Of course a physician will be obtained in these serious cases if possible.
Retention of urine in the newly born infant if slight is easily removed by giving two or three drops of spirits of nitre once an hour in a little sweetened water, or if obstinate it may be aided by castor oil and the warm bath. A little pumpkin seed or parsley root tea also succeeds remarkably well.
Apthæ is usually called the baby’s sore mouth. It generally begins on the inner part of the lower lip or corner of the mouth, as a small white speck which resembles a coagulum of milk. These aphthous white pustules soon appear over the inside of the cheeks and on the tongue and gums. The eruption is very white and looks as if whey or curds were spread over the mouth, which is hot and painful, and the disease sometimes does, and at other times does not cause fever. I regard this complaint as being one of the germ diseases, although the fact has not yet been demonstrated. The children fed upon farinaceous food are most liable to this disease, and during its continuance, if the child is not at the breast it should be kept entirely to the milk of one cow. Medicine should be given with regard to the stomach and bowels. If the passages from the bowels are green, magnesia is a proper kind of physic, and when there is diarrhœa use formula 80, 77, 81.
Genuine jaundice may attack a young child, but this is to be distinguished from those cases where there is only a generally diffused YELLOW COLOR OF THE SKIN. In the latter class of cases there are no symptoms indicating any serious disease; the yellowness may continue for several days, and this disappears without the aid of any medicine and without leaving any evil behind. But in jaundice the whites of the eyes and the tears are tinged yellow, and, besides, the feces are paler than they should be, the urine is yellow, and other serious symptoms are added. If the bowels be costive, or irritated to frequent efforts, if the abdomen swells and becomes tense, if the child is uneasy and inclined to vomit, if it refuse the breast and frequently moans as if in pain, if it emaciate rapidly, jaundice in a bad form is present, and there is probable disease of the liver. Call the doctor.
I need not continue my instructions any farther in regard to the diseases of infancy, as you are expected to act as far as you can under the directions of a physician. But I must again advise you as to how you are to treat your medical advisor. Give him your entire confidence. Be truthful and candid with him. Have no reservations; give him a plain statement of the symptoms. Be prepared to state the exact time the child showed any illness. Tell him if the child had a chill; if there be any eruption on the skin, note the quantity and appearance of the urine, the number, color, &c., of the stools—all the symptoms of the disease. Strictly obey the doctor’s orders in diet, in medicine, in everything, and never omit any of his suggestions. If the case be severe, never call a second physician without first consulting and advising with the one first chosen; speak in the presence of children with respect and reverence of the doctor, and endeavor to have them like him. Send for the doctor when practicable early in the morning, as the daylight is most favorable for making the examination, but if the illness come in the night do not delay on that account; if you do not know what to do, it is better that the doctor be called early than late.
CHAPTER V.
CASES OF DIFFICULT LABOR.
I wish to give you so much instruction in regard to cases of difficult labor that you may at least be prepared to decide in any case when the services of a physician is indispensably necessary, to decide whether the parturition in a given case is a natural one that does not need any assistance, or an unnatural one requiring the assistance of the art of midwifery, scientific or manual, for the relief of irregularities and difficulties. In general I shall adopt Churchill’s divisions and definitions as I think they are very concise and correct.
TEDIOUS LABOR.
“Definition. The head of the child presents and the labor is terminated without manual or instrumental assistance, but it is prolonged beyond twenty-four hours from causes which occasion delay in the first stage.”
Prolongation of labor is of comparatively small consequence when the membranes are still intact, as they serve to protect the soft parts of the mother as well as the body of the child from injurious pressure, but the mere lengthening of the labor may become a serious thing when the head has entered the pelvis, when the uterus is strongly excited by reflex stimulation, and when the maternal soft parts as well as the fœtus and cord are exposed to severe pressure. When we find no evil resulting from the delay we need not interfere, but when we can remove the cause of it we are bound to do so.