Chapter 44

Physiology of Life, as illustrated by Respiration, Circulation, and Digestion.

2445. The infantine management of children, like the mother's love for her offspring, seems to be born with the child, and to be a direct intelligence of Nature. It may thus, at first sight, appear as inconsistent and presumptuous to tell a woman how to rear her infant as to instruct her in the manner of loving it. Yet, though Nature is unquestionably the best nurse, Art makes so admirable a foster-mother, that no sensible woman, in her novitiate of parent, would refuse the admonitions of art, or the teachings of experience, to consummate her duties of nurse. It is true that, in a civilized state of society, few young wives reach the epoch that makes them mothers without some insight, traditional or practical, into the management of infants: consequently, the cases wherein a woman is left to her own unaided intelligence, or what, in such a case, may be called instinct, and obliged to trust to the promptings of nature alone for the well-being of her child, are very rare indeed. Again, every woman is not gifted with the same physical ability for the harassing duties of a mother; and though Nature, as a general rule, has endowed all female creation with the attributes necessary to that most beautiful and, at the same time, holiest function,--the healthy rearing of their offspring,--the cases are sufficiently numerous to establish the exception, where the mother is either physically or socially incapacitated from undertaking these most pleasing duties herself, and where, consequently, she is compelled to trust to adventitious aid for those natural benefits which are at once the mother's pride and delight to render to her child.

2446. In these cases, when obliged to call in the services of hired assistance, she must trust the dearest obligation of her life to one who, from her social sphere, has probably notions of rearing children diametrically opposed to the preconceived ideas of the mother, and at enmity with all her sentiments of right and prejudices of position.

2447. It has justly been said--we think by Hood--that the children of the poor are not brought up, but _dragged up_. However facetious this remark may seem, there is much truth in it; and that children, reared in the reeking dens of squalor and poverty, live at all, is an apparent anomaly in the course of things, that, at first sight, would seem to set the laws of sanitary provision at defiance, and make it appear a perfect waste of time to insist on pure air and exercise as indispensable necessaries of life, and especially so as regards infantine existence.

2448. We see elaborate care bestowed on a family of children, everything studied that can tend to their personal comfort,--pure air, pure water, regular ablution, a dietary prescribed by art, and every precaution adopted that medical judgment and maternal love can dictate, for the well-being of the parents' hope; and find, in despite of all this care and vigilance, disease and death invading the guarded treasure. We turn to the foetor and darkness that, in some obscure court, attend the robust brood who, coated in dirt, and with mud and refuse for playthings, live and thrive, and grow into manhood, and, in contrast to the pale face and flabby flesh of the aristocratic child, exhibit strength, vigour, and well-developed frames, and our belief in the potency of the life-giving elements of air, light, and cleanliness receives a shock that, at first sight, would appear fatal to the implied benefits of these, in reality, all-sufficient attributes of health and life.

2449. But as we must enter more largely on this subject hereafter, we shall leave its consideration for the present, and return to what we were about to say respecting trusting to others' aid in the rearing of children. Here it is that the young and probably inexperienced mother may find our remarks not only an assistance but a comfort to her, in as far as, knowing the simplest and best system to adopt, she may be able to instruct another, and see that her directions are fully carried out.

2450. The human body, materially considered, is a beautiful piece of mechanism, consisting of many parts, each one being the centre of a system, and performing its own vital function irrespectively of the others, and yet dependent for its vitality upon the harmony and health of the whole. It is, in fact, to a certain extent, like a watch, which, when once wound up and set in motion, will continue its function of recording true time only so long as every wheel, spring, and lever performs its allotted duty, and at its allotted time; or till the limit that man's ingenuity has placed to its existence as a moving automaton has been reached, or, in other words, till it has run down.

2451. What the key is to the mechanical watch, air is to the physical man. Once admit air into the mouth and nostrils, and the lungs expand, the heart beats, the blood rushes to the remotest part of the body, the mouth secretes saliva, to soften and macerate the food; the liver forms its bile, to separate the nutriment from the digested aliment; the kidneys perform their office; the eye elaborates its tears, to facilitate motion and impart that glistening to the orb on which depends so much of its beauty; and a dewy moisture exudes from the skin, protecting the body from the extremes of heat and cold, and sharpening the perception of touch and feeling. At the same instant, and in every part, the arteries, like innumerable bees, are everywhere laying down layers of muscle, bones, teeth, and, in fact, like the coral zoophyte, building up a continent of life and matter; while the veins, equally busy, are carrying away the _débris_ and refuse collected from where the zoophyte arteries are building,--this refuse, in its turn, being conveyed to the liver, there to be converted into bile.

2452. All these--and they are but a few of the vital actions constantly taking place--are the instant result of one gasp of life-giving air. No subject can be fraught with greater interest than watching the first spark of life, as it courses with electric speed "through all the gates and alleys" of the soft, insensate body of the infant. The effect of air on the new-born child is as remarkable in its results as it is wonderful in its consequence; but to understand this more intelligibly, it must first be remembered that life consists of the performance of _three_ vital functions--RESPIRATION, CIRCULATION, and DIGESTION. The lungs digest the air, taking from it its most nutritious element, the _oxygen_, to give to the impoverished blood that circulates through them. The stomach digests the food, and separates the nutriment--_chyle_--from the aliment, which it gives to the blood for the development of the frame; and the blood, which is understood by the term circulation, digests in its passage through the lungs the nutriment--_chyle_--to give it quantity and quality, and the _oxygen_ from the air to give it vitality. Hence it will be seen, that, speaking generally, the three vital functions resolve themselves into one,--DIGESTION; and that the lungs are the primary and the most important of the vital organs; and respiration, the first in fact, as we all know it is the last in deed, of all the functions performed by the living body.

THE LUNGS.--RESPIRATION.

2453. The first effect of air on the infant is a slight tremor about the lips and angles of the mouth, increasing to twitchings, and finally to a convulsive contraction of the lips and cheeks, the consequence of sudden cold to the nerves of the face. This spasmodic action produces a gasp, causing the air to rush through the mouth and nostrils, and enter the windpipe and upper portion of the flat and contracted lungs, which, like a sponge partly immersed in water, immediately expand. This is succeeded by a few faint sobs or pants, by which larger volumes of air are drawn into the chest, till, after a few seconds, and when a greater bulk of the lungs has become inflated, the breast-bone and ribs rise, the chest expands, and, with a sudden start, the infant gives utterance to a succession of loud, sharp cries, which have the effect of filling every cell of the entire organ with air and life. To the anxious mother, the first voice of her child is, doubtless, the sweetest music she ever heard; and the more loudly it peals, the greater should be her joy, as it is an indication of health and strength, and not only shows the perfect expansion of the lungs, but that the process of life has set in with vigour. Having welcomed in its own existence, like the morning bird, with a shrill note of gladness, the infant ceases its cry, and, after a few short sobs, usually subsides into sleep or quietude.

2454. At the same instant that the air rushes into the lungs, the valve, or door between the two sides of the heart-and through which the blood had previously passed-is closed and hermetically sealed, and the blood taking a new course, bounds into the lungs, now expanded with air, and which we have likened to a wetted sponge, to which they bear a not unapt affinity, air being substituted for water. It here receives the _oxygen_ from the atmosphere, and the _chyle_, or white blood, from the digested food, and becomes, in an instant, arterial blood, a vital principle, from which every solid and fluid of the body is constructed. Besides the lungs, Nature has provided another respiratory organ, a sort of supplemental lung, that, as well as being a covering to the body, _in_spires air and _ex_pires moisture;--this is the cuticle, or skin; and so intimate is the connection between the skin and lungs, that whatever injures the first, is certain to affect the latter.

2455. _Hence the difficulty of breathing experienced after scalds or burns on the cuticle, the cough that follows the absorption of cold or damp by the skin, the oppressed and laborious breathing experienced by children in all eruptive diseases, while the rash is coming to the surface, and the hot, dry skin that always attends congestion of the lungs, and fever._

2456. The great practical advantage derivable from this fact is, the knowledge that whatever relieves the one benefits the other. Hence, too, the great utility of hot baths in all affections of the lungs or diseases of the skin; and the reason why exposure to cold or wet is, in nearly all cases, followed by tightness of the chest, sore throat, difficulty of breathing, and cough. These symptoms are the consequence of a larger quantity of blood than is natural remaining in the lungs, and the cough is a mere effort of Nature to throw off the obstruction caused by the presence of too much blood in the organ of respiration. The hot bath, by causing a larger amount of blood to rush suddenly to the skin, has the effect of relieving the lungs of their excess of blood, and by equalizing the circulation, and promoting perspiration from the cuticle, affords immediate and direct benefit, both to the lungs and the system at large.

THE STOMACH--DIGESTION.

2457. The organs that either directly or indirectly contribute to the process of digestion are, the mouth, teeth, tongue, and gullet, the stomach, small intestines, the pancreas, the salivary glands, and the liver. Next to respiration, digestion is the chief function in the economy of life, as, without the nutritious fluid digested from the aliment, there would be nothing to supply the immense and constantly recurring waste of the system, caused by the activity with which the arteries at all periods, but especially during infancy and youth, are building up the frame and developing the body. In infancy (the period of which our present subject treats), the series of parts engaged in the process of digestion may be reduced simply to the stomach and liver, or rather its secretion,--the bile. The stomach is a thick muscular bag, connected above with the gullet, and, at its lower extremity, with the commencement of the small intestines. The duty or function of the stomach is to secrete from the arteries spread over its inner surface, a sharp acid liquid called the _gastric_ juice; this, with a due mixture of saliva, softens, dissolves, and gradually digests the food or contents of the stomach, reducing the whole into a soft pulpy mass, which then passes into the first part of the small intestines, where it comes in contact with the bile from the gall-bladder, which immediately separates the digested food into two parts, one is a white creamy fluid called chyle, and the absolute concentration of all nourishment, which is taken up by proper vessels, and, as we have before said, carried directly to the heart, to be made blood of, and vitalized in the lungs, and thus provide for the wear and tear of the system. It must be here observed that the stomach can only digest solids, for fluids, being incapable of that process, can only be _absorbed_; and without the result of digestion, animal, at least human life, could not exist. Now, as Nature has ordained that infantine life shall be supported on liquid aliment, and as, without a digestion the body would perish, some provision was necessary to meet this difficulty, and that provision was found in the nature of the liquid itself, or in other words, THE MILK. The process of making cheese, or fresh curds and whey, is familiar to most persons; but as it is necessary to the elucidation of our subject, we will briefly repeat it. The internal membrane, or the lining coat of a calf's stomach, having been removed from the organ, is hung up, like a bladder, to dry; when required, a piece is cut off, put in a jug, a little warm water poured upon it, and after a few hours it is fit for use; the liquid so made being called _rennet_. A little of this rennet, poured into a basin of warm milk, at once coagulates the greater part, and separates from it a quantity of thin liquor, called _whey_. This is precisely the action that takes place in the infant's stomach after every supply from the breast. The cause is the same in both cases, the acid of the gastric juice in the infant's stomach immediately converting the milk into a soft cheese. It is gastric juice, adhering to the calf's stomach, and drawn out by the water, forming rennet, that makes the curds in the basin. The cheesy substance being a solid, at once undergoes the process of digestion, is separated into _chyle_ by the bile, and, in a few hours, finds its way to the infant's heart, to become blood, and commence the architecture of its little frame. This is the simple process of a baby's digestion:-milk converted into cheese, cheese into _chyle_, chyle into blood, and blood into flesh, bone, and tegument-how simple is the cause, but how sublime and wonderful are the effects!

2458. We have described the most important of the three functions that take place in the infant's body-respiration and digestion; the third, namely, circulation, we hardly think it necessary to enter on, not being called for by the requirements of the nurse and mother; so we shall omit its notice, and proceed from theoretical to more practical considerations. Children of weakly constitutions are just as likely to be born of robust parents, and those who earn their bread by toil, as the offspring of luxury and affluence; and, indeed, it is against the ordinary providence of Nature to suppose the children of the hardworking and necessitous to be hardier and more vigorous than those of parents blessed with ease and competence.

2459. All children come into the world in the same imploring helplessness, with the same general organization and wants, and demanding either from the newly-awakened mother's love, or from the memory of motherly feeling in the nurse, or the common appeals of humanity in those who undertake the earliest duties of an infant, the same assistance and protection, and the same fostering care.

THE INFANT.

2460. We have already described the phenomena produced on the new-born child by the contact of air, which, after a succession of muscular twitchings, becomes endowed with voice, and heralds its advent by a loud but brief succession of cries. But though this is the general rule, it sometimes happens (from causes it is unnecessary here to explain) that the infant does not cry, or give utterance to any audible sounds, or if it does, they are so faint as scarcely to be distinguished as human accents, plainly indicating that life, as yet, to the new visitor, is neither a boon nor a blessing; the infant being, in fact, in a state of suspended or imperfect vitality,--a state of _quasi_ existence, closely approximating the condition of a _still-birth_.

2461. As soon as this state of things is discovered, the child should be turned on its right side, and the whole length of the spine, from the head downwards, rubbed with all the fingers of the right hand, sharply and quickly, without intermission, till the quick action has not only evoked heat, but electricity in the part, and till the loud and sharp cries of the child have thoroughly expanded the lungs, and satisfactorily established its life. The operation will seldom require above a minute to effect, and less frequently demands a repetition. If there is brandy at hand, the fingers before rubbing may be dipped into that, or any other spirit.

2462. There-is another condition of what we may call "mute births," where the child only makes short ineffectual gasps, and those at intervals of a minute or two apart, when the lips, eyelids, and fingers become of a deep purple or slate colour, sometimes half the body remaining white, while the other half, which was at first swarthy, deepens to a livid hue. This condition of the infant is owing to the valve between the two sides of the heart remaining open, and allowing the unvitalized venous blood to enter the arteries and get into the circulation.

2463. The object in this case, as in the previous one, is to dilate the lungs as quickly as possible, so that, by the sudden effect of a vigorous inspiration, the valve may be firmly closed, and the impure blood, losing this means of egress, be sent directly to the lungs. The same treatment is therefore necessary as in the previous case, with the addition, if the friction along the spine has failed, of a warm bath at a temperature of about 80°, in which the child is to be plunged up to the neck, first cleansing the mouth and nostrils of the mucus that might interfere with the free passage of air.

2464. While in the bath, the friction along the spine is to be continued, and if the lungs still remain unexpended, while one person retains the child in an inclined position in the water, another should insert the pipe of a small pair of bellows into one nostril, and while the month is closed and the other nostril compressed on the pipe with the hand of the assistant, the lungs are to be slowly inflated by steady puffs of air from the bellows, the hand being removed from the mouth and nose after each inflation, and placed on the pit of the stomach, and by a steady pressure expelling it out again by the mouth. This process is to be continued, steadily inflating and expelling the air from the lungs, till, with a sort of tremulous leap, Nature takes up the process, and the infant begins to gasp, and finally to cry, at first low and faint, but with every gulp of air increasing in length and strength of volume, when it is to be removed from the water, and instantly wrapped (all but the face and mouth) in a flannel. Sometimes, however, all these means will fail in effecting an utterance from the child, which will lie, with livid lips and a flaccid body, every few minutes opening its mouth with a short gasping pant, and then subsiding into a state of pulseless inaction, lingering probably some hours, till the spasmodic pantings growing further apart, it ceases to exist.

2465. The time that this state of negative vitality will linger in the frame of an infant is remarkable; and even when all the previous operations, though long-continued, have proved ineffectual, the child will often rally from the simplest of means--the application of dry heat. When removed from the bath, place three or four hot bricks or tiles on the hearth, and lay the child, loosely folded in a flannel, on its back along them, taking care that there is but one fold of flannel between the spine and heated bricks or tiles. When neither of these articles can be procured, put a few clear pieces of red cinder in a warming-pan, and extend the child in the same manner along the closed