The Physical Training of Children

by Pye Henry Chavasse

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 makes the following sensible remarks on the subject: “I used to limit any aperient to a new-born infant to those which had not the first milk, and who had wet-nurses whose milk was, of course, some weeks old; but for many years I have never allowed any aperient at all to any new-born infant, and I am satisfied it is the safest and the wisest plan.”

This advice of Sir Charles Locock—to give no aperient to a new-born infant—is most valuable, and ought to be strictly followed. By adopting his recommendation much after-misery might be averted. If a new-born babe’s bowels be costive, rather than give him an aperient, try the effect of a little moist sugar dissolved in a little water; that is to say, dissolve half a teaspoonful of pure unadulterated raw sugar in a teaspoonful of warm water, and administer it to him; if in four hours it should not operate, repeat the dose. Butter and raw sugar is a popular remedy, and is sometimes used by a nurse to open the bowels of a new-born babe, and where there is costiveness answers the purpose exceedingly well, and is far superior to castor oil. Try, by all means to do, if possible, without a particle of opening medicine. If you once begin to give aperients, you will have frequently to repeat them. Opening physic leads to opening physic, until at length his stomach and bowels will become a physic shop! Let me, then, emphatically say, avoid, if possible, giving a new-born babe a drop or a grain of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterward. It is the first step that is so important to take in this as in all other things.

If a new-born babe has not for twelve hours made water, the medical man ought to be informed of it, in order that he may inquire into the matter and apply the proper remedies. Be particular in attending to these directions, or evil consequences will inevitably ensue.

91. Some persons say that new-born female infants have milk in their bosoms, and that it is necessary to squeeze them, and apply plasters to disperse the milk.

The idea of there being real milk in a baby’s breast is doubtful, the squeezing of the bosom is barbarous, and the application of plasters is useless. “Without actually saying,” says Sir Charles Locock, “there is milk secreted in the breasts of infants, there is undoubtedly not rarely considerable swelling of the breasts both in female and male infants, and on squeezing them a serous fluid oozes out. I agree with you that the nurses should never be allowed to squeeze them, but be ordered to leave them alone.”

92. Have the goodness to mention the SLIGHT ailments which are not of sufficient importance to demand the assistance of a medical man?

I deem it well to make the distinction between serious and slight ailments; I am addressing a mother. With regard to serious ailments, I do not think myself justified, except in certain urgent cases, in instructing a parent to deal with them. It might be well to make a mother acquainted with the symptoms, but not with the treatment, in order that she might lose no time in calling in medical aid. This I hope to have the pleasure of doing in future conversations.

Serious diseases, with a few exceptions, and which I will indicate in subsequent conversations, ought never to be treated by a parent, not even in the early stages, for it is in the early stages that the most good can generally be done. It is utterly impossible for any one who is not trained to the medical profession to understand a serious disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen, in future conversations, that Sir Charles Locock considers that a mother ought to be made acquainted with the treatment of some of the more serious diseases, where delay in obtaining immediate medical assistance might be death. I bow to his superior judgment, and have supplied the deficiency in subsequent conversations.

The ailments and the diseases of infants, such as may, in the absence of the doctor, be treated by a parent, are the following: Chafings, Convulsions, Costiveness, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhœa), Dysentery, Nettle-rash, Red-gum, Stuffing of the Nose, Sickness, Thrush. In all these complaints I will tell you—What to do, and—What NOT to do.

93. What are the causes and the treatment of chafing?

The want of water: inattention and want of cleanliness are the usual causes of chafing.

What to do.—The chafed parts ought to be well and thoroughly sponged with tepid rain water—allowing the water from a well-filled sponge to stream over them—and, afterward, they should be thoroughly but tenderly dried with a soft towel, and then be dusted, either with finely-powdered starch made of wheaten flour, or with violet powder, or with finely-powdered native carbonate of zinc, or they should be bathed with finely-powdered fuller’s-earth and tepid water.

INFANCY.—THE FIRST STEP.

If, in a few days, the parts be not healed, discontinue the above treatment, and use the following application: Beat up well together the whites of two eggs, then add, drop by drop, two tablespoonfuls of brandy. When well mixed put it into a bottle and cork it up. Before using it let the excoriated parts be gently bathed with lukewarm rain water, and, with a soft napkin, be tenderly dried; then, by means of a camel’s-hair brush, apply the above liniment, having first shaken the bottle.

But bear in mind, after all that can be said and done, that there is nothing in these cases like water—there is nothing like keeping the parts clean, and the only way of thoroughly effecting this object is by putting him every morning INTO his tub.

What NOT to do.—Do not apply white lead, as it is a poison. Do not be afraid of using plenty of water, as cleanliness is one of the most important items of the treatment.

94. What are the causes of convulsions in an infant?

Stuffing him, in the early months of his existence, with food, the mother having plenty of breast-milk the while; the constant physicking of a child by his own mother; teething; hooping-cough, when attacking a very young baby.

I never knew a case of convulsions occur—say for the first four months (except in very young infants laboring under hooping-cough)—where children lived on the breast-milk alone, and where they were not frequently quacked by their mothers!

For the treatment of the convulsions from teething, see page [61].

What to do in a case of convulsions which has been caused by feeding an infant either with too much or with artificial food. Give him, every ten minutes, a teaspoonful of ipecacuanha wine, until free vomiting be excited, then put him into a warm bath (see Warm Baths); and when he comes out of it administer to him a teaspoonful of castor oil, and repeat it every four hours until the bowels be well opened.

What NOT to do.—Do not, for at least a month after the fit, give him artificial food, but keep him entirely to the breast. Do not apply leeches to the head.

What to do in a case of convulsions from hooping-cough.—There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. In convulsions from hooping-cough I have found cod-liver oil a valuable medicine. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. In either case cod-liver oil is likely to be serviceable, as it helps to sustain and support him in his extremity.

Convulsions attending an attack of hooping-cough make it a serious complication, and requires the assiduous and skillful attention of a judicious medical man.

What NOT to do in such a case.—Do not apply leeches; the babe requires additional strength, and not to be robbed of it; and do not attempt to treat the case yourself.

95. What are the best remedies for the costiveness of an infant?

I strongly object to the frequent administration of opening medicine, as the repetition of it increases the mischief to a tenfold degree.

What to do.—If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan may be brought into a regular state.

Besides, it inducts an infant into clean habits. I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such incumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot, of course, at an early age be dispensed with, unless a mother has great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having the bowels relieved and the bladder emptied every time he is either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little raw sugar and water, either half a teaspoonful of raw sugar dissolved in a teaspoonful or two of water, or give him, out of your fingers, half a teaspoonful of raw sugar to eat. I mean by raw sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for awhile, opening medicine becomes a dire necessity, and then woe-betide the poor unfortunate child!

It might sometimes be necessary to give opening medicine, but the less frequently the better. The following, when it becomes absolutely necessary to give an aperient, are some of the best, simple, and safe that can be administered by a mother to her baby. I give you several, as it might be well, from time to time, to vary them: (1.) One or two teaspoonfuls of fluid magnesia, made palatable by the addition of a little sugar, may be chosen; or (2.) The popular remedy of syrup of rhubarb and castor oil:

Take of—Syrup of Rhubarb,

Castor Oil, of each half an ounce:

To make a Mixture. A teaspoonful to be taken early in the morning, first well shaking the bottle.

It might be well again to state, that the bottle must be violently shaken just before administering the mixture, or the oil will not mix with the syrup; or (3.) A teaspoonful of syrup of rhubarb, without the admixture of the castor oil may be given early in the morning occasionally; or (4.) A teaspoonful of equal parts, say half an ounce of each, of fluid magnesia and of syrup of rhubarb, may be taken for a change. Another safe and palatable aperient for an infant is (5.) Syrup of senna, from a half to a whole teaspoonful being the dose. Castor oil is another medicine prescribed for a baby’s costiveness, and, being a safe one, may occasionally be used. Care should be taken to have the castor oil freshly drawn, and of the best quality. (6.) Syrup of red roses and castor oil (of each equal parts), being a good, elegant, and pleasant way of giving it:

Take of—Syrup of Red Roses,

Castor Oil, of each six drachms:

To make a Mixture. A teaspoonful to be taken occasionally, first well shaking the bottle, and to be repeated every four hours, until the bowels be relieved.

(7.) An excellent remedy for the costiveness of a baby is a soap suppository, the application of which will be found a safe, speedy, and certain method of opening the bowels. It is made by paring a piece of white curd-soap round; it should be of the size, in circumference, of a cedar pencil, and it must be in length about two inches. This should be administered by dipping it in a little warm sweet oil, and should then be gently introduced up the bowel in the same manner as you would an enema pipe, allowing about a quarter of an inch to remain in view. It must then be left alone, and in a minute or two the soap suppository will be expelled, and instantly the bowels will be comfortably and effectually relieved. When a child is two or three years old and upwards a dip-candle suppository is superior to a soap suppository.

If it be absolutely necessary to give opening medicine, it will be well to alternate the use of them—that is to say, to give at one time the syrup of senna, at another the fluid magnesia sweetened, and a third to administer the soap suppository dipped in oil, but waiting at least two days between, the bowels being costive all the time, before resorting to an aperient. Bear in mind, and let it make a strong impression upon you, that the less the bowels of an infant are irritated by opening medicine, the aperient being ever so simple and well-selected, the better will it be for him both now and for the future.

When the infant is five or six months old, either oatmeal milk gruel, or Robinson’s Patent Groat Gruel made with new milk, occasionally given in lieu of the usual food, will often open the bowels, and will thus supersede the necessity of administering an aperient.

Castor oil, or Dr. Merriman’s Purgative Liniment, well rubbed every morning, for ten minutes at a time, over the region of the bowels, will frequently prevent costiveness, and thus will do away with the need—which is a great consideration—of giving an aperient.

Take of—Tincture of aloes, half an ounce;

Soap liniment, one ounce:

Make a liniment.

What NOT to do.—There are two preparations of mercury I wish to warn you against administering of your own accord, viz.—(1.) Calomel, and a milder preparation called (2.) gray powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it may be administered, it being small in quantity and nearly tasteless. Gray powder, also, is, with many mothers, a favorite in the nursery. It is a medicine of immense power—either for good or for evil; in certain cases it is very valuable; but in others, and in the great majority, it is very detrimental.

This practice, then, of a mother giving mercury, whether in the form either of calomel or of gray powder, cannot be too strongly reprobated, as the frequent administration either of one or of the other weakens the body, predisposes it to cold, and frequently excites king’s evil—a disease too common in this country. Calomel and gray powder, then, ought never to be administered unless ordered by a medical man.

Syrup of buckthorn and jalap are also frequently given, but they are griping medicines for a baby, and ought to be banished from the nursery.

The frequent repetition of opening medicines, then, in any shape or form, very much interferes with digestion; they must, therefore, be given as seldom as possible.

Let me, at the risk of wearying you, again urge the importance of your avoiding as much as possible, giving a babe purgative medicines. They irritate beyond measure the tender bowels of an infant, and only make him more costive afterward; they interfere with his digestion, and are liable to give him cold. A mother who is always of her own accord quacking her child with opening physic, is laying up for her unfortunate offspring a debilitated constitution—a miserable existence.

96. Are there any means of preventing the Costiveness of an infant?

If greater care were paid to the rules of health, such as attention to diet, exercise in the open air, thorough ablution of the whole body—more especially when he is being washed—causing the water, from a large and well-filled sponge, to stream over the lower part of his bowels; the regular habit of causing him, at stated periods, to be held out, whether he want or not, that he may solicit a stool. If all these rules were observed, costiveness would not so frequently prevail, and one of the miseries of the nursery would be done away with.

Some mothers are frequently dosing their poor unfortunate babies either with magnesia to cool them, or with castor oil to heal the bowels! Oh, the folly of such practices! The frequent repetition of magnesia, instead of cooling an infant, makes him feverish and irritable. The constant administration of castor oil, instead of healing the bowels, wounds them beyond measure. No! it would be a blessed thing if a baby could be brought up without giving him a particle of opening medicine; his bowels would then act naturally and well: but then, as I have just now remarked, a mother must be particular in attending to Nature’s medicines—to fresh air, to exercise, to diet, to thorough ablution, etc. Until that time comes, poor unfortunate babies must be occasionally dosed with an aperient.

97. What are the causes of, and remedies for, Flatulence?

Flatulence most frequently occurs in those infants who live on artificial food, especially if they are 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 four or five months entirely to the breast; and, if that be not practicable, of the times of feeding, and of the best kinds of artificial food, and of those which are least likely to cause “wind.”

What to do.—Notwithstanding these precautions, if the babe should still suffer, “One of the best and safest remedies for flatulence is sal-volatile,—a teaspoonful of a solution of one drachm to an ounce and a half of water.” Or, a little dill or aniseed may be added to the food—half a teaspoonful of dill water. Or, take twelve drops of oil of dill, and two lumps of sugar; rub them well in a mortar together; then add, drop by drop, three tablespoonfuls of spring water; let it be preserved in a bottle for use. A teaspoonful of this, first shaking the vial, may be added to each quantity of food. Or, three teaspoonfuls of bruised caraway seeds may be boiled for ten minutes in a teacupful of water, and then strained. One or two teaspoonfuls of the caraway-tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may be occasionally given.

Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at a time, by means of the warm hand, over the bowels, will frequently give relief. Turning the child over on his bowels, so that they may press on the nurse’s lap, will often afford great comfort. A warm bath (where he is suffering severely) generally gives immediate ease in flatulence; it acts as a fomentation to the bowels. But after all, a dose of mild aperient medicine, when the babe is suffering severely, is often the best remedy for “wind.”

Remember, at all times, prevention, whenever it be—and how frequently it is—possible, is better than cure.

What NOT to do.—“Godfrey’s Cordial,” “Infants’ Preservative,” and “Dalby’s Carminative” are sometimes given in flatulence; but as most of these quack medicines contain, in one form or another, either opium or poppy, and as opium and poppy are both dangerous remedies for children, ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to afford relief for flatulence; but let me urge upon you the importance of banishing it from the nursery. It has (when given by unprofessional persons) caused the untimely end of thousands of children. The medical journals and the newspapers teem with cases of deaths from mothers incautiously giving syrup of poppies to ease pain and to procure sleep.

98. What are the symptoms, the causes, and the treatment of “Gripings” of an infant?

The symptoms.—The child draws up his legs; screams violently; if put to the nipple to comfort him, he turns away from it and cries bitterly; he strains, as though he were having a stool; if he have a motion, it will be slimy, curdled, and perhaps green. If, in addition to the above symptoms, he pass a large quantity of watery fluid from the bowels, the case becomes one of watery gripes, and requires the immediate attention of a medical man.

The causes of “gripings” or “gripes” may proceed either from the infant or from the mother. If from the child, it is generally owing either to improper food or to over-feeding; if from the mother, it may be traced to her having taken either greens, or pork, or tart beer, or sour porter, or pickles, or drastic purgatives.

What to do.—The treatment, of course, must depend upon the cause. If it arise from over-feeding, I would advise a dose of castor oil to be given, and warm fomentations to be applied to the bowels, and the mother or the nurse to be more careful for the future. If it proceed from improper food, a dose or two of magnesia and rhubarb in a little dill water, made palatable with simple syrup.

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 teaspoonfuls (according to the age of the child) to be taken every four hours, 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 Hiccough, and what is its treatment?

Hiccough is of such a trifling nature as hardly to require interference. It may generally be traced to over-feeding. Should it be severe, four or five grains of calcined magnesia, with a little syrup and aniseed water, and attention to feeding, are all that will be necessary.

100. Will you describe the symptoms of Diarrhœa—“Looseness of the bowels?”

It will be well, before doing so, to tell you how many motions a young infant ought to have a day, their color, consistence, and smell. Well, then, he should have from three to six motions in the twenty-four hours; the color ought to be a bright yellow, inclining to orange; the consistence should be that of thick gruel; indeed, his motion, if healthy, ought to be somewhat of the color (but a little more orange-tinted) and of the consistence of mustard made for the table; it should be nearly, if not quite, devoid of smell; it ought to have a faint and peculiar, but not a strong disagreeable odor. If it has a strong and disagreeable smell, the child is not well, and the case should be investigated, more especially if there be either curds or lumps in the motions; these latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint—that is to say, that he has six or eight motions during the twenty-four hours,—and that the stools are of a thinner consistence than what I have described,—provided, at the same time, that he is not griped, that he has no pain, and has not lost his desire for the breast: What ought to be done? Nothing. A slight looseness of the bowels should never be interfered with,—it is often an effort of nature to relieve itself of some vitiated motion that wanted a vent—or to act as a diversion, by relieving the irritation of the gums. Even if he be not cutting his teeth, he may be “breeding” them, that is to say, the teeth may be forming in his gums, and may cause almost as much irritation as though he were actually cutting them. Hence, you see the immense good a slight “looseness of the bowels” may cause. I think that I have now proved to you the danger of interfering in such a case, and that I have shown you the folly and the mischief of at once giving astringents—such as Godfrey’s Cordial, Dalby’s Carminative, etc.—to relieve a slight relaxation.

A moderate “looseness of the bowels,” then, is often a safety-valve, and you may with as much propriety close the safety-valve of a steam engine as stop a moderate “looseness of the bowels!”

Now, if the infant, instead of having from three to six motions, should have more than double the latter number; if they be more watery; if they become slimy and green, or green in part and curdled; if they should have an unpleasant smell; if he be sick, cross, restless, fidgety, and poorly; if every time he has a motion he be griped and in pain, we should then say that he is laboring under diarrhœa; then, it will be necessary to give a little medicine, which I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case becomes more serious; still with proper care, relief can generally be quickly obtained. If the evacuations—instead of being stool—are merely blood and slime, and the child strain frequently and violently, endeavoring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of dysentery. 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 diarrhœa. This latter case requires great skill and judgment on the part of a medical man, and great attention and implicit obedience from the mother and the nurse. I merely mention these diseases in order to warn you of their importance, and of the necessity of strictly attending to a doctor’s orders.

101. What are the causes of diarrhœa—“Looseness of the bowels?”

Improper food; over-feeding; teething; cold; the mother’s milk from various causes disagreeing, namely, from her being out of health, from her eating unsuitable food, from her taking improper and drastic purgatives, or from her suckling her child when she is pregnant. Of course, if any of these causes are in operation, they ought, if possible, to be remedied, or medicine to the babe will be of little avail.

102. What is the treatment of Diarrhœa?

What to do.—If the case be slight, and has lasted two or three days (do not interfere by giving medicine at first), and if the cause, as it probably is, be some acidity or vitiated stool that wants a vent, and thus endeavors to obtain one by purging, the best treatment is to assist nature by giving either a dose of castor oil or a moderate one of rhubarb and magnesia, and thus to work off the enemy. For a rhubarb and magnesia mixture prescription, see question 98.

After the enemy has been worked off, either by the castor oil or by the magnesia and rhubarb, the purging will, in all probability, cease; but if the relaxation still continue, that is to say, for three or four days,—then, if medical advice cannot be procured, the following mixture should be given:

Take of—Compound Powdered Chalk with Opium, ten grains;

Oil of Dill, five drops;

Simple Syrup, three drachms;

Water, nine drachms;

Make a Mixture. Half a teaspoonful to be given to an infant of six months and under, and one teaspoonful to a child above that age, every four hours—first shaking the bottle. Let the mixture be made by a chemist.

The baby ought, for a few days, to be kept entirely to the breast. The mother should be most particular in her own diet.

What NOT to do.—The mother must neither take greens, nor cabbage, nor raw fruit, nor pastry, nor beer; indeed, while the diarrhœa of her babe continues, she had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought not, while the diarrhœa continues, to have any artificial food. He must neither be dosed with gray powder (a favorite but highly improper remedy in these cases), nor with any quack medicines, such as Dalby’s Carminative or Godfrey’s Cordial.

103. What are the symptoms of Dysentery?

Dysentery frequently arises from a neglected diarrhœa. It is more dangerous than diarrhœa, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skillful handling: hence the care and experience required in treating a case of dysentery.

Well, then, what are the symptoms? The infant, in all probability, has had an attack of diarrhœa—bowel complaint as it is called—for several days; he having had a dozen or two of motions, many of them slimy and frothy, like “frog-spawn,” during the twenty-four hours. Suddenly the character of the motion changes,—from being principally stool, it becomes almost entirely blood and mucus; he is dreadfully griped, which causes him to strain violently, as though his inside would come away every time he has a motion,—screaming and twisting about, evidently being in the greatest pain, drawing his legs up to his belly and writhing in agony. Sickness and vomiting are always present, which still more robs him of his little remaining strength, and prevents the repair of his system. Now, look at his face! It is the very picture of distress. Suppose he has been a plump, healthy little fellow, you will see his face, in a few days, become old-looking, care-worn, haggard, and pinched. Day and night the enemy tracks him (unless proper remedies be administered); no sleep, or, if he sleep, he is every few minutes roused. It is heart-rending to have to attend a bad case of dysentery in a child,—the writhing, the screaming, the frequent vomiting, the pitiful look, the rapid wasting and exhaustion, make it more distressing to witness than almost any other disease a doctor attends.

104. Can anything be done to relieve such a case?

Yes. A judicious medical man will do a great deal. But, suppose that you are not able to procure one, I will tell you what to do and what NOT to do.

What to do.—If the child be at the breast, keep him to it, and let him have nothing else, for dysentery is frequently caused by improper feeding. If your milk be not good, or it be scanty, instantly procure a healthy wet-nurse. Lose not a moment; for in dysentery moments are precious. But, suppose that you have no milk, and that no wet-nurse can be procured: what then? Feed him entirely on cow’s milk—the milk of one healthy cow; let the milk be unboiled, and be fresh from the cow. Give it in small quantities at a time, and frequently, so that it may be retained on the stomach. If a tablespoonful of the milk make him sick, give him a dessertspoonful; if a dessertspoonful cause sickness, let him only have a teaspoonful at a time, and let it be repeated every quarter of an hour. But remember, in such a case the breast-milk—the breast-milk alone—is incomparably superior to any other milk or to any other food whatever.

If he be a year old and weaned, then feed him, as above recommended, on the cow’s milk. If there be extreme exhaustion and debility, let fifteen drops of brandy be added to each tablespoonful of new milk, and let it be given every half hour.

Now with regard to medicine. I approach this part of the treatment with some degree of reluctance—for dysentery is a case requiring opium, and opium I never like a mother of her own accord to administer. But suppose a medical man cannot be procured in time, the mother must then prescribe or the child will die! What then is to be done? Sir Charles Locock considers “that in severe dysentery, especially where there is sickness, there is no remedy equal to pure calomel, in a full dose, without opium.” Therefore, at the very onset of the disease, let from three to five grains (according to the age of the patient) of calomel, mixed with an equal quantity of powdered white sugar, be put dry on the tongue. In three hours after let the following mixture be administered:

Take of—Compound Ipecacuanha Powder, five grains;

Ipecacuanha Wine, half a drachm;

Simple Syrup, three drachms;

Cinnamon Water, nine drachms:

To make a Mixture. A teaspoonful to be given every three or four hours, first well shaking the bottle. Let this mixture, or any other medicine I may prescribe, be always made by a respectable chemist.

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 ought, instead of the medicine recommended above, to be given. 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.

Take of—Mixture of Acacia, three drachms;

Simple Syrup, three drachms;

Tincture of Opium, ten drops (not minims);

Castor oil, two drachms;

Cinnamon Water, four drachms:

Make a Mixture. A teaspoonful to be taken every four hours, first well shaking the bottle.

A warm bath, at the commencement of the disease, is very efficacious; but it must be given at the commencement. If he has had dysentery for a day or two, he will be too weak to have a warm bath; then, instead of the bath, try the following: Wrap him in a blanket which has been previously wrung out of hot water, over which envelop him in a dry blanket. Keep him in this hot, damp blanket for half an hour; then take him out, put on his night-gown and place him in bed, which has been, if it be winter time, previously warmed. The above “blanket treatment” will frequently give great relief, and will sometimes cause him to fall into a sweet sleep. A flannel bag filled with hot powdered table salt, made hot in the oven, applied to the bowels, will afford much comfort.

What NOT to do.—Do not give aperients, unless it be, as before advised, the castor oil guarded with the opium; do not stuff him with artificial food; do not fail to send for a judicious and an experienced medical man; for, remember, it requires a skillful doctor to treat a case of dysentery, more especially in a child.

105. What are the symptoms, the causes, and the treatment of Nettle-rash?

Nettle-rash consists of several irregular raised wheals, red at the base and white on the summit, on different parts of the body; but it seldom attacks the face. It is not contagious, and it may occur at all ages and many times. It comes and goes, remaining only a short time in a place. It puts on very much the appearance of the child having been stung by nettles—hence its name. It produces great heat, itching, and irritation, sometimes to such a degree as to make him feverish, sick, and fretful. He is generally worse when he is warm in bed, or when the surface of his body is suddenly exposed to the air. Rubbing the skin, too, always aggravates the itching and the tingling, and brings out a fresh crop.

The cause of nettle-rash may commonly be traced to improper feeding; although, occasionally, it proceeds from teething.

What to do.—It is a complaint of no danger, and readily gives way to a mild aperient, and to attention to diet. There is nothing better to relieve the irritation of the skin than a warm bath. If it be a severe attack of nettle-rash, by all means call in a medical man.

What NOT to do.—Do not apply cold applications to his skin, and do not wash him (while the rash is out) in quite cold water. Do not allow him to be in a draught, but let him be in a well-ventilated room. If he be old enough to eat meat, keep it from him for a few days, and let him live on milk and farinaceous diet. Avoid strong purgatives, and calomel, and gray powder.

106. What are the symptoms and the treatment of Red-gum?

Red-gum, tooth-rash, red-gown, is usually owing to irritation from teething; not always from the cutting, but from the evolution, the “breeding,” of the teeth. It is also sometimes owing to unhealthy stools irritating the bowels, and showing itself, by sympathy, on the skin. Red-gum consists of several small papulæ, or pimples, about the size of pins’ heads, and may be known from measles—the only disease for which it is at all likely to be mistaken—by its being unattended by symptoms of cold, such as sneezing, running, and redness of the eyes, etc., and by the patches not assuming a crescentic, half-moon shape; red-gum, in short, may readily be known by the child’s health being unaffected, unless, indeed, there be a great crop of pimples; then there will be slight feverishness.

What to do.—Little need be done. If there be a good deal of irritation, a mild aperient should be given. The child ought to be kept moderately but not very warm.

What NOT to do.—Draughts of air, or cold, should be carefully avoided; as, by sending the eruption suddenly in, either convulsions or disordered bowels might be produced. Do not dose him with gray powder.

107. How would you prevent “Stuffing of the nose” in a new-born babe?

Rubbing a little tallow on the bridge of the nose is the old-fashioned remedy, and answers the purpose. It ought to be applied every evening just before putting him to bed.

If the “stuffing” be severe, dip a sponge in hot water, as hot as he can comfortably bear; ascertain that it be not too hot, by previously applying it to your own face, and then put it for a few minutes to the bridge of his nose. As soon as the hard mucus is within reach, it should be carefully removed.

108. Do you consider sickness injurious to an infant?

Many thriving babies are, after taking the breast, frequently sick; still we cannot look upon sickness otherwise than as an index of either a disordered or of an overloaded stomach. If the child be sick, and yet be thriving, it is a proof that he overloads his stomach. A mother, then, must not allow him to suck so much at a time. She should, until he retains all he takes, lessen the quantity of milk. If he be sick and does not thrive, the mother should notice if the milk he throws up has a sour smell; if it has, she must first of all look to her own health; she ought to ascertain if her own stomach be out of order; for if such be the case, it is impossible for her to make good milk. She should observe whether, in the morning, her own tongue be furred and dry; whether she have a disagreeable taste in her mouth, or pains at her stomach, or 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 the child.

But if the mother be in the enjoyment of good health, she must then look to the babe herself, and ascertain if he be cutting his teeth; if the gums require lancing; if the secretions from the bowels be proper both in quantity and in quality; and, if he have had artificial food—it being absolutely necessary to give such food—whether it agree with him.

What to do.—In the first place, if the gums are red, hot, and swollen, let them be lanced; in the second, if the secretions from the bowels are either unhealthy or scanty, give him a dose of aperient medicine, such as castor oil, or the following: Take two or three grains of powdered Turkey rhubarb, three grains of pure carbonate of magnesia, and one grain of aromatic powder. Mix. The powder to be taken at bedtime, mixed in a teaspoonful of sugar and water, and which should, if necessary, be repeated the following night. In the third place, if the food he be taking does not agree with him, change it (vide answer to question 33). Give it in smaller quantities at a time, and not so frequently; or, what will be better still, if it be possible, keep him, for awhile, entirely to the breast.

What NOT to do.—Do not let him overload his stomach either with breast-milk or with artificial food. Let the mother avoid, until his sickness be relieved, greens, cabbage, and all other green vegetables.

109. What are the causes, the symptoms, the prevention, and the cure of Thrush?

The thrush is a frequent disease of an infant, and is often brought on either by stuffing him or by giving him improper food. A child brought up entirely, for the first three or four months, on the breast, seldom suffers from this complaint. The thrush consists of several irregular, roundish, white specks on the lips, the tongue, the inside and the angles of the mouth, giving the parts affected the appearance of curds and whey having been smeared upon them. The mouth is hot and painful, and he is afraid to suck: the moment the nipple is put into his mouth he begins to cry. The thrush sometimes, although but rarely, runs through the whole of the alimentary canal. It should be borne in mind that nearly every child who is sucking has his or her tongue white or “frosted” as it is sometimes called. The thrush may be mild or very severe.

Now with regard to What to do.—As the thrush is generally owing to improper and to artificial feeding, if the child be at the breast, keep him, for a time entirely to it. Do not let him be always sucking, as that will not only fret his mouth, but will likewise irritate and make sore the mother’s nipple.

If he be not at the breast, but has been weaned, then keep him for a few days entirely to a milk diet—to the milk of ONE cow—either boiled, if it be hot weather, to keep it sweet; or unboiled, in cool weather—fresh as it comes from the cow.

The best medicine is the old-fashioned one of borax, a combination of powdered lump sugar and borax being a good one for the purpose: the powdered lump sugar increases the efficacy and the cleansing properties of the borax; it tends, moreover, to make it more palatable:

Take of—Biborate of Soda, half a drachm;

Lump-sugar, two scruples:

To be well mixed together, and made into twelve powders. One of the powders to be put dry on the tongue every four hours.

The best local remedy is honey of borax, which ought to be smeared frequently, by means of the finger, on the parts affected.

Thorough ventilation of the apartment must be observed; and great cleanliness of the vessels containing the milk should be insisted upon.

In a bad case of thrush, change of air to the country is most desirable; the effect is sometimes, in such cases, truly magical.

If the thrush be brought on either by too much or by improper food, in the first case, of course, a mother must lessen the quantity; and, in the second, she should be more careful in her selection.

What NOT to do.—Do not use either a calf’s teat or wash-leather for the feeding-bottle; fortunately, since the invention of india-rubber teats, they are now nearly exploded; they were, in olden times, fruitful causes of thrush. Do not mind the trouble of ascertaining that the cooking-vessels connected with the baby’s food are perfectly clean and sweet. Do not leave the purity and the goodness of the cow’s milk (it being absolutely necessary to feed him on artificial food) to be judged either by the milkman or by the nurse, but taste and prove it yourself. Do not keep the milk in a warm place, but either in the dairy or in the cellar; and, if it be summer time, let the jug holding the milk be put in a crock containing lumps of ice. Do not use milk that has been milked longer than twelve hours, but, if practicable, have it milked direct from the cow, and use it immediately—let it be really and truly fresh and genuine milk.

When the disease is severe, it may require more active treatment—such as a dose of calomel; which medicine must never be given, unless it be either under the direction of a medical man, or unless it be in an extreme case,—such as dysentery; therefore, the mother had better seek advice. See the Treatment of Dysentery.

In a severe case of thrush, where the complaint has been brought on by artificial feeding—the babe not having the advantage of the mother’s milk—it is really surprising how rapidly a wet-nurse—if the case has not been too long deferred—will effect a cure, where all other means have been tried and have failed. The effect has been truly magical! In a severe case of thrush, pure air and thorough ventilation are essential to recovery.

110. Is anything to be learned from the cry of an infant?

There is a language in the cry of an infant which a thoughtful medical man can well interpret. The cry of hunger, for instance, is very characteristic,—it is unaccompanied with tears, and is a wailing cry; the cry of teething is a fretful cry; the cry of earache is short, sharp, piercing, and decisive, the head being moved about from side to side, and the little hand being often put up to the affected side of the head; the cry of bowel-ache is also expressive,—the cry is not so piercing as from earache, and is an interrupted, straining cry, accompanied with a drawing up of the legs to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the cry of inflammation of the lungs is more a moan than a cry; the cry of croup is hoarse, and rough, and ringing, and is so characteristic that it may truly be called “the croupy cry,” moreover, he breathes as though he breathed through muslin; the cry of inflammation of the membranes of the brain is a piercing shriek—a danger signal—most painful to hear; the cry of a child recovering from a severe illness is a cross, and wayward, and tearful cry; he may truly be said to be in a quarrelsome mood; he bursts out without rhyme or reason into a passionate flood of tears; tears are always, in a severe illness, to be looked upon as a good omen, as a sign of amendment: tears, when a child is dangerously ill, are rarely if ever seen; a cry at night, for light—a frequent cause of a babe crying—is a restless cry:

“An infant crying in the night:

An infant crying for the light:

And with no language but a cry.”

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 to produce sickness, disorder the bowels, and create fever. I recommend you, therefore, not to make the attempt.

Although broth and beef-tea, when taken by the mouth, will seldom agree with an infant at the breast, yet, when used as an enema, and in small quantities, so that they may be retained, I have frequently found them to be of great benefit: they have, in some instances, appeared to have snatched delicate children from the brink of the grave.

112. My babe’s ankles are very weak: what do you advise to strengthen them?

If his ankles be weak, let them every morning be bathed, after the completion of his morning’s ablution, for five minutes each time, with bay salt and water, a small handful of bay salt dissolved in a quart of rain water (with the chill of the water taken off in the winter, and of its proper temperature in the summer time); then let them be dried; after the drying, let the ankles be well rubbed with the following liniment:

Take of—Oil of Rosemary, three drachms;

Liniment of Camphor, thirteen drachms:

To make a Liniment.

Do not let him be put on his feet early; but allow him to crawl, and sprawl, and kick about the floor, until his ankles become strong.

Do not, on any account, without having competent advice on the subject, use iron instruments or mechanical supports of any kind: the ankles are generally, by such artificial supports, made worse, in consequence of the pressure causing a further dwindling away and enfeebling of the ligaments of the ankles, already wasted and weakened.

Let him wear shoes, with straps over the insteps to keep them on, and not boots: boots will only, by wasting the ligaments, increase the weakness of the ankles.

113. Sometimes there is a difficulty in restraining the bleeding of leech-bites. What is the best method?

The difficulty in these cases generally arises from the improper method of performing it. For example—a mother endeavors to stop the hemorrhage by loading the part with rag; the more the bites discharge, the more rag she applies. At the same time, the child probably is in a room with a large fire, with two or three candles, with the doors closed, and with perhaps a dozen people in the apartment, whom the mother has, in her fright, sent for. This practice is strongly reprehensible.

If the bleeding cannot be stopped,—in the first place, the fire must be extinguished, the door and windows should be thrown open, and the room ought to be cleared of persons, with the exception of one, or, at the most, two; and every rag should be removed. “Stopping of leech-bites.—The simplest and most certain way, till the proper assistance is obtained, is the pressure of the finger, with nothing intervening. It cannot bleed through that.” [Sir Charles Locock, in a Letter to the Author.]

Many babies have lost their lives by excessive loss of blood from leech-bites, from a mother not knowing how to act, and also from the medical man either living at a distance, or not being at hand. Fortunately for the infantile community, leeches are now very seldom ordered by doctors.

114. Supposing a baby to be poorly, have you any advice to give to his mother as to her own management?

She must endeavor to calm her feelings, or her milk will be disordered, and she will thus materially increase his illness. If he be laboring under any inflammatory disorder, she ought to refrain from the taking of beer, wine, and spirits, and from all stimulating food; otherwise, she will feed his disease.

Before concluding the first part of my subject—the Management of Infancy—let me again urge upon you the importance—the paramount importance—if you wish your babe to be strong and hearty,—of giving him as little opening physic as possible. The best physic for him is Nature’s physic—fresh air and exercise and simplicity of living. A mother who is herself always drugging her child, can only do good to two persons—the doctor and the druggist!

If an infant from his birth be properly managed,—if he has an abundance of fresh air for his lungs,—if he has plenty of exercise for his muscles (by allowing him to kick and sprawl on the floor),—if he has a good swilling and sousing of water for his skin,—if, during the early months of his life, he has nothing but the mother’s milk for his stomach,—he will require very little medicine—the less the better! He does not want his stomach to be made into a doctor’s shop! The grand thing is not to take every opportunity of administering physic, but of using every means of withholding it! And if physic be necessary, not to doctor him yourself, unless it be in extreme and urgent cases (which in preceding and succeeding Conversations I either have or will indicate), but to employ an experienced medical man. A babe who is always, without rhyme or reason, being physicked, is sure to be puny, delicate, and unhealthy, and is ready, at any moment, to drop into an untimely grave!