Make a Mixture. Half a teaspoonful to be given to an infant of six months and under, and one teaspoonful to a child above that age, every four hours—first shaking the bottle. Let the mixture be made by a chemist.
The baby ought, for a few days, to be kept entirely to the breast. The mother should be most particular in her own diet.
What NOT to do.—The mother must neither take greens, nor cabbage, nor raw fruit, nor pastry, nor beer; indeed, while the diarrhœa of her babe continues, she had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought not, while the diarrhœa continues, to have any artificial food. He must neither be dosed with gray powder (a favorite but highly improper remedy in these cases), nor with any quack medicines, such as Dalby’s Carminative or Godfrey’s Cordial.
103. What are the symptoms of Dysentery?
Dysentery frequently arises from a neglected diarrhœa. It is more dangerous than diarrhœa, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skillful handling: hence the care and experience required in treating a case of dysentery.
Well, then, what are the symptoms? The infant, in all probability, has had an attack of diarrhœa—bowel complaint as it is called—for several days; he having had a dozen or two of motions, many of them slimy and frothy, like “frog-spawn,” during the twenty-four hours. Suddenly the character of the motion changes,—from being principally stool, it becomes almost entirely blood and mucus; he is dreadfully griped, which causes him to strain violently, as though his inside would come away every time he has a motion,—screaming and twisting about, evidently being in the greatest pain, drawing his legs up to his belly and writhing in agony. Sickness and vomiting are always present, which still more robs him of his little remaining strength, and prevents the repair of his system. Now, look at his face! It is the very picture of distress. Suppose he has been a plump, healthy little fellow, you will see his face, in a few days, become old-looking, care-worn, haggard, and pinched. Day and night the enemy tracks him (unless proper remedies be administered); no sleep, or, if he sleep, he is every few minutes roused. It is heart-rending to have to attend a bad case of dysentery in a child,—the writhing, the screaming, the frequent vomiting, the pitiful look, the rapid wasting and exhaustion, make it more distressing to witness than almost any other disease a doctor attends.
104. Can anything be done to relieve such a case?
Yes. A judicious medical man will do a great deal. But, suppose that you are not able to procure one, I will tell you what to do and what NOT to do.
What to do.—If the child be at the breast, keep him to it, and let him have nothing else, for dysentery is frequently caused by improper feeding. If your milk be not good, or it be scanty, instantly procure a healthy wet-nurse. Lose not a moment; for in dysentery moments are precious. But, suppose that you have no milk, and that no wet-nurse can be procured: what then? Feed him entirely on cow’s milk—the milk of one healthy cow; let the milk be unboiled, and be fresh from the cow. Give it in small quantities at a time, and frequently, so that it may be retained on the stomach. If a tablespoonful of the milk make him sick, give him a dessertspoonful; if a dessertspoonful cause sickness, let him only have a teaspoonful at a time, and let it be repeated every quarter of an hour. But remember, in such a case the breast-milk—the breast-milk alone—is incomparably superior to any other milk or to any other food whatever.
If he be a year old and weaned, then feed him, as above recommended, on the cow’s milk. If there be extreme exhaustion and debility, let fifteen drops of brandy be added to each tablespoonful of new milk, and let it be given every half hour.
Now with regard to medicine. I approach this part of the treatment with some degree of reluctance—for dysentery is a case requiring opium, and opium I never like a mother of her own accord to administer. But suppose a medical man cannot be procured in time, the mother must then prescribe or the child will die! What then is to be done? Sir Charles Locock considers “that in severe dysentery, especially where there is sickness, there is no remedy equal to pure calomel, in a full dose, without opium.” Therefore, at the very onset of the disease, let from three to five grains (according to the age of the patient) of calomel, mixed with an equal quantity of powdered white sugar, be put dry on the tongue. In three hours after let the following mixture be administered:
To make a Mixture. A teaspoonful to be given every three or four hours, first well shaking the bottle. Let this mixture, or any other medicine I may prescribe, be always made by a respectable chemist.
Supposing he cannot retain the mixture—the stomach rejecting it as soon as swallowed—what then? Give the opium, mixed with small doses of mercury with chalk and sugar, in the form of powder, and put one of the powders dry on the tongue every three hours:
Mix well in a mortar, and divide into twelve powders.
Now, suppose the dysentery has for several days persisted, and that, during that time, nothing but mucus and blood—that no real stool—has come from the bowels, then a combination of castor oil and opium ought, instead of the medicine recommended above, to be given. My friend, the late Dr. Baly, who had made dysentery his particular study, considered the combination of opium and castor oil very valuable in dysentery.
Make a Mixture. A teaspoonful to be taken every four hours, first well shaking the bottle.
A warm bath, at the commencement of the disease, is very efficacious; but it must be given at the commencement. If he has had dysentery for a day or two, he will be too weak to have a warm bath; then, instead of the bath, try the following: Wrap him in a blanket which has been previously wrung out of hot water, over which envelop him in a dry blanket. Keep him in this hot, damp blanket for half an hour; then take him out, put on his night-gown and place him in bed, which has been, if it be winter time, previously warmed. The above “blanket treatment” will frequently give great relief, and will sometimes cause him to fall into a sweet sleep. A flannel bag filled with hot powdered table salt, made hot in the oven, applied to the bowels, will afford much comfort.
What NOT to do.—Do not give aperients, unless it be, as before advised, the castor oil guarded with the opium; do not stuff him with artificial food; do not fail to send for a judicious and an experienced medical man; for, remember, it requires a skillful doctor to treat a case of dysentery, more especially in a child.
105. What are the symptoms, the causes, and the treatment of Nettle-rash?
Nettle-rash consists of several irregular raised wheals, red at the base and white on the summit, on different parts of the body; but it seldom attacks the face. It is not contagious, and it may occur at all ages and many times. It comes and goes, remaining only a short time in a place. It puts on very much the appearance of the child having been stung by nettles—hence its name. It produces great heat, itching, and irritation, sometimes to such a degree as to make him feverish, sick, and fretful. He is generally worse when he is warm in bed, or when the surface of his body is suddenly exposed to the air. Rubbing the skin, too, always aggravates the itching and the tingling, and brings out a fresh crop.
The cause of nettle-rash may commonly be traced to improper feeding; although, occasionally, it proceeds from teething.
What to do.—It is a complaint of no danger, and readily gives way to a mild aperient, and to attention to diet. There is nothing better to relieve the irritation of the skin than a warm bath. If it be a severe attack of nettle-rash, by all means call in a medical man.
What NOT to do.—Do not apply cold applications to his skin, and do not wash him (while the rash is out) in quite cold water. Do not allow him to be in a draught, but let him be in a well-ventilated room. If he be old enough to eat meat, keep it from him for a few days, and let him live on milk and farinaceous diet. Avoid strong purgatives, and calomel, and gray powder.
106. What are the symptoms and the treatment of Red-gum?
Red-gum, tooth-rash, red-gown, is usually owing to irritation from teething; not always from the cutting, but from the evolution, the “breeding,” of the teeth. It is also sometimes owing to unhealthy stools irritating the bowels, and showing itself, by sympathy, on the skin. Red-gum consists of several small papulæ, or pimples, about the size of pins’ heads, and may be known from measles—the only disease for which it is at all likely to be mistaken—by its being unattended by symptoms of cold, such as sneezing, running, and redness of the eyes, etc., and by the patches not assuming a crescentic, half-moon shape; red-gum, in short, may readily be known by the child’s health being unaffected, unless, indeed, there be a great crop of pimples; then there will be slight feverishness.
What to do.—Little need be done. If there be a good deal of irritation, a mild aperient should be given. The child ought to be kept moderately but not very warm.
What NOT to do.—Draughts of air, or cold, should be carefully avoided; as, by sending the eruption suddenly in, either convulsions or disordered bowels might be produced. Do not dose him with gray powder.
107. How would you prevent “Stuffing of the nose” in a new-born babe?
Rubbing a little tallow on the bridge of the nose is the old-fashioned remedy, and answers the purpose. It ought to be applied every evening just before putting him to bed.
If the “stuffing” be severe, dip a sponge in hot water, as hot as he can comfortably bear; ascertain that it be not too hot, by previously applying it to your own face, and then put it for a few minutes to the bridge of his nose. As soon as the hard mucus is within reach, it should be carefully removed.
108. Do you consider sickness injurious to an infant?
Many thriving babies are, after taking the breast, frequently sick; still we cannot look upon sickness otherwise than as an index of either a disordered or of an overloaded stomach. If the child be sick, and yet be thriving, it is a proof that he overloads his stomach. A mother, then, must not allow him to suck so much at a time. She should, until he retains all he takes, lessen the quantity of milk. If he be sick and does not thrive, the mother should notice if the milk he throws up has a sour smell; if it has, she must first of all look to her own health; she ought to ascertain if her own stomach be out of order; for if such be the case, it is impossible for her to make good milk. She should observe whether, in the morning, her own tongue be furred and dry; whether she have a disagreeable taste in her mouth, or pains at her stomach, or heart-burn, or flatulence. If she have all, or any of these symptoms, the mystery is explained why he is sick and does not thrive. She ought then to seek advice, and a medical man will soon put her stomach into good order; and, by so doing, will, at the same time, benefit the child.
But if the mother be in the enjoyment of good health, she must then look to the babe herself, and ascertain if he be cutting his teeth; if the gums require lancing; if the secretions from the bowels be proper both in quantity and in quality; and, if he have had artificial food—it being absolutely necessary to give such food—whether it agree with him.
What to do.—In the first place, if the gums are red, hot, and swollen, let them be lanced; in the second, if the secretions from the bowels are either unhealthy or scanty, give him a dose of aperient medicine, such as castor oil, or the following: Take two or three grains of powdered Turkey rhubarb, three grains of pure carbonate of magnesia, and one grain of aromatic powder. Mix. The powder to be taken at bedtime, mixed in a teaspoonful of sugar and water, and which should, if necessary, be repeated the following night. In the third place, if the food he be taking does not agree with him, change it (vide answer to question 33). Give it in smaller quantities at a time, and not so frequently; or, what will be better still, if it be possible, keep him, for awhile, entirely to the breast.
What NOT to do.—Do not let him overload his stomach either with breast-milk or with artificial food. Let the mother avoid, until his sickness be relieved, greens, cabbage, and all other green vegetables.
109. What are the causes, the symptoms, the prevention, and the cure of Thrush?
The thrush is a frequent disease of an infant, and is often brought on either by stuffing him or by giving him improper food. A child brought up entirely, for the first three or four months, on the breast, seldom suffers from this complaint. The thrush consists of several irregular, roundish, white specks on the lips, the tongue, the inside and the angles of the mouth, giving the parts affected the appearance of curds and whey having been smeared upon them. The mouth is hot and painful, and he is afraid to suck: the moment the nipple is put into his mouth he begins to cry. The thrush sometimes, although but rarely, runs through the whole of the alimentary canal. It should be borne in mind that nearly every child who is sucking has his or her tongue white or “frosted” as it is sometimes called. The thrush may be mild or very severe.
Now with regard to What to do.—As the thrush is generally owing to improper and to artificial feeding, if the child be at the breast, keep him, for a time entirely to it. Do not let him be always sucking, as that will not only fret his mouth, but will likewise irritate and make sore the mother’s nipple.
If he be not at the breast, but has been weaned, then keep him for a few days entirely to a milk diet—to the milk of ONE cow—either boiled, if it be hot weather, to keep it sweet; or unboiled, in cool weather—fresh as it comes from the cow.
The best medicine is the old-fashioned one of borax, a combination of powdered lump sugar and borax being a good one for the purpose: the powdered lump sugar increases the efficacy and the cleansing properties of the borax; it tends, moreover, to make it more palatable:
To be well mixed together, and made into twelve powders. One of the powders to be put dry on the tongue every four hours.
The best local remedy is honey of borax, which ought to be smeared frequently, by means of the finger, on the parts affected.
Thorough ventilation of the apartment must be observed; and great cleanliness of the vessels containing the milk should be insisted upon.
In a bad case of thrush, change of air to the country is most desirable; the effect is sometimes, in such cases, truly magical.
If the thrush be brought on either by too much or by improper food, in the first case, of course, a mother must lessen the quantity; and, in the second, she should be more careful in her selection.
What NOT to do.—Do not use either a calf’s teat or wash-leather for the feeding-bottle; fortunately, since the invention of india-rubber teats, they are now nearly exploded; they were, in olden times, fruitful causes of thrush. Do not mind the trouble of ascertaining that the cooking-vessels connected with the baby’s food are perfectly clean and sweet. Do not leave the purity and the goodness of the cow’s milk (it being absolutely necessary to feed him on artificial food) to be judged either by the milkman or by the nurse, but taste and prove it yourself. Do not keep the milk in a warm place, but either in the dairy or in the cellar; and, if it be summer time, let the jug holding the milk be put in a crock containing lumps of ice. Do not use milk that has been milked longer than twelve hours, but, if practicable, have it milked direct from the cow, and use it immediately—let it be really and truly fresh and genuine milk.
When the disease is severe, it may require more active treatment—such as a dose of calomel; which medicine must never be given, unless it be either under the direction of a medical man, or unless it be in an extreme case,—such as dysentery; therefore, the mother had better seek advice. See the Treatment of Dysentery.
In a severe case of thrush, where the complaint has been brought on by artificial feeding—the babe not having the advantage of the mother’s milk—it is really surprising how rapidly a wet-nurse—if the case has not been too long deferred—will effect a cure, where all other means have been tried and have failed. The effect has been truly magical! In a severe case of thrush, pure air and thorough ventilation are essential to recovery.
110. Is anything to be learned from the cry of an infant?
There is a language in the cry of an infant which a thoughtful medical man can well interpret. The cry of hunger, for instance, is very characteristic,—it is unaccompanied with tears, and is a wailing cry; the cry of teething is a fretful cry; the cry of earache is short, sharp, piercing, and decisive, the head being moved about from side to side, and the little hand being often put up to the affected side of the head; the cry of bowel-ache is also expressive,—the cry is not so piercing as from earache, and is an interrupted, straining cry, accompanied with a drawing up of the legs to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the cry of inflammation of the lungs is more a moan than a cry; the cry of croup is hoarse, and rough, and ringing, and is so characteristic that it may truly be called “the croupy cry,” moreover, he breathes as though he breathed through muslin; the cry of inflammation of the membranes of the brain is a piercing shriek—a danger signal—most painful to hear; the cry of a child recovering from a severe illness is a cross, and wayward, and tearful cry; he may truly be said to be in a quarrelsome mood; he bursts out without rhyme or reason into a passionate flood of tears; tears are always, in a severe illness, to be looked upon as a good omen, as a sign of amendment: tears, when a child is dangerously ill, are rarely if ever seen; a cry at night, for light—a frequent cause of a babe crying—is a restless cry:
111. If an infant be delicate, have you any objection to his having either veal or mutton broth to strengthen him?
Broths seldom agree with a babe at the breast. I have known them to produce sickness, disorder the bowels, and create fever. I recommend you, therefore, not to make the attempt.
Although broth and beef-tea, when taken by the mouth, will seldom agree with an infant at the breast, yet, when used as an enema, and in small quantities, so that they may be retained, I have frequently found them to be of great benefit: they have, in some instances, appeared to have snatched delicate children from the brink of the grave.
112. My babe’s ankles are very weak: what do you advise to strengthen them?
If his ankles be weak, let them every morning be bathed, after the completion of his morning’s ablution, for five minutes each time, with bay salt and water, a small handful of bay salt dissolved in a quart of rain water (with the chill of the water taken off in the winter, and of its proper temperature in the summer time); then let them be dried; after the drying, let the ankles be well rubbed with the following liniment:
To make a Liniment.
Do not let him be put on his feet early; but allow him to crawl, and sprawl, and kick about the floor, until his ankles become strong.
Do not, on any account, without having competent advice on the subject, use iron instruments or mechanical supports of any kind: the ankles are generally, by such artificial supports, made worse, in consequence of the pressure causing a further dwindling away and enfeebling of the ligaments of the ankles, already wasted and weakened.
Let him wear shoes, with straps over the insteps to keep them on, and not boots: boots will only, by wasting the ligaments, increase the weakness of the ankles.
113. Sometimes there is a difficulty in restraining the bleeding of leech-bites. What is the best method?
The difficulty in these cases generally arises from the improper method of performing it. For example—a mother endeavors to stop the hemorrhage by loading the part with rag; the more the bites discharge, the more rag she applies. At the same time, the child probably is in a room with a large fire, with two or three candles, with the doors closed, and with perhaps a dozen people in the apartment, whom the mother has, in her fright, sent for. This practice is strongly reprehensible.
If the bleeding cannot be stopped,—in the first place, the fire must be extinguished, the door and windows should be thrown open, and the room ought to be cleared of persons, with the exception of one, or, at the most, two; and every rag should be removed. “Stopping of leech-bites.—The simplest and most certain way, till the proper assistance is obtained, is the pressure of the finger, with nothing intervening. It cannot bleed through that.” [Sir Charles Locock, in a Letter to the Author.]
Many babies have lost their lives by excessive loss of blood from leech-bites, from a mother not knowing how to act, and also from the medical man either living at a distance, or not being at hand. Fortunately for the infantile community, leeches are now very seldom ordered by doctors.
114. Supposing a baby to be poorly, have you any advice to give to his mother as to her own management?
She must endeavor to calm her feelings, or her milk will be disordered, and she will thus materially increase his illness. If he be laboring under any inflammatory disorder, she ought to refrain from the taking of beer, wine, and spirits, and from all stimulating food; otherwise, she will feed his disease.
Before concluding the first part of my subject—the Management of Infancy—let me again urge upon you the importance—the paramount importance—if you wish your babe to be strong and hearty,—of giving him as little opening physic as possible. The best physic for him is Nature’s physic—fresh air and exercise and simplicity of living. A mother who is herself always drugging her child, can only do good to two persons—the doctor and the druggist!
If an infant from his birth be properly managed,—if he has an abundance of fresh air for his lungs,—if he has plenty of exercise for his muscles (by allowing him to kick and sprawl on the floor),—if he has a good swilling and sousing of water for his skin,—if, during the early months of his life, he has nothing but the mother’s milk for his stomach,—he will require very little medicine—the less the better! He does not want his stomach to be made into a doctor’s shop! The grand thing is not to take every opportunity of administering physic, but of using every means of withholding it! And if physic be necessary, not to doctor him yourself, unless it be in extreme and urgent cases (which in preceding and succeeding Conversations I either have or will indicate), but to employ an experienced medical man. A babe who is always, without rhyme or reason, being physicked, is sure to be puny, delicate, and unhealthy, and is ready, at any moment, to drop into an untimely grave!
115. In concluding the first part of our subject—Infancy—I beg to remark. There are four things essentially necessary to an infant’s well-doing, namely, (1) plenty of water for the skin; (2) plenty of milk for the stomach; (3) plenty of fresh air for the lungs; (4) plenty of sleep for the brain: these are the four grand essentials for a babe; without an abundance of each and all of them, perfect health is utterly impossible!