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Title: Advice to a wife and mother in two parts

Embracing advice to a wife, and advice to a mother

Author: Pye Henry Chavasse

Release date: October 15, 2023 [eBook #71887]

Language: English

Original publication: Philadelphia: J. B. Lippincott & Co, 1881

Credits: Richard Tonsing, MFR, and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)

*** START OF THE PROJECT GUTENBERG EBOOK ADVICE TO A WIFE AND MOTHER IN TWO PARTS ***

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New original cover art included with this eBook is granted to the public domain.

ADVICE
TO A
WIFE AND MOTHER.
IN TWO PARTS.
EMBRACING
ADVICE TO A WIFE,
AND
ADVICE TO A MOTHER.

BY
PYE HENRY CHAVASSE.
SEVENTEENTH EDITION.
PHILADELPHIA:
J. B. LIPPINCOTT & CO.
1881.

ADVICE TO A WIFE
ON THE
MANAGEMENT OF HER OWN HEALTH,
AND ON THE
TREATMENT OF SOME OF THE COMPLAINTS
INCIDENTAL TO
PREGNANCY, LABOR, AND SUCKLING;
WITH AN
INTRODUCTORY CHAPTER ESPECIALLY ADDRESSED TO A YOUNG WIFE.

BY
PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A MOTHER ON THE MANAGEMENT OF HER CHILDREN.”
“Thy wife shall be as the fruitful vine upon the walls of thine house.”
SEVENTEENTH EDITION.
PHILADELPHIA:
J. B. LIPPINCOTT & CO.
1881.
iiiTO
MY BIRMINGHAM PATIENTS,
MANY OF WHOM I HAVE ATTENDED FOR A PERIOD OF UPWARDS OF THIRTY YEARS; SOME OF WHOM, HAVING USHERED INTO THE WORLD, I AFTERWARD ATTENDED IN THEIR OWN CONFINEMENTS; AND FROM ALL OF WHOM I HAVE RECEIVED SO MUCH CONFIDENCE, COURTESY, AND KINDNESS,
This little Volume is Dedicated,
BY THEIR SINCERE FRIEND,
PYE HENRY CHAVASSE
Priory House, Old Square,
Birmingham.
v

PREFACE.

The sale of copies of this book is now to be reckoned by its tens of thousands! The last, the Seventh Edition, comprising five thousand copies, has been rapidly exhausted; a new Edition, the Eighth, is now urgently called for; and as the sale of the work is so enormous, and so extending, my worthy Publishers have deemed it advisable to publish of this edition at once seven thousand copies,—thus making of the two last editions alone twelve thousand copies; the two last editions being, in fact, equal to twelve ordinary editions! Moreover, this book has made me troops of friends, thus proving how much such a work was needed, and how thoroughly my humble efforts have been appreciated.

I have, in the Introductory Chapter especially addressed to a Young Wife, had some plain and unpalatable truths to tell; but it is absolutely necessary for a surgeon to probe a serious and deep-seated wound to the bottom before he can perform a cure; he is sometimes compelled to give pain before he can cure pain; he is frequently obliged to administer bitter medicine before sweet health can be restored. I have not shrunk from my duty; I have not uttered an “uncertain sound:” but have, without fear or favor, boldly spoken out, and have proclaimed what I have deemed to be the truth; the vital importance of my subject must excuse my plain-speaking and earnestness. When a person is on the edge of a precipice, and is ready at any moment to topple over, the viwords of warning must not be in the tones of a whisper, bland and gentle, but in the voice of thunder, bold and decisive. I have had to discourse on matters of the greatest moment to the well-being of wives; and have, therefore, in order not to be misapprehended, had to call things by their right names—the subject being of far too much importance to write in a namby-pamby style, or to use any other language than that of the plainest English.

The Introductory Chapter is, I trust, greatly improved; many of the quotations are either curtailed, or are altogether suppressed, in order to make room, without materially increasing the size of the book, for much new and important matter. The remaining pages have all been carefully revised and corrected, and made more clear, and additional advice, where needed, has been supplied. I therefore hope that this edition will be still more worthy of its great and extending success, and be the humble instrument of sowing broadcast through our land advice most necessary for wives to know; and at the same time be the means of dispelling prejudices which, in the lying-in room, are even, in this our day, most rife and injurious.

Barren wives! delicate wives! unhealthy wives! are the order of the day—are become institutions of the country—are so common as not to be considered strange, but to be, as a matter of course, as part and parcel of our everyday life! Should such things be? I emphatically say No! But then a thorough change, a complete reformation, must take place in the life and habits of a wife. It is no use blinking the question; the truth, the whole truth, must come out, and the sooner it is told the better. Oh! it is sad that the glorious mission of a wife should, as it often does, end so ingloriously! Broken health, neglected duties, a childless home, blighted hopes, misery, and discontent. What an awful catalogue of the consequences of luxury, of stimulants, of fashion, of ignorance, and of indolence—the five principal wife and babe viidestroyers! Sure I am that the foregoing melancholy results may, in the generality of cases, by timely and judicious treatment, be prevented.

This is an age of stimulants—’tis the curse of the day; wine, in excess, instead of being an element of strength, is one of weakness; instead of encouraging fecundity, is one of its greatest preventives. A lady who drinks daily five or six glasses of wine, is invariably weak, low, hysterical, and “nervous,”—complaining that she can neither eat, nor sleep, nor take exercise; she is totally unfit for the duties and responsibilities of either wife or mother. I shall endeavor in the following pages to prove the truth of these bold assertions.

Many young married ladies now drink as much wine in a day as their grandmothers did in a week; and which I verily believe is one cause of so few children, and of so much barrenness among them. It is no use: the subject is too important to allow false delicacy to stand in the way of this announcement; the truth must be told; the ulcer which is eating into the vitals of society must be probed; the danger, the folly, the wickedness of the system must be laid bare; the battle must be fought; and as no medical man has come forward to begin the conflict, I myself boldly throw down the gauntlet, and will, to the best of my strength and ability, do battle in the cause.

It is the abuse and not the use of wine that I am contending against. I am not advocating teetotal principles—certainly not. The one system is as absurd and as wrong as the other; extremes, either way, are most injurious to the constitution both of man and woman. The advice of St. Paul is glorious advice: “Use a little wine for thy stomach’s sake and thine often infirmities;” and again, when he says, “be temperate in all things.” These are my sentiments, and which I have, in the following pages, so earnestly contended for.

A lady who “eats without refreshment, and slumbers without repose,” is deeply to be pitied, even though she be as rich viiias Crœsus, or as beautiful as Venus! Nothing can compensate for the want of either sleep or appetite; life without proper appetite and without refreshing sleep will soon become a wearisome burden too heavy to bear. It is high time, when there are so many of the Young Wives of England, alas! too many, who daily “eat without refreshment,” and who nightly “slumber without repose,” that the subject was thoroughly looked into, and that proper means were suggested to abate the calamity. One of the principal objects of this book is to throw light upon the subject, and to counsel measures to remedy the evil.

The large number of barren wives in England has, in these pages, had my careful and earnest consideration. I have endeavored, to the best of my ability, to point out, as far as the wives themselves are concerned, many of the causes, and have advised remedies to abate the same. It is quite time, when the health among the wives of the higher classes is so much below par, and when children among them are so few, that the causes should be thoroughly inquired into, and that the treatment should be extensively made known. The subject is of immense, indeed I might even say, of national importance, and demands deep and earnest thought and careful investigation, as the strength and sinews of a nation depend mainly upon the number and healthfulness of her children.

Barren land can generally, with care and skill, be made fertile; an unfruitful vine can frequently, by an experienced gardener, be converted into a fruit-bearing one; a childless wife can often, by judicious treatment, be made a child-bearing one. Few things in this world are impossible: “where there is a will there is generally a way;” but if there be a will, it must be a determined and a persevering will; if there be a way, the way, however rough and rugged, must be trodden,—the rough and rugged path will, as she advances onward, become smooth and pleasant.

It is not the poor woman, who works hard and who lives ixhard, that is usually barren—certainly not: she has generally an abundance of children; but it is the rich lady—the one who is indolent, who lives luxuriously, and fares sumptuously every day—who leads a fashionable, and therefore an unnatural life—who turns night into day, who at night breathes suffocatingly hot rooms, who lives in a whirl of excitement, who retires not to rest until the small hours of the morning,—such a one is the one that is frequently barren; and well she might be,—it would be most strange if she were not so. One of the objects of this book will be to point out these causes, and to suggest remedies for the same, and thus to stem the torrent, and in some measure to do away with the curse of barrenness which in England, at the present time, so fearfully prevails.

I have undertaken a responsible task, but have thrown my whole energy and ability into it; I therefore have no excuse to make that I have not thought earnestly and well upon the subject, or that I have written unadvisedly; my thoughts and studies have for years been directed to these matters. I earnestly hope, then, that I have not written in vain, but that the seeds now sown will, in due time, bring forth much fruit.

Although my two books—Advice to a Wife and Advice to a Mother—are published as separate works, they might, in point of fact, be considered as one volume—one only being the continuation of the other. Advice to a Wife, treating on a mother’s own health, being, as it were, a preparation for Advice to a Mother on the management of her children’s health; it is quite necessary that the mother herself should be healthy to have healthy children; and if she have healthy offspring, it is equally important that she should be made thoroughly acquainted how to keep them in health. The object of Advice to a Wife and Advice to a Mother is for that end; indeed, the acquisition and the preservation of sound health, of mother and of child, have, in both my books, been my earnest endeavor, my constant theme, the beginning and xthe ending, the sum and the substance of my discourse, on which all else beside hinges.

I again resign this book into the hands of my fair readers, hoping that it may be of profit and of service to them during the whole period of their wifehood; and especially during the most interesting part of their lives—in their hour of anguish and of trial; and that it may be the humble means of making a barren woman “to be a joyful mother of children.”

PYE HENRY CHAVASSE
Priory House, Old Square,
Birmingham.
xi

CONTENTS.

PAGES
Dedication iii
Preface to Eighth Edition v–x
Introductory Chapter 13–102
   
PART I.
On Menstruation 103–116
   
PART II.
On Pregnancy 117–198
   
PART III.
On Labor 199–254
   
PART IV.
On Suckling 255–300
   
Index 301–309
13
Advice to a Wife.

A good wife is Heaven’s last, best gift to man—his angel and minister of graces innumerable—his gem of many virtues—his casket of jewels. Her voice is sweet music, her smiles his brightest day, her kiss the guardian of his innocence, her arms the pale of his safety, the balm of his health, the balsam of his life; her industry his surest wealth, her economy his safest steward, her lips his faithful counselors, her bosom the softest pillow of his cares, and her prayers the ablest advocate of Heaven’s blessings on his head.Jeremy Taylor.

Of earthly goods, the best is a good Wife;
A bad, the bitterest curse of human life.Simonides.

INTRODUCTORY CHAPTER.

1. It may be well—before I enter on the subjects of menstruation, of pregnancy, of labor, and suckling—to offer a few preliminary observations, especially addressed to a Young Wife.

2. My subject is health—the care, the restoration, and the preservation of health—one of the most glorious subjects that can be brought before a human being, and one that should engross much of our time and of our attention, and one that cannot be secured unless 14it be properly attended to. The human frame is, as every one knows, constantly liable to be out of order; it would be strange, indeed, if a beautiful and complex instrument like the human body were not occasionally out of tune:

“Strange that a harp with a thousand strings
Should keep in tune so long.”

3. The advice I am about to offer to my fair reader is of the greatest importance, and demands her deepest attention. How many wives are there with broken health, with feeble constitutions, and with childless homes! Their number is legion! It is painful to contemplate that, in our country, there are far more unhealthy than healthy wives! There must surely be numerous causes for such a state of things! A woman, born with every perfection, to be full of bodily infirmities! It was ordained by the Almighty that wives should be fruitful and multiply! Surely there must be something wrong in the present system if they do not do so!

4. It will, in the following pages, be my object to point out many of the causes of so much ill health among wives; ill health that sometimes leads to barrenness; and to suggest remedies both for the prevention and for the cure of such causes.

5. It is an astounding and lamentable fact, that one out of eight—that twelve and a half per cent. of all the wives of England are barren, are childless! A large 15majority of this twelve and a half per cent. might be made fruitful, if a more judicious plan of procedure than is at present pursued were adopted.

6. My anxious endeavors, in the following pages, will be to point out remedies for the evil, and to lay down rules—rules which, I hope, my fair reader will strenuously follow.

7. My theme, then, is Health—the Health of Wives—and the object I shall constantly have in view will be the best means both of preserving it and of restoring it when lost. By making a wife strong, she will not only, in the majority of cases, be made fruitful, but capable of bringing healthy children into the world. This latter inducement is of great importance; for puny children are not only an anxiety to their parents, but a misery to themselves, and a trouble to all around! Besides, it is the children of England that are to be her future men and women—her glory and her greatness! How desirable it is, then, that her children should be hardy and strong!

8. A wife may be likened to a fruit tree, a child to its fruit. We all know that it is as impossible to have fine fruit from an unhealthy tree as to have a fine child from an unhealthy mother. In the one case, the tree either does not bear fruit at all—is barren—or it bears undersized, tasteless fruit,—fruit which often either immaturely drops from the tree, or, if plucked from the tree, is useless; in the other case, the wife either does 16not bear children—she is barren—or she has frequent miscarriages—“untimely fruit”—or she bears puny, sickly children, who often either drop into an early grave, or, if they live, probably drag out a miserable existence. You may as well expect “to gather grapes of thorns, or figs of thistles,” as healthy children from unhealthy parents!

9. Unhealthy parents, then, as a matter of course have unhealthy children; this is as truly the case as the night follows the day, and should deter both man and woman so circumstanced from marrying. There are numerous other complaints besides scrofula and insanity inherited and propagated by parents. It is a fearful responsibility, both to men and women, if they be not healthy, to marry. The result must, as a matter of course, be misery!

10. If a wife is to be healthy and strong, she must use the means—she must sow before she can reap; health will not come by merely wishing for it! The means are not always at first agreeable; but, like many other things, habit makes them so. Early rising, for instance, is not agreeable to the lazy, and to one fond of her bed; but it is essentially necessary to sound health. Exercise is not agreeable to the indolent; but no woman can be really strong without it. Thorough ablution of the whole body is distasteful and troublesome to one not accustomed to much washing—to one laboring under a kind of hydrophobia; but there is no perfect health without the daily cleansing of the whole skin.

1711. But all these processes entail trouble. True: is anything in this world to be done without trouble? and is not the acquisition of precious health worth trouble? Yes, it is worth more than all our other acquisitions put together! Life without health is a burden; life with health is a joy and gladness! Up, then, and arouse yourself, and be doing! No time is to be lost if you wish to be well, to be a mother, and to be a mother of healthy children. The misfortune of it is, many ladies are more than half asleep, and are not aroused to danger till danger stares them in the face; they are not cognizant of ill health slowly creeping upon them, until, in too many cases, the time is gone by for relief, and ill health has become confirmed—has become a part and parcel of themselves; they do not lock the stable until the steed be stolen; they do not use the means until the means are of no avail:

“Our remedies oft in ourselves do lie,
Which we ascribe to Heaven: the fated sky
Gives us free scope; only doth backward pull
Our slow designs, when we ourselves are dull.”[1]

12. Idleness is the mother of many diseases; she breeds them, feeds them, and fosters them, and is, moreover, a great enemy to fecundity. Idleness makes people miserable. I have heard a young girl—surrounded with every luxury—bemoan her lot, and complain that she was most unhappy in consequence of not having anything to do, and who wished that she 18had been a servant, so that she might have been obliged to work for her living. Idleness is certainly the hardest work in the world.

13. It frequently happens that a lady, surrounded with every luxury and every comfort, drags out a miserable existence; she cannot say that she ever, even for a single day, really feels well and strong. This is not to live—

“For life is not to live, but to be well.”[2]

14. If a person be in perfect health, the very act of living is itself thorough enjoyment, the greatest this world can ever bestow. How needful it therefore is that all necessary instruction should be imparted to every Young Wife, and that proper means should, in every way, be used to insure health!

15. The judicious spending of the first year of married life is of the greatest importance in the making and in the strengthening of a wife’s constitution, and in preparing her for having a family. How sad it is, then, that it is the first twelve months that is, as a rule, especially chosen to mar and ruin her own health, and to make her childless! The present fashionable system of spending the first few months of married life in a round of visiting, of late hours, and in close and heated rooms, calls loudly for a change. How many valuable lives have been sacrificed to such a custom! How many 19miscarriages, premature births, and still-born children, have resulted therefrom! How many homes have been made childless—desolate—by it! Time it is that common sense should take the place of such folly! The present system is abominable, is rotten at the core, and is fraught with the greatest danger to human life and human happiness. How often a lady is, during the first year of her wifehood, gadding out night after night,—one evening to a dinner party, the next night to private theatricals, the third to an evening party, the fourth to the theater, the fifth to a ball, the sixth to a concert, until in some cases every night except Sunday night is consumed in this way,—coming home frequently in the small hours of the morning, through damp or fog, or rain or snow, feverish, flushed, and excited—too tired until the morning to sleep, when she should be up, out, and about. When the morning dawns she falls into a heavy, unrefreshing slumber, and wakes not until noon, tired, and unfit for the duties of the day! Night after night—gas, crowded rooms, carbonic acid gas, late hours, wine, and excitement are her portion. As long as such a plan is adopted the preacher preacheth but in vain. Night after night, week after week, month after month, this game is carried on, until at length either an illness or broken health supervenes. Surely these are not the best means to insure health and a family and healthy progeny! The fact is, a wife nowadays is too artificial; she lives on excitement; it is like drinking no wine but champagne, and, like champagne taken in excess, it soon plays sad havoc with her constitution. 20The pure and exquisite enjoyments of nature are with her too commonplace, tame, low, and vulgar. How little does such a wife know of the domestic happiness so graphically and sweetly described by that poet of the affections, Cowper:

“Fireside enjoyments, home-born happiness,
And all the comforts that the lowly roof
Of undisturb’d retirement, and the hours
Of long uninterrupted evening, know.”

16. A fashionable lady might say, “I cannot give up fashionable amusements; I must enjoy myself as others do; I might as well be out of the world as out of the fashion.” To such a one I reply, “I myself am not a fashionist—it is not in my line; and as in the following pages I have to tell some plain unvarnished truths, my advice to you is, close this book at once and read no more of it, as such a work as this cannot be of the slightest use to you, however it might be to one who values health ‘as a jewel of great price’—as one of her most precious earthly possessions.” Really the subject is assuming such a serious aspect that it behooves a medical man to speak out plainly and unreservedly, and to call things by their right names. Fashion is oftentimes but another name for suicide and for baby-slaughter—for “massacre of the innocents!” God help the poor unfortunate little child whose mother is a votary of fashion, who spends her time in a round and whirl of fashionable life, and leaves her child to the tender mercies of servants, who “gang their ain gait,” and leave their little charge to do the same. Such a mother is 21more unnatural than a wild beast; for a wild beast, as a rule, is gentle, tender, and attentive to its offspring, scarcely ever for a moment allowing its young to be out of its sight. Truly, fashionable life deadens the feelings and affections. I am quite aware that what I have just now written will, by many fashionable ladies, be pooh-poohed, and be passed by as “the idle wind.” They love their pleasures far above either their own or their children’s health, and will not allow anything, however precious, to interfere with them; but still I have confidence that many of my judicious readers will see the truth and justness of my remarks, and will profit by them.

17. A round of visiting, a succession of rich living, and a want of rest during the first year of a wife’s life, often plays sad havoc with her health, and takes away years from her existence. Moreover, such proceedings often mar the chances of her ever becoming a mother, and then she will have real cause to grieve over her fatuity.

18. A French poet once sung that a house without a child is like a garden without a flower, or like a cage without a bird. The love of offspring is one of the strongest instincts implanted in woman; there is nothing that will compensate for the want of children. A wife yearns for them; they are as necessary to her happiness as the food she eats and as the air she breathes. If this be true—which, I think, cannot be gainsayed—how important is our subject,—one of the most important that can in this world engage one’s attention, requiring deep consideration and earnest study.

2219. The first year of a married woman’s life generally determines whether, for the remainder of her existence, she shall be healthy and strong, or shall be delicate and weak; whether she shall be the mother of fine, healthy children, or—if, indeed, she be a mother at all—of sickly, undersized offspring—

“Born but to weep, and destined to sustain
A youth of wretchedness, an age of pain.”[3]

If she be not a parent, her mission in life will be only half performed, and she will be robbed of the greatest happiness this world can afford. The delight of a mother, on first calling a child her own, is exquisite, and is beautifully expressed in the following lines—

“He was my ain, and dear to me
As the heather-bell to the honey-bee,
Or the braird to the mountain hare.”[4]

20. I should recommend a young wife to remember the momentous mission she has to fulfill; to ponder on the importance of bringing healthy children into the world; to bear in mind the high duties that she owes herself, her husband, her children, and society; to consider well the value of health—“The first wealth is health;”[5] and never to forget that “life has its duties ever.”[6]

2321. A young married lady ought at once to commence to take regular and systematic out-door exercise, which might be done without in the least interfering with her household duties. There are few things more conducive to health than walking exercise; and one advantage of our climate is, that there are but few days in the year in which, at some period of the day, it might not be taken. Walking—I mean a walk, not a stroll—is a glorious exercise; it expands the chest and throws back the shoulders; it strengthens the muscles; it promotes digestion, making a person digest almost any kind of food; it tends to open the bowels, and is better than any aperient pill ever invented; it clears the complexion, giving roses to the cheeks and brilliancy to the eye, and, in point of fact, is one of the greatest beautifiers in the world. It exhilarates the spirits like a glass of champagne, but, unlike champagne, it never leaves a headache behind. If ladies would walk more than they do, there would be fewer lackadaisical, useless, complaining wives than there at present are; and, instead of having a race of puny children, we should have a race of giants. Walking exercise is worthy of all commendation, and is indispensable to content, health, strength, and comeliness. Of course, if a lady be pregnant, walking must then be cautiously pursued; but still, walking in moderation is even then absolutely necessary, and tends to keep off many of the wretchedly depressing symptoms, often, especially in a first pregnancy, accompanying that state. I am quite sure that there is nothing more conducive 24to health than the wearing out of lots of shoe-leather and that leather is cheaper than physic.

22. Walking is even more necessary in the winter than in the summer. If the day be cold, and the roads be dirty, provided it be dry above, I should advise my fair reader to put on thick boots and a warm shawl, and to brave the weather. Even if there be a little rain and much wind, if she be well wrapped up, neither the rain nor the wind will harm her. A little sprinkling of rain, provided the rules of health be followed, will not give her cold. Much wind will not blow her away. She must, if she wishes to be strong, fight against it; the conflict will bring the color to her cheek and beauty to her eye.

23. Let her exert herself; let her mind conquer any indolence of the body; let her throw off her lethargy—it only requires a little determination; let her be up and doing; for life, both to man and woman, is a battle, and must be fought valiantly.

24. Bear in mind, then, that if a lady is to be healthy, she must take exercise, and that not by fits and starts, but regularly and systematically. A stroll is of little use; she must walk! And let there be no mistake about it, for Nature will have her dues: the muscles require to be tired, and not to be trifled with; the lungs ask for the revivifying air of heaven, and not for the stifling air of a close room; the circulation demands the quickening influence of a brisk walk, and not to be made stagnant by idleness.

2525. This world was never made for idleness; everything around and about us tells of action and of progress. Idle people are miserable people; idle people are diseased people; there is no mistake about it. There is no substitute in this world for exercise and for occupation; neither physic nor food will keep people in health; they must be up and doing, and buckle on their armor, and fight, as every one has to fight, the battle of life! Mr. Milne, the master of the North Warwickshire hounds, lately, at a hunt dinner, pithily remarked “that fox-hunting was the best physic for improving a bad constitution.” I am quite sure, with regard to the fair sex, that an abundance of walking exercise and of household occupation is decidedly the best physic for improving a lady’s constitution, more especially if she have, as unfortunately too many of them have, a bad one; indeed, an abundance of walking exercise and of household occupation will frequently convert a bad into a good constitution.

26. Moreover, there is not a greater beautifier in the world than fresh air and exercise; a lady who lives half her time in the open air, in God’s sunshine, and who takes plenty of walking exercise, has generally a clear and beautiful complexion—

“She looks as clear
As morning roses newly washed with dew.”[7]

27. Do not let me be misunderstood: I am not advocating that a delicate lady, unaccustomed to exercise, 26should at once take violent and long-continued exercise; certainly not. Let a delicate lady learn to take exercise, as a young child would learn to walk—by degrees; let her creep, and then go; let her gradually increase her exercise, and let her do nothing either rashly or unadvisedly. If a child attempted to run before he could walk, he would stumble and fall. A delicate lady requires just as much care in the training to take exercise as a child does in the learning to walk; but exercise must be learned and must be practiced, if a lady, or any one else, is to be healthy and strong. Unfortunately, in this our day the importance of exercise as a means of health is but little understood and but rarely practiced; notwithstanding, a lady may rest assured that until a “change comes o’er the spirit of her dreams,” ill health will be her daily and constant companion.

28. A lady should walk early in the morning, and not late in the evening. The dews of evening are dangerous, and are apt to give severe colds, fevers, and other diseases. Dew is more likely to cause cold than rain—

“The dews of the evening most carefully shun—
Those tears of the sky for the loss of the sun.”[8]

29. A breath of wind is not allowed to blow on many a fair face. The consequence is, that her cheek becomes sallow, wan, “as wan as clay,” and bloodless, or if it has a color it is the hectic flush, which tells of speedy decay!

30. Sitting over the fire will spoil her complexion, 27causing it to be muddy, speckled, and sallow. The finest complexion in a lady I ever saw belonged to one who would never go, even in the coldest weather, near the fire: although she was nearly thirty years of age, her cheeks were like roses, and she had the most beautiful red and white I ever beheld; it reminded me of Shakspeare’s matchless description of a complexion:—

“’Tis beauty truly blent, whose red and white
Nature’s own sweet and cunning hand laid on.”

31. Sitting over the fire will make her chilly, nervous, dyspeptic, and dispirited. It will cause her to be more chilly, and thus will make her more susceptible of catching cold; and it will frequently produce chilblains. If she be cold, the sitting over the fire will only warm her for the time, and will make her feel more starved when she leaves it. Crouching over the fire, as many do, is ruination to health and strength and comeliness! Sitting over the fire will make her nervous: the heat from the fire is weakening beyond measure to the nerves. It will disorder and enfeeble her stomach—for nothing debilitates the stomach like great heat—and thus make her dyspeptic; and if she be dyspeptic, she will, she must be dispirited. The one follows the other as surely as the night follows the day.

32. If sitting over the fire be hurtful, sitting with the back to the fire is still more so. The back to the fire often causes both sickness and faintness, injures the spine, and weakens the spinal marrow, and thus debilitates the whole frame.

2833. A walk on a clear, frosty morning is as exhilarating to the spirits as the drinking of champagne—with this difference, that on the day following the head is improved by the one, but not always by the other. Simple nature’s pleasures are the most desirable—they leave no sting behind them!

34. There is nothing like a long walk to warm the body and to make the blood course merrily through the blood-vessels. I consider it to be a great misfortune that my fair countrywomen do not use their legs more and their carriages less. “As to exercise, few women care to take it for mere health’s sake. The rich are too apt to think that riding in a close varnish-smelling carriage ought to be a very good substitute for muscular struggles in the open air.”[9]

35. Unfortunately this is an age of luxury. Everything is artificial, and disease and weakness, and even barrenness, follow as a matter of course. In proof of my assertion that this is an age of luxury, look at the present sumptuous style of living: carriages rolling about in every direction; dining-tables groaning under the weight of rich dinners, and expensive wines flowing like water; grand dresses sweeping the streets, almost doing away with the necessity for scavengers. I say, advisedly, streets; for green fields are, unfortunately, scarcely ever visited by ladies. We are almost, in extravagance, rivaling ancient Rome just 29before luxury sapped her strength and laid her in ruins!

36. If a lady has to travel half a mile she must have her carriage. Strange infatuation! Is she not aware that she has hundreds of muscles that want exercising? that she has lungs that require expanding? that she has nerves that demand bracing? that she has blood that needs circulating? And how does she think that the muscles can be exercised, that the lungs can be expanded, that the nerves can be braced, and that the blood can be properly circulated, unless these are all made to perform their proper functions by an abundance of walking exercise? It is utterly impossible!

37. Does she desire to be strong? Then let her take exercise! Does she hope to retain her bloom and her youthful appearance, and still to look charming in the eyes of her husband? Then let her take exercise! Does she wish to banish nervousness and low spirits? Then let her take exercise! There is nothing standing still in Nature: if it were, creation would languish and die. There is a perpetual motion! And so must we be constantly employed (when not asleep), if we are to be healthy and strong! Nature will not be trifled with; these are her laws[10]—immutable and unchangeable, and we cannot infringe them with impunity:

30“Labor is life! ’Tis the still water faileth;
Idleness ever despaireth, bewaileth;
Keep the watch wound, for the dark night assaileth;
Flowers droop and die in the stillness of noon.
Labor is glory! The flying cloud lightens;
Only the waving wing changes and brightens;
Idle hearts only the dark future frightens;
Play the sweet keys, would’st thou keep them in tune!”

38. If a newly-married woman be delicate, as, unfortunately, too many are, she may be made to bear exercise well, provided she begins by taking a short walk at first—be it ever so short—and by gradually increasing it until she be able to take a tolerably long one. She might find it irksome at the beginning, and might be inclined to give it up in despair; but if she value her health and happiness, let me urge her to persevere, and she may depend upon it that she will be amply rewarded for her trouble.

39. A delicate lady frequently complains of cold feet; she has neither sufficient food nor sufficient exercise to keep them warm. Walking and plenty of nourishment are the best remedies she can use to warm them. If they be cold before retiring to rest—a frequent cause of keeping her awake—let her walk briskly for half an hour, before undressing for the night, about either the hall, or the landing, or a large room.

40. Some ladies declare that they are always cold, their feet especially, which are as cold as ice! The fact is, they not only do not take exercise enough, but they do not take nourishment enough—breakfast especially—to 31keep them warm. Many ladies really and truly half starve themselves; they consider it to be vulgar to eat much, and to satisfy their appetite! they deem it low to take a long walk: every poor woman can do that! it is much more easy and pleasant to loll back in an easy carriage, and to be rolled along! Truly; but if carriage exercise be more agreeable, is it as healthful? Certainly not: there is very little exercise in riding in a carriage; but every organ, muscle, nerve, and blood-vessel of the body is put into beneficial action by walking. Walking is essential to health; there is no substitute for it; there certainly is no perfect health without it.

41. The reason why my fair countrywomen take so much opening medicine is the want of exercise. How truly it has been said that “physic, for the most part, in nothing else but the substitute of exercise and temperance.”

42. I consider it to be a grievous misfortune for any one—man, woman, or child—who cannot, without the frequent taking of physic, keep their bowels regular. When such is the case there is something wrong, very wrong, about her system and about her proceedings, and the sooner the matter is inquired into and rectified the better. The necessity of a constant swallowing of opening medicine is a proof of chronic ill health, and will in time injure her constitution beyond remedy. I cannot speak too strongly on this subject; I have, in my professional experience, seen so much mischief and 32misery caused by the frequent swallowing of opening pills, that I should not do my duty if I did not raise my voice against the abominable custom. Why, many ladies make a practice, during the whole of their lives, of taking two or three times a week opening pills! The bowels, they say, will not act without them; but I maintain that if they would resolutely refrain from swallowing them, and adopt the rules of health laid down in these pages, they would be able altogether to dispense with them, to their great benefit and delectation. But then the rules of health require trouble and perseverance—(and what that is worth having does not?)—while the swallowing of a couple of pills might be done quickly, and with very little trouble; but although the frequent taking of pills gives at the time but little trouble, they cause much trouble afterwards! Look, then, at the results of each system, and decide accordingly! It has been said that “gluttony kills more than the sword;” my conviction is, that the constant taking of opening medicine kills more than gluttony and the sword combined! The abuse of aperients is one of the crying evils of the day, and who so proper as a medical man to raise his voice to suppress, or at all events to lessen, the evil?

43. If a lady be costive, and is in consequence inclined to take a dose of physic, let me advise her to take instead a long walk, which will in the majority of cases do her vastly more good; and if requiring repetition, the one is far more agreeable, and the effects are much more likely to be lasting than the other. 33Exercise, I am quite sure, is, as a rule, in the long run much more effectual and beneficial than opening physic.

44. A newly-married wife ought to be cautious in the taking of horse exercise. As long as she be not pregnant, horse exercise is very beneficial to health, and is a great enjoyment; but the moment symptoms of pregnancy develop themselves, she must instantly give it up, or it will probably cause her to miscarry.

45. Let her breathe the pure air of heaven, rather than the close contaminated air either of an assembly or of a concert-room. The air of an assembly or of a concert-room is contaminated with carbonic acid gas. The gas-lights and the respiration of numbers of persons give off carbonic acid gas, which gas is highly poisonous.

46. The truth of this assertion is patent to every one who will observe the effects that a large assembly, more especially in the evening, when the gas or candles are flaring away, has on the system; the headache, the oppression, the confusion of ideas, the loss of appetite, the tired feeling, followed by a restless night—all tell a tale, and loudly proclaim that either an assembly or a concert-room is not a fit place for a young wife desirous of having a family.

47. Let a young married lady attend well to the ventilation of her house. She may depend upon it 34that ventilation, thorough ventilation, will prove one of the best friends she has in the world. Let her give directions to her servant to have early every morning every window in the house opened, as the morning air is fresher and sweeter than it is later in the day. “For ventilation, open your windows both at top and bottom. The fresh air rushes in one way, while the foul makes its exit the other. This is letting in your friend and expelling your enemy.”[11] This opening of the window, top and bottom, of course applies only to the rooms that are unoccupied:—in an occupied room in hot weather one sash only—the lower, as a rule, is best—ought to be opened. If the upper be lowered when the room is occupied, the cold air is apt to strike on the top of the head, and to give cold.

48. Let her give orders that every chimney in the house be unstopped, and let her see for herself that her orders have been obeyed; for servants, if they have the chance, will stop up chimneys, as they are fully aware that dust and dirt will come down chimneys, and that it will give them a little extra work to do. But the mistress has to see to the health of herself and of her household, which is of far more consequence than either a little dirt or extra work for her servants.

49. She may rest assured that it is utterly impossible for herself and for her family to have perfect health if the chimneys are allowed to be stopped. I assert 35this fearlessly, for I have paid great attention to the subject. If the chimney be stopped, the apartment must necessarily become contaminated with carbonic acid gas, the refuse of respiration, which is, as I have before stated, a deadly poison.

50. Chimneys, in many country houses, are permanently and hermetically stopped: if we have the ill-fortune to sleep in such rooms, we feel half-suffocated. Sleep, did I say? No! tumble and toss are the right words to express the real meaning; for in such chambers very little sleep do we get,—unless, indeed, we open the windows to let in the air, which, in such an extremity, is the only thing, if we wish to get a wink of sleep, we can do! Stopped-up bedroom chimneys is one and an important reason why some persons do not derive the benefit they otherwise would do of change of air to the country.

51. I unhesitatingly declare that ninety-nine bedrooms out of every hundred are badly ventilated; that in the morning, after they have been slept in, they are full both of impure and of poisoned air. I say, advisedly, impure and poisoned air, for the air becomes foul and deadly if not perpetually changed—if not constantly mixed, both by day and by night, with fresh, pure, external air. Many persons, by breathing the same air over and over again, are literally “poisoned by their own breaths!” This is not an exaggerated statement—alas, it is too true! Let every young wife remember that she requires just as much pure air in the night as in 36the day; and if she does not have it, her sleep will neither refresh her nor strengthen her, but that she will rise in the morning more weary than on the previous night when she retired to rest.

52. The way to make a house healthy, and to keep off disease, is by thorough ventilation—by allowing a current of air, both by day and by night, to constantly enter and to sweep through the house, and every room of the house. This may be done either by open skylight or by open landing windows, which should always be left open; and by allowing every chamber window to be wide open during the day, and every chamber door to be a little open both by night and by day, having a door-chain on each door during the night to prevent intrusion.

53. Let her, if she can, live in the country. In a town, coal fires—manufactories, many of them unhealthy—confined space—the exhalations from the lungs and from the skin of the inhabitants, numbers of them diseased,—all tend to load the air with impurities. Moreover, if in the town she desire a walk, it is often itself a walk, and a long one too, before she can get into the country—before she can obtain glimpses of green fields and breathe the fresh air; hence walks in the town do but comparatively little good. In the country her lungs are not cheated: they get what they want—a good article, pure air—and the eye and heart are both gladdened with the beauties of nature. I consider the following remark of Dr. Grosvenor, in his 37excellent Essay on Health, very pertinent. He observes: “Hence it is that one seldom sees in cities, courts, and rich houses, where people eat and drink, and indulge in the pleasure of appetite, that perfect health and athletic soundness and vigor which is commonly seen in the country, in the poor houses and cottages, where nature is their cook and necessity is their caterer, where they have no other doctor but the sun and fresh air, and no other physic but exercise and temperance.”

54. Cold air is frequently looked upon as an enemy, instead of being contemplated as, what it really is to a healthy person, a friend. The effect of cold upon the stomach is well exemplified in a walk in frosty weather, producing an appetite. “Cold air,” says Dr. Cullen, “applied with exercise, is a most powerful tonic with respect to the stomach; and this explains why, for that purpose, no exercise within doors, or in close carriages, is so useful as that in the open air.”

55. Hot and close rooms, soft cushions, and luxurious couches must be eschewed. I have somewhere read, that if a fine, healthy whelp of the bull-dog species were fed upon chicken, rice, and delicacies, and made to lie upon soft cushions, and if, for some months, he were shut up in a close room, when he grew up he would become unhealthy, weak, and spiritless. So it is with a young married woman; the more she indulges, the more unhealthy, weak, and inanimate she becomes—unfit to perform the duties of a wife and the offices of a mother, if, indeed, she be a mother at all!

3856. Rich and luxurious ladies are less likely to be blessed with a family than poor and hard-worked women. Here is, to a vengeance, compensation! Compensation usually deals very justly both to man and womankind. For instance, riches and childlessness, poverty and children, laziness and disease, hard work and health, a hard-earned crust and contentment, a gilded chamber and discontent—

“These are ofttimes wedded as a man and wife,
And linked together, hand in hand, through life.”

Riches seldom bring health, content, many children, and happiness; they more frequently cause disease, discontent, childlessness, and misery.[12] Riches and indolence are often as closely united as the Siamese twins, disease and death frequently following in their train. “Give me neither poverty nor riches” was a glorious saying of the wisest of men. Rich and luxurious living, then, is very antagonistic to fecundity. This might be one reason why poor curates’ wives and poor Irish women generally have such large families. It has been proved by experience that a diet, principally consisting of milk, buttermilk, and vegetables, is more conducive to fecundity than a diet almost exclusively of meat. In illustration of my argument, the poor Irish, who have usually such enormous families, live almost exclusively on buttermilk and potatoes; they scarcely eat meat from year’s end to year’s end. 39Riches, if it prevent a lady from having children, is an evil and a curse, rather than a good and a blessing; for, after all, the greatest treasures in this world are “household treasures”—healthy children! If a wife be ever so rich, and she be childless, she is, as a rule, discontented and miserable. Many a married lady would gladly give up half her worldly possessions to be a mother; and well she might—children are far more valuable. I have heard a wife exclaim with Rachel, “Give me a child, or I die.”

57. If a young wife be likely to have a family, let her continue to live heartily and well; but if she have been married a year or two without any prospect of an increase, let her commence to live abstemiously on fresh milk, buttermilk, bread, potatoes, and farinaceous diet, with very little meat, and no stimulants whatever; let her live, indeed, very much either as a poor curate’s wife, or as a poor Irish woman is compelled to live.

58. It is not the poor woman that is cursed with barrenness—she has often more mouths than she can well fill; but the one that frequently labors under that ban is the pampered, the luxurious, the indolent, the fashionable wife; and most assuredly, until she change her system of living to one more consonant with common sense, she will continue to do so. It is grievous to contemplate that oftentimes a lady, with every other temporal good, is deficient of two earthly blessings—health and children; and still more lamentable, when we know that they frequently arise from her own seeking, 40that they are withheld from her in consequence of her being a votary of fashion. Many of the ladies of the present day, too, if they do bear children, are, from delicacy of constitution, quite unable to suckle them. Should such things be? But why, it might be asked, speak so strongly and make so much fuss about it? Because the disease is become desperate, and delays are dangerous—because children among the higher ranks are become few and far between; and who so proper as a medical man to raise his voice to proclaim the facts, the causes, and the treatment? I respectfully inquire of my fair reader, Is fashion a wife’s mission? If it be not, what is her mission? I myself have an idea—a very ancient and an almost obsolete one—that the mission of a wife is a glorious mission, far removed from fashion and from folly. A fashionable wife, after a fashionable season, is frequently hysterical and excitable, and therefore exhausted; she is more dead than alive, and is obliged to fly to the country and dose herself with quinine to recruit her wasted energies. Is such a wife as this likely to become a joyful mother of children? I trow not. Her time is taken up between pleasure and excitement to make herself ill, and nursing to make herself well, in order that she may, at the earliest possible moment, again return to her fashionable pursuits, which have with her become, like drinking in excess, a necessity. Indeed, a fashionable life is a species of intoxication. Moreover, wine-drinking in excess and a fashionable life are usually joined together. Sad infatuation, destructive alike to human life and human 41happiness—a road that often leads to misery, disappointment, and death! These are strong expressions, but they are not stronger than the subject imperatively demands—a subject which is becoming of vital importance to the well-being of society, and, in the higher ranks, even to its very existence, and which must, ere long, engross the attention of all who love their country. Fashion is a sapper and miner, and is ever hard at work sapping and undermining the constitutions of its votaries. Something must be done, and that quickly, to defeat its machinations, otherwise evils will, past remedy, be consummated.

59. I consider thorough ablution of the body every morning one of the most important means of health to a young wife; “while the poor, in the matter of washing, are apt to think that they can put off till Saturday what ought to be performed every day, and that they can wind up the week by a good wash with impunity.”[13] There is nothing more tonic and invigorating and refreshing than cold ablution. Moreover, it makes one feel clean and sweet and wholesome; and you may depend upon it, that it not only improves our physical constitution, but likewise our moral character, and makes our minds more pure and holy. A dirty man has generally a dirty mind!

60. The ewers and basins in our own country are, for the purposes of thorough ablution, ridiculously small, 42while on the Continent they are still smaller. They are of pigmy dimensions—the basins being of the size of an ordinary slop-basin, and the ewer holding enough water to wash a finger. How can persons with such appliances be either decently clean, or sweet, or thoroughly healthy? It is utterly impossible. Many people on the Continent have a dread of water—they labor under a species of hydrophobia: hence one reason why the ewers and basins are of such dwarfish proportions.

61. A young wife ought to strip to the waist, and then proceed to wash her face after the manner so well described by Erasmus Wilson in his work on Healthy Skin. He says: “Fill your basin about two-thirds full with fresh water; dip your face in the water, and then your hands. Soap the hands well, and pass the soaped hands with gentle friction over the whole face. Having performed this part of the operation thoroughly, dip the face in the water a second time, and rinse it completely; you may add very much to the luxury of the latter part of the process by having a second basin ready with fresh water to perform a final rinsing.... In washing the face you have three objects to fulfill: to remove the dirt, to give freshness, and to give tone and vigor to the skin.” Now for the remaining process of ablution. Having well rubbed her neck with her soaped hands, she ought thoroughly to bathe her neck, her chest, and arms, by means of a large sponge dipped in cold water—the colder the better. She cannot cleanse her own shoulders, back, and loins with a sponge—she cannot get to them. To obviate this difficulty, 43she ought to soak a piece of flannel, a yard and a half long and half a yard wide, folded lengthways, in cold water, and throwing it over her shoulders, as she would a skipping-rope, she should for a few times work it from right to left and from left to right, “and up and down, and then athwart,” her loins and back and shoulders. This plan will effectually cleanse parts that she could not otherwise reach, and will be most refreshing and delightful. She should then put both her hands, her forearms, and her arms into the basin of water as far as they will reach, and keep them in for a few seconds, or while she can count fifty. The wet parts should be expeditiously dried. Then, having thrown off her remaining clothes, and merely having her slippers on, she ought to sit for a few seconds, or while in the winter she can count fifty, or while in the summer she can count a hundred, either in a sitz-bath,[14] or in a very large wash-hand basin—called a nursery-basin[15] (sold for the purpose of giving an infant his morning bath)—containing water to the depth of three or four inches. While sitting either in the bath or in the basin, she ought in the winter time to have either a small blanket or a woolen shawl 44thrown over her shoulders. If she has any difficulty in getting in and out of the basin, she should place a chair on each side of the basin; she can then, by pressing upon the chairs with her elbows, arms, and hands, readily do so.

62. If a lady be too delicate to take a sitz-bath, or if a sitz-bath should not agree with her, then she ought every morning to use the bidet, and, while sitting over it, she should well sponge the parts with the water, allowing the water for a few seconds to stream over them. Every lady should bear in mind that either the sitz-bath or the bidet, every morning of her life (except under certain circumstances), is absolutely essential to her comfort and her well-being.

63. At first, until she become accustomed to the cold (which she will do in a few days), she ought to use the water tepid, but the sooner she can use cold water, and that plentifully, the better—as it will greatly contribute to her health and strength. But, as I said before, the process ought to be quickly performed, as it is the shock in bracing and in strengthening the system that does so much good.

64. When a lady is very delicate, it may, during the winter, be necessary to put a dash of warm water into the bath, in order to take off the extreme chill; but, as she becomes stronger, she will be able to dispense with the warm water, as the colder the water is, provided she can bear it, the more good it will do her.

4565. If her loins or her back are at all weak, the addition either of a large handful of table salt, or of a small handful of bay salt, or of a lump of rock-salt,[16] dissolved in the water in the sitz-bath, will be of great service to her.

66. The feet and the legs ought every morning to be bathed—not by standing in the water, but, on the completion of the washing of the other parts of the body, by putting one foot at a time for a few seconds (not minutes) in the basin containing the water (the basin for that purpose being placed on the floor), and well and quickly washing the foot, either with a flannel or with a sponge, and well cleansing with the finger and thumb between each toe, and allowing the water from the sponge or flannel to stream into the basin from the knee downwards. All this, of course, must be done expeditiously; and care ought to be taken, after such ablution, to well dry with a towel between each toe. The washing of the feet as above directed will be a great refreshment, and will be most beneficial to health, and will be a means of warding off colds, of preventing chilblains, and of preserving the feet in a sweet and healthy state. The feet ought to be kept as clean, if not cleaner, than the hands. Parts that are not seen should be kept cleaner than parts that are seen. Filth is apt to gather in covered up places.

4667. The moment she has finished her bath she ought quickly to dry herself. I should recommend her to use as a towel the Turkish rubber: it will cause a delightful glow of the whole body.

68. The whole of the body, except the hair of the head, is, by the above method, every morning thoroughly washed. The hair of the head ought occasionally, even with soap and water, to be cleansed, to keep it clean and sweet and wholesome; for nothing is more dirty if it be not well attended to than human hair, and nothing is more repulsive than a dirty head.

69. Brushing of the hair, although beneficial both to the hair and health, will not alone thoroughly cleanse the hair and scalp.

70. Some ladies attempt to clean their hair by simply washing it either with rosemary or with rosewater, or with other washes; but there is no more effectual way of doing it than occasionally by a flannel and soap and water.

71. Bathing in the sea during the season, provided no grease has been previously used, is very good for the hair; it both strengthens the roots and beautifies the color.

72. I should advise my fair reader not to plaster her hair either with grease or with pomade, or with other unknown compounds: many of them are apt to make the head dirty, scurfy, and sore.

4773. It might be said that it is utterly impossible for a lady to keep her hair tidy, unless she uses some application to it. If such be the case, either a little best olive oil or scented castor oil, or cocoanut oil, may, by means of an old tooth-brush, be applied to smooth the hair.

74. If the hair should fall off, either a little cocoanut oil or a little scented castor oil, well rubbed every night and morning into the roots, is an excellent dressing. These are simple remedies, and can never do any harm, which is more than can be said of many quack nostrums, which latter often injure the hair irreparably.

75. The best carpet, either for a bath-room or for a dressing-room, is kamptulicon, as the water spilt upon it after the use of a bath or ablution can, by means of a flannel, be readily absorbed; the window ought then to be thrown wide open, and the room will quickly be dried.

76. It would be well for her, when practicable, to have, after she has finished dressing, a quarter of an hour’s walk, either in the garden or in the grounds, in order to insure a reaction, and thus to induce a healthy glow of the circulation, and to give her an appetite for her breakfast. A quarter of an hour’s walk before breakfast is more beneficial to health than an hour’s walk after breakfast.

77. If a lady have not been accustomed to a thorough 48ablution, as just directed, of her whole body, let her, if possible, before commencing, take a trip to the coast, and have a few dips in the sea; after which she might at once go through the processes above advised with safety, comfort, and advantage; but whether she be able to bathe in the sea or not, she must, if she is to be strong and healthy, gradually accustom herself to a daily ablution of the whole of her body. The skin is a breathing apparatus, and unless it be kept clean it cannot properly perform its functions. It might be said, it will take time and trouble daily to cleanse the whole of the skin: it will; but no more than ten minutes, or a quarter of an hour, to go through the whole of the above processes of bathing and of drying the skin. The acquisition of health takes both time and trouble; but nothing worth having in this world is done without it! There is no royal road to health; but although the path at first might be a little rugged and disagreeable, it soon becomes from practice smooth and pleasant!

78. Oh, if my fair reader did but know the value of thorough cold water ablutions, she would not lose a day before giving the plan I have above recommended a trial. It would banish all, or nearly all, her little ailments and nervousness; it would make her dispense with many of her wrappings; it would, in the winter time, keep her from coddling and crudling over the fire; it would cause her to resist cold and disease; it would, if she were inclined to constipation, tend to regulate her bowels; it would strengthen her back and loins; it 49would make her blooming, healthy, and strong; and it would pave the way, and fit her, in due time, to become a mother, and the mother of fine, hearty children! My reader must not fancy that I have overdrawn the picture; I have painted it from the life. “I only tell what I do know, and declare what I do believe.” Let me urge but a trial, and then my fair inquirer will have cause to be thankful that she had been induced to carry out my views, and I shall rejoice that I have been the means of her doing so. Hear what a physician and a poet, a man of sound sense and of sterling intellect, says of the value of ablution. He speaks of warm ablution, which certainly is, at the beginning of using thorough ablution, the best; but the sooner cold can be substituted for warm the better it will be for the health and strength and spirits of the bather:

“The warm ablution, just enough to clear
The sluices of the skin, enough to keep
The body sacred from indecent soil.
Still to be pure, even did it not conduce
(As much as it does) to health, were greatly worth
Your daily pains; it is this adorns the rich;
The want of it is poverty’s worst foe.
With this external virtue age maintains
A decent grace! without it, youth and charms
Are loathsome.”[17]

79. With regard to diet.—Although I have a great objection (which I either have or will particularize) of a young wife taking rich food and many stimulants, yet 50I am a great advocate for an abundance of good wholesome nourishment.

80. The meager breakfasts of many young wives (eating scarcely anything) is one cause of so much sickness among them, and of so many puny children in the world.

81. Let every young wife, and, indeed, every one else, make a substantial breakfast. It is the foundation meal of the day; it is the first meal after a long—the longest fast. The meager, miserable breakfasts many young wives make is perfectly absurd; no wonder that they are weak, “nervous,” and delicate. A breakfast ought, as a rule, to consist either of eggs or of cold chicken, or of cold game, or of bacon, or of ham, or of cold meat, or of mutton-chops, or of fish, and of plenty of good bread, and not of either hot buttered toast, or of hot rolls swimming in butter; both of which latter articles are like giving the stomach sponge to digest, and making the partaker of such food for the rest of the day feel weak, spiritless, and miserable. If she select coffee for breakfast, let the half consist of good fresh milk; if she prefer cocoa, let it be made of new milk instead of water; if she choose tea, let it be black tea, with plenty of cream in it. Milk and cream are splendid articles of diet. Let her then make a hearty breakfast, and let there be no mistake about it. There is no meal in the day so wretchedly managed, so poor and miserable, and so devoid of nourishment, as an English breakfast. Let every young wife, therefore, 51look well to the breakfast, that it be good and varied and substantial, or ill health will almost certainly ensue.[18]

82. A meager unsubstantial breakfast causes a sinking sensation of the stomach and bowels, and for the remainder of the day a miserable depression of spirits. Robert Browning truly and quaintly remarks that

“A sinking at the lower abdomen
Begins the day with indifferent omen.”

83. It frequently happens that a young wife has no appetite for her breakfast. She may depend upon it, in such a case, there is something wrong about her, and that the sooner it is rectified the better it will be for her health, for her happiness, and for her future prospects. Let her, then, without loss of time seek medical advice, that means may be used to bring back her appetite. The stomach in all probability is at fault; if it be, the want of appetite, the consequent sensation of sinking of the stomach, and the depression of the spirits are all explained; but which, with judicious treatment, may soon be set to rights.

84. If the loss of appetite for breakfast arise from pregnancy—and sometimes it is one of the earliest 52symptoms—time will rectify it, and the appetite, without the necessity of a particle of medicine, will shortly, with its former zest, return.

85. A young married woman’s diet ought to be substantial, plain, and nourishing. She must frequently vary the kind of food, of meat especially, as also the manner of cooking it. Nature delights in variety of food, of air, and of exercise. If she were fed, for some considerable period, on one kind of meat, she could scarcely digest any other; and in time either a disordered or a diseased stomach would be likely to ensue. I have sometimes heard, with pain and annoyance, a patient advised to live on mutton-chops, and to have no other meat than mutton! Now this is folly in the extreme. Such an unfortunate patient’s stomach, in the course of time, would not be able to digest any other meat, and after awhile would have a difficulty in digesting even mutton-chops, and wretched and ruined health would to a certainty ensue.

86. Three substantial and nourishing meals a day will be sufficient. It is a mistaken notion to imagine that “little and often” is best. The stomach requires rest as much as, or more than, any other part of the body; and how, if food be constantly put into it, can it have rest? There is no part of the body more imposed and put upon than the human stomach:

“To spur beyond
Its wiser will the jaded appetite,—
Is this for pleasure? Learn a juster taste,
And know that temperance is true luxury.”

5387. It is a mistaken notion, and injurious to health, for a young wife, or for any one else, to eat, just before retiring to rest, a hearty meat supper:

“Oppress, not nature sinking down to rest
With feasts too late, too solid, or too full.”

88. How often we hear a delicate lady declare that she can only eat one meal a day, and that is a hearty meat supper the last thing at night; and who, moreover, affirms that she can neither sleep at night, nor can she have the slightest appetite for any other meal but her supper, and that she should really starve if she could not have food when she could eat it! The fact is, the oppressed stomach oppresses the brain, and drives away sleep, and appetite, and health. The habit is utterly wrong, and oftentimes demands professional means to correct it.

89. How is it that sometimes a lady who has an excellent appetite is, notwithstanding, almost as thin as a rake? It is not what she eats, but what she digests, that makes her fat. Some people would fatten on bread and water, while others would, on the fat of the land, be as thin as Pharaoh’s lean kine. Our happiness and our longevity much depend on the weakness or on the soundness of our stomachs: it is the stomach, as a rule, that both gauges our happiness and that determines the span of the life of both men and women. How necessary it is, then, that due regard should be paid to such an important organ, and that everything should be done to conduce to the stomach’s welfare,—not by overloading 54the stomach with rich food; not by a scanty and meager diet; but by adopting a middle course, betwixt and between high living and low living—the juste milieu. We should all of us remember that glorious saying—those immortal words of St. Paul—“Be temperate in all things.”

90. Where a lady is very thin, good fresh milk (if it agree) should form an important item of her diet. Milk is both fattening and nourishing, more so than any other article of food known; but it should never be taken at the same meal (except it be in the form of pudding) with either beer or wine: they are incompatibles, and may cause disarrangement of the stomach and bowels. Milk would often agree with an adult, where it now disagrees, if the admixture of milk with either beer or wine were never allowed.

91. Let me advise my fair reader to take plenty of time over her meals, and to chew her food well; as nothing is more conducive to digestion than thoroughly masticated food. No interruptions should be allowed to interfere with the meals; the mind, at such times, should be kept calm, cheerful, and unruffled, for “unquiet meals make ill digestions.”

92. Many persons bolt their food! When they do, they are drawing bills on their constitutions which must inevitably be paid! The teeth act as a mill to grind and prepare the food for the stomach; if they do not do their proper work, the stomach has double 55labor to perform, and being unable to do it efficiently, the stomach and the whole body in consequence suffer.

93. The teeth being so essential to health, the greatest care should be taken of them: they should be esteemed among one’s most precious possessions.[19]

94. With regard to beverage, there is, as a rule, nothing better for dinner than either toast and water, or, if it be preferred, plain spring water—

“Naught like the simple element dilutes;”[20]

and after dinner, one or two glasses of sherry. A lady sometimes, until she has had a glass of wine, cannot eat her dinner; when such be the case, by all means let a glass of wine be taken,—that is to say, let her have it either just before or during dinner, instead of after dinner; or let her have one glass of sherry before or during dinner, and one glass after dinner.

95. A young wife sometimes has a languid circulation, a weak digestion, and constipated bowels; then, a glass of sherry during dinner and another glass after dinner is beneficial; and however much she might dislike wine, she should be induced to take it, as the wine will improve her circulation, will strengthen her digestion, 56and will tend to open her bowels. But let me urge her never, unless ordered by a medical man, to exceed the two glasses of wine daily.

96. If wine does not agree, and if she require a stimulant, a tumblerful either of home-brewed ale or of Burton bitter ale ought, instead of water, to be taken at dinner. But remember, if she drink either beer or porter, she must take a great deal of out-door exercise; otherwise it will probably make her bilious. If she be inclined to be bilious, wine is superior to either beer or porter.

91. Brandy ought never to be taken by a young wife but as a medicine, and then but rarely, and only in cases of extreme exhaustion. It would be a melancholy and gloomy prospect for her to drink brandy daily; she would, in all probability, in a short time become a confirmed drunkard. There is nothing, when once regularly taken, more fascinating and more desperately dangerous than brandy-drinking. It has caused the destruction of tens of thousands both of men and of women!

98. A wife ought not, if she feel low, to fly on every occasion to wine to raise her spirits, but should try the effects of a walk in the country, and

“Draw physic from the fields in draughts of vital air.”[21]

5799. An excitable wife is a weakly wife: “excitement is the effect of weakness, not of strength.” Wine in large quantities will not strengthen, but, on the contrary, will decidedly weaken; the more the wine, the greater the debility and the greater the excitement—one follows the other as the night the day. A person who drinks much wine is always in a state of excitement, and is invariably weak, low, and nervous, and frequently barren. Alcoholic stimulants in excess are “a delusion and a snare,” and are one of the most frequent causes of excitement, and therefore both of weakness and of barrenness. Alcohol, pure and undiluted, and in excess, is a poison, and is ranked among the deadly poisons; if a person were to drink at one draught half a pint of undiluted alcohol it would be the last draught he or she would ever, in this world, drink,—it would be as surely fatal as a large dose of either arsenic or strychnine! Brandy, whisky, gin, and wine are composed of alcohol as the principal ingredient; indeed, each and all of them entirely owe their strength to the quantity of alcohol contained therein. Brandy, whisky, gin, and wine, without the alcohol, would, each one of them, be as chip in porridge—perfectly inert. Brandy and wine, the former especially, contain large proportions of alcohol, and both the one and the other, in excess, either prevents a woman from conceiving, and thus makes her barren, or if she do conceive, it poisons the unborn babe within her; and it either makes him puny and delicate, or it downright kills him in the womb, and thus causes a miscarriage. If he survive the poison, and he be born 58alive, he is usually, when born, delicate and undersized; if such a one be suckled by such a mother, he is subjected, if the mother can nurse him, which in such cases she rarely can, to a second course of poisoning; the mother’s milk is poisoned with the alcohol, and the poor unfortunate little wretch, having to run the gantlet in the womb and out of the womb, pines and dwindles away, until at length he finds a resting-place in the grave! If you wish to make a dog small, give him, when he is a puppy, gin; the alcohol of the gin will readily do it: this is a well-known fact, and is, by dog-fanciers, constantly practiced. If you desire, in like manner, to make a Tom Thumb of a baby, give him the milk of a mother or of a wet-nurse who imbibes, in the form of wine or of brandy or of gin, alcohol in quantities, and the deed is done! Gin-drinking nursing mothers, it is well known, have usually puny children; indeed, the mother drinking the gin is only another way of giving gin to the babe—an indirect instead of a direct route, both leading to the same terminus. Brandy was formerly sold only by the apothecary; brandy is a medicine—a powerful medicine—and ought only to be prescribed as a medicine; that is to say, but seldom, in small and in measured quantities at a time, and only when absolutely necessary: now it is resorted to on every occasion as a panacea for every ill! If taken regularly, and in quantities, as unfortunately it frequently now is, it becomes a desperate poison—a pathway leading to the grave! It is utterly impossible for any person to hold in the mouth, for five minutes at a time, a mouthful of 59neat brandy without experiencing intense suffering: if it has this fearful effect on the mouth, what effect must this burning fluid, when taken in quantities, have upon the stomach? Injury, most decided injury to the stomach, and, through the stomach, disease and weakness to the remainder of the body! Brandy is a wonderful and powerful agent: brandy has the effect, if taken in excess and for a length of time, of making the liver as hard as a board. Brandy in large quantities, and in the course of time, has the power of making the body marvelously big—as big again; but not with firm muscle and strong sinew, not with good blood and wholesome juices—nothing of the kind; but of filling it full, even to bursting, with water! Brandy has the power of taking away a giant’s strength, and of making him as helpless as a little child! Habitual brandy-drinking poisons the very streams of life! It would take more time and space than I have to spare to tell of the wonderful powers of brandy; but unfortunately, as a rule, its powers are more those of an angel of darkness than those of an angel of light! If the above statements be true (and they cannot be contravened), they show the folly, the utter imbecility, and the danger, both to mother and to babe, of dosing a wife, be she strong or be she delicate, and more especially if she be delicate, with large quantities either of wine or of brandy. Brandy, gin, and whisky act on the human economy very much alike; for, after all, it is the quantity of alcohol contained in each of them that gives them their real strength and danger. I have selected brandy as the type of all of them, as brandy is 60now the fashionable remedy for all complaints, and, unfortunately, in too many instances the habit of drinking it imperceptibly but rapidly increases, until at length, in many cases, that which was formerly a teaspoonful becomes a tablespoonful, and eventually a wineglassful, with what result I have earnestly endeavored faithfully to portray. Avoid, then, the first step in regular brandy-drinking: it is the first step that ofttimes leads to danger, and eventually to destruction!

100. I am quite convinced that one cause of barrenness among ladies of the present day is excessive wine-drinking. This is an age of stimulants, and the practice is daily increasing. A delicate lady is recommended to take three or four glasses of wine daily. It seems for the moment to do her good, and whenever she feels low she flies to it again. The consequence is, that she almost lives upon wine, and takes but little else besides! Who are the fruitful women? Poor women who cannot afford to drink stimulants; for instance, poor Irish women and poor curates’ wives, who have only, principally, water and milk and buttermilk to drink.

101. There is decidedly, among the higher ranks, more barrenness than formerly, and one cause of it, in my opinion, is the much larger quantity of wine now consumed than in the olden times. Many ladies now drink as many glasses of wine in one day as their grandmothers drank in a week; moreover, the wineglasses of the present day are twice the size of old-fashioned 61wineglasses; so that half a dozen glasses of wine will almost empty a bottle; and many ladies now actually drink, in the day, half a dozen glasses of wine!

102. In the wine-growing and wine-drinking country of France, barrenness prevails to a fearful extent; it has become there a serious consideration and a State question. Wine is largely consumed in France by ladies as well as by gentlemen. The usual and everyday quantity of wine allowed at dinner at the restaurants of Paris, for each lady, is half a wine quart bottle-full—a similar quantity to that allowed for each gentleman. Where a gentleman and a lady are dining together, and have a bottle of wine between them, it is probable that the former might consume more than his own share of the wine; but whether he does or not, the quantity the lady herself drinks is sadly too much either for her health or for her fruitfulness. I am, moreover, quite convinced that the quantity of wine—sour wine—consumed by French wives is not only very antagonistic to their fertility, but likewise to their complexions.

103. Wine was formerly a luxury, it is now made a necessary of life. Fruitful women, in olden times, were more common than they are now. Riches, and consequently wine, did not then so much abound, but children did much more abound. The richer the person, the fewer the children.

104. Wine is now oftentimes sucked in with a mother’s 62milk! Do not let me be misunderstood; wine and brandy, in certain cases of extreme exhaustion, are, even for very young children, most valuable remedies; but I will maintain that both wine and brandy require the greatest judgment and skill in administering, and do irreparable mischief unless they are most carefully and judiciously prescribed. Wine ought to be very rarely given to the young; indeed, it should be administered to them with as much care and as seldom as any other dangerous or potent medicine.

105. Statistics prove that wine-bibbing in England is greatly on the increase, and so is barrenness. You might say there is no connection between the two. I maintain that there is a connection, and that, the alcohol contained in the wine (if wine be taken to excess, which unfortunately it now frequently is) is most antagonistic to fruitfulness.

106. It is surprising, nowadays, the quantity of wine some few young single ladies, at parties, can imbibe without being intoxicated; but whether, if such ladies marry, they will make fruitful vines is quite another matter; but of this I am quite sure, that such girls will, as a rule, make delicate, hysterical, and unhealthy wives. The young are peculiarly sensitive to the evil effects of overstimulation. Excessive wine-drinking with them is a canker eating into their very lives. Time it is that these facts were proclaimed through the length and breadth of our land, before mischief be done past remedy.

63107. Champagne is a fashionable and favorite beverage at parties, especially at dances. It is a marvel to note how girls will, in quantities, imbibe the dangerous liquid. How cheerful they are after it; how bright their colors; how sparkling their eyes; how voluble their tongues; how brilliant their ideas! But, alas! the effects are very evanescent—dark clouds soon o’ershadow the horizon, and all is changed! How pale, after it, they become; how sallow their complexions; how dim their eyes; how silent their tongues; how depressed their spirits—depression following in an inverse ratio to overstimulation; and if depression, as a matter of course, weakness and disease! Champagne is one of the most fascinating but most desperately dangerous and deceptive drinks a young girl can imbibe, and should be shunned as the plague! Young men who witness their proceedings admire them vastly as partners for the evening, but neither covet nor secure them as partners for life. Can they be blamed? Certainly not! They well know that girls who, at a dance, imbibe freely of the champagne-cup, and who at a dinner party drink, as some few are in the habit of drinking, four or five, or even six, glasses of wine,—that such wives as these, if ever they do become mothers (which is very doubtful), will be mothers of a degenerate race. It is folly blinking the question; it is absolutely necessary that it be looked boldly in the face, and that the evil be remedied before it be too late.

108. There is an immense deal of drinking in England, 64which, I am quite convinced, is one reason of so few children in families, and of so many women being altogether barren. It is high time that these subjects were looked into, and that the torrent be stemmed, ere it o’erflow its banks, and carry with it a still greater amount of barrenness, of misery, and of destruction.

109. It might be said that the light wines contain but little alcohol, and therefore can cause, even if taken to excess, but slight injurious effects on the constitution. I reply, that even light wines, taken in quantities, conduce to barrenness, and that, as a rule, if a lady once unfortunately takes to drinking too much wine, she is not satisfied with the light wines, but at length flies to stronger wines—to wines usually fortified with brandy, such as either to sherry or to port wine, or even, at last, to brandy itself! I know that I am treading on tender ground, but my duty as a medical man, and as a faithful chronicler of these matters, obliges me to speak out plainly, without fear or without favor, and to point out the deplorable consequences of such practices. I am quite aware that many ladies have great temptations and great inducements to resort to wine to cheer them in their hours of depression and of loneliness; but unless the danger be clearly pointed out and defined, it is utterly impossible to suggest a remedy, and to snatch such patients from certain destruction.

110. I am quite convinced of one thing, namely, that the drinking of much wine—be it light as claret, or be 65it heavy as port—sadly injures the complexion, and makes it muddy, speckled, broken-out, and toad-like.

111. It is high time that medical men should speak out on the subject, and that with no “uncertain sound,” before mischief be done past remedy, and before our island become as barren of children as France unfortunately now is.

112. If a lady be laboring under debility, she is generally dosed with quantities of wine—the greater the debility the more wine she is made to take, until at length the poor unfortunate creature almost lives upon wine. Her appetite for food is by such means utterly destroyed, and she is for a time kept alive by stimulants; her stomach will at length take nothing else, and she becomes a confirmed invalid, soon dropping into an untimely grave! This is a most grievous, and, unfortunately, in this country, not an uncommon occurrence. Much wine will never make a delicate lady strong—it will increase her weakness, not her strength. Wine in excess does not strengthen, but, on the contrary, produces extreme debility. Let this be borne in mind, and much misery might then be averted.

113. Remember I am not objecting to a lady taking wine in moderation—certainly not; a couple of glasses, for instance, in the day, of either sherry or claret, might do her great good; but I do strongly object to her drinking, as many ladies do, five or six glasses of wine 66during that time. I will maintain that such a quantity is most detrimental both to her health and to her fecundity.

114. The effect of the use of wine is beneficial; but the effect of the abuse of it is deplorable in the extreme. Wine is an edge-tool, and will, if not carefully handled, assuredly wound most unmercifully. I have not the slightest doubt that the quantity of wine consumed by many ladies is one cause, in this our day, of so much delicacy of constitution. It is a crying evil, and demands speedy redress; and as no more worthy medical champion has appeared in the field to fight the battle of moderate wine-drinking, I myself have boldly come forward to commence the affray, fervently trusting that some earnest men may join me in the conflict. I consider that the advocates for a plentiful supply of alcoholic stimulants are wrong, and that the upholders of total abstinence principles are equally wrong; and that the only path of health and of safety lies between them both—in moderation. A teetotaller and an advocate for a plentiful supply of alcoholic drinks are both very difficult to please; indeed, the one and the other are most intemperate. I am aware that what I have written will be caviled at, and will give great offense to both extreme parties; but I am quite prepared and willing to abide the consequences, and sincerely hope that what I have said will be the means of ventilating the subject, which is sadly needed. It is the violence and obstinacy of the contending parties, each of whom is partly right and partly wrong, that 67have long ago prevented a settlement of the question at issue, and have consequently been the means of causing much heart-burning, misery, and suffering. The Times once pithily remarked that it would be well if the two combatants were “to mix their liquors.”

115. A young wife ought to rise betimes in the morning, and after she be once awake should never doze. Dozing is both weakening to the body and enervating to the mind. It is a species of dram-drinking; let my fair reader, therefore, shun it with all her might. Let her imitate the example of the Duke of Wellington, who, whenever he turned in bed, made a point of turning out of it; indeed, so determined was that illustrious man not to allow himself to doze after he was once awake, that he had his bed made so small that he could not conveniently turn in it without first of all turning out of it. Let her, as soon as she is married, commence early rising; let her establish the habit, and it will for life cling to her:

“Awake! the morning shines, and the fresh field
Calls us; we lose the prime, to mark how spring
Our tender plants; how blows the citron grove,
What drops the myrrh, and what the balmy reed;
How Nature paints her colors; how the bee
Sits on the bloom.”[22]

116. It is wonderful how much may be done betimes in the morning. There is nothing like a good start. It 68makes for the remainder of the day the occupation easy and pleasant—

“Happy, thrice happy, every one
Who sees his labor well begun,
And not perplexed and multiplied
By idly waiting for time and tide.”[23]

117. How glorious, and balmy, and health-giving, is the first breath of the morning, more especially to those living in the country! It is more exhilarating, invigorating, and refreshing than it is all the rest of the day. If you wish to be strong, if you desire to retain your good looks and your youthful appearance, if you are desirous of having a family, rise betimes in the morning; if you are anxious to lay the foundation of a long life, jump out of bed the moment you are awake. Let there be no dallying, no parleying with the enemy, or the battle is lost, and you will never after become an early riser; you will then lose one of the greatest charms and blessings of life, and will, probably, not have the felicity of ever becoming a mother; if you do become one, it will most likely be of puny children. The early risers make the healthy, bright, long-lived wives and mothers. But if a wife is to be an early riser, she must have a little courage and determination; great advantages in this world are never gained without; but what is either man or woman good for if they have not those qualities?

118. An early riser ought always to have something 69to eat and drink, such as a little bread and butter, and either a cup of tea or a draught of new milk, before she goes out of a morning; this need not interfere with, at the usual hour, her regular breakfast. If she were to take a long walk on an empty stomach, she would for the remainder of the day feel tired and exhausted, and she would then, but most unfairly, fancy that early rising did not agree with her.

119. The early morning is one of the best and most enjoyable portions of the day. There is a perfect charm in nature which early risers alone can appreciate. It is only the early riser that ever sees “the rosy morn,” the blushing of the sky, which is gloriously beautiful! Nature, in the early morning, seems to rejoice and be glad, and to pour out her richest treasures: the birds vie with each other in their sweetest carols; the dew on the grass, like unto myriads of diamonds, glittering and glistening, and glinting in the rays of the sun; occasionally the cobwebs on the shrubs and bushes, like exquisite lace sparkling with gems; the fresh and matchless perfume and fragrance of the earth and flowers;—these, one and all, are gloriously beautiful to behold, and can only be enjoyed to perfection in the early morning, while the majority of people, during the choicest periods of their existence, are sweltering, and dozing, and deteriorating both in body and mind, on beds of down, when they ought to be up, out, and about! Can it be wondered at, when such weakening and enervating practices are so much in vogue—for luxury is the curse of the day—that there 70are so many barren wives in England? It looks, on the first blush, that many of the customs and practices of the present day were to cause barrenness; for, assuredly, if they had been instituted on purpose, they could not have performed their task more surely and successfully.

120. It might be said that the dews of the morning are dangerous! The dews of the early morning are beneficial to health, while the dews of the evening are detrimental. How truly the poet sings—

“Dew-drops are the gems of morning,
But the tears of mournful eve!”[24]

121. Early rising imparts health to the frame, strength to the muscles, and comeliness to the countenance; it clears the brain, and thus brightens the intellect; it is a panacea for many of the ills of life, and, unlike many panaceas, it is both simple and pleasant in its operation; it calms the troubled breast; it gives a zest to the after-employments and pleasures of the day; and makes both man and woman look up from “nature’s works to nature’s God!”

122. Early rising rejuvenizes the constitution: it makes the middle-aged look young, and the old look middle-aged; it is the finest cosmetic in the world, and tints the cheeks with a bloom the painter emulates, but in vain! On the other hand, late rising adds 71years to the looks, fills the body with aches and pains, and the countenance with crow-feet and wrinkles; gives a yellowness and pimples to the face, and depression to the spirits. Aged looks and ill health invariably follow in the wake of late rising.

123. If a mistress rise early the servants are likely to follow suit: a lazy mistress is almost sure to have lazy servants; the house becomes a sluggard’s dwelling! Do not let me be misunderstood; I do not recommend any unreasonable hours for rising in the morning; I do not advise a wife to rise early for the sake of rising early: there would be neither merit nor sense in it; I wish her to have her full complement of sleep—seven or eight hours; but I do advise her to go to bed early, in order that she might be up every morning at six o’clock in the summer, and at seven o’clock in the winter. I maintain that it is the duty of every wife, unless prevented by illness, to be an early riser. This last reason should have greater weight with her than any other that can possibly be brought forward! All things in this world ought to be done from a sense of duty; duty ought to be a wife’s and every other person’s pole-star!

124. There is a wonderful and glorious object in creation which few, very few, ladies, passing strange though it be, have ever seen—the rising of the sun! The few who have seen it are, probably, those who have turned night into day, who are returning home in the early morning, jaded and tired, after dancing the 72whole of the previous night. These, of course, cannot enjoy, and most likely do not even see, the magnificent spectacle!

125. I am not advising my fair reader to rise every morning with the rising of the sun—certainly not; but if she be an early riser, she might occasionally indulge herself in beholding the glorious sight!

126. “The top of the morning to you” is a favorite Irish salutation, and is very expressive and complimentary. “The top of the morning”—the early morning, the time when the sun first rises in his majesty and splendor—is the most glorious, and health-giving, and best part of the whole day; when nature and all created beings rejoice and are glad:

“But mighty Nature bounds as from her birth,
The sun is in the heavens, and life on earth;
Flowers in the valley, splendor in the beam,
Health in the gale, and freshness in the stream.”[25]

127. Let a young wife, if she be anxious to have a family and healthy progeny, be in bed betimes. It is impossible that she can rise early in the morning unless she retire early at night. “One hour’s sleep before midnight is worth three after.” Sleep before midnight is most essential to health, and if to health, to beauty; hence, sleep before midnight is called beauty-sleep. The finest cosmetic is health!

73128. She ought to pay particular attention to the ventilation of her sleeping apartment, and she herself, before leaving the chamber in the morning, ought never to omit to open the windows; and in the summer, if the room be large, she should during the night leave, for about six or eight inches, the window-sash open. If the room be small it will be desirable to have, instead of the window, the door (secured from intrusion by a door-chain) unclosed; and to have, as well, either the skylight or the landing window open. There ought by some means or other, if the inmates of the room are to have sweet and refreshing sleep, to be thorough ventilation of the sleeping apartment. I have no patience to hear some men assert that it is better to sleep in a close room—in a foul room! They might, with equal truth, declare that it is desirable for a healthy person to swallow every night a dose of arsenic in order to prolong his life! Carbonic acid gas is as truly a poison as arsenic! If there be a dressing-room next to the bedroom, it will be well to have the dressing-room window, instead of the bedroom window, open at night. The dressing-room door will regulate the quantity of air to be admitted into the bedroom, opening it either little or much as the weather might be cold or otherwise.[26] The idea that it will give cold is erroneous; it will be more likely, by strengthening the system and by carrying off the impurities of the lungs and skin, to prevent cold.

74129. Some persons, accustomed all their lives to sleep in a close, foul room—in a room contaminated with carbonic acid gas—cannot sleep in a fresh, well-ventilated chamber, in a chamber with either door or window open: they seem to require the stupefying effects of the carbonic acid gas, and cannot sleep without it! If such be the case, and as sleep is of such vital importance to the human economy, let both window and door be closed, but do not, on any account, let the chimney be stopped, as there must be, in a bedroom, ventilation of some kind or another, or ill health will inevitably ensue.

130. It is madness to sleep in a room without ventilation—it is inhaling poison; for the carbonic acid gas, the refuse of respiration, which the lungs are constantly throwing off, is a poison—a deadly poison—and, of course, if there be no ventilation, a person must breathe this carbonic acid gas mixed with the atmospheric air. Hence the importance, the vital importance, of either an open chimney or of an open window, or of both. The chimney, then, even if the window be closed, ought never to be stopped; and the window, either of the bedroom or of the dressing-room, should not be closed, even in the night, unless the weather be either very wet or bitterly cold. I should strongly recommend my fair reader, and, indeed, every one else, to peruse the good and talented Florence Nightingale’s Notes on Nursing. They ought to be written in letters of gold, and should be indelibly impressed on the memory of every one who has the interest of human life 75and happiness at heart. Florence Nightingale declares that no one, while in bed, ever catches cold from proper ventilation. I believe her; and I need not say that no one has had more experience and better opportunities of judging about what she writes than this accomplished authoress.

131. I fearlessly assert that no one can sleep sweetly and refreshingly unless there be thorough ventilation of the chamber. She may have, in an unventilated apartment, heavy, drowsy, deathlike sleep, and well she might! She is under the stupefying effects of poison; the carbonic acid gas, which is constantly being evolved from the lungs, and which wants a vent, but cannot obtain it, is, as I have before remarked, a deadly poison! She may as well take every night a stupefying opiate, as breathe nightly a bedroom charged with carbonic acid gas; the one would, in the long run, be as pernicious as the other. To show the power of carbonic acid gas in sending people to sleep, we have only to notice a crowded church of an evening; when, even if the preacher be an eloquent man, the majority of the congregation is fast asleep,—is, in point of fact, under the soporific influence of the carbonic acid gas, the church being at the time full of it. Carbonic acid gas is as certain, if not more certain, to produce a heavy deathlike slumber as either numbing opium or drowsy poppy.

132. I moreover declare that she cannot have sweet refreshing sleep at night unless during the day she 76take plenty of exercise, and unless she has an abundance of active, useful occupation.

133. Occupation—active, useful occupation—is the best composing medicine in the world; and the misfortune of it is that the wealthy have little or no occupation to cause them to sleep. Pleasure they have in abundance, but little or no real occupation. “The sleep of a laboring man is sweet, whether he eat little or much: but the abundance of the rich will not suffer them to sleep.”[27]

134. Sleep is of more consequence to the human economy than food. Nothing should therefore be allowed by a young wife to interfere with sleep. And as the attendance on large assemblies, balls, and concerts sadly, in every way, interfere with sleep, they ought, one and all, to be sedulously avoided.

135. As exercise is very conducive and provocative of sleep—sound, sweet, childlike sleep—exercise must be practiced, and that not by fits and starts, but regularly and systematically. She ought, then, during the day, with exercise and with occupation, to tire herself, and she will then have sweet and refreshing sleep. But some ladies never do tire themselves except with excitement; they do not know what it is to be tired either by a long walk or by household work. They can tire themselves with dancing at a ball; poor fragile 77creatures can remain up the whole night waltzing, quadrilling, and galloping, but would be shocked at the idea and at the vulgarity of walking a mile at a stretch! Poor creatures, they are to be pitied; and, if they ever marry, so are their husbands. Are such wives as these likely to be mothers, and if they are, are their offspring likely to be strong? Are such wives as these likely to be the mothers of our future warriors, of our future statesmen, and of our other worthies—men of mark, who,

“Departing, leave behind them
Footprints on the sands of time!”

136. Sleep is the choicest gift of God. Sleep is a comforter, a solace, a boon, a nourisher, a friend. Happy, thrice happy, is a wife who can sleep like unto a little child! When she is well, what a comfort is sleep; when she is ill, what a soother of pain is sleep; when she is in trouble, what a precious balm is sleep!

137. Hear what our noblest poet, Shakspeare, says of sleep:

“Sleep that knits up the raveled sleeve of care,
The death of each day’s life, sore labor’s bath,
Balm of hurt minds, great nature’s second course
Chief nourisher in life’s feast.”

138. A luxurious, idle wife cannot sleep; she, night after night, tumbles and tosses on her bed of down. What has she done during the day to tire herself, and 78thus to induce sleep? Alas, nothing! She in consequence never experiences

“Tired nature’s sweet restorer, balmy sleep.”

For, after all, out-door exercise and useful occupation are the best composing medicines in the world! Encompassed as she is with every luxury—partaking of all the delicacies of the season, of the richest viands, and of the choicest wines—decked out in costly apparel—reclining on the softest cushions—surrounded with exquisite scenery, with troops of friends, and with bevies of servants;—yet, notwithstanding all these apparent advantages, she is oftentimes one of the most debilitated, complaining, “nervous,” hysterical and miserable of mortals. The causes of all these afflictions are—she has nothing to do; she is overwhelmed with prosperity; she is like a fire that is being extinguished in consequence of being overloaded with fuel; she is being killed with overmuch kindness; she is a drone in a hive where all must work if they are to be strong and well, and bright and cheerful; for labor is the lot of all and the law for all, for “God is no respecter of persons.” The remedies for a lady affected as above described are simple and yet efficacious—namely, simplicity of living, and an abundance of out-door exercise and of useful occupation. It would have been to the manifest advantage of many a fair dame if she were obliged to put down her close carriage, and were compelled to walk instead of drive. Riding in close carriages nurse many ailments which walking 79would banish; a brisk walk is the best tonic and the most reviving medicine in the world, and would prevent the necessity of her swallowing so much nauseous physic. Nature’s simple remedies are oftentimes far superior and far more agreeable than any to be found in the Pharmacopœia. It would have been a blessing to many a rich, indolent, and luxurious lady if she had been born in a lower rank—in one in which she had been compelled to work for her daily bread; if she had been, she would, in many instances, have been far happier and healthier than she now is. Indolence and luxury kill more than hard work and hard fare ever did or ever will kill. Indolence and luxury are slow poisons; they destroy by degrees, but are in the end as certain in their deleterious effects as either arsenic or deadly nightshade—

“Come hither, ye that press your beds of down,
And sleep not; see him sweating o’er his bread
Before he eats it. ’Tis the primal curse,
But softened into mercy—made the pledge
Of cheerful days, and nights without a groan.”

139. I must not forget to speak of the paramount importance in a dwelling of an abundance of light—of daylight. Light is life, light is health, light is a physician! Light is life: the sun gives life as well as light; if it were not for the sun, all creation would wither and die. There is “no vitality or healthful structure without light.”[28] Light is health: it strengthens the 80frame, it cheers the heart, and tints the cheeks with a roseate hue! Light is a physician: it drives away many diseases, as the mists vanish at the approach of the sun; and it cures numerous ailments which drugs alone are unable to relieve.

140. Look at the bloom on the face of a milkmaid! What is it that tints her cheeks? An abundance of light. Behold the pallid, corpselike countenance of a factory girl! What blanches her cheek? The want of light, of air, and of sunshine.

141. A room, then, ought to have large windows in order that the sun might penetrate into every nook and corner of the apartment. A gardener thoroughly appreciates the importance of light to his flowers; he knows, also, that if he wishes to blanch some kinds of vegetables—such as celery and sea-kale—he must keep the light from them; and if my fair reader desires to blanch her own cheeks, she ought to keep the light from them; but, on the other hand, if she be anxious to be healthy and rosy, she must have plenty of light in her dwelling.

142. The want of light stunts the growth, dims the sight, and damps the spirits. Colliers, who a great part of their lives live in the bowels of the earth, are generally stunted; prisoners, confined for years in a dark dungeon, frequently become blind; people who live in dark houses are usually melancholic.

143. Light banishes from rooms foulness, fustiness, 81mustiness, and smells. Light ought therefore to be freely allowed to enter every house, and be esteemed as the most welcome of visitors. Let me then advise every young wife to admit into her dwelling an abundance of light, of air, and of sunshine.

144. Some ladies, to keep off the sun, to prevent it from fading the furniture, have, in the summer time, all the blinds of the windows of the house down. Hence they save the fading of their furniture, and, instead of which, they fade their own and their children’s cheeks. Many houses, with all their blinds down, look like so many prisons, or as if the inmates were in deep affliction, or as if they were performing penance; for is it not a penance to be deprived of the glorious light of day, which is as exhilarating to the spirits as, and much more beneficial than, a glass of champagne?

145. It is a grievous sin to keep out from a dwelling the glorious sunshine. We have heard of “a trap to catch a sunbeam:” let the open windows be a trap, and a more desirable prize cannot be caught than a sunbeam. Sunbeams, both physical and metaphorical, make a house a paradise upon earth!

146. Let me strongly caution the newly made wife against the evil effects of tight lacing. The waist ought, as a rule, to be from twenty-seven to twenty-nine inches in circumference; if, therefore, she bind and gird herself in until she be only twenty-three 82inches, and, in some cases, until she be only twenty-one inches, it must be done at the expense of comfort, of health, and happiness. If stays be worn tightly, they press down the contents of the lower part of the belly, which might either prevent a lady from having a family, or might produce a miscarriage.[29]

147. Let her dress be loose, and be adapted to the season. She ought not to adopt the fashion of wearing in the morning warm clothes with long sleeves, and in the evening thin dresses with short sleeves. “It is hopeless to battle with fashion in matters of dress; women will never believe that their bonnets, neck-wrappers, or huge petticoats (until they go out of fashion) can have anything to do with headaches, sore throats, or rheumatism; but they ought to know that the more they swathe themselves, the more tender and delicate they are likely to be. If they wish to withstand cold, they should accustom themselves to bear it.”[30]

83148. If a young wife be delicate, and if her circulation be languid, a flannel vest next the skin, and in the daytime, should, winter and summer, be worn. Scarlet is, in such a case, a favorite color, and may be selected for the purpose.

149. It is important that it should be borne in mind that the wearing of flannel next the skin is more necessary in the summer than in the winter time. A lady in the summer is apt, when hot, either from the weather or from exertion, to get into a draught to cool herself, and not wearing flannel next the skin, she is almost sure at such times to catch a cold. Now, flannel being a bad conductor of heat, keeps the body at a tolerably equal temperature, and thus materially lessens the risk. When it is considered that many of the diseases afflicting humanity arise from colds, the value of wearing flannel next the skin as a preventive is at once apparent.

150. Never was there such a time as the present when dress was so much thought of. Grand dresses now sweep our dirty streets and thoroughfares; rich velvets, silks, and satins are as plentiful as dead leaves in autumn. “There is so much to gaze and stare at in the dress, one’s eyes are quite dazzled and weary, and can hardly pierce through to that which is clothed upon.” Dress is become a crying evil; many ladies clothe themselves in gorgeous apparel at the expense of household comforts, and even of household necessaries:

84“We sacrifice to dress, till household joys
And comforts cease. Dress drains our cellars dry,
And keeps our larder lean—puts out our fires,
And introduces hunger, frost, and woe,
Where peace and hospitality might reign.”[31]

151. It might be said, What has all this to do with the health of a wife? I reply, much. The customs, habits, and luxuries of the present day are very antagonistic both to health and fecundity.

152. She must not coddle, nor should she muffle up her throat with furs. Boas are the most frequent cause of sore throats and quinsies, and therefore the sooner they are discarded the better. “And this is perfectly true, though few seem to be aware of the fact. Relaxed throats would be rare if cold water was more plentifully used, both externally and internally, and mufflers were laid aside.”[32]

153. If my gentle reader will freely use cold water ablutions, she will find that she will not require nearly so much clothing and muffling up. It is those who use so little water who have to wear so much clothing; and the misfortune of it is, the more clothes they wear the more they require. Many young people are wrapped and muffled up in the winter time like old folks, and by coddling they become prematurely old—frightened at a breath of air and at a shower of 85rain, and shaking in their shoes at an easterly wind! Should such things be?

154. Pleasure, to a certain degree, is as necessary to the health of a young wife, and every one else, as the sun is to the earth—to warm, to cheer, and to invigorate it, and to bring out its verdure. Pleasure, in moderation, rejuvenizes, humanizes, and improves the character, and expands and exercises the good qualities of the mind; but, like the sun, in its intensity it oppresseth drieth up, and withereth. Pleasures kept within due bounds are good, but in excess are utterly subversive of health and happiness. A wife who lives in a whirl of pleasure and excitement is always weakly and “nervous,” and utterly unfitted for her duties and responsibilities.

155. Let the pleasures of a newly-married wife, then, be dictated by reason, and not by fashion. She ought to avoid all recreations of an exciting kind, as depression always follows excitement. I would have her prefer the amusements of the country to those of the town, such as a flower-garden, botany, archery, croquet, bowls,—everything, in fact, that will take her into the open air, and will cause her to appreciate the pure, simple, and exquisite beauties of nature. Croquet I consider to be one of the best games ever invented: it induces a lady to take exercise which perhaps she would not otherwise do; it takes her into the open air, it strengthens her muscles, it expands her chest, it promotes digestion, it circulates her blood, and 86it gives her an interest in the game which is most beneficial both to mind and body.

156. Oh, that my countrywomen should prefer the contaminated and foul air of ball and of concert-rooms, to the fresh, sweet, and health-giving air of the country!

157. Let me in this place enter my strong protest against a young wife dancing, more especially if she be enceinte. If she be anxious to have a family, it is a most dangerous amusement, as it is a fruitful source of miscarriage; and the misfortune is, that if she once have a miscarriage, she might go on again and again, until her constitution be severely injured, and until all hopes of her ever becoming a mother are at an end.

158. The quiet retirement of her own home ought then to be her greatest pleasure and her most precious privilege. Home is, or ought to be, the kingdom of woman, and she should be the reigning potentate. England is the only place in the world that truly knows what home really means. The French have actually no word in their language to express its meaning:

“That home, the sound we English love so well,
Has been as strange to me as to those nations
That have no word, they tell me, to express it.”[33]

87159. Cheerfulness, contentment, occupation, and healthy activity of mind cannot be too strongly recommended. A cheerful, happy temper is one of the most valuable attributes a wife can have. The possession of such a virtue not only makes herself, but every one around her, happy. It gilds with sunshine the humblest dwelling, and often converts an indifferent husband into a good one. Contentment is the finest medicine in the world; it not only frequently prevents disease, but, if disease be present, it assists in curing it. Happy is the man who has a contented wife! A peevish, discontented helpmate (helpmate, save the mark!) is always ailing, is never satisfied, and does not know, and does not deserve to know, what real happiness is. She is “a thorn in the flesh.”

160. One of the greatest requisites, then, for a happy home is a cheerful, contented, bright, and merry wife; her face is a perpetual sunshine, her presence is that of an angel; she is happy in herself, and she imparts happiness to all around her. A gentle, loving, confiding, placid, hopeful, and trusting disposition has a great charm for a husband, and ought, by a young wife, to be assiduously cultivated—

“For gentleness, and love, and trust
Prevail o’er angry wave and gust.”[34]

161. Every young wife, let her station be ever so exalted, ought to attend to her household duties. Her 88health, and consequently her happiness, demand the exertion. The want of occupation—healthy, useful occupation—is a fruitful source of discontent, of sin,[35] of disease, and barrenness. If a young married lady did but know the importance of occupation—how much misery might be averted, and how much happiness might, by attending to her household duties, be insured—she would appreciate the importance of the advice. Occupation improves the health, drives away ennui, cheers the hearth and home, and, what is most important, if household duties be well looked after, her house becomes a paradise, and she the ministering angel to her husband. But she might say—I cannot always be occupied; it bores me; it is like a common person: I am a lady; I was not made to work; I have neither the strength nor the inclination for it; I feel weak and tired, nervous and spiritless, and must have rest. I reply, in the expressive words of the poet, that—

“Absence of occupation is not rest,—
A mind quite vacant is a mind distress’d.”[36]

“If time be heavy on your hands,” are there no household duties to look after, no servants to instruct, no flower-beds to arrange, no school children to teach, no sick-room to visit, no aged people to comfort, no widow nor orphan to relieve?—

89“Nor any poor about your lands?
Oh! teach the orphan boy to read,
Or teach the orphan girl to sew—
Pray Heaven for a human heart.”[37]

162. To have nothing to do is most wretched, wearisome, and destructive to the mind. The words of Martin Luther on this subject should be written in letters of gold, and ought to be kept in constant remembrance by every man and woman, be they rich or poor, lettered or unlettered, gentle or simple. “The mind,” said he, “is like a mill that cannot stop working; give it something to grind, and it will grind that. If it has nothing to grind, it grinds on yet, but it is itself it grinds and wears away.”

163. A lady in this enlightened age of ours considers it to be horribly low and vulgar to strengthen her loins with exercise and her arms with occupation, although such a plan of procedure is recommended in the Bible by the wisest of men,—“She girdeth her loins with strength, and strengthened her arms.”[38]

164. A husband soon becomes tired of grand performances on the piano, of crotchet and worsted work, and of other fiddle-faddle employments; but he can always appreciate a comfortable, clean, well-ordered, bright, cheerful, happy home, and a good dinner. It might be said that a wife is not the proper person to cook her 90husband’s dinner. True; but a wife should see and know that the cook does her duty; and if she did, perchance, understand how the dinner ought to be cooked, I have yet to learn that the husband would for such knowledge think any the worse of her.

165. A grazing farmer is three or four years in bringing a beast to perfection, fit for human food. Is it not a sin, after so much time and pains, for an idiot of a cook, in the course of one short hour or two, to ruin, by vile cookery, a joint of such meat? Is it not time, then, that a wife herself should know how a joint of meat ought to be cooked, and thus to be able to give instructions accordingly?

166. A boy is brought up to his profession, and is expected to know it thoroughly; how is it that a girl is not brought up to her profession of a wife; and why is it that she is not taught to thoroughly understand all household duties? The daughters of a gentleman’s family in olden time spent an hour or two every morning in the kitchen and in the laundry, and were initiated into the mysteries of pastry and pudding-making, of preserving fruit, of ironing, etc. Their mothers’ and their grandmothers’ receipt-books were at their finger-ends. But now look at the picture; the daughters of a gentleman’s family of the present day consider it very low and horridly vulgar to understand any such matters. It is just as absurd to ask a lady to play on the piano who has never been taught music as to ask a wife to direct her servants to perform duties which she 91herself knows nothing about. The duties of a wife cannot come either by intuition or by instinct more than music can. Again I say, every lady, before she be married, ought to be thoroughly taught her profession—the duties of a wife; she then would not be at the tender mercies of her servants, many of whom are either unprincipled or inefficient.

167. Do not think that I am overstating the importance of the subject. A good dinner—I mean a well-cooked dinner (which, be it ever so plain, is really a good dinner)—is absolutely essential to the health, to the very existence of yourself and your husband; and how, if it be left to the tender mercies of the present race of cooks, can you have it? High time it is that every wife, let her station be either high or low, should look into the matter herself, and remedy the crying evil of the day. They manage these things better in Sweden. There the young ladies of wealthy families cook—actually themselves cook—the dinners; and instead of their considering it a disgrace, and to be horridly low and vulgar, they look upon it as one of their greatest privileges! And what is the consequence? A badly-cooked dinner is rare, and not, as it frequently is in this country, of frequent occurrence; and “peace and happiness” reign triumphant. It is a pity, too, that we do not take a leaf out of the book of our neighbors the French. Every woman in France is a good cook; good cookery with them is the rule—with us it is the exception. A well-cooked dinner is a blessing to all who partake of it; it promotes digestion, it 92sweetens the temper, it cheers the hearth and home. There is nothing tries the temper more than an ill-cooked dinner; it makes people dyspeptic, and for a dyspeptic to be sweet-tempered is an utter impossibility. Let me, therefore, advise my fair reader to look well into the matter; either the gloom or the sunshine of a house much depends upon herself and upon her household management. It might be said—What a poor creature a man must be to require so much attention. Truly, if his health be not looked after, if his comforts be not attended to, he is indeed a poor creature!

168. Every young wife should be able—ought to be instructed by her mother or by some competent person—it should be a part of her education—to teach and to train her own servants aright. Unfortunately, in the present day there is too much cant and humbug about the instruction of the lower orders, and domestic servants among the rest. They are instructed in many things that are perfectly useless to them, the knowledge of which only makes them dissatisfied with their lot and tends to make them bad servants. Among other useless subjects taught them are the “ologies.” It would be much more to the purpose if they were thoroughly instructed in all household duties, and “in the three R’s—reading, ’riting, and ’rithmetic,”—in obedience to their mistresses, and in simplicity of demeanor and dress. The servants themselves would be immensely benefited by such lessons.

93169. A “blue-stocking” makes, as a rule, a wretched wife; it would be far better for the health of her husband, of herself, and her family, if, instead of cultivating Latin and Greek, she would cultivate her household duties, more especially a thorough knowledge of the culinary department. “A man is, in general, better pleased when he has a good dinner upon his table than when his wife speaks Greek.”[39]

170. As soon as a lady marries, the romantic nonsense of school-girls will rapidly vanish, and the stern realities of life will take their place, and she will then know, and sometimes to her grievous cost, that a useful wife will be thought much more of than either an ornamental or a learned one.

171. It is better for a young wife, and for every one else, to have too much than too little occupation. The misfortune of the present day is, that servants are made to do all the work, while the mistress of the house remains idle. Remains idle! Yes; and by remaining idle, remains out of health! Idleness is a curse, and brings misery in its train! How slow the hours crawl on when a person has nothing to do; but how rapidly they fly when she is fully occupied! Besides, idleness is a frequent cause of barrenness. Hard-worked, industrious women are prolific; while idle ladies are frequently childless, or, if they do have a family, their children are puny, and their labors are usually both 94hard and lingering. We doctors know full well the difference there often is between the labor of a poor hard-worked woman and of a rich, idle lady: in the one case the labor is usually quick and easy; in the other, it is often hard and lingering. Oh, if wives would consider betimes the importance of an abundance of exercise and of occupation, what an immense amount of misery, of pain, of anxiety, and anguish they might avert! Work is a blessed thing; if we do not work we pay the penalty—we suffer “in mind, body, and estate.” An idle man or an idle woman is an object of the deepest pity and commiseration.

172. Longfellow, in his Song of the Blacksmith, beautifully and graphically describes the importance and the value of occupation; and as occupation is as necessary to a woman as to a man, I cannot resist transcribing it:

“Toiling—rejoicing—sorrowing,
Onward through life he goes;
Each morning sees some task begin,
Each evening sees its close;
Something attempted, something done,
Has earned a night’s repose.”

173. Truly may it be said that “occupation earns a night’s repose.” It is the finest composing medicine in the world, and, unlike an opiate, it never gives a headache; it never produces costiveness; and never, by repetition, loses its effect. Sloth and restlessness, even on down, are generally bed-fellows:

95“Weariness
Can snore upon the flint, when rusty sloth
Finds the down pillow hard.”

174. The mind, it is well known, exerts great influence over the body in promoting health, and in causing and in curing disease. A delicate woman is always nervous; she is apt to make mountains of molehills; she is usually too prone to fancy herself worse than she really is. I should recommend my gentle reader not to fall into this error, and not to magnify every slight ache or pain. Let her, instead of whining and repining, use the means which are within the reach of all to strengthen her frame; let her give battle to the enemy; let her fight him with the simple weapons indicated in these pages, and the chances are she will come off victorious.

175. There is nothing like occupation, active occupation, to cure slight pains—“constant occupation physics pain”—to drive away little ailments, and the dread of sickness. “The dread of sickness,” says Dr. Grosvenor, “is a distemper of itself, and the next disposition to a many more. What a bondage does this keep some people in! ’Tis an easy transition from the fear and fancy of being sick to sickness indeed. In many cases there is but little difference between those two. There is one so afraid of being ill that he would not stir out of doors, and for want of air and exercise he contracts a distemper that kills him.”

176. What a blessed thing is work! What a precious 96privilege for a girl to have a mother who is both able and anxious to instruct her daughter, from her girlhood upwards, in all household management and duties! Unfortunately, in this our age girls are not either educated or prepared to be made wives—useful, domesticated wives. Accomplishments they have without number, but of knowledge of the management of an establishment they are as ignorant as the babe unborn. Verily, they and their unfortunate husbands and offspring will in due time pay the penalty of their ignorance and folly! It is, forsooth, unladylike for a girl to eat much; it is unladylike for her to work at all; it is unladylike for her to take a long walk; it is unladylike for her to go into the kitchen; it is unladylike for her to make her own bed; it is unladylike for her to be useful; it is unladylike for her to have a bloom upon her cheek like unto a milkmaid![40] All these are said to be horridly low and vulgar, and to be only fit for the common people! Away with such folly! The system of the bringing up of the young ladies of the present day is “rotten to the core.”

177. If a young married lady, without having any actual disease about her, be delicate and nervous, there is no remedy equal in value to change of air—more especially to the sea-coast. The sea breezes, and, if she be not pregnant, sea-bathing, frequently act like 97magic upon her in restoring her to perfect health. I say, if she be not pregnant; if she be, it would, without first obtaining the express permission of a medical man, be highly improper for her to bathe.

178. A walk on the mountains is delightful to the feelings and beneficial to the health. In selecting a sea-side resort, it is always, where it be practicable, to have mountain-air as well as the sea breeze. The mounting of high hills, if a lady be pregnant, would not be desirable, as the exertion would be too great, and, if she be predisposed, might bring on a miscarriage; but the climbing of hills and mountains, if she be not enceinte, is most advantageous to health, strengthening the frame, and exhilarating to the spirits. Indeed, we may compare the exhilaration it produces to the drinking of champagne, with this difference,—it is much more beneficial to health than champagne, and does not leave, the next morning, as champagne sometimes does, either a disagreeable taste in the mouth or headache behind,—

“Oh, there is a sweetness in the mountain-air,
And life, that bloated ease can never hope to share!”[41]

179. Bugs and fleas.—This is a very commonplace subject, but like most commonplace subjects is one necessary to be known, as these pests of society sometimes 98destroy the peace, comfort, and enjoyment of a person when away from home. Many ladies who travel from home are made miserable and wretched by having to sleep in strange beds—in beds infested either with bugs or with fleas. Now, it will be well for such ladies never to go any distance from home without having four things in their trunks with them, namely: (1) A box of matches, in order, at any moment of the night, to strike a light, both to discover and frighten the enemies away. (2) A box of night-lights. Bugs never bite when there is a light in the room. It would therefore be well, in an infested room, and until fresh lodgings can be procured, to keep a night-light burning all night. (3) A packet of “La Poudre Insecticide,” manufactured in France, but which may be procured in England: a preparation which, although perfectly harmless to the human economy, is utterly destructive to fleas. (4) A 4 oz. bottle of oil of turpentine, a little of which, in case of a discovery of bugs in the bed, should be sprinkled between the sheets and on the pillow. The oil of turpentine will, until fresh lodgings can be procured, keep the bugs at a respectful distance. Care should be observed while sprinkling the sheets with the turpentine not to have (on account of its inflammability) a lighted candle too near the bed. I know, from experience, that bugs and fleas are, when ladies are away from home, a source of torment and annoyance, and am therefore fully persuaded of the value and importance of the above advice.

180. If it be not practicable for her to visit the sea-coast, 99let her be in the fresh air—in the country air. Let her mornings be spent out of doors; and if she cannot inhale the sea breezes, let her inhale the morning breezes—

“The skies, the air, the morning’s breezy call
Alike are free, and full of health to all.”[42]

181. Cheerfulness and evenness of temper ought, by a young wife, to be especially cultivated. There is nothing that promotes digestion, and thus good health, more than a cheerful, placid temper. We know that the converse is very detrimental to that process; that violent passion takes away the appetite, deranges the stomach, and frequently disorders the bowels. Hence it is that those who attain great ages are usually of an even, cheerful temper. “Our passions are compared to the winds in the air, which, when gentle and moderate, let them fill the sail, and they will carry the ship on smoothly to the desired port; but when violent, unmanageable, and boisterous, it grows to a storm, and threatens the ruin and destruction of all.”[43]

182. A young wife is apt to take too much opening medicine; the more she takes, the more she requires. Hence she irritates the nerves of the stomach and bowels, and injures herself beyond measure. If the bowels are costive, and variety of food, and of fruit, and of other articles of diet, which I either have or will recommend in these pages, together with an 100abundance of air, and of exercise, and of occupation, will not open, then let her give herself an enema; which she can, without the slightest pain or annoyance, and with very little trouble, readily do, provided she has a proper apparatus for the purpose, namely, a “self-injecting enema apparatus,”—one made purposely for the patient, either to administer it to herself, or to be administered to her by another person. A pint of cold water is as good an enema as can be used, and which, if the first should not operate, ought in a few minutes to be repeated. The clyster does nothing more than wash the bowels out, removing any offending matter, and any depression of spirits arising therefrom, and neither interfering with the stomach nor with the digestion.

183. Until she become accustomed to the cold, she might for the first few mornings slightly warm the water; but gradually she should reduce the temperature of it until she use it quite cold. A cold water is more bracing and strengthening to the bowels, and more efficacious in action, than a warm water enema.

184. It will, during pregnancy and after a confinement, be safer to use a tepid than a cold water enema.

185. No family ought to be without a good enema apparatus, to fly to in any emergency. Many valuable lives have been saved by means of it, and having it always in good order and at hand.

101186. By adopting the dictates of reason and of common sense, many of the nervous, useless, lackadaisical, fine ladies will be unknown; and we shall have instead blooming wives, who will in due time become the mothers of hardy, healthy, happy children.

187. In the foregoing pages the burden of my song has been health—the preservation of health—the most precious of God’s gifts, and one that is frittered and fooled away as though it were but of little value. Health ought to be the first consideration of all, and of every young wife especially, as, when she is married, her life, her health is not altogether her own, but her husband’s and her family’s. Oh! it is a glorious gift, a precious boon, to be in the enjoyment of perfect health, and is worth a little care and striving for.

188. In concluding the first division of my subject, let me entreat my fair reader to ponder well on what I have already said; let her remember that she has a glorious mission; let her thoroughly understand that if good habits and good rules be not formed and followed during the first year of her wifehood, they are not at all likely to be instituted afterwards. The first year, then, is the golden opportunity to sow the seeds of usefulness; to make herself healthy and strong, and to cause her to be a blessing, a solace, and a comfort to her husband, her children, and all around her.

102189. Menstruation, during a period of about thirty years, plays a momentous part in the female economy; indeed, unless it be in every way properly and duly performed, it is neither possible that such a lady can be well, nor is it at all probable that she will conceive. I therefore purpose devoting an especial chapter to its due and careful consideration.

103

PART I.
MENSTRUATION.

190. There are two most important epochs in the life of a woman—namely (1) the commencement, and (2) the close of menstruation. Each is apt, unless carefully watched and prevented, to bring in its train many serious diseases. Moreover, unless menstruation be healthfully and properly performed, conception, as a rule, is not likely to take place: hence the importance of our subject.

191. Menstruation—the appearance of the catamenia or the menses—is then one of the most important epochs in a girl’s life. It is the boundary line, the landmark, between childhood and womanhood; it is the threshold, so to speak, of a woman’s life. Her body now develops and expands, and her mental capacity enlarges and improves. She then ceases to be a child, and she becomes a woman. She is now for the first time, as a rule, able to conceive.

192. Although puberty has at this time commenced, it cannot be said that she is at her full perfection; it takes eight or ten years more to complete her organization, 104which will bring her to the age of twenty-three or twenty-five years; which perhaps are the best ages for a woman, if she have both the chance and the inclination, to marry.

193. If she marry when very young, marriage weakens her system, and prevents a full development of the body. Besides, if she marry when she be only eighteen or nineteen, the bones of the pelvis—the bones of the lower part of the belly—are not at that time sufficiently developed; are not properly shaped for the purpose of labor; do not allow of sufficient space for the head of the child to readily pass, as though she were of the riper age of twenty-three or twenty-five. She might have in consequence a severe and dangerous confinement. If she marry late in life, say after she be thirty, the soft parts engaged in parturition are more rigid and more tense, and thus become less capable of dilatation, which might cause, for the first time, a hard and tedious labor. Again, when she marries late in life, she might not live to see her children grow up to be men and women. Moreover, as a rule, “the offspring of those that are very young or very old lasts not.” Everything, therefore, points out that the age above indicated—namely, somewhere between twenty and thirty—is the most safe and suitable time for a woman to marry.

194. Menstruation generally comes on once every month—that is to say, every twenty-eight days; usually to the very day, and frequently to the hour. Some 105ladies, instead of being “regular” every month, are “regular” every three weeks.

195. Each menstruation continues from three to five days; in some for a week; and in others for a longer period. It is estimated that, during each menstruation, from four to six ounces is, on an average, the quantity discharged.

196. A lady seldom conceives unless she be “regular,” although there are cases on record where women have conceived who have never been “unwell;” but such cases are extremely rare.

197. Menstruation in this country usually commences at the ages of from thirteen to sixteen, sometimes earlier; occasionally as early as eleven or twelve; at other times later, and not until a girl be seventeen or eighteen years of age. Menstruation in large towns is supposed to commence at an earlier period than in the country, and earlier in luxurious than in simple life.[44]

106198. Menstruation continues for thirty, and sometimes even for thirty-five years; and, while it lasts, is a sign that a lady is liable to become pregnant—unless, indeed, menstruation should be protracted much beyond the usual period of time. As a rule, then, when a woman “ceases to be unwell,” she ceases to have a family; therefore, as menstruation usually leaves her at forty-five, it is seldom, after that age, that she has a child.

199. I have known ladies become mothers when they have been upwards of fifty years of age. I myself delivered a woman in her fifty-first year of a fine healthy child. She had a kind and easy labor, and was the mother of a large family, the youngest being at the time twelve years old.[45] “Dr. Carpenter, of Durham, tells us that he has attended in their confinements several women whose ages were fifty. ‘I well recollect a case occurring in my father’s practice in 1839, where a woman became a widow at forty-nine years of age. Shortly afterwards she married her second husband, and within twelve months of this time gave birth to her first child. These cases belong to the working 107classes. But I know of two others, where gentlewomen became mothers at fifty-one with her first child, the other with her eighth. I can say nothing of how they menstruated, but I know of a virgin in whom the catamenia appeared regularly and undiminished up to and at the end of sixty.’ Dr. Powell says that he last year attended a woman in her fifty-second year; and Mr. Heckford, that he attended a woman who stated her age to be at least fifty. Mr. Clarke, of Mold, states that he has attended several women whose ages were upwards of forty-four, and that he lately delivered a woman of her first child at forty-eight. Mr. Bloxham, of Portsmouth, delivered at fifty-two, in her first confinement, a woman who had been married thirty-five years.”[46]

200. In very warm climates, such as in Abyssinia and in India, girls menstruate when very young—at ten or eleven years old; indeed, they are sometimes mothers at those ages.[47] But when it commences early, it leaves early; so that they are old women at thirty. “Physically, we know that there is a very large latitude 108of difference in the periods of human maturity, not merely between individual and individual, but also between nation and nation—differences so great that in some southern regions of Asia we hear of matrons at the age of twelve.”[48] Dr. Montgomery[49] brings forward some interesting cases of early maturity. He says: “Bruce mentions that in Abyssinia he has frequently seen mothers of eleven years of age; and Dunlop witnessed the same in Bengal. Dr. Goodeve, Professor of Midwifery at Calcutta, in reply to a query on the subject, said: ‘The earliest age at which I have known a Hindu woman bear a child is ten years, but I have heard of one at nine.’”

201. In cold climates, such as Russia, women begin to menstruate late in life, frequently not until they are between twenty and thirty years old; and, as it lasts on them thirty or thirty-five years, it is not an unusual occurrence for them to bear children at a very advanced age—even so late as sixty. They are frequently not “regular” oftener than three or four times a year, and when it does occur the menstrual discharge is generally sparing in quantity.

202. The menstrual fluid is not exactly blood, although, both in appearance and in properties, it much resembles it; yet it never in the healthy state clots as blood does. It is a secretion from the womb, and, when healthy, ought to be of a bright-red color, 109in appearance very much like blood from a recently cut finger.[50]

203. The menstrual fluid ought not, as before observed, to clot. If it does, a lady, during menstruation, suffers intense pain; moreover, she seldom conceives until the clotting has ceased. Application must therefore, in such a case, be made to a medical man, who will soon relieve the above painful symptoms, and, by doing so, will probably pave the way to her becoming pregnant.

204. Menstruation ceases entirely in pregnancy, during suckling, and usually both in diseased and in disordered states of the womb. It also ceases in cases of extreme debility, and in severe illness, especially in consumption; indeed, in the latter disease—consumption—it is one of the most unfavorable of the symptoms.

205. It has been asserted, and by men of great experience, that sometimes a woman menstruates during pregnancy. In this assertion I cannot agree; it appears utterly impossible that she should be able to do so. The moment she conceives, the neck of the womb becomes plugged up by means of mucus; it is, in fact, 110hermetically sealed. There certainly is sometimes a slight red discharge, looking very much like menstrual fluid, and coming on at her monthly periods; but being usually very sparing in quantity, and lasting only a day or so, and sometimes only for an hour or two; but this discharge does not come from the cavity of, but from some small vessels at, the mouth of the womb, and is not menstrual fluid at all, but a few drops of real blood. If this discharge came from the cavity of the womb, it would probably lead to a miscarriage. My old respected and talented teacher, the late Dr. D. D. Davis,[51] declared that it would be quite impossible during pregnancy for menstruation to occur. He considered that the discharge which was taken for menstruation arose from the rupture of some small vessels about the mouth of the womb.

206. Some ladies, though comparatively few, menstruate during suckling; when they do, it may be considered not the rule, but the exception. It is said, in such instances, that they are more likely to conceive. Many persons have an idea that when a woman, during lactation, menstruates, the milk is both sweeter and purer. Such is an error. Menstruation during suckling is more likely to weaken the mother, and consequently to deteriorate the milk. It therefore behooves a parent never to take a wet nurse who menstruates during the period of suckling.

207. A lady sometimes suffers severe pains both just 111before and during her “poorly” times. When such be the case, she seldom conceives until the pain be removed. She ought therefore to apply to a medical man, as relief may soon be obtained. When she is freed from the pain, she will, in all probability, in due time become enceinte.

208. If a married woman have painful menstruation, even if she become pregnant, she is more likely, in the early stage, to miscarry. This is an important consideration, and requires the attention of a doctor.

209. If a single lady, who is about to be married, have painful menstruation, it is incumbent on either her mother or a female friend to consult, two or three months before the marriage takes place, an experienced medical man, on her case; if this be not done, she will most likely, after marriage, either labor under ill health, or be afflicted with barrenness, or, if she do conceive, be prone to miscarry.

210. The menstrual discharge, as before remarked, ought, if healthy, to be of the color of blood—of fresh, unclotted blood. If it be either too pale (and it sometimes is almost colorless), or, on the other hand, if it be both dark and thick (it is occasionally as dark, and sometimes nearly as thick, as treacle), there will be but scant hopes of a lady conceiving. A medical man ought, therefore, at once to be consulted, who will in the generality of cases, be able to remedy the defect. The chances are, that as soon as the defect be remedied, she will become pregnant.

112211. Menstruation at another time is too sparing; this is a frequent cause of a want of family. Luckily a doctor is, in the majority of cases, able to remedy the defect, and by doing so will probably be the means of bringing the womb into a healthy state, and thus predispose her to become a mother.

212. A married lady is very subject to the “whites;” the more there will be of the “whites” the less there will usually be of the menstrual discharge;—so that in a bad case of the “whites” menstruation might entirely cease, until proper means be used both to restrain the one and to bring back the other. Indeed, as a rule, if the menstrual discharge, by proper treatment, be healthily established and restored, the “whites” will often cease of themselves. Deficient menstruation is a frequent cause of the “whites,” and the consequent failure of a family; and as deficient menstruation is usually curable, a medical man ought, in all such cases, to be consulted.

213. Menstruation at other times is either too profuse or too long continued. Either the one or the other is a frequent source of barrenness, and is also weakening to the constitution, and thus tends to bring a lady into a bad state of health. This, like the former cases, by judicious management may generally be rectified; and being rectified, will in all probability result in the wife becoming a mother.

214. When a lady is neither pregnant nor “regular,” she ought immediately to apply to a doctor, as she 113may depend upon it there is something wrong about her, and that she is not likely to become enceinte[52] until menstruation be properly established. As soon as menstruation be duly and healthily established, pregnancy will most likely, in due time, ensue.

215. When a lady is said to be “regular,” it is understood that she is “regular” as to quality, and quantity, and time. If she be only “regular” as to the time, and the quantity be either deficient or in excess, or if she be “regular” as to the time, and the quality be bad, either too pale or too dark; or if she be “regular” as to the quality and quantity, and be irregular as to the time, she cannot be well; and the sooner means are adopted to rectify the evil, the better it will be for her health and happiness.

216. There is among young wives, of the higher ranks, of the present time, an immense deal of hysteria; indeed it is, among them, in one form or another, the most frequent complaint of the day. Can it be wondered 114at? Certainly not. The fashionable system of spending married life, such as late hours, close rooms, excitement, rounds of visiting, luxurious living, is quite enough to account for its prevalence. The menstrual functions in a case of this kind are not duly performed; she is either too much or too little “unwell;” menstruation occurs either too soon, or too late, or at irregular periods. I need scarcely say that such a one, until a different order of things be instituted, and until proper and efficient means be used to restore healthy menstruation, is not likely to conceive; or, if she did conceive, she would most likely either miscarry, or, if she did go her time, bring forth a puny, delicate child. A fashionable wife and happy mother are incompatibilities! Oh, it is sad to contemplate the numerous victims that are sacrificed yearly on the shrine of fashion! The grievous part of the business is, that fashion is not usually amenable to reason and common sense; argument, entreaty, ridicule, are each and all alike in turn powerless in the matter. Be that as it might, I am determined boldly to proclaim the truth, and to make plain the awful danger of a wife becoming a votary of fashion.

217. Many a lady, either from suppressed or from deficient menstruation, who is now chlorotic, hysterical, and dyspeptic, weak and nervous, looking wretchedly, and whose very life is a burden, may, by applying to a medical man, be restored to health and strength.

218. As soon as a lady “ceases to be after the manner 115of women”—that is to say, as soon as she ceases to menstruate—it is said that she has “a change of life;” and if she does not take care, she will soon have “a change of health” to boot, which, in all probability, will be for the worse.

219. After a period of about thirty years’ continuation of menstruation, a woman ceases to menstruate; that is to say, when she is about forty-four or forty-five years of age, and, occasionally, as late in life as when she is forty-eight years of age, she has “change of life,” or, as it is sometimes called, a “turn of years.” Now, before this takes place, she oftentimes becomes very “irregular;” at one time she is “regular” before her proper period; at another time either before or after; so that it becomes a dodging time with her, as it is so styled. In a case of this kind menstruation is sometimes very profuse; at another it is very sparing; occasionally it is light colored, almost colorless; sometimes it is as red as from a cut finger; while now and then it is as black as ink.

220. When “change of life” is about, and during the time, and for some time afterwards, a lady labors under, at times, great flushings of heat; she, as it were, blushes all over; she goes very hot and red, almost scarlet; then perspires; and afterwards becomes cold and chilly. These flushings occur at very irregular periods; they might come on once or twice a day, at other times only once or twice a week, and occasionally only at what would have been her “poorly times.” These 116flushings might be looked upon as rather favorable symptoms, and as an effort of nature to relieve itself through the skin. These flushings are occasionally, although rarely, attended with hysterical symptoms. A little appropriate medicine is for these flushings desirable. A lady while laboring under these heats is generally both very much annoyed and distressed; but she ought to comfort herself with the knowledge that they are in all probability doing her good service, and that they might be warding off, from some internal organ of her body, serious mischief.

221. “Change of life” is one of the most important periods of a lady’s existence, and generally determines whether, for the rest of her days, she shall either be healthy or otherwise; it therefore imperatively behooves her to pay attention to the subject, and in all cases when it is about taking place to consult a medical man, who will, in the majority of cases, be of great benefit to her, as he will be able to ward off many important and serious diseases to which she would otherwise be liable. When “change of life” ends favorably, which, if properly managed, it most likely will do, she may improve in constitution, and may really enjoy better health and spirits, and more comfort, then she has done for many previous years. A lady who has during the whole of her wifehood eschewed fashionable society, and who has lived simply, plainly, and sensibly, and who has taken plenty of out-door exercise, will, during the autumn and winter of life, reap her reward by enjoying what is the greatest earthly blessing—health!

117

PART II.
PREGNANCY.

SIGNS OF PREGNANCY.

222. The first sign that leads a lady to suspect that she is pregnant is her ceasing to be unwell. This, provided she has just before been in good health, is a strong symptom of pregnancy; but still there must be others to corroborate it.

223. The next symptom is morning sickness. This is one of the earliest symptoms of pregnancy; as it sometimes occurs a few days, and indeed generally not later than a fortnight or three weeks, after conception. Morning sickness is frequently distressing, oftentimes amounting to vomiting, and causing a loathing of breakfast. This sign usually disappears after the first three or four months. Morning sickness is not always present in pregnancy; but, nevertheless, it is a frequent accompaniment; and many who have had families place more reliance on this than on any other symptom.

224. A third symptom is shooting, throbbing, and lancinating pains, and enlargement of the breasts, 118with soreness of the nipples, occurring about the second month; and in some instances, after the first few months, a small quantity of watery fluid, or a little milk, may be squeezed out of them. This latter symptom, in a first pregnancy, is valuable, and can generally be relied on as conclusive that the female is pregnant. It is not so valuable in an after pregnancy, as a little milk might, even should she not be pregnant, remain in the breasts for some months after she has weaned her child.

225. The veins of the breast look more blue, and are consequently more conspicuous than usual, giving the bosom a mottled appearance. The breasts themselves are firmer and more knotty to the touch. The nipples, in the majority of cases, look more healthy than customary, and are somewhat elevated and enlarged; there is generally a slight moisture upon their surface, sufficient in some instances to mark the linen.

226. A dark-brown areola or disk may usually be noticed around the nipple,[53] the change of color commencing about the second month. The tint at first is light brown, which gradually deepens in intensity, until, toward the end of pregnancy, the color may be very dark. Dr. Montgomery, who has paid great attention to the subject, observes: “During the progress of the 119next two or three months the changes in the areola are in general perfected, or nearly so, and then it presents the following characters: a circle around the nipple, whose color varies in intensity according to the particular complexion of the individual, being usually much darker in persons with black hair, dark eyes, and sallow skin, than in those of fair hair, light-colored eyes, and delicate complexion. The area of this circle varies in diameter from an inch to an inch and a half, and increases in most persons as pregnancy advances, as does also the depth of color.” The dark areola is somewhat swollen. “There is,” says Dr. Montgomery, “a puffy turgescence, not only of the nipple, but of the whole surrounding disk.”

227. A fourth symptom is quickening. This generally occurs about the completion of the fourth calendar month; frequently a week or two before the end of that period; at other times a week or two later. A lady sometimes quickens as early as the third month, while others, although rarely, quicken as late as the fifth, and, in very rare cases, the sixth month.

228. It will therefore be seen that there is an uncertainty as to the period of quickening, although, as I before remarked, the usual period occurs either on, or more frequently a week or two before, the completion of the fourth calendar month of pregnancy.

229. A lady at this time frequently either feels faint, or actually faints away; she is often either giddy, or 120sick, or nervous, and in some instances even hysterical. Although, in rare cases, some women do not even know the precise time when they quicken.

230. The sensation of “quickening” is said by many ladies to resemble the fluttering of a bird. “Quickening” arises from the ascent of the womb higher into the belly, as, from its increased size, there is not room for it below. The old-fashioned idea was that the child was not alive until a woman had quickened. This is a mistaken notion, as he is alive, or “quick,” from the very commencement of his formation.

231. Hence the heinous and damnable sin of a single woman, in the early months of pregnancy, using means to promote abortion: it is as much murder as though the child were at his full time, or as though he were butchered when he was actually born!

232. An attempt, then, to procure abortion is a crime of the deepest dye, viz., a heinous murder! It is attended, moreover, with fearful consequences to the mother’s own health; it may either cause her immediate death, or it may so grievously injure her constitution that she might never recover from the shock. If these fearful consequences ensue, she ought not to be pitied: she richly deserves them all. Our profession is a noble one, and every qualified member of it would scorn and detest the very idea either of promoting or of procuring an abortion; but there are unqualified villains who practice the damnable art. Transportation, 121if not hanging, ought to be their doom. The seducers, who often assist and abet them in their nefarious practices, should share their punishment.

233. Flatulence has sometimes misled a young wife to fancy that she has quickened; but, in determining whether she be pregnant, she ought never to be satisfied with one symptom alone; if she be, she will be frequently misled. The following are a few of the symptoms that will distinguish the one from the other: in flatulence, the patient is small one hour and large the next; while in pregnancy the enlargement is persistent, and daily and gradually increases. In flatulence, on pressing the bowels firmly, a rumbling of wind may be heard, which will move about at will; while the enlargement of the womb in pregnancy is solid, resistant, and stationary. In flatulence, on tapping—percussing—the belly there will be a hollow sound elicited as from a drum; while in pregnancy it will be a dull, heavy sound, as from thrumming on a table. In flatulence, if the points of the fingers be firmly pressed into the belly, the wind will wobble about; in pregnancy they will be resisted as by a wall of flesh.

234. The fifth symptom is, immediately after the quickening, increased size and hardness of the belly. An accumulation of fat covering the belly has sometimes led a lady to suspect that she is pregnant; but the soft and doughy feeling of the fat is very different to the hardness, solidity, and resistance of pressure of pregnancy.

122235. The sixth symptom is pouting or protrusion of the navel. This symptom does not occur until some time after a lady has quickened; indeed, for the first two months of pregnancy the navel is drawn in and depressed. As the pregnancy advances, the navel gradually comes more forward. “The navel, according to the progress of the pregnancy, is constantly emerging, till it comes to an even surface with the integuments of the abdomen [belly]; and to this circumstance much regard is to be paid in cases of doubtful pregnancy.”[54]

236. Sleepiness, heartburn, increased flow of saliva, toothache, loss of appetite, longings, excitability of mind, a pinched appearance of countenance, liver or sulphur-colored patches on the skin, and likes and dislikes in eating,—either the one or the other of these symptoms frequently accompany pregnancy; but, as they might arise from other causes, they are not to be relied on further than this—that if they attend the more certain signs of pregnancy, such as cessation of being “regular,” morning sickness, pains and enlargement of and milk in the breasts, the gradually darkening brown areola or mark around the nipple, etc., they will then make assurance doubly sure, and a lady may know for certain that she is pregnant.[55]

123

CLOTHING.

237. A lady who is pregnant ought on no account to wear tight dresses, as the child should have plenty of room. She ought to be, as enceinte signifies, incincta, or unbound. Let the clothes be adapted to the gradual development both of the belly and the breasts. She must, whatever she may usually do, wear her stays loose. If there be bones in the stays, let them be removed. Tight lacing is injurious both to the mother and to the child, and frequently causes the former to miscarry; at another time it has produced a crossbirth; and sometimes it has so pressed in the nipples as to prevent a proper development of them, so that where a lady has gone her time, she has been unable to suckle her infant, the attempt often causing a gathered bosom. These are great misfortunes, and entail great misery both on the mother and the child (if it has not already killed him), and ought to be a caution and a warning to every lady for the future.

238. The feet and legs during pregnancy are very apt to swell and to be painful, and the veins of the legs to be largely distended. The garters ought at such times to be worn slack, as tight garters are highly injurious, 124and, if the veins be very much distended, it will be necessary for her to wear a properly-adjusted elastic silk stocking, made purposely to fit her foot and leg, and which a medical man will himself procure for her.

ABLUTION.

239. A warm bath in pregnancy is too relaxing. A tepid bath once a week is beneficial. Sponging the whole of the body every morning with lukewarm water may with safety and advantage be adopted, gradually reducing the temperature of the water until it be used quite cold. The skin should, with moderately coarse towels, be quickly but thoroughly dried.

240. Either the bidet or sitz-bath[56] ought every morning to be used. The patient should first sponge herself, and then finish up by sitting for a few seconds, or while, in the winter, she can count fifty, or while, in the summer, she can count a hundred, in the water. It is better not to be long in it; it is a slight shock that is required, which, where the sitz-bath agrees, is immediately followed by an agreeable glow of the whole body. If she sits in the water for a long time she becomes chilled and tired, and is very likely to catch cold. She ought, until she become accustomed to the cold, to have a dash of warm water added; but the sooner she can use quite cold water the better. While sitting in the 125bath she should throw either a woolen shawl or a small blanket over her shoulders. She will find the greatest comfort and benefit from adopting the above recommendation. Instead of giving, it will prevent cold, and it will be one of the means of warding off a miscarriage, and of keeping her in good health.

241. A shower-bath in pregnancy gives too great a shock, and might induce a miscarriage. I should not recommend, for a lady who is pregnant, sea-bathing; nevertheless, if she be delicate, and if she be prone to miscarry, change of air to the coast (provided it be not too far away from home), and inhaling the sea breezes, may brace her, and ward off the tendency. But although sea-bathing be not desirable, sponging the body with sea water may be of great service to her.

AIR AND EXERCISE.

242. A young wife, in her first pregnancy, usually takes too long walks. This is a common cause of flooding, of miscarriage, and of bearing down of the womb. As soon, therefore, as a lady has the slightest suspicion that she is enceinte, she must be careful in the taking of exercise.

243. Although long walks are injurious, she ought not to run into an opposite extreme; short, gentle, and frequent walks during the whole period of pregnancy cannot be too strongly recommended; indeed, a lady 126who is enceinte ought to live half her time in the open air. Fresh air and exercise prevent many of the unpleasant symptoms attendant on that state; they keep her in health; they tend to open her bowels; and they relieve that sensation of faintness and depression so common and distressing in early pregnancy.

244. Exercise, fresh air, and occupation are then essentially necessary in pregnancy. If they be neglected, hard and tedious labors are likely to ensue. One, and an important, reason of the easy and quick labors and rapid “gettings about” of poor women, is the abundance of exercise and of occupation which they are both daily and hourly obliged to get through. Why, many a poor woman thinks but little of a confinement, while a rich one is full of anxiety about the result. Let the rich lady adopt the poor woman’s industrious and abstemious habits, and labor need not then be looked forward to, as it frequently now is, either with dread or with apprehension.

245. Stooping, lifting of heavy weights, and overreaching ought to be carefully avoided. Running, horse exercise, and dancing are likewise dangerous—they frequently induce a miscarriage.

246. Indolence is most injurious in pregnancy. A lady who, during the greater part of the day, lolls either on the sofa or on an easy-chair, and who seldom walks out, has a much more lingering and painful labor than one who takes moderate and regular open-air exercise, and who attends to her household duties.

127247. An active life is, then, the principal reason why the wives of the poor have such quick and easy labors, and such good recoveries; why their babies are so rosy, healthy, and strong; notwithstanding the privations and hardships and poverty of the parents.

248. Bear in mind, then, that a lively, active woman has an easier and quicker labor, and a finer race of children, than one who is lethargic and indolent. Idleness brings misery, anguish, and suffering in its train, and particularly affects pregnant ladies. Oh, that these words would have due weight, then this book will not have been written in vain. The hardest work in the world is having nothing to do! “Idle people have the most labor;” this is particularly true in pregnancy; a lady will, when labor actually sets in, find to her cost that idleness has given her most labor. “Idleness is the badge of gentry, the bane of body and mind, the nurse of Naughtiness, the step-mother of Discipline, the chief author of all Mischief, one of the seven deadly sins, the cushion upon which the Devil chiefly reposes, and a great cause not only of Melancholy, but of many other diseases, for the mind is naturally active; and, if it be not occupied about some honest business, it rushes into Mischief or sinks into Melancholy.”[57]

249. A lady sometimes looks upon pregnancy more as a disease than as a natural process; hence she 128treats herself as though she was a regular invalid, and, unfortunately, she too often makes herself really one by improper and by foolish indulgences.

VENTILATION—DRAINAGE.

250. Let a lady look well to the ventilation of her house; let her take care that every chimney be unstopped, and during the daytime that every window in every unoccupied room be thrown open.

251. Where there is a skylight at the top of the house, it is well to have it made to open and to shut, so that in the daytime it may, winter and summer, be always open; and in the summer time it may, day and night, be left unclosed. Nothing so thoroughly ventilates and purifies a house as an open skylight.

252. If a lady did but know the importance—the vital importance—of ventilation, she would see that the above directions were carried out to the very letter. My firm belief is that if more attention were paid to ventilation—to thorough ventilation—child-bed fever would be an almost unknown disease.

253. The cooping-up system is abominable; it engenders all manner of infectious and of loathsome diseases, and not only engenders them, but feeds them, and thus keeps them alive. There is nothing wonderful in all this, if we consider but for one moment that the exhalations from the lungs are poisonous! That is 129to say, that the lungs give off carbonic acid gas (a deadly poison), which, if it be not allowed to escape out of the room, must over and over again be breathed. That if the perspiration of the body (which in twenty-four hours amounts to two or three pounds) be not permitted to escape out of the apartment, must become fetid—repugnant to the nose, sickening to the stomach, and injurious to the health. Oh, how often the nose is a sentinel, and warns its owner of approaching danger!

254. Truly the nose is a sentinel! The Almighty has sent bad smells for our benefit to warn us of danger. If it were not for an unpleasant smell, we should be constantly running into destruction. How often we hear of an ignorant person using disinfectants and fumigations to deprive drains and other horrid places of their odors, as though, if the place could be robbed of its smell, it could be robbed of its danger! Strange infatuation! No; the frequent flushings of drains, the removal of nuisances, cleanliness, a good scrubbing of soap and water, sunshine, and the air and winds of heaven, are the best disinfectants in the world. A celebrated and eccentric lecturer on surgery,[58] in addressing his class, made the following quaint and sensible remark: “Fumigations, gentlemen, are of essential importance; they make so abominable a stink that they compel you to open the windows and admit fresh air.”

130255. It is doubtless, then, admirably appointed that, we are able to detect “the well-defined and several stinks;” for the danger is not in them,—to destroy the smell is not to destroy the danger; certainly not! The right way to do away with the danger is to remove the cause, and the effect will cease; flushing a sewer is far more efficacious than disinfecting one; soap and water and the scrubbing-brush, and sunshine and thorough ventilation, each and all are far more beneficial than either permanganate of potash, or chloride of zinc, or chloride of lime. People nowadays think too much of disinfectants and too little of removal of causes; they think too much of artificial, and too little of natural means. It is a sad mistake to lean so much on, and to trust so much to, man’s inventions!

256. What is wanted, nowadays, is a little less theory and a great deal more common sense. A rat, for instance, is, in theory, grossly maligned; he is considered to be very destructive, an enemy to man, and one that ought to be destroyed—every man’s hand being against him. Now, a rat is, by common sense, well known to be, in its proper place—that is to say, in sewers and in drains—destructive only to man’s enemies—to the organic matter that breeds fevers, cholera, diphtheria, etc.; the rat eats the pabulum or food which would otherwise convert towns into hot-beds of terrible diseases. That which is a rat’s food is often a man’s poison; hence a rat is one of the best friends that a man has, and ought, in his proper place, to be in every way protected; the rat, in drains, is the very best of scavengers; 131in a sewer he is invaluable; in a house he is most injurious; a rat in a sewer is worth gallons of disinfectants, and will, in purifying a sewer, beat all man’s inventions hollow; the maligned rat, therefore, turns out, if weighed by common sense, to be not only one of the most useful of animals, but of public benefactors! The rat’s element, then, is the sewer; he is the king of the sewer, and should there reign supreme, and ought not to be poisoned by horrid disinfectants.

257. If a lady, while on an errand of mercy, should in the morning go into a poor person’s bedroom after he, she, or they (for oftentimes the room is crowded to suffocation) have during the night been sleeping, and where a breath of air is not allowed to enter—the chimney and every crevice having been stopped up—and where too much attention has not been paid to personal cleanliness, she will experience a faintness, an oppression, a sickness, a headache, a terribly fetid smell; indeed, she is in a poisoned chamber! It is an odor sui generis, which must be smelt to be remembered, and will then never be forgotten! Pity the poor who live in such styes—not fit for pigs! For pigs, styes are ventilated. But take warning, ye well-to-do in the world, and look well to your ventilation, or beware of the consequences. “If,” says an able writer on fever in the last century, “any person will take the trouble to stand in the sun and look at his own shadow on a white plastered wall, he will easily perceive that his whole body is a smoking dunghill, with a vapor exhaling from every part of it. This vapor is subtle, 132acrid, and offensive to the smell; if retained in the body it becomes morbid, but if reabsorbed, highly deleterious. If a number of persons, therefore, are long confined in any close place not properly ventilated, so as to inspire and swallow with their spittle the vapors of each other, they must soon feel its bad effects.”[59]

258. Not only should a lady look well to the ventilation of her house, but either she or her husband ought to ascertain that the drains are in good and perfect order, and that the privies are frequently emptied of their contents. Bad drainage and overflowing privies are fruitful sources of child-bed fever, of gastric fever, of scarlatina, of diphtheria, of cholera, and of a host of other infections and contagious and dangerous diseases. It is an abominable practice to allow dirt to fester near human habitations; more especially as dirt, when mixed with earth, is really so valuable in fertilizing the soil. Lord Palmerston wisely says that “dirt is only matter in the wrong place.”

259. A lady ought to look well to the purity of her pump-water, and to ascertain that no drain either enters or percolates, or contaminates in any way whatever, the spring; if it should do so, disease, such as either cholera, or diarrhœa, or dysentery, or diphtheria, or scarlet fever, or gastric fever, will, one or the other, as a matter of course, ensue. If there be the slightest 133danger or risk of drain contamination, whenever it be practicable, let the drain be taken up and be examined, and let the defect be carefully rectified. When it be impracticable to have the drain taken up and examined, then let the pump-water, before drinking it, be always previously boiled. The boiling of the water, as experience teaches, has the power either of destroying or of making innocuous the specific organic fecal life poison, which propagates in drain contamination the diseases above enumerated.

NECESSITY OF OCCASIONAL REST.

260. A lady who is pregnant ought, for half an hour each time, to lie one or two hours every day on the sofa. This, if there be either a bearing down of the womb, or if there be a predisposition to a miscarriage, will be particularly necessary. I should recommend this plan to be adopted throughout the whole period of the pregnancy: in the early months, to prevent a miscarriage, and, in the latter months, on account of the increased weight and size of the womb.

261. There is, occasionally, during the latter months, a difficulty in lying down; the patient feeling as though, every time she makes the attempt, she should be suffocated. When such be the case, she ought to rest herself upon the sofa, and be propped up with cushions, as I consider rest at different periods of the day necessary and beneficial. If there be any difficulty in lying 134down at night, a bed-rest, well covered with pillows, will be found a great comfort.

DIETARY.

262. An abstemious diet, during the early period of pregnancy, is essential, as the habit of body, at that time, is usually feverish and inflammatory. I should therefore recommend abstinence from beer, porter, and spirits. Let me, in this place, urge a lady, during her pregnancy, not to touch spirits, such as either brandy or gin; they will only inflame her blood, and will poison and make puny her unborn babe; they will only give her false spirits, and will depress her in an increased ratio as soon as the effects of the brandy or of the gin have passed away. She ought to eat meat only but once a day. Rich soups and highly-seasoned stews and dishes are injurious.

263. A lady who is enceinte may depend upon it that the less stimulants she takes at these times the better it will be both for herself and for her infant; the more kind will be her labor and her “getting about,” and the more vigorous and healthy will be her child.

264. It is a mistaken notion that she requires more nourishment during early pregnancy than at any other time; she, if anything, requires less. It has often been asserted that a lady who is pregnant ought to eat very heartily, as she has two to provide for. When it is taken into account that during pregnancy she “ceases 135to be unwell,” and therefore that there is no drain on that score; and when it is also considered how small the ovum containing the embryo is, not being larger for the first two or three months than a hen’s egg, it will be seen how futile is the assertion. A wife, therefore, in early pregnancy, does not require more than at another time; if anything, she requires less. Again: during pregnancy, especially in the early stages, she is more or less sick, feverish, and irritable, and a superabundance of food would only add fuel to the fire, and would increase her sickness, fever, and irritability. Moreover, she frequently suffers from heartburn and from indigestion. Can anything be more absurd, when such is the case, than to overload a stomach already loaded with food which it is not able to digest? No, let nature in this, as in everything else, be her guide, and she will not then go far wrong! When she is further advanced in her pregnancy,—that is to say, when she has quickened,—her appetite generally improves, and she is much better in health than she was before; indeed, after she has quickened, she is frequently in better health than she ever has been. The appetite is now increased. Nature points out that she requires more nourishment than she did at first; for this reason, the fœtus is now rapidly growing in size, and consequently requires more support from the mother. Let the food, therefore, of a pregnant woman be now increased in quantity, but let it be both light and nourishing. Occasionally, at this time, she has taken a dislike to meat; if she has, she ought not to be forced to eat it, but should have instead, poultry, game, fish, chicken-broth, 136beef-tea, new milk, farinaceous food, such as rice, sago, batter puddings, and, above all, if she has a craving for it, good sound, ripe fruit.

265. Roasted apples, ripe pears, raspberries, strawberries, grapes, tamarinds, figs, Muscatel raisins, stewed rhubarb, stewed pears, stewed prunes, the inside of ripe gooseberries, and the juice of oranges, are, during pregnancy, particularly beneficial; they both quench the thirst and tend to open the bowels.

266. The food of a pregnant woman cannot be too plain; high-seasoned dishes ought, therefore, to be avoided. Although the food be plain, it must be frequently varied. She should ring the changes upon butcher’s meat, poultry, game, and fish. It is a mistaken notion, that people ought to eat the same food over and over again, one day as another. The stomach requires variety, or disease, as a matter of course, will ensue.

267. Light puddings, such as either rice, or batter, or suet-pudding, or fruit puddings, provided the paste be plain, may be taken with advantage. Rich pastry is highly objectionable.

268. If she be plethoric, abstinence is still more necessary, or she might have a tedious labor, or might suffer severely. The old-fashioned treatment was to bleed a pregnant patient if she were of a full habit of body. A more absurd plan could not be adopted! 137Bleeding would, by causing more blood to be made, only increase the mischief; but certainly it would be blood of an inferior quality, watery and poor. The best way to diminish the quantity of blood is to moderate the amount of food, to lessen the supplies.

SLEEP.

269. The bedroom of a pregnant lady ought, if practicable, to be large and airy. Particular attention must be paid to the ventilation. The chimney should on no account be stopped. The door and the windows ought in the daytime to be thrown wide open, and the bedclothes should be thrown back, that the air might, before the approach of night, well ventilate them.

270. It is a mistaken practice for a pregnant woman, or for any one else, to sleep with closely-drawn curtains. Pure air and a frequent change of air are quite as necessary—if not more so—during the night as during the day: and how can it be pure, and how can it be changed, if curtains are closely drawn around the bed? Impossible. The roof of the bedstead ought not to be covered with bed furniture; it should be open to the ceiling, in order to prevent any obstruction to a free circulation of air.

271. The bed must not be loaded with clothes, more especially with a thick coverlet. If the weather be cold, let an extra blanket be put on the bed, as the 138perspiration can permeate through a blanket when it cannot through a thick coverlet.

272. A lady who is pregnant is sometimes restless at night—she feels oppressed and hot. The best remedies are:—(1) Scant clothing on the bed. (2) The lower sash of the window, during the summer months, to be left open to the extent of six or eight inches, and during the winter months, to the extent of two or three inches; provided the room be large, the bed be neither near nor under the window, and the weather be not intensely cold. If any or all of these latter circumstances occur, then (3) the window to be closed and the door to be left ajar (the landing or the skylight window at the top of the house being left open all night, and the door being secured from intrusion by means of a door-chain.) (4) Attention to be paid, if the bowels be costive—but not otherwise—to a gentle action of the bowels by castor oil. (5) An abstemious diet, avoiding stimulants of all kinds. (6) Gentle walking exercise. (7) Sponging the body every morning—in the winter with tepid water, and in the summer with cold water. (8) Cooling fruits in the summer are in such a case very grateful and refreshing. (See paragraph 264.)

273. A pregnant woman sometimes experiences an inability to lie down, the attempt occasionally producing a feeling of suffocation and of faintness. She ought, under such circumstances, to lie on a bed-rest, which must, by means of pillows, be made comfortable; 139and she should take, every night at bedtime, a teaspoonful of sal-volatile in a wineglassful of water.

274. Pains at night, during the latter end of the time, are usually frequent, so as to make an inexperienced lady fancy that her labor was commencing. Little need be done; for unless the pains be violent, nature ought not to be interfered with. If they be violent, application should be made to a medical man.

275. A pregnant lady must retire early to rest. She ought to be in bed every night by ten o’clock, and should make a point of being up in good time in the morning, that she may have a thorough ablution, a stroll in the garden, and an early breakfast; and that she may afterwards take a short walk either in the country or in the grounds while the air is pure and invigorating. But how often, more especially when a lady is first married, is an opposite plan adopted! The importance of bringing a healthy child into the world, if not for her own and her husband’s sake, should induce a wife to attend to the above remarks.

276. Although some ladies, during pregnancy, are very restless, others are very sleepy, so that they can scarcely, even in the day, keep their eyes open! Fresh air, exercise, and occupation are the best remedies for keeping them awake.

140

MEDICINE.

277. A young wife is usually averse to consult a medical man concerning several trifling ailments, which are nevertheless, in many cases, both annoying and distressing. I have therefore deemed it well to give a brief account of such slight ailments, and to prescribe a few safe and simple remedies for them. I say safe and simple, for active medicines require skillful handling, and therefore ought not—unless in certain emergencies—to be used except by a doctor himself.

278. I wish it, then, to be distinctly understood that in all serious attacks, and in slight ailments if not quickly relieved, a medical man ought to be called in.

279. A costive state of the bowels is common in pregnancy; a mild aperient is therefore occasionally necessary. The mildest must be selected, as a strong purgative is highly improper, and even dangerous. Calomel and all other preparations of mercury are to be especially avoided, as a mercurial medicine is apt to weaken the system and sometimes even to produce a miscarriage.

280. An abstemious diet, where the bowels are costive, is more than usually desirable, for if the bowels be torpid, a quantity of food will only clog and make them more sluggish. Besides, when labor comes on, a loaded state of the bowels will add much to a lady’s sufferings as well as to her annoyance.

141281. The best aperients are castor oil, salad oil, compound rhubarb pills, honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes, roasted apples, Normandy pippins, oatmeal and milk gruel, coffee, brown bread and treacle, raw sugar (as a sweetener of the food), Du Barry’s Arabica Revalenta.

282. Castor oil, in pregnancy, is a valuable aperient. Frequent and small are preferable to occasional and large doses. If the bowels be constipated (but certainly not otherwise), castor oil ought to be taken regularly twice a week. The best time for administering it is early in the morning. The dose is from a teaspoonful to a dessertspoonful.

283. The best ways of administering it are the following: Let a wineglass be well rinsed out with water, so that the sides may be well wetted; then, let the wineglass be half filled with cold water, fresh from the pump. Let the necessary quantity of oil be now carefully poured into the center of the wineglass, taking care that it does not touch the sides; and if the patient will, thus prepared, drink it off at one draught, she will scarcely taste it. Another way of taking it is, swimming on warm new milk. A third and a good method is, floating on warm coffee; the coffee ought, in the usual way, to be previously sweetened and mixed with cream. There are two advantages in giving castor oil on coffee: (1) it is a pleasant way of giving it—the oil is scarcely tasted; and (2) the coffee itself, more especially if it be sweetened with raw 142sugar, acts as an aperient; less castor oil, in consequence, being required; indeed, with many patients the coffee, sweetened with raw sugar, alone is a sufficient aperient. A fourth and an agreeable way of administering it is on orange-juice—swimming on the juice of one orange.

284. Some ladies are in the habit of taking it on brandy and water; but the spirit is apt to dissolve a portion of the oil, which afterwards rises in the throat.

285. If salad oil be preferred, the dose ought to be as much again as of castor oil; and the patient should, during the day she takes it, eat either a fig or two, or a dozen or fifteen of stewed prunes, or of stewed French plums, as salad oil is much milder in its effects than castor oil.

286. Where a lady cannot take oil, one or two compound rhubarb pills may be taken at bedtime; or a Seidlitz powder early in the morning, occasionally; or a quarter of an ounce of tasteless salts—phosphate of soda—may be dissolved in lieu of table salt, in a cupful either of soup, or of broth, or of beef-tea, and be occasionally taken at luncheon.

287. When the motions are hard, and when the bowels are easily acted upon, two, or three, or four pills made of Castile soap will frequently answer the purpose; and if they will, are far better than any ordinary aperient. The following is a good form:

143Take of—Castile Soap, five scruples;
Oil of Caraway, six drops:

To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally.[60]

288. A teaspoonful of honey, either eaten at breakfast, or dissolved in a cup of tea, will frequently comfortably and effectually open the bowels, and will supersede the necessity of taking aperient medicine.

289. A basin of thick Derbyshire oatmeal gruel, made either with new milk or with cream and water, with a little salt, makes an excellent luncheon or supper for a pregnant lady; it is both nourishing and aperient, and will often entirely supersede the necessity of giving opening medicine. If she prefers sugar to salt, let raw sugar be substituted for the salt. The occasional substitution of coffee for tea at breakfast usually acts beneficially on the bowels.

290. Let me again urge the importance of a lady, during the whole period of pregnancy, being particular as to the state of her bowels, as costiveness is a fruitful cause of painful, of tedious, and of hard labors. It is my firm conviction that if a patient who suffers from constipation were to attend more to the regularity of her bowels, difficult cases of labor would rarely occur, more especially if the simple rules of health were adopted, such as: attention to diet—the 144patient partaking of a variety of food, and allowing the farinaceous, such as oatmeal and the vegetable and fruit element, to preponderate; the taking of exercise in the open air; attending to her household duties; avoiding excitement, late hours, and all fashionable amusements.

291. Many a pregnant lady does not leave the house—she is a fixture. Can it, then, be wondered at that costiveness so frequently prevails? Exercise in the fresh air, and occupation, and household duties are the best opening medicines in the world. An aperient, let it be ever so judiciously chosen, is apt, after the effect is over, to bind up the bowels, and thus to increase the evil. Now, nature’s medicines,—exercise in the open air, occupation, and household duties,—on the contrary, not only at the time open the bowels, but keep up a proper action for the future: hence their inestimable superiority.

292. Where a lady cannot take medicine, or where it does not agree with her, a good remedy for constipation in pregnancy is the external application of castor oil—castor oil as a liniment—to the bowels The bowels should be well rubbed every night and morning with the castor oil. This, if it succeed, will be an agreeable and safe method of opening the bowels.

293. Another excellent remedy for the costiveness of pregnancy is an enema, either of warm water or of Castile soap and water, which the patient, by means 145of a self-injecting enema apparatus, may administer to herself. The quantity of warm water to be used is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week. The advantages of clysters are, they never disorder the stomach—they do not interfere with the digestion—they do not irritate the bowels—they are given with the greatest facility by the patient herself—and they do not cause the slightest pain. If an enema be used to open the bowels, it may be well to occasionally give one of the aperients recommended above, in order, if there be costiveness, to insure a thorough clearance of the whole of the bowels.

294. If the bowels should be opened once every day, it would be the height of folly for a pregnant lady to take either castor oil or any other aperient. She ought then to leave her bowels undisturbed, as the less medicine she takes the better. If the bowels be daily and properly opened, aperients of any sort whatever would be highly injurious to her. The plan in this, as in all other cases, is to leave well alone, and never to give physic for the sake of giving it.

295. Diarrhœa.—Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to their having been too much constipated, and nature is trying to relieve itself by purging. Such being the case, a patient ought to be careful how, 146by the taking of chalk and of astringents, she interferes with the relaxation.

296. The fact is, that in all probability there is something in the bowels that wants coming away, and nature is trying all she can to afford relief. Sometimes, provided she is not unnecessarily interfered with, she succeeds; at others, it is advisable to give a mild aperient to help nature in bringing it away.

297. When such be the case, a gentle aperient, such as either castor oil or rhubarb and magnesia, ought to be chosen. If castor oil, a teaspoonful or a dessertspoonful, swimming on a little new milk, will generally answer the purpose. If rhubarb and magnesia be the medicine selected, then a few doses of the following mixture will usually set all to rights:

Take of—Powdered Turkey Rhubarb, half a drachm;
Carbonate of Magnesia, one drachm;
Essence of Ginger, one drachm;
Compound Tincture of Cardamoms, half an ounce;
Peppermint Water, five ounces and a half:

Two tablespoonfuls of the mixture to be taken three times a day, first shaking the bottle.

298. The diet ought to be simple, plain, and nourishing, and should consist of beef-tea, of chicken-broth, of arrow-root, and of well-made and well-boiled oatmeal gruel. Meat, for a few days, ought not to be eaten; and stimulants of all kinds must be avoided.

299. If the diarrhœa be attended with pain in the 147bowels, a flannel bag filled with hot table salt, and then applied to the part affected, will afford great relief. A hot-water bag, too, in a case of this kind, is a great comfort.[61] The patient ought, as soon as the diarrhœa has disappeared, gradually to return to her usual diet, provided it be plain, wholesome, and nourishing. She should pay particular attention to keeping her feet warm and dry; and, if she be much subject to diarrhœa, she ought to wear around her bowels, and next to her skin, a broad flannel belly-band.

300. Heartburn is a common and often a distressing symptom of pregnancy. The acid producing the heartburn is frequently much increased by an overloaded stomach. The patient labors under the mistaken notion that, as she has two to sustain, she requires more food during this than at any other time; she consequently is induced to take more than her appetite demands, and more than her stomach can digest;—hence heartburn, indigestion, etc. are caused, and her unborn babe, as well as herself, is thereby weakened.

301. An abstemious diet ought to be strictly observed. Great attention should be paid to the quality of the food; greens, pastry, hot buttered toast, melted 148butter, and everything that is rich and gross, ought to be carefully avoided.

302. Either a teaspoonful of Henry’s magnesia, or half a teaspoonful of carbonate of soda—the former to be preferred if there be constipation—should occasionally be taken in a wineglassful of warm water. If these do not relieve—the above directions as to diet having been strictly attended to—the following mixture ought to be tried:

Take of—Sesquicarbonate of Ammonia, half a drachm;
Bicarbonate of Soda, a drachm and a half;
Water, eight ounces:

To make a mixture. Two tablespoonfuls to be taken twice or three times a day, until relief be obtained.

Chalk is sometimes given in heartburn, but as it produces costiveness, it ought not in such a case to be used.

303. Piles are a common attendant upon pregnancy. They are small, soft, spongy, dark-red tumors, about the size either of a bean or of a cherry—they are sometimes as large as a walnut—and are either within or around the fundament; they are then, according to their situation, called either internal or external piles—they may be either blind or bleeding. If the latter, blood may be seen to exude from them, and blood will come away every time the patient has a stool; hence the patient ought to be as quick as possible over relieving her bowels, and should not at such times sit one moment longer than is absolutely necessary.

149304. When the pile or piles are very large, they sometimes, more especially when she has a motion, drag down a portion of the bowel, which adds much to her sufferings.

305. If the bowel should protrude, it ought, by means of the patient’s index finger, to be immediately and carefully returned, taking care, in order that it may not scratch the bowel, that the nail be cut close.

306. Piles are very painful and are exceedingly sore, and cause great annoyance, and frequently continue, notwithstanding proper and judicious treatment, during the whole period of pregnancy.

307. A patient is predisposed to piles from the womb pressing upon the blood-vessels of the fundament. They are excited into action by her neglecting to keep her bowels gently opened, or by diarrhœa, or from her taking too strong purgatives, especially pills containing either aloes or colocynth, or both.

308. If the piles be inflamed and painful, they ought, by means of a sponge, to be well fomented three times a day, and for half an hour each time, with hot chamomile and poppy-head tea;[62] and at bedtime a hot white-bread poultice should be applied.

150309. Every time after and before the patient has a motion, she had better well anoint the piles and the fundament with the following ointment:

Take of—Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Prepared Lard, two ounces:

Mix, to make an ointment.

310. If there be great irritation and intense pain, let some very hot water be put into a close stool, and let the patient sit over it. “In piles attended with great irritation and pain, much relief is often obtained by sitting over the steam of hot water for fifteen or twenty minutes, and immediately applying a warm bread-and-milk poultice. These measures should be repeated five or six times a day (Greeves).”[63]

311. If the heat be not great, and the pain be not intense, the following ointment will be found efficacious:

Take of—Powdered Opium, one scruple;
Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Powdered Galls, one drachm;
Spermaceti Ointment, three drachms:

Mix.—The ointment to be applied to the piles three times a day.[64] Or the compound Gall Ointment (B.P.) may, in the same manner, be applied.

151312. If the heat and the pain be great, the following liniment will be found useful:

Take of—French Brandy,
Glycerin, of each, half an ounce:

Mix.—The liniment to be frequently applied, by means of a camel’s-hair pencil, to the piles, first shaking the bottle.

313. The bowels ought to be kept gently and regularly opened, either by taking every morning one or two teaspoonfuls of compound confection of senna, or by a dose of the following electuary:

Take of—Sublimed Sulphur, half an ounce;
Powdered Ginger, half a drachm;
Cream of Tartar, half an ounce;
Confection of Senna, one ounce;
Simple Syrup, a sufficient quantity:

To make an electuary. One or two teaspoonfuls to be taken early every morning.

314. Magnesia and milk of sulphur is an excellent remedy for piles:

Take of—Carbonate of Magnesia,
Milk of sulphur, of each, three drachms;

Mix.—To make nine powders. One to be taken early every, or every other morning, mixed in half a teaspoonful of new milk.

315. Remember, in these cases, it is necessary to keep the motions in a softened state, as hard lumps of stool would, in passing, give intense pain.

316. If the confection of senna and the other remedies do not act sufficiently, it may be well to give, once 152or twice a week, a teaspoonful or a dessertspoonful of castor oil.

317. In piles, if they are not much inflamed, and provided there be constipation, a pint of tepid water, administered early every morning as an enema, will be found serviceable. Care and gentleness ought, of course, to be observed in introducing the enema pipe (but which only requires ordinary care), in order not to press unduly on the surrounding piles.

318. The patient ought to lie down frequently in the day. She will derive great comfort from sitting either on an air-cushion or on a water-cushion about half filled with water, placed on the chair; for sometimes she is unable to sit on an ordinary seat.

319. In piles, the patient ought to live on a plain, nourishing, simple diet, but should avoid all stimulants; any food or beverage that will inflame the blood will likewise inflame the piles.

320. Piles in pregnancy are frequently troublesome, and sometimes resist all treatment until the patient is confined, when they generally get well of themselves; but still the remedies recommended above will usually afford great relief, even if they do not effect a cure.

321. Swollen legs from enlarged veins (varicose veins).—The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and 153very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable to varicose veins than others. If a lady marry late in life, or if she be very heavy in her pregnancy—carrying the child low down—she is more likely to have the veins to distend.

322. The best plan will be for her to wear an elastic silk stocking,[65] which ought to be made on purpose for her, in order that it may properly fit the leg and foot. It will draw on like a common stocking. She ought to wear a gauze stocking next the skin, and the elastic stocking over it, as the gauze stocking can then, from time to time, be washed, as can likewise the foot and leg. Moreover, the gauze stocking will be more comfortable next the skin than the elastic stocking.

323. If the varicose veins should be very painful, she had better apply to a medical man, as it may be necessary, in such a case, to have them enveloped in mild plasters, and then rolled.

324. If the feet and legs be cold as well as swollen, a domette[66] bandage, two inches and a half wide and 154eight yards long, nicely applied to each leg, from the toes to the knee, will be found a great comfort. One great advantage that domette has over calico is that it will keep in its place for days, while calico will be loose in an hour or two.

325. Stretching of the skin of the belly is frequently, especially in a first pregnancy, distressing, from the soreness it causes. The best remedy is to rub the bowels, every night and morning, with warm camphorated oil, and to apply a broad flannel belt, which should be put on moderately but comfortably tight. The belt ought to be secured in its situation by means of properly adjusted tapes.

326. If the skin of the belly, from the violent stretching, be cracked, the patient had better dress the part affected, every night and morning, with equal parts of simple cerate and of lard—lard without salt—well mixed together, spread on lint; which ought to be kept in its place by means of a broad bandage, similar to the one used in confinements, and which is described in a subsequent paragraph (Bandage after Confinements).

321. Pendulous belly.—A lady sometimes, from being at these times unusually large, suffers severely; so much so, that she cannot, without experiencing great inconvenience, move about. This, where a patient is stout, and where she has had a large family of children, is more likely to occur, and especially if she has neglected proper bandaging after her previous confinements.

155328. She ought in such a case to procure, from a surgical-instrument-maker, an elastic abdominal belt, made purposely for pendulous bellies, which will, without unduly pressing on the belly, be a support. It is a good plan to have the belt made either to lace behind or with straps and buckles, in order to accommodate the belly to its gradually increasing size.

329. If the patient be delicate, and if she has a languid circulation, she ought, instead of the elastic belt, to apply a broad flannel belly-band, which should go twice around the bowels, and must be put on moderately and comfortably tight.

330. The patient, before the approach of labor, ought to take particular care to have the bowels gently opened, as during that time a costive state of them greatly increases her sufferings, and lengthens the period of her labor. I say a gentle action is all that is necessary; a violent one would do more harm than good.

331. Toothache is a frequent complaint of pregnancy; and I wish to caution my gentle reader not to have, during the time she is enceinte, a tooth extracted; miscarriage or premature labor has frequently followed the extraction of a tooth.

332. If the tooth be decayed, the hollow ought to be filled with cotton wool, soaked either in oil of cloves, or in equal parts of oil of cloves and of chloroform, and which should be frequently renewed; or with what I 156have found an excellent remedy, a little alum dissolved in chloroform.[67] A bit of cotton wool placed in the ear of the affected side will oftentimes relieve the toothache arising from a decayed tooth. This simple remedy ought always to be tried before resorting to more active treatment. If the above remedies do not relieve, soak a small ball of cotton wool in chloroform, and insert it inside the ear, and let it remain there until the pain be relieved; let it be from time to time renewed. I have frequently found in toothache the above plan most efficacious, and to afford relief when other means have failed.

333. Creasote (spirits of tar) is sometimes applied, but of all remedies it is the worst for the purpose. I have known it, when thus used, severely injure and decay the whole of the remaining teeth: one case in particular I remember, of a gentleman who, by the frequent use of creasote, for the relief of toothache, lost the whole of his teeth!

334. If the teeth be not decayed, especially if the stomach be disordered, let an aperient be taken. The state of the bowels ought always to be attended to, as toothache is frequently relieved, and when the tooth is not decayed, cured by a dose of opening medicine. Let the sides of the face be well fomented with hot chamomile and poppy-head tea, and let a piece of crumb of 157bread (but not crumbed bread) be soaked for five minutes in boiling milk, and be frequently placed inside the mouth, between the cheek and gum; and let a large hot bread poultice be applied at bedtime to the outside of the face.

335. If the above does not have the desired effect, a piece of brown paper, the size of the palm of the hand, soaked in brandy, and then well peppered with black pepper, should be applied outside the cheek, over the part affected, and kept on for several hours. It ought from time to time to be renewed. This simple and old-fashioned remedy will sometimes afford great relief. It is in these cases preferable to a mustard poultice, as it is less painful, and neither blisters nor injures the skin.

336. If the pepper plaster does not afford relief, a ginger plaster should be tried:

Take of—Powdered Ginger,
Flour, of each one tablespoonful;
Water, a sufficient quantity:

To be well mixed together, adding the water drop by drop (stirring it the while) until it be of the consistence of paste. Let it be applied at bedtime, on linen rag, outside the cheek, and let it remain on all night, or until the pain be relieved.

337. If the tooth be not decayed, and if the pain of the face be more of a neuralgic (tic-douloureux) character, the following pills will frequently afford great relief:

158Take of—Sulphate of Quinine, twenty-four grains;
Powdered Extract of Liquorice, six grains;
Treacle, a sufficient quantity:

To make twelve pills. One to be taken three times a day.

338. The teeth, in pregnancy, are very apt to decay: I have known several patients, each of whom has lost a tooth with every child!

339. Morning sickness.—It is said to be “morning,” as in these cases, unless the stomach be disordered, it seldom occurs during any other part of the day. Morning sickness may be distinguished from the sickness of a disordered stomach by the former occurring only early in the morning, on the first sitting up in bed, the patient during the remainder of the day feeling quite free from sickness, and generally being able to eat and relish her food as though nothing ailed her.

340. Morning sickness begins with a sensation of nausea early in the morning, and as soon as she rises from bed she feels sick and retches; and sometimes, but not always, vomits a little sour, watery, glairy fluid; and occasionally, if she has eaten heartily at supper the night previously, the contents of the stomach are ejected. She then feels all right again, and is usually ready for her breakfast, which she eats with her usual relish. Many ladies have better appetites during pregnancy than at any other period of their lives.

341. The sickness of a disordered stomach unaccompanied 159with pregnancy may be distinguished from morning sickness by the former continuing during the whole day, by the appetite remaining bad after the morning has passed, by a disagreeable taste in the mouth, and by the tongue being generally furred. Moreover, in such a case there is usually much flatulence. The patient not only feels but looks bilious.

342. If the stomach be disordered during pregnancy, there will, of course, be a complication of the symptoms, and the morning sickness may become both day and night sickness. Proper means ought then to be employed to rectify the disordered stomach, and the patient will soon have only the morning sickness to contend against; which latter, after she has quickened, will generally leave of its own accord.

343. Morning sickness is frequently a distressing, although not a dangerous complaint. It is only distressing while it lasts, for after the stomach is unloaded, the appetite generally returns, and the patient usually feels, until the next morning, quite well again, when she has to go through the same process as before.

344. It occurs both in the early and in the latter months of pregnancy; more especially during the former, up to the period of quickening, at which time it usually ceases. Morning sickness is frequently the first harbinger of pregnancy, and is looked upon by many ladies who have had children as a sure and certain sign. Morning sickness does not always occur in pregnancy; some women, at such times, are neither sick nor sorry.

160345. A good way to relieve it is by taking, before rising in the morning, a cup of strong coffee. If this should not have the desired effect, she ought to try an effervescing draught:

Take of—Bicarbonate of Potash, one drachm and a half;
Water, eight ounces:

Two Tablespoonfuls of this mixture to be taken with one of lemon-juice every hour, while effervescing, until relief be obtained.

346. A glass of champagne, taken the overnight, I have sometimes found to be the best remedy, and, if it has the desired effect, it certainly is the most agreeable.

347. I have known, too, cider, where other things have failed, to succeed in abating morning sickness.

348. Sometimes, until the whole contents of the stomach be brought up, she does not obtain relief from her sickness. She had better, when such is the case, drink plentifully of warm water, in order to encourage free vomiting. Such a plan, of course, is only advisable when the morning sickness is obstinate, and when the treatment recommended above has failed to afford relief.

349. The morning sickness, during the early months, is caused by sympathy between the stomach and the womb; and during the latter months by pressure of the upper part of the womb against the stomach. As we cannot remove the sympathy and the pressure, we cannot always relieve the sickness; the patient, therefore, is sometimes obliged to bear with the annoyance.

161350. The bowels ought to be kept gently opened, either by a Seidlitz powder taken early in the morning, or by one or two compound rhubarb pills at bedtime, or by the following mixture:

Take of—Carbonate of Magnesia, two drachms;
Sulphate of Magnesia, one ounce;
Peppermint water, seven ounces:

A wineglassful of this mixture to be taken early in the morning, occasionally, first shaking the bottle.

351. Great attention ought in such a case to be paid to the diet; it should be moderate in quantity, and simple in quality. Rich dishes, highly-seasoned soups and melted butter must be avoided. Hearty meat suppers ought not on any account to be allowed. There is nothing better, if anything be taken at night, than either a teacupful of nicely-made and well-boiled oatmeal gruel, or of arrow-root, or of Arabica Revalenta. Any of the above may be made either with water, or with new milk, or with cream and water.

352. It is an old saying, and, I believe as a rule, a true one, “that sick pregnancies are safe,” more especially if the sickness leaves, which it generally does, after she has quickened. The above remarks, of course, do not include obstinate, inveterate vomiting, occasionally occurring in the latter period of pregnancy, and which not only takes place in the morning, but during the whole of the day and of the night, and for weeks together, sometimes bringing a patient to the brink of the grave. Such a case, fortunately, is extremely 162rare. Another old and generally true saying is, “that females who have sick pregnancies seldom miscarry.”

353. Means to harden the nipples.—A mother, especially with her first child, sometimes suffers severely from sore nipples. Such suffering may frequently be prevented, if for six weeks or two months before her confinement, she were to bathe her nipples, every night and morning, for five minutes each time, either with eau de Cologne, or with brandy and water, equal parts of each. The better plan will be to have the brandy and water in a small bottle ready for use, and putting a little each time into a teacup, using it fresh and fresh. A soft piece of fine old linen rag should be used for the purpose of bathing. All pressure ought to be taken from the nipples; if the stays, therefore, unduly press them, either let them be enlarged or let them be entirely removed. The nipples themselves ought to be covered with a soft linen rag, as the friction of a flannel vest would be apt to irritate them. Let me recommend every pregnant lady, more especially in her first pregnancy, to adopt either the one or the other of the above plans to harden the nipples; it might avert much misery, as sore nipples are painful and distressing; and prevention at all times is better than cure.

354. The breasts are, at times, during pregnancy, much swollen and very painful; and, now and then, they cause the patient great uneasiness, as she fancies that she is going to have either some dreadful tumor 163or a gathering of the bosom. There need, in such a case, be no apprehension. The swelling and the pain are the consequences of the pregnancy, and will in due time subside without any unpleasant result. The fact is, great changes are taking place in the breasts; they are developing themselves, and are preparing for the important functions they will have to perform the moment the labor is completed.

355. Treatment.—She cannot do better than, every night and morning, to well rub them with equal parts of eau de Cologne and of olive oil, and to wear a piece of new flannel over them; taking care to cover the nipples with soft linen, as the friction of the flannel may irritate them. The liniment encourages a little milky fluid to ooze out of the nipple, which will afford relief.

356. If stays be worn, the patient should wear them slack, in order to allow the bosoms plenty of room to develop themselves. The bones of the stays ought all to be removed, or serious consequences might ensue.

357. Bowel complaints, during pregnancy, are not unfrequent. A dose either of rhubarb and magnesia, or of castor oil, are the best remedies, and are generally, in the way of medicine, all that is necessary.

358. The diet at such times ought to be simple, small in quantity, and nourishing. Farinaceous food, such as rice, tapioca, sago, Du Barry’s Arabica Revalenta, 164and arrow-root, are particularly beneficial. Green vegetables and fruits, especially stone fruits and uncooked fruits, ought to be avoided.

359. The surface of the body—the bowels and feet particularly—ought to be kept warm. If a lady suffer habitually from relaxation of the bowels, let her, by all means, wear a flannel vest next the skin.

360. The bladder.—The patient during pregnancy is liable to various affections of the bladder. There is sometimes a sluggishness of that organ, and she has little or no inclination to make water. There is, at another time, a great irritability of the bladder, and she is constantly wanting to pass urine; while, in a third case, more especially toward the latter period of the time, she can scarcely hold her water at all,—the slightest bodily exertion, such as walking, stooping, coughing, sneezing, etc., causing it to come away involuntarily; and even in some cases, where she is perfectly still, it dribbles away without her having any power to prevent its doing so.

361. A sluggish state of the bladder is best remedied by gentle exercise, and by the patient attempting, whether she want or not, to make water at least every four hours.

362. Irritability of the bladder.—The patient ought, during the day, to drink freely of the following beverage:

165Take of—Best Gum Arabic, one ounce;
Pearl Barley, one ounce;
Water, one pint and a half:

Boil for a quarter of an hour, then strain, and sweeten either with sugar candy or lump sugar.

363. The bowels ought to be gently opened with small doses of castor oil. The patient must abstain from beer, wine, or spirits, and should live on a mild, bland, nourishing diet.

364. Where the patient cannot hold her water there is not a great deal to be done, as the pregnant womb by pressing on the bladder prevents much present relief. The comfort is, as soon as the labor is over, it will cure itself. She ought frequently in the day to lie down either on a horse-hair mattress or on a couch. She should drink but a moderate quantity of liquid, and if she has a cough (for a cough greatly increases this inability to hold the water), she ought to take the following mixture:

Take of—Compound Tincture of Camphor, half an ounce;
Compound Spirits of Lavender, half a drachm;
Oxymel of Squills, six drachms;
Water, six ounces and a half:

Two tablespoonfuls of this mixture to be taken three times a day.

365. Fainting.—A delicate woman, when she is enceinte, is apt either to feel faint or to actually faint away. When it is considered the enormous changes that, during pregnancy, take place, and the great pressure there is upon the nerves and the blood-vessels, 166it is not at all surprising that she should do so. There is one consolation, that although fainting at such times is disagreeable, it is not at all dangerous, unless the patient be really laboring under a disease of the heart.

366. Treatment.—If the patient feel faint, she ought immediately to lie down flat upon her back, without a pillow under her head; that is to say, her head should be on a level with her body. The stays and any tight articles of dress—if she has been foolish enough to wear either tight stays or tight clothes—ought to be loosened; the windows should be thrown wide open; water ought to be sprinkled on her face; and sal-volatile—a teaspoonful in a wineglassful of water, or a glass of wine ought to be administered. Smelling-salts must be applied to the nostrils. The attendants—there should only be one or two present—should not crowd around her, as she ought to have plenty of room to breathe.

367. She must, in the intervals, live on a good, light, generous diet. She should keep early hours, and ought to sleep in a well-ventilated apartment. The following strengthening medicine will be found serviceable:

Take of—Sulphate of Quinine, twelve grains;
Diluted Sulphuric Acid, half a drachm;
Syrup of Orange-peel, half an ounce;
Water, seven ounces and a half:

Two tablespoonfuls of the mixture to be taken three times a day.

If she be delicate, a change either to the country, or, if 167the railway journey be not very long, to the coast, will be desirable.

368. A nervous patient during this period is subject to palpitation of the heart. This palpitation, provided it occur only during pregnancy, is not dangerous; it need therefore cause no alarm. It is occasioned by the pressure of the pregnant womb upon the large blood-vessels, which induces a temporary derangement of the heart’s action. This palpitation is generally worse at night, when the patient is lying down. There is, at these times, from the position, greater pressure on the blood-vessels. Moreover, when she is lying down, the midriff, in consequence of the increased size of the belly, is pressed upward, and hence the heart has not its accustomed room to work in, and palpitation is in consequence the result.

369. The best remedies will be either half a teaspoonful of compound spirits of lavender or a teaspoonful of sal-volatile in a wineglassful of camphor julep,[68] or a combination of lavender and of sal-volatile:

Take of—Compound Spirits of Lavender, one drachm;
Sal-Volatile, eleven drachms:

Mix.—A teaspoonful of the drops to be taken occasionally in a wineglassful of water.

168370. These medicines ought to lie on a table by the bedside of the patient, in order that they may, if necessary, be administered at once. Brandy is in these cases sometimes given, but it is a dangerous remedy to administer every time there is palpitation; while the lavender and the sal-volatile are perfectly safe medicines, and can never do the slightest harm.

371. Mental emotion, fatigue, late hours, and close rooms ought to be guarded against. Gentle out-door exercise, and cheerful but not boisterous company are desirable.

372. Cramps of the legs and of the thighs during the latter period, and especially at night, are apt to attend pregnancy, and are caused by the womb pressing upon the nerves which extend to the lower extremities. Treatment.—Tightly tie a handkerchief folded like a neckerchief round the limb a little above the part affected, and let it remain on for a few minutes. Friction by means of the hand either with opodeldoc or with laudanum (taking care not to drink it by mistake) will also give relief. Cramp sometimes attacks either the bowels or the back of a pregnant woman; when such is the case, let a bag of hot salt, or a hot-water bag,[69] or a tin stomach warmer filled with hot water 169and covered with flannel, or a stone bottle containing hot water, wrapped in flannel, be applied over the part affected; and let either a stone bottle of hot water or a hot brick, which should be incased in flannel, be placed to the soles of the feet. If the cramp of the bowels, of the back, or of the thighs be very severe, the following mixture will be serviceable:

Take of—Compound Tincture of Camphor, one ounce;
Dill Water, five ounces:

A wineglassful of this mixture to be taken at bedtime occasionally, and to be repeated, if necessary, in four hours.

373. “The whites,” during pregnancy, especially during the latter months, and particularly if the lady has had many children, are frequently troublesome, and are, in a measure, owing to the pressure of the womb on the parts below causing irritation. The best way, therefore, to obviate such pressure, is for the patient to lie down a great part of each day either on a bed or on a sofa.

374. She ought to retire early to rest; she should sleep on a horse-hair mattress and in a well-ventilated apartment, and she must not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pass readily through it as through 170blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; but she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning.

375. The best application will be, to bathe the parts with warm fuller’s earth and water, in the proportion of a handful of powdered fuller’s earth to half a wash-hand-basinful of warm water; and the internal parts ought, night and morning, to be bathed with it. If the fuller’s earth should not have the desired effect, an alum injection[70] ought, every night and morning, by means of an india-rubber vaginal syringe,[71] to be syringed up the parts; or fifteen drops of solution of diacetate of lead should be added to a quarter of a pint of lukewarm water, and be used in a similar manner as the alum injection.

376. Cleanliness, in these cases, cannot be too strongly urged. Indeed, every woman, either married or single, ought, unless special circumstances forbid, to use either the bidet or a sitz-bath. If she has not the “whites,” or if she has them only slightly, cold, quite cold water is preferable to tepid. I should advise, 171then, every lady, both married and single, whether she has the “whites” or not, a regular sitz-bath[72] every morning (except during her “poorly times”)—that is to say, I should recommend her to sit every morning in the water (in cold water) for a few seconds, or while she can count a hundred; throwing the while either a small blanket or shawl over her shoulders, but having no other clothing on except slippers on her feet. She should, for the first few mornings, make the water lukewarm; but the sooner she can use it cold—quite cold—the more good it will do her.

377. If the above plan were more generally followed, women of all classes and ages would derive immense benefit from its adoption, and many serious diseases would be warded off. Besides, the use of the sitz-bath, after a time, would be a great comfort and enjoyment.

378. Where a lady suffers severely from the “whites,” she ought to visit the coast. There is nothing in such cases that generally affords so much relief as the bracing effects of sea-air. Of course, if she be pregnant, she ought not to bathe in the sea, but should, every night and morning, bathe the external parts with sea water.

379. When the patient has been much weakened by the “whites,” she will derive benefit from a quinine mixture[73]—a dose of which ought to be taken twice or three times a day.

172380. Irritation and itching of the external parts.—This is a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy; and as it is a subject that a lady is too delicate and too sensitive to consult a medical man about, I think it well to lay down a few rules for her relief. The misery it entails, if not relieved, is almost past endurance.

381. Well, then, in the first place, let her diet be simple and nourishing; let her avoid stimulants of all kinds. In the next place, and this is a most important item of treatment, let her use a tepid salt and water sitz-bath.[74]

382. The way to prepare the bath is to put a large handful of table salt into the sitz-bath, then to add cold water to the depth of three or four inches, and sufficient hot water to make the water tepid or lukewarm. The patient must sit in the bath; her slippered feet being, of course, out of the water, and on the ground, and either a woolen shawl or a small blanket being thrown over her shoulders: which shawl or blanket ought to be the only covering she has on the while. She should remain only for a few seconds, or while she can count, in the winter, fifty, or the summer, a hundred, in the bath. Patients generally derive great comfort and benefit from these salt and water sitz-baths.

173383. If the itching, during the daytime, continue, the following lotion ought to be used:

Take of—Solution of Diacetate of Lead, one drachm;
Rectified Spirits of Wine, one drachm;
Distilled Water, one pint:

To make a lotion. The parts affected to be bathed three or four times a day with the lotion. Or the parts may be bathed two or three times a day with equal parts of vinegar and water.

384. The external parts, and the passage to the womb (the vagina), in these cases, are not only irritable and itching, but are sometimes hot and inflamed, and are covered either with small pimples, or with a whitish exudation of the nature of aphtha (thrush), somewhat similar to the thrush on the mouth of an infant; then the addition of glycerin to the lotion is a great improvement, and usually gives immense relief. Either of the following is a good lotion for the purpose:

Take of—Biborate of Soda, eight drachms;
Glycerin five ounces;
Distilled Water, ten ounces:

To make a lotion. The part affected to be bathed every four hours with the lotion, first shaking the bottle.

Or,

Take of—Solution of Diacetate of Lead,
Rectified Spirits of Wine, of each, one drachm;
Glycerin, five ounces;
Rose Water, ten ounces and a half:

To make a lotion. To be used in the same manner as the preceding one.

174

MISCARRIAGE.

385. If a premature expulsion of the child occur before the end of the seventh month, it is called either a miscarriage or an abortion; if between the seventh month and before the full period of nine months, a premature labor.

386. There is a proneness for a young wife to miscarry, and woe betide her, if she once establish the habit! for it, unfortunately, often becomes a habit. A miscarriage is a serious calamity, and should be considered in that light; not only to the mother herself, whose constitution frequent miscarriages might seriously injure, and eventually ruin; but it might rob the wife of one of her greatest earthly privileges, the inestimable pleasure and delight of being a mother!

387. Now, as a miscarriage may generally be prevented, it behooves a wife to look well into the matter, and to study the subject thoroughly for herself, in order to guard against her first miscarriage; for the first miscarriage is the one that frequently leads to a series. How necessary it is that the above important fact should be borne in mind! How much misery might be averted; as, then, means would, by avoiding the usual causes, be taken to ward off such an awful calamity. I am quite convinced that in the majority of cases, miscarriages may be prevented.

175388. Hence the importance of a popular work of this kind, to point out dangers, to give judicious advice, that a wife may read, ponder over, and “inwardly digest,” and that she may see the folly of the present practices that wives—young wives especially—usually indulge in, and thus, that she may avoid the rocks they split on, which make a shipwreck of their most cherished hopes and treasures.

389. Let it then be thoroughly understood,—first, that a miscarriage is very weakening—more weakening than a labor; and, secondly, that if a lady has once miscarried, she is more likely to miscarry again and again; until, at length, her constitution is broken, and the chances of her having a child become small indeed!

390. Causes.—A slight cause will frequently occasion the separation of the child from the mother, and the consequent death and expulsion of the fœtus; hence the readiness with which a lady sometimes miscarries. The following are the most common causes of a young wife miscarrying: Taking long walks; riding on horseback; or over rough roads in a carriage; a long railway journey; overexerting herself, and sitting up late at night. Her mind, just after marriage, is frequently too much excited by large parties, by balls, and concerts.

391. The following are, moreover, frequent causes of a miscarriage: Falls; all violent emotions of the mind, passion, fright, etc.; fatigue; overreaching; sudden shocks; taking a wrong step either in ascending or in 176descending stairs; falling down stairs; lifting heavy weights; violent drastic purgatives; calomel; obstinate constipation; debility of constitution; consumptive habit of body; fashionable amusements; dancing; late hours; tight lacing; indeed, anything and everything that injuriously affects either the mind or the body.

392. The old maxim that “prevention is better than cure” is well exemplified in the case of a miscarriage. Let me, then, appeal strongly to my fair reader to do all that she can, by avoiding the usual causes of a miscarriage which I have above enumerated, to prevent such a catastrophe. A miscarriage is no trifling matter; it is one of the most grievous accidents that can occur to a wife, and is truly a catastrophe.

393. Threatening or warning symptoms of a miscarriage.—A lady about to miscarry usually, for one or two days, experiences a feeling of lassitude, of debility, of malaise, and depression of spirits; she feels as though she were going to be taken “poorly;” she complains of weakness and of uneasiness about the loins, the hips, the thighs, and the lower part of the belly. This is an important stage of the case, and one in which a judicious medical man may, almost to a certainty, be able to stave off a miscarriage.

394. More serious, but still only threatening symptoms of a miscarriage.—If the above symptoms are allowed to proceed, unchecked and untended, she will, after a day or two, have a slight show of blood; this 177show may soon increase to a flooding, which will shortly become clotted. Then, perhaps, she begins for the first time to dread a miscarriage! There may at this time be but little pain, and the miscarriage might, with judicious treatment, be even now warded off. At all events, if the miscarriage cannot be prevented, the ill effects to her constitution may, with care, be palliated, and means may be used to prevent a future miscarriage.

395. Decided symptoms of a miscarriage.—If the miscarriage be still proceeding, a new train of symptoms develop themselves; pains begin to come on, at first slight, irregular, and of a “grinding” nature, but which soon become more severe, regular, and “bearing down.” Indeed, the case is now a labor in miniature; it becomes le commencement de la fin; the patient is sure to miscarry, as the child is now dead, and separated from its connection with the mother.

396. The most usual time for a lady to miscarry is from the eighth to the twelfth week. It is not, of course, confined to this period, as during the whole time of pregnancy there is a chance of a premature expulsion of the contents of the womb. A miscarriage before the fourth month is at the time attended with little danger; although, if neglected, it may forever injure the constitution.

397. There is, in every miscarriage, more or less of flooding, which is the most important symptom. After 178the fourth month it is accompanied with more risk; as the further a lady is advanced in her pregnancy, the greater is the danger of increased flooding; notwithstanding, under judicious treatment, there is every chance of her doing well.

398. A medical man ought in such a case always to be sent for. There is as much care required in a miscarriage as, or more than, in a labor.

399. If bearing down, expulsive pains—similar to labor pains—should accompany the flooding; if the flooding increase, and if large clots come away; if the breasts become smaller and softer; if there be coldness, and heaviness, and diminution in the size of the belly; if the motion of the child (the patient having quickened) cannot be felt; if there be “the impression of a heavy mass rolling about the uterus [womb], or the falling of the uterine tumor from side to side in the abdomen [belly] as the patient changes her position;”[75] and if there be an unpleasant discharge, she may rest assured that the child is dead, and that it is separated from all connection with her, and that the miscarriage must proceed, it being only a question of time. Of course, in such a case—if she has not already done so—she ought immediately to send for a medical man. A miscarriage sometimes begins and ends in a few days—five or six; it at other times continues a fortnight, and even in some cases three weeks.

179400. Treatment.—If a patient has the slightest “show,” she ought immediately to confine herself either to a sofa or she should keep in bed. A soft feather bed must be avoided; it both enervates the body and predisposes to a miscarriage. There is nothing better for her to sleep on than a horse-hair mattress. She either ought to lie flat upon her back or should lie upon her side, as it is quite absurd for her merely to rest her legs and feet, as it is the back and the belly, not the feet and the legs, that require rest.

401. Let her put herself on a low diet, such as on arrow-root, tapioca, sago, gruel, chicken-broth, tea, toast and water, and lemonade; and whatever she does drink ought, during the time of the miscarriage, to be cold. Grapes, at these times, are cooling and refreshing.

402. The temperature of the bedroom should be kept cool; and, if it be summer, the window ought to be thrown open; aperient medicines must be avoided; and if the flooding be violent, cold water should be applied externally to the parts.

403. Let me strongly urge upon the patient the vast importance of preserving any and every substance that might come away, in order that it may be carefully examined by the medical man.

404. It is utterly impossible for a doctor to declare positively that a lady has miscarried, and that all has properly come away, if he have not had an opportunity 180of examining the substances for himself. How often has a lady declared to her medical man that she has miscarried, when she has only parted with clots of blood! Clots sometimes put on strange appearances, and require a practiced and professional eye to decide at all times upon what they really are.

405. The same care is required after a miscarriage as after a labor; indeed, a patient requires to be treated much in the same manner—that is to say, she ought for a few days to keep her bed, and should live upon the diet I have recommended after a confinement, avoiding for the first few days stimulants of all kinds. Many women date their ill state of health to a neglected miscarriage; it therefore behooves a lady to guard against such a catastrophe.

406. A patient prone to miscarry, ought, before she become pregnant again, to use every means to brace and strengthen her system. The best plan that she can adopt will be TO LEAVE HER HUSBAND FOR SEVERAL MONTHS, and go to some healthy spot; neither to a fashionable watering-place nor to a friend’s house, where much company is kept, but to some quiet country place; if to a healthy farm-house so much the better.

407. Early hours are quite indispensable. She ought to lie on a horse-hair mattress, and should have but scant clothing on the bed. She must sleep in a well-ventilated apartment. Her diet should be light and 181nourishing. Gentle exercise ought to be taken, which should alternate with frequent rest.

408. Cold ablutions ought every morning to be used, and the body should be afterward dried with a coarse cloth. If it be winter, let the water be made tepid and let its temperature be gradually lowered until it be used quite cold. A shower-bath is, in these cases, serviceable; it braces and invigorates the system, and is one of the best tonics that she can use.

409. If she be already pregnant it would not be admissible, as the shock of the shower-bath would be too great, and may bring on a miscarriage; but still she ought to continue the cold ablutions.

410. A lady who is prone to miscarry, ought, as soon as she is pregnant, to lie down a great part of every day; she must keep her mind calm and unruffled; she should live on a plain diet; she ought to avoid wine and spirits and beer; she should retire early to rest, and she must have a separate sleeping apartment. She ought as much as possible to abstain from taking opening medicine; and if she be actually obliged to take an aperient—for the bowels must not be allowed to be constipated—she should select the mildest (such as either castor oil or lenitive electuary or syrup of senna), and even of these she ought not to take a larger dose than is absolutely necessary, as a free action of the bowels is a frequent cause of a miscarriage.

182411. The external application of castor oil as a liniment, and as recommended at page 144, is a good and safe remedy for a patient prone to miscarry; and if sufficiently active, is far preferable to the mildest aperient. Another great advantage of the external application of castor oil is, it does not afterward produce constipation as the internal administration of castor oil is apt to do. If the external application of castor oil in the manner advised at page 144 should not have the desired effect, then an enema—a clyster of warm water, a pint—ought, in the morning, two or three times a week to be administered.

412. Gentle walking exercise daily is desirable: long walks and horseback exercise ought to be sedulously avoided. A trip to the coast, provided the railway journey be not very long, would be likely to prevent a miscarriage; although I would not, on any account, recommend such a patient either to bathe or to sail on the water, as the shock of the former would be too great, and the motion of the vessel and the sea-sickness would be likely to bring on what we are anxious to avoid.

413. As the usual period for miscarrying approaches (for it frequently comes on at one particular time), let the patient be more than usually careful; let her lie down the greatest part of the day; let her mind be kept calm and unruffled; let all fashionable society and every exciting amusement be eschewed; let both the sitting and the sleeping apartments be kept cool and 183well ventilated; let the bowels (if they be costive) be opened by an enema (if the external application of castor oil, as before recommended, be not sufficient); let the diet be simple and yet be nourishing; let all stimulants, such as beer, wine, and spirits, be at this time avoided; and if there be the slightest symptoms of an approaching miscarriage, such as pains in the loins, in the hips, or in the lower belly, or if there be the slightest show of blood, let a medical man be instantly sent for, as he may, at an early period, be able to ward off the threatened mishap.

FALSE LABOR PAINS.

414. A lady, especially in her first pregnancy, is sometimes troubled with spurious labor pains; these pains usually come on at night, and are frequently owing to a disordered stomach. They affect the belly, the back, and the loins; and occasionally they extend down the hips and the thighs. They attack first one place and then another; they come on at irregular intervals; at one time they are violent, at another they are feeble. The pains, instead of being grinding or bearing down, are more of a colicky nature.

415. Now, as these false pains more frequently occur in a first pregnancy, and as they are often more violent two or three weeks toward the completion of the full time, and as they usually come on either at night or in the night, it behooves both the patient and the monthly nurse to be cognizant of the fact, in order that they 184may not make a false alarm and summon the doctor before he is wanted, and when he cannot be of the slightest benefit to the patient.

416. It is sometimes stated that a woman has been in labor two or three weeks before the child was born! Such is not the fact. The case in question is one probably of false pains ending in true pains.

417. How, then, is the patient to know that the pains are false and not true labor pains? False labor pains come on three or four weeks before the full time; true labor pains at the completion of the full time; false pains are unattended with “show;” true pains generally commence the labor with “show;” false pains are generally migratory—changing from place to place—first attacking the loins, then the hips, then the lower portions, and even other portions of the belly—first one part, then another; true pains generally begin in the back; false pains commence as spasmodic pains; true pains as “grinding” pains; false pains come on at uncertain periods, at one time a quarter of an hour elapsing, at others, an hour or two hours between each pain; at one time the pain is sharp, at another trifling; true pains come on with tolerable regularity, and gradually increase in severity.

418. But remember—the most valuable distinguishing symptom is the absence of “show” in false labor pains, and the presence of “show” in true labor pains. It might be said that “show” does not always usher in 185the commencement of labor. Granted; but such cases are exceedingly rare, and may be considered as the exception and not the rule.

419. Treatment.—A dose of castor oil is generally all that is necessary; but if the pains still continue, the patient ought to be abstemious, abstaining for a day or two from beer and from wine, and rubbing the bowels every night at bedtime either with camphorated oil, previously warmed, or with laudanum (taking care not to drink it by mistake). Either hot salt, in a flannel bag, or a hot-water bag applied every night at bedtime to the bowels, frequently affords great relief.

420. If the pains be not readily relieved she ought to send for a medical man. A little appropriate medicine will soon have the desired effect.

421. These false labor pains might go on either for days, or even for weeks, and at length may terminate in real labor pains.

PERIOD OF GESTATION—“THE COUNT.”

422. The period of gestation is usually[76] two hundred and eighty days—forty weeks—ten lunar or nine calendar months.

186423. It will be well for a lady, in making her “count,” to commence her “reckoning” about three days after the last day of her being “unwell.” The reason we fix on a woman conceiving a few days after she has “ceased to be unwell” is that she is more apt to do so soon after menstruation than at any other time.[77]

424. A good plan to make the “reckoning” is as follows: Let forty weeks and a few days, from the time specified above, be marked on an almanac, and a lady will seldom be far from her calculation. Suppose, for instance, the last day of her “ceasing to be unwell” 187was on January the 15th, she may expect to be confined very near October 23d.

425. Another plan, and one recommended by Dr. Tanner, to make the “count,” is the following: “To effect this readily, we cannot do better than follow the plan of most German obstetricians, who learn the probable day of delivery thus: the date of the last menstruation being given, they calculate three months backward and add seven days. For example, suppose the 20th January to be the last day of the last menstrual period, labor will be due about the 27th October—i.e. on the 280th day.”[78]

BEING OUT IN THE RECKONING.

426. A lady, sometimes, by becoming pregnant while she is suckling, is put out of her reckoning; not being unwell at such time, she consequently does not know how to “count.” She ought, in a case of this kind, to reckon from the time that she quickens—that is to say, she must then consider herself nearly half-gone in her pregnancy, and to be within a fortnight of half her time; or, to speak more accurately, as soon as she has quickened, we have reason to believe that she has gone about one hundred and twenty-four days: she has therefore about one hundred and fifty-six more days to complete the period of her pregnancy. Suppose, for instance, that she first quickened on May the 17th, she 188may expect to be confined somewhere near October the 23d. She must bear in mind, however, that she can never make so correct a “count” from quickening (quickening takes place at such various periods) as from the last day of her being “unwell.”

427. A lady is occasionally thrown out of her reckoning by the appearance, the first month after she is enceinte, of a little “show.” This discharge does not come from the womb, as that organ is hermetically sealed; but from the upper part of the vagina, the passage to the womb, and from the mouth of the womb, and may be known from the regular menstrual fluid by its being much smaller in quantity, by its clotting, and by its lasting generally but a few hours. This discharge, therefore, ought not to be reckoned in the “count,” but the one before must be the guide, and the plan should be adopted as recommended in page 186, paragraph 423.

“IS IT A BOY OR A GIRL?”

428. It has frequently been asked, “Can a medical man tell, before the child is born, whether it will be a boy or girl?” Dr. F. J. W. Packman, of Wimborne, answers in the affirmative. “Queen bees lay female eggs first, and male eggs afterward. In the human female, conception in the first half of the time between menstrual periods produces female offspring, and male in the latter. When a female has gone beyond the time she calculated upon, it will generally turn out to 189be a boy.”[79] It is well to say generally, as the foregoing remarks are not invariably to be depended upon, as I have had cases to prove. Notwithstanding, I believe that there is a good deal of truth in Mr. Packman’s statement.

MONTHLY NURSE.

429. It is an important, a most important, consideration to choose a nurse rightly and well.

430. A monthly nurse ought to be middle-aged. If she be young, she is apt to be thoughtless and giggling; if she be old, she may be deaf and stupid, and may think too much of her trouble. She should have calmness and self-possession. She must be gentle, kind, good-tempered, and obliging, but firm withal, and she should have a cheerful countenance. “Some seem by nature to have a vocation for nursing; others not. Again, nursing has its separate branches; some have the light step, the pleasant voice, the cheering smile, the dextrous hand, the gentle touch; others are gifted in cookery for the sick.”[80] The former good qualities are essential to a monthly nurse, and if she can combine the latter—that is to say, “if she is gifted in cookery for the sick”—she will, as a monthly nurse, be invaluable. Unless a woman have the gift of nursing, 190she will never make a nurse. “Dr. Thynne held that sick-nurses, like poets, were born, not made.”[81]

431. She ought neither to be a tattler, nor a tale-bearer, nor a “croaker,” nor a “potterer.” A tattler is an abomination; a clacking tongue is most wearisome and injurious to the patient. A tale-bearer is to be especially avoided; if she tell tales of her former ladies, my fair reader may depend upon it that her turn will come.[82] But of all nurses to be shunned as the plague is the “croaker,” one that discourses of the dismal and of the dreadful cases that have occurred in her experience, many of which, in all probability, she herself was the cause of. She is a very upas-tree in a house. A “potterer” should be banished from the lying-in room; she is a perpetual worry—a perpetual blister! She is a nurse without method, without system, and without smartness. She potters at this and potters at that, and worries the patient beyond measure. She dreams, and drawls, and “potters.” It is better to have a brusque and noisy nurse than a pottering one—the latter individual is far more irritating to the patient’s nerves, and is aggravating beyond endurance. “There is one kind of nurse that is not uncommon in hospitals [and in lying-in rooms], and that gives more trouble and worry than all the others together, viz., the ‘pottering’ nurse. Of all nuisances, defend us from a potterer.... The woman always 191has the very best intentions in the world, but is totally devoid of method and smartness. You never know when she has begun anything, and you certainly will never know when she has finished it. She never does finish it, but she sometimes leaves off.... She seems incapable of taking in a complete and accurate idea of anything, and even while you are speaking to her it is easy to see that her attention cannot be concentrated, and that her mind is flying about among half a dozen subjects. If she is in the least hurried, she loses what little intellect she ordinarily possesses, moans feebly in a sotto voce monotone, fetches the wrong articles, does the wrong thing at the wrong time, and is always in the way.”[83]

432. Some monthly nurses have a knack of setting the servants at loggerheads, and of poisoning the minds of their mistresses toward them. They are regular mischief-makers, and frequently cause old and faithful domestics to leave their situations. It will be seen, therefore, that it is a momentous undertaking to choose a monthly nurse rightly and well.

433. Fortunately for ladies the class of nurses is wonderfully improved, and the race of Sairey Gamp and Betsey Prig is nearly at an end.

434. She ought to be either a married woman or a 192widow. A single woman cannot so well enter into the feelings of a lying-in patient, and has not had the necessary experience. Moreover, a single woman, as a rule, is not so handy with an infant (more especially in putting him for the first time to the breast) as a married woman.

435. She must be sober, temperate, and healthy, and free from deafness and from any defect of vision. She should have a gentle voice and manner, but yet be neither melancholy nor hippish. She ought to be fond of children, and must neither mind her trouble nor being disturbed at night. She should be a light sleeper. “Scrupulous attention to cleanliness, freshness, and neatness” in her own person, and toward the lady and the infant, are most important requisites.

436. A fine lady-nurse that requires to be constantly waited upon by a servant is not the one that I would recommend. A nurse should be willing to wait upon herself, upon her mistress, and upon the baby with alacrity, with cheerfulness, and without assistance, or she is not suitable for her situation.

437. As the nurse, if she does her duty, devotes her time, her talent, and her best energies to the lady and infant, a mistress ought to be most liberal in the payment of a monthly nurse. A good one is cheap at almost any price, while a bad one, though she come for nothing, is dear indeed. A cheap nurse is frequently the ruin of the patient’s and of the baby’s health, and of the peace of a household.

193438. The monthly nurse ought to be engaged early in the pregnancy, as a good nurse is caught up soon, and is full of engagements. This is most important advice. A lady frequently has to put up with an indifferent nurse from neglecting to engage her betimes. The medical man at the eleventh hour is frequently besought to perform an impossibility—to select a good nurse; and which he could readily have done if time had been given him to make the selection. Some of my best nurses are engaged by my patients as early as two or three months after the latter have conceived, in order to make sure of having their favorite nurses. My patients are quite right; a good nurse is quite of as much importance to her well-doing as a good doctor; indeed, a bad nurse oftentimes makes a good doctor’s efforts perfectly nugatory.

439. It is always desirable, whenever it be possible, that the doctor in attendance should himself select the monthly nurse, as she will then be used to his ways, and he will know her antecedents—whether she be sober, temperate, and kind, and that she understands her business, and whether she be in the habit of attending and of following out his directions, for frequently a nurse is self-opinionated, and fancies that she knows far better than the medical man. Such a nurse is to be scrupulously avoided. There cannot be two masters in a lying-in room; if there be, the unfortunate patient will inevitably be the sufferer. A doctor’s directions must be carried out to the very letter. It rests with the patient to select a judicious medical man, 194who, although he will be obeyed, will be kind and considerate to the nurse.

440. A monthly nurse ought to be in the house a week or ten days before the commencement of the labor, in order that there may be neither bustle nor excitement, and no hurrying to and fro at the last moment to find her; and that she may have everything prepared, and the linen well aired for the coming event.

441. She must never be allowed, unless ordered by the medical man, to give either the patient or the baby a particle of medicine. A quacking monthly nurse is an abomination. An infant who is everlastingly being drugged by a nurse is sure to be puny and delicate.

442. A monthly nurse ought to understand the manner of putting on and of tightening the bandage after a confinement. This, every night and morning, she must do. The doctor generally does it the first time himself, viz., immediately after the labor. It requires a little knack, and if the nurse be at all awkward in the matter, the medical man will only be too happy to show her the way, for he is quite aware the support, the comfort, and the advantage it will be to his patient, and he will be glad to know that the nurse herself will be able to continue putting it on properly for some weeks—for at least three weeks—after the lying-in.

443. If nurses better understood the proper method of bandaging patients after their labors, there would 195not be so many ladies with pendulous bellies and with ungainly figures. It is a common remark that a lady’s figure is spoiled in consequence of her having had so many children. This, provided efficient bandaging after every confinement had been properly resorted to, ought not to be. But then, if a monthly nurse is to do those things properly, she ought to be properly trained, and many of them have little or no training; hence the importance of choosing one who thoroughly knows and will conscientiously do her duty.

444. A monthly nurse who thoroughly understands her business will always have the lying-in room tidy, cheerful, and well ventilated. She will not allow dirty linen to accumulate in the drawers, in corners, and under the bed; nor will she allow any chamber utensil to remain for one moment in the room after it has been used. If it be winter, she will take care that the fire in the grate never goes out, and that it is never very large, and that the room is kept as nearly as possible at one temperature—namely, at 60° Fahrenheit. She will use her authority as a nurse, and keep the other children from frequently running into the room, and from exciting and disturbing her mistress; and she will make a point of taking charge of the baby, and of keeping him quiet while the mother, during the day, is having her necessary sleep.

445. A good monthly nurse fully comprehends and thoroughly appreciates the importance of bathing the external parts concerned in parturition every night and 196morning, and sometimes even oftener, for at least two or three weeks after a confinement. And if the medical man deem it necessary, she ought to understand the proper manner of using a vaginal syringe. If the nurse be self-opinionated, and tries to persuade her mistress not to have proper ablution—that such ablution will give cold—she is both ignorant and prejudiced, and quite unfit for a monthly nurse; and my advice is, that a lady ought on no account to engage such a person a second time.

446. In another part of this work I have entered fully on the vital importance of ablution after a confinement, and I need not say more than again to urge my fair reader to see that the monthly nurse properly carries it out, and that, if there be any objections made to it by the nurse, the medical man be appealed to in the matter, and that his judgment be final. Assured I am that every doctor who understands his profession will agree with me, that the regular ablution of the parts after a labor is absolutely indispensable. The nurse, of course, will take care to guard the bed from being wet, and will not expose the patient unnecessarily during the process; she will be quick over it, and she will have in readiness soft, warm, dry towels to speedily dry the parts that have been bathed. The above is most important advice, and I hope that my fair inquirer will engage a monthly nurse that will do her duty in the matter.

447. Before concluding a list of some of the duties 197of a monthly nurse, there are four more pieces of advice I wish to give both to a wife and to a monthly nurse herself, which are these: (1) Never to allow a nurse, until she be ordered by the doctor, to give either brandy, or wine, or porter, or ale to the patient. (2) I should recommend every respectable monthly nurse to carry about with her an india-rubber vaginal syringe. One of the best for the purpose is Higginson’s syringe,[84] which is one constructed to act either as an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as a vaginal syringe. She will thus be armed at all points, and will be ready for any emergency. It is an admirable invention, and cannot be too well known. (3) I should advise a monthly nurse while on duty, whatever she may do at other times, to doff her crinoline. A woman nursing a baby with a stuck-out crinoline is an absurdity, and if it were not injurious both 198to the mother and to the infant (as the nurse in crinoline cannot do her duty either to the one or to the other) she would be a laughable object. A new-born baby pillowed in steel! (4) I should recommend every monthly nurse, while in the lying-in room, to wear either list slippers or the rubber slippers, as creaking shoes are very irritating to a patient. “Nurses at these times should wear slippers and not shoes. The best slippers in sick-rooms are those manufactured by the North British Rubber Company, Edinburgh: they enable nurses to walk in them about the room without causing the slightest noise; indeed, they may be called ‘the noiseless slipper’—a great desideratum in such cases, more especially in all head affections of children. If the above slippers cannot readily be obtained, then list slippers—soles and all being made of list—will answer the purpose equally as well.”[85]

199

PART III.
LABOR.

THE PRECURSORY SYMPTOMS OF LABOR.

448. A day or two before the labor commences, the patient usually feels better than she has done for a long time; she is light and comfortable; she is smaller, and the child is lower down; she is more cheerful, breathes more freely, and is more inclined to take exercise, and to attend to her household duties.

449. A few days, sometimes a few hours, before labor commences, the child “falls,” as it is called, that is to say, there is a subsidence—a dropping—of the womb lower down the belly. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely.

450. The only inconvenience of the subsidence of the womb is that the womb presses on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water.

200451. The subsidence—the dropping—of the womb may then be considered one of the earliest of the precursory symptoms of the labor, and as the herald of the coming event.

452. She has, at length, slight pains, and then she has a “show,” as it is called; which is the coming away of a mucous plug, which, during pregnancy, had hermetically sealed the mouth of the womb. The “show” is generally tinged with a little blood. When a “show” takes place, she may rest assured that labor has actually commenced. One of the early symptoms of labor is a frequent desire to relieve the bladder.

453. She has now “grinding pains,” coming on at uncertain periods; sometimes once during two hours, at other times every hour or half hour. These “grinding pains” ought not to be interfered with; at this stage, therefore, it is useless to send for a doctor; yet the monthly nurse should be in the house, to make preparations for the coming event. Although, at this early period, it is not necessary to send for the medical man, nevertheless, it is well to let him know that his services might shortly be required, in order that he might be in the way, or that he might leave word where he might quickly be found.

454. These “grinding pains” gradually assume more regularity in their character, return at shorter intervals, and become more severe. About this time, shivering, in the majority of cases, is apt to occur, so as to make 201the teeth chatter again. Shivering during labor is not an unfavorable symptom; it proves, indeed, that the patient is in real earnest, and that she is making progress.

455. She ought not, on any account, unless it be ordered by the medical man, to take brandy as a remedy for the shivering. A cup either of hot tea or of hot gruel will be the best remedy for the shivering; and an extra blanket or two should be thrown over her, which ought to be well tucked around her, in order to thoroughly exclude the air from the body. The extra clothing should, as soon as she is warm and perspiring, be gradually removed, as she ought not to be kept very hot, or it will weaken her, and will thus retard her labor.

456. Sickness frequently comes on in the beginning of the labor, and may continue during the whole process. She is not only sick, but she actually vomits, and she can keep little or nothing on her stomach.

457. Now, sickness in labor is rather a favorable symptom, and is usually indicative of a kind and easy confinement. There is an old saying that “sick labors are safe.” Although they may be safe, they are decidedly disagreeable!

458. In such a case there is little or nothing to be done, as the less an irritable stomach is meddled with the better. The sickness will probably leave as soon 202as the labor is over. Brandy, unless prescribed by the medical man, ought not to be given.

459. She must not, on any account, force down—as her female friends or as a “pottering” old nurse may advise to—“grinding pains:” if she do, it will rather retard than forward her labor.

460. She had better, during this stage, either walk about or sit down, and not confine herself to bed; indeed, there is no necessity for her, unless she particularly desire it, to remain in her chamber.

461. If, at the commencement of the labor, the “waters should break,” even if there be no pain, the medical man ought immediately to be sent for; as, in such a case, it is necessary that he should know the exact presentation of the child.

462. After an uncertain length of time, the character of the pains alters. From being “grinding,” they become “bearing down,” and are now more regular and frequent, and the skin becomes both hot and perspiring. These may be considered the true labor pains. The patient ought to bear in mind then that “the true labor pains are situated in the back and loins; they come on at regular intervals, rise gradually up to a certain pitch of intensity, and abate as gradually; it is a dull, heavy, deep sort of pain, producing occasionally a low moan from the patient; not sharp 203or twinging, which would elicit a very different expression of suffering from her.”[86]

463. As soon as the pains assume a “bearing down” character, the medical man ought to be in attendance; if he be sent for during the early stage, when the pains are of a “grinding” character, and when they come on “few and far between,” and at uncertain intervals (unless, as before stated, “the waters should break” early), he can do no good; for if he attempt in the early stage to force on the labor, he might do irreparable mischief.

464. Cramps of the legs and of the thighs are a frequent, although not a constant, attendant on labor. These cramps come on more especially if the patient be kept for a lengthened period in one position; hence the importance of allowing her, during the first and the second stages of labor, to move about the room.

465. Cramps are generally worse during the third or last stage of labor, and then, if they occur at all, they usually accompany each pain. The poor patient, in such a case, has not only to bear the labor pains but the cramp pains! Now, there is no danger in these cramps; it is rather a sign that the child is making rapid progress, as he is pressing upon the nerves which supply the thighs.

466. The nurse ought to well rub, with her warm 204hand, the cramped parts; and, if the labor be not too far advanced, it would be well for the patient to change her position, and to sit on a chair, or, if she feel inclined, to walk about the room; there being of course an attendant, one on each side, to support her the while. If either a pain or a cramp should come on while she is thus moving about, let her instantly take hold of the bedpost for support.

467. I observe, in a subsequent paragraph, that in a case of labor, a four-post mahogany bedstead without a foot-board is preferable to either a brass or an iron bedstead. It will now be seen that this was one of my reasons for advising the old-fashioned bedstead; as the support of a bedpost is oftentimes a relief and a comfort. The new-fashioned mahogany bedsteads made with fixed foot-board, and both the iron and brass bedsteads with railings at the foot, are each and all, during the progress of labor, very inconvenient; as the patient, with either of these kinds of bedsteads, is not able to plant her feet firmly against the bedpost—the foot-board of the former and the railings of the latter being in the way of her doing so. The man who invented these new-fangled bedsteads was an ignoramus in such matters.

468. Labor—and truly it may be called “labor”[87]—is 205a natural process, and therefore ought not unnecessarily to be interfered with, or woe betide the unfortunate patient.

469. I firmly believe that a woman would stand a much better chance of getting well over her confinement without assistance, than if she had been hurried with assistance.

470. In a natural labor very little assistance is needed, and the doctor is only required in the room occasionally, to ascertain that things are going on rightly. Those ladies do best, both at the time and afterward, whose labors are the least interfered with. Bear this in mind, and let it be legibly written on your memory. This advice, of course, only holds good in natural confinements.

471. Meddlesome midwifery cannot be too strongly reprobated. The duty of a doctor is to watch the progress of a labor, in order that, if there be anything wrong, he may rectify it; but if the labor be going on well, he has no business to interfere, and he need not be much in the lying-in room, although he should be in an adjoining apartment.

472. These remarks are made to set a lady right 206with regard to the proper offices of an obstetrician; as sometimes she has an idea that a medical man is able, by constantly “taking a pain,” to greatly expedite a natural labor. Now, this is a mistaken and mischievous, although a popular notion.

473. The frequent “taking of a pain” is very injurious and most unnatural. It irritates and inflames the passages, and frequently retards the labor.

474. The occasional, but only the occasional, “taking of a pain” is absolutely necessary to enable the medical man to note the state of the parts, and the progress of the labor; but the frequent “taking of a pain” is very objectionable and most reprehensible.

475. As a rule, then, it is neither necessary nor desirable for a medical man to be much in a lying-in room. Really, in a natural labor, it is surprising how very little his presence is required. After he has once ascertained the nature of the case, which it is absolutely necessary that he should do, and has found all going on “right and straight,” it is better, much better, that he retire in the daytime to the drawing-room, in the night season to a bedroom, and thus to allow nature time and full scope to take her own course without hurry and without interference, without let and without hindrance. Nature hates hurry and resents interference.

476. The above advice, for many reasons, is particularly 207useful. In the first place, nature is not unnecessarily interfered with. Secondly, it allows a patient, from time to time, to empty her bladder and bowels,—which, by giving more room to the adjacent parts, greatly assists and expedites the progress of the labor. Thirdly, if the doctor is not present he is not called upon to be frequently “taking a pain,” which she may request him to do, as she fancies it does her good and relieves her sufferings; but which frequent taking of a pain in reality does her harm, and retards the progress of the labor. No; a doctor ought not to be much in a lying-in room. Although it may be necessary that he be near at hand, within call, to render assistance toward the last, I emphatically declare that in an ordinary confinement—that is to say, in what is called a natural labor—the only time, as a rule, that the presence of the doctor can be useful, is just before the child is born; although he ought to be in readiness, and should therefore be in the house some little time before the event takes place. Let the above most important advice be strongly impressed upon your memory. Oh! if a patient did but know what a blessed thing is patience, and, in an ordinary labor, the importance of non-interference!

477. Bear in mind, then, that in every well-formed woman, and in every ordinary confinement, nature is perfectly competent to bring, without the assistance of man, a child into the world, and that it is only an ignorant person who would, in a natural case of labor, 208interfere to assist nature.[88] Assist nature! Can any thing be more absurd? As though God in his wisdom, in performing one of his greatest wonders and processes, required the assistance of man! It might with as much truth be said that in every case of the process of healthy digestion it is necessary for a doctor to assist the stomach in the process of digesting the food! No; it is high time that such fallacies were exploded, and that common sense should take the place of such folly. A natural labor, then, ought never to be either hurried or interfered with, or frightful consequences might, and in all probability will, ensue. Let every lying-in woman bear in mind that the more patient she is, the more kind and the more speedy will be her labor and her “getting about.” Let her, moreover, remember, then, that labor is a natural process—that all the “grinding” pains she has are doing her good service, are dilating, softening, and relaxing the parts, and preparing for the final or “bearing down” pains; let her further bear in mind that these pains must not, on any account whatever, be interfered with either by the doctor, by the nurse, or by herself. These pains are sent for a wise purpose, and they ought to be borne with patience and resignation, and she will in due time be rewarded for all her sufferings and anxieties by having a living child. Oh, how often have I heard an ignorant nurse desire her mistress to bear down to a “grinding” pain, as though it could do the 209slightest good! No, it only robs her of her strength and interferes with the process and progress of the labor. Away with such folly, and let nature assert her rights and her glorious prerogative! It might be thought that I am tedious and prolix in insisting on non-interference in a natural labor, but the subject is of paramount importance, and cannot be too strongly dwelt upon, and cannot be too often brought, and that energetically, before the notice of a lying-in woman.

478. Fortunately for ladies, there is great talent in the midwifery department, which would prevent—however anxious a patient may be to get out of her trouble—any improper interference.[89]

479. I say improper interference. A case sometimes, although rarely, occurs, in which it might be necessary for the medical man to properly interfere and to help the labor; then the patient must leave herself entirely in the hands of her doctor—to act as he thinks best, and who may find it necessary to use promptness and decision, and thus to save her an amount of unnecessary lingering pain, risk, and anxiety. But these cases, fortunately, are exceptions—rare exceptions—and not the rule.

210480. It is, then, absolutely necessary, in some few cases, that a medical man should act promptly and decisively; delay in such emergencies would be dangerous:

“If it were done when ’tis done, then ’twere well
It were done quickly.”

481. There are times, and times without number, when a medical man is called upon to do but little or nothing; and there are others—few and far between—when it is imperatively necessary that he should do a great deal. He ought at all times to be, as gentle as a lamb, but should, in certain contingencies, be as fearless as a lion!

482. Should the husband be present during the labor? Certainly not; but as soon as the labor is over, and all the soiled clothes have been put out of the way, let him instantly see his wife for a few minutes, to whisper in her ear words of affection, of gratitude, and consolation.

483. The first confinement is generally twice the length of time of an after one, and usually the more children a lady has had, the quicker is the labor; but this is by no means always the case, as some of the after labors may be the tedious, while the early confinements may be the quick ones.

484. It ought to be borne in mind, too, that tedious labors are oftentimes natural labors, and that they only require time and patience from all concerned to bring them to a successful issue.

211485. It may be said that a first labor, as a rule, lasts six hours, while an after labor probably lasts but three. This space of time, of course, does not usually include the commencement of labor pains, but the time that a lady may be actually said to be in real labor. If we are to reckon from the commencement of the labor, we ought to double the above numbers—that is to say, we should make the average duration of a first labor twelve; of an after labor, six hours.

486. When a lady marries late in life—for instance, after she has passed the age of thirty—her first labor is usually much more lingering, painful, and tedious, demanding a great stock of patience from the patient, from the doctor, and from the friends; notwithstanding which, if she be not hurried and be not much interfered with, both she and the baby generally do remarkably well. Supposing a lady marries late in life, it is only the first confinement that is usually hard and lingering; the after labors are as easy as though she had married when young.

487. Slow labors are not necessarily dangerous; on the contrary, a patient frequently has a better and more rapid recovery, provided there has been no interference, after a tedious than after a quick confinement—proving beyond doubt that nature hates hurry and interference. It is an old saying, and, I believe, a true one, that a lying-in woman must have pain either before or after a labor; and it certainly is far preferable that she should have the pain and suffering before than after the labor is over.

212488. It is well for a patient to know that, as a rule, after a first confinement she never has after pains. This is some consolation, and is a kind of compensation for her usually suffering more with her first child.

489. The after pains generally increase in intensity with every additional child. This only bears out, in some measure, what I before advanced, namely, that the pain is less severe and of shorter duration before each succeeding labor, and that the pain is greater and of longer duration after each succeeding one.

490. The after pains are intended by nature to contract—to reduce—the womb somewhat to its non-pregnant size, and to assist clots in coming away, and therefore ought not to be needlessly interfered with. A judicious medical man will, however, if the pains be very severe, prescribe medicine to moderate—not to stop—them. A doctor fortunately possesses valuable remedies to alleviate the after pains.

491. Nature—beneficent nature—ofttimes works in secret, and is doing good service by preparing for the coming event, unknown to all around. In the very earliest stages of labor pain is not a necessary attendant.

492. Although pain and suffering are the usual concomitants of childbirth, there are, nevertheless, well-authenticated cases on record of painless parturition.[90]

213493. A natural labor may be divided into three stages. The first, the premonitory stage, comprising the “falling” or subsidence of the womb, and the “show.” The second, the dilating stage, which is known by the pains being of a “grinding” nature, and in which the mouth of the womb gradually opens or dilates until it is sufficiently large to admit the exit of the head of the child, when it becomes the third, the completing stage, which is now indicated by the pains being of a “bearing down” expulsive character.

494. Now, in the first or premonitory stage, which is much the longest of the three stages, it is neither necessary nor desirable that the patient should be confined to her room; on the contrary, it is better for her to be moving about the house, and to be attending to her household duties.

495. In the second or dilating stage, it will be necessary that she should be confined to her room, but not to her bed. If the drawing-room be near at hand, she ought occasionally to walk to it, and if a pain should come on the while, lie on the sofa. In this stage it is not at all desirable that she should keep her bed, or even lie much on it. She is better up and about, and walking about the room.

496. In the first and the second stages she must not, on any account, strain or bear down to the pains, as many ignorant nurses advise, as, by robbing her of her strength, it would only retard the labor. Besides, 214while the mouth of the womb is dilating, bearing down cannot be of the slightest earthly use—the womb is not in a fit state to expel its contents. If by bearing down she could (but which fortunately she cannot) cause the expulsion of the child, it would, at this stage, be attended with frightful consequences—no less than the rupture of the womb! Therefore, for the future, let not a lady be persuaded, either by any ignorant nurse or by any officious friend, to bear down until the last or the complete stage, when a gentle bearing down will assist the pains to expel the child.

491. In the third or completing stage, of course it is necessary that she should lie on a bed, and that she should, as above advised, bear gently down to the pains. The bearing down pains will indicate to her when to bear down.

498. If, toward the last, she be in great pain, and if she feel inclined to do so, let her cry out,[91] and it will relieve her. A foolish nurse will tell her that if she make a noise, it will do her harm. Away with such folly, and have nothing to do with such simpletons!

499. Even in the last stage, she ought never to bear down unless the pain be actually upon her; it will do her great harm if she does. In bearing down, the plan is to hold the breath, and strain down as though she were straining to have a stool.

215500. By a patient adopting the rules just indicated, much weariness might be avoided; cramp, from her not being kept long in one position, might be warded off; the labor, from her being amused by change of room and scene, might be expedited; and thus the confinement might be deprived of much of its monotony and misery.

501. Nurses sometimes divide a labor into two kinds—a “back labor,” and a “belly labor.” The latter is not a very elegant, although it might be an expressive, term. Now, in a “back labor,” the patient will derive comfort by having her back held by the nurse. This ought not to be done by the bare hand, but let the following plan be adopted: Let a pillow be placed next to the back, and then the nurse should apply firm pressure, the pillow intervening between the back and the nurse’s hand or hands. If the above method be followed, the back will not be injured, which it otherwise would be by the pressure of the hard hand of the nurse. Where the bare hand alone has been applied, I have known the back to continue sore and stiff for days.

502. During the latter stage of labor, the patient ought always to beep her eyelids closed, or the straining might cause an attack of inflammation of the eyes, or, at all events, might make them bloodshot.

503. Let a large room, if practicable, be selected for the labor, and let it be airy and well ventilated; and, 216if it be summer, take care that the chimney be not stopped. If the weather be intensely hot, there is no objection to the window being from time to time a little opened.

504. The old-fashioned four-post mahogany bedstead is the most convenient for a confinement, and is far preferable either to brass or to iron. The reasons are obvious: in the first place, the patient can, in the last stage of labor, press her feet against the bedpost, which is often a great comfort, relief, and assistance to her. And secondly, while she is walking about the room, and “a pain” suddenly comes on, she can, by holding the bedpost, support herself.

505. If there be a straw mattress and a horse-hair mattress, besides the bed, let the straw mattress be removed; as a high bed is inconvenient, not only to the patient, but to the doctor.

PREPARATIONS FOR LABOR.

506. I should strongly urge a patient not to put everything off to the last. She must take care to have in readiness a good pair of scissors and a skein of whity-brown thread. And she ought to have in the house a small pot of fresh lard—that is to say, unsalted lard,[92] that it may be at hand in case it is wanted. 217Let everything necessary both for herself and the babe be well aired and ready for immediate use, and be placed in such order that all things may, without hurry or bustle, at a moment’s notice, be found.

507. Another preparation for labor, and a most important one, is, attending to the state of the bowels. If they are at all costive, the moment there is the slightest premonitory symptom of labor, she ought to take either a teaspoonful or a dessertspoonful (according to the nature of her bowels, whether she be easily moved or otherwise) of castor oil. If she object to taking the oil, then let her have an enema of warm water, a pint, administered. By adopting either of the above plans she will derive the greatest comfort and advantage. It will prevent her delicacy from being shocked by having her bowels opened, without her being able to prevent them, during the last stage of labor; and it will, by giving the adjacent parts more room, much expedite the confinement and lessen her sufferings.

508. The next thing to be attended to is the way in which she ought to be dressed for the occasion. I would recommend her to put on her clean night-gown, which, in order to keep it clean and unsoiled, should be smoothly and carefully rolled up about her waist; then she ought to wear over it a short bed-gown reaching to the hips, and have on a flannel petticoat to meet it, and then she should put on a dressing-gown over all. If it be winter, the dressing-gown had better either 218be composed of flannel or be lined with that material. The stays must not be worn, as they would interfere with the progress of the labor.

509. The valances of the bed, and the carpet, and the curtains at the foot of the bed, had better all be removed; they are only in the way, and may get soiled and spoiled.

510. “The guarding of the bed.”—This is done in the following way: Cover the right side of the bed (as the patient will have to lie on her left side), with a large piece—a yard and a half square—of waterproof cloth, or bed-sheeting, as it is sometimes called, which is sold for the purpose;[93] over this, folded sheets ought to be placed. If a waterproof cloth cannot be procured, an oil-cloth table-cover will answer the purpose. Either of the above plans will effectually protect the bed from injury.

511. The lying-in room should be kept not hot, but comfortably warm; if the temperature of the room be high, the patient will become irritable, feverish, and restless.

512. Every now and then, in order to change the air, let the door of the room be left ajar; and if, in the early periods of the labor, she should retire for awhile 219to the drawing-room, let the lying-in room window be thrown wide open, so as to thoroughly ventilate the apartment, and to make it fresh and sweet on her return. If the weather be very warm, the lower sash of the window may for a few inches be opened. It is wonderful how refreshing to the spirits, and how strengthening to the frame, a well-ventilated room is to a lying-in patient.

513. Many attendants are not only unnecessary but injurious. They excite and flurry the patient, they cause noise and confusion, and rob the air of its purity. One lady friend besides the doctor and the monthly nurse is all that is needed.

514. In making the selection of a friend, care should be taken that she is the mother of a family, that she is kind-hearted and self-possessed, and of a cheerful turn of mind. At these times all “chatterers,” “croakers,” and “potterers” ought to be carefully excluded from the lying-in room. No conversation of a depressing character should for one moment be allowed. Nurses and friends who are in the habit of telling of bad cases that have occurred in their experience must be avoided as the plague. If nurses have had bad cases, many of them have probably been of their own making; such nurses, therefore, ought on every account to be shunned.

515. During the progress of the labor, boisterous and noisy conversation ought never to be permitted; 220it only irritates and excites the patient. Although boisterous merriment is bad, yet at such times quiet, cheerful, and agreeable conversation is beneficial.

516. A mother on these occasions is often present; but of all persons she is the most unsuitable, as, from her maternal anxiety, she tends rather to depress than to cheer her daughter. Though the mother ought not to be in the room, it is, if practicable, desirable that she should be in the house. The patient, in the generality of cases, derives comfort from the knowledge of her mother being so near at hand.

517. Another preparation for labor is to soothe her mind by telling her of the usual safety of confinements, and by assuring her that, in the generality of instances, it is a natural process; and that all she has to do is to keep up her spirits, to adhere strictly to the rules of her doctor, and she will do well.

518. Tell her that “sweet is pleasure after pain;”[94] tell her, too, of the exquisite happiness and joy she will feel as soon as the labor is over, as perhaps the greatest thrill of delight a woman ever experiences in this world is when her babe is first born. She, as if by magic, forgets all the sorrow and suffering she has endured. “A woman when she is in travail hath sorrow, because her hour is come; but as soon as she is delivered of the child, she remembereth no more the anguish, for joy 221that a man is born into the world.”[95] Keble, in the Christian Year, well observes:

“Mysterious to all thought,
A mother’s prime of bliss,
When to her eager lips is brought
Her infant’s thrilling kiss.”

Rogers, too, in referring to this interesting event, sweetly sings:

“The hour arrives, the moment wished and feared;
The child is born, by many a pang endeared!
And now the mother’s ear has caught his cry—
Oh! grant the cherub to her asking eye!
He comes—she clasps him; to her bosom pressed,
He drinks the balm of life, and drops to rest.”

519. The doctor, too, will be able to administer comfort to her when he has “tried a pain” or has “taken a pain,” as it is called, and when he can assure her that it “is all right and straight”—that is to say, that the child is presenting in the most favorable position, and that everything is progressing satisfactorily. He will, moreover, be able to inform her of the probable duration of the labor.

520. Let me in this place urge upon the patient the importance of her allowing the medical man to inquire fully into her state. She may depend upon it that this inquiry will be conducted in the most delicate manner. If there be anything wrong in the labor, it is in the 222early stage, and before the “waters have broken,” that the most good can be done. If a proper examination be not allowed to the medical man whenever he deems it right and proper (and a judicious doctor will do it as seldom as he can), her life, and perhaps that of her child, might pay the penalty of such false delicacy.

521. French brandy, in case it is wanted, ought always to be in the house; but let me impress upon the minds of the attendants the importance of withholding it, unless it be ordered by the doctor, from a lying-in woman. Numbers have fallen victims to brandy being indiscriminately given. I am of opinion that the great caution which is now adopted in giving spirits to women in labor is one reason, among others, of the great safety of the confinements of the present day, compared with those of former times.

522. The best beverage for a patient during labor is either a cup of warm tea, or of gruel, or of arrow-root. It is folly in the extreme, during the progress of labor, to force her to eat: her stomach recoils from it, as at these times there is generally a loathing of food, and if we will, as we always ought to, take the appetite as our guide, we shall never go far wrong.

523. A patient during labor ought frequently to make water; by doing so she will add materially to her ease and comfort, and it will give the adjacent parts more room, and will thus expedite the labor. I wish to call attention to this point, as many ladies, especially 223with their first children, have, from false delicacy, suffered severely from not attending to it; one of the ill effects of which is inability after the labor is over to make water without the assistance of the doctor, who might in an extreme case deem it necessary to introduce a catheter into the bladder, and thus to draw the water off.

524. I recommended, in a previous paragraph, that the doctor ought to have either the drawing-room or a bedroom to retire to, in order that the patient may, during the progress of the labor, be left very much to herself, and that thus she may have full opportunities, whenever she feels the slightest inclination to do so, of thoroughly emptying either her bladder or her bowels. Now, this advice is of very great importance, and if it were, more than it is, attended to, would cause a great diminution of misery, of annoyance, and suffering. I have given the subject great attention; as I have had large experience in midwifery practice; I therefore speak “like one having authority,” and if my advice in this particular be followed, this book will not have been written in vain.

525. If the patient, twelve hours after the labor, and having tried two or three times during that time, is unable to make water, the medical man ought to be made acquainted with it, or serious consequences might ensue.

224

CHLOROFORM IN HARD AND IN LINGERING LABOR.

526. Mothers and doctors are indebted to Dr.—now Sir James—Simpson for the introduction of chloroform, one of the greatest and most valuable discoveries ever conferred on suffering humanity.

527. Sulphuric ether was formerly used to cause insensibility to pain; but it is far inferior to chloroform, and is now, in this country, very seldom employed; while the inhalation of chloroform, especially in cases of hard and of lingering labor, is every day becoming more general, and will do so still more extensively as its value is better understood, and when, in well-selected cases, its comparative freedom from danger is sufficiently appreciated.

528. Chloroform, then, is a great boon in midwifery practice; indeed, we may say with Dr. Kidd,[96] that in labor cases “it has proved to be almost a greater boon than in the experimental and gigantic operations of the surgeon.” It may be administered in labor by a medical man with perfect safety. I have given it in numerous instances, and have always been satisfied with the result.

529. The inhalation of chloroform causes either partial 225or complete unconsciousness, and freedom from pain either for a longer or for a shorter time, according to the will of the operator. In other words, the effects might with perfect safety be continued either for a few minutes, or from time to time for several hours; indeed, if given in proper cases, and by a judicious medical man, with immense benefit.

530. Chloroform is more applicable and useful in a labor—more especially in a first labor—when it is lingering, when the pains are very severe, and when, notwithstanding the pain, it is making but little progress,—then chloroform is a priceless boon.

531. Chloroform, too, is very beneficial when the patient is of a nervous temperament, and when she looks forward with dread and apprehension to each labor pain.

532. It might be asked,—Would you give chloroform in every case of labor, be it ever so easy and quick? Certainly not: it is neither advisable nor expedient, in an ordinary, easy, quick labor, to administer it.

533. The cases in which it is desirable to give chloroform are all lingering, hard, and severe ordinary labors. In such I would gladly use it. But before administering it, I would, as a rule, wait for at least six hours from the commencement of the labor.

534. Oh, the delightful and magical effects of it in the cases here described! the lying-in room, from being 226in a state of gloom, despondency, and misery, is instantly transformed, by its means, into one of cheerfulness, hope, and happiness!

535. When once a lying-in woman has experienced the good effects of chloroform in assuaging her agony, she importunately, at every recurrence of “the pain,” urges her medical man to give her more! In all her subsequent confinements, having once tasted the good effects of chloroform, she does not dread them. I have frequently heard a lady declare that, now (if her labor be either hard or lingering) she can have chloroform, she looks forward to the period of childbirth with confidence and hope.

536. It might be asked,—Does the inhalation of chloroform retard the patient’s “getting about”? I emphatically declare that it does not do so. Those who have had chloroform have always, in my practice, had as good and as speedy recoveries as those who have not inhaled it.

537. One important consideration in the giving of chloroform in labor is, that a patient has seldom, if ever, while under the effects of it, been known to die; which is more than can be said when it has been administered in surgical operations, in the extraction of teeth, etc. “I know there is not one well-attested death from chloroform in midwifery in all our journals.”[97]

227538. One reason why it may be so safe to give chloroform in labor is, that in the practice of midwifery a medical man does not deem it needful to put his patient under the extreme influence of it. He administers just enough to ease her pain, but not sufficient to rob her of total consciousness; while in a surgical operation the surgeon may consider it necessary to put his patient under the full influence of chloroform: hence the safety in the one, and the danger in the other case. “It is quite possible to afford immense relief, to ‘render the pains quite bearable,’ as a patient of mine observed, by a dose which does not procure sleep or impair the mental condition of the patient, and which all our experience would show is absolutely free from danger.”[98]

539. There is another advantage in chloroform,—the child, when he is born, is usually both lively and strong, and is not at all affected by the mother having had chloroform administered to her. This is a most important consideration.

540. The doctor, too, as I before remarked, is deeply indebted to Sir J. Simpson for this great boon: formerly he dreaded a tedious and hard labor; now he does not do so, as he is fully aware that chloroform will rob such a lying-in of much of its terror and most of its pain and suffering, and will in all probability materially shorten the duration of the confinement.

228541. Chloroform ought never to be administered, either to a labor patient or to any one else, except by a medical man. This advice admits of no exception. And chloroform should never be given unless it be either in a lingering or in a hard labor. As I have before advised, in a natural, easy, everyday labor, nature ought not to be interfered with, but should be allowed to run its own course. Patience, gentleness, and non-interference are the best and the chief requisites required in the majority of labor cases.

HINTS TO ATTENDANTS IN CASE THE DOCTOR IS UNAVOIDABLY ABSENT.

542. It frequently happens that after the first confinement the labor is so rapid that the child is born before the doctor has time to reach the patient.

543. It is consequently highly desirable—nay, imperatively necessary—for the interest and for the well-doing both of the mother and of the baby, that either the nurse or the lady friend should, in such an emergency, know what to do and what NOT to do. I therefore, in the few following paragraphs, purpose, in the simplest and clearest language I can command, to enlighten them on the subject.

544. In the first place, let the attendants be both calm and self-possessed, and let there be no noise, no scuffling, no excitement, no whispering, and no talking, and let the patient be made to thoroughly understand 229that there is not the slightest danger; as the principal danger will be in causing unnecessary fears both as to herself and her child. Tens of thousands are annually delivered in England, and everywhere else, without the slightest assistance from a doctor,[99]—he not being at hand or not being in time; and yet both mother and child almost invariably do well. Let her be informed of this fact—for it is a fact—and it will be a comfort to her and will assuage her fears. The medical man, as soon as he arrives, will soon make all right and straight.

545. In the mean time let the following directions be followed: Supposing a child to be born before the medical man arrives, the nurse ought then to ascertain whether a coil of navel-string be around the neck of the infant; if it be, it must be instantly liberated, or he might be strangled. Care should be taken that he has sufficient room to breathe, that there be not a “membrane” 230over his mouth;[100] and that his face be not buried in the clothes. Any mucus about the mouth of the babe ought, with a soft napkin, to be wiped away, or it might impede the breathing.

546. Every infant, the moment he comes into the world, ought to cry; if he does not naturally, he should be made to do so by smacking his buttocks until he does cry. He will then be safe:

“We came crying hither.
Thou know’st, the first time we smell the air
We waul and cry.”[101]

547. If the doctor has not arrived, cheerfulness, quietness, and presence of mind must be observed by all around; otherwise, the patient may become excited and alarmed, and dangerous consequences might ensue.

548. If the infant should be born apparently dead, a few smart blows must be given on the buttocks and on the back; a smelling-bottle ought to be applied to the 231nostrils, or rag should be singed under the nose, taking care that the burning tinder does not touch the skin; and cold water must be freely sprinkled on the face. The navel-string, as long as there is pulsation in it, ought not to be tied.

549. The limbs, the back, and the chest of the child ought to be well rubbed with the warm hand. The face should not be smothered up in the clothes. If pulsation has ceased in the navel-string (the above rules having been strictly followed, and having failed), let the navel-string be tied and divided,[102] and then let the child be plunged into warm water—98° Fahr. If the sudden plunge does not rouse respiration into action, let him be taken out of the warm bath, as the keeping him for any length of time in the water will be of no avail.

550. If these simple means should not quickly succeed, although they generally will, Dr. Marshall Hall’s Ready Method ought in the following manner to be tried: “Place the infant on his face; turn the body gently but completely on the side and a little beyond, and then on the face, alternately; repeating these measures deliberately, efficiently, and perseveringly, fifteen times in the minute only.”

551. Another plan of restoring suspended animation is by artificial respiration, which should be employed 232in the following manner: Let the nurse (in the absence of the doctor) squeeze, with her left hand, the child’s nose, to prevent any passage of air through the nostrils; then let her apply her mouth to the child’s mouth, and breathe into it, in order to inflate the lungs; as soon as they are inflated, the air ought, with the right hand, to be pressed out again, so as to imitate natural breathing. Again and again, for several minutes, and for about fifteen times a minute, should the above process be repeated; and the operator will frequently be rewarded by hearing a convulsive sob, which will be the harbinger of renewed life.

552. Until animation be restored, the navel-string, provided there be pulsation in it, ought not to be tied. If it be tied before the child has breathed, and before he has cried, he will have but a slight chance of recovery. While the navel-string is left entire, provided there be still pulsation in it, the infant has the advantage of the mother’s circulation and support.

553. If Dr. Marshall Hall’s Ready Method and if artificial respiration should not succeed, he must be immersed up to his neck in a warm bath of 98° Fahrenheit. A plentiful supply of warm water ought always to be in readiness, more especially if the labor be either hard or lingering.

554. Should the child have been born for some time before the doctor has arrived, it may be necessary to tie and to divide the navel-string. The manner of performing 233it is as follows: A ligature, composed of four or five whity-brown threads, nearly a foot in length and with a knot at each end, ought, by a double knot, to be tightly tied, at about two inches from the body of the child, around the navel-string. A second ligature must, in a similar manner, be applied about three inches from the first, and the navel-string should be carefully divided midway between the two ligatures. Of course, if the medical man should shortly be expected, any interference would not be advisable, as such matters ought always to be left entirely to him.

555. The after birth must never be brought away by the nurse: if the doctor has not yet arrived, it should be allowed to come away (which, if left alone in the generality of cases, it generally will) of its own accord. The only treatment that the nurse ought in such a case to adopt is, that she apply, by means of her right hand, firm pressure over the region of the womb: this will have the effect of encouraging the contraction of the womb, of throwing off the after birth, and of preventing violent flooding.

556. If the after birth does not soon come away, say in an hour, or if there be flooding, another medical man ought to be sent for; but on no account should the nurse be allowed to interfere with it further than by applying firm pressure over the region of the womb, and not touching the navel-string at all; as I have known dangerous, and in some cases even fatal, consequences to ensue from such meddling.

234

REST AFTER DELIVERY.

557. A lady ought never to be disturbed for at least an hour after the delivery; if she be, violent flooding might be produced. The doctor, of course, will make her comfortable by removing the soiled napkins, and by applying clean ones in their place.

558. Her head ought to be made easy; she must still lie on her side; indeed, for the first hour let her remain nearly in the same position as that in which she was confined—with this only difference, that if her feet have been pressing against the bedpost, they should be removed from that position.

CLOTHING AFTER LABOR.

559. She ought, after the lapse of an hour or two, to be moved from one side of the bed to the other. It ought to be done in the most tender and cautious manner. She must not, on any account whatever, be allowed to sit erect in the bed. While being moved, she herself should be passive—that is to say, she ought to use no exertion, no effort, but should, by two attendants, be removed from side to side; one must take hold of her shoulders, the other of her hips.

560. A patient, after delivery, usually feels shivering and starved; it will therefore be necessary to throw 235additional clothing, such as a blanket or two, over her, which ought to envelop the body, and should be well tucked around her; but the nurse ought to be careful not to overload her with clothes, or it might produce flooding, fainting, etc.; as soon, therefore, as she is warmer, let the extra clothing be gradually removed. If the feet be cold, let them be wrapped in a warm flannel petticoat, over which a pillow should be placed.

561. A frequent change of linen after confinement is desirable. Nothing is more conducive to health than cleanliness. Great care should be taken to have the sheets and linen well aired.

REFRESHMENT.

562. A cup of cool, black tea, directly after a patient is confined, ought to be given. I say cool, not cold, as cold tea might chill her. Hot tea would be improper, as it might induce flooding.

563. As soon as she is settled in bed, there is nothing better than a small basin of warm gruel.

564. Brandy ought never, unless ordered by the medical man, to be given after a confinement. Warm beer is also objectionable; indeed, stimulants of all kinds must, unless advised by the doctor, be carefully avoided, as they would only produce fever, and probably inflammation. Caudle is now seldom given; but 236still, some old-fashioned people are fond of recommending it after a labor. Caudle ought to be banished the lying-in room; it caused in former times the death of thousands.

BANDAGE AFTER A CONFINEMENT.

565. (1) This consists of thick linen, similar to sheeting, about a yard and a half long, and sufficiently broad to comfortably support the belly. It ought to be put on moderately tight; and should be retightened every night and morning, or oftener, if it become slack. (2) Salmon’s Obstetric Binder is admirably adapted to give support after a confinement, and may be obtained of any respectable surgical-instrument-maker.

566. If there be not either a proper bandage or binder at hand—(3) a yard and a half of unbleached calico, folded double, will answer the purpose. The best pins to fasten the bandages are the patent safety nursery-pins. The binder requires no pins.

567. A support to the belly after labor is important: in the first place, it is a great comfort; in the second, it induces the belly to return to its original size; and lastly, it prevents flooding. Those ladies, more especially if they have had large families, who have neglected proper bandaging after their confinements, frequently suffer from enlarged and pendulous bellies, which give them an unwieldy and ungainly appearance.

237

POSITION.

568. The way of placing the patient in bed.—She ought not, immediately after a labor, under any pretext or pretense whatever, to be allowed to raise herself in bed. If she be dressed, as recommended at paragraph 508, her soiled linen may readily be removed; and she may be drawn up by two assistants—one being at the shoulders and the other at the legs—to the proper place, as she herself must not be allowed to use the slightest exertion.

569. Inattention to the above recommendation has caused violent flooding, fainting, bearing down of the womb, etc., and in some cases even fatal consequences.

THE LYING-IN ROOM.

570. The room to be kept cool and well ventilated.—A nurse is too apt, after the confinement is over, to keep a large fire. Nothing is more injurious than to have the temperature of a lying-in room high. A little fire, provided the weather be cold, to dress the baby by, and to encourage a circulation of the air, is desirable. A fire-guard ought to be attached to the grate of the lying-in room. The door must occasionally be left ajar, in order to change the air of the apartment; a lying-in woman requires pure air as much as any other 238person; but how frequently does the nurse fancy that it is dangerous for her to breathe it!

571. After the affair is over, the blinds ought to be put down, and the window curtains should be drawn, in order to induce the patient to have a sleep, and thus to rest herself after her hard work. Perfect stillness must reign both in the room and in the house.

572. It is really surprising, in this present enlightened age, how much misconception and prejudice there still is among the attendants of a lying-in room; they fancy labor to be a disease, instead of being what it really is—a natural process; and that old-fashioned notions, and not common sense, ought to guide them.

573. The patient should, after the labor, be strictly prohibited from talking; and noisy conversation ought not to be allowed; indeed, she cannot be kept too quiet, as she may then be induced to fall into a sweet sleep, which would recruit her wasted strength. As soon as the baby is washed and dressed, and the mother is made comfortable in bed, the nurse ought alone to remain; let every one else be banished the lying-in room. Visitors should on no account, until the medical man gives permission, be allowed to see the patient.

239

THE BLADDER.

574. Ought a patient to go to sleep before she has made water?—There is not the least danger in her doing so (although some old-fashioned person might tell her that there is); nevertheless, before she goes to sleep, if she have the slightest inclination she should respond to it, as it would make her feel more comfortable and sleep more sweetly.

575. Let me urge the importance of the patient, immediately after childbirth, making water while she is in a lying position. I have known violent flooding to arise from a lying-in woman being allowed, soon after delivery, to sit up while passing her water.

576. The “female slipper”[103] (previously warmed by dipping it in very hot water and then quickly drying it) ought, at these times, and for some days after a confinement, to be used. It is admirably adapted for the purpose, as it takes up but little room and is conveniently shaped, and readily slips under the patient, and enables her to make water comfortably, she being perfectly passive the while. It should be passed under her in front, and not at the side of the body.

240577. If there be any difficulty in her making water, the medical man must, through the nurse, be immediately informed of it. False delicacy ought never to stand in the way of this advice. It should be borne in mind that, after either a very lingering or a severe labor, there is frequently retention of urine,—that is to say, that although the bladder may be full of water, the patient is, without assistance, unable to make it.

578. After the patient, while lying down, trying several times to pass her water, and after, allowing twelve or fifteen hours to elapse, and not being able to do so, it will be well for her to try the following method: Let the pot de chambre be well warmed, let the rim be covered with flannel, let her, supported the while by the nurse, kneel on the bed, her shoulders being covered with a warm shawl; then let her, with the pot de chambre properly placed between her knees on the bed, try to make water, and the chances are that she will now succeed.

579. If she does not, twenty-four hours having elapsed, the doctor must be informed of the fact; and it will then be necessary, absolutely necessary, for him, by means of a catheter, to draw off the water. It might be well to state that the passing of a catheter is unattended with either the slightest danger or pain; and that it is done without exposing her, and thus without shocking her modesty.

241

THE BOWELS.

580. The bowels are usually costive after a confinement. This confined state of the bowels after labor is doubtless a wise provision of nature, in order to give repose to the surrounding parts—especially to the womb; it is well, therefore, not to interfere with them, but to let them have perfect rest for three days. Sometimes before the expiration of the third day the bowels are relieved, either without medicine or merely by the taking of a cupful of warm coffee. If such be the case, all well and good; as it is much better that the bowels should be relieved without medicine than by medicine; but if, having taken the coffee, at the end of the third day they are not opened, then early on the following—the fourth—morning, a dose of castor oil should be given in the manner recommended at paragraph 281. Either a teaspoonful or a dessertspoonful, according to the constitution of the patient, will be a proper dose. If, in the course of twelve hours, it should not have the desired effect, it must be repeated. The old-fashioned custom was to give castor oil on the morning after the confinement; this, as I have before proved, was a mistaken plan.

581. After a lying-in, and when the bowels are not opened either naturally or by the taking of a cupful of warm coffee, if medicine be given by the mouth, castor oil is the best medicine, as it does not irritate 242either the patient’s bowels, or, through the mother’s milk, gripe the infant. Aperient pills, as they most of them contain either colocynth or aloes, or both, frequently give great pain to the babe, and purge him much more than they do the mother herself; aperient pills, therefore, after a confinement ought never to be taken.

582. If the patient object to the taking of castor oil, let the nurse, by means of an enema apparatus, administer an enema. This is an excellent, indeed the best, method of opening the bowels, as it neither interferes with the appetite nor with the digestion; it does away with the nauseousness of castor oil, and does not, in the administration, give the slightest pain. If the first enema should not have the desired effect, let one be given every quarter of an hour until relief be obtained. One of the best for the purpose is the following:

Take of—Olive oil, two tablespoonfuls;
Table salt, two tablespoonfuls;
Warm oatmeal gruel, one pint;

To make a clyster.

Another capital enema for the purpose is one made of Castile soap dissolved in warm water.

583. If the patient object both to the taking of the castor oil and to the administration of an enema, then the following draught will be found useful; it will act kindly, and will neither gripe the mother nor the child:

243Take of—Concentrated Essence of Senna, half an ounce;
Syrup of Ginger, one drachm;
Distilled Water, seven drachms:

To make a draught. To be taken early in the morning.

If in twelve hours the above draught should not have the desired effect (although, if the essence of senna be good, it usually does long before that time), let the draught be repeated. If the bowels be easily moved, half of the above draught is generally sufficient; if it be not so in twelve hours, the remainder should be taken. But let every lying-in woman bear in mind that as soon as her bowels will act, either naturally or by the taking of a cupful of warm coffee, without an aperient, not a particle of opening medicine should be taken.

584. But, after all that can be said on the subject, there is no better method in the world for opening a lying-in patient’s bowels, when costive, than (if the cup of coffee be not sufficiently powerful) by giving her an enema, as advised in a previous paragraph. An enema is safe, speedy, painless, and effectual, and does not induce costiveness afterward, which castor oil, and all other aperients, if repeatedly taken, most assuredly will.

585. An enema, then, is an admirable method of opening costive bowels, both during suckling and during pregnancy, and deserves to be more universally followed than it now is; fortunately, the plan just recommended is making rapid progress, and shortly will, with ladies at such times, entirely supersede the necessity of administering aperients by the mouth.

244586. Aperients, after a confinement, were in olden times, as a matter of course, repeatedly given both to the mother and to the babe, to their utter disgust and to their serious detriment! This was only one of the numerous mistakes and follies that formerly prevailed in the lying-in room. Unfortunately, in those days a confinement was looked upon as a disease, and to be physicked accordingly. A better state of things is happily now dawning.

587. When the patient’s bowels, for the first few days after the confinement, require to be opened, she ought to use either the French bed-pan or the bed-pan of the Liverpool Northern Hospital. Either the one or the other of these pans is a great improvement on the old-fashioned bed-pans, as they will readily slip under the patient, and will enable her, while lying down and while she is perfectly passive in bed, to have her bowels relieved, which at these times is very desirable. The French bed-pan or the bed-pan of the Liverpool Northern Hospital is admirably adapted for a lying-in room; indeed, no lying-in room ought to be without either the one or the other of these useful inventions. “A flannel cap for the toe-part, held on by strings round the heel, will afford considerable comfort to the patient.”[104]

245

“CLEANSINGS”—ABLUTIONS.

588. The “Cleansings.”—This watery discharge occurs directly after a lying-in, and lasts either a week or a fortnight, and sometimes even longer. It is, at first, of a reddish color; this gradually changes to a brownish hue, and afterward to a greenish shade; hence the name of “green waters.” It has in some cases a disagreeable odor. A moderate discharge is necessary; but when it is profuse, it weakens the patient.

589. Some ignorant nurses object to have the parts bathed after delivery; they have the impression that such a proceeding would give cold. Now, warm fomentation twice a day, and even oftener, either if the discharge or if the state of the parts requires it, is absolutely indispensable to health, to cleanliness, and comfort. Ablutions, indeed, at this time are far more necessary than at any other period of a woman’s existence.

590. There is nothing better for the purpose than a soft sponge and warm water, unless the parts be very sore; if they be, a warm fomentation, two or three times a day, of marshmallows and chamomile,[105] will afford great relief, or the parts may be bathed with warm oatmeal gruel, of course without salt. In these cases, 246too, I have found warm barm (yeast) and water a great comfort, and which will soon take away the soreness. The parts ought, after each fomentation, to be well but quickly dried with warm, dry, soft towels.

591. If the internal parts be very sore, it may be necessary, two or three times a day, to syringe them out, by means of an india-rubber vaginal syringe,[106] with either of the above remedies. Hence the importance of having a good monthly nurse, of having one who thoroughly understands her business.

592. Let the above rules be strictly followed. Let no prejudices and no old-fashioned notions, either of the nurse or of any female friend, stand in the way of the above advice. Ablution of the parts, then, after a confinement, and that frequently, is absolutely required, or evil results will, as a matter of course, ensue.

REST AND QUIETUDE.

593. A horizontal—a level—position for either ten days or a fortnight after a labor is important. A lady frequently fancies that if she supports her legs, it is all that is necessary. Now, this is absurd; it is the womb and not the legs that requires rest; and the only way to obtain it is by lying flat either on a bed or on a sofa: for the first five or six days, day and night, on a bed, and then for the next five or six days she ought to be 247removed for a short period of the day either to another bed or to a sofa; which other bed or sofa should be wheeled to the side of the bed, and she must be placed on it by two assistants, one taking hold of her shoulders and the other of her hips, and thus lifting her on the bed or sofa, she herself being perfectly passive, and not being allowed to sit erect the while. She ought, during the time she is on the sofa, to maintain the level position.

594. She ought, after the first nine days, to sit up for an hour; she should gradually prolong the time of the sitting; but still she must, for the first fortnight, lie down a great part of every day. She should, after the first week, lie either on a sofa or on a horse-hair mattress.

595. The above plan may appear irksome, but my experience tells me that it is necessary, absolutely necessary. The benefit the patient will ultimately reap from it will amply repay the temporary annoyance of so much rest. Where the above rules have not been adopted, I have known flooding, bearing down of the womb, and even “falling” of the womb, frequent miscarriages, and ultimately ruin of the constitution, to ensue.

596. “Falling of the womb” is a disagreeable complaint, and the misfortune of it is, that every additional child increases the infirmity. Now, all this might, in the majority of cases, have been prevented, if the recumbent posture for ten days or a fortnight after delivery had been strictly adopted.

248597. If a patient labor under a “falling of the womb,” she ought to apply to a medical man, who will provide her with a proper support, called a pessary, which will prevent the womb from “falling down,” and will effectually keep it in its proper place.

598. It is only a medical man, accustomed to these matters, who can select a pessary suitable for each individual case. A proper kind of, and duly-adjusted, pessary is a great comfort to a patient, and will enable her both to take her proper exercise and to follow her ordinary employments; indeed, if a suitable pessary be used, it is so comfortable that the patient often forgets that she is wearing one at all. Those pessaries ought only to be employed that can be removed every night, as there is not the least necessity for a patient to sleep in one, as the womb does not usually come down when the patient is lying down. Moreover, a pessary ought to be kept perfectly clean, and unless it be daily removed it is utterly impossible to keep it so. It is a great comfort and advantage to a patient to be able both to introduce and to remove the pessary herself, which, if a proper kind be employed, she can, when once taught, readily do.

599. If “falling of the womb” be early and properly treated, there is a good chance of a patient being perfectly cured, and thus of being able to dispense with a pessary altogether.

249

DIETARY.

600. For the first day the diet should consist of nicely made and well-boiled gruel, arrow-root and milk, bread and milk, tea, dry toast and butter, or bread and butter; taking care not to overload the stomach with too much fluid. Therefore, either a cupful of gruel, or of arrow-root, or of tea, at a time, should not be exceeded, otherwise the patient will feel oppressed; she will be liable to violent perspiration, and there will be a too abundant secretion of milk.

601. For the next—the second day.—Breakfast,—either dry toast and butter, or bread and butter, and black tea. Luncheon,—either a breakfast-cupful of strong beef-tea,[107] or of bread and milk, or of arrow-root 250made with good fresh milk. Dinner,—either chicken or game, mashed potatoes, and bread. Tea, the same as for breakfast. Supper,—a breakfast-cupful of well-boiled and well-made gruel, made either with water or with fresh milk, or with water with a tablespoonful of cream added to it.

602. If beef-tea and arrow-root and milk be distasteful to the patient, or if they do not agree, then for luncheon let her have either a light egg pudding or a little rice pudding instead of either the beef-tea or the arrow-root.

603. On the third and fourth days.—Similar diet to the second day, with this difference, that for her dinner the patient should have mutton—either a mutton-chop or a cut out of a joint of mutton, instead of the chicken or game. The diet ought gradually to be improved, so that at the end of four days she should return to her usual diet, provided it be plain, wholesome, and nourishing.

604. The above, for the generality of cases, is the scale of dietary; but of course every lying-in woman ought not to be treated alike. If she be weak and delicate, she may from the beginning require good nourishment, and instead of giving her gruel, it may, from the very commencement, be necessary to prescribe good 251strong beef-tea, veal-and-milk broth,[108] chicken-broth, mutton-chops, grilled chicken, game, the yelk and the white of an egg beaten up together in half a teacupful of good fresh milk, etc. Common sense ought to guide us in the treatment of a lying-in as of every other patient. We cannot treat people by rule and compass; we must be guided by circumstances; we can only lay down general rules. There is no universal guide, then, to be followed in the dietary of a lying-in woman; each case may and will demand separate treatment; a delicate woman, as I have just remarked, may, from the very first day, require generous living; while, on the other hand, a strong, robust, inflammatory patient may, for the first few days, require only simple bland nourishment, without a particle of stimulants. “And hence the true secret of success rests in the use of common sense and discretion—common sense to read nature aright, and discretion in making a right use of what the dictates of nature prescribe.”[109]

BEVERAGE.

605. For the first week, either toast and water, or barley-water and milk,[110] with the chill taken off, is the best 252beverage. Wine, spirits, and beer, during this time, unless the patient be weak and exhausted, or unless ordered by the medical man, ought not to be given. All liquids given during this period should be administered by means of a feeding-cup; this plan I strongly recommend, as it is both a comfort and a benefit to the patient; it prevents her from sitting up in bed every time she has to take fluids, and it keeps her perfectly still and quiet, which, for the first week after confinement, is very desirable.

606. When she is weak, and faint, and low, it may, as early as the first or second day, be necessary to give a stimulant, such as either a tumblerful of home-brewed ale or a glass or two of wine daily; but, as I before remarked, in the generality of cases, either toast and water, or barley-water and milk, for the first week after a confinement, is the best beverage.

607. After a week, either a tumblerful of mild home-brewed ale or of London or Dublin porter, where it agrees, should be taken at dinner; but if ale or porter be given, wine ought not to be allowed. It would be well to keep either to ale or to porter, as may best agree with the patient, and not to mix them, nor to take porter at one meal and ale at another.

253608. Barreled, in this case, is superior to bottled porter, as it contains less fixed air. On the whole, however, I should prefer home-brewed ale to porter. Either old, or very new, or very strong ale, ought not, at this time, to be given.

609. Great care is required in the summer, as the warm weather is apt to turn the beer acid. Such beer would not only disagree with the mother, but would disorder the milk, and thus the infant. A nursing mother sometimes endeavors to correct sour porter or beer by putting soda in it. This plan is objectionable, as the constant taking of soda is weakening to the stomach and impoverishing to the blood. Moreover, it is impossible, by any artificial expedient, to make either tart beer or porter sound and wholesome, and fit for a nursing mother. If beer or porter be sour, it is not fit to drink, and ought either to be thrown away or should be given to the pigs.

610. Sometimes neither wine nor malt liquor agrees; then, either new milk and water, or equal parts of fresh milk and barley-water, will generally be found the best beverage. If milk should also disagree, either barley-water, or toast and water, ought to be substituted.

CHANGE OF ROOM.

611. The period at which a lying-in woman should leave her room will, of course, depend upon the season, and upon the state of her health. She may, after the 254first fourteen days, usually change the chamber for the drawing-room, provided it be close at hand; if it be not, she ought, during the day, to remove—be either wheeled or carried in a chair—from one bedroom to another, as change of apartment will then be desirable. The windows, during her absence from the room, ought to be thrown wide open; and the bedclothes, in order that they may be well ventilated, should be thrown back. She should, at the end of three weeks, take her meals with the family; but even then she ought occasionally, during the day, to lie on the sofa to rest her back.

EXERCISE IN THE OPEN AIR.

612. The period at which a lady, after her confinement, ought to take exercise in the open air, will, of course, depend upon the season, and upon the state of the wind and weather. In the winter, not until the expiration of a month, and not even then unless the weather be fine for the season. Carriage exercise will at first be the most suitable. In the summer she may, at the end of three weeks, take an airing in a carriage, provided the weather be fine, and the wind be neither in an easterly nor in a northeasterly direction. At the expiration of the month she may, provided the season and weather will allow, go out of doors regularly, and gradually resume her household duties and employments.

255

PART IV.
SUCKLING.

THE DUTIES OF A NURSING MOTHER

613. A mother ought not, unless she intend to devote herself to her baby, to undertake to suckle him. She must make up her mind to forego the so-called pleasures of fashionable life. There ought, in a case of this kind, to be no half-and-half measures; she should either give up her helpless babe to the tender mercies of a wet-nurse, or she must devote her whole time and energy to his welfare—to the greatest treasure that God hath given her.

614. If a mother be blessed with health and strength, it is most unnatural and very cruel for her not to suckle her child—

“Connubial fair! whom no fond transport warms
To lull your infant in maternal arms;
Who, blessed in vain with tumid bosoms, hear
His tender wailings with unfeeling ear;
The soothing kiss and milky rill deny
To the sweet pouting lip and glistening eye!
Ah! what avails the cradle’s damask roof,
The eider bolster, and embroidered woof!
256Oft hears the gilded couch unpitied plains,
And many a tear the tasseled cushion stains!
No voice so sweet attunes his cares to rest,
So soft no pillow as his mother’s breast!—
Thus charmed to sweet repose, when twilight hours
Shed their soft influence on celestial bowers,
The cherub Innocence, with smile divine,
Shuts his white wings, and sleeps on beauty’s shrine.”[111]

615. Oh, if a mother did but know the joy that suckling her infant imparts, she would never for one moment contemplate having a wet-nurse to rob her of that joy—

“The starting beverage meets the thirsty lip;
’Tis joy to yield it, and ’tis joy to sip.”[112]

616. Lamentable, indeed, must it be, if any unavoidable obstacle should prevent a mother from nursing her own child!

THE BREAST.

617. As soon as the patient has recovered from the fatigue of the labor—that is to say, in about four or six hours—attention ought to be paid, more especially in a first confinement, to the bosoms.

618. In a first confinement, there is, until the third day, but very little milk; although there is usually on that day, and for two or three days afterward, a great deal of swelling, of hardness, of distention, and of uneasiness 257of the breasts, in consequence of which, in a first confinement, both care and attention are needed.

619. If there be milk in the breast, which may be readily ascertained by squeezing the nipple between the finger and the thumb, the infant should, at first, be applied—not frequently, as some do, but at considerable intervals, say until the milk be properly secreted—every four hours; when the milk flows, the child ought to be applied more frequently, but still at stated times.

620. To wash away any viscid mucus from the nipple, or any stale perspiration from the bosom, let the breasts and the nipples, before applying the baby, be first sponged with a little warm water, and then be dried with a warm, dry, soft napkin; for some infants are so particular that unless the breasts and the nipples be perfectly free from mucus and from perspiration, they will not suck. If after the above cleansing process there be any difficulty in making him take the bosom, smear a little cream on the nipple, and then immediately apply him to it.

621. If the breasts be full, hard, knotty, and painful, which they generally are two or three days after a first confinement, let them be well but tenderly rubbed every four hours, either with the best olive oil (a little of which should, before using it, be previously warmed, by putting a little of the oil in a teacup on the hob by the fire) or with equal parts of olive oil and of eau de Cologne, 258which should be well shaken up in a bottle every time before it be used.

622. On the third day, more especially after a first confinement, the breasts are apt to become very much swollen, painful, and distended. If such be the case, it might be necessary, for a few days, to have them drawn, once or twice daily, by a woman who makes it her business, and who is usually called either a breast-drawer, or, in vulgar parlance, a suck-pap. A clean, sober, healthy, respectable woman ought to be selected. There is, in nearly every large town, one generally to be found who is at the head of her profession. Such a one should be chosen.

623. If the bosoms be more than usually large and painful, in addition to assiduously using the above liniment, apply to the breasts, in the intervals, young cabbage-leaves, which should be renewed after each rubbing. Before applying them, the “veins” of the leaves, with a sharp knife, must be cut smooth, level with the leaf. It will require several, as the whole of the breast ought to be covered. The cabbage-leaves will be found both cooling and comfortable. Each bosom should then be nicely supported with a soft folded silk handkerchief, going under each breast and suspending it; each handkerchief should then be tied at the back of the neck, thus acting as a kind of sling.

624. The patient ought not, while the breasts are full and uncomfortable, to drink much fluid, as it would only encourage a larger secretion of milk.

259625. When the milk is at “its height,” as it is called, she ought every morning, for a couple of mornings, to take a little cooling medicine—a Seidlitz powder—and, every four hours, the following effervescing mixture:

Take of—Bicarbonate of Potash, one drachm and a half;
Distilled Water, eight ounces:

To make a mixture. Two tablespoonfuls to be taken, with two tablespoonfuls of the Acid Mixture, every four hours, while effervescing.

Take of—Citric Acid, three drachms;
Distilled Water, eight ounces:
Mix.—The Acid Mixture.

The best way of taking the above effervescing medicine is to put two tablespoonfuls of the first mixture into a tumbler, and two tablespoonfuls of the acid mixture into a wineglass, then to add the latter to the former, and it will bubble up like soda-water; she should instantly drink it off while effervescing.

626. In two or three days, under the above management, the size of the bosoms will decrease, all pain will cease, and the infant will take the breast with ease and comfort.

627. Second and succeeding confinements.—If the breasts are tolerably comfortable (which in the second and in succeeding confinements they probably will be), let nothing be done to them except, as soon as the milk comes, at regular intervals applying the child alternately to each of them. Many a bosom has been made uncomfortable, irritable, swollen, and even sometimes 260gathered, by the nurse’s interference and meddling. Meddlesome midwifery is bad, and I am quite sure that meddlesome breast-tending is equally so. A nurse, in her wisdom, fancies that by rubbing, by pressing, by squeezing, by fingering, by liniment, and by drawing, she does great good, while in reality, in the majority of cases, by such interference she does great harm.

628. The child will, in second and in succeeding confinements, as a rule, be the best and the only doctor the bosoms require. I am quite convinced that, in a general way, nurses interfere too much, and that the bosoms in consequence suffer. It is, of course, the doctor’s and not the nurse’s province in such matters, to direct the treatment; while it is the nurse’s duty to fully carry out the doctor’s instructions.

629. There is nothing, in my opinion, that so truly tells whether a nurse be a good one or otherwise, as the way she manages the breasts; a good nurse is judicious, and obeys the medical man’s orders to the very letter; while, on the other hand, a bad nurse acts on her own judgment, and is always quacking, interfering, and fussing with the breasts, and doing on the sly what she dare not do openly: such conceited, meddlesome nurses are to be studiously avoided; they often cause, from their meddlesome ways, the breasts to gather.

630. Let the above advice be borne in mind, and much trouble, misery, and annoyance might be averted. Nature, in the majority of cases, manages these things 261much better than any nurse possibly can do, and does not, as a rule, require helping. The breasts are sadly too much interfered and messed with by nurses, and by nurses who are, in other respects, tolerably good ones.

STATED TIMES FOR SUCKLING.

631. A mother ought to suckle her baby at stated times. It is a bad habit to give him the bosom every time he cries, regardless of the cause; for be it what it may—over-feeding, griping, “wind,” or acidity—she is apt to consider the breast a panacea for all his sufferings. “A mother generally suckles her infant too often—having him almost constantly at the bosom. This practice is injurious both to parent and to child. For the first month he should be suckled about every hour and a half; for the second month, every two hours; gradually, as he becomes older, increasing the distance of time between, until at length he has the breast about every four hours. If he were suckled at stated periods he would only look for it at those times, and be satisfied.”[113]

632. A mother frequently allows her babe to be at the bosom a great part of every night. Now, this plan is hurtful both to her and to him; it weakens her, and thus enfeebles him; it robs them both of their sleep; and generates bad habits, which it will be difficult to 262break through; it often gives the mother a sore nipple and the child a sore mouth.

633. It is surprising how soon an infant, at a very early age, may, by judicious management, be brought into good habits; it only requires, at first, a little determination and perseverance: therefore a nursing mother ought at once to commence by giving the child the breast at stated periods, and she should rigidly adhere to the times above recommended.

634. A mother should not, directly after taking a long walk, and while her skin is in a state of violent perspiration, give her baby the bosom; the milk being at that time in a heated state, will disorder the child’s bowels, or it may originate in him some skin disease, and one which it might be difficult to cure. She ought, therefore, before she gives him the breast, to wait until the surface of her body be moderately cool. Let her be careful the while not to sit in draughts.

CLOTHING.

635. A nursing mother ought to have her dress, more especially her stays, made loose and comfortable.

636. A gathered breast sometimes arises from the bones of the stays pressing into the bosom; I should, therefore, recommend her to have the bones removed.

263637. If a lady be not in the habit of wearing a flannel waistcoat, she ought at least to have her bosoms covered with flannel, taking care that there be a piece of soft linen over the nipples.

638. I should advise a nursing mother to provide herself with a waterproof nursing apron, which may be procured either at any baby-linen establishment or at an india-rubber warehouse.

DIETARY.

639. A nursing mother ought to live plainly; her diet should be both light and nourishing. It is a mistaken notion that at these times she requires extra good living. She ought never to be forced to eat more than her appetite demands; if she be, either indigestion, or heartburn, or sickness, or costiveness, or a bowel complaint will ensue. It is a folly at any time to force the appetite. If she be not hungry, compelling her to eat will do her more harm than good. A medical man, in such a case, ought to be consulted.

640. The best meats are mutton and beef; veal and pork may, for a change, be eaten. Salted meats are hard of digestion; if boiled beef, therefore, be eaten, it ought to be only slightly salted. It is better, in winter, to have the boiled beef unsalted; it is then, especially if it be the rump, deliciously tender. Salt, of course, must be eaten with the unsalted meat. High-seasoned 264dishes are injurious; they inflame the blood, and thus they disorder the milk.

641. Some persons consider that there is no care required in the selection of the food, and that a nursing mother may eat anything, be it ever so gross and unwholesome; but, if we appeal to reason and to facts, we shall be borne out in saying that great care is required. It is well known that cow’s milk very much partakes of the properties of the food on which the animal lives. Thus, if a cow feed on swedes, the milk and the butter will have a turnipy flavor. This, beyond a doubt, decides that the milk does partake of the qualities of the food on which she feeds. The same reasoning holds good in the human species, and proves the absurdity of a nursing mother being allowed to eat anything, be it ever so gross, indigestible, or unwholesome. Again, either a dose of purgative medicine given to her, or greens taken by her at dinner, will sometimes purge the baby as violently, or even more so, than it will herself.

642. Even the milk of a healthy wet-nurse acts differently, and less beneficially, upon the child than the mother’s own milk. The ages of the mother and of the wet-nurse, the ages of her own and the latter’s infant, the constitutions of the one and of the other, the adaptability of a mother’s milk for her own particular child—all tend to make a foster-mother not so desirable a nurse as the mother herself. Again, a mother cannot at all times get to the antecedents of a 265wet-nurse; and, if she can, they will not always bear investigation.

643. With regard to the ages of the mother and of the wet-nurse—for instance, as a wet-nurse’s milk is generally a few weeks older than the mother’s own milk, the wet-nurse’s milk may, and frequently does, produce costiveness of the bowels of her foster-child; while, on the other hand, the mother’s own milk, being in age just adapted to her babe’s, may and generally does keep her own infant’s bowels regular. The milk, according to the age of the child, alters in properties and qualities to suit the age, constitution, and acquirements of her baby—adapting itself, so to speak, to his progressive development. Hence the importance of a mother, if possible, suckling her own child.

644. A babe who is suckled by a mother who lives grossly is more prone to disease, particularly to skin and to inflammatory complaints, and to disease which is more difficult to subdue.

645. Do not let me be misunderstood: I am not advocating that a mother should be fussily particular—by no means. Let her take a variety of food, both animal and vegetable; let her from day to day vary her diet; let her ring the changes on boiled and stewed, on grilled and roast meats; on mutton and lamb and beef; on chicken and game and fish; on vegetables, potatoes, and turnips; on broccoli and cauliflower, on asparagus and peas (provided they are young and well 266boiled), and French beans. “The maxim of the greatest importance in reference to the materials of human food is, mixture and variety—a maxim founded, as has been stated, upon man’s omnivorous nature. Animal and vegetable substances, soups and solid meat, fish, flesh, and fowl, in combination or succession, ought, if due advantage is to be taken of the health-sustaining element in food, to form the dietary of every household.”[114]

646. But what I object to a nursing mother taking are—gross meats, such as goose and duck; highly-salted beef; shell-fish, such as lobster and crab; rich dishes; highly-seasoned soup; pastry, unless it be plain; and cabbages and greens and pickles, if found to disagree with the baby; and any other article of food which is either rich, or gross, or indigestible, and which, from experience, she has found to disagree either with herself or with her child. It will be seen, therefore, from the above catalogue, that my restrictions as to diet are limited, and are, I hope, founded both on reason and on common sense.

647. A moderate quantity—say a tumblerful—either of fresh mild ale or of porter will generally be found the best beverage both for dinner and for supper. There is much more nourishment in either ale—home-brewed—or in porter, than in wine; therefore, for a nursing 267mother, either ale or porter is far preferable to wine. Wine, if taken at all, ought to be used very sparingly, and then not at the same meal with the porter or ale. In the higher ranks of life, where a lady is in the habit of drinking wine, it is necessary to continue it, although the quantity should not be increased, and ought never to exceed a couple of glasses—dry sherry being the best wine for the purpose.

648. A nursing mother is subject to thirst. When such be the case, she ought not to fly either to beer or to wine to quench it; this will only add fuel to the fire. The best beverages will be either toast and water, milk and water, barley-water, barley-water and new milk (in equal proportions), or black tea, either hot or cold. Cold black tea is a good quencher of thirst.

649. A lady who is nursing is at times liable to fits of depression. Let me strongly urge the importance of her abstaining from wine and from all other stimulants as a remedy; they would only raise for a time her spirits, and then would depress them in an increased ratio. Either a drive in the country, or a short walk, or a cup of tea, or a chat with a friend, would be the best medicine. The diet should be good and nourishing; plenty of bread and plenty of meat should be her staple food, in addition to which Du Barry’s Arabica Revalenta, made either with fresh milk or with cream and water, is, in these cases, most useful and sustaining. The best time for taking it is either for luncheon or for supper. A lady subject to depression should 268bear in mind that she requires nourishment, not stimulants,—that much wine and spirits might cheer her for the moment, but will assuredly depress her afterward. Depression always follows overstimulation; wine and spirits therefore, in such a case, if taken largely, are false and hollow friends. It is necessary to bear the above facts in mind, as there are many advocates who strongly recommend, in a case of this kind, a large consumption of wine and brandy. Such men are, at the present moment, doing an immense deal of mischief; they are, in point of fact, inducing and encouraging drunkenness.

650. Spirits—brandy, rum, gin, and whisky—are, during suckling, injurious; I may even say that they are insidious poisons to the parent, and, indirectly, to the child.

651. When an infant is laboring under an inflammatory complaint, a nursing mother ought not to take stimulants, such as either ale or wine. In a case of this kind, toast and water will, for her dinner, be the best beverage, gruel for her supper, and black tea—not coffee, as it would be too stimulating—both for her breakfast and tea.

FRESH AIR AND EXERCISE.

652. Out-door exercise during suckling cannot be too strongly insisted upon; it is the finest medicine both for babe and mother. Whenever the weather will 269admit, it must be taken. It is utterly impossible for a nursing mother to make good milk, unless she do take an abundance of exercise and breathe plenty of fresh air.

653. Whatever improves the health of the mother, of course at the same time benefits the child: there is nothing more conducive to health than an abundance of out-door exercise. It often happens that a mother who is nursing seldom leaves her house; she is a regular fixture; the consequence is, both she and her babe are usually delicate and prone to sickness.

654. A mother ought not, immediately after taking exercise, to nurse her infant, but wait for half an hour. Nor should she take violent exercise, as it would be likely to disorder the milk.

655. Carriage exercise, if the weather be hot and sultry, is preferable to walking; if that be not practicable, she ought to have the windows thrown wide open, and should walk about the hall, the landings, and the rooms, as she would by such means avoid the intense heat of the sun. Although carriage exercise during intensely hot weather is preferable to walking exercise, yet, notwithstanding, walking must, during some portion of the day, be practiced. There is no substitute, as far as health is concerned, for walking. Many ailments that ladies now labor under could be walked away; and really it would be a pleasant physic—far more agreeable than pills and potions!

270

THE POSITION OF A MOTHER DURING SUCKLING.

656. Good habits are as easily formed as bad ones. A mother, when in bed, ought always to suckle her child while she is lying down. The sitting up in bed, during such times, is a fruitful source of inflammation and of gathering of the breasts. Of course, during the day the sitting-up position is the best. Let me caution her not to nurse her baby in a half-sitting and half-lying posture; it will spoil her figure, disturb her repose, and weaken her back.

THE TEMPER.

657. Passion is injurious to the mother’s milk, and consequently to the child. Sudden joy and grief frequently disorder the infant’s bowels, producing griping, looseness, etc.; hence, a mother who has a mild, placid temper generally makes an excellent nurse, on which account it is a fortunate circumstance that she is frequently better-tempered during suckling than at any other period of her life; indeed, she usually, at such times, experiences great joy and gladness.

658. The happiest period of a woman’s existence is, as a rule, when she first becomes a mother. “The pleasure of the young mother in her babe is said to be more exquisite than any other earthly bliss.”[115]

271659. It is an old and, I believe, a true saying, that the child inherits the temper of his mother or of his wet-nurse. This may be owing to the following reasons: If the mother or the wet-nurse be good-tempered, the milk will be more likely to be wholesome, which will, of course, make him more healthy, and consequently better-tempered.

660. While, on the other hand, if the mother or the nurse be of an irritable, cross temper, the milk will suffer, and will thus cause disarrangement to his system; and hence ill health and ill temper will be likely to ensue. We all know the influence that good or bad health has on the temper.

661. An important reason, then, why a nursing mother is often better-tempered than she is at other times is, she is in better health, her stomach is in a healthier state:

“A good digestion turneth all to health.”[116]

There is an old and a true saying, “that it is the stomach that makes the man,” and if the man, the woman:

“Your stomach makes your fabric roll,
Just as the bias rules the bowl.”[117]

662. Hear what Shakspeare says of the functions of the stomach. The stomach is supposed to speak (and 272does it not frequently speak, and in very unmistakable language, if we will but only listen to its voice?):

“True is it, my incorporate friends, quoth he,
That I receive the general food at first
Which you do live upon: and fit it is;
Because I am the store-house and the shop
Of the whole body: But if you do remember,
I send it through the rivers of your blood,
Even to the court, the heart,—to the seat o’ the brain;
And, through the cranks and offices of man,
The strongest nerves, and small inferior veins,
From me receive that natural competency
Whereby they live: And though that all at once,
You, my good friends, though all at once cannot
See what I do deliver out to each;
Yet I can make my audit up, that all
From me do back receive the flour of all,
And leave me but the bran.”
Coriolanus, act i. sc. 1.

OCCUPATION.

663. I strongly recommend a nursing mother to attend to her household duties. She is never so happy, nor so well, as when her mind is moderately occupied at something useful. She never looks so charming as when she is attending to her household duties—

“For nothing lovelier can be found
In woman, than to study household good.”[118]

664. I do not mean by occupation the frequenting 273of balls, of routs, or of parties: a nursing mother has no business to be at such places; she ought to devote herself to her infant and to her household, and she will then experience the greatest happiness this world can afford.

665. One reason why the poor make so much better nursing mothers than the rich is the former having so much occupation; while the latter, having no real work to do, the health becomes injured, and in consequence the functions of the breasts suffer; indeed, many a fashionable lady has no milk at all, and is therefore compelled to delegate to a wet-nurse one of her greatest privileges and enjoyments.

666. What would not some rich mother give for the splendid supply of milk—of healthy, nourishing, life-giving milk—of the poor woman who has to labor for her daily bread!

667. What is the reason that wealthy ladies so frequently require wet-nurses? The want of occupation! And from whom do they obtain the supply of wet-nurses? From the poor women who have no lack of occupation, as they have to labor for their daily food, and have in consequence the riches of health, though poor in this world’s goods—

“For health is riches to the poor.”[119]

274Bear this in mind, ye wealthy, and indolent, and pampered ladies, and alter your plans of life, or take the consequences, and still let the poor women have the healthy, the chubby, the rosy, the laughing children; and you, ye rich ones, have the unhealthy, the skinny, the sallow, the dismal little old men and women who are constantly under the doctor’s care, and who have to struggle for their very existence! “Employment, which Galen calls ‘nature’s physician,’ is so essential to human happiness, that Indolence is justly considered as the mother of Misery.”[120]

668. Occupation, then—bustling occupation, real downright work, either in the form of out-door exercise, or of attending to her household duties—a lady, if she desire to have a good breast of milk, ought to take; if, in point of fact, she wishes to have healthy children. For the Almighty is no respecter of persons. And he has ordained that work shall be the lot of man and of woman too! It is a blessed thing to be obliged to work. If we do not work, we have all to pay a heavy penalty, in the form of loss of both health and happiness. “For work is the grand cure of all the maladies and miseries that ever beset mankind—honest work, which you intend getting done.”[121]

669. A mother who is listless and idle, lolling either the greater part of every day in an easy-chair, or reclining 275on a sofa in a room where a breath of air is not allowed to enter, usually makes a miserable and a wretched nurse. She is nervous, dyspeptic, and emaciated; having but little milk, and that little of a bad quality, her baby is puny, pallid, and unhealthy, and frequently drops into an untimely grave. Occupation, then, with fresh air and exercise, is indispensable to a mother who is suckling.

AILMENTS, Etc.

670. The Nipple.—A good nipple is important both to the comfort of the mother and to the well-doing of the child.

671. One, among many, of the ill effects of stays and of corsets is the pushing-in of the nipples; sore nipples, and consequent suffering, are the result. Moreover, a mother thus circumstanced may be quite unable to suckle her infant; and then she will be severely punished for her ignorance and folly; she will be compelled to forego the pleasure of nursing her own children, and she will be obliged to delegate to hirelings her greatest privilege! Ladies who never wear stays have much better nipples, and more fully-developed bosoms; hence such mothers are more likely to make better nurses to their babies. There is no doubt that the pressure of the stays on the bosom tends both to waste away the gland of the breast (where the milk is secreted), and to cause the nipple either to dwindle or 276to be pushed in, and thus to sadly interfere with its functions. I should strongly advise every mother who has daughters old enough to profit by it, to bear this fact in mind, and thus to prevent mischief when mischief might be prevented, by not allowing them, when young, to wear stays.

672. Treatment of very small and drawn-in nipples.—The baby ought to suck through the intervention of an india-rubber teat fastened on a boxwood shield, or through an india-rubber teat and shield, made entirely of india-rubber.[122] The india-rubber teat must, before it is used, be softened by dipping it in warm but not in hot water. I have known many mothers able to suckle their children with this contrivance who otherwise would have been obliged either to have weaned them, or to have procured the assistance of a wet-nurse. The above aid, in the generality of instances, will enable the infant to suck with ease. After this has for a time been used, the nipples will be so improved as to render the continuance of it unnecessary. Of course I do not advise the use of an india-rubber teat until a fair trial has been given by applying the babe at once to the nipple; but if he cannot draw out the nipple, then, rather than wean him, or than employ a wet-nurse, let the teat be tried.

673. Remember, as soon as the nipple be sufficiently 277drawn out, which in all probability it will in a few days, the teat ought to be dispensed with. In such a case, when the infant is not at the breast, Dr. Wansbrough’s Metallic Nipple Shields should be worn. Small and bad nipples have, by the wearing of these shields, frequently been drawn out and made good ones; the dress will suffice to keep them in their places.

674. Sore nipples.—If a lady, during the latter few months of her pregnancy, were to adopt the plan recommended at page 162, paragraph 353, sore nipples, during the period of suckling, would not be so prevalent as they now are.

675. A sore nipple is frequently produced by the injudicious custom of allowing the child to have the nipple almost constantly in his mouth. Stated periods for suckling, as recommended at paragraph 631, ought to be strictly adopted. Another frequent cause of a sore nipple is from the babe having the thrush. It is a folly to attempt to cure the nipple without at the same time curing the mouth of the infant.

676. Treatment.—One of the best remedies for a sore nipple is the following powder:

Take of—Biborate of Soda, one drachm;
Powdered Starch, seven drachms:

Mix,—A pinch of the powder to be frequently applied to the nipple.

677. Dr. A. Todd Thomson’s—my old preceptor—remedy 278for sore nipple is a very good one; it is as follows:

Take of—Finely-powdered Gum Arabic, half an ounce;
Powdered Alum, five grains:

To be well mixed together in a mortar to make a powder, of which a pinch should either be sprinkled over the nipple, or it may be applied to the part by means of a camel’s-hair brush every time directly after the child has done sucking. Let the brush, covered with the dry powder, gently sweep over the sore nipple.

As there is nothing in either of the above powders injurious to the infant, the powder, before applying him to the breast, ought not to be wiped off; indeed, either the one or the other of the powders (the former one especially, as it contains borax) is likely to be of service in preventing or in curing the sore mouth of the child.

678. If the above powders should not have the desired effect (efficacious though they usually are), “a liniment composed of equal parts of glycerin and of brandy” (say a vial containing two drachms of each) ought to be tried, which must be shaken up just before using. It should, by means of a camel’s-hair brush, every time directly after the baby has been suckled, be painted on the nipple. A piece of either old soft cambric or lawn, about the size of the palm of the hand, snipped around to make it fit, ought then to be moistened in the glycerin and the brandy, and should be applied to each of the sore nipples, and worn (until they are cured) whenever the child is not at the breast. 279These applications will be found of much service and of great comfort, and will act as nipple shields, protecting and healing the nipples. A soft sponge of warm water may be gently applied to the nipple just before putting the child to the bosom.

679. If the above remedies should not succeed in curing the sore nipple, then she ought to try Dr. Wansbrough’s Metallic Nipple Shield (as recommended previously for small and drawn-in nipples), and should, whenever the babe is not sucking, constantly wear it on the nipple. It is very cooling and healing, and keeps off all pressure from the clothes. It will frequently cure a sore nipple when other remedies have failed. The shield may be procured of any respectable surgical-instrument-maker.

680. Cracked and fissured nipples.—Sometimes the nipple is sore from having either cracks or fissures upon it. These cracks or fissures may attack any part of the nipple, but are very apt to form where the nipple joins the breast; and, when very severe, an ignorant nurse, who is always fond of dealing in the marvelous, declares that the child has nearly bitten the nipple off! Treatment.—Now, the best remedy for a cracked and fissured nipple is for the infant, until the cracks and fissures are cured, to suck through the intervention of an india-rubber teat and shield; and every time, directly after the babe has been put to the nipple, to apply to the parts affected either neat brandy or the glycerin and brandy liniment, as I have before recommended. 280When the child is not at the breast, Dr. Wansbrough’s Nipple Shields should be worn; the dress will keep them in their places.

681. Another cause of a sore nipple is from the mother, after the babe has been sucking, putting up the nipple wet. She, therefore, ought always to dry the nipple—not by rubbing it, but by dabbing it with either a soft cambric or lawn handkerchief, or with a piece of soft linen rag (one or other of which ought always to be at hand), every time directly after the infant has done sucking, and just before applying either of the above powders or liniment to the nipple.

682. When the nipple is very sore, a mother, whenever the child is put to the bosom, suffers intense pain. This being the case, she had better suckle him through the intervention of an india-rubber teat, properly fastened on a shield, as before recommended. See page 276, paragraph 672. But she ought never to use an india-rubber teat unless it be absolutely necessary—that is to say, if the nipple be only slightly sore, she should not, on any account, apply it; but there are cases where the nipple is so very sore that a mother would have to give up nursing if the shield and teat were not used; these, and very small and drawn-in-nipples, are the only cases in which an india-rubber teat and shield is admissible.

683. A nursing mother is sometimes annoyed by the milk flowing constantly away, making her wet and uncomfortable. All she can do under such circumstances 281is to wear nipple-glasses, and to apply a piece of flannel to the bosom, which will prevent the milk from chilling her, and will thus do away with the danger of her catching cold, etc.

684. The breast.—A mother ought, before applying the infant to the bosom, to carefully ascertain if there be milk. This may readily be done by squeezing the nipple between the finger and the thumb. If there be no milk, she must wait until the milk be secreted, or serious consequences both to her and to him might ensue: to the former, inflammation and gathering of the bosom, and sore nipples; to the latter, thrush, diarrhœa, and eruptions on the skin.[123]

685. If there be a supply of milk in the breast, and if still the child will not suck, the medical man’s attention ought to be drawn to the fact, in order that he may ascertain whether the child be tongue-tied; if he be, the mystery is explained, and a trifling, painless operation will soon make all right.

686. If the bosoms be full and uneasy, they ought, three or four times a day, to be well although tenderly rubbed with olive oil and eau de Cologne (equal parts of each, mixed in a vial). Some nurses rub with their fingers only. Now, such rubbing does harm. The proper way to apply friction is to pour a small quantity 282of the oil and eau de Cologne—first shaking the bottle—into the palm of the hand, the hand being warm, and then to well rub the breasts, taking care to use the whole of the inside of the hand.

687. After the bosoms have been well rubbed, each ought to be nicely supported with a large, soft, folded silk handkerchief; each handkerchief must pass under each breast and over the shoulders, and should be tied at the back of the neck, thus acting as a sling.

688. If the bosoms be very uncomfortable, young cabbage-leaves (with the “veins” of each leaf cut level to the leaf) ought, after each application of the oil and eau de Cologne, to be applied; or a large warm white-bread-and-milk and olive oil poultice ought to be used, which must be renewed three or four times a day. The way to make the poultice is as follows: A thick round of bread should be cut from a white loaf; the crust should be removed, the crumb ought to be cut into pieces about an inch square, upon which boiling-hot new milk should be poured; it ought to be covered over for ten minutes; then the milk should be drained off, and the olive oil—previously warmed by placing a little in a teacup on the hob—should be beaten up by means of a fork with the moistened bread until it be of the consistence of a soft poultice. It ought to be applied to the bosom as hot as it can comfortably be borne.

689. Gathered breast.—A gathered bosom, or “bad 283breast” as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms.

690. Another cause of a gathered breast arises from a mother sitting up in bed to suckle her baby. An infant ought to be accustomed to take the bosom while he is lying down; if this habit be not at first instituted, it will be difficult to adopt it afterward. Good habits may be taught a child from the very earliest period of his existence.

691. A sore nipple is another fruitful cause of a gathered breast. A mother, in consequence of the suffering it produces, dreads putting the baby to it; she therefore keeps him almost entirely to the other bosom. The result is, the breast with the sore nipple becomes distended with milk, which, being unrelieved, ends in inflammation, and subsequently in gathering.

692. The fruitless attempt of an infant, to procure milk when there is very little or none secreted is another and a frequent cause of a gathered bosom. Dr. 284Ballard, in his valuable little work before quoted, considers this to be the principal cause of a gathered breast; and, as the subject is of immense importance, I cannot do better than give it in his own words, more especially as he has the merit of originating and of bringing the subject prominently before his professional brethren. He says: “This (mammary abscess or gathered breast) is another form of disease entirely referable to the cause under consideration [fruitless sucking]. In the case last related, the formation of mammary abscess [gathered breast] was only just prevented by arresting any further irritation of the breast by suckling; and since I have kept careful notes of my cases, I have observed that in all instances of abscess there has been abundant evidence of a demand being made upon the gland for a supply of milk beyond that which it had the power of secreting. If the child only has been kept to the breast, then it has suffered with disordered bowels; but in the majority of cases an additional irritation has been applied; the commonly-received doctrine that a turgid breast is necessarily overloaded with milk, leads mothers and nurses to the use of breast-pumps, exhausted bottles, or even the application of the powerful sucking powers of the nurse herself, to relieve the breasts of their supposed excess; and it is this extraordinary irritation which, in the majority of cases, determines the formation of an abscess [gathering]. Sometimes these measures are adopted to remove the milk when a woman is not going to suckle, and then an abscess not unfrequently is established. I have previously alluded to the mistake 285into which mothers and nurses are led by the appearance of a swollen breast; it is not evidence that the gland can secrete freely, and it is in this turgid state that the excessive irritation tells most severely. This hyperæmic [plethoric] condition seems to be a step toward inflammation, and the irritation supplies that which is wanting to complete the process. If a woman will only remove the child from the breast directly the act of sucking produces pain, she may be pretty sure to avoid abscess. So long as the milk can be obtained there is no pain.” The above most valuable advice deserves great attention, and ought to be strictly followed.

693. How is a patient to know that she is about to have a gathered bosom?—There are two forms of gathered breast; one being of vast and the other of trifling importance. The first, the serious one, consists of gathering of the structure of the gland of the breast itself; the latter, merely of the superficial part of the bosom, and ought to be treated in the same manner as any other external gathering, with warm poultices.

694. In the mild or superficial kind of gathered bosom, the mother may still persevere in suckling her child, as the secreting portion of the breast is not at all implicated in the gathering; but in the severe form, she ought not, on any account whatever, to be allowed to do so, but should instantly wean her child from the affected side. The healthy breast she may still continue to nurse from.

286695. The important form of a gathered breast I will now describe: A severe gathered bosom is always ushered in with a shivering fit. Let this fact be impressed deeply upon my reader’s mind. This shivering is either accompanied or followed by sharp lancinating pains of the bosom. The breast now greatly enlarges, becomes hot, and is very painful. The milk in the affected bosom either lessens or entirely disappears. If the child be applied to the breast (which he ought not to be), it gives the mother intense pain. She is now feverish and ill; she loses her strength and appetite, and is very thirsty.

696. A medical man must, at the very onset of the shivering fit, be sent for; and he will, in the generality of instances, be able to prevent such a painful and distressing occurrence as a gathered breast. If twelve hours be allowed to elapse after the shivering has taken place, the chances are that the gathering cannot altogether be prevented; although even then it may, by judicious treatment, be materially lessened and ameliorated.

697. We sometimes hear of a poor woman suffering dreadfully for months, and of her having a dozen or twenty holes in her bosom! This is generally owing to the doctor not having been sent for immediately after the shivering; I therefore cannot too strongly insist, under such circumstances, upon a mother obtaining prompt assistance, not only to obviate present suffering, but, at the same time, to prevent the function 287of the breast from being injured, which it inevitably, more or less, will be, if the important form of gathering be allowed to take place.

698. When a nursing mother feels faint, she ought immediately to lie down and to take a little nourishment; either a crust of bread and a draught of ale or of porter, or a glass of wine, or a cup of tea with the yelk of an egg beaten up in it, either of which will answer the purpose extremely well. Brandy, or any other spirit, I would not recommend, as it will only cause, as soon as the immediate effects of the brandy are gone off, a greater depression to ensue; not only so, but the frequent taking of brandy might become a habit—a necessity which would be a calamity deeply to be deplored!

699. A mother is sometimes faint from suckling her child too often, she having him almost constantly at the bosom. So long, of course, as she continues this foolish practice, she must expect to suffer from faintness.

700. Aperients, etc. during suckling.—Strong purgatives, during this period, are highly improper, as they are apt to give pain to the infant as well as to injure the mother. If it be absolutely necessary to give an aperient, the mildest, such as a dose of castor oil, should be chosen.

701. If she cannot take oil, then she should apply it 288externally to the bowels as a liniment, as recommended at page 144.

702. An enema, either of warm water, or of gruel, oil, and table salt,[124] applied by means of a good self-injecting enema apparatus, is in such a case an excellent—indeed, the very best—method of opening the bowels, as it neither interferes with the digestion of the mother nor of the child.

703. The less opening medicine, whatever be the kind, a mother who is suckling takes, the better will it be both for herself and for her babe. Even castor oil, the least objectionable, during suckling, of aperients, if she once begin to take it regularly, the bowels will not act without it, and a wretched state of things is established. No, if the bowels will not act, an enema is by far the best remedy; you can never do any harm, either to the mother or to the babe, by the administration of an enema; it will neither induce future constipation, nor will it interfere with the digestion of the mother, nor with the bowels, nor with the health of the infant.

704. When a lady who is nursing is habitually costive, she ought to eat brown instead of white-bread. This will, in the majority of cases, enable her to do without an aperient. The brown bread may be made 289by mixing one part of bran and three parts of fine wheaten flour together, and then making it in the usual way into bread. Treacle instead of butter on the brown bread increases its efficacy as an aperient.

705. Either stewed prunes or stewed French plums are an excellent remedy to prevent constipation. The patient ought to eat, every morning, a dozen or fifteen of them. The best way to stew either prunes or French plums is the following: Put a pound, either of prunes or of French plums, and two tablespoonfuls of raw sugar, into a brown jar; cover them with water, put them into a slow oven, and stew them for three or four hours. Both stewed rhubarb and stewed pears often act as mild or gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes, without medicine, relieve the bowels.

706. A Bee-master in The Times, or, as he is usually called, The Times Bee-master, has satisfactorily proved that honey—pure honey—is most wholesome and beneficial to the human economy. He recommends it to be occasionally eaten in lieu of butter for breakfast. Butter, in some localities, and in some seasons of the year, is far from good and wholesome.

707. The Germans are in the habit of eating for breakfast and for tea a variety of fruit jams instead of butter with their bread. Now, if the bowels be costive, jam is an excellent substitute for butter. The Scotch, too, scarcely ever sit down either to breakfast or tea 290without there being a pot of marmalade on the tables. English ladies, in this matter, may well take a leaf out of the books of the Germans and of the Scotch.

708. A basinful of gruel, made either with Robinson’s Patent Groats, or with the Derbyshire oatmeal, sweetened with brown sugar, every night for supper will often supersede the necessity of giving opening medicine. A tumblerful of cold spring water—cold from the pump—taken early every morning, sometimes effectually relieves the bowels. Coffee ought to be substituted for tea for breakfast, as coffee frequently acts as an aperient, more especially if the coffee be sweetened with brown sugar. A glass of sherry should be taken every day during dinner, as, if the bowels be sluggish, it sometimes stimulates them to action. I should strongly recommend a patient, in such a case, to eat a great variety of food, and to let the vegetable element predominate. Much meat encourages constipation. Fruit—Muscatel raisins especially—farinaceous food, coffee, and a variety of vegetables, each and all incite the bowels to do their duty.

709. Although a nursing mother ought, more especially if she be costive, to take a variety of well-cooked vegetables—such as potatoes, asparagus, broccoli, cauliflower, French beans, stewed celery, and turnips; she should avoid eating greens, cabbages, and pickles, as they would be likely to affect the baby, and might cause him to suffer from gripings, pain, and “looseness” of the bowels.

291710. The “wet compress” is another excellent method of opening the bowels. The way of applying it is as follows: Fold a large napkin a few thicknesses until it is about half a foot square; then dip it in cold water and place it over the bowels; over which apply either oilskin or gutta-percha skin, which should be, in order to exclude the air, considerably larger than the folded napkin. It should be kept in its place by means of either a bolster-case or a broad bandage, and must be applied at bedtime, and ought to remain on for three or four hours, or until the bowels be opened.

711. Let me again—for it cannot be too urgently insisted upon—strongly advise a nursing mother to use every means in the way of diet, etc., to supersede the necessity of the taking of opening medicine, as the repetition of aperients injures, and that severely, both mother and child. Moreover, the more opening medicine a person swallows, the more she requires; so that if she once get into the habit of regularly taking aperients, the bowels will not act without them. What a miserable existence, to be always swallowing physic!

712. If a lady, then, during the period of suckling, were to take systematic exercise in the open air; to bustle about the house and to attend to her household duties; if she were to drink, the moment she awakes in the morning, a tumbler of cold water, and every day during dinner a glass of sherry; if she were to substitute brown bread for white bread, and coffee for tea at breakfast, and brown for white sugar; if she were to 292vary her food, both animal and vegetable, and partake plentifully of sound ripe fruit; if she were to use an abundance of cold water to her skin; if she were, occasionally, at bedtime, to apply a “wet compress” to her bowels, and to visit the water-closet daily at one hour; if she were—even if the bowels were not opened for four or five days—not to take an aperient of any kind whatever, and avoid quacking herself with physic; in short, if she would adopt the above safe and simple remedies, which are in the reach of all, she would not suffer so much from costiveness, which is frequently the bane, the misery, and the curse of her existence! But then, to get the bowels into a proper and healthy state, it would take both time and trouble; and how readily can a couple of pills be swallowed, and how quickly they act, and how soon they have to be repeated; until at length the bowels will not act at all unless goaded into action, and the pills become a necessity! Oh, the folly and the mischief of such a system!

WEANING.

713. There is an old saying, “that a woman should carry her child nine months, and should suckle him nine months.” It is well known that the first part of the old adage is correct, and experience has proved the latter to be equally so. If a babe be weaned before he be nine months, he loses that muscular strength which the breast-milk alone can give; if he be suckled after he be nine months, he becomes flabby, weak, and 293delicate. “It is generally recognized that the healthiest children are those weaned at nine months complete. Prolonged nursing hurts both child and mother; in the child, causing a tendency to brain disease, probably through disordered digestion and nutrition; in the mother, causing a strong tendency to deafness and blindness. It is a very singular fact, to which it is desirable that attention were paid, that in those districts of Scotland—viz., the Highland and insular—where the mothers suckle their infants from fourteen to eighteen months, deaf-dumbness and blindness prevail to a very much larger extent among the people than in districts where nine or ten months is the usual limit of the nursing period.”[125]

714. The time, then, when an infant ought to be weaned.—“This, of course, must depend upon the strength of the child, and upon the health of the mother: nine months on an average is the proper time. If she be delicate, it may be found necessary to wean him at six months; or if he be weak, or laboring under any disease, it may be well to continue suckling him for twelve months; but after that time the breast will do him more harm than good, and will, moreover, injure the mother’s health.”[126]

715. If he be suckled after he be twelve months old, he is generally pale, flabby, unhealthy, and rickety; 294and the mother is usually nervous, emaciated, and hysterical. A child who is suckled beyond the proper time, more especially if there be any predisposition, sometimes dies either of water on the brain, or of consumption of the lungs, or of mesenteric disease.

716. The manner in which a mother ought to act when she weans her child.—“She must, as the word signifies, do it gradually—that is to say, she should by degrees give him less and less of the breast, and more and more of artificial food; she ought, at length, only to suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and for a few days to go away herself.”[127]

717. “A good plan is for the nurse to have in the bed a half-pint bottle of new milk, which, to prevent it from turning sour, has been previously boiled, so as to give a little to the child in lieu of the breast. The warmth of the body will keep the milk of a proper temperature; and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.”[128]

718. If the mother be not able to leave home herself, or to send her child from home, she ought then to let the child sleep in another room, with some responsible person—I say responsible person, for a baby must 295not be left to the tender mercies of a giggling, thoughtless young girl.

719. If the mother, during the daytime, cannot resist having her child in the room with her, then I should advise her to make a paste of aloes—that is to say, let her mix a little powdered aloes with a few drops of water, until it be of the consistence of paste—and let her smear it on the nipple every time just before putting him to the breast; this will be quite enough for him; and one or two aloe applications to the nipple will make him take a disgust to the bosom, and thus the weaning will be accomplished. A mother need not be afraid that the aloes will injure her baby; the minute quantity he will swallow will do no harm; for the moment he tastes it, the aloes being extremely bitter, he will splutter it out of his mouth.

720. Another application for the nipple, to effect weaning, is wormwood. There are two ways of applying it, either (1) by sprinkling a very small pinch of powdered wormwood on the nipple; or (2) by bathing the nipple with a small quantity of wormwood tea just before applying the babe to it—either the one or the other of these plans will make him take a dislike to the breast, and thus the weaning will be accomplished. Wormwood is excessively bitter and disagreeable, and a slight quantity of it on the nipple will cause an infant to turn away from it with loathing and disgust—the wormwood, the minute quantity he will taste, will not at all injure him. Wormwood was in Shakspeare’s time used for the purpose of weaning:

296“And she was wean’d,—I never shall forget it—
Of all the days of the year upon that day:
For I had then laid wormwood to my dug [breast],
Sitting in the sun under the dove-house wall,
My lord and you were then at Mantua:
Nay, I do bear a brain: but, as I said,
When it did taste the wormwood on the nipple
Of my dug, and felt it bitter, pretty fool!
To see it tetchy, and fall out with the dug.”[129]

721. The best way of “drying up the milk” is to apply to each breast soap plaster (emplastrum saponis), spread on soft pieces of wash-leather, the shape and size of the top of a hat, with a round hole the size of a shilling in the middle of each to admit the nipple, and with a slit from the center to the circumference of each plaster to make a better fit. These plasters ought to be spread by a chemist.

722. When the child is once weaned, the breasts ought not to be drawn, as the drawing of them would cause them to secrete larger quantities of milk; if, therefore, the bosoms be ever so full or uncomfortable, a mother ought to leave them alone; she should wait patiently, and the milk will gradually diminish, and will at length disappear.

723. The drawing of the bosoms, during weaning, either by means of a breast-pump, or by the mouth, or by other like contrivances, has frequently caused gathered breasts. If not drawn, they scarcely, if ever, gather.

297724. The foregoing plan of “drying up the milk” will generally in five or six days assuage the milk away; but if, at the end of three days, the bosoms still continue full and uncomfortable, the plasters should be removed, and the breasts ought, every four hours, to be well but tenderly rubbed with equal parts of olive oil and of eau de Cologne; the nurse supporting the bosom, during such friction, with her other hand.

725. Let me impress the above important advice on a nursing mother’s mind; it might save a great deal of after-suffering and misery.

726. It might be well to state that, after the child has been weaned, the milk does not always entirely leave the breast, not even for weeks, and, in some cases, not even for months; it is not of the slightest consequence, and requires no treatment to get rid of it.

727. A mother ought, during the period of weaning, to live abstemiously, and should drink as little as possible. In many cases, it is necessary to give, every morning, for two or three mornings, a few doses of mild aperient medicine, such as either a Seidlitz powder, or a teaspoonful of Henry’s magnesia and a teaspoonful of Epsom salts in half a tumbler of warm water.

728. Symptoms denoting the necessity of weaning.—A mother sometimes cannot suckle her child; the attempt bringing on a train of symptoms somewhat 298similar to the following: singing in the ears; dimness of sight; aching of the eyeballs; throbbing in the head; nervousness; hysterics; tremblings; faintness; loss of appetite and of flesh; fluttering and palpitation of the heart; feelings of great exhaustion; indigestion; costiveness; sinking sensations of the stomach; pains in the left side; great weakness and dragging pains of the loins, which are usually increased whenever the infant is put to the bosom; pallor of the countenance; shortness of breath; swelling of the ankles.

729. Of course, every mother who is suffering from suckling does not have the whole of the above long catalogue of symptoms! But if she has three or four of the more serious of them, she ought not to disobey the warnings, but should discontinue nursing; although it may be necessary, if the babe himself be not old enough to wean, to obtain a healthy wet-nurse to take her place.

730. Remember, then, that if the above warning symptoms be disregarded, dangerous consequences, both to parent and child, might be the result. It might either throw the mother into a consumption, or it might bring on heart disease; and, in consequence of his not being able to obtain sufficient or proper nourishment, it might cause the infant to dwindle and pine away, and, eventually, to die of water on the brain.

731. Soon after nine months’ nursing, “the monthly courses” generally return. This is another warning 299that the babe ought immediately to be weaned, as the milk will lessen both in quantity and in nourishment, and the child in consequence will become delicate and puny, and every day he is suckled will lose, instead of gain, ground. I have known many children, from protracted suckling, smaller at twelve months than they were at nine months; and well they might be, as, after nine months, the mother’s milk usually does them harm instead of doing them good, and thus causes them to dwindle away.

732. At another time, although the above train of symptoms does not occur, and notwithstanding she may be in perfect health, a mother may not be able to suckle her baby. Such a one usually has very small breasts, and but little milk in them, and if she endeavor to nurse her infant, it produces a violent aching of the bosom. Should she disregard these warnings, and should still persevere, it might produce inflammation of the breast, which will probably end in a gathering.

733. An obstinate sore nipple is sometimes a symptom denoting the necessity of weaning.—When the nipples are, and, notwithstanding judicious treatment, persistently for some time continue, very sore, it is often an indication that a lady ought to wean her baby. Long-continued, obstinate sore nipples frequently occur in a delicate woman, and speak, in language unmistakable, that the child, as far as the mother herself is concerned, must be weaned. Of course, if the infant be not old enough to wean, when practicable a wet-nurse 300ought to take the mother’s place. If the above advice were more frequently followed than it is, gathered breasts, much suffering, and broken health would not so frequently prevail as they now do.

734. If a mother be predisposed to consumption; if she has had spitting of blood; if she be subject to violent palpitation of the heart; if she be laboring under great debility and extreme delicacy of constitution; if she has any of the above complaints or symptoms, she ought not on any account to suckle her child, but should by all means procure a healthy wet-nurse.

735. Occasionally a mother suckles her infant when she is pregnant. This is highly improper, as it not only injures her own health, and may bring on a miscarriage, but it is also prejudicial to the baby, and may produce a delicacy of constitution from which he might never recover.


In conclusion, I fervently hope that this little book will, through God’s blessing, be to my fair reader, during the whole period of her wifehood, a friend in her need, a guide in her difficulties, and a silent but trusty counselor in all things pertaining to her health. I sincerely trust that it will give her as much pleasure in the reading of these pages as it has given me in the writing of them.

301

INDEX.

mi

ADVICE TO A MOTHER
ON THE
MANAGEMENT OF HER CHILDREN,
AND ON THE
TREATMENT ON THE MOMENT
OF
SOME OF THEIR MORE PRESSING ILLNESSES AND ACCIDENTS.

BY
PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A WIFE ON THE MANAGEMENT OF HER OWN HEALTH.”
“Lo, children and the fruit of the womb are an heritage and cometh of the Lord.”
SEVENTEENTH EDITION.
PHILADELPHIA
J. B. LIPPINCOTT & CO.
1881.
miiTO
Sir CHARLES LOCOCK, Bart., F.R.S.,
FIRST PHYSICIAN-ACCOUCHEUR TO HER MAJESTY THE QUEEN.
Dear Sir Charles:

Your kind and flattering approval of this little Book, and your valuable suggestions for its improvement, demand my warmest gratitude and acknowledgments, and have stimulated me to renewed exertions to make it still more complete and useful, and thus more worthy of your approbation.

You have greatly added to my obligation, by allowing me to indicate those passages of the work that you considered required correction, addition, and improvement. On reference to these pages, it will be at once perceived how greatly I am indebted to you, and how much I have profited by your valuable advice.

I have the honor to remain,
Dear Sir Charles,
Your faithful and obliged servant,
PYE HENRY CHAVASSE.
Priory House, Old Square,
Birmingham.
miv

PREFACE.

The sale of this book is enormous; where hundreds were formerly disposed of, thousands are now sold; and the sale still increases with increasing velocity.

The book has been a great success: I had the good fortune, some thirty years ago, to turn up new ground—to hit upon a mine, which I have, ever since, even until now, worked with my best energy and ability. One cause of the immense success this work has achieved is, that it treats of some subjects which, although they be subjects of vital importance to the well-being of children, all other works of a kindred nature do not even touch upon.

I have, during the last thirty years, been constantly on the watch to give a mother additional and useful advice on the management of her children; so that, in point of fact, this present edition consists of more than treble the quantity of information contained in the earlier editions. The quantity is not only increased, but the quality is, I trust, greatly improved.

The last edition, comprising five thousand copies, has been rapidly exhausted: to supply the increased and increasing demand, seven thousand copies of this—the Ninth Edition—are now published. The enormous, and, for a medical work, unusually large sale, is most gratifying to me as well as to my worthy publishers.

I have taken great pains to improve the present edition: much new matter has been introduced; several paragraphs have been abridged; some portions have been rewritten—as mvmy extended experience has enabled me to enter on many of the subjects more fully, and, I trust, more usefully; and the book has been throughout thoroughly revised.

Lord Chesterfield, in writing to his son, once said: “If I had had longer time, I would have written you a shorter letter.” Now, I have found time both to curtail some of the passages of this work, and to remove many, indeed, a large majority of the quotations from the text. I have, consequently, been able to fill up the various spaces with much original, and, I trust, useful matter; and thus, without materially increasing the bulk of the book, to keep it within reasonable bounds. The notes and annotations of Sir Charles Locock are, however, perfectly intact—they are too valuable either to be omitted, or to be, in the slightest degree, curtailed.

The writing, revising, improving, and enlarging of this, and of my other work—Advice to a Wife—have, for upwards of a quarter of a century, been my absorbing occupation—my engrossing study. I have loved, and cherished, and tended the two books as though they were my children; and have, in each successive edition, always striven to bring them, as nearly as my abilities would allow, to a state of completeness—to make them, in fact, a perfect Vade-mecum for Wives and Mothers. I might truly say, that the occupation has ever been to me a source of pure and unalloyed enjoyment. The correction of the pages has often cheered me when I have been in grief or in trouble, and has soothed me when, in my profession, I have been either harassed or vexed: truly, I have had my reward! My fervent desire is, that some portion of the pleasure and comfort I have derived from the writing of these books may be experienced by my readers. If it be only a tithe of what I myself have felt, I shall be more than amply rewarded for my pains.

P. H. C.
mxi

CONTENTS.

PART I.—INFANCY.
PAGE
Preliminary Conversation 1013
Ablution 1016
Management of the Navel 1024
Clothing 1028
Diet 1032
Vaccination 1056
Dentition 1062
Exercise 1075
Sleep 1077
The Bladder and the Bowels 1084
Ailments, Disease, etc. 1085
Concluding Remarks on Infancy 1119
   
PART II.—CHILDHOOD.
Ablution 1120
Clothing 1123
Diet 1132
The Nursery 1150
Exercise 1172
Amusements 1177
Education 1183
Sleep 1188
Second Dentition 1194
mxiiDisease, etc. 1195
Warm Baths 1294
Warm External Applications 1295
Accidents 1297
   
PART III.—BOYHOOD AND GIRLHOOD.
Ablution, etc. 1318
Clothing 1327
Diet 1332
Air and Exercise 1337
Amusements 1341
Education 1347
Household Work for Girls 1355
Choice of Profession or Trade 1355
Sleep 1359
On the Teeth and the Gums 1364
Prevention of Disease, etc. 1366
   
Index 1403
Advice to a Mother.
1013

PART I.—INFANCY.

I hardly know so melancholy a reflection, as that Parents are necessarily the sole directors of the management of Children; whether they have, or have not judgment, penetration, or taste, to perform the task.Greville.

Man’s breathing Miniature!Coleridge.

PRELIMINARY CONVERSATION.

1. I wish to consult you on many subjects appertaining to the management and the care of children,—will you favor me with your advice and counsel?

I shall be happy to accede to your request, and to give you the fruits of my experience in the clearest manner I am able, and in the simplest language I can command—freed from all technicalities. I will endeavor to guide you in the management of the health of your offspring;—I will describe to you the symptoms of the diseases of children;—I will warn you of approaching danger, in order that you may promptly apply for medical assistance before disease has gained too firm a footing;—I will give you the treatment on the moment of some of their more pressing illnesses—when 1014medical aid cannot quickly be procured, and where delay may be death;—I will instruct you, in case of accidents, on the immediate employment of remedies—where procrastination may be dangerous;—I will tell you how a sick child should be nursed, and how a sick room ought to be managed;—I will use my best energy to banish injurious practices from the nursery;—I will treat of the means to prevent disease where it be possible;—I will show you the way to preserve the health of the healthy,—and how to strengthen the delicate;—and will strive to make a medical man’s task more agreeable to himself,—and more beneficial to his patient,—by dispelling errors and prejudices, and by proving the importance of your strictly adhering to his rules. If I can accomplish any of these objects, I shall be amply repaid by the pleasing satisfaction that I have been of some little service to the rising generation.

2. Then you consider it important that I should be made acquainted with, and be well informed upon, the subjects you have just named?

Certainly. I deem it to be your imperative duty to study the subjects well. The proper management of children is a vital question,—a mother’s question,—and the most important that can be brought under the consideration of a parent; and, strange to say, it is one that has been more neglected than any other. How many mothers undertake the responsible management of children without previous instruction, or without forethought; they undertake it as though it may be learned either by intuition or by instinct or by affection! The consequence is, that frequently they are 1015in a sea of trouble and uncertainty, tossing about without either rule or compass; until, too often, their hopes and treasures are shipwrecked and lost!

The care and management, and consequently the health and future well-doing of the child, principally devolve upon the mother; “for it is the mother after all that has most to do with the making or the marring of the man.”[130] Dr. Guthrie justly remarks that—“Moses might never have been the man he was unless he had been nursed by his own mother. How many celebrated men have owed their greatness and their goodness to a mother’s training!” Napoleon owed much to his mother. “‘The fate of a child,’ said Napoleon, ‘is always the work of his mother;’ and this extraordinary man took pleasure in repeating, that to his mother he owed his elevation. All history confirms this opinion.... The character of the mother influences the children more than that of the father, because it is more exposed to their daily, hourly observation.”[131]

I am not overstating the importance of the subject in hand when I say that a child is the most valuable treasure in the world, that “he is the precious gift of God,” that he is the source of a mother’s greatest and purest enjoyment, that he is the strongest bond of affection between her and her husband, and that

“A babe in a house is a well-spring of pleasure,
A messenger of peace and love.”[132]

1016In the writing of the following pages I have had one object constantly in view—namely, health—

“That salt of life, which does to all a relish give;
Its standing pleasure, and intrinsic wealth,
The body’s virtue, and the soul’s good fortune—health.”

ABLUTION.

3. Is a new-born infant, for the first time, to be washed in warm or in cold water?

It is not an uncommon plan to use cold water from the first, under the impression of its strengthening the child. This appears to be a cruel and barbarous practice, and is likely to have a contrary tendency. Moreover, it frequently produces either inflammation of the eyes, or stuffing of the nose, or inflammation of the lungs, or looseness of the bowels. Although I do not approve of cold water, we ought not to run into an opposite extreme, as hot water would weaken and enervate the babe, and thus would predispose him to disease. Lukewarm rain water will be the best to wash him with. This, if it be summer, should have its temperature gradually lowered, until it be quite cold; if it be winter, a dash of warm water ought still to be added, to take off the chill.

It will be necessary to use soap—Castile soap being the best for the purpose—it being less irritating to the skin than the ordinary soap. Care should be taken that it does not get into the eyes, as it may produce either inflammation or smarting of those organs.

If the skin be delicate, or if there be any excoriation 1017or “breaking-out” on the skin, then Glycerin soap, instead of the Castile soap, ought to be used.

4. At what age do you recommend a mother to commence washing her infant in the tub or in the nursery-basin?[133]

As soon as the navel-string comes away.[134] Do not be afraid of water,—and that in plenty,—as it is one of the best strengtheners to a child’s constitution. How many infants suffer, for the want of water, from excoriation!

5. Which do you prefer—flannel or sponge—to wash a child with?

For the first part of the washing a piece of flannel is very useful—that is to say, to use with the soap, and to loosen the dirt and the perspiration; but for the finishing-up process, a sponge—a large sponge—is superior to flannel, to wash all away, and to complete the bathing. A sponge cleanses and gets into all the nooks, corners, and crevices of the skin. Besides, sponge, to finish up with, is softer and more agreeable to the tender skin of a child than flannel. Moreover, a sponge holds more water than flannel, and thus enables 1018you to stream the water more effectually over him. A large sponge will act like a miniature shower-bath, and will thus brace and strengthen him.

6. To prevent a new-born babe from catching cold, is it necessary to wash his head with brandy?

It is not necessary. The idea that it will prevent cold is erroneous, as the rapid evaporation of heat which the brandy causes is more likely to give than to prevent cold?

7. Ought that tenacious, paste-like substance, adhering to the skin of a new-born babe, to be washed off at the first dressing?

It should, provided it be done with a soft sponge and with care. If there be any difficulty in removing the substance, gently rub it, by means of a flannel,[135] either with a little lard, or fresh butter, or sweet oil. After the parts have been well smeared and gently rubbed with the lard, or oil, or butter, let all be washed off together, and be thoroughly cleansed away, by means of a sponge and soap and warm water, and then, to complete the process, gently put him for a minute or 1019two in his tub. If this paste-like substance be allowed to remain on the skin, it might produce either an excoriation or a “breaking-out.” Besides, it is impossible, if that tenacious substance be allowed to remain on it, for the skin to perform its proper functions.

8. Have you any general observations to make on the washing of a new-born infant?

A babe ought, every morning of his life, to be thoroughly washed from head to foot; and this can only be properly done by putting him bodily either into a tub, or into a bath, or into a large nursery-basin half filled with water. The head, before placing him in the bath, should be first wetted (but not dried); then immediately put him into the water, and, with a piece of flannel well soaked, cleanse his whole body, particularly his armpits, between his thighs, his groins, and his hams; then take a large sponge in hand, and allow the water from it, well filled, to stream all over his body, particularly over his back and loins. Let this advice be well observed, and you will find the plan most strengthening to your child. The skin must, after every bath, be thoroughly but quickly dried with warm, dry, soft towels, first enveloping the child in one, and then gently absorbing the moisture with the towel, not roughly scrubbing and rubbing his tender skin as though a horse were being rubbed down.

The ears must after each ablution be carefully and well dried with a soft dry napkin; inattention to this advice has sometimes caused a gathering in the ear—a painful and distressing complaint; and at other times it has produced deafness.

1020Directly after the infant is dried, all the parts that are at all likely to be chafed ought to be well powdered. After he is well dried and powdered, the chest, the back, the bowels, and the limbs should be gently rubbed, taking care not to expose him unnecessarily during such friction.

He ought to be partially washed every evening; indeed it may be necessary to use a sponge and a little warm water frequently during the day, namely, each time after the bowels have been relieved. Cleanliness is one of the grand incentives to health, and therefore cannot be too strongly insisted upon. If more attention were paid to this subject, children would be more exempt from chafings, “breakings-out,” and consequent suffering, than they at present are. After the second month, if the babe be delicate, the addition of two handfuls of table salt to the water he is washed with in the morning will tend to brace and strengthen him.

With regard to the best powder to dust an infant with, there is nothing better for general use than starch—the old-fashioned starch made of wheaten flour—reduced by means of a pestle and mortar to a fine powder; or Violet Powder, which is nothing more than finely-powdered starch scented, and which may be procured of any respectable chemist. Some mothers are in the habit of using white lead; but as this is a poison, it ought on no account to be resorted to.[136]

9. If the parts about the groin and fundament be excoriated, what is then the best application?

1021After sponging the parts with tepid rain water, holding him over his tub, and allowing the water from a well-filled sponge to stream over the parts, and then drying them with a soft napkin (not rubbing, but gently dabbing with the napkin), there is nothing better than dusting the parts frequently with finely-powdered Native Carbonate of Zinc. The best way of using this powder is, tying up a little of it in a piece of muslin, and then gently dabbing the parts with it.

Remember excoriations are generally owing to the want of water—to the want of an abundance of water. An infant who is every morning well soused and well swilled with water, seldom suffers either from excoriations or from any other of the numerous skin diseases. Cleanliness, then, is the grand preventive of, and the best remedy for, excoriations. Naaman the Syrian was ordered “to wash and be clean,” and he was healed, “and his flesh came again like unto the flesh of a little child, and he was clean.”[137] This was, of course, a miracle; but how often does water, without any special intervention, act miraculously both in preventing and in curing skin diseases!

An infant’s clothes, napkins especially, ought never to be washed with soda; the washing of napkins with soda is apt to produce excoriations and breakings-out. “As washerwomen often deny that they use soda, it can be easily detected by simply soaking a clean napkin in fresh water and then tasting the water; if it be brackish and salt, soda has been employed.”[138]

102210. Who is the proper person to wash and dress the babe?

The monthly nurse, as long as she is in attendance; but afterward the mother, unless she should happen to have an experienced, sensible, thoughtful nurse, which, unfortunately, is seldom the case.[139]

11. What is the best kind of apron for a mother, or for a nurse to wear, while washing the infant?

Flannel—a good, thick, soft flannel, usually called bath-coating—apron, made long and full, and which of course ought to be well dried every time before it is used.

12. Perhaps you will kindly recapitulate, and give me further advice on the subject of the ablution of my babe?

Let him by all means, then, as soon as the navel-string has separated from the body, be bathed either in his tub, or in his bath, or in his large nursery-basin; for if he is to be strong and hearty, in the water every morning he must go. The water ought to be slightly warmer than new milk. It is dangerous for him to 1023remain for a long period in his bath; this, of course, holds good in a tenfold degree if the child has either a cold, or a pain in his bowels. Take care that, immediately after he comes out of his tub, he is well dried with warm towels. It is well to let him have his bath the first thing in the morning, and before he has been put to the breast; let him be washed before he has his breakfast; it will refresh him and give him an appetite. Besides, he ought to have his morning ablution on an empty stomach, or it may interfere with digestion, and might produce sickness and pain. In putting him in his tub, let his head be the first part washed. We all know, that in bathing in the sea, how much better we can bear the water if we first wet our head; if we do not do so, we feel shivering and starved and miserable. Let there be no dawdling in the washing; let it be quickly over. When he is thoroughly dried with warm dry towels, let him be well rubbed with the warm hand of the mother or of the nurse. As I previously recommended, while drying him and while rubbing him, let him repose and kick and stretch either on the warm flannel apron, or else on a small blanket placed on the lap. One bathing in the tub, and that in the morning, is sufficient, and better than night and morning. During the day, as I before observed, he may, after the action either of his bowels or of his bladder, require several spongings of lukewarm water, for cleanliness is a grand incentive to health and comeliness.

Remember it is absolutely necessary to every child from his earliest babyhood to have a bath, to be immersed every morning of his life in the water. This 1024advice, unless in cases of severe illness, admits of no exception. Water to the body—to the whole body—is a necessity of life, of health, and of happiness; it wards off disease, it braces the nerves, it hardens the frame, it is the finest tonic in the world. Oh, if every mother would follow to the very letter this advice, how much misery, how much ill health, might then be averted!

MANAGEMENT OF THE NAVEL.

13. Should the navel-string be wrapped in SINGED rag?

There is nothing better than a piece of fine old linen rag, unsinged; when singed, it frequently irritates the infant’s skin.

14. How ought the navel-string to be wrapped in the rag?

Take a piece of soft linen rag, about three inches wide and four inches long, and wrap it neatly round the navel-string, in the same manner you would around a cut finger, and then, to keep on the rag, tie it with a few rounds of whity-brown thread. The navel-string thus covered should, pointing upward, be placed on the belly of the child, and must be secured in its place by means of a flannel belly-band.

15. If, after the navel-string has been secured, bleeding should (in the absence of the medical man) occur, how must it be restrained?

The nurse or the attendant ought immediately to take off the rag, and tightly, with a ligature composed of four or five whity-brown threads, retie the navel-string; 1025and to make assurance doubly sure, after once tying it, she should pass the threads a second time around the navel-string and tie it again; and after carefully ascertaining that it no longer bleeds, fasten it up in the rag as before. Bleeding of the navel-string rarely occurs, yet, if it should do so—the medical man not being at hand—the child’s after-health, or even his life, may, if the above directions be not adopted, be endangered.

16. When does the navel-string separate from the child?

From five days to a week after birth; in some cases not until ten days or a fortnight, or even, in rare cases, not until three weeks.

17. If the navel-string does not at the end of a week come away, ought any means to be used to cause the separation?

Certainly not; it ought always to be allowed to drop off, which, when in a fit state, it will readily do. Meddling with the navel-string has frequently cost the babe a great deal of suffering, and in some cases even his life.

18. The navel is sometimes a little sore after the navel-string comes away; what ought then to be done?

A little simple cerate should be spread on lint, and be applied every morning to the part affected; and a white-bread poultice, every night, until it be quite healed.

19. What are the causes of a rupture of the navel? What ought to be done? Can it be cured?

(1.) A rupture of the navel is sometimes occasioned by a meddlesome nurse. She is very anxious to cause 1026the navel-string to separate from the infant’s body, more especially when it is longer in coming away than usual. She, therefore, before it is in a fit state to drop off, forces it away. (2.) The rupture, at another time, is occasioned by the child incessantly crying. A mother, then, should always bear in mind that a rupture of the navel is often caused by much crying, and that it occasions much crying; indeed, it is a frequent cause of incessant crying. A child, therefore, who, without any assignable cause, is constantly crying, should have his navel carefully examined.

A rupture of the navel ought always to be treated early—the earlier the better. Ruptures of the navel can only be cured in infancy and in childhood. If it be allowed to run on until adult age, a cure is impossible. Palliative means can then only be adopted.

The best treatment is a Burgundy pitch plaster, spread on a soft piece of wash-leather about the size of the top of a tumbler, with a properly adjusted pad (made from the plaster) fastened on the center of the plaster, which will effectually keep up the rupture, and in a few weeks will cure it. It will be necessary, from time to time, to renew the plaster until the cure be effected. These plasters will be found both more efficacious and pleasant than either a truss or an elastic bandage; which latter appliances sometimes gall, and do more harm than they do good.

20. If a child has a groin rupture (an inguinal rupture), can that also be cured?

Certainly, if, soon after birth, it be properly attended to. Consult a medical man, and he will supply you 1027with a well-fitting truss, which will eventually cure him. If the truss be properly made (under the direction of an experienced surgeon) by a skillful surgical-instrument-maker, a beautiful, nicely fitting truss will be supplied, which will take the proper and exact curve of the lower part of the infant’s belly, and will thus keep on without using any under-strap whatever—a great desideratum, as these under-straps are so constantly wetted and soiled as to endanger the patient constantly catching cold. But if this under-strap is to be superseded, the truss must be made exactly to fit the child—to fit him like a ribbon; which is a difficult thing to accomplish, unless it be fashioned by a skillful workman. It is only lately that these trusses have been made without under-straps. Formerly the under-straps were indispensable necessaries.

These groin ruptures require great attention and supervision, as the rupture (the bowel) must, before putting on the truss, be cautiously and thoroughly returned into the belly; and much care should be used to prevent the chafing and galling of the tender skin of the babe, which an ill-fitting truss would be sure to occasion. But if care and skill be bestowed on the case, a perfect cure might in due time be insured. The truss must not be discontinued until a perfect cure be effected.

Let me strongly urge you to see that my advice is carried out to the very letter, as a groin rupture can only be cured in infancy and in childhood. If it be allowed to run on, unattended to, until adult age, he will be obliged to wear a truss all his life, which would be a great annoyance and a perpetual irritation to him.

1028

CLOTHING.

21. Is it necessary to have a flannel cap in readiness to put on as soon as a babe is born?

Sir Charles Locock considers that a flannel cap is not necessary, and asserts that all his best nurses have long discarded flannel caps. Sir Charles states that since the discontinuance of flannel caps infants have not been more liable to inflammation of the eyes.

Such authority is, in my opinion, conclusive. My advice, therefore, to you is, by all means discontinue the use of flannel caps.

22. What kind of belly-band do you recommend—a flannel or a calico one?

I prefer flannel, for two reasons—first, on account of its keeping the child’s bowels comfortably warm; and, secondly, because of its not chilling him (and thus endangering cold, etc.) when he wets himself. The belly-band ought to be moderately but not tightly applied, as, if tightly applied, it would interfere with the necessary movement of the bowels.

23. When should the belly-band be discontinued?

When the child is two or three months old. The best way of leaving it off is to tear a strip off daily for a few mornings, and then to leave it off altogether. “Nurses who take charge of an infant when the monthly nurse leaves are frequently in the habit of at once leaving off the belly-band, which often leads to ruptures when the child cries or strains. It is far wiser to retain it too long than too short a time; and 1029when a child catches hooping-cough while still very young, it is safer to resume the belly-band.”[140]

24. Have you any remarks to make on the clothing of an infant?

A baby’s clothing ought to be light, warm, loose, and free from pins. (1.) It should be light, without being too airy. Many infants’ clothes are both too long and too cumbersome. It is really painful to see how some poor little babies are weighed down with a weight of clothes. They may be said to “bear the burden,” and that a heavy one, from the very commencement of their lives! How absurd, too, the practice of making them wear long clothes. Clothes to cover a child’s feet, and even a little beyond, may be desirable; but for clothes, when the infant is carried about, to reach to the ground, is foolish and cruel in the extreme. I have seen a delicate baby almost ready to faint under the infliction. (2.) It should be warm, without being too warm. The parts that ought to be kept warm are the chest, the bowels, and the feet. If the infant be delicate, especially if he be subject to inflammation of the lungs, he ought to wear a fine flannel, instead of his usual shirts, which should be changed as frequently. (3.) The dress should be loose, so as to prevent any pressure upon the blood-vessels, which would otherwise impede the circulation, and thus hinder a proper development of the parts. It ought to be loose about the chest and waist, so that the lungs and the heart may have free play. It should be loose about 1030the stomach, so that digestion may not be impeded; it ought to be loose about the bowels, in order that the spiral motion of the intestines may not be interfered with; hence the importance of putting on a belly-band moderately slack; it should be loose about the sleeves, so that the blood may course, without let or hindrance, through the arteries and veins; it ought to be loose, then, everywhere, for nature delights in freedom from restraint, and will resent, sooner or later, any interference. Oh that a mother would take common sense, and not custom, as her guide! (4.) As few pins should be used in the dressing of a baby as possible. Inattention to this advice has caused many a little sufferer to be thrown into convulsions.

The generality of mothers use no pins in the dressing of their children; they tack with a needle and thread every part that requires fastening. They do not even use pins to fasten the baby’s napkins. They make the diapers with loops and tapes, and thus altogether supersede the use of pins in the dressing of an infant. The plan is a good one, takes very little extra time, and deserves to be universally adopted. If pins be used for the napkins, they ought to be the Patent Safety Pins.

25. Is there any necessity for a nurse being particular in airing an infant’s clothes before they are put on? If she were less particular, would it not make him more hardy?

A nurse cannot be too particular on this head. A baby’s clothes ought to be well aired the day before they are put on, as they should not be put on warm 1031from the fire. It is well, where it can be done, to let him have clean clothes daily. Where this cannot be afforded, the clothes, as soon as they are taken off at night, ought to be well aired so as to free them from the perspiration, and that they may be ready to put on the following morning. It is truly nonsensical to endeavor to harden a child, or any one else, by putting on damp clothes!

26. What is your opinion of caps for an infant?

The head ought to be kept cool; caps, therefore, are unnecessary. If caps be used at all, they should only be worn for the first month in summer, or for the first two or three months in winter. If a babe take to caps, it requires care in leaving them off, or he will catch cold. When you are about discontinuing them, put a thinner and a thinner one on, every time they are changed, until you leave them off altogether.

But remember, my opinion is, that a child is better without caps; they only heat his head, cause undue perspiration, and thus make him more liable to catch cold.

If a babe does not wear a cap in the day, it is not at all necessary that he should wear one at night. He will sleep more comfortably without one, and it will be better for his health. Moreover, night-caps injure both the thickness and the beauty of the hair.

27. Have you any remarks to make on the clothing of an infant, when, in the winter time, he is sent out for exercise?

Be sure that he is well wrapped up. He ought to have under his cloak a knitted worsted spencer, which 1032should button behind; and if the weather be very cold, a shawl over all; and, provided it be dry above, and the wind be not in the east or in the northeast, he may then brave the weather. He will then come from his walk refreshed and strengthened, for cold air is an invigorating tonic. In a subsequent conversation I will indicate the proper age at which a child should be first sent out to take exercise in the open air.

28. At what age ought an infant “to be shortened?”

This, of course, will depend upon the season. In the summer, the right time “for shortening a babe,” as it is called, is at the end of two months; in the winter, at the end of three months. But if the right time for “shortening” a child should happen to be in the spring, let it be deferred until the end of May. The English springs are very trying and treacherous; and sometimes, in April, the weather is almost as cold, and the wind as biting, as in winter. It is treacherous, for the sun is hot, and the wind, which is at this time of the year frequently easterly, is keen and cutting. I should far prefer “to shorten” a child in the winter than in the early spring.

DIET.

29. Are you an advocate for putting a baby to the breast soon after birth, or for waiting, as many do, until the third day?

The infant ought to be put to the breast soon after birth; the interest, both of the mother and of the child, demands it. It will be advisable to wait three or four hours, that the mother may recover from her fatigue; 1033and then the babe must be put to the breast. If this be done, he will generally take the nipple with avidity.

It might be said that at so early a period there is no milk in the breast; but such is not usually the case. There generally is a little from the very beginning; which acts on the baby’s bowels like a dose of purgative medicine, and appears to be intended by nature to cleanse the system. But, provided there be no milk at first, the very act of sucking not only gives the child a notion, but, at the same time, causes a draught (as it is usually called) in the breast, and enables the milk to flow easily.

Of course, if there be no milk in the breast—the babe having been applied once or twice to determine the fact—then you must wait for a few hours before applying him again to the nipple, that is to say, until the milk be secreted.

An infant who, for two or three days, is kept from the breast, and who is fed upon gruel, generally becomes feeble, and frequently, at the end of that time, will not take the nipple at all. Besides, there is a thick cream (similar to the biestings of a cow), which, if not drawn out by the child, may cause inflammation and gathering of the bosom, and, consequently, great suffering to the mother. Moreover, placing him early to the breast moderates the severity of the mother’s after pains, and lessens the risk of her flooding. A new-born babe must not have gruel given to him; as it disorders the bowels, causes a disinclination to suck, and thus makes him feeble.

30. If an infant show any disinclination to suck, or 1034if he appear unable to apply his tongue to the nipple, what ought to be done?

Immediately call the attention of the medical man to the fact, in order that he may ascertain whether he be tongue-tied. If he be, the simple operation of dividing the bridle of the tongue will remedy the defect, and will cause him to take the nipple with ease and comfort.

31. Provided there be no milk AT FIRST; what ought then to be done?

Wait with patience: the child (if the mother has no milk) will not, for at least twelve hours, require artificial food. In the generality of instances, then, artificial food is not at all necessary; but if it should be needed, one-third of new milk and two-thirds of warm water, slightly sweetened with loaf sugar (or with brown sugar, if the babe’s bowels have not been opened), should be given, in small quantities at a time, every four hours, until the milk be secreted, and then it must be discontinued. The infant ought to be put to the nipple every four hours, but not oftener, until he be able to find nourishment.

If, after the application of the child for a few times, he is unable to find nourishment, then it will be necessary to wait until the milk be secreted. As soon as it is secreted, he must be applied, with great regularity, alternately to each breast.

I say alternately to each breast. This is most important advice. Sometimes a child, for some inexplicable reason, prefers one breast to the other, and the mother, to save a little contention, concedes the point, 1035and allows him to have his own way. And what is frequently the consequence?—a gathered breast!

We frequently hear of a babe having no notion of sucking. This “no notion” may generally be traced to bad management, to stuffing him with food, and thus giving him a disinclination to take the nipple at all.

32. How often should a mother suckle her infant?

A mother generally suckles her baby too often, having him almost constantly at the breast. This practice is injurious both to parent and to child. The stomach requires repose as much as any other part of the body; and how can it have it if it be constantly loaded with breast-milk? For the first month, he ought to be suckled about every hour and a half; for the second month, every two hours,—gradually increasing, as he becomes older, the distance of time between, until at length he has it about every four hours.

If a baby were suckled at stated periods, he would only look for the bosom at those times, and be satisfied. A mother is frequently in the habit of giving the child the breast every time he cries, regardless of the cause. The cause too frequently is, that he has been too often suckled—his stomach has been overloaded; the little fellow is constantly in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavor to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in every thing—in times for suckling, for sleeping, etc. No children thrive so well as those who are thus early taught.

33. Where the mother is MODERATELY strong, do you 1036advise that the infant should have any other food than the breast?

Artificial food must not, for the first three or four months, be given, if the parent be moderately strong; of course, if she be feeble, a little food will be necessary. Many delicate women enjoy better health while suckling than at any other period of their lives.

34. What food is the best substitute for a mother’s milk?

The food that suits one infant will not agree with another. (1.) The one that I have found the most generally useful, is made as follows: Boil the crumb of bread for two hours in water, taking particular care that it does not burn; then add only a little lump sugar (or brown sugar, if the bowels be costive), to make it palatable. When he is five or six months old, mix a little new milk—the milk of ONE cow—with it, gradually, as he becomes older, increasing the quantity until it be nearly all milk, there being only enough water to boil the bread; the milk should be poured boiling hot on the bread. Sometimes the two milks—the mother’s and the cow’s milk—do not agree; when such is the case, let the milk be left out, both in this and in the foods following, and let the food be made with water instead of with milk and water. In other respects, until the child is weaned, let it be made as above directed; when he is weaned, good fresh cow’s milk MUST, as previously recommended, be used. (2.) Or, cut thin slices of bread into a basin, cover the bread with cold water, place it in an oven for two hours to bake; take it out, beat the bread up with a fork, and 1037then slightly sweeten it. This is an excellent food. (3.) If the above should not agree with the infant (although, if properly made, they almost invariably do), “tous-les-mois”[141] may be given. (4.) Or, Robb’s Biscuit, as it is “among the best bread compounds made out of wheat-flour, and is almost always readily digested.”—Routh.

(5.) Another good food is the following: Take about a pound of flour, put it in a cloth, tie it up tightly, place it in a saucepanful of water, and let it boil for four or five hours; then take it out, peel off the outer rind, and the inside will be found quite dry, which grate. (6.) Another way of preparing an infant’s food, is to bake flour—biscuit flour—in a slow oven, until it be of a light fawn color. (7.) An excellent food for a baby, is baked crumbs of bread. The manner of preparing it is as follows: Crumb some bread on a plate; put it a little distance from the fire to dry. When dry, rub the crumbs in a mortar, and reduce them to a fine powder; then pass them through a sieve. Having done which, put the crumbs of bread into a slow oven, and let them bake until they be of a light fawn color. A small quantity either of the boiled, or of the baked flour, or of the baked crumb of bread, ought to be made into food in the same way as gruel is made, and should then 1038be slightly sweetened, according to the state of the bowels, either with lump or with brown sugar.

(8.) Baked flour sometimes produces constipation; when such is the case, Mr. Appleton of Budleigh Salterton, Devon, wisely recommends a mixture of baked flour and prepared oatmeal,[142] in the proportion of two of the former and one of the latter. He says: “To avoid the constipating effects, I have always had mixed, before baking, one part of prepared oatmeal with two parts of flour; this compound I have found both nourishing, and regulating to the bowels. One tablespoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavored, and sweetened with white sugar, produces a thick, nourishing, and delicious food for infants or invalids.” He goes on to remark: “I know of no food, after repeated trials, that can be so strongly recommended by the profession to all mothers in the rearing of their infants, without or with the aid of the breast, at the same time relieving them of much draining and dragging while nursing with an insufficiency of milk, as baked flour and oatmeal.”[143]

(9.) A ninth food may be made with “Farinaceous Food for Infants, prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces costiveness—as it sometimes does—let it be mixed either with equal parts or with one-third of Robertson’s Patent Groats. The 1039mixture of the two together makes a splendid food for a baby. (10.) A tenth, and an excellent one, may be made with rusks, boiled for an hour in water, which ought then to be well beaten up by means of a fork, and slightly sweetened with lump sugar. Great care should be taken to select good rusks, as few articles vary so much in quality. (11.) An eleventh is—the top crust of a baker’s loaf, boiled for an hour in water, and then moderately sweetened with lump sugar. If, at any time, the child’s bowels should be costive, raw must be substituted for lump sugar. (12.) Another capital food for an infant, is that made by Lemann’s Biscuit Powder. (13.) Or, Brown and Polson’s Patent Corn Flour will be found suitable. The Queen’s cook, in his recent valuable work,[144] gives the following formula for making it: “To one dessertspoonful of Brown & Polson, mixed with a wineglassful of cold water, add half a pint of boiling water; stir over the fire for five minutes; sweeten lightly, and feed the baby; but if the infant is being brought up by the hand, this food should then be mixed with milk—not otherwise.”

(14.) The following is a good and nourishing food for a baby: Soak, for an hour, some best rice in cold water; strain, and add fresh water to the rice; then let it simmer till it will pulp through a sieve; put the pulp and the water in a saucepan, with a lump or two of sugar, and again let it simmer for a quarter of an hour; a portion of this should be mixed with one-third of fresh milk, so as to make it of the consistence of good cream.

1040When the baby is five or six months old, new milk should be added to any of the above articles of food, in a similar way to that recommended for boiled bread.

(15.) For a delicate infant, lentil powder, better known as Du Barry’s “Revalenta Arabica,” is invaluable. It ought to be made into food, with new milk, in the same way that arrow-root is made, and should be moderately sweetened with loaf sugar. Whatever food is selected ought to be given by means of a nursing-bottle.

If a child’s bowels be relaxed and weak, or if the motions be offensive, the milk must be boiled. The following (16.) is a good food when an infant’s bowels are weak and relaxed: “Into five large spoonfuls of the purest water rub smooth one dessertspoonful of fine flour. Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour it into the flour and water, and stir it over a slow fire twenty minutes.”

Where there is much emaciation, I have found (17.) genuine arrow-root a very valuable article of food for an infant, as it contains a great deal of starch, which starch helps to form fat and to evolve caloric (heat)—both of which a poor, emaciated, chilly child stands so much in need of. It must be made with good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

I have given you a large and well-tried infant’s dietary to choose from, as it is sometimes difficult to fix on one that will suit; but remember, if you find one of the above to agree, keep to it, as a baby requires a simplicity in food—a child a greater variety.

1041Let me, in this place, insist upon the necessity of great care and attention being observed in the preparation of any of the above articles of diet. A babe’s stomach is very delicate, and will revolt at either ill-made, or lumpy, or burnt food. Great care ought to be observed as to the cleanliness of the cooking utensils. The above directions require the strict supervision of the mother.

Broths have been recommended, but, for my own part, I think that, for a young infant, they are objectionable; they are apt to turn acid on the stomach, and to cause flatulence and sickness; they sometimes disorder the bowels and induce griping and purging.

Whatever artificial food is used ought to be given by means of a bottle, not only as it is a more natural way than any other of feeding a baby, as it causes him to suck as though he were drawing it from the mother’s breast, but as the act of sucking causes the salivary glands to press out their contents, which materially assists digestion. Moreover, it seems to satisfy and comfort him more than it otherwise would do.

The food ought to be of the consistence of good cream, and should be made fresh and fresh. It ought to be given milk-warm. Attention must be paid to the cleanliness of the vessel, and care should be taken that the milk be that of ONE cow,[145] and that it be new and 1042of good quality; for if not, it will turn acid and sour, and disorder the stomach, and will thus cause either flatulence or looseness of the bowels, or perhaps convulsions.

The only way to be sure of having it from one cow, is (if you have not a cow of your own) to have the milk from a respectable cow-keeper, and to have it brought to your house in a can of your own (the London milk-cans being the best for the purpose). The better plan is to have two cans, and to have the milk fresh and fresh every night and morning. The cans, after each time of using, ought to be scalded out; and, once a week, the can should be filled with cold water, and the water should be allowed to remain in it until the can be again required.

Very little sugar should be used in the food, as much sugar weakens the digestion. A small pinch of table salt ought to be added to whatever food is given, as “the best savor is salt.” Salt is most wholesome—it strengthens and assists digestion, prevents the formation 1043of worms, and, in small quantities, may with advantage be given (if artificial food be used) to the youngest baby.

35. Where it is found to be absolutely necessary to give an infant artificial food WHILE SUCKLING, how often ought he to be fed?

Not oftener than twice during the twenty-four hours, and then only in small quantities at a time, as the stomach requires rest, and at the same time can manage to digest a little food better than it can a great deal.

Let me again urge upon you the importance, if it be at all practicable, of keeping the child entirely to the breast for the first three or four months of his existence. Remember there is no real substitute for a mother’s milk; there is no food so well adapted to his stomach; there is no diet equal to it in developing muscle, in making bone, or in producing that beautiful plump rounded contour of the limbs; there is nothing like a mother’s milk alone in making a child contented and happy, in laying the foundation of a healthy constitution, in preparing the body for a long life, in giving him tone to resist disease, or in causing him to cut his teeth easily and well; in short, the mother’s milk is the greatest temporal blessing an infant can possess.

As a general rule, therefore, when the child and the mother are tolerably strong, he is better without artificial food until he has attained the age of three or four months; then, it will usually be necessary to feed him twice a day, so as gradually to prepare him to be weaned (if possible) at the end of nine months. The 1044food mentioned in the foregoing conversation will be the best for him, commencing without the cow’s milk, but gradually adding it, as less mother’s milk and more artificial food be given.

36. When the mother is not able to suckle her infant herself, what ought to be done?

It must first be ascertained, beyond all doubt, that a mother is not able to suckle her own child. Many delicate ladies do suckle their infants with advantage, not only to their offspring, but to themselves. “I will maintain,” says Steele, “that the mother grows stronger by it, and will have her health better than she would have otherwise. She will find it the greatest cure and preservative for the vapors [nervousness] and future miscarriages, much beyond any other remedy whatsoever. Her children will be like giants, whereas otherwise they are but living shadows, and like unripe fruit; and certainly if a woman is strong enough to bring forth a child, she is beyond all doubt strong enough to nurse it afterward.”

Many mothers are never so well as when they are nursing; besides, suckling prevents a lady from becoming pregnant so frequently as she otherwise would. This, if she be delicate, is an important consideration, and more especially if she be subject to miscarry. The effects of a miscarriage are far more weakening than those of suckling.

A hireling, let her be ever so well inclined, can never have the affection and unceasing assiduity of a mother, and, therefore, cannot perform the duties of suckling with equal advantage to the baby.

1045The number of children who die under five years of age is enormous—many of them from the want of the mother’s milk. There is a regular “parental baby-slaughter”—“a massacre of the innocents”—constantly going on in England, in consequence of infants being thus deprived of their proper nutriment and just dues! The mortality from this cause is frightful, chiefly occurring among rich people who are either too grand, or, from luxury, too delicate, to perform such duties: poor married women, as a rule, nurse their own children, and, in consequence, reap their reward.

If it be ascertained, past all doubt, that a mother cannot suckle her child, then, if the circumstances of the parents will allow—and they ought to strain a point to accomplish it—a healthy wet-nurse should be procured, as, of course, the food which nature has supplied is far, very far superior to any invented by art.

Never bring up a baby, then, if you can possibly avoid it, on artificial food. Remember, as I proved in a former conversation, there is in early infancy no real substitute for either a mother’s or a wet-nurse’s milk. It is impossible to imitate the admirable and subtle chemistry of nature. The law of nature is, that a baby, for the first few months of his existence, shall be brought up by the breast; and nature’s law cannot be broken with impunity.[146] It will be imperatively necessary, then—

1046“To give to nature what is nature’s due.”[147]

Again, in case of a severe illness occurring during the first nine months of a child’s life, what a comfort either the mother’s or the wet-nurse’s milk is to him! it often determines whether he shall live or die.

But if a wet-nurse cannot fill the place of a mother, then, asses’ milk will be found the best substitute, as it approaches nearer, in composition, than any other animal’s, to human milk; but it is both difficult and expensive to obtain. The next best substitute is goats’ milk. Either the one or the other ought to be milked fresh and fresh, as it is wanted, and should be given by means of a feeding-bottle.

Asses’ milk is more suitable for delicate infants, and goats’ milk for those who are strong.

If neither asses’ milk nor goats’ milk can be procured, then the following from the very commencement should be given:

New milk, the produce of ONE healthy cow,
Warm water, of each, equal parts;
Table salt,[148] a few grains;
Lump sugar, a sufficient quantity to slightly sweeten it.

The milk itself ought not to be heated over the fire,[149] 1047but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. The milk and water should be of the same temperature as the mother’s milk, that is to say, at about ninety to ninety-five degrees Fahrenheit. It ought to be given by means of a feeding-bottle, and care must be taken to scald the bottle out twice a day, for if attention be not paid to this point the delicate stomach of an infant is soon disordered. As he grows older the milk should be gradually increased, and the water decreased, until nearly all milk be given.

There will, in many cases, be quite sufficient nourishment in the above; I have known some robust infants brought up on it alone. But if it should not agree with the child, or if there should not be sufficient nourishment in it, then the food recommended in answer to No. 34 question ought to be given, with this only difference—a little new milk must from the beginning be added, and should be gradually increased, until nearly all milk be used.

The milk, as a general rule, ought to be unboiled; but if it purge violently, or if it cause offensive motions—which it sometimes does—then it must be boiled. The moment the milk boils up it should be taken off the fire.

Food ought, for the first month, to be given about every two hours; for the second month, about every three hours; lengthening the space of time as the baby advances in age. A mother must be careful not to over-feed a child, as over-feeding is a prolific source of disease.

1048Let it be thoroughly understood, and let there be no mistake about it, that a babe, during the first nine months of his life, MUST have—it is absolutely necessary for his very existence—milk of some kind, as the staple and principal article of his diet, either mother’s, or wet-nurse’s, or asses’, or goat’s, or cow’s own milk.

37. How would you choose a wet-nurse?

I would inquire particularly into the state of her health; whether she be of a healthy family, of a consumptive habit, or if she or any of her family have labored under “king’s evil;” ascertaining if there be any seams or swellings about her neck; any eruptions or blotches upon her skin; if she has a plentiful breast of milk, and if it be of good quality[150] (which may readily be ascertained by milking a little into a glass); if she has good nipples, sufficiently long for the baby to hold; that they be not sore; and if her own child be of the same or nearly of the same age as the one you wish her to nurse. Ascertain whether she menstruates during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her.[151] Assure yourself that her own babe is strong and 1049healthy, and that he is free from a sore mouth and from a “breaking-out” of the skin. Indeed, if it be possible to procure such a wet-nurse, she ought to be from the country, of ruddy complexion, of clear skin, and of between twenty and five and twenty years of age, as the milk will then be fresh, pure, and nourishing.

I consider it to be of great importance that the infant of the wet-nurse should be, as nearly as possible, of the same age as your own, as the milk varies in quality according to the age of the child. For instance, during the commencement of suckling, the milk is thick and creamy, similar to the biestings of a cow, which, if given to a babe of a few months old, would cause derangement of the stomach and bowels. After the first few days, the appearance of the milk changes; it becomes of a bluish-white color, and contains less nourishment. The milk gradually becomes more and more nourishing as the infant becomes older and requires more support.

In selecting a wet-nurse for a very small and feeble babe, you must carefully ascertain that the nipples of the wet-nurse are good and soft, and yet not very large: if they be very large, the child’s mouth being very small, he may not be able to hold them. You must note, too, whether the milk flows readily from the nipple into the child’s mouth; if it does not, he may not have strength to draw it, and he would soon die of starvation. The only way of ascertaining whether the infant actually draws the milk from the nipple, can be done by examining the mouth of the child immediately after his 1050taking the breast, and seeing for yourself whether there be actually milk in his mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good. In such a case, cow’s milk and water, sugar and salt, as recommended at page 46, must be given in small quantities at a time—from two to four teaspoonfuls—but frequently; if the child be awake, every hour or every half hour, both night and day, until he be able to take the breast. If, then, a puny, feeble babe is only able to take but little at a time, and that little by teaspoonfuls, he must have little and often, in order that “many a little might make a mickle.”

I have known many puny, delicate children who had not strength to hold the nipple in their mouths, but who could take milk and water (as above recommended) by teaspoonfuls only at a time, with steady perseverance, and giving it every half hour or hour (according to the quantity swallowed), at length be able to take the breast, and eventually become strong and hearty children; but such cases require unwearied watching, perseverance, and care. Bear in mind, then, that the smaller the quantity of the milk and water given at a time, the oftener must it be administered, as, of course, the babe must have a certain quantity of food to sustain life.

38. What ought to be the diet either of a wet-nurse, or of a mother who is suckling?

It is a common practice to cram a wet-nurse with food, and to give her strong ale to drink, to make good nourishment and plentiful milk! This practice is absurd; 1051for it either, by making the nurse feverish, makes the milk more sparing than usual, or it causes the milk to be gross and unwholesome. On the other hand, we must not run into an opposite extreme. The mother, or the wet-nurse, by using those means most conducive to her own health, will best advance the interest of her little charge.

A wet-nurse ought to live somewhat in the following way: Let her for breakfast have black tea, with one or two slices of cold meat, if her appetite demand it, but not otherwise. It is customary for a wet-nurse to make a hearty luncheon; of this I do not approve. If she feel either faint or low at eleven o’clock, let her have either a tumbler of porter, or of mild fresh ale, with a piece of dry toast soaked in it. She ought not to dine later than half past one or two o’clock; she should eat, for dinner, either mutton or beef, with either mealy potatoes, or asparagus, or French beans, or secale, or turnips, or brocoli, or cauliflower, and stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted meats, greens, and cabbage must one and all be carefully avoided, as they only tend to disorder the stomach, and thus to deteriorate the milk.

It is a common remark, that “a mother who is suckling may eat anything.” I do not agree with this opinion. Can impure or improper food make pure and proper milk, or can impure or improper milk make good blood for an infant, and thus good health?

The wet-nurse ought to take with her dinner a moderate quantity of either sound porter, or of mild (but not old or strong) ale. Tea should be taken at half past 1052five or six o’clock; supper at nine, which should consist either of a slice or two of cold meat, or of cheese if she prefer it, with half a pint of porter or of mild ale; occasionally, a basin of gruel may with advantage be substituted. Hot and late suppers are prejudicial to the mother or to the wet-nurse, and, consequently, to the child. The wet-nurse ought to be in bed every night by ten o’clock.

It might be said that I have been too minute and particular in my rules for a wet-nurse; but when it is considered of what importance good milk is to the well-doing of an infant, in making him strong and robust, not only now, but as he grows up to manhood, I shall, I trust, be excused for my prolixity.

39. Have you any more hints to offer with regard to the management of a wet-nurse?

A wet-nurse is frequently allowed to remain in bed until a late hour in the morning, and during the day to continue in the house, as if she were a fixture! How is it possible that any one, under such treatment, can continue healthy?

A wet-nurse ought to rise early, and, if the weather and season will permit, take a walk, which will give her an appetite for breakfast and will make a good meal for her little charge. This, of course, cannot, during the winter months, be done; but even then, she ought, some part of the day, to take every opportunity of walking out; indeed, in the summer time she should live half the day in the open air.

She ought strictly to avoid crowded rooms; her mind should be kept calm and unruffled, as nothing disorders 1053the milk so much as passion and other violent emotions of the mind; a fretful temper is very injurious, on which account you should, in choosing your wet-nurse, endeavor to procure one of a mild, calm, and placid disposition.[152]

A wet-nurse ought never to be allowed to dose her little charge either with Godfrey’s Cordial, or with Dalby’s Carminative, or with Syrup of White Poppies, or with medicine of any kind whatever. Let her thoroughly understand this, and let there be no mistake in the matter. Do not, for one moment, allow your children’s health to be tampered and trifled with. A baby’s health is too precious to be doctored, to be experimented upon, and to be ruined by an ignorant person.

40. Have the goodness to state at what age a child ought to be weaned?

This, of course, must depend both upon the strength of the child and upon the health of the parent; on an average, nine months is the proper time. If the mother be delicate it may be found necessary to wean the infant at six months; or if he be weak, or laboring under any disease, it may be well to continue suckling 1054him for twelve months; but after that time the breast will do him more harm than good, and will, moreover, injure the mother’s health, and may, if she be so predisposed, excite consumption.

41. How would you recommend a mother to act when she weans her child?

She ought, as the word signifies, do it gradually—that is to say, she should, by degrees, give him less and less of the breast, and more and more of artificial food; at length she must only suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and, for a few days, to go away herself.

A good plan is, for the nurse-maid to have a half-pint bottle of new milk—which has been previously boiled[153]—in the bed, so as to give a little to him in lieu of the breast. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.

42. While a mother is weaning her infant, and after she has weaned him, what ought to be his diet?

Any one of the foods recommended in answer to question 34, page 36.

43. If a child be suffering severely from “wind,” is there any objection to the addition of a small quantity either of gin or of peppermint to his food to disperse it?

1055It is a murderous practice to add either gin or peppermint of the shops (which is oil of peppermint dissolved in spirits) to his food. Many children have, by such a practice, been made puny and delicate, and have gradually dropped into an untimely grave. An infant who is kept, for the first three or four months, entirely to the breast—more especially if the mother be careful in her own diet—seldom suffers from “wind;” those, on the contrary, who have much or improper food,[154] suffer severely.

Care in feeding, then, is the grand preventive of “wind;” but if, notwithstanding all your precautions, the child be troubled with flatulence, the remedies recommended under the head of Flatulence will generally answer the purpose.

44. Have you any remarks to make on sugar for sweetening a baby’s food?

A small quantity of sugar in an infant’s food is requisite, sugar being nourishing and fattening, and making cows’ milk to resemble somewhat in its properties human milk; but, bear in mind, it must be used sparingly. Much sugar cloys the stomach, weakens the digestion, produces acidity, sour belchings, and wind.

If a baby’s bowels be either regular or relaxed, lump sugar is the best for the purpose of sweetening his food; if his bowels are inclined to be costive, brown sugar 1056ought to be substituted for lump sugar, as brown sugar acts on a young babe as an aperient, and, in the generality of cases, is far preferable to physicking him with opening medicine. An infant’s bowels, whenever it be practicable (and it generally is), ought to be regulated by a judicious dietary rather than by physic.

VACCINATION.

45. Are you an advocate for vaccination?

Certainly. I consider it to be one of the greatest blessings ever conferred upon mankind. Small-pox, before vaccination was adopted, ravaged the country like a plague, and carried off thousands annually; and those who did escape with their lives were frequently made loathsome and disgusting objects by it. Even inoculation (which is cutting for the small-pox) was attended with danger—more especially to the unprotected—as it caused the disease to spread like wildfire, and thus it carried off immense numbers.

Vaccination is one and an important cause of our increasing population; small-pox, in olden times, decimated the country.

46. But vaccination does not always protect a child from small-pox?

I grant you that it does not always protect him, neither does inoculation; but when he is vaccinated, if he take the infection, he is seldom pitted, and very rarely dies, and the disease assumes a comparatively mild form. There are a few, very few fatal cases recorded after vaccination, and these may be considered 1057as only exceptions to the general rule; and, possibly some of these may be traced to the arm, when the child was vaccinated, not having taken proper effect.

If children and adults were revaccinated,—say every seven years after the first vaccination,—depend upon it, even these rare cases would not occur, and in a short time small-pox would only be known by name.

47. Do you consider it, then, the imperative duty of a mother in every case to have, after the lapse of every seven years, her children revaccinated?

I decidedly do; it would be an excellent plan for every person, once every seven years, to be revaccinated, and even oftener, if small-pox be rife in the neighborhood. Vaccination, however frequently performed, can never do the slightest harm, and might do inestimable good. Small-pox is both a pest and a disgrace, and ought to be constantly fought and battled with until it be banished (which it may readily be) the kingdom.

I say that small-pox is a pest; it is worse than the plague, for if not kept in subjection it is more general—sparing neither young nor old, rich nor poor, and commits greater ravages than the plague ever did. Small-pox is a disgrace; it is a disgrace to any civilized land, as there is no necessity for its presence: if cow-pox were properly and frequently performed, small-pox would be unknown. Cow-pox is a weapon to conquer small-pox, and to drive it ignominiously from the field.

My firm belief then is, that if every person were, every seven years, duly and properly vaccinated, small-pox might be utterly exterminated; but as long as 1058there are such lax notions on the subject, and such gross negligence, the disease will always be rampant, for the poison of small-pox never slumbers nor sleeps, but requires the utmost diligence to eradicate it. The great Dr. Jenner, the discoverer of cow pox as a preventative of small-pox, strongly advocated the absolute necessity of every person being revaccinated once every seven years, or even oftener, if there was an epidemic of small-pox in the neighborhood.

48. Are you not likely to catch not only the cow-pox, but any other disease that the child has from whom the matter is taken?

The same objection holds good in cutting for small-pox (inoculation)—only in a tenfold degree—small-pox being such a disgusting complaint. Inoculated small-pox frequently produced and left behind inveterate “breakings-out,” scars, cicatrices, and indentations of the skin, sore eyes, blindness, loss of eyelashes, scrofula, deafness—indeed, a long catalogue of loathsome diseases. A medical man, of course, will be careful to take the cow-pox matter from a healthy child.

49. Would it not be well to take the matter direct from the cow?

If a doctor be careful—which, of course, he will be—to take the matter from a healthy child, and from a well-formed vesicle, I consider it better than taking it direct from the cow, for the following reasons: The cow-pox lymph, taken direct from the cow, produces much more violent symptoms than after it has passed through several persons; indeed, in some cases, it has produced effects as severe as cutting for the small-pox; 1059besides, it has caused, in many cases, violent inflammation and even sloughing of the arm. There are also several kinds of spurious cow-pox to which the cow is subject, and which would be likely to be mistaken for the real lymph. Again, if even the genuine matter were not taken from the cow exactly at the proper time, it would be deprived of its protecting power.

50. At what age do you recommend an infant to be first vaccinated?

When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighborhood, he may, with perfect safety, be vaccinated at the month’s end; indeed, if the small-pox be near at hand, he must be vaccinated, regardless of his age and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. “A case in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house, varying from one day to a fortnight and more. All took the vaccination; and the woman’s own child, which suckled 1060her and slept with her; and all escaped the small-pox.”[155]

51. Do you consider that the taking of matter from a child’s arm weakens the effect of vaccination on the system?

Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. It is always well to leave one vesicle undisturbed.

52. If the infant has any “breaking-out” upon the skin, ought that to be a reason for deferring the vaccination?

It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. “It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth.”[156] The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red-gum, unless it be severe, ought not, at the proper age, to prevent vaccination. If small-pox be rife in the neighborhood, the child must be vaccinated, regardless of any “breaking-out” on the skin.

53. Does vaccination make a child poorly?

At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth 1061is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel complaint. The arm, about the ninth or tenth day, is usually much inflamed—that is to say, it is, for an inch or two or more around the vesicles, red, hot, and swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.

54. Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?

No; as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination in any way whatever (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.

What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic? And if the matter be not of good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is not necessary; but, on the contrary, hurtful. If the vaccination produce a slight feverish attack, it will, without the administration of a particle of medicine, subside in two or three days.

106255. Have you any directions to give respecting the arm AFTER vaccination?

The only precaution necessary, is to take care that the arm be not rubbed; otherwise the vesicles may be prematurely broken, and the efficacy of the vaccination may be lessened. The sleeve, in vaccination, ought to be large and soft, and should not be tied up. The tying up of a sleeve makes it hard, and is much more likely to rub the vesicles than if it were put on in the usual way.

56. If the arm, AFTER vaccination, be much inflamed, what ought to be done?

Smear frequently, by means of a feather or a camel’s-hair brash, a little cream on the inflamed part. This simple remedy will afford great relief and comfort.

57. Have the goodness to describe the proper appearance, after the falling off of the scab, of the arm?

It might be well to remark that the scabs ought always to be allowed to fall off of themselves. They must not, on any account, be picked or meddled with. With regard to the proper appearance of the arm after the falling off of the scab, “a perfect vaccine scar should be of small size, circular, and marked with radiations and indentations.”[157]

DENTITION.

58. At what time does dentition commence?

The period at which it commences is uncertain. It may, as a rule, be said that a babe begins to cut his 1063teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspeare notices it thus:

York.—Marry, they say my uncle grew so fast
That he could gnaw a crust at two hours old;
’Twas full two years ere I could get a tooth.
Grandam, this would have been a biting jest.”
Act 2, sc. 5.

When a babe is born with teeth they generally drop out. On the other hand, teething in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.

Dentition has been known to occur in old age. A case is recorded by M. Carre, in the Gazette Médicale de Paris (Sept. 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!

59. What is the number of the FIRST set of teeth, and in what order do they generally appear?

The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. “I may say that nearly invariably the order is—1st, the lower front incisors [cutting-teeth], then the upper front, then the upper two lateral incisors, and that not uncommonly a double tooth is cut before the two lower laterals; but at all events the lower laterals come 7th and 8th, and not 5th and 6th, as nearly all books on the subject testify”[158]. 1064Then the first grinders in the lower jaw, afterward the first upper grinders, then the lower corner pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. He is usually, from the time they first appear, two years in cutting his first set of teeth. As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.

60. If an infant be either feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced?

Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.

61. But it has been stated that lancing the gums hardens them?

This is a mistake—it has a contrary effect. It is a well-known fact that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing.

It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth or the teeth be near at hand. It is not to 1065be considered a panacea for every baby’s ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.

62. How ought the lancing of a child’s gums to be performed?

The proper person, of course, to lance his gums is a medical man. But, if perchance you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse’s lap upon his back, and let the nurse take hold of his hands, in order that he may not interfere with the operation.

Then, if it be the upper gum that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then you should take hold of the gum-lancet with your right hand—holding it as if it were a table-knife at dinner—and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.

If it be the lower gum that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.

Although the lancing of the gums, to make it intelligible to a non-professional person, requires a long 1066description, it is, in point of fact, a simple affair, is soon performed, and gives but little pain.

63. If teething cause convulsions, what ought to be done?

The first thing to be done (after sending for a medical man) is to freely dash cold water upon the face, and to sponge the head with cold water, and as soon as warm water can be procured, to put him into a warm bath[159] of 98 degrees Fahrenheit. If a thermometer be not at hand,[160] you must plunge your own elbow into the water: a comfortable heat for your elbow will be the proper heat for the infant. He must remain in the bath for a quarter of an hour, or until the fit be at an end. The body must, after coming out of the bath, be wiped with warm and dry and coarse towels; he ought then to be placed in a warm blanket. The gums must be lanced, and cold water should be applied to the head. An enema, composed of table salt, of olive oil, and warm oatmeal gruel—in the proportion of one tablespoonful of salt, of one of oil, and a teacupful of gruel—ought then to be administered, and should, until the bowels have been well opened, be repeated every quarter of an hour; as soon as he comes to himself a dose of aperient medicine ought to be given.

64. A nurse is in the habit of giving a child who is 1067teething either coral or ivory to bite—do you approve of the plan?

I think it a bad practice to give him any hard, unyielding substance, as it tends to harden the gums, and by so doing causes the teeth to come through with greater difficulty. I have found softer substances, such as either a piece of wax-taper, or an india-rubber ring, or a piece of the best bridle-leather, or a crust of bread, of great service. If a piece of crust be given as a gum-stick, he must, while biting it, be well watched, or by accident he might loosen a large piece of it, which might choke him. The pressure of any of these excites a more rapid absorption of the gum, and thus causes the tooth to come through more easily and quickly.

65. Have you any objection to my baby, when he is cutting his teeth, sucking his thumb?

Certainly not; the thumb is the best gum-stick in the world—it is convenient, it is handy (in every sense of the word), it is of the right size, and of the proper consistence—neither too hard nor too soft; there is no danger, as of some artificial gum-sticks, of its being swallowed, and thus of its choking the child. The sucking of the thumb causes the salivary glands to pour out their contents, and thus not only to moisten the dry mouth, but assists the digestion; the pressure of the thumb eases, while the teeth are “breeding,” the pain and irritation of the gums, and helps, when the teeth are sufficiently advanced, to bring them through the gums. Sucking of the thumb will often make a cross infant contented and happy, and will 1068frequently induce a restless babe to fall into a sweet refreshing sleep. Truly may the thumb be called a baby’s comfort. By all means, then, let your child suck his thumb whenever he likes, and as long as he chooses to do so.

There is a charming, bewitching little picture of a babe sucking his thumb in Kingsley’s Water Babies, which I cordially commend to your favorable notice and study.

66. But if an infant be allowed to suck his thumb, will it not be likely to become a habit, and stick to him for years—until, indeed, he become a big boy?

After he has cut the whole of his first set of teeth, that is to say, when he is about two years and a half old, he might, if it be likely to become a habit, be readily cured by the following method, namely, by making a paste of aloes and water and smearing it upon his thumb. One or two dressings will suffice, as after just tasting the bitter aloes he will take a disgust to his former enjoyment, and the habit will at once be broken.

Many persons, I know, have an objection to children sucking their thumbs, as, for instance,—

“Perhaps it’s as well to keep children from plums,
And from pears in the season, and sucking their thumbs.”[161]

My reply is—

P’rhaps ’tis as well to keep children from pears;
The pain they might cause is oft followed by tears;
1069’Tis certainly well to keep them from plums;
But certainly not from sucking their thumbs!
If a babe suck his thumb
’Tis an ease to his gum;
A comfort; a boon; a calmer of grief;
A friend in his need, affording relief;
A solace; a good; a soother of pain;
A composer to sleep; a charm; and a gain;
’Tis handy at once to his sweet mouth to glide;
When done with, drops gently down by his side;
’Tis fixed like an anchor while the babe sleeps,
And the mother with joy her still vigil keeps.

67. A child who is teething dribbles, and thereby wets his chest, which frequently causes him to catch cold; what had better be done?

Have in readiness to put on several flannel dribbling-bibs, so that they may be changed as often as they become wet; or, if he dribble very much, the oiled silk dribbling-bibs, instead of the flannel ones, may be used, and which may be procured at any baby-linen warehouse.

68. Do you approve of giving a child, during teething, much fruit?

No; unless it be a few ripe strawberries or raspberries, or a roasted apple, or the juice of five or six grapes—taking care that he does not swallow either the seeds or the skin—or the insides of ripe gooseberries, or an orange. Such fruits, if the bowels be in a costive state, will be particularly useful.

All stone fruits, raw apples, or pears ought to be carefully avoided, as they not only disorder the stomach and the bowels—causing convulsions, gripings, 1070etc.—but they have the effect of weakening the bowels, and thus of engendering worms.

69. Is a child, during teething, more subject to disease, and if so, to what complaints, and in what manner may they be prevented?

The teeth are a fruitful source of suffering and of disease, and are with truth styled “our first and our last plagues.” Dentition is the most important period of a child’s life, and is the exciting cause of many infantile diseases; during this period, therefore, he requires constant and careful watching. When we consider how the teeth elongate and enlarge in his gums, pressing on the nerves and on the surrounding parts, and thus how frequently they produce pain, irritation, and inflammation; when we further contemplate what sympathy there is in the nervous system, and how susceptible the young are to pain, no surprise can be felt at the immense disturbance and the consequent suffering and danger frequently experienced by children while cutting their first set of teeth.

The complaints or the diseases induced by dentition are numberless, affecting almost every organ of the body,—the brain, occasioning convulsions, water on the brain, etc.; the lungs, producing congestion, inflammation, cough, etc.; the stomach, exciting sickness, flatulence, acidity, etc.; the bowels, inducing griping, at one time costiveness, and at another time purging; the skin, causing “breakings-out.”

To prevent these diseases, means ought to be used to invigorate a child’s constitution by plain, wholesome food, as recommended under the article of diet; by exercise 1071and fresh air;[162] by allowing him, weather permitting, to be out of doors a great part of every day; by lancing the gums when they get red, hot, and swollen; by attention to the bowels, and if he suffer more than usual, by keeping them rather in a relaxed state by any simple aperient, such as either castor oil or magnesia and rhubarb, etc.; and, let me add, by attention to his temper. Many children are made feverish and ill by petting and spoiling them. On this subject I cannot do better than refer you to an excellent little work entitled Abbott’s Mother at Home, wherein the author proves the great importance of early training.

70. Have the goodness to describe the symptoms and the treatment of Painful Dentition.

Painful dentition may be divided into two forms—(1.) the Mild; and (2.) the Severe. In the mild form the child is peevish and fretful, and puts his fingers, and everything within reach, to his mouth; he likes to have his gums rubbed, and takes the breast with avidity; indeed, it seems a greater comfort to him than ever. There is generally a considerable flow of 1072saliva, and he has frequently a more loose state of bowels than is his wont.

Now, with regard to the more severe form of painful dentition: The gums are red, swollen, and hot, and he cannot, without expressing pain, bear to have them touched; hence, if he be at the breast, he is constantly loosing the nipple. There is dryness of the mouth, although before there had been a great flow of saliva. He is feverish, restless, and starts in his sleep. His face is flushed. His head is heavy and hot. He is sometimes convulsed.[163] He is frequently violently griped and purged, and suffers severely from flatulence. He is predisposed to many and severe diseases.

The treatment of the mild form consists of friction of the gums with the finger; with a little “soothing syrup,” as recommended by Sir Charles Locock;[164] a tepid bath of about 92 degrees Fahrenheit, every night at bedtime; attention to diet and 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 1073near 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.[165] If he be purged more than usual, 1074attention 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 if there is 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 laboring 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 1075I 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 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 be 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 1076be 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 northeasterly 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 baby 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 untrammeled. 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 1077manifest 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 up 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 exercise 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 afterward, 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 must 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.

1078A 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° 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 1079feverish, 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 baby 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 1080it were dangerous for a breath of air to blow upon him![166] This practice is most injurious. An infant must have the full benefit of the air of the room; indeed, the bedroom 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, while in cradled rest your infant sleeps,
Your watchful eye unceasing vigils keeps,
Lest cramping bonds his pliant limbs constrain,
And cause defects that manhood may retain.”[167]

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[168] small and delicate, but who slept the 1081greatest 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?

1082If 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 be 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 color—namely, a bright yellow, inclining to orange color—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.

1083A foolish mother sometimes goes to sleep while allowing her child to continue sucking. The unconscious babe, after a time, looses the nipple, and buries his head in the bedclothes. She awakes in the morning, finding, to her horror, a corpse by her side! A mother ought, therefore, never to go to sleep until her child has 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 be 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 bedclothes; 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, giddy, and thoughtless servant.

1084

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 color (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 napkins, 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 napkins?

A baby of three months and upward, ought to be held out at least a dozen times during the twenty-four hours; if such a plan were adopted, napkins might at the end of three months be dispensed with—a great 1085desideratum—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.”[169] 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[170] makes the following sensible remarks on the 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 1086milk 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.”

This 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 teaspoonful of pure unadulterated raw sugar in a teaspoonful 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 grain of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterward. It is the first step that is so important to take in this as in all other things.

If a new-born babe has not for twelve hours made water, the medical man ought to be informed of it, in 1087order 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.”[171]

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.

1088Serious 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, Costiveness, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhœa), 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, afterward, they should be thoroughly but 1089tenderly 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 tablespoonfuls 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 lukewarm 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 in 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 a 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 1090laboring 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 66.

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 teaspoonful 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 teaspoonful 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. In convulsions from hooping-cough I have found cod-liver oil a valuable medicine. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. In either case cod-liver oil is likely to be serviceable, as it helps to sustain and support him in his extremity.

Convulsions attending an attack of hooping-cough make it a serious complication, and requires the assiduous and skillful attention of a judicious medical man.

1091What 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 incumbrances 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 has great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having the bowels relieved and the 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 1092raw sugar and water, either half a teaspoonful of raw sugar dissolved in a teaspoonful or two of water, or give him, out of your fingers, half a teaspoonful 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 awhile, opening medicine becomes a dire necessity, and then woe-betide the poor unfortunate child!

It might sometimes be necessary to give opening medicine, but the less frequently the better. The following, when it becomes absolutely necessary to give an aperient, are some of the best, simple, and safe that can be administered by a mother to her baby. I give you several, as it might be well, from time to time, to vary them: (1.) One or two teaspoonfuls of fluid magnesia, made palatable by the addition of a little sugar, may be chosen; or (2.) The popular remedy of syrup of rhubarb and castor oil:

Take of—Syrup of Rhubarb,
Castor Oil, of each half an ounce:

To make a Mixture. A teaspoonful to be taken early in the morning, first well shaking the bottle.

It might be well again to state, that the bottle must be violently shaken just before administering the mixture, or the oil will not mix with the syrup; or (3.) A teaspoonful of syrup of rhubarb, without the admixture of the castor oil may be given early in the morning occasionally; or (4.) A teaspoonful of equal parts, say half an ounce of each, of fluid magnesia and of syrup of 1093rhubarb, may be taken for a change. Another safe and palatable aperient for an infant is (5.) Syrup of senna, from a half to a whole teaspoonful being the dose. Castor oil is another medicine prescribed for a baby’s costiveness, and, being a safe one, may occasionally be used. Care should be taken to have the castor oil freshly drawn, and of the best quality. (6.) Syrup of red roses and castor oil (of each equal parts), being a good, elegant, and pleasant way of giving it:

Take of—Syrup of Red Roses,
Castor Oil, of each six drachms:

To make a Mixture. A teaspoonful to be taken occasionally, first well shaking the bottle, and to be repeated every four hours, until the bowels be relieved.

(7.) An excellent remedy for the costiveness of a baby is a soap suppository, the application of which will be found a safe, speedy, and certain method of opening the bowels. It is made by paring a piece of white curd-soap round; it should be of the size, in circumference, of a cedar pencil, and it must be in length about two inches. This should be administered by dipping it in a little warm sweet oil, and should then be gently introduced up the bowel in the same manner as you would an enema pipe, allowing about a quarter of an inch to remain in view. It must then be left alone, and in a minute or two the soap suppository will be expelled, and instantly the bowels will be comfortably and effectually relieved. When a child is two or three years old and upwards a dip-candle suppository is superior to a soap suppository.

1094If it be absolutely necessary to give opening medicine, it will be well to alternate the use of them—that is to say, to give at one time the syrup of senna, at another the fluid magnesia sweetened, and a third to administer the soap suppository dipped in oil, but waiting at least two days between, the bowels being costive all the time, before resorting to an aperient. Bear in mind, and let it make a strong impression upon you, that the less the bowels of an infant are irritated by opening medicine, the aperient being ever so simple and well-selected, the better will it be for him both now and for the future.

When the infant is five or six months old, either oatmeal milk gruel, or Robinson’s Patent Groat Gruel made with new milk, occasionally given in lieu of the usual food, will often open the bowels, and will thus supersede the necessity of administering an aperient.

Castor oil, or Dr. Merriman’s Purgative Liniment,[172] well rubbed every morning, for ten minutes at a time, over the region of the bowels, will frequently prevent costiveness, and thus will do away with the need—which is a great consideration—of giving an aperient.

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.) gray powder (mercury with chalk). It is a common practice in this country to 1095give calomel, on account of the readiness with which it may be administered, it being small in quantity and nearly tasteless. Gray powder, also, is, with many mothers, a favorite 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 gray powder, cannot be too strongly reprobated, as the frequent administration either of 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 gray 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 afterward; 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.

109696. 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 babies either with magnesia to cool them, or with castor oil to heal the 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 baby could be brought up without giving him 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, etc. 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 1097who live on artificial food, especially if they are overfed. I therefore beg to refer you to the precautions I have given, when speaking of the importance of keeping a child for the first four or five 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 teaspoonful of a solution of one drachm to an ounce and a half of water.”[173] Or, a little dill or aniseed may be added to the food—half a teaspoonful 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 tablespoonfuls of spring water; let it be preserved in a bottle for use. A teaspoonful of this, first shaking the vial, may be added to each quantity of food. Or, three teaspoonfuls of bruised caraway seeds may be boiled for ten minutes in a teacupful of water, and then strained. One or two teaspoonfuls of the caraway-tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may be occasionally 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 nurse’s lap, will often afford great comfort. 1098A 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 of 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 the bowels, the case becomes one of watery 1099gripes, and requires the immediate attention of a medical man.

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 pork, 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.[174] 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 1100above 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 Hiccough, and what is its treatment?

Hiccough 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 Diarrhœa—“Looseness of the bowels?”

It will be well, before doing so, to tell you how many motions a young infant ought to have a day, their color, consistence, and smell. Well, then, he should have from three to six motions in the twenty-four hours; the color 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 color (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 odor. If it has 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.

1101Now, 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 is not griped, that he has no pain, and has 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, etc.—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 has a motion he 1102be griped and in pain, we should then say that he is laboring under diarrhœa; 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, endeavoring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of dysentery.[175]

If there be a mixture of blood, slime, and stool from the bowels, the case would be called dysenteric diarrhœa. This latter case requires great skill and judgment on the part of a medical man, 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 Diarrhœa—“Looseness of the bowels?”

Improper food; over-feeding; 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.

1103102. What is the treatment of Diarrhœa?

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 endeavors 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,[176] 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—Compound Powdered Chalk with Opium, ten grains;
Oil of Dill, five drops;
Simple Syrup, three drachms;
Water, nine drachms:

Make a Mixture.[177] Half a teaspoonful to be given to an infant of six months and under, and one teaspoonful to a child above that age, every four hours—first shaking the bottle.

The baby ought, for a few days, to be kept entirely to the breast. 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 diarrhœa of her babe continues, she 1104had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought not, while the diarrhœa continues, to have any artificial food. He must neither be dosed with gray powder (a favorite 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 diarrhœa. It is more dangerous than diarrhœa, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skillful 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 diarrhœa—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 1105will 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 you 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 tablespoonful of the milk make him sick, give him a dessertspoonful; if a dessertspoonful cause sickness, let him only have a teaspoonful 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.

1106If 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 tablespoonful of new milk, and let it be given every half hour.

Now with regard to medicine. I approach this part of the treatment with some degree of reluctance—for dysentery is a case requiring opium, and opium I never like a mother of her own accord to administer. But suppose a medical man cannot be procured in time, the mother must then prescribe or the child will die! What then is to be done? Sir Charles Locock considers “that in severe dysentery, especially where there is sickness, there is no remedy equal to pure calomel, in a full dose, without opium.”[178] Therefore, at the very onset of the disease, let from three to five grains (according to the age of the patient) of calomel, mixed with an equal quantity of powdered white sugar, be put dry on the tongue. In three hours after let the following mixture be administered:

Take of—Compound Ipecacuanha Powder, five grains;
Ipecacuanha Wine, half a drachm;
Simple Syrup, three drachms;
Cinnamon Water, nine drachms:

To make a Mixture.[179] A teaspoonful to be given every three or four hours, first well shaking the bottle.

Supposing he cannot retain the mixture—the stomach rejecting it as soon as swallowed—what then? 1107Give the opium, mixed with small doses of mercury with chalk and sugar, in the form of powder, and put one of the powders dry on the tongue every three hours:

Take of—Powdered Opium, half a grain;
Mercury with Chalk, nine grains;
Sugar of Milk, twenty-four grains:

Mix well in a mortar, and divide into twelve powders.

Now, suppose the dysentery has for several days persisted, and that, during that time, nothing but mucus and blood—that no real stool—has come from the bowels, then a combination of castor oil and opium[180] ought, instead of the medicine recommended above, to be given.

Take of—Mixture of Acacia, three drachms;
Simple Syrup, three drachms;
Tincture of Opium, ten drops (not minims);
Castor Oil, two drachms;
Cinnamon Water, four drachms:

Make a Mixture. A teaspoonful to be taken every four hours, first well shaking the bottle.

A warm bath, at the commencement of the disease, is very efficacious; but it must be given at the commencement. If he has had dysentery for a day or two, he will be too weak to have a warm bath; then, instead of the bath, try the following: Wrap him in a blanket which has been previously wrung out of hot water, over which envelop him in a dry blanket. 1108Keep him in this hot, damp blanket for half an hour; then take him out, put on his night-gown and place him in bed, which has been, if it be winter time, previously warmed. The above “blanket treatment” will frequently give great relief, and will sometimes cause him to fall into a sweet sleep. A flannel bag filled with hot powdered table salt, made hot in the oven, applied to the bowels, will afford much comfort.

What NOT to do.—Do not give aperients, unless it be, as before advised, the castor oil guarded with the opium; do not stuff him with artificial food; do not fail to send for a judicious and an experienced medical man; for, remember, it requires a skillful doctor to treat a case of dysentery, more especially in a child.

105. What are the symptoms, the causes, and the treatment of Nettle-rash?

Nettle-rash consists of several irregular raised wheals, red at the base and white on the summit, on different parts of the body; but it seldom attacks the face. It is not contagious, and it may occur at all ages and many times. It comes and goes, remaining only a short time in a place. It puts on very much the appearance of the child having been stung by nettles—hence its name. It produces great heat, itching, and irritation, sometimes to such a degree as to make him feverish, sick, and fretful. He is generally worse when he is warm in bed, or when the surface of his body is suddenly exposed to the air. Rubbing the skin, too, always aggravates the itching and the tingling, and brings out a fresh crop.

The cause of nettle-rash may commonly be traced to 1109improper feeding; although, occasionally, it proceeds from teething.

What to do.—It is a complaint of no danger, and readily gives way to a mild aperient, and to attention to diet. There is nothing better to relieve the irritation of the skin than a warm bath. If it be a severe attack of nettle-rash, by all means call in a medical man.

What NOT to do.—Do not apply cold applications to his skin, and do not wash him (while the rash is out) in quite cold water. Do not allow him to be in a draught, but let him be in a well-ventilated room. If he be old enough to eat meat, keep it from him for a few days, and let him live on milk and farinaceous diet. Avoid strong purgatives, and calomel, and gray powder.

106. What are the symptoms and the treatment of Red-gum?

Red-gum, tooth-rash, red-gown, is usually owing to irritation from teething; not always from the cutting, but from the evolution, the “breeding,” of the teeth. It is also sometimes owing to unhealthy stools irritating the bowels, and showing itself, by sympathy, on the skin. Red-gum consists of several small papulæ, or pimples, about the size of pins’ heads, and may be known from measles—the only disease for which it is at all likely to be mistaken—by its being unattended by symptoms of cold, such as sneezing, running, and redness of the eyes, etc., and by the patches not assuming a crescentic, half-moon shape; red-gum, in short, 1110may readily be known by the child’s health being unaffected, unless, indeed, there be a great crop of pimples; then there will be slight feverishness.

What to do.—Little need be done. If there be a good deal of irritation, a mild aperient should be given. The child ought to be kept moderately but not very warm.

What NOT to do.—Draughts of air, or cold, should be carefully avoided; as, by sending the eruption suddenly in, either convulsions or disordered bowels might be produced. Do not dose him with gray powder.

107. How would you prevent “Stuffing of the nose” in a new-born babe?

Rubbing a little tallow on the bridge of the nose is the old-fashioned remedy, and answers the purpose. It ought to be applied every evening just before putting him to bed.

If the “stuffing” be severe, dip a sponge in hot water, as hot as he can comfortably bear; ascertain that it be not too hot, by previously applying it to your own face, and then put it for a few minutes to the bridge of his nose. As soon as the hard mucus is within reach, it should be carefully removed.

108. Do you consider sickness injurious to an infant?

Many thriving babies are, after taking the breast, frequently sick; still we cannot look upon sickness otherwise than as an index of either a disordered or of an overloaded stomach. If the child be sick, and yet be thriving, it is a proof that he overloads his stomach. A mother, then, must not allow him to suck so much at a time. She should, until he retains all he 1111takes, lessen the quantity of milk. If he be sick and does not thrive, the mother should notice if the milk he throws up has a sour smell; if it has, she must first of all look to her own health; she ought to ascertain if her own stomach be out of order; for if such be the case, it is impossible for her to make good milk. She should observe whether, in the morning, her own tongue be furred and dry; whether she have a disagreeable taste in her mouth, or pains at her stomach, or heartburn, or flatulence. If she have all, or any of these symptoms, the mystery is explained why he is sick and does not thrive. She ought then to seek advice, and a medical man will soon put her stomach into good order; and, by so doing, will, at the same time, benefit the child.

But if the mother be in the enjoyment of good health, she must then look to the babe herself, and ascertain if he be cutting his teeth; if the gums require lancing; if the secretions from the bowels be proper both in quantity and in quality; and, if he have had artificial food—it being absolutely necessary to give such food—whether it agree with him.

What to do.—In the first place, if the gums are red, hot, and swollen, let them be lanced; in the second, if the secretions from the bowels are either unhealthy or scanty, give him a dose of aperient medicine, such as castor oil, or the following: Take two or three grains of powdered Turkey rhubarb, three grains of pure carbonate of magnesia, and one grain of aromatic powder. Mix. The powder to be taken at bedtime, mixed in a teaspoonful of sugar and water, and which should, if 1112necessary, be repeated the following night. In the third place, if the food he be taking does not agree with him, change it (vide answer to question 33). Give it in smaller quantities at a time, and not so frequently; or, what will be better still, if it be possible, keep him, for awhile, entirely to the breast.

What NOT to do.—Do not let him overload his stomach either with breast-milk or with artificial food. Let the mother avoid, until his sickness be relieved, greens, cabbage, and all other green vegetables.

109. What are the causes, the symptoms, the prevention, and the cure of Thrush?

The thrush is a frequent disease of an infant, and is often brought on either by stuffing him or by giving him improper food. A child brought up entirely, for the first three or four months, on the breast, seldom suffers from this complaint. The thrush consists of several irregular, roundish, white specks on the lips, the tongue, the inside and the angles of the mouth, giving the parts affected the appearance of curds and whey having been smeared upon them. The mouth is hot and painful, and he is afraid to suck: the moment the nipple is put into his mouth he begins to cry. The thrush sometimes, although but rarely, runs through the whole of the alimentary canal. It should be borne in mind that nearly every child who is sucking has his or her tongue white or “frosted” as it is sometimes called. The thrush may be mild or very severe.

Now with regard to What to do.—As the thrush is generally owing to improper and to artificial feeding, if the child be at the breast, keep him, for a time, 1113entirely to it. Do not let him be always sucking, as that will not only fret his mouth, but will likewise irritate and make sore the mother’s nipple.

If he be not at the breast, but has been weaned, then keep him for a few days entirely to a milk diet—to the milk of ONE cow—either boiled, if it be hot weather, to keep it sweet; or unboiled, in cool weather—fresh as it comes from the cow.

The best medicine is the old-fashioned one of borax, a combination of powdered lump sugar and borax being a good one for the purpose: the powdered lump sugar increases the efficacy and the cleansing properties of the borax; it tends, moreover, to make it more palatable:

Take of—Biborate of Soda, half a drachm;
Lump sugar, two scruples:

To be well mixed together, and made into twelve powders. One of the powders to be put dry on the tongue every four hours.

The best local remedy is honey of borax, which ought to be smeared frequently, by means of the finger, on the parts affected.

Thorough ventilation of the apartment must be observed; and great cleanliness of the vessels containing the milk should be insisted upon.

In a bad case of thrush, change of air to the country is most desirable; the effect is sometimes, in such cases, truly magical.

If the thrush be brought on either by too much or by improper food, in the first case, of course, a mother must lessen the quantity; and, in the second, she should be more careful in her selection.

What NOT to do.—Do not use either a calf’s teat or 1114wash-leather for the feeding-bottle; fortunately, since the invention of india-rubber teats, they are now nearly exploded; they were, in olden times, fruitful causes of thrush. Do not mind the trouble of ascertaining that the cooking-vessels connected with the baby’s food are perfectly clean and sweet. Do not leave the purity and the goodness of the cow’s milk (it being absolutely necessary to feed him on artificial food) to be judged either by the milkman or by the nurse, but taste and prove it yourself. Do not keep the milk in a warm place, but either in the dairy or in the cellar; and, if it be summer time, let the jug holding the milk be put in a crock containing lumps of ice. Do not use milk that has been milked longer than twelve hours, but, if practicable, have it milked direct from the cow, and use it immediately—let it be really and truly fresh and genuine milk.

When the disease is severe, it may require more active treatment—such as a dose of calomel; which medicine must never be given, unless it be either under the direction of a medical man, or unless it be in an extreme case,—such as dysentery;[181] therefore, the mother had better seek advice.

In a severe case of thrush, where the complaint has been brought on by artificial feeding—the babe not having the advantage of the mother’s milk—it is really surprising how rapidly a wet-nurse—if the case has not been too long deferred—will effect a cure, where all other means have been tried and have failed. The 1115effect has been truly magical! In a severe case of thrush, pure air and thorough ventilation are essential to recovery.

110. Is anything to be learned from the cry of an infant?

There is a language in the cry of an infant which a thoughtful medical man can well interpret. The cry of hunger, for instance, is very characteristic,—it is unaccompanied with tears, and is a wailing cry; the cry of teething, is a fretful cry; the cry of earache is short, sharp, piercing, and decisive, the head being moved about from side to side, and the little hand being often put up to the affected side of the head; the cry of bowelache is also expressive,—the cry is not so piercing as from earache, and is an interrupted, straining cry, accompanied with a drawing up of the legs to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the cry of inflammation of the lungs is more a moan than a cry; the cry of croup is hoarse, and rough, and ringing, and is so characteristic that it may truly be called “the croupy cry,” moreover, he breathes as though he breathed through muslin; the cry of inflammation of the membranes of the brain is a piercing shriek—a danger signal—most painful to hear; the cry of a child recovering from a severe illness is a cross, and wayward, and tearful cry; he may truly be said to be in a quarrelsome mood; he bursts out without rhyme or reason into a passionate flood of tears; tears are always, in a severe illness, to be looked upon as a good omen, as a sign of amendment: tears, when a child is dangerously ill, are rarely if ever seen; a cry at night, 1116for light—a frequent cause of a babe crying—is a restless cry:

“An infant crying in the night:
An infant crying for the light:
And with no language but a cry.”[182]

111. If an infant be delicate, have you any objection to his having either veal or mutton broth to strengthen him?

Broths seldom agree with a babe at the breast. I have known them produce sickness, disorder the bowels, and create fever. I recommend you, therefore, not to make the attempt.

Although broth and beef-tea, when taken by the mouth, will seldom agree with an infant at the breast, yet, when used as an enema, and in small quantities, so that they may be retained, I have frequently found them to be of great benefit: they have, in some instances, appeared to have snatched delicate children from the brink of the grave.

112. My babe’s ankles are very weak: what do you advise to strengthen them?

If his ankles be weak, let them every morning be bathed, after the completion of his morning’s ablution, for five minutes each time, with bay salt and water, a small handful of bay salt dissolved in a quart of rain water (with the chill of the water taken off in the winter, and of its proper temperature in the summer time); then let them be dried; after the drying, let the ankles be well rubbed with the following liniment:

1117Take of—Oil of Rosemary, three drachms;
Liniment of Camphor, thirteen drachms:

To make a Liniment.

Do not let him be put on his feet early; but allow him to crawl, and sprawl, and kick about the floor, until his ankles become strong.

Do not, on any account, without having competent advice on the subject, use iron instruments or mechanical supports of any kind: the ankles are generally, by such artificial supports, made worse, in consequence of the pressure causing a further dwindling away and enfeebling of the ligaments of the ankles, already wasted and weakened.

Let him wear shoes, with straps over the insteps to keep them on, and not boots: boots will only, by wasting the ligaments, increase the weakness of the ankles.

113. Sometimes there is a difficulty in restraining the bleeding of leech-bites. What is the best method?

The difficulty in these cases generally arises from the improper method of performing it. For example—a mother endeavors to stop the hemorrhage by loading the part with rag; the more the bites discharge, the more rag she applies. At the same time, the child probably is in a room with a large fire, with two or three candles, with the doors closed, and with perhaps a dozen people in the apartment, whom the mother has, in her fright, sent for. This practice is strongly reprehensible.

If the bleeding cannot be stopped,—in the first place, the fire must be extinguished, the door and windows should be thrown open, and the room ought to be cleared 1118of persons, with the exception of one, or, at the most, two; and every rag should be removed. “Stopping of leech-bites.—The simplest and most certain way, till the proper assistance is obtained, is the pressure of the finger, with nothing intervening. It cannot bleed through that.”[183]

Many babies have lost their lives by excessive loss of blood from leech-bites, from a mother not knowing how to act, and also from the medical man either living at a distance, or not being at hand. Fortunately for the infantile community, leeches are now very seldom ordered by doctors.

114. Supposing a baby to be poorly, have you any advice to give to his mother as to her own management?

She must endeavor to calm her feelings, or her milk will be disordered, and she will thus materially increase his illness. If he be laboring under any inflammatory disorder, she ought to refrain from the taking of beer, wine, and spirits, and from all stimulating food; otherwise, she will feed his disease.

Before concluding the first part of my subject—the Management of Infancy—let me again urge upon you the importance—the paramount importance—if you wish your babe to be strong and hearty,—of giving him as little opening physic as possible. The best physic for him is Nature’s physic—fresh air and exercise and simplicity of living. A mother who is herself always drugging her child, can only do good to two persons—the doctor and the druggist!

1119If an infant from his birth be properly managed,—if he has an abundance of fresh air for his lungs,—if he has plenty of exercise for his muscles (by allowing him to kick and sprawl on the floor),—if he has a good swilling and sousing of water for his skin,—if, during the early months of his life, he has nothing but the mother’s milk for his stomach,—he will require very little medicine—the less the better! He does not want his stomach to be made into a doctor’s shop! The grand thing is not to take every opportunity of administering physic, but of using every means of withholding it! And if physic be necessary, not to doctor him yourself, unless it be in extreme and urgent cases (which in preceding and succeeding Conversations I either have or will indicate), but to employ an experienced medical man. A babe who is always, without rhyme or reason, being physicked, is sure to be puny, delicate, and unhealthy, and is ready, at any moment, to drop into an untimely grave!

CONCLUDING REMARKS ON INFANCY.

115. In concluding the first part of our subject—Infancy—I beg to remark. There are four things essentially necessary to an infant’s well-doing, namely, (1) plenty of water for the skin; (2) plenty of milk for the stomach; (3) plenty of fresh air for the lungs; (4) plenty of sleep for the brain: these are the four grand essentials for a babe; without an abundance of each and all of them, perfect health is utterly impossible!

1120

PART II.
CHILDHOOD.

Household treasures! household treasures!
Are they jewels rich and rare;
Or gems of rarest workmanship;
Or gold and silver ware?
Ask the mother as she gazes
On her little ones at play:
Household treasures! household treasures!
Happy children—ye are they.
J. E. Carpenter.

ABLUTION.

116. At twelve months old, do you still recommend a child to be PUT IN HIS TUB to be washed?

Certainly I do, as I have previously recommended at page 16, in order that his skin may be well and thoroughly cleansed. If it be summer time, the water should be used cold; if it be winter, a dash of warm must be added, so that it may be of the temperature of new milk; but do not, on any account, use very warm water. The head must be washed (but not dried) before he be placed in his tub; then, putting him in the tub (containing the necessary quantity of water, and washing 1121him as previously recommended),[184] a large sponge should be filled with the water and squeezed over the head, so that the water may stream over the whole surface of the body. A jugful of cold water should, just before taking him out of his bath, be poured over and down his loins; all this ought rapidly to be done, and he must be quickly dried with soft towels, and then expeditiously dressed. For the washing of your child I would recommend you to use Castile soap in preference to any other: it is more pure, and less irritating, and hence does not injure the texture of the skin. Take care that the soap does not get into his eyes, or it might produce irritation and smarting.

117. Some mothers object to a child’s STANDING in the water.

If the head be wetted before he be placed in the tub, and if he be washed as above directed, there can be no valid objection to it. He must not be allowed to remain in the tub more than five minutes.

118. Does not washing the child’s head, every morning, make him more liable to catch cold, and does it not tend to weaken his sight?

It does neither the one nor the other; on the contrary, it prevents cold, and strengthens the sight; it cleanses the scalp, prevents scurf, and, by that means, causes a more beautiful head of hair. The head, after each washing, ought to be well brushed with a soft brush, but should not be combed. The brushing causes a healthy circulation of the scalp.

1122119. If the head, notwithstanding the washing, be scurfy, what should be done?

After the head has been well dried, let a little cocoanut oil be well rubbed, for five minutes each time, into the roots of the hair, and, afterward, let the head be well brushed, but not combed. The fine-tooth comb will cause a greater accumulation of scurf, and will scratch and injure the scalp.

120. Do you recommend a child to be washed IN HIS TUB every night and morning?

No; once a day is quite sufficient; in the morning in preference to the evening; unless he be poorly, then, evening instead of morning; as, immediately after he has been washed and dried, he can be put to bed.

121. Ought a child to be placed in his tub while he is in a state of perspiration?

Not while he is perspiring violently, or the perspiration might be checked suddenly, and ill consequences would ensue; nor ought he to be put in his tub when he is cold, or his blood would be chilled, and would be sent from the skin to some internal vital part, and thus would be likely to light up inflammation—probably of the lungs. His skin, when he is placed in his bath, ought to be moderately and comfortably warm; neither too hot nor too cold.

122. When the child is a year old, do you recommend cold or warm water to be used?

If it be winter, a little warm water ought to be added, so as to raise the temperature to that of new milk. As the summer advances, less and less warm water is required, so that, at length, none is needed.

1123123. If a child be delicate, do you recommend anything to be added to the water which may tend to brace and strengthen him?

Either a handful of table salt or half a handful of bay salt should be previously dissolved in a quart jug—of cold water; then, just before taking the child out of his morning bath, let the above be poured over and down the back and loins of the child—holding the jug, while pouring its contents on the back, twelve inches from the child, in order that it might act as a kind of douche bath.

124. Do you recommend the child, after he has been dried with the towel, to be rubbed with the hand?

I do; as friction encourages the cutaneous circulation, and causes the skin to perform its functions properly, thus preventing the perspiration (which is one of the impurities of the body) from being sent inwardly either to the lungs or to other parts. The back, the chest, the bowels, and the limbs are the parts that ought to be well rubbed.

CLOTHING.

125. Have you any remarks to make on the clothing of a child?

Children—boys and girls—especially if they be delicate, ought always to wear high dresses up to their necks. The exposure of the upper part of the chest (if the child be weakly) is dangerous. It is in the upper part of the lungs, in the region of the collar bones, that consumption first shows itself. The 1124clothing of a child, more especially about the chest, should be large and full in every part, and be free from tight strings, so that the circulation of the blood may not be impeded, and that there may be plenty of room for the full development of the rapidly growing body.

His frock or tunic ought to be of woolen material—warm, light, and porous, in order that the perspiration may rapidly evaporate. The practice of some mothers in allowing their children to wear tight bands round their waists, and tight clothes, is truly reprehensible.

Tight bands or tight belts around the waist of a child are very injurious to health; they crib in the chest, and thus interfere with the rising and the falling of the ribs—so essential to breathing. Tight hats ought never to be worn; by interfering with the circulation they cause headaches. Nature delights in freedom, and resents interference!

126. What parts of the body in particular ought to be kept warm?

The chest, the bowels, and the feet should be kept comfortably warm. We must guard against an opposite extreme, and not keep them too hot. The head alone should be kept cool, on which account I do not approve either of night or of day caps.

127. What are the best kinds of hat for a child?

The best covering for the head, when he is out and about, is a loose-fitting straw hat, which will allow the perspiration to escape. It should have a broad brim, to screen the eyes. A sunshade, that is to say, a sea-side 1125hat—a hat made of cotton, with a wide brim to keep off the sun—is also an excellent hat for a child; it is very light, and allows a free escape of the perspiration. It can be bought, ready made, at a baby-linen warehouse.

A knitted or crocheted woolen hat, with woolen rosettes to keep the ears warm, and which may be procured at any baby-linen warehouse, makes a nice and comfortable winter’s hat for a child. It is also a good hat for him to wear while performing a long journey. The color chosen is generally scarlet and white, which, in cold weather, gives it a warm and comfortable appearance.

It is an abominable practice to cover a child’s head either with beaver or with felt, or with any thick, impervious material. It is a well-ascertained fact, that both beaver and silk hats cause men to suffer from headache, and to lose their hair—the reason being that the perspiration cannot possibly escape through them. Now, if the perspiration cannot escape, dangerous, or at all events injurious, consequences must ensue, as it is well known that the skin is a breathing apparatus, and that it will not with impunity bear interference.

Neither a child nor any one else should be permitted to be in the glare of the sun without his hat. If he be allowed, he is likely to have a sun-stroke, which might either at once kill him, or might make him an idiot for the remainder of his life, which latter would be the worse alternative of the two.

1126128. Have you any remarks to make on keeping a child’s hands and legs warm when, in the winter time, he is carried out?

When a child either walks or is carried out in wintry weather, be sure and see that both his hands and legs are well protected from the cold. There is nothing for this purpose like woolen gloves, and woolen stockings coming up over the knees.

129. Do you approve of a child wearing a flannel night-gown?

He frequently throws the clothes off him, and has occasion to be taken up in the night, and if he has not a flannel gown on is likely to catch cold; on which account I recommend it to be worn. The usual calico night-gown should be worn under it.

130. Do you advise a child to be LIGHTLY clad, in order that he may be hardened thereby?

I should fear that such a plan, instead of hardening, would be likely to produce a contrary effect. It is an ascertained fact that more children of the poor, who are thus lightly clad, die, than of those who are properly defended from the cold. Again, what holds good with a young plant is equally applicable to a young child; and we all know that it is ridiculous to think of unnecessarily exposing a tender plant to harden it. If it were thus exposed, it would wither and die!

131. If a child be delicate, if he has a cold body or a languid circulation, or if he be predisposed to inflammation of the lungs, do you approve of his wearing flannel instead of linen shirts?

I do; as flannel tends to keep the body at an equal 1127temperature, thus obviating the effects of the sudden changes of the weather, and promotes, by gentle friction, the cutaneous circulation, thus warming the cold body, and giving an impetus to the languid circulation, and preventing an undue quantity of blood from being sent to the lungs, either to light up or to feed inflammation. Fine flannel, of course, ought to be worn, which should be changed as frequently as the usual shirts.

If a child has had an attack either of bronchitis or of inflammation of the lungs, or if he has just recovered from scarlet fever, by all means, if he has not previously worn flannel, instantly let him begin to do so, and let him, next to the skin, wear a flannel waistcoat. This is important advice, and ought not to be disregarded.

Scarlet flannel is now much used instead of white flannel; and as scarlet flannel has a more comfortable appearance, and does not shrink so much in washing, it may for the white be substituted.

132. Have you any remarks to make on the shoes and stockings of a child? and on the right way of cutting the toe-nails?

He ought, during the winter, to wear lambs’ wool stockings that will reach above the knees, and thick calico drawers that will reach a few inches below the knees; as it is of the utmost importance to keep the lower extremities comfortably warm. It is really painful to see how many mothers expose the bare legs of their little ones to the frosty air, even in the depths of winter. “Tender little children are exposed to the bitterest weather, with their legs bared in a manner 1128that would inevitably injure the health of strong adults.”[185]

Garters ought not to be worn, as they impede the circulation, waste the muscles, and interfere with walking. The stocking may be secured in its place by means of a loop and tape, which should be fastened to a part of the dress.

Let me urge upon you the importance of not allowing your child to wear tight shoes; they cripple the feet, causing the joints of the toes, which ought to have free play, and which should assist in walking, to be, in a manner, useless; they produce corns and bunions, and interfere with the proper circulation of the foot. A shoe ought to be made according to the shape of the foot—rights and lefts are therefore desirable. The toe-part of the shoe must be made broad, so as to allow plenty of room for the toes to expand, and that one toe cannot overlap another. Be sure, then, that there be no pinching and no pressure. In the article of shoes you ought to be particular and liberal; pay attention to having nicely fitting ones, and let them be made of soft leather, and throw them on one side the moment they are too small. It is poor economy, indeed, because a pair of shoes be not worn out, to run the risk of incurring the above evil consequences.

Shoes are far preferable to boots; boots weaken instead of strengthen the ankle. The ankle and instep require free play, and ought not to be hampered by boots. Moreover, boots, by undue pressure, decidedly 1129waste away the ligaments of the ankle. Boots act on the ankles in a similar way that stays do on the waist—they do mischief by pressure. Boots waste away the ligaments of the ankle; stays waste away the muscles of the back and chest: and thus, in both cases, do irreparable mischief.

A shoe for a child ought to be made with a narrow strap over the instep, and with button and button-hole: if it be not made in this way, the shoe will not keep on the foot.

It is a grievous state of things that in this nineteenth century there are very few shoemakers in England who know how to make a shoe! The shoe is made not to fit the real foot, but a fashionable imaginary one!

Let me strongly urge you to be particular that the sock or stocking fits nicely—that it is neither too small nor too large; if it be too small, it binds up the toes unmercifully, and makes one toe to ride over the other, and thus renders the toes perfectly useless in walking; if it be too large, it is necessary to lap a portion of the sock or stocking either under or over the toes, which thus presses unduly upon them, and gives pain and annoyance. It should be borne in mind that if the toes have full play, they, as it were, grasp the ground, and greatly assist in locomotion—which, of course, if they are cramped up, they cannot possibly do. Be careful too, that the toe-part of the sock or stocking be not pointed; let it be made square, in order to give room to the toes. “At this helpless period of life the delicately feeble, outspreading toes, are wedged into a narrow-toed stocking, often so short as to double in the 1130toes, diminishing the length of the rapidly-growing foot! It is next, perhaps, tightly laced into a boot of less interior dimensions than itself; when the poor little creature is left to sprawl about with a limping, stumping gait, thus learning to walk as it best can, under circumstances the most cruel and torturing imaginable.”[186]

It is impossible for either a stocking or a shoe to fit nicely, unless the toe-nails be kept in proper order. Now, in cutting the toe-nails there is, as in everything else, a right and a wrong way. The right way of cutting a toe-nail is to cut it straight—in a straight line. The wrong way is to cut the corners of the nail—to round the nail, as it is called. This cutting the corners of the nails often makes work for the surgeon, as I myself can testify; it frequently produces “growing-in” of the nail, which sometimes necessitates the removal of either the nail or of a portion of it.

133. At what time of the year should a child leave off his winter clothing?

A mother ought not to leave off her children’s winter clothing until the spring be far advanced: it is far better to be on the safe side, and to allow the winter clothes to be worn until the end of May. The old adage is very good, and should be borne in mind:

“Button to chin
Till May be in;
Ne’er cast a clout
Till May be out.”

1131134. Have you any general remarks to make on the present fashion of dressing children?

The present fashion is absurd. Children are frequently dressed like mountebanks, with feathers and furbelows and finery: the boys go bare-legged; the little girls are dressed like women, with their stuck-out petticoats, crinolines, and low dresses! Their poor little waists are drawn in tight, so that they can scarcely breathe; their dresses are very low and short, the consequence is, that a great part of the chest is exposed to our variable climate; their legs are bare down to their thin socks, or, if they be clothed, they are only covered with gossamer drawers; while their feet are incased in tight shoes of paper thickness! Dress! dress! dress! is made with them at a tender age, and, when first impressions are the strongest, a most important consideration. They are thus rendered vain and frivolous, and are taught to consider dress “as the one thing needful.” And if they live to be women—which the present fashion is likely frequently to prevent—what are they? Silly, simpering, delicate, lackadaisical nonentities,—dress being their amusement, their occupation, their conversation, their everything, their thoughts by day and their dreams by night! Let children be dressed as children, not as men and women. Let them be taught that dress is quite a secondary consideration. Let health, and not fashion, be the first, and we shall have, with God’s blessing, blooming children, who will, in time, be the pride and strength of dear old England! Oh that the time may come, and may not be far distant, “That our sons may grow up as the young plants, and 1132that our daughters may be as the polished corners of the temple.”[187]

DIET.

135. At TWELVE months old, have you any objection to a child having any other food besides that you mentioned in answer to the 34th question?

There is no objection to his occasionally having for dinner either a mealy, mashed potato and gravy, or a few crumbs of bread and gravy. Rice pudding or batter pudding may, for a change, be given; but remember, the food recommended in a former Conversation is what, until he be eighteen months old, must be principally taken. During the early months of infancy—say, for the first six or seven—if artificial food be given at all, it should be administered by means of a feeding-bottle. After that time, either a spoon or a nursing-boat will be preferable. As he becomes older, the food ought to be made more solid.

136. At EIGHTEEN months old, have you any objection to a child having meat?

He ought not to have meat until he has several teeth to chew it with. If he has most of his teeth—which he very likely, at this age, will have—there is no objection to his taking a small slice either of mutton or occasionally of roast beef, which should be well cut into very small pieces, and mixed with a mealy, mashed potato, and a few crumbs of bread and gravy, either every day, if he be delicate, or every other day, if he be 1133a gross or a fast-feeding child. It may be well, in the generality of cases, for the first few months to give him meat every other day, and either potato and gravy, or rice or suet-pudding or batter pudding on the alternate days; indeed, I think so highly of rice, of suet, and of batter puddings, and of other farinaceous puddings, that I should advise you to let him have either the one or the other, even on those days that he has meat—giving it him after his meat. But remember, if he have meat and pudding, the meat ought to be given sparingly. If he be gorged with food, it makes him irritable, cross, and stupid; at one time, clogging up the bowels and producing constipation; at another, disordering the liver, and causing either clay-colored stools, denoting a deficiency of bile, or dark and offensive motions, telling of vitiated bile; while, in a third case, cramming him with food might bring on convulsions.

137. As you are so partial to puddings for a child, which do you consider the best for him?

He ought, every day, to have a pudding for his dinner—either rice, arrow-root, sago, tapioca, suet-pudding, batter pudding, or Yorkshire-pudding, mixed with crumbs of bread and gravy—free from grease. A well-boiled suet-pudding, with plenty of suet in it, is one of the best puddings he can have; it is, in point of fact, meat and farinaceous food combined, and is equal to and will oftentimes prevent the giving of cod-liver oil. Before cod-liver oil came into vogue, suet boiled in milk was the remedy for a delicate child; he may, occasionally, have fruit-pudding, provided the pastry be both plain and light.

1134The objection to fruit pies and puddings is, that the pastry is often too rich for the delicate stomach of a child: there is no objection, certainly not, to the fruit—cooked fruit being, for a child, most wholesome; if, therefore, fruit puddings and pies be eaten, the pastry part ought to be quite plain. There is, in “Murray’s Modern Cookery Book,” an excellent suggestion, which I will take the liberty of quoting, and of strongly urging my fair reader to carry into practice: “To prepare fruit for children, a far more wholesome way than in pies and puddings, is to put apples sliced, or plums, currants, gooseberries, etc. into a stone jar, and sprinkle among them as much Lisbon sugar as necessary. Set the jar on an oven or on a hearth, with a teacupful of water to prevent the fruit from burning; or put the jar into a saucepan of water, till its contents be perfectly done. Slices of bread or some rice may be put into the jar, to eat with the fruit.”

Jam—such as strawberry, raspberry, gooseberry—is most wholesome for a child, and ought occasionally to be given, in lieu of sugar, with the rice, with the batter, and with the other puddings. Marmalade, too, is very wholesome.

Puddings ought to be given after and not before his meat and vegetables; if you give him pudding before his meat, he might refuse to eat meat altogether.

By adopting the plan of giving puddings every day, your child will require less animal food: much meat is injurious to a young child.

But do not run into an opposite extreme: a little meat ought, every day, to be given, provided he has 1135cut the whole of his first set of teeth; until then, meat every other day will be often enough.

138. As soon as a child has cut the whole of his first set of teeth, what ought to be his diet? What should be his breakfast?

He can, then, have nothing better, where it agrees, than scalding-hot new milk poured on sliced bread, with a slice or two of bread and butter to eat with it. Butter, in moderation, is nourishing, fattening, and wholesome. Moreover, butter tends to keep the bowels regular. These facts should be borne in mind, as some mothers foolishly keep their children from butter, declaring it to be too rich for their children’s stomachs! New milk should be used in preference either to cream or to skimmed milk. Cream, as a rule, is too rich for the delicate stomach of a child, and skim-milk is too poor when robbed of the butter which the cream contains. But give cream and, water, where new milk (as is occasionally the case) does not agree; but never give skim-milk. Skim-milk (among other evils) produces costiveness, and necessitates the frequent administration of aperients. Cream, on the other hand, regulates and tends to open the bowels.

Although, as a rule, I am not so partial to cream as I am to good genuine fresh milk, yet I have found, in cases of great debility, more especially where a child is much exhausted by some inflammatory disease, such as inflammation of the lungs, the following food most serviceable: Beat up, by means of a fork, the yolk of an egg, then mix, little by little, half a teacupful of very weak black tea, sweeten with one lump of sugar, and 1136add a tablespoonful of cream. Let the foregoing, by teaspoonfuls at a time, be frequently given.

The above food is only to be administered until the exhaustion be removed, and is not to supersede the milk diet, which must, at stated periods, be given, as I have recommended in answers to previous and subsequent questions.

When a child has costive bowels, there is nothing better for his breakfast than well-made and well-boiled oatmeal stir-about, which ought to be eaten with milk fresh from the cow. Scotch children scarcely take anything else, and a finer race is not in existence; and, as for physic, many of them do not even know either the taste or the smell of it!

139. Have you any remarks to make on cow’s milk, as an article of food?

Cow’s milk is a valuable, indeed, an indispensable article of diet for children; it is most nourishing, wholesome, and digestible. The finest and the healthiest children are those who, for the first four or five years of their lives, are fed principally upon it. Milk ought then to be their staple food.

No young child, as a rule, can live, or, if he live, can be healthy, unless milk is the staple article of his diet. There is no substitute for milk. To prove the fattening and strengthening qualities of milk, look only at a young calf who lives on milk, and on milk alone! He is a Samson in strength, and is as fat as butter; and all young things are fat if they are in health!

Milk contains every ingredient to build up the body, which is more than can be said of any other known substance. 1137A child may live entirely, and become both healthy and strong, on milk, and on milk alone, as it contains every constituent of the human body. A child cannot “live by bread alone,” but he might on milk alone! Milk is animal and vegetable—it is meat and bread—it is a fluid, but as soon as it reaches the stomach it becomes a solid[188]—solid food; it is the most important and valuable article of diet for a child in existence. It is a glorious food for the young, and must never, in any case, be dispensed with. “Considering that milk contains in itself most of the constituents of a perfect diet, and is capable of maintaining life in infancy without the aid of any other substance, it is marvelous that the consumption of it is practically limited to so small a class; and not only so, but that in sick-rooms, where the patient is surrounded with every luxury, arrow-root, and other compounds containing much less nutriment, should so often be preferred to it.”[189]

Do not let me be misunderstood. I do not mean to 1138say but that the mixing of farinaceous food—such as Lemann’s Biscuit Powder, Robb’s Biscuit, Hard’s Farinaceous Food, Brown and Polson’s Corn Flour, and the like, with the milk, is an improvement—a great improvement; but still I maintain that a child might live and thrive, and that for a lengthened period, on milk—and on milk alone!

A dog will live and fatten for six weeks on milk alone! while he will starve and die in a shorter period on strong beef-tea alone!

It is a grievous sin for a milkman to adulterate milk. How many a poor infant has fallen a victim to that crime!—for crime it may truly be called.

It is folly in the extreme for a mother to bate a milkman down in the price of his milk; if she does, the milk is sure to be either of inferior quality, or adulterated, or diluted with water; and woe betide the poor unfortunate child if it be either the one or the other! The only way to insure good milk is to go to a respectable cow-keeper, and let him be made to thoroughly understand the importance of your child having genuine milk, and that you are then willing to pay a fair remunerative price for it. Rest assured, that if you have to pay one penny or even twopence a quart more for genuine milk, it is one of the best investments that you ever have made, or that you are ever likely to make, in this world! Cheap and inferior milk might well be called cheap and nasty; for inferior or adulterated milk is the very essence, the conglomeration, of nastiness; and, moreover, is very poisonous to a child’s stomach. One and the principal reason why so many children 1139are rickety and scrofulous, is the horrid stuff called milk that is usually given to them. It is a crying evil, and demands a thorough investigation and reformation, and the individual interference of every parent. Limited Liability Companies are the order of the day; it would really be not a bad speculation if one was formed in every large town, in order to insure good, genuine, and undiluted milk.

Young children, as a rule, are allowed to eat too much meat. It is a mistaken notion of a mother that they require so much animal food. If more milk were given, and less meat, they would be healthier, and would not be so predisposed to disease, especially to skin disease.

I should strongly recommend you, then, to be extravagant in your milk score. Each child ought, in the twenty-four hours, to take at least a quart of good, fresh, new milk. It should, of course, be given in various ways,—as bread and milk, rice puddings, milk, and different kinds of farinaceous food, stir-about, etc. etc.

140. But suppose my child will not take milk, he having an aversion to it, what ought then to be done?

Boil the milk, and sweeten it to suit his palate. After he has been accustomed to it for awhile, he will then, probably, like milk. Gradually reduce the sugar until at length it be dispensed with. A child will often take milk this way, whereas he will not otherwise touch it.

If a child will not drink milk, he must eat meat; it is absolutely necessary that he should have either the one or the other; and, if he has cut nearly all his teeth, 1140he ought to have both meat and milk—the former in moderation, the latter in abundance.

141. Supposing milk should not agree with my child, what must then be done?

Milk, either boiled or unboiled, almost always agrees with a child. If it does not, it must be looked upon as the exception, and not the rule. I would, in such a case, advise one-eighth of lime-water to be added to seven-eighths of new milk—that is to say, two tablespoonfuls of lime-water should be mixed with half a pint of new milk.

142. Can you tell me of a way to prevent milk, in hot weather, from turning sour?

Let the jug of milk be put into a crock containing ice—either in the dairy or in the cellar. The ice should be kept, wrapped either in flannel or in a blanket, in a cool place until it be wanted.

143. Is it necessary to give a child luncheon?

If he want anything to eat between breakfast and dinner, let him have a piece of dry bread; and if he has eaten very heartily at dinner, and, like Oliver Twist, “asks for more!” give him, to satisfy his craving, a piece of dry bread. He will never eat more of that than will do him good, and yet he will take sufficient to satisfy his hunger, which is very important.

144. What ought now to be his dinner?

He should now have meat, either mutton or beef, daily, which must be cut up very small, and should be mixed with mealy mashed potato and gravy. He ought always to be accustomed to eat salt with his dinner. Let a mother see that this advice is followed, or evil 1141consequences will inevitably ensue. Let him be closely watched, to ascertain that he well masticates his food, and that he does not eat too quickly; for young children are apt to bolt their food.

145. Have you any objection to pork for a change?

I have a great objection to it for the young. It is a rich, gross, and therefore unwholesome food for the delicate stomach of a child. I have known it, in several instances, produce violent pain, sickness, purging, and convulsions. If a child be fed much upon such meat, it will be likely to produce “breakings-out” on the skin. In fine, his blood will put on the same character as the food he is fed with. Moreover, pork might be considered a strong meat, and “strong meat and strong drink can only be taken by strong men.”

146. Do you approve of veal for a child?

My objection to pork was, that it was rich and gross; this does not apply to veal; but the objection to it is, that it is more difficult of digestion than either mutton or beef.

147. Do you disapprove of salted and boiled beef for a child?

If beef be much salted it is hard of digestion, and therefore ought not to be given to him; but if it has been but slightly salted, then for a change there will be no objection to a little.

There is no necessity in the winter time to salt meat intended for boiling; then, boiled unsalted meat makes a nice change for a child’s dinner. Salt, of course, must with the unsalted meat be eaten.

148. But suppose there is nothing on the table that a child may with impunity eat?

1142He should then have either a grilled mutton-chop, or a lightly boiled egg; indeed, the latter, at any time, makes an excellent change.

149. Are potatoes an unwholesome food for a child?

New ones are; but old potatoes, well cooked and mealy, are the best vegetable he can have. They ought to be well mashed, as I have known lumps of potatoes cause convulsions.

150. Do you approve of any other vegetables for a child?

Occasionally. Either asparagus, or broccoli, or cauliflower, or turnips, or French beans, which latter should be cut up fine, may with advantage be given.

151. Might not a mother be too particular in dieting her child?

Certainly not. If blood can be too pure and too good she might! When we take into account that the food we eat is converted into blood; that if the food be good, the blood is good; and that if the food be improper or impure, the blood is impure likewise; and, moreover, when we know that every part of the body is built up by the blood, we cannot be considered to be too particular in making our selection of food. Besides, if indigestible or improper food be taken into the stomach, the blood will not only be made impure, but the stomach and the bowels will be disordered.

Do not let me be misunderstood: I am no advocate for a child having the same food one day as another—certainly not. Let there be variety, but let it be wholesome variety. Variety in a child’s (not in an infant’s) food is necessary. If he were fed, day after day, on 1143mutton, his stomach would at length be brought into that state that in time it would not properly digest any other meat, and a miserable existence would be the result.

152. What ought a child to drink with his dinner?

Toast and water, or, if he prefer it, plain spring water. Let him have as much as he likes. If you give him water to drink, there is no fear of his taking too much; Nature will tell him when he has had enough. Be careful of the quality of the water, and the source from which you procure it. Soft spring water from a moderately deep well is the best. If it come from a land spring, it is apt, indeed is almost sure to be contaminated by drains, etc., which is a frequent cause of fevers, of diphtheria, of Asiatic cholera, and of other blood poisons.

Guard against the drinking water being contaminated with lead; never, therefore, allow the water to be collected in leaden cisterns, as it sometimes is if the water be obtained from Water-works’ companies. Lead pumps, for the same reason, ought never to be used for drinking purposes. Paralysis, constipation, lead colic, dropping of the wrist, wasting of the ball of the thumb, loss of memory and broken and ruined health might result from neglect of this advice.

All honor to the man who first invented the Drinking Fountain, and all honor to the mayors and corporations of towns who see that they are kept in good, efficient working order! The drinking fountains are a great boon to poor children, as water, and plenty of it, is one of the chief necessaries of their very existence: 1144and, unfortunately, at their own homes they are not, oftentimes, able to obtain a sufficient supply. Moreover, drinking fountains are the best advocates for temperance.

Some parents are in the habit of giving their children beer with their dinners, making them live as they live themselves! This practice is truly absurd, and fraught with great danger—not only so, but it is inducing a child to be fond of that which in after-life might be his bane and curse. No good end can be obtained by it; it will not strengthen so young a child; it will, on the contrary, create fever, and will thereby weaken him; it will act injuriously upon his delicate, nervous, and vascular systems, and might be a means of producing inflammation either of the brain or of its membranes, and might thus cause water on the brain (a disease to which young children are subject), or it might induce inflammation of the lungs.

153. What ought a child who has cut his teeth to have for his supper?

The same that he has for breakfast. He should sup at six o’clock.

154. Have you any general remarks to make on a child’s meals?

I recommended a great sameness in an infant’s diet; but a child’s meals, his dinners especially, ought to be much varied. For instance, do not let him have, day after day, mutton; but ring the changes on mutton, beef, poultry, game, and even occasionally fish—sole or cod.

Not only let there be a change of meat, but let there 1145be a change in the manner of cooking it: let the meat sometimes be roasted; at other times let it be boiled. I have known a mother who has prided herself as being experienced in these matters, feed her child, day after day, on mutton-chops! Such a proceeding is most injurious to him, as after awhile his unfortunate stomach will digest nothing but mutton-chops, and, in time, not even those!

With regard to vegetables, potatoes—mashed potatoes—ought to be his staple vegetable; but, every now and then, cauliflower, asparagus, turnips, and French beans should be given.

With respect to puddings, vary them,—rice, one day; suet, another; batter, a third; tapioca, a fourth; or, even occasionally, he might have either apple or gooseberry or rhubarb-pudding, provided the pastry be plain and light.

It is an excellent plan, as I have before remarked, to let a child eat jam—such as strawberry, raspberry, or gooseberry—and that without stint, either with rice or with batter puddings.

Variety of diet, then, is good for a child: it will give him muscle, bone, and sinew; and, what is very important, it will tend to regulate his bowels, and it will thus prevent the necessity of giving him aperients.

But do not stuff a child—do not press him, as is the wont of some mothers, to eat more than he feels inclined. On the contrary, if you think that he is eating too much—that he is overloading his stomach—and 1146if he should ask for more, then, instead of giving him either more meat or more pudding, give him a piece of dry bread. By doing so, you may rest assured that he will not eat more than is absolutely good for him.

155. If a child be delicate, is there any objection to a little wine, such as cowslip or tent, to strengthen him?

Wine ought not to be given to a child unless it be ordered by a medical man: it is even more injurious than beer. Wine, beer, and spirits principally owe their strength to the alcohol they contain; indeed, nearly all wines are fortified (as it is called) with brandy. Brandy contains a large quantity of alcohol, more than any other liquor, namely, 55.3 per cent. If, therefore, you give wine, it is, in point of fact, giving diluted brandy—diluted alcohol; and alcohol acts, unless it be used as a medicine, and under skillful medical advice, as a poison to a child.

156. Suppose a child suddenly to lose his appetite: is any notice to be taken of it?

If he cannot eat well, depend upon it there is something wrong about the system. If he be teething, let a mother look well to his gums, and satisfy herself that they do not require lancing. If they be red, hot, and swollen, send for a medical man, that he may scarify them. If his gums be not inflamed, and no tooth appears near, let her look well to the state of his bowels; let her ascertain that they be sufficiently opened, and that the stools be of a proper consistence, color, and smell. If they be neither the one nor the other, give a 1147dose of aperient medicine, which will generally put all to rights. If the gums be cool, and the bowels be right, and his appetite continue bad, call in medical aid.

A child asking for something to eat is frequently, in a severe illness, the first favorable symptom; we may generally then prognosticate that all will soon be well again.

If a child refuse his food, neither coax nor tempt him to eat: as food without an appetite will do him more harm than it will do him good; it may produce either sickness, bowel complaint, or fever. Depend upon it, there is always a cause for a want of appetite;—perhaps his stomach has been overworked, and requires repose; or his bowels are loaded, and Nature wishes to take time to use up the old material;—there might be fever lurking in his system; Nature stops the supplies, and thus endeavors, by not giving it food to work with, to nip it in the bud;—there might be inflammation; food would then be improper, as it would only add fuel to the fire; let, therefore, the cause be either an overworked stomach, overloaded bowels, fever, or inflammation, food would be injurious. Kind Nature, if we will but listen to her voice, will tell us when to eat and when to refrain.

157. When a child is four or five years old, have you any objection to his drinking tea?

Some parents are in the habit of giving their children strong (and frequently green) tea. This practice is most hurtful. It acts injuriously upon their delicate, nervous system, and thus weakens their whole frame. 1148If milk does not agree, a cup of very weak tea, that is to say, water with a dash of black tea in it, with a tablespoonful of cream, may be substituted for milk; but a mother must never give tea where milk agrees.

158. Have you any objection to a child occasionally having either cakes or sweetmeats?

I consider them as so much slow poison. Such things both cloy and weaken the stomach, and thereby take away the appetite, and thus debilitate the frame. Moreover, “sweetmeats are colored with poisonous pigments.” A mother, surely, is not aware that when she is giving her child sugar confectionery she is, in many cases, administering a deadly poison to him? “We beg to direct the attention of our readers to the Report of the Analytical Sanitary Commission, contained in the Lancet of the present week,[190] on the pigments employed in coloring articles of sugar confectionery. From this report it appears that metallic pigments, of a highly dangerous and even poisonous character, containing chromic acid, lead, copper, mercury, and arsenic, are commonly used in the coloring of such articles.”[191]

If a child be never allowed to eat cakes and sweetmeats, he will consider a piece of dry bread a luxury, and will eat it with the greatest relish.

159. Is bakers’ or is home-made bread the most wholesome for a child?

Bakers’ bread is certainly the lightest; and, if we could depend upon its being unadulterated, would, 1149from its lightness, be the most wholesome; but as we cannot always depend upon bakers’ bread, home-made bread, as a rule, should be preferred. If it be at all heavy, a child must not be allowed to partake of it; a baker’s loaf ought then to be sent for, and continued to be eaten until light home-made bread can be procured. Heavy bread is most indigestible. He must not be allowed to eat bread, until it be two or three days old. If it be a week old, in cold weather, it will be the more wholesome.

160. Do you approve either of caraway seeds or of currants in bread or in cakes—the former to disperse wind, the later to open the bowels?

There is nothing better than plain bread: the caraway seeds generally pass through the bowels undigested, and thus might irritate, and might produce, instead of disperse wind.[192] Some mothers put currants in cakes, with a view of opening the bowels of their children; but they only open them by disordering them.

161. My child has an antipathy to certain articles of diet: what would you advise to be done?

A child’s antipathy to certain articles of diet should be respected: it is a sin and a shame to force him to eat what he has a great dislike to: a child, for instance, sometimes dislikes the fat of meat, underdone meat, the 1150skin off boiled milk and off rice pudding. Why should he not have his likes and dislikes as well as “children of a larger growth?” Besides, there is an idiosyncrasy—a peculiarity of the constitution in some children—and Nature oftentimes especially points out what is good and what is bad for them individually, and we are not to fly in the face of Nature. “What is one man’s meat is another man’s poison.” If a child be forced to eat what he dislikes, it will most likely not only make him sick, but will disorder his stomach and bowels: food, if it is really to do him good, must be eaten by him with a relish, and not with disgust and aversion. Some mothers, who are strict disciplinarians, pride themselves on compelling their children to eat whatever they choose to give them! Such children are to be pitied!

162. When ought a child to commence to dine with his parents?

As soon as he be old enough to sit up at the table, provided the father and mother either dine or lunch in the middle of the day. “I always prefer having children about me at meal-times. I think it makes them little gentlemen and gentlewomen in a manner that nothing else will.”[193]

THE NURSERY.

163. Have you any remarks to make on the selection, the ventilation, the warming, the temperature, and the arrangements of a nursery? and have you 1151any further observations to offer conducive to the well-doing of my child?

The nursery ought to be the largest and the most airy room in the house. In the town, if it be in the topmost story (provided the apartment be large and airy) so much the better, as the air will then be purer. The architect, in the building of a house, ought to be particularly directed to pay attention to the space, the loftiness, the ventilation, the light, the warming, and the conveniences of a nursery. A bath-room attached to it will be of great importance and benefit to the health of a child.

It will, also, be advantageous to have a water-closet near at hand, which should be well supplied with water, be well drained, and be well ventilated. If this be not practicable, the evacuations ought to be removed as soon as they are passed. It is a filthy and an idle habit of a nurse-maid to allow a motion to remain for any length of time in the room.

The Ventilation of a nursery is of paramount importance. There ought to be a constant supply of fresh, pure air in the apartment. But how few nurseries have fresh, pure air? Many nurseries are nearly hermetically sealed—the windows are seldom, if ever, opened; the doors are religiously closed; and, in the summer time, the chimneys are carefully stuffed up, so that a breath of air is not allowed to enter! The consequences are, the poor unfortunate children “are poisoned by their own breaths,” and are made so delicate that they are constantly catching cold; indeed, it might be said that they are laboring under chronic catarrhs, all arising from Nature’s laws being set at defiance.

1152The windows ought to be large, and should be made to freely open both top and bottom. Whenever the child is out of the nursery the windows ought to be thrown wide open; indeed, when he is in it, if the weather be fine, the upper sash should be a little lowered. A child should be encouraged to change the room frequently, in order that it may be freely ventilated; for good air is as necessary to his health as wholesome food, and air cannot be good if it be not frequently changed. If you wish to have a strong and healthy child, ponder over and follow this advice.

I have to enter my protest against the use of a stove in a nursery. I consider a gas stove without a chimney to be an abomination, most destructive to human life. There is nothing like the old-fashioned open fire-place, with a good-sized chimney, so that it may not only carry off the smoke, but also the impure air of the room.

Be sure to have a fire-guard around the grate, and be strict in not allowing your child either to touch or to play with fire; frightful accidents have occurred from mothers and nurses being on these points lax.

The nursery ought to have a large fire-guard, to go all round the hearth, and which should be sufficiently high to prevent a child from climbing over. Not only must the nursery have a guard, but every room where he is allowed to go should be furnished with one on the bars.

Moreover, it will be necessary to have a guard in every room where a fire is burning, to protect the ladies, who, in accordance with the present fashion, wear such 1153preposterous crinolines, and thus to prevent the frightful deaths which are at the present time of such frequent and startling occurrence; lady-burning is now one of the institutions of our land!

A nursery is usually kept too hot; the temperature in the winter time ought not to exceed 60 degrees Fahrenheit. A good thermometer should be considered an indispensable requisite to a nursery. A child in a hot, close nursery is bathed in perspiration; if he leave the room to go to one of lower temperature, the pores of his skin are suddenly closed, and either a severe cold, or an inflammation of the lungs, or an attack of bronchitis, is likely to ensue. Moreover, the child is both weakened and enervated by the heat, and thus readily falls a prey to disease.

A child ought never to be permitted to sit with his back to the fire; if he be allowed, it weakens his spine, and thus his whole frame; it causes a rush of blood to the head and face, and predisposes him to catch cold.

Let a nurse make a point of opening the nursery window every time that she and her little charge leave the nursery, if their absence be only for half an hour. The mother herself ought to see that this advice is followed, pure air is so essential to the well-being of a child. Pure air and pure water,[194] and, let me add, pure milk, are for a child the grand and principal requirements of health.

Look well to the Drainage of your house and neighborhood. 1154A child is very susceptible to the influence of bad drainage. Bad drains are fruitful sources of scarlet fever, of diphtheria, of diarrhœa, etc. “It is sad to be reminded that, whatever evils threaten the health of a population, whether from pollutions of water or of air,—whether from bad drainage or overcrowding, they fall heaviest on the most innocent victims—upon children of tender years. Their delicate frames are infinitely more sensitive than the hardened constitutions of adults, and the breath of poison or the chill of hardships easily blights their tender life.”[195]

A nursery floor ought not to be washed oftener than once a week; and then the child or children should, until it be dry, be sent into another room. During the drying of the floor, the windows must, of course, be thrown wide open.

The constant wetting of a nursery is a frequent source of illness among children. The floor ought, of course, to be kept clean; but this may be done by the servant thoroughly sweeping the room out every morning before her little charge makes his appearance.

Do not have your nursery walls covered with green paper-hangings. Green paper-hangings contain large quantities of arsenic—arsenite of copper (Scheele’s green)—which, I need scarcely say, is a virulent poison, and which flies about the room in the form of powder. There is frequently enough poison on the walls of a room to destroy a whole neighborhood.

There is another great objection to having your nursery 1155walls covered with green paper-hangings; if any of the paper should become loose from the walls, a little child is very apt to play with it, and to put it, as he does everything else, to his mouth. This is not an imaginary state of things, as four children in one family have just lost their lives from sucking green paper-hangings.

Green dresses, as they are colored with a preparation of arsenic, are equally as dangerous as green paper-hangings; a child ought, therefore, never to wear a green dress. “It may be interesting to some of our readers,” says Land and Water, “to know that the new green, so fashionable for ladies’ dresses, is just as dangerous in its nature as the green wall-paper, about which so much was written some time since. It is prepared with a large quantity of arsenic; and we have been assured by several of the leading dressmakers that the work-women employed in making up dresses of this color are seriously affected with all the symptoms of arsenical poison. Let our lady friends take care.”

Children’s toys are frequently painted of a green color with arsenite of copper, and are, consequently, highly dangerous to play with. The best toy for a child is a box of unpainted wooden bricks, which is a constant source of amusement to him.

If you have your nursery walls hung with paintings and engravings, let them be of good quality. The horrid daubs and bad engravings that usually disfigure nursery walls, are enough to ruin the taste of a child, and to make him take a disgust to drawing, which would be a misfortune. A fine engraving and a good 1156painting expand and elevate his mind. We all know that first impressions are the most vivid and the most lasting. A taste in early life for everything refined and beautiful purifies his mind, cultivates his intellect, keeps him from low company, and makes him grow up a gentleman!

Lucifer matches, in case of sudden illness, should, both in the nursery and in the bedroom, always be in readiness; but they must be carefully placed out of the reach of children, as lucifer matches are a deadly poison.[196]

164. Have you any observation to make on the LIGHT of a nursery?

Let the window, or, what is better, the windows, of a nursery be very large, so as to thoroughly light up every nook and corner of the room, as there is nothing more conducive to the health of a child than an abundance of light in the dwelling.

A room cannot, then, be too light. The windows of a nursery are generally too small. A child requires as much light as a plant. Gardeners are well aware of the great importance of light in the construction of their greenhouses, and yet a child, who requires it as much, and is of much greater importance, is cooped up in dark rooms!

The windows of a nursery ought not only to be frequently opened to let in fresh air, but should be frequently cleaned, to let in plenty of light and of sunshine, 1157as nothing is so cheering and beneficial to a child as an abundance of light and sunshine!

With regard to the best artificial light for a nursery.—The air of a nursery cannot be too pure; I therefore do not advise you to have gas in it, as gas in burning gives off quantities of carbonic acid and sulphuretted hydrogen, which vitiate the air. There is no better light for a nursery than either Price’s patent candles or the old-fashioned tallow candle.

Let a child’s home be the happiest house to him in all the world; and to be happy he must be merry, and all around him should be merry and cheerful; and he ought to have an abundance of playthings, to help on the merriment.

If he has a dismal nurse, and a dismal home, he may as well be incarcerated in a prison, and be attended by a jailer. It is sad enough to see dismal, doleful men and women, but it is a truly lamentable and unnatural sight to see a doleful child! The young ought to be as playful and as full of innocent mischief as a kitten. There will be quite time enough in after-years for sorrow and for sadness.

Bright colors, plenty of light, clean windows (mind this, if you please), an abundance of good-colored prints, and toys without number, are the proper furnishings of a nursery. Nursery! why, the very name tells you what it ought to be—the home of childhood,—the most important room in the house,—a room that will greatly tend to stamp the character of your child for the remainder of his life.

1158165. Have you any more hints to offer conducive to the well-doing of my child?

You cannot be too particular in the choice of those who are in constant attendance upon him. You yourself, of course, must be his head-nurse—you only require some one to take the drudgery off your hands!

You ought to be particularly careful in the selection of his nurse. She should be steady, lively, truthful, and good-tempered; and must be free from any natural imperfection, such as squinting, stammering, etc., for a child is such an imitative creature that he is likely to acquire that defect, which in the nurse is natural. “Children, like babies, are quick at ‘taking notice.’ What they see they mark, and what they mark they are very prone to copy.”[197]

She ought not to be very young, or she may be thoughtless, careless, and giggling. You have no right to set a child to mind a child; it would be like the blind leading the blind. No! a child is too precious a treasure to be intrusted to the care and keeping of a young girl. Many a child has been ruined for life by a careless young nurse dropping him and injuring his spine.

A nurse ought to be both strong and active, in order that her little charge may have plenty of good nursing; for it requires great strength in the arms to carry a heavy child for the space of an hour or two, at a stretch, in the open air; and such is absolutely necessary, and is the only way to make him strong, and to cause him to cut his teeth easily, and at the same time to regulate 1159his bowels; a nurse, therefore, must be strong and active, and not mind hard work, for hard work it is; but after she is accustomed to it, pleasant notwithstanding.

Never should a nurse be allowed to wear a mask, nor to dress up and paint herself as a ghost, or as any other frightful object. A child is naturally timid and full of fears, and what would not make the slightest impression upon a grown-up person, might throw a child into fits—

“The sleeping, and the dead,
Are but as pictures: ’tis the age of childhood
That fears a painted devil.”[198]

Never should she be permitted to tell her little charge frightful stories of ghosts and hobgoblins; if this be allowed, the child’s disposition will become timid and wavering, and may continue so for the remainder of his life.

If a little fellow were not terrified by such stories, the darkness would not frighten him more than the light. Moreover, the mind thus filled with fear, acts upon the body, and injures the health. A child must never be placed in a dark cellar, nor frightened by tales of rats, etc. Instances are related of fear thus induced impairing the intellect for life; and there are numerous examples of sudden fright causing a dangerous and even a fatal illness.

Night-terrors.—This frightening of a child by a silly nurse frequently brings on night-terrors. He wakes 1160up suddenly, soon after going to sleep, frightened and terrified; screaming violently, and declaring that he has seen either some ghost, or thief, or some object that the silly nurse had been previously in the day describing, who is come for him to take him away. The little fellow is the very picture of terror and alarm; he hides his face in his mother’s bosom, the perspiration streams down him, and it is some time before he can be pacified—when, at length, he falls into a troubled, feverish slumber, to awake in the morning unrefreshed. Night after night these terrors harass him, until his health materially suffers, and his young life becomes miserable, looking forward with dread to the approach of darkness.

Treatment of night-terrors.—If they have been caused by the folly of the nurse, discharge her at once, and be careful to select a more discreet one. When the child retires to rest, leave a candle burning, and let it burn all night; sit with him until he be asleep; and take care, in case he should rouse up in one of his night-terrors, that either you yourself or some kind person be near at hand. Do not scold him for being frightened—he cannot help it; but soothe him, calm him, fondle him, take him into your arms, and let him feel that he has some one to rest upon, to defend and to protect him. It is frequently in these cases necessary before he can be cured to let him have change of air and change of scene. Let him live in the daytime, a great part of the day, in the open air.

A nurse-maid should never, on any account whatever, be allowed to whip a child. “Does ever any man or woman remember the feeling of being ‘whipped’ 1161as a child, the fierce anger, the insupportable ignominy, the longing for revenge, which blotted out all thought of contrition for the fault or rebellion against the punishment? With this recollection on their own parts, I can hardly suppose any parents venturing to inflict it, much less allowing its infliction by another under any circumstances whatever. A nurse-maid or domestic of any sort, once discovered to have lifted up her hand against a child, ought to meet instant severe rebuke, and on a repetition of the offense instant dismissal.”[199]

I have seen in the winter time a lazy nurse sit before the fire with a child on her lap, rubbing his cold feet just before putting him to his bed. Now this is not the way to warm his feet. The right method is to let him romp and run either about the room, or the landing, or the hall—this will effectually warm them; but, of course, it will entail a little extra trouble on the nurse, as she will have to use a little exertion to induce him to do so, and this extra trouble a lazy nurse will not relish. Warming the feet before the fire will give the little fellow chilblains, and will make him when he is in bed more chilly. The only way for him to have a good romp before he goes to bed, is for the mother to join in the game. She may rest assured, that if she does so, her child will not be the only one to benefit by it. She herself will find it of marvelous benefit to her own health; it will warm her own feet, it will be almost sure to insure her a good night, and will make her feel so light and buoyant as almost to fancy that 1162she is a girl again! Well, then, let every child, before he retire to bed, hold a high court of revelry, let him have an hour—the Children’s Hour—devoted to romp, to dance, to riot, and to play, and let him be the master of the revels—

“Between the dark and the daylight,
When the night is beginning to lower,
Comes a pause in the day’s occupation,
Which is known as the Children’s Hour.”[200]

Let a child be employed—take an interest in his employment, let him fancy that he is useful—and he is useful, he is laying in a stock of health. He is much more usefully employed than many other grown-up children are!

A child should be happy; he must, in every way, be made happy; everything ought to be done to conduce to his happiness, to give him joy, gladness, and pleasure. Happy he should be, as happy as the day is long. Kindness should be lavished upon him. Make a child understand that you love him; prove it in your actions—these are better than words; look after his little pleasures—join in his little sports; let him never hear a morose word—it would rankle in his breast, take deep root, and in due time bring forth bitter fruit. Love! let love be his pole-star; let it be the guide and the rule of all you do and all you say unto him. Let your face, as well as your tongue, speak love. Let your hands be ever ready to minister to his pleasures and to 1163his play. “Blessed be the hand that prepares a pleasure for a child, for there is no saying when and where it may again bloom forth. Does not almost everybody remember some kind-hearted man who showed him a kindness in the dulcet days of childhood? The writer of this recollects himself, at this moment, a bare-footed lad, standing at the wooden fence of a poor little garden in his native village, while, with longing eyes, he gazed on the flowers which were blooming there quietly in the brightness of the Sabbath morning. The possessor came from his little cottage. He was a woodcutter by trade, and spent the whole week at work in the woods. He had come into the garden to gather flowers to stick in his coat when he went to church. He saw the boy, and breaking off the most beautiful of his carnations (it was streaked with red and white), he gave it to him. Neither the giver nor the receiver spoke a word, and with bounding steps the boy ran home. And now, here, at a vast distance from that home, after so many events of so many years, the feeling of gratitude which agitated the breast of that boy, expressed itself on paper. The carnation has long since faded, but it now bloometh afresh.”[201]

The hearty ringing laugh of a child is sweet music to the ear. There are three most joyous sounds in nature—the hum of a bee, the purr of a cat, and the laugh of a child. They tell of peace, of happiness, and of contentment, and make one for awhile forget that there is so much misery in the world.

1164A man who dislikes children is unnatural; he has no “milk of human kindness” in him; he should be shunned. Give me, for a friend, a man—

“Who takes the children on his knee,
And winds their curls about his hand.”[202]

166. If a child be peevish, and apparently in good health, have you any plan to offer to allay his irritability?

A child’s troubles are soon over—his tears are soon dried; “nothing dries sooner than a tear”—if not prolonged by improper management:

“The tear down childhood’s cheek that flows,
Is like the dewdrop on the rose;
When next the summer breeze comes by,
And waves the bush, the flower is dry.”[203]

Never allow a child to be teased; it spoils his temper. If he be in a cross humor take no notice of it, but divert his attention to some pleasing object. This may be done without spoiling him. Do not combat bad temper with bad temper—noise with noise. Be firm, be kind, be gentle,[204] be loving, speak quietly, smile tenderly, and embrace him fondly; but insist upon implicit obedience, and you will have, with God’s blessing, a happy child:

“When a little child is weak,
From fever passing by,
Or wearied out with restlessness,
Don’t scold him if he cry.
1165Tell him some pretty story—
Don’t read it from a book;
He likes to watch you while you speak,
And take in every look.
Or sometimes singing gently—
A little song may please,
With quiet and amusing words,
And tune that flows with ease.
Or if he is impatient,
Perhaps from time to time
A simple hymn may suit the best,
In short and easy rhyme.
The measured verses flowing
In accents clear and mild,
May blend into his troubled thought,
And soothe the little child.
But let the words be simple,
And suited to his mind,
And loving, that his weary heart
A resting-place may find.”[205]

Speak gently to a child; speak gently to all; but more especially speak gently to a child. “A gentle voice is an excellent thing in woman,” and is a jewel of great price, and is one of the concomitants of a perfect lady. Let the hinges of your disposition be well oiled. “‘I have a dear friend. He was one of those well-oiled dispositions which turn upon the hinges of 1166the world without creaking.’ Would to heaven there were more of them! How many there are who never turn upon the hinges of this world without a grinding that sets the teeth of a whole household on edge! And somehow or other it has been the evil fate of many of the best spirits to be so circumstanced; both men and women, to whom life is ‘sweet habitude of being,’ which has gone far to reconcile them to solitude as far less intolerable! To these especially the creakings of those said rough hinges of the world is one continued torture, for they are all too finely strung; and the oft-recurring grind jars the whole sentient frame, mars the beautiful lyre, and makes cruel discord in a soul of music. How much of sadness there is in such thoughts! Seems there not a Past in some lives to which it is impossible ever to become reconciled?”[206]

Pleasant words ought always to be spoken to a child! there must be neither snarling, nor snapping, nor snubbing, nor loud contention toward him. If there be it will ruin his temper and disposition, and will make him hard and harsh, morose and disagreeable.

Do not be always telling your child how wicked he is; what a naughty boy he is; that God will never love him, and all the rest of such twaddle. Do not, in point of fact, bully him, as many poor little fellows are bullied! It will ruin him if you do; it will make him in after-years either a coward or a tyrant. Such conversations, like constant droppings of water, will make 1167an impression, and will cause him to feel that it is of no use to try to be good—that he is hopelessly wicked! Instead of such language, give him confidence in himself; rather find out his good points and dwell upon them; praise him where and whenever you can; and make him feel that, by perseverance and by God’s blessing, he will make a good man. Speak truthfully to your child; if you once deceive him, he will not believe you for the future. Not only so, but if you are truthful yourself you are likely to make him truthful—like begets like. There is something beautiful in truth! A lying child is an abomination! Sir Walter Scott says “that he taught his son to ride, to shoot, and to tell the truth.”

As soon as a child can speak, he should be made to lisp the noble words of truth, and to love it, and to abhor a lie! What a beautiful character he will then make! Blessed is that child who can say,—

“Parental cares watched o’er my growing youth,
And early stamped it with the love of truth.”[207]

Have no favorites, show no partiality; for the young are very jealous, sharp-sighted, and quick-witted, and take a dislike to the petted one. Do not rouse the old Adam in them. Let children be taught to be “kindly affectioned one to another, with brotherly love;”[208] let them be encouraged to share each other’s toys and playthings, and to banish selfishness.

Attend to a child’s little pleasures. It is the little 1168pleasures of a child that constitute his happiness. Great pleasures to him and to us all (as a favorite author remarks) come but seldom, and are the exceptions, and not the rule.

Let a child be nurtured in love. “It will be seen that I hold this law of kindness as the Alpha and Omega of education. I once asked one, in his own house, a father in everything but the name, his authority unquestioned, his least word held in reverence, his smallest wish obeyed—‘How did you ever manage to bring up these children?’ He said, ‘By love!’”[209]

Let every word and action prove that you love your children. Enter into all their little pursuits and pleasures. Join them in their play, and “be a child again!” If they are curious, do not check their curiosity; but rather encourage it; for they have a great deal—as we all have—to learn, and how can they know if they are not taught? You may depend upon it, the knowledge they obtain from observation is far superior to that obtained from books. Let all you teach them, let all you do, and let all you say, bear the stamp of love. “Endeavor, from first to last, in your intercourse with your children, to let it bear the impress of love. It is not enough that you feel affection toward your children—that you are devoted to their interests; you must show in your manner the fondness of your hearts toward them. Young minds cannot appreciate great sacrifices made for them; they judge their parents by the words and deeds of everyday life. They are won by little kindnesses, 1169and alienated by little acts of neglect or impatience. One complaint unnoticed, one appeal unheeded, one lawful request arbitrarily refused, will be remembered by your little ones more than a thousand acts of the most devoted affection.”[210]

A placid, well-regulated temper is very conducive to health. A disordered or an overloaded stomach is a frequent cause of peevishness. Appropriate treatment in such a case will, of course, be necessary.

167. My child stammers: can you tell me the cause, and can you suggest a remedy?

A child who stammers is generally “nervous,” quick, and impulsive. His ideas flow too rapidly for speech. He is “nervous:” hence, when he is alone, and with those he loves, he oftentimes speaks fluently and well; he stammers more both when he is tired, and when he is out of health—when the nerves are either weak or exhausted. He is emotional: when he is either in a passion or in excitement, either of joy or of grief, he can scarcely speak—“he stammers all over.” He is impulsive: he often stammers in consequence. He is in too great a hurry to bring out his words; they do not flow in a proper sequence; hence his words are broken and disjointed.

Stammering, of course, might be owing either to some organic defect, such as from defective palate, or from defective brain, then nothing will cure him; or it might be owing to “nervous” causes—to “irregular 1170nervous action,” then a cure might, with care and perseverance, be usually effected.

In all cases of stammering of a child, let both the palate of his mouth and the bridle of his tongue be carefully examined, to see that neither the palate be defective, nor the bridle of the tongue be too short—that he be not tongue-tied.

Now, with regard to Treatment. Make him speak slowly and deliberately; let him form each word, without clipping or chopping; let him be made, when you are alone with him, to exercise himself in elocution. If he speak quickly, stop him in his mid-career, and make him, quietly and deliberately, go through the sentence again and again, until he has mastered the difficulty; teach him to collect his thoughts, and to weigh each word ere he give it utterance; practice him in singing little hymns and songs for children; this you will find a valuable help in the cure. A stammerer seldom stutters when he sings. When he sings, he has a full knowledge of the words, and is obliged to keep in time—to sing neither too fast nor too slow. Besides, he sings in a different key to his speaking voice. Many professors for the treatment of stammering cure their patients by practicing lessons of a sing-song character.

Never jeer him for stammering, nor turn him to ridicule; if you do, it will make him ten times worse; but be patient and gentle with him, and endeavor to give him confidence, and encourage him to speak to you as quietly, as gently, and deliberately as you speak to him; tell him not to speak until he has arranged his thoughts and chosen his words; let him do nothing in a hurry.

1171Demosthenes was said, in his youth, to have stammered fearfully, and to have cured himself by his own prescription, namely, by putting a pebble in his mouth, and declaiming, frequently, slowly, quietly, and deliberately, on the sea-shore—the fishes alone being his audience,—until, at length, he cured himself, and charmed the world with his eloquence and with his elocution. He is held up, to this very day, as the personification and as the model of an orator. His patience, perseverance, and practice ought, by all who either are, or are interested in a stammerer, to be borne in mind and followed.

168. Do you approve of a carpet in a nursery?

No; unless it be a small piece for the child to roll upon. A carpet harbors dirt and dust, which dust is constantly floating about the atmosphere, and thus making it impure for him to breathe. The truth of this may easily be ascertained by entering a darkened room, where a ray of sunshine is struggling through a crevice in the shutters. If the floor of a nursery must be covered, let drugget be laid down; as this every morning may be taken up and shaken. The less furniture a nursery contains the better; for much furniture obstructs the free circulation of the air, and, moreover, prevents a child from taking proper exercise in the room.

169. Supposing there is not a fire in the nursery grate, ought the chimney to be stopped to prevent a draught in the room?

Certainly not. I consider the use of a chimney to be twofold: first, to carry off the smoke; and secondly 1172(which is of quite as much importance), to ventilate the room, by carrying off the impure air, loaded as it is with carbonic acid gas, the refuse of respiration. The chimney, therefore, should never, either winter or summer, be allowed for one moment to be stopped. This is important advice, and requires the strict supervision of every mother, as servants will, if they have the chance, stop all chimneys that have no fires in the grates.

EXERCISE.

170. Do you approve, during the summer months, of sending a child out BEFORE breakfast?

I do, when the weather will permit, and provided the wind be neither in an easterly nor in a northeasterly direction: indeed, he can scarcely be too much in the open air. He must not be allowed to stand about draughts or about entries, and the only way to prevent him doing so is for the mother herself to accompany the nurse. She will then kill two birds with one stone, as she will, by doing so, benefit her own as well as her child’s health.

171. Ought a child to be early put on his feet to walk?

No: let him learn to walk himself. He ought to be put upon a carpet; and it will be found that when he is strong enough, he will hold by a chair, and will stand alone: when he can do so, and attempts to walk, he should then be supported. You must, on first putting him upon his feet, be guided by his own wishes. He will, as soon as he is strong enough to walk, have the inclination to do so. When he has the inclination and 1173the strength, it will be folly to restrain him; if he has neither the inclination nor the strength, it will be absurd to urge him on. Rely, therefore, to a certain extent, upon the inclination of the child himself. Self-reliance cannot be too early taught him, and, indeed, every one else. In the generality of instances, however, a child is put on his feet too soon, and the bones, at that tender age, being very flexible, bend, causing bowed and bandy legs; and the knees, being weak, approximate too closely together, and thus they become knock-kneed.

This advice of not putting a child early on his feet, I must strongly insist on, as so many mothers are so ridiculously ambitious that their young ones should walk early, that they should walk before other children have attempted to do so, have frequently caused the above lamentable deformities!

172. Do you approve of perambulators?

I do not, for two reasons: first, because when a child is strong enough, he had better walk as much as he will; and, secondly, the motion is not so good, and the muscles are not so much put into action, and consequently cannot be so well developed, as when he is carried. A perambulator is very apt to make a child stoop, and to make him both crooked and round-shouldered. He is cramped by being so long in one position. It is painful to notice a babe a few months old in one of these new-fangled carriages. His little head is bobbing about, first on one side and then on the other—at one moment it is dropping on his chest, the next it is forcibly jolted behind: he looks, and doubtless feels, 1174wretched and uncomfortable. Again, these perambulators are dangerous in crowded thoroughfares. They are a public nuisance, inasmuch as they are wheeled against and between people’s legs, and are a fruitful source of the breaking of shins, of the spraining of ankles, of the crushing of corns, and of the ruffling of the tempers of the foot-passengers who unfortunately come within their reach; while, in all probability, the gaping nurses are staring another way, and every way indeed but the right!

Besides, in very cold weather, or in a very young infant, the warmth of the nurse’s body, while he is being carried, helps to keep him warm, he himself being naturally cold. In point of fact, the child, while being borne in the nurse’s arms, reposes on the nurse, warm and supported as though he were in a nest! While, on the other hand, if he be in a perambulator, he is cold and unsupported, looking the very picture of misery, seeking everywhere for rest and comfort, and finding none!

A nurse’s arm, then, is the only proper carriage for a young child to take exercise on. She ought to change about, first carrying him on the one arm, and then on the other. Nursing him on one arm only might give his body a twist on one side, and thus might cause deformity.

When he is old enough to walk, and is able properly to support the weight of his own neck and back, then there will be no objection, provided it be not in a crowded thoroughfare, to his riding occasionally in a perambulator; but when he is older still, and can sit 1175either a donkey or a pony, such exercise will be far more beneficial, and will afford him much greater pleasure.

173. Supposing it to be wet under foot, but dry above, do you then approve of sending a child out?

If the wind be neither in the east nor the northeast, and if the air be not damp, let him be well wrapped up and be sent out. If he be laboring under an inflammation of the lungs, however slight, or if he be just recovering from one, it would, of course, be highly improper. In the management of a child, we must take care neither to coddle nor to expose him unnecessarily, as both are dangerous.

Never send a child out to walk in a fog; he will, if you do, be almost sure to catch cold. It would be much safer to send him out in rain than in fog; though neither the one nor the other would be desirable.

174. How many times a day, in fine weather, ought a child to be sent out?

Let him be sent out as often as it be possible. If a child lived more in the open air than he is wont to do, he would neither be so susceptible of disease, nor would he suffer so much from teething.

175. Supposing the day to be wet, what exercise would you then recommend?

The child ought to run either about a large room or about the hall; and, if it does not rain violently, you should put on his hat and throw up the window, taking care while the window is open that he does not stand still.

Do not on any account allow him to sit any length 1176of time at a table, amusing himself with books, etc.; let him be acting and stirring, that his blood may freely circulate as it ought to do, and that his muscles may be well developed. I would rather see him actively engaged in mischief, than sitting still, doing nothing. He ought to be put on the carpet, and should then be tumbled and rolled about, to make the blood bound merrily through the vessels, to stir up the liver, to promote digestion, and to open the bowels. The misfortune of it is, the present race of nurses are so stuck out with crinoline, that they are not able to stoop properly, and thus to have a good game at romps with their little charges.

176. Supposing it to be winter, and the weather to be very cold, would you still send a child out?

Decidedly, provided he be well wrapped up. The cold will brace and strengthen him. Cold weather is the finest tonic in the world.

In frosty weather, the roads being slippery, when you send him out to walk, put a pair of large, old woolen stockings over his boots or shoes. This will not only keep his feet and his legs warm, but it will prevent him from falling down and hurting himself. While thus equipped, he may even walk on a slide of ice without falling down.

A child, in the winter time, requires, to keep him warm, plenty of flannel and plenty of food, plenty of fresh and genuine milk, and plenty of water in his tub to wash him in a morning, plenty of exercise and plenty of play, and then he may brave the frosty air. It is the coddled, the half-washed, and the half-starved 1177child (half-washed and half-starved from either the mother’s ignorance or from the mother’s timidity), that is the chilly starveling,—catching cold at every breath of wind, and every time he either walks or is carried out,—a puny, skinny, scraggy, scare-crow, more dead than alive, and more fit for his grave than for the rough world he will have to struggle in!

AMUSEMENTS.

177. Have you any remarks to make on the amusements of a child?

Let the amusements of a child be as much as possible out of doors; let him spend the greater part of every day in the open air; let him exert himself as much as he pleases, his feelings will tell him when to rest and when to begin again; let him be what Nature intended him to be—a happy, laughing, joyous child. Do not let him be always poring over books.

“Books! ’tis a dull and endless strife,
Come, hear the woodland linnet!
How sweet his music! On my life
There’s more of wisdom in it.
And hark! how blithe the throstle sings!
He, too, is no mean preacher:
Come forth into the light of things,—
Let Nature be your teacher.
She has a world of ready wealth,
Our minds and hearts to bless,—
Spontaneous wisdom breathed by health,
Truth breathed by cheerfulness.
1178One impulse from a vernal wood,
May teach you more of man,
Of moral evil and of good,
Than all the sages can.”[211]

He ought to be encouraged to engage in those sports wherein the greatest number of muscles are brought into play. For instance, to play at ball, or hoop, or football, to play at horses, to run to certain distances and back; and, if a girl, to amuse herself with a skipping-rope, such being excellent exercise—

“By sports like these are all their cares beguiled,—
The sports of children satisfy the child.”[212]

Every child, where it be practicable, should have a small plot of ground to cultivate, that he may dig and delve in, and make dirt-pies if he choose. Children, nowadays, unfortunately, are not allowed to soil their hands and their fine clothes. For my own part, I dislike such model children; let a child be natural—let him, as far as is possible, choose his own sports. Do not be always interfering with his pursuits, and be finding fault with him. Remember, what may be amusing to you may be distasteful to him. I do not, of course, mean but that you should constantly have a watchful eye over him; yet do not let him see that he is under restraint or surveillance; if you do, you will never discover his true character and inclinations. Not only so, but do not dim the bright sunshine of his early life by constantly checking and thwarting him. Tupper beautifully says:

1179“And check not a child in his merriment.—
Should not his morning be sunny?”

When, therefore, he is either in the nursery or in the play-ground, let him shout and riot and romp about as much as he pleases. His lungs and his muscles want developing, and his nerves require strengthening; and how can such be accomplished unless you allow them to be developed and strengthened by natural means?

The nursery is a child’s own domain; it is his castle, and he should be Lord Paramount therein. If he choose to blow a whistle, or to spring a rattle, or to make any other hideous noise, which to him is sweet music, he should be allowed, without let or hinderance, to do so. If any members of the family have weak nerves, let them keep at a respectful distance.

A child who never gets into mischief must be either sly, or delicate, or idiotic; indeed, the system of many persons in bringing up children is likely to make them either the one or the other. The present plan of training children is nearly all work (books), and very little play. Play, and plenty of it, is necessary to the very existence of a child.

A boy not partial to mischief, innocent mischief, and play, is unnatural; he is a man before his time, he is a nuisance, he is disagreeable to himself and to every one around. “A boy not fond of fun and frolic may possibly make a tolerable man, but he is an intolerable boy.”

Girls, at the present time, are made clever simpletons; their brains are worked with useless knowledge, which totally unfits them for everyday duties. Their muscles are allowed to be idle, which makes them limp 1180and flabby. The want of proper exercise ruins the complexion, and their faces become of the color of a tallow candle! And precious wives and mothers they make when they do grow up! Grow up, did I say! They grow all manner of ways, and are as crooked as crooked sticks!

What an unnatural thing it is to confine a child several hours a day to his lessons; why, you might as well put a colt in harness, and make him work for his living! A child is made for play; his roguish little eye, his lithe figure, his antics, and his drollery, all point out that he is cut out for play—that it is as necessary to his existence as the food he eats, and as the air he breathes!

A child ought not to be allowed to have playthings with which he can injure either himself or others, such as toy-swords, toy-cannons, toy-paint-boxes, knives, bows and arrows, hammers, chisels, saws, etc. He will not only be likely to injure himself and others, but will make sad havoc on furniture, house, and other property. Fun, frolic, and play ought, in all innocent ways, to be encouraged; but willful mischief and dangerous games ought, by every means, to be discountenanced. This advice is frequently much needed, as children prefer to have and delight in dangerous toys, and often coax and persuade weak and indulgent mothers to gratify their wishes.

Painted toys are, many of them, highly dangerous, those painted green especially, as the color generally consists of Scheele’s green—arsenite of copper.

Children’s paint-boxes are very dangerous toys for a 1181child to play with: many of the paints are poisonous, containing arsenic, lead, gamboge, etc., and a child, when painting, is apt to put the brush into his mouth, to absorb the superabundant fluid. Of all the colors, the green paint is the most dangerous, as it is frequently composed of arsenite of copper—arsenic and copper—two deadly poisons.

There are some paint-boxes warranted not to contain a particle of poison of any kind: these ought, for a child, to be chosen by a mother.

But, remember, although he ought not to be allowed to have poison paint-boxes and poison-painted toys, he must have an abundance of toys, such as the white-wood toys—brewers’ drays, millers’ wagons, boxes of wooden bricks, etc. The Noah’s Ark is one of the most amusing and instructive toys for a child. “Those fashioned out of brown, unpainted pine-wood by the clever carvers of Nuremberg or the Black Forest are the best, I think, not only because they are the most spirited, but because they will survive a good deal of knocking about, and can be sucked with impunity. From the first dawn of recollection, children are thus familiarized with the forms of natural objects, and may be well up in natural history before they have mastered the A B C.”[213]

Parents often make Sunday a day of gloom: to this I much object. Of all the days in the week, Sunday should be the most cheerful and pleasant. It is considered 1182by our Church a festival; and a glorious festival it ought to be made, and one on which our Heavenly Father wishes to see all His children happy and full of innocent joy! Let Sunday, then, be made a cheerful, joyous, innocently happy day, and not, as it frequently is, the most miserable and dismal in the week. It is my firm conviction that many men have been made irreligious by the ridiculously strict and dismal way they were compelled, as children, to spend their Sundays. You can no more make children religious by gloomy asceticism, than you can make people good by Act of Parliament!

One of the great follies of the present age is, children’s parties, where they are allowed to be dressed like grown-up women, stuck out in crinoline, and encouraged to eat rich cake and pastry, and to drink wine, and to sit up late at night! There is something disgusting and demoralizing in all this. Their pure minds are blighted by it. Do not let me be misunderstood: there is not the least objection, but, on the contrary, great advantage, for friends’ children to meet friends’ children; but then let them be treated as children, and not as men and women!

178. Do you approve of public play-grounds for children?

It would be well, in every village, and in the outskirts of every town, if a large plot of ground were set apart for children to play in, and to go through regular gymnastic exercises. Play is absolutely necessary to a child’s very existence, as much as food and sleep; but in many parts of England where is he to 1183have it? Play-grounds and play are the best schools we have; they teach a great deal not taught elsewhere; they give lessons in health, which is the grandest wealth that can be bestowed—“for health is wealth;” they prepare the soil for the future school-master; they clear the brain, and thus the intellect; they strengthen the muscles; they make the blood course merrily through the arteries; they bestow healthy food for the lungs; they give an appetite; they make a child, in due time, become every inch a man! Play-grounds and play are one of the finest Institutions we possess. What would our large public schools be without their play and cricket-grounds? They would be shorn of half their splendor and usefulness!

There is so much talk nowadays about useful knowledge, that the importance of play and play-grounds is likely to be forgotten. I cannot help thinking, however, that a better state of things is dawning. “It seems to be found out that in our zeal for useful knowledge, that knowledge is found to be not the least useful which treats boys as active, stirring, aspiring, and ready.”[214]

EDUCATION.

179. Do you approve of infant schools?

I do, if the arrangements be such that health is preferred before learning.[215] Let children be only confined 1184for three or four hours a day, and let what little they learn be taught as an amusement rather than as a labor. A play-ground ought to be attached to an infants’ school; where, in fine weather, for every half hour they spend in-doors, they should spend one in the open air; and, in wet weather, they ought to have, in lieu of the play-ground, a large room to romp, and shout, and riot in. To develop the different organs, muscles, and other parts of the body, children require fresh air, a free use of their lungs, active exercise, and their bodies to be thrown into all manner of attitudes. Let a child mope in a corner, and he will become stupid and sickly. The march of intellect, as it is called, or rather the double quick march of intellect, as it should be called, has stolen a march upon health. Only allow the march of intellect and the march of health to take equal strides, and then we shall have “mens sana in corpore sano” (a sound mind in a sound body).

In the education of a young child, it is better to instruct him by illustration and by encouraging observation on things around and about him, than by books. It is surprising how much, without endangering the health, may be taught in this way. In educating your 1185child, be careful to instill and to form good habits—they will then stick to him for life.

Children at the present day are too highly educated—their brains are overtaxed, and thus weakened. The consequence is, that as they grow up to manhood, if they grow up at all, they become fools! Children are now taught what formerly youths were taught. The chord of a child’s life is ofttimes snapped asunder in consequence of overeducation:

“Screw not the chord too sharply, lest it snap.”[216]

You should treat a child as you would a young colt. Think only at first of strengthening his body. Let him have a perfectly free, happy life, plenty of food to eat, abundance of air to breathe, and no work to do; there is plenty of time to think of his learning—of giving him brain work. It will come sadly too soon; but do not make him old before his time.

180. At what age do you advise my child to begin his course of education—to have his regular lessons?

In the name of the prophet,—Figs! Fiddlesticks! about courses of education and regular lessons for a child! You may as well ask me when he, a child, is to begin Hebrew, the Sanscrit, and Mathematics! Let him have a course of education in play; let him go through regular lessons in football, bandy, playing at tic, hares and hounds, and such like excellent and really useful and health-giving lessons. Begin his lessons! Begin brainwork, and make an idiot of him! Oh! for 1186shame, ye mothers! You who pretend to love your children so much, and to tax, otherwise to injure, irreparably to injure their brains, and thus their intellects and their health, and to shorten their very days. And all for what? To make prodigies of them! Forsooth! to make fools of them in the end.

181. Well, then, as you have such a great objection to a child commencing his education early in life, at what age may he, with safety, commence his lessons? and which do you prefer—home or school education?

Home is far preferable to a school education for a child. If at home, he is under your own immediate observation, and is not liable to be contaminated by naughty children; for, in every school, there is necessarily a great mixture of the good and of the bad; and a child, unfortunately, is more likely to be led by a bad than by a good child.

Moreover, if the child be educated at home, the mother can see that his brain be not overworked. At school the brain is apt to be overworked, and the stomach and the muscles to be underworked.

Remember, as above stated, the brain must have but very little work until the child be seven years old: impress this advice upon your memory, and let no foolish ambition to make your child a clever child allow you, for one moment, to swerve from this advice.

Build up a strong, healthy body, and in due time the brain will bear a moderate amount of intellectual labor.

As I have given you so much advice, permit me, for one moment, to address a word to the father of your child:

1187Let me advise you, then, Mr. Paterfamilias, to be careful how you converse, what language you use, while in the company of your child. Bear in mind, a child is very observant, and thinks much, weighs well, and seldom forgets all you say and all you do? Let no hasty word, then, and more especially no oath, or no impious language, ever pass your lips, if your child is within hearing. It is, of course, at all times wicked to swear; but it is heinously and unpardonably sinful to swear in the presence of your child! “Childhood is like a mirror, catching and reflecting images. One impious or profane thought, uttered by a parent’s lip, may operate upon the young heart like a careless spray of water thrown upon polished steel, staining it with rust, which no after-scouring can efface.”

Never talk secrets before a child—“little pitchers have long ears;” if you do, and he disclose your secrets,—as most likely he will,—and thus make mischief, it will be cruel to scold him; you will, for your imprudence, have yourself only to blame. Be most careful, then, in the presence of your child, of what you say and of whom you speak. This advice, if followed, might save a great deal of annoyance and vexation.

182. Are you an advocate for a child being taught singing?

I am; I consider singing a part of a child’s education. Singing expands the walls of the chest, strengthens and invigorates the lungs, gives sweetness to the voice, improves the pronunciation, and is a great pleasure and amusement to a child.

1188

SLEEP.

183. Do you approve of a child sleeping on a FEATHER bed?

A feather bed enervates his body, and, if he be so predisposed, causes rickets, and makes him crooked. A horse-hair mattress is the best for a child to lie on. The pillow, too, should be made of horse-hair. A feather pillow often causes the head to be bathed in perspiration, thus enervating the child and making him liable to catch cold. If he be at all rickety, if he be weak in the neck, if he be inclined to stoop, or if he be at all crooked, let him, by all means, lie without a pillow.

184. Do you recommend a child, in the middle of the day, to be put to sleep?

Let him be put on his mattress awake at twelve o’clock, that he may sleep for an hour or two before dinner, then he will rise both refreshed and strengthened for the remainder of the day. I said, let him be put down awake. He might, for the first few times, cry; but, by perseverance, he will without any difficulty fall to sleep. The practice of sleeping before dinner ought to be continued until he be two years old, and if he can be prevailed upon, even longer. For if he do not have sleep in the middle of the day, he will all the afternoon and the evening be cross; and when he does go to bed, he will probably be too tired to sleep, or his nerves, having been exhausted by the long wakefulness, he will fall into a troubled, broken slumber, and not into that sweet, soft, gentle repose, so characteristic of healthy, happy childhood!

1189185. At what hour ought a child to be put to bed in the evening?

At six in the winter, and at seven o’clock in the summer. Regularity ought to be observed, as regularity is very conducive to health. It is a reprehensible practice to keep a child up until nine or ten o’clock at night. If this be done, he will, before his time, become old, and the seeds of disease will be sown.

As soon as he can run, let him be encouraged, for half an hour before he goes to bed, to race either about the hall, or the landing, or a large room, which will be the best means of warming his feet, of preventing chilblains, and of making him sleep soundly.

186. Have you any directions to give me as to the placing of my child in his bed?

If a child lie alone, place him fairly on his side in the middle of the bed; if it be winter time, see that his arms and hands be covered with the bedclothes; if it be summer, his hands might be allowed to be outside the clothes.

In putting him down to sleep, you should ascertain that his face be not covered with the bedclothes; if it be, he will be poisoned with his own breath—the breath constantly giving off carbonic acid gas; which gas must, if his face be smothered in the clothes, be breathed—carbonic acid gas being highly poisonous.

You can readily prove the existence of carbonic acid gas in the breathing, by simply breathing into a little lime-water; after breathing for a few seconds into it, a white film will form on the top; the carbonic acid gas from the breath unites with the lime of the lime-water, 1190and the product of the white film is carbonate of lime.

187. Do you advise a bedroom to be darkened at night?

Certainly. A child sleeps sounder and sweeter in a dark than in a light room. There is nothing better, for the purpose of darkening a bed room, than Venetian blinds.

Remember, then, a well-ventilated, but a darkened chamber at night. The cot or the crib ought not to face the window, “as the light is best behind.”[217]

188. Which is the best position for a child when sleeping—on his back, or on his side?

His side. He ought to be accustomed to change about—on the right side one night, on the left another; and occasionally, for a change, he should lie on his back. By adopting this plan you will not only improve his figure, but likewise his health. Lying, night after night, in one position, would be likely to make him crooked.

189. Do you advise, in the winter time, that there should be a fire in the night nursery?

Certainly not, unless the weather be intensely cold. I dislike fires in bedrooms, especially for children; they are very enervating, and make a child liable to catch cold. Cold weather is very bracing, particularly at night. “Generally speaking,” says the Siècle, “during winter, apartments are too much heated. The temperature in them ought not to exceed 16° Centigrade (59° Fahrenheit); and even in periods of great cold, 1191scientific men declare that 12° or 14° had better not be exceeded. In the wards of hospitals, and in the chambers of the sick, care is taken not to have greater heat than 15°. Clerks in offices, and other persons of sedentary occupations, when the rooms in which they sit are too much heated, are liable to cerebral [brain] congestion and to pulmonary [lung] complaints. In bedrooms, and particularly those of children, the temperature ought to be maintained rather low; it is even prudent only rarely to make fires in them, especially during the night.”

“If a cold stable make a healthy horse,” I am quite sure that a moderately cold and well-ventilated bedroom helps to make a healthy child. But still, in the winter time, if the weather be biting cold, a little fire in the bedroom grate is desirable. In bringing up children, we must never run into extremes—the coddling system and the hardening system are both to be deprecated; the coddling system will make a strong child weakly, while the hardening system will probably kill a delicate one.

A child’s bed ought, of course, to be comfortably clothed with blankets—I say blankets, as they are much superior to coverlids; the perspiration will more readily pass through a blanket than a coverlid. A thick coverlid ought never to be used; there is nothing better for a child’s bed than the old-fashioned patchwork coverlid, as the perspiration will easily escape through it.

190. Should a child be washed and dressed AS SOON AS HE AWAKES in the morning?

1192He ought, if he awakes in anything like reasonable time; for if he doze after he be once awake, such slumber does him more harm than good. He should be up every morning as soon as it is light. If, as a child, he be taught to rise early, it will make him an early riser for life, and will tend greatly to prolong both his existence and his happiness.

Never awake a child from his sleep to dress him, to give him medicine, or for any other purpose; let him always sleep as long as he can; but the moment he awakes let him be held out, and then let him be washed and dressed, and do not wait, as many a silly nurse does, until he has wet his bed, until his blood be chilled, and until he be cross, miserable, and uncomfortable! How many babies are made ill by such foolish practices!

The moment he leaves his bed, turn back to the fullest extent the clothes, in order that they may be thoroughly ventilated and sweetened. They ought to be exposed to the air for at least an hour before the bed be made. As soon as he leaves his room, be it winter or summer, throw open the windows.

191. Ought a child to lie alone?

He should after he is weaned. He will rest more comfortably, and his sleep will be more refreshing.

192. Supposing a child should not sleep well, what ought to be done? Would you give him a dose of composing medicine?

Certainly not. Try the effects of exercise. Exercise in the open air is the best composing medicine in the world. Let the little fellow be well tired out, and there will be little fear of his not sleeping.

1193193. Have you any further observations to make on the subject of sleep?

Send a child joyful to bed. Do not, if you can possibly help it, let him go to bed crying. Let the last impressions he has at night be of his happy home, and of his loving father and mother, and let his last thoughts be those of joy and gladness. He will sleep all the sounder if he be sent to bed in such a frame of mind, and he will be more refreshed and nourished in the morning by his sleep.

194. What is the usual cause of a child walking in his sleep, and what measures, during such times, ought to be adopted to prevent his injuring himself?

A disordered stomach in a child of nervous temperament is usually the cause. The means to be adopted to prevent his throwing himself out of the window are to have bars to his chamber casement, and if that be not practicable, to have either nails or screws driven into the window-sash to allow the window to open only for a sufficient space for ventilation, and to have a screw window-fastening, in order that he cannot, without difficulty, open the window; to have a trusty person to sleep in his room, who should have directions given not to rouse him from his sleep, but to gently lead him back to his bed, which may frequently be done without awaking him; and to consult a medical man, who will adopt means to put his stomach into order, to brace his nerves, and to strengthen his general system. A trip to the coast and sea bathing, in such a case, is often of great service.

1194

SECOND DENTITION.

195. When does a child begin to cut his SECOND set of teeth?

Generally at seven years old. He begins to cut them at about that time; but it should be borne in mind (so wonderful are the works of God) that the second crop of teeth in embryo is actually bred and formed from the very commencement of his life, under the first tier of teeth, but which remain in abeyance for years, and do not come into play until the first teeth, having done their duty, loosen and fall out, and thus make room for the more numerous, larger, stronger, and more permanent teeth, which latter have to last for the remainder of his existence. The first set is sometimes cut with a great deal of difficulty, and produces various disease; the second, or permanent teeth, come easily, and are unaccompanied with any disorder. The following is the process: one after another of the first set gradually loosen, and either drop out, or with little pain are readily pulled out; under these, the second—the permanent teeth—make their appearance, and fill up the vacant spaces. The fang of the tooth that has dropped out is nearly all absorbed or eaten away, leaving little more than the crown. The first set consists of twenty; the second (including the wise teeth, which are not generally cut until after the age of twenty-seven) consists of thirty-two.

I would recommend you to pay particular attention to the teeth of your children; for, besides their being ornamental, their regularity and soundness are of great 1195importance to the present as well as to the future health of your offspring. If there be any irregularity in the appearance of the second set, lose no time in consulting an experienced and respectable dentist.

DISEASE, Etc.

196. Do you think it important that I should be made acquainted with the symptoms of the SERIOUS diseases of children?

Certainly. I am not advocating the doctrine of a mother treating serious diseases; far from it; it is not her province, except in certain cases of extreme urgency where a medical man cannot be procured, and where delay might be death; but I do insist upon the necessity of her knowing the symptoms of disease. My belief is, that if parents were better informed on such subjects, many children’s lives might be saved, much suffering might be averted, and much sorrow might be spared. The fact is, the knowledge of the symptoms of disease is, to a mother, almost a sealed book. If she were better acquainted with these matters, how much more useful would she be in a sick-room, and how much more readily would she enter into the plans and views of the medical man! By her knowledge of the symptoms, and by having his advice in time, she would nip disease in the bud, and the fight might end in favor of life, for “sickness is just a fight between life and death.”[218]

It is really lamentable to contemplate the amount of ignorance that still exists among mothers in all that 1196appertains to the diseases of children; although, fortunately, they are beginning to see and to feel the importance of gaining instruction on such subjects; but the light is only dawning. A writer of the present day makes the following remarks, which somewhat bear on the subject in question. He observes: “In spite of the knowledge and clear views possessed by the profession on all that concerns the management of children, no fact is more palpable than that the most grievous ignorance and incompetency prevail respecting it among the public. We want some means of making popular the knowledge which is now almost restricted to medical men, or at most, to the well-educated classes.”[219]

In the earlier editions of this work, I did not give the treatment of any serious diseases, however urgent. In the three last editions I have been induced, for reasons I will presently state, to give the treatment of some of the more urgent serious diseases, when a medical man cannot instantly be procured, and where delay might be death.

Sir Charles Locock, who has taken a kind interest in this little work, has given me valid reasons why a mother should be so enlightened. The following extracts are from a letter which I received from Sir Charles on the subject, and which he has courteously allowed me to publish. He says: “As an old physician of some experience in complaints of infants and children, I may perhaps be allowed to suggest that in a future edition you should add a few words on the 1197actual treatment of some of the more urgent infantile diseases. It is very right to caution parents against superseding the doctor, and attempting to manage serious illness themselves; but your advice, with very small exceptions, always being ‘to lose no time in sending for a medical man,’ much valuable and often irremediable time may be lost when a medical man is not to be had. Take, for instance, a case of croup: there are no directions given at all, except to send for a medical man, and always to keep medicines in the house which he may have directed. But how can this apply to a first attack? You state that a first attack is generally the worst. But why is it so? Simply because it often occurs when the parents do not recognize it, and it is allowed to get to a worse point than in subsequent attacks, when they are thoroughly alive to it. As the very best remedy, and often the only essential one, if given early, is a full emetic, surely it is better that you should give some directions as to this in a future edition, and I can speak from my own experience when I say that an emetic, given in time, and repeated to free vomiting, will cut short any case of croup. In nine cases out of ten the attack takes place in the evening or early night, and when vomiting is effected the dinner of that day is brought up nearly undigested, and the severity of the symptoms at once cut short. Whenever any remedy is valuable, the more by its being administered in time, it is surely wiser to give directions as to its use, although, as a general rule, it is much better to advise the sending for medical advice.”

The above reasons, coming from such a learned and 1198experienced physician as Sir Charles Locock, are conclusive, and have decided me to comply with his advice, to enlighten a mother on the treatment of some of the more urgent diseases of infants and of children.

In a subsequent letter addressed to myself, Sir Charles has given me the names of those urgent diseases which he considers may be treated by a mother, “where a medical man cannot be procured quickly, or not at all;” they are—Croup; Inflammation of the Lungs; Diphtheria; Dysentery; Diarrhœa; Hooping-cough, in its various stages; and Shivering Fit. Sir Charles sums up his letter to me by saying: “Such a book ought to be made as complete as possible, and the objections to medical treatment being so explained as to induce mothers to try to avoid medical men is not so serious as that of leaving them without any guide in those instances where every delay is dangerous, and yet where medical assistance is not to be obtained or not to be had quickly.”

In addition to the above, I shall give you the treatment of Bronchitis, Measles, and Scarlet Fever. Bronchitis is one of the most common diseases incidental to childhood, and, with judicious treatment, is, in the absence of the medical man, readily managed by a sensible mother. Measles is very submissive to treatment. Scarlet Fever, if it be not malignant, and if certain rules be strictly followed, is also equally amenable to treatment.

I have been fortunate in treating Scarlet Fever, and therefore think it desirable to enter fully into the treatment of a disease, which is looked upon by many 1199parents, and according to the usual mode of treatment, with just cause, with great consternation and dread. By giving my plan of treatment fully and simply, and without the slightest reservation, I am fully persuaded, through God’s blessing, that I may be the humble means of saving the lives of numbers of children.

The diseases that might be treated by a mother, in the absence of a medical, man, will form the subject of future Conversations.

197. At what age does Water on the Brain usually occur, and how is a mother to know that her child is about to labor under that disease?

Water on the brain is, as a rule, a disease of childhood; after a child is seven years old it is comparatively rare. It more frequently attacks delicate children—children who have been dry-nursed (especially if they have been improperly fed), or who have been suckled too long, or who have had consumptive mothers, or who have suffered severely from teething, or who are naturally of a feeble constitution. Water on the brain sometimes follows an attack of inflammation of the lungs, more especially if depressing measures (such as excessive leeching and the administration of emetic tartar) have been adopted. It occasionally follows in the train of contagious eruptive diseases, such as either small-pox or scarlatina. We may divide the symptoms of water on the brain into two stages. The first—the premonitory stage—which lasts four or five days, in which medical aid might be of great avail; the second—the stage of drowsiness and of coma—which usually ends in death.

1200I shall dwell on the first—the premonitory stage—in order that a mother may see the importance without loss of time of calling in a medical man:

If her child be feverish and irritable, if his stomach be disordered, if he have urgent vomitings, if he have a foul breath, if his appetite be capricious and bad, if his nights be disturbed (screaming out in his sleep), if his bowels be disordered, more especially if they be constipated, if he be more than usually excited, if his eye gleam with unusual brilliancy, if his tongue ran faster than it is wont, if his cheek be flushed and his head be hot, and if he be constantly putting his hand to his head, there is cause for suspicion. If to these symptoms be added, a more than usual carelessness in tumbling about, in hitching his foot in the carpet, or in dragging one foot after the other; if, too, he has complained of darting, shooting, lancinating pains in his head, it may then be known that the first stage of inflammation (the forerunner of water on the brain) either has taken or is about taking place. Remember, no time ought to be lost in obtaining medical aid; for the commencement of the disease is the golden opportunity, when life might probably be saved.

198. At what age, and in what neighborhood, is a child most liable to Croup, and when is a mother to know that it is about to take place?

It is unusual for a child until he be twelve months old to have croup; but, from that time until the age of two years, he is more liable to it than at any other period. The liability after two years gradually, until he be ten years old, lessens, after which time it is rare.

1201A child is more liable to croup in a low and damp, than in a high and dry neighborhood; indeed, in some situations, croup is almost an unknown disease; while in others it is only too well understood. Croup is more likely to prevail when the wind is either easterly or northeasterly.

There is no disease that requires more prompt treatment than croup, and none that creeps on more insidiously. The child at first seems to be laboring under a slight cold, and is troubled with a little dry cough; he is hot and fretful, and hoarse when he cries. Hoarseness is one of the earliest symptoms of croup; and it should be borne in mind that a young child, unless he be going to have croup, is seldom hoarse; if, therefore, your child be hoarse, he should be carefully watched, in order that, as soon as croup be detected, not a moment be lost in applying the proper remedies.

His voice at length becomes gruff, he breathes as though it were through muslin, and the cough becomes crowing. These three symptoms prove that the disease is now fully formed. These latter symptoms sometimes come on without any previous warning, the little fellow going to bed apparently quite well, until the mother is awakened, perplexed, and frightened, in the middle of the night, by finding him laboring under the characteristic cough and the other symptoms of croup. If she delay either to send for assistance, or if proper medicines be not instantly given, in a few hours it will probably be of no avail, and in a day or two the little sufferer will be a corpse!

When once a child has had croup the after-attacks 1202are generally milder. If he has once had an attack of croup, I should advise you always to have in the house medicine—a 4 oz. bottle of ipecacuanha wine, to fly to at a moment’s notice;[220] but never omit, where practicable, in a case of croup, whether the attack be severe or mild, to send immediately for medical aid. There is no disease in which time is more precious than in croup, and where the delay of an hour may decide either for life or for death.

199. But suppose a medical man is not IMMEDIATELY to be procured, what then am I to do? more especially, as you say, that delay might be death.

What to do.—I never in my life lost a child with croup where I was called in at the commencement of the disease, and where my plans were carried out to the very letter. Let me begin by saying, Look well to the goodness and purity of the medicine, for the life of your child may depend upon the medicine being genuine. What medicine? Ipecacuanha wine! At the earliest dawn of the disease give a teaspoonful of ipecacuanha wine every five minutes, until free vomiting be excited. In croup, before he is safe, free vomiting must be established, and that without loss of time. If, after the expiration of an hour, the ipecacuanha wine (having given during that hour a teaspoonful of it every five minutes) is not sufficiently powerful for the purpose—although it generally is so (if the ipecacuanha 1203wine be good)—then let the following mixture be substituted:

Take of—Powdered Ipecacuanha, one scruple;
Wine of Ipecacuanha, one ounce and a half:

Make a Mixture. A teaspoonful to be given every five minutes, until free vomiting be excited, first well shaking the bottle.

After the vomiting, place the child for a quarter of an hour in a warm bath.[221] When out of the bath give him small doses of ipecacuanha wine every two or three hours. The following is a palatable form for the mixture:

Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:

Make a Mixture. A teaspoonful to be taken every two or three hours.

But remember, the emetic which is given at first is pure ipecacuanha wine, without a drop of either water or of syrup.

A large sponge dipped out of very hot water, and applied to the throat, and frequently renewed, oftentimes affords great relief in croup, and ought during the time the emetic is being administered in all cases to be adopted.

If it be a severe case of croup, and does not in the course of two hours yield to the free exhibition of the ipecacuanha emetic, apply a narrow strip of Smith’s tela vesicatoria to the throat, prepared in the same 1204way as for a case of inflammation of the lungs (see the Conversation on the treatment of inflammation of the lungs). With this only difference, let it be a narrower strip, only one-half the width there recommended, and apply it to the throat instead of to the chest. If a child has a very short, fat neck, there may not be room for the tela, then you ought to apply it to the upper part of the chest—just under the collar bones.

Let it be understood that the tela vesicatoria is not a severe remedy, that the tela produces very little pain—not nearly so much as the application of leeches; although, in its action, it is much more beneficial, and is not nearly so weakening to the system.

Keep the child from all stimulants; let him live on a low diet, such as milk and water, toast and water, arrow-root, etc.; and let the room be, if practicable, at a temperate heat—60° Fahrenheit, and be well ventilated.

So you see that the treatment of croup is very simple, and that the plan might be carried out by an intelligent mother. Notwithstanding which, it is your duty, where practicable, to send at the very onset of the disease for a medical man.

Let me again reiterate that if your child is to be saved the ipecacuanha wine must be genuine and good. This can only be effected by having the medicine from a highly respectable chemist. Again, if ever your child has had croup, let me again urge you always to have in the house a 4 oz. bottle of ipecacuanha wine, that you may resort to at a moment’s notice in case there be the slightest return of the disease.

1205Ipecacuanha wine, unfortunately, is not a medicine that keeps well; therefore, every three or four months a fresh bottle ought to be procured either from a medical man or from a chemist. As long as the ipecacuanha wine remains clear, it is good; but as soon as it becomes turbid it is bad, and ought to be replaced by a fresh supply.

An intelligent correspondent of mine makes the following valuable remarks on the preservation of ipecacuanha wine: “Now, I know that there are some medicines and chemical preparations which, though they spoil rapidly when at all exposed to the air, yet will keep perfectly good for an indefinite time if hermetically sealed up in a perfectly full bottle. If so, would it not be a valuable suggestion if the Apothecaries’ Hall, or some other London firm of undoubted reliability, would put up 1 oz. phials of ipecacuanha wine of guaranteed purity, sealed up so as to keep good so long as unopened, and sent out in sealed packages, with the guarantee of their name. By keeping a few such ounce bottles in an unopened state in one’s house, one might rely on being ready for any emergency. If you think this suggestion worth notice, and could induce some first-rate house to carry it out, and mention the fact in a subsequent edition of your book, you would, I think, be adding another most valuable item to an already invaluable book.”

The above suggestion of preserving ipecacuanha wine in ounce bottles, quite full, and hermetically sealed, is a very good one. The best way of hermetically sealing the bottle would be to cut the cork level 1206with the lip of the bottle, and to cover the cork with sealing-wax, in the same manner wine merchants serve some kinds of their wines, and then to lay the bottles on their sides in sawdust in the cellar. I have no doubt, if such a plan were adopted, the ipecacuanha wine would for a length of time keep good. Of course, if the wine of ipecacuanha be procured from the Apothecaries’ Hall Company, London (as suggested by my correspondent), there can be no question as to the genuineness of the article.

What NOT to do.—Do not give emetic tartar; do not apply leeches; do not keep the room very warm; do not give stimulants; do not omit to have always in the house either a 4 oz. bottle, or three or four 1 oz. bottles of ipecacuanha wine.

200. I have heard Child-crowing mentioned as a formidable disease; would you describe the symptoms?

Child-crowing, or spurious croup, as it is sometimes called, is occasionally mistaken for genuine croup. It is a more frequent disorder than the latter, and requires a different plan of treatment. Child-crowing is a disease that almost invariably occurs only during dentition, and is most perilous. But if a child laboring under it can fortunately escape suffocation until he has cut the whole of his first set of teeth—twenty—he is then, as a rule, safe.

Child-crowing comes on in paroxysms. The breathing during the intervals is quite natural—indeed, the child appears perfectly well; hence the dangerous nature of the disease is either overlooked, or is lightly 1207thought of, until perhaps a paroxysm worse than common takes place, and the little patient dies of suffocation, overwhelming the mother with terror, with confusion, and dismay.

The symptoms in a paroxysm of child-crowing are as follows: The child suddenly loses and fights for his breath, and in doing so makes a noise very much like that of crowing; hence the name child-crowing. The face during the paroxysm becomes bluish or livid. In a favorable case, after either a few seconds, or even, in some instances, a minute, and a frightful struggle to breathe, he regains his breath, and is, until another paroxysm occurs, perfectly well. In an unfavorable case, the upper part (chink) of the windpipe remains for a minute or two closed, and the child, not being able to breathe, drops a corpse in his nurse’s arms. Many children, who are said to have died of fits, have really died of child-crowing.

I have entered thus rather fully into the subject, as many lives might be saved if a mother knew the nature of the complaint, and the great necessity, during the paroxysms, of prompt and proper measures. For, too frequently, before a medical man has had time to arrive, the child has breathed his last, the parent herself being perfectly ignorant of the necessary treatment; hence the vital importance of the subject, and the paramount necessity of imparting information, in a popular style, in a work of this kind.

201. What treatment, then, during a paroxysm of Child-crowing should you advise?

The first thing, of course, to be done is to send immediately 1208for a medical man. Have a plentiful supply of cold and of hot water always at hand, ready at a moment’s notice for use. The instant the paroxysm is upon the child, plentifully and perseveringly dash cold water upon his head and face. Put his feet and legs in hot salt, mustard, and water; and, if necessary, place him up to his neck in a hot bath, still dashing water upon his face and head. If he does not quickly come round, sharply smack his back and buttocks.

As soon as a medical man arrives, he will lose no time in thoroughly lancing the gums and in applying other appropriate remedies.

Great care and attention ought, during the intervals, to be paid to the diet. If the child is breathing a smoky, close atmosphere, he should be immediately removed to a pure one. In this disease, indeed, there is no remedy equal to a change of air—to a dry, bracing neighborhood. Change of air, even if it be winter, is the best remedy, either to the coast or to a healthy farm-house. I am indebted to Mr. Roberton, of Manchester (who has paid great attention to this disease, and who has written a valuable essay on the subject[222]), for the knowledge of this fact. Where, in a case of this kind, it is not practicable to send a child from home, then let him be sent out of doors the greater part of every day; let him, in point of fact, almost live in the open air. I am quite sure, from an extensive experience, that in this disease, fresh air, and plenty of it, is the best and principal remedy.

1209202. When is a mother to know that a cough is not a “tooth-cough,” but one of the symptoms of Inflammation of the Lungs?

If the child has had a shivering fit; if his skin be very hot and very dry; if his lips be parched; if there be great thirst; if his cheeks be flushed; if he be dull and heavy, wishing to be quiet in his cot or crib; if his appetite be diminished; if his tongue be furred; if his mouth be burning hot and dry;[223] if his urine be scanty and high-colored, staining the napkin or the linen; if his breathing be short, panting, hurried, and oppressed; if there be a hard, dry cough; and if his skin be burning hot; then there is no doubt that inflammation of the lungs has taken place.

No time should be lost in sending for medical aid; indeed, the hot, dry mouth and skin, and short hurried breathing would be sufficient cause for your procuring immediate assistance. If inflammation of the lungs were properly treated at the onset, a child would scarcely ever be lost by that disease. I say this advisedly, for in my own practice, provided I am called in early, and if my plans are strictly carried out, I scarcely ever lose a child from inflammation of the lungs.

You may ask—What are your plans? I will tell you, in case you cannot promptly obtain medical advice, as delay might be death.

1210The treatment of Inflammation of the Lungs, what to do.—Keep the child to one room, to his bedroom, and to his bed. Let the chamber be properly ventilated. If the weather be cool, let a small fire be in the grate; otherwise, he is better without a fire. Let him live on low diet, such as weak black tea, milk and water, and toast and water, thin oatmeal gruel, arrow-root, and such like simple beverages, and give him the following mixture:

Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:

Make a Mixture. A teaspoonful of the mixture to be taken every four hours.

Be careful that you go to a respectable chemist, in order that the quality of the ipecacuanha wine may be good, as the child’s life may depend upon it.

If the medicine produces sickness, so much the better; continue it regularly until the short, oppressed, and hurried breathing has subsided, and has become natural.

If the attack be very severe, in addition to the above medicine, at once apply a blister, not the common blister, but Smith’s tela vesicatoria—a quarter of a sheet, which ought to be fastened on to a piece of sticking-plaster, taking care to apply the tela vesicatoria (which is on paper) to the warmed plaster, so as to securely fasten the tela vesicatoria on the sticking-plaster. The plaster should be rather larger than the blister, so as to leave a margin. Any respectable chemist will understand the above directions, and will 1211prepare the tela ready for use. If the child be a year old, the blister ought to be kept on for three hours, and then a piece of dry, soft linen rag should be applied for another three hours. At the end of which time—six hours—there will be a beautiful blister, which must then, with a pair of scissors, be cut, to let out the water; and then let the blister be dressed, night and morning, with simple cerate spread on lint.

If the little patient be more than one year, say two years old, let the tela remain on for five hours, and the dry linen rag for five hours more, before the blister, as above recommended, be cut and dressed.

If in a day or two the inflammation still continue violent, let another tela vesicatoria be applied, not over the old blister, but let a narrow slip of it, on sticking-plaster, be applied on each side of the old blister, and managed in the same manner as before directed.

I cannot speak too highly of Smith’s tela vesicatoria. It has, in my hands, through God’s blessing, saved the lives of scores of children. It is far, very far superior to the old-fashioned blistering plaster. It seldom, if the above rules be strictly observed, fails to rise; it gives much less pain than the common blister; when it has had the desired effect, it readily heals, which cannot always be said of the common fly-blister, more especially with children.

My sheet-anchors, then, in the inflammation of the lungs of children, are, ipecacuanha wine and Smith’s tela vesicatoria. Let the greatest care, as I before advised, be observed in obtaining the ipecacuanha wine 1212genuine and good. This can only be depended upon by having the medicine from a highly respectable chemist. Ipecacuanha wine, when genuine and good, is, in many children’s diseases, one of the most valuable of medicines.

What, in a case of Inflammation of the Lungs, NOT to do.—Do not, on any account, apply leeches. They draw out the life of the child, but not his disease. Avoid—emphatically let me say so—giving emetic tartar. It is one of the most lowering and death-dealing medicines that can be administered either to an infant or to a child! If you wish to try the effect of it, take a dose yourself, and I am quite sure that you will then never be inclined to poison a baby with such an abominable preparation! In olden times—many, many years ago—I myself gave it in inflammation of the lungs, and lost many children! Since leaving it off, the recoveries of patients by the ipecacuanha treatment, combined with the external application of Smith’s tela vesicatoria, have been in many cases marvelous. Avoid broths and wine, and all stimulants. Do not put the child into a warm bath, it only oppresses the already oppressed breathing. Moreover, after he is out of the bath, it causes a larger quantity of blood to rush back to the lungs and to the bronchial tubes, and thus feeds the inflammation. Do not, by a large fire, keep the temperature of the room high. A small fire, in the winter time, encourages ventilation, and in such a case does good. When the little patient is on the mother’s or on the nurse’s lap, do not burden him either with a heavy blanket or with a thick shawl. 1213Either a child’s thin blanket, or a thin woolen shawl, in addition to his usual night-gown, is all the clothing necessary.

203. Is Bronchitis a more frequent disease than Inflammation of the Lungs? Which is the most dangerous? What are the symptoms of Bronchitis?

Bronchitis is a much more frequent disease than inflammation of the lungs; indeed, it is one of the most common complaints both of infants and of children, while inflammation of the lungs is comparatively a rare disease. Bronchitis is not nearly such a dangerous disease as inflammation of the lungs.

The symptoms.—The child for the first few days labors under symptoms of a heavy cold; he has not his usual spirits. In two or three days, instead of the cold leaving him, it becomes more confirmed; he is now really poorly, fretful, and feverish; his breathing becomes rather hurried and oppressed; his cough is hard and dry and loud; he wheezes, and if you put your ear to his naked back, between his shoulder-blades, you will hear the wheezing more distinctly. If at the breast, he does not suck with his usual avidity; the cough, notwithstanding the breast is a great comfort to him, compels him frequently to loose the nipple; his urine is scanty, and rather high-colored, staining the napkin, and smelling strongly. He is generally worse at night.

Well, then, remember if the child be feverish, if he have symptoms of a heavy cold, if he have an oppression of breathing, if he wheeze, and if he have a tight, dry, noisy cough, you may be satisfied that he has an attack of bronchitis.

1214204. How can I distinguish between Bronchitis and Inflammation of the Lungs?

In bronchitis the skin is warm but moist; in inflammation of the lungs it is hot and dry: in bronchitis the mouth is warmer than usual, but moist; in inflammation of the lungs it is burning hot: in bronchitis the breathing is rather hurried, and attended with wheezing; in inflammation of the lungs it is very short and panting, and is unaccompanied with wheezing, although occasionally a very slight crackling sound might be heard: in bronchitis the cough is long and noisy; in inflammation of the lungs it is short and feeble: in bronchitis the child is cross and fretful; in inflammation of the lungs he is dull and heavy, and his countenance denotes distress.

We have sometimes a combination of bronchitis and of inflammation of the lungs, an attack of the latter following the former. Then the symptoms will be modified, and will partake of the character of the two diseases.

205. How would you treat a case of Bronchitis?

If a medical man cannot be procured, I will tell you what to do: Confine the child to his bedroom, and if very ill, to his bed. If it be winter time, have a little fire in the grate, but be sure that the temperature of the chamber is not above 60° Fahrenheit, and let the room be properly ventilated, which may be effected by occasionally leaving the door a little ajar.

Let him lie either outside the bed or on a sofa; if he be very ill, inside the bed, with a sheet and a blanket only to cover him, but no thick coverlid. If he be 1215allowed to lie on the lap, it only heats him and makes him restless. If he will not lie on the bed, let him rest on a pillow placed on the lap; the pillow will cause him to lie cooler, and will more comfortably rest his wearied body. If he be at the breast, keep him to it; let him have no artificial food, unless, if he be thirsty, a little toast and water. If he be weaned, let him have either milk and water, arrow-root made with equal parts of milk and water, toast and water, barley-water, or weak black, tea, with plenty of new milk in it, etc.; but, until the inflammation has subsided, neither broth nor beef-tea.

Now, with regard to medicine, the best medicine is ipecacuanha wine, given in large doses, so as to produce constant nausea. The ipecacuanha abates fever, acts on the skin, loosens the cough, and, in point of fact, in the majority of cases will rapidly effect a cure. I have in a preceding Conversation[224] given you a prescription for the ipecacuanha wine mixture. Let a teaspoonful of the mixture be taken every four hours.

If in a day or two he be no better, but worse, by all means continue the mixture, whether it produce sickness or otherwise; and put on the chest a tela vesicatoria, prepared and applied as I recommended when treating of inflammation of the lungs.[224]

The ipecacuanha wine and the tela vesicatoria are my sheet-anchors in the bronchitis, both of infants and of children. They rarely, even in very severe cases, fail to effect a cure, provided the tela vesicatoria be 1216properly applied, and the ipecacuanha wine be genuine and of good quality.

If there be any difficulty in procuring good ipecacuanha wine, the ipecacuanha may be given in powder instead of the wine. The following is a pleasant form:

Take of—Powder of Ipecacuanha, twelve grains;
White Sugar, thirty-six grains:

Mix well together, and divide into twelve powders. One of the powders to be put dry on the tongue every four hours.

The ipecacuanha powder will keep better than the wine, an important consideration to those living in country places; nevertheless, if the wine can be procured fresh and good, I far prefer the wine to the powder.

When the bronchitis has disappeared, the diet ought gradually to be improved—rice, sago, tapioca, and light batter pudding, etc.; and in a few days, either a little chicken or a mutton-chop, mixed with a well-mashed potato and crumb of bread, should be given. But let the improvement in his diet be gradual, or the inflammation might return.

What NOT to do.—Do not apply leeches. Do not give either emetic tartar, or antimonial wine, which is emetic tartar dissolved in wine. Do not administer either paregoric or syrup of poppies, either of which would stop the cough, and would thus prevent the expulsion of the phlegm. Any fool can stop a cough, but it requires a wise man to rectify the mischief. A cough is an effort of nature to bring up the phlegm, which would otherwise accumulate, and in the end 1217cause death. Again, therefore, let me urge upon you the immense importance of not stopping the cough of a child. The ipecacuanha wine will, by loosening the phlegm, loosen the cough, which is the only right way to get rid of a cough. Let what I have now said be impressed deeply upon your memory, as thousands of children in England are annually destroyed by having their coughs stopped. Avoid, until the bronchitis be relieved, giving him broths, and meat, and stimulants of all kinds. For further observations on what NOT to do in bronchitis, I beg to refer you to a previous Conversation we had on what NOT to do in inflammation of the lungs. That which is injurious in the one case is equally so in the other.

206. What are the symptoms of Diphtheria, or, as it is sometimes called, Boulogne sore-throat?

This terrible disease, although by many considered to be a new complaint, is, in point of fact, of very ancient origin. Homer, and Hippocrates, the father of physic, have both described it. Diphtheria first appeared in England in the beginning of the year 1857, since which time it has never totally left our shores.

The symptoms.—The little patient, before the disease really shows itself, feels poorly, and is “out of sorts.” A shivering fit, though not severe, may generally be noticed. There is heaviness, and slight headache, principally over the eyes. Sometimes, but not always, there is a mild attack of delirium at night. The next day he complains of slight difficulty of swallowing. If old enough, he will complain of constriction about the swallow. On examining the throat the 1218tonsils will be found to be swollen and redder—more darkly red than usual. Slight specks will be noticed on the tonsils. In a day or two an exudation will cover them, the back of the swallow, the palate, the tongue, and sometimes the inside of the cheeks and the nostrils. This exudation of lymph gradually increases until it becomes a regular membrane, which puts on the appearance of leather; hence its name diphtheria. This membrane peels off in pieces; and if the child be old and strong enough he will sometimes spit it up in quantities, the membrane again and again rapidly forming as before. The discharges from the throat are occasionally, but not always offensive. There is danger of croup from the extension of the membrane into the windpipe. The glands about the neck and under the jaw are generally much swollen; the skin is rather cold and clammy; the urine is scanty and usually pale; the bowels at first are frequently relaxed. This diarrhœa may or may not cease as the disease advances.

The child is now in a perilous condition, and it becomes a battle between his constitution and the disease. If, unfortunately, as is too often the case—diphtheria being more likely to attack the weakly—the child be very delicate, there is but slight hope of recovery. The danger of the disease is not always to be measured by the state of the throat. Sometimes, when the patient appears to be getting well, a sudden change for the worse rapidly carries him off. Hence the importance of great caution, in such cases, in giving an opinion as to ultimate recovery. I have 1219said enough to prove the terrible nature of the disease, and to show the necessity of calling in, at the earliest period of the symptoms, an experienced and skillful medical man.

207. Is Diphtheria contagious?

Decidedly. Therefore, when practicable, the rest of the children ought instantly to be removed to a distance. I say children, for it is emphatically a disease of childhood. When adults have it, it is the exception, and not the rule. “Thus it will be seen, in the account given of the Boulogne epidemic, that of 366 deaths from this cause, 341 occurred among children under ten years of age. In the Lincolnshire epidemic, in the autumn of 1858, all the deaths at Horncastle, 25 in number, occurred among children under twelve years of age.”[225]

208. What are the causes of Diphtheria?

Bad and imperfect drainage;[226] want of ventilation; overflowing privies; low neighborhoods in the vicinity 1220of rivers; stagnant waters; indeed, everything that vitiates the air and thus depresses the system, more especially if the weather be close and muggy; poor and improper food; and last, though not least, contagion. Bear in mind, too, that a delicate child is much more predisposed to the disease than a strong one.

209. What is the treatment of Diphtheria?

What to do.—Examine well into the ventilation, for as diphtheria is frequently caused by deficient ventilation, the best remedy is thorough ventilation. Look well both to the drains and to the privies, and see that the drains from the water-closets and from the privies do not in any way contaminate the pump-water. If the drains be defective or the privies be full, the disease in your child will be generated, fed, and fostered. Not only so, but the disease will spread in your family and all around you.

Keep the child to his bedroom and to his bed. For the first two or three days, while the fever runs high, put him on a low diet, such as milk, tea, arrow-root, etc.

Apply to his throat every four hours a warm barm and oatmeal poultice. If he be old enough to have the knowledge to use a gargle, the following will be found serviceable:

Take of—Powdered Alum, one drachm;
Simple Syrup, one ounce;
Water, seven ounces:

To make a Gargle.

The best medicine for the first few days of the attack, is one of the following mixtures:

1221Take of—Chlorate of Potash, two drachms;
Boiling Water, seven ounces and a half;
Syrup of Red Poppy, half an ounce:

To make a Mixture. A tablespoonful to be taken every four hours.

Or,

Take of—Diluted Sulphuric Acid, one drachm;
Simple Syrup, one ounce and a half;
Infusion of Roses,[227] four ounces and a half;

To make a Mixture. A tablespoonful to be given every four hours.

As soon as the skin has lost its preternatural heat, beef-tea and chicken broth ought to be given. Or if great prostration should supervene, in addition to the beef-tea, port wine, a tablespoonful every four hours, should be administered. If the child be cold, and there be great sinking of the vital powers, brandy and water should be substituted for the port wine. Remember, in ordinary cases, port wine and brandy are not necessary, but in cases of extreme exhaustion they are most valuable.

As soon as the great heat of the skin has abated and the debility has set in, one of the following mixtures will be found useful:

Take of—Wine of Iron, one ounce and a half;
Simple Syrup, one ounce;
Water, three ounces and a half:

To make a Mixture. A tablespoonful to be taken every four hours.

1222Or,

Take of—Muriated Tincture of Iron, half a drachm;
Simple Syrup, one ounce;
Water, three ounces:

To make a Mixture. A tablespoonful to be taken three times a day.

If the disease should travel downward, it will cause all the symptoms of croup, then it must be treated as croup; with this only difference, that a blister (tela vesicatoria) must not be applied, or the blistered surface may be attacked by the membrane of diphtheria, which may either cause death or hasten that catastrophe. In every other respect treat the case as croup, by giving an emetic, a teaspoonful of ipecacuanha wine every five minutes, until free vomiting be excited, and then administer smaller doses of ipecacuanha wine every two or three hours, as I recommended when conversing with you on the treatment of croup.

What Not to do.—Do not, on any account, apply either leeches or a blister. If the latter be applied, it is almost sure to be covered with the membrane of diphtheria, similar to that inside of the mouth and of the throat, which would be a serious complication. Do not give either calomel or emetic tartar. Do not depress the system by aperients, for diphtheria is an awfully depressing complaint of itself; the patient, in point of fact, is laboring under the depressing effects of poison, for the blood has been poisoned either by the drinking water being contaminated by fecal matter from either a privy or from a water-closet; by some horrid drain; by proximity to a pig-sty; by an overflowing 1223privy, especially if vegetable matter be rotting at the same time in it; by bad ventilation, or by contagion. Diphtheria may generally be traced either to the one or to the other of the above causes; therefore let me urgently entreat you to look well into all these matters, and thus to stay the pestilence! Diphtheria might long remain in a neighborhood if active measures be not used to exterminate it.

210. Have the goodness to describe the symptoms of Measles?

Measles commences with symptoms of a common cold; the patient is at first chilly, then hot and feverish; he has a running at the nose, sneezing, watering and redness of the eyes, headache, drowsiness, a hoarse and peculiar ringing cough, which nurses call “measle-cough,” and difficulty of breathing. These symptoms usually last three days before the eruption appears; on the fourth it (the eruption) generally makes its appearance, and continues for four days and then disappears, lasting altogether, from the commencement of the symptoms of cold to the decline of the eruption, seven days. It is important to bear in mind that the eruption consists of crescent-shaped—half-moon-shaped—patches; that they usually appear first about the face and the neck, in which places they are the best marked; then on the body and on the arms; and, lastly, on the legs, and that they are slightly raised above the surface of the skin. The face is swollen, more especially the eyelids, which are sometimes for a few days closed.

Well, then, remember, the running at the nose, the 1224sneezing, the peculiar hoarse cough, and the half-moon-shaped patches, are the leading features of the disease, and point out for a certainty that it is measles.

211. What constitutes the principal danger in Measles?

The affection of the chest. The mucous or lining membrane of the bronchial tubes is always more or less inflamed, and the lungs themselves are sometimes affected.

212. Do you recommend “surfeit water” and saffron tea to throw out the eruption in Measles?

Certainly not. The only way to throw out the eruption, as it is called, is to keep the body comfortably warm, and to give the beverages ordered by the medical man, with the chill off. “Surfeit water,” saffron tea, and remedies of that class, are hot and stimulating. The only effect they can have, will be to increase the fever and the inflammation—to add fuel to the fire.

213. What is the treatment of Measles?

What to do.—The child ought to be confined both to his room and to his bed, the room being kept comfortably warm; therefore, if it be winter time, there should be a small fire in the grate; in the summer time, a fire would be improper. The child must not be exposed to draughts; notwithstanding, from time to time, the door ought to be left a little ajar in order to change the air of the apartment; for proper ventilation, let the disease be what it may, is absolutely necessary.

Let the child, for the first few days, be kept on a low diet, such as on milk and water, arrow-root, bread and butter, etc.

1225If the attack be mild, that is to say, if the breathing be not much affected (for in measles it always is more or less affected), and if there be not much wheezing, the acidulated infusion of roses’ mixture[228] will be all that is necessary.

But suppose that the breathing is short, and that there is a great wheezing, then, instead of giving him the mixture just advised, give him a teaspoonful of a mixture composed of ipecacuanha wine, syrup, and water,[229] every four hours. And if, on the following day, the breathing and the wheezing be not relieved, in addition to the ipecacuanha mixture, apply a tela vesicatoria, as advised under the head of inflammation of the lungs.

When the child is convalescing, batter puddings, rice, and sago puddings, in addition to the milk, bread and butter, etc., should be given; and, a few days later, chicken, mutton-chops, etc.

The child ought not, even in a mild case of measles, and in favorable weather, to be allowed to leave the house under a fortnight, or it might bring on an attack of bronchitis.

What NOT to do.—Do not give either “surfeit water” or wine. Do not apply leeches to the chest. Do not expose the child to the cold air. Do not keep the bedroom very hot, but comfortably warm. Do not let the child leave the house, even under favorable circumstances, under a fortnight. Do not, while the eruption is out, give aperients. Do not, “to ease the cough,” 1226administer either emetic tartar or paregoric—the former drug is awfully depressing; the latter will stop the cough, and will thus prevent the expulsion of the phlegm.

214. What is the difference between Scarlatina and Scarlet Fever?

They are, indeed, one and the same disease, scarlatina being the Latin for scarlet fever. But, in a popular sense, when the disease is mild, it is usually called scarlatina. The latter term does not sound so formidable to the ears either of patients or of parents.

215. Will you describe the symptoms of Scarlet Fever?

The patient is generally chilly, languid, drowsy, feverish, and poorly for two days before the eruption appears. At the end of the second day, the characteristic, bright scarlet efflorescence, somewhat similar to the color of a boiled lobster, usually first shows itself. The scarlet appearance is not confined to the skin; but the tongue, the throat, and the whites of the eyes put on the same appearance; with this only difference, that on the tongue and on the throat the scarlet is much darker; and, as Dr. Elliotson accurately describes it,—“the tongue looks as if it had been slightly sprinkled with Cayenne pepper.” The eruption usually declines on the fifth, and is generally indistinct on the sixth day; on the seventh it has completely faded away. There is usually, after the first few days, great itching on the surface of the body. The skin, at the end of the week, begins to peel and to dust off, making it look as though meal had been sprinkled upon it.

1227There are three forms of scarlet fever,—the one where the throat is little, if at all affected, and this is a mild form of the disease; the second, which is generally, especially at night, attended with delirium, where the throat is much affected, being often greatly inflamed and ulcerated; and the third (which is, except in certain unhealthy districts, comparatively rare, and which is VERY dangerous), the malignant form.

216. Would it be well to give a little cooling, opening physic as soon as a child begins to sicken for Scarlet Fever?

On no account whatever. Aperient medicines are, in my opinion, highly improper and dangerous both before and during the period of the eruption. It is my firm conviction that the administration of opening medicine, at such times, is one of the principal causes of scarlet fever being so frequently fatal. This is, of course, more applicable to the poor, and to those who are unable to procure a skillful medical man.

217. What constitutes the principal danger in Scarlet Fever?

The affection of the throat, the administration of opening medicine during the first ten days, and a peculiar disease of the kidneys ending in anasarca (dropsy), on which account, the medical man ought, when practicable, to be sent for at the onset, that no time may be lost in applying proper remedies.

218. How would you distinguish between Scarlet Fever and Measles?

Measles commences with symptoms of a common cold; scarlet fever does not. Measles has a peculiar 1228hoarse cough; scarlet fever has not. The eruption of measles is in patches of a half-moon shape, and is slightly raised above the skin; the eruption of scarlet fever is not raised above the skin at all, and is one continued mass. The color of the eruption is much more vivid in scarlet fever than in measles. The chest is the part principally affected in measles, and the throat in scarlet fever.

There is an excellent method of determining, for a certainty, whether the eruption be that of scarlatina or otherwise. I myself have, in several instances, ascertained the truth of it: “For several years M. Bouchut has remarked in the eruption of scarlatina a curious phenomenon, which serves to distinguish this eruption from that of measles, erythema, erysipelas, etc., a phenomenon essentially vital, and which is connected with the excessive contractability of the capillaries. The phenomenon in question is a white line, which can be produced at pleasure by drawing the back of the nail along the skin where the eruption is situated. On drawing the nail, or the extremity of a hard body (such as a pen-holder), along the eruption, the skin is observed to grow pale, and to present a white trace, which remains for one or two minutes, or longer, and then disappears. In this way the diagnosis of the disease may be very distinctly written on the skin; the word ‘Scarlatina’ disappears as the eruption regains its uniform tint.”[230]

1229219. Is it of so much importance, then, to distinguish between Scarlet Fever and Measles?

It is of great importance, as in measles the patient ought to be kept moderately warm, and the drinks should be given with the chill off; while in scarlet fever the patient ought to be kept cool—indeed, for the first few days, cold; and the beverages, such as spring water, toast and water, etc., should be administered quite cold.

220. What is the treatment of Scarlet Fever?[231]

What to do.—Pray pay particular attention to my rules, and carry out my directions to the very letter—as I can then promise you that if the scarlet fever be not malignant, the plan I am about to recommend will, with God’s blessing, be generally successful.

What is the first thing to be done? Send the child to bed; throw open the windows, be it winter or summer, and have a thorough ventilation; for the bedroom must be kept cool, I may say cold. Do not be afraid of fresh air, for fresh air, for the first few days, is essential to recovery. Fresh air, and plenty of it, in scarlet 1230fever, is the best doctor a child can have: let these words be written legibly on your mind.[232]

Take down the curtains of the bed; remove the valances. If it be summer time, let the child be only covered with a sheet: if it be winter time, in addition to the sheet, he should have one blanket over him.

1231Now for the throat.—The best external application is a barm and oatmeal poultice. How ought it to be made, and how applied? Put half a teacupful of barm into a saucepan, put it on the fire to boil; as soon as it boils take it off the fire, and stir oatmeal into it, until it is of the consistence of a nice soft poultice; then place it on a rag, and apply it to the throat; carefully fasten it on with bandage, two or three turns of the bandage going round the throat, and two or three over the crown of the head, so as nicely to apply the poultice where it is wanted—that is to say, to cover the tonsils. Tack the bandage: do not pin it. Let the poultice be changed three times a day. The best medicine is the acidulated infusion of roses, sweetened with syrup.[233] It is grateful and refreshing, it is pleasant to take, it abates fever and thirst, it cleans the throat and tongue of mucus, and is peculiarly efficacious in scarlet fever; as soon as the fever is abated it gives an appetite. My belief is that the sulphuric acid in the mixture is a specific in scarlet fever, as much as quinine is in ague, and sulphur in itch. I have reason to say so, for, in numerous cases, I have seen its immense value.

Now, with regard to food.—If the child be at the breast, keep him entirely to it. If he be weaned, and under two years old, give him milk and water, and cold water to drink. If he be older, give him toast and water, and plain water from the pump, as much as he 1232chooses; let it be quite cold—the colder the better. Weak black tea, or thin gruel, may be given, but not caring, unless he be an infant at the breast, if he take nothing but cold water. If the child be two years old and upwards, roasted apples with sugar, and grapes will be very refreshing, and will tend to cleanse both the mouth and the throat. Avoid broths and stimulants of every kind.

When the appetite returns, you may consider the patient to be safe. The diet ought now to be gradually improved. Bread and butter, milk and water, and arrow-root made with equal parts of new milk and water, should for the first two or three days be given. Then a light batter or rice pudding may be added, and in a few days afterward, either a little chicken or a mutton-chop.

The essential remedies, then, in scarlet fever, are, for the first few days—(1) plenty of fresh air and ventilation, (2) plenty of cold water to drink, (3) barm poultices to the throat, and (4) the acidulated infusion of roses’ mixture as a medicine.

Now, then, comes very important advice. After the first few days, probably five or six, sometimes as early as the fourth day, watch carefully and warily, and note the time, the skin will suddenly become cool, the child will say that he feels chilly; then is the time you must now change your tactics—instantly close the windows, and put extra clothing, a blanket or two, on his bed. A flannel night-gown should, until the dead skin has peeled off, be now worn next to the skin, when the flannel night-gown should be discontinued. The patient 1233ought ever after to wear, in the daytime, a flannel waistcoat.[234] His drinks must now be given with the chill off; he ought to have a warm cup of tea, and gradually his diet should, as I have previously recommended be improved.

There is one important caution I wish to impress upon you,—do not give opening medicine during the time the eruption is out. In all probability the bowels will be opened: if so, all well and good; but do not, on any account, for the first ten days, use artificial means to open them. It is my firm conviction that the administration of purgatives in scarlet fever is a fruitful source of dropsy, of disease, and death. When we take into consideration the sympathy there is between the skin and the mucous membrane, I think that we should pause before giving irritating medicines, such as purgatives. The irritation of aperients on the mucous membrane may cause the poison of the skin disease (for scarlet fever is a blood poison) to be driven internally to the kidneys, to the throat, to the pericardium (bag of the heart), or to the brain. You may say, Do you not purge if the bowels be not open for a week? I say emphatically, No!

I consider my great success in the treatment of scarlet fever to be partly owing to my avoidance of aperients during the first ten days of the child’s illness.

If the bowels, after the ten days, are not properly 1234opened, a dose or two of the following mixture should be given:

Take of—Simple Syrup, three drachms;
Essence of Senna, nine drachms:

To make a Mixture. Two teaspoonfuls to be given early in the morning occasionally, and to be repeated in four hours, if the first dose should not operate.

In a subsequent Conversation, I shall strongly urge you not to allow your child, when convalescent, to leave the house under at least a month from the commencement of the illness; I therefore beg to refer you to that Conversation, and hope that you will give it your best and earnest consideration! During the last seventeen years I have never had dropsy from scarlet fever, and I attribute it entirely to the plan I have just recommended, and in not allowing my patients to leave the house under the month—until, in fact, the skin that has peeled off has been renewed.

Let us now sum up the plan I adopt:

1. Thorough ventilation, a cool room, and scant clothes on the bed, for the first five or six days.

2. A change of temperature of the skin to be carefully regarded. As soon as the skin is cool, closing the windows, and putting additional clothing on the bed.

3. The acidulated infusion of roses with syrup is the medicine for scarlet fever.

4. Purgatives to be religiously avoided for the first ten days at least, and even afterward, unless there be absolute necessity.

5. Leeches, blisters, emetics, cold and tepid spongings, 1235and painting the tonsils with caustic, inadmissible in scarlet fever.

6. A strict antiphlogistic (low) diet for the first few days, during which time cold water to be given ad libitum.

7. The patient not to leave the house in the summer under the month; in the winter, under six weeks.

What NOT to do.—Do not, then, apply either leeches or blisters to the throat; do not paint the tonsils with caustic; do not give aperients; do not, on any account, give either calomel or emetic tartar; do not, for the first few days of the illness, be afraid of cold air to the skin, and of cold water as a beverage; do not, emphatically let me say, do not let the child leave the house for at least a month from the commencement of the illness.

My firm conviction is, that purgatives, emetics, and blisters, by depressing the patient, sometimes cause ordinary scarlet fever to degenerate into malignant scarlet fever.

I am aware that some of our first authorities advocate a different plan to mine. They recommend purgatives, which I may say, in scarlet fever, are my dread and abhorrence. They advise cold and tepid spongings—a plan which I think dangerous, as it will probably drive the disease internally. Blisters, too, have been prescribed; these I consider weakening, injurious, and barbarous, and likely still more to inflame the already inflamed skin. They recommend leeches to the throat, which I am convinced, by depressing the patient, will lessen the chance of his battling against the disease, and will increase the ulceration of the tonsils. Again, 1236the patient has not too much blood; the blood is only poisoned. I look upon scarlet fever as a specific poison of the blood, and one which will be eliminated from the system, not by bleeding, not by purgatives, not by emetics, but by a constant supply of fresh and cool air, by the acid treatment, by cold water as a beverage, and for the first few days by a strict antiphlogistic (low) diet.

Sydenham says that scarlet fever is oftentimes “fatal through the officiousness of the doctor.” I conscientiously believe that a truer remark was never made; and that under a different system to the usual one adopted, scarlet fever would not be so much dreaded.[235]

221. How soon ought a child to be allowed to leave the house after an attack of Scarlet Fever?

He must not be allowed to go out for at least a month from the commencement of the attack, in the summer, and six weeks in the winter; and not even then with out the express permission of a medical man. It might be said that this is an unreasonable recommendation 1237but when it is considered that the whole of the skin generally desquamates, or peels off, and consequently leaves the surface of the body exposed to cold, which cold flies to the kidneys, producing a peculiar and serious disease in them, ending in dropsy, this warning will not be deemed unreasonable.

Scarlet fever dropsy, which is really a formidable disease, generally arises from the carelessness, the ignorance, and the thoughtlessness of parents in allowing a child to leave the house before the new skin is properly formed and hardened. Prevention is always better than cure.

Thus far with regard to the danger to the child himself. Now, if you please, let me show you the risk of contagion that you inflict upon families, in allowing your child to mix with others before a month at least has elapsed. Bear in mind, a case is quite as contagious, if not more so, while the skin is peeling off, as it was before. Thus, in ten days or a fortnight, there is as much risk of contagion as at the beginning of the disease, and when the fever is at its height. At the conclusion of the month the old skin has generally all peeled off, and the new skin has taken its place; consequently there will then be less fear of contagion to others. But the contagion of scarlet fever is so subtle and so uncertain in its duration, that it is impossible to fix the exact time when it ceases.

Let me most earnestly implore you to ponder well on the above important facts. If these remarks should be the means of saving only one child from death, or from broken health, my labor will not have been in vain.

1238222. What means do you advise to purify a house from the contagion of Scarlet Fever?

Let every room be lime-washed and then be white washed;[236] if the contagion has been virulent, let every bedroom be freshly papered (the walls having been previously stripped of the old paper and then lime-washed); let the bed, the bolsters, the pillows, and the mattresses be cleansed and purified; let the blankets and coverlids be thoroughly washed, and then let them be exposed to the open air—if taken into a field so much the better; let the rooms be well scoured; let the windows, top and bottom, be thrown wide open; let the drains be carefully examined; let the pump-water be scrutinized, to see that it be not contaminated by fecal matter, either from the water-closet or from the privy; let privies be emptied of their contents—remember this is most important advice—then put into the empty places lime and powdered charcoal, for it is a well-ascertained fact that it is frequently impossible to rid a house of the infection of scarlet fever without adopting such a course. “In St. George’s, Southwark, the medical officer reports that scarlatina ‘has raged fatally, almost exclusively where privy or drain smells are to be perceived in the houses.’”[237] Let the children who 1239have not had, or who do not appear to be sickening for scarlet fever, be sent away from home—if to a farm-house so much the better. Indeed, leave no stone unturned, no means untried, to exterminate the disease from the house and from the neighborhood.

223. Will you describe the symptoms of Chicken-pox?

It is occasionally, but not always, ushered in with a slight shivering fit; the eruption shows itself in about twenty-four hours from the child first appearing poorly. It is a vesicular[238] disease. The eruption comes out in the form of small pimples, and principally attacks the scalp, the neck, the back, the chest, and the shoulders, but rarely the face; while in small-pox the face is generally the part most affected. The next day these pimples fill with water, and thus become vesicles; on the third day they are at maturity. The vesicles are quite separate and distinct from each other. There is a slight redness around each of them. Fresh ones, while the others are dying away, make their appearance. Chicken-pox is usually attended with a slight itching of the skin; when the vesicles are scratched the fluid escapes, and leaves hard pearl-like substances, which, in a few days, disappear. Chicken-pox never leaves pit-marks behind. It is a child’s complaint; adults scarcely, if ever, have it.

224. Is there any danger in Chicken-pox; and what treatment do you advise?

1240It is not at all a dangerous, but, on the contrary, a trivial complaint. It lasts only a few days, and requires but little medicine. The patient ought, for three or four days, to keep the house, and should abstain from animal food. On the sixth day, but not until then, a dose or two of a mild aperient is all that will be required.

225. Is Chicken-pox infectious?

There is a diversity of opinion on this head, but one thing is certain—it cannot be communicated by inoculation.

226. What are the symptoms of Modified Small-pox?

The modified small-pox—that is to say, small-pox that has been robbed of its virulence by the patient having been either already vaccinated, or by his having had a previous attack of small-pox—is ushered in with severe symptoms, with symptoms almost as severe as though the patient had not been already somewhat protected either by vaccination or by the previous attack of small-pox—that is to say, he has a shivering fit, great depression of spirits and debility, malaise, sickness, headache, and occasionally delirium. After the above symptoms have lasted about three days, the eruption shows itself. The immense value of the previous vaccination, or the previous attack of small-pox, now comes into play. In a case of unprotected small-pox, the appearance of the eruption aggravates all the above symptoms, and the danger begins; while in the modified small-pox, the moment the eruption shows itself, the patient feels better, and, as a rule, rapidly recovers. The eruption of modified small-pox varies 1241materially from the eruption of the unprotected small-pox. The former eruption assumes a varied character, and is composed, first of vesicles (containing water), and secondly of pustules (containing matter), each of which pustules has a depression in the center, and thirdly of several red pimples without either water or matter in them, and which sometimes assume a livid appearance. These “breakings-out” generally show themselves more upon the wrist, and sometimes up one or both of the nostrils. While in the latter disease—the unprotected small-pox—the “breaking-out” is composed entirely of pustules containing matter, and which pustules are more on the face than on any other part of the body. There is generally a peculiar smell in both diseases—an odor once smelt never to be forgotten.

Now, there is one most important remark I have to make,—the modified small-pox is contagious. This ought to be borne in mind, as a person laboring under the disease must, if there be children in the house, either be sent away himself, or else the children ought to be banished both the house and the neighborhood. Another important piece of advice is, let all in the house—children and adults, one and all—be vaccinated, even if any or all have been previously vaccinated.

Treatment.—Let the patient keep his room, and if he be very ill, his bed. Let the chamber be well ventilated. If it be winter time, a small fire in the grate will encourage ventilation. If it be summer, a fire is out of the question; indeed, in such a case, the window-sash ought to be opened, as thorough ventilation is an important requisite of cure, both in small-pox and in 1242modified small-pox. While the eruption is out, do not on any account give aperient medicine. In ten days from the commencement of the illness a mild aperient may be given. The best medicine in these cases is, the sweetened acidulated infusion of roses,[239] which ought to be given from the commencement of the disease, and should be continued until the fever be abated. For the first few days, as long as the fever lasts, the patient ought not to be allowed either meat or broth, but should be kept on a low diet, such as on gruel, arrow-root, milk puddings, etc. As soon as the fever is abated he ought gradually to resume his usual diet. When he is convalescent, it is well, where practicable, that he should have change of air for a month.

227. How would you distinguish between Modified Small-pox and Chicken-pox?

Modified small-pox may readily be distinguished from chicken-pox, by the former disease being, notwithstanding its modification, much more severe and the fever much more intense before the eruption shows itself than chicken-pox; indeed, in chicken-pox there is little or no fever either before or after the eruption; by the former disease, the modified small-pox, consisting partly of pustules (containing matter), each pustule having a depression in the center, and the favorite localities of the pustules being the wrists and the inside of the nostrils: while, in the chicken-pox, the eruption consists of vesicles (containing water), and not pustules (containing matter), and the vesicles having 1243neither a depression in the center, nor having any particular partiality to attack either the wrists or the wings of the nose. In modified small-pox each pustule is, as in unprotected small-pox, inflamed at the base; while in chicken-pox there is only very slight redness around each vesicle. The vesicles, too, in chicken-pox are small—much smaller than the pustules are in modified small-pox.

228. Is Hooping-cough an inflammatory disease?

Hooping-cough in itself is not inflammatory, it is purely spasmodic; but it is generally accompanied with more or less of bronchitis—inflammation of the mucous membrane of the bronchial tubes—on which account it is necessary, in all cases of hooping-cough, to consult a medical man, that he may watch the progress of the disease and nip inflammation in the bud.

229. Will you have the goodness to give the symptoms, and a brief history, of Hooping-cough?

Hooping-cough is emphatically a disease of the young; it is rare for adults to have it; if they do, they usually suffer more severely than children. A child seldom has it but once in his life. It is highly contagious, and therefore frequently runs through a whole family of children, giving much annoyance, anxiety, and trouble to the mother and the nurses; hence hooping-cough is much dreaded by them. It is amenable to treatment. Spring and summer are the best seasons of the year for the disease to occur. This complaint usually lasts from six to twelve weeks—sometimes for a much longer period, more especially if proper means are not employed to relieve it.

1244Hooping-cough commences as a common cold and cough. The cough, for ten days or a fortnight, increases in intensity; at about which time it puts on the characteristic “hoop.” The attack of cough comes on in paroxysms.

In a paroxysm the child coughs so long and so violently, and expires so much air from the lungs without inspiring any, that at times he appears nearly suffocated and exhausted; the veins of his neck swell; his face is nearly purple; his eyes, with the tremendous exertion, seem almost to start from their sockets; at length there is a sudden inspiration of air through the contracted chink of the upper part of the windpipe—the glottis—causing the peculiar “hoop; and, after a little more coughing, he brings up some glairy mucus from the chest; and sometimes, by vomiting, food from the stomach; he is at once relieved until the next paroxysm occurs, when the same process is repeated, the child during the intervals, in a favorable case, appearing quite well, and after the cough is over, instantly returning either to his play or to his food. Generally, after a paroxysm he is hungry, unless, indeed, there be severe inflammation either of the chest or of the lungs. Sickness, as I before remarked, frequently accompanies hooping-cough; when it does, it might be looked upon as a good sign. The child usually knows when an attack is coming on; he dreads it, and therefore tries to prevent it; he sometimes partially succeeds; but if he does, it only makes the attack, when it does come, more severe. All causes of irritation and excitement ought, as much as possible, 1245to be avoided, as passion is apt to bring on a severe paroxysm.

A new-born babe, an infant of one or two months old, commonly escapes the infection; but if at that tender age he unfortunately catch hooping-cough, it is likely to fare harder with him than if he were older—the younger the child the greater the risk. But still, in such a case, do not despair, as I have known numerous instances of new-born infants, with judicious care, recover perfectly from the attack, and thrive after it as though nothing of the kind had ever happened.

A new-born babe laboring under hooping-cough is liable to convulsions, which is, in this disease, one, indeed the great, source of danger. A child, too, who is teething, and laboring under the disease, is also liable to convulsions. When the patient is convalescing, care ought to be taken that he does not catch cold, or the “hoop” might return. Hooping-cough may either precede, attend, or follow an attack of measles.

230. What is the treatment of Hooping-cough?

We will divide the hooping-cough into three stages, and treat each stage separately.

What to do.In the first stage, the commencement of hooping-cough: For the first ten days give the ipecacuanha wine mixture,[240] a teaspoonful three times a day. If the child be not weaned, keep him entirely to the breast; if he be weaned, to a milk and farinaceous 1246diet. Confine him for the first ten days to the house, more especially if the hooping-cough be attended, as it usually is, with more or less of bronchitis. But take care that the rooms be well ventilated, for good air is essential to the cure. If the bronchitis attending the hooping-cough be severe, confine him to his bed, and treat him as though it were simply a case of bronchitis.[241]

In the second stage, discontinue the ipecacuanha mixture, and give Dr. Gibb’s remedy—namely, nitric acid—which I have found to be an efficacious and valuable one in hooping-cough:

Take of—Diluted Nitric Acid, two drachms;
Compound Tincture of Cardamoms, half a drachm;
Simple Syrup, three ounces;
Water, two ounces and a half:

Make a Mixture. One or two teaspoonfuls, or a tablespoonful, according to the age of the child—one teaspoonful for an infant of six months, and two teaspoonfuls for a child of twelve months, and one tablespoonful for a child of two years, every four hours, first shaking the bottle.

Let the spine and the chest be well rubbed every night and morning either with Roche’s Embrocation, or with the following stimulating liniment (first shaking the bottle):

Take of—Oil of Cloves, one drachm;
Oil of Amber, two drachms;
Camphorated Oil, nine drachms:

Make a Liniment.

Let him wear a broad band of new flannel, which 1247should extend round from his chest to his back, and which ought to be changed every night and morning, in order that it may be dried before putting on again. To keep it in its place it should be fastened by means of tapes and with shoulder-straps.

The diet ought now to be improved—he should gradually return to his usual food; and, weather permitting, should almost live in the open air—fresh air being, in such a case, one of the finest medicines.

In the third stage, that is to say, when the complaint has lasted a month, if by that time the child is not well, there is nothing like change of air to a high, dry, healthy, country place. Continue the nitric acid mixture, and either the embrocation or the liniment to the back and the chest, and let him continue to almost live in the open air, and be sure that he does not discontinue wearing the flannel until he be quite cured, and then let it be left off by degrees.

If the hooping-cough have caused debility, give him cod-liver oil, a teaspoonful twice or three times a day, giving it him on a full stomach after his meals.

But, remember, after the first three or four weeks, change of air, and plenty of it, is for hooping-cough the grand remedy.

What NOT to do.—Do not apply leeches to the chest, for I would rather put blood into a child laboring under hooping-cough than take it out of him—hooping-cough is quite weakening enough to the system of itself without robbing him of his life’s blood; do not, on any account whatever, administer either emetic tartar or antimonial wine; do not give either paregoric 1248or syrup of white poppies; do not drug him either with calomel or with gray powder; do not dose him with quack medicine; do not give him stimulants, but rather give him plenty of nourishment, such as milk and farinaceous food, but no stimulants; do not be afraid, after the first week or two, of his having fresh air, and plenty of it—for fresh, pure air is the grand remedy, after all that can be said and done, in hooping-cough. Although occasionally we find that if the child be laboring under hooping-cough and is breathing a pure country air, and is not getting well so rapidly as we could wish, change of air to a smoky, gas-laden town will sometimes quickly effect a cure; indeed, some persons go so far as to say that the best remedy for an obstinate case of hooping-cough is for the child to live the great part of every day in gas-works!

231. What is to be done during a paroxysm of Hooping-cough?

If the child be old enough, let him stand up; but if he be either too young or too feeble, raise his head, and bend his body a little forward; then support his back with one hand, and the forehead with the other. Let the mucus, the moment it is within reach, be wiped with a soft handkerchief out of his mouth.

232. In an obstinate case of Hooping-cough, what is the best remedy?

Change of air, provided there be no active inflammation, to any healthy spot. A farm-house, in a high, dry, and salubrious neighborhood, is as good a place as can be chosen. If, in a short time, he be not quite well, take him to the sea-side: the sea breezes will often, as if by magic, drive away the disease.

1249233. Suppose my child should have a shivering fit, is it to be looked upon as an important symptom?

Certainly. Nearly all serious illnesses commence with a shivering fit: severe colds, influenza, inflammations of different organs, scarlet fever, measles, small-pox, and very many other diseases, begin in this way. If, therefore, your child should ever have a shivering fit, instantly send for a medical man, as delay might be dangerous. A few hours of judicious treatment, at the commencement of an illness, is frequently of more avail than days and weeks, nay months, of treatment, when disease has gained a firm footing. A serious disease often steals on insidiously, and we have, perhaps, only the shivering fit, which might be but a slight one, to tell us of its approach.

A trifling ailment, too, by neglecting the premonitory symptom, which, at first, might only be indicated by a slight shivering fit, will sometimes become a mortal disorder:

“The little rift within the lute,
That by-and-by will make the music mute,
And ever widening slowly silence all.”[242]

1250234. In case of a shivering fit, perhaps you will tell me what to do?

Instantly have the bed warmed, and put the child to bed. Apply either a hot bottle or a hot brick, wrapped in flannel, to the soles of his feet. Put an extra blanket on his bed, and give him a hot cup of tea.

As soon as the shivering fit is over, and he has become hot, gradually lessen the extra quantity of clothes on his bed, and take away the hot bottle or the hot brick from his feet.

What NOT to do.—Do not give either brandy or wine, as inflammation of some organ might be about taking place. Do not administer opening medicine, as there might be some “breaking-out” coming out on the skin, and an aperient might check it.

235. My child, apparently otherwise healthy, screams out in the night violently in his sleep, and nothing for a time will pacify him: what is likely to be the cause, and what is the treatment?

The causes of these violent screamings in the night are various. At one time, they proceed from teething; at another, from worms; sometimes, from night-mare; occasionally, from either disordered stomach or bowels.

Each of the above causes will, of course, require a different plan of procedure; it will, therefore, be necessary 1251to consult a medical man on the subject, who will soon, with appropriate treatment, be able to relieve him.

236. Have the goodness to describe the complaint of children called Mumps.

The mumps, inflammation of the “parotid” gland, is commonly ushered in with a slight feverish attack. After a short time, a swelling, of stony hardness, is noticed before and under the ear, which swelling extends along the neck toward the chin. This lump is exceedingly painful, and continues painful and swollen for four or five days. At the end of which time it gradually disappears, leaving not a trace behind. The swelling of mumps never gathers. It may affect one or both sides of the face. It seldom occurs but once in a lifetime. It is contagious, and has been known to run through a whole family or school; but it is not dangerous, unless, which is rarely the case, it leaves the “parotid” gland, and migrates either to the head, to the breast, or to the testicle.

237. What is the treatment of Mumps?

Foment the swelling, four or five times a day, with a flannel wrung out of hot chamomile and poppy-head decoction;[243] and apply, every night, a barm and oatmeal poultice to the swollen gland or glands. Debar, for a few days, the little patient from taking meat and broth, and let him live on bread and milk, light puddings, and 1252arrow-root. Keep him in a well-ventilated room, and shut him out from the company of his brothers, his sisters, and young companions. Give him a little mild, aperient medicine. Of course, if there be the slightest symptom of migration to any other part or parts, instantly call in a medical man.

238. What is the treatment of a Boil?

One of the best applications is a Burgundy pitch plaster spread on a soft piece of wash-leather. Let a chemist spread a plaster, about the size of the hand; and, from this piece, cut small plasters, the size of a shilling or a florin (according to the dimensions of the boil), which snip around and apply to the part. Put a fresh one on daily. This plaster will soon cause the boil to break; when it does break, squeeze out the contents, the core, and the matter, and then apply one of the plasters as before, which, until the boil be well, renew every day.

The old-fashioned remedy for a boil—namely, common yellow soap and brown sugar, is a capital one for the purposes; it should be made into a paste, and spread on a piece of coarse linen, the size either of a shilling or of a florin (according to the size of the boil); it eases the pain and causes the boil soon to break, and draws it when it is broken; it should be renewed daily.

If the boils should arise from the child being in a delicate state of health, give him cod-liver oil, meat once a day, and an abundance of milk and farinaceous food. Let him have plenty of fresh air, exercise, and play.

If the boils should arise from gross and improper 1253feeding, then keep him for a time from meat, and let him live principally on a milk and farinaceous diet.

If the child be fat and gross, cod-liver oil would be improper; a mild aperient, such as rhubarb and magnesia, would then be the best medicine.

239. What are the symptoms of Earache?

A young child screaming shrilly, violently, and continuously, is oftentimes owing to earache; carefully, therefore, examine each ear, and ascertain if there be any discharge; if there be, the mystery is explained.

Screaming from earache may be distinguished from the screaming from bowelache by the former (earache) being more continuous—indeed, being one continued scream, and from the child putting his hand to his head; while, in the latter (bowelache), the pain is more of a coming and of a going character, and he draws up his legs to his bowels. Again, in the former (earache), the secretions from the bowels are natural; while, in the latter (bowelache), the secretions from the bowels are usually depraved, and probably offensive. But a careful examination of the ear will generally at once decide the nature of the case.

240. What is the best remedy for Earache?

Apply to the ear a small flannel bag, filled with hot salt—as hot as can be comfortably borne, or foment the ear with a flannel wrung out of hot chamomile and poppy-head decoction. A roasted onion, inclosed in muslin, applied to the ear, is an old-fashioned and favorite remedy, and may, if the bag of hot salt, or if the hot fomentation do not relieve, be tried. Put into the ear, but not very far, a small piece of cotton wool, 1254moistened with warm olive oil. Taking care that the wool is always removed before a fresh piece be substituted, as if it be allowed to remain in any length of time, it may produce a discharge from the ear. Avoid all cold applications. If the earache be severe, keep the little fellow at home, in a room of equal temperature, but well ventilated, and give him, for a day or two, no meat.

If a discharge from the ear should either accompany or follow the earache, more especially if the discharge be offensive, instantly call in a medical man, or deafness for life may be the result.

A knitted or crocheted hat, with woolen rosettes over the ears, is, in the winter time, an excellent hat for a child subject to earache. The hat may be procured at any baby-linen warehouse.

241. What are the causes and the treatment of discharges from the Ear?

Cold, measles, scarlet fever, healing up of “breakings-out” behind the ear; pellets of cotton wool, which had been put in the ear, and had been forgotten to be removed, are the usual causes of discharges from the ear. It generally commences with earache.

The treatment consists in keeping the parts clean, by syringing the ear every morning with warm water, by attention to food, keeping the child principally upon a milk and a farinaceous diet, and by change of air, more especially to the coast. If change of air be not practicable, great attention ought to be paid to ventilation. As I have before advised, in all cases of discharge from the ear, call in a medical man, as a little 1255judicious medicine is advisable—indeed, essential; and it may be necessary to syringe the ear with lotions, instead of with warm water; and, of course, it is only a doctor who has actually seen the patient who can decide these matters, and what is best to be done in each individual case.

242. What is the treatment of a “sty” in the eyelid?

Bathe the eye frequently with warm milk and water, and apply, every night at bedtime, a warm white-bread poultice.

No medicine is required; but if the child be gross, keep him for a few days from meat, and let him live on bread and milk and farinaceous puddings.

243. If a child have large bowels, what would you recommend as likely to reduce their size?

It ought to be borne in mind that the bowels of a child are larger in proportion than those of an adult. But, if they be actually larger than they ought to be, let them be well rubbed for a quarter of an hour at a time night and morning, with soap liniment, and then apply a broad flannel belt. “A broad flannel belt worn night and day, firm but not tight, is very serviceable.”[244] The child ought to be prevented from drinking as much as he has been in the habit of doing; let him be encouraged to exercise himself well in the open air; and let strict regard be paid to his diet.

244. What are the best aperients for a child?

If it be actually necessary to give him opening medicine, 1256one or two teaspoonfuls of syrup of senna, repeated if necessary, in four hours, will generally answer the purpose; or, for a change, one or two teaspoonfuls of castor oil may be substituted. Lenitive electuary (compound confection of senna) is another excellent aperient for the young, it being mild in its operation, and pleasant to take; a child fancying it is nothing more than jam, and which it much resembles both in appearance and in taste. The dose is half or one teaspoonful early in the morning occasionally. Senna is an admirable aperient for a child, and is a safe one, which is more than can be said of many others. It is worthy of note that “the taste of senna may be concealed by sweetening the infusion,[245] adding milk, and drinking as ordinary tea, which, when thus prepared, it much resembles.”[246] Honey, too, is a nice aperient for a child—a teaspoonful ought to be given either by itself, or spread on a slice of bread.

Some mothers are in the habit of giving their children jalap gingerbread. I do not approve of it, as jalap is a drastic griping purgative; besides, jalap is very nasty to take—nothing will make it palatable.

1257Fluid magnesia—solution of the bicarbonate of magnesia—is a good aperient for a child; and, as it has very little taste, is readily given, more especially if made palatable by the addition either of a little syrup or of brown sugar. The advantages which it has over the old solid form are, that it is colorless and nearly tasteless, and never forms concretions in the bowels, as the solid magnesia, if persevered in for any length of time, sometimes does. A child two or three years old may take one or two tablespoonfuls of the fluid, either by itself or in his food, repeating it every four hours until the bowels be opened. When the child is old enough to drink the draught off immediately, the addition of one or two teaspoonfuls of lemon-juice, to each dose of the fluid magnesia, makes a pleasant effervescing draught, and increases its efficacy as an aperient.

Bran-bread[247] and treacle will frequently open the bowels; and as treacle is wholesome, it may be substituted for butter when the bowels are inclined to be costive. A roasted apple, eaten with raw sugar, is another excellent mild aperient for a child. Milk gruel—that is to say, milk thickened with oatmeal—forms an excellent food for him, and often keeps his bowels regular, and thus (which is a very important consideration) supersedes the necessity of giving him an aperient. An orange (taking care he does not eat the peel or the 1258pulp), or a fig after dinner, or a few Muscatel raisins, will frequently regulate the bowels.

Stewed prunes is another admirable remedy for the costiveness of a child. The manner of stewing them is as follows: Put a pound of prunes in a brown jar, add two tablespoonfuls of raw sugar, then cover the prunes and the sugar with cold water; place them in the oven, and let them stew for four hours. A child should every morning eat half a dozen or a dozen of them, until the bowels be relieved, taking care that he does not swallow the stones.

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 1259giving 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 1260compelled. 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 1261shawl 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 1262especially 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 1263excessive 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:

1264“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 1265will 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 1266town, 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 1267would 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.

1268In 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]

1269A 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 1270dresses 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 1271detriment, 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, 1272might 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 1273and 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.

1274256. 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 1275ought 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 1276nourishing 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.

1277When 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. 1278He 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. 1279If 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.

1280Secondly, 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 1281following 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.

1282265. 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 1283voracious, 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. 1284The 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, 1285yet 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 1286one 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 1287their 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 1288milk 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, 1289sweeten 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 1290those 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 1291in. “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 1292magnify, 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!

A medical man has arduous duties to perform; smooth, therefore, his path as much as you can, and you will be amply repaid by the increased good he will be able to do your child. Strictly obey a doctor’s orders—in diet, in medicine, in everything. Never throw obstacles in his way. Never omit any of his suggestions; for depend upon it, that if he be a sensible man, directions, however slight, ought never to be neglected; bear in mind, with a judicious medical man,—

1293“That nothing walks with aimless feet.”[265]

If the case be severe, requiring a second opinion, never of your own accord call in a physician without first consulting and advising with your own medical man. It would be an act of great discourtesy to do so. Inattention to the foregoing advice has frequently caused injury to the patient, and heart-burnings and ill will among doctors.

Speak, in the presence of your child, with respect and kindness of your medical man, so that the former may look upon the latter as a friend—as one who will strive, with God’s blessing, to relieve his pain and suffering. Remember the increased power of doing good the doctor will have if the child be induced to like, instead of dislike, him. Not only be careful that you yourself speak before your child respectfully and kindly of the medical man, but see that your domestics do so likewise; and take care that they are never allowed to frighten your child, as many silly servants do, by saying that they will send for the doctor, who will either give him nasty medicine, or will perform some cruel operation upon him. A nurse-maid should, then, never for one moment be permitted to make a doctor an object of terror or of dislike to a child.

Send, whenever it be practicable, for your doctor early in the morning, as he will then make his arrangements accordingly, and can by daylight better ascertain the nature of the complaint, more especially if it be a skin disease. It is utterly impossible for him to form 1294a correct opinion of the nature of a “breaking-out” either by gas or by candle-light. If the illness come on at night, particularly if it be ushered in either with a severe shivering, or with any other urgent symptom, no time should be lost, be it night or day, in sending for him.

WARM BATHS.

275. Have the goodness to mention the complaints of a child for which warm baths are useful?

1. Convulsions; 2. Pains in the bowels, known by the child drawing up his legs, screaming violently, etc.; 3. Restlessness from teething; 4. Flatulence. The warm bath acts as a fomentation to the stomach and the bowels, and gives ease where the usual remedies do not rapidly relieve.

276. Will you mention the precautions and the rules to be observed in putting a child into a warm bath?

Carefully ascertain before he be immersed in the bath that the water be neither too hot nor too cold. Carelessness, or over-anxiety to put him in the water as quickly as possible, has frequently, from his being immersed in the bath when the water was too hot, caused him great pain and suffering. From 96 to 98 degrees of Fahrenheit is the proper temperature of a warm bath. If it be necessary to add fresh warm water, let him be either removed the while, or let it not be put in when very hot; for if boiling water be added to increase the heat of the bath, it naturally ascends, and may scald him. Again, let the fresh water be put in at as great a distance from him as possible. The usual time for him 1295to remain in a bath is a quarter of an hour or twenty minutes. Let the chest and the bowels be rubbed with the hand while he is in the bath. Let him be immersed in the bath as high up as the neck, taking care that he be the while supported under the armpits, and that his head be also rested. As soon as he comes out of the bath he ought to be carefully but quickly rubbed dry; and, if it be necessary to keep up the action on the skin, he should be put to bed, between the blankets; or, if the desired relief has been obtained, between the sheets, which ought to have been previously warmed, where, most likely, he will fall into a sweet refreshing sleep.

WARM EXTERNAL APPLICATIONS.

277. In case of a child suffering pain either in his stomach or in his bowels, or in case he has a feverish cold, can you tell me of the best way of applying heat to them?

In pain, either of the stomach or of the bowels, there is nothing usually affords greater or speedier relief than the external application of heat. The following are four different methods of applying heat: 1. A bag of hot salt—that is to say, powdered table salt—put either into the oven or into a frying-pan, and thus made hot, and placed in a flannel bag, and then applied, as the case may be, either to the stomach or to the bowels. Hot salt is an excellent remedy for these pains. 2. An india-rubber hot water bottle,[266] half 1296filled with hot water—it need not be boiling—applied to the stomach or to the bowels will afford great comfort. 3. Another, and an excellent remedy for these cases, is a hot bran poultice. The way to make it is as follows: Stir bran into a vessel containing either a pint or a quart (according to size of poultice required) of boiling water, until it be of the consistence of a nice soft poultice, then put it into a flannel bag and apply it to the part affected. When cool, dip it from time to time in hot water. 4. In case a child has a feverish cold, especially if it be attended, as it sometimes is, with pains in the bowels, the following is a good external application: Take a yard of flannel, fold it three widths, then dip it in very hot water, wring it out tolerably dry, and apply it evenly and neatly round and round the bowels; over this, and to keep it in its place and to keep in the moisture, put on a dry flannel bandage, four yards long and four inches wide. If it be put on at bedtime, it ought to remain on all night. Where there are children, it is desirable to have the yard of flannel and the flannel bandage in readiness, and then a mother will be prepared for emergencies. Either the one or the other, then, of the above applications will usually, in pains of the stomach and bowels, afford great relief. There is one great advantage of the external application of heat—it can never do harm; if there be inflammation, it will do good; if there be either cramp