CHILDHOOD. (continued 3)

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?

208The 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 209be 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 (See question 209), 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, 210either 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 centre, 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 centre, 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 211weeks—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 212harder 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, a teaspoonful three times a day. (For the prescription of the ipecacuanha wine mixture, see question 202.) 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. (For the treatment of bronchitis, see question 205.)

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:

213Take 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 214flannel 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 grey 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, gasladen 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 215with 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.”

The above extract from Tennyson is, in my humble opinion, one of the most beautiful pieces of poetry in the 216English 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.

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 217another, 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; and apply, every night, a barm and oatmeal poultice to the swollen gland or glands. 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. 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 218course, 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 purpose; 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.

219Screaming from earache may be distinguished from the screaming from bowel-ache 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 (bowel-ache), 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 (bowel-ache), 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 220subject 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 eye-lid?

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 221morning, 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.” (Sir Charles Locock, in a Letter to the Author.) 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, adding milk, and drinking as ordinary tea, which, when thus prepared, it much resembles.” 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. 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 222jalap 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 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. One part of bran to three parts of flour, mixed together and made into bread. 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 223tablespoonfuls 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 is a good one for the purpose. (See question 95.) Let the bowels be well rubbed every night and morning, for five minutes at a time, with the liniment.

224A 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 225he 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 226downright 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. 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.

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 227would be advisable to give, by the mouth, raw beef of the finest quality, which ought to be taken from the hipbone, 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.” 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:

228“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 229dessertspoon, 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.

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.

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; 230therefore, 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 231opened, 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 moment’s 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 232they 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.”

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 women. Do not let there be in the sick-room more than, besides the mother, one efficient nurse; a great number can be of no 233service—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. Nurses at these times ought to wear slippers, and not shoes. Creaking shoes 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.”

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 234he 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, her child’s head, in order to satisfy her mind that there be no vermin there. A 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. 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 hair brush 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 235be 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, 236with 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 237will 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, and give him as much as he can eat of fresh meat every day. 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. 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 238what 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 239have 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 240urine 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 water-proof cloth, 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 water-proof 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.

241Cream 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, 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.

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.

“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. 242With this the chilblains should be rubbed gently whenever they are in a state of irritation, and until the swelling and redness are dissipated.”

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; 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. 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. 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, 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 rose-water: fill a small bottle one-third with glycerin, and fill up the remaining two-thirds of the bottle with rose-water—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?

243Cold-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; an abundance of sweets; the neglecting of giving salt in the food. 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.

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 244a 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 245prevent 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 earth-worm. “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.” 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 246generally 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.

247Genuine 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 248potatoes, 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 249lump 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 grey 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.

250Symptoms.—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 scull-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,” 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 251consult 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, 252attention 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; smoothe, 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.”

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 253make 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 254bath, 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, half filled with hot water—it need not be boiling—applied to the stomach or to the bowels will afford great comfort. Every house where there are children ought to have one of these india-rubber hot water bottles. It may be procured at any respectable 255vulcanized india-rubber warehouse. 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 here 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 256coarsely 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.”

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 257apply 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: