To make a Mixture. Two teaspoonfuls to be given early in the morning occasionally, and to be repeated in four hours, if the first dose should not operate.

In a subsequent Conversation, I shall strongly urge you not to allow your child, when convalescent, to leave the house under at least a month from the commencement of the illness; I therefore beg to refer you to that Conversation, and hope that you will give it your best and earnest consideration! During the last seventeen years I have never had dropsy from scarlet fever, and I attribute it entirely to the plan I have just recommended, and in not allowing my patients to leave the house under the month—until, in fact, the skin that has peeled off has been renewed.

Let us now sum up the plan I adopt:

1. Thorough ventilation, a cool room, and scant clothes on the bed, for the first five or six days.

2. A change of temperature of the skin to be carefully regarded. As soon as the skin is cool, closing the windows, and putting additional clothing on the bed.

3. The acidulated infusion of roses with syrup is the medicine for scarlet fever.

4. Purgatives to be religiously avoided for the first ten days at least, and even afterward, unless there be absolute necessity.

5. Leeches, blisters, emetics, cold and tepid spongings, and painting the tonsils with caustic, inadmissible in scarlet fever.

6. A strict antiphlogistic (low) diet for the first few days, during which time cold water to be given ad libitum.

7. The patient not to leave the house in the summer under the month; in the winter, under six weeks.

What NOT to do.—Do not, then, apply either leeches or blisters to the throat; do not paint the tonsils with caustic; do not give aperients; do not, on any account, give either calomel or emetic tartar; do not, for the first few days of the illness, be afraid of cold air to the skin, and of cold water as a beverage; do not, emphatically let me say, do not let the child leave the house for at least a month from the commencement of the illness.

My firm conviction is, that purgatives, emetics, and blisters, by depressing the patient, sometimes cause ordinary scarlet fever to degenerate into malignant scarlet fever.

I am aware that some of our first authorities advocate a different plan to mine. They recommend purgatives, which I may say, in scarlet fever, are my dread and abhorrence. They advise cold and tepid spongings—a plan which I think dangerous, as it will probably drive the disease internally. Blisters, too, have been prescribed; these I consider weakening, injurious, and barbarous, and likely still more to inflame the already inflamed skin. They recommend leeches to the throat, which I am convinced, by depressing the patient, will lessen the chance of his battling against the disease, and will increase the ulceration of the tonsils. Again, the patient has not too much blood; the blood is only poisoned. I look upon scarlet fever as a specific poison of the blood, and one which will be eliminated from the system, not by bleeding, not by purgatives, not by emetics, but by a constant supply of fresh and cool air, by the acid treatment, by cold water as a beverage, and for the first few days by a strict antiphlogistic (low) diet.

Sydenham says that scarlet fever is oftentimes “fatal through the officiousness of the doctor.” I conscientiously believe that a truer remark was never made; and that under a different system to the usual one adopted, scarlet fever would not be so much dreaded.

If any of my medical brethren should do me the honor to read these pages, let me entreat them to try my plan of treating scarlet fever, as my success has been great. I have given full and minute particulars, in order that they and mothers (if mothers cannot obtain medical advice) may give my plan a fair and impartial trial. My only stipulations are that they must begin with my treatment, and not mix any other with it, and carry out my plan to the very letter. I then, with God’s blessing, shall not fear the result; but shall rejoice that I have been of some little service in my generation.

221. How soon ought a child to be allowed to leave the house after an attack of Scarlet Fever?

He must not be allowed to go out for at least a month from the commencement of the attack, in the summer, and six weeks in the winter; and not even then without the express permission of a medical man. It might be said that this is an unreasonable recommendation: but when it is considered that the whole of the skin generally desquamates, or peels off, and consequently leaves the surface of the body exposed to cold, which cold flies to the kidneys, producing a peculiar and serious disease in them, ending in dropsy, this warning will not be deemed unreasonable.

Scarlet fever dropsy, which is really a formidable disease, generally arises from the carelessness, the ignorance, and the thoughtlessness of parents in allowing a child to leave the house before the new skin is properly formed and hardened. Prevention is always better than cure.

Thus far with regard to the danger to the child himself. Now, if you please, let me show you the risk of contagion that you inflict upon families, in allowing your child to mix with others before a month at least has elapsed. Bear in mind, a case is quite as contagious, if not more so, while the skin is peeling off, as it was before. Thus, in ten days or a fortnight, there is as much risk of contagion as at the beginning of the disease, and when the fever is at its height. At the conclusion of the month the old skin has generally all peeled off, and the new skin has taken its place; consequently there will then be less fear of contagion to others. But the contagion of scarlet fever is so subtle and so uncertain in its duration, that it is impossible to fix the exact time when it ceases.

Let me most earnestly implore you to ponder well on the above important facts. If these remarks should be the means of saving only one child from death, or from broken health, my labor will not have been in vain.

222. What means do you advise to purify a house from the contagion of Scarlet Fever?

Let every room be lime-washed and then be whitewashed; if the contagion has been virulent, let every bed-room be freshly papered (the walls having been previously stripped of the old paper and then lime-washed); let the bed, the bolsters, the pillows, and the mattresses be cleansed and purified; let the blankets and coverlids be thoroughly washed, and then let them be exposed to the open air—if taken into a field so much the better; let the rooms be well scoured; let the windows, top and bottom, be thrown wide open; let the drains be carefully examined; let the pump water be scrutinized, to see that it be not contaminated by fecal matter, either from the water-closet or from the privy; let privies be emptied of their contents—remember this is most important advice—then put into the empty places lime and powdered charcoal, for it is a well-ascertained fact that it is frequently impossible to rid a house of the infection of scarlet fever without adopting such a course. “It would be well if we were to use whitewash in many cases where great cleanliness of surface cannot be obtained. We remove in this way, by an easy method, much of the dullness and still more of the unwholesomeness of dirt.”—Dr. Angus Smith. “In St. George’s, Southwark, the medical officer reports that scarlatina ‘has raged fatally, almost exclusively where privy or drain smells are to be perceived in the houses.’” Let the children who have not had, or who do not appear to be sickening for scarlet fever, be sent away from home—if to a farm-house so much the better. Indeed, leave no stone unturned, no means untried, to exterminate the disease from the house and from the neighborhood.

223. Will you describe the symptoms of Chicken-pox?

It is occasionally, but not always, ushered in with a slight shivering fit; the eruption shows itself in about twenty-four hours from the child first appearing poorly. It is a vesicular disease. Vesicles. Small elevations of the cuticle, covering a fluid which is generally clear and colorless at first, but becomes afterward whitish and opaque, or pearly.—Watson. The eruption comes out in the form of small pimples, and principally attacks the scalp, the neck, the back, the chest, and the shoulders, but rarely the face; while in small-pox the face is generally the part most affected. The next day these pimples fill with water, and thus become vesicles; on the third day they are at maturity. The vesicles are quite separate and distinct from each other. There is a slight redness around each of them. Fresh ones, while the others are dying away, make their appearance. Chicken-pox is usually attended with a slight itching of the skin; when the vesicles are scratched the fluid escapes, and leaves hard pearl-like substances; which, in a few days, disappear. Chicken-pox never leaves pit-marks behind. It is a child’s complaint; adults scarcely, if ever, have it.

224. Is there any danger in Chicken-pox; and what treatment do you advise?

It is not at all a dangerous, but, on the contrary, a trivial complaint. It lasts only a few days, and requires but little medicine. The patient ought, for three or four days, to keep the house, and should abstain from animal food. On the sixth day, but not until then, a dose or two of a mild aperient is all that will be required.

225. Is Chicken-pox infectious?

There is a diversity of opinion on this head, but one thing is certain—it cannot be communicated by inoculation.

226. What are the symptoms of Modified Small-pox?

The modified small-pox—that is to say, small-pox that has been robbed of its virulence by the patient having been either already vaccinated, or by his having had a previous attack of small-pox—is ushered in with severe symptoms, with symptoms almost as severe as though the patient had not been already somewhat protected either by vaccination or by the previous attack of small-pox—that is to say, he has a shivering fit, great depression of spirits and debility, malaise, sickness, headache, and occasionally delirium. After the above symptoms have lasted about three days, the eruption shows itself. The immense value of the previous vaccination, or the previous attack of small-pox, now comes into play. In a case of unprotected small-pox, the appearance of the eruption aggravates all the above symptoms, and the danger begins; while in the modified small-pox, the moment the eruption shows itself, the patient feels better, and, as a rule, rapidly recovers. The eruption of modified small-pox varies materially from the eruption of the unprotected small-pox. The former eruption assumes a varied character, and is composed, first of vesicles (containing water), and secondly of pustules (containing matter), each of which pustules has a depression in the center, and thirdly of several red pimples without either water or matter in them, and which sometimes assume a livid appearance. These “breakings-out” generally show themselves more upon the wrist, and sometimes up one or both of the nostrils. While in the latter disease—the unprotected small-pox—the “breaking-out” is composed entirely of pustules containing matter, and which pustules are more on the face than on any other part of the body. There is generally a peculiar smell in both diseases—an odor once smelt never to be forgotten.

Now, there is one most important remark I have to make,—the modified small-pox is contagious. This ought to be borne in mind, as a person laboring under the disease must, if there be children in the house, either be sent away himself, or else the children ought to be banished both the house and the neighborhood. Another important piece of advice is, let all in the house—children and adults, one and all—be vaccinated, even if any or all have been previously vaccinated.

Treatment.—Let the patient keep his room, and if he be very ill, his bed. Let the chamber be well ventilated. If it be winter time, a small fire in the grate will encourage ventilation. If it be summer, a fire is out of the question; indeed, in such a case, the window-sash ought to be opened, as thorough ventilation is an important requisite of cure, both in small-pox and in modified small-pox. While the eruption is out, do not on any account give aperient medicine. In ten days from the commencement of the illness a mild aperient may be given. The best medicine in these cases is, the sweetened acidulated infusion of roses (See question 209), which ought to be given from the commencement of the disease, and should be continued until the fever be abated. For the first few days, as long as the fever lasts, the patient ought not to be allowed either meat or broth, but should be kept on a low diet, such as on gruel, arrow-root, milk-puddings, etc. As soon as the fever is abated he ought gradually to resume his usual diet. When he is convalescent, it is well, where practicable, that he should have change of air for a month.

227. How would you distinguish between Modified Small-pox and Chicken-pox?

Modified small-pox may readily be distinguished from chicken-pox, by the former disease being, notwithstanding its modification, much more severe and the fever much more intense before the eruption shows itself than chicken-pox; indeed, in chicken-pox there is little or no fever, either before or after the eruption; by the former disease, the modified small-pox, consisting partly of pustules (containing matter), each pustule having a depression in the centre, and the favorite localities of the pustules being the wrists and the inside of the nostrils: while, in the chicken-pox, the eruption consists of vesicles (containing water), and not pustules (containing matter), and the vesicles having neither a depression in the centre, nor having any particular partiality to attack either the wrists or the wings of the nose. In modified small-pox each pustule is, as in unprotected small-pox, inflamed at the base; while in chicken-pox there is only very slight redness around each vesicle. The vesicles, too, in chicken-pox are small—much smaller than the pustules are in modified small-pox.

228. Is hooping-cough an inflammatory disease?

Hooping-cough in itself is not inflammatory, it is purely spasmodic; but it is generally accompanied with more or less of bronchitis—inflammation of the mucous membrane of the bronchial tubes—on which account it is necessary, in all cases of hooping-cough, to consult a medical man, that he may watch the progress of the disease and nip inflammation in the bud.

229. Will you have the goodness to give the symptoms, and a brief history, of Hooping-cough?

Hooping-cough is emphatically a disease of the young; it is rare for adults to have it; if they do, they usually suffer more severely than children. A child seldom has it but once in his life. It is highly contagious, and therefore frequently runs through a whole family of children, giving much annoyance, anxiety, and trouble to the mother and the nurses; hence hooping-cough is much dreaded by them. It is amenable to treatment. Spring and summer are the best seasons of the year for the disease to occur. This complaint usually lasts from six to twelve weeks—sometimes for a much longer period, more especially if proper means are not employed to relieve it.

Hooping-cough commences as a common cold and cough. The cough, for ten days or a fortnight, increases in intensity; at about which time it puts on the characteristic “hoop.” The attack of cough comes on in paroxysms.

In a paroxysm the child coughs so long and so violently, and expires so much air from the lungs without inspiring any, that at times he appears nearly suffocated and exhausted; the veins of his neck swell; his face is nearly purple; his eyes, with the tremendous exertion, seem almost to start from their sockets; at length there is a sudden inspiration of air through the contracted chink of the upper part of the windpipe—the glottis—causing the peculiar “hoop;” and, after a little more coughing, he brings up some glairy mucus from the chest; and sometimes, by vomiting, food from the stomach; he is at once relieved until the next paroxysm occurs, when the same process is repeated, the child during the intervals, in a favorable case, appearing quite well, and after the cough is over, instantly returning either to his play or to his food. Generally, after a paroxysm he is hungry, unless, indeed, there be severe inflammation either of the chest or of the lungs. Sickness, as I before remarked, frequently accompanies hooping-cough; when it does, it might be looked upon as a good sign. The child usually knows when an attack is coming on; he dreads it, and therefore tries to prevent it; he sometimes partially succeeds; but if he does, it only makes the attack, when it does come, more severe. All causes of irritation and excitement ought, as much as possible, to be avoided, as passion is apt to bring on a severe paroxysm.

A new-born babe, an infant of one or two months old, commonly escapes the infection; but if at that tender age he unfortunately catch hooping-cough, it is likely to fare harder with him than if he were older—the younger the child the greater the risk. But still, in such a case, do not despair, as I have known numerous instances of new-born infants, with judicious care, recover perfectly from the attack, and thrive after it as though nothing of the kind had ever happened.

A new-born babe laboring under hooping-cough is liable to convulsions, which is, in this disease, one, indeed the great, source of danger. A child, too, who is teething, and laboring under the disease, is also liable to convulsions. When the patient is convalescing, care ought to be taken that he does not catch cold, or the “hoop” might return. Hooping-cough may either precede, attend, or follow an attack of measles.

230. What is the treatment of Hooping-cough?

We will divide the hooping-cough into three stages, and treat each stage separately.

What to do.—In the first stage, the commencement of hooping-cough: For the first ten days give the ipecacuanha wine mixture, a teaspoonful three times a day. (For the prescription of the ipecacuanha wine mixture, see question 202.) If the child be not weaned, keep him entirely to the breast; if he be weaned, to a milk and farinaceous diet. Confine him for the first ten days to the house, more especially if the hooping-cough be attended, as it usually is, with more or less of bronchitis. But take care that the rooms be well ventilated, for good air is essential to the cure. If the bronchitis attending the hooping-cough be severe, confine him to his bed, and treat him as though it were simply a case of bronchitis. (For the treatment of bronchitis, see question 205.)

In the second stage, discontinue the ipecacuanha mixture, and give Dr. Gibb’s remedy—namely, nitric acid—which I have found to be an efficacious and valuable one in hooping-cough:

Make a Mixture. One or two teaspoonfuls, or a tablespoonful, according to the age of the child—one teaspoonful for an infant of six months, and two teaspoonfuls for a child of twelve months, and one tablespoonful for a child of two years, every four hours, first shaking the bottle.

Let the spine and the chest be well rubbed every night and morning either with Roche’s Embrocation, or with the following stimulating liniment (first shaking the bottle):

Make a Liniment.

Let him wear a broad band of new flannel, which should extend round from his chest to his back, and which ought to be changed every night and morning, in order that it may be dried before putting on again. To keep it in its place it should be fastened by means of tapes and with shoulder-straps.

The diet ought now to be improved—he should gradually return to his usual food; and, weather permitting, should almost live in the open air—fresh air being, in such a case, one of the finest medicines.

In the third stage, that is to say, when the complaint has lasted a month, if by that time the child is not well, there is nothing like change of air to a high, dry, healthy, country place. Continue the nitric acid mixture, and either the embrocation or the liniment to the back and the chest, and let him continue to almost live in the open air, and be sure that he does not discontinue wearing the flannel until he be quite cured, and then let it be left off by degrees.

If the hooping-cough have caused debility, give him cod-liver oil, a teaspoonful twice or three times a day, giving it him on a full stomach after his meals.

But, remember, after the first three or four weeks, change of air, and plenty of it, is for hooping-cough the grand remedy.

What NOT to do.—Do not apply leeches to the chest, for I would rather put blood into a child laboring under hooping-cough than take it out of him—hooping-cough is quite weakening enough to the system of itself without robbing him of his life’s blood; do not, on any account whatever, administer either emetic tartar or antimonial wine; do not give either paregoric or syrup of white poppies; do not drug him either with calomel or with grey powder; do not dose him with quack medicine; do not give him stimulants, but rather give him plenty of nourishment, such as milk and farinaceous food, but no stimulants; do not be afraid, after the first week or two, of his having fresh air, and plenty of it—for fresh, pure air is the grand remedy, after all that can be said and done, in hooping-cough. Although occasionally we find that if the child be laboring under hooping-cough and is breathing a pure country air, and is not getting well so rapidly as we could wish, change of air to a smoky, gasladen town will sometimes quickly effect a cure; indeed, some persons go so far as to say that the best remedy for an obstinate case of hooping-cough is for the child to live the great part of every day in gas-works!

231. What is to be done during a paroxysm of Hooping-cough?

If the child be old enough, let him stand up; but if he be either too young or too feeble, raise his head, and bend his body a little forward; then support his back with one hand, and the forehead with the other. Let the mucus, the moment it is within reach, be wiped with a soft handkerchief out of his mouth.

232. In an obstinate case of Hooping-cough, what is the best remedy?

Change of air, provided there be no active inflammation, to any healthy spot. A farm-house, in a high, dry, and salubrious neighborhood, is as good a place as can be chosen. If, in a short time, he be not quite well, take him to the sea-side: the sea breezes will often, as if by magic, drive away the disease.

233. Suppose my child should have a shivering fit, is it to be looked upon as an important symptom?

Certainly. Nearly all serious illnesses commence with a shivering fit: severe colds, influenza, inflammations of different organs, scarlet fever, measles, small-pox and very many other diseases, begin in this way. If, therefore, your child should ever have a shivering fit, instantly send for a medical man, as delay might be dangerous. A few hours of judicious treatment, at the commencement of an illness, is frequently of more avail than days and weeks, nay months, of treatment, when disease has gained a firm footing. A serious disease often steals on insidiously, and we have, perhaps, only the shivering fit, which might be but a slight one, to tell us of its approach.

A trifling ailment, too, by neglecting the premonitory symptom, which, at first, might only be indicated by a slight shivering fit, will sometimes become a mortal disorder:

The above extract from Tennyson is, in my humble opinion, one of the most beautiful pieces of poetry in the English language. It is a perfect gem, and a volume in itself, so truthful, so exquisite, so full of the most valuable reflections: for instance—(1) “The little rift within the lute,”—the little tubercle within the lung, “that by-and-by will make the music mute, and ever widening slowly silence all,” and the patient eventually dies of consumption. (2) The little rent—the little rift of a very minute vessel in the brain, produces an attack of apoplexy, and the patient dies. (3) Each and all of us, in one form or another, sooner or later will have “the little rift within the lute.” But why give more illustrations? a little reflection will bring numerous examples to my fair reader’s memory.

234. In case of a shivering fit, perhaps you will tell me what to do?

Instantly have the bed warmed, and put the child to bed. Apply either a hot bottle or a hot brick, wrapped in flannel, to the soles of his feet. Put an extra blanket on his bed, and give him a hot cup of tea.

As soon as the shivering fit is over, and he has become hot, gradually lessen the extra quantity of clothes on his bed, and take away the hot bottle or the hot brick from his feet.

What NOT to do.—Do not give either brandy or wine, as inflammation of some organ might be about taking place. Do not administer opening medicine, as there might be some “breaking-out” coming out on the skin, and an aperient might check it.

235. My child, apparently otherwise healthy, screams out in the night violently in his sleep, and nothing for a time will pacify him: what is likely to be the cause, and what is the treatment?

The causes of these violent screamings in the night are various. At one time, they proceed from teething; at another, from worms; sometimes, from night-mare; occasionally, from either disordered stomach or bowels.

Each of the above causes will, of course, require a different plan of procedure; it will, therefore, be necessary to consult a medical man on the subject, who will soon, with appropriate treatment, be able to relieve him.

236. Have the goodness to describe the complaint of children called Mumps.

The mumps, inflammation of the “parotid” gland, is commonly ushered in with a slight feverish attack. After a short time, a swelling, of stony hardness, is noticed before and under the ear, which swelling extends along the neck toward the chin. This lump is exceedingly painful, and continues painful and swollen for four or five days. At the end of which time it gradually disappears, leaving not a trace behind. The swelling of mumps never gathers. It may affect one or both sides of the face. It seldom occurs but once in a lifetime. It is contagious, and has been known to run through a whole family or school; but it is not dangerous, unless, which is rarely the case, it leaves the “parotid” gland, and migrates either to the head, to the breast, or to the testicle.

237. What is the treatment of Mumps?

Foment the swelling, four or five times a day, with a flannel wrung out of hot chamomile and poppy-head decoction; and apply, every night, a barm and oatmeal poultice to the swollen gland or glands. Four poppy-heads and four ounces of chamomile blows to be boiled in four pints of water for half an hour, and then strained to make the decoction. Debar, for a few days, the little patient from taking meat and broth, and let him live on bread and milk, light puddings, and arrow-root. Keep him in a well-ventilated room, and shut him out from the company of his brothers, his sisters, and young companions. Give him a little mild, aperient medicine. Of course, if there be the slightest symptom of migration to any other part or parts, instantly call in a medical man.

238. What is the treatment of a Boil?

One of the best applications is a Burgundy pitch plaster spread on a soft piece of wash-leather. Let a chemist spread a plaster, about the size of the hand; and, from this piece, cut small plasters, the size of a shilling or a florin (according to the dimensions of the boil), which snip around and apply to the part. Put a fresh one on daily. This plaster will soon cause the boil to break; when it does break, squeeze out the contents, the core, and the matter, and then apply one of the plasters as before, which, until the boil be well, renew every day.

The old-fashioned remedy for a boil—namely, common yellow soap and brown sugar, is a capital one for the purpose; it should be made into a paste, and spread on a piece of coarse linen, the size either of a shilling or of a florin (according to the size of the boil); it eases the pain and causes the boil soon to break, and draws it when it is broken; it should be renewed daily.

If the boils should arise from the child being in a delicate state of health, give him cod-liver oil, meat once a day, and an abundance of milk and farinaceous food. Let him have plenty of fresh air, exercise, and play.

If the boils should arise from gross and improper feeding, then keep him for a time from meat, and let him live principally on a milk and farinaceous diet.

If the child be fat and gross, cod-liver oil would be improper; a mild aperient, such as rhubarb and magnesia, would then be the best medicine.

239. What are the symptoms of Earache?

A young child screaming shrilly, violently, and continuously, is oftentimes owing to earache; carefully, therefore, examine each ear, and ascertain if there be any discharge; if there be, the mystery is explained.

Screaming from earache may be distinguished from the screaming from bowel-ache by the former (earache) being more continuous—indeed, being one continued scream, and from the child putting his hand to his head; while, in the latter (bowel-ache), the pain is more of a coming and of a going character, and he draws up his legs to his bowels. Again, in the former (earache), the secretions from the bowels are natural; while, in the latter (bowel-ache), the secretions from the bowels are usually depraved, and probably offensive. But a careful examination of the ear will generally at once decide the nature of the case.

240. What is the best remedy for Earache?

Apply to the ear a small flannel bag, filled with hot salt—as hot as can be comfortably borne, or foment the ear with a flannel wrung out of hot chamomile and poppy-head decoction. A roasted onion, inclosed in muslin, applied to the ear, is an old-fashioned and favorite remedy, and may, if the bag of hot salt, or if the hot fomentation do not relieve, be tried. Put into the ear, but not very far, a small piece of cotton-wool, moistened with warm olive oil. Taking care that the wool is always removed before a fresh piece be substituted, as if it be allowed to remain in any length of time, it may produce a discharge from the ear. Avoid all cold applications. If the earache be severe, keep the little fellow at home, in a room of equal temperature, but well ventilated, and give him, for a day or two, no meat.

If a discharge from the ear should either accompany or follow the earache, more especially if the discharge be offensive, instantly call in a medical man, or deafness for life may be the result.

A knitted or crocheted hat, with woolen rosettes over the ears, is in the winter time, an excellent hat for a child subject to earache. The hat may be procured at any baby-linen warehouse.

241. What are the causes and the treatment of discharges from the Ear?

Cold, measles, scarlet fever, healing up of “breakings-out” behind the ear; pellets of cotton-wool, which had been put in the ear, and had been forgotten to be removed, are the usual causes of discharges from the ear. It generally commences with earache.

The treatment consists in keeping the parts clean, by syringing the ear every morning with warm water, by attention to food, keeping the child principally upon a milk and a farinaceous diet, and by change of air, more especially to the coast. If change of air be not practicable, great attention ought to be paid to ventilation. As I have before advised, in all cases of discharge from the ear, call in a medical man, as a little judicious medicine is advisable—indeed, essential; and it may be necessary to syringe the ear with lotions, instead of with warm water; and, of course, it is only a doctor who has actually seen the patient who can decide these matters, and what is best to be done in each individual case.

242. What is the treatment of a “sty” in the eye-lid?

Bathe the eye frequently with warm milk and water, and apply, every night at bedtime, a warm white-bread poultice.

No medicine is required; but if the child be gross, keep him for a few days from meat, and let him live on bread and milk and farinaceous puddings.

243. If a child have large bowels, what would you recommend as likely to reduce their size?

It ought to be borne in mind that the bowels of a child are larger in proportion than those of an adult. But, if they be actually larger than they ought to be, let them be well rubbed for a quarter of an hour at a time night and morning, with soap liniment, and then apply a broad flannel belt. “A broad flannel belt worn night and day, firm but not tight, is very serviceable.” (Sir Charles Locock, in a Letter to the Author.) The child ought to be prevented from drinking as much as he has been in the habit of doing; let him be encouraged to exercise himself well in the open air; and let strict regard be paid to his diet.

244. What are the best aperients for a child?

If it be actually necessary to give him opening medicine, one or two teaspoonfuls of syrup of senna, repeated if necessary, in four hours, will generally answer the purpose; or, for a change, one or two teaspoonfuls of castor oil may be substituted. Lenitive electuary (compound confection of senna) is another excellent aperient for the young, it being mild in its operation, and pleasant to take; a child fancying it is nothing more than jam, and which it much resembles both in appearance and in taste. The dose is half or one teaspoonful early in the morning occasionally. Senna is an admirable aperient for a child, and is a safe one, which is more than can be said of many others. It is worthy of note that “the taste of senna may be concealed by sweetening the infusion, adding milk, and drinking as ordinary tea, which, when thus prepared, it much resembles.” Infusion of senna may be procured of any respectable druggist. It will take about one or two tablespoonfuls, or even more, of the infusion (according to the age of the child and the obstinacy of the bowels), to act as an aperient. Of course you yourself will be able, from time to time, as the need arises, to add the milk and the sugar, and thus to make it palatable. It ought to be given warm, so as the more to resemble tea. Honey, too, is a nice aperient for a child—a teaspoonful ought to be given either by itself, or spread on a slice of bread.

Some mothers are in the habit of giving their children jalap gingerbread. I do not approve of it, as jalap is a drastic griping purgative; besides, jalap is very nasty to take—nothing will make it palatable.

Fluid magnesia—solution of the bicarbonate of magnesia—is a good aperient for a child; and, as it has very little taste, is readily given, more especially if made palatable by the addition either of a little syrup or of brown sugar. The advantages which it has over the old solid form are, that it is colorless and nearly tasteless, and never forms concretions in the bowels, as the solid magnesia, if persevered in for any length of time, sometimes does. A child two or three years old may take one or two tablespoonfuls of the fluid, either by itself or in his food, repeating it every four hours until the bowels be opened. When the child is old enough to drink the draught off immediately, the addition of one or two teaspoonfuls of lemon-juice, to each dose of the fluid magnesia, makes a pleasant effervescing draught, and increases its efficacy as an aperient.

Bran-bread and treacle will frequently open the bowels; and as treacle is wholesome, it may be substituted for butter when the bowels are inclined to be costive. One part of bran to three parts of flour, mixed together and made into bread. A roasted apple, eaten with raw sugar, is another excellent mild aperient for a child. Milk gruel—that is to say, milk thickened with oatmeal—forms an excellent food for him, and often keeps his bowels regular, and thus (which is a very important consideration) supersedes the necessity of giving him an aperient. An orange (taking care he does not eat the peel or the pulp), or a fig after dinner, or a few Muscatel raisins, will frequently regulate the bowels.

Stewed prunes is another admirable remedy for the costiveness of a child. The manner of stewing them is as follows: Put a pound of prunes in a brown jar, add two tablespoonfuls of raw sugar, then cover the prunes and the sugar with cold water; place them in the oven, and let them stew for four hours. A child should every morning eat half a dozen or a dozen of them, until the bowels be relieved, taking care that he does not swallow the stones.

A suppository is a mild and ready way of opening the bowels of a child. When he is two or three years old and upwards, a candle suppository is better than a soap suppository. The way of preparing it is as follows: Cut a piece of dip-tallow candle—the length of three inches—and insert it as you would a clyster pipe, about two inches up the fundament, allowing the remaining inch to be in sight, and there let the suppository remain until the bowels be opened.

245. What are the most frequent causes of Protrusion of the lower bowel?

The too common and reprehensible practice of a parent administering frequent aperients, especially calomel and jalap, to her child. Another cause, is allowing him to remain for a quarter of an hour or more at a time on his chair; this induces him to strain, and to force the gut down.

246. What are the remedies?

If the protrusion of the bowel have been brought on by the abuse of aperients, abstain for the future from giving them; but if medicine be absolutely required, give the mildest—such as either syrup of senna or castor oil—and the less of those the better.

If the external application of a purgative will have the desired effect, it will, in such cases, be better than the internal administration of aperients. Dr. Merriman’s Purgative Liniment is a good one for the purpose. (See question 95.) Let the bowels be well rubbed every night and morning, for five minutes at a time, with the liniment.

A wet compress to the bowels will frequently open them, and will thus do away with the necessity of giving an aperient—a most important consideration. Fold a napkin in six thicknesses, soak it in cold water, and apply it to the bowels, over which put either a thin covering or sheet of gutta-percha, or a piece of oiled silk; keep it in its place with a broad flannel roller, and let it remain on the bowels for three or four hours, or until they be opened.

Try what diet will do, as opening the bowels by a regulated diet is far preferable to the giving of aperients. Let him have either bran-bread, Robinson’s Patent Groats made into gruel with new milk, or Du Barry’s Arabica Revalenta, or a slice of Huntley and Palmer’s lump gingerbread. Let him eat stewed prunes, stewed rhubarb, roasted apples, strawberries, raspberries, the inside of grapes and gooseberries, figs, etc. Give him early every morning a draught of cold water.

Let me, again, urge you not to give aperients in these cases, or in any case, unless you are absolutely compelled. By following my advice you will save yourself an immense deal of trouble, and your child a long catalogue of misery. Again, I say, look well into the matter, and whenever it be practicable, avoid purgatives.

Now, with regard to the best manner of returning the bowel, lay the child upon the bed on his face and bowels, with his hips a little raised; then smear lard on the forefinger of your right hand (taking care that the nail be cut close) and gently with your forefinger press the bowel into its proper place.

Remember, if the above methods be observed, you cannot do the slightest injury to the bowel, and the sooner it be returned the better it will be for the child; for, if the bowel be allowed to remain long down, it may slough or mortify, and death may ensue. The nurse, every time he has a motion, must see that the bowel does not come down, and if it does, she ought instantly to return it. Moreover, the nurse should be careful not to allow the child to remain on his chair more than two or three minutes at a time.

Another excellent remedy for the protrusion of the lower bowel is to use every morning a cold salt and water sitz bath. There need not be more than a depth of three inches of water in the bath; a small handful of table salt should be dissolved in the water; a dash of warm water in the winter time must be added to take off the extreme chill, and the child ought not to be allowed to sit in the bath for more than one minute, or while the mother can count a hundred, taking care the while to throw either a square of flannel or a small shawl over his shoulders. The sitz bath ought to be continued for months, or until the complaint be removed. I cannot speak in too high praise of these baths.

247. Do you advise me, every spring and fall, to give my child brimstone to purify and sweeten his blood, and as a preventive medicine?

Certainly not: if you wish to take away his appetite and to weaken and depress him, give him brimstone! Brimstone is not a remedy fit for a child’s stomach. The principal use and value of brimstone is as an external application in itch, and as an internal remedy, mixed with other laxatives, in piles—piles being a complaint of adults. In olden times poor unfortunate children were dosed every spring and fall with brimstone and treacle, to sweeten their blood! Fortunately for the present race, there is not so much of that folly practiced, but still there is room for improvement.

To dose a healthy child with physic is the grossest absurdity. No, the less physic a delicate child has the better it will be for him, but physic to a healthy child is downright poison!—and brimstone of all medicines! It is both weakening and depressing to the system, and by opening the pores of the skin and by relaxing the bowels, is likely to give cold, and thus to make a healthy a sickly child. Sweeten his blood! It is more likely to weaken his blood, and thus to make his blood impure! Blood is not made pure by drugs, but by Nature’s medicine: by exercise, by pure air, by wholesome diet, by sleep in a well-ventilated apartment, by regular and thorough ablution. Brimstone a preventive medicine! Preventive medicine—and brimstone especially in the guise of a preventive medicine—is “a mockery, a delusion, and a snare.”

248. When a child is delicate, and his body, without any assignable cause is gradually wasting away, and the stomach rejects all food that is taken, what plan can be adopted likely to support his strength, and thus, probably, be the means of saving his life?

I have seen, in such a case, great benefit to arise from half a teacupful of either strong mutton broth, or of strong beef-tea, used as an enema, every four hours. An enema apparatus is an important requisite in every nursery; it may be procured of any respectable surgical instrument-maker. The india-rubber enema bottle is, for a child’s use, a great improvement on the old syringe, as it is not so likely to get out of order, and, moreover, is more easily used.

It should be administered slowly, in order that it may remain in the bowel. If the child be sinking, either a dessertspoonful of brandy, or half a wineglassful of port wine ought to be added to each enema.

The above plan ought only to be adopted if there be no diarrhœa. If there be diarrhœa, an enema must not be used. Then, provided there be great wasting away, and extreme exhaustion, and other remedies having failed, it would be advisable to give, by the mouth, raw beef of the finest quality, which ought to be taken from the hipbone, and should be shredded very fine. All fat and skin must be carefully removed. One or two teaspoonfuls (according to the age of the child) ought to be given every four hours. The giving of raw meat to children in exhaustive diseases, such as excessive long-standing diarrhœa, was introduced into practice by a Russian physician, a Professor Weisse, of St. Petersburg. It certainly is, in these cases, a most valuable remedy, and has frequently been the means of snatching such patients from the jaws of death. Children usually take raw meat with avidity and with a relish.

249. If a child be naturally delicate, what plan would you recommend to strengthen him?

I should advise strict attention to the rules above mentioned, and change of air—more especially, if it be possible, to the coast. Change of air, sometimes, upon a delicate child, acts like magic, and may restore him to health when all other means have failed. If a girl be delicate, “carry her off to the farm, there to undergo the discipline of new milk, brown bread, early hours, no lessons, and romps in the hay-field.” This advice is, of course, equally applicable for a delicate boy, as delicate boys and delicate girls ought to be treated alike. Unfortunately, in these very enlightened days! there is too great a distinction made in the respective management and treatment of boys and girls.

The best medicines for a delicate child will be the wine of iron and cod-liver oil. Give them combined in the manner I shall advise when speaking of the treatment of Rickets.

In diseases of long standing, and that resist the usual remedies, there is nothing like change of air. Hippocrates, the father of medicine, says: