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 degrees 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 he for human life. The valances and bed-curtains ought to be removed, and there should be as little furniture in the room as possible.
If it be a case of measles, it will be necessary to adopt a different course; then the windows ought not to be opened, but the door must from time to time be left ajar. In a case of measles, if it be winter time, a small fire in the room will be necessary. In inflammation of the lungs or of the chest, the windows should not be opened, but the door ought occasionally to be left unfastened, in order to change the air and to make it pure. Remember, then, that ventilation, either by open window or by open door, is in all diseases most necessary. 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 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 he 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 they only increase the flow of blood to the head, and consequently do harm.
It is often a good sign for a child, who is seriously ill, to suddenly become 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."—Geo. McDonald.
A sick child must not be stuffed with much food at a time. He will take either a table-spoonful of new milk or a table-spoonful of chicken broth every half hour with greater advantage than a tea-cupful 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 humour 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 he young, she is frequently thoughtless and noisy; therefore choose a middle-aged woman. Do not let there be in the sick-room more than, besides the mother, one efficient nurse; a greater number can he of no service—they will only be in each other's way, and will distract the patient.
Let stillness, especially if the head be the part affected, reign in a sick-room. Creaking shoes [Footnote: Nurses at these times ought to wear slippers, and not shoes. The best slippers in sick-rooms are those manufactured by the North British Rubber Company, Edinburgh; they enable nurses to walk in them about the room without causing the slightest noise; indeed, they might truly be called "the noiseless slipper," a great desideratum in such cases, more especially in all head affections of children. If the above slippers cannot readily be obtained, then list slippers—soles and all bring made of list—will answer the purpose equally as well.] 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 he enjoined, not even a whisper should be heard:—
"In the sick-room be calm,
More 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."
[Footnote: Household verses on Health and Happiness. London: Jarrold and Sons. A most delightful little volume.]
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 he express 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 bad 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 end either in life or death!
Lice.—It is not very poetical, as many of the grim facts of every-day 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 behoves a mother herself to thoroughly examine, by means of a fine-tooth comb, [Footnote: Which fine-tooth comb ought not to be used at any other time except for the purpose of examination, as the constant use of a fine-tooth comb would scratch the scalp, and would encourage a quantity of scurf to accumulate.] her child's head, in order to satisfy her mind that there be no vermin there. As soon as he be well enough, he ought to resume his regular ablutions—that is to say, that he must go again regularly into his tub, and have his head every morning thoroughly washed with soap and water. A mother ought to be particular in seeing that the nurse washes the 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 be already lice on the head, in addition to the regular washing every morning with the soap and water, and after the head has been thoroughly dried, let the hair be well and plentifully dressed with camphorated oil—the oil being allowed to remain on until the next washing on the following morning. Lice cannot live in oil (more especially if, as in camphorated oil, camphor be dissolved in it), and as the camphorated oil will not, in the slightest degree, injure the hair, it is the best application that can be used. But as soon as the vermin have disappeared, let the oil be discontinued, as the natural oil of the hair is, at other times, the only oil that is required on the head.
The "nit"—the egg of the louse—might be distinguished from scurf (although to the naked eye it is very much like it in appearance) by the former fastening firmly on one of the hairs as a barnacle would on a rock, and by it not being readily brushed off as scurf would, which latter (scurf) is always loose.
259. 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 either by Creosote or by oil of Turpentine: the places they do love to congregate in should be well saturated by means of a brush, with the creosote or with the oil of turpentine. A few dressings will effectually destroy both them and their young ones.
260. Is not the pulse a great sign either of health or of disease?
It is, and every mother should have a general idea of what the pulse of children of different ages should be both in health and in disease. "Every person should know how to ascertain the state of the pulse in health; then, by comparing it with what it is when he is ailing, he may have some idea of the urgency of his case. Parents should know the healthy pulse of each child, since now and then a person is born with a peculiarly slow or fast pulse, and the very case in hand may be of such peculiarity. An infant's pulse is 140, a child of seven about 80, and from 20 to 60 years it is 70 beats a minute, declining to 60 at fourscore. A healthful grown person beats 70 times in a minute, declining to 60 at fourscore. At 60, if the pulse always exceeds 70, there is a disease; the machine working itself out, there is a fever or inflammation somewhere, and the body is feeding on itself, as in consumption, when the pulse is quick."
261. 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, or Tidman's Sea 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 a previous question.
262. Then do you not advise such a child to be confined within doors?
If any inflammation be present, or if he have but just recovered from one, it would be improper to send him into the open air, but not otherwise, as the fresh air would be a likely means of strengthening the lungs, and thereby of preventing an attack of inflammation for the future. Besides, the more a child is coddled within doors, the more likely will he be to catch cold, and to renew the inflammation. If the weather be cold, yet neither wet nor damp, he ought to be sent out, but let him be well clothed; and the nurse should have strict injunctions not to stand about entries or in any draughts—indeed, not to stand about at all, but to keep walking about all the time she is in the open air. Unless you have a trustworthy nurse, it will be well for you either to accompany her in her walk with your child, or merely to allow her to walk with him in the garden, as you can then keep your eye upon both of them.
263. 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 is 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, [Footnote: 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.] and give him as much as he can eat of fresh meat every day. Cod liver oil, a tea-spoonful or a dessert-spoonful, according to his age, twice a day, is serviceable in these cases. Stimulants ought to be carefully avoided. In short, let every means be used to nourish, to strengthen, and invigorate the system, without, at the same time, creating fever. Such a child should be a child of nature, he ought almost to live in the open air, and throw his books to the winds. Of what use is learning without health? In such a case as this you cannot have both.
264. 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 backwards, and not forwards.
Let books be utterly discarded until his shoulders have become strong, and thus no longer round, and his shoulder-blades have become straight. It is a painful sight to see a child stoop like an old man.
Let him have, twice daily, a tea-spoonful or a dessert-spoonful (according to his age) of cod-liver oil, giving it him on a full and not on an empty stomach.
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.
265. 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.
266. If a child, while asleep, "wet his bed" is there any method of preventing him from doing so?
Let him be held out just before he himself goes to bed, and again when the family retires to rest. If, at the time, he be asleep, he will become so accustomed to it, that he will, without awaking, make water. He ought to be made to lie on his side; for, if he be put on his back, the urine will rest upon an irritable part of the bladder, and, if he be inclined to wet his bed, he will not be able to avoid doing so. He must not be allowed to drink much with his meals, especially with his supper. Wetting the bed is an infirmity with some children—they cannot help it. It is, therefore, cruel to scold and chastise them for it. Occasionally, however, wetting the bed arises from idleness; in which case, of course, a little wholesome correction might be necessary.
Water-proof Bed-sheeting—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 a 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 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 ask 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!
267. 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 he fastened round the wrists. The nails must be cut very close.
Cream smeared, by means of a feather, frequently in the day, on the pustules, affords great comfort and benefit. Tripe liquor (without salt) 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.
268. Can you, tell me of any plan to prevent Chilblaine, 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 has 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-hail flesh-gloves, the best means of preventing them.
Secondly, the way to cure them.—If they be unbroken: the old-fashioned remedy of onion and salt is one of the best of remedies. Cut an onion in two; take one-half of it, dip it in table salt and well rub, for two or three minutes, the chilblain with it. The onion and salt is a famous remedy to relieve that intolerable itching which sometimes accompanies chilblains: then let them be covered with a piece of lint, over which a piece of wash-leather should be placed.
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.
269. During the winter time my child's hands, legs, &c., chap very much; what ought I to do?
Let a tea-cupful of bran be tied up in a muslin bag, and be put, over the night, into either a large water-can or jug of rain water; [Footnote: 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.] and let this water from the can or jug be the water he is to be washed with on the following morning, and every morning until the chaps be cured. As often as water is withdrawn, either from the water-can or from the jog, 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 bed-time, 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 glycerine, [Footnote: Glycerine prepared by Price's Patent Candle Company is by far the best. Sometimes, if the child's skin be very irritable, the glycerine requires diluting with water—say, two ounces of glycerine to be mixed in a bottle with four ounces of rain water—the bottle to be well shaken just before using it.] 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 glycerine with rose-water; fill a small bottle one-third with glycerine, and fill up the remaining two-thuds 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 glycerine soap: no other being required.
270. What is the best remedy for Chapped Lips?
Cold-cream (which may be procured of any respectable chemist) is an excellent application for chapped lips. It ought, by means of the finger, to be frequently smeared on the parts affected.
271. 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.
272. 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; [Footnote: 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 he 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.] an abundance of sweets; the neglecting of giving salt in the food.
273. What are the symptoms and the treatment of Worms?
The symptoms of worms are—emaciation; itching and picking of the nose; a dark mark under the eyes; grating, during sleep, of the teeth; starting in the sleep; foul breath; furred tongue; uncertain appetite—sometimes voracious, at other times bad, the little patient sitting down very hungry to his dinner, and before scarcely tasting a mouthful, the appetite vanishing; large bowels; colicky pains of the bowels; slimy motions; itching of the fundament. Tape-worm and round-worm, more especially the former, are apt, in children, to produce convulsions. Tape-worm is very weakening to the constitution, and usually causes great emaciation and general ill-health; the sooner, therefore, it is expelled from the bowels the better it will be for the patient.
Many of the obscure diseases of children arise from worms. In all doubtful cases, therefore, this fact should be borne in mind, in order that a thorough investigation may be instituted.
With regard to treatment, a medical man ought, of course, to be consulted. He will soon use means both to dislodge them, and to prevent a future recurrence of them.
Let me caution a mother never to give her child patent medicines for the destruction of worms. There is one favourite 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 tune, injuring health or constitution!
274. How may worms be prevented from infesting a child's bowels?
Worms generally infest weak bowels; hence, the moment a child becomes strong worms cease to exist. The reason why a child is so subject to them is owing to the improper food which is usually given to him. When he be stuffed with unsound and with unripe fruits, with much sweets, with rich puddings, and with pastry, and when he is oftentimes allowed to eat his meat without salt, and to bolt his food without chewing it, is there any wonder that he should suffer from worms? The way to prevent them is to avoid such things, and, at the same time, to give him plenty of salt to his fresh and well-cooked meat. Salt strengthens and assists digestion, and is absolutely necessary to the human economy. Salt is emphatically a worm destroyer. The truth of this statement may be readily tested by sprinkling a little salt on the common 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."—The Grocer. 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. All food, then, should be "flavoured with salt;" flavoured, that is to say, salt should be used in each and every kind of food—not in excess, but in moderation.
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.