The Mother and Her Child

While tuberculosis is known as the "great white plague," syphilis and gonorrhea constitute the "great black plague," which seen in the little folks is pitiable indeed, leading us to realize that surely "the children's teeth have been set on edge" because of the careless eating of sour grapes by the parents. Syphilitic parents who have not been properly treated, should think many times before they take upon themselves the awful responsibility of bringing into the world a tainted child. Proper mercurial treatment should be instituted at once not only for the child but also in the case of both parents.

In this chapter we wish to instruct the mother or the caretaker in doing the one thing needful for every one of the more common household accidents and emergencies while waiting for the doctor.

In every household there should be found an accident and emergency "kit" of necessary paraphernalia for the quick application of the one necessary medicine, dressing, etc. This "kit" should contain baking soda for burns, bandages and sterile gauze for cuts or tears, together with adhesive plaster, needle and thread, etc.

INSECT BITES AND STINGS

Far greater harm is often done the skin by the subsequent scratching of the insect bite with dirty finger nails than by the bite itself; and so it is very important that we remember to allay quickly the intense itching by the application of ammonia, water or camphor. Almost instantly the itching is stopped, and the added "scratching" irritation to the already injured skin is thus avoided.

By the aid of a magnifying glass, and often by the naked eye, we may detect the stinger which has been left behind by the greedy guest, and which should be removed by a pair of tweezers. Ice-water compresses will stop the swelling and even an old-fashioned mud dressing, which was used and appreciated by our great grandmothers, is a thing not to be despised.

If the much admired shrubbery be removed one hundred feet away from the porch, mosquitoes would trouble the household less. It has been demonstrated in many localities that clearing away the near-by clumps of shrubbery permits the family to sit on unscreened porches unharmed. Mosquitoes multiply rapidly in stagnant pools of water, but if oil is poured over these stagnant waters the increase of mosquitoes is abated, and their total extinction is not unheard of in swampy districts receiving such care.

Whenever baby is out of doors where mosquitoes, flies, or other insects are to be found, he should be properly protected from such pests by mosquito netting stretched over a frame eighteen inches above his face, for we can think of nothing more uncomfortable than a mosquito netting dragging over a sweaty baby's face. The fact that mosquitoes, flies, roaches, and other insects are carriers of tuberculosis, infantile paralysis, typhoid fever, cholera, yellow fever and malaria, as well as a host of minor ailments, should make us the more anxious for either their extermination or the protection of our children from their greedy bites and stings.

DOG BITES AND SNAKE BITES

Dogs, cats, rats, or mice bite at any time of the year, and provision should always be made for ample protection against such accidents.

Such a wound should always be squeezed or sucked until it has bled freely, and then be cauterized by a red-hot iron or touched with an applicator that has been dipped in sulphuric acid or nitric acid. A subsequent dressing of Balsam Peru is healing. The dog should be watched, and if it shows signs of hydrophobia the bitten child should be promptly taken to the nearest Pasteur Institute for treatment.

In the case of snake bites the same sucking and cauterizing treatment is indicated, with the additional tying of a handkerchief or cord a few inches above the wound to stay the progress of the blood and to keep the poison out of the general circulation. A solution of twenty-per-cent permanganate of potash should be used to wash the wound.

The popular administration of large draughts of whiskey is of no benefit, for the secondary depressant effect of alcohol increases the body's poison burden, and those who survive do so in spite of the whiskey, and not because of it.

SWALLOWING FOREIGN BODIES

Small articles such as buttons, safety pins, thimbles, coins, etc., are often swallowed by little folks, and if they lodge in the throat and the child struggles for his breath the treatment is as follows: grasp him by the heels and turn him upside down while a helper briskly slaps him on the back. The foreign body generally flies across the room. If it is lodged high up in the throat it may often be dislodged by the thumb and finger. If it cannot be reached and it will not go down, lose no time in seeking an X-ray laboratory where its exact location may quickly be discovered and proper measures instituted for its removal.

A troublesome fish bone is easily dislodged by swallowing a half-chewed piece of bread which carries it down to the stomach. Cathartics and purgatives are not to be given; in due time the object will appear in the stool. In all instances it is well to locate its exact position by the X ray—that there may be assurance that it will do no harm.

It is surprising what large objects can be swallowed. One old gentleman swallowed his false teeth, and a six months old baby swallowed, or at least had lodged in its throat, a silver dollar.

All detachable parts should be removed from toys that are given to babies, such as the whistle from rubber animals, the button eyes of wool kittens and dogs, and other such removable parts.

FOREIGN BODIES IN THE EYE

To begin with, do not get "panicky," but carefully, painstakingly, and patiently do the following:

1. Rub the well eye until the tears flow plentifully in both eyes.

2. Blow the nose on the injured eye side, closing the other side. This often encourages the tears to wash the foreign speck down through the tear duct, into the nose and out into the handkerchief (in case the child is old enough to follow such instruction). If the foreign body be sharp, as a piece of steel or flint is likely to be, it may be driven right into the eyeball. Seek a physician who will drop medicine into the eye to deaden the pain and then if it cannot be gently rubbed off the eyeball, a magnet will promptly remove it.

An eye bath of warm boracic acid is always comforting and never does harm, so that may be given while waiting for the doctor to come, if the object seems to be beyond the reach of family help.

If an alkaline, such as lime, be blown into the eye it is very painful, but much relief may be obtained by gently pouring into the eye, by means of a medicine dropper or eye cup, warm water to which has been added a little vinegar or lemon juice. Likewise, acid in the eye produces much pain. In this instance, an eye bath of a weak soda solution is indicated.

FOREIGN BODIES IN EAR AND NOSE

Insects that have crawled into the ear may be suffocated by dropping sweet oil or castor oil into the ear, which, after twenty minutes, should be washed out by gentle syringing with warm water from a fountain syringe, hung one foot above the child's head.

Peas, beans, shoe buttons, or beads are sometimes put into the ear and nose by adventurous or experimenting children.

The shoe button or bead will not swell as does the pea or the bean, and may often be safely washed out. If it is causing no pain and will not drop out in case of the ear, or will not be easily blown out in case of the nose, see your physician at once. He has in his possession just the necessary instruments for its immediate removal.

Peas and beans swell, and consequently cause greater discomfort the longer they are in; do not poke at any foreign body lodged either in the nose or the ear, for the ear drum may thus be injured, while in the former case it may be pushed into one of the accessory sinuses.

EARACHE

One of the most comforting and highly effectual forms of heat for an aching ear is a four-candle-power carbon electric light on an extension cord that permits the light to come in close contact with the ear. A shade is made from a piece of stiff letter paper that fits the socket snugly and flares out to a three inch opening, which should extend below the point of the bulb one inch. This shade holds all the heat and light and directs it into the aching ear.

In every well-ordered household there will be found a three-per-cent solution of carbolic acid and glycerine of which one drop should be put into the aching ear, and then the external heat, mentioned above, should be applied. A bag of warm salt, a hot water bag, or a warm plate will provide external heat if an electric light is not available. Do not put laudanum or other remedies into the ear, other than are herein suggested, without your physician's knowledge.

Earache is always serious, and since it is usually indicative of trouble which, if left untreated, may cause deafness, it demands thorough treatment from skilled hands.

Running ears invariably need medical attention and should never be neglected.

NOSEBLEED

If the nose bleeds whenever it is cleansed, more than likely there is an ulcer on the septum which will continue to bleed if left untreated. The physician should heal the ulcer, and the child should be taught always to vaseline the nostril before cleansing it.

In case of persistent nosebleed, put the child to bed with the head elevated. Pressure should be put on the blood vessels going to the nose by placing two fingers firmly on the outer angles of the nose on the upper lip, while a helper may put firm pressure at the root of the nose at the inner angle of each eye. An ice bag may be placed at the back of the neck, and another piece of ice held on the forehead at the root of the nose. If these measures do not stop the flow of blood a few drops of adrenalin may be put into the nose and repeated in five minutes if necessary. As the bleeding begins to stop, as well as during the bleeding, all blowing of the nose is forbidden as it will only cause the bleeding to start afresh. It sometimes helps to hold a piece of ice in the hands.

CUTS AND TEARS

A cut with smooth edges, if deep, should be allowed to bleed freely, should be washed in boracic acid solution, and its edges held together by a stitch which is usually put in by a physician; but if treatment is to be given at home, the hands of the nurse must be thoroughly washed and the thread and needle boiled for twenty minutes. If the physician has been sent for, make firm pressure over the wound by bandaging tightly with a dressing of sterile gauze dipped in boracic acid solution.

In case of a slight cut, make it bleed freely, then wash in boracic-acid solution and apply sterile gauze held in place by a binder. If no odor or pain follows, let alone for two or three days, when a new dressing is applied.

A physician should be called in case of ragged wounds or tears, as such usually leave bad scars. Cleanse carefully, leaving no dirt in the wound, cause it to bleed, if possible, and apply a sterile gauze compress wet in boracic-acid solution, bandaged on as directed above. Zinc ointment may be applied to surfaces that have been skinned. All dressings on dirty wounds should be changed daily.

Blood poisoning may readily follow a wound, hence the utmost cleanliness should prevail. The hands of the attendant, the dressings, the surrounding skin, must all be clean. The bowels should be kept open, and under-feeding rather than over-feeding is indicated.

If a needle be needed to open a sore or boil, always disinfect the part and surrounding area by painting with tincture of iodine, and heat the needle to red heat through a flame before it touches the sore.

In case of cuts or wounds of the eyeball apply a compress of sterile gauze wet in boracic acid, held on by a bandage, and go immediately to a good eye specialist.

PUNCTURED WOUNDS AND SLIVERS

Wounds made by pins, needles, fishhooks, tacks, and splinters are always very painful and great care must be exercised to force bleeding freely, which helps to wash out infection, as more than likely microbes entered with the instrument or sliver when the wound was made.

Fishhooks are exceedingly troublesome, as they often occasion the enlarging of the wound to get them out, especially if they have gone in beyond the barb.

Slivers are easily broken off, so great care is needed in their removal. A pair of tweezers is convenient for seizing the protruding portion, while all side movements are avoided lest it break off in the flesh, in which case it may be gotten out with a needle that has been sterilized in a flame.

All puncture wounds should be dressed with the wet, sterile compress, covered over with wax paper and bandaged loosely; this encourages cleanliness and favors healing.

BRUISES

If left untreated, bruises swell, become highly discolored, and in the process of healing pass through the dark blue, green, and yellow stages. The treatment is as follows: Apply hot and cold alternately—the heat should be as hot as can be borne and left on very hot for three minutes, then ice water compresses should be applied for one minute, then hot again—these changes should continue for an hour, and if carried out immediately after the injury all discolorations and most of the swelling may be avoided. Witch-hazel compresses are comforting. If discoloration has taken place, the application of hot compresses will often hasten its disappearance.

FRACTURES AND DISLOCATIONS

While there is very little a member of the family or a non-medical friend can do in case of a fracture, and while it is unwise to offer suggestions relative to the setting of bones, yet it is highly important that both the family and friends know how properly to support a broken leg while carrying a disabled person into the house or to near-by medical aid.

For instance, in the case of a fractured leg below the knee, if a couple of flat boards three inches wide be tied about the leg with two pocket handkerchiefs, the ends of the fractured bone will not rub against each other and the pain will be much less in carrying. In this way all danger of causing the broken bones to protrude and thus "compounding" the fracture is also avoided. And also, if there is no near-by ambulance, a good emergency stretcher may be improvised out of two or three buttoned vests with two poles, rakes, or brooms run through the armholes—one vest under the shoulders and one under the hips and still another under the fracture. An injured person may in this way be carried for miles quite comfortably.

Two people may fashion a seat out of their four hands on which the disabled child may sit with his arms about the necks of his two friends. If the fractured end of the bone penetrates the flesh it is then known as a compound fracture and the utmost cleanliness must prevail—as in dressing other wounds. An X ray laboratory should always be sought, where convenient, to ascertain if the ends of the bones are in good position.

In dislocations, the bone has slipped out of place at the joint. Medical aid should be called to replace the bone, while hot applications may be used in the meantime.

SPRAINS

All sprains (a twist or straining of a joint) should promptly be put into a very hot bath and held there for thirty minutes. If this is impossible, then a rubber tube or a handkerchief is tied snugly between the sprain and the trunk of the body. Almost instantly the pain, which is often intense and severe, is very much lessened. The hot-water bath is very hot, and the joint should be very red on taking it out. Immediately following the bath the injured joint is wrapped in a very cold wet compress, which is next completely covered by silk, gutta-percha, mackintosh, or many thicknesses of newspaper—anything that will hold all the heat in—as the cold compress is quickly heated up. Lastly, a bandage of heavy flannel completely covers the whole—compress, impervious covering, etc.

The joint is now elevated for three hours, when it is again immersed in a very hot bath and then again the cold compress is applied. This is continued every three hours, except during sleep, for two days, after which it may be done morning and evening. Massage is now administered every three hours, first four inches below the injury then four inches above it, while in a day or so the joint itself may be gently rubbed with well-oiled hands. By the end of one week the patient begins to use the injured member.

In the case of a sprained ankle a properly applied adhesive strap bandage will give no end of relief and support. Various liniments may be applied, but usually the good obtained is from the thorough rubbing which always accompanies their use according to directions.

Sprains treated as above directed will often liberate the child in one-third the usual time generally allotted for its healing.

FROST BITES AND CHILBLAINS

Keep the child who has frozen some part of his body in a cool room, and rub the frost-bitten part with snow or ice water, or wrap it up in cold water compresses.

The return to heat must be slow indeed, else much pain may be experienced; blisters followed by discoloration, and even mortification, may set in. You may be surprised some morning on awakening to find your child's hand twice its normal size and very red, because it was out from under the cover a good share of the night exposed to Jack Frost. Do not bring it to heat quickly but immerse it in cold water, gradually and slowly raising the temperature of the bath until it is warm and comfortable.

The intense itching and burning of a chilblain may often be relieved by painting with iodine or triple chloride of iron (Monsel's solution). Soap liniment has also been suggested, as well as alternate applications of hot and cold water. Chilblains are troublesome, painful, and their yearly recurrence is often very annoying.

SWALLOWING POISONS

Poisons of an acid nature, such as hydrochloric, sulphuric, nitric, or oxalic acids, are neutralized by alkalines, such as magnesia, chalk, soda, and soap, followed by soothing drinks or sweet oil.

Remember that carbolic acid is not an acid, and is not antidoted with alkalines. The swallowing of carbolic acid should be quickly followed by diluted alcohol, and if this drug is not ready at hand many of the numerous alcoholic patent medicines will do just as well. Epsom salts should be given in abundance.

Poisons of an alkaline nature, such as lye, washing soda, ammonia, etc., are antidoted with vinegar or lemon juice, followed by soothing drinks or sweet oil.

A complete table of poisons and their antidotes will be found in the appendix.

Poison ivy, as soon as detected, should be treated as follows: Thoroughly scrub the affected part with tincture of green soap and hot water, which often prevents the trouble developing. Clean pieces of gauze may be wrung out of lime water and placed over the inflamed and much swollen surface, keeping them very wet. At night an ointment of zinc oxide may be applied over a painting of "black wash" (to be obtained at drug stores). Poison (trifoliolate, or three-leaved) ivy resembles Virginia Creeper, and all nurses and caretakers should be able to recognize it.

Another treatment for poison ivy which is said to be very efficient is as follows: Moisten a bit of cotton with a ten-percent solution of carbolic acid and apply to the affected area—then immediately (about one-half minute) wipe off this carbolic acid with another piece of cotton saturated with alcohol.

Matches, roach powders, fly poisons, washing fluids, lye, paris green, antiseptic tablets, and pieces of green paper, should all be kept out of the child's reach; and, in case of accidental swallowing of any of them, the physician should be sent for at once, and with the message "Come!" should be given the name of the poison swallowed—if it is known.

After the antidote is given, soothing drinks are usually administered, such as raw white of egg, milk, flaxseed tea, slippery elm, etc.

Complete rest in bed is always essential, and external heat is necessary for the body chills easily as the child grows weak.

Toothache may be temporarily relieved by applying an ice bag below the jaw, thus diminishing the flow of blood to the tooth, and a hot-water bottle to the cheek, which causes the skin vessels to fill with blood, thus relieving the tension in the vessels of the tooth.

If there is a cavity, a small piece of cotton moistened with oil of cloves and packed well into it may give much relief.

Children and adults should make a bi-annual pilgrimage to the dentist, who seeks out beginning cavities, early treatment of which will prevent these dreadful aches and later ill health.

BURNS

Burns and scalds are not at all uncommon with children, whose eagerness to explore and desire to investigate often leads them into trouble.

1. The simple reddening of the skin—slight burns and sunburn—simply needs protecting oil, or equal parts of oil and lime water, and is to be covered with sterile gauze.

2. The burns which destroy the outer layer of the skin, producing a blister, are treated much as a wound would be treated. The blister, if larger than a half dollar, should be opened near the edge with a needle which has been passed through a flame. The serum should be pressed out and the parts protected by a piece of gutta-percha that has been disinfected with some antiseptic solution; this covering keeps the dressings from sticking, thus avoiding the destruction of the new-forming tissues.

3. When the tissues are injured in the more severe burns, the surrounding flesh is carefully disinfected with boracic-acid solution, and the same dressing applied as described for the "blister burns." Balsam Peru is a healing balm for burns of this classification.

If a child's clothes catch on fire he is instantly to be thrown on the floor and any heavy woolen fabric, such as a curtain, table spread, blanket, or rug, is to be thrown over him (beginning at the neck) and the flames thus smothered. The clothing is now cut off, and if more than one-third of the body is burned the child should be taken to the hospital for constant care; and if more than one-half of the body is injured recovery is doubtful. Great care should be taken in keeping the unburned portion of the body warm, as there is a great tendency for the child to become very cold as he weakens from both the nervous shock and from the absorption of toxins.

Acid chemical burns are treated with baking soda, except in the case of carbolic acid (misnamed), which is treated with alcohol; alkaline chemical burns are dressed in vinegar or lemon juice compresses.

Methods for restoring the drowned should be understood by every man, woman, and youth. These methods are more fully taken up in works devoted to emergencies and will not be discussed in detail at this time.

FAINTING

Consciousness is quickly restored to the fainting child by lowering the head—laying him flat on the floor—while an assistant raises the legs perpendicularly. Cold dashes of water may be slapped on the chest with a towel, while the face is bathed or sprinkled with cold water. Consciousness is usually quickly restored by the above suggestions, in connection with plenty of fresh air.

A sudden blow on the head occasionally results in a severe condition known as concussion of the brain. There is a partial or complete loss of consciousness lasting from a few moments to an hour or two. Pallor of the skin and a sense of bewilderment accompany concussion of the brain.

Rest, quiet, and darkness should prevail until the physician arrives and makes an examination. External heat to the extremities may be applied, but no stimulants are to be administered until so ordered by the physician.

It is wise to seek medical advice in the case of odd or unusual behavior after a fall on the head.

Most interesting is the study of the food as it passes through the processes of digestion, absorption, assimilation, and oxidation—all definite and important parts of the great cycle through which everything we eat passes on its way from the table to the tissues. Elimination is the last step in nutrition, and is the process by which the body rids itself of the broken down cells and other poisonous and useless wastes. These various phases of bodily nutrition may be expressed in a single term—metabolism.

What we eat and how much we eat must be carefully planned, for our body temple is really made of what we eat. If you were erecting a beautiful mansion you would not think of allowing cheap, trashy, and inferior building materials to enter into the construction of your home. Neither should you permit unfit and inferior materials to become a part of the daily dietary of your little boy or girl, thus to become a part of their bodily structure.

ASSIMILATION OF FOOD

Following the process of digestion in the stomach and intestine, the nutritive food elements are absorbed through the wall of the bowel by the wonderfully adapted little villus, and distributed by various routes to the uttermost parts of the body. The sugars (all starches are changed into sugar) are carried in the portal blood stream to the liver, where they are actually stored away in the form of glycogen which, in a most intelligent manner, is dealt out to the body from hour to hour as it is needed for fuel. If all the sugar, after a hearty meal, were poured into the circulation at once, the blood stream would be overwhelmed and the kidneys would be forced to excrete it in the urine. This unnecessary waste is avoided by the liver's storing sugar after each meal and dealing it out to the body as required.

Likewise, the proteins also pass through the liver on their way to the body. Just what action the liver exerts upon proteins is not wholly known at the present writing. The digested fats are absorbed at once by the lacteals, the beginning of the intestinal lymphatic system, by which they are carried to the large veins at the root of the neck and there emptied into the blood stream. We have now traced our various food elements through the processes of digestion and absorption in the alimentary tract, some going through the liver, and others through the lymphatic system, until they circulate in the blood stream itself.

It is from these food substances, circulating in the blood stream, that the various cells of the body must assimilate into themselves such portions as they require for purposes of heat and energy and for the repair of their cell substance. This specialized work of cell assimilation converts the dissolved watery food in the blood into solid tissues, exactly reversing the process of digestion.

With a most profound intelligence, each of these body cells and tissues, bone and nerve fiber, muscle and organ, selects from the blood stream just its supply or portion of the food elements requisite to its upbuilding and maintenance. The mysteries of assimilation are effected by means of chemical substances called "enzymes," similar to those found in the digestive organs, but acting in an entirely different manner, in that they build up solids out of liquids instead of converting solids into liquids.

ELIMINATION OF BODY WASTES

Metabolism consists of a twofold rôle—an upbuilding and a tearing down process. After the food is all digested, absorbed, and assimilated, having become a part of the bodily organ, bone, muscle, and nerve fiber, then begins the work of tearing it down—of liberating its heat and energy—to be followed by its elimination from the body through the sweat glands, uriniferous tubules of the kidneys, etc. The carbohydrates (starches and sugars), together with the fats, are completely burned up in the body and are then eliminated in the form of water (thrown off through the sweat) and carbonic acid gas given up by the lungs.

The proteins, or nitrogenous foods, are not so completely burned up in the body. The ashes which result from their combustion are not simple substances like the water and CO₂ of the carbohydrates. This protein ash is represented by a number of complicated substances, some of which are solid (protein clinkers), which accumulate in the body and help to bring about many diseases, such as gout, headache, fatigue, biliousness, etc.

These protein ashes and clinkers are further acted upon—split up and sifted—by the liver, and are finally eliminated by the kidneys in the form of urea, uric acid, etc. The body being unable to store up protein, is often greatly embarrassed when one eats more of this substance than is daily required to replenish the waste of the body, for it must all be immediately split up in the system, and the over-abundant and irritating ashes must be carried off by the eliminating organs. Now, the overeating of sugars, starches, or fats, is not such a serious matter, as they may be stored in the liver and subsequently used; and even if they are eaten in excess of what the liver can care for they accumulate as fat or add extra fuel to the fires of the body, their ashes being carried off in the form of such harmless substances as water and carbon dioxide (CO₂); but the overeating of protein substances is always a strain on the body and should be avoided.

ELEMENTS OF NUTRITION

There are seven distinct elements entering into the composition of human foods—protein, starch, sugar, fat, salts, cellulose, and water, not to mention enzymes, vitamines, and other little-known chemical principles. These elements are all variously concerned in the nourishment, energizing, and warming of the body.

PROTEINS

The proteins are the structure builders of the body. While starches, fats, and sugars may be compared to the coal that feeds the locomotive, the proteins represent the iron and steel that are used from time to time to repair the engine and replace its worn parts. The essential chemical difference between starch and protein is that the latter contains nitrogen and a small amount of sulphur and phosphorus. The most common forms in which protein is used for food are the glutens of the grains, the legumes, nuts, cheese, the white of egg, and lean meat.

STARCHES

The starches are by far the most abundant of all elements in human food. They enter largely into the composition of nearly all plants and seeds. Under the influence of the sunlight, the green-colored plants gather up the CO₂ of the air and, with the water absorbed from the ground, build up starch. The plant takes all the carbon from which starch is made from the air, but while the atmosphere contains almost eighty per cent of nitrogen, the plant is unable to use it; it must secure its nitrogen from the decaying refuse of the soil. Thus the plant utilizes the waste products found in air and earth in the building of its food substances.

Starch exists in the form of small granules. Since each little starch granule is surrounded by a woody envelope of cellulose, it becomes necessary to cook all starches thoroughly in order to burst this cellulose envelope and thus enable the saliva to begin, and other secretions to continue, the work of digestion.

FRUIT SUGARS

The sugar of fruits represents a form of food requiring practically no digestion; while the sugar found in beets, the cane plant, and the maple tree, must be acted upon by the digestive juices of the intestine before their absorption can take place. During the winter, the maple tree stores its carbohydrates in its roots in the form of starch. With the advent of spring Mother Nature begins the digestion of this starch—actually turns it into sugar—and in the form of the sweet sap it finds its way up into the tree trunk to be deposited in the leaves and bark in the form of cellulose, a process very similar to that performed by digestion in the human body, where starch by digestion is first turned into sugar, and afterwards deposited in another form in the liver and muscles.

Dextrine is a form of sugar resulting from thoroughly cooking or partially digesting starch. There are about twenty-five stages or forms of dextrine between raw starch and digested starch or fruit sugar. Dextrine is found in the brown-colored portions of well-toasted bread.

FATS

Fat is a combination of glycerine and certain fatty acids. As a food, it is derived from both the animal and the vegetable kingdom. Animal fat consists of lard, suet, fat meat, etc., while fat of animal origin is represented by cream, butter, and the yolks of eggs. The vegetable fats are found in nuts, especially the pecan, cocoanut, Brazil, and pine nuts; also in the grains, particularly oats and corn. The peanut also contains a considerable amount of fat. Of the fruits, the banana and strawberry contain a trace of fat, while the olive is the only fruit rich in fat.

As a food, fat is used in three forms. The emulsified form is represented by cream, olive oil, and nuts. When the tiny globules of fat, which are each surrounded by a little film of casein, are crushed—united into a solid mass—we have a free fat. This form is represented by butter and other animal fats. Another form is fried fat—fat which has been chemically changed by heat with the development of certain irritating acids.

MINERAL SALTS

The mineral elements comprise but a small part of human food as regards weight, but they are extremely important to the health of the child as well as the adult. As found in the food, they are not in the form of mineral salts, like common table salt. The salts of food are living salts, organic or organized salts, such as are found in the growing plant. These salts are of great value to the various fluids of the body, and also as stimulants to nerve action, but more particularly in the work of building up the bones.

Salts are found largely in the cereals. A small amount is also found in vegetables, particularly the potato, as well as in most fruits.

CELLULOSE

Cellulose represents the great bulk of all vegetables and fruits. It is digested by most animals, but in man it is digested only to the extent of about thirty per cent. The presence of a large amount of cellulose in the food enables us often to satisfy the appetite without injury from overeating. It serves to give bulk to the food, and thereby possibly acts as a preventive to constipation.

WATER

Water fills an important place in the nutrition of the body. The food changes in connection with digestion, assimilation, and elimination, can take place only in the presence of water. Water constitutes from fifteen to ninety-five per cent of the various foods. The watery juices of vegetables and fruits consist largely of pure, distilled water, in which fruit sugar is dissolved, with added flavoring substances. Water is absolutely essential to the performance of every vital function connected with human metabolism.

ANIMAL HEAT

The source of heat in the animal body was the subject of much superstitious speculation on the part of ancient scientists. It is now known that animal heat is derived from the food we eat by means of a peculiar process of vital oxidation—effected in the presence of oxygen—by the action of water and enzymes upon the food elements absorbed by the living cell. This process of oxidation liberates the heat and energy stored by the sun in the food, and thus the body is kept warm by this constant combustion of the digested foodstuffs. The starches and sugars, together with the fats, represent food elements which serve as the body's fuel. By this means we are able to maintain a constant body temperature of almost one hundred degrees.

The average human body produces enough heat every hour to raise two and one-half pounds of water from the freezing point to the boiling point. This is equivalent to boiling about seven gallons of ice-water every twenty-four hours. Differently expressed, the body gives off each hour the same amount of heat as a foot and a half of two-inch steam coil. This is the same amount of heat which would be produced by burning about two-thirds of a pound of coal.

FUEL VALUE OF FOODS

Expressed in terms of English weight, the fuel value of the three different food elements would be:

It will be observed that fat contains more than twice as much heat as the carbohydrates. This is due to the fact that fat contains more carbon than either starch or sugar. Next to fats, starches and sugars are the most important fuel elements. Protein is a very extravagant form of food for fuel purposes. Proteins are the most expensive elements of human food; they are incompletely burned in the body, and inasmuch as they leave behind distressing and disease-producing ashes, it is clearly evident that only sufficient amount of proteins should be eaten each day to supply the demand of the body for repairs. We should depend more largely upon the carbohydrates and fats for heat and energy.

A large part of our food is required to furnish heat to take the place of that lost by radiation from the skin, and this is why children require more food than adults—they have a larger skin surface in proportion to their weight, and therefore lose more heat by radiation, and it is for this reason that the food for the growing child must be wisely and carefully selected.

DIET FOR CHILD TWO TO THREE YEARS OLD

Breakfast, 7-8 a. m.: Fruit; cooked or toasted cereal served with thin cream; a soft boiled or coddled egg; bread (two or more days old) and butter; plenty of milk.

Dinner, 12-1: Soups; creamed vegetables—tomato, corn, peas, and celery; any two of potatoes—creamed, mashed, or baked—carrots, beets, spinach, peas, cornlet, squash, cauliflower, asparagus tips, string beans; protein dish—the puree of dried beans, peas, or lentils; macaroni or carefully selected meats; dessert—apples, baked or sauce—or other fruits, junket, custard, milk.

Supper, 5-6 p. m.: Fruit, bread (bran bread if constipated); milk; porridge, with rich milk or milk toast; sweetened graham crackers.

FOODS ALLOWED CHILDREN OF FOUR YEARS AND OLDER

Protein Dishes: Purees of dried peas; lentils; beans; macaroni; eggs—soft boiled, poached, scrambled, or omelette; meats—steak, chops, chicken, turkey, broiled fish.

Cereals: All the toasted-flake foods; toasted and not too fresh bread, including both graham and bran; hominy; corn meal; oatmeal; farina; rice; barley; tapioca; sago, etc.

Soups: Creamed vegetable soups of all kinds and broths.

Vegetables: Potatoes; all the small green vegetables; lettuce; stewed celery; beets; squash; cauliflower, etc.

Fruits: All, if stewed or baked. Raw fruits—pears, peaches, ripe apples, berries, oranges, persimmons, grape-pulp without seeds, etc.

Desserts: Custard; jellos; junkets; home-made ice cream; sponge cake; baked fruits with whipped cream, etc.

FOODS TO BE AVOIDED BY YOUNG CHILDREN

1. Doughy breads, griddle cakes, insides of muffins, hot biscuits, etc.

2. Fried meats, such as sausage, oysters, pork, ham, veal, salt fish, corned beef, dried beef, etc.

3. Foods that are hot when they are cold—such as catsup, horse radish, mustard, highly spiced pickles, sauces, etc.

4. Rich pastries, puddings, unripe fruit, salted peanuts, and highly concocted dishes.

5. Certain salads, containing coarse but easily swallowed foods, with highly seasoned sauces.

6. Tea, coffee, and all alcoholic beverages.

7. Soft candies, chocolate creams, bon-bons, patties, etc.

Average normal children crave sweets, and since their normal food is about seven per cent sugar it is not to be wondered at. There are many forms of pure, hard candies which may be taken by the three-year-old child. They are stick candy, fruit tablets, sunshine candies, and other varieties which may be sucked.

All soft candies, such as chocolate creams, bon-bons, patties, etc., are to be avoided. Hard candies, taken along with the desserts at meal time, in no wise injure the normal stomach of the healthy child.

The other members of the family should set a correct example by sucking the hard candies rather than chewing them; for if the hard candies are allowed to dissolve slowly in the mouth they produce a weak solution of sugar, which does not interfere with digestion as do the strong and concentrated sugar solutions which result from chewing chocolate creams, bon-bons, etc.

Candy, cookies, sandwiches, or bits of cake should never be allowed between the meals.

EATING BETWEEN MEALS

Children who do not eat well at the breakfast table, if given a "piece" at 10 a. m., will not be ready for the 12 o'clock meal; and then another "piece" at 2 p. m. interferes with the normal appetite at 6 p. m. Digestion is disturbed, the nervous system irritated, and a "puny child" is often the result.

Bring the three-or-four-year-old to a well-selected breakfast some time between 7 and 8 a. m. Then nothing—absolutely nothing—but water must pass the lips between that breakfast hour and the 12 o'clock meal, which should be a good one. Then the interval until 5 or 6 p. m. is passed in the same manner. At the evening meal the appetite is again whetted: and a good appetite always means good gastric juice to digest the meal. And so, good mother, guard carefully the interval between meals if you would have good digestion and good health for the little folks.

DAILY FOOD REQUIREMENT

The following table, taken from The Science of Living,^[4] shows the minimum of calories or food units required by boys from five to fourteen years of age and girls from five to twelve:

⁴ Sadler, William S., The Science of Living; or, The Art of Keeping Well. A. C. McClurg & Co.