PART II. (continued 4)

275. You have a great objection to the frequent administration of aperient medicines to a child: can you advise 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 Huntley and Palmer's loaf ginger-bread, 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.

276. 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, discoloured, 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 humpbacked 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 preventatives, 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!"

277. 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 puddings, bread and milk, etc.

To harden the bones, let lime water be added to the milk (a table-spoonful to each tea-cupful 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 tea-spoonful of wine of iron into a wine-glass, half fill the glass with water, sweeten it with a lump or two of sugar, then let a tea-spoonful 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.

278. 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 grey-powder.

279. 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 odour, and which is sometimes so large on the head as actually to form a skullcap, 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 the 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 humour, 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," 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 humour out, while some wiseacres are doing all they can to drive the humour 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 have 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.

280. Have you any advice to give me as to my conduct towards 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 colour, 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."—Tennyson.

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,

"A little fire is quietly trodden out, Which, being sufier'd, rivers cannot quench."

Shakespeare.

WARM BATHS

281. 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.

282. Will you mention the precautions, and the rules to be observed in gutting a child info 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.

283. 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 over the fire, 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-robber hot-water bottle, [Footnote: Every house where there are children ought to have one of these India-rubber hot-water bottles. It may be procured at any respectable Vulcanised India-rubber warehouse.] 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 the consistence of a nice soft poultice, then put 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 in 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 bed-time, 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 beneficial.

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, whilst a greasy poultice will be moist, but not wet."—South's Household Surgery.

ACCIDENTS.

284. 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.

285. 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 put 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.

286. 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 meantime, 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 round 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 from the arm-venesection; if you do, he will probably never rally, but will most likely "sleep the sleep that knows not breaking."

287. 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.

288. 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 mantel-piece. Many liniments contain large quantities of opium, a tea-spoonful 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 have swallowed a portion of a liniment containing opium, instantly send for a medical man. In the meantime force a strong mustard emetic (composed of two tea-spoonfuls of flour of mustard, mixed in half a tea-cupful of warm water) down his throat. Encourage the vomiting by afterwards forcing him to swallow warm water. Tickle the throat either with your finger or with a feather. Souse him alternately in 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 have swallowed "hartshorn and oil," force him to drink vinegar and water, lemon-juice and water sweetened with sugar, 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.

289. 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 have 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.

290. If a child's clothes take fire, what ought to be done to extinguished 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 woollen, 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 persist, 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 woollen or of stuff materials. The dreadful deaths from burning, which so often occur in winter, too frequently arise from cotton pinafores first taking fire. [Footnote: It has been computed that upwards of 1000 children are annually burned to death by accident in England.]

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.

Tangstate 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.

291. 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, the greater the danger.

Scalds both of the mouth and 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!

292. 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 bums and scalds cured by the above simple plan. Another excellent remedy is, cottonwool of superior quality, purposely made for surgeons. 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. 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 [Footnote: 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 neighbourhood]—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 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 Pare, "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."

It is nature, and not the surgeon, that really cures the wound, and it is done, like all Nature's works, principally in secret, by degrees, and by patience, and resents much interference. The seldom-dressing of a wound and patience are, then, two of the best remedies for effecting a cure. Shakspeare, who seemed to know surgery, as he did almost everything else beside was quite cognisant of the fact:—

"How poor are they, that have not patience What wound did ever heal, but by degrees"

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.

293. If a bit of quick-lime 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 eye-lashes; 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 neutralise the lime, and will rob it of its burning properties.

Having bathed the eye with 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 arrive.

If the above rules be not promptly and properly followed out, the child may irreparably lose his eyesight; hence the necessity of conversations 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.

294. If any other foreign substance should enter the eye, what is the best method of removing it?

If there be grit, or sand, or dust, or particle of coal, or gnat, or a hair, or an eye-lash in the eye, it ought to be tenderly removed by a small tightly-folded paper spill, holding down the lower lid with the fore-finger of the left hand the while; and the eye, if inflamed, should be frequently bathed with warm milk and water; but generally as soon as the cause is removed the effect will cease, and after treatment will be unnecessary.

If a particle of metal be sticking on the cornea of the eye, as it sometimes does, it will require the skilled hand of a surgeon to remove it.

Any foreign substance, however minute, in the eye, is very painful; but a piece of burning lime is excruciating. Shakspeare gives a graphic description of the pain from the presence of any foreign substance, however small, in the eye:—

"Oh heaven!—that there were but a mote in yours, A grain, a dust, a gnat, a wand'ring hair, Any annoyance in that precious sense! Then, feeling what small things are boist'rous there, Your vile intent must needs seem horrible."

295. What ought to be done in a case of choking?

How often does a hungry little child, if not carefully watched, fill his mouth so full, and swallow lumps of food in such hot haste, as to choke himself—

"With eager feeding, food doth choke the feeder"

Shakespeare.

Treatment.-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, endeavour 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 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 parieties [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 ensure immediate vomiting, and the subsequent ejection of the offending substance.

296. 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 or 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. [Footnote: A stick of pointed nitrate of silver, in a case, ready for use, may be procured of any respectable chemist.] 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 neutralise 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 forty 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 labouring 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 of 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 well 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.

Hydrophobia was by our forefathers graphically called water-fright: it was well named, for the horror of swallowing water is, by an hydrophobic patient, most intense, and is the leading symptom of this fell and incurable disease.

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 camomile and poppy-head fomentation.

Scratches of a cat are best treated by smearing, and that freely and continuously for an hour, and then afterwards 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.

297. What are the best remedies in ease of a sting from either a bee or a wasp?

Extract the sting, if it have been left behind, either by means of the pair of dressing forceps, or by the pressure of the hollow of a small key—a watch-key will answer the purpose; then, the blue-bag (which is used in washing) moistened with water, should be applied to the part; or a few drops of solution of potash, [Footnote: Which may be instantly procured of a druggist.] or "apply moist snuff or tobacco, rubbing it well in," [Footnote: A Bee-master. The Times, July 28,1864.] 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, foment the part with hot water, and then apply hot bread poultice, and renew it frequently. In eating apricots, or peaches, or other fruit, they ought beforehand to 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.

298. 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.

299. 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 tea-spoonfuls of flour of mustard in half a tea-cupful 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 the 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, pat his hair, tickle his nostrils, shout and holler 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 those things, of course, you ought to lose no time in sending for a medical man.

300. Have you any observation to make on parent's allowing the Deadly Nightshade (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.

301. 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 tea-cupful 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 has 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.

302. 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 further 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.

303. 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 the 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 further 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.

304. 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 tea-spoon, 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.

305. 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 spiculae 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."—Shaw's Medical Remembrancer, by Hutchinson.

306. 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.

307. 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 pennypiece, and pass it in his stool.

308. 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 downwards; 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.

309. How can a mother prevent her child from having an accident?

By strict supervision over frim on her own part, and by not permitting her child to be left to the tender mercies of servants; by not allowing him to play with fire, to swing over banisters, and to have knives and playthings of a dangerous character; to keep all poisonous articles and cutting instruments out of his reach; and, above all and before all, insisting, lovingly, affectionately, but firmly, upon implicit obedience.

Accidents generally arise from one of three causes, namely, either from wilful disobedience, or from gross carelessness, or from downright folly. I quite agree with Davenant, that they do not arise from chance—

"If we consider accident, And how, repugnant unto sense, It pays desert with bad event, We shall disparage Providence."