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.




                                   TO

                        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.




                                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
words 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 destroyers!
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 as 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 hard, 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 the 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.




                               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




                           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 it 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 majority 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 not 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.

11. 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 had
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 miscarriages, 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. The 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 more 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.

19. 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]

21. 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 to 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.

25. 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, should 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, causing 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.

33. 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
before 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:

         “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 keep 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 misery 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. Exercise, 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 that 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 this 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 the 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 excellent _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!

56. 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. Riches, 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, that 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 happiness—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, while 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, she 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 thrown 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.

65. 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.

67. 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.

73. 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 ablution, 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 would 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 I 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,
look 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 symptoms—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.”

87. 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 the 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 labor 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, and 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]

99. 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 alive, 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 neat 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 now 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 wineglasses; 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 milk! 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.

107. 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, which, 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 it 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
during 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 have 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 makes 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 to 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 are 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 years 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 whole 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!

128. 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.

129. 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
and 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 take 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 creatures 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 thus 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 would 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 frame, 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, mustiness, 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 inches, 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]

148. 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:

           “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 rain, 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 it 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]

159. 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 health, 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?—

                  “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 husband’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 herself 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 sweetens 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.

169. 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 hard 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:

                                   “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 privilege 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 magic 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 destroy 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, let 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 abundance 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.

186. 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.

189. 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.




                                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, which 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 ladies, 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]

198. 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 classes.
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 of 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, in 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, hermetically 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 before 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.

211. 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 may 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
at? 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 of 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 flushings 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!




                                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_, _with 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 next 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 sick, 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, if 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.

235. 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]


                               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, and, 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 bath 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
who 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.

247. 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 treats 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 to 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.”

255. 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; in 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, acrid, 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 danger 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 down 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 to 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, beef-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! Bleeding 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 perspiration 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; and 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.


                               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.

281. 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_ sugar, 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:

                    Take 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
patient 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 of 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, by 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 bowels, 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 butter, 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.

304. 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.

309. 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.

312. 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 or 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 very 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 eight 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.

328. 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 have 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 bread (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:

             Take 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 with 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.

345. 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.

350. 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 rare. 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 or 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, and 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:

                    Take 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, it 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 the 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.

370. 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 and
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 blankets, 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, then, _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.

380. _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.

383. 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.


                              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.

388. 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 descending 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 show 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_ the 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.

400. _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 of 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
nourishing. _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.

411. 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 well 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 may 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 the 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.

423. 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” was 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 may
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 be 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, she 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 has 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 widow. 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.

438. 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, who, 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 not 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 morning, 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 of 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 to 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]




                               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.

451. 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 the 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 as 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 or 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 hand, 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 a 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 with 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 useful. 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, interfere 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 slightest 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.

480. 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.

485. 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.

488. 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]

493. 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,
while 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.

500. 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, if 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. Let 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 be 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 to 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; it 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
that 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 _early_ 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 with 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.


               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 or 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 in 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]

538. 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.

541. 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 that 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” over 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 nostrils, 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 in 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 it 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.


                          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 additional 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 still, 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.


                               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 person; 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.


                              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.

577. 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.


                              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 either 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:

           Take 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.

586. 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]


                        “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, too, 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 _removed_ 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.

597. 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.


                                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 made 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 strong 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 beverage. 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.

608. 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 first 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.




                                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!
      Oft 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 of 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_, which 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.

625. 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 gathered, 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 much 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 break 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.

637. 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 dishes 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 wet-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 boiled), 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 mother, 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 bear 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 admit, 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!


               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]

659. 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 does 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 of 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]

Bear 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 on 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 to 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 drawn 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 for 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. These
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. When 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 is 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 of 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 breast” 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. Ballard, 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 into 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.

695. 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 of 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 _externally_ 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 by
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 without
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.

710. 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 vary 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
delicate. “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; and 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 not 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:

           “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.

724. 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 similar 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 that 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 ought 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.




                                 INDEX.


 Ablution after labor, 245.
   among the poor, 41.
   manner of young wife performing, 42.
   morning, 41.
   in pregnancy, 124.
   thorough, 41.

 Abortion, 174.
   the procuring of, 120.

 Accoucheur, the duties of, 206.

 Advice to a monthly nurse, 196.

 After birth should never be brought away by nurse, 233.

 After pains, 212.

 Age at which menstruation commences, 105.

 Age, best, to marry, 104.

 Ages of mother and wet-nurse, 265.

 Ailments of pregnancy, 140.
   during suckling, 236.

 Air, cold, the value of, 37.
   pure in bedroom, 34.

 Air and exercise in pregnancy, 125.
   during suckling, 268.
   and occupation, 126.

 Ale and porter, sour, 253.
   more nourishing than wine, 266.

 Alcohol a deadly poison, 57.
   in brandy and in wine, 57.

 Aloe paste in weaning, 295.

 Amusements of a young wife, 20.

 Aperient pills after confinement, 241.

 Aperients in pregnancy, 140.
   the abuse of, 244.
   before labor, 155.
   _immediately_ after, improper, 241.
   during suckling, 287.
   on frequent, 99.

 Appetite, bad, 51.
   and leanness, 54.

 Applications for hair, 47.

 Armstrong on ablution, 49.

 Articles wanted at labor, 216.

 Artificial respiration, 232.

 Assisting nature, on, 209.


 Bad breast, 282.

 Bandage after confinement, 236.

 Barley-water and new milk, 251.

 Barren wives, 14.
   diet of, 38.
   number of, 14.

 Barrenness and fashion, 68.
   in higher ranks, 60.

 Bathing feet, 45.
   shoulders and back, 42.
   whole body, 42.

 Bay salt, 45.

 Bearing down pains, 202.
   of womb, 247.

 Beauty-sleep, 72.

 Bed, “the guarding of,” 218.

 Bed-pan, the best kind of, 244.

 Bedroom for pregnant female, 137.
   ventilation of, 73.

 Bedstead, a four-post, in labor, 216.

 Beef-tea, how to make (_note_), 249.

 “Being out in reckoning,” 187.

 Beverage after labor, 251.
   the best for young wife, 55.
   for mother whose child is ill, 268.

 Bidet should be regularly used, 124.

 Bladder, irritability of, 164, 199.
   importance of attending to, 233.
   in pregnancy, 164.
   sluggishness of, 164.
   state of, after confinement, 239.

 “Blue-stocking,” as a wife, 93.

 Bosom after labor, 259.

 Bowels to be opened before labor, 155.
   if regular, _no_ aperient required, 145.

 Bowel complaints of pregnancy, 145.

 Bowels, state of, after labor, 241.

 Boy or girl?, 188.

 Brandy to be in the lying-in room, 222.
   on the use of, during labor, 222, 235.

 Bran-bread as an aperient, 289.

 Breakfast for young wife, 50.
   a meager, 50.

 Breast-drawer, 258.
   during suckling, 260, 282.

 Breast, full and uneasy, 282.
   in second and in succeeding confinements, 259.
   painful during pregnancy, 162.
   gathered, 282.
     causes of, 283.
     importance of early treatment, 286.
     shivering fit in, 286.
     symptoms of, 286.
     two forms of, 285.

 Breast-pump, ill effects of, 296.

 Bringing up of girls, 96.

 Bugs and fleas, 97.

 Business of a wife, 90.


 Calomel dangerous in pregnancy, 140.

 Carbonic acid gas in crowded rooms, 33, 86.

 Carpet for bath-room, 47.

 Carriage exercise, on the abuse of, 29.

 Castor oil, the dose and manner of administering, 141.
   external use of, 144.

 Caudle should be banished lying-in room, 236.

 “Caul,” a child’s (_note_), 230.

 Cause, one, of small families, 60.

 “Ceasing to be unwell,” 117.
   to menstruate, 115.

 Champagne-cup, 63.

 Change of air for delicate wife, 96.

 “Change of life,” 115.

 “Change of life,” great importance of _not_ neglecting, 115.
   of room after labor, 253.

 Cheerful wife, 87.

 Cheerfulness during labor, 220.
   and occupation, 87, 93.

 Child born before arrival of medical man, 228.
   should be gradually weaned, 294.

 Childless house, 14.

 Chimney, on stopping, 35.

 Chloroform in hard and lingering labor, 225.

 Chlorosis and hysteria, 113.

 Circulation, languid, 30, 55.

 Cleanliness of body, 41.

 “Cleansings,” 245.

 Clever wife a fortune, 90.

 Clothing in pregnancy, 123.
   after labor, 234.
   during suckling, 262.

 Clysters, 242, 288.

 Coffee as an aperient, 142, 290.

 Complexion, a fine, 25, 27.

 Contentment, 87.

 Cook, an idiot of a, 90.

 Cookery, good and careful, 89.

 Costiveness during pregnancy, 140.
   a cause of _hard_ labor, 143.

 “Count,” 185.
   the German method of making, 187.
   a good plan to make the, 186.

 Country, on living in the, 36, 137.

 Cramp of the bowels, 168.

 Cramps of the legs and thighs in pregnancy, 168, 203.

 Creasote in toothache, 156.

 “Croakers,” during labor, 190, 219.

 Croquet, best of games, 85.

 Crying out, when in pain, 214.

 Curates’ wives, 38.


 Dancing, danger of young wife, 86.

 Dangers of wine-drinking, 56.
   of early marriages, 104.

 Daylight, importance of, 79.

 Depression of spirits during suckling, 267.

 Derbyshire oatmeal gruel, 143.

 Dews of morning and evening, 26, 70.

 Diarrhœa in pregnancy, 145.

 Dietary of a young wife, 49.
   pregnant female, 134.
   after labor, 249.

 Diet during suckling, 263.
   of lying-in women, 249
   of young wife, 49.

 Digestion, a good, 271.

 Dirt in wrong place, 132.

 Difficulty of lying down in pregnancy, 138.
   of making water, 223.

 Dinners and tempers, 92.

 Disinfectant, 129.

 Dissipation and barrenness, 14.

 Domette bandages, 153.

 Dozing, ill effects of, 67.

 Drainage, 132.

 Dress for labor, 217.
   for young wife, 82.

 “Drying up the milk,” 296.

 Duration of menstruation, 105.

 Duties of a nursing mother, 255.
   of a wife, 92.


 Early Maturity, 106.
   riser needs refreshment, 68.
   rising and early to bed, 71.
     a cosmetic, 70.
     a duty, 71.
     good effects of, 70.

 Early rising rejuvenizes, 70.

 Economy, domestic, 87.

 Employment “nature’s doctor,” 274.

 _Enceinte_, the origin of the word (_note_), 113.

 Enema apparatus, 100, 197.
   for costiveness, 100.
   for lying-in patient, 242.

 Enemata of tepid water, 152.

 Ewers and basins, Liliputian, 41.

 Exercise for a young wife, 23.
   a necessity, 24.
   before breakfast, 47.
   best aperient, 144.
   for the delicate, 25.
   immense importance of, 23.
   in close carriages, 29.
   in pregnancy, 125.
   during suckling, 268
   fresh air and occupation during pregnancy, 126.
   in open air after labor, 254.
   promotes sleep, 78.


 False labor pains, 183.

 Fainting in pregnancy, 165.

 Faintness during suckling, 287.

 “Falling of the womb,” 247.

 Falling off of hair, 47.

 Fashion and barrenness, 38.

 Fashionable system of spending married life, 18.

 Fat and pregnancy, how to distinguish between, 121.

 Feet, cold, exercise the remedy for, 30.
   and legs, bathing, 45.

 Females who have sick pregnancies, 161.

 “Female slipper,” 239.

 Fire-guard on lying-in room grate, 237.

 Fire, ill effects of sitting near, 27.

 Flannel, 218.
   next skin, 83.

 Flatulence and “quickening,” 121.

 Fleas and bugs, 97.

 Fœtal circulation (_note_), 122.

 Folly of shutting out light, 79.

 Food, variety of, necessary, 265.

 French bed-pan, 244.
   cookery, 91.
   plums, stewed, 289.

 Friend, the choice of, during labor, 219.

 Fruit useful in pregnancy, 136.

 Fruitful women, 60.

 Fruit tree, a simile, 15.

 Fruitless suckling, 283.

 Fumigations, 129.


 Garters, ill effects of, in pregnancy, 123.

 Gathered breasts, 282.
   causes of, 283.
   importance of early treatment, 286.

 German breakfast, 289.

 Gestation, period of, 185.

 Ginger plaster, 157.

 Girl or boy?, 188.

 Greens, cabbages, and pickles, 290.

 “Guarding of the bed,” 218.


 Hair, on washing, 46.

 Health, a beautifier, 23.
   importance of, 101.
   of wives, 13.
   worth trying for, 17.

 Heart, palpitation of, during pregnancy, 167.

 Heartburn in pregnancy, 147.

 Hints to attendants, 228.
   to mother when infant is ill, 268.

 Home known only in England, 86.

 Honey, on the wholesomeness of, 289.

 Hot-water bag, 147, 168.

 House, a healthy, 36.

 Household duties, 86.
   good, 272.

 Hysteria, 113.

 Husband in lying-in room, 210.


 Idle ladies, 78.
   people, 25.

 Idleness brings misery, 127.
   effects of, 17.

 India-rubber teat and shield for drawn-in nipple, 276.
   for sore nipple, 280.

 Indolence, the ill effects of, in pregnancy, 126.

 Infant born apparently dead, 230.
   the period of suckling an, 293.
   the cry of an, 230.

 Introductory Chapter, 13.

 Irish women, poor, 38.

 Irritation and itching, 172.


 Jam as an aperient, 89.

 Jeremy Taylor’s description of a wife, 13.


 Labor, 199.
   the easy and the hard, 94.
   rapid, directions concerning, 228.
   symptoms of, 199–215.
   treatment of, 216–254.

 Lavements in pregnancy, 144.

 Leather cheaper than physic, 24.

 Legs, the swollen, of pregnancy, 152.

 Length of time of first labor, 210.
   of an after labor, 210.

 Life is to be well, 18.

 Light, effects of, 79.
   is life, 79.

 Little ablution—much clothing, 84.

 Lively women and easy labors, 127.

 Luxurious idle wife, 77.

 Luxury, an age of, 28.
   ill effects of, 38.

 Lying-in room, 237.
   temperature of, 237.


 Maid-servants and the “ologies,” 92.

 Marmalade as an aperient, 290.

 Marshmallow and chamomile fomentation (_note_), 245.

 Martin Luther on work, 89.

 Mastication, thorough, 54.

 Materials of food should be mixed and varied, 265.

 Means to strengthen, 16.

 Meddlesome breast-tending, 260.
   midwifery reprobated, 205.

 Medical men, 209.

 Medicines in pregnancy, 140–173.
   opening, danger of, 99.

 Menstrual fluid, 111.

 Menstruation, 103.
   accompanied with “the whites,” 112.
   before marriage, 111.
   during 30 years, 102.
   painful, 111.
   dangers of, 111.
   profuse, 112.
   sparing, 112.
   too pale or too dark, 111.
   when not properly performed, 111.

 Milk at its “height,” 259.
   the best way of “drying up” the, 296.
   flowing away constantly, 280.
   very fattening, 54.

 Miscarriage, 174.
   care required after, 178.
   causes of, 175.
   consequences of a neglected, 178.
   flooding in, 177.
   prevention of, 179.
   symptoms of a threatened, 176.
   treatment of, 179.
   usual time of taking place, 177.

 Misconception and prejudice, 238.

 Mission, the glorious, 101.

 Monthly nurse, 189–198.

 Morning sickness, 117, 158.

 Mothers predisposed to consumption, 300.
   who cannot suckle, 299.
   unnatural, 255.

 Mountain-air, 97.

 Mufflers and sore throats, 84.

 Mutton-chops, folly of living entirely on, 52.


 Nature in early morning, 68.

 Navel, pouting of, as a sign of pregnancy, 122.

 Navel-string, the manner of tying, 233.
   not to be tied until the child breathes, 232.

 Nipple, cracked and fissured, 279.
   during suckling, 257.
   means to harden, 162.
   great importance of hardening, 162.
   retraction of, 275.
   shields, 276.
   sore, 277.
   an obstinate, 299.
   washing of, and breast, 257.
   wet, 280.
   shields, Wansbrough’s, 279.

 Nose, a sentinel, 129.

 Nurse, monthly, 189–198.
   importance of choosing a good, 189.
   on wearing crinoline, 197.
   on wearing slippers instead of shoes, 198.

 Nursery-basin, 43.

 Nursing, prolonged, danger of, 293.
   apron, 263.


 Oatmeal, Derbyshire, 143.
   gruel as a fomentation, 245.

 Occupation, 87, 272.
   fresh air, and exercise, 272.

 Offspring of very young and very old, 104.

 Olive oil as an aperient, 142.

 Opening medicine, 99.


 Pains, “bearing down,” 203.
   _before_ and _during_ menstruation, 111.
   “grinding,” 200.
   at night in pregnancy, 139.

 Painless parturition, 212.

 Palpitation of the heart in pregnancy, 167.

 Passion, the ill effects of, during suckling, 270.

 Pendulous belly of pregnancy, 154.

 Pepper plaster, 157.

 Period of gestation, 185.
   of taking exercise, 254.

 Pessaries, 248.

 Physic, a substitute for exercise, 31.
   best, is exercise, 25.

 Piles in pregnancy, 148.

 Pleasure and health, 85.

 Plethoric pregnant females, 136.

 Poisoned by one’s own breath, 35.

 Porter and ale for a nursing mother, 266.

 Position after delivery, 237.
   of a mother during suckling, 270.
   of patient after labor, 237.

 “Pottering” nurse, 190.

 Poultice, a bread and milk and sweet oil, 282.

 Precursory symptoms of labor, 199.

 Pregnancy, 117.
   duration of, 185.
   a natural process, 127.
   period of, 185.
   signs of, 117.

 Preliminary observations, 13.

 Preparation for health, 47.
   for labor, 216.

 Profession of a wife, 90.

 Prolific mothers (_note_), 105.

 Proper time for a patient to sit up after labor, 246.
   to send for medical man, 200, 203.
   to send for the nurse, 200.

 Protrusion of the bowels, 149.

 Prunes, stewed, 289.

 Puberty, period of (_note_), 105.

 Pump-water, contamination, 132.
   on boiling, 133.
   on purity of, 132.


 “Quickening,” 120.
   flatulence mistaken for, 121.

 Quiet after confinement, 246.


 Rain and wind, exercise in, 24.

 Rats in drains and sewers, 130.

 “Reckoning,” to make the, 186.

 Refreshment after labor, 235.

 Remedies to prevent costiveness, 291.

 Respiration, artificial, 232.

 Rest after delivery, 234.
   in pregnancy, 133.
   and quietude after labor, 246.

 Restlessness at night, 138.
   remedies for, 138.

 Rich ladies, 38.

 Rising of the sun on seeing the, 71.

 Rock-salt, 45.

 Rules for a female prone to miscarry, 180.
   for barren wife, 14.
   of health, 99.


 Sea-bathing, in pregnancy, 125.

 Sea water good for hair, 46.

 Servants taught the “ologies,” 92.

 Shivering during labor, 201.

 “Show,” a sure sign of labor, 200.

 Shower-bath in pregnancy, 125.

 Sick pregnancies, 161.

 Sickness during labor, 201.

 Signs of the fœtal circulation (_note_) 123.
   of pregnancy, 117.

 Sitting over fire, 27.
   with back to fire, 27.

 Sitz-bath, the value of, 44, 124, 172.

 Skin of the abdomen cracked, 154.

 Skylight the best ventilator, 128.

 Sleep in pregnancy, 137.
   the choicest gift, 77.
   the value of, immediately after labor, 238.
   for young wife, 78.

 Sleepiness of pregnant females, 138.

 Sleeplessness of pregnant females, 138.

 Slipper bed-pan, 239, 244.

 Sluggard’s dwelling, 71.

 “Smoking dunghill,” a, 131.

 Sore nipples, 277.

 Spirits during suckling, 268.

 Spurious labor pains, 183.

 Stages of labor, 213.

 Stays should not be worn during labor, 218.

 Stocking, elastic, 153.

 Stomach, functions of, 271.

 Subsidence of the womb before labor, 199.

 “Suck-pap,” 258.

 Suckling, 255.
   when female is pregnant, 300.

 Suppers, hearty meal, 52.

 Support to bowels after confinement, 236.

 Swedish ladies, 91.

 Swollen legs in pregnancy, 152.

 Symptoms of labor, 199.
   denoting necessity of weaning, 298.


 Table of duration of pregnancy, 185.

 Taking, the frequent, of physic, 31.

 Teat, india-rubber, and shield, 276.

 Teeth frequently decay in pregnancy, 156.
   and gums, 55.

 Temperature of a lying-in room, 237.

 “The top of the morning,” 72.

 Things which will be wanted at a labor, 216.

 Tic-douloureux, 157.

 Tight lacing injurious to a young wife, 81.
   ill effects of, in pregnancy, 123.

 Time when a child should be weaned, 293.

 Toothache in pregnancy, 155.
   remedies for, 156.

 Tooth extraction, the danger of, in pregnancy, 155.

 “Trap to catch sunbeam,” 81.

 True labor pains, 202.

 “Trying of a pain,” 221.

 “Turn of years,” 115.


 Unladylike, on being, 96.

 Urine, retention of, 240.


 Vaginal syringe, 196.

 Veal-and-milk broth, 251.

 Veins, enlarged, of the leg, 152.

 Ventilation, importance of, 33, 128.
   manner of performing, 34.
   of lying-in room, 254.
   thorough, 36.

 Visitors in a lying-in room, 238.


 Walk before breakfast, 47.
   in frosty weather, 28.

 Walking glorious exercise, 23.

 Warm ablutions after labor, 245.
   baths for infants apparently still-born, 231.

 Water poisoned by drains, 132.

 Waters, “the breaking of the,” 202.

 Weaning, 292.

 Weaning an infant, the method of, 294.

 Wellington, the Duke of, 67.

 Westmoreland and Cumberland poor women, 229.

 Wet-nurses’ and mother’s milk, 265.

 Whining and repining, 95.

 “Whites” during pregnancy, 169.
   cause miscarriage, 112.
   when not pregnant, 112.

 Wife, a domestic, 90.
   educated to be useful, 90.
   instructing servants, 92.
   the mission of a, 22.
   the profession of a, 90.
   young, 13.

 Wine, abuse of, 57.
   bibbing causes barrenness, 57.
   drinking of, 55.
   in France, 61.
   on children taking, 61.
   much injures complexion, 64.
   during suckling, 267.

 Womb, bearing down of, 247.

 Work, a cure for many ailments, 93.

 Wormwood on nipples in weaning, 296.




                           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.




                                   TO

                   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.




                                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 my 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.




                               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
                   DISEASE, 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.




                            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 medical 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 in 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]

In 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 or
“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 you 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 two 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.

Directly 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?_

After 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]

10. _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 remain 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 advice, 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; and 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 the 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 with 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.


                               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 when 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 the
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 from 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 should 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;
and 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 if 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, and 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 advise 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 then 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 be
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 mixture 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.

When 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.

Let 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 of 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 of 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 food 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.

The 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—

             “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] but 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.

Let 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 healthy, 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 taking 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; for 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 five 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 the 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 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, 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?_

It 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 ought 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 as 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 there 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; besides, 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
her 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 is 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.

55. _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 teeth 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]. Then 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 be 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 description, 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 teething 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 frequently 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;
          ’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, etc.—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 and 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 saliva, 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 near at hand, and unless the gums be red, hot, and swollen.

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

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

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

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

The better plan is, in such a case, to give a dose of aperient medicine,
such as either castor oil or magnesia and rhubarb, and thus work it off.
IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE
MISCHIEF.[165] If he be purged more than usual, attention should be paid
to the diet—if it be absolutely necessary to give him artificial food
while suckling—and care must be taken not to overload the stomach.

72. _A child is subject to a slight cough during dentition—called by
nurses “tooth-cough”—which a parent would not consider of sufficient
importance to consult a doctor about; pray tell me 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 I should look upon
it as an effort of the constitution to relieve itself; and should
expect, if the “breaking-out” were repelled, that either convulsions, or
bronchitis, or inflammation of the lungs, or water on the brain would be
the consequence.

The only plan I should adopt would be, to be more careful in his diet:
to give him less meat (if he be old enough to eat animal food), and to
give him, once or twice a week, a few doses of mild aperient medicine;
and, if the irritation from the “breaking-out” be great, to bathe it
occasionally either with a little warm milk and water, or with rose
water.


                               EXERCISE.

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

I am a great advocate for 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 be carried out _every
day_, even if it be wet under foot, provided it be fine above, and the
wind be neither in an easterly nor in a 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 manifest detriment. A babe requires rest,
and not excitement. How wrong it is, then, for either a mother or a
nurse to be exciting and rousing a new-born babe. It is most injurious
and weakening to his brain. In the early period of his existence his
time ought to be almost entirely spent in sleeping and in sucking!

76. _Do you approve of tossing an infant much about?_

I have seen a child tossed 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.

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

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

78. _Ought a babe to lie alone from the first?_

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

79. _Do you approve of rocking an infant to sleep?_

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

80. _Then don’t you approve of a rocking-chair, and of rockers to the
cradle?_

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

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

If the head of the crib be covered, the 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 it 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 greatest part of their time, become strong and healthy. On
the other hand, I have known those who were born large and strong, yet
who slept but little, become weak and unhealthy.

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

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

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

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

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

Certainly not. The practice of giving composing medicine to a young
child cannot 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.

A 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.


                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
_desideratum_—and he would be inducted into clean habits—a blessing to
himself, and a comfort to all around, and a great saving of dresses and
of furniture. “Teach your children to be clean. A dirty child is the
mother’s disgrace.”[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 milk was, of course, some weeks old; but for many
years, I have never allowed any aperient at all to any new-born infant,
and I am satisfied it is the safest and the wisest plan.”

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 order that he may inquire into the
matter and apply the proper remedies. Be particular in attending to
these directions, or evil consequences will inevitably ensue.

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

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

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

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

The ailments and the diseases of infants, such as may, in the absence of
the doctor, be treated by a parent, are the following: Chafings,
Convulsions, 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 tenderly
dried with a soft towel, and then be dusted, either with finely-powdered
starch made of wheaten flour, or with violet powder, or with
finely-powdered native carbonate of zinc, or they should be bathed with
finely-powdered fuller’s-earth and tepid water.

If, in a few days, the parts be not healed, discontinue the above
treatment, and use the following application: Beat up well together the
whites of two eggs, then add, drop by drop, two 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 laboring 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.

_What_ NOT _to do_ in such a case.—Do not apply leeches; the babe
requires additional strength, and not to be robbed of it; and do not
attempt to treat the case yourself.

95. _What are the best remedies for the costiveness of an infant?_

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

_What to do._—If a babe, after the first few months, were held out, and
if, at regular intervals, he were put upon his chair, costiveness would
not so much prevail. It is wonderful how soon the bowels, in the
generality of cases, by this simple plan may be brought into a regular
state.

Besides, it inducts an infant into clean habits. I know many careful
mothers who have accustomed their children, after the first three
months, to do without diapers altogether. It causes at first a little
trouble, but that trouble is amply repaid by the good consequences that
ensue; among which must be named the dispensing with such 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 raw 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 rhubarb, 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.

If 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 give 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.

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

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

Some mothers are frequently dosing their poor unfortunate 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 who 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. A warm bath (where he
is suffering severely) generally gives _immediate_ ease in flatulence;
it acts as a fomentation to the bowels. But after all, a dose of mild
aperient medicine, when the babe is suffering severely, is often the
best remedy for “wind.”

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

_What_ NOT _to do_.—“Godfrey’s Cordial,” “Infants’ Preservative,” and
“Dalby’s Carminative” are sometimes given in flatulence; but as most of
these quack medicines contain, in one form or another, either opium or
poppy, and as opium and poppy are both dangerous remedies for children,
ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to
afford relief for flatulence; but let me urge upon you the importance 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 gripes_, 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 above treatment, he will
generally soon fall into a sweet sleep, and awake quite refreshed.

_What_ NOT _to do_.—Do not give opiates, astringents, chalk, or any
quack medicine whatever.

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

99. _What occasions 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.

Now, suppose a child should have a slight bowel complaint—that is to
say, that he has six or eight motions during the twenty-four hours,—and
that the stools are of a thinner consistence than what I have
described,—provided, at the same time, that he 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 be 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.

102. _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 had 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 will
see his face, in a few days, become old-looking, care-worn, haggard, and
pinched. Day and night the enemy tracks him (unless proper remedies be
administered); no sleep, or, if he sleep, he is every few minutes
roused. It is heart-rending to have to attend a bad case of dysentery in
a child,—the writhing, the screaming, the frequent vomiting, the pitiful
look, the rapid wasting and exhaustion, make it more distressing to
witness than almost any other disease a doctor attends.

104. _Can anything be done to relieve such a case?_

Yes. A judicious medical man will do a great deal. But, suppose that 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.

If he be a year old and weaned, then feed him, as above recommended, on
the cow’s milk. If there be extreme exhaustion and debility, let fifteen
drops of brandy be added to each 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? Give 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. Keep 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 improper 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, may 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 takes, 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 necessary, 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, entirely 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 wash-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 effect 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, for 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:

               Take 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 of 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!

If 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!




                                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 him 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.

119. _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.

123. _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 clothing 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 hat—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.

128. _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 temperature, 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 that 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 waste
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 toes, 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.”

134. _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 that 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 a 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.

The 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 cut 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 add 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. A 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 say 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 are
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, he 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 consequences 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?_

He 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 mutton, 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: and, 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 be 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
if 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 dose 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. If 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, from 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 skin 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 any 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.

The 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 preposterous 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. A 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 walls 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 painting 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, as 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.

165. _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 his 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 up 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’ as 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 she 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 his 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.

A 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.

                 Tell 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 the 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 an 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_ pleasures 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, and
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
nervous 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.

Demosthenes 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 (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 the
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, wretched 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 either 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 of 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 child (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.

                One 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:

               “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 and
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 child 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 by 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 have 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 for 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 child, 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 shame, 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:

Let 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.


                                 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!

185. _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, and 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, scientific 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_?

He 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.

193. _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.


                           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 importance 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 appertains 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 actual 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 experienced 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 parents, 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.

I 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.

A 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 are 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 wine 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 way 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.

Ipecacuanha 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 with 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
thought 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_ for 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.

202. _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.

_The 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 prepare 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
genuine 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. Either 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.

204. _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 allowed 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 properly 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 cause 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 tonsils 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 said 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 of 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:

              Take 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.

Or,

             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
privy, 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 sneezing, 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.

If 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,” administer 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.

There 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 hoarse_ 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]

219. _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 fever, 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.

Now 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 chooses; 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 ought 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 opened, 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, and 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, the 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 but 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.

222. _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 have 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?_

It 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 materially 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 _modified_ 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
neither 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.

Hooping-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, to 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 diet.
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 should 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 or 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.

233. _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]

234. _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 to 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 arrow-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 feeding_, 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,
moistened 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 judicious 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, one 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.

Fluid 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 pulp), 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 giving them; but if medicine be
absolutely required, give the mildest—such as either syrup of senna or
castor oil—_and the less of those the better_.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

266. _What are the causes of Worms?_

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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,—

              “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 a
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
to 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 filled
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 cramps or spasms of the stomach, it will be
serviceable; if there be colic, it will be one of the best remedies that
can be used; if it be a feverish cold, by throwing the child into a
perspiration, it will be useful.

It is well for a mother to know how to make a white-bread poultice; and
as the celebrated Abernethy was noted for his poultices, I will give you
his directions, and in his very words: “Scald out a basin, for you can
never make a good poultice unless you have perfectly boiling water,
then, having put in some hot water, throw in coarsely crumbled bread,
and cover it with a plate. When the bread has soaked up as much water as
it will imbibe, drain off the remaining water, and there will be left a
light pulp. Spread it a third of an inch thick on folded linen, and
apply it when of the temperature of a warm bath. It may be said that
this poultice will be very inconvenient if there be no lard in it, for
it will soon get dry; but this is the very thing you want, and it can
easily be moistened by dropping warm water on it, while a greasy
poultice will be moist, but not wet.”[267]


                               ACCIDENTS.

278. _Supposing a child to cut his finger, what is the best
application?_

There is nothing better than tying it up with rag in its blood, as
nothing is more healing than blood. Do not wash the blood away, but
apply the rag at once, taking care that no foreign substance be left in
the wound. If there be either glass or dirt in it, it will, of course,
be necessary to bathe the cut in warm water, to get rid of it before the
rag be applied. Some mothers use either salt, or Fryar’s Balsam, or
turpentine to a fresh wound; these plans are cruel and unnecessary, and
frequently make the cut difficult to heal. If it bleed immoderately,
sponge the wound freely with cold water. If it be a severe cut, surgical
aid, of course, will be required.

279. _If a child receive a blow, causing a bruise, what had better be
done?_

Immediately smear a small lump of _fresh_ butter on the part affected,
and renew it every few minutes for two or three hours; this is an
old-fashioned, but a very good remedy. Olive oil may—if _fresh_ butter
be not at hand—be used, or soak a piece of brown paper in one-third of
French brandy, and two-thirds of water, and immediately apply it to the
part; when dry renew it. Either of these simple plans—the butter plan is
the best—will generally prevent both swelling and disfiguration.

_A “Black Eye.”_—If a child, or indeed any one else, receive a blow over
the eye, which is likely to cause a “black eye,” there is no remedy
superior to, nor more likely to prevent one, than well buttering the
parts for two or three inches around the eye with fresh butter, renewing
it every few minutes for the space of an hour or two; if such be well
and perseveringly done, the disagreeable appearance of a “black eye”
will in all probability be prevented. A capital remedy for a “black eye”
is the arnica lotion:

                   Take of—Tincture of Arnica, one ounce;
                           Water, seven ounces:

  To make a Lotion. The eye to be bathed, by means of a soft piece of
    linen rag, with this lotion frequently; and, between times, let a
    piece of linen rag, wetted in the lotion, be applied to the eye, and
    be fastened in its place by means of a bandage.

The white lily leaf, soaked in brandy, is another excellent remedy for
the bruises of a child. Gather the white lily blossoms when in full
bloom, and pot them in a wide-mouthed bottle of brandy, cork the bottle,
and it will then always be ready for use. Apply a leaf to the part
affected, and bind it on either with a bandage or with a handkerchief.
The white lily root sliced is another valuable external application for
bruises.

280. _If a child fall upon his head and be stunned, what ought to be
done?_

If he fall upon his head and be stunned, he will look deadly pale, very
much as if he had fainted. He will in a few minutes, in all probability,
regain his consciousness. Sickness frequently supervenes, which makes
the case more serious, it being a proof that injury, more or less
severe, has been done to the brain; send, therefore, instantly, for a
medical man.

In the mean time, loosen both his collar and neckerchief, lay him flat
on his back, sprinkle cold water upon his face, open the windows so as
to admit plenty of fresh air, and do not let people crowd around him,
nor shout at him, as some do, to make him speak.

While he is in an unconscious state, do not on any account whatever
allow a drop of blood to be taken from him, either by leeches or by
bleeding; if you do, he will probably never rally, but will most likely
sleep “the sleep that knows no waking.”

281. _A nurse sometimes drops an infant and injures his back; what ought
to be done?_

Instantly send for a surgeon; omitting to have proper advice in such a
case has frequently made a child a cripple for life. A nurse frequently,
when she has dropped her little charge, is afraid to tell her mistress;
the consequences might then be deplorable. If ever a child scream
violently without any assignable cause, and the mother is not able for
some time to pacify him, the safer plan is that she send for a doctor,
in order that he might strip and carefully examine him; much
after-misery might often be averted if this plan were more frequently
followed.

282. _Have you any remarks to make and directions to give on accidental
poisoning by lotions, by liniments, etc.?_

It is a culpable practice of either a mother or nurse to leave
_external_ applications within the reach of a child. It is also highly
improper to put a mixture and an _external_ application (such as a
lotion or a liniment) on the same tray or on the same mantle-piece. Many
liniments contain large quantities of opium, a teaspoonful of which
would be likely to cause the death of a child. “Hartshorn and oil,” too,
has frequently been swallowed by children, and in several instances has
caused death. Many lotions contain sugar of lead, which is also
poisonous. There is not, fortunately, generally sufficient lead in the
lotion to cause death; but if there be not enough to cause death, there
may be more than enough to make the child very poorly. All these
accidents occur from disgraceful carelessness.

A mother or a nurse ought _always_, before administering a dose of
medicine to a child, to read the label on the bottle; by adopting this
simple plan many serious accidents and much after-misery might be
averted. Again, I say let every lotion, every liniment, and indeed
everything for _external_ use, be either locked up or be put out of the
way, and far away from all medicine that is given by the mouth. _This
advice admits of no exception._

If your child has swallowed a portion of a liniment containing opium,
instantly send for a medical man. In the mean time, force a strong
mustard emetic (composed of two teaspoonfuls of flour of mustard, mixed
in half a teacupful of warm water) down his throat. Encourage the
vomiting by afterward forcing him to swallow warm water. Tickle the
throat either with your finger or with a feather. Souse him alternately
in a hot and then in a cold bath. Dash cold water on his head and face.
Throw open the windows. Walk him about in the open air. Rouse him by
slapping him, by pinching him, and by shouting to him; rouse him,
indeed, by every means in your power, for if you allow him to go to
sleep, it will, in all probability, be the sleep that knows no waking!

If a child has swallowed “hartshorn and oil,” force him to drink vinegar
and water, lemon-juice and water, barley-water, and thin gruel.

If he have swallowed a lead lotion, give him a mustard emetic, and then
vinegar and water, sweetened either with honey or with sugar, to drink.

283. _Are not Lucifer Matches poisonous?_

Certainly, they are very poisonous; it is therefore desirable that they
should be put out of the reach of children. A mother ought to be very
strict with servants on this head. Moreover, lucifer matches are not
only poisonous but dangerous, as a child might set himself on fire with
them. A case bearing on the subject has just come under my own
observation. A little boy, three years old, was left alone for two or
three minutes, during which time he obtained possession of a lucifer
match, and struck a light by striking the match against the wall.
Instantly there was a blaze. Fortunately for him, in his fright, he
threw the match on the floor. His mother, at this moment, entered the
room. If his clothes had taken fire, which they might have done, had he
not thrown the match away, or if his mother had not been so near at
hand, he would, in all probability, have either been severely burned, or
have been burned to death.

284. _If a child’s clothes take fire, what ought to be done to
extinguish them?_

Lay him on the floor, then roll him either in the rug or in the carpet,
or in the door-mat, or in any thick article of dress you may either have
on, or have at hand—if it be woolen, so much the better; or throw him
down, and roll him over and over on the floor, as by excluding the
atmospheric air, the flame will go out: hence, the importance of a
mother cultivating presence of mind. If parents were better prepared for
such emergencies, such horrid disfigurations and frightful deaths would
be less frequent.

You ought to have a proper fire-guard before the nursery grate, and
should be strict in not allowing your child to play with fire. If he
still persevere in playing with it when he has been repeatedly cautioned
not to do so, he should be punished for his temerity. If anything would
justify corporal chastisement, it would surely be such an act of
disobedience. There are only two acts of disobedience that I would flog
a child for—namely, the playing with fire and the telling of a lie! If
after various warnings and wholesome corrections he still persists, it
would be well to let him slightly taste the pain of his doing so, either
by holding his hand for a moment very near the fire, or by allowing him
to slightly touch either the hot bar of the grate or the flame of the
candle. Take my word for it, the above plan will effectually cure him—he
will never do it again! It would be well for the children of the poor to
have pinafores made either of woolen or of stuff materials. The dreadful
deaths from burning, which so often occur in winter, too frequently
arise from _cotton_ pinafores first taking fire.[268]

If all dresses, after being washed, and just before being dried, were,
for a short time, soaked in a solution of tungstate of soda, such
clothes, when dried, would be perfectly fire-proof.

Tungstate of soda may be used either with or without starch; but full
directions for the using of it will, at the time of purchase, be given
by the chemist.

285. _Is a burn more dangerous than a scald?_

A burn is generally more serious than a scald. Burns and scalds are more
dangerous on the body, especially on the chest, than either on the face
or on the extremities. The younger the child, of course, the greater is
the danger.

Scalds, both of the mouth and of the throat, from a child drinking
boiling water from the spout of a tea-kettle, are most dangerous. A poor
person’s child is, from the unavoidable absence of the mother, sometimes
shut up in the kitchen by himself, and being very thirsty, and no other
water being at hand, he is tempted in his ignorance to drink from the
tea-kettle: if the water be unfortunately boiling, it will most likely
prove to him to be a fatal draught!

286. _What are the best immediate applications to a scald or to a burn?_

There is nothing more efficacious than flour. It ought to be thickly
applied, over the part affected, and should be kept in its place either
with a rag and a bandage, or with strips of old linen. If this be done,
almost instantaneous relief will be experienced, and the burn or the
scald, if superficial, will soon be well. The advantage of flour as a
remedy is this, that it is always at hand. I have seen some extensive
burns and scalds cured by the above simple plan. Another excellent
remedy is cotton wool. The burn or the scald ought to be enveloped in
it; layer after layer should be applied until it be several inches
thick. The cotton wool must not be removed for several days.[269] These
two remedies, flour and cotton wool, may be used in conjunction; that is
to say, the flour may be thickly applied to the scald or to the burn,
and the cotton wool over all.

Prepared lard—that is to say, lard without salt[270]—is an admirable
remedy for burns and for scalds. The advantages of lard are: (1) It is
almost always at hand; (2) It is very cooling, soothing, and
unirritating to the part, and it gives almost immediate freedom from
pain; (3) It effectually protects and sheathes the burn or the scald
from the air; (4) It is readily and easily applied: all that has to be
done is to spread the lard either on pieces of old linen rag, or on
lint, and then to apply them smoothly to the parts affected, keeping
them in their places by means of bandages—which bandages may be readily
made from either old linen or calico shirts. Dr. John Packard, of
Philadelphia, was the first to bring this remedy for burns and scalds
before the public—he having tried it in numerous instances, and with the
happiest results. I myself have, for many years, been in the habit of
prescribing lard as a dressing for blisters, and with the best effects.
I generally advise equal parts of prepared lard and of spermaceti cerate
to be blended together to make an ointment. The spermaceti cerate gives
a little more consistence to the lard, which, in warm weather,
especially, is a great advantage.

Another valuable remedy for burns is, “carron oil;” which is made by
mixing equal parts of linseed oil and lime-water together in a bottle,
and shaking it up before using it.

Cold applications, such as cold water, cold vinegar and water, and cold
lotions, are most injurious, and, in many cases, even dangerous.

Scraped potatoes, sliced cucumber, salt, and spirits of turpentine, have
all been recommended; but, in my practice, nothing has been so
efficacious as the remedies above enumerated.

Do not wash the wound, and do not dress it more frequently than every
_other_ day. If there be much discharge, let it be gently sopped up with
soft old linen rag; but do not, _on any_ account, let the burn be rubbed
or roughly handled. I am convinced that, in the majority of cases,
wounds are too frequently dressed, and that the washing of wounds
prevents the healing of them. “It is a great mistake,” said Ambrose
Paré, “to dress ulcers too often, and to wipe their surfaces clean, for
thereby we not only remove the useless excrement, which is the mud or
sanies of ulcers, but also the matter which forms the flesh.
Consequently, for these reasons, ulcers should not be dressed too
often.”

The burn or the scald may, after the first two days, if severe, require
different dressings; but, if it be severe, the child ought of course to
be immediately placed under the care of a surgeon.

If the scald be either on the leg or on the foot, a common practice is
to take the shoe and the stocking off; in this operation, the skin is
also at the same time very apt to be removed. Now, both the shoe and the
stocking ought to be slit up, and thus be taken off, so that neither
unnecessary pain nor mischief may be caused.

287. _If a bit of quicklime should accidentally enter the eye of my
child, what ought to be done?_

Instantly, but tenderly remove, either by means of a camel’s-hair brush
or by a small spill of paper, any bit of lime that may adhere to the
ball of the eye, or that may be within the eye or on the eyelashes; then
well bathe the eye (allowing a portion to enter it) with vinegar and
water—one part of vinegar to three parts of water, that is to say, a
quarter fill a clean half-pint medicine bottle with vinegar and then
fill it up with spring water, and it will be ready for use. Let the eye
be bathed for at least a quarter of an hour with it. The vinegar will
neutralize the lime, and will rob it of its burning properties.

Having bathed the eye with the vinegar and water for a quarter of an
hour, bathe it for another quarter of an hour simply with a little warm
water; after which, drop into the eye two or three drops of the best
sweet oil, put on an eye-shade made of three thicknesses of linen rag,
covered with green silk, and then do nothing more until the doctor
arrives.

If the above rules be not _promptly_ and _properly_ followed out, the
child may irreparably lose his eyesight; hence the necessity of a
_popular_ work of this kind, to tell a mother, provided _immediate_
assistance cannot be obtained, what ought _instantly_ to be done; for
moments, in such a case, are precious.

While doing all that I have just recommended, let a surgeon be sent for,
as a smart attack of inflammation of the eye is very apt to follow the
burn of lime; but which inflammation will, provided the _previous_
directions have been _promptly_ and _efficiently_ followed out, with
appropriate treatment, soon subside.

The above accident is apt to occur to a child who is standing near a
building when the slacking of quicklime is going on, and where portions
of lime, in the form of powder, are flying about the air. It would be
well not to allow a child to stand about such places, as prevention is
always better than cure. _Quicklime_ is sometimes called _caustic lime_:
it well deserves its name, for it is a _burning lime_, and if proper
means be not promptly used, will soon burn away the sight.

288. “_What is to be done in the case of Choking?_”

Instantly put your finger into the throat and feel if the substance be
within reach; if it be food, force it down, and thus liberate the
breathing; should it be a hard substance, endeavor to hook it out; if
you cannot reach it, give a good smart blow or two with the flat of the
hand on the back; or, as recommended by a contributor to the _Lancet_,
on the chest, taking care to “seize the little patient, and place him
between your knees side ways, and in this or some other manner to
_compress the abdomen_ [the belly], otherwise the power of the blow will
be lost by the yielding of the abdominal parietes [walls of the belly],
and the respiratory effort will not be produced.” If that does not have
the desired effect, tickle the throat with your finger, so as to insure
immediate vomiting, and the consequent ejection of the offending
substance.[271]

289. _Should my child be bitten by a dog supposed to be mad, what ought
to be done?_

Instantly well rub for the space of five of ten seconds—_seconds_, _not_
minutes—a stick of nitrate of silver (lunar caustic) into the wound. The
stick of lunar caustic should be pointed, like a cedar-pencil for
writing, in order the more thoroughly to enter the wound.[272] This, if
properly done directly after the bite, will effectually prevent
hydrophobia. The nitrate of silver acts not only as a caustic to the
part, but it appears effectually to neutralize the poison, and thus by
making the virus perfectly innocuous is a complete antidote. If it be
either the lip, or the parts near the eye, or the wrist, that have been
bitten, it is far preferable to apply the caustic than to cut the part
out; as the former is neither so formidable, nor so dangerous, nor so
disfiguring as the latter, and yet it is equally as efficacious. I am
indebted to the late Mr. Youatt, the celebrated veterinary surgeon, for
this valuable antidote or remedy for the _prevention_ of the most
horrible, heart-rending, and incurable disease known. Mr. Youatt had an
immense practice among dogs as well as among horses. He was a keen
observer of disease, and a dear lover of his profession, and he had paid
great attention to rabies—dog madness. He and his assistants had been
repeatedly bitten by rabid dogs; but knowing that he was in possession
of an infallible preventive remedy, he never dreaded the wounds
inflicted either upon himself or upon his assistants. Mr. Youatt never
knew lunar caustic, if properly and _immediately_ applied, to fail. It
is, of course, only a preventive. If hydrophobia be once developed in
the human system, no antidote has ever yet, for this fell and
intractable disease, been found.

While walking the London Hospitals, upwards of thirty-five years ago, I
received an invitation from Mr. Youatt to attend a lecture on rabies—dog
madness. He had, during the lecture, a dog present laboring under
_incipient_ madness. In a day or two after the lecture, he requested me
and other students to call at his infirmary and see the dog, as the
disease was at that time fully developed. We did so, and found the poor
animal raving mad—frothing at the mouth, and snapping at the iron bars
of his prison. I was particularly struck with a peculiar brilliancy and
wildness of the dog’s eyes. He seemed as though, with affright and
consternation, he beheld objects unseen by all around. It was pitiful to
witness his frightened and anxious countenance. Death soon closed the
scene!

I have thought it my duty to bring the value of lunar caustic as a
preventive of hydrophobia prominently before your notice, and to pay a
tribute of respect to the memory of Mr. Youatt—a man of talent and
genius.

Never kill a dog supposed to be mad who has bitten either a child, or
any one else, until it has, past all doubt, been ascertained whether he
be really mad or not. He ought, of course, to be tied up, and be
carefully watched, and be prevented the while from biting any one else.
The dog, by all means, should be allowed to live at least for some
weeks, as the fact of his remaining will be the best guarantee that
there is no fear of the bitten child having caught hydrophobia.

There is a foolish prejudice abroad, that a dog, be he mad or not, who
has bitten a person ought to be _immediately_ destroyed; that although
the dog be not at the time mad, but should at a future period become so,
the person who had been bitten when the dog was _not_ mad, would, when
the dog became mad, have hydrophobia! It seems almost absurd to bring
the subject forward; but the opinion is so very general and deep rooted,
that I think it well to declare that there is not the slightest
foundation of truth in it, but that it is a ridiculous fallacy!

A cat sometimes goes mad, and its bite may cause hydrophobia; indeed,
the bite of a mad cat is more dangerous than the bite of a mad dog. A
bite from a mad cat ought to be treated precisely in the same
manner—namely, with the lunar caustic—as for a mad dog.

A bite either from a dog or from a cat _who is not mad_, from a cat
especially, is often venomous and difficult to heal. The best
application is _immediately_ to apply a large hot white-bread poultice
to the part, and to renew it every four hours; and, if there be much
pain in the wound, to well foment the part, every time before applying
the poultice, with a hot chamomile and poppy-head fomentation.

Scratches of a cat are best treated by smearing, and that freely and
continuously for an hour, and then afterward at longer intervals, fresh
butter on the part affected. If fresh butter be not at hand, fresh
lard—that is to say, lard _without_ salt—will answer the purpose. If the
pain of the scratch be very intense, foment the part affected with hot
water, and then apply a hot white-bread poultice, which should be
frequently renewed.

290. _What is the best application in case of a sting either from a bee
or from a wasp?_

Extract the sting, if it have been left behind, either by means of a
pair of dressing forceps, or by the pressure of the hollow of a small
key—a watch-key will answer the purpose; then, a little blue (which is
used in washing) moistened with water, should be immediately applied to
the part; or, apply a few drops of solution of potash,[273] or “apply
moist snuff or tobacco, rubbing it well in,”[274] and renew from time to
time either of them: if either of these be not at hand, either honey, or
treacle, or fresh butter, will answer the purpose. Should there be much
swelling or inflammation, apply a hot white-bread poultice, and renew it
frequently. In eating apricots, or peaches, or other fruit, they ought
to, beforehand, be carefully examined, in order to ascertain that no
wasp is lurking in them; otherwise, it may sting the throat, and serious
consequences will ensue.

291. _If a child receive a fall, causing the skin to be grazed, can you
tell me of a good application?_

You will find gummed paper an excellent remedy; the way of preparing it
is as follows: Apply evenly, by means of a small brush, thick mucilage
of gum arabic to cap paper; hang it up to dry, and keep it ready for
use. When wanted, cut a portion as large as may be requisite, then
moisten it with your tongue, in the same manner you would a postage
stamp, and apply it to the grazed part. It may be removed when necessary
by simply wetting it with water. The part in two or three days will be
well. There is usually a margin of gummed paper sold with postage
stamps; this will answer the purpose equally well. If the gummed paper
be not at hand, then frequently, for the space of an hour or two, smear
the part affected with fresh butter.

292. _In case of a child swallowing by mistake either laudanum, or
paregoric, or Godfrey’s Cordial, or any other preparation of opium, what
ought to be done?_

Give, _as quickly as possible_, a strong mustard emetic; that is to say,
mix two teaspoonfuls of flour of mustard in half a teacupful of water,
and force it down his throat. If free vomiting be not induced, tickle
the upper part of the swallow with a feather; drench the little
patient’s stomach with large quantities of warm water. As soon as it can
be obtained from a druggist, give him the following emetic draught:

                  Take of—Sulphate of Zinc, one scruple;
                          Simple Syrup, one drachm;
                          Distilled Water, seven drachms:

  To make a Draught.

Smack his buttocks and his back; walk him, or lead him, or carry him
about in the fresh air; shake him by the shoulders; pull his hair;
tickle his nostrils; shout and holla in his ears; plunge him into a warm
bath and then into a cold bath alternately; well sponge his head and
face with cold water; dash cold water on his head, face, and neck; and
do not, on any account, until the effects of the opiate are gone off,
allow him to go to sleep; if you do, he will never wake again! While
doing all these things, of course, you ought to lose no time in sending
for a medical man.

293. _Have you any observations to make on parents allowing the Deadly
Nightshade—the Atropa Belladonna—to grow in their gardens?_

I wish to caution you _not_ on any account to allow the Belladonna—the
Deadly Nightshade—to grow in your garden. The whole plant—root, leaves,
and berries—is poisonous; and the berries, being attractive to the eye,
are very alluring to children.

294. _What is the treatment of poisoning by Belladonna?_

Instantly send for a medical man; but, in the mean time, give an
emetic—a mustard emetic;—mix two teaspoonfuls of flour of mustard in
half a teacupful of warm water, and force it down the child’s throat;
then drench him with warm water, and tickle the upper part of his
swallow either with a feather or with the finger, to make him sick; as
the grand remedy is an emetic to bring up the offending cause. If the
emetic have not acted sufficiently, the medical man when he arrives may
deem it necessary to use the stomach-pump; but remember not a moment
must be lost, for moments are precious in a case of belladonna
poisoning, in giving a mustard emetic, and repeating it again and again
until the enemy be dislodged. Dash cold water upon his head and face;
the best way of doing which is by means of a large sponge, holding his
head and his face over a wash-hand basin, half filled with cold water,
and filling the sponge from the basin, and squeezing it over his head
and face, allowing the water to continuously stream over them for an
hour or two, or until the effects of the poison have passed away. This
sponging of the head and face is very useful in poisoning by opium, as
well as in poisoning by belladonna; indeed, the treatment of poisoning
by the one is very similar to the treatment of poisoning by the other.
I, therefore, for the further treatment of poisoning by belladonna, beg
to refer you to a previous Conversation on the treatment of poisoning by
opium.

295. _Should a child put either a pea or a bead, or any other foreign
substance, up the nose, what ought to be done?_

Do not attempt to extract it yourself, or you might push it farther in,
but send instantly for a surgeon, who will readily remove it, either
with a pair of forceps, or by means of a bent probe, or with a director.
If it be a pea, and it be allowed for any length of time to remain in,
it will swell, and will thus become difficult to extract, and may
produce great irritation and inflammation. A child ought not to be
allowed to play with peas or with beads (unless the beads are on a
string), as he is apt, for amusement, to push them up his nose.

296. _If a child have put either a pea, a bean, a bead, a cherry-stone,
or any other smooth substance, into his ear, what ought to be done to
remove it?_

Turn his head on one side, in order to let the ear with the pea or bead
in it be undermost, then give with the flat of your hand two or three
sharp, sudden slaps or boxes on the other, or _upper_most ear, and most
likely the offending substance will drop out. Poking at the ear will, in
the majority of cases, only send the substance farther in, and will make
it more difficult (if the above simple plan does not succeed) for the
medical man to remove. The surgeon will, in all probability, syringe the
ear; therefore, have a supply of warm water in readiness for him, in
order that no time may be lost.

297. _If an earwig, or any other living thing, should get into the ear
of a child, what ought to be done?_

Lay the child on his side, the affected ear being uppermost, and fill
the ear, from a teaspoon, with either water or sweet oil. The water or
oil will carry the living thing, whatever it be, out of the ear, and the
child is at once relieved.

298. _If a child swallow a piece of broken glass, what ought to be
done?_

Avoid purgatives, as the free action on the bowels would be likely to
force the spiculæ of glass into the mucous membrane of the bowels, and
thus would wound them, and might cause ulceration, and even death. “The
object of treatment will be to allow them to pass through the intestines
well enveloped by the other contents of the tube; and for this purpose a
solid farinaceous diet should be ordered, and purgatives scrupulously
avoided.”[275]

299. _If a child swallow a pin, what should be done?_

Treat him as for broken glass. Give him no aperients, or it might, in
action, force the pin into the bowel. I have known more than one
instance where a child, after swallowing a pin, to have voided it in his
motion.

300. _If a child swallow a coin of any kind, is danger likely to ensue,
and what ought to be done?_

There is, as a rule, no danger. A dose or two of castor oil will be all
that is usually necessary. The evacuations ought to be carefully
examined until the coin be discovered. I once knew a child swallow a
penny-piece, and pass it in his motions.

301. _If a child, while playing with a small coin (such as either a
threepenny or a fourpenny piece), or any other substance, should toss it
into his mouth, and inadvertently allow it to enter the windpipe, what
ought to be done?_

Take hold of him by the legs, allowing his head to hang downward; then
give him, with the palm of your hand, several sharp blows on his back,
and you may have the good fortune to see the coin coughed out of his
mouth. Of course, if this plan does not succeed, send instantly for a
medical man.




                               PART III.
                         BOYHOOD AND GIRLHOOD.


                  _’Tis with him e’en standing water,
                  Between boy and man._
                                      SHAKSPEARE.

                  _Standing with reluctant feet
                  Where the brook and river meet,
                  Womanhood and childhood fleet!_
                                      LONGFELLOW.


                             ABLUTION, Etc.

302. _Have you any remarks to make on the Ablution of boys and girls?_

How is it that a mother thinks it absolutely necessary (which it really
is) that her babe’s _whole_ body should every morning be washed; and yet
who does not deem it needful that her girl or boy of twelve years old,
should go through the process of daily and _thorough_ ablution? If the
one case be necessary, sure I am that the other is equally if not more
needful.

Thorough ablution of the body every morning at least is essential to
health. I maintain that no one can be in the enjoyment of perfect health
who does not keep his skin—the whole of his skin—clean. In the absence
of cleanliness, a pellicle forms on the skin which engenders disease.
Moreover, a person who does not keep his skin clean is more susceptible
of contracting contagious disease, such as small-pox, typhus fever,
cholera, diphtheria, scarlet fever, etc.

Thorough ablution of the body is a grand requisite of health. I maintain
that no one can be perfectly healthy unless he thoroughly wash his
body—the whole of his body; if filth accumulate, which, if not washed
off, it is sure to do, disease must, as a matter of course, follow.
Besides, ablution is a delightful process; it makes one feel fresh and
sweet, and young and healthy; it makes the young look handsome and the
old look young! Thorough ablution might truly be said both to renovate
and to rejuvenize! A scrupulously clean skin is one of the grand
distinctive characteristics both of a lady and of a gentleman.

Dirty people are not only a nuisance to themselves, but to all around;
they are not only a nuisance, but a danger, as their dirty bodies are
apt to carry from place to place contagious diseases.

It is important that parts that are covered should be kept cleaner than
parts exposed to the air, as dirt is more apt to fester in dark places;
besides, parts exposed to the air have the advantage of the air’s
sweetening properties; air acts as a bath, and purifies the skin
amazingly.

It is desirable to commence a complete system of washing early in life,
as then it becomes a second nature, and cannot afterward be dispensed
with. One accustomed to the luxury of his morning ablution would feel
most uncomfortable if anything prevented him from taking it; he would as
soon think of dispensing with his breakfast as with his bath.

Every boy, every girl, and every adult ought each to have either a room
or a dressing-room to himself or to herself, in order that he or she
might strip to the skin and thoroughly wash themselves; no one can wash
properly and effectually without doing so.

Now, for the paraphernalia required for the process: (1) A large
nursery-basin, one that will hold six or eight quarts of water
(Wedgwood’s make being considered the best); (2) A piece of coarse
flannel, a yard long and half a yard wide; (3) A large sponge; (4) A
tablet either of the best yellow or of curd soap; (5) Two towels, one
being a diaper and the other a Turkish rubber.

Now, as to the manner of performing ablution. You ought to fill the
basin three parts full with _rain_ water; then, having well soaped and
cleansed your hands, re-soap them, dip your head and face into the
water, then with the soaped hands well rub and wash your head, face,
neck, chest, and armpits; having done which, take the wetted sponge, and
go over all the parts previously traveled over by the soaped hands; then
fold the flannel as you would a neckerchief, and dip it in the water,
then throw it, as you would a skipping-rope, over your shoulders, and
move it a few times from right to left and from left to right, and up
and down, and then across the back and loins; having done which, dip the
sponge in the water, and holding your head under the water, let the
water stream from the sponge a time or two over your head, neck, and
face. Dip your head and face in the water, then put your hands and arms
(as far as they will go) into the water, holding them there while you
can count thirty. Having reduced the quantity of water to a third of a
basinful, place the basin on the floor, and sit (while you can count
fifty) _in_ the water; then put one foot at a time in the water, and
quickly rub, with soaped hands, up and down your leg, over the foot, and
pass your thumb between each toe (this latter procedure tends to keep
away soft corns); then take the sponge, filled with water, and squeeze
it over your leg and foot, from the knee downward,—then serve your other
leg and foot in the same way. By adopting the above plan, the whole of
the body will, every morning, be thoroughly washed.

A little warm water might at first, and during the winter time, be
added, to take off the chill; but the sooner quite cold water is used
the better. The body ought to be quickly dried (taking care to wipe
between each toe), first with the diaper, and then with the Turkish
rubber. In drying your back and loins, you ought to throw, as you would
a skipping-rope, the Turkish rubber over your shoulders, and move it a
few times from side to side, until the parts be dry.

Although the above description is necessarily prolix, the washing itself
ought to be very expeditiously performed; there should be no dawdling
over it, otherwise the body will become chilled, and harm instead of
good will be the result. If due dispatch be used, the whole of the body
might, according to the above method, be thoroughly washed and dried in
the space of ten minutes.

A boy ought to wash his head, as above directed, every morning, a girl,
who has much hair, once a week, with soap and water, with flannel and
sponge. The hair, if not frequently washed, is very dirty, and nothing
is more repulsive than a dirty head!

It might be said, “Why do you go into particulars? why dwell so much
upon minutiæ? Every one, without being told, knows how to wash himself!”
I reply, “That very few people do know how to wash themselves properly;
it is a misfortune they do not—they would be both much healthier and
happier if they did!”

303. _Have you any remarks to make on boys and girls learning to swim?_

Let me strongly urge you to let your sons and daughters be _early_
taught to swim. Swimming is a glorious exercise—one of the best that can
be taken; it expands the chest; it promotes digestion; it develops the
muscles, and brings into action some muscles that in any other form of
exercise are but seldom brought into play; it strengthens and braces the
whole frame, and thus makes the swimmer resist the liability of catching
colds; it gives both boys and girls courage, energy, and
self-reliance,—splendid qualities in this rough world of ours. Swimming
is oftentimes the means of saving human life; this of itself would be a
great recommendation of its value. It is a delightful amusement; to
breast the waves is as exhilarating to the spirits as clearing on
horseback a five-barred gate.

The art of learning to swim is quite as necessary to be learned by a
girl as by a boy; the former has similar muscles, lungs, and other
organs to develop as the latter. It is very desirable that in large
towns swimming-baths for ladies should be instituted.

Swimming ought, then, to be a part and parcel of the education of every
boy and of every girl.

Swimming does not always agree. This sometimes arises from a person
being quite cold before he plunges into the water. Many people have an
idea that they ought to go into the water while their bodies are in a
cool state. Now this is a mistaken notion, and is likely to produce
dangerous consequences. The skin ought to be comfortably warm, neither
very hot nor very cold, and then the bather will receive every advantage
that cold bathing can produce. If he go into the bath while the body is
cold, the blood becomes chilled, and is driven to internal parts, and
thus mischief is frequently produced.

A boy, after using cold bathing, ought, if it _agree_ with him, to
experience a pleasing glow over the whole surface of his body, his
spirits and appetite should be increased, and he ought to feel stronger;
but if it _disagree_ with him, a chilliness and coldness, a lassitude
and a depression of spirits, will be the result; the face will be pale
and the features will be pinched, and, in some instances, the lips and
the nails will become blue; all these are signs that _cold_ bathing is
injurious, and, therefore, that it ought on no account to be persevered
in, unless these symptoms have hitherto proceeded from his going into
the bath while he was quite cold. He may, previously to entering the
bath, warm himself by walking briskly for a few minutes. Where _cold_
sea water bathing does not agree, _warm_ sea bathing should be
substituted.

304. _Which do you prefer—sea bathing or fresh water bathing?_

Sea bathing. Sea bathing is incomparably superior to fresh water
bathing; the salt water is far more refreshing and invigorating; the
battling with the waves is more exciting; the sea breezes, blowing on
the nude body, breathes (for the skin is a breathing apparatus) health
and strength into the frame, and comeliness into the face; the sea water
and the sea breezes are splendid cosmetics; the salt water is one of the
finest applications, both for strengthening the roots and brightening
the color of the hair, provided grease and pomatum have not been
previously used.

305. _Have you any directions to give as to the time and the seasons,
and the best mode of sea bathing?_

Summer and autumn are the best seasons of the year for cold sea
bathing—August and September being the best months. To prepare the skin
for the cold sea bathing, it would be well, before taking a dip in the
sea, to have on the previous day a warm salt-water bath. It is
injurious, and even dangerous, to bathe _immediately_ after a _full_
meal; the best time to bathe is about two hours after breakfast—that is
to say, at about eleven or twelve o’clock in the forenoon. The bather,
as soon as he enters the water, _ought instantly_ to wet his head; this
may be done either by his jumping at once from the machine into the
water, or, if he have not the courage to do so, by plunging his head
without loss of time _completely_ under the water. He should remain in
the water about a quarter of an hour, but never longer than half an
hour.

Many bathers by remaining a long time in the water do themselves great
injury. If sea bathing be found to be invigorating—and how often to the
delicate it has proved to be truly magical—a patient may bathe once
every day, but on no account oftener. If he be not strong, he had
better, at first, bathe only every other day, or even only twice a week.

The bather, after leaving the machine, ought, for half an hour, to take
a brisk walk in order to promote a reaction, and thus to cause a free
circulation of the blood.

306. _Do you think a tepid[276] bath may be more safely used?_

A tepid bath may be taken at almost any time; and a bather may remain
longer in one, with safety, than in a cold bath.

307. _Do you approve of warm bathing?_

A warm bath[277] may, with advantage, be occasionally used—say once a
week. A warm bath cleanses the skin more effectually than either a cold
or a tepid bath; but, as it is more relaxing, ought not to be employed
so often as either of them. A person should not continue longer than ten
minutes in a warm bath. Once a week, as a rule, is quite often enough
for a warm bath; and it would be an excellent plan if every boy and girl
and adult would make a practice of having one _regularly_ every week,
unless any special reason should arise to forbid its use.

308. _But does not warm bathing, by relaxing the pores of the skin,
cause a person to catch cold if he expose himself to the air immediately
afterward?_

There is, on this point, a great deal of misconception and unnecessary
fear. A person, _immediately_ after using a warm bath, should take
proper precautions—that is to say, he must not expose himself to
draughts, neither ought he to wash himself in _cold_ water, nor should
he, _immediately_ after taking one, drink _cold_ water. But he may
follow his usual exercise or employment, provided the weather be fine,
and the wind be neither in the east nor the northeast.

Every house of any pretension ought to have a bath-room. Nothing would
be more conducive to health than regular systematic bathing. A hot and
cold bath, a sitz-bath and a shower-bath—each and all in their turn—are
grand requisites to preserve and procure health. If the house cannot
boast of a bath-room, then the Corporation baths (which nearly every
large town possesses) ought to be liberally patronized.

309. _What is the best application for the hair?_

A sponge and _cold_ water, and two good hair-brushes. Avoid grease,
pomatum, bandoline, and all abominations of that kind. There is a
natural oil of the hair, which is far superior to either Rowland’s
Macassar oil or any other oil! The best scent for the hair is an
occasional dressing of soap and water; the best beautifier of the hair
is a downright thorough good brushing with two good hair-brushes! Again,
I say, _avoid grease of all kinds to the hair_. “And as for women’s
hair, don’t plaster it with scented and sour grease, or with any grease;
it has an oil of its own. And don’t tie up your hair tight, and make it
like a cap of iron over your skull. And why are your ears covered? You
hear all the worse, and they are not the cleaner. Besides, the ear is
beautiful in itself, and plays its own part in the concert of the
features.”[278]

If the hair cannot, without some application, be kept tidy, then a
little of the best sweet oil might, by means of an old tooth-brush, be
used to smooth it; sweet oil is, for the purpose, one of the most simple
and harmless of dressings; but, as I said before, the hair’s own natural
oil cannot be equaled, far less surpassed!

If the hair fall off, castor oil, scented with a few drops of essence of
bergamot and oil of lavender, is a good remedy to prevent its doing so;
a little of it ought, night and morning, to be well rubbed into the
roots of the hair. Cocoanut oil is another excellent application for the
falling off of the hair.


                               CLOTHING.

310. _Do you approve of a boy wearing flannel next the skin?_

England is so variable a climate, and the changes from heat to cold, and
from dryness to moisture of the atmosphere, are so sudden, that some
means are required to guard against their effects. Flannel, as it is a
bad conductor of heat, prevents the sudden changes from affecting the
body, and thus is a great preservative against cold.

Flannel is as necessary in the summer as in the winter time; indeed, we
are more likely both to sit and to stand in draughts in the summer than
in the winter; and thus we are more liable to become chilled and to
catch cold.

Woolen shirts are now much worn; they are very comfortable and
beneficial to health. Moreover, they simplify the dress, as they
supersede the necessity of wearing either both flannel and linen, or
flannel and calico shirts.

311. _Flannel sometimes produces great irritation of the skin; what
ought to be done to prevent it?_

Have a moderately fine flannel, and persevere in its use; the skin in a
few days will bear it comfortably. The Angola and wove-silk waistcoats
have been recommended as substitutes, but there is nothing equal to the
old-fashioned Welsh flannel.

312. _If a boy have delicate lungs, do you approve of his wearing a
prepared hare-skin over the chest?_

I do not. The chest may be kept too warm as well as too cold. The
hare-skin heats the chest too much, and thereby promotes a violent
perspiration; which, by his going into the cold air, may become suddenly
checked, and may thus produce mischief. If the chest be delicate, there
is nothing like flannel to ward off colds.

313. _After an attack of Rheumatic Fever, what extra clothing do you
advise?_

In the case of a boy, or a girl, just recovering from a severe attack of
rheumatic fever, flannel next the skin ought always to be worn—flannel
drawers as well as a flannel vest.

314. _Have you any remarks to make on boys’ waistcoats?_

Fashion in this, as in most other instances, is at direct variance with
common sense. It would seem that fashion was intended to make work for
the doctor, and to swell the bills of mortality! It might be asked, what
part of the chest, in particular, ought to be kept warm? The upper part
needs it most. It is in the _upper_ part of the lungs that tubercles
(consumption) usually first make their appearance; and is it not
preposterous to have such parts, in particular, kept cool?
Double-breasted waistcoats cannot be too strongly recommended for
_delicate_ youths, and for all men who have _weak_ chests.

315. _Have you any directions to give respecting the shoes and the
stockings?_

The shoes for winter should be moderately thick and waterproof. If boys
and girls be delicate, they ought to have double soles to their shoes,
with a piece of bladder between each sole, or the inner sole may be made
of cork; either of the above plans will make the soles of boots and
shoes completely waterproof. In wet or dirty weather, india-rubber
overshoes are useful, as they keep the _upper_ as well as the _under_
leathers perfectly dry.

The socks or stockings, for winter, ought to be either lamb’s-wool or
worsted; it is absurd to wear _cotton_ socks or stockings all the year
round. I should advise a boy to wear socks, not stockings; as he will
then be able to dispense with garters. Garters, as I have remarked in a
previous Conversation, are injurious—they not only interfere with the
circulation of the blood, but also, by pressure, injure the bones, and
thus the shape of the legs.

Boys and girls cannot be too particular in keeping their feet warm and
dry, as cold wet feet are one of the most frequent exciting causes of
bronchitis, of sore throats, and of consumption.

316. _When should a girl begin to wear stays?_

She ought never to wear them.

317. _Do not stays strengthen the body?_

No; on the contrary, they weaken it. (1) _They weaken the muscles._ The
pressure upon them causes them to waste; so that, in the end, a girl
cannot do without them, as the stays are then obliged to perform the
duty of the wasted muscles. (2) _They weaken the lungs_ by interfering
with their functions. Every inspiration is accompanied by a movement of
the ribs. If this movement be impeded, the functions of the lungs are
impeded likewise; and, consequently, disease is likely to follow; and
either difficulty of breathing, or cough, or consumption, may ensue. (3)
_They weaken the heart’s action_, and thus frequently produce
palpitation, and, perhaps, eventually organic or incurable disease of
the heart. (4) _They weaken the digestion_, by pushing down the stomach
and the liver, and by compressing the latter; and thus induce
indigestion, flatulence, and liver disease.[279] (5) _They weaken the
bowels_, by impeding their proper peristaltic (spiral) motion, and thus
might produce either constipation or a rupture. Is it not presumptuous
to imagine that man can improve upon God’s works; and that if more
support had been required the Almighty would not have given it!

            “God never made his work for man to mend.”[280]

318. _Have you any remarks to make on female dress?_

There is a perfect disregard of health in everything appertaining to
fashion. Parts that ought to be kept warm, remain unclothed: the _upper_
portion of the chest, most prone to tubercles (consumption), is
completely exposed; the feet, great inlets to cold, are covered with
thin stockings, and with shoes as thin as paper. Parts that should have
full play are cramped and hampered; the chest is cribbed in with stays,
the feet with _tight_ shoes,—hence causing deformity, and preventing a
free circulation of blood. The mind, that ought to be calm and
unruffled, is kept in a constant state of excitement by balls, and
concerts, and plays. Mind and body sympathize with each other, and
disease is the consequence. Night is turned into day; and a delicate
girl leaves the heated ball-room, decked out in her airy finery, to
breathe the damp and cold air of night. She goes to bed, but, for the
first few hours, she is too much excited to sleep; toward morning, when
the air is pure and invigorating, and, when to breathe it, would be to
inhale health and life, she falls into a feverish slumber, and wakes not
until noonday. Oh, that a mother should be so blinded and so infatuated!

319. _Have you any observations to make on a girl wearing a green
dress?_

It is injurious to wear a _green_ dress, if the color have been imparted
to it by means of _Scheele’s green_, which is arsenite of copper—a
deadly poison. I have known the arsenic to fly off from a _green_ dress
in the form of powder, and to produce, in consequence, ill health.
Gas-light green is a lovely green, and free from all danger, and is
fortunately superseding the Scheele’s green both in dresses and in
worsted work. I should advise my fair reader, when she selects green as
her color, always to choose the gas-light green, and to wear and to use
for worsted work no other green besides.


                                 DIET.

320. _Which is the most wholesome, coffee or tea, where milk does not
agree, for a youth’s breakfast?_

Coffee, provided it be made properly, and provided the boy or the girl
take a great deal of out-door exercise; if a youth be much confined
within doors, black tea is preferable to coffee. The usual practice of
making coffee is to boil it, to get out the strength! But the fact is,
the process of boiling boils the strength away; it drives off that
aromatic, grateful principle, so wholesome to the stomach, and so
exhilarating to the spirits; and, in lieu of which, extracts its dregs
and impurities, which are both heavy and difficult of digestion. The
coffee ought, if practicable, to be _freshly_ ground every morning, in
order that you may be quite sure that it be perfectly genuine, and that
none of the aroma of the coffee has flown off from long exposure to the
atmosphere. If a youth’s bowels be inclined to be costive, coffee is
preferable to tea for breakfast, as coffee tends to keep the bowels
regular. Fresh milk ought always to be added to the coffee in the
proportion of half coffee and half new milk. If coffee does not agree,
then _black_ tea should be substituted, which ought to be taken with
plenty of fresh milk in it. Milk may be frequently given in tea, when it
otherwise would disagree.

When a youth be delicate, it is an excellent plan to give him every
morning before he leaves his bed, a tumblerful of _new_ milk. The
draught of milk, of course, is not in any way to interfere with his
regular breakfast.

321. _Do you approve of a boy eating meat with his breakfast?_

This will depend upon the exercise he uses. If he have had a good walk
or run before breakfast, or if he intend, after breakfast, to take
plenty of athletic out-door exercise, meat, or a rasher or two of bacon,
may, with advantage be eaten, but not otherwise.

322. _What is the best dinner for a youth?_

Fresh mutton or beef, a variety of vegetables, and a farinaceous
pudding. It is a bad practice to allow him to dine exclusively, either
on a fruit-pudding or on any other pudding, or on pastry. Unless he be
ill, he must, if he is to be healthy, strong, and courageous, eat meat
every day of his life. “All courageous animals are carnivorous, and
greater courage is to be expected in a people, such as the English,
whose food is strong and hearty, than in the half-starved commonalty of
other countries.”[281]

Let him be debarred from rich soups and from high-seasoned dishes, which
only disorder the stomach and inflame the blood. It is a mistake to give
a boy or girl broth or soup, in lieu of meat for dinner; the stomach
takes such slops in a grumbling way, and is not at all satisfied. It may
be well, occasionally, to give a youth with his dinner, _in addition to
his meat_, either good soup or good broth, not highly-seasoned, made of
good _meat_ stock. But after all that can be said on the subject, a
plain joint of meat, either roast or boiled, is far superior for health
and strength than either soup or broth, let it be ever so good or so
well made.

He should be desired to take plenty of time over his dinner, so that he
may be able to chew his food well, and thus that it may be reduced to an
impalpable mass, and be well mixed with the saliva,—which the action of
the jaws will cause to be secreted—before it passes into the stomach. If
such were usually the case, the stomach would not have double duty to
perform, and a boy would not so frequently lay the foundation of
indigestion, etc., which may embitter and even make miserable his
after-life.

Meat, plain pudding, vegetables, bread, and hunger for sauce (which
exercise will readily give), is the best, and, indeed, should be as a
rule, the only dinner he should have. A youth ought not to dine later
than two o’clock.

323. _Do you consider broths and soups wholesome?_

The stomach can digest solid much more readily than it can liquid food;
on which account the dinner specified above is far preferable to one
either of broth or of soup. Fluids in large quantities too much dilute
the gastric juice and overdistend the stomach, and hence weaken it, and
thus produce indigestion.

324. _Do you approve of a boy drinking beer with his dinner?_

There is no objection to a little good, mild table-beer, but _strong_
ale ought never to be allowed. It is, indeed, questionable, whether a
boy, unless he takes unusual exercise, requires anything but water with
his meals.

325. _Do you approve of a youth, more especially if he be weakly, having
a glass or two of wine after dinner?_

I disapprove of it. His young blood does not require to be inflamed and
his sensitive nerves excited with wine; and if he be delicate, I should
be sorry to endeavor to strengthen him by giving him such an inflammable
fluid. If he be weakly, he is more predisposed to put on either fever or
inflammation of some organ; and, being thus predisposed, wine would be
likely to excite either the one or the other of them into action. A
parent ought on no account to allow a boy to touch spirits, however much
diluted; they are to the young still more deadly in their effects than
wine.

326. _Have you any objection to a youth drinking tea?_

Not at all, provided it be not green tea, that it be not made strong,
and that it have plenty of milk in it. Green tea is apt to make people
nervous, and boys and girls ought not even to know what it is to be
nervous.

327. _Do you object to supper for a youth?_

Meat suppers are highly prejudicial. If he be hungry (and if he have
been much in the open air, he is almost sure to be), a piece of bread
and cheese, or of bread and butter, with a draught either of new milk or
of table-beer, will form the best supper he can have. He ought not to
sup later than eight o’clock.

328. _Do you approve of a boy having anything between meals?_

I do not; let him have four meals a day, and he will require nothing in
the intervals. It is a mistaken notion that “little and often is best.”
The stomach requires rest as much as, or perhaps more than (for it is
frequently sadly overworked) any other part of the body. I do not mean
that he is to have “_much_ and seldom:” moderation, in everything, is to
be observed. Give him as much as a growing boy requires (_and that is a
great deal_), but do not let him eat gluttonously, as many indulgent
parents encourage their children to do. Intemperance in eating cannot be
too strongly condemned.

329. _Have you any objection to a boy having pocket money?_

It is a bad practice to allow a boy _much_ pocket money; if he be so
allowed, he will be loading his stomach with sweets, fruit, and pastry,
and thus his stomach will become cloyed and disordered, and the keen
appetite, so characteristic of youth, will be blunted, and ill health
will ensue. “In a public education, boys early learn temperance, and if
the parents and friends would give them less money upon their usual
visits, it would be much to their advantage, since it may justly be said
that a great part of their disorders arise from surfeit, ‘_plus occidit
gula quam gladius_’ (gluttony kills more than the sword).”[282]

How true is the saying that “many people dig their graves with their
teeth.” You may depend upon it that more die from stuffing than from
starvation!


                           AIR AND EXERCISE.

330. _Have you any remarks to make on fresh air and exercise for boys
and girls?_

Girls and boys, especially the former, are too much confined within
doors. It is imperatively necessary, if you wish them to be strong and
healthy, that they should have plenty of fresh air and exercise;
remember, I mean fresh air—country air, not the close air of a town. By
exercise, I mean the free unrestrained use of their limbs. Girls, in
this respect, are unfortunately worse off than boys, although they have
similar muscles to develop, similar lungs that require fresh air, and
similar nerves to be braced and strengthened. It is not considered
ladylike to be natural—all their movements must be measured by rule and
compass!

The reason why so many young girls of the present day are so sallow,
undersized, and ill shaped, is for the want of air and exercise. After a
time the want of air and exercise, by causing ill health, makes them
slothful and indolent—it is a trouble for them to move from their
chairs!

Respiration, digestion, and a proper action of the bowels imperatively
demand fresh air and exercise. Ill health will inevitably ensue if boys
and girls are cooped up a great part of the day in a close room. A
distinguished writer of the present day says: “The children of the very
poor are always out and about. In this respect they are an example to
those careful mammas who keep their children, the whole day long, in
their chairs, reading, writing, ciphering, drawing, practicing music
lessons, doing crochet work, or anything, in fact, except running about,
in spite of the sunshine always peeping in and inviting them out of
doors; and who, in the due course of time, are surprised to find their
children growing up with incurable heart, head, lung, or stomach
complaints.”

331. _What is the best exercise for youth?_

Walking or running, provided it be not carried to fatigue. The slightest
approach to it should warn a youth to desist from carrying it further.

Walking exercise is not sufficiently insisted upon. A boy or a girl, to
be in the enjoyment of good health, ought to walk at least ten miles
every day. I do not mean ten miles at a stretch, but at different times
of the day.

Some young ladies think it an awfully long walk if they manage a couple
of miles! How can they, with such exercise, expect to be well? How can
their muscles be developed? How can their nerves be braced? How can
their spines be strengthened and be straight? How can their blood course
merrily through their blood-vessels? How can their chests expand and be
strong? Why, it is impossible! Ill health must be the penalty of such
indolence, for Nature will not be trifled with!

Walking exercise, then, is the finest exercise that can be taken, and
must be taken, and that without stint, if boys and girls are to be
strong and well!

The advantage of our climate is, that there is not a day in the whole
year that walking exercise cannot be enjoyed. I use the term _enjoyed_
advisedly. The roads may of course be dirty; but what of that? A good,
thick pair of boots will be the remedy.

Do then, let me entreat you, insist upon your girls and boys taking
plenty of exercise; let them almost live in the open air! Do not coddle
them; this is a rough world of ours, and they must rough it; they must
be knocked about a little, and the knocks will do them good. Poor youths
who are, as it were, tied to their mothers’ apron-strings, are much to
be pitied; they are usually puny and delicate, and utterly deficient of
self-reliance.

332. _Do you approve of horse or pony exercise for boys and girls?_

Most certainly I do; but still it ought not to supersede walking. Horse
or pony exercise is very beneficial, and cannot be too strongly
recommended. One great advantage for those living in towns, which it has
over walking, is that a person may go farther into the country, and thus
be enabled to breathe a purer and more healthy atmosphere. Again, it is
a much more _amusing_ exercise than walking, and this, for the young, is
a great consideration indeed.

Horse exercise is for both boys and girls a splendid exercise; it
improves the figure, it gives grace to the movements, it strengthens the
chest, it braces the muscles, and gives to the character energy and
courage.

Both boys and girls ought to be early taught to ride. There is nothing
that gives more pleasure to the young than riding either on a pony or on
a horse, and for younger children, even on that despised, although
useful animal, a donkey. Exercise, taken with pleasure, is doubly
beneficial.

If girls were to ride more on horseback than they now do, we should hear
less of crooked spines and of round shoulders, of chlorosis and of
hysteria, and of other numerous diseases of that class, owing,
generally, to debility and to mismanagement.

Those ladies who “affect the saddle” are usually much healthier,
stronger, and straighter than those who either never or but seldom ride
on horseback.

Riding on horseback is both an exercise and an amusement, and is
peculiarly suitable for the fair sex, more especially as their modes of
exercise are somewhat limited, ladies being excluded from following many
games, such as cricket and football, both of which are practiced, with
such zest and benefit, by the rougher sex.

333. _Do you approve of carriage exercise?_

There is no muscular exertion in carriage exercise; its principal
advantage is, that it enables a person to have a change of air, which
may be purer than the one he is in the habit of breathing. But, whether
it be so or not, change of air frequently does good, even if the air be
not so pure. Carriage exercise, therefore, does only partial good, and
ought never to supersede either walking or horse exercise.

334. _What is the best time of the day for the taking of exercise?_

In the summer time, early in the morning and before breakfast, as “cool
morning air exhilarates young blood like wine.” If a boy cannot take
exercise upon an empty stomach, let him have a slice of bread and a
draught of milk. When he returns home, he will be able to do justice to
his breakfast. In fine weather he cannot take too much exercise,
provided it be not carried to fatigue.

335. _What is the best time for him to keep quiet?_

He ought not to take exercise immediately after—say for half an hour
after—a hearty meal, or it will be likely to interfere with his
digestion.


                              AMUSEMENTS.

336. _What amusements do you recommend for a boy as being most
beneficial to health?_

Many games—such as rowing, skating, cricket, quoits, football, rackets,
single-stick, bandy, bowls, skittles, and all gymnastic exercises. Such
games bring the muscles into proper action, and thus cause them to be
fully developed. They expand and strengthen the chest; they cause a due
circulation of the blood, making it to bound merrily through the
blood-vessels, and thus to diffuse health and happiness in its course.
Another excellent amusement for boys is the brandishing of clubs. They
ought to be made in the form of a constable’s staff, but should be much
larger and heavier. The manner of handling them is so graphically
described by Addison that I cannot do better than transcribe it: “When I
was some years younger than I am at present, I used to employ myself in
a more laborious diversion, which I learned from a Latin treatise of
exercises that is written with great erudition; it is there called the
σκιομαχια, or the fighting with a man’s own shadow, and consists in the
brandishing of two short sticks grasped in each hand, and loaded with
plugs of lead at either end. This opens the chest, exercises the limbs,
and gives a man all the pleasure of boxing without the blows. I could
wish that several learned men would lay out that time which they employ
in controversies and disputes about nothing, in this method of fighting
with their own shadows. It might conduce very much to evaporate the
spleen which makes them uneasy to the public as well as to themselves.”

Another capital healthful game is single-stick, which makes a boy “to
gain an upright and elastic carriage, and to learn the use of his
limbs.”[283] Single-stick may be taught by any drill-sergeant in the
neighborhood. Do everything to make a boy strong. Remember, “the glory
of young men is their strength.”[284]

If games were more patronized in youth, so many miserable, nervous,
useless creatures would not abound. Let a boy or a girl, then, have
plenty of play; let half of his or her time be spent in play.

There ought to be a gymnasium established in every town of the kingdom.
The gymnasium, the cricket ground, and the swimming bath are among our
finest institutions, and should be patronized accordingly.

First of all, by an abundance of exercise and of fresh air make your
boys and girls strong, and then, in due time, they will be ready and be
able to have their minds properly cultivated. Unfortunately, in this
enlightened age, we commence at the wrong end—we put the cart before the
horse—we begin by cultivating the mind, and we leave the body to be
taken care of afterward; the results are, broken health, precocious,
stunted, crooked, and deformed youths, and premature decay.

One great advantage of gymnastic exercise is, it makes the lungs expand,
it fills the lungs with air, and by doing so, strengthens the lungs
amazingly and wards off many diseases. The lungs are not sufficiently
exercised and expanded; boys and girls, girls especially, do not as a
rule half fill their lungs with air! now, air to the lungs is food to
the lungs, and portions of the lungs have not half their proper food,
and in consequence suffer.

It is very desirable that every boy and girl should, every day of his or
her life, and for a quarter of an hour at least each time, go through a
regular _breathing exercise_—that is to say, should be made to stand
upright, throw back the shoulders, and the while, alternately and
regularly, fully fill and fully empty the lungs of air. If this plan
were daily followed, the chest and lungs would be wonderfully
invigorated, and the whole body benefited.

337. _Is playing the flute, blowing the bugle, or any other wind
instrument, injurious to health?_

Decidedly so; the lungs and the windpipe are brought into unnatural
action by them. If a boy be of a consumptive habit, this will, of
course, hold good with tenfold force. If a youth must be musical, let
him be taught singing, as that, provided the lungs be not diseased, will
be beneficial.

338. _What amusements do you recommend for a girl?_

Archery, skipping, horse exercise, croquet, the hand-swing, the
fly-pole, skating, and dancing are among the best. Archery expands the
chest, throws back the shoulders, thus improving the figure, and
develops the muscles. Skipping is exceedingly good exercise for a girl,
every part of the body being put into action by it. Horse exercise is
splendid for a girl; it improves the figure amazingly—it is most
exhilarating and amusing; moreover, it gives her courage and makes her
self-reliant. Croquet develops and improves the muscles of the arms,
beautifies the complexion, strengthens the back, and throws out the
chest. Croquet is for girls and women what cricket is for boys and men—a
glorious game. Croquet has improved both the health and the happiness of
womankind more than any game ever before invented. Croquet, in the
bright sunshine, with the winds of heaven blowing about the players, is
not like a ball in a stifling hot ball-room, with gas-lights poisoning
the air. Croquet is a more sensible amusement than dancing; it brings
the intellect as well as the muscles into play. The man who invented
croquet has deserved greater glory, and has done more good to his
species, than many philosophers whose names are emblazoned in story.
Hand-swing is a capital exercise for a girl; the whole of the body is
thrown into action by it, and the spine, the shoulders, and the
shoulder-blades are especially benefited. The fly-pole, too, is good
exercise for the whole of the muscles of the body, especially of the
legs and the arms. Skating is as exhilarating as a glass of champagne,
but will do her far more good! Skating exhilarates the spirits, improves
the figure, and makes a girl balance and carry herself well; it is a
most becoming exercise for her, and is much in every way to be
commended. Moreover, skating gives a girl courage and self-reliance
Dancing, followed as a rational amusement, causes a free circulation of
the blood, and, provided it does not induce her to sit up late at night,
is most beneficial.

339. _If dancing be so beneficial, why are balls such fruitful sources
of coughs, of colds, and consumptions?_

On many accounts. They induce young ladies to sit up late at night; they
cause them to dress more lightly than they are accustomed to do; and
thus thinly clad, they leave their homes while the weather is perhaps
piercing cold, to plunge into a suffocating, hot ball-room, made doubly
injurious by the immense number of lights, which consume the oxygen
intended for the due performance of the healthy function of the lungs.
Their partners, the brilliancy of the scene, and the music excite their
nerves to undue, and thus to unnatural action, and what is the
consequence? Fatigue, weakness, hysterics, and extreme depression
follow. They leave the heated ball-room, when the morning has far
advanced, to breathe the bitterly cold and frequently damp air of a
winter’s night, and what is the result? Hundreds die of consumption who
might otherwise have lived. Ought there not, then, to be a distinction
between a ball at midnight and a dance in the evening?

340. _But still, would you have a girl brought up to forego the
pleasures of a ball?_

If a parent prefer her so-called pleasures to her health, certainly not;
to such a mother I do not address myself.

341. _Have you any remarks to make on singing, or on reading aloud?_

Before a mother allows her daughter to take lessons in singing, she
should ascertain that there be no actual disease of the lungs, for if
there be, it will probably excite it into action; but if no disease
exist, singing or reading aloud is very conducive to health. Public
singers are seldom known to die of consumption. Singing expands the
chest, improves the pronunciation, enriches the voice for conversation,
strengthens the lungs, and wards off many of their diseases.


                               EDUCATION.

342. _Do you approve of corporal punishment in schools?_

I do not. I consider it to be decidedly injurious both to body and mind.
Is it not painful to witness the pale cheeks and the dejected looks of
those boys who are often flogged? If their tempers are mild, their
spirits are broken; if their dispositions are at all obstinate, they
become hardened and willful, and are made little better than
brutes.[285] A boy who is often flogged loses that noble ingenuousness
and fine sensibility so characteristic of youth. He looks upon his
school as his prison, and his master as his jailer, and, as he grows up
to manhood, hates and despises the man who has flogged him. Corporal
punishment is revolting, disgusting, and demoralizing to the boy, and is
degrading to the school-master as a man and as a Christian.

If school-masters must flog, let them flog their own sons. If they must
ruin the tempers, the dispositions, and the constitutions of boys, they
have more right to practice upon their own than on other people’s
children! Oh that parents would raise—and that without any uncertain
sound—their voices against such abominations, and the detestable cane
would soon be banished the school-room! “I am confident that no boy,”
says Addison, “who will not be allured by letters without blows, will
never be brought to anything with them. A great or good mind must
necessarily be the worse for such indignities; and it is a sad change to
lose of its virtue for the improvement of its knowledge. No one has gone
through what they call a great school, but must have remembered to have
seen children of excellent and ingenuous natures (as have afterward
appeared in their manhood). I say, no man has passed through this way of
education but must have seen an ingenuous creature expiring with shame,
with pale looks, beseeching sorrow, and silent tears, throw up its
honest eyes, and kneel on its tender knees to an inexorable blockhead,
to be forgiven the false quantity of a word in making a Latin verse. The
child is punished, and the next day he commits a like crime, and so a
third, with the same consequence. I would fain ask any reasonable man
whether this lad, in the simplicity of his native innocence, full of
shame, and capable of any impression from that grace of soul, was not
fitter for any purpose in this life than after that spark of virtue is
extinguished in him, though he is able to write twenty verses in an
evening?”

How often is corporal punishment resorted to at school because the
master is in a passion, and he vents his rage upon the poor school-boy’s
unfortunate back!

Oh! the mistaken notion that flogging will make a bad-behaved boy a good
boy; it has the contrary effect. “‘I dunno how ’tis, sir,’ said an old
farm-laborer, in reply to a question from his clergyman respecting the
bad behavior of his children, ‘I dunno how ’tis; I beats ’em till
they’re black and blue, and when they won’t kneel down to pray I knocks
’em down, and yet they ain’t good.’”[286]

In an excellent article in _Temple Bar_ (November, 1864) on flogging in
the army, the following sensible remarks occur: “In nearly a quarter of
a century’s experience with soldiers, the writer has always, and without
a single exception, found flogging makes a good man bad, and a bad man
worse.” With equal truth it may be said that, without a single
exception, flogging makes a good boy bad, and a bad boy worse. How many
men owe their ferocity to the canings they received when school-boys!
The early floggings hardened and soured them, and blunted their
sensibility.

Dr. Arnold of Rugby, one of the best school-masters that England ever
produced, seldom caned a boy—not more than once or twice during the half
year; but when he did cane him, he charged for the use of the cane each
time in the bill, in order that the parents might know how many times
their son had been punished. At some of our public schools nowadays a
boy is caned as many times in a morning as the worthy doctor would have
caned him during the whole half year; but then the doctor treated the
boys as gentlemen, and trusted much to their honor; but now many
school-masters trust much to fear, little to honor, and treat them as
brute beasts.

It might be said that the discipline of a school cannot be maintained
unless the boys be frequently caned—that it must be either caning or
expulsion. I deny these assertions. Dr. Arnold was able to conduct his
school with honor to himself, and with immense benefit to the rising
generation, without either frequent canings or expulsions. The humane
plan, however, requires at first both trouble and patience; and trouble
some school-masters do not like, and patience they do not possess; the
use of the cane is quick, sharp, and at the time effective.

If caning be ever necessary, which it might occasionally be, for the
telling of lies for instance, or for gross immorality, let the head
master himself be the only one to perform the operation, but let him not
be allowed to delegate it to others. A law ought in all public schools
to be in force to that effect. High time that something was done to
abate such disgraceful practices.

Never should a school-master, or any one else, be allowed, _on any
pretense whatever_, to strike a boy upon his head. Boxing of the ears
has sometimes caused laceration of the drum of the ear, and consequent
partial deafness for life. Boxing of the ears injures the brain, and
therefore the intellect.

It might be said that I am traveling out of my province in making
remarks on corporal chastisement in schools. But, with deference, I
reply that I am strictly in the path of duty. My office is to inform you
of everything that is detrimental to your children’s health and
happiness; and corporal punishment is assuredly most injurious both to
their health and happiness. It is the bounden duty of every man, and
especially of every medical man, to lift up his voice against the
abominable, disgusting, and degrading system of flogging, and to warn
parents of the danger and the mischief of sending boys to those schools
where flogging is permitted.

343. _Have you any observations to make on the selection of a female
boarding-school?_

Home education, where it be practicable, is far preferable to sending a
girl to school; as _at_ home, her health, her morals, and her household
duties can be attended to much more effectually than _from_ home.
Moreover, it is a serious injury to a girl, in more ways than one, to
separate her from her own brothers; they very much lose their affection
for each other, and mutual companionship (so delightful and beneficial
between brothers and sisters) is severed.

If home education be not practicable, great care must be taken in making
choice of a school. Boarding-school education requires great
reformation. Accomplishments, superficial acquirements, and brainwork
are the order of the day; health is very little studied. You ought, in
the education of your daughters, to remember that they, in a few years,
will be the wives and the mothers of England; and if they have not
health and strength, and a proper knowledge of household duties to
sustain their characters, what useless, listless wires and mothers they
will make!

Remember, then, the body and not the mind ought in early life to be
principally cultivated and strengthened, and that the growing brain will
not bear, with impunity, much book learning. The brain of a schoolgirl
is frequently injured by getting up voluminous questions by rote, that
are not of the slightest use or benefit to her or to any one else.
Instead of this ridiculous system, educate a girl to be useful and
self-reliant. “From babyhood they are given to understand that
helplessness is feminine and beautiful; helpfulness, except in certain
received forms of manifestation, unwomanly and ugly. The boys may do a
thousand things which are ‘not proper for little girls.’”[287]

From her twelfth to her seventeenth year is the most important epoch of
a girl’s existence, as regards her future health, and consequently, in a
great measure, her future happiness; and one in which, more than at any
other period of her life, she requires a plentiful supply of fresh air,
exercise, recreation, a variety of innocent amusements, and an abundance
of good nourishment, more especially fresh meat; if therefore you have
determined on sending your girl to school, you must ascertain that the
pupils have as much plain, wholesome, nourishing food as they can
eat,[288] that the school be situated in a healthy spot, that it be well
drained, that there be a large play-ground attached to it, that the
young people are allowed plenty of exercise in the open air—indeed, that
at least one-third of the day is spent there in croquet, skipping,
archery, battledore and shuttlecock, gardening, walking, running, etc.

Take care that the school-rooms are well ventilated, that they are not
overcrowded, and that the pupils are allowed chairs to sit upon, and not
those abominations—forms and stools. If you wish to try the effect of
them upon yourself, sit for a couple of hours without stirring upon a
form or upon a stool, and take my word for it you will insist that forms
and stools be banished forever from the school-room.

Assure yourself that the pupils are compelled to rise early in the
morning, and that they retire early to rest: that each young lady has a
separate bed,[289] and that many are not allowed to sleep in the same
room, and that the apartments are large and well ventilated. In fine,
their health and their morals ought to be preferred far above all their
accomplishments.

344. _They use, in some schools, straight-backed chairs, to make a girl
sit upright and to give strength to her back: do you approve of them?_

Certainly not. The natural and the graceful curve of the back is not the
curve of a straight-backed chair. Straight-backed chairs are instruments
of torture, and are more likely to make a girl crooked than to make her
straight. Sir Astley Cooper ridiculed straight-backed chairs, and well
he might. It is always well for a mother to try, for some considerable
time, such ridiculous inventions upon herself before she experiments
upon her unfortunate daughter. The position is most unnatural. I do not
approve of a girl lounging and lolling on a sofa; but, if she be tired
and wants to rest herself, let her, like any other reasonable being, sit
upon a comfortable ordinary chair.

If you want her to be straight, let her be made strong; and if she is to
be strong, she must use plenty of exercise and exertion, such as
drilling, dancing, skipping, archery, croquet, hand-swinging, horse
exercise, swimming, bowls, etc. This is the plan to make her back
straight and her muscles strong. Why should we bring up a girl
differently from a boy? Muscular gymnastic exercises and health-giving
exertion are unladylike, forsooth!


                       HOUSEHOLD WORK FOR GIRLS.

345. _Do you recommend household work as a means of health for my
daughter?_

Decidedly. Whatever you do, do not make a fine lady of her, or she will
become puny and delicate, listless and miserable. A girl, let her
station be what it might, ought, as soon as she be old enough, to make
her own bed. There is no exercise to expand the figure and to beautify
the shape better than bed-making. Let her make tidy her own room. Let
her use her hands and her arms. Let her, to a great extent, be
self-reliant, and let her wait upon herself. There is nothing vulgar in
her being useful. Let me ask, Of what use are many girls of the present
day? They are utterly useless. Are they happy? No, for the want of
employment they are miserable—I mean, bodily employment, household work.
Many girls, nowadays, unfortunately, are made to look upon a pretty
face, dress, and accomplishments as the only things needed! And, when
they do become women and wives—if ever they do become women and
wives—what miserable, lackadaisical wives, and what senseless, useless
mothers they make!


                     CHOICE OF PROFESSION OR TRADE.

346. _What profession or trade would you recommend a boy of a delicate
or of a consumptive habit to follow?_

If a youth be delicate, it is a common practice among parents either to
put him to some light in-door trade, or, if they can afford it, to one
of the learned professions. Such a practice is absurd, and fraught with
danger The close confinement of an in-door trade is highly prejudicial
to health. The hard reading requisite to fit a man to fill, for
instance, the sacred office, only increases delicacy of constitution.
The stooping at a desk, in an attorney’s office, is most trying to the
chest. The harass, the anxiety, the disturbed nights, the interrupted
meals, and the intense study necessary to fit a man for the medical
profession, is still more dangerous to health than either law, divinity,
or any in-door trade. “Sir Walter Scott says of the country surgeon,
that he is worse fed and harder wrought than any one else in the parish,
except it be his horse.”[290]

A modern writer, speaking of the life of a medical man, observes: “There
is no career which so rapidly wears away the powers of life, because
there is no other which requires a greater activity of mind and body. He
has to bear the changes of weather, continued fatigue, irregularity in
his meals, and broken rest; to live in the midst of miasma and
contagion. If in the country, he has to traverse considerable distances
on horseback, exposed to wind and storm—to brave all dangers to go to
the relief of suffering humanity. A fearful truth for medical men has
been established by the table of mortality by Dr. Casper, published in
the _British Review_. Of 1000 members of the medical profession, 600
died before their sixty-second year; while of persons leading a quiet
life—such as agriculturists or theologians—the mortality is only 347. If
we take 100 individuals of each of these classes, 43 theologians, 40
agriculturists, 35 clerks, 32 soldiers, will reach their seventieth
year: of 100 professors of the healing art, 24 only will reach that age.
They are the sign-posts to health; they can show the road to old age,
but rarely tread it themselves.”

If a boy, therefore, be of a delicate or of a consumptive habit, an
out-door calling should be advised, such as that of a farmer, of a
tanner, or a land-surveyor; but, if he be of an inferior station of
society, the trade of a butcher may be recommended. Tanners and butchers
are seldom known to die of consumption.

I cannot refrain from reprobating the too common practice among parents
of bringing up their boys to the professions. The anxieties and the
heartaches which they undergo if they do not succeed (and how can many
of them succeed when there is such a superabundance of candidates?)
materially injure their health. “I very much wonder,” says Addison, “at
the humor of parents, who will not rather choose to place their sons in
a way of life where an honest industry cannot but thrive, than in
stations where the greatest probity, learning, and good sense may
miscarry. How many men are country curates, that might have made
themselves aldermen of London by a right improvement of a smaller sum of
money than what is usually laid out upon a learned education? A sober,
frugal person, of slender parts and a slow apprehension, might have
thrived in trade, though he starves upon physic; as a man would be well
enough pleased to buy silks of one whom he could not venture to feel his
pulse. Vagellius is careful, studious, and obliging, but withal a little
thick-skulled; he has not a single client, but might have had abundance
of customers. The misfortune is, that parents take a liking to a
particular profession, and therefore desire their sons may be of it;
whereas, in so great an affair of life, they should consider the genius
and abilities of their children more than their own inclinations. It is
the great advantage of a trading nation, that there are very few in it
so dull and heavy who may not be placed in stations of life which may
give them an opportunity of making their fortunes. A well-regulated
commerce is not, like law, physic, or divinity, to be overstocked with
hands; but, on the contrary, flourishes by multitudes, and gives
employment to all its professors. Fleets of merchantmen are so many
squadrons of floating shops, that vend our wares and manufactures in all
the markets of the world, and find out chapmen under both the tropics.”

347. _Then, do you recommend a delicate youth to be brought up either to
a profession or to a trade?_

Decidedly. There is nothing so injurious for a delicate boy, or for any
one else, as idleness. Work, in moderation, enlivens the spirits, braces
the nerves, and gives tone to the muscles, and thus strengthens the
constitution. Of all miserable people, the idle boy or the idle man is
the most miserable! If you are poor, of course you will bring him up to
some calling; but if you are rich, and your boy is delicate (if he be
not actually in a consumption), you will, if you are wise, still bring
him up to some trade or profession. You will, otherwise, be making a rod
for your own as well as for your son’s back. Oh, what a blessed thing is
work!


                                 SLEEP.

348. _Have you any remarks to make on the sleep of boys and girls?_

Sleeping-rooms are, generally, the smallest in the house, whereas, for
health’s sake, they ought to be the largest. If it be impossible to have
a _large_ bedroom, I should advise a parent to have a dozen or twenty
holes (each about the size of a florin) bored with a center-bit in the
upper part of the chamber-door, and the same number of holes in the
lower part of the door, so as constantly to admit a free current of air
from the passages. If this cannot readily be done, then let the bedroom
door be left ajar all night, a door-chain being on the door to prevent
intrusion; and, in the summer time, during the night, let the
window-sash, to the extent of about two or three inches, be left open.

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.

_Fresh air during sleep is indispensable to health._—If a bedroom be
close, the sleep, instead of being calm and refreshing, is broken and
disturbed; and the boy, when he awakes in the morning, feels more
fatigued than when he retired to rest.

If sleep is to be refreshing, the air, then, must be pure, and free from
carbonic acid gas, which is constantly being evolved from the lungs. If
sleep is to be health-giving, the lungs ought to have their proper food,
oxygen,—and not be cheated by giving them instead a poison, carbonic
acid gas.

It would be well for each boy to have a separate room to himself, and
each girl a separate room to herself. If two boys are obliged, from the
smallness of the house, to sleep in one room, and if two girls, from the
same cause, are compelled to occupy the same chamber, by all means let
each one have a _separate_ bed to himself and to herself, as it is so
much more healthy and expedient for both boys and girls to sleep alone.

The roof of the bed should be left open—that is to say, the top of the
bedstead ought not be covered with bed furniture, but should be open to
the ceiling, in order to encourage a free ventilation of air. A
bed-curtain may be allowed on the side of the bed where there are windy
currents of air; otherwise bed-curtains and valances ought on no account
to be allowed. They prevent a free circulation of the air. A youth
should sleep on a horse-hair mattress. Such mattresses greatly improve
the figure and strengthen the frame. During the daytime, provided it
does not rain, the windows must be thrown wide open, and, directly after
he has risen from bed, the clothes ought to be thrown entirely back, in
order that they may become, before the bed be made, well ventilated and
purified by the air:

                 “Do you wish to be healthy?—
                   Then keep the house sweet;
                 As soon as you’re up
                   Shake each blanket and sheet.

                 Leave the beds to get fresh
                   On the close-crowded floor;
                 Let the wind sweep right through—
                   Open window and door.

                 The bad air will rush out
                   As the good air comes in,
                 Just as goodness is stronger
                   And better than sin.

                 Do this, it’s soon done,
                   In the fresh morning air,—
                 It will lighten your labor
                   And lessen your care.

                 You are weary—no wonder,
                   There’s weight and there’s gloom
                 Hanging heavily round
                   In each overfull room.

                 Be sure all the trouble
                   Is profit and gain,
                 For there’s headache, and heartache,
                   And fever, and pain,

                 Hovering round, settling down
                   In the closeness and heat:
                 Let the wind sweep right through
                   Till the air’s fresh and sweet.

                 And more cheerful you’ll feel
                   Through the toil of the day;
                 More refreshed you’ll awake
                   When the night’s pass’d away.”[291]

Plants and flowers ought not to be allowed to remain in a chamber at
night. Experiments have proved that plants and flowers take up, in the
daytime, carbonic acid gas (the refuse of respiration), and give off
oxygen (a gas so necessary and beneficial to health), but give out in
the night season a poisonous exhalation.

Early rising cannot be too strongly insisted upon; nothing is more
conducive to health, and thus to long life. A youth is frequently
allowed to spend the early part of the morning in bed, breathing the
impure atmosphere of a bedroom, when he should be up and about, inhaling
the balmy and health-giving breezes of the morning:

            “Rise with the lark, and with the lark to bed:
            The breath of night’s destructive to the hue
            Of ev’ry flower that blows. Go to the field,
            And ask the humble daisy why it sleeps
            Soon as the sun departs? Why close the eyes
            Of blossoms infinite, long ere the moon
            Her oriental veil puts off? Think why,
            Nor let the sweetest blossom Nature boasts
            Be thus exposed to night’s unkindly damp.
            Well may it droop, and all its freshness lose,
            Compell’d to taste the rank and pois’nous steam
            Of midnight theater and morning ball.
            Give to repose the solemn hour she claims;
            And from the forehead of the morning steal
            The sweet occasion. Oh! there is a charm
            Which morning has, that gives the brow of age
            A smack of youth, and makes the lip of youth
            Shed perfume exquisite. Expect it not,
            Ye who till noon upon a down-bed lie,
            Indulging feverish sleep.”[292]

If early rising be commenced in childhood it becomes a habit, and will
then probably be continued through life. A boy ought on no account to be
roused from his sleep; but as soon as he be awake in the morning, he
should be encouraged to rise. Dozing—that state between sleeping and
waking—is injurious; it enervates both body and mind, and is as
detrimental to health as dram-drinking! But if he rise early, he must go
to bed betimes; it is a bad practice to keep him up until the family
retire to rest. He ought, winter and summer, to seek his pillow by nine
o’clock, and should rise as soon as he awakes in the morning.

Let me urge upon a parent the great importance of _not_ allowing the
chimney of any bedroom, or of any room in the house, to be stopped, as
many are in the habit of doing, to prevent, as _they_ call it, a
draught, but to prevent, as I should call it, health.

349. _How many hours of sleep ought a boy to have?_

This, of course, will depend upon the exercise he takes; but, on an
average, he should have every night at least eight hours. It is a
mistaken notion that a boy does _better_ with _little_ sleep. Infants,
children, and youths require more than those who are further advanced in
years; hence old people can frequently do with little sleep. This may in
a measure be accounted for from the quantity of exercise the young take.
Another reason may be, the young have neither pain nor care to keep them
awake; while, on the contrary, the old have frequently one or both:

           “Care keeps his watch on every old man’s eye,
           And where care lodges, sleep will never lie.”[293]


                       ON THE TEETH AND THE GUMS.

350. _What are the best means of keeping the teeth and the gums in a
healthy state?_

I would recommend the teeth and the gums to be well brushed with warm
salt and water, in the proportion of one large teaspoonful of salt to a
tumbler of water. I was induced to try the above plan by the
recommendation of an intelligent American writer.[294]

The salt and water should be used _every night_ at bedtime.

The following is an excellent tooth-powder:

         Take of finely-powdered Peruvian Bark;
                   „             Prepared Coral;
                   „             Prepared Chalk;
                   „             Myrrh, of each half an ounce;
                   „             Orris root, a quarter of an ounce:

  Mix them well together in a mortar, and preserve the powder in a
    wide-mouth stoppered bottle.

The teeth ought to be well brushed with the above tooth-powder every
morning.

If the teeth be much decayed, and if, in consequence, the breath be
offensive, two ounces of finely-powdered charcoal, well mixed with the
above ingredients, will be found a valuable addition.

Some persons clean their teeth every morning with soap; if soap be used
it ought to be Castile soap, and if the teeth be not white and clear,
Castile soap is an excellent cleanser of the teeth, and may be used in
lieu of the tooth-powder as before recommended.

There are few persons who brush the teeth properly. I will tell you the
right way. First of all procure a tooth-brush of the best make, and of
rather hard bristles, to enable it to penetrate into all the nooks and
corners of the teeth; then, having put a small quantity of warm water
into your mouth, letting the principal of it escape into the basin, dip
your brush in warm water, and if you are about using Castile soap, rub
the brush on a cake of the soap, and then well brush your teeth, first
upward and then downward, then from side to side—from right to left and
from left to right—then the backs of the teeth, then apply the brush to
the tops of the crowns of the teeth both of the upper and of the lower
jaw,—so that _every_ part of each tooth, including the gums, may in turn
be well cleansed, and be well brushed. Be not afraid of using the brush:
a good brushing and dressing will do the teeth and the gums an immensity
of good; it will make the breath sweet, and will preserve the teeth
sound and good. After using the brush the mouth must, of course, be well
rinsed out with warm water.

The finest set of teeth I ever saw in my life belonged to a middle-aged
gentleman; the teeth had neither spot nor blemish—they were like
beautiful pearls. He never had toothache in his life, and did not know
what toothache meant! He brushed his teeth, every morning, with soap and
water, in the manner I have previously recommended. I can only say to
you—go and do likewise!

Camphor ought never to be used as an ingredient of tooth-powder, it
makes the teeth brittle. Camphor certainly has the effect of making the
teeth, for a time, look very white; but it is an evanescent beauty.

Tartar is apt to accumulate between and around the teeth; it is better
in such a case _not_ to remove it by scaling instruments, but to adopt
the plan recommended by Dr. Richardson, namely, to well brush the teeth
with pure vinegar and water.


                      PREVENTION OF DISEASE, ETC.

351. _If a boy or a girl show great precocity of intellect, is any organ
likely to become affected?_

A greater quantity of arterial blood is sent to the brain of those who
are prematurely talented, and hence it becomes more than ordinarily
developed. Such advantages are not unmixed with danger; this same
arterial blood may excite and feed inflammation, and either convulsions,
or water on the brain, or insanity, or, at last, idiocy may follow. How
proud a mother is in having a precocious child! How little is she aware
that precocity is frequently an indication of disease!

352. _How can danger in such a case be warded off?_

It behooves a parent, if her son be precocious, to restrain him—to send
him to a quiet country place, free from the excitement of the town; and
when he is sent to school, to give directions to the master that he is
not on any account to tax his intellect (for a master is apt, if he have
a clever boy, to urge him forward); and to keep him from those
institutions where a spirit of rivalry is maintained, and where the
brain is thus kept in a state of constant excitement. Medals and prizes
are well enough for those who have moderate abilities, but dangerous,
indeed, to those who have brilliant ones.

An overworked precocious brain is apt to cause the death of the owner;
and if it does not do so, it in too many instances injures the brain
irreparably, and the possessor of such an organ, from being one of the
most intellectual of children, becomes one of the most commonplace of
men.

Let me urge you, if you have a precocious child, to give, and that
before it be too late, the subject in question your best consideration.

353. _Are precocious boys in their general health usually strong or
delicate?_

Delicate. Nature seems to have given a delicate body to compensate for
the advantages of a talented mind. A precocious youth is predisposed to
consumption, more so than to any other disease. The hard study which he
frequently undergoes excites the disease into action. It is not
desirable, therefore, to have a precocious child. A writer in “Fraser’s
Magazine” speaks very much to the purpose when he says, “Give us
intellectual beef rather than intellectual veal.”

354. _What habit of body is most predisposed to Scrofula?_

He or she who has a moist, cold, fair, delicate, and almost transparent
skin, large prominent blue eyes, protuberant forehead, light-brown or
auburn hair, rosy cheeks, pouting lips, milk-white teeth, long neck,
high shoulders, small, flat, and contracted chest, tumid bowels, large
joints, thin limbs, and flabby muscles, is the person most predisposed
to scrofula. The disease is not entirely confined to the above;
sometimes he or she who has black hair, dark eyes and complexion, is
subject to it, but yet far less frequently than the former. It is a
remarkable fact that the most talented are the most prone to scrofula,
and being thus clever their intellects are too often cultivated at the
expense of their health. In infancy and childhood, either water on the
brain or mesenteric disease; in youth, pulmonary consumption is
frequently their doom. They, are like shining meteors; their life is
brilliant, but short.

355. _How may Scrofula be warded off?_

Strict attention to the rules of health is the means to prevent
scrofula. Books, unless as an amusement, ought to be discarded. The
patient must almost live in the open air, and his residence should be a
healthy country place, where the air is dry and bracing; if it be at a
farm-house, in a salubrious neighborhood, so much the better. In
selecting a house for a patient predisposed to scrofula, _good pure
water should be an important requisite_—indeed for every one who values
his health. Early rising in such a case is most beneficial. Wine,
spirits, and all fermented liquors ought to be avoided. Beef-steaks and
mutton-chops in abundance, and plenty of milk and farinaceous food—such
as rice, sago, arrow-root, etc.—should be his diet.

Scrofula, if the above rules be strictly and perseveringly followed, may
be warded off; but there must be no half measures, no trying to serve
two masters—to cultivate at the same time the health and the intellect.
The brain, until the body becomes strong, must _not_ be taxed. “You may
prevent scrofula by care; but that some children are originally
predisposed to the disease there cannot be the least doubt, and in such
cases the education and the habits of youth should be so directed as to
ward off a complaint the effects of which are so frequently fatal.”[295]

356. _But suppose the disease to be already formed, what must then be
done?_

The plan recommended above must still be pursued, not by fits and
starts, but steadily and continuously, for it is a complaint that
requires a vast deal of patience and great perseverance. Warm and cold
sea-bathing in such a case is generally most beneficial. In a patient
with confirmed scrofula it will of course be necessary to consult a
skillful and experienced doctor.

But do not allow, without a second opinion, any plan to be adopted that
will weaken the system, which is already too much depressed. No, rather
build up the body by good nourishing diet (as previously recommended),
by cod-liver oil, by a dry, bracing atmosphere, such as either Brighton,
or Ramsgate, Llandudno; or, if the lungs be delicate, by a more
sheltered coast, such as either St. Leonard’s or Torquay.

Let no active purging, no mercurials, no violent, desperate remedies be
allowed. If the patient cannot be cured _without_ them, I am positive
that he will not be cured _with_ them.

But do not despair; many scrofulous patients are cured by time and by
judicious treatment. But if desperate remedies are to be used, the poor
patient had better _by far_ be left to Nature. “Let me fall now into the
hand of the LORD; for very great are his mercies: but let me not fall
into the hand of man.”[296]

357. _Have you any remarks to make on a girl stooping?_

A girl ought never to be allowed to stoop: stooping spoils the figure,
weakens the chest, and interferes with the digestion. If she cannot help
stooping, you may depend upon it that she is in bad health, and that a
medical man ought to be consulted. As soon as her health is improved the
dancing-master should be put in requisition, and calisthenic and
gymnastic exercises should be resorted to. Horse exercise and swimming
in such a case are very beneficial. The girl should live well, on good
nourishing diet, and not be too closely confined either to the house or
to her lessons. She ought during the night to lie on a horse-hair
mattress, and during the day, for two or three hours, flat on her back
on a reclining board. Stooping, if neglected, is very likely to lead to
consumption.

358. _If a boy be round-shouldered and slouching in his gait, what ought
to be done?_

Let him be drilled; there is nothing more likely to benefit him than
drilling. You never see a soldier round-shouldered nor slouching in his
gait. He walks every inch like a man. Look at the difference in
appearance between a country laborer and a soldier! It is the drilling
that makes the difference. “Oh, for a drill-sergeant to teach them to
stand upright, and to turn out their toes, and to get rid of that
slouching, hulking gait, which gives such a look of clumsiness and
stupidity!”[297]

359. _My daughter has grown out of shape, she has grown on one side, her
spine is not straight, and her ribs bulge out more on the one side than
on the other: what is the cause, and can anything be done to remedy the
deformity?_

The causes of this lateral curvature of the spine, and consequent
bulging out of the ribs that you have just now described, arise either
from delicacy of constitution, from the want of proper exercise, from
too much learning, or from too little play, or from not sufficient or
proper nourishment for a rapidly-growing body. I am happy to say that
such a case, by judicious treatment, can generally be cured—namely, by
gymnastic exercises, such as the hand-swing, the fly-pole, the patent
parlor gymnasium, the chest expander, the skipping-rope, the swimming
bath; all sorts of out-door games, such as croquet, archery, etc.; by
plenty of good nourishment, by making her a child of Nature, by letting
her almost live in the open air, and by throwing books to the winds. But
let me strongly urge you not, unless ordered by an experienced surgeon,
to allow any mechanical restraints or appliances to be used. If she be
made strong, the muscles themselves will pull both the spine and the
ribs into their proper places, more especially if judicious games and
exercises (as I have before advised), and other treatment of a
strengthening and bracing nature, which a medical man will indicate to
you, be enjoined. Mechanical appliances will, if not judiciously
applied, and in a proper case, waste away the muscles, and will thus
increase the mischief; if they cause the ribs to be pushed in in one
place, they will bulge them out in another, until, instead of being one,
there will be a series of deformities. No, the giving of strength and
the judicious exercising of the muscles are, for a lateral curvature of
the spine and the consequent bulging out of one side of the ribs, the
proper remedies, and, in the majority of cases, are most effectual, and
quite sufficient for the purpose.

I think it well to strongly impress upon a mother’s mind the great
importance of early treatment. If the above advice be followed, every
curvature in the beginning might be cured. Cases of several years’
standing might, with judicious treatment, be wonderfully relieved.

Bear in mind, then, that if the girl is to be made straight, she is
first of all to be made strong; the latter, together with the proper
exercises of the muscles, will lead to the former; and the _earlier_ a
medical man takes it in hand, the more rapid, the more certain, and the
more effectual will be the cure.

An inveterate, long-continued and neglected case of curvature of the
spine and bulging out of the ribs on one side might require mechanical
appliances, but such a case can only be decided on by an experienced
surgeon, who ought always, _in the first place_, to be consulted.

360. _Is a slight spitting of blood to be looked upon as a dangerous
symptom?_

Spitting of blood is always to be looked upon with suspicion, even when
a youth appears in other respects to be in good health; it is frequently
the forerunner of consumption. It might be said that, by mentioning the
fact, I am unnecessarily alarming a parent, but it would be a false
kindness if I did not do so:

                “I must be cruel only to be kind.”[298]

Let me ask when is consumption to be cured? Is it at the onset, or is it
when it is confirmed? If a mother had been more generally aware that
spitting of blood was frequently the forerunner of consumption, she
would, in the management of her offspring, have taken greater
precautions; she would have made everything give way to the preservation
of their health; and, in many instances, she would have been amply
repaid by having the lives of her children spared to her. We frequently
hear of patients in _confirmed_ consumption being sent to Mentone, to
Madeira, and to other foreign parts. Can anything be more cruel or
absurd? If there be any disease that requires the comforts of home—and
truly may an Englishman’s dwelling be called _home_!—and good nursing
more than another, it is consumption.

361. _What is the death-rate of Consumption in England? At what age does
Consumption most frequently occur? Are girls more liable to it than
boys? What are the symptoms of this disease?_

It is asserted, on good authority,[299] that there always are, in
England, 78,000 cases of consumption, and that the yearly death-rate of
this fell disease alone is 39,000! Consumption more frequently shows
itself between the ages of fourteen and twenty-one; after then, the
liability to the disease gradually diminishes, until at the age of
forty-five it becomes comparatively rare. Boys are more prone to this
complaint than girls. Some of the most important symptoms of pulmonary
consumption are indicated by the stethoscope; but, as I am addressing a
mother, it would, of course, be quite out of place to treat of such
signs in Conversations of this kind. The symptoms it might be well for a
parent to recognize, in order that she may seek aid early, I will
presently describe. It is perfectly hopeless to expect to cure
consumption unless advice be sought at the _onset_, as the only
effectual good in this disease is to be done at _first_.

It might be well to state that consumption creeps on insidiously. One of
the earliest symptoms of this dreadful scourge is a slight, dry, short
cough, attended with tickling and irritation at the top of the throat.
This cough generally occurs in the morning; but, after some time, comes
on at night, and gradually throughout the day and the night. Frequently
during the early stage of the disease _a slight spitting of blood
occurs_. Now this is a most dangerous symptom; indeed, I may go so far
as to say that, as a rule, it is almost a sure sign that the patient is
in the _first_ stage of a consumption.

There is usually hoarseness, not constant, but coming on if the patient
be tired, or toward the evening; there is also a sense of lassitude and
depression, shortness of breathing, a feeling of being quickly
wearied—more especially on the slightest exertion. The hair of a
consumptive person usually falls off, and what little remains is weak
and poor; the joints of the fingers become enlarged, or clubbed as it is
sometimes called; the patient loses flesh, and, after some time,
night-sweats make their appearance; then we may know that hectic fever
has commenced.

Hectic begins with chilliness, which is soon followed by flushings of
the face, and by burning heat of the hands and feet, especially of the
palms and the soles. This is soon succeeded by perspirations. The
patient has generally, during the day, two decided paroxysms of hectic
fever—the one at noon, which lasts about five hours, the other in the
evening, which is more severe, and ends in violent perspirations, which
perspirations continue the whole night through. He may, during the day,
have several attacks of hectic flushes of the face, especially after
eating; at one moment he complains of being too hot, and rushes to the
cool air; the next moment he is too cold, and almost scorches himself by
sitting too near the fire. Whenever the circumscribed hectic flush is on
the cheek, it looks as though the cheek had been painted with vermilion,
then is the time when the palms of the hands are burning hot.

The expectoration at first is merely mucus, but after a time it assumes
a characteristic appearance; it has a roundish, flocculent, woolly form,
each portion of phlegm keeping, as it were, distinct; and if the
expectoration be stirred in water, it has a milk-like appearance. The
patient is commonly harassed by frequent bowel complaints, which rob him
of what little strength he has left. The feet and ankles swell. The
perspiration, as before remarked, comes on in the evening, continues all
night, more especially toward morning and while the patient is asleep;
during the time he is awake, even at night, he seldom sweats much. The
thrush generally shows itself toward the close of the disease, attacking
the tongue, the tonsils, and the soft palate, _and is a sure harbinger
of approaching death_. Emaciation rapidly sets in.

If we consider the immense engines of destruction at work—viz., the
colliquative (melting) sweats, the violent bowel complaints, the vital
parts that are affected, the harassing cough, the profuse expectoration,
the hectic fever, the distressing exertion of struggling to breathe,—we
cannot be surprised that “consumption had hung out her red flag of no
surrender,” and that death soon closes the scene. In girls, provided
they have been previously regular, menstruation gradually declines, and
then entirely disappears.

362. _What are the causes of Consumption?_

The _predisposing_ causes of consumption are the scrofulous habit of
body, hereditary predisposition, narrow or contracted chest, deformed
spine, delicacy of constitution, bad and scanty diet, or food containing
but little nourishment, impure air, close in-door confinement in
schools, in shops, and in factories, ill-ventilated apartments,
dissipation, late hours, overtaxing with book learning the growing
brain, thus producing debility, want of proper out-door exercises and
amusements, tight lacing—indeed, anything and everything that either
will debilitate the constitution, or will interfere with or will impede
the proper action of the lungs, will be the predisposing causes of this
fearful and lamentable disease.

An ill, poor, and insufficient diet is the mother of many diseases, and
especially of consumption: “Whatsoever was the father of a disease, an
ill diet was the mother.”

The most common _exciting_ causes of consumption are slighted colds,
neglected inflammation of the chest, long continuance of influenza,
sleeping in damp beds, allowing wet clothes to dry on the body,
unhealthy employments—such as needle grinding, pearl-button making, etc.

363. _Supposing a youth to have spitting of blood, what precautions
would you take to prevent it from ending in Consumption?_

I should let his health be the first consideration; I should throw books
to the winds; if he be at school, I should advise you to take him away;
if he be in trade, I should cancel his indentures; if he be in the town,
I should send him to a sheltered healthy spot in the country, or to the
south coast; as, for instance, either to St. Leonards-on-Sea, or to
Torquay.

I should be particular in his clothing, taking especial care to keep his
chest and feet warm. If he did not already wear flannel waistcoats, let
it be winter or summer, I should recommend him immediately to do so; if
it be winter, I should advise him also to take to _flannel_ drawers. The
feet must be carefully attended to; they ought to be kept both warm and
dry, the slightest dampness of either shoes or stockings should cause
them to be immediately changed. If a boy, he ought to wear
double-breasted waistcoats; if a girl, high dresses.

The diet must be nutritious and generous; he should be encouraged to eat
plentifully of beef and mutton. There is nothing better for breakfast,
where it agrees, than milk; indeed, it may be frequently made to agree
by previously boiling it. Good home-brewed ale or sound porter ought, in
moderation, to be taken. Wine and spirits must on no account be allowed.
I caution parents in this particular, as many have an idea that wine, in
such cases, is strengthening, and that _rum_ and milk is a good thing
either to cure or to prevent a cough!

If it be summer, let him be much in the open air, avoiding the evening
and the night air. If it be winter, he should, unless the weather be
mild for the season, keep within doors. Particular attention ought to
be paid to the point the wind is in, as he should not be allowed to go
out if it is either in the north, in the east, or in the northeast;
the latter is more especially dangerous. If it be spring, and the
weather be favorable, or summer or autumn, change of air, more
especially to the south coast—to the Isle of Wight, for instance—would
be desirable; indeed, in a case of spitting of blood, I know of no
remedy so likely to ward off that formidable, and, generally,
intractable complaint—consumption—as change of air. The beginning of
the autumn is, of course, the best season for visiting the coast. It
would be advisable, at the commencement of October, to send him either
to Italy, to the south of France—to Mentone[300]—or to the mild parts
of England—more especially either to Hastings, or to Torquay, or to
the Isle of Wight—to winter. But remember, if he be actually in a
_confirmed_ consumption, I would not, on any account whatever, let him
leave his home; as then the comforts of home will far, very far
outweigh any benefit of change of air.

364. _Suppose a youth to be much predisposed to a Sore-Throat, what
precautions ought he to take to ward off future attacks?_

He must use every morning thorough ablution of the body, beginning
cautiously; that is to say, commencing with the neck one morning, then
by degrees, morning after morning, sponging a larger surface, until the
whole of the body be sponged. The chill at first must be taken off the
water; gradually the temperature ought to be lowered until the water be
quite cold, taking care to rub the body thoroughly dry with a coarse
towel—a Turkish rubber being the best for the purpose.

He ought to bathe his throat externally every night and morning with
lukewarm salt and water, the temperature of which must be gradually
reduced until at length no warm water be added. He should gargle his
throat either with barm, vinegar, and sage tea,[301] or with salt and
water—two teaspoonfuls of table salt dissolved in a tumbler of water. He
ought to harden himself by taking plenty of exercise in the open air. He
must, as much as possible, avoid either sitting or standing in a
draught; if he be in one he should face it. He ought to keep his feet
warm and dry. He should take as little aperient medicine as possible,
avoiding especially both calomel and blue-pill. As he grows up to
manhood he ought to allow his beard to grow, as such would be a natural
covering for his throat: I have known great benefit to arise from this
simple plan. The fashion is now to wear the beard, not to use the razor
at all, and a sensible fashion I consider it to be. The finest
respirator in the world is the beard. The beard is not only good for
sore throats, but for weak chests. The wearing of the beard is a
splendid innovation; it saves no end of trouble, is very beneficial to
health, and is a great improvement “to the human face divine.”

365. _Have you any remarks to make on the almost universal habit of boys
and of very young men smoking?_

I am not now called upon to give an opinion of the effects of tobacco
smoking on the middle-aged and on the aged. I am addressing a mother as
to the desirability of her sons, when boys, being allowed to smoke. I
consider tobacco smoking one of the most injurious and deadly habits a
boy or a young man can indulge in. It contracts the chest and weakens
the lungs, thus predisposing to consumption. It impairs the stomach,
thus producing indigestion. It debilitates the brain and nervous system,
thus inducing epileptic fits and nervous depression. It stunts the
growth, and is one cause of the present race of pigmies. It makes the
young lazy and disinclined for work. It is one of the greatest curses of
the present day. The following cases prove, more than any argument can
prove, the dangerous and deplorable effects of a boy smoking. I copy the
first case from _Public Opinion_.[302] “The _France_ mentions the
following fact as a proof of the evil consequences of smoking for boys:
‘A pupil in one of the colleges, only twelve years of age, was some time
since seized with epileptic fits, which became worse and worse in spite
of all the remedies employed. At last it was discovered that the lad had
been for two years past secretly indulging in the weed. Effectual means
were adopted to prevent his obtaining tobacco, and he soon recovered.’”

The other case occurred about five years ago, in my own practice. The
patient was a youth of nineteen. He was an inveterate smoker. From being
a bright, intelligent lad, he was becoming idiotic, and epileptic fits
were supervening. I painted to him, in vivid colors, the horrors of his
case, and assured him that if he still persisted in his bad practices,
he would soon become a driveling idiot! I at length, after some trouble
and contention, prevailed upon him to desist from smoking altogether. He
rapidly lost all epileptic symptoms, his face soon resumed its wonted
intelligence, and his mind asserted its former power. He remains well to
this day, and is now a married man with a family.

366. _What are the best methods to restrain a violent Bleeding from the
Nose?_

Do not interfere with a bleeding from the nose unless it be violent. A
bleeding from the nose is frequently an effort of Nature to relieve
itself, and therefore, unless it be likely to weaken the patient, ought
not to be restrained. If it be necessary to restrain the bleeding, press
firmly for a few minutes the nose between the finger and the thumb—this
alone will often stop the bleeding; if it should not, then try what
bathing the nose and the forehead and the nape of the neck with water
quite cold from the pump will do. If that does not succeed, try the
old-fashioned remedy of putting a cold large door-key down the back. If
these plans fail, try the effects either of powdered alum or of powdered
matico, used after the fashion of snuff—a pinch or two, either of the
one or the other, or of both, should be sniffed up the bleeding nostril.
If these should not answer the purpose, although they almost invariably
will, apply a large lump of ice to the nape of the neck, and put a small
piece of ice into the patient’s mouth for him to suck.

If these methods do not succeed, plunge the hand and the forearm into
cold water, keep them in for a few minutes, then take them out, and
either hold or let be held up the arms and hands high above the head;
this plan has frequently succeeded when others have failed. Let the room
be kept cool, throw open the windows, and do not have many in the room
to crowd around the patient.

Doubtless, Dr. Richardson’s local anæsthetic—the ether spray—playing
from a few seconds to a minute _on_ the nose and _up_ the bleeding
nostril, would act most beneficially in a severe case of this kind, and
would, before resorting to the disagreeable operation of plugging the
nose, deserve a trial. I respectfully submit this suggestion to my
medical brethren. The ether—rectified ether—used for the spray ought to
be perfectly pure, and of the specific gravity of 0.723.

If the above treatment does not soon succeed, send for a medical man, as
more active means, such as plugging of the nostrils—_which is not done
unless in extreme cases_—might be necessary.

But before plugging of the nose is resorted to, it will be well to try
the effects of a cold solution of alum:

                     Take of—Powdered Alum, one drachm;
                             Water, half a pint:

  To make a Lotion.

A little of the lotion should be put into the palm of the hand and
sniffed up the bleeding nostril; or, if that does not succeed, some of
the lotion ought, by means of a syringe, to be syringed up the nose.

367. _In case of a young lady Fainting, what had better be done?_

Lay her flat upon her back, taking care that the head be as low as or
lower than the body; throw open the windows; do not crowd around
her;[303] unloosen her dress as quickly as possible; ascertain if she
have been guilty of tight lacing, for fainting is sometimes produced by
that reprehensible practice. Apply smelling-salts to her nostrils; if
they be not at hand, burn a piece of rag under her nose; dash cold water
upon her face; throw open the window; fan her; and do not, as is
generally done, crowd round her, and thus prevent a free circulation of
air.

As soon as she can swallow, give her either a draught of _cold_ water,
or a glass of wine, or a teaspoonful of sal-volatile in a wineglassful
of water.

_To prevent fainting for the future._—I would recommend early hours;
country air and exercise; the stays, if worn at all, to be worn slack;
attention to diet; avoidance of wine, beer, spirits, excitement, and
fashionable amusements.

Sometimes the cause of a young lady fainting is either a disordered
stomach or a constipated state of the bowels.

If the fainting have been caused by _disordered stomach_, it may be
necessary to stop the supplies, and give the stomach, for a day or two,
but little to do; a fast will frequently prevent the necessity of giving
medicine. Of course, if the stomach be _much_ disordered, it will be
desirable to consult a medical man.

If your daughter’s fainting have originated from a _costive state of the
bowels_ (another frequent cause of fainting), I beg to refer you to a
subsequent Conversation, in which I will give you a list of remedies for
the prevention and the treatment of constipation.

A young lady’s fainting occasionally arises from debility—from downright
weakness of the constitution; then the best remedies will be change of
air to the coast, good nourishing diet, and the following strengthening
mixture:

         Take of—Muriated Tincture of Iron, one drachm and a half;
                 Tincture of Calumba, six drachms;
                 Distilled Water, seven ounces.

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

Or, for a change, the following:

              Take of—Wine of Iron, one ounce and a half;
                      Distilled Water, six ounces and a half:

  To make a Mixture. Two tablespoonfuls to be taken three times a day.

Iron medicines ought always to be taken _after_ instead of _before_ a
meal. The best times of the day for taking either of the above mixtures
will be eleven o’clock, four o’clock, and seven o’clock.

368. _You had a great objection to a mother administering calomel either
to an infant or to a child, have you the same objection to a boy or a
girl taking it when he or she requires an aperient?_

Equally as great. It is my firm belief that the frequent use, or rather
the abuse, of calomel and of other preparations of mercury, is often a
source of liver disease, and an exciter of scrofula. It is a medicine of
great value in some diseases, when given by a _judicious_ medical man;
but, at the same time, it is a drug of great danger when either given
indiscriminately, or when too often prescribed. I will grant that in
liver diseases it frequently gives temporary relief; but when a patient
has once commenced the regular use of it, he cannot do without it,
until, at length, the _functional_ ends in _organic_ disease of the
liver. The use of calomel predisposes to cold, and thus frequently
brings on either inflammation or consumption. Family aperient pills
ought never to contain, in any form whatever, a particle of mercury.

369. _Will you give me a list of remedies for the prevention and for the
cure of Constipation?_

If you find it necessary to give to your son or to your daughter
aperient medicine, the mildest ought to be selected; for instance, an
agreeable and an effectual one is an electuary composed of the following
ingredients:

              Take of—Best picked Alexandria Senna, one ounce;
                      Best Figs, two ounces;
                      Best Raisins (stoned), two ounces:

  All chopped very fine. The size of a nutmeg or two to be occasionally
    eaten.

Or, one or two teaspoonfuls of compound confection of senna (lenitive
electuary) may occasionally, early in the morning, be taken. Or, for a
change, a teaspoonful of Henry’s magnesia, in half a tumblerful of warm
water. If this should not be sufficiently active, a teaspoonful of Epsom
salts should be given with the magnesia. A Seidlitz powder forms another
safe and mild aperient; or one or two compound rhubarb pills may be
given at bedtime. The following prescription for a pill, where an
aperient is absolutely necessary, is a mild, gentle, and effective one
for the purpose:

         Take of—Extract of Socotrine Aloes, eight grains;
                 Compound Extract of Colocynth, forty-eight grains:
                 Hard Soap, twenty-four grains;
                 Treacle, a sufficient quantity:

  To make twenty-four Pills. One or two to be taken at bedtime
    occasionally.

But, after all, the best opening medicines are—cold ablutions every
morning of the whole body; attention to diet; variety of food;
bran-bread; grapes; stewed prunes;[304] French plums; Muscatel raisins;
figs; fruit both cooked and raw—if it be ripe and sound; oatmeal
porridge; lentil powder, in the form of Du Barry’s Arabica Revalenta;
vegetables of all kinds, especially spinach; exercise in the open air;
early rising; daily visiting the water-closet at a certain hour—there is
nothing keeps the bowels open so regularly and well as establishing the
habit of visiting the water-closet at a certain hour every morning; and
the other rules of health specified in these Conversations. If more
attention were paid to these points, poor school-boys and school-girls
would not be compelled to swallow such nauseous and disgusting messes as
they usually are.

Should these plans not succeed (although in the majority of cases, with
patience and perseverance, they will), I would advise an enema once or
twice a week, either simply of warm water, or of one made of gruel,
table salt, and olive oil, in the proportion of two tablespoonfuls of
salt, two of oil, and a pint of warm gruel, which a boy may administer
to himself, or a girl to herself, by means of a proper enema apparatus.

Hydropathy is oftentimes very serviceable in preventing and in curing
costiveness; and as it will sometimes prevent the necessity of
administering medicine, it is both a boon and a blessing. “Hydropathy
also supplies us with various remedies for constipation. From the simple
glass of cold water, taken early in the morning, to the various douches
and sea-baths, a long list of useful appliances might be made out, among
which we may mention the ‘wet compresses’ worn for three hours over the
abdomen [bowels], with a gutta-percha covering.”[305]

I have here a word or two to say to a mother who is always physicking
her family. It is an unnatural thing to be constantly dosing either a
child or any one else with medicine. One would suppose that some people
were only sent into the world to be physicked! If more care were paid to
the rules of health, very little medicine would be required! This is a
bold assertion; but I am confident that it is a true one. It is a
strange admission for a medical man to make, but, nevertheless, my
convictions compel me to avow it.

370. _What is the reason girls are so subject to Costiveness?_

The principal reason why girls suffer more from costiveness than boys,
is that their habits are more sedentary; as the best opening medicines
in the world are an abundance of exercise, of muscular exertion, and of
fresh air.

Unfortunately, poor girls in this enlightened age must be engaged,
sitting all the while, several hours every day at fancy work, the piano,
and other accomplishments, they, consequently, have little time for
exercise of any kind. The bowels, as a matter of course, become
constipated; they are, therefore, dosed with pills, with black draughts,
with brimstone and treacle—oh! the abomination!—and with medicines of
that class, almost _ad infinitum_. What is the consequence? Opening
medicines, by constant repetition, lose their effects, and, therefore,
require to be made stronger and still stronger, until at length the
strongest will scarcely act at all, and the poor unfortunate girl, when
she becomes a woman, _if she ever does become one_, is spiritless,
heavy, dull, and listless, requiring daily doses of physic, until she
almost lives on medicine!

All this misery and wretchedness proceed from Nature’s laws having been
set at defiance, from _artificial_ means taking the place of _natural_
ones—from a mother adopting as her rule and guide fashion and folly,
rather than reason and common sense. When will a mother awake from her
folly and stupidity? This is strong language to address to a lady; but
it is not stronger than the subject demands.

Mothers of England! do, let me entreat you, ponder well upon what I have
said. Do rescue your girls from the bondage of fashion and folly, which
is worse than the bondage of the Egyptian task-masters; for the
Israelites did, in making bricks without straw, work in the open air—“So
the people were scattered abroad throughout all the land of Egypt to
gather stubble instead of straw;”[306] but your girls, many of them at
least, have no work, either in the house or in the open air—they have no
exercise whatever. They are poor, drawling, dawdling, miserable
nonentities, with muscles, for the want of proper exercise, like
ribbons; and with faces, for the lack of fresh air, as white as a sheet
of paper. What a host of charming girls are yearly sacrificed at the
shrine of fashion and of folly!

Another, and a frequent cause of costiveness, is the bad habit of
disobeying the call of having the bowels opened. The moment there is the
slightest inclination to relieve the bowels, _instantly_ ought it to be
attended to, or serious results will follow. Let me urge a mother to
instill into her daughter’s mind the importance of this advice.

371. _Young people are subject to Pimples on the Face, what is the
remedy?_

These hard red pimples (_acne_) are a common and an obstinate affection
of the skin, principally affecting the forehead, the temples, the nose,
and the cheeks; occasionally attacking the neck, the shoulders, the
back, and the chest; and as they more frequently affect the young, from
the age of 15 to 35, and are disfiguring, they cause much annoyance.
“These pimples are so well known by most persons as scarcely to need
description; they are conical, red, and hard; after awhile, they become
white, and yellow at the point, then discharge a thick yellow-colored
matter, mingled with a whitish substance, and become covered by a hard,
brown scab, and lastly, disappear very slowly, sometimes very
imperfectly, and often leaving an ugly scar behind them. To these
symptoms are not unfrequently added considerable pain, and always much
unsightliness. When these little cones have the black head of a ‘grub’
at their point, they constitute the variety termed _spotted acne_. These
latter often remain stationary for months, without increasing or
becoming red; but when they inflame, they are nowise different in their
course from the common kind.”[307]

I find, in these cases, great benefit to be derived from bathing the
face, night and morning, with strong salt and water—a tablespoonful of
table salt to a teacupful of water; by paying attention to the bowels;
by living on plain, wholesome, nourishing food; and by taking a great
deal of out-door exercise. Sea bathing, in these cases, is often very
beneficial. Grubs and worms have a mortal antipathy to salt.

372. _What is the cause of a Gum-boil?_

A decayed root of a tooth, which causes inflammation and abscess of the
gum, which abscess breaks, and thus becomes a gum-boil.

373. _What is the treatment of a Gum-boil?_

Foment the outside of the face with a hot chamomile and poppy-head
fomentation,[308] and apply to the gum-boil, between the cheek and the
gum, a small white-bread and milk poultice,[309] which renew frequently.

As soon as the gum-boil has become quiet, _by all means_ have the
affected tooth extracted, or it might cause disease, and consequently
serious injury of the jaw; and whenever the patient catches cold there
will be a renewal of the inflammation, of the abscess, and of the
gum-boil, and, as a matter of course, renewed pain, trouble, and
annoyance. Moreover, decayed fangs of teeth often cause the breath to be
offensive.

374. _What is the best remedy for a Corn?_

The best remedy for a _hard corn_ is to remove it. The usual method of
cutting, or of paring a corn away, is erroneous. The following is the
right way: Cut with a _sharp_ pair of pointed scissors around the
circumference of the corn. Work gradually round and round and toward the
center. When you have for some considerable distance well loosened the
edges, you can either with your finger or with a pair of forceps
generally remove the corn bodily, and that with little pain and without
the loss of any blood.

If the corn be properly and wholly removed, it will leave a small cavity
or round hole in the center, where the blood-vessels and the nerve of
the corn—vulgarly called the root—really were, and which, in point of
fact, constituted the very existence or the essence of the corn.
Moreover, if the corn be entirely removed, you will, without giving
yourself the slightest pain, be able to squeeze the part affected
between your finger and thumb.

_Hard corns_ on the sole of the foot and on the sides of the foot are
best treated by filing—by filing them with a sharp cutting file (flat on
one side and convex on the other), neither too coarse nor too fine in
the cutting. The corn ought, once every day, to be filed, and should
daily be continued until you experience a slight pain, which tells you
that the end of the corn is approaching. Many cases of _hard corn_, that
have resisted every other plan of treatment, have been _entirely_ cured
by means of the file. One great advantage of the file is, it cannot
possibly do any harm, and may be used by a timid person, by one who
would not readily submit to any cutting instrument being applied to the
corn.

The file, if properly used, is an effectual remedy for a _hard_ corn on
the sole of the foot. I myself have seen the value of it in several
cases, particularly in one case, that of an old gentleman of
ninety-five, who had had a corn on the sole of his foot for upwards of
half a century, and which had resisted numerous, indeed, almost
innumerable remedies; at length I recommended the file, and after a few
applications entire relief was obtained, and the corn was completely
eradicated.

The corns between the toes are called _soft corns_. A _soft corn_ is
quickly removed by the strong acetic acid—acid. acetic. fort.—which
ought to be applied to the corn every night by means of a camel’s-hair
brush. The toes should be kept asunder for a few minutes, in order that
the acid may soak in; then apply between the toes a small piece of
cotton wool.

_Hard corns_, then, on the sole and on the side of the foot, are best
treated by the file; _hard corns_ on the toes by the scissors; and _soft
corns_ between the toes by the strong acetic acid.

In the generality of cases the plans recommended above, if properly
performed, will effect a cure; but if the corn, from pressure or from
any other cause, should return, remove it again and proceed as before
directed. If the corn have been caused either by tight or by ill-fitting
shoes, the only way to prevent a recurrence is, of course, to have the
shoes properly made by a clever shoemaker—by one who thoroughly
understands his business, and who will have a pair of lasts made
purposely for the feet.[310]

The German method of making boots and shoes is a capital one for the
prevention of corns, as the boots and shoes are made scientifically, to
fit a _real_ and not an _ideal_ foot.

One of the best preventives of, as well as of the best remedies for
corns, especially of soft corns between the toes, is washing the feet
every morning, as recommended in a previous Conversation,[311] taking
especial care to wash with the thumb, and afterward to wipe with the
towel between each toe.

375. _What is the best remedy to destroy a Wart?_

Pure nitric acid,[312] carefully applied to the wart by means of a small
stick of cedar wood, a camel’s-hair pencil-holder, every other day, will
soon destroy it. Care must be taken that the acid does not touch the
healthy skin, or it will act as a caustic to it.

The nitric acid should be preserved in a stoppered bottle, and must be
put out of the reach of children.

376. _What is the best remedy for Tender Feet, for Sweaty Feet, and for
Smelling Feet?_

Cold water: bathing the feet in cold water, beginning with tepid water;
but gradually from day to day reducing the warm until the water be quite
cold. A large nursery-basin, one-third full of water, ought to be placed
on the floor, and one foot at a time should be put in the water, washing
the while with a sponge the foot, and with the thumb between each toe.
Each foot should remain in the water about half a minute. The feet ought
after each washing to be well dried, taking care to dry with the towel
between each toe. The above process must be repeated at least once every
day, every morning, and, if the annoyance be great, every night as well.
A clean pair of stockings ought in these cases to be put on daily, as
perfect cleanliness is absolutely necessary both to afford relief and to
effect a cure.

If the feet be tender, or if there be either bunions or corns, the shoes
and the boots made according to the German method (which are fashioned
according to the actual shape of the foot) should alone be worn.

377. _What are the causes of so many young ladies of the present day
being weak, nervous, and unhappy?_

The principal causes are—ignorance of the laws of health, Nature’s laws
being set at naught by fashion and by folly, by want of fresh air and
exercise, by want of occupation, and by want of self-reliance. Weak,
nervous, and unhappy! Well they might be! What have they to make them
strong and happy? Have they work to do to brace the muscles? Have they
occupation—useful, active occupation—to make them happy? No! they have
neither the one nor the other!

378. _What diseases are girls most subject to?_

The diseases peculiar to girls are—Chlorosis, Greensickness, and
Hysterics.

379. _What are the usual causes of Chlorosis?_

Chlorosis is caused by torpor and debility of the whole frame,
_especially of the womb_. It is generally produced by scanty or by
improper food, by the want of air and exercise, and by too close
application within doors. Here we have the same tale over again—close
application within doors, and the want of fresh air and exercise! When
will the eyes of a mother be opened to this important subject?—the most
important that can engage her attention!

380. _What is the usual age for Chlorosis to occur, and what are the
symptoms?_

Chlorosis more frequently attacks girls from fifteen to twenty years of
age; although unmarried women, much older, occasionally have it. I say
_unmarried_, for, as a rule, it is a complaint of the _single_.

The patient, first of all, complains of being languid, tired, and out of
spirits; she is fatigued with the slightest exertion; she has usually
palpitation of the heart (so as to make her fancy that she has a disease
of that organ, which, in all probability, she has _not_); she has
shortness of breath, and a short dry cough; her face is flabby and pale;
her complexion gradually assumes a yellowish or greenish hue—hence the
name of chlorosis; there is a dark, livid circle around her eyes; her
lips lose their color, and become almost white; her tongue is generally
white and pasty; her appetite is bad, and is frequently depraved—the
patient often preferring chalk, slate-pencil, cinder, and even dirt, to
the daintiest food; indigestion frequently attends chlorosis; she has
usually pains over the short-ribs, on the _left_ side; she suffers
greatly from “wind,” and is frequently nearly choked by it; her bowels
are generally costive, and the stools are unhealthy; she has pains in
her hips, loins, and back; and her feet and ankles are oftentimes
swollen. _The menstrual discharge is either suspended, or very partially
performed_; if the latter, it is usually almost colorless. Hysterical
fits not unfrequently occur during an attack of chlorosis.

381. _How may Chlorosis be prevented?_

If health were more and fashion were less studied, chlorosis would not
be such a frequent complaint. This disease generally takes its rise from
mismanagement—from Nature’s laws having been set at defiance. I have
heard a silly mother express an opinion that it is not _genteel_ for a
girl to eat _heartily_! Such language is perfectly absurd and cruel. How
often, too, a weak mother declares that a healthy, blooming girl looks
like a milkmaid! It would be well if she did! How true and sad it is,
that “a pale, delicate face, and clear eyes, indicative of consumption,
are the fashionable _desiderata_ at present for complexion.”[313]

A growing girl requires _plenty_ of _good_ nourishment—as much as her
appetite demands; and if she have it not, she will become either
chlorotic, or consumptive, or delicate. Besides, _the greatest
beautifier in the world is health_; therefore, by a mother studying the
health of her daughter, she will, at the same time, adorn her body with
beauty! I am sorry to say that too many parents think more of the beauty
than of the health of their girls. Sad and lamentable infatuation!
Nathaniel Hawthorne gives a graphic description of a delicate young
lady. He says: “She is one of those delicate, nervous young creatures
not uncommon in New England, and whom I suppose to have become what we
find them by the gradually refining away of the physical system among
young women. Some philosophers choose to glorify this habit of body by
terming it spiritual; but, in my opinion, it is rather the effect of
unwholesome food, bad air, lack of out-door exercise, and neglect of
bathing, on the part of these damsels and their female progenitors, all
resulting in a kind of hereditary dyspepsia.”

Nathaniel Hawthorne, a distinguished American, was right. Such ladies,
when he wrote, were not uncommon; but within the last two or three
years, to their great credit be it spoken, “a change has come o’er the
spirit of their dreams,” and they are wonderfully improved in health;
for, with all reverence be it spoken, “God helps them who help
themselves,” and they have helped themselves by attending to the rules
of health: “The women of America are growing more and more handsome
every year for just this reason. They are growing rounder of chest,
fuller of limb, gaining substance and development in every direction.
Whatever may be urged to the contrary, we believe this to be a
demonstrable fact.... When the rising generation of American girls once
begin to wear thick shoes, to take much exercise in the open air, to
skate, to play croquet, and to affect the saddle, it not only begins to
grow more wise but more healthful, and—which must follow as the night
the day—more beautiful.”[314]

If a young girl had plenty of wholesome meat, varied from day to day,
either plain roast or boiled, and neither stewed, nor hashed, nor highly
seasoned, for her stomach; if she had an abundance of fresh air for her
lungs; if she had plenty of active exercise, such as skipping, dancing,
running, riding, swimming, for her muscles; if her clothing were warm
and loose, and adapted to the season; if her mind were more occupied
with active, _useful_ occupation, such as household work, than at
present, and if she were kept calm and untroubled from the hurly-burly
and excitement of fashionable life,—chlorosis would almost be an unknown
disease. It is a complaint of rare occurrence with country girls, but of
great frequency with fine city ladies.

382. _What treatment should you advise?_

The treatment which would prevent should be adopted when the complaint
first makes its appearance. If the above means do not quickly remove
it, the mother must then apply to a medical man, and he will give
medicines _which will soon have the desired effect_. If the disease be
allowed for any length of time to run on, it might produce either
organic—incurable—disease of the heart, or consumption, or
indigestion, or confirmed ill health.

383. _At what period of life is a lady most prone to Hysterics, and what
are the symptoms?_

The time of life when hysterics occur is generally from the age of
fifteen to fifty. Hysterics come on by paroxysms—hence they are called
hysterical fits. A patient, just before an attack, is low spirited;
crying without a cause; she is “nervous,” as it is called; she has
flushings of the face; she is at other times very pale; she has
shortness of breath and occasional palpitations of the heart; her
appetite is usually bad; she passes quantities of colorless limpid
urine, having the appearance of pump-water; she is much troubled with
flatulence in her bowels, and, in consequence, she feels bloated and
uncomfortable. The “wind” at length rises upward toward the stomach, and
still upward to the throat, giving her the sensation of a ball stopping
her breathing, and producing a feeling of suffocation. The sensation of
a ball in the throat (_globus hystericus_) is the commencement of the
fit.

She now becomes _partially_ insensible, although she seldom loses
_complete_ consciousness. Her face becomes flushed, her nostrils
dilated, her head thrown back, and her stomach and bowels enormously
distended with “wind.” After a short time she throws her arms and legs
about convulsively, she beats her breast, tears her hair and clothes,
laughs boisterously, and screams violently; at other times she makes a
peculiar noise; sometimes she sobs, and her face is much distorted. At
length she brings up enormous quantities of wind; after a time, she
bursts into a violent flood of tears, and then gradually comes to
herself.

As soon as the fit is at an end she generally passes enormous quantities
of colorless limpid urine. She might, in a short time, fall into another
attack similar to the above. When she comes to herself she feels
exhausted and tired, and usually complains of slight headache, and of
great soreness of the body and limbs. She seldom remembers what has
occurred during the fit. Hysterics are sometimes frightful to witness;
but, in themselves, are not at all dangerous.

384. _What are the causes of Hysterics?_

Delicate health, chlorosis, improper and not sufficiently nourishing
food, grief, anxiety, excitement of the mind, closely confined rooms,
want of exercise, indigestion, flatulence, and tight lacing are the
causes which usually produce hysterics. Hysterics are frequently
feigned; indeed, oftener than any other complaint; and even a _genuine_
case is usually much aggravated by a patient herself giving way to them.

385. _What do you recommend an Hysterical lady to do?_

To improve her health by proper management; to rise early and to take a
walk, that she may breathe pure and wholesome air,—indeed, she ought to
live nearly half her time in the open air, exercising herself with
walking, skipping, etc.; to employ her mind with botany, croquet,
archery, or with any other out-door amusement; to confine herself to
plain, wholesome, nourishing food; to avoid tight lacing; to eschew
fashionable amusements; and, above all, not to give way to her feelings,
but if she feel an attack approaching, to rouse herself.

_If the fit be upon her_, the better plan is to banish all the _male_
sex from the room, and not even to have many women about her, and for
those around to loosen her dress; to lay her in the center of the room,
flat upon the ground, with a pillow under her head; to remove combs and
pins and brooches from her person; to dash cold water upon her face; to
apply cloths, or a large sponge wetted in cold water, to her head; to
throw open the window, and then to leave her to herself; or, at all
events, to leave her with only one _female_ friend or attendant. If such
be done, she will soon come round; but what is the usual practice? If a
girl be in hysterics, the whole house, and perhaps the neighborhood, is
roused; the room is crowded to suffocation; fears are openly expressed
by those around that she is in a dangerous state; she hears what they
say, and her hysterics are increased tenfold.

                  *       *       *       *       *

If this book is to be of use to mothers and to the rising generation, as
I humbly hope and trust that it has been, and that it will be still more
abundantly, it ought not to be listlessly read, merely as a novel, or as
any other piece of fiction, but it must be thoughtfully and carefully
studied, until its contents, in all its bearings, be completely mastered
and understood.

In conclusion, I beg to thank you for the courtesy, confidence, and
attention I have received at your hands, and to express a hope that my
advice, through God’s blessing, may not have been given in vain.




                                 INDEX.


 Ablution of a child, 1120.
   of an infant, 1016.
   of a youth, 1318.
   thorough of boy and girl, 1318.

 Accidents of children, 1297.

 Acne, symptoms and treatment of, 1390.

 Advice to a mother if her infant be poorly, 1148.
   to _Mr. Paterfamilias_, 1087.

 Ailments, the distinction between _serious_ and _slight_, 1087.
   of infants, 1085.

 Air and exercise for youth, 1337.
   the importance of good, 1152.
   the necessity of fresh and changing the, 1151.

 American ladies, 1398.

 Amusements for a child, 1177.
   for a girl, 1344.
   for a boy, 1341.

 Ankles, weak, 1116.

 Antipathies of a child, 1149.

 Aperients for a child, 1255.
   for an infant, 1091.
   for a new-born babe, 1086.
   for a youth, 1385.
   danger of frequent, 1385.

 Appeal to mothers, 1389.

 Appetite, on a child losing his, 1146.

 Applications, hot, 1295.

 Apron, washing, 1022.

 Archery, 1344.

 Arnold, Doctor, on corporal punishment, 1349.

 Arrow-root for an infant, 1040.

 Artificial food for an infant at breast, 1036.

 Asses’ milk, 1046.


 Babes should kick on floor, 1076.

 Baby-slaughter, 1045.

 Baked crumb of bread for an infant, 1037.
   flour for an infant, 1038.

 Bakers’ and home-made bread, 1148.

 Bathing after _full_ meal, 1324.

 Baths, cold, tepid, and warm, 1325.

 Baths, warm, as a remedy for flatulence, 1099.

 Beard best respirator, 1380.

 Bed, on placing child in, 1189.

 Beds, feather, 1188.
   purification of, 1238.

 Bed-rooms, the ventilation of, 1359.
   cool, 1190.
   a plan to ventilate, 1359.

 Bee, the sting of, 1312.

 Beef, salted or boiled, 1141.

 Belladonna, poisoning by, 1314.

 Belly-band, when to discontinue, 1028.

 Beverage for a child, 1143.

 “Black eye,” remedies for, 1298.

 Bladder and bowels of an infant, 1084.

 Bleeding from navel, how to restrain, 1024.
   of nose, 1381.

 Blood, spitting of, 1374.

 Blows and bruises, 1298.

 Boarding-schools for females, 1351.
   on cheap (_note_), 1352.

 Boiled bread for infants, 1036.
   flour for infants’ food, 1037.

 Boils, the treatment of, 1252.

 Boots and shoes, 1127, 1394.

 Bottles, the best nursing, 1041.

 Boulogne sore-throat, 1217.

 Bow legs, 1277.

 Bowels, large, of children, 1255.
   looseness of, 1100.
   protrusion of lower, 1258.

 Boys should be made strong, 1343.

 Brain, water on the, 1199.

 Bran to soften water, 1280.

 Bran poultices, 1296.

 Breakfast of a child, 1135.
   of a youth, 1332.

 Breast, on early putting an infant to, 1032.

 Breathing exercise, 1344.

 Brimstone and treacle, 1261.

 Brown and Polson’s Corn Flour, 1039.

 Bronchitis, the treatment of, 1213.

 Broth for infants, 1116.
   for a new-born infant, 1041.
   and soup, 1335.

 Brothers and sisters, 1351.

 Bruises, remedies for, 1298.

 Burns and scalds, 1303.

 Burning of women, 1152.

 Bullying a child, 1166.

 Butter, wholesome, 1135.


 Calomel, the danger of a mother prescribing, 1095.
   the ill effects of, 1385.

 Camphor makes teeth brittle, 1365.

 Caning a boy, 1347.

 Caps, flannel, 1028.

 Carpets in nurseries, 1171.

 Carriage exercise, 1341.

 Carron oil in burns, 1305.

 Castor oil “to heal the bowels,” 1096.

 Cat, bites and scratches of a, 1311.

 “Chafings” of infants, the treatment of, 1088.

 Chairs, straight-backed, 1354.

 Change of air, 1263.
   linen in sickness, 1267.

 Chapped hands, legs, etc., 1280.
   lips, 1281.

 Chest, keeping warm the upper part of the, 1328.

 “Chicken-breasted” and narrow-breasted children, 1274.

 Chicken-pox, 1239.

 Chilblains, 1279.

 Child should dine with parents, 1150.

 “Child-crowing,” 1206.
   the treatment of a paroxysm, 1207.

 Children’s hour, 1162.
   parties, 1182.

 Chimneys, on the stopping of, 1171, 1266.

 Chiropodists (_note_), 1394.

 Chlorosis or green sickness, 1396, 1397.
   rare in rural districts, 1399.

 “Choking,” what to be done in a case of, 1308.

 Cisterns, best kind of, 1143.

 Clothes, on airing an infant’s, 1030.
   the ill effects of tight, 1124.

 Clothing of children, 1123.
   of infants, 1028.
     during winter, 1031.
   of youths, 1327.

 Coffee as an aperient, 1285, 1333.
   and tea, 1332.

 Coin, on the swallowing of a, 1317.

 Cold bedroom healthy, 1191.
   a feverish, 1296.
   on child always catching, 1264.
   feet, method to warm, 1161.

 Concluding remarks on infancy, 1119.

 Constipation, prevention and cure of, 1385.

 Consumption attacks the _upper_ part of the lungs, 1329.
   the age at which it usually appears, 1374.
   causes of, 1377.
   death-rate, 1373.
   importance of early consulting a medical man in, 1372.
   spitting of blood in, 1372.
   symptoms of, 1374.

 Consumptive patient, the treatment of a, 1377.

 Convulsions of children, 1066, 1089.
   from hooping-cough, 1090.

 Cooked fruit for child, 1134.

 Coroners’ inquests on infants, 1082.

 Corporal punishment at schools, 1347.

 Corns, 1392, 1394.

 Costiveness of infants, the means to prevent, 1096.
   remedies for, 1091.

 Costiveness, the reason why so prevalent, 1388.

 Cough, the danger of stopping a, 1074.

 Cow, the importance of having the milk from ONE, 1042, 1046.

 Cream and egg, 1135.
   and water for babe, 1135.

 Crinoline and burning of ladies, 1152.

 Croquet for girls, 1344.

 Crossness in a sick child, 1268.

 Croup, 1200.
   the treatment of, 1202.

 Cry of infant, 1115.

 Cure, artificial and natural, 1277.

 “Curious phenomenon” in scarlet fever, 1228.

 Cut finger, the application for, 1297.


 Dancing and skipping, 1344.

 Danger of constantly giving physic, 1119.

 Delicate child, plan to strengthen a, 1262.

 Dentition, 1062.
   lancing of gums, 1064.
   second, 1094.
   symptoms and treatment of painful, 1071.

 Diarrhœa of infants, 1100.
   treatment of, 1103.

 Diet of a child who has cut his teeth, 1135.
   of children, 1132.
   of a dry-nursed child, 1046.
   of infants, 1032.
   on a mother being particular in attending to, 1142.
   of youth, 1332.

 Dietary, an infant’s, 1036.

 Dinner for a child, 1133.
   youth, 1333.

 Diphtheria, symptoms, causes, and treatment of, 1217–223.

 Dirty child, a, 1085.

 Diseased nature and strange eruptions, 1291.

 Diseases of children, 1195.
   girls, 1396.
   infants, 1085.
   obscure, 1283.
   the prevention of, 1366.
   produced by tight lacing, 1330.
   symptoms of _serious_, 1088.

 Doctor, on early calling in, 1293.

 Dog, the bite of a, 1309.

 Doleful child, 1157.

 Drainage, 1153, 1238.

 Dress, female, 1331.
   of a child while asleep, 1080.

 Drinking fountains, 1043.

 Dropping child, danger of, 1299.

 Dry-nursed children, the best food for, 1046.

 “Dusting-powder” for infants, 1020.

 Dysentery, symptoms, and treatment of, 1104–108.


 Ear, discharges from, 1254.
   removal of a pea or bead from, 1316.

 Earache, treatment of, 1253.

 Earwig in ear, 1316.

 Early rising, 1192, 1362.

 Education of children, 1084.

 Education in infant schools, 1083.
   home, the best for girls, 1351.
   modern, 1351.
   for youth, 1347.

 Eggs for children, 1042.

 Enema apparatus (_note_), 1262.

 Engravings in nurseries, 1055.

 Eruptions about the mouth, 1289.

 Excoriations, applications for, 1021.
   best remedy for, 1021.

 Exercise, 1075, 1172, 1337.
   best composing medicine, 1092.
   for children, 1072.
   in wet weather, 1175.
   on violently tossing infants, 1077.
   horse and pony, 1339.
   an infant himself taking, 1076.
   in wet weather, 1075.
   for youth, 1338.


 Fecal matter in pump-water, 1238.

 Fainting, 1383.
   from constipation, 1384.
   from debility, 1384.
   from disordered stomach, 1384.

 Falling off of hair, 1327.

 Falls on the head, 1299.

 Fashion, dangerous effects of strictly attending to, 1331.
   the present, of dressing children, 1131.

 Fashionable _desiderata_ for complexion, 1397.

 Favoritism, 1067.

 Feeding infants, proper times for, at breast, 1043.

 Feet, smelling, 1395.
   sweating, 1395.
   tender, 1395.

 Female dress, 1331.

 Fire, on a child playing with, 1302.
   danger of back to, 1153.
   in night nursery, 1190.
   the manner of extinguishing, if clothes be on, 1302.
   guards, 1152, 1302.

 Fire-proof, making dresses, 1303.

 Flannel night-gowns, 1126.
   shirts for a delicate child, 1126.
   waistcoats, 1328.

 Flatulence, remedies for, 1097, 1294.

 Fleas, to drive away, 1272.

 Flute, bugle, and other wind instruments, 1344.

 Fly-pole, 1345.

 Fog, on sending child out in, 1175.

 Folly of giving physic after vaccination, 1061.

 Food, artificial, during suckling, 1043.
   care in preparing infants’, 1041.
   for dry-nursed infants, 1036, 1046.
   for infants who are sucking, 1036.

 Frightening a child, 1159.

 Fruit, as an aperient, 1258.


 Garters impede circulation, 1128.

 Gin or peppermint in infants’ food, 1055.

 Giving joy to a child, 1162.

 Glass, a child swallowing broken, 1316.

 Gluttony, 1337.

 Glycerin soap, 1281.

 Goat’s milk, 1046.

 _Godfrey’s Cordial_, 1098.
   poisoning by, treatment, 1313.

 Grazed skin, 1312.

 Green dresses poisonous, 1155, 1332.
   paper-hangings for nurseries, 1155.

 “Gripings” of infants, 1098.

 “Gross superstition,” 1230.

 Gums, the lancing of the, 1064.

 Gum-boil, cause and treatment, 1391.

 Gum-sticks, the best, 1067.

 Gymnasium, value of, 1343.


 Hair, the best application for the, 1326.
   falling off, 1327.
   making tidy, 1327.

 Half-washed and half-starved child, 1177.

 Hand-swing, 1345.

 Happiness to a child, 1162.

 Happy child, 1163.

 Hard’s Farinaceous Food, 1038.

 Hardening of children’s constitutions, 1126.
   of infants, 1078.

 Hats for a child, the best kind, 1124.

 Hawthorne, Nathaniel, on American ladies, 1398.

 Head, fall upon, 1299.

 Heat, external application of, 1295.

 Hiccoughs of infants, 1100.

 Hints conducive to the well-doing of a child, 1157.

 Home of childhood—the nursery, 1157.

 Hooping-cough, 1243.
   obstinate, 1248.
   treatment of, 1245.

 Horse exercise for boys or girls, 1339.
   and pony exercise, 1339.

 Hot-water bag or bottle, 1295.

 Household work for girls, 1355.

 Hydrophobia, 1309.

 Hysterics, 1400, 1402.


 India-rubber hot-water bottle, 1295.

 Infants should be encouraged to use exertion, 1076.

 Infant schools, 1183.

 Ipecacuanha wine, preservation of, 1205.


 Ladies “affecting the saddle,” 1344.

 Laudanum, poisoning by, 1313.

 Law, physic, and divinity, 1356.

 Leaden cisterns, 1143.

 Learning without health, 1275.

 Leech-bites, the way to restrain bleeding from, 1117.

 Lessons for child, 1180.

 Lice in head after illness, 1271.

 Light, best artificial, for nursery, 1156.
   the importance of, to health, 1156.

 Lime in the eye, 1307.
   to harden the bones, 1288.

 Lime-water and milk, 1140.

 “Looseness of the bowels,” the treatment of, 1101.

 Love of children, 1164.

 Lucifer matches, the poisonous effects of, 1156, 1301.

 Luncheon for a child, 1140.

 Lungs, inflammation of, 1126, 1209.
   precautions to prevent, 1273.
   symptoms of, 1209.
   treatment of, 1209.

 Lying lips of a child, 1167.


 Mad dog, the bite of, 1309.
   description of, 1310.

 Magnesia to cool a child, 1096.

 Massacre of innocents, 1045.

 Mattresses, horse-hair, best for child, 1188.

 Meals, a child’s, 1144.

 Measles, 1223.
   and scarlet fever, 1227.
   treatment of, 1224.

 Meat, daily, on giving, 1333.
   raw, in long-standing diarrhœa, 1262.
   in exhaustive diseases, 1262.
   when a child should commence taking, 1132.

 Meddlesome treatment, 1291.

 Medical man, a mother’s treatment toward, 1291.

 Medicine, the best way of administering, 1264.
   on giving new-born infants, 1085.
   on making palatable (_note_), 1265.

 Menstruating female during suckling, 1048.

 Mercury, on the danger of parents giving, 1094, 1385.

 Milk, on the importance of having it from ONE cow, 1036, 1046.
   bad, very nasty, 1138.
   for babe indispensable, 1048.
   or meat, or both, 1139.
   a plan to make a child take, 1139.
   the value of, for children, 1136.
   a way to prevent, turning sour, 1140.
   crust, 1289.

 Mismanaged baby, 1014.

 Modified small-pox and chicken-pox, 1242.

 Mother, fretting, injurious to infant, 1053.
   a foolish, 1083.
   of many diseases, 1377.

 Mother’s and cow’s milk, on mixing, 1036.

 Motions, healthy, of babe, 1100.

 Mumps, 1251.


 Napkins, when to dispense with, 1084.

 Nature’s physic, 1118.

 Navel, management of the, 1024.
   rupture of, 1025.

 Nervous and unhappy young ladies, 1395.

 Nettle-rash, 1108.

 New-born infants and aperients, 1085.

 Night-terrors, 1159.

 Nose, removal of foreign substances from, 1315.
   bleeding from, means to restrain, 1381.

 Nurse, on the choice of a, 1158.
   a lazy, 1161.
   strong and active, 1158.
   young, not desirable, 1158.
   for the sick, 1269.

 Nursery-basin, 1017.

 Nursery a child’s own domain, 1157, 1179.
   selection, warming, ventilation, arrangements of, 1150.

 Nursery of a sick child, 1266.
   on the light of a, 1156.
   must be airy, 1151.
   observations, further, 1151.
   windows to be often opened, 1156.


 Opium, a case of poisoning by, 1074.
   the danger of administering, to infants, 1098.
   the treatment of poisoning by, 1313.

 Over-education, 1184.


 Paint-boxes dangerous as toys, 1180.

 Peevishness of a child, the plan to allay, 1164.

 Perambulators, 1173.

 Physicking a child, on the frequent, 1118.

 Pies and puddings, 1133.

 Pimples of the face, treatment of, 1390.

 Pin, on a child’s swallowing, 1317.

 Play, a course of education in, 1185.

 Play-grounds for children, 1182.
   and play, 1182.

 Pleasant words to a child, 1166.

 Poisoning, accidental, 1313.
   by the breath, 1189.

 Poppy-syrup, 1098.

 Pork, an improper meat for children, 1141.

 Position of a sleeping child, 1190.

 Potatoes for children, 1142.

 Poultice, a white-bread, 1297.

 Powder, “dusting,” 1020.

 Precocity of intellect, 1366.

 Precocious youths, the health of, 1367.

 Princess of Wales and her baby (_note_), 1022.

 Professions and trades, 1355.

 Proper person to wash an infant, 1022.

 Prunes, the best way of stewing, 1258.

 Profession or trade, choice of, for delicate youth, 1355.
   delicate youths should be brought up to, 1357.

 Puddings for children, 1133.


 Quack medicines, 1098.

 Quacking an infant, 1096.

 Quicklime in eye, 1307.


 Red-gum, 1109.

 Respiration, products of, poisonous, 1359.

 Rest, the best time for a child to retire to, 1189.

 Revaccination, importance of, 1057.
   every seven years, 1057.

 Rheumatic fever, flannel vest and drawers, 1328.

 Ribs, bulging out of, 1371.

 Rice, prepared as an infant’s food, 1039.

 Richardson, Dr., ether spray, 1382.

 Rickets, 1285.
   various degrees of, 1286.

 Rocking-chairs, and rockers to cradle, 1079.

 Rocking infants to sleep, 1078.

 Rooms, ill effects of dark, 1156.

 Round shoulders, 1275, 1370.

 Round-worm, 1282.

 Running scall, 1289.

 Rupture, 1026, 1027.

 Rusks, 1039.


 Sallowness, cause of, in young girls, 1338.

 Salt water and fresh water, 1324.

 Salt should be added to an infant’s food, 1042.
   bag of hot, 1295.
   necessary to human life, 1284.
   meats for children, 1141.

 Salt and water ablutions for a delicate child, 1123.
   for teeth and gums, 1364.

 Scalds and burns, 1303.
   of mouth, 1304.

 Scarlatina, 1226.

 Scarlet fever, 1226.
   the contagion of, 1237.
   the danger of giving aperients in, 1227.
   the dropsy of, 1227, 1237.
   management of child after, 1236.
   and measles, the importance of distinguishing between, 1229.
   the principal danger of, 1227.
   purification of house after, 1238.
   treatment of, 1229.

 Schools, female boarding, 1351.
   public, 1350.

 Screaming in sleep, 1250.

 Scrofula, 1367.
   prevention of, 1368.

 Scurfy head, 1122.

 Sea bathing and fresh water bathing, 1324.
   for a young child, 1264.

 Secrets, talking, before child, 1187.

 Senna as an aperient, 1255.

 Shivering fit, importance of attending to a, 1249.
   treatment of, 1250.

 Shoes, plan to waterproof, 1329.
   preferable to boots, 1128.
   and stockings for children and youths, 1127, 1329.
   the ill effects of tight, 1128.

 “Shortening” an infant, 1032.

 Shoulder-blades “growing out,” 1275.

 Sick child, the nursing of a, 1265.
   not to be stuffed with food, 1269.

 Sick-room, management of, 1265.

 Sickness of infants, 1110.

 Singing and reading aloud, 1346.
   beneficial to a child, 1187.

 Single-stick, 1342.

 Sitting with back to fire, 1153.

 Sitz-bath, for protrusion of bowels, 1260.

 Skating for boys and girls, 1345.

 Skin, grazed, 1312.

 Sleeping-rooms, importance of well ventilating, 1359.

 Sleep of children, 1188.
   infants, 1077.
   in middle of day beneficial, 1188.
   much, necessary for infants, 1080.
   temperature of infant’s bedroom during, 1077.
   right time of putting a child to, 1189.
   rocking infants to, 1077.

 Sleep of youth, 1362.

 Slippers, the best for sick-room (_note_), 1269.

 Small-pox, 1056.
   a pest and disgrace, 1057.
   modified, 1240.
   when in neighborhood, 1059.
   to prevent pitting of, 1279.

 Smothering of infants, the cause, 1082.

 Socks and stockings for a child, 1127.

 Soda, ill effects of washing clothes with, 1021.

 Sounds, joyful, 1163.

 Soups and broths, 1254.

 Speak gently to a child, 1165.

 Spencer, a knitted worsted, 1371.

 Spines, distorted, 1188, 1371.
   injury to, 1299.
   curvature of, 1031.
   twisted, 1275.

 Spirits, deadly effects of, to the young, 1335.

 Spitting of blood, 1372, 1374.
   precautions, 1377.

 Spurious croup, 1206.

 Stammering, cause of, 1169.
   cure of, 1170.

 Stays, the ill effects of, 1330.

 Stillness of sick-room, 1269.

 Sting of bee or wasp, 1312.

 Stir-about and milk, 1136.

 Stockings and shoes, 1127, 1329.

 Stooping in a girl, 1370.

 Stopping of chimneys, 1171, 1266.

 Stuffing a sick child with food, 1269.

 “Stuffing of the nose,” of infants, 1110.

 “Sty,” treatment of, 1255.

 Suckling, the proper times of, 1035.

 Suet-pudding, 1133.

 Sugar for infants, 1042, 1055.
   confectionery, 1148.
   _raw_, as an aperient, 1056.

 Sunstroke, 1125.

 Sunday, 1181.

 Supper for a child and for a youth, 1144, 1336.

 Surfeit water and saffron tea, 1224.

 Sweetmeats and cakes, 1148.

 Swimming, on boys and girls, 1322.

 Symptoms of _serious_ diseases, 1195.


 Tape-worm, 1282.

 Taste for things refined, 1156.

 Tea, on giving a child, 1147.
   green, the ill effects of, 1147, 1336.

 Teeth, attention to, importance of, 1364.
   child should not have meat until he have cut several, 1132.
   the diet of a child who has cut all his, 1132.
   and gums, 1364.
   right way of brushing, 1365.
   appearance and number of _first_ set of, 1063.
   appearance and number of _second_ set of, 1194.
   second crop of, 1194.

 Teething, 1062.

 Teething, eruptions from, 1074.
   frequent cause of sickness, 1111.
   fruitful source of disease, 1070.
   purging during, 1073.
   restlessness from, 1294.
   _second_, 1194.
   symptoms and treatment of painful, 1071.
   in town and country, 1073.

 Temperature and ventilation of a nursery, 1150.
   of a warm bath, 1294.

 Thread-worm, 1282.

 Throats, sore, precautions to prevent, 1370.

 Thrush, cause, symptoms, prevention, and cure of, 1112.

 Thumb, best gum-stick, 1067.

 Tight bands, belts, and hats, 1124.

 Tight lacing, the ill effects of, 1330.

 Times for suckling an infant, 1035.

 Tobacco smoking for boys, 1380.
   cases illustrating the danger of, 1381.

 Toe-nails, the right way of cutting, 1130.

 Tongue-tied, an infant, 1034.

 “Tooth-cough,” 1074.

 Tooth-powder, an excellent, 1364.

 Top crust of bread as infant’s food, 1039.

 Tous-les-mois, 1037.

 Toys, children’s, 1181.
   painted with arsenic, 1155, 1180.

 Trade or profession for delicate youth, 1358.

 Treatment of a delicate child, 1263.
   of some urgent serious diseases, 1087, 1196.

 Truth, the love of, 1167.

 Tub, commencement of washing infant in, 1017.

 Tumbling and rolling of a child, 1176.


 Vaccination, 1056.

 Veal for a child, 1141.

 Vegetables for a child, 1142.

 Ventilation, and on stopping of chimneys, 1171, 1266.
   and sleep, 1359.
   of a nursery, 1151.

 Violet powder, 1020.


 Walking, on the early, of infants, 1172.
   exercise, value of, 1338.
   in his sleep, a child, 1193.

 Warm baths for children, 1294.
   external applications, 1295.

 Warts, 1394.

 Washing of a child, 1120.
   an infant, 1016.
   a new-born infant’s head with brandy, 1018.
   a nursery floor, 1154.

 Wasp, the sting of a, 1312.

 Water, on the importance of good, 1143.
   on the brain, 1199.
   -closet, on going regularly to, 1387, 1389.
   cold and warm, for ablution, 1119.

 Weaned child, the diet of a, 1054.

 Weaning, proper time and manner of, 1053, 1054.

 Weather, on a child almost living in the air in fine, 1175.
   on sending a child out in wet, 1175.

 Weight of new-born infants (_note_), 1080.

 Wet-flannel application, 1296.

 Wet-nurse, 1045.
   for feeble babe, 1049.

 “Wetting the bed” during sleep, 1277.

 Wheezing of a new-born infant, 1085.

 White lily leaf for bruises, 1299.

 Windows of a nursery, 1156.

 Windpipe, foreign substance in, 1317.

 Wine for children and youths, 1146, 1335.

 Winter clothing, 1130.

 Woolen garments, 1126, 1327.

 Worms, 1282.
   quack medicines for, 1283.


                                THE END.

-----

Footnote 1:

  Shakspeare.

Footnote 2:

  Martial.

Footnote 3:

  _The Nurse_; a Poem. Translated from the Italian of Luigi Tansillo by
  William Roscoe.

Footnote 4:

  _Good Words_, July, 1862.

Footnote 5:

  Emerson.

Footnote 6:

  Douglas Jerrold.

Footnote 7:

  Shakspeare.

Footnote 8:

  Chesterfield.

Footnote 9:

  From a notice of _this work_ in _The Reader_ of 14th February 1863.

Footnote 10:

  “The whole world around us, and the whole world within us, are ruled
  by law.”—The Duke of Argyle, _Good Words_, January, 1865.

Footnote 11:

  _The Family Friend_, vol. i. London: Houlston & Stoneman.

Footnote 12:

  “The indulgences and vices of prosperity are far more fatal than the
  privations entailed by any English form of distress.”—_The Times_,
  Feb. 3d, 1868.

Footnote 13:

  From a notice of _this work_ in _The Reader_ of 14th February 1863.

Footnote 14:

  Which may be procured of any respectable ironmonger.

Footnote 15:

  A nursery-basin (Wedgewood’s make is considered the best) holding six
  or eight quarts of water, according to the size of the patient—whether
  she be either a little or a large woman. It will only be necessary to
  fill it about one-third full with water: this, of course, is only for
  the sitz-bath—the sitting-bath. The same basin for the _previous_
  washing ought to have been three parts full of water.

Footnote 16:

  Rock-salt makes the strongest bath, but is much more difficult to
  dissolve in the water than either table salt or bay salt—the two
  latter being so readily dissolved.

Footnote 17:

  Armstrong.

Footnote 18:

  There is an admirable review in the _Spectator_ (Feb. 17th, 1866) of a
  work on _The Breakfast Book_, in which the reviewer proves the
  importance of people making good and substantial breakfasts, and in
  which he indicates the kinds most suitable for the purpose. I have, in
  the text, availed myself of many of his valuable suggestions.

Footnote 19:

  For the preservation of the teeth and gums, see Pye Chavasse’s _Advice
  to a Mother on the Management of her Children_, under the head of “On
  the Teeth and the Gums.”

Footnote 20:

  Armstrong.

Footnote 21:

  Armstrong.

Footnote 22:

  Milton.

Footnote 23:

  Longfellow.

Footnote 24:

  Coleridge.

Footnote 25:

  Byron.

Footnote 26:

  Pye Chavasse’s _Advice to a Mother_, Ninth Edition.

Footnote 27:

  Ecclesiastes, v. 12.

Footnote 28:

  _Light._ By Forbes Winslow, M.D.

Footnote 29:

  I have entered so fully into the evil effects of tight lacing in my
  other book, _Advice to a Mother_, that I consider it quite unnecessary
  to say more in this place on the subject. Moreover, it is not so
  necessary now as in the early editions of my two works to dwell upon
  the subject, as, I am happy to say, the evil effects of tight lacing
  are at the present time better understood. Stays used to be
  formidable-looking apparatuses; indeed, they were instruments of
  torture. Now they are more simple, and therefore more suitable.

Footnote 30:

  From a notice of _this work_ in _The Reader_ of 14th of February,
  1863.

Footnote 31:

  Cowper.

Footnote 32:

  From a notice of this work in _The Reader_ of 14th of February, 1868.

Footnote 33:

  _Poems_, by the author of _The Patience of Hope_.

Footnote 34:

  Longfellow.

Footnote 35:

  “Hold idleness to be the mother of sin; it both robs thee of the good
  thou hast and hinders thee of what thou hast not.”—“On some Guesses at
  Truth,” in _Good Words_, June, 1862.

Footnote 36:

  Cowper.

Footnote 37:

  Tennyson.

Footnote 38:

  Proverbs, xxxi. 17.

Footnote 39:

  Dr. Samuel Johnson.

Footnote 40:

  “A pale, delicate face, and clear eyes, indicative of consumption, are
  the fashionable _desiderata_ at present for complexion.”—_Dublin
  University Magazine._

Footnote 41:

  Byron.

Footnote 42:

  Sir Egerton Brydges.

Footnote 43:

  Dr. Grosvenor.

Footnote 44:

  “In the human female, the period of puberty, or of commencing aptitude
  for procreation, is usually between the thirteenth and sixteenth
  years. It is generally thought to be somewhat earlier in warm climates
  than in cold, and in densely populated manufacturing towns than in
  thinly populated agricultural districts. The mental and bodily habits
  of the individual have also considerable influence upon the time of
  its occurrence; girls brought up in the midst of luxury or sensual
  indulgence undergoing this change earlier than those reared in
  hardihood and self-denial.”—_Dr. Carpenter’s Human Physiology._

Footnote 45:

  “Some curious facts come to light in the Scotch Registrar-General’s
  report in reference to prolific mothers. One mother, who was only
  eighteen, had four children; one, who was twenty-two, had seven
  children; and of two who were only thirty-four, one had thirteen and
  the other fourteen children; and, on the other hand, two women became
  mothers as late in life as at fifty-one, and four at fifty-two; and
  one mother was registered as having given birth to a child in the
  fifty-seventh year of her age.”

Footnote 46:

  _British Medical Journal_, Nov. 21st, 1863.

Footnote 47:

  It is very unusual, in this climate, for a girl to become a mother
  until she be seventeen or eighteen years of age. A case has just
  occurred, however (1864), where a girl became a mother before she
  reached her fourteenth year. In his last report to the
  Registrar-General, the registrar for Park district, Sheffield, says:
  “I have registered the birth of a child in my district this quarter,
  the age of the mother being only thirteen years and ten months. She
  was employed in a cotton mill in the neighborhood of Manchester.”

Footnote 48:

  De Quincey.

Footnote 49:

  _Exposition of the Signs and Symptoms of Pregnancy._

Footnote 50:

  “The catamenial discharge, as it issues from the uterus [womb],
  appears to be nearly or quite identical with ordinary blood; but in
  its passage through the vagina it becomes mixed with the acid mucus
  exuded from its walls, which usually deprives it of the power of
  coagulating. If the discharge should be profuse, however, a portion of
  its fibrin remains unaffected, and clots are formed.”—_Dr. Carpenter’s
  Human Physiology._

Footnote 51:

  Dr. David D. Davis was physician-accoucheur in attendance at the birth
  of her present Majesty.

Footnote 52:

  With regard to the origin of the word _enceinte_, Dr. Montgomery, in
  his valuable _Exposition of the Signs and Symptoms of Pregnancy_,
  observes: “Many a one who confesses, with a smile or a blush, that she
  is _enceinte_, would do well to remember the origin of the word she
  uses. It was the habit of the Roman ladies to wear a tight girdle or
  cincture round their waists; but when pregnancy occurred, they were
  required by law—at least that of opinion—to remove this restraint; and
  hence a woman so situated was said to be _incincta_, or unbound, and
  hence also the adoption of the term _enceinte_ to signify a state of
  pregnancy.”

Footnote 53:

  “William Hunter had such faith in this sign that he always asserted he
  could judge by it alone whether or not a woman was pregnant.”—_Signs
  and Diseases of Pregnancy._ (Dr. Tanner.)

Footnote 54:

  Dr. Denman.

Footnote 55:

  This work is exclusively intended for the perusal of wives; I beg,
  however, to observe that there is one sign of pregnancy which I have
  not pointed out, but which to a medical man is very conclusive; I mean
  the sounds of the fœtal heart, indicated by the stethoscope. Moreover,
  there are other means besides the stethoscope known to a doctor, by
  which he can with certainty tell whether a woman be pregnant or
  otherwise, but which would be quite out of place to describe in a
  popular work of this kind.

Footnote 56:

  The _bidet_ may be procured of a cabinet-maker, the _sitz-bath_ of a
  furnishing ironmonger.

Footnote 57:

  Burton.

Footnote 58:

  Abernethy.

Footnote 59:

  _Popular Science Review._

Footnote 60:

  These pills and all medicines prescribed in this book ought to be
  prepared by a chemist.

Footnote 61:

  The hot-water bag, or bottle as it is sometimes called, is composed of
  vulcanized india-rubber, and is made purposely to hold very hot water.
  The bag ought not to be more than _half filled_ with water, as it will
  then better adapt itself to the shape of the bowels. The water must be
  hot, but not boiling hot; if it should be very hot, the bag ought to
  be wrapped in flannel.

Footnote 62:

  Take four poppy-heads and four ounces of chamomile blows, and boil
  them in four pints of water for half an hour, to make the fomentation,
  which should then be strained, and made quite hot in a saucepan when
  required.

Footnote 63:

  Waring’s _Manual of Therapeutics_.

Footnote 64:

  Let the ointments be made by a druggist.

Footnote 65:

  Which may be procured either of a medical man or of any respectable
  surgical-instrument-maker.

Footnote 66:

  _Domette_ is a mixture of flannel and cotton. One of good quality
  should be used for the purpose.

Footnote 67:

  Ten grains of powdered alum to half an ounce of chloroform.

Footnote 68:

  Camphor julep may be made by putting a few lumps of camphor in a
  wide-mouthed bottle of cold water; cork it up, and let it stand for a
  few days; then strain it, sweeten it with lump sugar, and it will be
  fit for use.

Footnote 69:

  A hot-water bag is composed of vulcanized india-rubber, and is made
  purposely to hold very hot water—boiling water. It ought only to be
  _half_ filled with water, in order that it may adapt itself to the
  surface of the stomach. The temperature of the water need only be hot,
  and not boiling hot. It is a most delightful stomach warmer and
  comforter, and should be in every house where there is a family. One
  great advantage of it is, that it is, in a few minutes, ready for use.
  It may be procured at any respectable india-rubber warehouse.

Footnote 70:

  Dissolve half a teaspoonful of powdered alum in a quarter of a pint of
  tepid water, to make the injection.

Footnote 71:

  Which may be procured either of a surgical-instrument-maker or of an
  india-rubber manufacturer. The best kind of india-rubber vaginal
  syringe is the one purposely made for the patient to use herself.

Footnote 72:

  See pages 43, 124, and 172.

Footnote 73:

  See page 166.

Footnote 74:

  Which sitz-bath may be procured of any respectable tinman or
  furnishing ironmonger.

Footnote 75:

  Tanner, _On Signs and Diseases of Pregnancy_.

Footnote 76:

  I say _usually_, for the duration of gestation is very uncertain. Dr.
  Reid gives (in _The Lancet_ of July 20th, 1850) an interesting table
  of the duration of pregnancy. The table comprises 500 cases; out of
  which numbers, nearly the half terminated in labor in the fortieth and
  forty-first weeks. The following is the order in which they occurred:

                       23 cases in the 37th week.
                       48   „     „    38th   „
                       81   „     „    39th   „
                      131   „     „    40th   „
                      112   „     „    41st   „
                       63   „     „    42d    „
                       28   „     „    43d    „
                        8   „     „    44th   „
                        6   „     „    45th   „

  The above is merely a summary of Dr. Reid’s valuable table.

Footnote 77:

  We are informed by Jourdan and other French writers that Fernel acted
  on the knowledge of this fact when consulted by Henry II. of France as
  to the best means of rendering his queen, Catherine de Medicis,
  fruitful. He advised the king to visit her only immediately after the
  cessation of the menstrual discharge, the adoption of which advice was
  attended with success, and the queen, after years of disappointment,
  gave birth to a son.—_Dr. Montgomery._

Footnote 78:

  _On the Signs and Diseases of Pregnancy._

Footnote 79:

  _Braithwaite’s Retrospect._ A Synopsis of Dr. Packman’s _Paper on
  Impregnation_, in _The Lancet_, July 18th, 1863.

Footnote 80:

  _Belforest. A Tale of English Country Life._ By the author of _Mary
  Powell_. London: Richard Bentley.

Footnote 81:

  _Not Proven._ London: Hurst & Blackett.

Footnote 82:

  “He that goeth about as a tale-bearer revealeth secrets.”—PROV. xx 19.

Footnote 83:

  The Rev. J. G. Wood’s _Duties of the Hospital Chaplain_, in the
  _Churchman’s Family Magazine_.

Footnote 84:

  Higginson’s syringe may be procured either of Weiss & Son, Strand,
  London, or of any other respectable surgical-instrument-maker. There
  are other india-rubber apparatuses besides Higginson’s which will
  answer a similar purpose. Sometimes they are made with two separate
  and distinct india-rubber pipes, the one of which is to be used in the
  administration of an enema, and the other either for giving an
  injection up the vagina, or for washing out the vagina with warm
  water. The best quality of apparatus ought always to be chosen. It
  might be procured either of a surgical-instrument-maker or at an
  india-rubber warehouse. C. Mackintosh & Co.’s Patent Vaginal Syringe
  (No. 2 size) is a capital vaginal syringe; but it will only act as a
  vaginal, while Higginson’s and some others will act a double
  purpose—as an enema and as a vaginal syringe.

Footnote 85:

  Pye Chavasse’s _Advice to a Mother_. Ninth edition.

Footnote 86:

  _A System of Midwifery._ By E. Rigby, M.D.

Footnote 87:

  “Adam’s children must work, Eve’s children must suffer.”—“On some
  Guesses at Truth,” in _Good Words_, June, 1862. Young, in his _Night
  Thoughts_, beautifully expresses the common lot of woman to suffer:

                           “’Tis the common lot;
             In this shape, or in that, has fate entailed
             The mother’s throes on all of woman born,
             Not more the children than sure heirs of pain.”

Footnote 88:

  “Through thee have I been holden up ever since I was born: thou art he
  that took me out of my mother’s womb; my praise shall be always of
  thee.”—_The Psalms of David_, lxxi. 5.

Footnote 89:

  Dr. David D. Davis used, in his valuable lectures, strongly to
  reprobate meddlesome midwifery: he justly observed that “accoucheurs
  were only life-guardsmen to women.” A life-guardsman, while on duty at
  the palace, does not interfere with every passer-by, but only removes
  those who obstruct the way.

Footnote 90:

  Dr. George Smith, of Madras, communicated an interesting case of the
  kind to the _Edinburgh Medical Journal_ (November, 1862).

Footnote 91:

  “Like as a woman with child, that draweth near the time of her
  delivery, is in pain, and crieth out in her pangs.”—Isa. xxvi. 17.

Footnote 92:

  A two-ounce pot of _unsalted_ or prepared lard, as it is usually
  called, should, previously to the labor, be procured from a chemist.

Footnote 93:

  And may be procured at any india-rubber warehouse or at a baby-linen
  establishment.

Footnote 94:

  Dryden.

Footnote 95:

  St. John, xvi. 21.

Footnote 96:

  Dr. Kidd on Chloroform, in the _Medical Press and Circular_, March
  14th, 1866.

Footnote 97:

  Dr. Kidd, in _Dublin Quarterly_. Dr. Kidd is an authority on
  chloroform.

Footnote 98:

  _The Theory and Practice of Midwifery._ By Fleetwood Churchill, M.D.

Footnote 99:

  “Dr. Vose (of Liverpool) said, that once, when in the remote valleys
  of Westmoreland and Cumberland, he used to ask the people how they got
  on without medical aid, particularly in regard to midwifery cases.
  People wondered that he should ask. He found that they had no midwives
  even; when a woman begins her troubles, they told him, they give her
  warm beer; if she is worse, more warm beer; but if that fails, then
  ‘she maun dee.’ So they give stimulants from the first. One word in
  the paper read seemed to contain the gist of the matter; we must treat
  the patients according to ‘common sense.’”—_Diet Suitable after
  Childbirth. British Medical Journal_, December 12th, 1863.

Footnote 100:

  As a rule, the “waters break” just before the head is born, then there
  is no fear of a membrane covering the mouth, as the head passes
  _through_ the ruptured membrane. “In other instances, the membrane
  does not burst before the expulsion of the head of the fœtus [child]
  externally, which it covers, and in such cases the infant is said by
  nurses to be born with _a caul_, and this is advertised in the London
  newspapers in our day, and sold at a high price by midwives, as it is
  superstitiously supposed to prevent shipwreck.”—_Ryan’s Manual of
  Midwifery._

Footnote 101:

  Shakspeare.

Footnote 102:

  See page 232, paragraph 554.

Footnote 103:

  _The female slipper_ may be procured either at any respectable
  earthenware warehouse, or of a surgical-instrument-maker.

Footnote 104:

  “The female slipper,” and the French bed-pan and the bed-pan of the
  Liverpool Northern Hospital, may be procured either at any respectable
  earthenware warehouse or of a surgical-instrument-maker.

Footnote 105:

  Boil two handfuls of marshmallows and two handfuls of chamomile blows
  in two quarts of water for a quarter of an hour, and strain.

Footnote 106:

  Which may be obtained either of a surgical-instrument-maker or at an
  india-rubber warehouse.

Footnote 107:

  There are few persons who know how to make beef-tea: let me tell you
  of a good way. Let the cook mince _very fine_—as fine as
  sausage-meat—one pound of the shoulder blade of beef, taking care that
  every particle of fat be removed; then let her put the meat either
  into a saucepan or into a digester with three pepper corns and a pint
  and a half of _cold_ water; let it be put on the fire to boil; let it
  slowly boil for an hour, and then let it be strained; and you will
  have most delicious beef-tea, light and nourishing, grateful to the
  stomach and palate. When cold, carefully skim any remaining fat (if
  there be any) from it, and warm it up when wanted. It is always well,
  when practicable, to make beef-tea the day before it is wanted, in
  order to be able to skim it when quite cold. It may be served up with
  a finger or two of dry toast, and with salt to suit the taste.
  Sometimes a patient prefers the beef-tea _without_ the pepper corns;
  when such be the case, let the pepper corns be omitted.

  If you wish your beef-tea to be particularly strong and nourishing,
  and if you have any beef bones in the house, let them be broken up and
  slowly boiled in a _digester_ for a couple of hours, or even longer,
  with the finely minced-up beef.

Footnote 108:

  A knuckle of veal boiled in new milk makes a light and nourishing food
  for a delicate lying-in woman. Milk is an admirable article of food
  for the lying-in room.

Footnote 109:

  Letter from Edward Crossman, Esq., in _British Medical Journal_, Nov.
  19th, 1864.

Footnote 110:

  Barley-water and new milk, in equal proportions, was Dr. Gooch’s
  favorite beverage for a lying-in woman. “After the fifth day,” he
  says, “the patient should be quite well, and your visits are merely
  for the purpose of watching her. Women now generally wish for wine or
  porter. I usually mix good barley-water with milk (equal parts),
  making barley gruel; and, presenting this beverage, I tell them, this
  is your wine and your porter too; it will relieve your thirst and
  sinking at the stomach, and will manufacture milk better than anything
  else.”

Footnote 111:

  Erasmus Darwin.

Footnote 112:

  _The Nurse_: a Poem.

Footnote 113:

  _Advice to a Mother on the Management of her Children_; the ninth
  edition. By Pye Henry Chavasse F.R.C.S.

Footnote 114:

  From an admirable paper on _Health of Body and Mind_, in _Good Words_,
  Jan. 1st, 1866.

Footnote 115:

  _Good Words_, October, 1861.

Footnote 116:

  Wordsworth.

Footnote 117:

  Prior.

Footnote 118:

  Milton.

Footnote 119:

  Fenton.

Footnote 120:

  Burton.

Footnote 121:

  Carlyle’s _Inaugural Address_ at his installation as Rector of the
  University of Edinburgh.

Footnote 122:

  Either of which may be procured of any respectable
  surgical-instrument-maker.

Footnote 123:

  For much valuable information on this subject, see _A New and Rational
  Explanation of the Diseases peculiar to Infants and Mothers_. By
  Thomas Ballard, M.D.

Footnote 124:

  Two tablespoonfuls of olive oil, two tablespoonfuls of table salt, and
  a pint of warm oatmeal gruel.

Footnote 125:

  Dr. William Parr _On the Mortality of Children_.

Footnote 126:

  _Advice to a Mother on the Management of her Children_; the ninth
  edition. By Pye Henry Chavasse, F.R.C.S.

Footnote 127:

  _Advice to a Mother on the Management of her Children_ the ninth
  edition. By Pye Henry Chavasse, F.R.C.S.

Footnote 128:

  Pye Chavasse’s _Advice to a Mother_.

Footnote 129:

  _Romeo and Juliet._

Footnote 130:

  _Good Words_, Dr. W. Lindsay Alexander, March, 1861.

Footnote 131:

  _Woman’s Mission._

Footnote 132:

  Tupper.

Footnote 133:

  A nursery-basin (Wedgwood’s make is considered the best) holding
  either six or eight quarts of water, and which will be sufficiently
  large to hold the whole body of the child. The basin is generally
  fitted into a wooden frame, which will raise it to a convenient height
  for the washing of the baby.

Footnote 134:

  Sir Charles Locock strongly recommends that an infant should be washed
  _in a tub_ from the _very_ commencement. He says: “All those that I
  superintend _begin_ with a tub.”—_Letter to the Author._

Footnote 135:

  Mrs. Baines (who has written so much and so well on the Management of
  Children), in a _Letter_ to the Author, recommends flannel to be used
  in the _first_ washing of an infant, which flannel ought afterward to
  be burned; and that the sponge should be only used to complete the
  process, to clear off what the flannel had already loosened. She also
  recommends that every child should have his own sponge, each of which
  should have a particular distinguishing mark upon it, as she considers
  the promiscuous use of the same sponge to be a frequent cause of
  _ophthalmia_ (inflammation of the eyes). The sponges cannot be kept
  too clean.

Footnote 136:

  In one case related by Koop (_Journ. de Pharm._, xx. 603), a child was
  destroyed by it.

Footnote 137:

  2 Kings, v. 13, 14.

Footnote 138:

  Communicated by Sir Charles Locock to the Author.

Footnote 139:

  “The Princess of Wales might have been seen on Thursday taking an
  airing, in a brougham in Hyde Park, with her baby—the future King of
  England—on her lap, without a nurse, and accompanied only by Mrs.
  Bruce. The Princess seems a very pattern of mothers, and it is
  whispered among the ladies of the Court that every evening the mother
  of this young gentleman may be seen in a flannel dress, in order that
  she may properly wash and put on baby’s night-clothes and see him
  safely in bed. It is a pretty subject for a picture.”—_Pall Mall
  Gazette._

Footnote 140:

  Communicated by Sir Charles Locock to the Author.

Footnote 141:

  “Tous-les-mois” is the starch obtained from the tuberous roots of
  various species of _canna_; and is imported from the West Indies. It
  is very similar to arrow-root. I suppose it is called “tous-les-mois,”
  as it is good to be eaten all the year round.

Footnote 142:

  If there is any difficulty in obtaining _prepared_ oatmeal,
  Robertson’s Patent Groats will answer equally as well.

Footnote 143:

  _British Medical Journal_, Dec. 18, 1858.

Footnote 144:

  _The Cook’s Guide._ By C. E. Francatelli.

Footnote 145:

  I consider it to be of immense importance to the infant, that the milk
  be had from ONE cow. A writer in the _Medical Times and Gazette_,
  speaking on this subject, makes the following sensible remarks: “I do
  not know if a practice common among French ladies, when they do not
  nurse, has obtained the attention among ourselves which it seems to me
  to deserve. When the infant is to be fed with cow milk, that from
  various cows is submitted to examination by the medical man, and if
  possible, tried on some child, and when the milk of any cow has been
  chosen, no other milk is ever suffered to enter the child’s lips, for
  a French lady would as soon offer to her infant’s mouth the breasts of
  half a dozen wet-nurses in the day, as mix together the milk of
  various cows, which must differ even as the animals themselves, in its
  constituent qualities. Great attention is also paid to the pasture, or
  other food of the cow thus appropriated.”—_December 29, 1860._

Footnote 146:

  For further reasons why artificial food is not desirable at an early
  period of infancy, see answer to 35th question, p. 1043.

Footnote 147:

  _The Nurse_, a Poem. Translated from the Italian of Luigi Tansillo. By
  William Roscoe.

Footnote 148:

  Liebig, the great chemist, asserts that a small quantity of table salt
  to the food is essential to the health of children.

Footnote 149:

  It now and then happens that if the milk be not boiled, the motions of
  an infant are offensive; _when such is the case_ let the milk be
  boiled, but not otherwise.

Footnote 150:

  “It should be thin, and of a bluish-white color, sweet to the taste,
  and when allowed to stand should throw up a considerable quantity of
  cream.”—_Maunsell and Evenson on the Diseases of Children._

Footnote 151:

  Sir Charles Locock considers that a woman who menstruates during
  lactation is objectionable as a wet-nurse, and “that as a mother with
  her first child is more liable to that objection, that a second or
  third child’s mother is more eligible than a first.”—_Letter to the
  Author._

Footnote 152:

  “The child is poisoned.”

  “Poisoned! by whom?”

  “By you. You have been fretting.”

  “Nay, indeed, mother. How can I help fretting?”

  “Don’t tell me, Margaret. A nursing mother has no business to fret.
  She must turn her mind away from her grief to the comfort that lies in
  her lap. Know you not that the child pines if the mother vexes
  herself?”—_The Cloister and the Hearth._ By Charles Reade.

Footnote 153:

  The previous boiling of the milk will prevent the warmth of the bed
  turning the milk sour, which it would otherwise do.

Footnote 154:

  For the first three or four months never, if you can possibly avoid
  it, give artificial food to an infant who is sucking. There is
  nothing, in the generality of cases, that agrees, for the first few
  months, like the mother’s milk _alone_.

Footnote 155:

  Communicated by Sir Charles Locock to the author.

Footnote 156:

  Dendy. _Lancet_, October 25, 1851.

Footnote 157:

  Dr. George Gregory.

Footnote 158:

  Sir Charles Locock, in a _Letter_ to the Author.

Footnote 159:

  For the precautions to be used in putting a child into a warm bath,
  see the answer to question on “Warm Baths.”

Footnote 160:

  No family, where there are young children, should be without
  Fahrenheit’s thermometer.

Footnote 161:

  _Ingoldsby Legends._

Footnote 162:

  The young of animals seldom suffer from cutting their teeth—and what
  is the reason? Because they live in the open air and take plenty of
  exercise, while children are frequently cooped up in close rooms and
  are not allowed the free use of their limbs. The value of fresh air is
  well exemplified in the Registrar-General’s Report for 1843: he says
  that in 1,000,000 deaths from all diseases, 616 occur in the town from
  teething, while 120 only take place in the country from the same
  cause.

Footnote 163:

  See answer to Question 63.

Footnote 164:

  “‘Soothing Syrup.’ Some of them probably contain opiates, but a
  perfectly safe and useful one is a little nitrate of potassa in syrup
  of roses—one scruple to half an ounce.”—_Communicated by Sir Charles
  Locock to the Author._

Footnote 165:

  “I should put this in capitals, it is so important and so often
  mistaken.”—_C. Locock._

Footnote 166:

  I have somewhere read that if a cage, containing a canary, be
  suspended at night within a bed where a person is sleeping, and the
  curtains be drawn closely around, that the bird will, in the morning,
  in all probability be found dead!

Footnote 167:

  The _Nurse_, a Poem.

Footnote 168:

  It may be interesting to a mother to know the average weight of
  new-born infants. There is a paper on the subject in the _Medical
  Circular_ (April 10, 1861), and which has been abridged in
  _Braithwaite’s Retrospect of Medicine_ (July and December, 1861). The
  following are extracts: “Dr. E. von Siebold presents a table of the
  weights of 3000 infants (1586 male and 1414 female), weighed
  immediately after birth. From this table (for which we have not space)
  it results that by far the greater number of the children (2215)
  weighed between 6 and 8 lbs. From 5¾ to 6 lbs. the number rose from 99
  to 268; and from 8 to 8¼ lbs. they fell from 226 to 67, and never rose
  again at any weight to 100. From 8¾ to 9½ lbs. they sank from 61 to 8,
  rising, however, at 9½ lbs to 21. Only six weighed 10 lbs., one 10¾
  lbs., and two 11 lbs. The author has never but once met with a child
  weighing 11¾ lbs. The most frequent weight in the 3000 was 7 lbs.,
  numbering 426. It is a remarkable fact, that until the weight of 7
  lbs. the female infants exceeded the males in number, the latter
  thenceforward predominating.... From these statements, and those of
  various other authors here quoted, the conclusion may be drawn that
  the normal weight of a mature new-born infant is not less than 6 nor
  more than 8 lbs., the average weight being 6½ or 7 lbs., the smaller
  number referring to female and the higher to male infants.”

Footnote 169:

  _Hints on Household Management._ By Mrs. C. L. Balfour Partridge,
  London.

Footnote 170:

  In a _Letter_ to the Author.

Footnote 171:

  _Letter_ to the Author.

Footnote 172:

                  Take of—Tincture of aloes, half an ounce;
                          Soap liniment, one ounce:

    Make a liniment.

Footnote 173:

  Sir Charles Locock, in a _Letter_ to the Author.

Footnote 174:

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

    Make a Mixture. One or two teaspoonfuls (according to the age of the
      child) to be taken every four hours, until relief be
      obtained—first shaking the bottle.

Footnote 175:

  See Symptoms and Treatment of Dysentery.

Footnote 176:

  For a rhubarb and magnesia mixture prescription, see page 1099
  (_note_).

Footnote 177:

  Let the mixture be made by a chemist.

Footnote 178:

  Communicated by Sir Charles Locock to the Author.

Footnote 179:

  Let this mixture, or any other medicine I may prescribe, be always
  made by a respectable chemist.

Footnote 180:

  My friend, the late Dr. Baly, who had made dysentery his particular
  study, considered the combination of opium and castor oil very
  valuable in dysentery.

Footnote 181:

  See the Treatment of Dysentery.

Footnote 182:

  Tennyson.

Footnote 183:

  Sir Charles Locock, in a _Letter_ to the Author.

Footnote 184:

  See Infancy—Ablution, page 1016.

Footnote 185:

  _The Lancet_, April 25, 1857.

Footnote 186:

  _The Foot and its Covering._ By James Dowie. London, 1861.

Footnote 187:

  The Psalms of David, cxliv. 12.

Footnote 188:

  How is milk, in the making of cheese, converted into curds? By rennet.
  What is rennet? The juice of a calf’s maw or stomach. The moment the
  milk enters the human maw or stomach, the juice of the stomach
  converts it into curds—into solid food, just as readily as when it
  enters a calf’s maw or stomach, and much more readily than by rennet,
  as the _fresh_ juice is stronger than the _stale_. An ignorant mother
  often complains that because, when her child is sick, the milk
  curdles, that it is a proof that it does not agree with him! If, at
  those times, it did _not_ curdle, it would, indeed, prove that his
  stomach was in a wretchedly weak state; she would, then, have abundant
  cause to be anxious.

Footnote 189:

  _The Times_, September 19, 1864.

Footnote 190:

  The _Lancet_, December 18, 1858.

Footnote 191:

  Ibid.

Footnote 192:

  Although caraway seeds _whole_ are unwholesome, yet caraway-tea, made
  as recommended at page 1097, is an excellent remedy to disperse wind.

Footnote 193:

  _Christian’s Mistake._ By the author of “John Halifax Gentlemen.”

Footnote 194:

  “Pure air and water are practically the two great elements of
  health.”—_The Times._

Footnote 195:

  _The Times._

Footnote 196:

  “Two little girls died in London last week from sucking some lucifer
  matches.”—_The Birmingham Daily Gazette_, June 21, 1864.

Footnote 197:

  _The Times_, October 5, 1863.

Footnote 198:

  Shakspeare.

Footnote 199:

  _A Woman’s Thoughts about Women._

Footnote 200:

  _Tales of a Wayside Inn._ By Henry Wadsworth Longfellow.

Footnote 201:

  Douglas Jerrold

Footnote 202:

  Tennyson.

Footnote 203:

  Sir Walter Scott.

Footnote 204:

  “But we were gentle among you, even as a woman cherisheth her
  children.”—I. Thess. ii. 7.

Footnote 205:

  _Household Verses on Health and Happiness._ London: Jarrold & Sons. I
  should advise _every_ mother to purchase a copy of this delightful
  little book. Unlike a great deal of poetry, it is both useful and
  truthful.

Footnote 206:

  _Life’s Problems._ London: Bell & Dalby.

Footnote 207:

  _The Leadbeater Papers._ London: Bell & Dalby.

Footnote 208:

  Romans, xii. 10.

Footnote 209:

  _A Woman’s Thoughts about Women._

Footnote 210:

  _The Protoplast._

Footnote 211:

  Wordsworth.

Footnote 212:

  Goldsmith.

Footnote 213:

  From an excellent article _About Toys_, by J. Hamilton Fyfe, in _Good
  Words_ for December, 1862, which I should strongly advise a mother to
  read.

Footnote 214:

  _The Saturday Review_, December 13, 1862.

Footnote 215:

  “According to Aristotle, more care should be taken of the body than of
  the mind for the first seven years; strict attention to diet be
  enforced, etc.... The eye and ear of the child be most watchfully and
  severely guarded against contamination of every kind, and unrestrained
  communication with servants be strictly prevented. Even his amusements
  should be under due regulation, and rendered as interesting and
  intellectual as possible.”—The Rev. John Williams, in his _Life and
  Actions of Alexander the Great_.

Footnote 216:

  Tennyson.

Footnote 217:

  Sir Charles Locock in a _Letter_ to the Author.

Footnote 218:

  Geo. M’Donald, M.A.

Footnote 219:

  _Medical Times and Gazette._

Footnote 220:

  In case of a sudden attack of croup, _instantly_ give a teaspoonful of
  ipecacuanha wine, and repeat it every five minutes until free vomiting
  be excited.

Footnote 221:

  See “Warm baths”—directions and precautions to be observed.

Footnote 222:

  _Essays and Notes._ Churchill.

Footnote 223:

  If you put your finger into the mouth of a child laboring under
  inflammation of the lungs, it is like putting your finger into a hot
  apple-pie, the heat is _so_ great.

Footnote 224:

  See page 1210.

Footnote 225:

  _Diphtheria_: by Ernest Hart. A valuable pamphlet on the subject. Dr.
  Wade, of Birmingham, has also written an interesting and useful
  monograph on diphtheria. I am indebted to the above authors for much
  valuable information.

Footnote 226:

  “Now all my carefully conducted inquiries induce me to believe that
  the disease comes from drain-poison. All the cases into which I could
  fully inquire have brought conviction to my mind that there is a
  direct law of sequence in some peculiar conditions of atmosphere
  between diphtheria and bad drainage; and if this be proved by
  subsequent investigations, we may be able to prevent a disease which,
  in too many cases, our known remedies cannot cure.”—W. Carr, Esq.,
  Blackheath. _British Medical Journal_, Dec. 7, 1861.

Footnote 227:

  Let the infusion of roses be made merely with the rose-leaves and
  boiling water.

Footnote 228:

  See page 1221.

Footnote 229:

  See page 1210.

Footnote 230:

  _Edinburgh Medical Journal._

Footnote 231:

  On the 4th of March, 1856, I had the honor to read a _Paper on the
  Treatment of Scarlet Fever_ before the members of Queen’s College
  Medico-Chirurgical Society, Birmingham,—which _Paper_ was afterward
  published in the _Association Journal_ (March 15, 1856); and in
  Braithwaite’s _Retrospect of Medicine_ (January-June, 1856); and in
  Ranking’s _Half-Yearly Abstract of the Medical Sciences_
  (July-December, 1856); besides in other publications. Moreover, the
  _Paper_ was translated into German, and published in _Canstatt’s
  Jahresbericht_, iv. 456, 1859.

Footnote 232:

  In the _Times_ of September 4, 1863, is the following, copied from the
  _Bridgewater Mercury_:

  “GROSS SUPERSTITION.—In one of the streets of Taunton there resides a
  man and his wife who have the care of a child. This child was attacked
  with scarlatina, and to all appearance death was inevitable. A jury of
  matrons was, as it were, impaneled, and, to prevent the child ‘dying
  hard,’ all the doors in the house, all the drawers, all the boxes, all
  the cupboards were thrown wide open, the keys taken out, and the body
  of the child placed under a beam, whereby a sure, certain, and easy
  passage into eternity could be secured. Watchers held their vigils
  throughout the weary night, and in the morning the child, to the
  surprise of all, did not die, and is now gradually recovering.”

  These old women—this jury of matrons—stumbled on the right remedy,
  “all the doors in the house ... were thrown wide open,” and thus they
  thoroughly ventilated the apartment. What was the consequence? The
  child who, just before the opening of the doors, had all the
  appearances “that death was inevitable,” as soon as fresh air was let
  in, showed symptoms of recovery, “and in the morning the child, to the
  surprise of all, did not die, and is now gradually recovering.” There
  is nothing wonderful—there is nothing surprising to my mind—in all
  this. Ventilation—thorough ventilation—is the grand remedy for
  scarlatina! Oh, that there were in scarlet fever cases a good many
  such old women’s—such a “jury of matrons”—remedies! We should not then
  be horrified, as we now are, at the fearful records of death, which
  the Returns of the Registrar-General disclose!

Footnote 233:

  For the prescription of the acidulated infusion of roses with syrup,
  see page 1221.

Footnote 234:

  On the importance, the vital importance, of the wearing of flannel
  next to the skin, see Flannel Waistcoats.

Footnote 235:

  If any of my medical brethren should do me the honor to read these
  pages, let me entreat them to try my plan of treating scarlet fever,
  as my success has been great. I have given full and minute
  particulars, in order that they and mothers (if mothers cannot obtain
  medical advice) may give my plan a fair and impartial trial. My only
  stipulations are that they must _begin_ with my treatment, and _not
  mix_ any other with it, and carry out my plan to the very letter. I
  then, with God’s blessing, shall not fear the result; but shall
  rejoice that I have been of some little service in my generation.

Footnote 236:

  “It would be well if we were to use whitewash in many cases where
  great cleanness of surface cannot be obtained. We remove in this way,
  by an easy method, much of the dullness and still more of the
  unwholesomeness of dirt.”—Dr. Angus Smith, in _Good Words_, April,
  1861.

Footnote 237:

  _Quarterly Report of the Board of Health_ upon Sickness in the
  Metropolis.

Footnote 238:

  _Vesicles._ Small elevations of the cuticle, covering a fluid which is
  generally clear and colorless at first, but becomes afterward whitish
  and opaque, or pearly.—_Watson._

Footnote 239:

  See page 1221.

Footnote 240:

  For the prescription of the ipecacuanha wine mixture, see page 1210.

Footnote 241:

  For the treatment of bronchitis, see page 1214.

Footnote 242:

  The above extract from Tennyson is, in my humble opinion, one of the
  most beautiful pieces of poetry in the English language. It is a
  perfect gem, and a volume in itself, so truthful, so exquisite, so
  full of the most valuable reflections: for instance—(1) “The little
  rift within the lute,”—the little tubercle within the lung, “that
  by-and-by will make the music mute, and ever widening slowly silence
  all,” and the patient eventually dies of consumption. (2) The little
  rent—the little rift of a very minute vessel in the brain, produces an
  attack of apoplexy, and the patient dies. (3) Each and all of us, in
  one form or another, sooner or later will have “the little rift within
  the lute.” But why give more illustrations? a little reflection will
  bring numerous examples to my fair reader’s memory.

Footnote 243:

  Four poppy-heads and four ounces of chamomile blows to be boiled in
  four pints of water for half an hour, and then strained to make the
  decoction.

Footnote 244:

  Sir Charles Locock, in a _Letter_ to the Author.

Footnote 245:

  Infusion of senna may be procured of any respectable druggist. It will
  take about one or two tablespoonfuls, or even more, of the infusion
  (according to the age of the child and the obstinacy of the bowels),
  to act as an aperient. Of course you yourself will be able, from time
  to time, as the need arises, to add the milk and the sugar, and thus
  to make it palatable. It ought to be given warm, so as the more to
  resemble tea.

Footnote 246:

  _A Manual of Practical Therapeutics._ By Edward John Waring, F.R.C.S.
  London: John Churchill and Sons.

Footnote 247:

  One part of bran to three parts of flour, mixed together and made into
  bread.

Footnote 248:

  See page 1094.

Footnote 249:

  An enema apparatus is an important requisite in every nursery; it may
  be procured of any respectable surgical-instrument-maker. The
  india-rubber enema bottle is, for a child’s use, a great improvement
  on the old syringe, as it is not so likely to get out of order, and,
  moreover, is more easily used.

Footnote 250:

  _Blackwood_, December, 1861.

Footnote 251:

  If any of my medical brethren should perchance read these
  Conversations, I respectfully and earnestly recommend them to take
  more pains in making medicines for children pleasant and palatable. I
  am convinced that, in the generality of instances, provided a little
  more care and thought were bestowed on the subject, it may be done;
  and what an amount of both trouble and annoyance it would save! It is
  really painful to witness the struggles and cries of a child when
  _nauseous_ medicine is to be given; the passion and the excitement
  often do more harm than the medicine does good.

Footnote 252:

  George M‘Donald, M.A.

Footnote 253:

  Nurses at these times ought to wear slippers, and not shoes.

Footnote 254:

  _Household Verses on Health and Happiness._ London: Jarrold & Sons. A
  most delightful little volume.

Footnote 255:

  Which fine-tooth comb ought _not_ to be used at any other time except
  for the purpose of examination, as the constant use of a fine-tooth
  comb would scratch the scalp, and would encourage a quantity of scurf
  to accumulate.

Footnote 256:

  Where milk does not agree, it may generally be made to do so by the
  addition of one part of lime-water to seven parts of new milk.
  Moreover, the lime will be of service in hardening his bones; and in
  these cases, the bones require hardening.

Footnote 257:

  Which may be procured at any respectable india-rubber warehouse.

Footnote 258:

                Take of—Spirits of Turpentine, three drachms;
                        Camphorated Oil, nine drachms:

    Mix for a Liniment. For an adult, four drachms of the former, and
      eight of the latter, may be used. If the child be young, or if the
      skin be very tender, the camphorated oil may be used without the
      turpentine.

Footnote 259:

  Wilson, on _Healthy Skin_.

Footnote 260:

  _Rain_ water ought _always_ to be used in the washing of a child;
  pump-water is likely to chap the skin, and to make it both rough and
  irritable.

Footnote 261:

  Sometimes, if the child’s skin be very irritable, the glycerin
  requires diluting with water—say, two ounces of glycerin to be mixed
  in a bottle with four ounces of spring water—the bottle to be well
  shaken just before using it.

Footnote 262:

  One frequent, if not the most frequent, cause of tape-worm is the
  eating of pork, more especially if it be underdone. _Underdone_ pork
  is the most unwholesome food that can be eaten, and is the most
  frequent cause of tape-worm known. _Underdone_ beef also gives
  tape-worm; let the meat, therefore, be well and properly cooked. These
  facts ought to be borne in mind, as prevention is always better than
  cure.

Footnote 263:

  _The Grocer._

Footnote 264:

  Shakspeare.

Footnote 265:

  Tennyson.

Footnote 266:

  Every house where there are children ought to have one of these
  india-rubber hot water bottles. It may be procured at any respectable
  vulcanized india-rubber warehouse.

Footnote 267:

  South’s _Household Surgery_.

Footnote 268:

  “It has been computed that upwards of 1000 children are annually
  burned to death by accident in England.”

Footnote 269:

  The cotton wool here recommended is that purposely made for surgeons,
  and is of a superior quality to that in general use.

Footnote 270:

  If there be no other lard in the house but lard _with_ salt, the salt
  may be readily removed by washing the lard in cold water. Prepared
  lard—that is to say, lard _without_ salt—can, at any moment, be
  procured from the nearest druggist in the neighborhood.

Footnote 271:

  See the _Lancet_ for October 10th, 17th, and 24th, 1840.

Footnote 272:

  A stick of _pointed_ nitrate of silver, in a case, ready for use, may
  be procured of any respectable chemist.

Footnote 273:

  Which may be instantly procured of a druggist, as he always keeps it
  ready prepared.

Footnote 274:

  A Bee-master. _The Times_, July 28, 1864.

Footnote 275:

  Shaw’s _Medical Remembrancer_, by Hutchinson.

Footnote 276:

  A tepid bath from 62 to 96 degrees of Fahrenheit.

Footnote 277:

  A warm bath from 97 to 100 degrees of Fahrenheit.

Footnote 278:

  _Health._ By John Brown, M.D. Edinburgh: Alexander Strahan & Co.

Footnote 279:

  Several years ago, while prosecuting my anatomical studies in London
  University College Dissecting-rooms, on opening a young woman, I
  discovered an immense indentation of the liver large enough to admit a
  rolling-pin, entirely produced by tight lacing!

Footnote 280:

  Dryden.

Footnote 281:

  Sir W. Temple.

Footnote 282:

  Goldsmith’s _Essays_.

Footnote 283:

  _Geoffry Hamlyn._ By H. Kingsley.

Footnote 284:

  Proverbs, xx. 29.

Footnote 285:

  “I would have given him, Captain Fleming, had he been _my_ son,” quoth
  old Pearson the elder, “such a good sound drubbing as he never would
  have forgotten—never!”

  “Pooh! pooh! my good sir. Don’t tell me. Never saw flogging in the
  navy do good. Kept down brutes; never made a man yet.”—Dr. Norman
  Macleod in _Good Words_, May, 1861.

Footnote 286:

  _The Birmingham Journal._

Footnote 287:

  _A Woman’s Thoughts about Women._

Footnote 288:

  If a girl has an _abundance_ of good nourishment, the school-mistress
  must, of course, be remunerated for the necessary and costly expense;
  and how this can be done on the paltry sum charged at _cheap_
  boarding-schools? It is utterly impossible! The school-mistress will
  live, even if the girls be half-starved. And what are we to expect
  from poor and insufficient nourishment to a fast-growing girl, and at
  the time of life, remember, when she requires an _extra_ quantity of
  good sustaining, supporting food? A poor girl, from such treatment,
  becomes either consumptive or broken down in constitution, and from
  which she never recovers, but drags out a miserable existence. A
  _cheap_ boarding-school is _dear_ at any price.

Footnote 289:

  A horse-hair mattress should always be preferred to a feather bed. It
  is not only better for the health, but it improves the figure.

Footnote 290:

  _Spare Hours._ By John Brown, M.D., F.R.S.E.

Footnote 291:

  _Household Verses on Health and Happiness._ London: Jarrold and Sons.

Footnote 292:

  Hurdis’s _Village Curate_.

Footnote 293:

  Shakspeare.

Footnote 294:

  Todd’s _Student’s Guide_.

Footnote 295:

  Sir Astley Cooper’s _Lectures on Scrofula_.

Footnote 296:

  I. Chronicles, xxi. 13.

Footnote 297:

  A. K. H. B., _Fraser’s Magazine_, October, 1861.

Footnote 298:

  Shakspeare.

Footnote 299:

  _The Times_, May 16, 1867.

Footnote 300:

  _Winter in the South of Europe._ By J. Henry Bennett. Third Edition.
  London: Churchill and Sons, 1865.

Footnote 301:

  A wineglassful of barm, a wineglassful of vinegar, and the remaining
  sage tea, to make a half-pint bottle of gargle.

Footnote 302:

  December 10, 1864.

Footnote 303:

  Shakspeare knew the great importance of not crowding around a patient
  who has fainted. He says:

        “So play the foolish throngs with one that swoons;
        Come all to help him, and so stop the air
        By which he should revive.”
                            _Measure for Measure_, Act ii. sc. 4.

Footnote 304:

  For the best way of stewing prunes, see page 1258.

Footnote 305:

  Professor Trousseau in _Medical Circular_, Feb. 5, 1862.

Footnote 306:

  Exodus, v. 12.

Footnote 307:

  Wilson on _Healthy Skin_.

Footnote 308:

  Four poppy-heads and four ounces of chamomile blows to be boiled in
  four pints of water for half an hour, and then to be strained to make
  the fomentation.

Footnote 309:

  Cut a piece of bread, about the size of the little finger—without
  breaking it into crumb—pour boiling hot milk upon it, cover it over,
  and let it stand for five minutes, then apply the soaked bread over
  the gum-boil, letting it rest between the cheek and the gum.

Footnote 310:

  As long as fashion, instead of common sense, is followed in the making
  of both boots and shoes, men and women will as a matter of course
  suffer from corns.

  It has often struck me as singular, when all the professions and
  trades are so overstocked, that there should be, as there is in every
  large town, such a want of chiropodists (corn-cutters)—of respectable
  chiropodists—of men who would charge a _fixed_ sum for every visit the
  patient may make; for instance, to every working-man a shilling, and
  to every gentleman half a crown or five shillings for _each_ sitting,
  and not for _each_ corn (which latter system is a most unsatisfactory
  way of doing business). I am quite sure that if such a plan were
  adopted, every town of any size in the kingdom would employ regularly
  one chiropodist at least. However we might dislike some few of the
  American customs, we may copy them with advantage in this
  particular—namely, in having a regular staff of chiropodists both in
  civil and in military life.

Footnote 311:

  Youth—Ablution, page 1321.

Footnote 312:

  A very small quantity of pure nitric acid—just a drain at the bottom
  of a stoppered bottle—is all that is needed, and which may be procured
  of a chemist.

Footnote 313:

  _Dublin University Magazine._

Footnote 314:

  _The Round Table._

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                          TRANSCRIBER’S NOTES


 1. Silently corrected obvious typographical errors and variations in
      spelling.
 2. Retained archaic, non-standard, and uncertain spellings as printed.
 3. Reindexed footnotes using numbers and collected together at the end
      of the last chapter.
 4. Renumbered pages “Advice to a Mother” by adding 1000.
 5. Enclosed italics font in _underscores_.
 6. Enclosed blackletter font in =equals=.