To prevent a return of the disorder, all those things which occasion it must be carefully avoided; as wet feet, cold, damp, easterly winds, &c. Children who have had frequent returns of this disease, or whose constitutions seem to dispose them to it, ought to have their diet properly regulated; all food that is viscid or hard of digestion, and all crude, raw, trashy fruits, are to be avoided. They ought likewise to have a drain constantly kept open in some part of their body, by means of a seton or issue. I have sometimes known a Burgundy-pitch plaster, worn continually between the shoulders for several years, have a very happy effect in preventing the return of this dreadful disorder.
OF TEETHING.
Dr. Arbuthnot observes, that above a tenth part of infants die in teething, by symptoms proceeding from the irritation of the tender nervous parts of the jaws, occasioning inflammations, fevers, convulsions, gangrenes, &c. These symptoms are in a great measure owing to the great delicacy and exquisite sensibility of the nervous system at this time of life, which is too often increased by an effeminate education. Hence it comes to pass, that children who are delicately brought up, always suffer most in teething, and often fall by convulsive disorders.
About the sixth or seventh month the teeth generally begin to make their appearance; first, the incisores, or fore-teeth; next, the canini, or dogteeth; and, lastly, the molares, or grinders. About the seventh year, there comes a new set; and about the twentieth, the two inner grinders, called dentes sapientiæ, the teeth of wisdom.
Children, about the time of cutting their teeth, slaver much, and have generally a looseness. When the teething is difficult, especially when the dogteeth begin to make their way through the gums, the child has startings in his sleep, tumours of the gums, watchings, gripes, green stools, the thrush, fever, difficult breathing, and convulsions.
Difficult teething requires nearly the same treatment as an inflammatory disease. If the body be bound, it must be opened either by emollient clysters or gentle purgatives; as manna, magnesia alba, rhubarb, senna, or the like. The food should be light, and in small quantity; the drink plentiful, but weak and diluting, as infusions of balm, or of the lime-tree flowers; to which about a third or fourth part of milk may be added.
If the fever be high, bleeding will be necessary; but this in very young children ought always to be sparingly performed. It is an evacuation which they bear the worst of any. Purging, vomiting, or sweating, agree much better with them, and are generally more beneficial. Harris, however, observes, that, when an inflammation appears, the physician will labour in vain, if the cure be not begun with applying a leech under each ear. If the child be seized with convulsion-fits, a blistering-plaster may be applied between the shoulders, or one behind each ear.
Sydenham says, that in fevers occasioned by teething, he never found any remedy so effectual as two, three, or four drops of spirits of hartshorn in a spoonful of simple water, or other convenient vehicle, given every four hours. The number of doses may be four, five, or six. I have often prescribed this medicine with success, but always found a larger dose necessary. It may be given from five drops to fifteen or twenty, according to the age of the child, and, when costiveness does not forbid it, three or four drops of laudanum may be added to each dose.
In Scotland, it is very common, when children are cutting their teeth, to put a small Burgundy-pitch plaster between their shoulders. This generally eases the tickling cough which attends teething, and is by no means an useless application. When the teeth are cut with difficulty, it ought to be kept on during the whole time of teething. It may be enlarged as occasion requires, and ought to be renewed at least once a fortnight.
Several things have been recommended for rubbing the gums, as oils, mucilages, &c.; but from these much is not to be expected. If any thing of this kind is to be used, we would recommend a little fine honey, which may be rubbed on with the finger three or four times a-day. Children are generally at this time disposed to chew whatever they get into their hands. For this reason they ought never to be without somewhat that will yield a little to the pressure of their gums, as a crust of bread, a wax-candle, a bit of liquorice-root, or such like.