Advice to a Mother on the Management of Her Children Part 22

240. _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.

241. _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 towards 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 t.e.s.t.i.c.l.e.

242. _What is the treatment of Mumps_?

Foment the swelling, four or five times a day, with a flannel wrung out of hot camomile and poppy-head decoction; [Footnote: Four poppy-heads and four ounces of camomile blows to be boiled in four pints of water for half an hour, and then strained to make the decoction.] and apply, every night, a barm and oatmeal poultice to the swollen gland or glands. 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.

243. _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 s.h.i.+lling 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-fas.h.i.+oned remedy for a boil--namely, common yellow soap and brown-sugar, is a capital one for the purpose. It is made with equal parts of brown sugar and of shredded yellow soap, and mixed by means of a table-knife on a plate, with a few drops of water, until it be all well blended together, and of the consistence of thick paste; it should then be spread either on a piece of wash-leather, or on thick linen, and applied to the boil, and kept in its place by means either of a bandage or of a folded handkerchief; and should he removed once or twice a day. This is an excellent application for a boil--soothing, comforting, and drawing--and will soon effect a cure. A paste of honey and flour, spread on linen rag, is another popular and good application for a boil.

_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 boil should arise from gross and improper feeding_, then keep him for a time from meat, and let him live princ.i.p.ally on a milk and farinaceous diet.

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

244. _What are the symptoms of Ear-ache_?

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

Screaming from ear-ache may be distinguished from the screaming from bowel-ache by the former (ear-ache) 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 (ear-ache), 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.

213. _What is the best remedy for Ear-ache_?

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 camomile and poppy head decoction. A roasted onion, inclosed in muslin applied to the ear, is an old-fas.h.i.+oned and favourite 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 subst.i.tuted, 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 ear-ache 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 ear-ache, _more especially if the discharge be offensive_, instantly call in a medical man, or deafness for life may be the result.

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

246. _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 ear-ache.

The _treatment_ consists in keeping the parts clean, by syringing the ear every morning with warm water, by attention to food--keeping the child princ.i.p.ally upon a milk and a farmaceous diet, and by change of air--more especially to the coast. If change of air be not practicable, great attention should 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 case.

247. _What is the treatment of a "stye" on 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.

248. _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." [Footnote: Sir Charles Loc.o.c.k, 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.

249. _What are the best aperients for a child_?

If it be _actually_ necessary to give him opening medicine, one or two tea-spoonfuls of Syrup of Senna, repeated, if necessary, in four hours, will generally answer the purpose; or, for a change, one or two tea-spoonfuls of Castor Oil may be subst.i.tuted. 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 tea-spoonful 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 sweeting the infusion, [Footnote: Infusion of Senna may be procured of any respectable druggist. It will take about one or two table-spoonfuls, 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.]

adding milk, and drinking as ordinary tea, which, when thus prepared, it much resembles" [Footnote: _Waring's Manual of Practical Therapeutics._] Honey, too, is a nice aperient for a child--a tea-spoonful 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 Carbonate 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 colourless 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 of two or three years old may take one or two table-spoonfuls of the fluid; either by itself or in his food, repeating it every four hours until the bowels be open. When the child is old enough to drink the draught off _immediately_, the addition of one or two tea-spoonfuls of Lemon Juice to each dose of the Fluid Magnesia, makes a pleasant effervescing draught, and increases its efficacy as an aperient.

Bran-bread [Footnote: One-part of bran to three parts of flour, mixed together and made into bread.] and _treacle_ will frequently open the bowels; and as treacle is wholesome, it may be subst.i.tuted for b.u.t.ter when the bowels are inclined to be costive. 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 table-spoonfuls 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. Stewed prunes may be given in treacle--treacle increasing the aperient properties of the prunes.

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.

Another excellent method of opening a child's bowels is by means of an enema of warm water,--from half a tea-cupful to a tea-cupful, or even more, according to the age of the child. I cannot speak too highly of this plan as a remedy for costiveness, as it entirely, in the generality of cases, prevents the necessity of administering a particle of aperient medicine by the mouth. The fact of its doing so stamps it as a most valuable remedy--opening physic being, as a rule, most objectionable, and injurious to a child's bowels. Bear this fact--for it is a fact--in mind and let it be always remembered.

450. _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.

251. _What are the remedies_?

If the protrusion of the bowel have been brought on by the abase 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 effects it will in such cases, be better than the _internal_ administration of aperients. Castor Oil used as a Liniment is a good one for the purpose. Let the bowels be well rubbed, every night and morning, for five minutes at a time with the oil.

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 or Robinson's Patent Groats, or Robinson's Pure Scotch Oatmeal made into gruel with new milk, or Du Barry's Arabica Revalenta, or a slice of Huntly and Palmer's lump gingerbread. Let him eat stewed prunes, stewed rhubarb, roasted apples, strawberries, raspberries, the inside of grapes and gooseberries, figs, &c. 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 fore-finger 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 whilst 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.

252. _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 appet.i.te, and to weaken and depress him, give brimstone! Brimstone is not a remedy fit for a child's stomach. The princ.i.p.al 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 practised, 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."

253. _When a child is delicate, and his body, without any a.s.signable 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 tea-cupful of either strong mutton-broth or of strong beef-tea, used as an enema every four hours. [Footnote: 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 dessert-spoonful of brandy, or half a wine-gla.s.sful of port wine, ought to be added to each enema.

The above plan ought only to be adopted if there be _no_ diarrhoea. If there be diarrhoea, 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 hip bone, and should be shredded very fine. All fat and skin must be carefully removed. One or two tea-spoonfuls (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 diarrhoea, was introduced into practice by a Russian physician, a Professor Wiesse of St Petersburg. It certainly is, in these cases, a most valuable remedy, and has frequently been the means of s.n.a.t.c.hing such patients from the jaws of death. Children usually take raw meat with avidity and with a relish.