Chapter IV: Part I: Infancy (3)

The _treatment,_ of the _mild_ form, consists of friction, of the gum with the finger, with a little "soothing syrup," as recommended by Sir Charles Locock, [Footnote: Soothing syrup--Some of them probably contain opiates, but a perfectly safe and useful one is a little Nitrate of Potass in syrup of Roses--one scruple to half an ounce.--_Communicated by Sir Charles Locock to the Author._ This 'soothing syrup' is not intended to be given us a mixture but to be used as an application to rub the gums with. It may be well to state that it is a perfectly harmless remedy even if a little of it were swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, every night at bed time, attention to diet and to bowels, fresh air and exercise. For the mild form, the above plan will usually be all that is required. If he dribble, and the bowels be relaxed, so much the better. The flow of saliva and the increased action of the bowels afford relief, and therefore must not be interfered with. In the _mild_ form, lancing of the gums is not desirable. The gums ought not to be lanced, unless the teeth be near at hand, and unless the gums be red, hot, and swollen.

In the _severe_ form a medical man should be consulted early, as more energetic remedies will be demanded; that is to say, the gums will require to be freely lanced, warm baths to be used, and medicines to be given, to ward off mischief from the head, from the chest, and from the stomach.

If you are living in the town, and your baby suffers much from teething, take him into the country. It is wonderful what change of air to the country will often do, in relieving a child who is painfully cutting his teeth. The number of deaths in London, from teething, is frightful; it is in the country comparatively trifling.

71. _Should an infant be purged during teething or indeed, during any other time, do you approve of either absorbent or astringent medicines to restrain it_?

Certainly not. I should look upon, the relaxation as an effort of nature to relieve itself. A child is never purged without a cause; that cause, in the generality of instances, is the presence of either some undigested food, or acidity, or depraved motions, that want a vent.

The better plan is, in such a case, to give a dose of aperient medicine, such as either castor oil, or magnesia and rhubarb; and thus work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so important and is often mistaken.--C. Locock.] If he be purged more than usual, attention should be paid to the diet--if it be absolutely necessary to give him artificial food while suckling--and care must be taken not to overload the stomach.

72. _A child is subject to a slight cough during dentition--called by nurses "tooth-cough"--which a parent would not consider of sufficient importance to consult a doctor about: pray tell me, is there any objection to a mother giving her child a small quantity either of syrup of white poppies, or of paregoric, to ease it_?

A cough is an effort of nature to bring up any secretion from the lining membrane of the lungs, or from the bronchial tubes, hence it ought not to be interfered with. I have known the administration of syrup of white poppies, or of paregoric, to stop the cough, and thereby to prevent the expulsion of the phlegm, and thus to produce either inflammation of the lungs, or bronchitis. Moreover, both paregoric and syrup of white poppies are, for a young child, dangerous medicines (unless administered by a judicious medical man), and _ought never to be given by a mother_.

In the month of April 1844, I was sent for, in great haste, to an infant, aged seventeen months, who was labouring under convulsions and extreme drowsiness, from the injudicious administration of paregoric, which had been given to him to ease a cough. By the prompt administration of an emetic he was saved.

73. _A child, who is teething, is subject to a "breaking-out," more especially behind the ears--which is most disfiguring, and frequently very annoying what would you recommend_?

I would apply no external application to cure it, as I should look upon it as an effort of the constitution to relieve itself, and should expect, if the "breaking-out" were repelled, that either convulsions, or bronchitis, or inflammation of the lungs, or water on the brain, would be the consequence. The only plan I should adopt would be, to be more careful in his diet, to give him less meat (if he be old enough to eat animal food), and to give him, once or twice a week, a few doses of mild aperient medicine, and, if the irritation from the "breaking-out" be great, to bathe it, occasionally, either with a little warm milk and water, or with rose water.

EXERCISE.

74. _Do you recommend exercise in the open air for a baby? and if so, how soon after birth_?

I am a great advocate for his having exercise in the open air. "The infant in arms makes known its desire for fresh air, by restlessness, it cries, for it cannot speak its wants, is taken abroad and is quiet."

The age at which he ought to commence taking exercise will, of course, depend upon the season and upon the weather. If it be summer, and the weather be fine, he should he carried in the open air, a week or a fortnight after birth, but if it be winter, he ought not on any account to be taken out under the month, and not even then, unless the weather be mild for the season, and it be the middle of the day. At the end of two months he should breathe the open air more frequently. And after the expiration of three months, he ought to be carried out _every day_, even if it be wet under foot, provided it be fine above, and the wind be neither in an easterly nor in a north-easterly direction. By doing so we shall make him strong and hearty, and give the skin that mottled appearance which is so characteristic of health. He must, of course, be well clothed.

I cannot help expressing my disapprobation of the practice of smothering up an infant's face with a handkerchief, with a veil or with any other covering, when he is taken out into the air. If his face be so muffled up, he may as well remain at home, as under such circumstances, it is impossible for him to receive any benefit from the invigorating effects of the fresh air.

75. _Can you devise any method to induce a babe himself to take exercise_?

He must be encouraged to use muscular exertion, and, for this purpose, he ought to be frequently laid either upon a rug, or carpet, or the floor. He will then stretch his limbs and kick about with perfect glee. It is a pretty sight, to see a little fellow kicking and sprawling on the floor. He crows with delight and thoroughly enjoys himself. It strengthens his back, it enables him to stretch his limbs, and to use his muscles, and is one of the best kinds of exercise a very young child can take. While going through his performances his diaper, if he wear one, should be unfastened, in order that he might go through his exercises untrammelled. By adopting the above plan, the babe quietly enjoys himself--his brain is not over excited by it; this is an important consideration, for both mothers and nurses are apt to rouse, and excite very young children to their manifest detriment. A babe requires rest, and not excitement. How wrong it is, then, for either a mother or a nurse to be exciting and rousing a new born babe. It is most injurious and weakening to his brain. In the early period of his existence his time ought to be almost entirely spent in sleeping and in sucking!

76. _Do you approve of tossing an infant much about_?

I have seen, a child tossed nearly to the ceiling! Can anything be more cruel or absurd! Violent tossing of a young babe ought never to be allowed, it only frightens him, and has been known to bring on convulsions. He should be gently moved up and down (not tossed), such exercises causes a proper circulation of the blood, promotes digestion, and soothes to sleep. He must always be kept quiet immediately after taking the breast, if he be tossed _directly_ afterwards, it interferes with his digestion, and is likely to produce sickness.

SLEEP

77. _Ought the infant's sleeping apartment to be kept warm_?

The lying-in room is generally kept too warm, its heat being, in many instances, more that of an oven than of a room. Such a place is most unhealthy, and is fraught with danger both to the mother and the baby. We are not, of course, to run into an opposite extreme, but are to keep the chamber at a moderate and comfortable temperature. The door ought occasionally to be left ajar, in order the more effectually to change the air and thus to make it more pure and sweet.

A new born babe, then, ought to be kept comfortably warm, but not very warm. It is folly in the extreme to attempt to harden a very young child either by allowing him, in the winter time, to be in a bedroom without a fire, or by dipping him in _cold_ water, or by keeping him with scant clothing on his bed. The temperature of a bedroom, in the winter time, should be, as nearly as possible, at 60 deg. Fahr. Although the room should be comfortably warm, it ought from time to time to be properly ventilated. An unventilated room soon becomes foul, and, therefore, unhealthy. How many in this world, both children and adults, are "poisoned with their own breaths!"

An infant should not be allowed to look at the glare either of a fire or of a lighted candle, as the glare tends to weaken the sight, and sometimes brings on an inflammation of the eyes. In speaking to, and in noticing a baby, you ought always to stand _before_, and not _behind_ him, or it might make him squint.

78. _Ought a babe to lie alone from the first_?

Certainly not: at first--say, for the first few months--he requires the warmth of another person's body, especially in the winter; but care must be taken not to overlay him, as many infants, from carelessness in this particular, have lost their lives. After the first few months he had better lie alone, on a horse-hair mattress.

79. _Do you approve of rocking an infant to sleep_?

I do not. If the rules of health be observed, he will sleep both soundly and sweetly without rocking; if they be not, the rocking might cause him to fall into a feverish, disturbed slumber, but not into a refreshing, calm sleep. Besides, if you once take to that habit, he will not go to sleep without it.

80. _Then don't you approve of a rocking-chair, and of rockers to the cradle_?

Certainly not: a rocking-chair, or rockers to the cradle, may be useful to a lazy nurse or mother, and may induce a child to sleep, but that restlessly, when he does not need sleep, or when he is wet and uncomfortable, and requires "changing;" but will not cause him to have that sweet and gentle and exquisite slumber so characteristic of a baby who has no artificial appliances to make him sleep. No! rockers are perfectly unnecessary, and the sooner they are banished the nursery the better will it be for the infant community. I do not know a more wearisome and monotonous sound than the everlasting rockings to and fro in some nurseries, they are often accompanied by a dolorous lullaby from the nurse, which adds much to the misery and depressing influence of the performance.

81. _While the infant is asleep, do you advise the head of the crib to be covered with a handkerchief, to shade his eyes from the light, and, if it be summer time, to keep off the flies_?

If the head of the crib be covered, the babe cannot breathe freely, the air within the crib becomes contaminated, and thus the lungs cannot properly perform their functions. If his sleep is to be refreshing, he must breathe pure air. I do not even approve of a head to a crib. A child is frequently allowed to sleep on a bed with the curtains drawn completely close, as though it were dangerous for a breath of air to blow upon him [Footnote: I have somewhere read that if a cage containing a canary, be suspended at night within a bed where a person is sleeping, and the curtains be drawn closely around, that the bird will, in the morning, in all probability, be found dead!] This practice is most injurious. An infant must have the full benefit of the air of the room, indeed, the bed room door ought to be frequently left ajar, so that the air of the apartment may be changed, taking care, of course, not to expose him to a draught. If the flies, while he is asleep, annoy him, let a net veil be thrown over his face, as he can readily breathe through net, but not through a handkerchief.

82. _Have you any suggestions to offer as to the way a babe should be dressed when he is put down to sleep_?

Whenever he be put down to sleep, be more than usually particular that his dress be loose in every part, be careful that there be neither strings nor bands, to cramp him. Let him, then, during repose, be more than ordinarily free and unrestrained--

"If, whilst in cradled rest your infant sleeps.
Your watchful eyes unceasing vigil keeps
Lest cramping bonds his pliant limbs constrain,
And cause defects that manhood may retain."

83. _Is it a good sign for a young child to sleep much_?

A babe who sleeps a great deal thrives much more than one who does not. I have known many children, who were born [Footnote: It may be interesting to a mother to know the average weight of new born infants. There is a paper on the subject in the _Medical Circular_ (April 10, 1861) and which has been abridged in _Braithwaite's Retrospect of Medicine_ (July and December 1861). The following are extracts--"Dr. E. von Siebold presents a table of the weights of 3000 infants (1586 male and 1414 female) weighed immediately after birth. From this table (for which we have not space) it results that by far the greater number of the children, 2215 weighed between 6 and 8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to 8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at 9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11 lbs. The author has never but once met with a child weighing 11 lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It is a remarkable fact, that until the weight of 7 lbs the female infants exceeded the males in number, the latter thenceforward predominating.

From these statements, and those of various other authors here quoted, the conclusion may be drawn that the normal weight of a mature new born infant is not less than six nor more than 8 lbs., the average weight being 6 1/2 or 7 lbs., the smaller number referring to female and the higher to male infants."] small and delicate, but who slept the greatest part of their time, become strong and healthy. On the other hand, I have known those who were born large and strong, yet who slept but little, become weak and unhealthy.

The common practice of a nurse allowing a baby to sleep upon her lap is a bad one, and ought never to be countenanced. He sleeps cooler, more comfortably, and soundly in his crib.

The younger an infant is the more he generally sleeps, so that during the early months he is seldom awake, and then only to take the breast.

84. _How is it that much sleep causes a young child to thrive so well_?

If there be pain in any part of the body, or if any of the functions be not properly performed, he sleeps but little. On the contrary, if there be exemption from pain, and if there be a due performance of all the functions, he sleeps a great deal, and thus the body becomes refreshed and invigorated.

85. _As much sleep is of such advantage, if an infant sleep but little, would you advise composing medicine to be given to him_?

Certainly not. The practice of giving composing medicine to a young child cannot he too strongly reprobated. If he does not sleep enough, the mother ought to ascertain if the bowels be in a proper state, whether they be sufficiently opened, that the motions be of a good colour--namely, a bright yellow, inclining to orange colour--and free from slime or from bad smell. An occasional dose of rhubarb and magnesia is frequently the best composing medicine he can take.

86. _We often hear of coroner's inquests upon infants who have been found dead in bed--accidentally overlaid what is usually the cause_?

Suffocation, produced either by ignorance, or by carelessness. From _ignorance_ in mothers, in their not knowing the common laws of life, and the vital importance of free and unrestricted respiration, not only when babies are up and about, but when they are in bed and asleep. From _carelessness_, in their allowing young and thoughtless servants to have the charge of infants at night, more especially as young girls are usually heavy sleepers, and are thus too much overpowered with sleep to attend to their necessary duties.

A foolish mother sometimes goes to sleep while allowing her child to continue sucking. The unconscious babe, after a tune, looses the nipple, and buries his head in the bed-clothes. She awakes in the morning, finding, to her horror, a corpse by her side, with his nose flattened, and a frothy fluid, tinged with, blood, exuding from his lips. A mother ought, therefore, never to go to sleep until her child have finished sucking.

_The following are a few rules to prevent an infant from being accidentally overlaid_--(1.) Let your baby while asleep have plenty of room in the bed. (2.) Do not allow him to be too near to you; or if he he unavoidably near you (from the small size of the bed), let his face be turned to the opposite side. (3.) Let him lie fairly either on his side, or on his back. (4.) Be careful to ascertain that his mouth be not covered with the bed-clothes; and, (5.) Do not smother his face with clothes, as a plentiful supply of pure air is as necessary when he is awake, or even more so, than when he is asleep. (6.) Never let him lie low in the bed. (7.) Let there be _no_ pillow near the one his head is resting on, lest he roll to it, and thus bury his head in it Remember, a young child has neither the strength nor the sense to get out of danger; and, if he unfortunately either turn on his face, or bury his head in a pillow that is near, the chances are that he will be suffocated, more especially as these accidents usually occur at night, when the mother, or the nurse, is fast asleep. (8.) Never intrust him at night to a young and thoughtless servant.

THE BLADDER AND THE BOWELS OF AN INFANT.

87. _Have you any hints to offer respecting the bowels and the bladder of an infant during the first three months of his existence_?

A mother ought daily to satisfy herself as to the state of the bladder and the bowels of her child. She herself should inspect the motions, and see that they are of a proper colour (bright-yellow, inclining to orange), and consistence (that of thick gruel), that they are neither slimy, nor curdled, nor green; if they should be either the one or the other, it is a proof that she herself has, in all probability, been imprudent in her diet, and that it will be necessary for the future that she be more careful both in what she eats and in what she drinks.

She ought, moreover, to satisfy herself that the urine does not smell strongly, that it does not stain the diapers, and that he makes a sufficient quantity.

A frequent cause of a child crying is, he is wet, and uncomfortable, and wants drying and changing, and the only way he has of informing his mother of the fact is by crying lustily, and thus telling her in most expressive language of her thoughtlessness and carelessness.

88. _How soon may an infant dispense with diapers_?

A babe of three months and upwards, ought to be held out, at least, a dozen times during the twenty-four hours; if such a plan were adopted, diapers might at the end of three months be dispensed with--a great _desideratum_-and he would be inducted into clean habits--a blessing to himself, and a comfort to all around, and a great saving of dresses and of furniture. "Teach your children to be clean. A dirty child is the mother's disgrace," [Footnote: Hints on Household Management, By Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS THE MOTHER'S DISGRACE.

AILMENTS, DISEASE, ETC.

89. _A new born babe frequently has a collection of mucus in the air passages, causing him to wheeze: is it a dangerous symptom_?

No, not if it occur _immediately_ after birth; as soon as the bowels have been opened, it generally leaves him, or even before, if he give a good cry, which as soon as he is born he usually does. If there be any mucus either within or about the mouth, impeding breathing, it must with a soft handkerchief be removed.

90. _Is it advisable, as soon as an infant is born, to give him medicine_?

It is now proved that the giving of medicine to a babe _immediately_ after birth is unnecessary, nay, that it is hurtful--that is, provided he be early put to the breast, as the mother's _first_ milk is generally sufficient to open the bowels. Sir Charles Locock [Footnote: In a _Letter_ to the Author.] makes the following sensible remarks on this subject:--"I used to limit any aperient to a new-born infant to those which had not the first milk, and who had wet nurses, whose milk was, of course, some weeks old, but for many years I have never allowed any aperient at all to any new born infant, and I am satisfied it is the safest and the wisest plan."

The advice of Sir Charles Locock--_to give no aperient to a new-born infant_--is most valuable, and ought to be strictly followed. By adopting his recommendation, much after misery might be averted. If a new born babe's bowels be costive, rather than give him an aperient, try the effect of a little moist sugar, dissolved in a little water, that is to say, dissolve half a tea-spoonful of pure unadulterated _raw_ sugar in a tea-spoonful of warm water and administer it to him, if in four hours it should not operate, repeat the dose. Butter and raw sugar is a popular remedy, and is sometimes used by a nurse to open the bowels of a new born babe, and where there is costiveness, answers the purpose exceedingly well, and is far superior to castor oil. Try by all means to do, if possible, without a particle of opening medicine. If you once begin to give aperients, you will have frequently to repeat them. Opening physic leads to opening physic, until at length his stomach and bowels will become a physic shop! Let me, then, emphatically say, avoid, if possible, giving a new born babe a drop or a gram of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterwards. It is the _first_ step, in this as in all other things, that is so important to take.

If a new-born babe have _not_ for twelve hours made water, the medical man ought to be informed of it, in order that he may inquire into the matter, and apply the proper remedies. Be particular in attending to these directions, or evil consequences will inevitably ensue.

91. _Some persons say, that new-born female infants have milk in their bosoms, and that it is necessary to squeeze them, and apply plasters to disperse the milk_.

The idea of there being real milk in a baby's breast is doubtful, the squeezing of the bosom is barbarous, and the application of plasters is useless. "Without actually saying," says Sir Charles Locock, "there is milk secreted in the breasts of infants, there is undoubtedly not rarely considerable swelling of the breasts both in _female_ and _male_ infants, and on squeezing them a serous fluid oozes out. I agree with you that the nurses should never be allowed to squeeze them, but be ordered to leave them alone." [Footnote: _Letter_ to the Author.]

92. _Have the goodness to mention the SLIGHT ailments which are not of sufficient importance to demand the assistance of a medical man_?

I deem it well to make the distinction between _serious_ and _slight_ ailments, I am addressing a mother. With regard to serious ailments, I do not think myself justified, except in certain _urgent_ cases, in instructing a parent to deal with them. It might be well to make a mother acquainted with the _symptoms_, but not with the _treatment_, in order that she might lose no time in calling in medical aid. This I hope to have the pleasure of doing in future Conversations.

_Serious diseases, with a few exceptions_, and which I will indicate in subsequent Conversations, ought never to be treated by a parent, not even in the _early_ stages, for it is in the early stages that the most good can generally be done. It is utterly impossible for any one who is not trained to the medical profession to understand a _serious_ disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen in future Conversations that Sir CHARLES LOCOCK considers that a mother ought to be made acquainted with the _treatment_ of _some_ of the more _serious_ diseases, where delay in obtaining _immediate_ medical assistance might be death. I bow to his superior judgment, and have supplied the deficiency in subsequent Conversations.

The ailments and the diseases of infants, such as may, in the absence of the doctor, be treated by a parent, are the following:--Chafings, Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of the Nose, Sickness, Thrush. In all these complaints I will tell you--_What to do_, and--_What NOT to do_.

93. _What are the causes and the treatment of Chafing_?

The want of water: inattention and want of cleanliness are the usual causes of chafing.

_What to do._--The chafed parts ought to be well and thoroughly sponged with tepid _rain_ water--allowing the water from a well-filled sponge to stream over them,--and, afterwards, they should be thoroughly, but tenderly, dried with a soft towel, and then be dusted, either with finely-powdered starch, made of wheaten flour, or with Violet Powder, or with finely-powdered Native Carbonate of Zinc, or they should be bathed with finely-powdered Fuller's-earth and tepid water.

If, in a few days, the parts be not healed discontinue the above treatment, and use the following application:--Beat up well together the whites of two eggs, then add, drop by drop, two table-spoonfuls of brandy. When well mixed, put it into a bottle and cork it up. Before using it let the excoriated parts be gently bathed with luke-warm rain water, and, with a soft napkin, be tenderly dried; then, by means of a camel's hair brush, apply the above liniment, having first shaken the bottle. But bear in mind, after all that can be said and done, _that there is nothing in these cases like water_--there is nothing like keeping the parts clean, and the only way of thoroughly effecting this object is _by putting him every morning INTO his tub_.

_What NOT to do_.--Do not apply white lead, as it is a poison. Do not be afraid of using _plenty_ of water, as cleanliness is one of the most important items of the treatment.

94. _What are the causes of Convulsions of an infant_?

Stuffing him, in the early months of his existence, _with food_, the mother having plenty of breast milk the while, the constant physicking of child by his own mother, teething, hooping-cough, when attacking a very young baby.

I never knew a case of convulsions occur--say for the first four months--(except in very young infants labouring under hooping-cough), where children lived on the breast-milk alone, and where they were _not_ frequently quacked by their mothers.

For the treatment of the convulsions from teething, see page 46.

_What to do_ in a case of convulsions which has been caused by feeding an infant either with too much or with _artificial_ food. Give him, every ten minutes, a tea-spoonful of ipecacuanha wine, until free vomiting be excited then put him into a warm bath (see Warm Baths), and when he comes out of it administer to him a tea-spoonful of castor oil, and repeat it every four hours, until the bowels be well opened.

_What NOT to do_--Do not for at least a month after the fit, give him artificial food, but keep him entirely to the breast. Do not apply leeches to the head.

_What to do in a case of convulsions from hooping cough_--There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. Convulsions attending an attack of hooping-cough make it a _serious_ complication, and requires the assiduous and skilful attention of a judicious medical man.

_What NOT to do in such a case_--Do not apply leeches, the babe requires additional strength, and not to be robbed of it, and do not attempt to treat the case yourself.

95. _What are the best remedies for the Costiveness of an infant_?

I strongly object to the frequent administration of opening medicine, as the repetition of it increases the mischief to a tenfold degree.

_What to do_.--If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan, may be brought into a regular state. Besides, it inducts an infant into clean habits, I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such encumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot of course, at an early age be dispensed with, unless a mother have great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having his bowels relieved and his bladder emptied every time he is either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little _raw_ sugar and water, either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or two of water, or give him, out of your fingers, half a tea-spoonful of raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for a while, opening medicine becomes a dire necessity, and then woe betide the poor unfortunate child. Or, give a third of a tea-spoonful of honey, early in the morning, occasionally. Or administer a warm water enema--a tablespoonful, or more, by means of a 2 oz. India Rubber Enema Bottle.

_What NOT to do_.--There are two preparations of mercury I wish to warn you against administering of your own accord, viz.--(1) Calomel, and a milder preparation called (2) Grey-powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it can be administered it being small in quantity, and nearly tasteless. Grey powder also, is, with many mothers, a favourite in the nursery. It is a medicine of immense power--either for good or for evil, in certain cases it is very valuable, but in others, and in the great majority, it is very detrimental. This practice, then, of a mother giving mercury, whether in the form either of calomel or of grey powder, cannot be too strongly reprobated, as the frequent administration either of the one or of the other weakens the body, predisposes it to cold, and frequently excites king's-evil--a disease too common in this country. Calomel and grey-powder, then, ought never to be administered unless ordered by a medical man.

Syrup of buckthorn and jalap are also frequently given, but they are griping medicines for a baby, and ought to be banished from the nursery.

The frequent repetition of opening medicines, then, in any shape or form, very much interferes with digestion, they must, therefore, be given as seldom as possible.

Let me, at the risk of wearying you, again urge the importance of your avoiding, as much as possible, giving a babe purgative medicines. They irritate beyond measure the tender bowels of an infant, and only make him more costive afterwards, they interfere with his digestion, and are liable to give him cold. A mother who is always, of her own accord, quacking her child with opening physic, is laying up for her unfortunate offspring a debilitated constitution--a miserable existence.

For further information on this important subject see the 3d edition of _Counsel to a Mother (being the companion volume of Advice to a Mother)_, on the great importance of desisting from irritating, from injuring, and from making still more costive, the obstinate bowels of a costive child,--by the administration of opening medicine,--however gentle and well-selected the aperients might be. Oh, that the above advice could be heard, and be acted upon, through the length and the breadth of the land, how much misery and mischief would then be averted!

96. _Are there any means of preventing the Costiveness of an infant_?

If greater care were paid to the rules of health, such as attention to diet, exercise in the open air, thorough ablution of the _whole_ body--more especially when he is being washed--causing the water, from a large and well-filled sponge, to stream over the lower part of his bowels; the regular habit of causing him, at stated periods, to be held out, whether he want or not, that he may solicit a stool. If all these rules were observed, costiveness would not so frequently prevail, and one of the miseries of the nursery would be done away with.

Some mothers are frequently dosing their poor unfortunate babes either with magnesia to cool them, or with castor oil to heal their bowels! Oh, the folly of such practices! The frequent repetition of magnesia, instead of cooling an infant, makes him feverish and irritable. The constant administration of castor oil, instead of healing the bowels, wounds them beyond measure. No! it would be a blessed thing if a babe could be brought up without giving ham a particle of opening medicine; his bowels would then act naturally and well: but then, as I have just now remarked, a mother, must be particular in attending to Nature's medicines--to fresh air, to exercise, to diet, to thorough ablution, &c. Until that time comes, poor unfortunate babies must be, occasionally, dosed with an aperient.

97. _What are the causes of, and remedies for, Flatulence_?

Flatulence most frequently occurs in those infants who live on _artificial_ food, especially if they be over-fed. I therefore beg to refer you to the precautions I have given, when speaking of the importance of keeping a child for the first five or six months _entirely_ to the breast; and, if that be not practicable, of the times of feeding, and of the _best_ kinds of artificial food, and of those which are least likely to cause "wind."

_What to do._--Notwithstanding these precautions, if the babe should still suffer, "One of the best and safest remedies for flatulence is Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce and a half of water" [Footnote: Sir Charles Locock, in a _Letter_ to the Author Since Sir Charles did me the honour of sending me, for publication, the above prescription for flatulence, a new "British Pharmacopoeia" has been published in which the sal volatile is much increased in strength it is therefore necessary to lessen the sal volatile in the above prescription one half--that is to say, a tea spoonful of the solution of _half_ a drachm to an ounce and a half of water.] Or, a little dill or aniseed may be added to the food--half a tea-spoonful of dill water Or, take twelve drops of oil of dill, and two lumps of sugar, rub them well in a mortar together, then add, drop by drop, three table-spoonfuls of spring water, let it be preserved in a bottle for use. A tea-spoonful of this, first shaking the vial, may be added to each quantity of food. Or, three tea-spoonfuls of bruised caraway-seeds may be boiled for ten minutes in a tea-cupful of water, and then strained. One or two tea-spoonfuls of the caraway tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may occasionally be given.

Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at a time, by means of the warm hand, over the bowels, will frequently give relief. Turning the child over on his bowels, so that they may press on the nurses' lap, will often afford great comfort. A warm bath (where he is suffering severely) generally gives _immediate_ ease in flatulence, it acts as a fomentation to the bowels. But after all, a dose of mild aperient medicine, when the babe is suffering severely, is often the best remedy for "wind."

Remember, at all times, prevention, whenever it be--and how frequently it is--possible, is better than cure.

_What NOT to do_--"Godfrey's Cordial," "Infants' Preservative," and "Dalby's Carminative," are sometimes given in flatulence, but as most of these quack medicines contain, in one form or another, either opium or poppy, and as opium and poppy are both dangerous remedies for children, ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to afford relief for flatulence; but let me urge upon you the importance for banishing it from the nursery. It has (when given by unprofessional persons) caused the untimely end of thousands of children. The medical journals and the newspapers teem with cases of deaths from mothers incautiously giving syrup of poppies to ease pain and to procure sleep.

98. _What are the symptoms, the causes, and the treatment of "Gripings" of an infant_?

_The symptoms._--The child draws up his legs; screams violently; if put to the nipple to comfort him, he turns away from it and cries bitterly; he strains, as though he were having a stool; if he have a motion, it will be slimy, curdled, and perhaps green. If, in addition to the above symptoms, he pass a large quantity of watery fluid from his bowels, the case becomes one of _watery gripes_, and requires the immediate attention of a doctor.

The _causes_ of "gripings" or "gripes" may proceed either from the infant or from the mother. If from the child, it is generally owing either to improper food or to over-feeding; if from the mother, it may be traced to her having taken either greens, or port, or tart beer, or sour porter, or pickles, or drastic purgatives.

_What to do._--The _treatment_, of course, must depend upon the cause. If it arise from over-feeding, I would advise a dose of castor oil to be given, and warm fomentations to be applied to the bowels, and the mother, or the nurse, to be more careful for the future. If it proceed from improper food, a dose or two of magnesia and rhubarb in a little dill water, made palatable with simple syrup. [Footnote:

Take of--Powdered Turkey Rhubarb, half a scruple;
Carbonate of Magnesia, one scruple;
Simple Syrup, three drachms;
Dill Water, eight drachms;

Make a Mixture, One or two tea-spoonfuls (according to the age of the child) to be taken every four boors, until relief be obtained--first shaking the bottle.) If it arise from a mother's imprudence in eating trash, or from her taking violent medicine, a warm bath, a warm bath, indeed, let the cause of "griping" be what it may, usually affords instant relief.

Another excellent remedy is the following--Soak a piece of new flannel, folded into two or three thicknesses, in warm water, wring it tolerably dry, and apply as hot as the child can comfortably bear it to the bowels, then wrap him in a warm, dry blanket, and keep him, for at least half an hour, enveloped in it. Under the above treatment, he will generally soon fall into a sweet sleep, and awake quite refreshed.

_What NOT to do_--Do not give opiates, astringents, chalk, or any quack medicine whatever.

If a child suffer from a mother's folly in her eating improper food, it will be cruel in the extreme for him a _second_ time to be tormented from the same cause.

99. _What occasions Hiccup, and what is its treatment_?

Hiccup is of such a trifling nature as hardly to require interference. It may generally be traced to over feeding. Should it be severe, four or five grains of calcined magnesia, with a little syrup and aniseed water, and attention to feeding are all that will be necessary.

100. _Will you describe the symptoms of Infantile Diarrhoea_?

Infantile diarrhoea, or _cholera infantum_, is one of the most frequent and serious of infantile diseases, and carries off, during the year, more children than any other complaint whatever a knowledge of the symptoms, therefore, is quite necessary for a mother to know, in order that she may, at the proper tune, call in efficient medical aid.

It will be well, before describing the symptoms, to tell you how many motions a young infant ought to have a day, their colour, consistence, and smell. Well, then, he should have from three to six motions in the twenty four hours, the colour ought to be a bright yellow, inclining to orange, the consistence should be that of thick gruel; indeed, his motion, if healthy, ought to be somewhat of the colour (but a little more orange-tinted) and of the consistence of mustard made for the table; it should be nearly, if not quite, devoid of smell; it ought to have a faint and peculiar, but not a strong disagreeable odour. If it have a strong and disagreeable smell, the child is not well, and the case should be investigated, more especially if there be either curds or lumps in the motions; these latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint--that is to say, that he has six or eight motions during the twenty-four hours,--and that the stools are of a thinner consistence than what I have described,--provided, at the same time, that he be not griped, that he have no pain, and have not lost his desire for the breast:--What ought to be done?_Nothing_. A slight looseness of the bowels should _never_ be interfered with,--it is often an effort of nature to relieve itself of some vitiated motion that wanted a vent--or to act as a diversion, by relieving the irritation of the gums. Even if he be not cutting his teeth, he may be "breeding" them--that is to say, the teeth may be forming in his gums, and may cause almost as much, irritation as though he were actually cutting them. Hence, you see the immense good a slight "looseness of the bowels" may cause. I think that I have now proved to you the danger of interfering in such a case, and that I have shown you, the folly and the mischief of at once giving astringents--such as Godfrey's Cordial, Dalby's Carminative, &c.--to relieve a _slight_ relaxation.

A moderate "looseness of the bowels," then, is often a safety-valve, and you may, with as much propriety, close the safety-valve of a steam engine, as stop a moderate "looseness of the bowels!"

Now, if the infant, instead of having from three to six motions, should have more than double the latter number; if they be more watery; if they become slimy and green, or green in part and curdled; if they should have an unpleasant smell; if he be sick, cross, restless, fidgety, and poorly; if every time he have a motion he be griped and in pain, we should then say that he is labouring under Diarrhoea; then, it will be necessary to give a little medicine, which I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case becomes more serious; still, with proper care, relief can generally be quickly obtained. If the evacuations--instead of being stool--are merely blood and slime, and the child strain frequently and violently, endeavouring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of Dysentery. [Footnote: See Symptoms and Treatment of Dysentery.]

If there be a mixture of blood, slime, and stool from the bowels, the case would be called Dysenteric-diarrhoea. The latter case requires great skill and judgment on the part of a medical men, and great attention and implicit obedience from the mother and the nurse. I merely mention these diseases in order to warn you of their importance, and of the necessity of strictly attending to a doctor's orders.

101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_

Improper food; overfeeding; teething; cold; the mother's milk from various causes disagreeing, namely, from her being out of health, from her eating unsuitable food, from her taking improper and drastic purgatives, or from her suckling her child when she is pregnant. Of course, if any of these causes are in operation, they ought, if possible, to be remedied, or medicine to the babe will be of little avail.

102. _What is the treatment of Diarrhoea_?

_What to do._--If the case be _slight_, and has lasted two or three days (do not interfere by giving medicine at first), and if the cause, as it probably is, be some acidity or vitiated stool that wants a vent, and thus endeavours to obtain one by purging, the best treatment is, to assist nature by giving either a dose of castor oil, or a moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and magnesia mixture prescription, see page 71 (_note_).] and thus to work off the enemy. After the enemy has been worked off, either by the castor oil, or by the magnesia and rhubarb, the purging will, in all probability, cease; but if the relaxation still continue, that is to say, for three or four days--then, if medical advice cannot be procured, the following mixture should be given:--

Take of--Aromatic Powder of Chalk and Opium, ten grains;
Oil of Dill, five drops;
Simple Syrup, three drachms;
Water, nine drachms;

Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half a tea-spoonful to be given to an infant of six months and under, and one tea-spoonful to a child above that age, every four hours--first shaking the bottle.

If the babe be at the breast, he ought, for a few days, to be kept _entirely_ to it. The mother should be most particular in her own diet.

_What NOT to do._--The mother must neither take greens, nor cabbage, nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of her babe continues, she had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought _not_, while the diarrhoea continues, to have any artificial food. He must neither be dosed with grey-powder (a favourite, but highly improper Remedy, in these cases), nor with any quack medicines, such as Dalby's Carminative or Godfrey's Cordial.

103. _What are the symptoms of Dysentery_?

Dysentery frequently arises from a neglected diarrhoea. It is more dangerous than diarrhoea, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skilful handling; hence the care and experience required in treating a case of dysentery.

Well, then, what are the symptoms? The infant, in all probability, has had an attack of diarrhoea--bowel complaint as it is called--for several days; he having had a dozen or two of motions, many of them slimy and frothy, like "frog-spawn," during the twenty-four hours. Suddenly the character of the motion changes,--from being principally stool, it becomes almost entirely blood and mucus; he is dreadfully griped, which causes him to strain violently, as though his inside would come away every time he has a motion,--screaming and twisting about, evidently being in the greatest pain, drawing his legs up to his belly and writhing in agony. Sickness and vomiting are always present, which still more robs him of his little remaining strength, and prevents the repair of his system. Now, look at his face! It is the very picture of distress. Suppose he has been a plump, healthy little fellow, you will see his face, in a few days, become old-looking, care-worn, haggard, and pinched. Day and night the enemy tracks him (unless proper remedies be administered); no sleep, or if he sleep, he is, every few minutes, roused. It is heart-rending to have to attend a bad case of dysentery in a child,--the writhing, the screaming, the frequent vomiting, the pitiful look, the rapid wasting and exhaustion, make it more distressing to witness than almost any other disease a doctor attends.

104. _Can anything be done to relieve such a case_?

Yes. A judicious medical man will do a great deal. But, suppose that yon are not able to procure one, I will tell you _what to do_ and _what NOT to do_.

_What to do_.--If the child be at the breast, keep him to it, and let him have nothing else for dysentery is frequently caused by improper feeding. If your milk be not good, or it be scanty, _instantly_ procure a healthy wet-nurse. _Lose not a moment;_ for in dysentery, moments are precious. But, suppose that you have no milk, and that no wet-nurse can be procured: what then? Feed him entirely on cow's milk--the milk of _one_ healthy cow; let the milk be unboiled, and be fresh from the cow. Give it in small quantities at a time, and frequently, so that it may be retained on the stomach. If a table-spoonful of the milk make him sick, give him a dessert-spoonful; if a dessert-spoonful cause sickness, let him only have a tea-spoonful at a time, and let it be repeated every quarter of an hour. But, remember, in such a case the breast milk--the breast milk alone--is incomparably superior to any other milk or to any other food whatever.

If he be a year old, and weaned, then feed him, as above recommended, on the cow's milk. If there be extreme exhaustion and debility, let fifteen drops of brandy be added to each table-spoonful of new milk, and let it be given every half hour.