Chapter XII: Part 12

Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the Purge No. 23 should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb.

Many Women die about this Age, as it is but too easy a Matter to injure them then; a Circumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before.

The Regimen I have just directed, the Powder No. 24, and the Potion No. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life.

_Of Disorders attending Gravidation, or the Term of going with Child._

Sec. 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary [83] for pregnant Women.

[83] Too great a Fulness of Blood is undoubtedly the Cause of all these
Complaints; but as there are different Methods of opposing this
Cause, the gentlest should always be preferred; nor should the
Constitution become habituated to such Remedies, as might either
impair the Strength of the Mother, or of her Fruit. Some Expedients
therefore should be thought of, that may compensate for the Want of
Bleeding, by enjoining proper Exercise in a clear Air, with a less
nourishing, and a less juicy Diet. _E. L._

This Note might have its Use sometimes, in the Cases of such
delicate and hysterical, yet pregnant Women, as are apt to suffer
from Bleeding, or any other Evacuation, though no ways immoderate.
But it should have been considered, that Dr. _Tissot_ was
professedly writing here to hearty active Country Wives, who are
very rarely thus constituted; and whom he might be unwilling to
confuse with such multiplied Distinctions and Directions, as would
very seldom be necessary, and might sometimes prevent them from
doing what was so. Besides which, this Editor might have seen, our
Author has hinted at such Cases very soon after. _K._

Sec. 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying.

To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible.

2, They should directly lose eight or nine Ounces of Blood from the Arm.

3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances.

4, They should take every two Hours half a Paper of the Powder No. 20; and should drink nothing but the Ptisan No. 2.

Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment.

_Of Delivery, or Child-birth._

Sec. 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health.

The Necessity there is for better instructed, better qualified Midwives, through a great Part of _Swisserland_, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government.

The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a whole Book, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Haemorrhages, which prove mortal in a few Hours.

Sec. 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it is painful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue.

During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses.

Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly.

The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, both Mother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish.

Sec. 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified.

I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us.

The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom; and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery.

_Of the Consequences of Labour, or Childbirth._

Sec. 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Haemorrhage. 2, An Inflammation of the Womb. 3, A sudden Suppression of the _Lochia_, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk.

Excessive Bleedings or Floodings, should be treated according to the Manner directed Sec. 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates.

Sec. 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a light _Delirium_ or Raving; a continual Fever with a weak and hard Pulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it.

Sec. 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond Milk No. 4.

Sec. 372. The total Suppression of the _Lochia_, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one.

Sec. 373. If the Milk-fever run very high, the Barley Ptisan directed Sec. 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it.

Sec. 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Want of due Perspiration, and an insufficient Discharge of the _Lochia_; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the Ptisan No. 58 is to be drank, and the Pultices No. 59 must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, and _Pus_, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other.

Sec. 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove a _Scirrhus_; and from a _Scirrhus_ in Process of Time a Cancer, that most tormenting and cruel Distemper.

This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the Prescriptions No. 57 and 60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible.

From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp, resinous and spirituous ones speedily change the _Scirrhus_ into a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that of No. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the Remedy No. 57; which nevertheless is not infallible, though it should always be tried. [84]

[84] The Use of Hemlock, which has been tried at _Lyons_, by all who
have had cancerous Patients, having been given in very large Doses,
has been attended with no Effect there, that merited the serious
Attention of Practitioners. Many were careful to obtain the Extract
from _Vienna_, and even to procure it from Dr. _Storck_ himself.
But now it appears to have had so little Success, as to become
entirely neglected. _E. L._

Having exactly translated in this Place, and in the Table of
Remedies, our learned Author's considerable Recommendation of the
Extract of Hemlock in Cancers, we think it but fair, on the other
Hand, to publish this Note of his Editor's against it; that the
real Efficacy or Inefficacy of this Medicine may at length be
ascertained, on the most extensive Evidence and Experience. As far
as my own Opportunities and Reflections, and the Experience of many
others, have instructed me on this Subject, it appears clear to
myself, that though the Consequences of it have not been constantly
unsuccessful with us, yet its Successes have come very short of its
Failures. Nevertheless, as in all such Cancers, every other
internal Medicine almost universally fails, we think with Dr.
_Tissot_ it should always be tried (from the meer Possibility of
its succeeding in some particular Habit and Circumstances) at least
till longer Experience shall finally determine against it. _K._

Sec. 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the Ointment No. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it.

__Chapter XXVII.__

_Medical Directions concerning Children._

__Sect.__ 377.

The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem to have been too much neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults.

It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nay every Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work.

Sec. 378. Nearly all the Children who die before they are one Year, and even two Years, old, die _with_ Convulsions: People say they died _of_ them, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, the _Meconium_; the Excrements contained in the Body of the Infant, at the Birth; _Acidities_, or sharp and sour Humours; the Cutting of the Teeth, and Worms. I shall treat briefly of each.

_Of the Meconium._

Sec.379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called the _Meconium_. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant.

The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute this _Meconium_, and promote the Discharge of it by Stool, and sometimes by vomiting.

To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup [85] of Succory, which should be diluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds.

[85] This Method (says the Editor and Annotator of _Lyons_) is useful,
whenever the Mother does not suckle her Child. Art is then obliged
to prove a Kind of Substitute to Nature, though always a very
imperfect one. But when a Mother, attentive to her own true
Interest, as well as her Infant's, and, listening to the Voice of
Nature and her Duty, suckles it herself, these Remedies [he adds]
seem hurtful, or at least, useless. The Mother should give her
Child the Breast as soon as she can. The first Milk, the
_Colostrum_, or _Strippings_, as it is called in Quadrupeds, which
is very serous or watery, will be serviceable as a Purgative; it
will forward the Expulsion of the _Meconium_, prove gradually
nourishing, and is better than Biscuits, or Panada, which (he
thinks) are dangerous in the first Days after the Birth. _E. L._

This Syrup of Succory being scarcely ever prepared with us, though
sufficiently proper for the Use assigned it here, I have retained
the preceding Note, as the Author of it directs these _Strippings_,
for the same Purpose, with an Air of certain Experience; and as
this Effect of them seems no Ways repugnant to the physical Wisdom
and Oeconomy of Nature, on such important Points. Should it in fact
be their very general Operation, it cannot be unknown to any Male
or Female Practitioner in Midwifery, and may save poor People a
little Expence, which was one Object of our humane Author's Plan.
The Oil Of _Ricinus_, corruptly called _Castor_ Oil (being
expressed from the Berries of the _Palma Christi_) is particularly
recommended by some late medical Writers from _Jamaica_, _&c._ for
this Purpose of expelling the _Meconium_, to the Quantity of a
small Spoonful. These Gentlemen also consider it as the most
proper, and almost specific Opener, in the dry Belly-ach of that
torrid Climate, which tormenting Disease has the closest Affinity
to the _Miserere_, or Iliac Passion, of any I have seen. The
Annotator's Objection to our Author's very _thin light_ Panada,
seems to be of little Weight. _K._

Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada.

_Of Acidities, or sharp Humours._

Sec. 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory [86] just mentioned.

[86] Or, for Want of it, the solutive Syrup of Roses. _K._

The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the Powder No. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves.

Sec. 381. It has been a Custom to load Children with Oil of Almonds, [87] as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increases the Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life.

[87] The _Magnesia_ is an excellent Substitute in Children, for these
Oils Dr. _Tissot_ so justly condemns here. _K._

A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues.

This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length often proves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult.

Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels.

Sec. 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving.

Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines, _&c._ of Soap, or of Honey boiled up to a proper Consistence.

But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life.

Sec. 383. Before I proceed to the third Cause of the Diseases of Children, which is, the Cutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them.

_Of washing Children._

Sec. 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Children should be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring.

For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears, the back Part of the Head (carefully avoiding the [88] _Fontanelle_, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head.

[88] That Part of the Head where a Pulsation may be very plainly felt,
where the Bones are less hard, and not as yet firmly joined with
those about them.

Weakly Infants [89] are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequently seen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation.

[89] There is however a certain Degree of Weakness, which may very
reasonably deter us from this Washing; as when the Infant
manifestly wants Heat, and needs some Cordial and frequent
Frictions, to prevent its expiring from downright Feebleness; in
which Circumstances Washing must be hurtful to it. _Tissot._

They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake.

After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it.

The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often called Kernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health.

Sec. 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances.

Sec. 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kinds of Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers.

_Of the Cutting of the Teeth._

Sec. 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging.

2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because the Stomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting.

3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added.

4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew.

It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels.

_Of Worms._

Sec. 388. The _Meconium_, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference among Children too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few.

They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even [90] gnawing them.

[90] I have seen a Child about three Years old, whose Navel, after
swelling and inflaming, suppurated, and through a small Orifice
(which must have communicated with the Cavity of the Gut or the
Belly) discharged one of these Worms we call _teretes_, about three
Inches long. He had voided several by Stool, after taking some
vermifuge Medicines. The Fact I perfectly remember; and to the best
of my Recollection, the Ulcer healed some Time after, and the
Orifice closed: but the Child died the following Year of a putrid
Fever, which might be caused, or was aggravated, by Worms. _K._

Sec. 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of the Body meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams or _Deliriums_, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note [90] p. 388.)

Sec. 390. There are a great Multitude of Medicines against Worms. The [91] _Grenette_ or Worm-seed, which is one of the commonest, is a very good one. The Prescription No. 62, is also a very successful one; and the Powder No. 14 is one of the best. Flower of Brimstone, the Juice of _Nasturtium_, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best. No. 63 is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years.

[91] This Word occurs in none of the common Dictionaries; but suspecting
it for the _Semen Santonici_ of the Shops, I find the learned Dr.
_Bikker_ has rendered it so, in his very well received Translation
of this valuable Work into _Low Dutch_. _K._

A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms, do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms.

_Of Convulsions._

Sec. 391. I have already said, Sec. 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following.

The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment.

It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness and Load at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep.

The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge of No. 63, very generally remove such Convulsions.

Sec. 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it.

The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated.

2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-tree Flowers, in giving it no other Nourishment for a Day or two, except Panada and other light Spoon-meat, without Milk.

3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it.

Sec. 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them.

Sec. 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Cause producing them, and which I have already pointed out in treating of each Cause.

The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are often useless, and still oftner prejudicial. Of this last Sort and Character are,

1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,--other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them.

2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an [92] Effort of Nature, in Order to effect a _Crisis_: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions.

[92] This very important Consideration, on which I have treated pretty
largely, in the _Analysis_, seems not to be attended to in
Practice, as frequently as it ought. _K._

3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advised to. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper,

1, When the Convulsions still continue, after the original Cause of them is removed.

2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and,

3, When the Cause producing them is of such a Nature, as is apt to yield to the Force of Anodynes; as when, for Instance, they have been the immediate Consequence of a Fright.

Sec. 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easily _convulsible_, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the Powder No. 14 are serviceable in such Circumstances.

_General Directions, with Respect to Children._

Sec. 396. I shall conclude this Chapter by such farther Advice, as may contribute to give Children a more vigorous Constitution and Temperament, and to preserve them from many Disorders.

First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same.

A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance, that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals.

A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Consideration of this Abuse, and agree to put an End to it.

Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.

Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs.

To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible, or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious.