Part 20

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 shivering 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 quantity 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 color, 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; smoothe, 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.”

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 God’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 shivering, or with any other urgent symptom, no time should be lost, be it night or day, in sending for him.

WARM BATHS.

275. _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.

276. _Will you mention the precautions and the rules to be observed in putting a child into 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 refreshing sleep.

WARM EXTERNAL APPLICATIONS.

277. _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, 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-rubber hot water bottle, half filled with hot water—it need not be boiling—applied to the stomach or to the bowels will afford great comfort. Every house where there are children ought to have one of these india-rubber hot water bottles. It may be procured at any respectable vulcanized india-rubber warehouse. 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 of the consistence of a nice soft poultice, then put it 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 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 bedtime, 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 here 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 useful.

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 coarsely 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, while a greasy poultice will be moist, but not wet.”

ACCIDENTS.

278. _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 glass 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.

279. _If a child receive a blow, causing a bruise, what had better be done?_

Immediately smear a small lump of _fresh_ butter on the part affected, and renew it every few minutes for two or three hours; this is an old-fashioned, but a very good remedy. Olive oil may—if _fresh_ butter 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 butter plan is the best—will generally prevent both swelling and disfiguration.

_A “Black Eye.”_—If a child, or indeed any one else, receive a blow over the eye, which is likely to cause a “black eye,” there is no remedy superior to, nor more likely to prevent one, than well buttering the parts for two or three inches around the eye with fresh butter, renewing it every few minutes for the space of an hour or two; if such be well and perseveringly done, the disagreeable appearance of a “black eye” will in all probability be prevented. A capital remedy for a “black eye” is the arnica lotion:

Take of—Tincture of Arnica, one ounce; Water, seven ounces:

To make a Lotion. The eye to be bathed, by means of a soft piece of linen rag, with this lotion frequently; and, between times, let a piece of linen rag, wetted in the lotion, be applied to the eye, and be fastened in its place by means of a bandage.

The white lily leaf, soaked in brandy, is another excellent remedy for the bruises of a child. Gather the white lily blossoms when in full bloom, and put them in a wide-mouthed bottle of brandy, cork the bottle, and it will then always be ready for use. Apply a leaf to the part affected, and bind it on either with a bandage or with a handkerchief. The white lily root sliced is another valuable external application for bruises.

280. _If a child fall upon his head and be stunned, what ought to be done?_

If he fall upon his head and be stunned, he will look deadly pale, very much as if he had fainted. He will in a few minutes, in all probability, regain his consciousness. Sickness frequently supervenes, which makes the case more serious, it being a proof that injury, more or less severe, has been done to the brain; send, therefore, instantly for a medical man.

In the mean time, loosen both his collar and neckerchief, lay him flat on his back, sprinkle cold water upon his face, open the windows so as to admit plenty of fresh air, and do not let people crowd around him, nor shout at him, as some do, to make him speak.

While he is in an unconscious state, do not on any account whatever allow a drop of blood to be taken from him, either by leeches or by bleeding; if you do, he will probably never rally, but will most likely sleep “the sleep that knows no waking.”

281. _A nurse sometimes drops an infant and injures his back; what ought to be done?_

Instantly send for a surgeon; omitting to have proper advice in such a case has frequently made a child a cripple for life. A nurse frequently, when she has dropped her little charge, is afraid to tell her mistress; the consequences might then be deplorable. If ever a child scream violently without any assignable cause, and the mother is not able for some time to pacify him, the safer plan is that she send for a doctor, in order that he might strip and carefully examine him; much after-misery might often be averted if this plan were more frequently followed.

282. _Have you any remarks to make and directions to give on accidental poisoning by lotions, by liniments, etc.?_

It is a culpable practice of either a mother or nurse to leave _external_ applications within the reach of a child. It is also highly improper to put a mixture and an _external_ application (such as a lotion or a liniment) on the same tray or on the same mantel-piece. Many liniments contain large quantities of opium, a teaspoonful of which would be likely to cause the death of a child. “Hartshorn and oil,” too, has frequently been swallowed by children, and in several instances has caused death. Many lotions contain sugar of lead, which is also poisonous. There is not, fortunately, generally sufficient lead in the lotion to cause death; but if there be not enough to cause death, there may be more than enough to make the child very poorly. All these accidents occur from disgraceful carelessness.

A mother or a nurse ought _always_, before administering a dose of medicine to a child, to read the label on the bottle; by adopting this simple plan many serious accidents and much after-misery might be averted. Again, I say let every lotion, every liniment, and indeed everything for _external_ use, be either locked up or be put out of the way, and far away from all medicine that is given by the mouth. _This advice admits of no exception._

If your child has swallowed a portion of a liniment containing opium, instantly send for a medical man. In the mean time, force a strong mustard emetic (composed of two teaspoonfuls of flour of mustard, mixed in half a teacupful of warm water) down his throat. Encourage the vomiting by afterward forcing him to swallow warm water. Tickle the throat either with your finger or with a feather. Souse him alternately in a hot and then in a cold bath. Dash cold water on his head and face. Throw open the windows. Walk him about in the open air. Rouse him by slapping him, by pinching him, and by shouting to him; rouse him, indeed, by every means in your power, for if you allow him to go to sleep, it will, in all probability, be the sleep that knows no waking!

If a child has swallowed “hartshorn and oil,” force him to drink vinegar and water, lemon-juice and water, barley-water, and thin gruel.

If he have swallowed a lead lotion, give him a mustard emetic, and then vinegar and water, sweetened either with honey or with sugar, to drink.

283. _Are not Lucifer Matches poisonous?_

Certainly, they are very poisonous; it is therefore desirable that they should be put out of the reach of children. A mother ought to be very strict with servants on this head. Moreover, lucifer matches are not only poisonous but dangerous, as a child might set himself on fire with them. A case bearing on the subject has just come under my own observation. A little boy, three years old, was left alone for two or three minutes, during which time he obtained possession of a lucifer match, and struck a light by striking the match against the wall. Instantly there was a blaze. Fortunately for him, in his fright, he threw the match on the floor. His mother, at this moment, entered the room. If his clothes had taken fire, which they might have done, had he not thrown the match away, or if his mother had not been so near at hand, he would, in all probability, have either been severely burned, or have been burned to death.

284. _If a child’s clothes take fire, what ought to be done to extinguish them?_

Lay him on the floor, then roll him either in the rug or in the carpet, or in the door-mat, or in any thick article of dress you may either have on, or have at hand—if it be woolen, so much the better; or throw him down, and roll him over and over on the floor, as by excluding the atmospheric air, the flame will go out; hence, the importance of a mother cultivating presence of mind. If parents were better prepared for such emergencies, such horrid disfigurations and frightful deaths would be less frequent.

You ought to have a proper fire-guard before the nursery grate, and should be strict in not allowing your child to play with fire. If he still persevere in playing with it when he has been repeatedly cautioned not to do so, he should be punished for his temerity. If anything would justify corporal chastisement, it would surely be such an act of disobedience. There are only two acts of disobedience that I would flog a child for—namely, the playing with fire and the telling of a lie! If after various warnings and wholesome corrections he still persists, it would be well to let him slightly taste the pain of his doing so, either by holding his hand for a moment very near the fire, or by allowing him to slightly touch either the hot bar of the grate or the flame of the candle. Take my word for it, the above plan will effectually cure him—he will never do it again! It would be well for the children of the poor to have pinafores made either of woolen or of stuff materials. The dreadful deaths from burning, which so often occur in winter, too frequently arise from _cotton_ pinafores first taking fire. “It has been computed that upwards of 1000 children are annually burned to death by accident in England.”

If all dresses, after being washed, and just before being dried, were, for a short time, soaked in a solution of tungstate of soda, such clothes, when dried, would be perfectly fire-proof.

Tungstate of soda may be used either with or without starch; but full directions for the using of it will, at the time of purchase, be given by the chemist.

285. _Is a burn more dangerous than a scald?_

A burn is generally more serious than a scald. Burns and scalds are more dangerous on the body, especially on the chest, than either on the face or on the extremities. The younger the child, of course, the greater is the danger.

Scalds, both of the mouth and of the throat, from a child drinking boiling water from the spout of a tea-kettle, are most dangerous. A poor person’s child is, from the unavoidable absence of the mother, sometimes shut up in the kitchen by himself, and being very thirsty, and no other water being at hand, he is tempted in his ignorance to drink from the tea-kettle: if the water be unfortunately boiling, it will most likely prove to him to be a fatal draught!

286. _What are the best immediate applications to a scald or to a burn?_

There is nothing more efficacious than flour. It ought to be thickly applied over the part affected, and should be kept in its place either with a rag and a bandage, or with strips of old linen. If this be done, almost instantaneous relief will be experienced, and the burn or the scald, if superficial, will soon be well. The advantage of flour as a remedy is this, that it is always at hand. I have seen some extensive burns and scalds cured by the above simple plan. Another excellent remedy is cotton-wool. The burn or the scald ought to be enveloped in it; layer after layer should be applied until it be several inches thick. The cotton-wool must not be removed for several days. The cotton-wool here recommended is that purposely made for surgeons, and is of a superior quality to that in general use. These two remedies, flour and cotton-wool, may be used in conjunction; that is to say, the flour may be thickly applied to the scald or to the burn, and the cotton-wool over all.

Prepared lard—that is to say, lard without salt—is an admirable remedy for burns and for scalds. If there be no other lard in the house but lard _with_ salt, the salt may be readily removed by washing the lard in cold water. Prepared lard—that is to say, lard _without_ salt—can, at any moment, be procured from the nearest druggist in the neighborhood. The advantages of lard are: (1) It is almost always at hand; (2) It is very cooling, soothing, and unirritating to the part, and it gives almost immediate freedom from pain; (3) It effectually protects and sheathes the burn or the scald from the air; (4) It is readily and easily applied: all that has to be done is to spread the lard either on pieces of old linen rag, or on lint, and then to apply them smoothly to the parts affected, keeping them in their places by means of bandages—which bandages may be readily made from either old linen or calico shirts. Dr. John Packard, of Philadelphia, was the first to bring this remedy for burns and scalds before the public—he having tried it in numerous instances, and with the happiest results. I myself have, for many years, been in the habit of prescribing lard as a dressing for blisters, and with the best effects. I generally advise equal parts of prepared lard and of spermaceti cerate to be blended together to make an ointment. The spermaceti cerate gives a little more consistence to the lard, which, in warm weather, especially, is a great advantage.

Another valuable remedy for burns is, “carron oil;” which is made by mixing equal parts of linseed oil and lime-water together in a bottle, and shaking it up before using it.

Cold applications, such as cold water, cold vinegar and water, and cold lotions, are most injurious, and, in many cases, even dangerous.

Scraped potatoes, sliced cucumber, salt, and spirits of turpentine, have all been recommended; but, in my practice, nothing has been so efficacious as the remedies above enumerated.

Do not wash the wound, and do not dress it more frequently than every _other_ day. If there be much discharge, let it be gently sopped up with soft old linen rag; but do not, _on any_ account, let the burn be rubbed or roughly handled. I am convinced that, in the majority of cases, wounds are too frequently dressed, and that the washing of wounds prevents the healing of them. “It is a great mistake,” said Ambrose Parè, “to dress ulcers too often, and to wipe their surfaces clean, for thereby we not only remove the useless excrement, which is the mud or sanies of ulcers, but also the matter which forms the flesh. Consequently, for these reasons, ulcers should not be dressed too often.”

The burn or the scald may, after the first two days, if severe, require different dressings; but, if it be severe, the child ought of course to be immediately placed under the care of a surgeon.

If the scald be either on the leg or on the foot, a common practice is to take the shoe and the stocking off; in this operation, the skin is also at the same time very apt to be removed. Now, both the shoe and the stocking ought to be slit up, and thus to be taken off, so that neither unnecessary pain nor mischief may be caused.

287. _If a bit of quicklime should accidentally enter the eye of my child, what ought to be done?_