Chapter XXII: Part II: Childhood (5)

A suppository is a mild and ready way of opening the bowels of a child. When he is two or three years old and upwards, a _candle_ suppository is better than a _soap_ suppository. The way of preparing it is as follows: Cut a piece of dip-tallow candle—the length of three inches—and insert it as you would a clyster pipe, about two inches up the fundament, allowing the remaining inch to be in sight, and there let the suppository remain until the bowels be opened.

245. _What are the most frequent causes of Protrusion of the lower bowel?_

The too common and reprehensible practice of a parent administering frequent aperients, especially calomel and jalap, to her child. Another cause, is allowing him to remain for a quarter of an hour or more at a time on his chair; this induces him to strain, and to force the gut down.

246. _What are the remedies?_

If the protrusion of the bowel have been brought on by the abuse of aperients, abstain for the future from giving them; but if medicine be absolutely required, give the mildest—such as either syrup of senna or castor oil—_and the less of those the better_.

If the _external_ application of a purgative will have the desired effect, it will, in such cases, be better than the _internal_ administration of aperients. Dr. Merriman’s Purgative Liniment[248] is a good one for the purpose. Let the bowels be well rubbed every night and morning, for five minutes at a time, with the liniment.

A wet compress to the bowels will frequently open them, and will thus do away with the necessity of giving an aperient—_a most important consideration_. Fold a napkin in six thicknesses, soak it in _cold_ water, and apply it to the bowels, over which put either a thin covering or sheet of gutta-percha, or a piece of oiled silk; keep it in its place with a broad flannel roller, and let it remain on the bowels for three or four hours, or until they be opened.

Try what diet will do, as opening the bowels by a regulated diet is far preferable to the giving of aperients. Let him have either bran-bread, Robinson’s Patent Groats made into gruel with new milk, or Du Barry’s Arabica Revalenta, or a slice of Huntley and Palmer’s lump gingerbread. Let him eat stewed prunes, stewed rhubarb, roasted apples, strawberries, raspberries, the inside of grapes and gooseberries, figs, etc. Give him early every morning a draught of _cold_ water.

Let me, again, urge you _not_ to give aperients in these cases, or in any case, unless you are absolutely compelled. By following my advice you will save yourself an immense deal of trouble, and your child a long catalogue of misery. Again, I say, look well into the matter, and whenever it be practicable, avoid purgatives.

Now, with regard to the best manner of returning the bowel, lay the child upon the bed on his face and bowels, with his hips a little raised; then smear lard on the forefinger of your right hand (taking care that the nail be cut close) and gently with your forefinger press the bowel into its proper place.

Remember, if the above methods be observed, you cannot do the slightest injury to the bowel, and the sooner it be returned the better it will be for the child; for, if the bowel be allowed to remain long down, it may slough or mortify, and death may ensue. The nurse, every time he has a motion, must see that the bowel does not come down, and if it does, she ought instantly to return it. Moreover, the nurse should be careful _not_ to allow the child to remain on his chair more than two or three minutes at a time.

Another excellent remedy for the protrusion of the lower bowel is to use every morning a cold salt and water sitz-bath. There need not be more than a depth of three inches of water in the bath; a small handful of table salt should be dissolved in the water; a dash of warm water in the winter time must be added to take off the extreme chill, and the child ought not to be allowed to sit in the bath for more than one minute, or while the mother can count a hundred, taking care the while to throw either a square of flannel or a small shawl over his shoulders. The sitz-bath ought to be continued for months, or until the complaint be removed. I cannot speak in too high praise of these baths.

247. _Do you advise me, every spring and fall, to give my child brimstone to purify and sweeten his blood, and as a preventive medicine?_

Certainly not: if you wish to take away his appetite and to weaken and depress him, give him brimstone! Brimstone is not a remedy fit for a child’s stomach. The principal use and value of brimstone is as an external application in itch, and as an internal remedy, mixed with other laxatives, in piles—piles being a complaint of adults. In olden times poor unfortunate children were dosed every spring and fall with brimstone and treacle, to sweeten their blood! Fortunately for the present race, there is not so much of that folly practiced, but still there is room for improvement.

To dose a _healthy_ child with physic is the grossest absurdity. No, the less physic a delicate child has the better it will be for him, but physic to a healthy child is downright poison!—and brimstone of all medicines! It is both weakening and depressing to the system, and by opening the pores of the skin and by relaxing the bowels, is likely to give cold, and thus to make a healthy a sickly child. Sweeten his blood! It is more likely to weaken his blood, and thus to make his blood impure! Blood is not made pure by drugs, but by Nature’s medicine: by exercise, by pure air, by wholesome diet, by sleep in a well-ventilated apartment, by regular and thorough ablution. Brimstone a preventive medicine? Preventive medicine—and brimstone especially in the guise of a preventive medicine—is “a mockery, a delusion, and a snare.”

248. _When a child is delicate, and his body, without any assignable cause is gradually wasting away, and the stomach rejects all food that is taken, what plan can be adopted likely to support his strength, and thus, probably, be the means of saving his life?_

I have seen, in such a case, great benefit to arise from half a teacupful of either strong mutton broth, or of strong beef-tea, used as an enema, every four hours.[249]

It should be administered slowly, in order that it may remain in the bowel. If the child be sinking, either a dessertspoonful of brandy, or half a wineglassful of port wine ought to be added to each enema.

The above plan ought only to be adopted if there be _no_ diarrhœa. If there be diarrhœa, an enema must _not_ be used. Then, provided there be great wasting away, and extreme exhaustion, and other remedies having failed, it would be advisable to give, by the mouth, _raw_ beef of the finest quality, which ought to be taken from the hip-bone, and should be shredded very fine. All fat and skin must be carefully removed. One or two teaspoonfuls (according to the age of the child) ought to be given every four hours. The giving of _raw_ meat to children in exhaustive diseases, such as excessive long-standing diarrhœa, was introduced into practice by a Russian physician, a Professor Weisse, of St. Petersburg. It certainly is, in these cases, a most valuable remedy, and has frequently been the means of snatching such patients from the jaws of death. Children usually take raw meat with avidity and with a relish.

249. _If a child be naturally delicate, what plan would you recommend to strengthen him?_

I should advise strict attention to the rules above mentioned, and _change of air_—more especially, if it be possible, to the coast. Change of air, sometimes, upon a delicate child, acts like magic, and may restore him to health when all other means have failed. If a girl be delicate, “carry her off to the farm, there to undergo the discipline of new milk, brown bread, early hours, no lessons, and romps in the hay-field.”[250] This advice is, of course, equally applicable for a delicate boy, as delicate boys and delicate girls ought to be treated alike. Unfortunately, in these very enlightened days! there is too great a distinction made in the respective management and treatment of boys and girls.

The best medicines for a delicate child will be the wine of iron and cod-liver oil. Give them combined in the manner I shall advise when speaking of the treatment of Rickets.

In diseases of long standing, and that resist the usual remedies, there is nothing like _change of air_. Hippocrates, the father of medicine, says:

“In longis morbis solum mutare.”
(In tedious diseases to change the place of residence.)

A child who, in the winter, is always catching cold, whose life during half of the year is one continued catarrh, who is in consequence likely, if he grow up at all, to grow up a confirmed invalid, ought, during the winter months, to seek another clime; and if the parents can afford the expense, they should, at the beginning of October, cause him to bend his steps to the south of Europe—Mentone being as good a place as they could probably fix upon.

250. _Do you approve of sea bathing for a delicate young child?_

No: he is frequently so frightened by it that the alarm would do him more harm than the bathing would do him good. The better plan would be to have him every morning well sponged, especially his back and loins, with sea water; and to have him as much as possible carried on the beach, in order that he may inhale the sea breezes.

When he be older, and is not frightened at being dipped, sea bathing will be very beneficial to him. If bathing is to do good, either to an adult or to a child, it must be anticipated with pleasure, and neither with dread nor with distaste.

251. _What is the best method of administering medicine to a child?_

If he be old enough, appeal to his reason; for, if a mother endeavor to deceive her child, and he detect her, he will for the future suspect her.

If he be too young to be reasoned with, then, if he will not take his medicine, he must be compelled. Lay him across your knees, let both his hands and his nose be tightly held, and then, by means of the patent medicine-spoon, or, if that be not at hand, by either a tea or a dessertspoon, pour the medicine down his throat, and he will be obliged to swallow it.

It may be said that this is a cruel procedure; but it is the only way to compel an unruly child to take physic, and is much less cruel than running the risk of his dying from the medicine not having been administered.[251]

252. _Ought a sick child to be roused from his sleep to give him physic, when it is time for him to take it?_

On no account, as sleep, being a natural restorative, must not be interfered with. A mother cannot be too particular in administering the medicine, at stated periods, while he is awake.

253. _Have you any remarks to make on the management of a sick-room, and have you any directions to give on the nursing of a sick child?_

In sickness select a large and lofty room; if in the town, the back of the house will be preferable—in order to keep the patient free from noise and bustle—as a sick-chamber cannot be kept too quiet. Be sure that there be a chimney in the room—as there ought to be in _every_ room in the house—and that it be not stopped, as it will help to carry off the impure air of the apartment. Keep the chamber _well ventilated_, by, from time to time, opening the window. The air of the apartment cannot be too pure; therefore, let the evacuations from the bowels be instantly removed, either to a distant part of the house, or to an out-house, or to the cellar, as it might be necessary to keep them for the medical man’s inspection.

Let there be a frequent change of linen, as in sickness it is even more necessary than in health, more especially if the complaint be fever. In an attack of fever clean sheets ought, every other day, to be put on the bed; clean body-linen every day. A frequent change of linen in sickness is most refreshing.

If the complaint be fever, a fire in the grate will not be necessary. Should it be a case either of inflammation of the lungs or of the chest, a small fire in the winter time is desirable, keeping the temperature of the room as nearly as possible at 60° Fahrenheit. Bear in mind that a large fire in a sick-room cannot be too strongly condemned; for if there be fever—and there are scarcely any complaints without—a large fire only increases it. Small fires, in cases either of inflammation of the lungs or of the chest, in the winter time, encourage ventilation of the apartment, and thus carry off impure air. If it be summer time of course fires would be improper. A thermometer is an indispensable requisite in a sick-room.

In fever, free and thorough ventilation is of vital importance, more especially in scarlet fever; then a patient cannot have too much air; in scarlet fever, for the first few days the windows, be it winter or summer, must to the widest extent be opened. The fear of the patient catching cold by doing so is one of the numerous prejudices and baseless fears that haunt the nursery, and the sooner it is exploded the better it will be for human life. The valances and bed-curtains ought to be removed, and there should be as little furniture in the room as possible.

If it be a case of measles, it will be necessary to adopt a different course; then the windows ought not to be opened, but the door must from time to time be left ajar. In a case of measles, if it be winter time, a _small_ fire in the room will be necessary. In inflammation of the lungs or of the chest, the windows should not be opened, but the door ought occasionally to be left unfastened, in order to change the air and to make it pure. Remember, then, that ventilation, either by open window or by open door, is most necessary in all diseases. Ventilation is one of the best friends a doctor has.

In fever, do not load the bed with clothes; in the summer a sheet is sufficient, in the winter a sheet and a blanket.

In fever, do not be afraid of allowing the patient plenty either of cold water or of cold toast and water; Nature will tell him when he has had enough. In measles, let the chill be taken off the toast and water.

In _croup_, have always ready a plentiful supply of hot water, in case a warm bath might be required.

In _child-crowing_, have always in the sick-room a supply of cold water, ready at a moments notice to dash upon the face.

In fever, do not let the little patient lie on the lap; he will rest more comfortably on a horse-hair mattress in his crib or cot. If he have pain in the bowels, the lap is most agreeable to him: the warmth of the body, either of the mother or of the nurse, soothes him; besides, if he be on the lap, he can be turned on his stomach and on his bowels, which often affords him great relief and comfort. If he be much emaciated, when he is nursed, place a pillow upon the lap and let him lie upon it.

In _head affections_, darken the room with a _green_ calico blind; keep the chamber more than usually quiet; let what little talking is necessary be carried on in whispers, but the less of that the better; and in _head affections_, never allow smelling-salts to be applied to the nose, as they only increase the flow of blood to the head, and consequently do harm.

It is often a good sign when a child, who is seriously ill, suddenly becomes cross. It is then he begins to feel his weakness, and to give vent to his feelings. “Children are almost always cross when recovering from an illness, however patient they may have been during its severest moments, and the phenomenon is not by any means confined to children.”[252]

A sick child must _not_ be stuffed with _much_ food at a time. He will take either a tablespoonful of new milk or a tablespoonful of chicken-broth every half hour, with greater advantage than a teacupful of either the one or the other every four hours, which large quantity would very probably be rejected from his stomach, and may cause the unfortunately treated child to die of starvation!

If a sick child be peevish, attract his attention either by a toy or by an ornament; if he be cross, win him over to good humor by love, affection, and caresses, but let it be done gently and without noise. Do not let visitors see him; they will only excite, distract, and irritate him, and help to consume the oxygen of the atmosphere, and thus rob the air of its exhilarating health-giving qualities and purity; a sick-room, therefore, is not a proper place either for visitors or for gossips.

In selecting a sick-nurse, let her be gentle, patient, cheerful, quiet, and kind, but firm withal; she ought to be neither old nor young; if she be old, she is often garrulous and prejudiced, and thinks too much of her trouble; if she be young, she is frequently thoughtless and noisy; therefore choose a middle-aged woman. Do not let there be in the sick-room more than, besides the mother, one efficient nurse; a great number can be of no service—they will only be in each other’s way, and will distract the patient.

Let stillness, especially if the head be the part affected, reign in a sick-room. Creaking shoes[253] and rustling silk dresses ought not to be worn in sick-chambers—they are quite out of place there. If the child be asleep, or if he be dozing, perfect stillness must be enjoined—not even a whisper should be heard:

“In the sick-room be calm,
Move gently and with care,
Lest any jar or sudden noise
Come sharply unaware.

You cannot tell the harm,
The mischief it may bring,
To wake the sick one suddenly,
Besides the suffering.

The broken sleep excites
Fresh pain, increased distress;
The quiet slumber undisturb’d
Soothes pain and restlessness.

Sleep is the gift of God:
Oh! bear these words at heart,—
‘He giveth his beloved sleep,’
And gently do thy part.”[254]

If there be other children, let them be removed to a distant part of the house; or, if the disease be of an infectious nature, let them be sent away from home altogether.

In all illnesses—and bear in mind the following is most important advice—a child must be encouraged to try and make water, whether he ask or not, at least four times during the twenty-four hours; and at any other time, if be expresses the slightest inclination to do so. I have known a little fellow to hold his water, to his great detriment, for twelve hours, because either the mother had in her trouble forgotten to inquire, or the child himself was either too ill or too indolent to make the attempt.

See that the medical man’s directions are, to the very letter, carried out. Do not fancy that you know better than he does, otherwise you have no business to employ him. Let him, then, have your implicit confidence and your exact obedience. What _you_ may consider to be a trifling matter, may frequently be of the utmost importance, and may sometimes decide whether the case shall either end in life or death!

_Lice._—It is not very poetical, as many of the grim facts of everyday life are not, but, unlike a great deal of poetry, it is unfortunately too true that after a severe and dangerous illness, especially after a bad attack of fever, a child’s head frequently becomes infested with vermin—with lice! It therefore behooves a mother herself to thoroughly examine, by means of a fine-tooth comb,[255] her child’s head, in order to satisfy her mind that there be no vermin there. As soon as he be well enough, he ought to resume his regular ablutions—that is to say, that he must go again regularly into his tub, and have his head every morning thoroughly washed with soap and water. A mother ought to be particular in seeing that the nurse washes the hairbrush at least once every week; if she does not do so, the dirty brush which had, during the illness, been used, might contain the “nits,”—the eggs of the lice,—and would thus propagate the vermin, as they will, when on the head of the child, soon hatch. If there be already lice on the head, in addition to the regular washing every morning with the soap and water, and after the head has been thoroughly dried, let the hair be well and plentifully dressed with camphorated oil—the oil being allowed to remain on until the next washing on the following morning. Lice cannot live in oil (more especially if, as in camphorated oil, camphor be dissolved in it), and as the camphorated oil will not, in the slightest degree, injure the hair, it is the best application that can be used. But as soon as the vermin have disappeared, let the oil be discontinued, as the _natural_ oil of the hair is, at other times, the only oil that is required on the head.

The “nit”—the egg of the louse—might be distinguished from scurf (although to the _naked_ eye it is very much like it in appearance) by the former fastening firmly on one of the hairs as a barnacle would on a rock, and by it not being readily brushed off as scurf would, which latter (scurf) is always loose.

254. _My child, in the summer time, is much tormented with fleas: what are the best remedies?_

A small muslin bag, filled with camphor, placed in the cot or bed, will drive fleas away. Each flea-bite should, from time to time, be dressed by means of a camel’s-hair brush, with a drop or two of spirit of camphor, an ounce bottle of which ought, for the purpose, to be procured from a chemist. Camphor is also an excellent remedy to prevent bugs from biting. Bugs and fleas have a horror of camphor; and well they might, for it is death to them!

There is a famous remedy for the destruction of fleas manufactured in France, entitled “_La Poudre Insecticide_,” which, although perfectly harmless to the human economy, is utterly destructive to fleas. Bugs are best destroyed by oil of turpentine; the places they do love to congregate in should be well saturated, by means of a brush, with the oil of turpentine. A few dressings will effectually destroy both them and their young ones.

255. _Suppose a child to have had an attack either of inflammation of the lungs or of bronchitis, and to be much predisposed to a return: what precautions would you take to prevent either the one or the other for the future?_

I would recommend him to wear fine flannel instead of lawn shirts; to wear good lamb’s-wool stockings _above the knees_, and good, strong, dry shoes to his feet; to live, weather permitting, a great part of every day in the open air; to strengthen his system by good nourishing food—by an abundance of both milk and meat (the former especially); to send him, in the autumn, for a couple of months, to the sea-side; to administer to him, from time to time, cod-liver oil; in short, to think only of his health, and to let learning, until he be stronger, be left alone.

I also advise either table salt or bay salt to be added to the water in which the child is washed with in the morning, in a similar manner as recommended in answer to the 123d question.

256. _Then do you not advise such a child to be confined within doors?_

If any inflammation be present, or if he have but just recovered from one, it would be improper to send him into the open air, but not otherwise, as the fresh air would be a likely means of strengthening the lungs, and thereby of preventing an attack of inflammation for the future. Besides, the more a child is coddled within doors, the more likely will he be to catch cold, and to renew the inflammation. If the weather be cold, yet neither wet nor damp, he ought to be sent out, but let him be well clothed; and the nurse should have strict injunctions _not_ to stand about entries, or in any draughts—indeed, not to stand about at all, but to keep walking about all the time she is in the open air. Unless you have a trustworthy nurse, it will be well for you either to accompany her in her walk with your child, or merely to allow her to walk with him in the garden, as you can then keep your eye upon both of them.

257. _If a child be either chicken-breasted, or if he be narrow-chested, are there any means of expanding and of strengthening his chest?_

Learning ought to be put out of the question; attention must be paid to his health alone, or consumption will probably mark him as its own! Let him live as much as possible in the open air; if it be country, so much the better. Let him rise early in the morning, and let him go to bed betimes; and if he be old enough to use the dumb-bells, or, what is better, an india-rubber chest expander, he should do so daily. He ought also to be encouraged to use two short sticks, similar to, but heavier than, a policeman’s staff, and to go, every morning, through regular exercises with them. As soon as he be old enough, let him have lessons from a drill-sergeant and from a dancing-master. Let him be made both to walk and to sit upright, and let him be kept as much as possible upon a milk diet,[256] and give him as much as he can eat of fresh meat every day. Cod-liver oil, a teaspoonful or a dessertspoonful, according to his age, twice a day, is serviceable in these cases. Stimulants ought to be carefully avoided. In short, let every means be used to nourish, to strengthen, and invigorate the system, without at the same time creating fever. Such a child should be a child of nature; he ought almost to live in the open air, and throw his books to the winds. Of what use is learning without health? In such a case as this you cannot have both.

258. _If a child be round-shouldered, or if either of his shoulder-blades have “grown out,” what had better be done?_

Many children have either round shoulders, or have their shoulder-blades grown out, or have their spines twisted, from growing too fast, from being allowed to slouch in their gait, and from not having sufficient nourishing food, such as meat and milk, to support them while the rapid growth of childhood is going on.

If your child be affected as above described, nourish him well on milk and on farinaceous food, and on meat once a day, but let milk be his staple diet; he ought, during the twenty-four hours, to take two or three pints of new milk. He should almost live in the open air, and must have plenty of play. If you can so contrive it, let him live in the country. When tired, let him lie, for half an hour, two or three times daily, flat on his back on the carpet. Let him rest at night on a horse-hair mattress, and not on a feather bed.

Let him have every morning, if it be summer, a thorough cold water ablution; if it be winter, let the water be made tepid. Let either two handfuls of table salt or a handful of bay salt be dissolved in the water. Let the salt and water stream well over his shoulders and down his back and loins. Let him be well dried with a moderately coarse towel, and then let his back be well rubbed, and his shoulders be thrown back—exercising them, much in the same manner as in skipping, for five or ten minutes at a time. Skipping, by-the-by, is of great use in these cases, whether the child be either a boy or a girl—using, of course, the rope backward, and not forward.

Let books be utterly discarded until his shoulders have become strong, and thus no longer round, and his shoulder-blades have become straight. It is a painful sight to see a child stoop like an old man.

Let him have twice daily a teaspoonful or a dessertspoonful (according to his age) of cod-liver oil.

When he is old enough, let the drill-sergeant give him regular lessons, and let the dancing-master be put in requisition. Let him go through regular gymnastic exercises, provided they are not of a violent character.

But, bear in mind, let there be in these cases no mechanical restraints—no shoulder-straps, no abominable stays. Make him straight by natural means—by making him strong. Mechanical means would only, by weakening and wasting the muscles, increase the mischief, and thus the deformity. In this world of ours there is too much reliance placed on artificial, and too little on natural means of cure.

259. _What are the causes of Bow Legs in a child; and what is the treatment?_

Weakness of constitution, poor and insufficient nourishment, and putting a child, more especially a fat and heavy one, on his legs too early.

_Treatment._—Nourishing food, such as an abundance of milk, and, if he be old enough, of meat; iron medicines; cod-liver oil; thorough ablution, every morning, of the whole body; an abundance of exercise either on pony, or on donkey, or in carriage, but not, until his legs be stronger, on foot. If they are much bowed, it will be necessary to consult an experienced surgeon.

260. _If a child, while asleep, “wet his bed,” is there any method of preventing him from doing so?_

Let him be held out just before he himself goes to bed, and again when the family retires to rest. If, at the time, he be asleep, he will become so accustomed to it that he will, without awaking, make water. He ought to be made to lie on his side; for, if he be put on his back, the urine will rest upon an irritable part of the bladder, and, if he be inclined to wet his bed, he will not be able to avoid doing so. He must not be allowed to drink much with his meals, especially with his supper. Wetting the bed is an infirmity with some children—they cannot help it. It is, therefore, cruel to scold and chastise them for it. Occasionally, however, wetting the bed arises from idleness, in which case, of course, a little wholesome correction might be necessary.

A waterproof cloth,[257] or bed-sheeting, as it is sometimes called—one yard by three-quarters of a yard—will effectually preserve the bed from being wetted, and ought always, on these occasions, to be used.

A mother ought, every morning, to ascertain for herself whether her child have wet his bed; if he have, and if unfortunately the waterproof cloth have not been used, the mattress, sheets, and blankets must be instantly taken to the kitchen fire and be properly dried. Inattention to the above has frequently caused a child to suffer, either from a cold, from a fever, or from an inflammation; not only so, but if they be not dried, he is wallowing in filth and in an offensive effluvium. If both mother and nurse were more attentive to their duties—in frequently holding a child out, whether he asks or not—a child wetting his bed would be the exception, and not, as it frequently is, the rule. If a child be dirty, you may depend upon it the right persons to blame are the mother and the nurse, and not the child!

261. _If a child should catch Small-pox, what are the best means to prevent pitting?_

He ought to be desired neither to pick nor to rub the pustules. If he be too young to attend to these directions, his hands must be secured in bags (just large enough to hold them), which bags should be fastened round the wrists. The nails must be cut very close.

Cream smeared by means of a feather, frequently in the day, on the pustules, affords great comfort and benefit. Tripe-liquor has, for the same purpose, been strongly recommended. I, myself, in several cases have tried it, and with the happiest results. It is most soothing, comforting, and healing to the skin.

262. _Can you tell me of any plan to prevent Chilblains, or, if a child be suffering from them, to cure them?_

_First, then, the way to prevent them._—Let a child, who is subject to them, wear, in the winter time, a square piece of wash-leather over the toes, a pair of warm lamb’s-wool stockings, and good shoes; but, above all, let him be encouraged to run about the house as much as possible, especially before going to bed; and on no account allow him either to warm his feet before the fire, or to bathe them in _hot_ water. If the feet be cold, and the child be too young to take exercise, then let them be well rubbed with the warm hand. If adults suffer from chilblains, I have found friction, night and morning, with horse-hair flesh-gloves, the best means of preventing them.

_Secondly, the way to cure them._—_If they be unbroken_, let them be well rubbed, every night and morning, with spirits of turpentine and camphorated oil,[258] first shaking the bottle, and then let them be covered with a piece of lint, over which a piece of wash-leather should be placed. “An excellent chilblain remedy is made by shaking well together, in a bottle, spirits of turpentine, white vinegar, and the contents of an egg, in equal proportion. With this the chilblains should be rubbed gently whenever they are in a state of irritation, and until the swelling and redness are dissipated.”[259]

_If they be broken_, let a piece of lint be spread with spermaceti cerate, and be applied, every morning, to the part, and let a white-bread poultice be used every night.

263. _During the winter time my child’s hands, legs, etc. chap very much: what ought I to do?_

Let a teacupful of bran be tied up in a muslin bag, and be put, over night, into either a large water-can or jug of _rain_ water;[260] and let this water from the can or jug be the water he is to be washed with on the following morning, and every morning until the chaps be cured. As often as water is withdrawn, either from the water-can or from the jug, let fresh rain water take its place, in order that the bran may be constantly soaking in it. The bran in the bag should be renewed about twice a week.

Take particular care to dry the skin well every time he be washed; then, after each ablution, as well as every night at bedtime, rub a piece of deer’s suet over the parts affected: a few dressings will perform a cure. The deer’s suet may be bought at any of the shops where venison is sold. Another excellent remedy is glycerin,[261] which should be smeared, by means of the finger or by a camel’s-hair brush, on the parts affected, two or three times a day. If the child be very young, it might be necessary to dilute the glycerin with rosewater: fill a small bottle one-third with glycerin, and fill up the remaining two-thirds of the bottle with rosewater—shaking the bottle every time just before using it. The best soap to use for chapped hands is the glycerin soap: no other being required.

264. _What is the best remedy for Chapped Lips?_

Cold-cream (which may be procured of any respectable chemist) is an excellent application for _chapped lips_. It ought, by means of the finger, to be frequently smeared on the parts affected.

265. _Have the goodness to inform me of the different varieties of Worms that infest a child’s bowels?_

Principally three—1, The tape-worm; 2, the long round-worm; and 3, the most frequent of all, the common thread or maw-worm. The tape-worm infests the whole course of the bowels, both small and large: the long round-worm, principally the small bowels, occasionally the stomach; it sometimes crawls out of the child’s mouth, causing alarm to the mother; there is, of course, no danger in its doing so: the common thread-worm or maw-worm infests the rectum or fundament.

266. _What are the causes of Worms?_

The causes of worms are—weak bowels; bad and improper food, such as unripe, unsound, or uncooked fruit, and much green vegetables; pork, especially underdone pork;[262] an abundance of sweets; the neglecting of giving salt in the food.

267. _What are the symptoms and the treatment of Worms?_

_The symptoms_ of worms are—emaciation; itching and picking of the nose; a dark mark under the eyes; grating, during sleep, of the teeth; starting in the sleep; foul breath; furred tongue; uncertain appetite—sometimes voracious, at other times bad, the little patient sitting down very hungry to his dinner, and before scarcely tasting a mouthful, the appetite vanishing; large bowels; colicky pains of the bowels; slimy motions; itching of the fundament. Tape-worm and round-worm, more especially the former, are apt, in children, to produce convulsions. Tape-worm is very weakening to the constitution, and usually causes great emaciation and general ill health; the sooner therefore it is expelled from the bowels the better it will be for the patient.

Many of the obscure diseases of children arise from worms. In all doubtful cases, therefore, this fact should be borne in mind, in order that a thorough investigation may be instituted.

With regard to _treatment_, a medical man ought, of course, to be consulted. He will soon use means both to dislodge them, and to prevent a future recurrence of them.

Let me caution a mother never to give her child patent medicines for the destruction of worms. There is one favorite quack powder, which is composed principally of large doses of calomel, and which is quite as likely to destroy the patient as the worms! No, if your child have worms, put him under the care of a judicious medical man, who will soon expel them, without, at the same time, injuring health and constitution!

268. _How may Worms be prevented from infesting a child’s bowels?_

Worms generally infest _weak_ bowels; hence, the moment a child becomes strong worms cease to exist. The reason why a child is so subject to them is owing to the improper food which is usually given to him. When he be stuffed with unsound and with unripe fruits, with much sweets, with rich puddings, and with pastry, and when he is oftentimes allowed to eat his meat _without_ salt, and to _bolt_ his food without chewing it, is there any wonder that he should suffer from worms? The way to prevent them is to avoid such things, and, at the same time, to give him plenty of salt to his _fresh_ and well-cooked meat. Salt strengthens and assists digestion, and is absolutely necessary to the human economy. Salt is emphatically a worm-destroyer. The truth of this statement may be readily tested by sprinkling a little salt on the common earthworm. “What a comfort and real requisite to human life is salt! It enters into the constituents of the human blood, and to do without it is wholly impossible.”[263] To do without it is wholly impossible! These are true words. Look well to it, therefore, ye mothers, and beware of the consequences of neglecting such advice, and see for yourselves that your children regularly eat salt with their food. If they neglect eating salt with their food, _they must, of necessity, have worms_, and worms that will eventually injure them and make them miserable.

269. _You have a great objection to the frequent administration of aperient medicines to a child: can you devise any method to prevent their use?_

Although we can scarcely call constipation a disease, yet it sometimes leads to disease. The frequent giving of aperients only adds to the stubbornness of the bowels.

I have generally found a draught, early every morning, of _cold_ pump-water, the eating either of loaf gingerbread or of oatmeal gingerbread, a variety of animal and vegetable food, ripe sound fruit, Muscatel raisins, a fig, or an orange after dinner, and, when he be old enough, _coffee_ and milk instead of _tea_ and milk, to have the desired effect, more especially if, for a time, aperients be studiously avoided.

270. _Have you any remarks to make on Rickets?_

Rickets is owing to a want of a sufficient quantity of earthy matter in the bones; hence the bones bend and twist, and lose their shape, causing deformity. Rickets generally begins to show itself between the first and second years of a child’s life. Such children are generally late in cutting their teeth, and when the teeth do come, they are bad, deficient of enamel, discolored, and readily decay. A rickety child is generally stunted in stature; he has a large head, with overhanging forehead, or what nurses call a watery-head-shaped forehead. The fontanelles, or openings of the head as they are called, are a long time in closing. A rickety child is usually talented; his brain seems to thrive at the expense of his general health. His breast-bone projects out, and the sides of his chest are flattened—hence he becomes what is called chicken-breasted or pigeon-breasted; his spine is usually twisted, so that he is quite awry, and, in a bad case, he is hump-backed; the ribs, from the twisted spine, on one side bulge out; he is round-shouldered; the long bones of his body, being soft, bend; he is bow-legged, knock-kneed, and weak ankled.

Rickets are of various degrees of intensity, the hump-backed being among the worst. There are many mild forms of rickets; weak ankles, knocked-knees, bowed-legs, chicken-breasts, being among the latter number. Many a child, who is not exactly hump-backed, is very round-shouldered, which latter is also a mild species of rickets.

Show me a child that is rickety, and I can generally prove that it is owing to poor living, more especially to poor milk. If milk were always genuine, and if a child had an abundance of it, my belief is that rickets would be a very rare disease. The importance of genuine milk is of national importance. We cannot have a race of strong men and women unless, as children, they have had a good and plentiful supply of milk. It is utterly impossible. Milk might well be considered one of the necessaries of a child’s existence.

Genuine fresh milk, then, is one of the grand preventives, as well as one of the best remedies, for rickets. Many a child would not now have to swallow quantities of cod-liver oil if previously he had imbibed quantities of good genuine milk. An insufficient and a poor supply of milk in childhood sows the seeds of many diseases, and death often gathers the fruit. Can it be wondered at, when there is so much poor and nasty milk in England, that rickets in one shape or another is so prevalent?

When will mothers arouse from their slumbers, rub their eyes, and see clearly the importance of the subject? When will they know that all the symptoms of rickets I have just enumerated _usually_ proceed from the want of nourishment, more especially from the want of genuine and of an abundance of milk? There are, of course, other means of warding off rickets besides an abundance of nourishing food, such as thorough ablution, plenty of air, exercise, play, and sunshine; but of all these splendid remedies, nourishment stands at the top of the list.

I do not mean to say that rickets _always_ proceeds from poorness of living—from poor milk. It sometimes arises from scrofula, and is an inheritance of one or of both the parents.

Rickety children, if not both carefully watched and managed, frequently, when they become youths, die of consumption. A mother, who has for some time neglected the advice I have just given, will often find, to her grievous cost, that the mischief has, past remedy, been done, and that it is now “too late!—too late!”

271. _How may a child be prevented from becoming Rickety? or, if he be Rickety, how ought he to be treated?_

If a child be predisposed to be rickety, or if he be actually rickety, attend to the following rules:

Let him live well, on good nourishing diet, such as on tender rump-steaks, cut very fine, and mixed with mashed potatoes, crumb of bread, and with the gravy of the meat. Let him have, as I have before advised, an abundance of good new milk—a quart or three pints during every twenty-four hours. Let him have milk in every form—as milk gruel, Du Barry’s Arabica revalenta made with milk, batter and rice puddings, suet-pudding, bread and milk, etc.

_To harden the bones_, let lime-water be added to the milk (a tablespoonful to each teacupful of milk).

Let him have a good supply of fresh, pure, dry air. He must almost live in the open air—the country, if practicable, in preference to the town, and the coast in summer and autumn. Sea bathing and sea breezes are often, in these cases, of inestimable value.

He ought not, at an early age, to be allowed to bear his weight upon his legs. He must sleep on a horse-hair mattress, and not on a feather bed. He should use, every morning, cold baths in the summer, and tepid baths in the winter, with bay salt (a handful) dissolved in the water.

Friction with the hand must, for half an hour at a time, every night and morning, be sedulously applied to the back and to the limbs. It is wonderful how much good in these cases friction does.

Strict attention ought to be paid to the rules of health as laid down in these Conversations. Whatever is conducive to the general health is preventive and curative of rickets.

Books, if he be old enough to read them, should be thrown aside; health, and health alone, must be the one grand object.

The best medicines in these cases are a combination of cod-liver oil and the wine of iron, given in the following manner: Put a teaspoonful of wine of iron into a wineglass, half fill the glass with water, sweeten it with a lump or two of sugar, then let a teaspoonful of cod-liver oil swim on the top; let the child drink it all down together, twice or three times a day. An hour after a meal is the _best_ time to give the medicine, as both iron and cod-liver oil sit better on a _full_ than on an _empty_ stomach. The child in a short time will become fond of the above medicine, and will be sorry when it is discontinued.

A case of rickets requires great patience and steady perseverance; let, therefore, the above plan have a fair and long-continued trial, and I can then promise that there will be every probability that great benefit will be derived from it.

272. _If a child be subject to a scabby eruption about the mouth, what is the best local application?_

Leave it to Nature. Do not, on any account, apply any local application to heal it; if you do, you may produce injury; you may either bring on an attack of inflammation, or you may throw him into convulsions. No! This “breaking-out” is frequently a safety-valve, and must not therefore be needlessly interfered with. Should the eruption be severe, reduce the child’s diet; keep him from butter, from gravy, and from fat meat, or, indeed, for a few days from meat altogether; and give him mild aperient medicine; but, above all things, do not quack him either with calomel or with gray powder.

273. _Will you have the goodness to describe the eruption on the face and on the head of a young child, called Milk-Crust or Running Scall?_

Milk-crust is a complaint of very young children—of those who are cutting their teeth—and as it is a nasty-looking complaint, and frequently gives a mother a great deal of trouble, of anxiety, and annoyance, it will be well that you should know its symptoms, its causes, and its probable duration.

_Symptoms._—When a child is about nine months or a year old, small pimples are apt to break out around the ears, on the forehead, and on the head. These pimples at length become vesicles (that is to say, they contain water), which run into one large one, break, and form a nasty dirty-looking yellowish, and sometimes greenish scab, which scab is moist, indeed, sometimes quite wet, and gives out a disagreeable odor, and which is sometimes so large on the head as actually to form a skull-cap, and so extensive on the face as to form a mask! These, I am happy to say, are rare cases. The child’s beauty is, of course, for a time completely destroyed, and not only his beauty, but his good temper; for as the eruption causes great irritation and itching, he is constantly clawing himself, and crying with annoyance a great part of the day, and sometimes also of the night, the eruption preventing him from sleeping. It is not contagious, and soon after he has cut the whole of his _first_ set of teeth, it will get well, provided it has not been improperly interfered with.

_Causes._—Irritation from teething; stuffing him with overmuch meat, thus producing a humor, which Nature tries to get rid of by throwing it out on the surface of the body, the safest place she could fix on for the purpose, hence the folly and danger of giving medicines and applying _external_ applications to drive the eruption in. “Diseased nature oftentimes breaks forth in strange eruptions,”[264] and cures herself in this way, if she be not too much interfered with, and if the eruption be not driven in by injudicious treatment. I have known in such cases disastrous consequences to follow over-officiousness and meddlesomeness. Nature is trying all she can to drive the humor out, while some wiseacres are doing all they can to drive the humor in.

_Duration._—As milk-crust is a tedious affair, and will require a variety of treatment, it will be necessary to consult an experienced medical man; and although he will be able to afford great relief, the child will not, in all probability, be quite free from the eruption until he has cut the whole of his first set of teeth—until he be upwards of two years and a half old—when, with judicious and careful treatment, it will gradually disappear, and eventually leave not a trace behind.

It will be far better to leave the case alone—to get well of itself rather than to try to cure the complaint either by outward applications or by strong internal medicines; “the remedy is often worse than the disease,” of this I am quite convinced.

274. _Have you any advice to give me as to my conduct toward my medical man?_

Give him your entire confidence. Be truthful and be candid with him. Tell him the truth, the whole truth, and nothing but the truth. Have no reservations; give him, as near as you can, a plain, unvarnished statement of the symptoms of the disease. Do not magnify, and do not make too light of any of them. Be prepared to state the exact time the child first showed symptoms of illness. If he have had a shivering fit, however slight, do not fail to tell your medical man of it. Note the state of the skin; if there be a “breaking-out,” be it ever so trifling, let it be pointed out to him. Make yourself acquainted with the quantity and with the appearance of the urine, taking care to have a little of it saved, in case the doctor may wish to see and examine it. Take notice of the state of the motions—their number during the twenty-four hours, their color, their smell, and their consistence, keeping one for his inspection. Never leave any of these questions to be answered by a servant; a mother is the proper person to give the necessary and truthful answers, which answers frequently decide the fate of the patient. Bear in mind, then, a mother’s untiring care and love, attention and truthfulness, frequently decide whether, in a serious illness, the little fellow shall live or die! Fearful responsibility!