WILL SHE GROW OUT OF IT?
By Dr. GORDON STABLES, M.D., C.M., R.N. (“MEDICUS”).
The first part of this paper at all events may be supposed to be addressed to young mothers, rather than to young girls, but I have no doubt that the latter will have a peep at it just to see if there is anything in it which concerns them. I shall not tell them whether there is or not. Let them read on and see.
My main difficulty in writing it I feel will be one of condensation. The subject of inherited ailments and congenital malformation is one of such importance that it is a book thereon I should publish, and not a single paper. However, if it leads young parents to think, thinking is sure to lead to action, and with the hints I shall give, and of course the help of their family doctor, many a young life may not only be saved, but children may grow up strong and bonnie, who through neglect or ignorance might have anything but happy futures, and lives so weary that their brevity might well be looked upon as a blessing.
I must say a few words at the outset on the terrible scourge of these islands, which most people call consumption, and the medical profession phthisis. The question “Is it hereditary?” stares us in the face at once whenever we think of it, and it is a somewhat difficult one to answer. I myself do not believe in heredity in the ordinary sense of the word as applied to disease. A beautiful young shoot of wood may spring from a fast-decaying tree, and if this be transplanted into good soil, it will grow as well as any other. What holds good as regards vegetable life cannot of course be shown to be quite true as regards animal, nevertheless there is a certain analogy. Consumption we believe to be infectious; if so, it is caused by a disease germ. Now your old-school hereditists would tell us that this germ descends from mother to child. In some cases it does or may, but the child very soon succumbs to tabes mesenterica, or some other terrible infantile disease. A germ will do one of two things: it will either assert itself very speedily, or be killed in the system. Nature sets about at once getting rid of these disease germs, supposing them to exist at the time of birth. She brings, among other organs of relief, the absorbents and glands into play; there is a struggle for life, in which nature often fails, because those very glands become overladen and diseased, tubercle being formed and multiplied within them. Nature does her best, but she is beaten—another proof of the struggle betwixt what we call evil and good, which is constantly going on in this world.
Well, on the other hand, if the child is born of delicate parents, but free from germs, it has, if carefully fed, nursed, and tended, a very excellent chance of growing up well. It is difficult to conceive of a child having germs of, say, consumption in its system and these lying latent or dormant until she is a certain age, and then springing suddenly into life after she has suffered from some exposure and caught cold in the chest. There are easier theories than this by far and away to account for the children of consumptive parents dying of the same disease in their later teens. Besides, that word “latent” may be convenient, but it is a shockingly unmeaning one. I remember my father buying for a good round sum a few grains of wheat that were said to have been in the grasp of a mummy for a thousand years. The wheat when sown grew most certainly. It may never have been in the hands of a mummy at all, but it may have been. If so, it was surrounded by dead matter, it was hermetically sealed against any influence that could cause it to germinate. Life was latent or asleep. But in the human body germs have no chance of dorminating, for so constant are the changes, that everything is constantly getting shifted, and by the time a man or woman is fifty he or she may have used up a score of bodies.
However, there is this to be said concerning the children of consumptive parents: they are born delicate, and therefore far more likely to fall victims to the scourge than others.
May they grow out of this delicacy of constitution? Yes, and that is the question I am going to consider, but I must answer another one, and it is one, too, that strikes at the very root of sociality: should consumptive people, or those suffering from other so-called hereditary ailments, marry? I say, “No.” They are, if they do so, guilty of as great a crime as many a felon who leaves the dock with the dread sentence of the judge ringing in his ears. It is sad to have to answer the question in such seemingly cruel words, but nevertheless I believe I am doing my duty in giving that reply.
There are two ways in which a young woman can give herself to God in this world, and both are honourable. One is by marrying the man she loves if he be healthy in body and pure in mind—not else—and thus becoming Heaven’s own servant for the happy propagation of healthful species and the progress of the world; the other is by—if weakly—remaining celibate and devoting her time, her talents and energies to doing good to her fellow beings without hope of reward in this world. There is a charm about a woman like this (though foolish people may sneer at her as an old maid) that it is difficult to describe.
I have met many such, and seem to have seen a halo already around their heads. I am a physician, naturalist, scientist, if you will, and something of an astronomer, and being so of course—to some extent—a doubter, but I do most sincerely believe that the good in this weary wicked world will ultimately prevail, and those who help it onwards will not go unrewarded in a future life whatever that life may be.
Now to lay down a few simple rules for the treatment of weakly children whether born of delicate parents or not. Will she grow out of it? The answer to this question is a hopeful one or the reverse just as you choose to make it, young mother.
There is one stumbling-block of which I bid you beware at the very outset of your girl-child’s life. It is the bogey “cold.” That young children need warmth is very true. They are for the time being little hot-house plants, but the sooner you recognise the truth that they are not intended to remain so, the better it will be for yourself, and for the child as well. Those wee things have to be hardened off because the world isn’t a hot-house, and they have got to live hardy, healthy, and therefore happy lives, in spite of the many and daily changes of this changeable climate of ours.
If you desire the wee lassie to grow up as tender as a mushroom and perhaps die just as soon, comparatively, then all you’ve got to do is to permit her to sleep night after night in a badly-ventilated stuffy room and to plot her. The verb “to plot” is essentially Scotch, but as applied to over-coddled children or young canaries or pigeons in a nest that the nervous mother is sweating to death, it is exceedingly expressive. Many of the Scotch words are derived from the French as, in olden times, the two nations were great allies. It would be going a little out of the way perhaps to seek its derivation from sur le plat, on the plate, as an egg when poached. A pig is plotted when boiling water is poured over it in order to get off the bristles easily, the cook plots herself when she gets a splash of hot water over her hands, a boy or man is said to be plotting himself when he wears more clothes than is wanted as a guard against the weather, and babies are all too often plotted in bed or bassinette. The single word “plotted” means sweated, blanched (faire pâlir), poached, all in one. Well, however nice a poached egg may be, poached baby looked at from a doctor’s point of view is very unsatisfactory.
Now just think of the folly, not to say the iniquity, of treating a tender infant as many do. Here lies the mite at the mercy of a mother who may be wise, but who may be otherwise. It is already struggling with the arch-enemy, death. Pray do not misunderstand me: I do not mean to say it is dying, only from the very day we begin to live we begin to die, as it were, at least, to struggle against all that is inimical to life. And life is change, you know, merely that. “I live, therefore I must die.” But we want to keep the spark in this little body, and what is more we want to fan it into health that shall fill every vein and nerve in its body, and produce future health, happiness, and strength. In order to do this, in order to give the child a chance to grow out of its inherited weakness (I do not say “disease,” for that is an ugly word, and quite unnecessary), we must place it under conditions most favourable to existence.
I think this is the proper place in which to mention a very injurious fallacy as regards what are called infantile ailments. It is a fact that children of tender years are more likely to be attacked by certain ailments, of which measles is as good an illustration as any, simply because they are weak, and these, in certain states of the atmosphere, especially in villages where sanitation is utterly neglected, are apt to become epidemic, carrying away to their little graves victims that are not strong enough to fight against the trouble, for Nature’s law that the fittest shall survive is fixed and immutable. But it is a great mistake to believe that children must have such ailments, and the sooner such an error of belief is written down and eradicated the better. Scarlatina is another ailment which often breaks out in villages, especially in Board schools; and remembering the utter want of fresh air and cleanliness which prevails in these seminaries, one cannot wonder. During an epidemic of this sort the school is closed, and the children, sick or well, go to their squalid dens and unhealthy huts to live or die, as the case may be, for they “break up” at school only to hatch out the seeds of illness already sown in their systems. But your well-fed, well-cared-for children, and such as sleep at night in fresh air without more than sufficient bed-clothing, do not succumb to these disorders, be they ever so rife.
Surely, then, prevention is better than cure. I shall now mention one or two of these so-called infantile troubles that some young mothers who read this brief paper may know a little more about them and their causes. I advise everyone who has the care of children to keep in the house in its little case a clinical thermometer. The family doctor will be very pleased, I am sure, to show parents how to use it, and whenever the temperature mounts over a hundred the physician should be called in.
Measles.—The ailment is ushered in somewhat similarly to a bad cold, and often passes at first for a touch of influenza. But the girl is feverish with loss of appetite, and no heart for play. Then about the third day come out the rose-coloured spots, first on the brow. They are so close together as to almost coalesce. The fever now gets worse, and the case is one for the doctor to superintend; but the parents ask the question: “Will she get over it?” I am glad to answer in the affirmative, only that nasty wee word “if” comes in—if the case does not become complicated, for bronchitis may ensue, or inflammation of the lungs itself, and then there is great danger. And bear this in mind; the child that has been treated while in health in a common-sense way, not “plotted,” over-coddled, or over-crammed as to food, has by far and away the greatest chance of getting over this ailment or scarlatina either.
Scarlatina.—When this becomes epidemic in small towns and badly-drained villages, the Angel of Death has indeed spread his wings on the blast.
If there is scarlet fever or scarlatina (the milder sort) about, and your little girl begins to ail from no apparent cause, suffering from loss of appetite and cheerfulness, if she has chills alternating with flushing, hot skin and uneasy sleep, with a little headache and maybe sore throat, with a high temperature and furred tongue, having little red papillæ showing through—the “strawberry tongue”—then in all probability she has an attack of scarlatina. We shall hope it is to be a simple one. Cure it you can’t; but the little patient may be guided through it.
The doctor is the man to trust. But there is one thing you can assist him in most materially, and that is in seeing that the patient is completely isolated from the rest of the house, for the simplest cases in one child may generate the worst in others. It is a more dangerous disorder than measles, and mind that, until the doctor gives a clean bill of health, and the skin has entirely peeled, no other child should be allowed into the room. Indeed, the success in any one case depends on careful nursing, and isolation will prevent it spreading. Disinfectants must of course be used—but the doctor will tell you all this—and food taken from the room must not even be given to the cat or dog. She will pull through if scientifically treated, and soon grow out of any little weaknesses that may remain.
St. Vitus’s Dance.—Will she grow out of this? I do really think that the medical profession has a good deal to learn even yet concerning this strange ailment. But its symptoms are unmistakable. The uncontrollable, fidgety movements may be slight or very great; they may be on one side of the body or both. She will grow out of it, however, if the treatment is most skilful. The health must be properly attended to, and all rules obeyed which the doctor shall lay down. The digestion and the teeth must be seen to, with abundance of fresh air and non-exciting exercise and recreation. The bath often does wonders—tepid, of course—given in a warm room. There are certain kinds of methodical drill which, moreover, do good, and many kinds of tonics. But cod-liver oil or marrol is perhaps one of the best, as it is a food. The doctor will for each case prescribe the necessary tonic. Dear me! what thousands of thousands of lives might be saved if we could only act up to the physician’s instructions. I must bid the young mother beware of quack medicines, and of all such dangerous drugs as chloral, bromides, and phenaticin, etc. In the hands of the physician these are useful; in those of the uninitiated they are verily like razors grasped by infant fingers.
There are three ailments or more which I hope to treat of in papers succeeding this. One is incipient consumption and its fresh air cure, another rickets and bandy legs, and a third scrofula, a disease of the glands, but, of course, from constitutional causes. Scrofula used to be called King’s Evil; and, although one suffering therefrom may do much good by strict adherence to the laws of health, medical advice should in all cases be sought for.