Thrush in the child is of far less serious import than in the grown person. In the latter it indicates the existence of some very serious, almost hopeless disease, and hence it is that we meet with it in the last stages of dysentery, cancer, and consumption. In the child a slight attack of thrush may occur from causes which are by no means serious, and may disappear under the use of simple means, such as I have already described when speaking of the troubles of digestion in early infancy.
While in any case it must rest with the doctor to regulate as he best knows how the constitutional treatment of the condition on which the thrush depends, it must be for the mother to see that appropriate local measures are adopted. One point of considerable moment, and to which less care than it deserves is usually paid, is the removing from the mouth, each time after the infant has been fed, of all remains of the milk or other food. For this purpose whenever the least sign of thrush appears, the mouth should be carefully wiped out with a piece of soft rag dipped in a little warm water every time after food has been given. Supposing the attack to be but slight this precaution will of itself suffice in many instances to remove all traces of the affection in two or three days. If, however, there is much redness of the mouth, or if the specks of thrush are numerous, some medicated application is desirable.
The once popular honey and borax is not the best application, and this for a reason which I will at once explain. The secretion of the mouth in infants is acid, disease increases this acidity; and it has been found that this acid state is not merely favourable to the increase of thrush, but also to the development between the specks of thrush of a sort of membrane formed by a peculiar microscopic growth, of whose existence, just as of that of the phylloxera which destroys the vine, or the muscardine which kills the silkworm, we were ignorant till brought to light by recent scientific research.
You will therefore at once see why saccharine substances, apt as they are to pass into a state of fermentation, are not suitable, and why it is better to employ a solution of—
Borax, twenty grains
Glycerine, one teaspoonful
Water, an ounce.
Now and then the use once or twice a day in addition of a very weak solution of caustic, as two grains of lunar caustic to an ounce of water, in bad cases is necessary; but of this it must be left to the doctor to decide.
Teething.—The transition is a very natural one by which we pass from the study of the dangers and difficulties which attend the feeding and rearing of young infants, to those which accompany teething.
The time of teething is looked forward to by most mothers with undisguised apprehension, nurses attribute to it the most varied forms of constitutional disturbance, and doctors constantly hold forth to anxious parents the expectation that their child will have better health when it has cut all its teeth. The time of teething, too, is in reality one of more than ordinary peril,[9] though why it should be so is not always rightly understood. It is a time of most active development, a time of transition from one mode of being to another, in respect of all those important functions by whose due performance the body is nourished and built up.
The error which has been committed with reference to this matter, consists not in overrating the hazard of the time, when changes so important are being accomplished, but in regarding only one of the manifestations—though that indeed is the most striking one of the many important ends which nature is then labouring to bring about. A child in perfect health usually cuts its teeth at a certain time and in a certain order, just as a girl at a certain age begins to show signs of approaching womanhood; and at length attains it with but slight inconvenience or discomfort. The two processes, however, have this in common, that during both, constitutional disturbance is more common, and serious diseases are more frequent than at other times, and the cause in both lies far deeper than the outward manifestation.
The great changes which nature is constantly bringing about around us and within us are the result of laws operating silently but unceasingly; and hence it is that in her works we see little of the failure which often disappoints human endeavours, or of the dangers which often attend on their accomplishment. Thus when her object is to render the child no longer dependent on the mother for its food, she begins to prepare for this long beforehand. The first indication of it is furnished by the greatly increased activity of the salivary glands, which during the first few months of existence have scarcely begun to perform their function, a fact which accounts for the tendency to dryness of the tongue of the young infant under the influence of very trivial ailments. About the fourth or fifth month, this condition undergoes a marked alteration; the mouth is now found continually full of saliva, and the child is constantly drivelling; but no other indication appears of the approach of the teeth to the surface, except that the ridge of the gums sometimes becomes broader than it was before. No further change may take place for many weeks; and it is generally near the end of the seventh month before the first teeth make their appearance. The middle cutting teeth of the lower jaw are in most instances the first to pierce the gum; next the middle cutting teeth of the upper jaw; then usually the side cutting teeth of the lower jaw, and lastly, the corresponding ones of the upper. This, however, is not quite invariable, for sometimes all the cutting teeth in one jaw precede in their appearance any of those in the other. The first four grinding teeth next succeed, and often without any very definite order as to whether those of the upper or of the lower jaw are first visible, though in the majority of instances the lower are the first to appear. The four eye teeth follow, and lastly, the remaining four grinding teeth, which complete the set of first, or as they are often called, milk teeth.