Part 19

Let him have every morning, if it be summer, a thorough cold water ablution; if it be winter, let the water be made tepid. Let either two handfuls of table salt or a handful of bay salt be dissolved in the water. Let the salt and water stream well over his shoulders and down his back and loins. Let him be well dried with a moderately coarse towel, and then let his back be well rubbed, and his shoulders be thrown back—exercising them, much in the same manner as in skipping, for five or ten minutes at a time. Skipping, by-the-by, is of great use in these cases, whether the child be either a boy or a girl—using, of course, the rope backward, and not forward.

Let books be utterly discarded until his shoulders have become strong, and thus no longer round, and his shoulder-blades have become straight. It is a painful sight to see a child stoop like an old man.

Let him have twice daily a teaspoonful or a dessertspoonful (according to his age) of cod-liver oil.

When he is old enough, let the drill-sergeant give him regular lessons, and let the dancing-master be put in requisition. Let him go through regular gymnastic exercises, provided they are not of a violent character.

But, bear in mind, let there be in these cases no mechanical restraints—no shoulder-straps, no abominable stays. Make him straight by natural means—by making him strong. Mechanical means would only, by weakening and wasting the muscles, increase the mischief, and thus the deformity. In this world of ours there is too much reliance placed on artificial, and too little on natural means of cure.

259. _What are the causes of Bow Legs in a child; and what is the treatment?_

Weakness of constitution, poor and insufficient nourishment, and putting a child, more especially a fat and heavy one, on his legs too early.

_Treatment._—Nourishing food, such as an abundance of milk, and, if he be old enough, of meat; iron medicines; cod-liver oil; thorough ablution, every morning, of the whole body; an abundance of exercise either on pony, or on donkey, or in carriage, but not, until his legs be stronger, on foot. If they are much bowed, it will be necessary to consult an experienced surgeon.

260. _If a child while asleep, “wet his bed,” is there any method of preventing him from doing so?_

Let him be held out just before he himself goes to bed, and again when the family retires to rest. If, at the time, he be asleep, he will become so accustomed to it that he will, without awaking, make water. He ought to be made to lie on his side; for, if he be put on his back, the urine will rest upon an irritable part of the bladder, and, if he be inclined to wet his bed, he will not be able to avoid doing so. He must not be allowed to drink much with his meals, especially with his supper. Wetting the bed is an infirmity with some children—they cannot help it. It is, therefore, cruel to scold and chastise them for it. Occasionally, however, wetting the bed arises from idleness, in which case, of course, a little wholesome correction might be necessary.

A water-proof cloth, or bed-sheeting, as it is sometimes called—one yard by three-quarters of a yard—will effectually preserve the bed from being wetted, and ought always, on these occasions, to be used.

A mother ought, every morning, to ascertain for herself whether her child have wet his bed; if he have, and if unfortunately the water-proof cloth have not been used, the mattress, sheets, and blankets must be instantly taken to the kitchen fire and be properly dried. Inattention to the above has frequently caused a child to suffer, either from a cold, from a fever, or from an inflammation; not only so, but if they be not dried, he is wallowing in filth and in an offensive effluvium. If both mother and nurse were more attentive to their duties—in frequently holding a child out, whether he asks or not—a child wetting his bed would be the exception, and not, as it frequently is, the rule. If a child be dirty, you may depend upon it the right persons to blame are the mother and the nurse, and not the child!

261. _If a child should catch Small-pox, what are the best means to prevent pitting?_

He ought to be desired neither to pick nor to rub the pustules. If he be too young to attend to these directions, his hands must be secured in bags (just large enough to hold them), which bags should be fastened round the wrists. The nails must be cut very close.

Cream smeared by means of a feather, frequently in the day, on the pustules, affords great comfort and benefit. Tripe-liquor has, for the same purpose, been strongly recommended. I, myself, in several cases have tried it, and with the happiest results. It is most soothing, comforting, and healing to the skin.

262. _Can you tell me of any plan to prevent Chilblains, or, if a child be suffering from them, to cure them?_

_First, then, the way to prevent them._—Let a child, who is subject to them, wear, in the winter time, a square piece of wash-leather over the toes, a pair of warm lamb’s-wool stockings, and good shoes; but, above all, let him be encouraged to run about the house as much as possible, especially before going to bed; and on no account allow him either to warm his feet before the fire, or to bathe them in _hot_ water. If the feet be cold, and the child be too young to take exercise, then let them be well rubbed with the warm hand. If adults suffer from chilblains, I have found friction, night and morning, with horse-hair flesh-gloves, the best means of preventing them.

_Secondly, the way to cure them._—_If they be unbroken_, let them be well rubbed, every night and morning, with spirits of turpentine and camphorated oil, first shaking the bottle, and then let them be covered with a piece of lint, over which a piece of wash-leather should be placed.

Take of—Spirits of Turpentine, three drachms; Camphorated Oil, nine drachms:

Mix for a Liniment. For an adult, four drachms of the former, and eight of the latter, may be used. If the child be young, or if the skin be very tender, the camphorated oil may be used without the turpentine.

“An excellent chilblain remedy is made by shaking well together, in a bottle, spirits of turpentine, white vinegar, and the contents of an egg, in equal proportion. With this the chilblains should be rubbed gently whenever they are in a state of irritation, and until the swelling and redness are dissipated.”

_If they be broken_, let a piece of lint be spread with spermaceti cerate, and be applied, every morning, to the part, and let a white-bread poultice be used every night.

263. _During the winter time my child’s hands, legs, etc., chap very much: what ought I to do?_

Let a teacupful of bran be tied up in a muslin bag, and be put, over night, into either a large water-can or jug of _rain_ water; and let this water from the can or jug be the water he is to be washed with on the following morning, and every morning until the chaps be cured. _Rain_ water ought _always_ to be used in the washing of a child; pump water is likely to chap the skin, and to make it both rough and irritable. As often as water is withdrawn, either from the water-can or from the jug, let fresh rain water take its place, in order that the bran may be constantly soaking in it. The bran in the bag should be renewed about twice a week.

Take particular care to dry the skin well every time he be washed; then, after each ablution, as well as every night at bedtime, rub a piece of deer’s suet over the parts affected: a few dressings will perform a cure. The deer’s suet may be bought at any of the shops where venison is sold. Another excellent remedy is glycerin, which should be smeared, by means of the finger or by a camel’s-hair brush, on the parts affected, two or three times a day. If the child be very young, it might be necessary to dilute the glycerin with rose-water: fill a small bottle one-third with glycerin, and fill up the remaining two-thirds of the bottle with rose-water—shaking the bottle every time just before using it. The best soap to use for chapped hands is the glycerin soap: no other being required.

264. _What is the best remedy for Chapped Lips?_

Cold-cream (which may be procured of any respectable chemist) is an excellent application for _chapped lips_. It ought, by means of the finger, to be frequently smeared on the parts affected.

265. _Have the goodness to inform me of the different varieties of Worms that infest a child’s bowels?_

Principally three—1, The tape-worm; 2, the long round-worm; and 3, the most frequent of all, the common thread or maw-worm. The tape-worm infests the whole course of the bowels, both small and large: the long round-worm, principally the small bowels, occasionally the stomach; it sometimes crawls out of the child’s mouth, causing alarm to the mother; there is, of course, no danger in its doing so: the common thread-worm or maw-worm infests the rectum or fundament.

266. _What are the causes of Worms?_

The causes of worms are—weak bowels; bad and improper food, such as unripe, unsound, or uncooked fruit, and much green vegetables; pork, especially underdone pork; an abundance of sweets; the neglecting of giving salt in the food. One frequent, if not the most frequent, cause of tape-worm is the eating of pork, more especially if it be underdone. _Underdone_ pork is the most unwholesome food that can be eaten, and is the most frequent cause of tape-worm known. _Underdone_ beef also gives tape-worm; let the meat, therefore, be well and properly cooked. These facts ought to be borne in mind, as prevention is always better than cure.

267. _What are the symptoms and the treatment of Worms?_

_The symptoms_ of worms are—emaciation; itching and picking of the nose; a dark mark under the eyes; grating, during sleep, of the teeth; starting in the sleep; foul breath; furred tongue; uncertain appetite—sometimes voracious, at other times bad, the little patient sitting down very hungry to his dinner, and before scarcely tasting a mouthful, the appetite vanishing; large bowels; colicky pains of the bowels; slimy motions; itching of the fundament. Tape-worm and round-worm, more especially the former, are apt, in children, to produce convulsions. Tape-worm is very weakening to the constitution, and usually causes great emaciation and general ill health; the sooner therefore it is expelled from the bowels the better it will be for the patient.

Many of the obscure diseases of children arise from worms. In all doubtful cases, therefore, this fact should be borne in mind, in order that a thorough investigation may be instituted.

With regard to _treatment_, a medical man ought, of course, to be consulted. He will soon use means both to dislodge them, and to prevent a future recurrence of them.

Let me caution a mother never to give her child patent medicines for the destruction of worms. There is one favorite quack powder, which is composed principally of large doses of calomel, and which is quite as likely to destroy the patient as the worms! No, if your child have worms, put him under the care of a judicious medical man, who will soon expel them, without, at the same time, injuring health and constitution!

268. _How may Worms be prevented from infesting a child’s bowels?_

Worms generally infest _weak_ bowels; hence, the moment a child becomes strong worms cease to exist. The reason why a child is so subject to them is owing to the improper food which is usually given to him. When he be stuffed with unsound and with unripe fruits, with much sweets, with rich puddings, and with pastry, and when he is oftentimes allowed to eat his meat _without_ salt, and to _bolt_ his food without chewing it, is there any wonder that he should suffer from worms? The way to prevent them is to avoid such things, and, at the same time, to give him plenty of salt to his _fresh_ and well-cooked meat. Salt strengthens and assists digestion, and is absolutely necessary to the human economy. Salt is emphatically a worm-destroyer. The truth of this statement may be readily tested by sprinkling a little salt on the common earth-worm. “What a comfort and real requisite to human life is salt! It enters into the constituents of the human blood, and to do without it is wholly impossible.” To do without it is wholly impossible! These are true words. Look well to it, therefore, ye mothers, and beware of the consequences of neglecting such advice, and see for yourselves that your children regularly eat salt with their food. If they neglect eating salt with their food, they _must, of necessity, have worms_, and worms that will eventually injure them and make them miserable.

269. _You have a great objection to the frequent administration of aperient medicines to a child: can you devise any method to prevent their use?_

Although we can scarcely call constipation a disease, yet it sometimes leads to disease. The frequent giving of aperients only adds to the stubbornness of the bowels.

I have generally found a draught, early every morning, of _cold_ pump water, the eating either of loaf gingerbread or of oatmeal gingerbread, a variety of animal and vegetable food, ripe sound fruit, Muscatel raisins, a fig, or an orange after dinner, and, when he be old enough, _coffee_ and milk instead of _tea_ and milk, to have the desired effect, more especially if, for a time, aperients be studiously avoided.

270. _Have you any remarks to make on Rickets?_

Rickets is owing to a want of a sufficient quantity of earthy matter in the bones; hence the bones bend and twist, and lose their shape, causing deformity. Rickets generally begins to show itself between the first and second years of a child’s life. Such children are generally late in cutting their teeth, and when the teeth do come, they are bad, deficient of enamel, discolored, and readily decay. A rickety child is generally stunted in stature; he has a large head, with overhanging forehead, or what nurses call a watery-head-shaped forehead. The fontanelles, or openings of the head as they are called, are a long time in closing. A rickety child is usually talented; his brain seems to thrive at the expense of his general health. His breast-bone projects out, and the sides of his chest are flattened—hence he becomes what is called chicken-breasted or pigeon-breasted; his spine is usually twisted, so that he is quite awry, and, in a bad case, he is hump-backed; the ribs, from the twisted spine, on one side bulge out; he is round-shouldered; the long bones of his body, being soft, bend; he is bow-legged, knock-kneed, and weak ankled.

Rickets are of various degrees of intensity, the hump-backed being among the worst. There are many mild forms of rickets; weak ankles, knocked-knees, bowed-legs, chicken-breasts, 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 preventives, as well as one of the best remedies, for rickets. Many a child would not now have to swallow quantities of cod-liver oil if previously he had imbibed quantities 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 nourishing food, such as thorough ablution, plenty of air, exercise, play, and sunshine; 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!”

271. _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 nourishing 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-pudding, bread and milk, etc.

_To harden the bones_, let lime-water be added to the milk (a tablespoonful to each teacupful 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 teaspoonful of wine of iron into a wineglass, half fill the glass with water, sweeten it with a lump or two of sugar, then let a teaspoonful 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.

272. _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 butter, 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.

273. _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 odor, and which is sometimes so large on the head as actually to form a scull-cap, 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 a 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 humor, 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 humor out, while some wiseacres are doing all they can to drive the humor 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 has 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.

274. _Have you any advice to give me as to my conduct toward my medical man?_