he will become +stupid and sickly. The march of intellect, as it is called, or rather +the double quick march of intellect, as it should be called, has +stolen a march upon health. Only allow the march of intellect and the +march of health to take equal strides, and then we shall have "_mens +sana in corpore sano_" (a sound mind in a sound body). + +In the education of a young child, it is better to instruct him by +illustration, by pictures, and by encouraging observation on things +around and about him, than by books. It is surprising how much, +without endangering his health, may be taught in this way. In +educating your child, be careful to instil and to form good +habits--they will then stick to him for life. + +Children at the present day are too highly educated--their brains are +over-taxed, and thus weakened. The consequence is, that as they grow +up to manhood, if they grow up at all, they become fools! _Children_ +are now taught what formerly _youths_ were taught. The chord of a +child's life is ofttimes snapped asunder in consequence of over +education:-- + + "Screw not the cord too sharply, lest it snap"--_Tennyson_. + +You should treat a child as you would a young colt. Think only at +first of strengthening his body. Let him have a perfectly free, happy +life, plenty of food to eat, abundance of air to breathe, and no work +to do; there is plenty of time to think of his learning--of giving him +brain work. It will come sadly too soon; but do not make him old +before his time. + +182. _At what age do you advise my child to begin his course of +education--to have his regular lessons_? + +In the name of the prophet,--Figs! Fiddlesticks! about courses of +education and regular lessons for a child! You may as well ask me +when he, a child, is to begin Hebrew, the Sanscrit, and Mathematics! +Let him have a course of education in play; let him go through regular +lessons in foot-ball, bandy, playing at tic, hares and hounds, and +such like excellent and really useful and health-giving lessons. Begin +his lessons! Begin brain work, and make an idiot of him! Oh! for +shame, ye mothers! You who pretend to love your children so much, and +to tax, otherwise to injure, irreparably to injure their brains, and +thus their intellects and their health, and to shorten their very +days. And all for what? To make prodigies of them! Forsooth! to make +fools of them in the end, + +183. _Well, then, as you have such a great objection to a child +commencing his education early in life, at what age may he, with +safety, commence his lessons? and which do you prefer--home or school +education_? + +Home is far preferable to a school education. He is, if at home, under +your own _immediate_ observation, and is not liable to be contaminated +by naughty children; for, in every school, there is necessarily a +great mixture of the good and of the bad; and a child, unfortunately, +is more likely to be led by the bad than by the good. Moreover, if he +be educated at home, the mother can see that his brain is not +over-worked. At school the brain is apt to be over-worked, and the +stomach and the muscles to be under-worked. + +Remember, as above stated, _the brain must have but very little work +until the child be seven years old;_ impress this advice upon your +memory, and let no foolish ambition to make your child a clever child +allow you, for one moment, to swerve from this advice. + +Build up a strong, healthy body, and in due time the brain will bear a +_moderate_ amount of intellectual labour. + +As I have given _you_ so much advice, permit me, for one moment, to +address a word to the father of your child:-- + +Let me advise you, then, Mr. _Pater familias_, to be careful how you +converse, what language you use, while in the company of your +child. Bear in mind, a child is very observant, and thinks much, +weighs well, and seldom forgets all you say and all you do! Let no +hasty word, then, and more especially no oath, or no impious language, +ever pass your lips, if your child be within hearing. It is, of +course, at all times wicked to swear; but it is heinously and +unpardonably sinful to swear in the presence of your child! "Childhood +is like a mirror, catching and reflecting images. One impious or +profane thought, uttered by a parent's lip, may operate upon the young +heart like a careless spray of water thrown upon polished steel, +staining it with rust, which no after scouring can efface." + +Never talk secrete before a child--"little pitchers have long ears;" +if you do, and he disclose your secrets--as most likely he will--and +thus make mischief, it will be cruel to scold him; you will, for your +imprudence, have yourself only to blame. Be most careful, then, in the +presence of your child, of what you say, and of whom you speak. This +advice, if followed, might save a great deal of annoyance and +vexation. + +184. _Are you an advocate for a child being taught singing?_ + +I am: I consider singing a part of his education. Singing expands the +walls of his chest, strengthens and invigorates his lungs, gives +sweetness to his voice, improves his pronunciation, and is a great +pleasure and amusement to him. + + +SLEEP. + +185. _Do you approve of a child sleeping on a_ FEATHER _bed_? + +A _feather_ bed enervates his body, and, if he be so predisposed, +causes rickets, and makes him crooked. A horse-hair mattress is the +best for a child to lie on. The pillow, too, should be made of +horse-hair. A _feather_ pillow often causes the bead to be bathed in +perspiration, thus enervating the child, and making him liable to +catch cold. If he be at all rickety, if he be weak in the neck, if he +be inclined to stoop, or if he be at all crooked, let him, by all +means, lie without a pillow. + +186. _Do you recommend a child, in the middle of the day, to be put to +sleep_? + +Let him be put on his mattress _awake_, that he may sleep for a couple +of hours before dinner, then he will rise both refreshed and +strengthened for the remainder of the day. I said, let him be put down +_awake_. He might, for the first few times, cry, but, by perseverance, +he will without any difficulty fall to sleep. The practice of sleeping +before dinner ought to be continued until he be three years old, and, +if he can be prevailed upon, even longer. For if he do not have sleep +in the middle of the day, he will all the afternoon and the evening be +cross; and when he does go to bed, he will probably be too tired to +sleep, or his nerves having been exhausted by the long wakefulness, he +will fall into a troubled, broken slumber, and not into that sweet, +soft, gentle repose, so characteristic of healthy, happy childhood! + +187. _At what hour ought a child to be put to bed in the evening_? + +At six in the winter, and at seven o'clock in the summer. _Regularity_ +ought to be observed, _as regularity is very conducive to health._ It +is a reprehensible practice to keep a child up until nine or ten +o'clock at night. If this be done, he will, before his time, become +old, and the seeds of disease will be sown, + +As soon as he can run, let him be encouraged, for half an hour before +he goes to bed, to race either about the hall, or the landing, or a +large room, which will be the best means of warming his feet, of +preventing chilblains, and of making him sleep soundly. + +188. _Have you any directions to give me at to the placing of my child +in his bed_? + +If a child lie alone, place him fairly on his aide in the middle of +the bed; if it be winter time, see that his arms and hands be covered +with the bed-clothes; if it be summer, his hands might be allowed to +be outside the clothes. In putting him down to sleep, you should +ascertain that his face be not covered with the bedclothes; if it be, +he will he poisoned with his own breath--the breath constantly giving +off carbonic acid gas; which gas must, if his face be smothered in the +clothes; be breathed--carbonic acid gas being highly poisonous. + +You can readily prove the existence of carbonic and gas in the +breathing, by simply breathing into a little lime-water; after +breathing for a few seconds into it, a white film will form on the +top; the carbonic acid gas from the breath unites with the lime of the +lime-water and the product of the white film is carbonate of lime. + +189. _Do you advise a bedroom to be darkened at night_? + +Certainly: a child sleeps sounder and sweeter in a dark than in a +light room. There is nothing better for the purpose of darkening a +bedroom, than Venetian blinds. Remember, then, a well-ventilated, but +a darkened, chamber at night. The cot or the crib ought _not_ to face +the window, "as the light is best behind." [Footnote: Sir Charles +Locock in a Letter to the Author. ] + +190. _Which is the beat position for a child when sleeping--on his +back, or on his side_? + +His side: he ought to be accustomed to change about on the right side +one night, on the left another; and occasionally, for a change, he +should lie on his back. By adopting this plan, you will not only +improve his figure, but likewise his health. Lying, night after night, +in one position, would be likely to make him crooked. + +191. _Do you advise, in the winter time, that there should be a fire +in the night nursery_? + +Certainly not, unless the weather be intensely cold. I dislike fires +in bedrooms, especially for children; they are very enervating, and +make a child liable to catch cold. Cold weather is very bracing, +particularly at night "Generally speaking," says the _Siecle_, "during +winter, apartments are too much heated. The temperature in them ought +not to exceed 16 deg. Centigrade (59 deg. Fahrenheit); and even in periods of +great cold scientific men declare that 12 deg. or 14 deg. had better not be +exceeded. In the wards of hospitals, and in the chambers of the sick, +care is taken not to have greater heat than 15 deg.. Clerks in offices, +and other persons of sedentary occupations, when rooms in which they +sit are too much heated, are liable to cerebral [brain] congestion and +to pulmonary [lung] complaints. In bedrooms, and particularly those of +children, the temperature ought to be maintained rather low; it is +even prudent only rarely to make fires in them, especially during the +night" + +If "a cold stable make a healthy horse," I am quite sure that a +moderately cold and well-ventilated bedroom helps to make a healthy +child. But, still, in the winter time, if the weather be biting cold, +a _little_ fire in the bedroom grate is desirable. In bringing up +children, we must never run into extremes--the coddling system and the +hardening system are both to be deprecated; the coddling system will +make the strong child weakly, while the hardening system will probably +kill a delicate one. + +A child's bed ought, of course, to be comfortably clothed with +blankets--I say blankets, as they are much superior to coverlids; the +perspiration will more readily pass through a blanket than a +coverlid. A _thick_ coverlid ought never to be used; there is nothing +better, for a child's bed, than the old-fashioned patchwork coverlid, +as the perspiration will easily escape through it. + +192. _Should a child be washed and dressed_ AS SOON AS HE AWAKE _in +the morning_? + +He ought, if he awake in anything like reasonable time; for if he doze +after he be once awake, such slumber does him more harm than good. He +should be up every morning as soon as it is light If, as a child, he +be taught to rise early, it will make him an early riser for life, and +will tend greatly to prolong both his existence and his happiness. + +_Never awake a child from his sleep_ to dress him, to give him +medicine, or for any other purpose; _let him always sleep as long as +he can;_ but the moment he awakes let him be held out, and then let +him be washed and dressed, and do not wait, as many a silly nurse +does, until he have wet his bed, until his blood be chilled, and until +he be cross, miserable, and uncomfortable! How many babes are made +ill by such foolish practices! + +The moment he leaves his bed, turn back to the fullest extent the +clothes, in order that they may be thoroughly ventilated and +sweetened. They ought to be exposed to the air for at least an hour +before the bed be made. As soon as he leaves his room, be it winter or +summer, throw open the windows. + +193. _Ought a child to lie alone_? + +He should, after he is weaned. He will rest more comfortably, and his +sleep will be more refreshing. + +194. _Supposing a child should not sleep well, what ought to be done? +Would you give him a dose of composing medicine_? + +Certainly not. Try the effects of exercise. Exercise in the open air +is the best composing medicine in the world. Let the little fellow be +well tired out, and there will be little fear of his not sleeping. + +195. _Have you any further observations to make on the subject of +sleep_? + +Send a child joyful to bed. Do not, if you can possibly help it, let +him go to bed crying. Let the last impressions he has at night be of +his happy home, and of his loving father and mother and let his last +thoughts be those of joy and gladness. He will sleep all the sounder +if he be sent to bed in such a frame of mind, and he will be more +refreshed and nourished in the morning by his sleep. + +196. _What are the usual causes of a child walking in his sleep, and +what measures during such times, ought to be adopted to prevent his +injuring himself_? + +A disordered stomach, in a child of nervous temperament, or worms, are +usually the causes. The means to be adopted to prevent his throwing +himself out of the window, are to have bars to his chamber present, +and if that be not practicable, to have either nails or screws driven +into the window sash to allow the window to open only for a sufficient +space for ventilation, and to have a screw window fastening, in order +that he cannot, without difficulty, open the window, to have a trusty +person to sleep in his room, who should have directions given not to +rouse him from his sleep, but to gently lead him back to his bed, +which may frequently be done without awaking him, and to consult a +medical man, who will adopt means to destroy the worms, to put his +stomach into order, to brace his nerves, and to strengthen his general +system. A trip to the coast and sea bathing, in such a case, is often +of great service. + + +SECOND DENTITION. + +197. _When does a child commence to cut his SECOND set of teeth_? + +Generally at seven years old. He _begins to cut_ them at about that +time: but it should be borne in mind (so wonderful are the works of +God) that the _second_ crop of teeth, _in embryo_, is actually bred +and formed from the very commencement of his life, _under_ the first +tier of teeth, but which remain in abeyance for years, and do not come +into play until the _first_ teeth, having done their duty, loosen and +fall out, and thus make room for the more numerous, larger, stronger, +and more permanent teeth, which latter have to last for the remainder +of his existence. The _first_ set is sometimes cut with a great deal +of difficulty, and produces various diseases; the _second_, or +permanent teeth, come easily, and are unaccompanied with any disorder. +The following is the process:--One after another of the _first_ set +gradually loosen, and either drop out, or with little pain are readily +pulled out; under these, the _second_--the permanent--teeth make their +appearance, and fill up the vacant spaces. The fang of the tooth that +has dropped out is nearly all absorbed or eaten away, leaving little +more than the crown. The _first_ set consists of twenty; the _second_ +(including the wise-teeth, which are not, generally cut until after +the the age of twenty-seven) consists of thirty-two. + +I would recommend you to pay particular attention to the teeth of your +children; for, besides their being ornamental, their regularity and +soundness are of great importance to the present as well as to the +future health of your offspring. If there be any irregularity in the +appearance of the _second_ set, lose no time in consulting an +experienced and respectable dentist. + + +ON DISEASE, ETC. + +198. _Do you think it important that I should be made acquainted with +the symptoms of the SERIOUS diseases of children_? + +Certainly I am not advocating the doctrine of a mother _treating +serious_ diseases; far from it, it is not her province, except in +certain cases of extreme urgency, where a medical man cannot be +procured, and where delay might be death; but I do insist upon the +necessity of her knowing the _symptoms_ of disease. My belief is, that +if parents were better informed on such subjects, many children's +lives might be saved, much suffering averted, and sorrow spared. The +fact is, the knowledge of the symptoms of disease is, to a mother, +almost a sealed book. If she were better acquainted with these +matters, how much more useful would she be in a sick-room, and how +much more readily would she enter into the plans and views of the +medical man! By her knowledge of the symptoms, and by having his +advice in time, she would nip disease in the bud, and the fight might +end in favour of life, for "sickness is just a fight between life and +death."--_Geo. M'Donald._ + +It is really lamentable to contemplate the amount of ignorance that +still exists among mothers in all that appertains to the diseases of +children; although, fortunately, they are beginning to see and to feel +the importance of gaining instruction on such subjects; but the light +is only dawning. A writer of the _Medical Times and Gazette_ makes the +following remarks, which somewhat bear on the subject in question. He +observes--"In spite of the knowledge and clear views possessed by the +profession on all that concerns the management of children, no fact is +more palpable than that the most grievous ignorance and incompetency +prevail respecting it among the public. We want some means of making +popular the knowledge which is now almost restricted to medical men, +or, at most, to the well-educated classes." + +In the earlier editions of this work I did not give the _treatment_ of +any serious diseases, however urgent. In the eight last editions, I +have been induced, for reasons I will presently state, to give the +_treatment_ of some of the more urgent _serious_ diseases, when a +medical man cannot instantly be procured, and where delay might be +death. + +Sir CHARLES LOCOCK, who has taken a kind interest in this little work, +has given me valid reasons why a mother should be so enlightened. The +following extracts are from a letter which I received from Sir CHARLES +on the subject, and which he has courteously allowed me to publish. He +says,--"As an old physician of some experience in complaints of +infants and children, I may perhaps be allowed to suggest that in a +future edition you should add a few words on the actual treatment of +some of the more urgent infantile diseases. It is very right to +caution parents against superseding the doctor, and attempting to +manage serious illness themselves, but your advice, with very small +exceptions, always being 'to lose no tune in sending for a medical +man,' much valuable and often irremediable time may be lost _when a +medical man is not to be had_. Take, for instance, a case of croup +there are no directions given at all, except to send for a medical +man, and always to keep medicines in the house which he may have +directed. But how can this apply to a first attack? You state that a +first attack is generally the worst. But why is it so? Simply because +it often occurs when the parents do not recognise it, and it is +allowed to get a worse point than in subsequent attacks, when they are +thoroughly alive to it. As the very best remedy, and often the only +essential one, if given early, is a full emetic, surely it is better +that you should give some directions as to this in a future edition, +and I can speak from my own experience when I say that an emetic, +_given in time_, and repeated to free vomiting, will cut short _any_ +case of croup. In nine cases out of ten the attack takes place in the +evening or early night, and when vomiting is effected the dinner of +that day is brought up nearly undigested, and the seventy of the +symptoms at once cut short. Whenever any remedy is valuable, the more +by its being administered _in time_, it is surely wiser to give +directions as to its use, although, as a general rule, it is much +better to advise the sending for medical advice." + +The above reasons, coming from such a learned and experienced +physician as Sir Charles Locock, are conclusive, and have decided me +to comply with his advice, to enlighten a mother on the _treatment_ of +some of the more urgent diseases of infants and of children. In a +subsequent letter addressed to myself, Sir Charles has given me the +names of those _urgent_ diseases, which he considers may be treated by +a mother "where a medical man cannot be procured quickly, or not at +all." They are Croup: Inflammation of the Lungs; Diptheria; Dysentry; +Diarrhoea; Hooping Cough, in its various stages; and Shivering +Fit. Sir Charles sums up his letter to me by saying, "Such a book +ought to be made as complete as possible, and the objections to +medical treatment being so explained as to induce mothers to try to +avoid medical men is not so serious as that of leaving them without +any guide in those instances where every delay is dangerous, and yet +where medical assistance is not to be obtained or not to be had +quickly." + +In addition to the above I shall give you the _treatment_ of +Bronchitis, Measles, and Scarlet Fever. Bronchitis is one of the most +common diseases incidental to childhood, and, with judicious +treatment, is, in the absence of the medical man, readily managed by a +sensible mother. Measles is very submissive to treatment. Scarlet +Fever, _if it be not malignant_, and, _if it be not complicated with +diphtheric-croup_, and if certain rules be strictly followed, is also +equally amenable to treatment. + +I have been fortunate in treating Scarlet Fever, and I therefore think +it desirable to enter fully into the _treatment_ of a disease which is +looked upon by many parents, and, according to the usual mode of +treatment, with just cause, with great consternation and dread. By +giving my plan of treatment, fully and simply, and without the +slightest reservation, I am fully persuaded, through God's blessing, +that I may be the humble means of saving the lives of numbers of +children. + +The diseases that might be treated by a mother, in the absence of a +medical man, will form the subject of future Conversations. + +I think it right to promise that in all the prescriptions for a child +I have for the use of a mother given, I have endeavoured to make them +as simple as possible, and have, whenever practicable, avoided to +recommend powerful drugs. Complicated prescriptions and powerful +medicines might, as a rule, to be seldom given; and when they are, +should only be administered by a judicious medical man: a child +requiring much more care and gentleness in his treatment than an +adult: indeed, I often think it would be better to leave a child to +nature rather than to give him powerful and large doses of +medicines. A remedy--calomel, for instance--has frequently done more +mischief than the disease itself; and the misfortune of it is, the +mischief from that drug has oftentimes been permanent, while the +complaint might, if left alone, have only been temporary. + +199. _At what age does Water in the Brain usually occur, and how is a +mother to know that her child is about to labour under that disease_? + +Water on the brain is, as a rule, a disease of childhood: after a +child is seven years old it is comparatively rare. It more frequently +attacks delicate children--children who have been dry nursed +(especially if they have been improperly fed), or who have been +suckled too long, or who have had consumptive mothers, or who have +suffered severely from toothing, or who are naturally of a feeble +constitution. Water on the brain sometimes follows an attack of +inflammation of the lungs, more especially if depressing measures +(such as excessive leeching and the administration of emetic tartar) +have been adopted. It occasionally follows in the train of contagious +eruptive diseases, such as either small-pox or scarlatina. We may +divide the symptoms of water on the brain into two stages. The +first--the premonitory stage--which lasts for or five days, in which +medical aid might be of great avail: the second--the stage of +drowsiness and of coma--which usually ends in death. + +I shall dwell on the first--the premonitory stage--in order that a +mother may see the importance without loss of time of calling in a +medical man:-- + +If her child be feverish and irritable, if his stomach be disordered, +if he have urgent vomitings, if he have a foul breath, if his appetite +be capricious and bad, if his nights be disturbed (screaming out in +his sleep), if his bowels be disordered, more especially if they be +constipated, if he be more than usually excited, if his eye gleam with +unusual brilliancy, if his tongue run faster than it is wont, if his +cheek be flushed and his head be hot, and if he be constantly putting +his hand to his head; there is cause for suspicion. If to these +symptoms be added, a more than usual carelessness in tumbling about, +in hitching his foot in the carpet, or in dragging one foot after the +other; if, too, he has complained of darting, shooting, lancinating +pains in his head, it may then be known that the _first_ stage of +inflammation (the forerunner of water on the brain) either has taken, +or is about taking place. Remember no time ought to be lost in +obtaining medical aid; for the _commencement_ of the disease is the +golden opportunity, when life might probably be saved. + +200. _At what age, and in what neighbourhood, is a child most liable +to croup, and when is a mother to know that it is about to take +place_? + +It is unusual for a child until he be twelve months old to have croup: +but, from that time until the age of two years, he is more liable to +it than at any other period. The liability after two years, gradually, +until he be ten years old, lessens, after which time it is rare. + +A child is more liable to croup in a low and damp, than in a high and +dry neighbourhood; indeed, in some situations, croup is almost an +unknown disease; while in others it is only too well understood. Croup +is more likely to prevail when the wind is either easterly or +north-easterly. + +There is no disease that requires more prompt treatment than croup, +and none that creeps on more insidiously. The child at first seems to +be labouring under a slight cold, and is troubled with a little _dry_ +cough, he is hot and fretful, and hoarse when he cries. Hoarseness is +one of the earliest symptoms of croup, and it should be borne in mind +that a young child, unless he be going to have croup, is seldom +hoarse, if, therefore, your child be hoarse, he should be carefully +watched, in order that, as soon as croup be detected, not a moment be +lost in applying the proper remedies. + +His voice at length becomes gruff, he breathes as though it were +through muslin, and the cough becomes crowing. These three symptoms +prove that the disease is now fully formed. These latter symptoms +sometimes come on without any previous warning, the little fellow +going to bed apparently quite well, until the mother is awakened, +perplexed and frightened, in the middle of the night, by finding him +labouring under the characteristic cough and the other symptoms of +croup. If she delay either to send for assistance, _or if proper +medicines be not instantly given_, in a few hours it will probably be +of no avail, and in a day or two the little sufferer will be a corpse. + +When once a child has had croup the after attacks are generally +milder. If he has once had an attack of croup, I should advise you +always to have in the house medicine--a 4 oz. bottle of Ipecacuanha +Wine, to fly to at a moments notice, [Footnote: In case of a sudden +attack of croup, _instantly_ give a teaspoonful of Ipecacuanha Wine, +and repeat it every fire minutes natal free vomiting be excited.] but +never omit, where practicable, in a case of croup, whether the case be +severe or mild to send _immediately_ for medical aid. There is no +disease in which time is more precious than in croup, and where the +delay of an hour may decide either for life or for death. + +201. _But suppose a medical man is not IMMEDIATELY to be procured, +what then am I to do? more especially, as you say, that delay might be +death_? + +_What to do_.--I never, in my life, lost a child with croup with +catarrhal croup where I was called in at the _commencement_ of the +disease, and where my plans were carried out to the very letter. Let +me begin by saying, look well to the goodness and purity of the +medicine, for the life of your child may depend upon the medicine +being genuine. What medicine! _Ipecacuanha Wine!_ At the earliest dawn +of the disease give a few spoonful of Ipecacuanha Wine every five +minutes, until free vomiting be exerted. In croup, then, before he be +safe, free vomiting _must_ be established, and that without loss of +time. If, _after_ the expiration of an hour, the Ipecacuanha Wine +(having given during that hour one or two tea-spoonfuls of it every +five minutes) be not sufficiently powerful for the purpose--although +it generally is so--(_if the Ipecacuanha Wine be good_)--then let the +following mixture be substituted-- + + Take of--Powdered Ipecacuanha, one scruple, + Wine of Ipecacuanha, one ounce and a half + +Make a mixture. One or two tea spoonfuls to be given every five +minutes, until free vomiting be excited, first well shaking the +bottle. + +After the vomiting, place the child for a quarter of an hour in a warm +bath. [Footnote: See "Warm Baths"--directions and precautions to be +observed.] When out of the bath give him small doses of Ipecacuanha +Wine every two or three hours. The following is a palatable form for +the mixture-- + + Take of--Wine of Ipecacuanha, three drachms; + Simple syrup, three drachms, + Water, six drachms + +Make a Mixture. A tea-spoonful to be taken every two or three hours. + +But remember the emetic which is given at _first_ is _pure Ipecacuanha +Wine, without a drop of either water or of syrup._ + +A large sponge dipped out of very hot water, and applied to the +throat, and frequently renewed, oftentimes affords great relief in +croup, and ought during the time the emetic is being administered in +all cases to be adopted. + +If it be a _severe_ case of croup, and does not in the course of two +hours yield to the free exhibition of the Ipecacuanha Emetic, apply a +narrow strip of _Smith's Tela Vesicularia_ to the throat, prepared in +the same way as for a case of inflammation of the lungs (see the +Conversation on the _treatment_ of inflammation of the lungs). With +this only difference, let it be a narrower strip, only one-half the +width there recommended, and apply it to the throat instead of to the +chest. If a child has a very short, fat neck, there may not be room +for the _Tela_, then you ought to apply it to the _upper_ part of the +chest--just under the collar-bones. + +Let it be understood, the the _Tela Vesicularia_ is not a severe +remedy, that the _Tela_ produces very little pain--not nearly so much +as the application of leeches; although, in its action, it is much +more beneficial, and is not nearly so weakening to the system. + +Keep the child from all stimulants; let him live on a low diet, such +as milk and water, toast and water, arrowroot, &c.; and let the room +be, if practicable, at a temperate heat--60 deg. Fahrenheit, and be well +ventilated. + +So you see that the _treatment_ of croup is very simple, and the the +plan might be carried out by an intelligent mother. Notwithstanding +which, it is your duty, where practicable, to send, at the very +_onset_ of the disease, for a medical man. + +Let me again reiterate that, if your child is to be saved, the +_Ipecacuanha Wine must be genuine and good_. This can only be effected +by having the medicine from a highly respectable chemist. Again, if +ever your child has had croup, let me again urge you _always_ to have +in the house a 4 oz. bottle of Ipecacuanha Wine, that you may resort +to at a moment's notice, in case there be the slightest return of the +disease. + +Ipecacuanha Wine, unfortunately, is not a medicine that keeps well, +therefore, every three or four months a fresh bottle ought to be +procured, either from a medical man or from a chemist. As long as the +Ipecacuanha Wine remains _clear_, it is good; but as soon as it +becomes _turbid_, it is bad, and ought to be replaced by a fresh +supply. An intelligent correspondent of mine makes the following +valuable remarks on the preservation of Ipecacuanha Wine:--"Now, I +know that there are some medicines and chemical preparations which, +though they spoil rapidly when at all exposed to the air, yet will +keep perfectly good for an indefinite time if hermetically sealed up +in a _perfectly full_ bottle. If so, would it not be a valuable +suggestion if the Apothecaries' Hall, or some other London firm of +_undoubted_ reliability, would put up 1 oz. phials of Ipecacuanha Wine +of guaranteed purity, sealed up so as to keep good so long as +unopened, and sent out in sealed packages, with the guarantee of their +name. By their keeping a few such ounce bottles in an unopened state +in one's house, one might rely in being ready for any emergency. If +you think this suggestion worth notice, and could induce some +first-rate house to carry it out, and mention the fact in a subsequent +edition of your book, you would, I think, be adding another most +valuable item to an already invaluable book." + +The above suggestion of preserving Ipecacuanha Wine in ounce bottles, +quite full, and hermetically sealed, is a very good one. The best way +of hermetically sealing the bottle would be, to cut the cork level +with the lip of the bottle, and to cover the cork with sealing-wax, in +the same manner wine merchants serve some kinds of their wines, and +then to lay the bottles on their sides in sawdust in the cellar. I +have no doubt, if such a plan were adopted, the Ipecacuanha Wine would +for a length of time keep good. Of course, if the Wine of Ipecacuanha +be procured from the Apothecaries' Hall Company, London (as suggested +by my correspondent), there can be no question as to the genuineness +of the article. + +_What NOT to do_--Do not give emetic tartar, do not apply leeches, do +not keep the room very warm, do not give stimulants, do not omit to +have always in the house either a 4 oz. bottle, or three or four 1 +oz. bottles, of Ipecacuanha Wine. + +202. _I have heard Child crowing mentioned as a formidable disease, +would you describe the symptoms_? + +Child-crowing, or spasm of the glottis, or _spurious croup_, as it is +sometimes called, is occasionally mistaken for _genuine croup_. It is +a more frequent disorder than the latter, and requires a different +plan of treatment Child crowing is a disease that invariably occurs +only during dentition, and is _most perilous_, indeed, painful +dentition is _the_ cause--_the_ only cause--of child crowing. But, if +a child labouring under it can fortunately escape suffocation until he +have cut the whole of his first set of teeth--twenty--he is then safe. + +Child-crowing comes on in paroxysms. The breathing during the +intervals is quite natural--indeed, the child appears perfectly well, +hence, the dangerous nature of the disease is either overlooked, or is +lightly thought of, until perhaps a paroxysm worse than common takes +place, and the little patient dies of suffocation, overwhelming the +mother with terror, with confusion, and dismay. + +The _symptoms_ in a paroxysm of child-crowing are as follows--The +child suddenly loses and fights for his breath, and in doing so, makes +a noise very much like that of crowing, hence the name child-crowing. +The face during the paroxysm becomes bluish or livid. In a favourable +case, after either a few seconds, or even, in some instances, a +minute, and a frightful straggle to breathe, he regains his breath, +and is, until another paroxysm occurs, perfectly well. In an +unfavourable case, the upper part (chink) of the windpipe--the +glottis--remains for a minute or two closed, and the child, not being +able to breathe, drops a corpse in his nurse's arms! Many children, +who are said, to have died of fits, hare really died of child-crowing. + +Child-crowing is very apt to cause convulsions, which complication, of +course, adds very much to the danger. Such a complication requires +the constant supervision of an experienced and skilful medical man. + +I have entered thus rather fully into the subject, as nearly every +life might be saved, if a mother knew the nature and the treatment of +the complaint, and of the _great necessity during the paroxysm of +prompt and proper measures_. For, too frequently, before a medical man +has had time to arrive, the child has breathed his last, the parent +himself being perfectly ignorant of the necessary treatment; hence the +vital importance of the subject, and the paramount necessity of +imparting such information, in a _popular_ style, in conversations of +this kind. + +203. _What treatment, then, during a paroxysm of Child-crowing should +you advise_? + +The first thing, of course, to be done, is to send _immediately_ for a +medical man. Have a plentiful supply of cold and of hot water always +at hand, ready at a moment's notice for use. The instant the paroxysm +is upon the child, plentifully and perseveringly dash _cold_ water +upon his head and face. Put his foot and legs in _hot_ salt, mustard, +and water; and, if necessary, place him up to his neck in a hot bath, +still dashing water upon his face and head. If he does not quickly +come round, sharply smack his back and buttocks. + +In every severe paroxysm of child-crowing, put your fore-finger down +the throat of the child, and pull his tongue forward. This plan of +pulling the tongue forward opens the epiglottis (the lid of the +glottis), and thus admits air (which is so sorely needed) into the +glottis and into the lungs, and thus staves off impending +suffocation. If this plan were generally known and adopted, many +precious lives might be saved. [Footnote: An intelligent correspondent +first drew my attention to the efficacy of pulling forward the tongue +in every severe paroxysm of child-crowing.] + +There is nothing more frightfully agonising to a mother's feelings +than to see her child strangled,--as it were,--before her eyes, by a +paroxysm of child crowing. + +As soon as a medical man arrives, he will lose no time in thoroughly +lancing the gums, and in applying other appropriate remedies. + +Great care and attention ought, during the intervals, to be paid to +his diet. If the child be breathing a smoky, close atmosphere, he +should be immediately removed to a pure one. In this disease, indeed, +there is no remedy equal to a change of air--to a dry, bracing +neighbourhood. Change of air, even if it be winter, is the best +remedy, either to the coast or to a healthy mountainous district. I am +indebted to Mr Roberton of Manchester (who has paid great attention to +this disease, and who has written a valuable essay on the subject +[Footnote: See the end of the volume of "Physiology and Diseases of +Women," &c. Churchill, 1851.]) for the knowledge of this fact. Where, +in a case of this kind, it is not practicable to send a child _from_ +home, then let him be sent out of doors the greater part of every day; +let him, in point of fact, almost live in the open air. I am quite +sure, from an extensive experience, that in this disease, fresh air, +and plenty of it, is the best and principal remedy. Cold sponging of +the body too is useful. + +Mr Roberton, who, at my request, has kindly given me the benefit of +his extensive experience in child-crowing, considers that there is no +remedy, in this complaint, equal to fresh air--to dry cold winds--that +the little patient ought, in fact, nearly to live, during the day, out +of doors, whether the wind be in the east or in the north-east, +whether it be biting cold or otherwise, provided it be dry and +bracing, for "if the air be dry, the colder the better,"--taking care, +of course, that he be well wrapped up. Mr Roberton, moreover, advises +that the child should be sent away at once from home, either to a +bracing sea-side place, such as Blackpool or Fleetwood; or to a +mountainous district, such as Buxton. + +As the subject is so important, let me recapitulate: the gums ought, +from time to time, to be well lanced, in order to remove the +irritation of painful dentition--painful dentition being the real +cause of the disease. Cold sponging should be used twice or thrice +daily. The diet should be carefully attended to (see Dietary of +Child); and everything conducive to health should (as recommended in +these Conversations) be observed. But, remember, after all that can +be said about the treatment, there is nothing like change of air, of +fresh air, of cold, dry pure air, and of plenty of it--the more the +little fellow can inhale, during the day, the better it will be for +him, it will be far better than any drug contained in the +pharmacopoeia. + +I have dwelt on this subject at some length--it being a most important +one--as, if the above advice were more generally known and followed, +nearly every child, labouring under this complaint, would be saved; +while now, as coroners' inquests abundantly testify, the disease +carries off yearly an immense number of victims. + +204. _When is a mother to know that a cough is not a "tooth cough" but +one of the symptoms of Inflammation of the lungs_? + +If the child has had a shivering fit; if his skin be very hot and very +dry; if his lips be parched; if there be great thirst; if his cheeks +be flushed; if he be dull and heavy, wishing to be quiet in his cot or +crib; if his appetite be diminished; if his tongue be furred; if his +mouth be _burning_ hot and dry; [Footnote: If you put your finger into +the mouth of a child labouring under inflammation of the lungs, it is +like putting your finger into a hot apple pie, the heat is so great.] +if his urine be scanty and high-coloured, staining the napkin or the +linen; _if his breathing be short, panting, hurried, and oppressed; if +there be a hard dry cough, and if his skin be burning hot;_--then +there is no doubt that inflammation of the lungs has taken place. + +No time should be lost in sending for medical aid; indeed, the _hot, +dry mouth and skin, and short, hurried breathing_ would be sufficient +cause for your procuring _immediate_ assistance. If inflammation of +the lungs were properly treated at the _onset_, a child would scarcely +ever be lost by that disease. I say this advisedly, for in my own +practice, _provided I am called in early, and if my plans are strictly +carried out_, I scarcely ever lose a child from inflammation of the +lungs. + +You may ask--What are your plans? I will tell you, in case _you cannot +promptly obtain medical advice,_ as delay might be death! + +_The treatment of Inflammation of the Lungs, what to do._--Keep the +child to one room, to his bedroom, and to his bed. Let the chamber be +properly ventilated. If the weather be cool, let a small fire be in +the grate; otherwise, he is better without a fire. Let him live on low +diet, such as weak black tea, milk and water (in equal quantities), +and toast and water, thin oatmeal gruel, arrow-root, and such like +simple beverages, and give him the following mixture:-- + + Take of--Wine of Ipecacuanha, three drachms; + Simple Syrup, three drachms; + Water, six drachms; + +Make a Mixture. A tea-spoonful of the mixture to be taken every four +hours. + +Be careful that you go to a respectable chemist, in order _that the +totality of the Ipecacuanha Wine may be good, as the child's life may +depend upon it._ + +If the medicine produce sickness, so much the better; continue it +regularly until the short, oppressed, and hurried breathing has +subsided, and has become natural. + +If the attack be very severe, in addition to the above medicine, at +once apply a blister, not the common blister, but _Smith's Tela +Vesicatoria_ [Footnote: Manufactured by T. & H. Smith, chemists, +Edinburgh, and may be procured of Southalls, chemists, Birmingham.]--a +quarter of a sheet. If the child be a year old, the blister ought to +be kept on for three hours, and then a piece of dry, soft linen rag +should be applied for another three hours. At the end of which +time--six hours--there will be a beautiful blister, which must then, +with a pair of scissors, be cut, to let out the water, and then let +the blister be dressed, night and morning, with simple cerate spread +on lint. + +If the little patient be more than one year, say two years old, let +the Tela remain on for five hours, and the dry linen rag for five +hours more, before the blister, as above recommended, be cut and +dressed. + +If in a day or two the inflammation still continue violent, let +another Tela Vesicatoria be applied, not over the old blister, but let +a narrow strip of it be applied on each side of the old blister, and +managed in the same manner as before directed. + +_I cannot speak too highly of Smith's Tela Vesicatoria._ It has, in my +hands, through God's blessing, saved the lives of scores of +children. It is far, very far, superior to the old fashioned +blistering plaster. It seldom, if the above rules be strictly +observed, fails to rise, it gives much less pain than the common +blister, when it has had the desired effect, it readily heals, which +cannot always be said of the common fly blister, more especially with +children. + +My sheet anchors, then, in the inflammation of the lungs of children +are, Ipecacuanha Wine and Smith's _Tela Vesicatoria_. Let the greatest +care, as I before advised, be observed in obtaining the Ipecacuanha +Wine genuine and good. This can be only depended upon by having the +medicine from a highly respectable chemist, Ipecacuanha Wine, when +genuine and good, is, in many children's diseases, is one of the most +valuable of medincies. + +_What, in a case of inflammation of the lungs, NOT to do_--Do not, on +any account, apply leeches. They draw out the life of the child, but +not his disease. Avoid--_emphatically let me say so_--giving emetic +tartar It is one of the most lowering and death-dealing medicines that +can be administered either to an infant or to a child! If you wish to +try the effect of it, take a dose yourself, and I am quite sure that +you will then never be inclined to poison a child with such an +abominable preparation! In olden times--many, many years ago--I myself +gave it in inflammation of the lungs, and lost many children! Since +leaving it off, the recoveries of patients by the Ipecacuanha +treatment, combined with the external application of Smith's _Tela +Vesicatoria_, have been in many cases marvellous. Avoid broths and +wine, and all stimulants. Do _not_ put the child into a warm bath, it +only oppresses the already oppressed breathing. Moreover, after he is +out of the bath, it causes a larger quantity of blood to rush back to +the lungs and to the bronchial tubes, and thus feeds the +inflammation. Do not, by a large fire, keep the temperature of the +room high. A small fire, in the winter time, encourages ventilation, +and in such a case does good. When the little patient is on the +mother's or on the nurse's lap, do not burden him either with a +_heavy_ blanket or with a _thick_ shawl. Either a _thin_ child's +blanket, or a _thin_ woollen shawl, in addition to his usual +nightgown, is all the clothing necessary. + +205. _Is Bronchitis a more frequent disease than Inflammation of the +Lungs? Which is the most dangerous? What are the symptoms of +Bronchitis_? + +Bronchitis is a much more frequent disease than inflammation of the +lungs, indeed, it is one of the most common complaints both of infants +and of children, while inflammation of the lungs is comparatively a +rare disease. Bronchitis is not nearly such a dangerous disease as +inflammation of the lungs. + +_The symptoms_--The child for the first few days labours under +symptoms of a heavy cold, he has not his usual spirits. In two or +three days, instead of the cold leaving him, it becomes more +confirmed, he is now really poorly, fretful, and feverish, his +breathing becomes rather hurried and oppressed, his cough is hard and +dry, and loud, he wheezes, and if you put your ear to his naked back, +between his shoulder blades, you will hear the wheezing more +distinctly. If at the breast, he does not suck with his usual avidity; +the cough, notwithstanding the breast is a great comfort to him, +compels him frequently to loose the nipple; his urine is scanty, and +rather high-coloured, staining the napkin, and smelling strongly. He +is generally worse at night. + +Well, then, remember if the child be feverish, if he have symptoms of +a heavy cold, if he have an oppression of breathing, if he wheeze, and +if he have a tight, dry, noisy cough, you may be satisfied that he has +an attack of bronchitis. + +206. _How can I distinguish between Bronchitis and Inflammation of the +Lungs_? + +In bronchitis the skin is warm, but moist; in inflammation of the +lungs it is hot and dry: in bronchitis the mouth is warmer than usual, +but moist; in inflammation of the lungs it is burning hot: in +bronchitis the breathing is rather hurried, and attended with +wheezing; in inflammation of the lungs it is very short and panting, +and is unaccompanied with wheezing, although occasionally a very +slight crackling sound might be heard: in bronchitis the cough is long +and noisy; in inflammation of the lungs it is short and feeble: in +bronchitis the child is cross and fretful; in inflammation of the +lungs he is dull and heavy, and his countenance denotes distress. + +We have sometimes a combination of bronchitis and of inflammation of +the lungs, an attack of the latter following the former. Then the +symptoms will be modified, and will partake of the character of the +two diseases. + +207. _How would you treat a case of Bronchitis_? + +If a medical man cannot be procured, I will tell you _What to do_: +Confine the child to his bedroom, and if very ill, to his bed. If it +be winter time, have a little fire in the grate, but be sure that the +temperature of the chamber be not above 60 degrees Fahrenheit, and let +the room be properly ventilated, which may be effected by occasionally +leaving the door a little ajar. + +Let him lie either _outside_ the bed or on a sofa, if he be very ill, +_inside_ the bed, with a sheet and a blanket only to cover him, but no +thick coverlid. If he be allowed to be on the lap, it only heats him +and makes him restless. If he will not lie on the bed, let him rest on +a pillow placed on the lap, the pillow will cause him to lie cooler, +and will more comfortably rest his weaned body. If he be at the +breast, keep him to it, let him have no artificial food, unless, if he +be thirsty a little toast and water. If he be weaned, let him have +either milk and water, arrow root made with equal parts of milk and +water, toast and water, barley water, or weak black tea, with plenty +of new milk in it, &c., but, until the inflammation have subsided, +neither broth nor beef tea. + +Now, with regard to medicine, the best medicine is Ipecacuanha Wine, +given in large doses, so as to produce constant nausea. The +Ipecacuanha abates fever, acts on the skin, loosens the cough, and, in +point of fact, in the majority of cases, will rapidly effect a cure. I +have in a preceding Conversation given you a prescription for the +Ipecacuanha Wine Mixture. Let a tea-spoonful of the mixture be taken +every four hours. + +If in a day or two he be no better, but worse, by all means continue +the mixture, whether it produce sickness or otherwise, and put on the +chest a _Tela Vesicatoria_, a quarter of a sheet. + +The Ipecacuanha Wine and the Tela Vesicatoria are my sheet anchors in +the bronchitis, both of infants and of children. They rarely, even in +very severe cases, fail to effect a cure, provided the Tela +Vesicatorina be properly applied, and the Ipecacuanha Wine be genuine +and of good quality. + +If there be any difficulty in procuring _good_ Ipecacuanha Wine, the +Ipecacuanha may be given in powder instead of the wine The following +is a pleasant form-- + + Take of--Powder of Ipecacuanha, twelve grains + White Sugar thirty six grains + +Mix well together and divide into twelve powders. One of the powders +to be put dry on the tongue every four hours. + +The Ipecacuanha Powder will keep better than the Wine--an important +consideration to those living in country places, nevertheless, if the +Wine can be procured fresh and good, I far prefer the Wine to the +Powder. + +When the bronchitis has disappeared, the diet ought gradually to be +improved--rice, sago, tapioca, and light batter-pudding, &c.; and, in +a few days, either a little chicken or a mutton chop, mixed with a +well-mashed potato and crumb of bread, should be given. But let the +improvement in his diet be gradual, or the inflammation might return. + +_What NOT to do_.--Do not apply leeches. Do not give either emetic +tartar or antimonial wine, which is emetic tartar dissolved in +wine. Do not administer either paregoric or syrup of poppies, either +of which would stop the cough, and would thus prevent the expulsion of +the phlegm. Any fool can stop a cough, but it requires a wise man to +rectify the mischief. A cough is an effort of Nature to bring up the +phlegm, which would otherwise accumulate, and in the end cause +death. Again, therefore, let me urge upon you the immense importance +of _not_ stopping the cough of a child. The Ipecacuanha Wine will, by +loosening the phlegm, loosen the cough, which is the only right way to +get rid of a cough. Let what I have now said be impressed deeply upon +your memory, as thousands of children in England are annually +destroyed by having their coughs stopped. Avoid, until the bronchitis +be relieved, giving him broths, and meat, and stimulants of all +kinds. For further observations on _what NOT to do_ in bronchitis, I +beg to refer you to a previous Conversation we had on _what NOT to do_ +in inflammation of the lungs. That which is injurious in the one case +is equally so in the other. + +208. _What are the symptoms of Diphtheria, or, as it is sometimes +called, Boulogne Sore-throat_? + +This terrible disease, although by many considered to be a new +complaint, is, in point of fact, of very ancient origin. Homer, and +Hippocrates, the Father of Physic, have both described it. Diphtheria +first appeared in England in the beginning of the year 1857, since +which time it has never totally left our shores. + +_The symptoms_--The little patient, before the disease really shows +itself, feels poorly, and is "out of sorts." A shivering fit, though +not severe, may generally be noticed. There is heaviness, and slight +headache, principally over the eyes. Sometimes, but not always, there +is a mild attack of delirium at night The next day he complains of +slight difficulty of swallowing. If old enough, he will complain of +constriction about the swallow. On examining the throat, the tonsils +will be found to be swollen and redder--more darkly red than +usual. Slight specks will be noticed on the tonsils. In a day or two +an exudation will cover them, the back of the swallow, the palate, the +tongue, and sometimes the inside of the cheeks and of the +nostrils. This exudation of lymph gradually increases until it becomes +a regular membrane, which puts on the appearance of leather, hence its +name diphtheria. This membrane peels off in pieces, and if the child +be old and strong enough he will sometimes spit it up in quantities, +the membrane again and again rapidly forming as before. The discharges +from the throat are occasionally, but not always, offensive. There is +danger of croup from the extension of the membrane into the wind +pipe. The glands about the neck and under the jaw are generally much +swollen, the skin is rather cold and clammy, the urine is scanty and +usually pale, the bowels at first are frequently relaxed. This +diarrhoea may, or may not, cease as the disease advances. + +The child is now in a perilous condition, and it becomes a battle +between his constitution and the disease. If, unfortunately, as is +too often the case--diphtheria being more likely to attack the +weakly--the child be very delicate, there is but slight hope of +recovery. The danger of the disease is not always to be measured by +the state of the throat. Sometimes, when the patient appears to be +getting well, a sudden change for the worse rapidly carries him +off. Hence the importance of great caution, in such cases, in giving +an opinion as to ultimate recovery. I have said enough to prove the +terrible nature of the disease, and to show the necessity of calling +in, at the earliest period of the symptoms, an experienced and skilful +medical man. + +209. _Is Diphtheria contagious_? + +_Decidedly_. Therefore, when practicable, the rest of the children +ought instantly to be removed to a distance. I say _children_, for it +is emphatically a disease of childhood. When adults have it, it is the +exception and not the rule: "Thus it will be seen, in the account +given of the Boulogne epidemic, that of 366 deaths from this cause, +341 occurred amongst children under ten years of age. In the +Lincolnshire epidemic, in the autumn of 1858, all the deaths at +Horncastle, 25 in number, occurred amongst children under twelve years +of age." [Footnote: _Diphtheria_: by Ernest Hart. A valuable pamphlet +on the subject. Dr Wade of Birmingham has also written an interesting +and useful monograph on Diphtheria. I am indebted to the above authors +for much valuable information.] + +210. _What are the causes of Diphtheria_? + +Bad and imperfect drainage; [Footnote: "Now all my carefully conducted +inquiries induce me to believe that the disease comes from +drain-poison. All the cases into which I could fully inquire, have +brought conviction to my mind that there is a direct law of sequence +in some peculiar conditions of atmosphere between diphtheria and bad +drainage; and, if this be proved by subsequent investigations, we may +be able to prevent a disease which, in too many cases, our known +remedies cannot cure."--W. Carr, Esq., Blackheath, _British Medical +Journal_, December 7, 1861.] want of ventilation; overflowing privies; +low neighbourhoods in the vicinity of rivers; stagnant waters; indeed, +everything that vitiates the air, and thus depresses the system, more +especially if the weather be close and muggy; poor and, improper food; +and last, though not least, contagion. Bear in mind, too, that a +delicate child is much more predisposed to the disease than a strong +one. + +211. _What is the treatment of Diptheria_? + +_What to do_--Examine well into the ventilation, for as diphtheria is +frequently caused by deficient ventilation, the best remedy is +thorough ventilation. Look well both to the drains and to the privies, +and see that the drains from the water-closets and from the privies do +not in any way contaminate the pump-water. If the drains be defective +or the privies be full, the disease in your child will be generated, +fed, and fostered. Not only so, but the disease will spread in your +family and all around you. + +Keep the child to his bedroom and to his bed. For the first two or +three days, while the fever runs high, put him on a low diet, such as +milk, tea, arrow root, &c. + +Apply to his throat every four hours a warm barm and oatmeal +poultice. If he be old enough to have the knowledge to use a gargle, +the following will be found serviceable-- + + Take of--Permanganate of Potash, pure, four grams, + Water eight ounces + +To make a Gargle + +Or, + + Take of--Powdered Alum, one drachm, + Simple Syrup one ounce, + Water, seven ounces + +To make a Gargle + +The best medicine for the first few days of the attack, is the +following mixture-- + + Take of--Chlorate of Potash two drachms, + Boiling Water seven ounces + Syrup of Red Poppy one ounce + +To Make a mixture. A table spoonful to be taken every four hours. + + +Or the chlorate of potash might be given in the form of powder-- + + Take of--Chlorate of Potash two scruples, + Lump Sugar one drachm + +Mix and divide into eight powders. One to be put into a dry tea spoon +and then placed on the tongue every three hours, These powders are +very useful in diphtheria; they are very cleansing to the tongue and +throat. If they produce much smarting as where the mouth is very sore +they sometimes do, let the patient, after taking one, drink +plentifully of milk, indeed I have known these powders induce a +patient to take nourishment, in the form of milk, which he otherwise +would not have done, and thus to have saved him from dying of +starvation, which, before taking the powders, there was every +probability of his doing. An extensive experience has demonstrated to +me the great value of these powders in diphtheria, but they must be +put on the tongue dry. + +As soon as the skin has lost its preternatural heat, beef tea and +chicken broth ought to be given. Or if great prostration should +supervene, in addition to the beef tea, port wine, a table spoonful +every four hours, should be administered. If the child be cold, and +there be great sinking of the vital powers, brandy and water should be +substituted for the port wine. Remember, in ordinary cases, port wine +and brandy are not necessary, _but in cases of extreme exhaustion_ +they are most valuable. + +As soon as the great heat of the skin has abated and the debility has +set in, one of the following mixtures will be found useful-- + + Take of--Wine of Iron, one ounce and a half, + Sample Syrup, one ounce, + Water, three ounces and a half + +To make a Mixture. A table spoonful to be taken every four hours. + +Or, + + Take of--Tincture of Perchloride of Iron, one drachm + Simple Syrup, one ounce, + Water, three ounces + +To make a Mixture. A table spoonful to be taken three times a day. + +If the disease should travel downwards, it will cause all the symptoms +of croup, then it must be treated as croup, with this only difference, +that a blister (_Tela Vesicatoria_) must _not_ be applied, or the +blistered surface may be attacked by the membrane of diphtheria, which +may either cause death or hasten that catastrophe. In every other +respect treat the case as croup, by giving an emetic, a tea spoonful +of Ipecacuanha Wine every five minutes, until free vomiting be +excited, and then administer smaller doses of Ipecacuanha Wine every +two or three hours, as I recommended when conversing with you on the +treatment of croup. + +_What NOT to do_--Do not, on any account, apply either leeches or a +blister. If the latter be applied, it is almost sure to be covered +with the membrane of diphtheria, similar to that inside of the mouth +and of the throat, which would be a serious complication. Do not give +either calomel or emetic tartar. Do not depress the system by +aperients, for diphtheria is an awfully depressing complaint of +itself, the patient, in point of fact, is labouring under the +depressing effects of poison, for the blood has been poisoned either +by the drinking water being contaminated by faecal matter from either a +privy or from a water-closet, by some horrid drain, by proximity to a +pig-sty, by an overflowing privy, especially if vegetable matter be +rotting at the same time in it, by bad ventilation, or by +contagion. Diphtheria may generally be traced either to the one or to +the other of the above causes, therefore let me urgently entreat you +to look well into all these matters, and thus to stay the pestilence! +Diphtheria might long remain in a neighbourhood if active measures be +not used to exterminate it. + +212. _Have the goodness to describe the symptoms of Measles_? + +Measles commences with symptoms of a common cold, the patient is at +first chilly, then hot and feverish, he has a running at the nose, +sneezing, watering, and redness of the eyes, headache, drowsiness, a +hoarse and peculiar ringing cough, which nurses call "measle-cough," +and difficulty of breathing. These symptoms usually last three days +before the eruption appears, on the fourth it (the eruption) generally +makes its appearance, and continues for four days and then disappears, +lasting altogether, from the commencement of the symptoms of cold to +the decline of the eruption, seven days. It is important to bear in +mind that the eruption consists of _crescent-shaped--half +moon-shaped--patches_, that they usually appear first about the face +and the neck, in which places they are the best marked; then on the +body and on the arms; and, lastly, on the legs, and that they are +slightly raised above the surface of the skin. The face is swollen, +more especially the eye-lids which are sometimes for a few days +closed. + +Well, then, remember, _the running at the nose, the, sneezing, the +peculiar hoarse cough, and the half-moon-shaped patches_, are the +leading features of the disease, and point out for a certainty that it +is measles. + +213. _What constitutes the principal danger in Measles_? + +The affection of the chest. The mucous or lining membrane of the +bronchial tubes is always more or less inflamed, and the lungs +themselves are sometimes affected. + +214. _Do you recommend "surfeit water" and saffron tea to throw out +the eruption in Measles_? + +Certainly not. The only way to throw out the eruption, as it is +called, is to keep the body comfortably warm, and to give the +beverages ordered by the medical man, with the chill off. "Surfeit +water," saffron tea, and remedies of that class, are hot and +stimulating. The only effect they can have, will be to increase the +fever and the inflammation--to add fuel to the fire. + +215. _What is the treatment of Measles_? + +_What to do_.--The child ought to be confined both to his room and to +his bed, the room being kept comfortably warm; therefore, if it be +winter time, there should be a small fire in the grate; in the summer +time, a fire would be improper. The child must not be exposed to +draughts; notwithstanding, from time to time, the door ought to be +left a little ajar in order to change the air of the apartment; for +proper ventilation, let the disease be what it may, is absolutely +necessary. + +Let the child, for the first few days, be kept on a low diet, such as +on milk and water, arrow-root, bread and butter, &c. + +If the attack be mild, that is to say, if the breathing be not much +affected (for in measles it always is more or less affected), and if +there be not much wheezing, the Acidulated Infusion of Roses' Mixture +[Footnote: See page 178] will be all that is necessary. + +But suppose that the breathing is short, and that there is a great +wheezing, then instead of giving him the mixture just advised, give +him a tea-spoonful of a mixture composed of Ipecacuanha Wine, Syrup, +and Water, [Footnote: See page 161] every four hours. And if, on the +following day, the breathing and the wheezing be not relieved in +addition to the Ipecacuanha Mixture, apply a Tola Vesicatoria, as +advised under the head of Inflammation of the Lungs. + +When the child is convalescing, batter puddings, rice, and sago +puddings, in addition to the milk, bread and butter, &c, should be +given, and, a few days later, chicken, mutton chops, &c. + +The child ought not, even in a mild case of measles, and in favourable +weather to be allowed to leave the house under a fortnight, or it +might bring on an attack of bronchitis. + +_What NOT to do_--Do not give either "surfeit water" or wine. Do not +apply leeches to the chest. Do not expose the child to the cold +air. Do not keep the bed room very hot, but comfortably warm. Do not +let the child leave the house, even under favourable circumstances, +under a fortnight. Do not, while the eruption is out, give +aperients. Do not, "to ease the cough," administer either emetic +tartar or paregoric--the former drug is awfully depressing, the latter +will stop the cough, and will thus prevent the expulsion of the +phlegm. + +216. _What is the difference between Scarlatina and Scarlet Fever_? + +They are indeed one and the same disease, scarlatina being the Latin +for scarlet fever. But, in a _popular_ sense, when the disease is +mild, it is usually called scarlatina. The latter term does not sound +so formidable to the ears either of patients or of parents. + +217. _Will you describe the symptoms of Scarlet Fever_? + +The patient is generally chilly, languid, drowsy, feverish, and poorly +for two days before the eruption appears. At the end of the second +day, the characteristic, bright scarlet efflorescence, somewhat +similar to the colour of a boiled lobster, usually first shows itself. +The scarlet appearance is not confined to the skin; but the tongue, +the throat, and the whites of the eyes put on the same appearance; +with this only difference, that on the tongue and on the throat the +scarlet is much darker; and, as Dr Elliotson accurately describes +it,--"the tongue looks as if it had been slightly sprinkled with +Cayenne pepper;" the tongue, at other times, looks like a strawberry; +when it does, it is called "the strawberry tongue." The eruption +usually declines on the fifth, and is generally indistinct on the +sixth day; on the seventh it has completely faded away. There is +usually, after the first few days, great itching on the surface of the +body. The skin, at the end of the week, begins to peel and to dust +off, making it look as though meal had been sprinkled upon it. + +There are three forms of scarlet fever;--the one where the throat is +little, if at all, affected, and this is a mild form of the disease; +the second, which is generally, especially at night, attended with +delirium, where the throat is _much_ affected, being often greatly +inflamed and ulcerated; and the third (which is, except in certain +unhealthy districts, comparatively rare, and which is VERY dangerous), +the malignant form. + +218. _Would it be well to give a little cooling, opening physic as +soon as a child begins to sicken for Scarlet Fever_? + +_On no account whatever._ Aperient medicines are, in my opinion, +highly improper and dangerous both before and during the period of the +eruption. It is my firm conviction, that the administration of opening +medicine, at such times, is one of the principal causes of scarlet +fever being so frequently fatal. This is, of course, more applicable +to the poor, and to those who are unable to procure a skilful medical +man. + +219. _What constitutes the principal danger in Scarlet Fever_? + +The affection of the throat, the administration of opening medicine +during the first ten days, and a peculiar disease of the kidneys +ending in _anasarca_ (dropsy), on which account, the medical man +ought, when practicable, to be sent for at the onset, that no time may +be lost in applying _proper_ remedies. + +When Scarlet Fever is complicated--as it sometimes is--with +diphtheria, the diphtheric membrane is very apt to travel into the +wind-pipe, and thus to cause diphtheric croup, it is almost sure, when +such is the case, to end in death. When a child dies from such a +complication, the death might truly be said to be owing to the +diphtheric croup, and not to the Scarlet Fever, for if the diphtheric +croup had not occurred, the child would, in all probability, have been +saved. The deaths from diphtheria are generally from diphtheric croup, +if there be no croup, there is, as a rule, frequent recovery. + +220. _How would you distinguish between Scarlet Fever and Measles_? + +Measles commences with symptoms of a common cold, scarlet fever does +not. Measles has a _peculiar hoarse_ cough, scarlet fever has not. The +eruption of measles is in patches of a half moon shape, and is +slightly raised above the skin, the eruption of scarlet fever is _not_ +raised above the skin at all, and is one continued mass. The colour of +the eruption is much more vivid in scarlet fever than in measles. The +chest is the part principally affected in measles, and the throat in +scarlet fever. + +There is an excellent method of determining, for a certainty, whether +the eruption be that of scarlatina or otherwise. I myself have, in +several instances, ascertained the truth of it--"For several years M +Bouchut has remarked in the eruptions of scarlatina a curious +phenomenon, which serves to distinguish this eruption from that of +measles, erythema, erysipelas &c., a phenomenon essentially vital, +and which is connected with the excessive contractability of the +capillaries. The phenomenon in question is a _white line_, which can +be produced at pleasure by drawing the back of the nail along the skin +where the eruption, is situated. On drawing the nail, or the extremity +of a hard body (such as a pen-holder), along the eruption, the skin is +observed to grow pale, and to present a white trace, which remains for +one or two minutes, or longer, and then disappears. In this way the +diagnosis of the disease may be very distinctly written on the skin; +the word 'Scarlatina' disappears as the eruption regains its uniform +tint."--_Edinburgh Medical Journal._ + +221. _Is it of so much importance, then, to distinguish between +Scarlet fever and Measles_? + +It is of great importance, as in measles the patient ought to be kept +_moderately_ warm, and the drinks should be given with the chill off; +while in scarlet fever the patient ought to be kept cool--indeed, for +the first few days, _cold_--and the beverages, such as spring-water, +toast and water, &c., should be administered quite cold. + +222. _Do you believe in "Hybrid" Scarlet Fever--that is to say, in a +cross between Scarlet Fever and Measles_? + +I never in my life saw a case of "hybrid" scarlet fever--nor do I +believe in it. Scarlet fever and measles are both blood poisons, each +one being perfectly separate and distinct from the other. "Hybrid" +Scarlet fever is, in my opinion, an utter impossibility. In olden +times, when the symptoms of diseases were not so well and carefully +distinguished as now, scarlet fever and measles were constantly +confounded one with the other, and was frequently said to be +"hybrid"--a cross between measles and scarlet fever--to the patient's +great detriment and danger, the two diseases being as distinct and +separate as their treatment-and management ought to be. + +223. _What is the treatment of Scarlet Fever?_ [Footnote: On the 4th +of March 1856, I had the honour to read a _Paper on the Treatment of +Scarlet Fever_ before the members of Queens College Medico-Chirugical +Society, Birmingham--which _Paper_ was afterwards published in the +_Association Journal_ (March 15 1856) and in Braithwaite's _Retrospect +of Medicine_ (January--June, 1856) and in Rankings _Half Yearly +Abstract of the Medical Sciences_ (July--December, 1856), besides in +other publications. Moreover the _Paper_ was translated into German, +and published in _Canstatts Jahresbericht_, iv 456, 1859] + +_What to do_--Pray pay attention to my rules, and carry out my +directions to the letter--I can then promise, _that if the scarlet +fever be neither malignant nor complicated with diphtheria_, the plan +I am about to advise will, with God's blessing, be usually successful. + +What is the first thing to be done? Send the child to bed, throw open +the windows, be it winter or summer, and have a thorough ventilation, +for the bedroom must be kept cool, I may say cold. Do not be afraid of +fresh air, for fresh air, for the first few days, is essential to +recovery. _Fresh air, and plenty of it, in scarlet fever, is the best +doctor_ a child can have let these words be written legibly on your +mind. [Footnote: In the _Times_ of Sept 4, 1863, is the following +copied from the _Bridgewater Mercury_-- + +GROSS SUPERSTITION--In one of the streets of Taunton, there resides a +man and his wife who have the care of a child This child was attacked +with scarlatina, and to all appearance death was inevitable. A jury of +matrons was as it were empanelled, and to prevent the child 'dying +hard' all the doors in the house all the drawers, all the boxes all +the cupboards were thrown wide open, the keys taken out and the body +of the child placed under a beam, whereby a sure, certain, and easy +passage into eternity could be secured. Watchers held their vigils +throughout the weary night, and in the morning the child, to the +surprise of all, did not die, and is now gradually recovering. + +These old women--this jury of matrons--stumbled on the right remedy, +"all the doors in the house....were thrown vide open," and thus they +thoroughly ventilated the apartment. What was the consequence? The +child who, just before the opening of the doors, had all the +appearances "that death was inevitable," as soon as fresh air was let +in showed symptoms of recovery, "and in the morning the child, to the +surprise of all, did not die, and is now gradually recovering." There +is nothing wonderful--there is nothing surprising to my mind--in all +this. Ventilation--thorough ventilation--is the grand remedy for +scarlatina! Oh, that there were in scarlet fever cases a good many +such old women's--such a "jury of matrons'"--remedies! We should not +then be horrified, as we now are, at the fearful records of death, +which the Returns of the Registrar General disclose!] + +If the weather be either intensely cold, or very damp, there is no +objection to a small fire in the grate provided there be, at the same +time, air--an abundance of fresh air--admitted into the room. + +Take down the curtains of the bed, remove the valances. If it be +summer time, let the child be only covered with a sheet. If it be +winter time, in addition to the sheet, he should have one blanket over +him. + +Now for the throat--The best _external_ application is a barm and +oatmeal poultice How ought it to be made, and how applied? Put half a +tea-cupful of barm into a saucepan, put it on the fire to boil; as +soon as it boils, take it off the fire, and stir oatmeal into it, +until it be of the consistence of a nice soft poultice; then place it +on a rag, and apply it to the throat, carefully fasten it on with a +bandage, two or three turns of the bandage going round the throat, and +two or three over the crown of the head, so as nicely to apply the +poultice where it is wanted--that is to say, to cover the tonsils. +Tack the bandage: do not pin it. Let the poultice be changed three +times a day. The best medicine is the Acidulated Infusion of Roses, +sweetened with syrup:-- + + Take of--Dilated Sulphuric Acid, half a drachm; + Simple Syrup, one ounce and a half; + Acid Infusion of Roses, four ounces and a half: + +To make a Mixture. A table-spoonful to be taken every four hours. + +It is grateful and refreshing, it is pleasant to take, it abates fever +and thirst, it cleanses the throat and tongue of mucus, and is +peculiarly efficacious in scarlet fever; as soon as the fever is +abated it gives an appetite. My belief is that the sulphuric acid in +the mixture is a specific in scarlet fever, as much as quinine is in +ague, and sulphur in itch. I have reason to say so, for, in numerous +cases I have seen its immense value. + +Now, with regard to food.--If the child be at the breast, keep him +entirely to it. If he be weaned, and under two years old, give him +milk and water, and cold water to drink. If he be older, give him +toast and water, and plain water from the pump, as much as he chooses; +let it be quite cold--the colder the better. Weak black tea, or thin +gruel, may be given, but not caring, unless he be an infant at the +breast, if he take nothing but _cold_ water. If the child be two years +old and upwards, roasted apples with sugar, and grapes, will be very +refreshing, and will tend to cleanse both the mouth and the throat +Avoid broths and stimulants. + +When the appetite returns, you may consider the patient to be +safe. The diet ought now to be gradually improved. Bread and butter, +milk and water, and arrowroot made with equal parts of new milk and +water, should for the first two or three days be given. Then a light +batter or rice pudding may be added, and in a few days, either a +little chicken or a mutton chop. + +The essential remedies, then, in scarlet fever, are, for the first few +days--(1) plenty of fresh air and ventilation, (2) plenty of cold +water to drink, (3) barm poultices to the throat, and (4) the +Acidulated Infusion of Roses Mixture as a medicine. + +Now, then, comes very important advice. After the first few days, +probably five or six, sometimes as early as the fourth day--_watch +carefully and warily, and note the time, the skin will suddenly become +cool_, the child will say that he feels chilly; then is the time you +must now change your tactics--_instantly close the windows and put +extra clothing_, a blanket or two, on his bed. A flannel nightgown +should, until the dead skin have peeled off, be now worn next to the +skin, when the flannel nightgown should be discontinued. The patient +ought ever after to wear, in the day time, a flannel waistcoat. +[Footnote: On the importance--the vital importance--of the wearing of +flannel next to the skin, see "Flannel Waistcoats."] His drinks must +now be given with the chill off; he ought to have a warm cup of tea, +and gradually his diet should, as I have previously advised, be +improved. + +There is one important caution I wish to impress upon you,--_do not +give opening medicine during the time the eruption is out_. In all +probability the bowels will be opened: if so, all well and good; but +do not, on any account, for the first ten days, use artificial means +to open them. It is my firm conviction that the administration of +purgatives in scarlet fever is a fruitful source of dropsy, of +disease, and death. When we take into consideration the sympathy there +is between the skin and the mucous membrane, I think that we should +pause before giving irritating medicines, such as purgatives. The +irritation of aperients on the mucous membrane may cause the poison of +the skin disease (for scarlet fever is a blood-poison) to be driven +internally to the kidneys, to the throat, to the pericardium (bag of +the heart), or to the brain. You may say, Do you not purge if the +bowels be not open for a week? I say emphatically, No! + +I consider my great success in the treatment of scarlet fever to be +partly owing to my avoidance of aperients during the first ten days of +the child's illness. + +If the bowels, after the ten days, be not properly opened, a dose or +two of syrup of senna should be given: that is to say, one or two +tea-spoonfuls should be administered early in the morning, and should, +if the first dose does not operate, be repeated in four hours. + +In a subsequent Conversation, I shall strongly urge you not to allow +your child, when convalescent, to leave the house under at least a +month from the commencement of the illness; I, therefore, beg to refer +you to that Conversation, and hope that you will give it your best and +earnest consideration! During the last twenty years I have never had +dropsy from scarlet fever, and I attribute it entirely to the plan I +have just recommended, and in not allowing my patients to leave the +house under the month--until, in fact, the skin that had peeled off +has been renewed. + +Let me now sum up the plan I adopt, and which I beg leave to designate +as--Pye Chavasse's Fresh Air Treatment of Scarlet Fever:-- + +1. Thorough ventilation, a cool room, and scant clothes on the bed, +for the first five or six days. + +2. A change of temperature of the skin to be carefully regarded. As +soon as the skin is cool, closing the windows, and putting additional +clothing on the bed. + +3. The Acidulated Infusion of Hoses with Syrup is _the_ medicine for +scarlet fever. + +4. Purgatives to be religiously avoided for the first ten days at +least, and even afterwards, unless there be absolute necessity. + +5. Leeches, blisters, emetics, cold and tepid spongings, and painting +the tonsils with caustic, inadmissible in scarlet fever. + +6. A strict antiphlogistic (low) diet for the first few days, during +which time cold water to be given _ad libitum_. + +7. The patient not to leave the house in the summer under the month; +in the winter, under six weeks. + +_What NOT to do._--Do not, then, apply either leeches or blisters to +the throat; do not paint the tonsils with caustic; do not give +aperients; do not, on any account, give either calomel or emetic +tartar; do not, for the first few days of the illness, be afraid of +_cold air_ to the skin, and of cold water as a beverage; do not, +emphatically let me say, _do not_ let the child leave the house for at +least a month from the commencement of the illness. + +My firm conviction is, that purgatives, emetics, and blisters, by +depressing the patient, sometimes cause ordinary scarlet fever to +degenerate into malignant scarlet fever. + +I am aware that some of our first authorities advocate a different +plan to mine. They recommend purgatives, which I may say, in scarlet +fever, are my dread and abhorrence. They advise cold and tepid +spongings--a plan which I think dangerous, as it will probably drive +the disease internally. Blisters, too, have been prescribed; these I +consider weakening, injurious, and barbarous, and likely still more to +inflame the already inflamed skin. They recommend leeches to the +throat, which I am convinced, by depressing the patient, will lessen +the chance of his battling against the disease, and will increase the +ulceration of the tonsils. Again, the patient has not too much blood; +the blood is only poisoned. I look upon scarlet fever as a specific +poison of the blood, and one which will be eliminated from the system, +_not_ by bleeding, _not_ by purgatives, _not_ by emetics but by a +constant supply of fresh and cool air, by the acid treatment, by cold +water as a beverage, and for the first few days by a strict +antiphlogistic (low) diet. Sydenham says that scarlet fever is +oftentimes "fatal through the officiousness of the doctor." I +conscientiously believe that a truer remark was never made; and that, +under a different system to the usual one adopted, scarlet fever would +not be so much dreaded. [Footnote: If any of my medical brethren +should do me the honour to read these pages, let me entreat them to +try my plan of treating scarlet fever, as my success has been great. I +have given full and minute particulars, in order that they and mothers +(if mothers cannot obtain medical advice) may give my plan a fair and +impartial trial. My only stipulations are that they must _begin_ with +my treatment, and _not mix_ any other with it, and carry out my plan +to the very letter. I then, with God's blessing, provided the cases be +neither malignant nor complicated with diphtheria, shall not fear the +result. If any of my _confreres_ have tried my plan of treatment of +scarlet fever--and I have reason to know that many have--I should feel +grateful to them if they would favour me with their opinion as to its +efficacy. Address--"Pye Chavasse, 214 Hagley Road, Birmingham."] + +Dr Budd, of Bristol, recommends, in the _British Medical Journal_, +that the body, including the scalp, of a scarlet fever patient, +should, after about the fourth day, be anointed, every night and +morning, with camphorated oil; this anointing to be continued until +the patient is able to take a warm bath and use disinfectant soap: +this application will not only be very agreeable to the patient's +feelings, as there is usually great irritation and itching of the +skin, but it will, likewise, be an important means of preventing the +dead skin, which is highly infectious, and which comes off partly in +flakes and partly floats about the air as dust, from infecting other +persons. The plan is an excellent one, and cannot be too strongly +recommended. + +If the case be a combination of scarlet fever and of diphtheria, as it +unfortunately now frequently is, let it be treated as a case of +diphtheria. + +224. _I have heard of a case of Scarlet Fever, where the child, before +the eruption showed itself, was suddenly struck prostrate, cold, and +almost pulseless: what, in such a case, are the symptoms, and what +immediate treatment do you advise_? + +There is an _exceptional_ case of scarlet fever, which now and then +occurs, and which requires _exceptional_ and prompt treatment, or +death will quickly ensue. We will suppose a case: one of the number, +where nearly all the other children of a family are labouring under +scarlet fever, is quite well, when suddenly--in a few hours, or even, +in some cases, in an hour--utter prostration sets in, he is very cold, +and is almost pulseless, and is nearly insensible--comatose. + +Having sent instantly for a judicious medical man, apply, until he +arrives, hot bottles, hot bricks, hot bags of salt to the patient's +feet and legs and back, wrap him in hot blankets, close the window, +and give him hot brandy and water--a tablespoonful of brandy to half a +tumblerful of hot water--give it him by teaspoonfuls, continuously--to +keep him alive; when he is warm and restored to consciousness, the +eruption will probably show itself, and he will become hot and +feverish; then your tactics must, at once, be changed, and my Fresh +Air Treatment, and the rest of the plan I have before advised must in +all its integrity, be carried out. + +We sometimes hear of a child, before the eruption comes out and within +twenty-four hours of the attack, dying of scarlet fever. When such be +the case it is probably owing to low vitality of the system--to utter +prostration--he is struck down, as though for death, and if the plan +be not adopted of, for a few hours, keeping him alive by heat, and by +stimulants, until, indeed, the eruption comes out, he will never rally +again, but will die from scarlet fever poisoning and from utter +exhaustion. These cases are comparatively rare, but they do, from +time to time, occur, and, when they do, they demand exceptional and +prompt and energetic means to save them from ending in almost +immediate and certain death. "To be forewarned is to be forearmed." +[Footnote: I have been reminded of this _exceptional_ case of scarlet +fever by a most intelligent and valued patient of mine, who had a +child afflicted as above described, and whose child was saved from +almost certain death, by a somewhat similar plan of treatment as +advised in the text.] + +225. _How soon ought a child to be allowed to leave the house after an +attack of Scarlet Fever_? + +He must not be allowed to go out for at least a month from the +commencement of the attack, in the summer, and six weeks in the +winter; and not even then without the express permission of a medical +man. It might be said that this is an unreasonable recommendation: but +when it is considered that the whole of the skin generally +desquamates, or peels off, and consequently leaves the surface of the +body exposed to cold, which cold flies to the kidneys, producing a +peculiar and serious disease in them, ending in dropsy, this warning +will not be deemed unreasonable. + +Scarlet fever dropsy, which is really a _formidable disease, generally +arises from, the carelessness, the ignorance, and the thoughtlessness +of parents in allowing a child to leave the house before the new skin +be properly formed and hardened._ Prevention is always better than +cure. + +Thus far with regard to the danger to the child himself. Now, if you +please, let me show you the risk of contagion that you inflict upon +families, in allowing your child to mix with others before a month at +least has elapsed. Bear in mind, a case is quite as contagious, if not +more so, while the skin is peeling off, as it was before. Thus, in ten +days or a fortnight, there is as much risk of contagion as at the +_beginning_ of the disease, and when the fever is at its height. At +the conclusion of the month, the old skin has generally all peeled +off, and the new skin has taken its place; consequently there will +then be less fear of contagion to others. But the contagion of scarlet +fever is so subtle and so uncertain in its duration, that it is +impossible to fix the exact time when it ceases. + +Let me most earnestly implore you to ponder well on the above +important facts. If these remarks should be the means of saving only +one child from death, or from broken health, my labour will not have +been in vain. + +226. _What means do you advise to purify a house, clothes, and +furniture, from the contagion of Scarlet Fever_? + +Let every room in the house, together with its contents, and clothing +and dresses that cannot be washed, be well fumigated with +sulphur--taking care the while to close both windows and door; let +every room be _lime-washed_ and then be white-washed; if the contagion +have been virulent, let every bedroom be freshly papered (the walls +having been previously stripped of the old paper and then +lime-washed); let the bed, the holsters, the pillows, and the +mattresses be cleansed and purified; let the blankets and coverlids be +thoroughly washed, and then let them be exposed to the open air--if +taken into a field so much the better; let the rooms be well scoured; +let the windows, top and bottom, be thrown wide open; let the drains +be carefully examined; let the pump water be scrutinised, to see that +it be not contaminated by faecal matter, either from the water-closet, +from the privy, from the pig-stye, or from the stable; let privies be +emptied of their contents--_remember this is most important +advice_--then put, into the empty places, either lime and powdered +charcoal or carbolic acid, for it is a well ascertained fact that it +is frequently impossible to rid a house of the infection of scarlet +fever without adopting such a course. "In St George's, Southwark, the +medical officer reports that scarlatina 'has raged fatally, almost +exclusively where privy or drain, smells are to be perceived in the +houses.'" [Footnote: _Quarterly Report of the Board of Health_ upon +Sickness in the Metropolis.] Let the children, who have not had, or +who do not appear to be sickening for scarlet fever, be sent away from +home--if to a farm house so much the better. Indeed, leave no stone +unturned, no means untried, to exterminate the disease from the house +and from the neighbourhood. Remember the young are more prone to catch +contagious diseases than adults; for + + "in the morn and liquid dew of youth + Contagious blastments are most imminent."--_Shakspeare_. + +227. _Have you any further observations to offer on the precautions to +be taken against the spread of Scarlet Fever_? + +Great care should be taken to separate the healthy from the +infected. The nurses selected for attending scarlet fever patients +should be those who have previously had scarlet fever themselves. +Dirty linen should be removed at once, and be put into boiling +water. Very little furniture should be in the room of a scarlet fever +patient--the less the better--it only obstructs the circulation of the +air, and harbours the scarlet fever poison. The most scrupulous +attention to cleanliness should, in these cases, be observed. A +patient who has recovered from scarlet fever, and before he mixes with +healthy people, should, for three or four consecutive mornings, have a +warm bath, and well wash himself, while in the bath, with soap; he +will, by adopting this plan, get rid of the dead skin, and thus remove +the infected particles of the disease. If scarlet fever should appear +in a school, the school must for a time be broken up, in order that +the disease might be stamped out There must be no half measures where +such a fearful disease is in question. A house containing scarlet +fever patients should, by parents, be avoided as the plague; it is a +folly at any time to put one's head into the lion's mouth! Chloralum +and carbolic acid, and chloride of lime, and Condy's fluid, are each +and all good disinfectants; but not one is to be compared to perfect +cleanliness and to an abundance of fresh and pure air--the last of +which may truly _par excellence_ be called God's disinfectant! Either +a table-spoonful of chloralum, or two tea-spoonfuls of carbolic acid, +or two tea-spoonfuls of Condy's fluid, or a tea-spoonful of chloride +of lime in a pint of water, are useful to sprinkle the soiled +handkerchiefs as soon as they be done with, and before the be washed, +to put in the _pot-de-chambre_, and to keep in saucers about the room; +but, remember, as I have said before, and cannot repeat too often, +there is no preventative like the air of heaven, which should be +allowed to permeate and circulate freely through the apartment and +through the house: air, air, air is the best disinfectant, curative, +and preventative of scarlet fever in the world! + +I could only wish that my _Treatment of Scarlet Fever_ were, in all +its integrity, more generally adopted; if it were, I am quite sure +that thousands of children would annually be saved from broken health +and from death. Time still further convinces me that my treatment is +based on truth as I have every year additional proofs of its value and +of its success; but error and prejudice are unfortunately ever at +work, striving all they can to defeat truth and common sense. One of +my principal remedies in the treatment of scarlet fever is an +abundance of fresh air; but many people prefer their own miserable +complicated inventions to God's grand and yet simple remedies--they +pretend that they know better than the Mighty Framer of the universe! + +228. _Will you describe the symptoms of Chicken pox_? + +It is occasionally, but not always, ushered in with a slight shivering +fit; the eruption shows itself in about twenty-four hours from the +child first appearing poorly. It is a vesicular [Footnote: +_Vesicles_. Small elevations of the cuticle, covering a fluid which +is generally clear and colourless at first, but afterwards whitish and +opaque, or pearly.--_Watson_.] disease. The eruption comes out in the +form of small pimples, and principally attacks the scalp, the neck, +the back, the chest, and the shoulders, but rarely the face; while in +small-pox the face is generally the part most affected. The next day +these pimples fill with water, and thus become vesicles; on the third +day they are at maturity. The vesicles are quite separate and distinct +from each other. There is a slight redness around each of them. Fresh +ones, whilst the others are dying away, make their appearance. +Chicken-pox is usually attended with a slight itching of the skin; +when the vesicles are scratched the fluid escapes, and leaves hard +pearl-like substances, which, in a few days, disappear. Chicken-pox +never leaves pit marks behind. It is a child's complaint; adults +scarcely, if ever, have it. + +229. _Is there any danger in Chicken-pox; and what treatment do you +advise_? + +It is not at all a dangerous, but, on the contrary, a trivial +complaint. It lasts only a few days, and requires but little +medicine. The patient ought, for three or four days, to keep the +house, and should abstain from animal food. On the sixth day, but not +until then, a dose or two of a mild aperient is all that will be +required. + +230. _Is Chicken-pox infectious_? + +There is a diversity of opinion on this head, but one thing is +certain--it cannot be communicated by inoculation. + +231. _What are the symptoms of Modified Small-pox_? + +The Modified Small-pox--that is to say, small-pox that has been robbed +of its virulence by the patient having been either already vaccinated, +or by his having had a previous attack of small-pox--is ushered in +with severe symptoms, with symptoms almost as severe as though the +patient had not been already somewhat protected either by vaccination +or by the previous attack of small-pox--that is to say, he has a +shivering fit, great depression of spirits and debility, _malaise_, +sickness, headache, and occasionally delirium. After the above +symptoms have lasted about three days, the eruption shows itself. The +immense value of the previous vaccination, or the previous attack of +small-pox, now comes into play. In a case of _unprotected_ small-pox, +the appearance of the eruption _aggravates_ all the above symptoms, +and the danger begins; while in the _modified_ small-pox, the moment +the eruption shows itself the patient feels better, and, as a rule, +rapidly recovers. The eruption, of _modified_ small-pox varies +materially from the eruption of the _unprotected_ small-pox. The +former eruption assumes a varied character, and is composed, first, of +vesicles (containing water); and, secondly, of pustules (containing +matter), each of which pustules has a depression in the centre; and, +thirdly, of several red pimples without either water or matter in +them, and which sometimes assume a livid appearance. These +"breakings-out" generally show themselves more upon the wrist, and +sometimes up one or both of the nostrils. While in the latter +disease--the _unprotected_ small-pox--the "breaking-out" is composed +entirely of pustules containing matter, and which pustules are more on +the face than on any other part of the body. There is generally a +peculiar smell in both diseases--an odour once smelt never to be +forgotten. + +Now, there is one most important remark I have to make,--the _modified +small-pox is contagious_. This ought to be borne in mind, as a person +labouring under the disease must, if there be children in the house, +either be sent away himself, or else the children ought to be banished +both the house and the neighbourhood. Another important piece of +advice is,--let _all_ in the house--children and adults, one and +all--be vaccinated, even if any or all have been previously +vaccinated. + +_Treatment_.--Let the patient keep his room, and if he be very ill, +his bed. Let the chamber be well ventilated. If it be winter time, a +small fire in the grate will encourage ventilation. If it be summer, a +fire is out of the question; indeed, in such a case, the window-sash +ought to be opened, as thorough ventilation is an important requisite +of cure, both in small-pox and in _modified_ small-pox. While the +eruption is out, do not on any account give aperient medicine. In ten +days from the commencement of the illness a mild aperient may be +given. The best medicine in these cases is, the sweetened Acidulated +Infusion of Roses, [Footnote: See page 178] which ought to be given +from the commencement of the disease, and should be continued until +the fever be abated. For the first few days, as long as the fever +lasts, the patient ought not to be allowed either meat or broth, but +should be kept on a low diet, such as on gruel, arrow-root, +milk-puddings, &c. As soon as the fever is abated he ought gradually +to resume his usual diet. When he is convalescent, it is well, where +practicable, that he should have change of air for a month. + +232. _How would you distinguish between Modified Small-pox and +Chicken-pox_? + +Modified small-pox may readily be distinguished from chicken-pox, by +the former disease being, notwithstanding its modification, much more +severe and the fever much more intense before the eruption shows +itself than chicken-pox; indeed, in chicken-pox there is little or no +fever either before or after the eruption; by the former disease--the +modified small-pox--consisting _partly_ of pustules (containing +matter), each pustule having a depression in the centre, and the +favourite localities of the pustules being the wrists and the inside +of the nostrils; while, in the chicken-pox, the eruption consists of +vesicles (containing water), and _not_ pustules (containing matter), +and the vesicles having neither a depression in the centre, nor having +any particular partiality to attack either the wrists or the inside of +the nose. In modified small-pox each pustule is, as in unprotected +small-pox, inflamed at the base; while in chicken-pox there is only +very slight redness around each vesicle. The vesicles in chicken-pox +are small--much smaller than the pustules in modified small-pox. + +233. _Is Hooping-cough an inflammatory disease_? + +Hooping-cough in itself is not inflammatory, it is purely spasmodic; +but it is generally accompanied with more or less of bronchitis-- +inflammation of the mucous membrane of the bronchial tubes--on which +account it is necessary, _in all cases_ of hooping-cough, to consult a +medical man, that he may watch the progress of the disease and nip +inflammation in the bud. + +234. _Will you have the goodness to give the symptoms, and a brief +history of, Hooping-cough_? + +Hooping-cough is emphatically a disease of the young; it is rare for +adults to have it; if they do, they usually suffer more severely than +children. A child seldom has it but once in his life. It is highly +contagious, and therefore frequently runs through a whole family of +children, giving much annoyance, anxiety, and trouble to the mother +and the nurses; hence hooping-cough is much dreaded by them. It is +amenable to treatment. Spring and summer are the best seasons of the +year for the disease to occur. This complaint usually lasts from six +to twelve weeks--sometimes for a much longer period, more especially +if proper means are not employed to relieve it. + +Hooping-cough commences as a common cold and cough. The cough, for ten +days or a fortnight, increases in intensity; at about which time it +puts on the characteristic "hoop." The attack of cough comes on in +paroxysms. In a paroxysm, the child coughs so long and so violently, +and _expires_ so much air from the lungs without _inspiring_ any, that +at times he appears nearly suffocated and exhausted; the veins of his +neck swell; his face is nearly purple; his eyes, with the tremendous +exertion, almost seem to start from their sockets; at length there is +a sudden _inspiration_ of air through the contracted chink of the +upper part of the wind-pipe--the glottis--causing the peculiar "hoop;" +and after a little more coughing, he brings up some glairy mucus from +the chest; and sometimes, by vomiting, food from the stomach; he is at +once relieved, until the next paroxysm occur, when the same process is +repeated, the child during the intervals, in a favourable case, +appearing quite well, and after the cough is over, instantly returning +either to his play or to his food. Generally, after a paroxysm he is +hungry, unless, indeed, there be severe inflammation either of the +chest or of the lungs. Sickness, as I before remarked, frequently +accompanies hooping-cough; when it does, it might be looked upon as a +good sign. The child usually knows when an attack is coming on; he +dreads it, and therefore tries to prevent it; he sometimes partially +succeeds; but, if he does, it only makes the attack, when it does +come, more severe. All causes of irritation and excitement ought, as +much as possible, to be avoided, as passion is apt to bring on a +severe paroxysm. + +A new-born babe--an infant of one or two months old--commonly escapes +the infection; but if, at that tender age, he unfortunately catch +hooping-cough, it is likely to fare harder with him than if he were +older--the younger the child, the greater the risk. But still, in such +a case, do not despair, as I have known numerous instances of new-born +infants, with judicious care, recover perfectly from the attack, and +thrive after it as though nothing of the kind had ever happened. + +A new-born babe, labouring under hooping-cough, is liable to +convulsions, which is in this disease one, indeed the great, source of +danger. A child, too, who is teething, and labouring under the +disease, is also liable to convulsions. When the patient is +convalescing, care ought to be taken that he does not catch cold, or +the "hoop" might return. Hooping-cough may either precede, attend, or +follow an attack of measle. + +235. _What is the treatment of Hooping-cough_? + +We will divide the hooping-cough into three stages, and treat each +stage separately, + +_What to do.--In the first stage_, the commencement of hooping-cough: +For the first ten days give the Ipecacuanha Wine Mixture, [Footnote: +For the prescription of the Ipecacuanha Wine Mixture, see page 161.] a +tea-spoonful three times a day. If the child be not weaned, keep him +entirely to the breast, if he be weaned, to a milk and farinaceous +diet. Confine him for the first ten days to the house, more especially +if the hooping-cough be attended, as it usually is, with more or less +bronchitis. But take care that the rooms be well ventilated; for good +air is essential to the cure. + +If the bronchitis attending the hooping-cough be severe, confine him +to his bed, and treat him as though it were simply a case of +bronchitis. [Footnote: For the treatment of bronchitis, see answer to +207th question.] + +_In the second stage_, discontinue the Ipecacuanha Mixture, and give +Dr Gibb's remedy--namely, Nitric Acid--which I have found to be an +efficacious and valuable one in hooping-cough:-- + + Take of--Diluted Nitric Acid, two drachms; + Compound Tincture of Cardamons, half a drachm; + Simple Syrup, three ounces; + Water, two ounces and a half: + +Make a Mixture. One or two tea-spoonfuls, or a table-spoonful, +according to the age of the child--one tea-spoonful for an infant of +six months, and two tea-spoonfuls for a child of twelve months, and +one table-spoonful for a child of two years, every four hours, first +shaking the bottle. + +Let the spine and the chest be well rubbed every night and morning +either with Roche's Embrocation, or with the following stimulating +liniment (first shaking the bottle):-- + + Take of--Oil of Cloves, one drachm; + Oil of Amber, two drachms; + Camphorated Oil, nine drachms: + +Make a Liniment. + +Let him wear a broad band of new flannel, which should extend round +from his chest to his back, and which ought to be changed every night +and morning, in order that it may be dried before putting on again. To +keep it in its place it should be fastened by means of tapes and with +shoulder-straps. + +The diet ought now to be improved--he should gradually return to his +usual food; and, weather permitting, should almost live in the open +air--fresh air being, in such a case, one of the finest medicines. + +_In the third stage_, that is to say, when the complaint has lasted a +month, if by that time the child is not well, there is nothing like +change of air to a high, dry, healthy, country place. Continue the +Nitric Acid Mixture, and either the Embrocation or the Liniment to the +back and the chest, and let him continue to almost live in the open +air, and be sure that he does not discontinue wearing the flannel +until he be quite cured, and then let it be left off by degrees. + +If the hooping-cough have caused debility, give him Cod-liver Oil--a +tea-spoonful twice or three times a day, giving it him on a full +stomach, after his meals. But, remember, after the first three or four +weeks, change of air, and plenty of it, is for hooping-cough the grand +remedy. + +_What NOT to do_.--"Do not apply leeches to the chest, for I would +rather put blood into a child labouring under hooping-cough than take +it out of him--hooping-cough is quite weakening enough to the system +of itself without robbing him of his life's blood; do not, on any +account whatever, administer either emetic tartar or antimonial wine; +do not give either paregoric or syrup of white poppies; do not drug +him either with calomel or with grey-powder; do not dose him with +quack medicine; do not give him stimulants, but rather give him plenty +of nourishment, such as milk and farinaceous food, but _no_ +stimulants; do not be afraid, after the first week or two, of his +having fresh air, and plenty of it--for fresh, pure air is the grand +remedy, after all that can be said and done, in hooping-cough. +Although occasionally we find that, if the child to labouring under +hooping-cough, and is breathing a pure country air, and is not getting +well so rapidly as we could wish, change of air to a smoky gas-laden +town will sometimes quickly effect a cure; indeed, some persons go so +far as to say that the _best_ remedy for an _obstinate_ case of +hooping-cough is, for the child to live, the great part of every day, +in gas-works!" + +236. _What is to be done during a paroxysm of Hooping-cough_? + +If the child be old enough, let him stand up; but if he be either too +young or too feeble, raise his head, and bend his body a little +forward; then support his back with one hand, and the forehead with +the other. Let the mucus, the moment it be within reach, be wiped with +a soft handkerchief out of his mouth. + +237. _In an obstinate case of Hooping-cough, what is the best remedy_? + +Change of air, provided there be no active inflammation, to any +healthy spot. A farm-house, in a high, dry, and salubrious +neighbourhood, is as good a place as can be chosen. If, in a short +time, he be not quite well, take him to the sea-side: the sea breezes +will often, as if by magic, drive away the disease. + +238. _Suppose my child should have a shivering fit, is it to be looked +upon as an important symptom_? + +Certainly. Nearly all _serious_ illnesses commence with a shivering +fit: severe colds, influenza, inflammations of different organs, +scarlet fever, measles, small-pox, and very many other diseases, begin +in this way. If, therefore, your child should ever have a shivering +fit, _instantly_ send for a medical man, as delay might be +dangerous. A few hours of judicious treatment, at the commencement of +an illness, is frequently of more avail than days and weeks, nay +months, of treatment, when disease has gained a firm footing. A +_serious_ disease often steals on insidiously, and we have perhaps +only the shivering fit, which might be but a _slight_ one, to tell us +of its approach. + +A _trifling_ ailment, too, by neglecting the premonitory symptom, +which, at first might only be indicated by a _slight_ shivering fit, +will sometimes become a mortal disorder:-- + + "The little rift within the lute, + That by-and-by will make the music mute, + And ever widening slowly silence all." [Footnote: The above extract + from Tennyson is, in my humble opinion, one of the most beautiful + pieces of poetry in the English language. It is a perfect gem, and a + volume in itself, so truthful, so exquisite, so full of the most + valuable reflections; for instance--(1.) "The little rift within the + lute,"--the little tubercle within the lung "that by-and-by will + make the music mute, and ever widening slowly silence all," and the + patient eventually dies of consumption. (2.) The little rent--the + little rift of a very minute vessel in the brain, produces an attack + of apoplexy, and the patient dies. (3.) Each and all of us, in one + form or another, sooner or later, will have "the little rift within + the lute." But why give more illustrations?--a little reflection + will bring numerous examples to my fair reader's memory.] + +239. _In case of a shivering fit, perhaps you will tell me what to +do_? + +_Instantly_ have the bed warmed, and put the child to bed. Apply +either a hot bottle or a hot brick, wrapped in flannel, to the soles +of his feet. Put an extra blanket on his bed, and give him a cup of +hot tea. As soon as the shivering fit is over, and he has become hot, +gradually lessen the _extra_ quantity of clothes on his bed, and take +away the hot bottle or the hot brick from his feet. + +_What NOT to do_.--Do not give either brandy or wine, as inflammation +of some organ might be about taking place. Do not administer opening +medicine, as there might be some "breaking out" cooling out on the +skin, and an aperient might check it. + +240. _My child, apparently otherwise healthy, screams out in the night +violently in his sleep, and nothing for a time will pacify him: what +is likely to be the cause, and what is the treatment_? + +The causes of these violent screamings in the night are various. At +one time, they proceed from teething; at another, from worms; +sometimes, from night-mare; occasionally, from either disordered +stomach or bowels. Each of the above causes will, of course, require +a different plan of procedure; it will, therefore, be necessary to +consult a medical man on the subject, who will soon, with appropriate +treatment, be able to relieve him. + +241. _Have the goodness to describe the complaint of children called +Mumps_. + +The mumps, inflammation of the "parotid" gland, is commonly ushered in +with a slight feverish attack. After a short time, a swelling, of +stony hardness, is noticed before and under the ear, which swelling +extends along the neck towards the chin. This lump is exceedingly +painful, and continues painful and swollen for four or five days. At +the end of which time it gradually disappears, leaving not a trace +behind. The swelling of mumps never gathers. It may affect one or both +sides of the face. It seldom occurs but once in a lifetime. It is +contagious, and has been known to run through a whole family or +school; but it is not dangerous, unless, which is rarely the case, it +leaves the "parotid" gland, and migrates either to the head, to the +breast, or to the testicle. + +242. _What is the treatment of Mumps_? + +Foment the swelling, four or five times a day, with a flannel wrung +out of hot camomile and poppy-head decoction; [Footnote: Four +poppy-heads and four ounces of camomile blows to be boiled in four +pints of water for half an hour, and then strained to make the +decoction.] and apply, every night, a barm and oatmeal poultice to the +swollen gland or glands. Debar, for a few days, the little patient +from taking meat and broth, and let him live on bread and milk, light +puddings, and arrow-root. Keep him in a well-ventilated room, and shut +him out from the company of his brothers, his sisters, and young +companions. Give him a little mild, aperient medicine. Of course, if +there be the slightest symptom of migration to any other part or +parts, instantly call in a medical man. + +243. _What is the treatment of a Boil_? + +One of the best applications is a Burgundy-pitch plaster spread on a +soft piece of wash leather. Let a chemist spread a plaster, about the +size of the hand; and, from this piece, cut small plasters, the size +of a shilling or a florin (according to the dimensions of the boil), +which snip around and apply to the part. Put a fresh one on +daily. This plaster will soon cause the boil to break; when it does +break, squeeze out the contents--the core and the matter--and then +apply one of the plasters as before, which, until the boil be well, +renew every day. + +The old-fashioned remedy for a boil--namely, common yellow soap and +brown-sugar, is a capital one for the purpose. It is made with equal +parts of brown sugar and of shredded yellow soap, and mixed by means +of a table-knife on a plate, with a few drops of water, until it be +all well blended together, and of the consistence of thick paste; it +should then be spread either on a piece of wash-leather, or on thick +linen, and applied to the boil, and kept in its place by means either +of a bandage or of a folded handkerchief; and should he removed once +or twice a day. This is an excellent application for a boil--soothing, +comforting, and drawing--and will soon effect a cure. A paste of honey +and flour, spread on linen rag, is another popular and good +application for a boil. + +_If the boils should arise from the child being in a delicate state of +health_, give him cod-liver oil, meat once a day, and an abundance of +milk and farinaceous food. Let him have plenty of fresh air, +exercise, and play. + +_If the boil should arise from gross and improper feeding_, then keep +him for a time from meat, and let him live principally on a milk and +farinaceous diet. + +_If the child be fat and gross_, cod-liver oil would he improper; a +mild aperient, such as rhubarb and magnesia, would then be the best +medicine. + +244. _What are the symptoms of Ear-ache_? + +A young child screaming shrilly, violently, and continuously, is +oftentimes owing to ear-ache; carefully, therefore, examine each ear, +and ascertain if there be any discharge; if there be, the mystery is +explained. + +Screaming from ear-ache may be distinguished from the screaming from +bowel-ache by the former (ear-ache) being more continuous--indeed, +being one continued scream, and from the child putting his hand to his +head; while, in the latter (bowel-ache), the pain is more of a coming +and of a going character, and he draws up his legs to his +bowels. Again, in the former (ear-ache), the secretions from the +bowels are natural; while, in the latter (bowel-ache), the secretions +from the bowels are usually depraved, and probably offensive. But a +careful examination of the ear will generally at once decide the +nature of the case. + +213. _What is the best remedy for Ear-ache_? + +Apply to the ear a small flannel bag, filled with hot salt--as hot as +can be comfortably borne, or foment the ear with a flannel wrung out +of hot camomile and poppy head decoction. A roasted onion, inclosed in +muslin applied to the ear, is an old-fashioned and favourite remedy, +and may, if the bag of hot salt, or if the hot fomentation do not +relieve, be tried. Put into the ear, but not very far, a small piece +of cotton wool, moistened with warm olive oil. Taking care that the +wool is always removed before a fresh piece be substituted, as if it +be allowed to remain in any length of time, it may produce a discharge +from the ear. Avoid all _cold_ applications. If the ear-ache be +severe, keep the little fellow at home, in a room of equal +temperature, but well-ventilated, and give him, for a day or two, no +meat. + +If a discharge from the ear should either accompany or follow the +ear-ache, _more especially if the discharge be offensive_, instantly +call in a medical man, or deafness for life may be the result. + +A knitted or crotcheted hat, with woollen rosettes over the ears, is, +in the winter time, an excellent hat for a child subject to +ear-ache. The hat may be procured at any baby-linen warehouse. + +246. _What are the causes and the treatment of discharges from the +Ear_? + +Cold, measles, scarlet fever, healing up of "breakings out" behind the +ear; pellets of cotton wool, which had been put in the ear, and had +been forgotten to be removed, are the usual causes of discharges from +the ear. It generally commences with ear-ache. + +The _treatment_ consists in keeping the parts clean, by syringing the +ear every morning with warm water, by attention to food--keeping the +child principally upon a milk and a farmaceous diet, and by change of +air--more especially to the coast. If change of air be not +practicable, great attention should be paid to ventilation. As I have +before advised, in all cases of discharge from the ear call in a +medical man, as a little judicious medicine is advisable--indeed, +essential; and it may be necessary to syringe the ear with lotions, +instead of with warm water; and, of course, it is only a doctor who +has actually seen the patient who can decide these matters, and what +is best to be done in each case. + +247. _What is the treatment of a "stye" on the eye-lid_? + +Bathe the eye frequently with warm milk and water, and apply, every +night at bedtime, a warm white-bread poultice. + +No medicine is required; but, if the child be gross, keep him for a +few days from meat, and let him live on bread and milk and farinaceous +puddings. + +248. _If a child have large bowels, what would you recommend as likely +to reduce their size_? + +It ought to be borne in mind, that the bowels of a child are larger in +proportion than those of an adult. But, if they be actually larger +than they ought to be, let them be well rubbed for a quarter of an +hour at a time night and morning, with soap liniment, and then apply a +broad flannel belt. "A broad flannel belt worn night and day, firm but +not tight, is very serviceable." [Footnote: Sir Charles Locock, in a +_Letter_ to the Author.] The child ought to be prevented from drinking +as much as he has been in the habit of doing; let him be encouraged to +exercise himself well in the open air; and let strict regard be paid +to his diet. + +249. _What are the best aperients for a child_? + +If it be _actually_ necessary to give him opening medicine, one or two +tea-spoonfuls of Syrup of Senna, repeated, if necessary, in four +hours, will generally answer the purpose; or, for a change, one or two +tea-spoonfuls of Castor Oil may be substituted. Lenitive Electuary +(Compound Confection of Senna) is another excellent aperient for the +young, it being mild in its operation, and pleasant to take; a child +fancying it is nothing more than jam, and which it much resembles both +in appearance and in taste. The dose is half or one tea-spoonful +early in the morning occasionally. Senna is an admirable aperient for +a child, and is a safe one, which is more than can be said of many +others. It is worthy of note that "the taste of Senna may be concealed +by sweeting the infusion, [Footnote: Infusion of Senna may be procured +of any respectable druggist. It will take about one or two +table-spoonfuls, or even more, of the infusion (according to the age +of the child, and the obstinacy of the bowels), to act as an +aperient. Of course, you yourself will be able, from time to time, as +the need arises, to add the milk and the sugar, and thus to make it +palatable. It ought to be given warm, so as the more to resemble tea.] +adding milk, and drinking as ordinary tea, which, when thus prepared, +it much resembles" [Footnote: _Waring's Manual of Practical +Therapeutics._] Honey, too, is a nice aperient for a child--a +tea-spoonful ought to be given either by itself, or spread on a slice +of bread. + +Some mothers are in the habit of giving their children jalap +gingerbread. I do not approve of it, as jalap is a drastic, griping +purgative; besides, jalap is very nasty to take--nothing will make it +palatable. + +Fluid Magnesia--Solution of Carbonate of Magnesia--is a good aperient +for a child; and, as it has very little taste, is readily given, more +especially if made palatable by the addition either of a little syrup +or of brown sugar. The advantages which it has over the old solid form +are, that it is colourless and nearly tasteless, and never forms +concretions in the bowels, as the _solid_ magnesia, if persevered in +for any length of time, sometimes does. A child of two or three years +old may take one or two table-spoonfuls of the fluid; either by itself +or in his food, repeating it every four hours until the bowels be +open. When the child is old enough to drink the draught off +_immediately_, the addition of one or two tea-spoonfuls of Lemon Juice +to each dose of the Fluid Magnesia, makes a pleasant effervescing +draught, and increases its efficacy as an aperient. + +Bran-bread [Footnote: One-part of bran to three parts of flour, mixed +together and made into bread.] and _treacle_ will frequently open the +bowels; and as treacle is wholesome, it may be substituted for butter +when the bowels are inclined to be costive. A roasted apple, eaten +with _raw_ sugar, is another excellent mild aperient for a child. Milk +gruel--that is to say, milk thickened with oatmeal--forms an excellent +food for him, and often keeps his bowels regular, and thus (_which is +a very important consideration_) supersedes the necessity of giving +him an aperient. An orange (taking care he does not eat the peel or +the pulp), or a fig after dinner, or a few Muscatel raisins, will +frequently regulate the bowels. + +Stewed prunes is another admirable remedy for the costiveness of a +child. The manner of stewing them is as follows:--Put a pound of +prunes in a brown jar, add two table-spoonfuls of _raw_ sugar, then +cover the prunes and the sugar with cold water; place them in the +oven, and let them stew for four hours. A child should every morning +eat half a dozen or a dozen of them, until the bowels be relieved, +taking care that he does not swallow the stones. Stewed prunes may be +given in treacle--treacle increasing the aperient properties of the +prunes. + +A suppository is a mild and ready way of opening the bowels of a +child. When he is two or three years old and upwards, a _Candle_ +suppository is better than a _Soap_ suppository. The way of preparing +it is as follows:--Cut a piece of dip-tallow candle--the length of +three inches--and insert it as you would a clyster pipe, about two +inches up the fundament, allowing the remaining inch to be in sight, +and there let the suppository remain until the bowels be opened. + +Another excellent method of opening a child's bowels is by means of an +enema of warm water,--from half a tea-cupful to a tea-cupful, or even +more, according to the age of the child. I cannot speak too highly of +this plan as a remedy for costiveness, as it entirely, in the +generality of cases, prevents the necessity of administering a +particle of aperient medicine by the mouth. The fact of its doing so +stamps it as a most valuable remedy--opening physic being, as a rule, +most objectionable, and injurious to a child's bowels. Bear this +fact--for it is a fact--in mind and let it be always remembered. + +450. _What are the most frequent causes of Protrusion of the +lower-bowel_? + +The too common and reprehensible practice of a parent administering +frequent aperients, especially calomel and jalap, to her +child. Another cause, is allowing him to remain for a quarter of an +hour or more at a time on his chair; this induces him to strain, and +to force the gut down. + +251. _What are the remedies_? + +If the protrusion of the bowel have been brought on by the abase of +aperients, abstain, for the future from giving them; but if medicine +be absolutely required, give the mildest--such as either Syrup of +Senna or Castor Oil--_and the less of those the better._ + +If the _external_ application of a purgative will have the desired +effects it will in such cases, be better than the _internal_ +administration of aperients. Castor Oil used as a Liniment is a good +one for the purpose. Let the bowels be well rubbed, every night and +morning, for five minutes at a time with the oil. + +A wet compress to the bowels will frequently open them, and will thus +do away with the necessity of giving an aperient--_a most important +consideration_. Fold a napkin in six thicknesses, soak it in _cold_ +water, and apply it to the bowels; over which put either a thin +covering or sheet of gutta-percha, or a piece of oiled-silk; keep it +in its place with a broad flannel roller; and let it remain on the +bowels for three or four hours, or until they be opened. + +Try what diet will do, as opening the bowels by a regulated diet is +far preferable to the giving of aperients. Let him have either +bran-bread or Robinson's Patent Groats, or Robinson's Pure Scotch +Oatmeal made into gruel with new milk, or Du Barry's Arabica +Revalenta, or a slice of Huntly and Palmer's lump gingerbread. Let him +eat stewed prunes, stewed rhubarb, roasted apples, strawberries, +raspberries, the inside of grapes and gooseberries, figs, &c. Give him +early every morning a draught of _cold_ water. + +Let me, again, urge you _not_ to give aperients in these cases, or in +any case, unless you are absolutely compelled. By following my advice +you will save yourself an immense deal of trouble, and your child a +long catalogue of misery. Again, I say, look well into the matter, and +whenever it be practicable avoid purgatives. + +Now, with regard to the best manner of returning the bowel, lay the +child upon the bed on his face and bowels, with his hips a little +raised; then smear lard on the forefinger of your right hand (taking +care that the nail be cut close), and gently with, your fore-finger +press the bowel into its proper place. Remember, if the above methods +be observed, you cannot do the slightest injury to the bowel; and the +sooner it be returned, the better it will be for the child; for if the +bowel be allowed to remain long down, it may slough or mortify, and +death may ensue. The nurse, every time he has a motion, must see that +the bowel does not come down, and if it does, she ought instantly to +return it. Moreover, the nurse should be careful _not_ to allow the +child to remain on his chair more than two or three minutes at a time. + +Another excellent remedy for the protrusion of the lower bowel, is to +use every morning a cold salt and water sitz bath. There need not be +more than a depth of three inches of water in the bath; a small +handful of table salt should be dissolved in the water; a dash of warm +water in the winter time must be added, to take off the extreme chill; +and the child ought not to be allowed to sit in the bath for more than +one minute, or whilst the mother can count a hundred; taking care, the +while, to throw either a square of flannel or a small shawl over his +shoulders. The sitz bath ought to be continued for months, or until +the complaint be removed. I cannot speak in too high praise of these +baths. + +252. _Do you advise me, every spring and fall, to give my child +brimstone to purify and sweeten his blood, and as a preventive +medicine_? + +Certainly not; if you wish to take away his appetite, and to weaken +and depress him, give brimstone! Brimstone is not a remedy fit for a +child's stomach. The principal use and value of brimstone is as an +external application in itch, and as an internal remedy, mixed with +other laxatives, in piles--piles being a complaint of adults. In olden +times poor unfortunate children were dosed, every spring and fall, +with brimstone and treacle to sweeten their blood! Fortunately for the +present race, there is not so much of that folly practised, but still +there is room for improvement. To dose a _healthy_ child with physic +is the grossest absurdity. No, the less physic a delicate child has +the better it will be for him, but physic to a healthy child is +downright poison! And brimstone of all medicines! It is both weakening +and depressing to the system, and by opening the pores of the skin and +by relaxing the bowels, is likely to give cold, and thus to make a +healthy, a sickly child. Sweeten his blood! It is more likely to +weaken his blood, and thus to make his blood impure! Blood is not made +pure by drugs, but by Nature's medicine; by exercise, by pure air, by +wholesome diet, by sleep in a well-ventilated apartment, by regular +and thorough ablution. Brimstone a preventive medicine! Preventive +medicine--and brimstone especially in the guise of a preventive +medicine--is "a mockery, a delusion, and a snare." + +253. _When a child is delicate, and his body, without any assignable +cause, is gradually wasting away, and the stomach rejects all food +that is taken, what plan can be adopted likely to support his +strength, and thus probably be the means of saving his life_? + +I have seen, in such a case, great benefit to arise from half a +tea-cupful of either strong mutton-broth or of strong beef-tea, used +as an enema every four hours. [Footnote: An enema apparatus is an +important requisite in every nursery; it may be procured of any +respectable surgical instrument maker. The India-rubber Enema Bottle +is, for a child's use, a great improvement on the old syringe, as it +is not so likely to get out of order, and, moreover, is more easily +used.] It should be administered slowly, in order that it may remain +in the bowel. If the child be sinking, either a dessert-spoonful of +brandy, or half a wine-glassful of port wine, ought to be added to +each enema. + +The above plan ought only to be adopted if there be _no_ diarrhoea. If +there be diarrhoea, an enema must _not_ be used. Then, provided there +be great wasting away, and extreme exhaustion, and other remedies +having failed, it would be advisable to give, by the mouth, _raw_ beef +of the finest quality, which ought to be taken from the hip bone, and +should be shredded very fine. All fat and skin must be carefully +removed. One or two tea-spoonfuls (according to the age of the child) +ought to be given every four hours. The giving of _raw_ meat to +children in exhaustive diseases, such as excessive long-standing +diarrhoea, was introduced into practice by a Russian physician, a +Professor Wiesse of St Petersburg. It certainly is, in these cases, a +most valuable remedy, and has frequently been the means of snatching +such patients from the jaws of death. Children usually take raw meat +with avidity and with a relish. + +254. _If a child be naturally delicate, what plan would you recommend +to strengthen him_? + +I should advise strict attention to the rules above mentioned, and +_change of air_--more especially, if it be possible, to the +coast. Change of air, sometimes, upon a delicate child, acts like +magic, and may restore him to health when all other means have +failed. If a girl be delicate, "carry her off to the farm, there to +undergo the discipline of new milk, brown bread, early hours, no +lessons, and romps in the hay-field."--_Blackwood_. This advice is, of +course, equally applicable for a delicate boy, as delicate boys and +delicate girls ought to be treated alike. Unfortunately in these very +enlightened days there is too great a distinction made in the +respective management and treatment of boys and girls. + +The best medicines for a delicate child will be the wine of iron and +cod-liver oil. Give them combined in the manner I shall advise when +speaking of the treatment of Rickets. + +In diseases of long standing, and that resist the usual remedies, +there is nothing like _change of air_. Hippocrates, the father of +medicine, says-- + + "In longis morbis solum mutare." + (In tedious diseases to change the place of residence.) + +A child who, in the winter, is always catching cold, whose life during +half of the year is one continued catarrh, who is in consequence, +likely, if he grow up at all, to grow up a confirmed invalid, ought, +during the winter months, to seek another clime; and if the parents +can afford the expense, they should at the beginning of October, cause +him to bend his steps to the south of Europe--Mentone being as good a +place as they could probably fix upon. + +255. _Do you approve of sea bathing for a delicate young child_? + +No: he is frequently so frightened by it that the alarm would do him +more harm than the bathing would do him good. The better plan would be +to have him every morning well sponged, especially his back and loins, +with sea water; and to have him as much as possible carried on the +beach, in order that he may inhale the sea breezes. When he be older, +and is not frightened at being dipped, sea bathing will be very +beneficial to him. If bathing is to do good, either to an adult or to +a child, it must be anticipated with pleasure, and neither with dread +nor with distaste. + +256. _What is the best method for administering medicine to a child_? + +If he be old enough, appeal to his reason; for, if a mother endeavour +to deceive her child, and he detect her, he will for the future +suspect her. If he be too young to be reasoned with, then, if he will +not take his medicine, he must be compelled. Lay him across your +knees, let both his hands and his nose be tightly held, and then, by +means of the patent medicine-spoon, or, if that be not at hand, by +either a tea or a dessert-spoon, pour the medicine down his throat, +and he will be obliged to swallow it. + +It may be said that this is a cruel procedure; but it is the only way +to compel an unruly child to take physic, and is much less cruel than +running the risk of his dying from the medicine not having been +administered. [Footnote: If any of my medical brethren should +perchance read these Conversations, I respectfully and earnestly +recommend them to take more pains in making medicines for children +pleasant and palatable. I am convinced that, in the generality of +instances, provided a little more care and thought were bestowed on +the subject, it may be done; and what an amount of both trouble and +annoyance it would save! It is really painful to witness the struggles +and cries of a child when _nauseous_ medicine is to be given; the +passion and excitement often do more harm than the medicine does +good.] + +257. _Ought a sick child to be roused from his sleep to give him +physic, when it is time for him to take it_? + +On no account, as sleep, being a natural restorative, must not be +interfered with. A mother cannot be too particular in administering +the medicine, at stated periods, whilst he is awake. + +258. _Have you any remarks to make on the management of a sick-room, +and have you any directions to give on the nursing of a child_? + +In sickness select a large and lofty room; if in the town, the back of +the house will be preferable--in order to keep the patient free from +noise and bustle--as a sick-chamber cannot be kept too quiet. Be sure +that there be a chimney in the room--as there ought to be in _every_ +room in the house--and that it be not stopped, as it will help to +carry off the impure air of the apartment. Keep the chamber _well +ventilated_, by, from time to time, opening the window. The air of the +apartment cannot be too pure; therefore, let the evacuations from the +bowels be instantly removed, either to a distant part of the house, or +to an out-house or to the cellar, as it might be necessary to keep +them for the medical man's inspection. + +Before using either the night-commode, or the _pot-de-chambre_, let a +little water, to the depth of one or two inches, be put in the pan, or +_pot_; in order to sweeten the motion, and to prevent the faecal +matter from adhering to the vessel. + +Let there be frequent change of linen, as in sickness it is even more +necessary than in health, more especially if the complaint be +fever. In an attack of fever, clean sheets ought, every other day, to +be put on the bed; clean body-linen every day. A frequent change of +linen in sickness is most refreshing. + +If the complaint be fever, a fire in the grate will not be +necessary. Should it be a case either of inflammation of the lungs or +of the chest, a small fire in the winter time is desirable, keeping +the temperature of the room as nearly as possible at 60 degrees +Fahrenheit. Bear in mind that a large fire in a sick-room cannot be +too strongly condemned; for if there be fever--and there are scarcely +any complaints without--a large fire only increases it. Small fires, +in cases either of inflammation of the lungs or of the chest, in the +winter time, encourage ventilation of the apartment, and thus carry +off impure air. If it be summer time, of course fires would be +improper. A thermometer is an indispensable requisite in a sick-room. + +In fever, free and thorough ventilation is of vital importance, more +especially in scarlet fever; then a patient cannot have too much air; +in scarlet fever, for the first few days the windows, be it winter or +summer, must to the widest extent be opened. The fear of the patient +catching cold by doing so is one of the numerous prejudices and +baseless fears that haunt the nursery, and the sooner it is exploded +the better it will he for human life. The valances and bed-curtains +ought to be removed, and there should be as little furniture in the +room as possible. + +If it be a case of measles, it will be necessary to adopt a different +course; then the windows ought not to be opened, but the door must +from time to time be left ajar. In a case of measles, if it be winter +time, a _small_ fire in the room will be necessary. In inflammation of +the lungs or of the chest, the windows should not be opened, but the +door ought occasionally to be left unfastened, in order to change the +air and to make it pure. Remember, then, that ventilation, either by +open window or by open door, is in all diseases most necessary. +Ventilation is one of the best friends a doctor has. + +In fever, do not load the bed with clothes; in the summer a sheet is +sufficient, in winter a sheet and a blanket. + +In fever, do not be afraid of allowing the patient plenty either of +cold water or of cold toast and water; Nature will tell him when he +has had enough. In measles, let the chill be taken off the toast and +water. + +In _croup_, have always ready a plentiful supply of hot water, in case +a warm bath might he required. + +In _child-crowing_, have always in the sick-room a supply of cold +water, ready at a moment's notice to dash upon the face. + +In fever, do not let the little patient lie on the lap; he will rest +more comfortably on a horse-hair mattress in his crib or cot. If he +have pain in the bowels, the lap is most agreeable to him; the warmth +of the body, either of the mother or of the nurse, soothes him; +besides, if he be on the lap, he can be turned on his stomach and on +his bowels, which, often affords him great relief and comfort. If he +be much emaciated, when he is nursed, place a pillow upon the lap and +let him lie upon it. + +In _head affections_, darken the room with a _green_ calico blind; +keep the chamber more than usually quiet; let what little talking is +necessary be carried on in whispers, but the less of that the better; +and in _head affections_, never allow smelling salts to be applied to +the nose, as they only increase the flow of blood to the head, and +consequently do harm. + +It is often a good sign for a child, who is seriously ill, to suddenly +become cross. It is then he begins to feel his weakness and to give +vent to his feelings. "Children are almost always cross when +recovering from an illness, however patient they may have been during +its severest moments, and the phenomenon is not by any means confined +to children."--Geo. McDonald. + +A sick child must _not_ be stuffed with _much_ food at a time. He will +take either a table-spoonful of new milk or a table-spoonful of +chicken broth every half hour with greater advantage than a tea-cupful +of either the one or the other every four hours, which large quantity +would very probably be rejected from his stomach, and may cause the +unfortunately treated child to die of starvation! + +If a sick child be peevish, attract his attention either by a toy or +by an ornament; if he be cross, win him over to good humour by love, +affection, and caresses, but let it be done gently and without +noise. Do not let visitors see him; they will only excite, distract, +and irritate him, and help to consume the oxygen of the atmosphere, +and thus rob the air of its exhilarating health-giving qualities and +purity; a sick-room, therefore, is not a proper place, either for +visitors or for gossips. + +In selecting a sick-nurse, let her be gentle, patient, cheerful, +quiet, and kind, but firm withal; she ought to be neither old nor +young: if she be old she is often garrulous and prejudiced, and thinks +too much of her trouble; if she he young, she is frequently +thoughtless and noisy; therefore choose a middle-aged woman. Do not +let there be in the sick-room more than, besides the mother, one +efficient nurse; a greater number can he of no service--they will only +be in each other's way, and will distract the patient. + +Let stillness, especially if the head be the part affected, reign in a +sick-room. Creaking shoes [Footnote: Nurses at these times ought to +wear slippers, and not shoes. The best slippers in sick-rooms are +those manufactured by the North British Rubber Company, Edinburgh; +they enable nurses to walk in them about the room without causing the +slightest noise; indeed, they might truly be called "the noiseless +slipper," a great desideratum in such cases, more especially in all +head affections of children. If the above slippers cannot readily be +obtained, then list slippers--soles and all bring made of list--will +answer the purpose equally as well.] and rustling silk dresses ought +not to be worn in sick-chambers--they are quite out of place there. If +the child be asleep, or if he be dozing, perfect stillness must he +enjoined, not even a whisper should be heard:-- + + "In the sick-room be calm, + More gently and with care. + Lest any jar or sudden noise, + Come sharply unaware. + + You cannot tell the harm. + The mischief it may bring, + To wake the sick one suddenly, + Besides the suffering. + + The broken sleep excites + Fresh pain, increased distress; + The quiet slumber undisturb'd + Soothes pain and restlessness. + + Sleep is the gift of God: + Oh! bear these words at heart, + 'He giveth His beloved sleep,' + And gently do thy part." + +[Footnote: _Household verses on Health and Happiness._ London: Jarrold +and Sons. A most delightful little volume.] + +If there be other children, let them be removed to a distant part of +the house; or, if the disease be of an infectious nature, let them be +sent away from home altogether. + +In all illnesses--and bear in mind the following is most important +advice--a child must be encouraged to try and make water, whether he +ask or not, at least four times during the twenty-four hours; and at +any other time, if he express the slightest inclination to do so. I +have known a little fellow to hold his water, to his great detriment, +for twelve hours, because either the mother bad in her trouble +forgotten to inquire, or the child himself was either too ill or too +indolent to make the attempt. + +See that the medical man's directions are, to the very letter, carried +out. Do not fancy that you know better than he does, otherwise you +have no business to employ him. Let him, then, have your implicit +confidence and your exact obedience. What _you_ may consider to be a +trifling matter, may frequently be of the utmost importance, and may +sometimes decide whether the case shall end either in life or death! + +_Lice_.--It is not very poetical, as many of the grim facts of +every-day life are not, but, unlike a great deal of poetry, it is +unfortunately too true that after a severe and dangerous illness, +especially after a bad attack of fever, a child's head frequently +becomes infested with vermin--with lice. It therefore behoves a mother +herself to thoroughly examine, by means of a fine-tooth comb, +[Footnote: Which fine-tooth comb ought not to be used at any other +time except for the purpose of examination, as the constant use of a +fine-tooth comb would scratch the scalp, and would encourage a +quantity of scurf to accumulate.] her child's head, in order to +satisfy her mind that there be no vermin there. As soon as he be well +enough, he ought to resume his regular ablutions--that is to say, that +he must go again regularly into his tub, and have his head every +morning thoroughly washed with soap and water. A mother ought to be +particular in seeing that the nurse washes the hair-brush at least +once every week; if she does not do so, the dirty brush which had +during the illness been used, might contain the "nits"--the eggs of +the lice--and would thus propagate the vermin, as they will, when on +the head of the child, soon hatch. If there be already lice on the +head, in addition to the regular washing every morning with the soap +and water, and after the head has been thoroughly dried, let the hair +be well and plentifully dressed with camphorated oil--the oil being +allowed to remain on until the next washing on the following +morning. Lice cannot live in oil (more especially if, as in +camphorated oil, camphor be dissolved in it), and as the camphorated +oil will not, in the slightest degree, injure the hair, it is the best +application that can be used. But as soon as the vermin have +disappeared, let the oil be discontinued, as the _natural oil_ of the +hair is, at other times, the only oil that is required on the head. + +The "nit"--the egg of the louse--might be distinguished from scurf +(although to the _naked_ eye it is very much like it in appearance) by +the former fastening firmly on one of the hairs as a barnacle would on +a rock, and by it not being readily brushed off as scurf would, which +latter (scurf) is always loose. + +259. _My child, in the summer time, is much tormented with fleas: what +are the best remedies_? + +A small muslin bag, filled with camphor, placed in the cot or bed, +will drive fleas away. Each flea-bite should, from time to time, be +dressed by means of a camel's hair brush, with a drop or two of Spirit +of Camphor; an ounce bottle of which ought, for the purpose, to be +procured from a chemist. Camphor is also an excellent remedy to +prevent bugs from biting. Bugs and fleas have a horror of camphor; and +well they might, for it is death to them! + +There is a famous remedy for the destruction of fleas manufactured in +France, entitled "_La Poudre Insecticide,_" which, although perfectly +harmless to the human economy, is utterly destructive to fleas. Bugs +are best destroyed either by Creosote or by oil of Turpentine: the +places they do love to congregate in should be well saturated by means +of a brush, with the creosote or with the oil of turpentine. A few +dressings will effectually destroy both them and their young ones. + +260. _Is not the pulse a great sign either of health or of disease_? + +It is, and every mother should have a general idea of what the pulse +of children of different ages should be both in health and in +disease. "Every person should know how to ascertain the state of the +pulse in health; then, by comparing it with what it is when he is +ailing, he may have some idea of the urgency of his case. Parents +should know the healthy pulse of each child, since now and then a +person is born with a peculiarly slow or fast pulse, and the very case +in hand may be of such peculiarity. An infant's pulse is 140, a child +of seven about 80, and from 20 to 60 years it is 70 beats a minute, +declining to 60 at fourscore. A healthful grown person beats 70 times +in a minute, declining to 60 at fourscore. At 60, if the pulse always +exceeds 70, there is a disease; the machine working itself out, there +is a fever or inflammation somewhere, and the body is feeding on +itself, as in consumption, when the pulse is quick." + +261. _Suppose a child to have had an attack either of inflammation of +the lungs or of bronchitis, and to be much predisposed to a return: +what precautions would you take to prevent either the one or the other +for the future_? + +I would recommend him to wear fine flannel instead of lawn shirts; to +wear good lamb's-wool stockings _above the knees_, and good, strong, +dry shoes to his feet; to live, weather permitting, a great part of +every day in the open air; to strengthen his system by good nourishing +food--by an abundance of both milk and meat (the former especially); +to send him, in the autumn, for a couple of months, to the sea-side; +to administer to him, from time to time, cod-liver oil; in short, to +think only of his health, and to let learning, until he be stronger, +be left alone. I also advise either table salt or bay salt, or +Tidman's Sea Salt, to be added to the water in which the child is +washed with in the morning, in a similar manner as recommended in +answer to a previous question. + +262. _Then do you not advise such a child to be confined within +doors_? + +If any inflammation be present, or if he have but just recovered from +one, it would be improper to send him into the open air, but not +otherwise, as the fresh air would be a likely means of strengthening +the lungs, and thereby of preventing an attack of inflammation for the +future. Besides, the more a child is coddled within doors, the more +likely will he be to catch cold, and to renew the inflammation. If the +weather be cold, yet neither wet nor damp, he ought to be sent out, +but let him be well clothed; and the nurse should have strict +injunctions _not_ to stand about entries or in any draughts--indeed, +not to stand about at all, but to keep walking about all the time she +is in the open air. Unless you have a trustworthy nurse, it will be +well for you either to accompany her in her walk with your child, or +merely to allow her to walk with him in the garden, as you can then +keep your eye upon both of them. + +263. _If a child be either chicken-breasted, or if he be +narrow-chested, are there any means of expanding and of strengthening +his chest_? + +Learning ought to be put out of the question, attention must be paid +to his health alone, or consumption will probably mark him as its own! +Let him live as much as possible in the open air; if it be country, so +much the better. Let him rise early in the morning, and let him go to +bed betimes; and if he be old enough to use the dumb-bells, or what is +better, an India-rubber chest-expander, he should do so daily. He +ought also to be encouraged to use two short sticks, similar to, but +heavier than, a policeman's staff, and to go, every morning, through +regular exercises with them. As soon as he is old enough, let him have +lessons from a drill-sergeant and from a dancing master. Let him be +made both to walk and to sit upright, and let him be kept as much as +possible upon a milk diet, [Footnote: Where milk does not agree, it may +generally be made to do so by the addition of one part of lime water +to seven parts of new milk. Moreover, the lime will be of service in +hardening his bones, and, in these cases, the bones require +hardening.] and give him as much as he can eat of fresh meat every +day. Cod liver oil, a tea-spoonful or a dessert-spoonful, according to +his age, twice a day, is serviceable in these cases. Stimulants ought +to be carefully avoided. In short, let every means be used to nourish, +to strengthen, and invigorate the system, without, at the same time, +creating fever. Such a child should be a child of nature, he ought +almost to live in the open air, and throw his books to the winds. Of +what use is learning without health? In such a case as this you +cannot have both. + +264. _If a child be round-shouldered, or if either of his +shoulder-blades have "grown out," what had better be done_? + +Many children have either round shoulders, or have their shoulder +blades grown out, or have their spines twisted, from growing too fast, +from being allowed to slouch in their gait, and from not having +sufficient nourishing food, such as meat and milk, to support them +while the rapid growth of childhood is going on. + +If your child be affected as above described, nourish him well on milk +and on farinaceous food, and on meat once a day, but let milk be his +staple diet; he ought, during the twenty four hours, to take two or +three pints of new milk. He should almost live in the open air, and +must have plenty of play. If you can so contrive it, let him live in +the country. When tired, let him lie, for half an hour, two or three +times daily, flat on his back on the carpet. Let him rest at night on +a horse-hair mattress, and not on a feather bed. + +Let him have every morning, if it be summer, a thorough cold water +ablution, if it be winter, let the water be made tepid. Let either two +handfuls of table salt or a handful of bay salt be dissolved in the +water. Let the salt and water stream well over his shoulders and down +his back and loins. Let him be well dried with a moderately coarse +towel, and then let his back be well rubbed, and his shoulders be +thrown back-exercising them much in the same manner as in skipping, +for five or ten minutes at a time. Skipping, by-the-by, is of great +use in these cases, whether the child be either a boy or a girl-using, +of course, the rope backwards, and not forwards. + +Let books be utterly discarded until his shoulders have become strong, +and thus no longer round, and his shoulder-blades have become +straight. It is a painful sight to see a child stoop like an old man. + +Let him have, twice daily, a tea-spoonful or a dessert-spoonful +(according to his age) of cod-liver oil, giving it him on a full and +not on an empty stomach. + +When he is old enough, let the drill-sergeant give him regular +lessons, and let the dancing-master be put in requisition. Let him go +through regular gymnastic exercises, provided they are not of a +violent character. + +But, bear in mind, let there be in these cases no mechanical +restraints--no shoulder-straps, no abominable stays. Make him straight +by natural means--by making him strong. Mechanical means would only, +by weakening and wasting the muscles, increase the mischief, and thus +the deformity. In this world of ours there is too much reliance placed +on artificial, and too little on natural means of cure. + +265. _What are the causes of Bow Legs in a child; and what is the +treatment_? + +Weakness of constitution, poor and insufficient nourishment, and +putting a child, more especially a fat and heavy one, on his legs too +early. + +_Treatment._--Nourishing food, such as an abundance of milk, and, if +he be old enough, of meat; iron medicines; cod-liver-oil; thorough +ablution, every morning of the whole body; an abundance of exercise, +either on pony, or on donkey, or in carriage, but not, until his legs +be stronger, on foot. If they are much bowed, it will be necessary to +consult an experienced surgeon. + +266. _If a child, while asleep, "wet his bed" is there any method of +preventing him from doing so_? + +Let him be held out just before he himself goes to bed, and again when +the family retires to rest. If, at the time, he be asleep, he will +become so accustomed to it, that he will, without awaking, make water. +He ought to be made to lie on his side; for, if he be put on his back, +the urine will rest upon an irritable part of the bladder, and, if he +be inclined to wet his bed, he will not be able to avoid doing so. He +must not be allowed to drink much with his meals, especially with his +supper. Wetting the bed is an infirmity with some children--they +cannot help it. It is, therefore, cruel to scold and chastise them for +it. Occasionally, however, wetting the bed arises from idleness; in +which case, of course, a little wholesome correction might be +necessary. + +Water-proof Bed-sheeting--one yard by three-quarters of a yard--will +effectually preserve the bed from being wetted, and ought always, on +these occasions, to be used. + +A mother ought, every morning, to ascertain for herself, whether a +child have wet his bed; if he have, and if, unfortunately, the +water-proof cloth have not been used, the mattress, sheets, and +blankets must be instantly taken to the kitchen fire and be properly +dried. Inattention to the above has frequently caused a child to +suffer either from cold, from a fever, or from an inflammation; not +only so, but, if they be not dried, he is wallowing in filth and in an +offensive effluvium. If both mother and nurse were more attentive to +their duties--in frequently holding a child out, whether he ask or +not--a child wetting his bed would be the exception, and not, as it +frequently is, the rule. If a child be dirty, you may depend upon it, +the right persons to blame are the mother and the nurse, and not the +child! + +267. _If a child should catch Small-pox, what are the best means to +prevent pitting_? + +He ought to be desired neither to pick nor to rub the pustules. If he +be too young to attend to these directions, his hands must be secured +in bags (just large enough to hold them), which bags should he +fastened round the wrists. The nails must be cut very close. + +Cream smeared, by means of a feather, frequently in the day, on the +pustules, affords great comfort and benefit. Tripe liquor (without +salt) has, for the same purpose, been strongly recommended. I myself, +in several cases, have tried it, and with the happiest results. It is +most soothing, comforting, and healing to the skin. + +268. _Can you, tell me of any plan to prevent Chilblaine, or, if a +child be suffering from them, to cure them_? + +_First, then, the way to prevent them._--Let a child, who is subject +to them, wear, in the winter time, a square piece of wash-leather over +the toes, a pair of warm lamb's-wool stockings, and good shoes; but, +above all, let him be encouraged to run about the house as much as +possible, especially before going to bed; and on no account allow him +either to warm has feet before the fire, or to bathe them in hot +water. If the feet be cold, and the child be too young to take +exercise, then let them be well rubbed with the warm hand. If adults +suffer from chilblains, I have found friction, night and morning, with +horse-hail flesh-gloves, the best means of preventing them. + +_Secondly, the way to cure them._--If they be unbroken: the +old-fashioned remedy of onion and salt is one of the best of +remedies. Cut an onion in two; take one-half of it, dip it in table +salt and well rub, for two or three minutes, the chilblain with +it. The onion and salt is a famous remedy to relieve that intolerable +itching which sometimes accompanies chilblains: then let them be +covered with a piece of lint, over which a piece of wash-leather +should be placed. + +_If they be broken_, let a piece of lint be spread with +spermaceti-cerate, and be applied, every morning, to the part, and let +a white-bread poultice be used every night. + +269. _During the winter time my child's hands, legs, &c., chap very +much; what ought I to do_? + +Let a tea-cupful of bran be tied up in a muslin bag, and be put, over +the night, into either a large water-can or jug of _rain_ water; +[Footnote: _Rain_ water ought _always_ to be used in the washing of a +child; pump water is likely to chap the skin, and to make it both +rough and irritable.] and let this water from the can or jug be the +water he is to be washed with on the following morning, and every +morning until the chaps be cured. As often as water is withdrawn, +either from the water-can or from the jog, let fresh rain water take +its place, in order that the bran may be constantly soaking in it. The +bran in the bag should be renewed about twice a week. + +Take particular care to dry the skin well every time he be washed; +then, after each ablution, as well as every night at bed-time, rub a +piece of deer's suet over the parts affected: a few dressings will +perform a cure. The deer's suet may be bought at any of the shops +where venison is sold. Another excellent remedy is glycerine, +[Footnote: Glycerine prepared by Price's Patent Candle Company is by +far the best. Sometimes, if the child's skin be very irritable, the +glycerine requires diluting with water--say, two ounces of glycerine +to be mixed in a bottle with four ounces of rain water--the bottle to +be well shaken just before using it.] which should be smeared, by +means of the finger or by a camel's hair brush, on the parts affected, +two or three times a day. If the child be very young, it might be +necessary to dilute the glycerine with rose-water; fill a small bottle +one-third with glycerine, and fill up the remaining two-thuds of the +bottle with rose-water--shaking the bottle every time just before +using it. The best soap to use for chapped hands is the glycerine +soap: no other being required. + +270. _What is the best remedy for Chapped Lips_? + +Cold-cream (which may be procured of any respectable chemist) is an +excellent application for _chapped lips_. It ought, by means of the +finger, to be frequently smeared on the parts affected. + +271. _Have the goodness to inform me of the different varieties of +Worms that infest a child's bowels_? + +Principally three--1, The tape-worm; 2, the long round-worm; and 3, +the most frequent of all, the common thread or maw-worm. The tape-worm +infests the whole course of the bowels, both small and large: the long +round-worm, principally the small bowels, occasionally the stomach; it +sometimes crawls out of the child's mouth, causing alarm to the +mother; there is, of course, no danger in its doing so: the common +thread-worm or maw-worm infests the rectum or fundament. + +272. _What are the causes of Worms_? + +The causes of worms are: weak bowels; bad and improper food, such as +unripe, unsound, or uncooked fruit, and much green vegetables; pork, +especially underdone pork; [Footnote: One frequent, if not the most +frequent, cause of tape-worm is the eating of pork, more especially if +it be underdone. _Underdone_ pork is the most unwholesome food that +can he eaten, and is the most frequent cause of tape-worm +known. _Underdone_ beef also gives tape-worm; let the meat, therefore, +be well and properly cooked. These facts ought to be borne in mind, as +prevention is always better than cure.] an abundance of sweets; the +neglecting of giving salt in the food. + +273. _What are the symptoms and the treatment of Worms_? + +_The symptoms_ of worms are--emaciation; itching and picking of the +nose; a dark mark under the eyes; grating, during sleep, of the teeth; +starting in the sleep; foul breath; furred tongue; uncertain +appetite--sometimes voracious, at other times bad, the little patient +sitting down very hungry to his dinner, and before scarcely tasting a +mouthful, the appetite vanishing; large bowels; colicky pains of the +bowels; slimy motions; itching of the fundament. Tape-worm and +round-worm, more especially the former, are apt, in children, to +produce convulsions. Tape-worm is very weakening to the constitution, +and usually causes great emaciation and general ill-health; the +sooner, therefore, it is expelled from the bowels the better it will +be for the patient. + +Many of the obscure diseases of children arise from worms. In all +doubtful cases, therefore, this fact should be borne in mind, in order +that a thorough investigation may be instituted. + +With regard to _treatment_, a medical man ought, of course, to be +consulted. He will soon use means both to dislodge them, and to +prevent a future recurrence of them. + +Let me caution a mother never to give her child patent medicines for +the destruction of worms. There is one favourite quack powder, which +is composed principally of large doses of calomel, and which is quite +as likely to destroy the patient as the worms! No, if your child have +worms, put him under the care of a judicious medical man, who will +soon expel them, without, at the same tune, injuring health or +constitution! + +274. _How may worms be prevented from infesting a child's bowels_? + +Worms generally infest _weak_ bowels; hence, the moment a child +becomes strong worms cease to exist. The reason why a child is so +subject to them is owing to the improper food which is usually given +to him. When he be stuffed with unsound and with unripe fruits, with +much sweets, with rich puddings, and with pastry, and when he is +oftentimes allowed to eat his meat _without_ salt, and to _bolt_ his +food without chewing it, is there any wonder that he should suffer +from worms? The way to prevent them is to avoid such things, and, at +the same time, to give him plenty of salt to his _fresh_ and +well-cooked meat. Salt strengthens and assists digestion, and is +absolutely necessary to the human economy. Salt is emphatically a worm +destroyer. The truth of this statement may be readily tested by +sprinkling a little salt on the common earth-worm. "What a comfort +and real requisite to human life is salt! It enters into the +constituents of the human blood, and to do without it is wholly +impossible."--_The Grocer_. To do without it is wholly impossible! +These are true words. Look well to it, therefore, ye mothers, and +beware of the consequences of neglecting such advice, and see for +yourselves that your children regularly eat salt with their food. If +they neglect eating salt with their food, they _must of necessity have +worms_, and worms that will eventually injure them, and make them +miserable. All food, then, should be "flavoured with salt;" +_flavoured_, that is to say, salt should be used in each and every +kind of food--_not in excess, but in moderation_. + +275. _You have a great objection to the frequent administration of +aperient medicines to a child: can you advise any method to prevent +their use_? + +Although we can scarcely call constipation a disease, yet it sometimes +leads to disease. The frequent giving of aperients only adds to the +stubbornness of the bowels. + +I have generally found a draught, early every morning, of _cold_ pump +water, the eating either of Huntley and Palmer's loaf ginger-bread, or +of oatmeal gingerbread, a variety of animal and vegetable food, ripe +sound fruit, Muscatel raisins, a fig, or an orange after dinner, and, +when he be old enough, _coffee_ and milk instead of _tea_ and milk, to +have the desired effect, more especially if, for a time, aperients be +studiously avoided. + +276. _Have you any remarks to make on Rickets_? + +Rickets is owing to a want of a sufficient quantity of earthy matter +in the bones; hence the bones bend and twist, and lose their shape, +causing deformity. Rickets generally begins to show itself between the +first and second years of a child's life. Such children are generally +late in cutting their teeth, and when the teeth do come they are bad, +deficient of enamel, discoloured, and readily decay. A rickety child +is generally stunted in stature; he has a large head, with overhanging +forehead, or what nurses call a watery-head-shaped forehead. The +fontanelles, or openings of the head, as they are called, are a long +time in closing. A rickety child is usually talented; his brain seems +to thrive at the expense of his general health. His breast-bone +projects out, and the sides of his chest are flattened; hence he +becomes what is called chicken-breasted or pigeon-breasted; his spine +is usually twisted, so that he is quite awry, and, in a bad case, he +is hump-backed; the ribs, from the twisted spine, on one side bulge +out; he is round-shouldered; the long bones of his body, being soft, +bend; he is bow-legged, knock-kneed, and weak-ankled. + +Rickets are of various degrees of intensity, the humpbacked being +among the worst There are many mild forms of rickets; weak ankles, +knocked-knees, bowed-legs, chicken-breasts, being among the latter +number. Many a child, who is not exactly hump-backed, is very +round-shouldered, which latter is also a mild species of rickets. + +Show me a child that is rickety, and I can generally prove that it is +owing to poor living, more especially to poor milk. If milk were +always genuine, and if a child had an abundance of it, my belief is +that rickets would be a very rare disease. The importance of genuine +milk is of national importance. We cannot have a race of strong men +and women unless, as children, they have had a good and plentiful +supply of milk. It is utterly impossible. Milk might well be +considered one of the necessaries of a child's existence. Genuine, +fresh milk, then, is one of the grand preventatives, as well as one of +the best remedies, for rickets. Many a child would not now have to +swallow quantities Of cod-liver oil if previously he had imbibed +quantities of good genuine milk. An insufficient and a poor supply of +milk in childhood sows the seeds of many diseases, and death often +gathers the fruit. Can it be wondered at, when there is so much poor +and nasty milk in England, that rickets in one shape or another is so +prevalent? + +When will mothers arouse from their slumbers, rub their eyes, and see +clearly the importance of the subject? When will they know that all +the symptoms of rickets I have just enumerated _usually_ proceed from +the want of nourishment, more especially from the want of genuine, and +of an abundance of, milk? There are, of, course, other means of +warding off rickets besides an abundance of nourishing food, such as +thorough ablution, plenty of air, exercise, play, and sunshine; but of +all these splendid remedies, nourishment stands at the top of the +list. + +I do not mean to say that rickets _always_ proceeds from poorness of +living--from poor milk. It sometimes arises from scrofula, and is an +inheritance of one or of both the parents. + +Rickety children, if not both carefully watched and managed, +frequently, when they become youths, die of consumption. + +A mother, who has for some time neglected the advice I have just +given, will often find, to her grievous cost, that the mischief has, +past remedy, been done, and that it is now "too late!--too late!" + +277. _How may a child be prevented from becoming rickety? or, if he be +rickety, how ought he to be treated_? + +If a child be predisposed to be rickety, or if he be actually rickety, +attend to the following rules:-- + +Let him live well, on good nourishing diet, such as on tender +rump-steaks, cut very fine, and mixed with mashed potatoes, crumb of +bread, and with the gravy of the meat. Let him have, as I have before +advised, an abundance of good new milk--a quart or three pints during +every twenty-four hours. Let him have milk in every form--as milk +gruel, Du Barry's Arabica Revalenta made with milk, batter and rice +puddings, suet puddings, bread and milk, etc. + +_To harden the bones_, let lime water be added to the milk (a +table-spoonful to each tea-cupful of milk.) + +Let him have a good supply of fresh, pure, dry air. He must almost +live in the open air--the country, if practicable, in preference to +the town, and the coast in summer and autumn. Sea bathing and sea +breezes are often, in these cases, of inestimable value. + +He ought not, at an early age, to be allowed to bear his weight upon +his legs. He must sleep on a horse-hair mattress, and not on a feather +bed. He should use every morning cold baths in the summer and tepid +baths in the winter, with bay salt (a handful) dissolved in the water. + +Friction with the hand must, for half an hour at a time, every night +and morning, be sedulously applied to the back and to the limbs. It is +wonderful how much good in these cases friction does. + +Strict attention ought to be paid to the rules of health as laid down +in these Conversations. Whatever is conducive to the general health is +preventive and curative of rickets. + +Books, if he be old enough to read them, should be thrown aside; +health, and health alone, must be the one grand object. + +The best medicines in these cases are a combination of cod-liver oil +and the wine of iron, given in the following manner:--Put a +tea-spoonful of wine of iron into a wine-glass, half fill the glass +with water, sweeten it with a lump or two of sugar, then let a +tea-spoonful of cod-liver oil swim on the top; let the child drink it +all down together, twice or three times a day. An hour after a meal is +the _best_ time to give the medicine, as both iron and cod-liver oil +sit better on a _full_ than on an _empty_ stomach. The child in a +short time will become fond of the above medicine, and will be sorry +when it is discontinued. + +A case of rickets requires great patience and steady perseverance; +let, therefore, the above plan have a fair and long-continued trial, +and I can then promise that there will be every probability that great +benefit will be derived from it. + +278. _If a child be subject to a scabby eruption about the mouth, what +is the best local application_? + +Leave it to nature. Do not, on any account, apply any local +application to heal it; if you do, you may produce injury; you may +either bring on an attack of inflammation, or you may throw him into +convulsions. No! This "breaking-out" is frequently a safety-valve, +and must not therefore be needlessly interfered with. Should the +eruption be severe, reduce the child's diet; keep him from butter, +from gravy, and from fat meat, or, indeed, for a few days from meat +altogether; and give him mild aperient medicine; but, above all +things, do not quack him either with calomel or with grey-powder. + +279. _Will you have the goodness to describe the eruption on the face +and on the head of a young child, called Milk-Crust or Running Scall_? + +Milk-crust is a complaint of very young children--of those who are +cutting their teeth--and, as it is a nasty looking complaint, and +frequently gives a mother a great deal of trouble, of anxiety, and +annoyance, it will be well that you should know its symptoms, its +causes, and its probable duration. + +_Symptoms_.--When a child is about nine months or a year old, small +pimples are apt to break out around the ears, on the forehead, and on +the head. These pimples at length become vesicles (that is to say, +they contain water), which run into one large one, break, and form a +nasty dirty-looking yellowish, and sometimes greenish, scab, which +scab is moist, indeed, sometimes quite wet, and gives out a +disagreeable odour, and which is sometimes so large on the head as +actually to form a skullcap, and so extensive on the face as to form a +mask. These, I am happy to say, are rare cases. The child's beauty +is, of, course, for a time completely destroyed, and not only his +beauty, but his good temper; for as the eruption causes great +irritation and itching, he is constantly clawing himself, and crying +with annoyance the great part of the day, and sometimes also of the +night--the eruption preventing him from sleeping. It is not +contagious, and soon after he has cut the whole of his first set of +teeth it will get well, provided it has not been improperly interfered +with. + +_Causes_.--Irritation from teething; stuffing him with overmuch meat, +thus producing a humour, which Nature tries to get rid of by throwing +it out on the surface of the body; the safest place she could fix on +for the purpose; hence the folly and danger of giving medicines and +applying _external_ applications to drive the eruption in. "Diseased +nature oftentimes breaks forth in strange eruptions," and cures +herself in this way, if she be not too much interfered with, and if +the eruption be not driven in by injudicious treatment. I have known +in such cases disastrous consequences to follow over-officiousness and +meddlesomeness. Nature is trying all she can to drive the humour out, +while some wiseacres are doing all they can to drive the humour in. + +_Duration_.--As milk-crust is a tedious affair, and will require a +variety of treatment, it will be necessary to consult an experienced +medical man; and although he will be able to afford great relief, the +child will not, in all probability, be quite free from the eruption +until he have cut the whole of his first set of teeth--until he be +upwards of two years and a half old--when, with judicious and careful +treatment, it will gradually disappear, and eventually leave not a +trace behind. + +It will be far better to leave the case alone--to get well of +itself--rather than to try to cure the complaint either by outward +applications or by strong internal medicines; "the remedy is often +worse than the disease," of this I am quite convinced. + +280. _Have you any advice to give me as to my conduct towards my +medical man_? + +Give him your entire confidence. Be truthful and be candid with +him. Tell him the truth, the whole truth, and nothing but the +truth. Have no reservations; give him, as near as you can, a plain, +unvarnished statement of the symptoms of the disease. Do not magnify, +and do not make too light of any of them. Be prepared to state the +exact time the child first showed symptoms of illness. If he have had +a shivering fit, however slight, do not fail to tell your medical man +of it. Note the state of the skin; if there be a "breaking-out"--be it +ever so trifling--let it be pointed out to him. Make yourself +acquainted with the quantity and with the appearance of the urine, +taking care to have a little of it saved, in case the doctor may wish +to see and examine it. Take notice of the state of the motions--their +number during the twenty-four hours, their colour, their smell, and +their consistence, keeping one for his inspection. Never leave any of +these questions to be answered by a servant; a mother is the proper +person to give the necessary and truthful answers, which answers +frequently decide the fate of the patient. Bear in mind, then, a +mother's untiring care and love, attention and truthfulness, +frequently decide whether, in a serious illness, the little fellow +shall live or die! Fearful responsibility! + +A medical man has arduous duties to perform; smooth, therefore, his +path as much as you can, and you will be amply repaid by the increased +good he will be able to do your child. Strictly obey a doctor's +orders--in diet, in medicine, in everything. Never throw obstacles in +his way. Never omit any of his suggestions; for, depend upon it that +if he be a sensible man, directions, however slight, ought never to be +neglected; bear in mind, with a judicious medical man, + + "That nothing walks with aimless feet."--_Tennyson_. + +If the case be severe, requiring a second opinion, never of your own +accord call in a physician, without first consulting and advising with +your own medical man. It would be an act of great discourtesy to do +so. Inattention to the foregoing advice has frequently caused injury +to the patient, and heart-burnings and ill-will among doctors. + +Speak, in the presence of your child, with respect and kindness of +your medical man, so that the former may look upon the latter as a +friend--as one who will strive, with God's blessing, to relieve his +pain and suffering. Remember the increased power of doing good the +doctor will have if the child be induced to like, instead of dislike, +him. Not only be careful that you yourself speak before your child, +respectfully and kindly of the medical man, but see that your +domestics do so likewise; and take care that they are never allowed to +frighten your child, as many silly servants do, by saying that they +will send for the doctor, who will either give him nasty medicine, or +will perform some cruel operation upon him. A nurse-maid should, then, +never for one moment be permitted to make a doctor an object of terror +or of dislike to a child. + +Send, whenever it be practicable, for your doctor _early_ in the +morning, as he will then make his arrangements accordingly, and can by +daylight better ascertain the nature of the complaint, more especially +if it be a skin disease. It is utterly impossible for him to form a +correct opinion of the nature of a "breaking-out" either by gas or by +candle light. If the illness come on at night, particularly if it be +ushered in either with a severe shivering, or with any other urgent +symptom, no time should be lost, be it night or day, in sending for +him, + + "A little fire is quietly trodden out, + Which, being sufier'd, rivers cannot quench." + + _Shakespeare_. + + +WARM BATHS + +281. _Have the goodness to mention the complaints of a child for which +warm baths are useful_. + +1. Convulsions; 2. Pains in the bowels, known by, the child drawing up +his legs, screaming violently, etc.; 3. Restlessness from teething; +4. Flatulence. The warm bath acts as a fomentation to the stomach and +the bowels, and gives ease where the usual remedies do not rapidly +relieve. + +282. _Will you mention the precautions, and the rules to be observed +in gutting a child info a warm bath_? + +Carefully ascertain before he be immersed in the bath that the water +be neither too hot nor too cold. Carelessness, or over-anxiety to put +him in the water as quickly as possible, has frequently, from his +being immersed in the bath when the water was too hot, caused him +great pain and suffering. From 96 to 98 degrees of Fahrenheit is the +proper temperature of a warm bath. If it be necessary to add fresh +warm water, let him be either removed the while, or let it not be put +in when very hot; for if boiling water be added to increase the heat +of the bath, it naturally ascends, and may scald him. Again, let the +fresh water be put in at as great a distance from him as possible. The +usual time for him to remain in a bath is a quarter of an hour or +twenty minutes. Let the chest and the bowels be rubbed with the hand +while he is in the bath. Let him be immersed in the bath as high up as +the neck, taking care that he be the while supported under the +armpits, and that his head be also rested. As soon as he comes out of +the bath, he ought to be carefully but quickly rubbed dry; and if it +be necessary to keep up the action on the skin, he should be put to +bed, between the blankets; or if the desired relief has been obtained, +between the sheets, which ought to have been previously warmed, where, +most likely, he will fall into a sweet refreshing sleep. + + +WARM EXTERNAL APPLICATIONS. + +283. _In case of a child suffering pain either in his stomach or in +his bowels, or in case he has a feverish cold, can you tell me of the +best way of applying heat to them_? + +In pain either of the stomach or of the bowels, there is nothing +usually affords greater or speedier relief than the _external_ +application of heat The following are four different methods of +applying heat:--1. A bag of hot salt--that is to say, powdered +table-salt--put either into the oven or into a frying-pan over the +fire, and thus made hot, and placed in a flannel bag, and then +applied, as the case may be, either to the stomach or to the +bowels. Hot salt is an excellent remedy for these pains. 2. An +india-robber hot-water bottle, [Footnote: Every house where there are +children ought to have one of these India-rubber hot-water bottles. It +may be procured at any respectable Vulcanised India-rubber warehouse.] +half filled with hot water--it need not be boiling--applied to the +stomach or to the bowels, will afford great comfort 3. Another and an +excellent remedy for these cases is a hot bran poultice. The way to +make it is as follows:--Stir bran into a Vessel containing either a +pint or a quart (according to size of poultice required) of boiling +water, until it be the consistence of a nice soft poultice, then put +into a flannel bag and apply it to the part affected. When cool, dip +it from time to time in _hot_ water. 4. In case a child has a feverish +cold, especially if it be attended, as it sometimes is, with pains in +the bowels, the following is a good external application.--Take a yard +of flannel, fold it in three widths, then dip it in very hot water, +wring it out tolerably dry, and apply it evenly and neatly round and +round the bowels; over this, and to keep it in its place, and to keep +in the moisture, put on a _dry_ flannel bandage, four yards long and +four inches wide. If it be put on at bed-time, it ought to remain on +all night. Where there are children, it is desirable to have the yard +of flannel and the flannel bandage in readiness, and then a mother +will be prepared for emergencies. Either the one or the other, then, +of the above applications will usually, in pains of the stomach and +bowels, afford great relief. There is one great advantage of the +_external_ application of heat--it can never do harm; if there be +inflammation, it will do good; if there be either cramps or spasms of +the stomach, it will be serviceable; if there be colic, it will be one +of the best remedies that can be used; if it be a feverish cold, by +throwing the child into a perspiration, it will be beneficial. + +It is well for a mother to know how to make a white bread poultice; +and as the celebrated Abernethy was noted for his poultices, I will +give you his directions, and in his very words:--"Scald out a basin, +for you can never make a good poultice unless you have perfectly +boiling water, then, having put in some hot water, throw in coarsely +crumbled bread, and cover it with a plate. When the bread has soaked +up as much water as it will imbibe, drain off the remaining water, and +there will be left a light pulp. Spread it a third of an inch thick on +folded linen, and apply it when of the temperature of a warm bath. It +may be said that this poultice will be very inconvenient if there be +no lard in it, for it will soon get dry; but this is the very thing +you want, and it can easily be moistened by dropping warm water on it, +whilst a greasy poultice will be moist, but not wet."--_South's +Household Surgery_. + + +ACCIDENTS. + +284. _Supposing a child to cut his finger, what is the best +application_? + +There is nothing better than tying it up with rag in its blood, as +nothing is more healing than blood. Do not wash the blood away, but +apply the rag at once, taking care that no foreign substance be left +in the wound. If there be either glass or dirt in it, it will of +course be necessary to bathe the cut in warm water, to get rid of it +before the rag be applied. Some mothers use either salt or Fryar's +Balsam, or turpentine, to a fresh wound; these plans are cruel and +unnecessary, and frequently make the cut difficult to heal. If it +bleed immoderately, sponge the wound freely with cold water. If it be +a severe cut, surgical aid, of course, will be required. + +285. _If a child receive a blow, causing a bruise, what had better be +done_? + +Immediately smear a small lump of _fresh_ butter on the part affected, +and renew it every few minutes for two or three hours; this is an +old-fashioned, but a very good remedy. Olive oil may--if _fresh_ +butter be not at hand--be used, or soak a piece of brown-paper in one +third of French brandy and two-thirds of water, and immediately apply +it to the part; when dry renew it. Either of these simple plans--the +butter plan is the best--will generally prevent both swelling and +disfiguration. + +A "_Black Eye_."--If a child, or indeed any one else, receive a blow +over the eye, which is likely to cause a "black eye," there is no +remedy superior to, nor more likely to prevent one, than well +buttering the parts for two or three inches around the eye with fresh +butter, renewing it every few minutes for the space of an hour or two; +if such be well and perseveringly done, the disagreeable appearance of +a "black eye" will in all probability be prevented. A capital remedy +for a "black eye" is the Arnica Lotion,-- + + Take of--Tincture of Arnica, one ounce; + Water, seven ounces; + +To make a Lotion. The eye to be bathed by means of a soft piece of +linen rag, with this lotion frequently; and, between times, let a +piece of linen rag, wetted in the lotion, be applied: to the eye, and +be fastened in its place by means of a bandage. + +The white lily leaf, soaked in brandy, is another excellent remedy for +the bruises of a child. Gather the white lily blossoms when in full +bloom, and put them in a wide-mouthed bottle of brandy, cork the +bottle, and it will then always be ready for use. Apply a leaf to the +part affected, and bind it on either with a bandage or with a +handkerchief. The white lily root sliced is another valuable external +application for bruises. + +286. _If a child fall upon his head and be stunned, what ought to be +done_? + +If he fall upon his head and be stunned, he will look deadly pale, +very much as if he had fainted. He will in a few minutes, in all +probability, regain his consciousness. Sickness frequently +supervenes, which makes the case more serious, it being a proof that +injury, more or less severe, has been done to the brain; send, +therefore, instantly for a medical man. + +In the meantime, loosen both his collar and neckerchief, lay him flat +on his back, sprinkle cold water upon his face, open the windows so as +to admit plenty of fresh air, and do not let people crowd round him, +nor shout at him, as some do, to make him speak. + +While he is in an unconscious state, do not on any account whatever +allow a drop of blood to be taken from him, either by leeches or from +the arm-venesection; if you do, he will probably never rally, but will +most likely "sleep the sleep that knows not breaking." + +287. _A nurse sometimes drops an infant and injures his back; what +ought to be done_? + +Instantly send for a surgeon; omitting to have proper advice in such a +case has frequently made a child a cripple for life. A nurse +frequently, when she has dropped her little charge, is afraid to tell +her mistress; the consequences might then be deplorable. If ever a +child scream violently without any assignable cause, and the mother is +not able for some time to pacify him, the safer plan is that she send +for a doctor, in order that he might strip and carefully examine him; +much after misery might often be averted if this plan were more +frequently followed. + +288. _Have you any remarks to make and directions to give on +accidental poisoning by lotions, by liniments, etc_? + +It is a culpable practice of either a mother or nurse to leave +_external_ applications within the reach of a child. It is also +highly improper to put a mixture and an _external_ application (such +as a lotion or a liniment) on the same tray or on the same +mantel-piece. Many liniments contain large quantities of opium, a +tea-spoonful of which would be likely to cause the death of a +child. "Hartshorn and oil," too, has frequently been swallowed by +children, and in several instances has caused death. Many lotions +contain sugar of lead, which is also poisonous. There is not, +fortunately, generally sufficient lead in the lotion to cause death; +but if there be not enough to cause death, there may be more than +enough to make the child very poorly. All these accidents occur from +disgraceful carelessness. + +A mother or a nurse ought _always_, before administering a dose of +medicine to a child, to read the label on the bottle; by adopting this +simple plan many serious accidents and much after misery might be +averted. Again, I say, let every lotion, every liniment, and indeed +everything for external use, be either locked up or be put out of the +way, and far away from all medicine that is given by the mouth. This +advice admits of no exception. + +If your child have swallowed a portion of a liniment containing opium, +instantly send for a medical man. In the meantime force a strong +mustard emetic (composed of two tea-spoonfuls of flour of mustard, +mixed in half a tea-cupful of warm water) down his throat. Encourage +the vomiting by afterwards forcing him to swallow warm water. Tickle +the throat either with your finger or with a feather. Souse him +alternately in hot and then in a cold bath. Dash cold water on his +head and face. Throw open the windows. Walk him about in the open +air. Rouse him by slapping him, by pinching him, and by shouting to +him; rouse him, indeed, by every means in your power, for if you allow +him to go to sleep, it will, in all probability, be the sleep that +knows no waking! + +If a child have swallowed "hartshorn and oil," force him to drink +vinegar and water, lemon-juice and water sweetened with sugar, barley +water, and thin gruel. + +If he have swallowed a lead lotion, give him a mustard emetic, and +then vinegar and water, sweetened either with honey or with sugar, to +drink. + +289. _Are not lucifer matches poisonous_? + +Certainly, they are very poisonous; it is, therefore, desirable that +they should be put out of the reach of children. A mother ought to be +very strict with servants on this head. Moreover, lucifer matches are +not only poisonous but dangerous, as a child might set himself on fire +with them. A case bearing on the subject has just come under my own +observation. A little boy three years old, was left alone for two or +three minutes, during which time he obtained possession of a lucifer +match, and struck a light by striking the match against the +wall. Instantly there was a blaze. Fortunately for him, in his fright, +he threw the match on the floor. His mother at this moment entered the +room. If his clothes had taken fire, which they might have done, had +he not have thrown the match away, or if his mother had not been so +near at hand, he would, in all probability, have either been severely +burned or have been burned to death. + +290. _If a child's clothes take fire, what ought to be done to +extinguished them_? + +Lay him on the floor, then roll him either in the rug, or in the +carpet, or in the door-mat, or in any thick article of dress you may +either have on, or have at hand--if it be woollen, so much the better; +or, throw him down, and roll him over and over on the floor, as, by +excluding the atmospheric air, the flame will go out:--hence the +importance of a mother cultivating presence of mind. If parents were +better prepared for such emergencies, such horrid disfigurations and +frightful deaths would be less frequent. + +You ought to have a proper fire-guard before the nursery grate, and +should be strict in not allowing your child to play with fire. If he +still persevere in playing with it, when he has been repeatedly +cautioned not to do so, he should be punished for his temerity. If +anything would justify corporal chastisement, it would surely be such +an act of disobedience. There are only two acts of disobedience that I +would flog a child for--namely, the playing with fire and the telling +of a lie! If after various warnings and wholesome corrections he still +persist, it would be well to let him slightly taste the pain of his +doing so, either by holding his hand for a moment very near the fire, +or by allowing him to slightly touch either the hot bar of the grate +or the flame of the candle. Take my word for it the above plan, will +effectually cure him--he will never do it again. It would be well for +the children of the poor to have pinafores made either of woollen or +of stuff materials. The dreadful deaths from burning, which so often +occur in winter, too frequently arise from _cotton_ pinafores first +taking fire. [Footnote: It has been computed that upwards of 1000 +children are annually burned to death by accident in England.] + +If all dresses after being washed, and just before being dried, were, +for a short time, soaked in a solution of tungstate of soda, such +clothes, when dried, would, be perfectly fire-proof. + +Tangstate of soda may be used either with or without starch; but full +directions for the using of it will, at the time of purchase, be given +by the chemist. + +291. _Is a burn more dangerous than a scald_? + +A burn is generally more serious than a scald. Burns and scalds are +more dangerous on the body, especially on the chest, than either on +the face or on the extremities. The younger the child, the greater +the danger. + +Scalds both of the mouth and the throat, from a child drinking boiling +water from the spout of a tea-kettle, are most dangerous. A poor +person's child is, from the unavoidable absence of the mother, +sometimes shut up in the kitchen by himself, and being very thirsty, +and no other water being at hand, he is tempted, in his ignorance, to +drink from the tea-kettle: If the water be unfortunately boiling, it +will most likely prove to him to be a fatal draught! + +292. _What are the best immediate applications to a scald or to a +burn_? + +There is nothing more efficacious than flour. It ought to be thickly +applied over the part affected, and should be kept in its place either +with a rag and a bandage, or with, strips of old linen. If this be +done, almost instantaneous relief will be experienced, and the burn or +the scald, if superficial, will soon be well. The advantage of flour +as a remedy, is this, that it is always at hand. I have seen some +extensive bums and scalds cured by the above simple plan. Another +excellent remedy is, cottonwool of superior quality, purposely made +for surgeons. The burn or the scald ought to be enveloped in it; +layer after layer should be applied until it be several inches +thick. The cotton-wool must not be removed for several days. These two +remedies, flour and cotton-wool, may be used in conjunction; that is +to say, the flour may be thickly applied to the scald or to the burn, +and the cotton wool over all. + +Prepared lard--that is to say, lard without salt [Footnote: If there +be no other lard in the house but lard _with_ salt, the salt may be +readily removed by washing the lard in cold water. Prepared +lard--that is to say, lard _without_ salt--can, at any moment, be +procured from the nearest druggist in the neighbourhood]--is an +admirable remedy for burns and for scalds. The advantages of lard +are,--(1.) It is almost always at hand; (2.) It is very cooling, +soothing, and unirritating to the part, and it gives almost immediate +freedom from pain; (3.) It effectually protects and sheathes the burn +or the scald from the air; (4.) It is readily and easily applied: all +that has to be done is to spread the lard either on pieces of old +linen rag, or on lint, and then to apply them smoothly to the parts +affected, keeping them in their places by means of bandages--which +bandages may be readily made from either old linen or calico shirts. +Dr John Packard, of Philadelphia, was the first to bring this remedy +for burns and scalds before the public--he having tried it in numerous +instances, and with the happiest results. I myself have, for many +years been in the habit of prescribing lard as a dressing for +blisters, and with the best effects. I generally advise equal parts of +prepared lard and of spermaceti-cerate to be blended together to make +an ointment. The spermaceti-cerate gives a little more consistence to +the lard, which, in warm weather especially, is a great advantage. + +Another valuable remedy for burns is "carron-oil;" which is made by +mixing equal parts of linseed-oil and lime-water in a bottle, and +shaking it up before using it. + +Cold applications, such as cold water, cold vinegar and water, and +cold lotions, are most injurious, and, in many cases, even +dangerous. Scraped potatoes, sliced cucumber, salt, and spirits of +turpentine, have all been recommended; but, in my practice, nothing +has been so efficacious as the remedies above enumerated. + +Do not wash the wound, and do not dress it more frequently than every +_other_ day. If there be much discharge, let it be gently sopped up +with soft old linen rag; but do not, _on any_ account, let the burn be +rubbed or roughly handled. I am convinced that, in the majority of +cases, wounds are too frequently dressed, and that the washing of +wounds prevents the healing of them. "It is a great mistake," said +Ambrose Pare, "to dress ulcers too often, and to wipe their surfaces +clean, for thereby we not only remove the useless excrement, which is +the mud or sanies of ulcers, but also the matter which forms the +flesh. Consequently, for these reasons, ulcers should not be dressed +too often." + +It is nature, and not the surgeon, that really cures the wound, and it +is done, like all Nature's works, principally in secret, by degrees, +and by patience, and resents much interference. The seldom-dressing of +a wound and patience are, then, two of the best remedies for effecting +a cure. Shakspeare, who seemed to know surgery, as he did almost +everything else beside was quite cognisant of the fact:-- + + "How poor are they, that have not patience + What wound did ever heal, but by degrees" + +The burn or the scald may, after the first two days, if severe, +require different dressings; but, if it be severe, the child ought of +course to be immediately placed under the care of a surgeon. + +If the scald be either on the leg or on the foot, a common practice is +to take the shoe and the stocking off; in this operation the skin is +also at the same time very apt to be removed. Now, both the shoe and +the stocking ought to be slit up, and thus be taken off, so that +neither unnecessary pain nor mischief may be caused. + +293. _If a bit of quick-lime should accidentally enter the eye of my +child, what ought to be done_? + +Instantly, but tenderly remove, either by means of a camel's hair +brush, or by a small spill of paper, any bit of lime that may adhere +to the ball of the eye, or that may be within the eye or on the +eye-lashes; then well bathe the eye (allowing a portion to enter it) +with vinegar and water-one part of vinegar to three parts of water, +that is to say, a quarter fill a clean half-pint medicine bottle with +vinegar, and then fill it up with spring water, and it will be ready +for use. Let the eye be bathed for at least a quarter of an hour with, +it The vinegar will neutralise the lime, and will rob it of its +burning properties. + +Having bathed the eye with vinegar and water for a quarter of an hour, +bathe it for another quarter of an hour simply with a little warm +water, after which, drop into the eye two or three drops of the best +sweet-oil, put on an eye-shade made of three thicknesses of linen rag, +covered with green silk, and then do nothing more until the doctor +arrive. + +If the above rules be not _promptly_ and _properly_ followed out, the +child may irreparably lose his eyesight; hence the necessity of +conversations of this kind, to tell a mother, provided _immediate_ +assistance cannot be obtained, what ought _instantly_ to be done; for +moments, in such a case, are precious. + +While doing all that I have just recommended, let a surgeon be sent +for, as a smart attack of inflammation, of the eye is very apt to +follow the burn of lime; but which inflammation will, provided the +_previous_ directions have been _promptly_ and _efficiently_ followed +out, with appropriate treatment, soon subside. + +The above accident is apt to occur to a child who is standing near a +building when the slacking of quicklime is going on, and where +portions of lime in the form of powder are flying about the air. It +would be well not to allow a child to stand about such places, as +prevention is always better than cure. _Quicklime_ is sometimes called +_caustic-lime_--it well deserves its name, for it is a _burning-lime_, +and if proper means be not promptly used, will soon burn away the +sight. + +294. _If any other foreign substance should enter the eye, what is the +best method of removing it_? + +If there be grit, or sand, or dust, or particle of coal, or gnat, or a +hair, or an eye-lash in the eye, it ought to be tenderly removed by a +small tightly-folded paper spill, holding down the lower lid with the +fore-finger of the left hand the while; and the eye, if inflamed, +should be frequently bathed with warm milk and water; but generally as +soon as the cause is removed the effect will cease, and after +treatment will be unnecessary. + +If a particle of metal be sticking on the cornea of the eye, as it +sometimes does, it will require the skilled hand of a surgeon to +remove it. + +Any foreign substance, however minute, in the eye, is very painful; +but a piece of burning lime is excruciating. Shakspeare gives a +graphic description of the pain from the presence of any foreign +substance, however small, in the eye:-- + + "Oh heaven!--that there were but a mote in yours, + A grain, a dust, a gnat, a wand'ring hair, + Any annoyance in that precious sense! + Then, feeling what small things are boist'rous there, + Your vile intent must needs seem horrible." + +295. _What ought to be done in a case of choking_? + +How often does a hungry little child, if not carefully watched, fill +his mouth so full, and swallow lumps of food in such hot haste, as to +choke himself-- + + "With eager feeding, food doth choke the feeder" + + _Shakespeare._ + +_Treatment_.-Instantly put your finger into the throat and feel if the +substance be within reach; if it be food, force it down, and thus +liberate the breathing; should it be a hard substance, endeavour to +hook it out; if you cannot reach it, give a good smart blow or two +with the flat of the hand on the back; or, as recommended by +contributor to the _Lancet_, on the chest, taking care to "seize the +little patient, and place him between your knees side ways, and in +this or some other manner to _compress the abdomen_ [the belly], +otherwise the power of the blow will be lost by the yielding of the +abdominal parieties [walls of the belly], and the respiratory effort +will not be produced." If that does not have the desired effect, +tickle the throat with your finger, so as to ensure immediate +vomiting, and the subsequent ejection of the offending substance. + +296. _Should my child be bitten by a dog supposed to be mad, what +ought to be done_? + +Instantly well rub for the space of five or ten _seconds_--seconds, +_not_ minutes--a stick of nitrate of silver (lunar-caustic) into the +wound. The stick of lunar-caustic should be pointed, like a cedar +pencil for writing, in order the more thoroughly to enter the +wound. [Footnote: A stick of pointed nitrate of silver, in a case, +ready for use, may be procured of any respectable chemist.] This, if +properly done directly after the bite, will effectually prevent +hydrophobia. The nitrate of silver acts not only as a caustic to the +part, but it appears effectually to neutralise the poison, and thus, +by making the virus perfectly innocuous, is a complete antidote. If it +be either the lip, or the parts near the eye, or the wrist, that have +been bitten, it is far preferable to apply the caustic than to cut the +part out; as the former is neither so formidable, nor so dangerous, +nor so disfiguring as the latter, and yet it is equally as +efficacious. I am indebted to the late Mr Youatt, the celebrated +veterinary surgeon, for this valuable antidote or remedy for the +_prevention_ of the most horrible, heart-rending, and incurable +disease known. Mr Youatt had an immense practice among, dogs as well +as among horses. He was a keen observer of disease, and a dear lover +of his profession, and he had paid great attention to rabies-- +dog-madness. He and his assistants had been repeatedly bitten by +rabid dogs; but knowing that he was in possession of an infallible +preventive remedy, he never dreaded the wounds inflicted either upon +himself or upon his assistants. Mr Youatt never knew lunar-caustic, if +properly and _immediately_ applied, to fail. It is, of course, only a +preventive. If hydrophobia be once developed in the human system, no +antidote has ever yet, for this fell and intractable disease, been +found. + +While walking the London Hospitals, upwards of forty years ago, I +received an invitation from Mr Youatt to attend a lecture on +rabies--dog-madness. He had, during the lecture, a dog present +labouring under _incipient_ madness. In a day or two after the +lecture, he requested me and other students to call at his infirmary +and see the dog, as the disease was at that time fully developed. We +did so, and found the poor animal raving mad--frothing at the mouth, +and snapping at the iron bars of his prison. I was particularly struck +with a peculiar brilliancy and wildness of the dog's eyes. He seemed +as though, with affright and consternation, he beheld objects unseen +by all around. It was pitiful to witness his frightened and anxious +countenance. Death soon closed the scene! + +I have thought it my duty to bring the value of lunar-caustic as a +preventive of hydrophobia prominently before your notice, and to pay a +tribute of respect to the memory of Mr Youatt--a man of talent and of +genius. + +Never kill a dog supposed to be mad who has bitten either a child, or +any one else, until it has, past all doubt, been ascertained whether +he be really mad or not. He ought, of course, to be tied up; and be +carefully watched, and be prevented the while from biting any one +else. The dog by all means should be allowed to live at least for some +weeks, as the fact of his remaining well will be the best guarantee +that there is no fear of the bitten child having caught hydrophobia. + +There is a foolish prejudice abroad, that a dog, be he mad or not, who +has bitten a person ought to be _immediately_ destroyed; that although +the dog be not at the time mad, but should at a future period become +so, the person who had been bitten when the dog was _not_ mad, would, +when the dog became mad, have hydrophobia! It seems almost absurd to +bring the subject forward; but the opinion is so very general and +deep-rooted, that I think it well to declare that there is not the +slightest foundation of truth in it, but that it is a ridiculous +fallacy! + +A cat sometimes goes mad, and its bite may cause hydrophobia; indeed, +the bite of a mad cat is more dangerous than the bite of a mad dog. A +bite from a mad cat ought to be treated precisely in the same +manner-namely, with the lunar-caustic--as for a mad dog. + +Hydrophobia was by our forefathers graphically called _water-fright_: +it was well named, for the horror of swallowing water is, by an +hydrophobic patient, most intense, and is _the_ leading symptom of +this fell and incurable disease. + +A bite either from a dog or from a cat _who is not mad_, from a cat +especially, is often venomous and difficult to heal. The best +application is, _immediately_ to apply a large hot white bread +poultice to the part, and to renew it every four hours; and, if there +be much pain in the wound, to well foment the part, every time before +applying the poultice, with a hot camomile and poppy-head fomentation. + +Scratches of a cat are best treated by smearing, and that freely and +continuously for an hour, and then afterwards at longer intervals, +fresh butter on the part affected. If fresh butter Be not at hand, +fresh lard--that is to say, lard _without_ salt--will answer the +purpose. If the pain of the scratch be very intense, foment the part +affected with hot water, and then apply a hot white bread poultice, +which should be frequently renewed. + +297. _What are the best remedies in ease of a sting from either a bee +or a wasp_? + +Extract the sting, if it have been left behind, either by means of the +pair of dressing forceps, or by the pressure of the hollow of a small +key--a watch-key will answer the purpose; then, the blue-bag (which is +used in washing) moistened with water, should be applied to the part; +or a few drops of solution of potash, [Footnote: Which may be +instantly procured of a druggist.] or "apply moist snuff or tobacco, +rubbing it well in," [Footnote: A Bee-master. _The Times_, July +28,1864.] and renew from time to time either of them: if either of +these be not at hand, either honey, or treacle, or fresh butter, will +answer the purpose. Should there be much swelling or inflammation, +foment the part with hot water, and then apply hot bread poultice, and +renew it frequently. In eating apricots, or peaches, or other fruit, +they ought beforehand to be carefully examined, in order to ascertain +that no wasp is lurking in them; otherwise, it may sting the throat, +and serious consequences will ensue. + +298. _If a child receive a fall, causing the skin to be grazed, can +you tell me of a good application_? + +You will find gummed paper an excellent remedy: the way of preparing +it is as follows:--Apply evenly, by means of a small brush, thick +mucilage of gum-arabic to cap-paper; hang it up to dry, and keep it +ready for use. When wanted, cut a portion as large as may be +requisite, then moisten it with your tongue, in the same manner you +would a postage stamp, and apply it to the grazed part. It may be +removed when necessary by simply wetting it with water. The part in +two or three days will be well. There is usually a margin of gummed +paper sold with postage stamps; this will answer the purpose equally +well. If the gummed paper be not at hand, then frequently, for the +space of an hour or two, smear the part affected with fresh butter. + +299. _In case of a child swallowing by mistake either laudanum, or +paregoric, or Godfrey's Cordial, or any other preparation of opium, +what ought to be done_? + +Give, as _quickly as possible_, a strong mustard emetic; that is to +say, mix two tea-spoonfuls of flour of mustard in half a tea-cupful +of water, and force it down his throat. If free vomiting be not +induced, tickle the upper part of the swallow with a feather, drench +the little patient's stomach with large quantities of warm water. As +soon as it can be obtained from the druggist, give him the following +emetic draught-- + + Take of--Sulphate of Zinc, one scruple; + Simple Syrup, one drachm. + Distilled Water, seven drachms; + +To make a Draught. + +Smack his buttocks and his back, walk him, or lead him, or carry him +about in the fresh air, shake him by the shoulders, pat his hair, +tickle his nostrils, shout and holler in his ears, plunge him into a +warm bath and then into a cold bath alternately. Well sponge his head +and face with cold water, dash cold water on his head, face, and neck, +and do not, on any account, until the effects of the opiate are gone +off, allow him to go to sleep, if you do, he will never wake again! +While doing all those things, of course, you ought to lose no time in +sending for a medical man. + +300. _Have you any observation to make on parent's allowing the Deadly +Nightshade (Atropa Belladonna) to grow in their gardens_? + +I wish to caution you not on any account to allow the Belladonna--the +Deadly Nightshade--to grow in your garden. The whole plant--root, +leaves, and berries--is poisonous and the berries, being attractive to +the eye, are very alluring to children. + +301. _What is the treatment of poisoning by Belladonna_? + +Instantly send for a medical man, but, in the mean time, give an +emetic-a mustard emetic--mix two teaspoonfuls of flour of mustard in +half a tea-cupful of warm water, and force it down the child's throat +then drench him with warm water, and tickle the upper part of his +swallow either with a feather or with the finger, to make him sick as +the grand remedy is an emetic to bring up the offending cause. If the +emetic has not acted sufficiently, the medical man when he arrives may +deem it necessary to use the stomach pump, but remember not a moment +must be lost, for moments are precious in a case of belladonna +poisoning, in giving a mustard emetic, and repeating it again and +again until the enemy be dislodged. Dash cold water upon his head and +face; the best way of doing which is by means of a large sponge, +holding his head and his face over a wash-hand basin, half filled with +cold water, and filling the sponge from the basin, and squeezing it +over his head and face, allowing the water to continuously stream over +them for an hour or two, or until the effects of the poison have +passed away. This sponging of the head and face is very useful in +poisoning by opium, as well as in poisoning by belladonna; indeed, the +treatment of poisoning by the one is very similar to the treatment of +poisoning by the other. I, therefore, for the further treatment of +poisoning by belladonna, beg to refer you to a previous Conversation, +on the treatment of poisoning by opium. + +302. _Should a child put either a pea or a bead, or any other foreign +substance, up the nose, what ought to be done_? + +Do not attempt to extract it yourself, or you might push it further +in, but send instantly for a surgeon, who will readily remove it, +either with a pair of forceps, or by means of a bent probe, or with a +director. If it be a pea, and it be allowed for any length of time to +remain in, it will swell, and will thus become difficult to extract, +and may produce great irritation and inflammation. A child ought not +to be allowed to play with peas or with beads (unless the beads are on +a string), as he is apt, for amusement, to push them up his nose. + +303. _If a child have put either a pea, a bean, a bead, a +cherry-stone, or any other smooth substance, into his ear, what ought +to be done to remove it_? + +Turn his head on one side, in order to let the ear with the pea or the +bead in it be undermost, then give with the flat of your hand two or +three sharp, sudden slaps or boxes on the other, or _upper_most ear, +and most likely the offending substance will drop out. Poking at the +ear will, in the majority of cases, only send the substance further +in, and will make it more difficult (if the above simple plan does not +succeed) for the medical man to remove. The surgeon will, in all +probability, syringe the ear; therefore have a supply of warm water in +readiness for him, in order that no time may be lost. + +304. _If an earwig or any other living thing, should get into the ear +of a child, what ought to be done_? + +Lay the child on his side, the affected ear being uppermost, and fill +the ear, from a tea-spoon, with either water or sweet oil. The water +or oil will carry the living thing, whatever it be, out of the ear, +and the child is at once relieved. + +305. _If a child swallow a piece of broken glass, what ought to be +done_? + +Avoid purgatives, as the free action on the bowels would be likely to +force the spiculae of glass into the mucous membrane of the bowels, and +thus would wound them, and might cause ulceration, and even death. +"The object of treatment will be to allow them to pass through the +intestines well enveloped by the other contents of the tube, and for +this purpose a solid, farinaceous diet should be ordered, and +purgatives scrupulously avoided."--_Shaw's Medical Remembrancer_, by +Hutchinson. + +306. _If a child swallow a pin, what should be done_? + +Treat him as for broken glass. Give him no aperients, or it might, in +action, force the pin into the bowel. I have known more than one +instance where a child, after swallowing a pin, to have, voided it in +his motion. + +307. _If a child swallow a coin of any kind, is danger likely, to +ensue, and what ought to be done_? + +There is, as a rule, no danger. A dose or two of castor oil will be +all that is usually necessary. The evacuations ought to be carefully +examined until the coin be discovered. I once knew a child swallow a +pennypiece, and pass it in his stool. + +308. _If a child, while playing with a small coin (such as either a +threepenny or a fourpenny piece), or any other substance, should toss +it into his mouth, and inadvertently allow it to enter the windpipe, +what ought to be done_? + +Take hold of him by the legs, allowing his head to hang downwards; +then give him with the palm of your hand several sharp blows on his +back, and you may have the good fortune to see the coin coughed out of +his mouth. Of course, if this plan does not succeed, send instantly, +for a medical man. + +309. _How can a mother prevent her child from having an accident_? + +By strict supervision over frim on her own part, and by not permitting +her child to be left to the tender mercies of servants; by not +allowing him to play with fire, to swing over banisters, and to have +knives and playthings of a dangerous character; to keep all poisonous +articles and cutting instruments out of his reach; and, above all and +before all, insisting, lovingly, affectionately, but firmly, upon +implicit obedience. + +Accidents generally arise from one of three causes, namely, either +from wilful disobedience, or from gross carelessness, or from +downright folly. I quite agree with Davenant, that they do not arise +from chance-- + + "If we consider accident, + And how, repugnant unto sense, + It pays desert with bad event, + We shall disparage Providence." + + + + +PART III. + +BOYHOOD AND GIRLHOOD. + + + _Just at the age 'twixt boy and youth + When thought is speech and speech is truth_--SCOTT + + _'Tis with him e'en standing water. + Between man and boy_--SHAKESPEARE + + _Standing with reluctant feet, + Where the brook and river meet, + Womanhood and childhood fleet_--LONGFELLOW + + +ABLUTION, ETC. + +310. _Have you any remarks to make on the ablution of boys and girls_? + +How is it that a mother thinks it absolutely necessary (which it +really is) that her babe's _whole_ body should, every morning, be +washed; and yet who does not deem it needful that her girl or boy, of +twelve years old, should go through the process of daily and +_thorough_ ablution? If the one case be necessary, sure I am that the +other is equally if not more needful. + +Thorough ablution of the body every morning at least is essential to +health. I maintain that no one can be in the enjoyment of perfect +health who does not keep his skin--the whole of his skin--clean. In +the absence of cleanliness, a pellicle forms on the skin which +engenders disease. Moreover, a person who does not keep his skin clean +is more susceptible of contracting contagious disease, such as +small-pox, typhus fever, cholera, diphtheria, scarlet fever, etc. + +Thorough ablution of the body is a grand requisite of I maintain that +no one can be perfectly healthy unless he thoroughly wash his +body--the whole of his body; if filth accumulate which, if not washed +off, it is sure to do, disease must, as a matter of course, follow. +Besides, ablution is a delightful process; it makes one feel fresh and +sweet, and young and healthy; it makes the young look handsome, and +the old look young! Thorough ablution might truly be said both to +renovate and to rejuvenise! A scrupulously clean skin is one of the +grand distinctive characteristics both of a lady and of a gentleman, + +Dirty people are not only a nuisance to themselves, but to all around; +they are not only a nuisance but a danger, as their dirty bodies are +apt to carry from place to place contagious diseases. + +It is important that parts that are covered should be kept cleaner +than parts exposed to the air, as dirt is more apt to fester in dark +places; besides, parts exposed to the air have the advantage of the +air's sweetening properties; air acts as a bath, and purifies the skin +amazingly. + +It is desirable to commence a complete system of washing early in +life, as it then becomes a second nature, and cannot afterwards be +dispensed with. One accustomed to the luxury of his morning ablution, +if anything prevented him from taking it, would feel most +uncomfortable; he would as soon think of dispensing with his breakfast +as with his bath. + +Every boy, every girl, and every adult, ought each to have either a +room or a dressing-room to himself or to herself, in order that he or +she might strip to the skin and thoroughly wash themselves; no one can +wash properly and effectually without doing so. + +Now, for the paraphernalia required for the process--(1.) A large +nursery basin, one that will hold six or eight quarts of water +(Wedgwood's make being considered the best); (2.) A piece of coarse +flannel, a yard long and half a yard wide; (3.) A large sponge; (4.) A +tablet either of the best yellow or of curd soap; (5.) Two towels-one +being a diaper, and the other a Turkish rubber. Now, as to the manner +of performing ablution. You ought to fill the basin three parts full +with _rain_ water, then, having well-soaped and cleansed your hands, +re-soap them, dip your head and face into the water, then with the +soaped hands well rub and wash your head, face, neck, chest, and +armpits; having done which, take the wetted sponge, and go over all +the parts previously travelled over by the soaped hands; then fold the +flannel, as you would a neck-kerchief, and dip it in the water, then +throw it, as you would a skipping-rope, over your shoulders and move +it a few times from right to left and from left to right, and up and +down, and then across the back and loins; having done which, dip the +sponge in the water, and holding your head over the water, let the +water stream from the sponge a time or two over your head, neck, and +face. Dip your head and face in the water, then put your hands and +arms (as far as they will go) into the water, holding them there while +you can count thirty. Having reduced the quantity of water to a third +of a basinful, place the basin on the floor, and sit (while you can +count fifty) in the water; then put one foot at a time in the water, +and quickly rub, with soaped hands, up and down your leg, over the +foot, and pass your thumb between each toe (this latter procedure +tends to keep away soft corns); then take the sponge, filled with +water, and squeeze it over your leg and foot, from the knee +downwards,--then serve your other leg and foot in the same way. By +adopting the above plan, the whole of the body will, every morning, be +thoroughly washed. + +A little warm water might at first, and during the winter time, be +added, to take off the chill; but the sooner quite cold water is used +the better. The body ought to be quickly dried (taking care to wipe +between each toe), first with the diaper, and then with the Turkish +rubber. In drying your back and loins, you ought to throw as you would +a skipping-rope, the Turkish rubber over your shoulders, and move it a +few times front side to side, until the parts be dry. + +Although the above description is necessarily prolix, the washing +itself ought to be very expeditiously performed; there should be no +dawdling over it, otherwise the body will become chilled, and harm +instead of good will be the result. If due dispatch be used, the whole +of the body might, according to the above method, be thoroughly washed +and dried in the space of ten minutes. + +A boy ought to wash his head, as above directed, every morning, a +girl, who has much hair, once a week, with soap and water, with +flannel and sponge. The hair, if not frequently washed, is very dirty, +and nothing is more repulsive than a dirty head! + +It might be said, "Why do you go into particulars? why dwell so much +upon minutiae? Every one, without being told, knows how to wash +himself!" I reply, "That very few people do know how to wash +themselves properly; it is a misfortune that they do not--they would +be healthier and happier and sweeter if they did!" + +311. _Have you any remarks to make on boys and girls learning to +swim_? + +Let me strongly urge you to let your sons and daughters be _early_ +taught to swim. Swimming is a glorious exercise--one of the best that +can be taken; it expands the chest; it promotes digestion; it develops +the muscles, and brings into action some muscles that in any other +form of exercise are but seldom brought into play; it strengthens and +braces the whole frame, and thus makes the swimmer resist the +liability of catching cold; it gives both boys and girls courage, +energy, and self-reliance,--splendid qualities in this rough world of +ours. Swimming is oftentimes the means of saving human life; this of +itself would be a great recommendation of its value. It is a +delightful amusement; to breast the waves is as exhilarating to the +spirits as clearing on horse-back a five-barred gate. + +The art of learning to swim is quite as necessary to be learned by a +girl as by a boy; the former has similar muscles, lungs, and other +organs to develop as the latter. + +It is very desirable that in large towns swimming-baths for ladies +should be instituted. Swimming ought, then, to be a part and parcel of +the education of every boy and of every girl. + +Swimming does not always agree. This sometimes arises from a person +being quite cold before he plunges into the water. Many people have an +idea that they ought to go into the water while their bodies are in a +cool state. Now this is a mistaken notion, and is likely to produce +dangerous consequences. The skin ought to be comfortably warm, neither +very hot nor very cold, and then the bather will receive every +advantage that cold bathing can produce, If he go into the bath whilst +the body is cold, the blood becomes chilled, and is driven to internal +parts, and thus mischief is frequently produced. + +A boy, after using cold bathing, ought, if it _agree_ with him, to +experience a pleasing glow over the whole surface of his body, his +spirits and appetite should be increased, and he ought to feel +stronger; but if it _disagree_ with him, a chilliness and coldness, a +lassitude and a depression of spirits, will be the result; the face +will be pale and the features will be pinched, and, in some instances, +the lips and the nails will become blue; all these are signs that +_cold_ bathing is injurious, and, therefore, that it ought on no +account to be persevered in, unless these symptoms have hitherto +proceeded from his going into the bath whilst he was quite cold. He +may, previously to entering the bath, warm himself by walking briskly +for a few minutes. Where cold, sea water bathing does not agree, +_warm_ sea bathing should be substituted. + +312. _Which do you prefer--sea bathing or fresh water bathing_? + +Sea bathing. Sea bathing is incomparably superior to fresh water +bathing; the salt water is far more refreshing and invigorating; the +battling with the waves is more exciting; the sea breezes, blowing on +the nude body, breathes (for the skin is a breathing apparatus) health +and strength into the frame, and comeliness into the face; the sea +water and the sea breezes are splendid cosmetics; the salt water is +one of the finest applications, both for strengthening the roots and +brightening the colour of the hair, provided grease and pomatum have +not been previously used. + +313. _Have you any directions to give as to the time and the seasons, +and the best mode of sea bathing_? + +Summer and autumn are the best seasons of the year for cold sea +bathing--August and September being the best months. To prepare the +skin for the cold sea bathing, it would be well, before taking a dip +in the sea, to have on the previous day a warm salt water bath. It is +injurious, and even dangerous, to bathe _immediately_ after a _full_ +meal; the best time to bathe is about two hours after breakfast-that +is to say, at about eleven or twelve o'clock in the forenoon. The +bather as soon as he enters the water, ought _instantly_ to wet his +head; this may be done either by his jumping at once from the machine +into the water, or, if he have not the courage to do so, by plunging +his head without loss of time _completely_ under the water. He should +remain in the water about a quarter of an hour, but never longer than +half an hour. Many bathers by remaining a long time in the water do +themselves great injury. If sea bathing be found to be invigorating-- +and how often to the delicate it has proved to be truly magical--a +patient may bathe once every day, but on no account oftener. If he be +not strong, he had better, at first, bathe only every other day, or +even only twice a week. The bather, after leaving the machine, ought +for half an hour to take a brisk walk in order to promote a reaction, +and thus to cause a free circulation of the blood. + +314. _Do you think a tepid bath [Footnote: A tepid bath from 62 to 96 +degrees of, Fahrenheit.] may be more safely used_? + +A tepid bath may be taken at almost any time, and a bather may remain +longer in one, with safety, than in a cold bath. + +315. _Do you approve of warm bathing_? + +A warm, bath [Footnote: A warm bath from 97 to 100 degrees of +Fahrenheit] may with advantage be occasionally used--say, once a +week. A warm bath cleanses the skin more effectually than either a +cold or a tepid bath; but, as it is more relaxing, ought not to be +employed so often as either of them. A person should not continue +longer than ten minutes in a warm bath. Once a week, as a rule is +quite often enough for a warm bath; and it would be an excellent plan +if every boy and girl and adult would make a practice of having one +regularly every week, unless any special reason should arise to forbid +its use. + +316. _But does not warm bathing, by relaxing the pores of the skin, +cause a person to catch cold if he expose himself to the air +immediately afterwards_? + +There is, on this point, a great deal of misconception and unnecessary +fear. A person, _immediately_ after using a warm bath, should take +proper precautions--that is to say, he must not expose himself to +draughts, neither ought he to wash himself in _cold_ water, nor should +he, _immediately_ after taking one, drink _cold_ water. But he may +follow his usual exercise or employment, provided the weather be fine, +and the wind be neither in the east nor the north-east. + +Every house of any pretension ought to have a bathroom. Nothing would +be more conducive to health than regular systematic bathing. A hot and +cold bath, a sitz bath, and a shower bath--each and all in their +turn--are grand requisites to preserve and procure health. If the +house cannot boast of a bath-room, then the Corporation Baths (which +nearly every large town possesses) ought to be liberally patronised. + + +MANAGEMENT OF THE HAIR + +317. _What is the best application for the hair_? + +A sponge and _cold_ water, and two good hair-brushes. Avoid grease, +pomatum, bandoline, and all abominations of that kind. There is a +natural oil of the hair, which is far superior to either Rowland's +Macassar Oil or any other oil! The best scent for the hair is an +occasional dressing of soap and water; the best beautifier of the hair +is a downright thorough good brushing with two good hair brushes! +Again, I say, _avoid grease of all kinds to the hair_. "And as for +woman's hair, don't plaster it with scented and sour grease, or with +any grease; it has an oil of its own. And don't tie up your hair +tight, and make it like a cap of iron over your skull. And why are +your ears covered? You hear all the worse, and they are not the +cleaner. Besides, the ear is beautiful in itself, and plays its own +part in the concert of the features." [Footnote: _Health._ By John +Brown, M.D.] + +If the hair cannot, without some application, be kept tidy, then a +little castor oil, scented, might, by means of an old tooth-brush, be +used to smooth it; castor oil is, for the purpose, one of the most +simple and harmless of dressings; but, as I said before, the hair's +own natural oil cannot be equalled, far less surpassed! + +If the hair fall off, the castor oil, scented with a few drops either +of otto of roses or of essence of bergamot, is a good remedy to +prevent its doing so; a little of it ought, night and morning, to be +well rubbed into the roots of the hair. Cocoa-nut oil is another +excellent application for the falling off of the hair, and can never +do harm, which is more than can be said of many vaunted remedies for +the Hair! + + +CLOTHING. + +318. _Do you approve of a boy wearing flannel next to the skin?_ + +England is so variable a climate, and the changes from heat to cold, +and from dryness to moisture of the atmosphere, are so sudden, that +some means are required to guard against their effects. Flannel, as it +is a bad conductor of heat, prevents the sudden changes from affecting +the body, and thus is a great preservative against cold. + +Flannel is as necessary in the summer as in the winter time; indeed, +we are more likely both to sit and to stand in draughts in the summer +than in the winter; and thus we are more liable to become chilled and +to catch cold. + +Woollen shirts are now much worn; they are very comfortable and +beneficial to health. Moreover, they simplify the dress, as they +supersede the necessity of wearing either both flannel and linen, or +flannel and calico shirts. + +319. _Flannel sometimes produces great irritation of the skin: what +ought to be done to prevent it_? + +Have a moderately fine flannel, and persevere in its use; the skin in +a few days will bear it comfortably. The Angola and wove-silk +waistcoats have been recommended as substitutes, but there is nothing +equal to the old-fashioned Welsh flannel. + +320. _If a boy have delicate lungs, do you approve of his wearing a +prepared hare-skin over the chest_? + +I do not: the chest may be kept too warm as well as too cold. The +hare-skin heats the chest too much, and thereby promotes a violent +perspiration; which, by his going into the cold air, may become +suddenly checked, and may thus produce mischief. If the chest be +delicate, there is nothing like flannel to ward off colds. + +321. _After an attack of Rheumatic Fever, what extra clothing do you +advise_? + +In the case of a boy, or a girl, just recovering from a severe attack +of Rheumatic Fever, flannel next the skin ought always, winter and +summer, to be worn--flannel drawers as well as a flannel vest. + +322. _Have you any remarks to make on boys' waistcoats_? + +Fashion in this, as in most other instances, is at direct variance +with common sense. It would seem that fashion was intended to make +work for the doctor, and to swell the bills of mortality! It might be +asked, What part of the chest, in particular, ought to be kept warm? +The upper part needs it most. It is in the _upper_ part of the lungs +that tubercles (consumption) usually first make their appearance; and +is it not preposterous to have such parts, in particular, kept cool? + +Double-breasted waistcoats cannot be too strongly recommended for +_delicate_ youths, and for all men who have _weak_ chests. + +323. _Have you any directions to give respecting the shoes and the +stockings_? + +The shoes for winter should be moderately thick and waterproof. If +boys and girls be delicate, they ought to have double soles to their +shoes, with a piece of bladder between each sole, or the inner sole +may be made of cork; either of the above plans will make the soles of +boots and shoes completely water-proof. In wet or dirty weather +India-rubber over-shoes are useful, as they keep the _upper_ as well +as the _under_ leathers perfectly dry. + +The socks, or stockings, for winter, ought to be either lambs-wool or +worsted; it is absurd to wear _cotton_ socks or stockings all the year +round. I should advise a boy to wear socks not stockings, as he will +then be able to dispense with garters. Garters, as I have remarked in +a previous Conversation, are injurious--they not only interfere with +the circulation of the blood, but also, by pressure, injure the bones, +and thus the shape of the legs. + +Boys and girls cannot be too particular in keeping their feet warm and +dry, as cold wet feet are one of the most frequent exciting causes of +bronchitis, of sore throats, and of consumption. + +324. _When should a girl begin to wear stays_? + +She ought never to wear them. + +325. _Do not stays strengthen the body_? + +No; on the contrary, they weaken it (1.) _They, weaken the +muscles_. The pressure upon them causes them to waste; so that, in the +end, a girl cannot do without them, as the stays are then obliged to +perform the duty of the wasted muscles. (2.) _They weaken the lungs_ +by interfering with their functions. Every inspiration is accompanied +by a movement of the ribs. If this movement be impeded, the functions +of the lungs are impeded likewise, and, consequently, disease is +likely to follow, and either difficulty of breathing, or cough, or +consumption, may ensue. (3) _They weaken the heart's action_, and thus +frequently produce palpitation, and, perhaps, eventually, organic or +incurable disease of the heart (4) _They weaken the digestion_, by +pushing down the stomach and the liver, and by compressing the latter, +and thus induce indigestion, flatulence, and liver-disease. [Footnote: +Several years ago, while prosecuting my anatomical studies in London +University College Dissecting rooms, on opening a young women, I +discovered an immense indentation of the liver large enough to admit a +rolling pin, produced by tight lacing!] (5) _They weaken the bowels_, +by impeding their proper peristaltic (spiral) motion, and thus might +produce either constipation or a rupture. Is it not presumptuous to +imagine that man can improve upon God's works, and that if more +support had been required, the Almighty would not have given it?-- + + "God never made his work for man to mend"--_Dryden._ + +326. _Have you any remarks to make on female dress_? + +There is a perfect disregard of health in everything appertaining to +fashion. Parts that ought to be kept warm, remain unclothed, the +_upper_ portion of the chest, most prone to tubercles (consumption), +is completely exposed, the feet, great inlets to cold, are covered +with thin stockings, and with shoes as thin as paper. Parts that +should have full play are cramped and hampered, the chest is cribbed +in with stays, the feet with _tight_ shoes,--hence causing deformity, +and preventing a free circulation of blood. The mind, that ought to be +calm and unruffled, is kept in a constant state of excitement by +balls, and concerts, and plays. Mind and body sympathise with each +other, and disease is the consequence. Night is turned into day, and +a delicate girl leaves the heated ball room, decked out in her airy +finery, to breathe the damp and cold air of night. She goes to bed, +but, for the first few hours, she is too much excited to sleep, +towards morning, when the air is pure and invigorating, and, when to +breathe it, would be to inhale health and life, she falls into a +feverish slumber, and wakes not until noon-day. Oh, that a mother +should be so blinded and so infatuated! + +327. _Have you any observations to make on a girl wearing a green +dress_? + +It is injurious to wear a green dress, if the colour have been +imparted to it by means of _Scheele's green_, which is arsenite of +copper--a deadly poison. I have known the arsenic to fly off from a +_green_ dress in the form of powder, and to produce, in consequence, +ill-health. Gas-light green is a lovely green, and free from all +danger, and is fortunately superseding the Scheele's green both in +dresses and in worsted work. I should advise my fair reader, when she +selects green as her colour, always to choose the gas-light green, and +to wear and to use for worsted work no other green besides, unless it +be imperial green. + + +DIET. + +328. _Which is the more wholesome, coffee or tea, where milk does not +agree, for a youth's breakfast_? + +Coffee, provided it be made properly, and provided the boy or the girl +take a great deal of out-door exercise; if a youth be much confined +within doors, black tea is preferable to coffee. The usual practice of +making coffee is to boil it, to get out the strength! But the fact is, +the process of boiling boils the strength away; it drives off that +aromatic, grateful principle, so wholesome to the stomach, and so +exhilarating to the spirits; and, in lieu of which, extracts its dregs +and impurities, which are both heavy and difficult of digestion. The +coffee ought, if practicable, to be _freshly_ ground every morning, in +order that you may be quite sure that it be perfectly genuine, and +that none of the aroma of the coffee has flown off from long exposure +to the atmosphere. If a youth's bowels be inclined to be costive, +coffee is preferable to tea for breakfast, as coffee tends to keep the +bowels regular. Fresh milk ought always to be added to the coffee in +the proportion of half coffee and half new milk. If coffee does not +agree, then _black_ tea should be substituted, which ought to be taken +with plenty of fresh milk in it. Milk may be frequently given in tea, +when it otherwise would disagree. + +When a youth is delicate, it is an excellent plan to give him, every +morning before he leaves his bed, a tumblerful of _new_ milk. The +draught of milk, of course, is not in any way to interfere with his +regular breakfast. + +329. _Do you approve of a boy eating meat with his breakfast_? + +This will depend upon the exercise he uses. If he have had a good walk +or run before breakfast, or if he intend, after breakfast, to take +plenty of athletic out-door exercise, meat, or a rasher or two of +bacon, may, with advantage, be eaten; but not otherwise. + +330. _What is the best dinner for a youth_? + +Fresh mutton or beef, a variety of vegetables, and a farinaceous +pudding. It is a bad practice to allow him to dine, exclusively, +either on a fruit pudding, or on any other pudding, or on +pastry. Unless he be ill, he must, if he is to be healthy, strong, and +courageous, eat meat every day of his life. "All courageous animals +are carnivorous, and greater courage is to be expected in a people, +such as the English, whose food is strong and hearty, than in the +half-starved commonalty of other countries."--Sir W. Temple. + +Let him be debarred from rich soups and from high-seasoned dishes, +which only disorder the stomach and inflame the blood. It is a mistake +to give a boy or a girl broth or soup, in lieu of meat for dinner; the +stomach takes such slops in a discontented way, and is not at all +satisfied. It may be well, occasionally, to give a youth with his +dinner, _in addition to his meat_, either good soup or good broth not +highly seasoned, made of good _meat_ stock. But after all that can be +said on the subject, a plain joint of meat, either roast or boiled, is +far superior for health and strength than either soup or broth, let it +be ever so good or so well made. + +He should be desired to take plenty of time over his dinner, so that +he may be able to chew his food well, and thus that it may be reduced +to an impalpable mass, and be well mixed with the saliva,--which the +action of the jaws will cause to be secreted--before it passes into +the stomach. If such were usually the case, the stomach would not have +double duty to perform, and a boy would not so frequently lay the +foundation of indigestion, etc., which may embitter, and even make +miserable, his after-life. Meat, plain pudding, vegetables, bread, and +hunger for sauce (which exercise will readily give), is the best, and, +indeed, should be, as a rule, the only dinner he should have. A youth +ought not to dine later than two o'clock. + +331. _Do you consider broths and soups wholesome_? + +The stomach can digest solid much more readily than it can liquid +food; on which account the dinner, specified above, is far preferable +to one either of broth or of soup. Fluids in large quantities too +much dilute the gastric juice, and over-distend the stomach, and hence +weaken it, and thus produce indigestion: indeed, it might truly be +said that the stomach often takes broths and soups in a grumbling way! + +332. _Do you approve of a boy drinking beer with his dinner_? + +There is no objection to a little good, mild table-beer, but _strong_ +ale ought never to be allowed. It is, indeed, questionable whether a +boy, unless he take unusual exercise, requires anything but water with +his meals. + +333. _Do you approve of a youth, more especially if he be weakly, +having a glass or two of wine after dinner_? + +I disapprove of it: his young blood does not require to be inflamed, +and his sensitive nerves excited, with wine; and, if he he delicate, I +should be sorry to endeavour to strengthen him by giving him such an +inflammable fluid. If he be weakly, he is more predisposed to put on +either fever or inflammation of some organ; and, being thus +predisposed, wine would be likely to excite either the one or the +other of them into action. + + "Wine and youth are fire upon fire."--_Fielding._ + +A parent ought on no account to allow a boy to touch spirits, however +much diluted; they are, to the young, still more deadly in their +effects than wine. + +334. _Have you any objection to a youth drinking tea_? + +Not at all, provided it be not _green_ tea, that it be not made +strong, and that it have plenty of milk in it. Green tea is apt to +make people nervous, and boys and girls ought not even to know what it +is to be nervous. + +335. _Do you object to supper for a youth_? + +Meat suppers are highly prejudicial. If he be hungry (and if he have +been much in the open air, he is almost sure to be), a piece of bread +and cheese, or of bread and butter, with a draught either of new milk +or of table beer, will form the best supper he can have. He ought not +to sup later than eight o'clock. + +336. _Do you approve of a boy having anything between meals_? + +I do not; let him have four meals a day, and he will require nothing +in the intervals. It is a mistaken notion that "little and often is +best," The stomach requires rest as much as, or perhaps more than (for +it is frequently sadly over-worked) any other part of the body. I do +not mean that he is to have "_much_ and seldom:" moderation, in +everything, is to be observed. Give him as much as a growing boy +requires (_and that is a great deal_), but do not let him eat +gluttonously, as many indulgent parents encourage their children to +do. Intemperance in eating cannot be too strongly condemned. + +337. _Have you any objection to a boy having pocket money_? + +It is a bad practice to allow a boy _much_ pocket money; if he be so +allowed, he will be loading his stomach with sweets, fruit, and +pastry, and thus his stomach will become cloyed and disordered, and +the keen appetite, so characteristic of youth, will be blunted, and +ill-health will ensue. "In a public education, boys early learn +intemperance, and if the parents and friends would give them less +money upon their usual visits, it would be much to their advantage, +since it may justly be said that a great part of their disorders arise +from surfeit, '_plus occidit gula quam gladius_' (gluttony kills more +than the sword)."--_Goldsmith._ + +How true is the saying that "many people dig their graves with their +teeth." You may depend upon it that more die from stuffing than from +starvation! There would be little for doctors to do if there were not +so much stuffing and imbibing of strong drinks going on in the world! + + +AIR AND EXERCISE. + +338. _Have you any remarks to make on fresh air and exercise for boys +and girls_? + +Girls and boys, especially the former, are too much confined within +doors. It is imperatively necessary, if you wish them to be strong and +healthy, that they should have plenty of fresh air and exercise; +remember, I mean fresh air--country air, not the close air of a town. +By exercise, I mean the free unrestrained use of their limbs. Girls, +in this respect, are unfortunately worse off than boys, although they +have similar muscles to develop, similar lungs that require fresh air, +and similar nerves to be braced and strengthened. It is not considered +lady-like to be natural--all then: movements must be measured by rule +and compass! + +The reason why so many young girls of the present day are so sallow, +under-sized, and ill-shaped, is for the want of air and +exercise. After a time the want of air and exercise, by causing ill +health, makes them slothful and indolent-it is a trouble for them to +move from their chairs! + +Respiration, digestion, and a proper action of the bowels, +imperatively demand fresh air and exercise. Ill health will inevitably +ensue if boys and girls are cooped up a great part of the day in a +close room. A distinguished writer of the present day says: "The +children of the very poor are always out and about. In this respect +they are an example to those careful mammas who keep their children, +the whole day long, in their chairs, reading, writing, ciphering, +drawing, practising music lessons, doing crotchet work, or anything, +in fact, except running about in spite of the sunshine always peeping +in and inviting them out of doors; and who, in the due course of time, +are surprised to find their children growing up with incurable heart, +head, lung, or stomach complaints." + +339. _What is the lest exercise for a youth_? + +Walking or running: provided either of them be not carried to +fatigue,--the slightest approach to it should warn a youth to desist +from carrying it further. Walking exercise is not sufficiently +insisted upon. A boy or a girl, to be in the enjoyment of good health, +ought to walk at least ten miles every day. I do not mean ten miles at +a stretch, but at different times of the day. Some young ladies think +it an awfully long walk if they manage a couple of miles! How can +they, with such exercise, expect to be well? How can their muscles be +developed? How can their nerves be braced? How can their spines be +strengthened and be straight? How can their blood course merrily +through their blood-vessels? How can their chests expand and be +strong? Why, it is impossible! Ill health must be the penalty of such +indolence, for Nature will not be trifled with! Walking exercise, +then, is the finest exercise that can be taken, and must be taken, and +that without stint, if boys and girls are to be strong and well! The +advantage of our climate is, that there is not a day in the whole year +that walking exercise cannot be enjoyed. I use the term enjoyed +advisedly. The roads may, of course, be dirty; but what of that A good +thick pair of boots will be the remedy. + +Do then, let me entreat you, insist upon your--girls and boys taking +plenty of exercise; let them almost live in the open air! Do not +coddle them; this is a rough; world of ours, and they must rough it; +they must be knocked about a great deal, and the knocks will do them, +good. Poor youths who are, as it were, tied to their mother's apron +strings, are much to be pitied; they are usually puny and delicate, +and effeminate, and utterly deficient of self-reliance. + +340. _Do you approve of--horse or pony exercise for boys and girls_? + +Most certainly I do; but still it ought not to supersede +walking. Horse or pony exercise is very beneficial, and cannot be too +strongly recommended. One great advantage for those living in towns, +which it has over walking, is, that a person may go further into the +country, and thus be enabled to breathe a purer and more healthy +atmosphere. Again, it is a much more amusing exercise than walking, +and this, for the young, is a great consideration indeed. + +Horse exercise is for both boys and girls a splendid exercise; it +improves the figure, it gives grace to the movements, it strengthens +the chest, it braces the muscles, and gives to the character energy +and courage. Both boys and girls ought to be early taught to ride. +There is nothing that gives more pleasure to the young than riding +either on a pony or on a horse, and for younger children, even on that +despised, although useful animal, a donkey. Exercise, taken with +pleasure, is doubly beneficial. + +If girls were to ride more on horseback than they now do, we should +hear less of crooked spines and of round shoulders, of chlorosis and +of hysteria, and of other numerous diseases of that class, owing, +generally, to debility and to mismanagement. + +Those ladies who "affect the saddle" are usually much healthier, +stronger, and straighter than those who either never or but seldom +ride on horseback. + +Siding on horseback is both an exercise and an amusement, and is +peculiarly suitable for the fair sex, more especially as their modes +of exercise are somewhat limited, ladies being excluded from following +many games, such as cricket, and foot-ball, both of which are +practised, with such zest and benefit, by the rougher sex. + +341. _Do you approve of carriage exercise_? + +There is no muscular exertion in carriage exercise; its principal +advantage is, that it enables a person to have a change of air, which +may be purer than the one he is in the habit of breathing. But, +whether it be so or not, change of air frequently does good, even, if +the air be not so pure. Carriage exercise, therefore, does only +partial good, and ought never to supersede either walking or horse +exercise. + +342. _What is the best time of the day, for the taking of exercise_? + +In the summer time, early in the morning and before breakfast, as +"cool morning air exhilarates young blood like wine." If a boy cannot +take exercise upon an empty stomach, let him have a slice of bread and +a draught of milk. When he returns home he will be able to do justice +to his breakfast. In fine weather he cannot take too much exercise, +provided it be not carried to fatigue. + +343. _What is the best time for him to keep quiet_? + +He ought not to take exercise immediately after--say for half an hour +after--a hearty meal, or it will be likely to interfere with his +digestion. + + +AMUSEMENTS. + +344. _What amusements do you recommend for a boy as being most +beneficial to health_? + +Manly games--such as rowing, skating, cricket, quoits, foot-ball, +rackets, single-stick, bandy, bowls, skittles, and all gymnastic +exercises. Such games bring the muscles into proper action, and thus +cause them to be fully developed. They expand and strengthen the +chest; they cause a due circulation of the blood, making it to bound +merrily through the blood-vessels, and thus to diffuse health and +happiness in its course. Another excellent amusement for boys, is the +brandishing of clubs. They ought to be made in the form of a +constable's staff, but should be much larger and heavier. The manner +of handling them is so graphically described by Addison that I cannot +do better than transcribe it--"When I was some years younger than I am +at present, I used to employ myself in a more laborious diversion, +which I learned from a Latin treatise of exercises that is written +with great erudition; it is there called the [Greek: skiomachia] or +the fighting with a man's own shadow, and consists in the brandishing +of two short sticks grasped in each hand, and loaded with plugs of +lead at either end. This opens the chest, exercises the limbs, and +gives a man all the pleasure of boxing without the blows. I could wish +that several learned men would lay out that time which they employ in +controversies and disputes about nothing, in this method of fighting +with their own shadows. It might conduce very much to evaporate the +spleen which makes them uneasy to the public as well as to +themselves." + +Another capital, healthful game is single-stick, which makes a boy "to +gain an upright and elastic carriage, and to learn the use of his +limbs."--_H. Kingsley_. Single-stick may be taught by any +drill-sergeant in the neighbourhood. Do everything to make a boy +strong. Remember, "the glory of young men is their strength." + +If games were more patronised in youth, so many miserable, nervous, +useless creatures would not abound. Let a boy or girl, then, have +plenty of play; let half of his or her time be spent in play. + +There ought to be a gymnasium established in every town of the +kingdom. The gymnasium, the cricket ground, and the swimming bath, are +among our finest establishments, and should be patronised accordingly. + +First of all, by an abundance of exercise and fresh air make your boys +and girls strong, and then, in due time, they will be ready and be +able to have their minds properly cultivated. Unfortunately, in this +enlightened age, we commence at the wrong end--we put the cart before +the horse--we begin by cultivating the mind, and we leave the body to +be taken care of afterwards; the results are, broken health, +precocious, stunted, crooked, and deformed youths, and premature +decay. + +One great advantage of gymnastic exercise is, it makes the chest +expand, it fills the lungs with air, and by doing so strengthens them +amazingly, and wards off many diseases. The lungs are not sufficiently +exercised and expanded; boys and girls, girls especially, do not as a +rule half fill their lungs with air; now air to the lungs is food to +the lungs, and portions of the lungs have not half their proper food, +and in consequence suffer. + +It is very desirable that every boy and girl should, every day of his +or her life, and for a quarter of an hour at least each time, go +through a regular _breathing exercise_--that is to say, should be made +to stand upright, throw back the shoulders, and the while alternately +and regularly fully fill and fully empty the lungs of air. If this +plan were daily followed, the chest and lungs would be wonderfully +invigorated, and the whole body benefited. + +345. _Is playing the flute, blowing the bugle, or any other wind +instrument, injurious to health_? + +Decidedly so: the lungs and the windpipe are brought into unnatural +action by them. If a boy be of a consumptive habit, this will, of +course, hold good with tenfold force. If a youth must be musical let +him be taught singing, as that, provided the lungs be not diseased, +will be beneficial. + +346. _What amusements do you recommend for a girl_? + +Archery, skipping, horse exercise, croquet, the hand-swing, the +fly-pole, skating, and dancing, are among the best. Archery expands +the chest, throws back the shoulders, thus improving the figure, and +develops the muscles. Skipping is exceedingly good exercise for a +girl, every part of the body being put into action by it Horse +exercise is splendid for a girl; it improves the figure amazingly--it +is most exhilarating and amusing; moreover, it gives her courage and +makes her self-reliant Croquet develops and improves the muscles of +the arms, beautifies the complexion, strengthens the back, and throws +out the chest. Croquet is for girls and women what cricket is for boys +and men--a glorious game. Croquet has improved both the health and +the happiness of womankind more than any game ever before invented. +Croquet, in the bright sunshine, with the winds of heaven blowing +about the players, is not like a ball in a stifling hot ball-room, +with gas-lights poisoning the air. Croquet is a more sensible +amusement than dancing; it brings the intellect as well as the muscles +into play. The man who invented croquet has deserved greater glory, +and has done more good to his species, than many philosophers whose +names are emblazoned in story. Hand-swing is a capital exercise for a +girl, the whole of the body is thrown into action by it, and the +spine, the shoulders, and the shoulder-blades, are especially +benefited. The fly-pole, too, is good exercise for the whole of the +muscles of the body, especially of the legs and the arms. Skating is +for a girl excellent exercise, and is as exhilarating as a glass of +champagne, but will do her far more good! Skating improves the figure, +and makes a girl balance and carry herself upright and well; it is a +most becoming exercise for her, and is much in every way to be +commended. Moreover, skating gives a girl courage and self-reliance. +Dancing, followed as a rational amusement, causes a free circulation +of the blood, and provided it does not induce her to sit up late at +night, is most beneficial. + +347. _If dancing be so beneficial why are balls such fruitful sources +of coughs, of cold, and consumptions_? + +On many accounts. They induce young ladies to sit up late at night; +they cause them to dress more lightly than they are accustomed to do; +and thus thinly clad, they leave their homes while the weather is +perhaps piercingly cold, to plunge into a suffocating, hot ballroom, +made doubly injurious by the immense number of lights, which consume +the oxygen intended for the due performance of the healthy functions +of the lungs. Their partners, the brilliancy of the scene, and the +music, excite their nerves to undue and thus to unnatural, action, and +what is the consequence? Fatigue, weakness, hysterics, and extreme +depression follow. They leave the heated ball-room when the morning +has far advanced, to breathe the bitterly cold and frequently damp air +of a winter's night, and what is the result? Hundreds die of +consumption, who might otherwise have lived. Ought there not, then, to +be a distinction between a ball at midnight and a dance in the +evening? + +348. _But still, would you have a girl brought up to forego the +pleasure of a ball_? + +If a parent prefer her so-called pleasures to her health, certainly +not; to such a mother I do not address myself. + +349. _Have you any remarks to make on singing, or on reading aloud_? + +Before a mother allows her daughter to take lessons in singing, she +should ascertain that there be no actual disease of the lungs, for if +there be, it will probably excite it into action; but if no disease +exist, singing or reading aloud is very conducive to health. Public +singers are seldom known to die of consumption. Singing expands the +chest, improves the pronunciation, enriches the voice for +conversation, strengthens the lungs, and wards off many of their +diseases. + +350. _Do you approve of corporal punishments in schools_? + +I do not. I consider it to be decidedly injurious both to body and +mind. Is it not painful to witness the pale cheeks and the dejected +looks of those boys who are often flogged? If their tempers are mild, +their spirits are broken; if their dispositions are at all obstinate, +they become hardened and wilful, and are made little better than +brutes. [Footnote: "I would have given him, Captain Fleming, had he +been my son," quoth old Pearson the elder, "such's good sound drubbing +as he never would have forgotten--never!" + +"Pooh! pooh! my good sir. Don't tell me. Never saw flogging in the +navy do good. Kept down brutes; never made a man yet."--Dr Norman +Macleod in _Good Words_, May 1861.] A boy who is often flogged loses +that noble ingenuousness and fine sensibility so characteristic of +youth. He looks upon his school as his prison, and his master as his +gaoler, and as he grows up to manhood, hates and despises the man who +has flogged him. Corporal punishment is revolting, disgusting, and +demoralising to the boy; and is degrading to the schoolmaster as a man +and as a Christian, + +If schoolmasters must flog, let them flog their own sons. If they must +ruin the tempers, the dispositions, and the constitution of boys, they +have more right to practise upon their own than on other people's +children! Oh! that parents would raise--and that without any +uncertain sound--their voices against such abominations, and the +detestable cane would soon be banished the school-room! "I am +confident that no boy," says Addison, "who will not be allured by +letters without blows, will never be brought to anything with them. A +great or good mind must necessarily be the worse for such indignities; +and it is a sad change to lose of its virtue for the improvement of +its knowledge. No one has gone through what they call a great school, +but must have remembered to have seen children of excellent and +ingenuous natures (as have afterwards appeared in their manhood). I +say, no man has passed through this way of education but must have +seen an ingenuous creature expiring with shame, with pale looks, +beseeching sorrow, and silent tears, throw up its honest sighs, and +kneel on its tender knees to an inexorable blockhead, to be forgiven +the false quantity of a word in making a Latin verse. The child is +punished, and the next day he commits a like crime, and so a third, +with the same consequence. I would fain ask any reasonable man whether +this lad, in the simplicity of his native innocence, full of shame, +and capable of any impression from that grace of soul, was not fitter +for any purpose in this life than after that spark of virtue is +extinguished in him, though he is able to write twenty verses in an +evening?" + +How often is corporal punishment resorted to at school because the +master is in a passion, and he vents his rage upon the poor +school-boy's unfortunate back! + +Oh! the mistaken notion that flogging will make a bad-behaved boy a +good boy; it has the contrary effect. "'I dunno how 'tis, sir,' said +an old farm labourer, in reply to a question from his clergyman +respecting the bad behaviour of his children, 'I dunno how 'tis; I +beats 'em till they're black and blue, and when they won't kneel down +to pray I knocks 'em down, and yet they ain't good.'"--_The Birmingham +Journal._ + +In an excellent article in _Temple Bar_(November 1864) on flogging in +the army, the following sensible remarks occur:--"In nearly a quarter +of a century's experience with soldiers, the writer has always, and +without a single exception, found flogging makes a good man bad, and a +bad man worse." With equal truth it may be said that, without a single +exception, flogging makes a good boy bad, and a bad boy worse. How +many men owe their ferocity to the canings they received when +school-boys! The early floggings hardened and soured them, and blunted +their sensibility. + +Dr Arnold of Rugby, one of the best schoolmasters that England ever +produced, seldom caned a boy--not more than once or twice during the +half year; but when he did cane him, he charged for the use of the +cane each time in the bill, in order that the parents might know how +many times their son had been punished. At some of our public schools +now-a-days, a boy is caned as many times in a morning as the worthy +doctor would have caned him during the whole half year; but then, the +doctor treated the boys as gentlemen, and trusted much to their +honour; but now many schoolmasters trust much to fear, little to +honour, and treat them as brute beasts. + +It might be said that the discipline of a school cannot be maintained +unless the boys be frequently caned, that it must be either caning or +expulsion. I deny these assertions. Dr Arnold was able to conduct his +school with honour to himself, and with immense benefit to the rising +generation, without either frequent canings or expulsions. The humane +plan, however, requires at first both trouble and patience; and +trouble some schoolmasters do not like, and patience they do not +possess; the use of the cane is quick, sharp, decisive, and at the +time effective. + +If caning be ever necessary, which it might occasionally be, for the +telling of lies for instance, or for gross immorality, let the head +master himself be the only one to perform the operation, but let him +not be allowed to delegate it to others. A law ought in all public +schools to be in force to that effect. High time that something were +done to abate such disgraceful practices. + +Never should a schoolmaster, or any one else, be allowed, _on any +pretence whatever_, to strike a boy upon his head. Boxing of the ears +has sometimes caused laceration of the drum of the ear, and consequent +partial deafness for life. Boxing of the ears injures the brain, and +therefore the intellect. + +It might be said, that I am travelling out of my province in making +remarks on corporal chastisement in schools? But, with deference, I +reply that I am strictly in the path of duty. My office is to inform +you of everything that is detrimental to your children's health and +happiness; and corporal punishment is assuredly most injurious both to +their health and happiness. It is the bounden duty of every man, and +especially of every medical man, to lift up his voice against the +abominable, disgusting, and degrading system of flogging, and to warn +parents of the danger and the mischief of sending boys to those +schools where flogging is, except in rare and flagrant cases, +permitted. + +351. _Have you any observations to make on the selection, of a female +boarding-school_? + +Home education, where it be practicable, is far preferable to sending +a girl to school; as _at_ home, her health, her morals, and her +household duties, can be attended to much more effectually than _from_ +home. Moreover, it is a serious injury to a girl, in more ways than +one, to separate her from her own brothers: they very much lose their +affection for each other, and mutual companionship (so delightful and +beneficial between brothers and sisters) is severed. + +If home education be not practicable, great care must be taken in +making choice of a school. Boarding school education requires great +reformation. Accomplishments, superficial acquirements, and +brain-work, are the order of the day; health is very little +studied. You ought, in the education of your daughters, to remember +that they, in a few years, will be the wives and the mothers of +England; and, if they have not health and strength, and a proper +knowledge of household duties to sustain their characters, what +useless, listless wives and mothers they will make! + +Remember, then, the body, and not the mind, ought, in early life, to +be principally cultivated and strengthened, and that the growing brain +will not bear, with impunity, much book learning. The brain of a +school-girl is frequently injured by getting up voluminous questions +by rote, that are not of the slightest use or benefit to her, or to +any one else. Instead of this ridiculous system, educate a girl to be +useful and self-reliant. "From babyhood they are given to understand +that helplessness is feminine and beautiful; helpfulness, except in +certain received forms of manifestation, unwomanly and ugly. The boys +may do a thousand things which are 'not proper for little girls.'"--_A +Woman's Thoughts about Women_. + +From her twelfth to her seventeenth year, is the most important epoch +of a girl's existence, as regards her future health, and consequently, +in a great measure, her future happiness; and one, in which, more than +at any other period of her life, she requires a plentiful supply of +fresh air, exercise, recreation, a variety of innocent amusements, and +an abundance of good nourishment--more especially of fresh meat; if +therefore you have determined on sending your girl to school, you must +ascertain that the pupils have as much plain wholesome nourishing food +as they can eat, [Footnote: If a girl have an _abundance_ of good +nourishment, the schoolmistress must, of coarse, be remunerated for +the necessary and costly expense; and how can this be done on the +paltry sum charged at _cheap_ boarding schools? It is utterly +impossible! And what are we to expect from poor and insufficient +nourishment to a fast-growing girl, and at the time of life, remember, +when she requires an _extra_ quantity of good sustaining, supporting +food? A poor girl, from such treatment, becomes either consumptive or +broken down in constitution, and from which she never recovers, but +drags on a miserable existence.] that the school be situated in a +healthy spot, that it be well-drained, that there be a large +play-ground attached to it, that the young people are allowed plenty +of exercise in the open air--indeed, that at least one-third of the +day is spent there in croquet, skipping, archery, battle-dore and +shuttlecock, gardening, walking, running, &c. + +Take care that the school-rooms are well-ventilated, that they are not +over-crowded, and that the pupils are allowed chairs to sit upon, and +not those abominations--forms and stools. If you wish to try the +effect of them upon yourselves, sit for a couple of hours without +stirring upon a form or upon a stool, and, take my word for it, you +will insist that forms and stools be banished for ever from the +schoolroom. + +Assure yourself that the pupils are compelled to rise early in the +morning, and that they retire early to rest; that each young lady has +a separate bed [Footnote: A horse-hair mattress should always be +preferred to a feather-bed. It is not only better for the health, but +it improves the figure] and that many are not allowed to sleep in the +same room, and that the apartments are large and well-ventilated. In +fine, their health and their morals ought to be preferred far above +all their accomplishments. + +352. _They use, in some schools, straight-backed chairs to make a girl +sit upright, and to give strength to her back: do you approve of +them_? + +Certainly not: the natural and the graceful curve of the back is not +the curve of a straight-backed chair. Straight-backed chairs are +instruments of torture, and are more likely to make a girl crooked +than to make her straight. Sir Astley Cooper ridiculed straight-backed +chairs, and well he might. It is always well for a mother to try, for +some considerable time, such ridiculous inventions upon herself before +she experiments upon her unfortunate daughter. The position is most +unnatural. I do not approve of a girl lounging and lolling on a sofa; +but, if she be tired and wants to rest herself, let her, like any +other reasonable being, sit upon a comfortable ordinary chair. + +If you want her to be straight, let her be made strong; and if she is +to be strong, she must use plenty of exercise and exertion, such as +drilling, dancing, skipping, archery, croquet, hand-swinging, +horse-exercise, swimming, bowls, etc. This is the plan to make her +back straight and her muscles strong. Why should we bring up a girl +differently from a boy? Muscular exercises, gymnastic performances, +and health-giving exertion, are unladylike, forsooth! + + +HOUSEHOLD WORK FOR GIRLS. + +353. _Do you recommend household work as a means of health for my +daughter_? + +Decidedly: whatever you do, do not make a fine lady of her, or she +will become puny and delicate, listless, and miserable. A girl, let +her station be what it might, ought, as soon as she be old enough, to +make her own bed. There is no better exercise to expand the figure and +to beautify the shape than is bed-making. Let her make tidy her own +room. Let her use her hands and her arms. Let her, to a great extent, +be self-reliant, and let her wait upon herself. There is nothing +vulgar in her being useful. Let me ask, of what use are many girls of +the present day? They are utterly useless. Are they happy? No, for +the want of employment, they are miserable--I mean bodily employment, +household work. Many girls, now-a-days, unfortunately, are made to +look upon a pretty face, dress, and accomplishments, as the only +things needed! And, when they do become women and wives--if ever they +do become women and wives--what miserable lackadaisical wives, and +what senseless, useless mothers they will make! + + +CHOICE OF PROFESSION OR TRADE. + +354. _What profession or trade would you recommend a boy of a delicate +or of a consumptive habit to follow_? + +If a youth be delicate, it is a common practice among parents either +to put him to some light in-door trade, or, if they can afford it, to +one of the learned professions. Such a practice is absurd, and +fraught with danger. The close confinement of an in-door trade is +highly prejudicial to health. The hard reading requisite to fit a man +to fill, for instance, the sacred office, only increases delicacy of +constitution. The stooping at a desk, in an attorney's office, is most +trying to the chest. The harass, the anxiety, the disturbed nights, +the interrupted meals, and the intense study necessary to fit a man +for the medical profession, is still more dangerous to health than +either law, divinity, or any in-door trade. "Sir Walter Scott says of +the country surgeon, that he is worse fed and harder wrought than any +one else in the parish, except it be his fiorse."--_Brown's Horoe +Subsecivoe._ + +A modern writer, speaking of the life of a medical man, observes, +"There is no career which so rapidly wears away the powers of life, +because there is no other which requires a greater activity of mind +and body. He has to bear the changes of weather, continued fatigue, +irregularity in his meals, and broken rest; to live in the midst of +miasma and contagion. If in the country, he has to traverse +considerable distances on horseback, exposed to wind and storm; to +brave all dangers to go to the relief of suffering humanity. A fearful +truth for medical men has been established by the table of mortality +of Dr. Caspar, published in the _British Review_. Of 1000 members of +the medical profession, 600 died before their sixty-second year; +whilst of persons leading a quiet life--such as agriculturists or +theologians--the mortality is only 347. If we take 100 individuals of +each of these classes, 43 theologians, 40 agriculturists, 35 clerks, +32 soldiers, will reach their seventieth year; of 100 professors of +the healing art, 24 only will reach that age. They are the sign-posts +to health; they can show the road to old age, but rarely tread it +themselves." + +If a boy, therefore, be of a delicate or of a consumptive habit, an +out-door calling should be advised, such as that of a farmer, of a +tanner, or a land-surveyor; but, if he be of an inferior station of +society, the trade of a butcher may be recommended. Tanners and +butchers are seldom known to die of consumption. + +I cannot refrain from reprobating the too common practice among +parents of bringing up their boys to the professions. The anxieties +and the heartaches which they undergo if they do not succeed (and how +can many of them succeed when there is such a superabundance of +candidates?) materially injure their health. "I very much wonder," +says Addison, "at the humour of parents, who will not rather choose to +place their sons in a way of life where an honest industry cannot but +thrive, than in stations where the greatest probity, learning, and +good sense, may miscarry. How many men are country curates, that might +have made themselves aldermen of London by a right improvement of a +smaller sum of money than what is usually laid out upon a learned +education? A sober, frugal person, of slender parts and a slow +apprehension, might have thrived in trade, though he starves upon +physic; as a man would be well enough pleased to buy silks of one whom +he could not venture to feel his pulse. Vagellius is careful, +studious, and obliging, but withal a little thick-skulled; he has not +a single client, but might have had abundance of customers. The +misfortune is that parents take a liking to a particular profession, +and therefore desire their sons may be of it; whereas, in so great an +affair of life, they should consider the genius and abilities of their +children more than their own inclinations. It is the great advantage +of a trading nation, that there are very few in it so dull and heavy +who may not be placed in stations of life which may give them an +opportunity of making their fortunes. A well-regulated commerce is +not, like law, physic, or divinity, to be overstocked with hands; but, +on the contrary, flourishes by multitudes, and gives employment to all +its professors. Fleets of merchantmen are so many squadrons of +floating shops, that vend our wares and manufactures in all the +markets of the world, and find out chapmen under both the tropics." + +355. _Then, do you recommend a delicate youth to be brought up either +to a profession or to a trade_? + +Decidedly; there is nothing so injurious for a delicate boy, or for +anyone else, as idleness. Work, in moderation, enlivens the spirits, +braces the nerves, and gives tone to the muscles, and thus strengthens +the constitution. Of all miserable people, the idle boy, or the idle +man, is the most miserable! If you be poor, of course you will bring +him up to some calling; but if you be rich, and your boy be delicate +(if he be not actually in a consumption), you will, if you are wise, +still bring him up to some trade or profession. You will, otherwise, +be making a rod for your own as well as for your son's back. Oh, what +a blessed thing is work! + +356. _Have you any remarks to make on the sleep of boys and girls_? + +Sleeping-rooms, are, generally, the smallest in the house, whereas, +for health's sake, they ought to be the largest If it be impossible to +have a _large_ bedroom, I should advise a parent to have a dozen or +twenty holes (each about the size of a florin) bored with a centre-bit +in the upper part of the chamber door, and the same number of holes in +the lower part of the door, so as constantly to admit a free current +of air from the passages. If this cannot readily be done, then let the +bedroom door be left ajar all night, a door chain being on the door to +prevent intrusion; and, in the summer time, during the night, let the +window-sash, to the extent of about two or three inches, be left open. + +If there be a dressing-room next to the bedroom, it will be well to +have the dressing-room window, instead of the bedroom window, open at +night. The dressing-room door will regulate the quantity of air to be +admitted into the bedroom, opening it either little or much, as the +weather might be cold or otherwise. + +_Fresh air during deep is indispensable to health._--If a bedroom be +close, the sleep, instead of being calm and refreshing, is broken and +disturbed; and the boy, when he awakes in the morning, feels more +fatigued than when he retired to rest. + +If sleep is to be refreshing, the air, then, must be pure, and free +from carbonic acid gas, which, is constantly being evolved from the +lungs. If sleep is to be health-giving, the lungs ought to have their +proper food--oxygen, and not to be cheated by giving them instead a +poison--carbonic acid gas. + +It would be well for each boy to have a separate room to himself, and +each girl a separate room to herself. If two boys are obliged, from +the smallness of the house, to sleep in one room, and if two girls, +from the same cause, are compelled to occupy the same chamber, by all +means let each one have a _separate_ bed to himself and to herself, as +it is so much more healthy and expedient for both boy and girl to +sleep alone. + +The roof of the bed should be left open--that is to say, the top of +the bedstead ought not to be covered with bed furniture, but should be +open to the ceiling, in order to encourage a free ventilation of +air. A bed-curtain may be allowed on the side of the bed where there +are windy currents of air; otherwise bed-curtains and valances ought +on no account to be allowed. They prevent a free circulation of the +air. A youth should sleep on a horse-hair mattress. Such mattresses +greatly improve the figure and strengthen the frame. During the day +time, provided it does not rain, the windows must be thrown wide open, +and, directly after he has risen from bed, the clothes ought to be +thrown entirely back, in order that they may become, before the bed be +made, well ventilated and purified by the air-- + + "Do yon wish to be healthy?-- + Then keep the home sweet, + As soon as you're up + Shake each blanket and sheet. + + Leave the beds to get fresh + On the close crowded floor + Let the wind sweep right through-- + Open window and door + + The bad air will rush out + As the good air comes in, + Just as goodness is stronger + And better than sin. + + Do this, it's soon done, + In the fresh morning air, + It will lighten your labour + And lessen your care + + You are weary--no wonder, + There's weight and there's gloom + Hanging heavily round + In each over full room. + + Be sure all the trouble + Is profit and gain + For there's head ache and heart-ache, + And fever and pain + + Hovering round, settling down + In the closeness and heat + Let the wind sweep right through + Till the air's fresh and sweet, + + And more cheerful you'll feel + Through the toil of the day, + More refreshed you'll awake + When the night's paved away" [Footnote: _Household Verses on + Health and Happiness_ London. Jarrold and Sons. Every mother + should read these _Verses_.] + +Plants and flowers ought not to be allowed to remain in a chamber at +night. Experiments have proved that plants and flowers take up, in +the day-time, carbonic acid gas (the refuse of respiration), and give +off oxygen (a gas so necessary and beneficial to health), but give +out, in the night season, a poisonous exhalation. + +Early rising cannot be too strongly insisted upon; nothing is more +conducive to health and thus to long life. A youth is frequently +allowed to spend the early part of the morning in bed, breathing the +impure atmosphere of a bedroom, when he should be up and about, +inhaling the balmy and health-giving breezes of the morning:-- + + "Rise with the lark, and with the lark to bed: The breath of night's + destructive to the hue Of ev'ry flower that blows. Go to the field, + And ask the humble daisy why it sleeps Soon as the sun departs? Why + close the eyes Of blossoms infinite long ere the moon Her oriental + veil puts off? Think why, Nor let the sweetest blossom Nature + boasts Be thus exposed to night's unkindly damp. Well may it droop, + and all its freshness lose, Compell'd to taste the rank and + pois'nous steam Of midnight theatre and morning ball Gire to repose + the solemn hour she claims; And from the forehead of the morning + steal The sweet occasion. Oh! there is a charm Which morning has, + that gives the brow of age, a smack of youth, and makes the lip of + youth Shed perfume exquisite. Expect it not Ye who till noon upon a + down-bed lie, Indulging feverish sleep."--_Hurdis_. + +If early rising be commenced in childhood it becomes a habit, and will +then probably be continued through life. A boy ought on no account to +be roused from his sleep; but, as soon as he be awake in the morning, +he should be encouraged to rise. Dozing--that state between sleeping +and waking--is injurious; it enervates both body and mind, and is as +detrimental to health as dram drinking! But if he rise early he must +go to bed betimes; it is a bad practice to keep him up until the +family retire to rest. He ought, winter and summer, to seek his pillow +by nine o'clock, and should rise as soon as he awake in the morning. + +Let me urge upon a parent the great importance of _not_ allowing the +chimney of any bedroom, or of any room in the house, to be stopped, as +many are in the habit of doing to prevent, as _they_ call it, a +draught, but to prevent, as _I_ should call it, health. + +357. _How many hours of deep ought a boy to have_? + +This, of course, will depend upon the exercise he takes: but, on an +average, he should have every night at least eight hours. It is a +mistaken notion that a boy does _better_ with _little_ sleep. Infants, +children, and youths require more than those who are further advanced +in years; hence old people can frequently do with little sleep. This +may in a measure be accounted for from the quantity of exercise the +young take. Another reason may be, the young have neither racking +pain, nor hidden sorrow, nor carking care, to keep them awake; while, +on the contrary, the old have frequently, the one, the other, or +all:-- + + "Care keeps his watch on every old man's eye, + And where care lodges, sleep will never lie."--_Shakspeare_. + + +ON THE TEETH AND THE GUMS. + +358. _What are the beet means of keeping the teeth and the gums in a +healthy state_? + +I would recommend the teeth and the gums to be well brushed with warm +salt and water, in the proportion of one large tea-spoonful of, salt +to a tumbler of water. I was induced to try the above plan by the +recommendation of an American writer--_Todd_. The salt and water +should be used _every night_. + +The following is an excellent tooth-powder:-- + + Take of--Finely-powder Peruvian Bark; + '' Prepared Coral; + '' Prepared Chalk; + '' Myrrh, of each half an ounce + '' Orris root, a quarter of an ounce: + +Mix them well together in a mortar, and preserve the powder in a wide +mouthed stoppered bottle. + +The teeth ought to be well brushed with the above tooth-powder every +morning. + +If the teeth be much decayed, and if, in consequence, the breath be +offensive, two ounces of finely-powdered charcoal well mixed with the +above ingredients will be found a valuable addition. Some persons +clean their teeth every morning with soap; if soap be used it ought to +be Castile soap; and if the teeth be not white and clean, Castile soap +is an excellent cleanser of the teeth, and may be used in lieu of the +tooth powder as before recommended. + +There are few persons who brush their teeth properly. I will tell you +the right way. First of all procure a tooth brush of the best make, +and of rather hard bristles, to enable it to penetrate into all the +nooks and corners of the teeth; then, having put a small quantity of +warm water into your mouth, letting the principal of it escape into +the basin, dip your brush in warm water, and if you are about using +Castile soap, rub the brush on a cake of the soap, and then well brush +your teeth, first upwards and then downwards, then from side to +side--from right to left, and from left to right--then the backs of +the teeth, then apply the brush to the tops of the crowns of the teeth +both of the upper and of the lower jaw,--so that _every_ part of each +tooth, including the gums, may in turn be well cleansed and be well +brushed. Be not afraid of using the brush; a good brushing and +dressing will do the teeth and the gums an immensity of good; it will +make the breath sweet, and will preserve the teeth sound and +good. After using the brush the mouth must, of course, be well rinsed +out with warm water. + +The finest get of teeth I ever saw m my life belonged to a middle-aged +gentleman; the teeth had neither spot nor blemish, they were like +beautiful pearls. He never had toothache in his life, and did not know +what toothache meant! He brushed his teeth, every morning, with soap +and water, in the manner I have previously recommended. I can only say +to you--go and do likewise! + +Camphor ought never to be used as an ingredient of tooth-powder, it +makes the teeth brittle. Camphor certainly has the effect of making +the teeth, for a time, look very white; but it is an evanescent +beauty. + +Tartar is apt to accumulate between and around the teeth; it is better +in such a case not to remove it by sealing instruments, but to adopt +the plan recommended by Dr Richardson, namely, to well brush the teeth +with pure vinegar and water. + + +PREVENTION OF DISEASE, ETC + +359. _If a boy or a girl show great precocity of intellect, is any +organ likely to become affected_? + +A greater quantity of arterial blood is sent to the brain of those who +are prematurely talented, and hence it becomes more than ordinarily +developed. Such advantages are not unmixed with danger; this same +arterial blood may exite and feed inflammation, and either +convulsions, or water on the brain, or insanity, or, at last, idiocy +may follow. How proud a mother is in having a precocious child! How +little is she aware that precocity is frequently an indication of +disease! + +360. _How can danger in such a case be warded off_? + +It behoves a parent, if her son be precocious, to restrain him--to +send him to a quiet country place, free from the excitement of the +town; and when he is sent to school, to give directions to the master +that he is not on any account to tax his intellect (for a master is +apt, if he have a clever boy, to urge him forward); and to keep him +from those institutions where a spirit of rivalry is maintained, and +where the brain is thus kept in a state of constant excitement. Medals +and prizes are well enough for those who have moderate abilities, but +dangerous, indeed, to those who have brilliant ones. + +An over-worked precocious brain is apt to cause the death of the +owner; and if it does not do so, it in too many instances injures the +brain irreparably, and the possessor of such an organ, from being one +of the most intellectual of children becomes one of the most +commonplace of men. + +Let me urge you, if you have a precocious child, to give, and that +before it be too late, the subject in question your best +consideration. + +361. _Are precocious boys in their general health usually strong or +delicate_? + +Delicate: nature seems to have given a delicate body to compensate for +the advantages of a talented mind. A precocious youth is predisposed +to consumption, more so than to any other disease. The hard study +which he frequently undergoes excites the disease into action. It is +not desirable, therefore, to have a precocious child. A writer in +"Eraser's Magazine" speaks very much to the purpose when he says, +"Give us intellectual beef rather than intellectual veal." + +362. _What Habit of body is most predisposed to scrofula_? + +He or she who has a moist, cold, fair, delicate and almost transparent +skin, large prominent blue eyes, protuberant forehead, light-brown or +auburn hair, rosy cheeks, pouting lips, milk-white teeth, long neck, +high shoulders, small, flat, and contracted chest, tumid bowels, large +joints, thin limbs, and flabby muscles, is the person, most +predisposed to scrofula. The disease is not entirely confined to the +above; sometimes she or he who has black hair, dark eyes and +complexion, is subject to it, but yet, far less frequently than the +former. It is a remarkable fact that the most talented are the most +prone to scrofula, and being thus clever their intellects are too +often cultivated at the expense of their health. In infancy and +childhood, either water on the brain or mesenteric disease; in youth, +pulmonary consumption is frequently their doom: they are like shining +meteors; their life is short, but brilliant. + +363. _How may scrofula be warded off_? + +Strict attention to the roles of health is the means to prevent +scrofula. Books, unless as an amusement, ought to be discarded. The +patient must almost live in the open air, and his residence should be +a healthy country place, where the air is dry and bracing; if it be at +a farm-house, in a salubrious neighbourhood, so much the better. In +selecting a house for a patient predisposed to scrofula, _good pure +water should be an important requisite;_ indeed for every one who +values his health. Early rising in such a case is most beneficial. +Wine, spirits, and all fermented liquors ought to be avoided. +Beef-steaks and mutton-chops in abundance, and plenty of milk and of +farinaceous food--such as rice, sago, arrowroot, &c., should be his +diet. + +Scrofula, if the above rules be strictly and perseveringly followed, +may be warded off; but there must be no half measures, no trying to +serve two masters--to cultivate at the same time the health and the +intellect. The brain, until the body becomes strong, must _not_ be +taxed. "You may prevent scrofula by care, but that some children are +originally predisposed to the disease there cannot be the least doubt, +and in such cases the education and the habits of youth should be so +directed as to ward off a complaint, the effects of which are so +frequently fatal."--_Sir Astley Cooper on Scrofula_. + +364. _But suppose the disease to be already formed, what must then be +done_? + +The plan recommended above must still be pursued, not by fits and +starts, but steadily and continuously, for it is a complaint that +requires a vast deal of patience and great perseverance. Warm and cold +sea-bathing in such a case are generally most beneficial. In a patient +with confirmed scrofula it will of course be necessary to consult a +skilful and experienced doctor. + +But do not allow without a second opinion any plan to be adopted that +will weaken the system, which is already too much depressed. No, +rather build up the body by good nourishing diet (as previously +recommended), by cod-liver oil, by a dry bracing atmosphere, such as, +either Brighton, or Ramsgate, or Llandudno; or if the lungs be +delicate, by a more sheltered coast, such as, either St Leonards or +Torquay. + +Let no active purging, no-mercurials, no violent, desperate remedies +be allowed. If the patient cannot be cured _without_ them, I am +positive that he will not be cured _with_ them. + +But do not despair; many scrofulous patients are cured by time and by +judicious treatment But if desperate remedies are to be used, the poor +patient had better by jar be left to Nature: "Let me fall now into the +hand of the Lord; for very great are his mercies; but let me not fall +into the hand of man."--_Chronicles_. + +365. _Have you any remarks to make on a girl stooping_? + +A girl ought never to be allowed to stoop: stooping spoils the figure, +weakens the chest, and interferes with the digestion. If she cannot +help stooping, you may depend upon it that she is in bad health, and +that a medical man ought to be consulted. As soon as her health is +improved the dancing-master should be put in requisition, and +calisthenic and gymnastic exercises should be resorted to. Horse +exercise and swimming in such a case are very beneficial The girl +should live well, on good nourishing diet, and not be too closely +confined either to the house or to her lessons. She ought during the +night to lie on a horsehair mattress, and during the day, for two or +three hours, flat on, her back on a reclining board. Stooping, if +neglected, is very likely to lead to consumption. + +366. _If a boy be round-shouldered and slouching in his gait, what +ought to be done_? + +Let him be drilled; there is nothing more likely to benefit him than +drilling. You never see a soldier round-shouldered nor slouching in +his gait He walks every inch like a man. Look at the difference in +appearance between a country bumpkin and a soldier! It is the drilling +that makes the difference: "Oh, for a drill-sergeant to teach them to +stand upright, and to turn out their toes, and to get rid of that +slouching, hulking gait, which gives such a look of clumsiness and +stupidity!" [Footnote: A. K, H. B., _Fraser's Magazine_, October +1861.] + +367. _My daughter has grown out of shape, she has grown on one ride, +her spine is not straight, and her ribs bulge out more on the one side +than on the other; what is the cause, and can anything be done to +remedy the deformity_? + +The causes of this lateral curvature of the spine, and consequent +bulging out of the ribs that you have just now described, arise either +from delicacy of constitution, from the want of proper exercise, from +too much learning, or from too little play, or from not sufficient or +proper nourishment for a rapidly-growing body. I am happy to say that +such a case, by judicious treatment, can generally be cured--namely, +by gymnastic exercises, such as the hand-swing, the fly-pole, the +patent parlour gymnasium, the chest-expander, the skipping rope, the +swimming bath; all sorts of out-door games, such as croquet, archery, +&c.; by plenty of good nourishment, by making her a child of Nature, +by letting her almost live in the open air, and by throwing books to +the winds. But let me strongly urge you not, unless ordered by an +experienced surgeon, to allow any mechanical restraints or appliances +to be used. If she be made strong, the muscles themselves will pull +both the spine and the ribs into their proper places, more especially +if judicious games and exercises (as I have before advised), and other +treatment of a strengthening and bracing nature, which a medical man +will indicate to you, be enjoined. Mechanical appliances will, if not +judiciously applied, and in a proper case, waste away the muscles, and +will thus increase the mischief; if they cause the ribs to be pushed +in in one place, they will bulge them out in another, until, instead +of being one, there will be a series of deformities. No, the giving of +strength and the judicious exercising of the muscles are, for a +lateral curvature of the spine and the consequent bulging out of one +side of the ribs, the proper remedies, and, in the majority of cases, +are most effectual, and quite sufficient for the purpose. + +I think it well to strongly impress upon a mother's mind the great +importance of early treatment. If the above advice be followed, every +curvature in the beginning might be cured. Cases of several years' +standing might, with judicious treatment, be wonderfully relieved. + +Bear in mind, then, that if the girl is to be made straight, she is +first of all to be made strong; the latter, together with the proper +exercises of the muscles, will lead to the former; and the _earlier_ a +medical man takes it in hand, the more rapid, the more certain, and +the more effectual will be the cure. + +An inveterate, long-continued, and neglected case of curvature of the +spine and bulging out of the ribs on one side might require mechanical +appliances, but such a case can only be decided on by an experienced +surgeon, who ought always, _in the first place_, to be consulted. + +368. _Is a slight spitting of blood to be looked upon as a dangerous +symptom_? + +Spitting of blood is always to be looked upon with suspicion; even +when a youth appears, in other respects, to be in good health, it is +frequently the forerunner of consumption. It might be said that, by +mentioning the fact, I am unnecessarily alarming a parent, but it +would be a false kindness if I did not do so:-- + + "I most be cruel, only to be kind."--_Shakspeare_. + +Let me ask, When is consumption to be cured? Is it at the onset, or is +it when it is confirmed? If a mother had been more generally aware +that spitting of blood was frequently the forerunner of consumption, +she would, in the management of her offspring, have taken greater +precautions; she would have, made everything give way to the +preservation of their health; and, in many instances, she would have +been amply repaid by having the lives of her children spared to +her. We frequently hear of patients, in _confirmed_ consumption, being +sent to Mentone, to Madeira, and to other foreign parts. Can anything +be more cruel or absurd? If there be any disease that requires the +comforts of home--and truly may an Englishman's dwelling be called +_home!_--and good nursing more than another, it is consumption. + +369. _What it the death-rate of consumption in England? At what age +does consumption most frequently occur? Are girls more liable to it +than boys? What are the symptoms of this disease_? + +It is asserted, on good authority, that there always are in England, +78,000 cases of consumption, and that the yearly death-rate of this +fell disease alone is 39,000! Consumption more frequently shows +itself between the ages of fourteen and twenty-one: after then, the +liability to the disease gradually diminishes, until, at the age of +forty-five, it becomes comparatively rare. Boys are more prone to this +complaint than girls. Some of the most important symptoms of pulmonary +consumption are indicated by the stethoscope; but, as I am addressing +a mother, it would, of course, be quite out of place to treat of such +signs in Conversations of this kind. The symptoms it might be well for +a parent to recognise, in order that she may seek aid early, I will +presently describe. It is perfectly hopeless to expect to cure +consumption unless advice be sought at the _onset_, as the only +effectual good in this disease is to be done _at first_. + +It might be well to state that consumption creeps on insidiously. One +of the earliest symptoms of this dreadful scourge is a slight, dry, +short cough, attended with tickling and irritation at the top of the +throat. This cough generally occurs in the morning; but, after some +time, comes on at night, and gradually throughout the day and the +night. Frequently during the early stage of the disease _a slight +spitting of blood occurs_. Now, this is a most dangerous symptom; +indeed, I may go so far as to say that, as a rule, it is almost a sure +sign that the patient is in the _first_ stage of a consumption. + +There is usually hoarseness, not constant, but coming on if the +patient be tired, or towards the evening; there is also a sense of +lassitude and depression, shortness of breath, a feeling of being +quickly wearied--more especially on the slightest exertion. The hair +of a consumptive person usually falls off, and what little remains is +weak and poor; the joints of the fingers become enlarged, or clubbed +as it is sometimes called; the patient loses flesh, and, after some +time, night sweats make their appearance: then we may know that hectic +fever has commenced. + +Hectic begins with chilliness, which is soon followed by flushings of +the face, and by burning heat of the hands and the feet, especially of +the palms and the soles. This is soon succeeded by perspirations. The +patient has generally, during the day, two decided paroxysms of hectic +fever--the one at noon, which lasts above five hours; the other in the +evening, which is more severe, and ends in violent perspirations, +which perspirations continue the whole night through. He may, during +the day, have several attacks of hectic flushes of the face, +especially after eating; at one moment he complains of being too hot, +and rushes to the cool air; the next moment he is too cold, and almost +scorches himself by sitting too near the fire. Whenever the +circumscribed hectic flush is on the cheek, it looks as though the +cheek had been painted with vermilion, then is the time when the palms +of the hands are burning hot. Crabbe, in the following lines, +graphically describes the hectic flush:-- + + "When his thin cheek assumed a deadly hue, + And all the rose to one small spot withdrew: + They call'd it hectic; 'twas a fiery flush, + More fix'd and deeper than the maiden blush." + +The expectoration at first is merely mucus, but after a time it +assumes a characteristic appearance; it has a roundish, flocculent, +woolly form, each portion of phlegm keeping, as it were, distinct; and +if the expectoration be stirred in water, it has a milk-like +appearance. The patient is commonly harassed by frequent bowel +complaints, which rob him of what little strength he has left. The +feet and ankles swell. The perspiration, as before remarked, comes on +in the evening, continues all night--more especially towards morning, +and while the patient is asleep; during the time he is awake, even at +night, he seldom sweats much. The thrush generally shows itself +towards the close of the disease, attacking the tongue, the tonsils, +and the soft palate, and _is a sure harbinger of approaching +death_. Emaciation rapidly sets in. + +If we consider the immense engines of destruction at work-viz., +the-colliquative (melting) sweats, the violent bowel complaints, the +vital parts that are affected, the harassing cough, the profuse +expectoration, the hectic fever, the distressing exertion of +struggling to breathe--we cannot be surprised that "consumption had +hung out her red flag of no surrender," and that death soon closes the +scene. In girls, provided they have been previously regular, +menstruation gradually declines, and then entirely disappears. + +370. _What are the causes of consumption_? + +The _predisposing_ causes of consumption are the tuberculous habit of +body, hereditary predisposition, narrow or contracted chest, deformed +spine, delicacy of constitution, bad and scanty diet, or food +containing but little nourishment, impure air, close in-door +confinement in schools, in shops, and in factories, ill-ventilated +apartments, dissipation, late hours, over-taxing with book-learning +the growing brain, thus producing debility, want of proper out-door +exercises and amusements, tight lacing; indeed, anything and +everything, that either will debilitate the constitution, or will +interfere with, or will impede, the proper action of the lungs, will +be the predisposing causes of this fearful and lamentable disease. + +An ill, poor, and insufficient diet is the mother of many diseases, +and especially of consumption: "Whatsoever was the father of a +disease, an ill diet was the mother." + +The most common _exciting_ causes of consumption are slighted colds, +neglected inflammation of the chest, long continuance of influenza, +sleeping in damp beds, allowing wet clothes to dry on the body, +unhealthy employments--such as needle-grinding, pearl button making +etc. + +371. _Supposing a youth to have spitting of blood, what precautions +would you take to prevent it from ending in consumption_? + +Let his health be the first consideration; throw books to the winds; +if he be at school, take him away; if he be in trade, cancel his +indentures; if he be in the town, send him to a sheltered healthy spot +in the country, or to the south coast; as, for instance, either to St +Leonards-on-Sea, to Torquay, or to the Isle of Wight. + +I should be particular in his clothing, taking especial care to keep +his chest and feet warm. If he did not already wear flannel +waistcoats, let it be winter or summer, I should recommend him +immediately to do so: if it be winter, I should advise him also to +take to _flannel_ drawers. The feet must be carefully attended to; +they ought to be kept both warm and dry, the slightest dampness of +either shoes or stockings should cause them to be immediately +changed. If a boy, he ought to wear double-breasted waistcoats; if a +girl, high dresses. + +The diet must be nutritious and generous; he should be encouraged to +eat plentifully of beef and mutton. There is nothing better for +breakfast, where it agree, than milk; indeed, it may be frequently +made to agree by previously boiling it. Good home-brewed ale or sound +porter ought, in moderation, to be taken. Wine and spirits must on no +account be allowed. I caution parents in this particular, as many have +an idea that wine, in such cases, is strengthening, and that _rum_ and +milk is a good thing either to cure or to prevent a cough! + +If it be summer, let him be much in the open air, avoiding the evening +and the night air. If it be winter, he should, unless the weather be +mild for the season, keep within doors. Particular attention ought to +be paid to the point the wind is in, as he should not be allowed to go +out if it is either in the north, in the east, or in the north-east; +the latter is more especially dangerous. If it be spring, and the +weather be favourable, or summer or autumn, change of air, more +especially to the south-coast--to the Isle of Wight, for instance-- +would be desirable; indeed, in a case of spitting of blood, I know of +no remedy so likely to ward off that formidable, and, generally, +intractable complaint--consumption--as change of air. The beginning of +the autumn is, of course, the beat season for visiting the coast. It +would be advisable, at the commencement of October, to send him either +to Italy, to the south of France--to Mentone [Footnote: See _Winter +and Spring on the Shores of the Mediterranean_, By J. Henry Bennet, +M.D., London: Churchill.]--or to the mild parts of England--more +especially either to Hastings, or to Torquay, or to the Isle of +Wight--to winter. But remember, if he be actually in a _confirmed_ +consumption, I would not on any account whatever let him leave his +home; as then the comforts of home will far, very far, out-weigh any +benefit of change of air. + +372. _Suppose a youth to be much predisposed to a sore throat, what +precautions ought he to take to ward off future attacks_? + +He must use every morning thorough ablution of the body, beginning +cautiously; that is to say, commencing with the neck one morning, then +by degrees, morning after morning, sponging a larger surface, until +the whole of the body be sponged. The chill at first must be taken off +the water; gradually the temperature ought to be lowered until the +water be quite cold, taking care to rub the body thoroughly dry with a +coarse towel--a Turkish rubber being the best for the purpose. + +He ought to bathe his throat externally every night and morning with +luke-warm salt and water, the temperature of which must be gradually +reduced until at length no warm water be added. He should gargle his +throat either with barm, vinegar, and sage tea, [Footnote: A +wine-glassful of barm, a wine-glassful of vinegar, and the remainder +sage tea, to make a half-pint bottle of gargle.] or with salt and +water--two tea-spoonfuls of table salt dissolved in a tumbler of +water. He ought to harden himself by taking plenty of exercise in the +open air. He must, as much as possible, avoid either sitting or +standing in a draught, if he be in one, he should face it. He ought to +keep his feet warm and dry. He should take as little aperient +medicine as possible, avoiding especially both calomel and blue +pill. As he grows up to manhood he ought to allow his beard to grow, +as such would be a natural covering for his throat. I have known great +benefit to arise from this simple plan. The fashion is now to wear the +beard, not to use the razor at all, and a sensible fashion I consider +it to be. The finest respirator in the world is the beard. The beard +is not only good for sore throats, but for weak chests. The wearing of +the beard is a splendid innovation, it saves no end of trouble, is +very beneficial to health, and is a great improvement "to the human +face divine." + +373. _Have you any remarks to make on the almost universal habit of +boys and of very young men smoking_? + +I am not now called upon to give an opinion of the effects of tobacco +smoking on the middle-aged and on the aged. I am addressing a mother +as to the desirability of her sons, when boys, being allowed to smoke. +I consider tobacco smoking one of the most injurious and deadly habits +a boy or young man can indulge in. It contracts the chest and weakens +the lungs, thus predisposing to consumption. It impairs the stomach, +thus producing indigestion. It debilitates the brain and nervous +system, thus inducing epileptic fits and nervous depression. It stunts +the growth, and is one cause of the present race of pigmies. It makes +the young lazy and disinclined for work. It is one of the greatest +curses of the present day. The following cases prove, more than any +argument can prove, the dangerous and deplorable effects of a boy +smoking. I copy the first case from _Public Opinion_. "The _France_ +mentions the following fact as a proof of the evil consequences of +smoking for boys--'A pupil in one of the colleges, only twelve years +of age, was some tune since seized with epileptic fits, which became +worse and worse in spite of all the remedies employed. At last it was +discovered that the lad had been for two years past secretly indulging +in the weed. Effectual means were adopted to prevent his obtaining +tobacco, and he soon recovered.'" + +The other case occurred about fifteen years ago in my own +practice. The patient was a youth of nineteen. He was an inveterate +smoker. From being a bright intelligent lad, he was becoming idiotic, +and epileptic fits were supervening. I painted to him, in vivid +colours, the horrors of his case, and assured him that if he still +persisted in his bad practices, he would soon become a drivelling +idiot! I at length, after some trouble and contention, prevailed upon +him to desist from smoking altogether. He rapidly lost all epileptic +symptoms, his face soon resumed its wonted intelligence, and his mind +asserted its former power. He remains well to this day, and is now a +married man with a family. + +374. _What are the best methods to restrain a violent bleeding from +the nose_? + +Do not, unless it be violent, interfere with a bleeding from the +nose. A bleeding from the nose is frequently an effort of Nature to +relieve itself, and therefore, unless it be likely to weaken the +patient, ought not to be restrained. If it be necessary to restrain +the bleeding, press firmly, for a few minutes, the nose between the +finger and the thumb; this alone will often stop the bleeding; if it +should not, then try what bathing the nose and the forehead and the +nape of the neck with water quite cold from the pump, will do. If that +does not succeed, try the old-fashioned remedy of putting a cold large +door-key down the back. If these plans fail, try the effects either of +powdered alum or of powdered matico, used after the fashion of +snuff--a pinch or two either of the one or of the other, or of both, +should be sniffed up the bleeding nostril. If these should not answer +the purpose, although they almost invariably will, apply a large lump +of ice to the nape of the neck, and put a small piece of ice into the +patient's mouth for him to suck. + +If these methods do not succeed, plunge the hand and the fore-arm into +cold water, keep them in for a few minutes, then take them out, and +either hold, or let be held up, the arms and the hands high above the +head: this plan has frequently succeeded when others have failed. Let +the room he kept cool, throw open the windows, and do not have many in +the room to crowd around the patient. + +Doubtless Dr Richardson's local anaesthetic--the ether spray--playing +for a few seconds to a minute _on_ the nose and _up_ the bleeding +nostril, would act most beneficially in a severe case of this kind, +and would, before resorting to the disagreeable operation of plugging +the nose, deserve a trial. I respectfully submit this suggestion to my +medical brethren. The ether--rectified ether--used for the spray ought +to be perfectly pure, and of the specific gravity of 0.723. + +If the above treatment does not soon succeed, send for a medical man, +as more active means, such as plugging of the nostrils--_which, is not +done unless in extreme cases_--might be necessary. + +But before plugging of the nose is resorted to, it will be well to try +the effects of a cold solution of alum:-- + + Take of--Powdered Alum, one drachm; + Water, half a pint: + +To make a Lotion. + +A little of the lotion should be put into the palm of the hand and +sniffed up the bleeding nostril; or, if that does not succeed, some of +the lotion ought, by means of a syringe, to be syringed up the nose. + +375. _In case of a young lady fainting, what had better be done_? + +Lay her flat upon her back, taking care that the head be as low as, or +lower than, the body; throw open the-windows, do not crowd around +her, [Footnote: Shakspeare knew the great importance of not crowding +around a patient who has fainted. He says-- + + "So play the foolish throngs with one that swoons; Come all to help + him, and so stop the air By which he should revive."] unloosen her + dress as quickly as possible; ascertain if she have been guilty of + tight-lacing--for fainting is sometimes produced by that + reprehensible practice. Apply smelling salts to her nostrils; if + they be not at hand, burn a piece of rag under her nose; dash cold + water upon her face; throw open the window; fan her; and do not, as + is generally done, crowd round her, and thus prevent a free + circulation of air. As soon as she can swallow, give her either a + draught of _cold_ water or a glass of wine, or a tea-spoonful of + sal-volatile in a wine-glassful of water. + +_To prevent fainting for the future._--I would recommend early hours; +country air and exercise; the stays, if worn at all, to be worn slack; +attention to diet; avoidance of wine, beer, spirits, excitement, and +fashionable amusements. + +Sometimes the cause of a young lady fainting, is either a disordered +stomach, or a constipated state of the bowels. If the fainting have +been caused by _disordered stomach_, it may be necessary to stop the +supplies, and give the stomach, for a day or two, but little to do; a +fast will frequently prevent the necessity of giving medicine. Of +course, if the stomach be _much_ disordered, it will be desirable to +consult a medical man. + +If your daughter's fainting have originated from a _costive state of +the bowels_ (another frequent cause of fainting), I beg to refer you +to a subsequent Conversation, in which I will give you a list of +remedies for the prevention and the treatment of constipation. + +A young lady's fainting occasionally arises from debility--from +downright weakness of the constitution; then the best remedies will +be, change of air to the coast, good nourishing diet, and the +following strengthening mixture: + + Take of--Tincture of Perchloride of Iron, two drachms; + Tincture of Calumba, six drachms; + Distilled Water, seven ounces: + +Two table-spoonfuls of this mixture to be taken three times a day. + +Or for a change, the following:-- + + Take of--Wine of Iron, one ounce and a half + Distilled Water, six ounces and a half + +To make a Mixture. Two table spoonfuls to be taken three times a day. + +Iron medicines ought always to be taken _after_ instead of _before_ a +meal. The best times of the day for taking either of the above +mixtures will be eleven o'clock, four o'clock, and seven o'clock. + +376. _You had a great objection to a mother administering calomel +either to an infant or to a child, have you the same objection to a +boy or a girl taking it when he or she requires an aperient_? + +Equally as great. It is my firm belief that the frequent use, or +rather the abuse, of calomel and of other preparations of mercury, is +often a source of liver disease and an exciter of scrofula. It is a +medicine of great value in some diseases, when given by a _judicious_ +medical man, but, at the same time, it is a drag of great danger when +either given indiscriminately, or when too often prescribed. I will +grant that in liver diseases it frequently gives temporary relief, but +when a patient has once commenced the regular use of it, he cannot do +without it, until, at length, the _functional_ ends in _organic_ +disease of the liver. The use of calomel predisposes to cold, and thus +frequently brings on either inflammation or consumption. Family +aperient pills ought never to contain, in any form whatever, a +particle of mercury. + +377. _Will you give me a list of remedies for the prevention and for +the cure of constipation_? + +If you find it necessary to give your son or daughter an aperient, the +mildest should be selected, for instance, an agreeable and effectual +one, is an electuary composed of the following ingredients-- + + Take of--Beat Alexandria Senna, powdered, one ounce + Best figs, two ounces, + Best Raisins (stoned), two ounces, + +All chopped very fine. The size of a nutmeg or two to be eaten, either +early in the morning or at bedtime. + +Or, one or two tea-spoonfuls of Compound Confection. of Senna +(lenitive electuary) may occasionally, early in the morning, be +taken. Or, for a change, a tea-spoonful of Henry's Magnesia, in half a +tumblerful of warm water. If this should not be sufficiently active, +a tea-spoonful of Epsom salts should be given with the magnesia. A +Seidlitz Powder forms another safe and mild aperient, or one or two +Compound Rhubarb Pills may be given at bed time. The following +prescription for a pill, where an aperient is absolutely necessary, is +a mild, gentle, and effective one for the purpose-- + + Take of--Extract of Socotrine Aloes, eight grains, + Compound Extract of Colocynth, forty-eight grains, + Hard Soap, twenty four grains, + Treacle, a sufficient quantity + +To make twenty four Pills. One or two to be taken at bedtime +occasionally. + +But, after all, the best opening medicines are--cold ablutions every +morning of the whole body, attention to diet, variety of food, +bran-bread, grapes, stewed prunes, French plums, Muscatel raisins, +figs, fruit both cooked and raw--if it be ripe and sound, oatmeal +porridge, lentil powder, in the form of Du Barry's Arabica Revalenta, +vegetables of all kinds, especially spinach, exercise in the open air, +early rising, daily visiting the water-closet at a certain hour--there +is nothing keeps the bowels open so regularly and well as establishing +the habit of visiting the water-closet at a certain hour every +morning, and the other rules of health specified in these +Conversations. If more attention were paid to these points, poor +school boys and school girls would not be compelled to swallow such +nauseous and disgusting messes as they usually do to their aversion +and injury. + +Should these plans not succeed (although in the majority of cases, +with patience and perseverance, they will) I would advise an enema +once or twice a week, either simply of warm water, or of one made of +gruel, table-salt, and olive-oil, in the proportion of two +table-spoonfuls of salt, two of oil, and a pint of warm gruel, which a +boy may administer to himself, or a girl to herself, by means of a +proper enema apparatus. + +Hydropathy is oftentimes very serviceable in preventing and in curing +costiveness; and as it will sometimes prevent the necessity of +administering medicine, it is both a boon and a blessing. "Hydropathy +also supplies us with various remedies for constipation. From the +simple glass of cold water, taken early in the morning, to the various +douches and sea-baths, a long list of useful appliances might be made +out, among which we may mention the 'wet compresses' worn for three +hours over the abdomen [bowels], with a gutta percha covering." + +I have here a word or two to say to a mother who is always physicking +her family. It is an unnatural thing to be constantly dosing either a +child, or any one else, with medicine. One would suppose that some +people were only sent into the world to be physicked! If more care +were paid to the rules of health, very little medicine would be +required! This is a hold assertion; but I am confident that it is a +true one. It is a strange admission for a medical man to make, but, +nevertheless, my convictions compel me to avow it. + +378. _What is the reason girls are so subject to costiveness_? + +The principal reason why girls suffer more from costiveness than boys, +is that their habits are more sedentary; as the best opening medicines +in the world are an abundance of exercise, of muscular exertion, and +of fresh air. Unfortunately, poor girls in this enlightened age must +be engaged, sitting all the while, several hours every day at fancy +work, the piano, and other accomplishments; they, consequently, have +little time for exercise of any kind. The bowels, as a matter of +course, become constipated; they are, therefore, dosed with pills, +with black draughts, with brimstone and treacle--Oh! the abomination! +--and with medicines of that class, almost _ad infinitum_. What is the +consequence? Opening medicines, by constant repetition, lose their +effects, and, therefore, require to be made stronger and still +stronger, until at length, the strongest will scarcely act at all, and +the poor unfortunate girl, when she becomes a woman, _if she ever does +become one_, is spiritless, heavy, doll, and listless, requiring daily +doses of physic, until she almost lives on medicine! + +All this misery and wretchedness proceed from Nature's laws having +been set at defiance, from _artificial_ means taking the place of +_natural_ ones--from a mother adopting as her rule and guide fashion +and folly, rather than reason and common sense. When will a mother +awake from her folly and stupidity? This is strong language to address +to a lady, but it is not stronger than the subject demands. + +Mothers of England do, let me entreat you, ponder well upon what I +have said. Do rescue your girls from the bondage of fashion and of +folly, which is worse than the bondage of the Egyptian task masters, +for the Israelites did, in making bricks without straw, work m the +open air--"So the people were scattered abroad throughout all the land +of Egypt to gather stubble instead of straw," but your girls, many of +them, at least, have no work, either in the house or in the open +air--they have no exercise whatever. They are poor, drawling, +dawdling, miserable nonentities, with muscles, for the want of proper +exercise, like ribands, and with faces, for the lack of fresh air, as +white as a sheet of paper. What a host of charming girls are yearly +sacrificed at the shrine of fashion and of folly. + +Another, and a frequent cause of costiveness, is the bad habit of +disobeying the call of having the bowels opened. The moment there is +the slightest inclination to relieve the bowels, _instantly_ it ought +to be attended to, or serious results will follow. Let me urge a +mother to instil into her daughter's mind the importance of this +advice. + +379. _Young people are subject to pimples on the face, what is the +remedy_? + +These hard red pimples (acne--"the grub pimple") are a common and an +obstinate affection of the skin, affecting the forehead, the temples, +the nose, the chin, and the cheeks, occasionally attacking the neck, +the shoulders, the back, and the chest; and as they more frequently +affect the young, from the age of 15 to 35, and are disfiguring, they +cause much annoyance. "These pimples are so well known by most persons +as scarcely to need description; they are conical, red, and hard; +after a while, they become white, and yellow at the point, then +discharge a thick, yellow-coloured matter, mingled with a whitish +substance, and become covered by a hard brown scab, and lastly, +disappear very slowly, sometimes very imperfectly, and often leaving +an ugly scar behind them. To these symptoms are not unfrequently added +considerable pain, and always much unsightliness. When these little +cones have the black head of a 'grub' at their point, they constitute +the variety termed _spotted acne_. These latter often remain +stationary for months, without increasing or becoming red; but when +they inflame, they are in nowise different in their course from the +common kind."--_Wilson on Healthy Skin_. + +I find, in these cases, great benefit to be derived from bathing the +face, night and morning, with strong salt and water--a table-spoonful +of table-salt to a tea-cupful of water; by paying attention to the +bowels; by living on plain, wholesome, nourishing food; and by taking +a great of out-door exercise. Sea-bathing, in these cases, is often +very beneficial. Grubs and worms have a mortal antipathy to salt. + +380. _What is the cause of a Gum-boil_? + +A decayed root of a tooth, which causes inflammation and abscess of +the gum, which abscess breaks, and thus becomes a gum-boil. + +381. _What is the treatment of a Gum-boil_? + +Foment the outside of the face with a hot camomile and poppy head +fomentation, [Footnote: Four poppy heads and four ounces of camomile +blows to be boiled in four pints of water for half an hoar, and then +to be strained to make the fomentation.] and apply to the gum-boil, +between the cheek and the gum, a small white bread and milk poultice, + [Footnote: Cut a piece of bread, about the size of the little finger-- +without breaking it into crumb--pour boiling hot milk upon it, cover +it over, and let it stand for five minutes, then apply the soaked +bread over the gum-boil, letting it rest between the cheek and the +gum.] which renew frequently. + +As soon as the gum-boil has become quiet, _by all means_ have the +affected tooth extracted, or it might cause disease, and consequently +serious injury of the jaw; and whenever the patient catches cold there +will be a renewal of the inflammation, of the abscess, and of the +gum-boil, and, as a matter of course, renewed pain, trouble, and +annoyance. Moreover, decayed fangs of teeth often cause the breath to +be offensive. + +382. _What is the best remedy for a Corn_? + +The best remedy for a _hard corn_ is to remove it. The usual method of +cutting, or of paring a corn away, is erroneous. The following is the +right way--Cut with a _sharp_ pair of pointed scissors around the +circumference of the corn. Work gradually round and round and towards +the centre. When you have for some considerable distance well loosened +the edges, you can either with your fingers or with a pair of forceps +generally remove the corn bodily, and that without pain and without +the loss of any blood: this plan of treating a corn I can recommend to +you as being most effectual. + +If the corn be properly and wholly removed it will leave a small +cavity or round hole in the centre, where the blood-vessels and the +nerve of the corn--vulgarly called the root--really were, and which, +in point of fact, constituted the very existence or the essence of the +corn. Moreover, if the corn be entirely removed, you will, without +giving yourself the slightest pain, be able to squeeze the part +affected between your finger and thumb. + +_Hard corns_ on the sole of the foot and on the sides of the foot are +best treated by filing--by filing them with a sharp cutting file (flat +on one side and convex on the other) neither too coarse nor too fine +in the cutting. The corn ought, once every day, to be filed, and +should daily be continued until you experience a slight pain, which +tells you that the end of the corn is approaching. Many cases of _hard +corn_ that have resisted every other plan of treatment, have been +_entirely_ cured by means of the file. One great advantage of the file +is, it cannot possibly do any harm, and may be used by a timid +person--by one who would not readily submit to any cutting instrument +being applied to the corn. + +The file, if properly used, is an effectual remedy for a _hard_ corn +on the sole of the foot. I myself have seen the value of it in several +cases, particularly in one case, that of an old gentleman of ninety +five, who had had a corn on the sole of his foot for upwards of half a +century, and which had resisted numerous, indeed almost innumerable +remedies, at length I recommended the file, and after a few +applications entire relief was obtained, and the corn was completely +eradicated. + +The corns between the toes are called _soft corns_. A _soft corn_ is +quickly removed by the strong Acetic Acid--Acid. Acetic Fort--which +ought to be applied to the corn every night by means of a camel's hair +brush. The toes should be kept asunder for a few minutes, in order +that the acid may soak in, then apply between the toes a small piece +of cotton wool. + +Galbanum Plaster spread either on wash leather, or on what is better, +on an old white kid glove, has been, in one of our medical journals, +strongly recommended as a corn plaster, it certainly is an admirable +one, and when the corn is between the toes is sometimes most +comfortable--affording immense relief. + +Corns are like the little worries of life--very teazing and +troublesome a good remedy for a corn--which the Galbanum Plaster +undoubtedly is-is therefore worth knowing. + +_Hard corns_, then, on the sole and on the side of the foot are best +treated by the file, _hard corns_ on the toes by the scissors, and +_soft corns_ between the toes either by the strong Acetic Acid or by +the Galbanum Plaster. + +In the generality of cases the plans recommended above, if properly +performed, will effect a cure, but if the corn, from pressure or from +any other cause, should return, remove it again, and proceed as before +directed. If the corn have been caused either by tight or by ill +fitting shoes, the only way to prevent a recurrence is, of course, to +have the shoes, properly made by a clever shoemaker--by one who +thoroughly understands his business, and who will have a pair of lasts +made purposely for the feet. [Footnote: As long as fashion instead of +common sense is followed in the making of both boots and shoes, men +and women will, as a matter of course, suffer from corns. + +It has, often struck me as singular, when all the professions and +trades are so overstocked, that there should be, as there is in every +large town, such a want of chiropodists (corn-cutters)--of respectable +chiropodists--of men who would charge a _fixed_ sum for every visit +the patient may make, for instance to every working man a shilling, +and to every gentleman half-a-crown or five shillings for _each_ +sitting, and not for _each_ corn (which latter system is a most +unsatisfactory way of doing business). I am quite sure that of such a +plan were adopted, every town of any size in the kingdom would +employee regularly one chiropodist at least. However we might dislike +some few of the American customs, we may copy them with advantage in +this particular--namely, in having a regular staff of chiropodists +both in civil and in military life.] + +The German method of making boots and shoes is a capital one for the +prevention of corns, as the boots and shoes are made, scientifically +to fit a _real_ and not an _ideal_ foot. + +One of the best preventatives of as well as of the best remedies for +corns, especially of soft corns between the toes, is washing the feet +every morning as recommended in a previous Conversation, [Footnote: +Youth--Ablution, page 250.] taking especial care to wash with the +thumb, and afterwards to wipe with the towel between each toe. + +383. _What are the best remedies to destroy a Wart_? + +Pure nitric acid, [Footnote: A very small quantity of Pure Nitric +Acid--just a drain at the bottom of a stoppered bottle--is all that is +needed, and which may be procured of a chemist.] carefully applied to +the wart by means of a small stick of cedar wood--a camel's hair +pencil-holder--every other day, will soon destroy it. Care must be +taken that the acid does not touch the healthy skin, or it will act as +a caustic to it. The nitric acid should be preserved in a stoppered +bottle and must be put out of the reach of children. + +Glacial Acetic Acid is another excellent destroyer of warts: it +should, by means of a camel's hair brush, be applied to each wart, +every night just before going to bed. The warts will, after a few +applications, completely disappear. + +384. _What is the best remedy for tender feet, for sweaty feet, and +for smelling feet_? + +Cold water: bathing the feet in cold water, beginning with tepid +water; but gradually from day to day reducing the warm until the water +be quite cold. A large nursery-basin one-third full of water, ought to +be placed on the floor, and one foot at a time should be put in the +water, washing the while with a sponge the foot, and with the thumb +between each toe. Each foot should remain in the water about half a +minute. The feet ought, after each washing, to be well dried, taking +care to dry with the towel between each toe. The above process must be +repeated at least once every day--every morning, and if the annoyance +be great, every night as well. A clean pair of stockings ought in +these cases to be put on daily, as perfect cleanliness is absolutely +necessary both to afford relief and to effect a cure. + +If the feet be tender, or if there be either bunions, or corns, the +shoes and the boots made according to the German method (which are +fashioned according to the actual shape of the foot) should alone be +worn. + +385. _What are the causes of so many young ladies of the present day +being weak, nervous, and unhappy_? + +The principal causes are--ignorance of the laws of health, Nature's +laws being set at nought by fashion and by folly, by want of fresh air +and exercise, by want of occupation, and by want of self-reliance. +Weak, nervous, and unhappy! Well they might be! What have they to +make them strong and happy? Have they work to do to brace the +muscles? Have they occupation--useful, active occupation--to make +them happy? No! they have neither the one nor the other! + +386. What diseases are girls most subject to? + +The diseases peculiar to girls are--Chlorosis--Green-sickness--and +Hysterics. + +387. What are the usual causes of Chlorosis? Chlorosis is caused by +torpor and debility of the whole frame, especially of the womb. It is +generally produced by scanty or by improper food, by the want of air +and of exercise, and by too close application within doors. Here we +have the same tale over again--close application within doors, and the +want of fresh air and of exercise. When will the eyes of a mother he +opened, to this important subject?--the most important that can engage +her attention! + +388. What is the usual age for Chlorosis to occur and what are the +symptoms? + +Chlorosis more frequently attacks girls from fifteen to twenty years +of age; although unmarried women, much older, occasionally have it. I +say _unmarried_, for, as a rule, it is a complaint of the _single_. + +The patient, first of all, complains of being languid, tired, and out +of spirits; she is fatigued with the slightest exertion; she has +usually palpitation of the heart (so as to make her fancy that she has +a disease of that organ, which, in all probability, she has not); she +has shortness of breath, and a short dry cough; her face is flabby and +pale; her complexion gradually assumes a yellowish or greenish +hue--hence the name of chlorosis; there is a dark, livid circle around +her eyes; her lips lose their colour, and become almost white; her +tongue is generally white and pasty, her appetite is bad, and is +frequently depraved--the patient often preferring chalk, slate pencil, +cinder, and even dirt, to the daintiest food, indigestion frequently +attends chlorosis, she has usually pains over the short-ribs, on the +_left_ side, she suffers greatly from "wind"--is frequently nearly +choken by it, her bowels are generally costive, and the stools are +unhealthy, she has pains in her hips, loins, and back, and her feet +and ankles are oftentimes swollen. _The menstrual discharge is either +suspended or very partially performed_, if the latter, it is usually +almost colourless. Hysterical fits not unfrequently occur during an +attack of chlorosis. + +389. _How may Chlorosis be prevented_? + +If health were more and fashion were less studied, chlorosis would not +be such a frequent complaint. This disease generally takes its rise +from mismanagement--from Nature's laws having been set at defiance. I +have heard a silly mother express an opinion that it is not _genteel_ +for a girl to eat _heartily!_ Such language is perfectly absurd and +cruel. How often, too, a weak mother declares that a healthy, blooming +girl looks like a milk maid! It would be well if she did! How true and +sad it is, that "a pale, delicate face, and clear eyes, indicative of +consumption, are the fashionable _desiderata_ at present for +complexion."--_Dublin University Magazine._ + +A growing girl requires _plenty_ of _good_ nourishment--as much as her +appetite demands, and if she have it not, she will become either +chlorotic, or consumptive, or delicate. Besides, _the greatest +beautifier in the world is health_, therefore, by a mother studying +the health of her daughter, she will, at the same time, adorn her body +with, beauty! I am sorry to say that too many parents think more of +the beauty than of the health of their girls. Sad and lamentable +infatuation! Nathaniel Hawthorne--a distinguished American--gives a +graphic description of a delicate young lady. He says--"She is one of +those delicate nervous young creatures not uncommon in New England, +and whom I suppose to have become what we find them by the gradually +refining away of the physical system among young women. Some +philosophers choose to glorify this habit of body by terming it +spiritual, but in my opinion, it is rather the effect of unwholesome +food, bad air, lack of out-door exercise, and neglect of bathing, on +the part of these damsels and their female progenitors, all resulting +in a kind of hereditary dyspepsia." + +Nathaniel Hawthorne was right. Such ladies, when he wrote, were not +uncommon, but within the last two or three years, to their great +credit be it spoken, "a change has come o'er the spirit of their +dreams," and they are wonderfully improved in health, for, with all +reverence be it spoken, "God helps them who help themselves," and they +have helped themselves by attending to the rales of health--"The women +of America are growing more and more handsome every year for just this +reason. They are growing rounder of chest, fuller of limb, gaining, +substance and development in every direction. Whatever may be urged to +the contrary we believe this to be a demonstrable fact. When the +rising generation of American girls once begin to wear thick shoes, to +take much exercise in the open air, to skate, to play at croquet, and +to affect the saddle, it not only begins to grow more wise but more +healthful, and which must follow as the night the day--more +beautiful"--_The Round Table_. + +If a young girl had plenty-of wholesome meat, varied from day to day, +either plain roast or boiled, and neither stewed, nor hashed, nor +highly seasoned for the stomach, if she has had an abundance of fresh +air for her lungs, if she had plenty of active exercise, such as +skipping, dancing, running, riding, swimming, for her muscles, if her +clothing were warm and loose, and adapted to the season, if her mind +were more occupied with active _useful_ occupation, such as household +work, than at present, and if she were kept calm and untroubled from +the hurly-burly and excitement of fashionable life--chlorosis would +almost be an unknown disease. It is a complaint of rare occurrence +with country girls, but of great frequency with fine city ladies. + +390. _What treatment should you advise_? + +The treatment which would prevent should be adopted when the complaint +first makes its appearance. If the above means do not quickly remove +it, the mother must then apply to a medical man, and he will give +medicines _which will soon have the desired effect_. Chlorosis is very +amenable to treatment. If the disease be allowed for any length of +time to run on, it may produce either organic--incurable--disease of +the heart, or consumption or indigestion, or confirmed ill-health. + +391. _At what period of life is a lady most prone in Hysterics, and +what are the symptoms_? + +The time of life when hysterics occur is generally from the age of +fifteen to fifty. Hysterics come on by paroxysms--hence they are +called hysterical fits. A patient, just before an attack, is +low-spirited; crying without a cause; she is "nervous," as it is +called; she has flushings of the face; she is at other times very +pale; she has shortness of breath and occasional palpitations of the +heart; her appetite is usually bad; she passes quantities of +colourless limpid urine, having the appearance of pump water; she is +much troubled with flatulence in her bowels, and, in consequence, she +feels bloated and uncomfortable. The "wind" at length rises upwards +towards the stomach, and still upwards to the throat, giving her the +sensation of a ball stopping her breathing, and producing a feeling of +suffocation. The sensation of a ball in the throat (_globus +hystericus_) is the commencement of the fit. + +She now becomes _partially_ insensible, although she seldom loses +_complete_ consciousness. Her face becomes flushed, her nostrils +dilated, her head thrown back, and her stomach and bowels enormously +distended with "wind." After a short time she throws her arms and her +legs about convulsively, she beats her breast, tears her hair and +clothes, laughs boisterously and screams violently; at other times she +makes a peculiar noise; sometimes she sobs and her face is much +distorted. At length she brings up enormous quantities of wind; after +a time she bursts into a violent flood of tears, and then gradually +comes to herself. + +As soon as the fit is at an end she generally passes enormous +quantities of colourless limpid urine. She might, in a short time, +fall into another attack similar to the above. When she comes to +herself she feels exhausted and tired, and usually complains of a +slight headache, and of great soreness of the body and limbs. She +seldom remembers what has occurred during the fit. Hysterics are +sometimes frightful to witness, but, in themselves, are not at all +dangerous. + +Hysterics--an hysterical fit--is sometimes styled hysterical +passion. Shakspeare, in one of his plays, calls it _hysterica +passio_-- + + "Oh how this, mother, swells up toward my Heart! _Hysterica + passio!_" + +Sir Walter Scott graphically describes an attack--"The hysterical +passion that impels tears is a terrible violence--a sort of throttling +sensation--then succeeded by a state of dreaming stupidity" + +392. _What are the causes of Hysterics_? + +Delicate health, chlorosis, improper and not sufficiently nourishing +food, grief, anxiety, excitement of the mind, closely confined rooms, +want of exercise, indigestion, flatulence and tight-lacing, are the +causes which usually produce hysterics. Hysterics are frequently +feigned, indeed, oftener than any other complaint, and even a genuine +case is usually much aggravated by a patient herself giving way to +them. + +393. _What do you recommend an hysterical lady to do_? + +To improve her health by proper management, to rise early and to take +a walk, that she may breathe pure and wholesome air,--indeed, she +ought to live nearly half her time in the open air, exercising herself +with walking, skipping, etc., to employ her mind with botany, croquet, +archery, or with any out-door amusement, to confine herself to plain, +wholesome, nourishing food, to avoid tight lacing; to eschew +fashionable amusements; and, above all, not to give way to her +feelings, but, if she feel an attack approaching, to rouse herself. + +_If the fit be upon her_, the better plan is, to banish all the _male_ +sex from the room, and not even to have many women about her, and for +those around to loosen her dress; to lay her in the centre of the +room, flat upon the ground, with a pillow under her head, to remove +combs and pins and brooches from her person; to dash cold water upon +her face; to apply cloths, or a large sponge wetted in cold water, to +her head; to throw open the window, and then to leave her to herself; +or, at all events, to leave her with only one _female_ friend or +attendant. If such be done, she will soon come round; but what is the +usual practice? If a girl be in hysterics, the whole house, and +perhaps the neighbourhood, is roused; the room is crowded to +suffocation; fears are openly expressed by those around that she is in +a dangerous state; she hears what they say, and her hysterics are +increased ten-fold. + +394. _Have you any remarks to make on a patient recovering from a +severe illness_? + +There is something charming and delightful in the feelings of a +patient recovering from a severe illness: it is like a new birth: it +is almost worth the pain and anguish of having been ill to feel quite +well again: everything around and about him wears a charming aspect--a +roseate hue: the appetite for food returns with pristine vigour; the +viands, be they ever so homely, never tasted before so deliciously +sweet; and a draught of water from the spring has the flavour of +ambrosial nectar: the convalescent treads the ground as though he were +on the ambient air; and the earth to him for a while is Paradise: the +very act of living is a joy and gladness:-- + + "See the wretch that long has tost + On the thorny bed of pain + Again repair his vigour lost + And walk and run again. + + The meanest flow'ret of the vale, + The amplest note that swells the gale, + The common air, the earth, the skies, + To him are opening Paradise."--_Grey_ + + + * * * * * + + +CONCLUDING REMARKS + +If this book is to be of use to mothers and to the rising generation, +as I humbly hope and trust that it has been, and that it will be still +more abundantly, it ought not to be listlessly read, merely as a novel +or as any other piece of fiction; but it must be thoughtfully and +carefully studied, until its contents, in all its bearings, be +completely mastered and understood. + + + * * * * * + + +In conclusion: I beg to thank you for the courtesy, confidence, and +attention I have received at your hands; and to express a hope that my +advice, through God's blessing, may not have been given in vain; but +that it may be--one among many--an humble instrument for improving the +race of our children--England's priceless treasures! O, that the time +may come, and may not be far distant, "That our sons may grow up as +the young plants, and that our daughters may be as the polished +corners of the temple!" + + + + +INDEX. + + +ABLUTION of a child + + of an infant + + of a youth + + thorough, of boy and girl + +Accidents of children + + how to prevent + +Acne, symptoms and treatment of + +Advice to a mother if her infant be poorly + + to _Mr Pater familias_ + +Ailments, the distinction between between _serious_ and _slight_ + + of infants + +Air and exercise for youth + + the importance of good + + the necessity of fresh, and changing the + +Airing an infant's clothes + +Alternately to each breast + +American ladies + +Amusements for a child + + for a boy + + for a girl + +Ankles, weak + +Antipathies of a child + +Aperients for a child + + for an infant + + for a new-born babe + + for a youth + + danger of frequent + +Appeal to mothers + +Appetite, on a child losing his + +Applications, hot + +Apron, washing + +Archery + +Arnold, Dr, on corporal punishment + +Arrow-root for an infant + +Artificial food for an infant at breast + +Asses' milk + + +BABES should kick on floor + +Babe's clothing + +Babe himself taking exercise + +Babyhood, the language of + +Baby daughter + +Baked crumb of bread for an infant + + flour for an infant + +Bakers' and home made bread + +Bathing after _full_ meal + +Baths, cold, tepid, and warm + + warm, as a remedy for flatulence + +Beard, best respirator + +Bed, on placing child in + +Beds, feather + + purification of + +Bed-rooms, the ventilation of + + cool + + large + + a plan to ventilate + +Bee, the sting of + +Beef, salted or boiled + +Beer, on giving child + +Belladonna, poisoning by + +Belly-band, best kind + + when to discontinue + +Beverage for a child + +"Black-eye," remedies for + +Bladder and bowels of an infant + +Bleeding from navel, how to restrain + + of nose + +Blood, spitting of + +Blows and bruises + +Boarding schools for females + + on cheap (note) + +Boiled bread for infants' food + + flour for infants' food + +Boils, the treatment of + +Boots and shoes + +Bottles, the best nursing + +Boulogne sore-throat + +Bow-legs + +Bowels, large, of children + + looseness of + + protrusion of lower + + regulation of, by diet + +Boys should be made strong + +Brain, water on the + +Bran to soften water + +Bran Poultices + +Breakfast of a child + + of a youth + +Breast on early putting an infant to + +Breathing exercise + +Brimstone and treacle + +Brown and Polson's Corn Flour + +Bronchitis, the treatment of + +Broth for Infants + + for a new born infant + + and soup + +Brothers and sisters + +Bruises, remedies for + +Bullying a child + +Burns and scalds + +Butter, wholesome + + +CADBURY'S Cocoa Essence + +Calomel, the danger of a mother prescribing + + the ill effects of + +Camphor makes teeth brittle + +Caning a boy + +Caps, flannel + +Care in preparation of food + +Carpets in nurseries + +Carriage exercise + +Carron oil in burns + +Castor oil to heal the bowels + +Cat, bites and scratches of a + +"Chafings" of infants, the treatment of + +Chairs, straight backed + +Change of air + + linen in sickness + +Chapped hands, legs, &c + + lips + +Chest, keeping warm the upper part of the + +"Chicken breasted" and narrow breasted children + + pox + +Chilblains + +Child should dine with parents + +"Child-crowing" + + the treatment of a paroxysm of + +Children's hour + + parties + +Chimneys, on the stopping of + +Chiropodists (_note_) + +Chloralum as a disinfectant + +Chlorosis and green sickness + + not in rural districts + +Choking, what to be done in a case of + +_Cholera infantum_ + +Cisterns, best kind of + +Clothes, on airing an infant's + + the ill effects of tight + +Clothing of children + + of infants + + during winter + + of youths + +Coffee as an aperient + + and tea + +Coin, on the swallowing of a + +Cold bed-room healthy + +Cold, a feverish + + on child always catching + + feet, method to warm + +Concluding remarks on infancy + +Conclusion + +Constipation, prevention and cure of + +Consumption attacks the _upper_ part of the lungs + + the age at which it usually appears + + causes of + + death rate + + importance of early consulting a medical man in + + spitting of blood in + + symptoms of + +Consumptive patient, the treatment of a + +Convulsions of children + + cause insensibility + + from hooping-cough + + no pain in + +Cooked fruit for child + +Corns + +Corn plaster, an excellent + +Coroners inquests on infants + +Corporal punishment at schools + +Costiveness of infants, the means to prevent + + remedies for + + the reason why so prevalent + + in weak children + +Cough, the danger of stopping a + +Cow, the importance of having the milk from one + + pox lymph direct from heifer + + from healthy child + +Cream and egg, 200 + + and water for babe + +Crinoline and burning of ladles + +Crib, covering head of + +Croquet for girls + +Crossness in a sick child + +Croup + + the treatment of + +Cry of infant + +Cure, artificial and natural + +"Curious phenomenon" in scarlet fever + +Cut finger, the application for + + +DANCING, and skipping + +Danger of constantly giving physic + +Delicate child, plan to strengthen a + +Dentition + + lancing of gums + + second + + painful + +Diarrhoea of infants + + treatment of + +Diet of a child who has cut his teeth + + of children + + of a dry nursed child + + of infants + + on a mother being particular in attending to + + variety of for child + + of youth + +Dietary in infants + +Dieting a child + +Dinner for a child + + youth + +Diphtheria symptoms, causes, and treatment of + +Dirty child + +Diseased nature and strange eruptions + +Diseases of children + + girls + + infants + + obscure + + the prevention of + + produced by tight lacing + + symptoms of _serious_ + +Disinfectants in scarlet fever + +Doctor on early calling in + +Dog the bide of a + +Doleful child + +Don't + +Dowle on _The Foot and its Covering_ + +Drainage + +Dress, female + + of a child while asleep + + of a babe, child, and youth + +Dresses, high for delicate child + +Dressing babe for sleep + +Dribbling bibs + +Drinking fountains + +Dropping child, danger of + +Dry nursed children, the best food for + +"Dusting powder" for infants + +Dysentery, symptoms and treatment of + + +EAR, discharges from + + removal of a pea or bead from + +Ear-ache, treatment of + + wig in ear + +Early rising + +Education of children + + infant schools + + home, the best for girls + +Education, modern + + for youth + +Eggs for children + +Electuary of figs + +Emetic tarter dangerous for child + +Eneme apparatus (_note_) + + of warm water + +Engravings in nurseries + +Eruptions about the mouth + +Excorations applications for + + best remedy for + +Exercise + + best composing medicine + + during teething + + for children + + in wet weather + + on violently tossing infants + + horse and pony + + an infant himself taking + + in very cold weather + + in wet weather + + for youth + +Eve, substances in + + +FAECAL matter in pump-water + +Fainting + + from constipation + + from debility + + from disordered stomach + +Falling-off of hair + +Falls on the head + +Farinaceous food give _babes_ wind + +Fash on dangerous effects of strictly attending to + + the present, of dressing children + +Fashionable _desiderata_ for complexion + +Favouritism + +Feeding bottles + + infants, proper times for at breast + + new born babe with gruel + +Feet smelling + + sweating + + tender + +Female dress + +Fire, on a child playing with + + danger of back to + + in night nursery + + the manner of extinguishing, if clothes be on + + guards + +Fire-proof, making dresses + +Flannel cap for babe + + night-gowns + + shifts for a delicate child + + waistcoats + + to wash child with + +Flatulence, remedies for + +Fleas, to drive away + +Flute, bugle and other wind-instruments + +Fly pole + +Fog, on sending a child out in + +Folly, of giving physic after vaccination + +Food, artificial, during snacking + + care in preparing infant's + + for dry-nursed infants + + for infants who are sucking + +Formula, for milk, water, salt, and sugar + +Friction after ablation + +Frightening a child + +Fruit as an aperient + + during teething + + +GARTERS impede circulation + +Gently speak to child + +Gin or pepperment in infant's food + +Giving joy to a child + +Glass, a child swallowing broken + +Gluttony + +Glycerine + +Goats' milk + +_Godfrey's Cordial_ + + poisoning by treatment + +Grazed skin + +Green dresses poisonous + + paper hangings for nurseries + + peas as a vegetable + +"Gripings" for infants + +Groin rupture + +"Gross superstition," + +"Grub-pimple" + +Gums, the lancing of the + +Gum-bod, cause and treatment + +Gum-sticks, the best + +Gymnasium, value of + + +HAIR, the best application for + + falling off + + making tidy + + management of + +Half-washed and half starved child + +Hand-swing + +Happiness to a child + +Happy child + +Hard's Farinaceous Food + +Hardening of children's constitutions + + of infants + +Hartehorn, on swallowing + +Hats for a child, the best kind + +Hawthorn, Nathaniel, on American ladies + +Head, fall upon + +Heat, external application of + +Hectic flush, description of + +Hiccups of infants + +Hints conducive to the well-doing of a child + +Home of childhood--the nursery + +Hooping-cough + + obstinate + + treatment of + +Horse exercise for boys or girls + + and pony exercise + +Hot-water bag or bottle + +Household work for girls + +Hurdle on early rising + +Hydrophobia + +_Hysterica passio_ + +Hysterics + + +ICE, on the value of + +Illness, recovery from + +Importance of our subject + +India-rubber hot-water bottle + +Ingoldsby Legend on thumb-sucking + +Infants should be encouraged to use exertion + +Infant schools + +Ipecacuantis wine, preservation of + + +JOYFUL to bed, on sending child + + +LADIES "affecting the saddle" + +Laudanum, poisoning by + +Laugh of a child + +Law, physic, and divinity + +Leaden cisterns + +Learning without health + +Leech bites, the way to restrain bleeding from + +Lessons for child + +Lice in head after illness + +Light, best artificial, for nursery + + the importance of, to health + +Lightly clad child + +Lime in the eye + + to harden the bones + +Lime-water and milk + +"Looseness of the the bowels" the treatment + +Love of children + +Lucifer-matches the poisonous effects of + +Luncheon for a child + +Lungs, inflammation of + + precautions to + + symptoms of + + treatment of + +Lying lips of a child + + +MAD DOG, the bite of + + description of + +Magnesia to cool a child + +Management of child's mother's question + +Massacre of innocents + +Mattresses, horse-hair, best for child + +May, the month of + +Meals, a child's + +Measles + + and scarlet fever + + treatment of + +Meat, daily, on giving + + raw in long-standing diarrhoea + + in exhaustive diseases + + when a child should commence taking + +Meddlesome treatment + +Medical man, a mother's treatment towards + +Medicine, the best way of administering + + on giving new-born infants + + on making palatable (_note_) + +Menstruating female during suckling + +Mercury, on the danger of parents giving + +Milk, on the importance of having it from ONE cow + + bad, very nasty + + for babe indispensable + + in every form + + or meat, or both + + a plan to make a child take + + sugar of, and water + + the value of, for children + + unboiled + + a way to prevent, turning sour + + -crust + +Mismanaged baby + +Modified small-pox and chicken-pox + +Mother fretting, injurious to infant + + a foolish + + of many diseases + +Mother's and cow's milk, on mixing + + health during suckling + + influence + +Motions, healthy, of babe + +Mumps + + +NAAMAN, the Syrian + +Napkins, when to dispense with + +Nature's physic + +Navel, management of the + + rupture of + + sore + + -string separation of + +Neaves' Farinaceous Food + +Nervous and unhappy young ladies + +Nettle-rash + +New-born infants and aperients + + when feeble + +Night-commode + +Night-terrors + +Nose, removal of foreign substances from + + bleeding from, means to restrain + +Nurse, on the choice of a + + a lazy + + strong and active + + young, not desirable + + for the sick + +Nursery-basin + + of a sick child + + a child's own domain + + selection, warming, ventilation, arrangements of + + on the light of a + + must be airy + + observations, further + + windows to be often opened + +Nursing-bottles, the best + + +OPIUM, a case of poisoning by + + the danger of administering to infants + + the treatment of poisoning by + +Over-education + +Over-lying a child + + +PAIN, convulsions, and death + +Paint-boxes dangerous as toys + +Parental baby-slaughter + +Parritch, the halesome + +Peevishness of a child, the plan to allay + +Perambulators + +Physicking a child, on the frequent + +Pies and Puddings + +Pimples on the face, treatment of + +Pin, on a child swallowing + +Pins, in dressing of babe + +Play, a course of education in + +Play-grounds for children + + and play + +Pleasant words to a child + +Poisoning, accidental + + by the breath + +Poppy-syrup + +Pork an improper meat for children + +Position of a sleeping child + +Potatoes for children + +Poultice, a white-bread + +Powder, "dusting" + +_Precocity of intellect_ + +Precocious youths, the health of + +Prescriptions for a child + +Princess of Wales and her baby (note) + +Professions and trades + +Proper person to wash an Infant + +Prunes, the best way of stewing + +Profession or trade, choice of, for delicate youth + + delicate youth should be brought up to + +Puddings for children + +Pals of child + +Pye Chavasse's Fresh Air Treatment of scarlet fever + + Milk Food + + +QUACK MEDICINES + +Quacking an infant + +Quick lime in eye + + +RAIN WATER + +Recapitulation of ablution + +Red gum + +Respiration, products of poisonous + +Rest, the best time for a child to retire to + +Re-vaccination, Importance of + + every seven years + + recommended by Jenner + +Revalenta Arabica + +Rheumatic fever, flannel vest and drawers + +Ribs, bulging out of + +Rice, prepared as an infant's food + +Rich children + +_Richardson, Dr, ether spray_ + +Rickets + + various degrees of + +Roberton on child-crowing + +Rocking-chairs, and rockers to cradle, + +Rocking infants to sleep + +Rooms ill effects, of dark + +Round shoulders + +Round worm + +Running scall + +Rupture + +Rusks + + + +SALLOWNESS, cause of in young girls + +Salt water and fresh water + + should be added to an infants food + + bag of hot + + necessary to human life + +Salt-and water ablations for a delicate child + + for teeth and gums + + meats for children + +Scalds and burns + + of mouth + +Scarlatina + +Scarlet-fever + + and diphtheria + + the contagion of + + the danger of giving aperients in + + the dropsy of + + Fresh Air Treatment of + + hybrid + + management of child after + + and measles, the importance of distinguishing between + + the principal danger of + + purification of house after + + treatment of + + utter prostration in + +Schools, female boarding + + public + +Screaming in sleep + +Scrofula + + prevention of + +Scurfy head + +Sea-bathing and fresh-water bathing + + for a young child + +Secrets, talking, before child + +Senna as an aperient + +Shivering fit, importance of attending to a + + treatment of + +Shoes, _plan to waterproof_ + + preferable to boots + + sound and whole + + and stockings for children and youths + + the ill effects of tight + +"Shortening" an infant + +Shoulder-blades "growing out" + +Sick child, the nursing of a + + not to be staffed with food + +Sick-room, management of, + +Sickness of infants + +Singing and reading aloud + + beneficial to a child + +Single-stick + +Sitting with back to fire + +Sitz-bath for protrusion of bowels + +Skating for boys and girls + +Skin, grazed + +Sleep of children + +Sleep, infant's + + in middle of day beneficial + + much, necessary for infants + + temperature of an infant's bedroom during + + right time of putting a child to + + putting infants to + + of youth + + -walker + +Sleeping on lap + + -rooms, importance of well-ventilating + +Sleepless child + +Slippers, the best for sick-room (_note_) + +Small-pox + + a pest and disgrace + + modified + + when in neighborhood, + + to prevent pitting of + +Smoking, on a boy + +Smothering of infants, the cause + +Socks and Stockings for a child + +Soda, ill effects of washing clothes with + +Sounds, joyful + +Soups and broths + +Speak gently to a child + +Spencer, a knitted worsted + +Spines, distorted + +Spine, injury to + + curvature of + + twisted + +Spirits, deadly effects of, to the young + +Spitting of blood + + precautions + +Spurious croup + +Stammering, cause of + + cure of + +Stays, the ill effects of + +Stillness of sick-room + +Sting of bee or wasp + +Stir-about and milk + +Stockings and shoes + +Stooping in a girl + +Stopping of chimneys + +Stoves in nursery + +Strawberry-tongue + +Stuffing a sick child with food + + a babe + +"Stuffing of the nose" of infants + +Stunning of a child + +"Stye," treatment of + +Substitute for mother's milk + +Sucking of thumb + +Suckling, the proper times of + +Suet pudding + +Sugar for infants + + confectionery + + -of-milk + + _raw_, as an aperient + +Sun-stroke + +Sunday + +Supper for a child and for a youth + +Surfeit water and saffron tea + +Sweet things and sour digestion + +Sweetmeats and cakes + +Swimming, on boys and girls + +Symptoms of serious diseases + + +TAPE-WORM + +Taste for things refined + +Tea, on giving a child + + green, the ill effects of + +Teeth, attention to, importance of + + child should not have meat till he have cut several + + the diet of a child who has cut all his + + and gums + + right way of brushing + + appearance and number of _first_ set of + + _second_ set of + + second crop of + +Teething + + causing convulsions + + eruptions from + + frequent cause of sickness + + fruitful source of disease + + purging during + + restlessness from + + second + + symptoms and treatment of painful + + in town or country + +Temperature and ventilation of a nursery + + of a warm-bath + +Thread-worm + +Throats, sore, precautions to prevent + +Thrush, cause, symptoms, prevention and cure of + +Thumb best gum-stick + +Tight bands, belts, and hats + +Tight-lacing, the ill effects of + +Times for suckling an infant + +Tobacco-smoking for boys + + cases illustrating the danger of + +Toe-nails, the right way of cutting, + +Tongue-tied, an infant + +"Tooth-cough," + +Tooth-powder, an excellent + +Top-crust of bread as infant's food + +Tossing an infant + +Tous-les-mois + +Toys, children's + + painted with arsenic + +Trade or profession for delicate youth, + +Treatment of a delicate child + + of some urgent serious diseases + +Troubles of child + +Truth, the love of + +Tub, commencement of washing infant +in + +Tubbing a child + +Tumbling and rolling of a child + + +VACCINATION + + appearance of scab + + arm after + + giving medicine after, + + making babe poorly + +Veal for a child + +Vegetables for a child + +Ventilation, and stopping of chimneys + + and sleep + + of a nursery + +Violet-powder + + +WALKING, on the early, of infants + + exercise, value + + in his sleep, a child + +Warm-bathe for children + + external applications + +Warts + +Washing of boys and girls + +Washing a child + + an infant + + a new-born infant's head with brandy + +Washing a nursery floor + +Wasp, the sting of a + +Water, on the importance of good, + + on the brain + + closet, on going regularly to, + + cold and warm for ablution, + + hard for drinking + + -fright + + pure, essential to health + + to whole of skin + +Weaned child, the diet of a + +Weaning, proper time and manner of + +Weather, on a child almost living in the air in flue + + on the sending a child out in wet + +Weight of new-born infants (_note_) + +Wet flannel application + +Wet-nurse + + diet of + + for feeble babe + + management of + +"Wetting the bed" during sleep + +Wheezing of a new-born infant + +White lily leaf for bruises + +"Wind," babe suffering from + +Windows of a nursery + +Wind pipe, foreign substance in + +Wine and youth + +Wine for children and youths + +Winter clothing + +Woolen garments + +Worms + + quick medicines for + + + + + + +End of the Project Gutenberg EBook of Advice to a Mother on the Management +of her Children, by Pye Henry Chavasse + +*** END OF THE PROJECT GUTENBERG EBOOK ADVICE TO A MOTHER *** + +This file should be named 6595.txt or 6595.zip + +Produced by Charles Aldarondo, Charles Franks, Arno Peters +and the Online Distributed Proofreading Team. + +This file was produced from images generously made available by the +Canadian Institute for Historical Microreproductions. + +Project Gutenberg eBooks are often created from several printed +editions, all of which are confirmed as Public Domain in the US +unless a copyright notice is included. Thus, we usually do not +keep eBooks in compliance with any particular paper edition. + +We are now trying to release all our eBooks one year in advance +of the official release dates, leaving time for better editing. +Please be encouraged to tell us about any error or corrections, +even years after the official publication date. + +Please note neither this listing nor its contents are final til +midnight of the last day of the month of any such announcement. +The official release date of all Project Gutenberg eBooks is at +Midnight, Central Time, of the last day of the stated month. A +preliminary version may often be posted for suggestion, comment +and editing by those who wish to do so. + +Most people start at our Web sites at: +https://gutenberg.org or +http://promo.net/pg + +These Web sites include award-winning information about Project +Gutenberg, including how to donate, how to help produce our new +eBooks, and how to subscribe to our email newsletter (free!). + + +Those of you who want to download any eBook before announcement +can get to them as follows, and just download by date. This is +also a good way to get them instantly upon announcement, as the +indexes our cataloguers produce obviously take a while after an +announcement goes out in the Project Gutenberg Newsletter. + +http://www.ibiblio.org/gutenberg/etext03 or +ftp://ftp.ibiblio.org/pub/docs/books/gutenberg/etext03 + +Or /etext02, 01, 00, 99, 98, 97, 96, 95, 94, 93, 92, 92, 91 or 90 + +Just search by the first five letters of the filename you want, +as it appears in our Newsletters. + + +Information about Project Gutenberg (one page) + +We produce about two million dollars for each hour we work. The +time it takes us, a rather conservative estimate, is fifty hours +to get any eBook selected, entered, proofread, edited, copyright +searched and analyzed, the copyright letters written, etc. Our +projected audience is one hundred million readers. If the value +per text is nominally estimated at one dollar then we produce $2 +million dollars per hour in 2002 as we release over 100 new text +files per month: 1240 more eBooks in 2001 for a total of 4000+ +We are already on our way to trying for 2000 more eBooks in 2002 +If they reach just 1-2% of the world's population then the total +will reach over half a trillion eBooks given away by year's end. + +The Goal of Project Gutenberg is to Give Away 1 Trillion eBooks! +This is ten thousand titles each to one hundred million readers, +which is only about 4% of the present number of computer users. + +Here is the briefest record of our progress (* means estimated): + +eBooks Year Month + + 1 1971 July + 10 1991 January + 100 1994 January + 1000 1997 August + 1500 1998 October + 2000 1999 December + 2500 2000 December + 3000 2001 November + 4000 2001 October/November + 6000 2002 December* + 9000 2003 November* +10000 2004 January* + + +The Project Gutenberg Literary Archive Foundation has been created +to secure a future for Project Gutenberg into the next millennium. + +We need your donations more than ever! + +As of February, 2002, contributions are being solicited from people +and organizations in: Alabama, Alaska, Arkansas, Connecticut, +Delaware, District of Columbia, Florida, Georgia, Hawaii, Illinois, +Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, +Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New +Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, +Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South +Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West +Virginia, Wisconsin, and Wyoming. + +We have filed in all 50 states now, but these are the only ones +that have responded. + +As the requirements for other states are met, additions to this list +will be made and fund raising will begin in the additional states. +Please feel free to ask to check the status of your state. + +In answer to various questions we have received on this: + +We are constantly working on finishing the paperwork to legally +request donations in all 50 states. If your state is not listed and +you would like to know if we have added it since the list you have, +just ask. + +While we cannot solicit donations from people in states where we are +not yet registered, we know of no prohibition against accepting +donations from donors in these states who approach us with an offer to +donate. + +International donations are accepted, but we don't know ANYTHING about +how to make them tax-deductible, or even if they CAN be made +deductible, and don't have the staff to handle it even if there are +ways. + +Donations by check or money order may be sent to: + +Project Gutenberg Literary Archive Foundation +PMB 113 +1739 University Ave. +Oxford, MS 38655-4109 + +Contact us if you want to arrange for a wire transfer or payment +method other than by check or money order. + +The Project Gutenberg Literary Archive Foundation has been approved by +the US Internal Revenue Service as a 501(c)(3) organization with EIN +[Employee Identification Number] 64-622154. Donations are +tax-deductible to the maximum extent permitted by law. As fund-raising +requirements for other states are met, additions to this list will be +made and fund-raising will begin in the additional states. + +We need your donations more than ever! + +You can get up to date donation information online at: + +https://www.gutenberg.org/donation.html + + +*** + +If you can't reach Project Gutenberg, +you can always email directly to: + +Michael S. Hart <hart@pobox.com> + +Prof. Hart will answer or forward your message. + +We would prefer to send you information by email. + + +**The Legal Small Print** + + +(Three Pages) + +***START**THE SMALL PRINT!**FOR PUBLIC DOMAIN EBOOKS**START*** +Why is this "Small Print!" statement here? You know: lawyers. +They tell us you might sue us if there is something wrong with +your copy of this eBook, even if you got it for free from +someone other than us, and even if what's wrong is not our +fault. So, among other things, this "Small Print!" statement +disclaims most of our liability to you. It also tells you how +you may distribute copies of this eBook if you want to. + +*BEFORE!* YOU USE OR READ THIS EBOOK +By using or reading any part of this PROJECT GUTENBERG-tm +eBook, you indicate that you understand, agree to and accept +this "Small Print!" statement. If you do not, you can receive +a refund of the money (if any) you paid for this eBook by +sending a request within 30 days of receiving it to the person +you got it from. If you received this eBook on a physical +medium (such as a disk), you must return it with your request. + +ABOUT PROJECT GUTENBERG-TM EBOOKS +This PROJECT GUTENBERG-tm eBook, like most PROJECT GUTENBERG-tm eBooks, +is a "public domain" work distributed by Professor Michael S. Hart +through the Project Gutenberg Association (the "Project"). +Among other things, this means that no one owns a United States copyright +on or for this work, so the Project (and you!) can copy and +distribute it in the United States without permission and +without paying copyright royalties. Special rules, set forth +below, apply if you wish to copy and distribute this eBook +under the "PROJECT GUTENBERG" trademark. + +Please do not use the "PROJECT GUTENBERG" trademark to market +any commercial products without permission. + +To create these eBooks, the Project expends considerable +efforts to identify, transcribe and proofread public domain +works. Despite these efforts, the Project's eBooks and any +medium they may be on may contain "Defects". Among other +things, Defects may take the form of incomplete, inaccurate or +corrupt data, transcription errors, a copyright or other +intellectual property infringement, a defective or damaged +disk or other eBook medium, a computer virus, or computer +codes that damage or cannot be read by your equipment. + +LIMITED WARRANTY; DISCLAIMER OF DAMAGES +But for the "Right of Replacement or Refund" described below, +[1] Michael Hart and the Foundation (and any other party you may +receive this eBook from as a PROJECT GUTENBERG-tm eBook) disclaims +all liability to you for damages, costs and expenses, including +legal fees, and [2] YOU HAVE NO REMEDIES FOR NEGLIGENCE OR +UNDER STRICT LIABILITY, OR FOR BREACH OF WARRANTY OR CONTRACT, +INCLUDING BUT NOT LIMITED TO INDIRECT, CONSEQUENTIAL, PUNITIVE +OR INCIDENTAL DAMAGES, EVEN IF YOU GIVE NOTICE OF THE +POSSIBILITY OF SUCH DAMAGES. + +If you discover a Defect in this eBook within 90 days of +receiving it, you can receive a refund of the money (if any) +you paid for it by sending an explanatory note within that +time to the person you received it from. If you received it +on a physical medium, you must return it with your note, and +such person may choose to alternatively give you a replacement +copy. If you received it electronically, such person may +choose to alternatively give you a second opportunity to +receive it electronically. + +THIS EBOOK IS OTHERWISE PROVIDED TO YOU "AS-IS". NO OTHER +WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, ARE MADE TO YOU AS +TO THE EBOOK OR ANY MEDIUM IT MAY BE ON, INCLUDING BUT NOT +LIMITED TO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A +PARTICULAR PURPOSE. + +Some states do not allow disclaimers of implied warranties or +the exclusion or limitation of consequential damages, so the +above disclaimers and exclusions may not apply to you, and you +may have other legal rights. + +INDEMNITY +You will indemnify and hold Michael Hart, the Foundation, +and its trustees and agents, and any volunteers associated +with the production and distribution of Project Gutenberg-tm +texts harmless, from all liability, cost and expense, including +legal fees, that arise directly or indirectly from any of the +following that you do or cause: [1] distribution of this eBook, +[2] alteration, modification, or addition to the eBook, +or [3] any Defect. + +DISTRIBUTION UNDER "PROJECT GUTENBERG-tm" +You may distribute copies of this eBook electronically, or by +disk, book or any other medium if you either delete this +"Small Print!" and all other references to Project Gutenberg, +or: + +[1] Only give exact copies of it. Among other things, this + requires that you do not remove, alter or modify the + eBook or this "small print!" statement. You may however, + if you wish, distribute this eBook in machine readable + binary, compressed, mark-up, or proprietary form, + including any form resulting from conversion by word + processing or hypertext software, but only so long as + *EITHER*: + + [*] The eBook, when displayed, is clearly readable, and + does *not* contain characters other than those + intended by the author of the work, although tilde + (~), asterisk (*) and underline (_) characters may + be used to convey punctuation intended by the + author, and additional characters may be used to + indicate hypertext links; OR + + [*] The eBook may be readily converted by the reader at + no expense into plain ASCII, EBCDIC or equivalent + form by the program that displays the eBook (as is + the case, for instance, with most word processors); + OR + + [*] You provide, or agree to also provide on request at + no additional cost, fee or expense, a copy of the + eBook in its original plain ASCII form (or in EBCDIC + or other equivalent proprietary form). + +[2] Honor the eBook refund and replacement provisions of this + "Small Print!" statement. + +[3] Pay a trademark license fee to the Foundation of 20% of the + gross profits you derive calculated using the method you + already use to calculate your applicable taxes. If you + don't derive profits, no royalty is due. Royalties are + payable to "Project Gutenberg Literary Archive Foundation" + the 60 days following each date you prepare (or were + legally required to prepare) your annual (or equivalent + periodic) tax return. Please contact us beforehand to + let us know your plans and to work out the details. + +WHAT IF YOU *WANT* TO SEND MONEY EVEN IF YOU DON'T HAVE TO? +Project Gutenberg is dedicated to increasing the number of +public domain and licensed works that can be freely distributed +in machine readable form. + +The Project gratefully accepts contributions of money, time, +public domain materials, or royalty free copyright licenses. +Money should be paid to the: +"Project Gutenberg Literary Archive Foundation." + +If you are interested in contributing scanning equipment or +software or other items, please contact Michael Hart at: +hart@pobox.com + +[Portions of this eBook's header and trailer may be reprinted only +when distributed free of all fees. Copyright (C) 2001, 2002 by +Michael S. Hart. Project Gutenberg is a TradeMark and may not be +used in any sales of Project Gutenberg eBooks or other materials be +they hardware or software or any other related product without +express permission.] + +*END THE SMALL PRINT! FOR PUBLIC DOMAIN EBOOKS*Ver.02/11/02*END* + |