Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

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

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