The Young Mother Part 5
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Whims. Views of Dr. Dewees. Hardening. Rules for the cold bath. Securing a glow. Coming out of the bath. Local baths. Shower bath. Vapor bath.
Sponging. Neglect of bathing. The Romans. Treatment of children compared with that of domestic animals.
Some of the hardy nations of antiquity, as well as a few savage tribes of modern times, have been accustomed to plunge their new-born infants into cold water. This is done for the two-fold purpose of was.h.i.+ng and hardening them.
To all who reason but for a moment on this subject, the danger of such a practice must be obvious. So sudden a change from a temperature of nearly 100 of Fahrenheit to one quite low, perhaps scarcely 40, must and does have a powerful effect on the nervous system even of an adult; but how much more on that of a tender infant? We may form some idea of this, by the suddenness and violence of its cries, by the sudden contractions and relaxations of its limbs and body, and by its palpitating heart and difficult breathing.
Every one's experience may also remind him, that what produces at best a momentary pain to himself, cannot otherwise than be painful to the infant. In making a comparison between adults and infants, however, in this respect, we should remember that the lungs of the infant do not get into full and vigorous action until some time after birth; and that, on this account, the hold they have on life is so feeble, that any powerful shock, and especially that given by the cold bath, is ten times more dangerous to them than to adults, or even to infants themselves, after a few months have elapsed.
It is surprising to me that so sensible a writer as Rousseau generally is on education, should have encouraged this dangerous practice; and still more so that many fathers even now, blinded by theory, should persist in it, notwithstanding the pleadings of the mother or the nurse, and the plainest dictates of common sense and common prudence.[Footnote: Nothing is intended to be said here, which shall encourage unthinking nurses or mothers in setting themselves against measures which have been prescribed by higher authority,--I mean the physician. There are cases of this kind, where it requires all the resolution which a father, uninterrupted, can summon to his aid, to administer a dose or perform a task, on which he knows the existence of his child may be depending: but when the thoughtless entreaties of the mother or nurse are interposed, it makes his condition most distressing. Mothers, in such cases, ought to encourage rather than remonstrate. They who _do not_, are guilty of cruelty, and--perhaps--of infanticide.]
A child plunged into cold water at birth, by those whose theories carry them so far as to do it even in the coldest weather, has sometimes been twenty-four hours in recovering, notwithstanding the most active and judicious efforts to restore it. In other instances the results have been still more distressing. Dr. Dewees is persuaded that he has "known death itself to follow the use of cold water," in this way--I believe he means _immediate_ death--and adds, with great confidence, that he has "repeatedly seen it require the lapse of several hours before reaction could establish itself; during which time the pale and sunken cheeks and livid lips declared the almost exhausted state" of the infant's excitability.[Footnote: "Dewees on children" p. 72.]
We need not hesitate to put very great confidence in the opinion here expressed; for besides being a close and just observer of human nature, Dr. D. has had the direction and management, in a greater or less degree, of several thousands of new-born infants.
Nothing, indeed, in the whole range of physical education, seems better proved, than that while some few infants, whose const.i.tutions are naturally very strong, are invigorated by the practice in question, others, in the proportion of hundreds for one, who are _less_ robust, are injured for life; some of them seriously.
Nor will spirits added to the water make any material difference. I am aware that there is a very general notion abroad, that the injurious effects of cold water, in its application both internally and externally, are greatly diminished by the addition of a little spirit; but it is not so. Does the addition of such a small quant.i.ty of spirit as is generally used in these cases, materially alter the temperature?
Is it not the application of a cold liquid to a heated surface, still?
Can we make anything else of it, either more or less?
I do not undertake to say, that the cold bath may not be so managed in the progress of infancy, as to make it beneficial, especially to strong const.i.tutions. It is its indiscriminate application to all new-born children, without regard to strength of const.i.tution, or any other circ.u.mstances, that I most strenuously oppose. Of its occasional use, under the eye of a physician, and by parents who will discriminate, I shall say more presently.
Our first duty on receiving a new inhabitant of the world is, to see that it is gently but thoroughly washed, in moderately warm soft water, with fine soap. Special attention should be paid to the folds of the joints, the neck, the arm pits, &c. For rubbing the body, in order to disengage anything which might obstruct the pores, or irritate or fret the skin, nothing can be preferable to a piece of soft sponge or flannel. Though the operation should be thorough, and also as rapid as the nature of circ.u.mstances will permit, all harshness should be avoided. When finished, the child should be wiped perfectly dry with soft flannel.
While the was.h.i.+ng is performed, the temperature of the room should be but a few degrees lower than that of the water; and the child should not be exposed to currents of cold air. If the weather is severe, or if currents of air in the room cannot otherwise be avoided, the dressing, undressing, was.h.i.+ng, &c., may be done near the fire. And I repeat the rule, it should always be done with as much rapidity as is compatible with safety.
Here will be seen one great advantage of simplicity in the form of dress. If the more rational suggestions of our chapter on that subject are attended to, it will greatly facilitate the process of was.h.i.+ng, and the subsequent daily process of bathing, which I am about to recommend to my readers.
This was.h.i.+ng process is also an introduction to bathing. For it should be repeated every day; but with less and less attention to the was.h.i.+ng, and more and more reference to the bathing. How long the child should stay in the bath, must be left to experience. If he is quiet, fifteen minutes can never be too long; and I should not object to twenty. If otherwise, and you are obliged to remove him in five minutes, or even in three, still the bathing will be of too much service to be dispensed with.
Nothing should be mixed with the water, if the infant is healthy, except a little soap, as already mentioned. Some are fond of using salt; but it is by no means necessary, and may do harm.
The proper hour for bathing is the early part of the day, or about the middle of the forenoon. This season is selected, because the process, manage it as carefully as we may, is at first a little exhausting. As the child grows older, however, and not only becomes stronger, but appears to be actually refreshed and invigorated by the bath, it will be advisable to defer it to a later and later hour. By the time the babe is three months old, particularly in the warm season, the hour of bathing may be at sunset.
The degree of heat must be determined, in part, by observing its effect on the child; and in part by a thermometer. For this, and for other purposes, a thermometer, as I have already more than hinted, is indispensable in every nursery. Our own sensations are often at best a very unsafe guide. There is one rule which should always be observed--never to have the temperature of the bath below that of the air of the room. If the thermometer show the latter to be 70, the bath should be something like 80; perhaps with feeble children, rather more.
Great care ought always to be taken to proportion the air of the room and the water of the bath to each other. If, for example, the temperature of the room have been, for some time, unusually warm, that of the water must not be so low as if it had been otherwise. On the contrary, if the room have been, for a considerable time, rather cool, the bath may be made several degrees cooler than in other circ.u.mstances.
But in no case and in no circ.u.mstances must a _warm_ bath--intended as such, simply--be so warm or so cold, as to make the child uncomfortable; whether the temperature be 70, 80, or 90.
It is hardly necessary to add, that in bathing a young child, the vessel used for the purpose should be large enough to give free scope to all the motions of its extremities. Most children are delighted to play and scramble about in the water. I know, indeed, that the contrary sometimes happens; but when it does, it is usually--I do not say _always_--because the countenances of those who are around express fear or apprehension; for it is surprising how early these little beings learn to decipher our feelings by our very countenances.
Some of our readers may be surprised at the intimation that there are mothers and nurses who have fears or apprehensions in regard to the effects of the warm bath; but others--and it is for such that I write this paragraph--will fully understand me. I have been often surprised at the fact, but it is undoubted, that there is a strong prejudice against warm bathing, in many parts of the country. In endeavoring to trace the cause, I have usually found that it arose from having seen or heard of some child who died soon after its application. I have had many a parent remonstrate with me on the danger of the warm bath; and this, too, in circ.u.mstances when it appeared to me, that the child's existence depended, under G.o.d, on that very measure. Perhaps it is useless in such cases, however, to reason with parents on the subject. The medical pract.i.tioner must do his duty boldly and fearlessly, and risk the consequences.
But as I am writing, not for persons under immediate excitement, but for those that may be reasoned with, it is proper to say, that in medicine, the warm bath is so often used in extreme cases, and as a last resort, even when death has already grasped, or is about to fix his grasp on the sufferer, that it would be very strange if many persons _did not_ die, just after bathing. But that the bathing itself ever produced this result, in one case in a thousand, there is not the slightest reason for believing. [Footnote: Let me not be understood as intimating that, the general neglect of bathing, of which I complain so loudly, is _chiefly_ owing to this unreasonable prejudice, though this no doubt has its sway.
On the contrary, I believe it is much oftener owing to ignorance, indolence, and parsimony.]
There are many more whims connected with bathing, as with almost everything else, which it were equally desirable to remove. Some nurses and mothers think that if the child's skin is wiped dry after bathing, it will impair, if not destroy, the good effects of the operation.
Others still, shocking to relate, will even put it to bed in its wet clothes; this, too, from principle. Not unlike this, is the belief, very common among adults, that if we get our clothes wet--even our stockings--we must, by all means, suffer them to dry on us; a belief which, in its results, has sent thousands to a premature grave--and, what is still worse, made invalids, for life, of a still greater number.
I am aware, that in rejecting the indiscriminate cold bathing of infants, I am treading on ground which is rather unpopular, even with medical men; a large proportion of whom seem to believe that the practice may be useful. But I am not _wholly_ alone. Dr. Dewees--of whose large experience I have already spoken--and some others, do not hesitate to avow similar sentiments.
The objections of Dr. Dewees to cold bathing are the following. 1. There often exists a predisposition to disease, which cold bathing is sure to rouse to action. Or if the disease have already begun to affect the system, the bath is sure to aggravate it. 2. Some children have such feeble const.i.tutions that they are sure to be permanently weakened by it, rather than invigorated. 3. To those in whom there is the tendency of a large quant.i.ty of blood to the head, lungs, liver, &c., it is injurious. 4. In some, the shock produces a species of syncope, or catalepsy. 5. The _reaction_, as shown by the heat which follows the cold bath, is, in some cases, so great as to produce a degree of fever, and consequent debility. 6. It never answers the purposes of cleanliness--one great object of bathing--so well as the warm bath. 7.
It is always unpleasant or painful to the child; especially at first. 8.
It sometimes produces severe pain in the bowels.
This is a very formidable list of objections; and certainly deserves consideration. There is one statement made by Dr. D. in the progress of his remarks on this subject, in which I do not concur. He says--"The object of all bathing is to remove impurities arising from dust, perspiration, &c., from the surface; that the skin may not be obstructed in the performance of its proper offices."
But the object of cold bathing, with many, is to _harden_; consequently it is not true that cleanliness is the _only object_. If he means, even, that cleanliness is the only _legitimate_ object of all bathing, I shall still be compelled to dissent.
If the cold bath could be used, always, by and with the direction of a skilful physician, I believe its occasional use might be rendered salutary. And although as it is now commonly used, I believe its effects are almost anything but salutary, I do not deny that if its use were cautiously and gradually begun, and judiciously conducted, it might be the means of making children who are already robust, still more hardy and healthy than before, and better able to resist those sudden changes of temperature so common in our climate, and so apt to produce cold, fever, and consumption.
Cold bathing, in the hands of those who are ignorant of the laws of the human frame--and such unfortunately and unaccountably most fathers and mothers are--I cannot help regarding as a highly dangerous weapon; and therefore it is, that in view of the whole subject, I cannot recommend its general and indiscriminate use.
If there are individuals, however, who are determined to employ it, in the case of their more vigorous children, and without the advice or direction of their family physician, I beg them to attend to the following rules or principles, expressed as briefly as possible.
In no ordinary case whatever, is the cold bath useful, unless it is succeeded by that degree of warmth on the surface of the body which is usually called a _glow_. This is a leading and important principle. The contrary, that is, the injurious effects of cold bathing--its _immediate_ bad effects, I mean--are shown by the skin remaining pale and shrivelled after coming out of the bath, by its blue appearance, and by its coldness, as well as by a sunken state of the eyes, and much general languor.
To secure this point--I mean the GLOW--it is indispensably important to begin the use of cold water gradually; that is, to use it at first of so high a temperature as to produce only a slight sensation of cold, and to take special care that the skin be immediately wiped very dry, and the temperature of the room be quite as high as usual. Afterward the water may be cooled gradually, from week to week, though never more than a degree or two at once.
It will probably be unsafe to commence this practice of cold bathing--even in the case of the most robust children--until they are at least six months of age.
The appropriate season will be the middle of the forenoon, the hour when the system is usually the most vigorous, and at which we shall be most likely to secure a reaction. At first, twice or three times a week are as often as it will be safe to repeat it. Some writers recommend it twice a day; but once is enough, under any ordinary circ.u.mstances.
The method at first is, to give the infant a single plunge. Afterward, when he becomes older, and more inured to it, he may be plunged several times in succession.
On taking him out of the bath, the skin should be wiped perfectly dry, as in the case of the warm bath, and with the same or an increased degree of attention to other circ.u.mstances--the temperature of the room, the avoiding currents of air, &c. He should next be put in a soft, warm blanket, and be kept for some time in a state of gentle motion; and after a little time, should be dressed.
I have already mentioned the importance of avoiding the manifestation of fear, when we bathe a child; and the caution is particularly necessary in the administration of the cold bath. Some writers even recommend, that during the whole process of undressing, bathing, exercising, and dressing, singing should be employed. There is philosophy in this advice, and it is easily tried; but I cannot speak of it from experience.
There is one thing which may serve to calm our apprehensions--if we have any--of danger; which is, that though the child's lungs are feeble at first, from their not having been, like the heart, accustomed to previous action, yet when they get fairly into motion and action, and the child is a few months old, they are probably as strong, if not stronger, in proportion, than those of adults.
Bathing in cold water should never be performed immediately after a full meal. Neither is it desirable to go to the contrary extreme, and bathe when the stomach has been long empty; nor when the child's mental or bodily powers are more than usually exhausted by fatigue.
Although I have given these rules for those who are determined to use the cold bath with their children, yet, for fear I shall be misunderstood, I must be suffered to repeat, in this place, that, uninformed as people generally are in regard to physiology, I cannot advise even its moderate use. On the contrary, I would gladly dissuade from it, as most likely, in the way it would inevitably be used, to do more harm than good.
There is no sort of objection to what might be called local bathing with cold water. If the child's head is hot at any time, the temples, and indeed the whole upper part of the head, may be very properly wet with moderately cold water--taking care to avoid wetting the clothes. But avoid, by all means, the common but foolish practice of putting spirits in the water.
A tea-spoonful of cold water cannot be too early put into the mouth of the infant. The object is to cleanse or rinse the mouth; and the process may be aided by wiping it out with a piece of soft linen rag. If a part or all of the water should be swallowed, no harm will be done. This practice, commenced almost as soon as children are born, has saved many a sore mouth.
There are other forms of bathing besides those already mentioned; among which are the shower bath, the vapor bath, and the medicated bath. The shower bath--for which purpose the water is commonly used cold--is but poorly adapted to the wants of infants. The shock is much greater than the common cold bath, and more apt to frighten; and fear is unfavorable to reaction, or the production of a genial glow.
The vapor bath is much better; and probably has quite as good an effect as the common warm bath. The trouble and expense of procuring the necessary apparatus is somewhat greater, however, as a mere bathing tub costs but little, and can be made by every father who possesses common ingenuity. But whatever may be the expense, it is indispensable in every family; and whenever the pores of the skin are obstructed, a vapor bathing apparatus is equally desirable.
The medicated vapor bath is sometimes used; but I am not now treating of infants who are sick, but of those who are in a state of health.
The common warm bath is sometimes medicated by putting in salt. This, of course, renders the water more stimulating to the skin; but except when the perspiration is checked, or the skin peculiarly inactive from some other cause--in other words, unless we are sick--it is seldom expedient to use it.
There is one subst.i.tute for the bathing tub, in the case of the cold bath. I refer to the use of a wet cloth or sponge, applied rapidly to the whole surface of the body. When this is done, the skin should be wiped thoroughly dry immediately afterwards, as in the case of complete immersion.
The Young Mother Part 5
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