The Physical Training of Children

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

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

CHOICE OF PROFESSION OR TRADE.

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

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

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

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

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

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

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

SLEEP.

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

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

If there be a dressing-room next to the bed-room, it will be well to have the dressing-room window, instead of the bed-room window, open at night. The dressing-room door will regulate the quantity of air to be admitted into the bed-room, opening it either little or much, as the weather might be cold or otherwise.

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

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

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

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

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

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

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

Let me urge upon a parent the great importance of not allowing the chimney of any bed-room, or of any room in the house, to be stopped, as many are in the habit of doing, to prevent, as they call it, a draught, but to prevent, as I should call it, health.

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

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

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

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

The salt and water should be used every night at bedtime.

The following is an excellent tooth-powder:

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

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

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

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

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

The finest set of teeth I ever saw in my life belonged to a middle-aged gentleman; the teeth had neither spot not blemish—they were like beautiful pearls. He never had toothache in his life, and did not know what toothache meant! He brushed his teeth, every morning, with soap and water, in the manner I have previously recommended. I can only say to you—go and do likewise!

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

Tartar is apt to accumulate between and around the teeth; it is better in such a case not to remove it by scaling instruments, but to adopt the plan recommended by Dr. Richardson, namely, to well brush the teeth with pure vinegar and water.

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

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

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

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

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

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

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

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

354. What habit of body is most predisposed to Scrofula?

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

355. How may Scrofula be warded off?

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

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

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

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

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

Let no active purging, no mercurials, no violent, desperate remedies be allowed. If the patient cannot be cured without them, I am positive that he will not be cured with them.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

362. What are the causes of Consumption?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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