Advice to a Mother on the Management of Her Children Part 8

Make a Mixture, One or two tea-spoonfuls (according to the age of the child) to be taken every four boors, until relief be obtained--first shaking the bottle.) If it arise from a mother's imprudence in eating trash, or from her taking violent medicine, a warm bath, a warm bath, indeed, let the cause of "griping" be what it may, usually affords instant relief.

Another excellent remedy is the following--Soak a piece of new flannel, folded into two or three thicknesses, in warm water, wring it tolerably dry, and apply as hot as the child can comfortably bear it to the bowels, then wrap him in a warm, dry blanket, and keep him, for at least half an hour, enveloped in it. Under the above treatment, he will generally soon fall into a sweet sleep, and awake quite refreshed.

_What NOT to do_--Do not give opiates, astringents, chalk, or any quack medicine whatever.

If a child suffer from a mother's folly in her eating improper food, it will be cruel in the extreme for him a _second_ time to be tormented from the same cause.

99. _What occasions Hiccup, and what is its treatment_?

Hiccup is of such a trifling nature as hardly to require interference. It may generally be traced to over feeding. Should it be severe, four or five grains of calcined magnesia, with a little syrup and aniseed water, and attention to feeding are all that will be necessary.

100. _Will you describe the symptoms of Infantile Diarrhoea_?

Infantile diarrhoea, or _cholera infantum_, is one of the most frequent and serious of infantile diseases, and carries off, during the year, more children than any other complaint whatever a knowledge of the symptoms, therefore, is quite necessary for a mother to know, in order that she may, at the proper tune, call in efficient medical aid.

It will be well, before describing the symptoms, to tell you how many motions a young infant ought to have a day, their colour, consistence, and smell. Well, then, he should have from three to six motions in the twenty four hours, the colour ought to be a bright yellow, inclining to orange, the consistence should be that of thick gruel; indeed, his motion, if healthy, ought to be somewhat of the colour (but a little more orange-tinted) and of the consistence of mustard made for the table; it should be nearly, if not quite, devoid of smell; it ought to have a faint and peculiar, but not a strong disagreeable odour. If it have a strong and disagreeable smell, the child is not well, and the case should be investigated, more especially if there be either curds or lumps in the motions; these latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint--that is to say, that he has six or eight motions during the twenty-four hours,--and that the stools are of a thinner consistence than what I have described,--provided, at the same time, that he be not griped, that he have no pain, and have not lost his desire for the breast:--What ought to be done?_Nothing_. A slight looseness of the bowels should _never_ be interfered with,--it is often an effort of nature to relieve itself of some vitiated motion that wanted a vent--or to act as a diversion, by relieving the irritation of the gums. Even if he be not cutting his teeth, he may be "breeding"

them--that is to say, the teeth may be forming in his gums, and may cause almost as much, irritation as though he were actually cutting them. Hence, you see the immense good a slight "looseness of the bowels" may cause. I think that I have now proved to you the danger of interfering in such a case, and that I have shown you, the folly and the mischief of at once giving astringents--such as G.o.dfrey's Cordial, Dalby's Carminative, &c.--to relieve a _slight_ relaxation.

A moderate "looseness of the bowels," then, is often a safety-valve, and you may, with as much propriety, close the safety-valve of a steam engine, as stop a moderate "looseness of the bowels!"

Now, if the infant, instead of having from three to six motions, should have more than double the latter number; if they be more watery; if they become slimy and green, or green in part and curdled; if they should have an unpleasant smell; if he be sick, cross, restless, fidgety, and poorly; if every time he have a motion he be griped and in pain, we should then say that he is labouring under Diarrhoea; then, it will be necessary to give a little medicine, which I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case becomes more serious; still, with proper care, relief can generally be quickly obtained. If the evacuations--instead of being stool--are merely blood and slime, and the child strain frequently and violently, endeavouring thus, but in vain, to relieve himself, crying at each effort, the case a.s.sumes the character of Dysentery. [Footnote: See Symptoms and Treatment of Dysentery.]

If there be a mixture of blood, slime, and stool from the bowels, the case would be called Dysenteric-diarrhoea. The latter case requires great skill and judgment on the part of a medical men, and great attention and implicit obedience from the mother and the nurse. I merely mention these diseases in order to warn you of their importance, and of the necessity of strictly attending to a doctor's orders.

101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_

Improper food; overfeeding; teething; cold; the mother's milk from various causes disagreeing, namely, from her being out of health, from her eating unsuitable food, from her taking improper and drastic purgatives, or from her suckling her child when she is pregnant. Of course, if any of these causes are in operation, they ought, if possible, to be remedied, or medicine to the babe will be of little avail.

102. _What is the treatment of Diarrhoea_?

_What to do._--If the case be _slight_, and has lasted two or three days (do not interfere by giving medicine at first), and if the cause, as it probably is, be some acidity or vitiated stool that wants a vent, and thus endeavours to obtain one by purging, the best treatment is, to a.s.sist nature by giving either a dose of castor oil, or a moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and magnesia mixture prescription, see page 71 (_note_).] and thus to work off the enemy. After the enemy has been worked off, either by the castor oil, or by the magnesia and rhubarb, the purging will, in all probability, cease; but if the relaxation still continue, that is to say, for three or four days--then, if medical advice cannot be procured, the following mixture should be given:--

Take of--Aromatic Powder of Chalk and Opium, ten grains; Oil of Dill, five drops; Simple Syrup, three drachms; Water, nine drachms;

Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half a tea-spoonful to be given to an infant of six months and under, and one tea-spoonful to a child above that age, every four hours--first shaking the bottle.

If the babe be at the breast, he ought, for a few days, to be kept _entirely_ to it. 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 diarrhoea 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 diarrhoea continues, to have any artificial food. He must neither be dosed with grey-powder (a favourite, but highly improper Remedy, in these cases), nor with any quack medicines, such as Dalby's Carminative or G.o.dfrey's Cordial.

103. _What are the symptoms of Dysentery_?

Dysentery frequently arises from a neglected diarrhoea. It is more dangerous than diarrhoea, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skilful 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 diarrhoea--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-sp.a.w.n," during the twenty-four hours.

Suddenly the character of the motion changes,--from being princ.i.p.ally 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 yon 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 quant.i.ties at a time, and frequently, so that it may be retained on the stomach. If a table-spoonful of the milk make him sick, give him a dessert-spoonful; if a dessert-spoonful cause sickness, let him only have a tea-spoonful 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 table-spoonful 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 Loc.o.c.k considers "that, in severe dysentery, especially where there is sickness, there is no remedy equal to pure Calomel, in a full dose without opium." [Footnote: Communicated by Sir Charles Loc.o.c.k to the Author.] 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 quant.i.ty of powdered white sugar, be put dry on the tongue. In three hours after let the following mixture be administered:--

Take of--Compound Powder of Ipecacuanha, five grains; Ipecacuanha Wine, one drachm; Simple Syrup, three drachms; Cinnamon Water, nine drachms;

To make a Mixture, A tea-spoonful to be given every three or four hours, first _well_ shaking the bottle.

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:--

Take of--Powdered Opium, half a grain; Mercury with chalk, nine grains; Sugar of Milk, twenty-four grains;

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 [Footnote: 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.] ought, instead of the medicine recommended above, to be given:--

Take of--Mucilage of Gum Acacia, three drachms; Simple Syrup, three drachms; Tincture of Opium, ten drops (_not_ minims); Castor Oil, two drachms; Cinnamon water, four drachms:

Make a Mixture. A tea spoonful 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 envelope him in a _dry_ blanket. Keep him in this hot, damp blanket for half an hour; then take him out, put on his nightgown 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 skilful 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 grey-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 papulae, 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, &c., and by the patches _not_ a.s.suming a crescentic--half-moon shape; red-gum, in short, may readily he 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 grey-powder.