Chapter VIII: Part II: Childhood (3)

It would be well, in every village, and in the outskirts of every town, if a large plot of ground were set apart for children to play in, and to go through regular gymnastic exercises. Play is absolutely necessary to a child's very existence, as much as food and sleep; but in many parts of England where is he to have it? Playgrounds and play are the best schools we have; they teach a great deal not taught elsewhere; they give lessons in health, which is the grandest wealth that can be bestowed--"for health is wealth;" they prepare the soil for the future schoolmaster; they clear the brain, and thus the intellect, they strengthen the muscles; they make the blood course merrily through the arteries; they bestow healthy food for the lungs; they give an appetite; they make a child, in due time, become every inch a man! Play-grounds and play are one of the finest institutions we possess. What would our large public schools be without their play and cricket grounds? They would be shorn of half their splendour and their usefulness!

There is so much talk now-a-days about _useful_ knowledge, that the importance of play and play-grounds is likely to be forgotten. I cannot help thinking however, that a better state of things is dawning. "It seems to be found out that in our zeal for useful knowledge, that knowledge is found to be not the least useful which treat boys as active, stirring, aspiring, and ready." [Footnote: _The Saturday Review_, December 13, 1862.]

181. _Do you approve of infant schools_?

I do, if the arrangements be such that health is preferred before learning. [Footnote: "According to Aristotle, more care should be taken of the body than of the mind for the first seven years; strict attention to diet be enforced, &c. . . . . . The eye and ear of the child should be most watchfully and severely guarded against contamination of every kind, and unrestrained communication with servants be strictly prevented. Even his amusements should be under due regulation, and rendered as interesting and intellectual as possible."--The Rev John Williams, in his _Life and Actions of Alexander the Great_] Let children be only confined for three or four hours a day, and let what little they learn be taught as an amusement rather than as a labour. A play-ground ought to be attached to an infant school; where, in fine weather, for every half-hour they spend in-doors, they should spend one in the open air; and, in wet weather, they ought to have, in lieu of the play-ground, a large room to romp, and shout, and riot in. To develop the different organs, muscles, and other parts of the body, children require fresh air, a free use of their lungs, active exercise, and their bodies to be thrown into all manner of attitudes. Let a child mope in a corner, and he will become stupid and sickly. The march of intellect, as it is called, or rather the double quick march of intellect, as it should be called, has stolen a march upon health. Only allow the march of intellect and the march of health to take equal strides, and then we shall have "_mens sana in corpore sano_" (a sound mind in a sound body).

In the education of a young child, it is better to instruct him by illustration, by pictures, and by encouraging observation on things around and about him, than by books. It is surprising how much, without endangering his health, may be taught in this way. In educating your child, be careful to instil and to form good habits--they will then stick to him for life.

Children at the present day are too highly educated--their brains are over-taxed, and thus weakened. The consequence is, that as they grow up to manhood, if they grow up at all, they become fools! _Children_ are now taught what formerly _youths_ were taught. The chord of a child's life is ofttimes snapped asunder in consequence of over education:--

"Screw not the cord too sharply, lest it snap"--_Tennyson_.

You should treat a child as you would a young colt. Think only at first of strengthening his body. Let him have a perfectly free, happy life, plenty of food to eat, abundance of air to breathe, and no work to do; there is plenty of time to think of his learning--of giving him brain work. It will come sadly too soon; but do not make him old before his time.

182. _At what age do you advise my child to begin his course of education--to have his regular lessons_?

In the name of the prophet,--Figs! Fiddlesticks! about courses of education and regular lessons for a child! You may as well ask me when he, a child, is to begin Hebrew, the Sanscrit, and Mathematics! Let him have a course of education in play; let him go through regular lessons in foot-ball, bandy, playing at tic, hares and hounds, and such like excellent and really useful and health-giving lessons. Begin his lessons! Begin brain work, and make an idiot of him! Oh! for shame, ye mothers! You who pretend to love your children so much, and to tax, otherwise to injure, irreparably to injure their brains, and thus their intellects and their health, and to shorten their very days. And all for what? To make prodigies of them! Forsooth! to make fools of them in the end,

183. _Well, then, as you have such a great objection to a child commencing his education early in life, at what age may he, with safety, commence his lessons? and which do you prefer--home or school education_?

Home is far preferable to a school education. He is, if at home, under your own _immediate_ observation, and is not liable to be contaminated by naughty children; for, in every school, there is necessarily a great mixture of the good and of the bad; and a child, unfortunately, is more likely to be led by the bad than by the good. Moreover, if he be educated at home, the mother can see that his brain is not over-worked. At school the brain is apt to be over-worked, and the stomach and the muscles to be under-worked.

Remember, as above stated, _the brain must have but very little work until the child be seven years old;_ impress this advice upon your memory, and let no foolish ambition to make your child a clever child allow you, for one moment, to swerve from this advice.

Build up a strong, healthy body, and in due time the brain will bear a _moderate_ amount of intellectual labour.

As I have given _you_ so much advice, permit me, for one moment, to address a word to the father of your child:--

Let me advise you, then, Mr. _Pater familias_, to be careful how you converse, what language you use, while in the company of your child. Bear in mind, a child is very observant, and thinks much, weighs well, and seldom forgets all you say and all you do! Let no hasty word, then, and more especially no oath, or no impious language, ever pass your lips, if your child be within hearing. It is, of course, at all times wicked to swear; but it is heinously and unpardonably sinful to swear in the presence of your child! "Childhood is like a mirror, catching and reflecting images. One impious or profane thought, uttered by a parent's lip, may operate upon the young heart like a careless spray of water thrown upon polished steel, staining it with rust, which no after scouring can efface."

Never talk secrete before a child--"little pitchers have long ears;" if you do, and he disclose your secrets--as most likely he will--and thus make mischief, it will be cruel to scold him; you will, for your imprudence, have yourself only to blame. Be most careful, then, in the presence of your child, of what you say, and of whom you speak. This advice, if followed, might save a great deal of annoyance and vexation.

184. _Are you an advocate for a child being taught singing?_

I am: I consider singing a part of his education. Singing expands the walls of his chest, strengthens and invigorates his lungs, gives sweetness to his voice, improves his pronunciation, and is a great pleasure and amusement to him.

SLEEP.

185. _Do you approve of a child sleeping on a_ FEATHER _bed_?

A _feather_ bed enervates his body, and, if he be so predisposed, causes rickets, and makes him crooked. A horse-hair mattress is the best for a child to lie on. The pillow, too, should be made of horse-hair. A _feather_ pillow often causes the bead to be bathed in perspiration, thus enervating the child, and making him liable to catch cold. If he be at all rickety, if he be weak in the neck, if he be inclined to stoop, or if he be at all crooked, let him, by all means, lie without a pillow.

186. _Do you recommend a child, in the middle of the day, to be put to sleep_?

Let him be put on his mattress _awake_, that he may sleep for a couple of hours before dinner, then he will rise both refreshed and strengthened for the remainder of the day. I said, let him be put down _awake_. He might, for the first few times, cry, but, by perseverance, he will without any difficulty fall to sleep. The practice of sleeping before dinner ought to be continued until he be three years old, and, if he can be prevailed upon, even longer. For if he do not have sleep in the middle of the day, he will all the afternoon and the evening be cross; and when he does go to bed, he will probably be too tired to sleep, or his nerves having been exhausted by the long wakefulness, he will fall into a troubled, broken slumber, and not into that sweet, soft, gentle repose, so characteristic of healthy, happy childhood!

187. _At what hour ought a child to be put to bed in the evening_?

At six in the winter, and at seven o'clock in the summer. _Regularity_ ought to be observed, _as regularity is very conducive to health._ It is a reprehensible practice to keep a child up until nine or ten o'clock at night. If this be done, he will, before his time, become old, and the seeds of disease will be sown,

As soon as he can run, let him be encouraged, for half an hour before he goes to bed, to race either about the hall, or the landing, or a large room, which will be the best means of warming his feet, of preventing chilblains, and of making him sleep soundly.

188. _Have you any directions to give me at to the placing of my child in his bed_?

If a child lie alone, place him fairly on his aide in the middle of the bed; if it be winter time, see that his arms and hands be covered with the bed-clothes; if it be summer, his hands might be allowed to be outside the clothes. In putting him down to sleep, you should ascertain that his face be not covered with the bedclothes; if it be, he will he poisoned with his own breath--the breath constantly giving off carbonic acid gas; which gas must, if his face be smothered in the clothes; be breathed--carbonic acid gas being highly poisonous.

You can readily prove the existence of carbonic and gas in the breathing, by simply breathing into a little lime-water; after breathing for a few seconds into it, a white film will form on the top; the carbonic acid gas from the breath unites with the lime of the lime-water and the product of the white film is carbonate of lime.

189. _Do you advise a bedroom to be darkened at night_?

Certainly: a child sleeps sounder and sweeter in a dark than in a light room. There is nothing better for the purpose of darkening a bedroom, than Venetian blinds. Remember, then, a well-ventilated, but a darkened, chamber at night. The cot or the crib ought _not_ to face the window, "as the light is best behind." [Footnote: Sir Charles Locock in a Letter to the Author. ]

190. _Which is the beat position for a child when sleeping--on his back, or on his side_?

His side: he ought to be accustomed to change about on the right side one night, on the left another; and occasionally, for a change, he should lie on his back. By adopting this plan, you will not only improve his figure, but likewise his health. Lying, night after night, in one position, would be likely to make him crooked.

191. _Do you advise, in the winter time, that there should be a fire in the night nursery_?

Certainly not, unless the weather be intensely cold. I dislike fires in bedrooms, especially for children; they are very enervating, and make a child liable to catch cold. Cold weather is very bracing, particularly at night "Generally speaking," says the _Siecle_, "during winter, apartments are too much heated. The temperature in them ought not to exceed 16 deg. Centigrade (59 deg. Fahrenheit); and even in periods of great cold scientific men declare that 12 deg. or 14 deg. had better not be exceeded. In the wards of hospitals, and in the chambers of the sick, care is taken not to have greater heat than 15 deg.. Clerks in offices, and other persons of sedentary occupations, when rooms in which they sit are too much heated, are liable to cerebral [brain] congestion and to pulmonary [lung] complaints. In bedrooms, and particularly those of children, the temperature ought to be maintained rather low; it is even prudent only rarely to make fires in them, especially during the night"

If "a cold stable make a healthy horse," I am quite sure that a moderately cold and well-ventilated bedroom helps to make a healthy child. But, still, in the winter time, if the weather be biting cold, a _little_ fire in the bedroom grate is desirable. In bringing up children, we must never run into extremes--the coddling system and the hardening system are both to be deprecated; the coddling system will make the strong child weakly, while the hardening system will probably kill a delicate one.

A child's bed ought, of course, to be comfortably clothed with blankets--I say blankets, as they are much superior to coverlids; the perspiration will more readily pass through a blanket than a coverlid. A _thick_ coverlid ought never to be used; there is nothing better, for a child's bed, than the old-fashioned patchwork coverlid, as the perspiration will easily escape through it.

192. _Should a child be washed and dressed_ AS SOON AS HE AWAKE _in the morning_?

He ought, if he awake in anything like reasonable time; for if he doze after he be once awake, such slumber does him more harm than good. He should be up every morning as soon as it is light If, as a child, he be taught to rise early, it will make him an early riser for life, and will tend greatly to prolong both his existence and his happiness.

_Never awake a child from his sleep_ to dress him, to give him medicine, or for any other purpose; _let him always sleep as long as he can;_ but the moment he awakes let him be held out, and then let him be washed and dressed, and do not wait, as many a silly nurse does, until he have wet his bed, until his blood be chilled, and until he be cross, miserable, and uncomfortable! How many babes are made ill by such foolish practices!

The moment he leaves his bed, turn back to the fullest extent the clothes, in order that they may be thoroughly ventilated and sweetened. They ought to be exposed to the air for at least an hour before the bed be made. As soon as he leaves his room, be it winter or summer, throw open the windows.

193. _Ought a child to lie alone_?

He should, after he is weaned. He will rest more comfortably, and his sleep will be more refreshing.

194. _Supposing a child should not sleep well, what ought to be done? Would you give him a dose of composing medicine_?

Certainly not. Try the effects of exercise. Exercise in the open air is the best composing medicine in the world. Let the little fellow be well tired out, and there will be little fear of his not sleeping.

195. _Have you any further observations to make on the subject of sleep_?

Send a child joyful to bed. Do not, if you can possibly help it, let him go to bed crying. Let the last impressions he has at night be of his happy home, and of his loving father and mother and let his last thoughts be those of joy and gladness. He will sleep all the sounder if he be sent to bed in such a frame of mind, and he will be more refreshed and nourished in the morning by his sleep.

196. _What are the usual causes of a child walking in his sleep, and what measures during such times, ought to be adopted to prevent his injuring himself_?

A disordered stomach, in a child of nervous temperament, or worms, are usually the causes. The means to be adopted to prevent his throwing himself out of the window, are to have bars to his chamber present, and if that be not practicable, to have either nails or screws driven into the window sash to allow the window to open only for a sufficient space for ventilation, and to have a screw window fastening, in order that he cannot, without difficulty, open the window, to have a trusty person to sleep in his room, who should have directions given not to rouse him from his sleep, but to gently lead him back to his bed, which may frequently be done without awaking him, and to consult a medical man, who will adopt means to destroy the worms, to put his stomach into order, to brace his nerves, and to strengthen his general system. A trip to the coast and sea bathing, in such a case, is often of great service.

SECOND DENTITION.

197. _When does a child commence to cut his SECOND set of teeth_?

Generally at seven years old. He _begins to cut_ them at about that time: but it should be borne in mind (so wonderful are the works of God) that the _second_ crop of teeth, _in embryo_, is actually bred and formed from the very commencement of his life, _under_ the first tier of teeth, but which remain in abeyance for years, and do not come into play until the _first_ teeth, having done their duty, loosen and fall out, and thus make room for the more numerous, larger, stronger, and more permanent teeth, which latter have to last for the remainder of his existence. The _first_ set is sometimes cut with a great deal of difficulty, and produces various diseases; the _second_, or permanent teeth, come easily, and are unaccompanied with any disorder. The following is the process:--One after another of the _first_ set gradually loosen, and either drop out, or with little pain are readily pulled out; under these, the _second_--the permanent--teeth make their appearance, and fill up the vacant spaces. The fang of the tooth that has dropped out is nearly all absorbed or eaten away, leaving little more than the crown. The _first_ set consists of twenty; the _second_ (including the wise-teeth, which are not, generally cut until after the the age of twenty-seven) consists of thirty-two.

I would recommend you to pay particular attention to the teeth of your children; for, besides their being ornamental, their regularity and soundness are of great importance to the present as well as to the future health of your offspring. If there be any irregularity in the appearance of the _second_ set, lose no time in consulting an experienced and respectable dentist.

ON DISEASE, ETC.

198. _Do you think it important that I should be made acquainted with the symptoms of the SERIOUS diseases of children_?

Certainly I am not advocating the doctrine of a mother _treating serious_ diseases; far from it, it is not her province, except in certain cases of extreme urgency, where a medical man cannot be procured, and where delay might be death; but I do insist upon the necessity of her knowing the _symptoms_ of disease. My belief is, that if parents were better informed on such subjects, many children's lives might be saved, much suffering averted, and sorrow spared. The fact is, the knowledge of the symptoms of disease is, to a mother, almost a sealed book. If she were better acquainted with these matters, how much more useful would she be in a sick-room, and how much more readily would she enter into the plans and views of the medical man! By her knowledge of the symptoms, and by having his advice in time, she would nip disease in the bud, and the fight might end in favour of life, for "sickness is just a fight between life and death."--_Geo. M'Donald._

It is really lamentable to contemplate the amount of ignorance that still exists among mothers in all that appertains to the diseases of children; although, fortunately, they are beginning to see and to feel the importance of gaining instruction on such subjects; but the light is only dawning. A writer of the _Medical Times and Gazette_ makes the following remarks, which somewhat bear on the subject in question. He observes--"In spite of the knowledge and clear views possessed by the profession on all that concerns the management of children, no fact is more palpable than that the most grievous ignorance and incompetency prevail respecting it among the public. We want some means of making popular the knowledge which is now almost restricted to medical men, or, at most, to the well-educated classes."

In the earlier editions of this work I did not give the _treatment_ of any serious diseases, however urgent. In the eight last editions, I have been induced, for reasons I will presently state, to give the _treatment_ of some of the more urgent _serious_ diseases, when a medical man cannot instantly be procured, and where delay might be death.

Sir CHARLES LOCOCK, who has taken a kind interest in this little work, has given me valid reasons why a mother should be so enlightened. The following extracts are from a letter which I received from Sir CHARLES on the subject, and which he has courteously allowed me to publish. He says,--"As an old physician of some experience in complaints of infants and children, I may perhaps be allowed to suggest that in a future edition you should add a few words on the actual treatment of some of the more urgent infantile diseases. It is very right to caution parents against superseding the doctor, and attempting to manage serious illness themselves, but your advice, with very small exceptions, always being 'to lose no tune in sending for a medical man,' much valuable and often irremediable time may be lost _when a medical man is not to be had_. Take, for instance, a case of croup there are no directions given at all, except to send for a medical man, and always to keep medicines in the house which he may have directed. But how can this apply to a first attack? You state that a first attack is generally the worst. But why is it so? Simply because it often occurs when the parents do not recognise it, and it is allowed to get a worse point than in subsequent attacks, when they are thoroughly alive to it. As the very best remedy, and often the only essential one, if given early, is a full emetic, surely it is better that you should give some directions as to this in a future edition, and I can speak from my own experience when I say that an emetic, _given in time_, and repeated to free vomiting, will cut short _any_ case of croup. In nine cases out of ten the attack takes place in the evening or early night, and when vomiting is effected the dinner of that day is brought up nearly undigested, and the seventy of the symptoms at once cut short. Whenever any remedy is valuable, the more by its being administered _in time_, it is surely wiser to give directions as to its use, although, as a general rule, it is much better to advise the sending for medical advice."

The above reasons, coming from such a learned and experienced physician as Sir Charles Locock, are conclusive, and have decided me to comply with his advice, to enlighten a mother on the _treatment_ of some of the more urgent diseases of infants and of children. In a subsequent letter addressed to myself, Sir Charles has given me the names of those _urgent_ diseases, which he considers may be treated by a mother "where a medical man cannot be procured quickly, or not at all." They are Croup: Inflammation of the Lungs; Diptheria; Dysentry; Diarrhoea; Hooping Cough, in its various stages; and Shivering Fit. Sir Charles sums up his letter to me by saying, "Such a book ought to be made as complete as possible, and the objections to medical treatment being so explained as to induce mothers to try to avoid medical men is not so serious as that of leaving them without any guide in those instances where every delay is dangerous, and yet where medical assistance is not to be obtained or not to be had quickly."

In addition to the above I shall give you the _treatment_ of Bronchitis, Measles, and Scarlet Fever. Bronchitis is one of the most common diseases incidental to childhood, and, with judicious treatment, is, in the absence of the medical man, readily managed by a sensible mother. Measles is very submissive to treatment. Scarlet Fever, _if it be not malignant_, and, _if it be not complicated with diphtheric-croup_, and if certain rules be strictly followed, is also equally amenable to treatment.

I have been fortunate in treating Scarlet Fever, and I therefore think it desirable to enter fully into the _treatment_ of a disease which is looked upon by many parents, and, according to the usual mode of treatment, with just cause, with great consternation and dread. By giving my plan of treatment, fully and simply, and without the slightest reservation, I am fully persuaded, through God's blessing, that I may be the humble means of saving the lives of numbers of children.

The diseases that might be treated by a mother, in the absence of a medical man, will form the subject of future Conversations.

I think it right to promise that in all the prescriptions for a child I have for the use of a mother given, I have endeavoured to make them as simple as possible, and have, whenever practicable, avoided to recommend powerful drugs. Complicated prescriptions and powerful medicines might, as a rule, to be seldom given; and when they are, should only be administered by a judicious medical man: a child requiring much more care and gentleness in his treatment than an adult: indeed, I often think it would be better to leave a child to nature rather than to give him powerful and large doses of medicines. A remedy--calomel, for instance--has frequently done more mischief than the disease itself; and the misfortune of it is, the mischief from that drug has oftentimes been permanent, while the complaint might, if left alone, have only been temporary.

199. _At what age does Water in the Brain usually occur, and how is a mother to know that her child is about to labour under that disease_?

Water on the brain is, as a rule, a disease of childhood: after a child is seven years old it is comparatively rare. It more frequently attacks delicate children--children who have been dry nursed (especially if they have been improperly fed), or who have been suckled too long, or who have had consumptive mothers, or who have suffered severely from toothing, or who are naturally of a feeble constitution. Water on the brain sometimes follows an attack of inflammation of the lungs, more especially if depressing measures (such as excessive leeching and the administration of emetic tartar) have been adopted. It occasionally follows in the train of contagious eruptive diseases, such as either small-pox or scarlatina. We may divide the symptoms of water on the brain into two stages. The first--the premonitory stage--which lasts for or five days, in which medical aid might be of great avail: the second--the stage of drowsiness and of coma--which usually ends in death.

I shall dwell on the first--the premonitory stage--in order that a mother may see the importance without loss of time of calling in a medical man:--

If her child be feverish and irritable, if his stomach be disordered, if he have urgent vomitings, if he have a foul breath, if his appetite be capricious and bad, if his nights be disturbed (screaming out in his sleep), if his bowels be disordered, more especially if they be constipated, if he be more than usually excited, if his eye gleam with unusual brilliancy, if his tongue run faster than it is wont, if his cheek be flushed and his head be hot, and if he be constantly putting his hand to his head; there is cause for suspicion. If to these symptoms be added, a more than usual carelessness in tumbling about, in hitching his foot in the carpet, or in dragging one foot after the other; if, too, he has complained of darting, shooting, lancinating pains in his head, it may then be known that the _first_ stage of inflammation (the forerunner of water on the brain) either has taken, or is about taking place. Remember no time ought to be lost in obtaining medical aid; for the _commencement_ of the disease is the golden opportunity, when life might probably be saved.

200. _At what age, and in what neighbourhood, is a child most liable to croup, and when is a mother to know that it is about to take place_?

It is unusual for a child until he be twelve months old to have croup: but, from that time until the age of two years, he is more liable to it than at any other period. The liability after two years, gradually, until he be ten years old, lessens, after which time it is rare.

A child is more liable to croup in a low and damp, than in a high and dry neighbourhood; indeed, in some situations, croup is almost an unknown disease; while in others it is only too well understood. Croup is more likely to prevail when the wind is either easterly or north-easterly.

There is no disease that requires more prompt treatment than croup, and none that creeps on more insidiously. The child at first seems to be labouring under a slight cold, and is troubled with a little _dry_ cough, he is hot and fretful, and hoarse when he cries. Hoarseness is one of the earliest symptoms of croup, and it should be borne in mind that a young child, unless he be going to have croup, is seldom hoarse, if, therefore, your child be hoarse, he should be carefully watched, in order that, as soon as croup be detected, not a moment be lost in applying the proper remedies.

His voice at length becomes gruff, he breathes as though it were through muslin, and the cough becomes crowing. These three symptoms prove that the disease is now fully formed. These latter symptoms sometimes come on without any previous warning, the little fellow going to bed apparently quite well, until the mother is awakened, perplexed and frightened, in the middle of the night, by finding him labouring under the characteristic cough and the other symptoms of croup. If she delay either to send for assistance, _or if proper medicines be not instantly given_, in a few hours it will probably be of no avail, and in a day or two the little sufferer will be a corpse.

When once a child has had croup the after attacks are generally milder. If he has once had an attack of croup, I should advise you always to have in the house medicine--a 4 oz. bottle of Ipecacuanha Wine, to fly to at a moments notice, [Footnote: In case of a sudden attack of croup, _instantly_ give a teaspoonful of Ipecacuanha Wine, and repeat it every fire minutes natal free vomiting be excited.] but never omit, where practicable, in a case of croup, whether the case be severe or mild to send _immediately_ for medical aid. There is no disease in which time is more precious than in croup, and where the delay of an hour may decide either for life or for death.

201. _But suppose a medical man is not IMMEDIATELY to be procured, what then am I to do? more especially, as you say, that delay might be death_?

_What to do_.--I never, in my life, lost a child with croup with catarrhal croup where I was called in at the _commencement_ of the disease, and where my plans were carried out to the very letter. Let me begin by saying, look well to the goodness and purity of the medicine, for the life of your child may depend upon the medicine being genuine. What medicine! _Ipecacuanha Wine!_ At the earliest dawn of the disease give a few spoonful of Ipecacuanha Wine every five minutes, until free vomiting be exerted. In croup, then, before he be safe, free vomiting _must_ be established, and that without loss of time. If, _after_ the expiration of an hour, the Ipecacuanha Wine (having given during that hour one or two tea-spoonfuls of it every five minutes) be not sufficiently powerful for the purpose--although it generally is so--(_if the Ipecacuanha Wine be good_)--then let the following mixture be substituted--

Take of--Powdered Ipecacuanha, one scruple,
Wine of Ipecacuanha, one ounce and a half

Make a mixture. One or two tea spoonfuls to be given every five minutes, until free vomiting be excited, first well shaking the bottle.

After the vomiting, place the child for a quarter of an hour in a warm bath. [Footnote: See "Warm Baths"--directions and precautions to be observed.] When out of the bath give him small doses of Ipecacuanha Wine every two or three hours. The following is a palatable form for the mixture--

Take of--Wine of Ipecacuanha, three drachms;
Simple syrup, three drachms,
Water, six drachms

Make a Mixture. A tea-spoonful to be taken every two or three hours.

But remember the emetic which is given at _first_ is _pure Ipecacuanha Wine, without a drop of either water or of syrup._

A large sponge dipped out of very hot water, and applied to the throat, and frequently renewed, oftentimes affords great relief in croup, and ought during the time the emetic is being administered in all cases to be adopted.

If it be a _severe_ case of croup, and does not in the course of two hours yield to the free exhibition of the Ipecacuanha Emetic, apply a narrow strip of _Smith's Tela Vesicularia_ to the throat, prepared in the same way as for a case of inflammation of the lungs (see the Conversation on the _treatment_ of inflammation of the lungs). With this only difference, let it be a narrower strip, only one-half the width there recommended, and apply it to the throat instead of to the chest. If a child has a very short, fat neck, there may not be room for the _Tela_, then you ought to apply it to the _upper_ part of the chest--just under the collar-bones.

Let it be understood, the the _Tela Vesicularia_ is not a severe remedy, that the _Tela_ produces very little pain--not nearly so much as the application of leeches; although, in its action, it is much more beneficial, and is not nearly so weakening to the system.

Keep the child from all stimulants; let him live on a low diet, such as milk and water, toast and water, arrowroot, &c.; and let the room be, if practicable, at a temperate heat--60 deg. Fahrenheit, and be well ventilated.

So you see that the _treatment_ of croup is very simple, and the the plan might be carried out by an intelligent mother. Notwithstanding which, it is your duty, where practicable, to send, at the very _onset_ of the disease, for a medical man.

Let me again reiterate that, if your child is to be saved, the _Ipecacuanha Wine must be genuine and good_. This can only be effected by having the medicine from a highly respectable chemist. Again, if ever your child has had croup, let me again urge you _always_ to have in the house a 4 oz. bottle of Ipecacuanha Wine, that you may resort to at a moment's notice, in case there be the slightest return of the disease.

Ipecacuanha Wine, unfortunately, is not a medicine that keeps well, therefore, every three or four months a fresh bottle ought to be procured, either from a medical man or from a chemist. As long as the Ipecacuanha Wine remains _clear_, it is good; but as soon as it becomes _turbid_, it is bad, and ought to be replaced by a fresh supply. An intelligent correspondent of mine makes the following valuable remarks on the preservation of Ipecacuanha Wine:--"Now, I know that there are some medicines and chemical preparations which, though they spoil rapidly when at all exposed to the air, yet will keep perfectly good for an indefinite time if hermetically sealed up in a _perfectly full_ bottle. If so, would it not be a valuable suggestion if the Apothecaries' Hall, or some other London firm of _undoubted_ reliability, would put up 1 oz. phials of Ipecacuanha Wine of guaranteed purity, sealed up so as to keep good so long as unopened, and sent out in sealed packages, with the guarantee of their name. By their keeping a few such ounce bottles in an unopened state in one's house, one might rely in being ready for any emergency. If you think this suggestion worth notice, and could induce some first-rate house to carry it out, and mention the fact in a subsequent edition of your book, you would, I think, be adding another most valuable item to an already invaluable book."

The above suggestion of preserving Ipecacuanha Wine in ounce bottles, quite full, and hermetically sealed, is a very good one. The best way of hermetically sealing the bottle would be, to cut the cork level with the lip of the bottle, and to cover the cork with sealing-wax, in the same manner wine merchants serve some kinds of their wines, and then to lay the bottles on their sides in sawdust in the cellar. I have no doubt, if such a plan were adopted, the Ipecacuanha Wine would for a length of time keep good. Of course, if the Wine of Ipecacuanha be procured from the Apothecaries' Hall Company, London (as suggested by my correspondent), there can be no question as to the genuineness of the article.

_What NOT to do_--Do not give emetic tartar, do not apply leeches, do not keep the room very warm, do not give stimulants, do not omit to have always in the house either a 4 oz. bottle, or three or four 1 oz. bottles, of Ipecacuanha Wine.

202. _I have heard Child crowing mentioned as a formidable disease, would you describe the symptoms_?

Child-crowing, or spasm of the glottis, or _spurious croup_, as it is sometimes called, is occasionally mistaken for _genuine croup_. It is a more frequent disorder than the latter, and requires a different plan of treatment Child crowing is a disease that invariably occurs only during dentition, and is _most perilous_, indeed, painful dentition is _the_ cause--_the_ only cause--of child crowing. But, if a child labouring under it can fortunately escape suffocation until he have cut the whole of his first set of teeth--twenty--he is then safe.

Child-crowing comes on in paroxysms. The breathing during the intervals is quite natural--indeed, the child appears perfectly well, hence, the dangerous nature of the disease is either overlooked, or is lightly thought of, until perhaps a paroxysm worse than common takes place, and the little patient dies of suffocation, overwhelming the mother with terror, with confusion, and dismay.

The _symptoms_ in a paroxysm of child-crowing are as follows--The child suddenly loses and fights for his breath, and in doing so, makes a noise very much like that of crowing, hence the name child-crowing. The face during the paroxysm becomes bluish or livid. In a favourable case, after either a few seconds, or even, in some instances, a minute, and a frightful straggle to breathe, he regains his breath, and is, until another paroxysm occurs, perfectly well. In an unfavourable case, the upper part (chink) of the windpipe--the glottis--remains for a minute or two closed, and the child, not being able to breathe, drops a corpse in his nurse's arms! Many children, who are said, to have died of fits, hare really died of child-crowing.

Child-crowing is very apt to cause convulsions, which complication, of course, adds very much to the danger. Such a complication requires the constant supervision of an experienced and skilful medical man.

I have entered thus rather fully into the subject, as nearly every life might be saved, if a mother knew the nature and the treatment of the complaint, and of the _great necessity during the paroxysm of prompt and proper measures_. For, too frequently, before a medical man has had time to arrive, the child has breathed his last, the parent himself being perfectly ignorant of the necessary treatment; hence the vital importance of the subject, and the paramount necessity of imparting such information, in a _popular_ style, in conversations of this kind.

203. _What treatment, then, during a paroxysm of Child-crowing should you advise_?

The first thing, of course, to be done, is to send _immediately_ for a medical man. Have a plentiful supply of cold and of hot water always at hand, ready at a moment's notice for use. The instant the paroxysm is upon the child, plentifully and perseveringly dash _cold_ water upon his head and face. Put his foot and legs in _hot_ salt, mustard, and water; and, if necessary, place him up to his neck in a hot bath, still dashing water upon his face and head. If he does not quickly come round, sharply smack his back and buttocks.

In every severe paroxysm of child-crowing, put your fore-finger down the throat of the child, and pull his tongue forward. This plan of pulling the tongue forward opens the epiglottis (the lid of the glottis), and thus admits air (which is so sorely needed) into the glottis and into the lungs, and thus staves off impending suffocation. If this plan were generally known and adopted, many precious lives might be saved. [Footnote: An intelligent correspondent first drew my attention to the efficacy of pulling forward the tongue in every severe paroxysm of child-crowing.]

There is nothing more frightfully agonising to a mother's feelings than to see her child strangled,--as it were,--before her eyes, by a paroxysm of child crowing.

As soon as a medical man arrives, he will lose no time in thoroughly lancing the gums, and in applying other appropriate remedies.

Great care and attention ought, during the intervals, to be paid to his diet. If the child be breathing a smoky, close atmosphere, he should be immediately removed to a pure one. In this disease, indeed, there is no remedy equal to a change of air--to a dry, bracing neighbourhood. Change of air, even if it be winter, is the best remedy, either to the coast or to a healthy mountainous district. I am indebted to Mr Roberton of Manchester (who has paid great attention to this disease, and who has written a valuable essay on the subject [Footnote: See the end of the volume of "Physiology and Diseases of Women," &c. Churchill, 1851.]) for the knowledge of this fact. Where, in a case of this kind, it is not practicable to send a child _from_ home, then let him be sent out of doors the greater part of every day; let him, in point of fact, almost live in the open air. I am quite sure, from an extensive experience, that in this disease, fresh air, and plenty of it, is the best and principal remedy. Cold sponging of the body too is useful.

Mr Roberton, who, at my request, has kindly given me the benefit of his extensive experience in child-crowing, considers that there is no remedy, in this complaint, equal to fresh air--to dry cold winds--that the little patient ought, in fact, nearly to live, during the day, out of doors, whether the wind be in the east or in the north-east, whether it be biting cold or otherwise, provided it be dry and bracing, for "if the air be dry, the colder the better,"--taking care, of course, that he be well wrapped up. Mr Roberton, moreover, advises that the child should be sent away at once from home, either to a bracing sea-side place, such as Blackpool or Fleetwood; or to a mountainous district, such as Buxton.

As the subject is so important, let me recapitulate: the gums ought, from time to time, to be well lanced, in order to remove the irritation of painful dentition--painful dentition being the real cause of the disease. Cold sponging should be used twice or thrice daily. The diet should be carefully attended to (see Dietary of Child); and everything conducive to health should (as recommended in these Conversations) be observed. But, remember, after all that can be said about the treatment, there is nothing like change of air, of fresh air, of cold, dry pure air, and of plenty of it--the more the little fellow can inhale, during the day, the better it will be for him, it will be far better than any drug contained in the pharmacopoeia.

I have dwelt on this subject at some length--it being a most important one--as, if the above advice were more generally known and followed, nearly every child, labouring under this complaint, would be saved; while now, as coroners' inquests abundantly testify, the disease carries off yearly an immense number of victims.

204. _When is a mother to know that a cough is not a "tooth cough" but one of the symptoms of Inflammation of the lungs_?

If the child has had a shivering fit; if his skin be very hot and very dry; if his lips be parched; if there be great thirst; if his cheeks be flushed; if he be dull and heavy, wishing to be quiet in his cot or crib; if his appetite be diminished; if his tongue be furred; if his mouth be _burning_ hot and dry; [Footnote: If you put your finger into the mouth of a child labouring under inflammation of the lungs, it is like putting your finger into a hot apple pie, the heat is so great.] if his urine be scanty and high-coloured, staining the napkin or the linen; _if his breathing be short, panting, hurried, and oppressed; if there be a hard dry cough, and if his skin be burning hot;_--then there is no doubt that inflammation of the lungs has taken place.

No time should be lost in sending for medical aid; indeed, the _hot, dry mouth and skin, and short, hurried breathing_ would be sufficient cause for your procuring _immediate_ assistance. If inflammation of the lungs were properly treated at the _onset_, a child would scarcely ever be lost by that disease. I say this advisedly, for in my own practice, _provided I am called in early, and if my plans are strictly carried out_, I scarcely ever lose a child from inflammation of the lungs.

You may ask--What are your plans? I will tell you, in case _you cannot promptly obtain medical advice,_ as delay might be death!

_The treatment of Inflammation of the Lungs, what to do._--Keep the child to one room, to his bedroom, and to his bed. Let the chamber be properly ventilated. If the weather be cool, let a small fire be in the grate; otherwise, he is better without a fire. Let him live on low diet, such as weak black tea, milk and water (in equal quantities), and toast and water, thin oatmeal gruel, arrow-root, and such like simple beverages, and give him the following mixture:--

Take of--Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms;

Make a Mixture. A tea-spoonful of the mixture to be taken every four hours.

Be careful that you go to a respectable chemist, in order _that the totality of the Ipecacuanha Wine may be good, as the child's life may depend upon it._

If the medicine produce sickness, so much the better; continue it regularly until the short, oppressed, and hurried breathing has subsided, and has become natural.

If the attack be very severe, in addition to the above medicine, at once apply a blister, not the common blister, but _Smith's Tela Vesicatoria_ [Footnote: Manufactured by T. & H. Smith, chemists, Edinburgh, and may be procured of Southalls, chemists, Birmingham.]--a quarter of a sheet. If the child be a year old, the blister ought to be kept on for three hours, and then a piece of dry, soft linen rag should be applied for another three hours. At the end of which time--six hours--there will be a beautiful blister, which must then, with a pair of scissors, be cut, to let out the water, and then let the blister be dressed, night and morning, with simple cerate spread on lint.

If the little patient be more than one year, say two years old, let the Tela remain on for five hours, and the dry linen rag for five hours more, before the blister, as above recommended, be cut and dressed.

If in a day or two the inflammation still continue violent, let another Tela Vesicatoria be applied, not over the old blister, but let a narrow strip of it be applied on each side of the old blister, and managed in the same manner as before directed.

_I cannot speak too highly of Smith's Tela Vesicatoria._ It has, in my hands, through God's blessing, saved the lives of scores of children. It is far, very far, superior to the old fashioned blistering plaster. It seldom, if the above rules be strictly observed, fails to rise, it gives much less pain than the common blister, when it has had the desired effect, it readily heals, which cannot always be said of the common fly blister, more especially with children.

My sheet anchors, then, in the inflammation of the lungs of children are, Ipecacuanha Wine and Smith's _Tela Vesicatoria_. Let the greatest care, as I before advised, be observed in obtaining the Ipecacuanha Wine genuine and good. This can be only depended upon by having the medicine from a highly respectable chemist, Ipecacuanha Wine, when genuine and good, is, in many children's diseases, is one of the most valuable of medincies.

_What, in a case of inflammation of the lungs, NOT to do_--Do not, on any account, apply leeches. They draw out the life of the child, but not his disease. Avoid--_emphatically let me say so_--giving emetic tartar It is one of the most lowering and death-dealing medicines that can be administered either to an infant or to a child! If you wish to try the effect of it, take a dose yourself, and I am quite sure that you will then never be inclined to poison a child with such an abominable preparation! In olden times--many, many years ago--I myself gave it in inflammation of the lungs, and lost many children! Since leaving it off, the recoveries of patients by the Ipecacuanha treatment, combined with the external application of Smith's _Tela Vesicatoria_, have been in many cases marvellous. Avoid broths and wine, and all stimulants. Do _not_ put the child into a warm bath, it only oppresses the already oppressed breathing. Moreover, after he is out of the bath, it causes a larger quantity of blood to rush back to the lungs and to the bronchial tubes, and thus feeds the inflammation. Do not, by a large fire, keep the temperature of the room high. A small fire, in the winter time, encourages ventilation, and in such a case does good. When the little patient is on the mother's or on the nurse's lap, do not burden him either with a _heavy_ blanket or with a _thick_ shawl. Either a _thin_ child's blanket, or a _thin_ woollen shawl, in addition to his usual nightgown, is all the clothing necessary.

205. _Is Bronchitis a more frequent disease than Inflammation of the Lungs? Which is the most dangerous? What are the symptoms of Bronchitis_?

Bronchitis is a much more frequent disease than inflammation of the lungs, indeed, it is one of the most common complaints both of infants and of children, while inflammation of the lungs is comparatively a rare disease. Bronchitis is not nearly such a dangerous disease as inflammation of the lungs.