Part 7

_What to do in a case of convulsions from hooping-cough._—There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. In convulsions from hooping-cough I have found cod-liver oil a valuable medicine. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. In either case cod-liver oil is likely to be serviceable, as it helps to sustain and support him in his extremity.

Convulsions attending an attack of hooping-cough make it a _serious_ complication, and requires the assiduous and skillful attention of a judicious medical man.

_What_ NOT _to do_ in such a case.—Do not apply leeches; the babe requires additional strength, and not to be robbed of it; and do not attempt to treat the case yourself.

95. _What are the best remedies for the costiveness of an infant?_

I strongly object to the frequent administration of opening medicine, as the repetition of it increases the mischief to a tenfold degree.

_What to do._—If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan may be brought into a regular state.

Besides, it inducts an infant into clean habits. I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such incumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot, of course, at an early age be dispensed with, unless a mother has great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having the bowels relieved and the bladder emptied every time he is either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little _raw_ sugar and water, either half a teaspoonful of raw sugar dissolved in a teaspoonful or two of water, or give him, out of your fingers, half a teaspoonful of raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for awhile, opening medicine becomes a dire necessity, and then woe-betide the poor unfortunate child!

It might sometimes be necessary to give opening medicine, but the less frequently the better. The following, when it becomes absolutely necessary to give an aperient, are some of the best, simple, and safe that can be administered by a mother to her baby. I give you several, as it might be well, from time to time, to vary them: (1.) One or two teaspoonfuls of fluid magnesia, made palatable by the addition of a little sugar, may be chosen; or (2.) The popular remedy of syrup of rhubarb and castor oil:

Take of—Syrup of Rhubarb, Castor Oil, of each half an ounce:

To make a Mixture. A teaspoonful to be taken early in the morning, first well shaking the bottle.

It might be well again to state, that the bottle must be _violently_ shaken _just_ before administering the mixture, or the oil will not mix with the syrup; or (3.) A teaspoonful of syrup of rhubarb, without the admixture of the castor oil may be given early in the morning occasionally; or (4.) A teaspoonful of equal parts, say half an ounce of each, of fluid magnesia and of syrup of rhubarb, may be taken for a change. Another safe and palatable aperient for an infant is (5.) Syrup of senna, from a half to a whole teaspoonful being the dose. Castor oil is another medicine prescribed for a baby’s costiveness, and, being a safe one, may occasionally be used. Care should be taken to have the castor oil freshly drawn, and of the best quality. (6.) Syrup of red roses and castor oil (of each equal parts), being a good, elegant, and pleasant way of giving it:

Take of—Syrup of Red Roses, Castor Oil, of each six drachms:

To make a Mixture. A teaspoonful to be taken occasionally, first well shaking the bottle, and to be repeated every four hours, until the bowels be relieved.

(7.) An excellent remedy for the costiveness of a baby is a soap suppository, the application of which will be found a safe, speedy, and certain method of opening the bowels. It is made by paring a piece of white curd-soap round; it should be of the size, in circumference, of a cedar pencil, and it must be in length about two inches. This should be administered by dipping it in a little warm sweet oil, and should then be gently introduced up the bowel in the same manner as you would an enema pipe, allowing about a quarter of an inch to remain in view. It must then be left alone, and in a minute or two the soap suppository will be expelled, and instantly the bowels will be comfortably and effectually relieved. When a child is two or three years old and upwards a dip-candle suppository is superior to a soap suppository.

If it be _absolutely_ necessary to give opening medicine, it will be well to alternate the use of them—that is to say, to give at one time the syrup of senna, at another the fluid magnesia sweetened, and a third to administer the soap suppository dipped in oil, but waiting at least two days between, the bowels being costive all the time, before resorting to an aperient. Bear in mind, and let it make a strong impression upon you, that the less the bowels of an infant are irritated by opening medicine, the aperient being ever so simple and well-selected, the better will it be for him both now and for the future.

When the infant is five or six months old, either oatmeal milk gruel, or Robinson’s Patent Groat Gruel made with new milk, occasionally given in lieu of the usual food, will often open the bowels, and will thus supersede the necessity of administering an aperient.

Castor oil, or Dr. Merriman’s Purgative Liniment, well rubbed every morning, for ten minutes at a time, over the region of the bowels, will frequently prevent costiveness, and thus will do away with the need—which is a great consideration—of giving an aperient.

Take of—Tincture of aloes, half an ounce; Soap liniment, one ounce:

Make a liniment.

_What_ NOT _to do_.—There are two preparations of mercury I wish to warn you against administering of your own accord, viz.—(1.) Calomel, and a milder preparation called (2.) gray powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it may be administered, it being small in quantity and nearly tasteless. Gray powder, also, is, with many mothers, a favorite in the nursery. It is a medicine of immense power—either for good or for evil; in certain cases it is very valuable; but in others, and in the great majority, it is very detrimental.

This practice, then, of a mother giving mercury, whether in the form either of calomel or of gray powder, cannot be too strongly reprobated, as the frequent administration either of one or of the other weakens the body, predisposes it to cold, and frequently excites king’s evil—a disease too common in this country. Calomel and gray powder, then, ought never to be administered unless ordered by a medical man.

Syrup of buckthorn and jalap are also frequently given, but they are griping medicines for a baby, and ought to be banished from the nursery.

The frequent repetition of opening medicines, then, in any shape or form, very much interferes with digestion; they must, therefore, be given as seldom as possible.

Let me, at the risk of wearying you, again urge the importance of your avoiding as much as possible, giving a babe purgative medicines. They irritate beyond measure the tender bowels of an infant, and only make him more costive afterward; they interfere with his digestion, and are liable to give him cold. A mother who is always of her own accord quacking her child with opening physic, is laying up for her unfortunate offspring a debilitated constitution—a miserable existence.

96. _Are there any means of preventing the Costiveness of an infant?_

If greater care were paid to the rules of health, such as attention to diet, exercise in the open air, thorough ablution of the _whole_ body—more especially when he is being washed—causing the water, from a large and well-filled sponge, to stream over the lower part of his bowels; the regular habit of causing him, at stated periods, to be held out, whether he want or not, that he may solicit a stool. If all these rules were observed, costiveness would not so frequently prevail, and one of the miseries of the nursery would be done away with.

Some mothers are frequently dosing their poor unfortunate babies either with magnesia to cool them, or with castor oil to heal the bowels! Oh, the folly of such practices! The frequent repetition of magnesia, instead of cooling an infant, makes him feverish and irritable. The constant administration of castor oil, instead of healing the bowels, wounds them beyond measure. No! it would be a blessed thing if a baby could be brought up without giving him a particle of opening medicine; his bowels would then act naturally and well: but then, as I have just now remarked, a mother must be particular in attending to Nature’s medicines—to fresh air, to exercise, to diet, to thorough ablution, etc. Until that time comes, poor unfortunate babies must be occasionally dosed with an aperient.

97. _What are the causes of, and remedies for, Flatulence?_

Flatulence most frequently occurs in those infants who live on _artificial_ food, especially if they are over-fed. I therefore beg to refer you to the precautions I have given, when speaking of the importance of keeping a child for the first four or five months _entirely_ to the breast; and, if that be not practicable, of the times of feeding, and of the _best_ kinds of artificial food, and of those which are least likely to cause “wind.”

_What to do._—Notwithstanding these precautions, if the babe should still suffer, “One of the best and safest remedies for flatulence is sal-volatile,—a teaspoonful of a solution of one drachm to an ounce and a half of water.” Or, a little dill or aniseed may be added to the food—half a teaspoonful of dill water. Or, take twelve drops of oil of dill, and two lumps of sugar; rub them well in a mortar together; then add, drop by drop, three tablespoonfuls of spring water; let it be preserved in a bottle for use. A teaspoonful of this, first shaking the vial, may be added to each quantity of food. Or, three teaspoonfuls of bruised caraway seeds may be boiled for ten minutes in a teacupful of water, and then strained. One or two teaspoonfuls of the caraway-tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may be occasionally given.

Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at a time, by means of the warm hand, over the bowels, will frequently give relief. Turning the child over on his bowels, so that they may press on the nurse’s lap, will often afford great comfort. A warm bath (where he is suffering severely) generally gives _immediate_ ease in flatulence; it acts as a fomentation to the bowels. But after all, a dose of mild aperient medicine, when the babe is suffering severely, is often the best remedy for “wind.”

Remember, at all times, prevention, whenever it be—and how frequently it is—possible, is better than cure.

_What_ NOT _to do_.—“Godfrey’s Cordial,” “Infants’ Preservative,” and “Dalby’s Carminative” are sometimes given in flatulence; but as most of these quack medicines contain, in one form or another, either opium or poppy, and as opium and poppy are both dangerous remedies for children, ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to afford relief for flatulence; but let me urge upon you the importance of banishing it from the nursery. It has (when given by unprofessional persons) caused the untimely end of thousands of children. The medical journals and the newspapers teem with cases of deaths from mothers incautiously giving syrup of poppies to ease pain and to procure sleep.

98. _What are the symptoms, the causes, and the treatment of “Gripings” of an infant?_

_The symptoms._—The child draws up his legs; screams violently; if put to the nipple to comfort him, he turns away from it and cries bitterly; he strains, as though he were having a stool; if he have a motion, it will be slimy, curdled, and perhaps green. If, in addition to the above symptoms, he pass a large quantity of watery fluid from the bowels, the case becomes one of _watery gripes_, and requires the immediate attention of a medical man.

The _causes_ of “gripings” or “gripes” may proceed either from the infant or from the mother. If from the child, it is generally owing either to improper food or to over-feeding; if from the mother, it may be traced to her having taken either greens, or pork, or tart beer, or sour porter, or pickles, or drastic purgatives.

_What to do._—The _treatment_, of course, must depend upon the cause. If it arise from over-feeding, I would advise a dose of castor oil to be given, and warm fomentations to be applied to the bowels, and the mother or the nurse to be more careful for the future. If it proceed from improper food, a dose or two of magnesia and rhubarb in a little dill water, made palatable with simple syrup.

Take of—Powdered Turkey Rhubarb, half a scruple; Carbonate of Magnesia, one scruple; Simple Syrup, three drachms; Dill Water, eight drachms;

Make a Mixture. One or two teaspoonfuls (according to the age of the child) to be taken every four hours, 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 Hiccough, and what is its treatment?_

Hiccough 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 Diarrhœa—“Looseness of the bowels?”_

It will be well, before doing so, to tell you how many motions a young infant ought to have a day, their color, consistence, and smell. Well, then, he should have from three to six motions in the twenty-four hours; the color 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 color (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 odor. If it has 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 is not griped, that he has no pain, and has 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 Godfrey’s Cordial, Dalby’s Carminative, etc.—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 has a motion he be griped and in pain, we should then say that he is laboring under diarrhœa; 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, endeavoring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of dysentery. 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 diarrhœa. This latter case requires great skill and judgment on the part of a medical man, 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 diarrhœa—“Looseness of the bowels?”_

Improper food; over-feeding; 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 Diarrhœa?_

_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 endeavors to obtain one by purging, the best treatment is to assist nature by giving either a dose of castor oil or a moderate one of rhubarb and magnesia, and thus to work off the enemy. For a rhubarb and magnesia mixture prescription, see question 98.

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—Compound Powdered Chalk with Opium, ten grains; Oil of Dill, five drops; Simple Syrup, three drachms; Water, nine drachms;

Make a Mixture. Half a teaspoonful to be given to an infant of six months and under, and one teaspoonful to a child above that age, every four hours—first shaking the bottle. Let the mixture be made by a chemist.

The baby ought, for a few days, to be kept _entirely_ to the breast. 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 diarrhœa 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 diarrhœa continues, to have any artificial food. He must neither be dosed with gray powder (a favorite but highly improper remedy in these cases), nor with any quack medicines, such as Dalby’s Carminative or Godfrey’s Cordial.

103. _What are the symptoms of Dysentery?_

Dysentery frequently arises from a neglected diarrhœa. It is more dangerous than diarrhœa, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skillful 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 diarrhœa—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-spawn,” during the twenty-four hours. Suddenly the character of the motion changes,—from being principally 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 you are not able to procure one, I will tell you _what to do_ and _what_ NOT _to do_.