Advice to a Mother on the Management of Her Children Part 25

Rickets are of various degrees of intensity, the humpbacked being among the worst There are many mild forms of rickets; weak ankles, knocked-knees, bowed-legs, chicken-b.r.e.a.s.t.s, being among the latter number. Many a child, who is not exactly hump-backed, is very round-shouldered, which latter is also a mild species of rickets.

Show me a child that is rickety, and I can generally prove that it is owing to poor living, more especially to poor milk. If milk were always genuine, and if a child had an abundance of it, my belief is that rickets would be a very rare disease. The importance of genuine milk is of national importance. We cannot have a race of strong men and women unless, as children, they have had a good and plentiful supply of milk. It is utterly impossible. Milk might well be considered one of the necessaries of a child's existence. Genuine, fresh milk, then, is one of the grand preventatives, as well as one of the best remedies, for rickets. Many a child would not now have to swallow quant.i.ties Of cod-liver oil if previously he had imbibed quant.i.ties of good genuine milk. An insufficient and a poor supply of milk in childhood sows the seeds of many diseases, and death often gathers the fruit. Can it be wondered at, when there is so much poor and nasty milk in England, that rickets in one shape or another is so prevalent?

When will mothers arouse from their slumbers, rub their eyes, and see clearly the importance of the subject? When will they know that all the symptoms of rickets I have just enumerated _usually_ proceed from the want of nourishment, more especially from the want of genuine, and of an abundance of, milk? There are, of, course, other means of warding off rickets besides an abundance of nouris.h.i.+ng food, such as thorough ablution, plenty of air, exercise, play, and suns.h.i.+ne; but of all these splendid remedies, nourishment stands at the top of the list.

I do not mean to say that rickets _always_ proceeds from poorness of living--from poor milk. It sometimes arises from scrofula, and is an inheritance of one or of both the parents.

Rickety children, if not both carefully watched and managed, frequently, when they become youths, die of consumption.

A mother, who has for some time neglected the advice I have just given, will often find, to her grievous cost, that the mischief has, past remedy, been done, and that it is now "too late!--too late!"

277. _How may a child be prevented from becoming rickety? or, if he be rickety, how ought he to be treated_?

If a child be predisposed to be rickety, or if he be actually rickety, attend to the following rules:--

Let him live well, on good nouris.h.i.+ng diet, such as on tender rump-steaks, cut very fine, and mixed with mashed potatoes, crumb of bread, and with the gravy of the meat. Let him have, as I have before advised, an abundance of good new milk--a quart or three pints during every twenty-four hours. Let him have milk in every form--as milk gruel, Du Barry's Arabica Revalenta made with milk, batter and rice puddings, suet puddings, bread and milk, etc.

_To harden the bones_, let lime water be added to the milk (a table-spoonful to each tea-cupful of milk.)

Let him have a good supply of fresh, pure, dry air. He must almost live in the open air--the country, if practicable, in preference to the town, and the coast in summer and autumn. Sea bathing and sea breezes are often, in these cases, of inestimable value.

He ought not, at an early age, to be allowed to bear his weight upon his legs. He must sleep on a horse-hair mattress, and not on a feather bed. He should use every morning cold baths in the summer and tepid baths in the winter, with bay salt (a handful) dissolved in the water.

Friction with the hand must, for half an hour at a time, every night and morning, be sedulously applied to the back and to the limbs. It is wonderful how much good in these cases friction does.

Strict attention ought to be paid to the rules of health as laid down in these Conversations. Whatever is conducive to the general health is preventive and curative of rickets.

Books, if he be old enough to read them, should be thrown aside; health, and health alone, must be the one grand object.

The best medicines in these cases are a combination of cod-liver oil and the wine of iron, given in the following manner:--Put a tea-spoonful of wine of iron into a wine-gla.s.s, half fill the gla.s.s with water, sweeten it with a lump or two of sugar, then let a tea-spoonful of cod-liver oil swim on the top; let the child drink it all down together, twice or three times a day. An hour after a meal is the _best_ time to give the medicine, as both iron and cod-liver oil sit better on a _full_ than on an _empty_ stomach. The child in a short time will become fond of the above medicine, and will be sorry when it is discontinued.

A case of rickets requires great patience and steady perseverance; let, therefore, the above plan have a fair and long-continued trial, and I can then promise that there will be every probability that great benefit will be derived from it.

278. _If a child be subject to a scabby eruption about the mouth, what is the best local application_?

Leave it to nature. Do not, on any account, apply any local application to heal it; if you do, you may produce injury; you may either bring on an attack of inflammation, or you may throw him into convulsions. No! This "breaking-out" is frequently a safety-valve, and must not therefore be needlessly interfered with. Should the eruption be severe, reduce the child's diet; keep him from b.u.t.ter, from gravy, and from fat meat, or, indeed, for a few days from meat altogether; and give him mild aperient medicine; but, above all things, do not quack him either with calomel or with grey-powder.

279. _Will you have the goodness to describe the eruption on the face and on the head of a young child, called Milk-Crust or Running Scall_?

Milk-crust is a complaint of very young children--of those who are cutting their teeth--and, as it is a nasty looking complaint, and frequently gives a mother a great deal of trouble, of anxiety, and annoyance, it will be well that you should know its symptoms, its causes, and its probable duration.

_Symptoms_.--When a child is about nine months or a year old, small pimples are apt to break out around the ears, on the forehead, and on the head. These pimples at length become vesicles (that is to say, they contain water), which run into one large one, break, and form a nasty dirty-looking yellowish, and sometimes greenish, scab, which scab is moist, indeed, sometimes quite wet, and gives out a disagreeable odour, and which is sometimes so large on the head as actually to form a skullcap, and so extensive on the face as to form a mask. These, I am happy to say, are rare cases. The child's beauty is, of, course, for a time completely destroyed, and not only his beauty, but his good temper; for as the eruption causes great irritation and itching, he is constantly clawing himself, and crying with annoyance the great part of the day, and sometimes also of the night--the eruption preventing him from sleeping. It is not contagious, and soon after he has cut the whole of his first set of teeth it will get well, provided it has not been improperly interfered with.

_Causes_.--Irritation from teething; stuffing him with overmuch meat, thus producing a humour, which Nature tries to get rid of by throwing it out on the surface of the body; the safest place she could fix on for the purpose; hence the folly and danger of giving medicines and applying _external_ applications to drive the eruption in. "Diseased nature oftentimes breaks forth in strange eruptions," and cures herself in this way, if she be not too much interfered with, and if the eruption be not driven in by injudicious treatment. I have known in such cases disastrous consequences to follow over-officiousness and meddlesomeness. Nature is trying all she can to drive the humour out, while some wiseacres are doing all they can to drive the humour in.

_Duration_.--As milk-crust is a tedious affair, and will require a variety of treatment, it will be necessary to consult an experienced medical man; and although he will be able to afford great relief, the child will not, in all probability, be quite free from the eruption until he have cut the whole of his first set of teeth--until he be upwards of two years and a half old--when, with judicious and careful treatment, it will gradually disappear, and eventually leave not a trace behind.

It will be far better to leave the case alone--to get well of itself--rather than to try to cure the complaint either by outward applications or by strong internal medicines; "the remedy is often worse than the disease," of this I am quite convinced.

280. _Have you any advice to give me as to my conduct towards my medical man_?

Give him your entire confidence. Be truthful and be candid with him. Tell him the truth, the whole truth, and nothing but the truth. Have no reservations; give him, as near as you can, a plain, unvarnished statement of the symptoms of the disease. Do not magnify, and do not make too light of any of them. Be prepared to state the exact time the child first showed symptoms of illness. If he have had a s.h.i.+vering fit, however slight, do not fail to tell your medical man of it. Note the state of the skin; if there be a "breaking-out"--be it ever so trifling--let it be pointed out to him. Make yourself acquainted with the quant.i.ty and with the appearance of the urine, taking care to have a little of it saved, in case the doctor may wish to see and examine it. Take notice of the state of the motions--their number during the twenty-four hours, their colour, their smell, and their consistence, keeping one for his inspection. Never leave any of these questions to be answered by a servant; a mother is the proper person to give the necessary and truthful answers, which answers frequently decide the fate of the patient. Bear in mind, then, a mother's untiring care and love, attention and truthfulness, frequently decide whether, in a serious illness, the little fellow shall live or die! Fearful responsibility!

A medical man has arduous duties to perform; smooth, therefore, his path as much as you can, and you will be amply repaid by the increased good he will be able to do your child. Strictly obey a doctor's orders--in diet, in medicine, in everything. Never throw obstacles in his way. Never omit any of his suggestions; for, depend upon it that if he be a sensible man, directions, however slight, ought never to be neglected; bear in mind, with a judicious medical man,

"That nothing walks with aimless feet."--_Tennyson_.

If the case be severe, requiring a second opinion, never of your own accord call in a physician, without first consulting and advising with your own medical man. It would be an act of great discourtesy to do so. Inattention to the foregoing advice has frequently caused injury to the patient, and heart-burnings and ill-will among doctors.

Speak, in the presence of your child, with respect and kindness of your medical man, so that the former may look upon the latter as a friend--as one who will strive, with G.o.d's blessing, to relieve his pain and suffering. Remember the increased power of doing good the doctor will have if the child be induced to like, instead of dislike, him. Not only be careful that you yourself speak before your child, respectfully and kindly of the medical man, but see that your domestics do so likewise; and take care that they are never allowed to frighten your child, as many silly servants do, by saying that they will send for the doctor, who will either give him nasty medicine, or will perform some cruel operation upon him. A nurse-maid should, then, never for one moment be permitted to make a doctor an object of terror or of dislike to a child.

Send, whenever it be practicable, for your doctor _early_ in the morning, as he will then make his arrangements accordingly, and can by daylight better ascertain the nature of the complaint, more especially if it be a skin disease. It is utterly impossible for him to form a correct opinion of the nature of a "breaking-out" either by gas or by candle light. If the illness come on at night, particularly if it be ushered in either with a severe s.h.i.+vering, or with any other urgent symptom, no time should be lost, be it night or day, in sending for him,

"A little fire is quietly trodden out, Which, being sufier'd, rivers cannot quench."

_Shakespeare_.

WARM BATHS

281. _Have the goodness to mention the complaints of a child for which warm baths are useful_.

1. Convulsions; 2. Pains in the bowels, known by, the child drawing up his legs, screaming violently, etc.; 3. Restlessness from teething; 4. Flatulence. The warm bath acts as a fomentation to the stomach and the bowels, and gives ease where the usual remedies do not rapidly relieve.

282. _Will you mention the precautions, and the rules to be observed in gutting a child info a warm bath_?

Carefully ascertain before he be immersed in the bath that the water be neither too hot nor too cold. Carelessness, or over-anxiety to put him in the water as quickly as possible, has frequently, from his being immersed in the bath when the water was too hot, caused him great pain and suffering. From 96 to 98 degrees of Fahrenheit is the proper temperature of a warm bath. If it be necessary to add fresh warm water, let him be either removed the while, or let it not be put in when very hot; for if boiling water be added to increase the heat of the bath, it naturally ascends, and may scald him. Again, let the fresh water be put in at as great a distance from him as possible. The usual time for him to remain in a bath is a quarter of an hour or twenty minutes. Let the chest and the bowels be rubbed with the hand while he is in the bath. Let him be immersed in the bath as high up as the neck, taking care that he be the while supported under the armpits, and that his head be also rested. As soon as he comes out of the bath, he ought to be carefully but quickly rubbed dry; and if it be necessary to keep up the action on the skin, he should be put to bed, between the blankets; or if the desired relief has been obtained, between the sheets, which ought to have been previously warmed, where, most likely, he will fall into a sweet refres.h.i.+ng sleep.

WARM EXTERNAL APPLICATIONS.

283. _In case of a child suffering pain either in his stomach or in his bowels, or in case he has a feverish cold, can you tell me of the best way of applying heat to them_?

In pain either of the stomach or of the bowels, there is nothing usually affords greater or speedier relief than the _external_ application of heat The following are four different methods of applying heat:--1. A bag of hot salt--that is to say, powdered table-salt--put either into the oven or into a frying-pan over the fire, and thus made hot, and placed in a flannel bag, and then applied, as the case may be, either to the stomach or to the bowels. Hot salt is an excellent remedy for these pains. 2. An india-robber hot-water bottle, [Footnote: Every house where there are children ought to have one of these India-rubber hot-water bottles. It may be procured at any respectable Vulcanised India-rubber warehouse.]

half filled with hot water--it need not be boiling--applied to the stomach or to the bowels, will afford great comfort 3. Another and an excellent remedy for these cases is a hot bran poultice. The way to make it is as follows:--Stir bran into a Vessel containing either a pint or a quart (according to size of poultice required) of boiling water, until it be the consistence of a nice soft poultice, then put into a flannel bag and apply it to the part affected. When cool, dip it from time to time in _hot_ water. 4. In case a child has a feverish cold, especially if it be attended, as it sometimes is, with pains in the bowels, the following is a good external application.--Take a yard of flannel, fold it in three widths, then dip it in very hot water, wring it out tolerably dry, and apply it evenly and neatly round and round the bowels; over this, and to keep it in its place, and to keep in the moisture, put on a _dry_ flannel bandage, four yards long and four inches wide. If it be put on at bed-time, it ought to remain on all night. Where there are children, it is desirable to have the yard of flannel and the flannel bandage in readiness, and then a mother will be prepared for emergencies. Either the one or the other, then, of the above applications will usually, in pains of the stomach and bowels, afford great relief. There is one great advantage of the _external_ application of heat--it can never do harm; if there be inflammation, it will do good; if there be either cramps or spasms of the stomach, it will be serviceable; if there be colic, it will be one of the best remedies that can be used; if it be a feverish cold, by throwing the child into a perspiration, it will be beneficial.

It is well for a mother to know how to make a white bread poultice; and as the celebrated Abernethy was noted for his poultices, I will give you his directions, and in his very words:--"Scald out a basin, for you can never make a good poultice unless you have perfectly boiling water, then, having put in some hot water, throw in coa.r.s.ely crumbled bread, and cover it with a plate. When the bread has soaked up as much water as it will imbibe, drain off the remaining water, and there will be left a light pulp. Spread it a third of an inch thick on folded linen, and apply it when of the temperature of a warm bath. It may be said that this poultice will be very inconvenient if there be no lard in it, for it will soon get dry; but this is the very thing you want, and it can easily be moistened by dropping warm water on it, whilst a greasy poultice will be moist, but not wet."--_South's Household Surgery_.

ACCIDENTS.

284. _Supposing a child to cut his finger, what is the best application_?

There is nothing better than tying it up with rag in its blood, as nothing is more healing than blood. Do not wash the blood away, but apply the rag at once, taking care that no foreign substance be left in the wound. If there be either gla.s.s or dirt in it, it will of course be necessary to bathe the cut in warm water, to get rid of it before the rag be applied. Some mothers use either salt or Fryar's Balsam, or turpentine, to a fresh wound; these plans are cruel and unnecessary, and frequently make the cut difficult to heal. If it bleed immoderately, sponge the wound freely with cold water. If it be a severe cut, surgical aid, of course, will be required.

285. _If a child receive a blow, causing a bruise, what had better be done_?

Immediately smear a small lump of _fresh_ b.u.t.ter on the part affected, and renew it every few minutes for two or three hours; this is an old-fas.h.i.+oned, but a very good remedy. Olive oil may--if _fresh_ b.u.t.ter be not at hand--be used, or soak a piece of brown-paper in one third of French brandy and two-thirds of water, and immediately apply it to the part; when dry renew it. Either of these simple plans--the b.u.t.ter plan is the best--will generally prevent both swelling and disfiguration.