The Diet of the Sick Child.—Prescribing the diet of the sick child is an important undertaking. It should be remembered that during sickness the digestive capacity is reduced; consequently the food must be lessened in quantity and in strength. If the patient is an infant at breast the best way to accomplish our purpose is to give before each feeding two ounces of boiled water, cooled to the temperature of the body. This dilutes the mother's milk and renders it more easy of digestion. If bottle-fed, it is accomplished by replacing one-half of the milk with water. In certain diseases milk is totally withdrawn, but these cases will be noted when discussing the treatment of the various diseases. With older children, we give milk diluted with water, or gruels, soups, or cereals, as conditions warrant.
Needless interference with the patient must not be indulged in. Sleep and quiet are essential features of nature's reparative process. It is seldom necessary to disturb a sick child for the giving of food or medicine oftener than every second or third hour. Medicine may always be given with food. Meddlesome interference, talkative attendants, or excessive noise may exhaust a child and may prolong and render dangerous or fatal a condition that would otherwise go on to recovery.
One satisfactory movement of the bowel daily is essential to the comfort and progress of a sick person. If this does not take place naturally, it should be obtained by an enema.
At the beginning of any illness in childhood it is a safe procedure to give a dose of a suitable cathartic as soon as it is discovered that the child is sick.
A Child is the Most Helpless Living Thing.—Nature endows the young of every species—except those of the human family—with certain instincts, which, when developed, govern and control their lives absolutely. The technical definition of an instinct is an exceedingly complicated word picture. It is only essential to an intelligent understanding of our subject that the reader should have a definite idea of the difference between an act that is the result of a process of reasoning and an act that is the result of an instinct. If a man finds his way out of his burning home he will stay out as long as there is any danger. The crudest kind of reasoning will teach this lesson. A horse, on the other hand—and incidentally it may be noted that a horse is regarded as an intelligent animal—if led out of a burning stable and let loose, will immediately reënter and be burned to death. The horse is the victim of instinct; he obeys the unconquerable instinct to return to his stall—he cannot reason as the man can that a home that is burning is not a proper place to seek safety in. When an ostrich fears danger he buries his head in the sand, under the impression that if his head is out of sight he is safe from danger. This is his instinctive plan of procedure in the presence of danger, and it is the plan of every ostrich, everywhere, always. A little reasoning would show them how foolish the idea is—but they cannot reason. That is the province of man alone. If the first member of a flock of sheep jumps over a fence to get into the next field, every member of the flock will follow, each one jumping the fence, though there may be an open gate between the two fields a few yards away. Instinct dictates the plan to the sheep as they have received instructions from their ancestors always to "follow the lead." This is their hereditary legacy and they cannot disobey it.
Animals are born with instincts which need only circumstances to bring them out. Now a baby is not born with instincts of this character,—it has not even the instinct to help itself; it cannot find the breasts that were made for it; it is more helpless than the baby cat or dog or worm. Therefore a baby in whose brain the potential faculty of reason is slumbering must of necessity begin its career wholly dependent upon the supervision and love of its mother, until such time as it may be capable of reasoning for itself. Motherhood is therefore the supreme privilege of womanhood. It cannot be superseded, hence the fundamental factor in any system of race culture, or in any system of infant mortality, must tend to raise the quality and the intelligence of motherhood as a basic necessity. Motherhood at the present time, though the most important and sacred profession in the world, is almost exclusively carried on by unskilled labor. The maternal instinct is deeply rooted and universal; its absence must be regarded as an abnormality, or as a product of misdirected education. The requisites for the mothers of the future should be absolute physical health and love of children.
If nature endowed a baby with instincts there would be no need for reason or education. Education cannot teach a cat how to nurse or wash a kitten any better than it does,—its instinct is good enough. The mother of a human baby, however, is not born with the instinct which enables her to care for her baby equally as well as the cat cares for her kitten. She must be educated or taught to care for it. She can then care for it better than the cat cares for the kitten, and she can be taught to bake, to sew, to read; to play on the piano, which a cat cannot be taught. So while a baby may be the most helpless living thing at one stage of its career it has in it—in the faculty of reasoning—the ability to become the Lord of all the Earth and of all the animals therein. To limit the environment of a child by imposing instincts upon it, would be to limit its inherent freedom. To be obliged to obey a prescribed instinctive law would rob mankind of his creative or reasoning faculty, and that would be to lower him to the level of the brute creation. Reason is of no use if our acts are already determined for us. There are therefore good reasons why the human baby should be, at the moment of its birth, the most helpless living thing; and as a consequence it is imperative, if the eugenic ideal is worthy of attainment, that every baby should have the benefit of trained and efficient care and education.
THE DELICATE CHILD
There is a certain standard by which we measure the physical and mental development of children. This standard we regard as the evidence of normal development. Some children exceed these requirements; they are bigger and stronger at a given age than the average child at the same age. There are other children who cannot be called sick, but who are physically and mentally inferior to the average standard, whom we designate as "delicate." These children are not as big, or as strong, or as heavy, as other children of the same age. They are born with a reduced vitality, or through mismanagement in early infancy they have acquired a subnormal standard of development. Children born of parents who are not of standard vitality are predisposed to be delicate. If the parents are of average development, and the delicacy of the child is acquired by mismanagement, the proper dietetic and hygienic management will, as a rule, promptly result in a satisfactory restoration to normal health.
Treatment.—When a mother awakes to the knowledge that her child is delicate; when she understands that her child's vitality is not what it should be, and when she resolves to "do something" in the interest of her child, she is on the right road, and we hope to encourage her in the good intention. We would however tell her that her effort must be thorough, and that she must be patient and persevering. If she does not falter in well doing she will succeed beyond her expectation, and the satisfaction she will experience in noting the evidences of returning health and strength in the appearance and conduct of her child, should be ample recompense for the effort made and the time bestowed.