Part I.--Infancy

Infant and suckling.--I. SAMUEL A rose with all its sweetest leaves yet folded.--BYRON. Man's breathing Miniature!--COLERIDGE.

PRELIMINARY CONVERSATION

1. I wish to consult you on many subjects appertaining to the management and the care of children; will you favour me with your advice and counsel?

I shall be happy to accede to your request, and to give you the fruits of my experience in the clearest manner I am able, and in the simplest language I can command--freed from all technicalities. I will endeavour to guide you in the management of the health of your offspring;--I will describe to you the symptoms of the diseases of children;--I will warn you of approaching danger, in order that you may promptly apply for medical assistance before disease has gained too firm a footing;--I will give you the treatment on the moment; of some of their more pressing illnesses--when medical aid cannot at once be procured, and where delay may be death;--I will instruct you, in case of accidents, on the immediate employment of remedies--where procrastination may be dangerous;--I will tell you how a sick child should be nursed, and how a sick-room ought to be managed;--I I will use my best energy to banish injurious practices from the nursery;--I will treat of the means to prevent disease where it be possible;--I will show you the way to preserve the health of the healthy,--and how to strengthen the delicate;--and will strive to make a medical man's task more agreeable to himself,--and more beneficial to his patient,--by dispelling errors and prejudices, and by proving the importance of your strictly adhering to his rules. If I can accomplish any of these objects, I shall be amply repaid by the pleasing satisfaction that I have been of some little service to the rising generation.

2. Then you consider it important that I should be made acquainted with, and be well informed upon, the subjects you have just named?

Certainly! I deem it to be your imperative duty to study the subjects well. The proper management of children is a vital question,--a mother's question,--and the most important that can be brought under the consideration of a parent; and, strange to say, it is one that has been more neglected than any other. How many mothers undertake--the responsible management of children without previous instruction, or without forethought; they undertake it, as though it may be learned either by intuition or by instinct, or by affection. The consequence is, that frequently they are in a sea of trouble and uncertainty, tossing about without either rule or compass; until, too often, their hopes and treasures are shipwrecked and lost.

The care and management, and consequently the health and future well-doing of the child, principally devolve upon the mother, "for it is the mother after all that has most to do with the making or marring of the man." [Footnote: Good Words, Dr W. Lindsay Alexander, March 1861.] Dr Guthrie justly remarks that--"Moses might have never been the man he was unless he had been nursed by his own mother. How many celebrated men have owed their greatness and their goodness to a mother's training!" Napoleon owed much to his mother. "'The fate of a child,' said Napoleon, 'is always the work of his mother;' and this extraordinary man took pleasure in repeating, that to his mother he owed his elevation. All history confirms this opinion..." The character of the mother influences the children more than that of the father, because it is more exposed to their daily, hourly observation.--Woman's Mission.

I am not overstating the importance of the subject in hand when I say, that a child is the most valuable treasure in the world, that "he is the precious gift of God," that he is the source of a mother's greatest and purest enjoyment, that he is the strongest bond of affection between her and her husband, and that

"A babe in a house is a well-spring of pleasure, A messenger of peace and love."--Tupper,

I have, in the writing of the following pages, had one object constantly in view--namely, health--

"That salt of life, which does to all a relish give, Its standing pleasure, and intrinsic wealth, The body's virtue, and the soul's good fortune--health."

If the following pages insist on the importance of one of a mother's duties more than another it is this,--that the mother herself look well into everything appertaining to the management of her own child.

Blessed is that mother among mothers of whom it can be said, that "she hath done what she could" for her child--for his welfare, for his happiness, for his health!

For if a mother hath not "done what she could for her child"--mentally, morally, and physically--woe betide the unfortunate little creature;--better had it been for him had he never been born!

ABLUTION

3. Is a new-born infant, for the first time, to be washed in warm or in cold water?

It is not an uncommon plan to use cold water from the first, under the impression of its strengthening the child. This appears to be a cruel and barbarous practice, and is likely to have a contrary tendency. Moreover, it frequently produces either inflammation of the eyes, or stuffing of the nose, or inflammation of the lungs, or looseness of the bowels. Although I do not approve of cold water, we ought not to run into an opposite extreme, as hot water would weaken and enervate the babe, and thus would predispose him to disease. Luke warm rain water will be the best to wash him with. This, if it be summer, should have its temperature gradually lowered, until it be quite cold, if it be winter, a dash of warm water ought still to be added, to take oft the chill [Footnote: A nursery basin (Wedgwoode make is considered the best), holding either six or eight quarts of water, and which will be sufficiently large to hold the whole body of the child. The baton is generally fitted into a wooden frame which will raise it to a convenient height for the washing of the baby.] (By thermometer = 90 to 92 degrees.)

It will be necessary to use soap--Castile soap being the best for the purpose--it being less irritating to the skin than the ordinary soap. Care should be taken that it does not get into the eyes, as it may produce either inflammation or smarting of those organs.

If the skin be delicate, or if there be any excoriation or "breaking-out" on the skin, then glycerine soap, instead of the Castile soap, ought to be used.

4. At what age do you recommend a mother to commence washing her infant either in the tub, or in the nursery basin?

As soon as the navel string comes away [Footnote: Sir Charles Locock strongly recommends that an infant should be washed in a tub from the very commencement. He says,--"All those that I superintend begin with a tub."--Letter to the Author.] Do not be afraid of water,--and that in plenty,--as it is one of the best strengtheners to a child's constitution. How many infants suffer, for the want of water from excoriation!

5. Which do you prefer--flannel or sponge--to wash a child with?

A piece of flannel is, for the first part of the washing very useful--that is to say, to use with the soap, and to loosen the dirt and the perspiration; but for the finishing-up process, a sponge--a large sponge--is superior to flannel, to wash all away, and to complete the bathing. A sponge cleanses and gets into all the nooks, corners, and crevices of the skin. Besides, sponge, to finish up with, is softer and more agreeable to the tender skin of a babe than flannel. Moreover, a sponge holds more water than flannel, and thus enables you to stream the water more effectually over him. A large sponge will act Like a miniature shower bath, and will thus brace and strengthen him.

6. To prevent a new-born babe from catching cold, is it necessary to wash his head with brandy?

It is not necessary. The idea that it will prevent cold is erroneous, as the rapid evaporation of heat which the brandy causes is more likely to give than to prevent cold.

7. Ought that tenacious, paste like substance, adhering to the skin of a new-born babe, to be washed off at the first dressing?

It should, provided it be done with a soft sponge and with care. If there be any difficulty in removing the substance, gently rub it, by means of a flannel, [Footnote: Mrs Baines (who has written so much and so well on the Management of Children), in a Letter to the Author, recommends flannel to be used in the first washing of an infant, which flannel ought afterwards to be burned; and that the sponge should be only used to complete the process, to clear off what the flannel had already loosened. She also recommends that every child should have his own sponge, each of which should have a particular distinguishing mark upon it, as she considers the promiscuous use of the same sponge to be a frequent cause of ophthalmia (inflammation of the eyes). The sponges cannot be kept too clean.] either with a little lard, or fresh butter, or sweet-oil. After the parts have been well smeared and gently rubbed with the lard, or oil, or butter, let all be washed off together, and be thoroughly cleansed away, by means of a sponge and soap and warm water, and then, to complete the process, gently put him in for a minute or two in his tub. If this paste like substance be allowed to remain on the skin, it might produce either an excoriation, or a "breaking-out" Besides, it is impossible, if that tenacious substance be allowed to remain on it, for the skin to perform its proper functions.

8. Have you any general observations to make on the washing of a new-born infant?

A babe ought, every morning of his life, to be thoroughly washed from head to foot, and this can only be properly done by putting him bodily either into a tub or into a bath, or into a large nursery basin, half filled with water. The head, before placing him in the bath, should be first wetted (but not dried), then immediately put him into the water, and, with a piece of flannel well soaked, cleanse his whole body, particularly his arm pits, between his thighs, his groins, and his hams, then take a large sponge in hand, and allow the water from it, well filled, to stream all over the body, particularly over his back and loins. Let this advice be well observed, and you will find the plan most strengthening to your child. The skin must, after every bath, be thoroughly but quickly dried with warm, dry, soft towels, first enveloping the child in one, and then gently absorbing the moisture with the towel, not roughly scrubbing and rubbing his tender skin as though a horse were being rubbed down.

The ears must, after each ablution, be carefully and well dried with a soft dry napkin, inattention to this advice has sometimes caused a gathering in the ear--a painful and distressing complaint, and at other times it has produced deafness.

Directly after the infant is dried, all the parts that are at all likely to be chafed ought to be well powdered. After he is well dried and powdered, the chest, the back, the bowels, and the limbs should be gently rubbed, taking care not to expose him unnecessarily during such friction.

He ought to be partially washed every evening, indeed it may be necessary to use a sponge and a little warm water frequently during the day, namely, each time after the bowels have been relieved. Cleanliness is one of the grand incentives to health, and therefore cannot be too strongly insisted upon. If more attention were paid to this subject, children would be more exempt from chafings, "breakings-out," and consequent suffering, than they at present are. After the second month, if the babe be delicate, the addition of two handfuls of table-salt to the water he is washed with in the morning will tend to brace and strengthen him.

With regard to the best powder to dust an infant with, there is nothing better for general use than starch--the old fashioned starch made of wheaten flour--reduced by means of a pestle and mortar to a fine powder, or Violet Powder, which is nothing more than finely powdered starch scented, and which may be procured of any respectable chemist. Some others are in the habit of using white lead, but as this is a poison, it ought on no account to be resorted to.

9. If the parts about the groin and fundament be excoriated, what is then the best application?

After sponging the parts with tepid rain water, holding him over his tub, and allowing the water from a well filled sponge to stream over the parts, and then drying them with a soft napkin (not rubbing, but gently dabbing with the napkin), there is nothing better than dusting the parts frequently with finely powdered Native Carbonate of Zinc-Calamine Powder. The best way of using this powder is, tying up a little of it in a piece of muslin, and then gently dabbing the parts with it.

Remember excoriations are generally owing to the want of water,--to the want of an abundance of water. An infant who is every morning well soused and well swilled with water seldom suffers either from excoriations, or from any other of the numerous skin diseases. Cleanliness, then, is the grand preventative of, and the best remedy for excoriations. Naaman the Syrian was ordered "to wash and be clean," and he was healed, "and his flesh came again like unto the flesh of a little child and he was clean." This was, of course, a miracle; but how often does water, without any special intervention, act miraculously both in preventing and in curing skin diseases!

An infant's clothes, napkins especially, ought never to be washed with soda; the washing of napkins with soda is apt to produce excoriations and breakings-out. "As washerwomen often deny that they use soda, it can be easily detected by simply soaking a clean white napkin in fresh water and then tasting the water; if it be brackish and salt, soda has been employed." [Footnote: Communicated by Sir Charles Locock to the Author.]

10. Who is the proper person to wash and dress the babe?

The monthly nurse, as long as she is in attendance; but afterwards the mother, unless she should happen to have an experienced, sensible, thoughtful nurse, which, unfortunately, is seldom the case. [Footnote: "The Princess of Wales might have been seen on Thursday taking an airing in a brougham in Hyde Park with her baby--the future King of England--on her lap, without a nurse, and accompanied only by Mrs Brace. The Princess seems a very pattern of mothers, and it is whispered among the ladies of the Court that every evening the mother of this young gentleman may be seen in a flannel dress, in order that she may properly wash and put on baby's night clothes, and see him safely in bed. It is a pretty subject for a picture."--Pall Mall Gazette.]

11. What is the best kind of apron for a mother, or for a nurse, to wear, while washing the infant?

Flannel--a good, thick, soft flannel, usually called bathcoating--apron, made long and full, and which of course ought to be well dried every time before it is used.

12. Perhaps you will kindly recapitulate, and give me further advice on the subject of the ablution of my babe.

Let him by all means, then, as soon as the navel-string has separated from the body, be bathed either in his tub, or in his bath, or in his large nursery-basin, for if he is to be strong and hearty, in the water every morning he must go. The water ought to be slightly warmer than new milk. It us dangerous for him to remain for a long period in his bath, this, of course, holds good in a ten fold degree if the child have either a cold or pain in his bowels. Take care that, immediately after he comes out of his tub, he is well dried with warm towels. It is well to let him have his bath the first thing in the morning, and before he has been put to the breast, let him be washed before he has his breakfast, it will refresh him and give him an appetite. Besides, he ought to have his morning ablution on an empty stomach, or it may interfere with digestion, and might produce sickness and pain. In putting him in his tub, let his head be the first part washed. We all know, that in bathing in the sea, now much better we can bear the water if we first wet our head, if we do not do so, we feel shivering and starved and miserable. Let there be no dawdling in the washing, let it be quickly over. When he is thoroughly dried with warm dry towels, let him be well rubbed with the warm hand of the mother or of the nurse. As I previously recommended, while drying him and while rubbing him, let him repose and kick and stretch either on the warm flannel apron, or else on a small blanket placed on the lap. One bathing in the tub, and that in the morning, is sufficient, and better than night and morning. During the day, as I before observed, he may, after the action either of his bowels or of his bladder, require several spongings of lukewarm water, for cleanliness is a grand incentive to health and comeliness.

Remember it is absolutely necessary to every child from his earliest babyhood to have a bath, to be immersed every morning of his life in the water. This advice, unless in cases of severe illness, admits of no exception. Water to the body--to the whole body--is a necessity of life, of health, and of happiness, it wards off disease, it brace? the nerves, it hardens the frame, it is the finest tonic in the world. Oh, if every mother would follow to the very letter this counsel how much misery, how much ill-health might then be averted!

MANAGEMENT OF THE NAVEL.

13. Should the navel-string be wrapped in SINGED rag?

There is nothing better than a piece of fine old linen rag, unsinged; when singed, it frequently irritates the infant's skin.

14. How ought the navel-string to be wrapped in the rag?

Take a piece of soft linen rag, about three inches wide and four inches long, and wrap it neatly round the navel string, in the same manner you would around a cut finger, and then, to keep on the rag, tie it with a few rounds of whity-brown thread. The navel-string thus covered should, pointing upwards, be placed on the belly of the child, and must be secured in its place by means of a flannel belly-band.

15. If after the navel-string has been secured, bleeding should (in the absence of the medical man) occur, how must it be restrained?

The nurse or the attendant ought immediately to take off the rag, and tightly, with a ligature composed of four or five whity-brown threads, retie the navel-string; and to make assurance doubly sure, after once tying it, she should pass the threads a second time around the navel-string, and tie it again; and after carefully ascertaining that it no longer bleeds, fasten it up in the rag as before. Bleeding of the navel-string rarely occurs, yet, if it should do so--the medical man not being at hand--the child's after-health, or even his life, may, if the above directions be not adopted, be endangered.

16. When does the navel-string separate from the child?

From five days to a week after birth; in some cases not until ten days or a fortnight, or even, in rare cases, not until three weeks.

17. If the navel-string does not at the end of a week came away, ought any means to be used to cause the separation?

Certainly not, it ought always to be allowed to drop off, which, when in a fit state, it will readily do. Meddling with the navel string has frequently cost the babe a great deal of suffering, and in some cases even his life.

18. The navel is sometimes a little sore, after the navel-string comes away, what ought then to be done?

A little simple cerate should be spread on lint, and be applied every morning to the part affected, and a white-bread poultice, every night, until it is quite healed.

NAVEL RUPTURE--GROIN RUPTURE.

19. What are the causes of a rupture of the navel? What ought to be done? Can it be cured?

(1) A rupture of the navel is sometimes occasioned by a meddlesome nurse. She is very anxious to cause the navel-string to separate from the infant's body, more especially when it is longer in coming away than usual. She, therefore, before it is in a fit state to drop off, forces it away. (2) The rapture, at another time, is occasioned by the child incessantly crying. A mother, then, should always bear in mind, that a rupture of the navel is often caused by much crying, and that it occasions much crying, indeed, it is a frequent cause of incessant crying. A child, therefore, who, without any assignable cause, is constantly crying, should have his navel carefully examined.

A rupture of the navel ought always to be treated early--the earlier the better. Ruptures of the navel can only be cured in infancy and in childhood. If it be allowed to run on until adult age, a cure is impossible. Palliative means can then only be adopted.

The best treatment is a Burgundy pitch plaster, spread on a soft piece of wash leather, about the size of the top of a tumbler, with a properly-adjusted pad (made from the plaster) fastened on the centre of the plaster, which will effectually keep up the rupture, and in a few weeks will cure it. It will be necessary, from time to time, to renew the plaster until the cure be effected. These plasters will be found both more efficacious and pleasant than either truss or bandage; which latter appliances sometimes gall, and do more harm than they do good.

20. If an infant have a groin-rupture (an inguinal rupture), can that also be cured?

Certainly, if, soon after birth, it be properly attended to. Consult a medical man, and he will supply you with a well-fitting truss, which will eventually cure him. If the truss be properly made (under the direction of an experienced surgeon) by a skilful surgical-instrument maker, a beautiful, nicely-fitting truss will be supplied, which will take the proper and exact curve of the lower part of the infant's belly, and will thus keep on without using any under-strap whatever--a great desideratum, as these under-straps are so constantly wetted and soiled as to endanger the patient constantly catching cold. But if this under-strap is to be superseded, the truss must be made exactly to fit the child--to fit him like a ribbon; which is a difficult thing to accomplish unless it be fashioned by a skilful workman. It is only lately that these trusses have been made without under-straps. Formerly the under-straps were indispensable necessaries.

These groin-ruptures require great attention and supervision, as the rupture (the bowel) must, before putting on the truss be cautiously and thoroughly returned into the belly; and much care should be used to prevent the chafing and galling of the tender skin of the babe, which an ill-fitting truss would be sure to occasion. But if care and skill be bestowed on the case, a perfect cure might in due time be ensured. The truss must not be discontinued, until a perfect cure be effected.

Let me strongly urge you to see that my advice is carried out to the very letter, as a groin-rupture can only be cured in infancy and in childhood. If it be allowed to ran on, unattended to, until adult age, he will be obliged to wear a truss all his life, which would be a great annoyance and a perpetual irritation to him.

CLOTHING.

21. Is it necessary to have a flannel cap in readiness to put on as soon as the babe is born?

Sir Charles Locock considers that a flannel cap is not necessary, and asserts that all his best nurses have long discarded flannel caps. Sir Charles states that since the discontinuance of flannel caps infants have not been more liable to inflammation of the eyes. Such authority is, in my opinion, conclusive. My advice, therefore, to you is, discontinue by all means the use of flannel caps.

22. What kind of a belly-band do you recommend--a flannel or a calico one?

I prefer flannel, for two reasons--first, on account of its keeping the child's bowels comfortably warm; and secondly, because of its not chilling him (and thus endangering cold, &c.) when he wets himself. The belly-band ought to be moderately, but not tightly applied, as, if tightly applied, it would interfere with the necessary movement of the bowels.

23. When should the belly-band be discontinued?

When the child is two or three months old. The best way of leaving it off is to tear a strip off daily for a few mornings, and then to leave it off altogether. "Nurses who take charge of an infant when the monthly nurse leaves, are frequently in the habit of at once leaving off the belly-band, which often leads to ruptures when the child cries or strains. It is far wiser to retain it too long than too short a time; and when a child catches whooping-cough, whilst still very young, it is safer to resume the belly-band." [Footnote: Communicated by Sir Charles Locock to the Author.]

24. Have you any remarks to make on the clothing of on infant?

A babe's clothing ought to be light, warm, loose, and free from pins. (1.) It should be light, without being too airy. Many infant's clothes are both too long and too cumbersome. It is really painful to see how some poor little babies are weighed down with a weight of clothes. They may be said to "bear the burden," and that a heavy one, from the very commencement of their lives! How absurd, too, the practice of making them wear long clothes. Clothes to cover a child's feet, and even a little beyond, may be desirable; but for clothes, when the infant is carried about, to reach to the ground, is foolish and cruel in the extreme. I have seen a delicate baby almost ready to faint under the infliction. (2.) It should be warm, without being too warm. The parts that ought to be kept warm are the chest, the bowels, and the feet. If the infant be delicate, especially if he be subject to inflammation of the lungs, he ought to wear a fine flannel, instead of his usual shirts, which should be changed as frequently. (3.) The dress should be loose, so as to prevent any pressure upon the blood-vessels, which would otherwise impede the circulation, and thus hinder a proper development of the parts. It ought to be loose about the chest and waist, so that the lungs and the heart may have free play. It should be loose about the stomach, so that digestion may not be impeded; it ought to be loose about the bowels, in order that the spiral motion of the intestines may not be interfered with--hence the importance of putting on a belly-band moderately slack; it should be loose about the sleeves, so that the blood may course, without let or hindrance, through the arteries and veins; it ought to be loose, then, everywhere, for nature delights in freedom from restraint, and will resent, sooner or later, any interference. Oh, that a mother would take common sense, and not custom, as her guide! (4.) As few pins should be used in the dressing of a baby as possible. Inattention to this advice has caused many a little sufferer to be thrown into convulsions.

The generality of mothers use no pins in the dressing of their children; they tack every part that requires fastening with a needle and thread. They do not even use pins to fasten the baby's diapers. They make the diapers with loops and tapes, and thus altogether supersede the use of pins in the dressing of an infant. The plan is a good one, takes very little extra time, and deserves to be universally adopted. If pins be used for the diapers, they ought to be the Patent Safety Pins.

25. Is there any necessity for a nurse being particular in airing an infant's clothes before they are put on? If she were less particular, would it not make him more hardy?

A nurse cannot be too particular on this head. A babe's clothes ought to be well aired the day before they are put on, as they should not be put on warm from the fire. It is well, where it can be done, to let him have clean clothes daily. Where this cannot be afforded, the clothes, as soon as they are taken off at night, ought to be well aired, so as to free them from the perspiration, and that they may be ready to put on the following morning. It is truly nonsensical to endeavour to harden a child, or any one else, by putting on damp clothes!

26. What is your opinion of caps for an infant?

The head ought to be kept cool; caps, therefore, are unnecessary. If caps be used at all, they should only be worn for the first month in summer, or for the first two or three months in winter. If a babe take to caps, it requires care in leaving them off, or he will catch cold. When you are about discontinuing them, put a thinner and a thinner one on, every time they are changed, until you leave them off altogether.

But remember, my opinion is, that a child is better without caps; they only heat his head, cause undue perspiration, and thus make him more liable to catch cold.

If a babe does not wear a cap in the day, it is not at all necessary that he should wear one at night. He will sleep more comfortably without one, and it will be better for his health. Moreover, night-caps injure both the thickness and beauty of the hair.

27. Have you any remarks to make on the clothing of an infant, when, in the winter time, he is sent out for exercise?

Be sure that he is well wrapped up. He ought to have under his cloak a knitted worsted spencer, which should button behind, and if the weather be very cold, a shawl over all, and, provided it be dry above, and the wind be not in the east or in the north-east, he may then brave the weather. He will then come from his walk refreshed and strengthened, for cold air is an invigorating tonic. In a subsequent Conversation I will indicate the proper age at which a child should be first sent out to take exercise in the open air.

28. At what age ought an infant "to be shortened?"

This, of course, will depend upon the season. In the summer, the right time "for shortening a babe," as it is called, is at the end of two months, in the winter, at the end of three months. But if the right time for "shortening" a child should happen to be in the spring, let it be deferred until the end of May. The English springs are very trying and treacherous, and sometimes, in April the weather is almost as cold, and the wind as biting as in winter. It is treacherous, for the sun is hot, and the wind, which is at this time of the year frequently easterly, is keen and cutting I should far prefer "to shorten" a child in the winter than in the early spring.

DIET

29. Are you an advocate for putting a baby to the breast soon after birth, or for waiting, as many do, until the third day?

The infant ought to be put to the bosom soon after birth, the interest, both of the mother and of the child demands it. It will be advisable to wait three or four hours, that the mother may recover from her fatigue, and, then, the babe must be put to the breast. If this be done, he will generally take the nipple with avidity.

It might be said, at so early a period that there is no milk in the bosom; but such is not usually the case. There generally is a little from the very beginning, which acts on the baby's bowels like a dose of purgative medicine, and appears to be intended by nature to cleanse the system. But, provided there be no milk at first, the very act of sucking not only gives the child a notion, but, at the same time, causes a draught (as it is usually called) in the breast, and enables the milk to flow easily.

Of course, if there be no milk in the bosom--the babe having been applied once or twice to determine the fact--then you must wait for a few hours before applying him again to the nipple, that is to say, until the milk be secreted.

An infant, who, for two or three days, is kept from the breast, and who is fed upon gruel, generally becomes feeble, and frequently, at the end of that time, will not take the nipple at all. Besides, there is a thick cream (similar to the biestings of a cow), which, if not drawn out by the child, may cause inflammation and gathering of the bosom, and, consequently, great suffering to the mother. Moreover, placing him early to the breast, moderates the severity of the mother's after pains, and lessens the risk of her flooding. A new-born babe must not have gruel given to him, as it disorders the bowels, causes a disinclination to suck, and thus makes him feeble.

30. If an infant show any disinclination to suck, or if he appear unable to apply his tongue to the nipple, what ought to be done?

Immediately call the attention of the medical man to the fact, in order that he may ascertain whether he be tongue-tied. If he be, the simple operation of dividing the bridle of the tongue will remedy the defect, and will cause him to take the nipple with ease and comfort.

31. Provided there be not milk AT FIRST, what ought then to be done?

Wait with patience; the child (if the mother have no milk) will not, for at least twelve hours, require artificial food. In the generality of instances, then, artificial food is not at all necessary; but if it should be needed, one-third of new milk and two-thirds of warm water, slightly sweetened with loaf sugar (or with brown sugar, if the babe's bowels have not been opened), should be given, in small quantities at a time, every four hours, until the milk be secreted, and then it must be discontinued. The infant ought to be put to the nipple every four hours, but not oftener, until he be able to find nourishment.

If after the application of the child for a few times, he is unable to find nourishment, then it will be necessary to wait until the milk be secreted. As soon as it is secreted, he must be applied with great regularity, alternately to each breast.

I say alternately to each breast. This is most important advice. Sometimes a child, for some inexplicable reason, prefers one breast to the other, and the mother, to save a little contention, concedes the point, and allows him to have his own way. And what is frequently the consequence?--a gathered breast!

We frequently hear of a babe having no notion of sucking. This "no notion" may generally be traced to bad management, to stuffing him with food, and thus giving him a disinclination to take the nipple at all.

32. How often should a mother suckle her infant?

A mother generally suckles her baby too often, having him almost constantly at the breast. This practice is injurious both to parent and to child. The stomach requires repose as much as any other part of the body; and how can it have if it be constantly loaded with breast-milk? For the first month, he ought to be suckled, about every hour and a half; for the second month, every two hours,--gradually increasing, as he becomes older, the distance of time between, until at length he has it about every four hours.

If a baby were suckled at stated periods, he would only look for the bosom at those times, and be satisfied. A mother is frequently in the habit of giving the child the breast every time he cries, regardless of the cause. The cause too frequently is that he has been too often suckled--his stomach has been overloaded, the little fellow is consequently in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavour to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in everything, in times for sucking, for sleeping, &c. No children thrive so well as those who are thus early taught.

33. Where the mother is MODERATELY strong, do you advise that the infant should have any other food than the breast?

Artificial food must not, for the first five or six months, be given, if the parent be moderately strong, of course, if she be feeble, a little food will be necessary. Many delicate women enjoy better health whilst ambling than at any other period of their lives.

It may be well, where artificial food, in addition to the mother's own milk, is needed, and before giving any farinaceous food whatever (for farinaceous food until a child is six or seven months old is injurious), to give, through a feeding bottle, every night and morning, in addition to the mother's breast of milk, the following Milk-Water-and Sugar-of Milk Food--

Fresh milk, from ONE cow, Warm water, of each a quarter of a pint, Sugar of milk one tea spoonful

The sugar of milk should first be dissolved in the warm water, and then the fresh milk unboiled should be mixed with it. The sweetening of the above food with sugar-of-milk, instead of with lump sugar, makes the food more to resemble the mother's own milk. The infant will not, probably, at first take more than half of the above quantity at a time, even if he does so much as that but still the above are the proper proportions, and as he grows older, he will require the whole of it at a meal.

34. What food, when a babe is six or seven months old, is the best substitute for a mother's milk?

The food that suits one infant will not agree with another. (1) The one that I have found the most generally useful, is made as follows--Boil the crumb of bread for two hours in water, taking particular care that it does not burn, then add only a little lump-sugar (or brown sugar, if the bowels be costive), to make it palatable. When he is six or seven months old, mix a little new milk--the milk of ONE cow--with it gradually as he becomes older, increasing the quantity until it be nearly all milk, there being only enough water to boil the bread, the milk should be poured boiling hot on the bread. Sometimes the two milks--the mother's and the cow's milk--do not agree, when such is the case, let the milk be left out, both in this and in the foods following, and let the food be made with water, instead of with milk and water. In other respects, until the child is weaned, let it be made as above directed, when he is weaned, good fresh cow's milk MUST, as previously recommended, be used. (2) Or cut thin slices of bread into a basin, cover the bread with cold water, place it in an oven for two hours to bake, take it out, beat the bread up with a fork, and then slightly sweeten it. This is an excellent food. (3) If the above should not agree with the infant (although, if properly made, they almost invariably do), "tous les-mois" may be given. [Footnote: "Tous les mois" is the starch obtained from the tuberous roots of various species of canna, and is imported from the West Indies. It is very similar to arrow root. I suppose it is called "tous les-mois," as it is good to be eaten all the year round.](4) Or Robb's Biscuits, as it is "among the best bread compounds made out of wheat-flour, and is almost always readily digested."--Routh.

(5) Another good food is the following--Take about a pound of flour put it in a cloth, tie it up tightly, place it a saucepanful of water, and let it boil for four or five hours, then take it out, peel off the outer rind, and the inside will be found quite dry, which grate. (6) Another way of preparing an infant's food, is to bake flour--biscuit flour--in a slow oven, until it be of a light fawn colour. Baked flour ought after it is baked, to be reduced, by means of a rolling pin, to a fine powder, and should then be kept in a covered tin, ready for use. (7) An excellent food for a baby is baked crumbs of bread. The manner of preparing it is as follows--Crumb some bread on a plate, put it a little distance from the fire to dry. When dry, rub the crumbs in a mortar, and reduce them to a fine powder, then pass them through a sieve. Having done which, put the crumbs of bread into a slow oven, and let them bake until they be of a light fawn colour. A small quantity either of the boiled, or of the baked flour, or of the baked crumb of bread, ought to be made into food, in the same way as gruel is made, and should then be slightly sweetened, according to the state of the bowels, either with lump or with brown sugar.

(8) Baked flour sometimes produces constipation, when such is the case, Mr. Appleton, of Budleigh Salterton, Devon, wisely recommends a mixture of baked flour, and prepared oatmeal, [Footnote: If there is any difficulty in obtaining prepared oatmeal, Robinson's Scotch Oatmeal will answer equally as well.] in the proportion of two of the former and one of the latter. He says--"To avoid the constipating effects, I have always had mixed, before baking, one part of prepared oatmeal with two parts of flour, this compound I have found both nourishing, and regulating to the bowels. One table-spoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavoured and sweetened with white sugar, produces a thick, nourishing, and delicious food for infants or invalids." He goes on to remark--"I know of no food, after repeated trials, that can be so strongly recommended by the profession to all mothers in the rearing of their infants, without or with the aid of the breasts, at the same time relieving them of much draining and dragging whilst nursing with an insufficiency of milk, as baked flour and oatmeal." [Footnote: British Medical Journal, Dec 18, 1858]

(9) A ninth food may be made with "Farinaceous Food for Infants, prepared by Hards of Dartford". If Hard's Farinaceous food produces costiveness--as it sometimes does--let it be mixed either with equal parts or with one third of Robinson's Scotch Oatmeal. The mixture of the two together makes a splendid food for a baby. (10) A tenth, and an excellent one, may be made with rusks, boiled for an hour in water, which ought then to be well beaten up, by means of a fork, and slightly sweetened with lump sugar. Great care should be taken to select good rusks, as few articles vary so much in quality. (11) An eleventh is--the top crust of a baker's loaf, boiled for an hour in water, and then moderately sweetened with lump sugar. If, at any time, the child's bowels should be costive, raw must be substituted for lump sugar. (12) Another capital food for an infant is that made by Lemann's Biscuit Powder. [Footnote: Lemann's Biscuit Powder cannot be too strongly recommended--It is of the finest quality, and may be obtained of Lemann, Threadneedle Street, London. An extended and an extensive experience confirms me still more in the good opinion I have of this food.] (13) Or, Brown and Polson's Patent Corn Flour will be found suitable. Francatelli, the Queen's cook, in his recent valuable work, gives the following formula for making it--"To one dessert-spoonful of Brown and Polson, mixed with a wineglassful of cold water, add half a pint of boiling water, stir over the fire for five minutes, sweeten lightly, and feed the baby, but if the infant is being brought up by the hand, this food should then be mixed with milk--not otherwise." (14) A fourteenth is Neaves' Farinaceous Food for Infants, which is a really good article of diet for a babe, it is not so binding to the bowels as many of the farinaceous foods are, which is a great recommendation.

(15) The following is a good and nourishing food for a baby:--Soak for an hour, some best rice in cold water; strain, and add fresh water to the rice; then let it simmer till it will pulp through a sieve; put the pulp and the water in a saucepan, with a lump or two of sugar, and again let it simmer for a quarter of an hour; a portion of this should be mixed with one-third of fresh milk, so as to make it of the consistence of good cream. This is an excellent food for weak bowels.

When the baby is six or seven months old, new milk should be added to any of the above articles of food, in a similar way to that recommended for boiled bread.

(16.) For a delicate infant, lentil powder, better known as Du Barry's "Ravalenta Arabica," is invaluable. It ought to be made into food, with new milk, in the same way that arrow-root is made, and should be moderately sweetened with loaf-sugar. Whatever food is selected ought to be given by means of a nursing bottle.

If a child's bowels be relaxed and weak, or if the motions be offensive, the milk must be boiled, but not otherwise. The following (17) is a good food when an infant's bowels are weak and relaxed:--"Into five large spoonfuls of the purest water, rub smooth one dessert-spoonful of fine flour. Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour it into the flour and water, and stir it over a slow fire twenty minutes."

Where there is much emaciation, I have found (18) genuine arrow-root [Footnote: Genuine arrow-root, of first-rate quality, and at a reasonable price, may be obtained of H. M. Plumbe, arrow-root merchant, 8 Alie Place. Great Alie Street. Aldgate, London, E.] a very valuable article of food for an infant, as it contains a great deal of starch, which starch helps to form fat and to evolve caloric (heat)--both of which a poor emaciated chilly child stands so much in need of. It must be made with equal parts of water and of good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

Arrow-root will not, as milk will, give bone and muscle; but it will give--what is very needful to a delicate child--fat and warmth. Arrow-root, as it is principally composed of starch, comes under the same category as cream, butter, sugar, oil, and fat. Arrowroot, then, should always be given with new milk (mixed with one-half of water); it will then fulfil, to perfection, the exigencies of nourishing, of warming, and fattening the child's body.

New milk, composed in due proportions as it is, of cream and of skim milk--the very acme of perfection--is the only food, which of itself alone, will nourish and warm and fatten. It is, for a child, par excellence, the food of foods!

Arrow-root, and all other farinaceous foods are, for a child, only supplemental to milk--new milk being, for the young, the staple food of all other kinds of foods whatever.

But bear in mind, and let there be no mistake about it, that farinaceous food, be it what it may, until the child be six or seven months old, until, indeed, he begin to cut his teeth, is not suitable for a child; until then, The Milk-water-salt-and-sugar Food (see page 29) is usually, if he be a dry-nursed child, the best artificial food for him.

I have given you a large and well-tried infant's dietary to chose from, as it is sometimes difficult to fix on one that will suit; but, remember, if you find one of the above to agree, keep to it, as a babe requires a simplicity in food--a child a greater variety.

Let me, in this place, insist upon the necessity of great care and attention being observed in the preparation of any of the above articles of diet. A babe's stomach is very delicate, and will revolt at either ill-made, or lumpy, or burnt food. Great care ought to be observed as to the cleanliness of the cooking utensils. The above directions require the strict supervision of the mother.

Broths have been recommended, but, for my own part, I think that, for a young infant, they are objectionable; they are apt to turn acid on the stomach, and to cause flatulence and sickness, they, sometimes, disorder the bowels and induce griping and purging.

Whatever artificial food is used ought to be given by means of a bottle, not only as it is a more natural way than any other of feeding a baby, as it causes him to suck as though he were drawing it from the mother's breasts, but as the act of sucking causes the salivary glands to press out their contents, which materially assist digestion. Moreover, it seems to satisfy and comfort him more than it otherwise would do.

One of the best, if not the best feeding bottle I have yet seen, is that made by Morgan Brothers, 21 Bow Lane, London. It is called "The Anglo-French Feeding Bottle" S Maw, of 11 Aldersgate Street, London, has also brought out an excellent one--"The Fountain Infant's Feeding Bottle" Another good one is "Mather's Infant's Feeding Bottle" Either of these three will answer the purpose admirably. I cannot speak in terms too highly of these valuable inventions.

The food ought to be of the consistence of good cream, and should be made fresh and fresh. It ought to be given milk warm. Attention must be paid to the cleanliness of the vessel, and care should be taken that the milk be that of ONE cow, [Footnote: I consider it to be of immense importance to the infant, that the milk be had from ONE cow. A writer in the Medical Times and Gazette speaking on this subject, makes the following sensible remarks--"I do not know if a practice common among French ladies when they do not nurse, has obtained the attention among ourselves which it seems to me to deserve. When the infant is to be fed with cow milk that from various cows is submitted to examination by the medical man and if possible, tried on some child, and when the milk of any cow has been chosen, no other milk is ever suffered to enter the child's lips for a French lady would as soon offer to her infant's mouth the breasts of half a dozen wet-nurses in the day, as mix together the milk of various cows, which must differ, even as the animals themselves, in its constituent qualities. Great attention is also paid to the pasture, or other food of the cow thus appropriated."] and that it be new and of good quality, for if not it will turn acid and sour, and disorder the stomach, and will thus cause either flatulence or looseness of the bowels, or perhaps convulsions. The only way to be sure of having it from one cow, is (if you have not a cow of your own), to have the milk from a respectable cow keeper, and to have it brought to your house in a can of your own (the London milk cans being the best for the purpose). The better plan is to have two cans, and to have the milk fresh and fresh every night and morning. The cans, after each time of using, ought to be scalded out, and, once a week the can should be filled with cold water, and the water should be allowed to remain in it until the can be again required.

Very little sugar should be used in the food, as much sugar weakens the digestion. A small pinch of table-salt ought to be added to whatever food is given, as "the best savour is salt." Salt is most wholesome--it strengthens and assists digestion, prevents the formation of worms, and, in small quantities, may with advantage be given (if artificial food be used) to the youngest baby.

35. Where it is found to be absolutely necessary to give an infant artificial food WHILST SUCKLING, how often ought he to be fed?

Not oftener than twice during the twenty four hours, and then only in small quantities at a time, as the stomach requires rest, and at the same time, can manage to digest a little food better than it can a great deal. Let me again urge upon you the importance, if it be at all practicable, of keeping the child entirely to the breast for the first five or six months of his existence. Remember there is no real substitute for a mother's milk, there is no food so well adapted to his stomach, there is no diet equal to it in developing muscle, in making bone, or in producing that beautiful plump rounded contour of the limbs, there is nothing like a mother's milk alone in making a child contented and happy, in laying the foundation of a healthy constitution, in preparing the body for a long life, in giving him tone to resist disease, or in causing him to cut his teeth easily and well, in short, the mothers milk is the greatest temporal blessing an infant can possess.

As a general rule, therefore, when the child and the mother are tolerably strong, he is better without artificial food until he have attained the age of three or four months, then, it will usually be necessary to feed him with The Milk-water-and-sugar-of milk Food (see p 19) twice a day, so as gradually to prepare him to be weaned (if possible) at the end of nine months. The food mentioned in the foregoing Conversation will, when he is six or seven months old, be the best for him.

36. When the mother is not able to suckle her infant herself, what ought to be done?

It must first be ascertained, beyond all doubt, that a mother is not able to suckle her own child Many delicate ladies do suckle their infants with advantage, not only to their offspring, but to themselves. "I will maintain," says Steele, "that the mother grows stronger by it, and will have her health better than she would have otherwise She will find it the greatest cure, and preservative for the vapours [nervousness] and future miscarriages, much beyond any other remedy whatsoever Her children will be like giants, whereas otherwise they are but living shadows, and like unripe fruit, and certainly if a woman is strong enough to bring forth a child, she is beyond all doubt strong enough to nurse it afterwards."

Many mothers are never so well as when they are nursing, besides, suckling prevents a lady from becoming pregnant so frequently as she otherwise would. This, if she be delicate, is an important consideration, and more especially if she be subject to miscarry. The effects of miscarriage are far more weakening than those of suckling.

A hireling, let her be ever so well inclined, can never have the affection and unceasing assiduity of a mother, and, therefore, cannot perform the duties of suckling with equal advantage to the baby.

The number of children who die under five years of age is enormous--many of them from the want of the mother's milk. There is a regular "parental baby-slaughter"--"a massacre of the innocents"-- constantly going on in England, in consequence of infants being thus deprived of their proper nutriment and just dues! The mortality from this cause is frightful, chiefly occurring among rich people who are either too grand, or, from luxury, too delicate to perform such duties; poor married women, as a rule, nurse their own children, and, in consequence reap their reward.

If it be ascertained, past all doubt, that a mother cannot suckle her child, then, if the circumstances of the parents will allow--and they ought to strain a point to accomplish it--a healthy wet-nurse should be procured, as, of course, the food which nature has supplied is far, very far superior to any invented by art. Never bring up a baby, then, if you can possibly avoid it, on artificial food. Remember, as I proved in a former Conversation, there is in early infancy no real substitute for either a mother's or a wet-nurse's milk. It is impossible to imitate the admirable and subtle chemistry of nature. The law of nature is, that a baby, for the first few months of his existence, shall be brought up by the breast, and nature's law cannot be broken with impunity. [Footnote: For further reasons why artificial food is not desirable, at an early period of infancy, see answer to 35th question, page 26.] It will be imperatively necessary then--

"To give to nature what is nature's due."

Again, in case of a severe illness occurring during the first nine months of a child's life, what a comfort either the mother's or the wet-nurse's milk is to him! It often determines whether he shall live or die. But if a wet-nurse cannot fill the place of a mother, then asses' milk will be found the best substitute, as it approaches nearer, in composition, than any other animal's, to human milk; but it is both difficult and expensive to obtain. The next best substitute is goats' milk. Either the one or the other ought to be milked fresh and fresh, when wanted, and should be given by means of a feeding-bottle. Asses' milk is more suitable for a delicate infant, and goats' milk for a strong one.

If neither asses' milk nor goats' milk can be procured, then the following Milk-water-salt-and-sugar Food, from the very commencement, should be given; and as I was the author of the formula, [Footnote: It first appeared in print in the 4th edition of Advice to a Mother, 1852.] I beg to designate it as--Rye Chavasse's Milk Food:--

New milk, the produce of ONE healthy cow; Warm water, of each, equal parts; Table salt, a few grains--a small pinch; Lump sugar, a sufficient quantity, to slightly sweeten it.

The milk itself ought not to be heated over the fire, [Footnote: It now and then happens that if the milk be not boiled, the motions of an infant are offensive; when such is the case, let the milk be boiled, but not otherwise.] but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. The milk and water should be of the same temperature as the mother's milk, that is to say, at about ninety degrees Fahrenheit. It ought to be given by means of either Morgan's, or Maw's, or Mather's feeding-bottle, [Footnote: See answer to Question 24, page 24.] and care must be taken to scald the bottle out twice a day, for if attention be not paid to this point, the delicate stomach of an infant is soon disordered. The milk should, as he grows older, be gradually increased and the water decreased, until two-thirds of milk and one-third of water be used; but remember, that either much or little water must always be given with the milk.

The above is my old form, and which I have for many years used with great success. Where the above food does not agree (and no food except a healthy mother's own milk does invariably agree) I occasionally substitute sugar-of milt for the lump sugar, in the proportion of a tea spoonful of sugar-of milk to every half pint of food.

If your child bring up his food, and if the ejected matter be sour-smelling, I should advise you to leave out the sugar-of milk altogether, and simply to let the child live, for a few days, on milk and water alone, the milk being of one cow, and in the proportion of two-thirds to one-third of warm water--not hot water, the milk should not be scalded with hot water, as it injures its properties, besides, it is only necessary to give the child his food with the chill just off. The above food, where the stomach is disordered, is an admirable one, and will often set the child to rights without giving him any medicine whatever. Moreover, there is plenty of nourishment in it to make the babe thrive, for after all it is the milk that is the important ingredient in all the foods of infants, they can live on it, and on it alone, and thrive amazingly.

Mothers sometimes say to me, that farinaceous food makes their babes flatulent, and that my food (Pye Chavasse's Milk Food) has not that effect.

The reason of farinaceous food making babes, until they have commenced cutting their teeth, "windy" is, that the starch of the farinaceous food (and all farinaceous foods contain more or less of starch) is not digested, and is not, as it ought to be, converted by the saliva into sugar [Footnote: See Pye Chavasse's Counsel to a Mother, 3d edition.] hence "wind" is generated, and pain and convulsions often follow in the train.

The great desideratum, in devising an infant's formula for food, is to make it, until he be nine months old, to resemble as much as possible, a mother's own milk, and which my formula, as nearly as is practicable, does resemble hence its success and popularity.

As soon as a child begins to cut his teeth the case is altered, and farinaceous food, with milk and with water, becomes an absolute necessity.

I wish, then, to call your especial attention to the following-facts, for they are facts--Farinaceous foods, of all kinds, before a child commences cutting his teeth (which is when he is about six or seven months old) are worse than useless--they are, positively, injurious, they are, during the early period of infant life, perfectly indigestible, and may bring on--which they frequently do-- convulsions. A babe fed on farinaceous food alone would certainly die of starvation, for, "up to six or seven months of age, infants have not the power of digesting farinaceous or fibrinous substances"--Dr Letheby on Food.

A babe's salivary glands, until he be six or seven months old, does not secrete its proper fluid--namely, ptyalin, and consequently the starch of the farinaceous food--and all farinaceous food contains starch--is not converted into dextrine and grape-sugar, and is, therefore, perfectly indigestible and useless--nay, injurious to an infant, and may bring on pain and convulsions, and even death, hence, the giving of farinaceous food, until a child be six or seven months old, is one and the principal cause of the frightful infant mortality at the present time existing in England, and which is a disgrace to any civilized land!

In passing, allow me to urge you never to stuff a babe--never to overload his little stomach with food, it is far more desirable to give him a little not enough, than to give him a little too much. Many a poor child has been, like a young bird, killed with stuffing. If a child be at the breast, and at the breast alone, there is no fear of his taking too much, but if he be brought up on artificial food, there is great fear of his over loading his stomach. Stuffing a child brings on vomiting and bowel-complaints, and a host of other diseases which now it would be tedious to enumerate. Let me, then, urge you on no account, to over load the stomach of a little child.

There will, then, in many cases, be quite sufficient nourishment in the above. I have known some robust infants brought up on it, and on it along, without a particle of farinaceous food, or of any other food, in any shape or form whatever. But if it should not agree with the child, or if there should not be sufficient nourishment in it, then the food recommended in answer to No. 34 question ought to be given, with this only difference--a little new milk must from the beginning be added, and should be gradually increased, until nearly all milk be used.

The milk, as a general rule, ought to be unboiled; but if it purge violently, or if it cause offensive motions--which it sometimes does--then it must be boiled. The moment the milk boils up, it should be taken off the fire.

Food ought for the first month to be given about every two hours; for the second month, about every three hours; lengthening the space of time as the baby advances in age. A mother must be careful not to over-feed a child, as over-feeding is a prolific source of disease.

Let it be thoroughly understood, and let there be no mistake about it, that a babe during the first nine months of his life, MUST have--it is absolutely necessary for his very existence--milk of some kind, as the staple and principal article of his diet, either mother's, wet-nurse's, or asses', or goats', or cow's milk.

37. How would you choose a wet-nurse?

I would inquire particularly into the state of her health; whether she be of a healthy family, of a consumptive habit, or if she or any of her family have laboured under "king's evil;" ascertaining if there be any seams or swellings about her neck; any eruptions or blotches upon her skin; if she has a plentiful breast of milk, and if it be of good quality [Footnote: "It should be thin, and of a bluish-white colour, sweet to the taste, and when allowed to stand, should throw up a considerable quantity of cream,"--Maxell and Evenson on the Diseases of Children.] (which may readily be ascertained by milking a little into a glass); if she has good nipples, sufficiently long for the baby to hold; that they be not sore; and if her own child be of the same, or nearly of the same age, as the one you wish her to nurse. Ascertain, whether she menstruate during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her. [Footnote: Sir Charles Locock considers that a woman who menstruates during lactation is objectionable as a wet-nurse, and "that as a mother with her first child is more liable to that objection, that a second or third child's mother is more eligible than a first"--Letter to the Author.] Assure yourself that her own babe is strong and healthy that he be free from a sore mouth, and from a "breaking-out" of the skin. Indeed, if it be possible to procure such a wet-nurse, she ought to be from the country, of ruddy complexion, of clear skin, and of between twenty and five-and-twenty years of age, an the milk will then be fresh, pure, and nourishing.

I consider it to be of great importance that the infant of the wet-nurse should be, as nearly as possible, of the same age as your own, as the milk varies in quality according to the age of the child. For instance, during the commencement of suckling, the milk is thick and creamy, similar to the biestings of a cow, which, if given to a babe of a few months old, would cause derangement of the stomach and bowels. After the first few days, the appearance of the milk changes; it becomes of a bluish-white colour, and contains less nourishment. The milk gradually becomes more and more nourishing as the infant becomes older and requires more support.

In selecting a wet-nurse for a very small and feeble babe, you must carefully ascertain that the nipples of the wet-nurse are good and soft, and yet not very large. If they be very large, the child's mouth being very small, he may not be able to hold them. You must note, too, whether the milk flows readily from the nipple into the child's mouth; if it does not, he may not have strength to draw it, and he would soon die of starvation. The only way of ascertaining whether the infant really draws the milk from the nipple, can be done by examining the mouth of the child immediately after his taking the breast, and seeing for yourself whether there be actually milk, or not, in his mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good, and although Maw's nipple-shield and glass tube had been tried. In such a case, cow's milk-water-sugar-and-salt, as recommended at page 29, must be given in small quantities at a time--from two to four tea-spoonfuls--but frequently; if the child be awake, every hour, or every half hour, both night and day, until he be able to take the breast. If, then, a puny, feeble babe is only able to take but little at a time, and that little by tea-spoonfuls, he must have little and often, in order that "many a little might make a mickle."

I have known many puny, delicate children who had not strength to hold the nipple in their mouths, but who could take milk and water (as above recommended) by tea-spoonfuls only at a time, with steady perseverance, and giving it every half hour or hour (according to the quantity swallowed), at length be able to take the breast, and eventually become strong and hearty children; but such cases require unwearied watching, perseverance, and care. Bear in mind, then, that the smaller the quantity of the milk and water given at a time, the oftener must it be administered, as, of course, the babe must have a certain quantity of food to sustain life.

38. What ought to be the diet either of a wet-nurse, or of a mother, who is suckling?

It is a common practice to cram a wet-nurse with food, and to give her strong ale to drink, to make good nourishment and plentiful milk! This practice is absurd; for it either, by making the nurse feverish, makes the milk more sparing than usual, or it causes the milk to be gross and unwholesome. On the other hand, we must not run into an opposite extreme. The mother, or the wet-nurse, by using those means most conducive to her own health, will best advance the interest of her little charge.

A wet-nurse, ought to live somewhat in the following way:--Let her for breakfast have black tea, with one or two slices of cold meat, if her appetite demand it, but not otherwise. It is customary for a wet-nurse to make a hearty luncheon; of this I do not approve. If she feel either faint or low at eleven o'clock, let her have either a tumbler of porter, or of mild fresh ale, with a piece of dry toast soaked in it. She ought not to dine later than half-past one or two o'clock; she should eat, for dinner, either mutton or beef, with either mealy potatoes, or asparagus, or French beans, or secale, or turnips, or broccoli, or cauliflower, and stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted meats, greens, and cabbage, must one and all be carefully avoided; as they only tend to disorder the stomach, and thus to deteriorate the milk.

It is a common remark, that "a mother who is suckling may eat anything." I do not agree with this opinion. Can impure or improper food make pure and proper milk, or can impure and improper milk make good blood for an infant, and thus good health?

The wet-nurse ought to take with her dinner a moderate quantity of either sound porter, or of mild (but not old or strong) ale. Tea should be taken at half past five or six o'clock; supper at nine, which should consist either of a slice or two of cold meat, or of cheese if she prefer it, with half a pint of porter or of mild ale; occasionally a basin of gruel may with advantage be substituted. Hot and late suppers are prejudicial to the mother, or to the wet-nurse, and, consequently, to the child. The wet-nurse ought to be in bed every night by ten o'clock.

It might be said, that I have been too minute and particular in my rules for a wet-nurse; but when it is considered of what importance good milk is to the well-doing of an infant, in making him strong and robust, not only now, but as he grows up to manhood, I shall, I trust, be excused for my prolixity.

39. Have you any more hints to offer with regard to the management of a wet-nurse?

A wet-nurse is frequently allowed to remain in bed until a late hour in the morning, and during the day to continue in the house, as if she were a fixture! How is it possible that any one, under such treatment, can continue healthy! A wet nurse ought to rise early, and, if the weather and season will permit, take a walk, which will give her an appetite for breakfast, and will make a good meal for her little charge. This, of course, cannot, during the winter mouths, be done; but even then, she ought, some part of the day, to take every opportunity of walking out; indeed, in the summer time she should live half the day in the open air.

She ought strictly to avoid crowded rooms; her mind should be kept calm and unruffled, as nothing disorders the milk so much as passion, and other violent emotions of the mind; a fretful temper is very injurious, on which account you should, in choosing your wet-nurse, endeavour to procure one of a mild, calm, and placid disposition. [Footnote: "'The child is poisoned.'

'Poisoned! by whom?'

'By you. You have been fretting.'

'Nay, indeed, mother. How can I help fretting!'

'Don't tell me, Margaret. A nursing mother has no business to fret. She must turn her mind away from her grief to the comfort that lies in her lap. Know you not that the child pines if the mother vexes herself?'"--The Cloister and the Hearth. By Charles Reade.]

A wet-nurse ought never to be allowed to dose her little charge either with Godfrey's Cordial, or with Dalby's Carminative, or with Syrup of White Poppies, or with medicine of any kind whatever. Let her thoroughly understand this, and let there be no mistake in the matter. Do not for one moment allow your children's health to be tampered and trifled with. A baby's health is too precious to be doctored, to be experimented upon, and to be ruined by an ignorant person.

40. Have the goodness to state at what age a child ought to be weaned?

This, of course, must depend both upon the strength of the child, and upon the health of the parent; on an average, nine months is the proper time. If the mother be delicate, it may be found necessary to wean the infant at six months; or if he be weak, or labouring under any disease, it may be well to continue suckling him for twelve months; but after that time, the breast will do him more harm than good, and will, moreover, injure the mother's health, and may, if she be so predisposed, excite consumption.

41. How would you recommend a mother to act when, she weans her child?

She ought, as the word signifies, do it gradually--that is to say, she should, by degrees, give him less and less of the breast, and more and more of artificial food; at length, she must only suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and, for a few days, to go away herself.

A good plan is, for the nurse-maid to have a half-pint bottle of new milk--which has been previously boiled [Footnote: The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it otherwise would do.]--in the bed, so as to give a little to him in lieu of the breast. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and of other troublesome contrivances.

42. While a mother is weaning her infant, and after she have weaned him, what ought to be his diet?

Any one of the foods recommended in answer to question 34.

43. If a child be suffering severely from "wind," is there any objection to the addition of a small quantity either of gin or of peppermint to his food to disperse it?

It is a murderous practice to add either gin or peppermint of the shops (which is oil of peppermint dissolved in spirits) to his food. Many children have, by such a practice, been made puny and delicate, and have gradually dropped into an untimely grave. An infant who is kept, for the first five or six months, entirely to the breast--more especially if the mother be careful in her own diet--seldom suffers from "wind;" those, on the contrary, who have much or improper food, [Footnote: For the first five or six months never, if you can possibly avoid it, give artificial food to an infant who is sucking. There is nothing, in the generality of cases, that agrees, for the first few months, like the mother's milk alone.] suffer severely.

Care in feeding, then, is the grand preventative of "wind;" but if, notwithstanding all your precautions, the child be troubled with flatulence, the remedies recommended under the head of Flatulence will generally answer the purpose.

44. Have you any remarks to make on sugar for sweetening a baby's food?

A small quantity of sugar in an infant's food is requisite, sugar being nourishing and fattening, and making cow's milk to resemble somewhat, in its properties human milk; but, bear in mind, it must be used sparingly. Much sugar cloys the stomach, weakens the digestion, produces acidity, sour belchings, and wind:--

"Things sweet to taste, prove in digestion sour."

Shakspeare.

If a babe's bowels be either regular or relaxed, lump sugar is the best for the purpose of sweetening his food; if his bowels are inclined to be costive, raw sugar ought to be substituted for lump sugar, as raw sugar acts on a young babe as an aperient, and, in the generality of cases, is far preferable to physicking him with opening medicine. An infant's bowels, whenever it be practicable (and it generally is), ought to be regulated by a judicious dietary rather than by physic.

VACCINATION AND RE-VACCINATION.

45. Are you an advocate for vaccination?

Certainly. I consider it to be one of the greatest blessings ever conferred upon mankind. Small-pox, before vaccination was adopted, ravaged the country like a plague, and carried off thousands annually; and those who did escape with their lives were frequently made loathsome and disgusting objects by it. Even inoculation (which is cutting for the small-pox) was attended with danger, more especially to the unprotected--as it caused the disease to spread like wildfire, and thus it carried off immense numbers.

Vaccination is one, and an important cause of our increasing population; small-pox, in olden times, decimated the country.

46. But vaccination does not always protect a child from, small-pox?

I grant you that it does not always protect him, neither does inoculation; but when he is vaccinated, if he take the infection, he is seldom pitted, and very rarely dies, and the disease assumes a comparatively mild form. There are a few, very few fatal cases recorded after vaccination, and these may be considered as only exceptions to the general rule; and, possibly, some of these may be traced to the arm, when the child was vaccinated, not having taken proper effect.

If children, and adults were re-vaccinated,--say every seven years after the first vaccination,--depend upon it, even these rare cases would not occur, and in a short time small-pox would be known only by name.

47. Do you consider it, then, the imperative duty of a mother, in every case, to have, after the lapse of every seven years, her children re-vaccinated?

I decidedly do: it would be an excellent plan for every person, once every seven years to be re-vaccinated, and even oftener, if small-pox be rife in the neighbourhood. Vaccination, however frequently performed, can never do the slightest harm, and might do inestimable good. Small-pox is both a pest and a disgrace, and ought to be constantly fought and battled with, until it be banished (which it may readily be) the kingdom.

I say that small-pox is a pest; it is worse than the plague, for if not kept in subjection, it is more general--sparing neither young nor old, rich nor poor, and commits greater ravages than the plague ever did. Small-pox is a disgrace: it is a disgrace to any civilised land, as there is no necessity for its presence, if cow-pox were properly and frequently performed, small-pox would be unknown. Cow-pox is a weapon to conquer small-pox and to drive it ignominiously from the field.

My firm belief, then, is, that if every person were, every seven years, duly and properly vaccinated, small-pox might be utterly exterminated; but as long as there are such lax notions on the subject, and such gross negligence, the disease will always be rampant, for the poison of small-pox never slumbers nor sleeps, but requires the utmost diligence to eradicate it. The great Dr Jenner, the discoverer of cow-pox as a preventative of small-pox, strongly advocated the absolute necessity of every person being re-vaccinated once every seven years, or even, oftener, if there was an epidemic of small-pox in the neighbourhood.

48. Are you not likely to catch not only the cow-pox, but any other disease that the child has from whom the matter is taken?

The same objection holds good in cutting for small pox (inoculation)--only in a ten-fold degree--small-pox being such a disgusting complaint. Inoculated small-pox frequently produced and left behind inveterate "breakings-out," scars, cicatrices, and indentations of the skin, sore eyes, blindness, loss of eyelashes, scrofula, deafness--indeed, a long catalogue of loathsome diseases. A medical man, of course, will be careful to take the cow-pox matter from a healthy child.

49. Would it not be well to take the matter direct from the cow?

If a doctor be careful--which, of course, he will be--to take the matter from a healthy child, and from a well-formed vesicle, I consider it better than taking it direct from the cow, for the following reasons:--The cow-pox lymph, taken direct from the cow, produces much more violent symptoms than after it has passed through several persons; indeed, in some cases, it has produced effects as severe as cutting for the small-pox, besides, it has caused, in many cases, violent inflammation and even sloughing of the arm. There are also several kinds of spurious cow-pox to which the cow is subject, and which would be likely to be mistaken for the real lymph. Again, if even the genuine matter were not taken from the cow exactly at the proper time, it would he deprived of its protecting power.

50. At what age do you recommend an infant to be first vaccinated?

When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighbourhood, he may, with perfect safety, be vaccinated at the month's end; indeed if the small-pox be near at hand, he must be vaccinated, regardless of his age, and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. "A case, in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission, and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house varying from one day to a fortnight and more. All took the vaccination; and the woman's own child, which suckled her and slept with her; and all escaped the small pox." [Footnote: Communicated by Sir Charles Locock to the Author.]

51. Do you consider that taking of matter from a child's arm weakens the effect of vaccination on the system?

Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. It is always well to leave one vesicle undisturbed.

52. If the infant have any "breaking out" upon the skin, ought that to be a reason for deferring the vaccination?

It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. "It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth."--Dendy. The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red gum, unless it be severe, ought not, at the proper age to prevent vaccination. If small-pox be rife in the neighbourhood, the child must be vaccinated, regardless of any "breaking-out" on the skin.

53. Does vaccination make a child poorly?

At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel-complaint. The arm, about the ninth or tenth day, is usually much inflamed--that is to say it is, for an inch or two or more around the vesicles, red, hot, swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.

54. Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?

No, as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination in any way whatever (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.

What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic! And if the matter be not of good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is not necessary; but, on the contrary, hurtful. If the vaccination produce slight feverish attack, it will, without the administration of a particle of medicine, subside in two or three days.

55. Have you any directions to give respecting the arm AFTER vaccination?

The only precaution necessary is to take care that the arm be not rubbed; otherwise the vesicles may be prematurely broken, and the efficacy of the vaccination may be lessened. The sleeve, in vaccination, ought to be large and soft, and should not be tied up. The tying up of a sleeve makes it hard, and is much more likely to rub the vesicles than if it were put on the usual way.

56. If the arm, AFTER vaccination, be much inflamed, what ought to be done?

Smear frequently, by means of a feather or a camel's hair brush, a little cream on the inflamed part. This simple remedy will afford great comfort and relief.

57. Have the goodness to describe the proper appearance, after the falling-off of the scab of the arm?

It might be well to remark, that the scabs ought always to be allowed to fall off of themselves. They must not, on any account, be picked or meddled with. With regard to the proper appearance of the arm, after the falling-off of the scab, "a perfect vaccine scar should be of small size, circular, and marked with radiations and indentations."-- Gregory.

DENTITION

58. At what time does dentition commence?

The period at which it commences is uncertain. It may, as a rule, be said that a babe begins to cut his teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspeare notices it thus:--

"YORK.--Marry, they say my uncle grew so fast, That he could gnaw a crust at two hours old. 'Twas full two years ere I could get a tooth, Grandam, this would have been a biting jest."

When a babe is born with teeth, they generally drop out. On the other hand, teething, in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.

Dentition has been known to occur in old age. A case is recorded by M. Carre, in the Gazette Medicale de Paris (Sept 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!

59. What is the number of the FIRST set of teeth, and in what order do they generally appear?

The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. "I may say that nearly invariably the order is--1st, the lower front incissors [cutting teeth], then the upper front, then the upper two lateral incissors, and that not uncommonly a double tooth is cut before the two lower laterals; but at all events the lower laterals come 7th and 8th, and, not 5th and 6th, as nearly all books on the subject testify." [Footnote: Sir Charles Locock in a Letter to the Author.] Then the first grinders, in the lower jaw, afterwards the first upper grinders, then the lower corner-pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. He is, usually, from the time they first appear, two years in cutting the first set of teeth. As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.

60. If an infant be feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced?

Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.

61. But it has been stated that lancing the gums hardens them?

This is a mistake--it has a contrary effect. It is a well-known fact, that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing. It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth, or the teeth, be near at hand. It is not to be considered a panacea for every baby's ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.

62. How ought the lancing of a child's gums to be performed?

The proper person, of course, to lance his gums is a medical man. But if, perchance, you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse's lap upon his back, and let the nurse take hold of his hands in order that he may not interfere with the operation.

Then, if it be the upper gum that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then, you should take hold of the gum-lancet with your right hand--holding as if it were a table-knife at dinner--and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.

If it be the lower gum that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.

Although the lancing of the gums, to make it intelligible to a non-professional person, requires a long description, it is, in point of fact, a simple affair, is soon performed, and gives but little pain.

63. If teething cause convulsions, what ought to be done?

The first thing to be done (after sending for a medical man) is to freely dash water upon the face, and to sponge the head with cold water, and as soon as warm water can be procured, to put him into a warm bath [Footnote: For the precautions to be used in putting a child into a warm bath, see the answer to question on "Warm Baths."] of 98 degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No family, where there are young children, should be without Fahrenheit's thermometer.] you must plunge your own elbow into the water: a comfortable heat for your elbow will be the proper heat for the infant. He must remain in the bath for a quarter of an hour, or until the fit be at an end. The body must, after coming out of the bath, be wiped with warm and dry and coarse towels; he ought then to be placed in a warm blanket. The gums must be lanced, and cold water should be applied to the head. An enema, composed of table salt, of olive oil, and warm oatmeal gruel--in the proportion of one table-spoonful of salt, of one of oil, and a tea-cupful of gruel--ought then to be administered, and should, until the bowels have been well opened, be repeated every quarter of an hour; as soon as he comes to himself a dose of aperient medicine ought to be given.

It may be well, for the comfort of a mother, to state that a child in convulsions is perfectly insensible to all pain whatever; indeed, a return to consciousness speedily puts convulsions to the rout.

64. A nurse is in the habit of giving a child, who is teething, either coral, or ivory, to bite: do you approve of the plan?

I think it a bad practice to give him any hard, unyielding substance, as it tends to harden the gums, and, by so doing, causes the teeth to come through with greater difficulty. I have found softer substances, such as either a piece of wax taper, or an India-rubber ring, or a piece of the best bridle leather, or a crust of bread, of great service. If a piece of crust be given as a gum-stick, he must, while biting it, be well watched, or by accident he might loosen a large piece of it, which might choke him. The pressure of any of these excites a more rapid absorption of the gum, and thus causes the tooth to come through more easily and quickly.

65. Have you any objection to my baby, when he is cutting his teeth, sucking his thumb?

Certainly not: the thumb is the best gum-stick in the world:--it is convenient; it is handy (in every sense of the word): it is of the right size, and of the proper consistence, neither too hard nor too soft; there is no danger, as of some artificial gum-sticks, of its being swallowed, and thus of its choking the child. The sucking of the thumb causes the salivary glands to pour out their contents, and thus not only to moisten the dry mouth, but assist the digestion; the pressure of the thumb eases, while the teeth are "breeding," the pain and irritation of the gums, and helps, when the teeth are sufficiently advanced, to bring them through the gums. Sucking of the thumb will often make a cross infant contended and happy, and will frequently induce a restless babe to fall into a sweet refreshing sleep. Truly may the thumb be called a baby's comfort. By all means, then, let your child suck his thumb whenever he likes, and as long as he chooses to do so.

There is a charming, bewitching little picture of a babe sucking his thumb in Kingsley's Water Babies, which I heartily commend to your favourable notice and study.

66. But if an infant be allowed to suck his thumb, will it not be likely to become a habit, and stick to him for years--until, indeed, he become a big boy?

After he have cut the whole of his first set of teeth, that is to say, when he is about two years and a half old, he might, if it be likely to become a habit, be readily cured by the following method, namely, by making a paste of aloes and water, and smearing it upon his thumb. One or two dressings will suffice as after just tasting the bitter aloes he will take a disgust to his former enjoyment, and the habit will at once be broken.

Many persons I know have an objection to children sucking their thumbs, as for instance,--

"Perhaps it's as well to keep children from plums, And from pears in the season, and sucking their thumbs." [Footnote: Ingoldsby Legends.]

My reply is,--

P'rhaps 'tis as well to keep children from pears; The pain they might cause, is oft follow'd by tears; 'Tis certainly well to keep them from plums; But certainly not from sucking their thumbs! If a babe suck his thumb 'Tis an ease to his gum; A comfort; a boon; a calmer of grief; A friend in his need--affording relief; A solace; a good; a soother of pain; A composer to sleep; a charm; and a gain.

'Tis handy, at once, to his sweet mouth to glide; When done with, drops gently down by his side; 'Tis fix'd, like an anchor, while the babe sleeps. And the mother, with joy, her still vigil keeps.

67. A child who is teething dribbles, and thereby wets his chest, which frequently causes him to catch cold; what had better be done?

Have in readiness to put on several flannel dribbling bibs, so that they may be changed as often as they become wet; or, if he dribble very much, the oiled silk dribbling-bibs, instead of the flannel ones, may be used, and which may be procured at any baby-linen ware house.

68. Do you approve of giving a child, during teething, much fruit?

No; unless it be a few ripe strawberries or raspberries, or a roasted apple, or the juice of five or six grapes--taking care that he does not swallow either the seeds or the skin--or the insides of ripe gooseberries, or an orange. Such fruits, if the bowels be in a costive state, will be particularly useful.

All stone fruit, raw apples or pears, ought to be carefully avoided, as they not only disorder the stomach and the bowels,--causing convulsions, gripings, &c.,--but they have the effect of weakening the bowels, and thus of engendering worms.

69. Is a child, during teething, more subject to disease, and, if so, to what complaints, and in what manner may they be prevented?

The teeth are a fruitful source of suffering and of disease; and are, with truth, styled "our first and our last plagues." Dentition is the most important period of a child's life, and is the exciting cause of many infantile diseases; during this period, therefore, he requires constant and careful watching. When we consider how the teeth elongate and enlarge in his gums, pressing on the nerves and on the surrounding parts, and thus how frequently they produce pain, irritation, and inflammation; when we further contemplate what sympathy there is in the nervous system, and how susceptible the young are to pain, no surprise can be felt, at the immense disturbance, and the consequent suffering and danger frequently experienced by children while cutting their first set of teeth. The complaints or the diseases induced by dentition are numberless, affecting almost every organ of the body,--the brain, occasioning convulsions, water on the brain, &c.; the lungs, producing congestion, inflammation, cough, &c.; the stomach, exciting sickness, flatulence, acidity, &c,; the bowels, inducing griping, at one time costiveness, and at another time purging; the skin, causing "breakings-out."

To prevent these diseases, means ought to be used to invigorate a child's constitution by plain, wholesome food, as recommended under the article of diet; by exercise and fresh air; [Footnote: The young of animals seldom suffer from cutting their teeth--and what is the reason? Because they live in the open air, and take plenty of exercise; while children are frequently cooped up in close rooms, and are not allowed the free use of their limbs. The value of fresh air is well exemplified in the Registrar-General's Report for 1843; he says that in 1,000,000 deaths, from all diseases, 616 occur in the town from teething while 120 only take place in the country from the same cause.] by allowing him, weather permitting, to be out of doors a great part of every day; by lancing the gums when they get red, hot, and swollen; by attention to the bowels, and if he suffer more than usual, by keeping them rather in a relaxed state by any simple aperient, such as either castor oil, or magnesia and rhubarb, &c.; and, let me add, by attention to his temper: many children are made feverish and ill by petting and spoiling them. On this subject I cannot do better than refer you to an excellent little work entitled Abbot's Mother of Home, wherein the author proves the great importance of early training.

70. Have the goodness to describe the symptoms and the treatment of Painful Dentition?

Painful dentition may be divided into two forms--(1) the Mild; and (2) the Severe. In the mild form the child is peevish and fretful, and puts his fingers, and everything within reach, to his mouth, he likes to have his gums rubbed, and takes the breast with avidity, indeed it seems a greater comfort to him than ever. There is generally a considerable flow of saliva, and he has frequently a more loose state of bowels than is his wont.

Now, with regard to the more severe form of painful dentition--The gums are red, swollen, and hot, and he cannot without expressing pain bear to have them touched, hence, if he be at the breast, he is constantly loosing the nipple. There is dryness of the mouth, although before there had been a great flow of saliva. He is feverish, restless, and starts in his sleep. His face is flashed. His head is heavy and hot. He is sometimes convulsed. [Footnote: See answer to Question 63.] He is frequently violently griped and purged, and suffers severely from flatulence. He is predisposed to many and severe diseases.

The treatment, of the mild form, consists of friction, of the gum with the finger, with a little "soothing syrup," as recommended by Sir Charles Locock, [Footnote: Soothing syrup--Some of them probably contain opiates, but a perfectly safe and useful one is a little Nitrate of Potass in syrup of Roses--one scruple to half an ounce.--Communicated by Sir Charles Locock to the Author. This 'soothing syrup' is not intended to be given us a mixture but to be used as an application to rub the gums with. It may be well to state that it is a perfectly harmless remedy even if a little of it were swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, every night at bed time, attention to diet and to bowels, fresh air and exercise. For the mild form, the above plan will usually be all that is required. If he dribble, and the bowels be relaxed, so much the better. The flow of saliva and the increased action of the bowels afford relief, and therefore must not be interfered with. In the mild form, lancing of the gums is not desirable. The gums ought not to be lanced, unless the teeth be near at hand, and unless the gums be red, hot, and swollen.

In the severe form a medical man should be consulted early, as more energetic remedies will be demanded; that is to say, the gums will require to be freely lanced, warm baths to be used, and medicines to be given, to ward off mischief from the head, from the chest, and from the stomach.

If you are living in the town, and your baby suffers much from teething, take him into the country. It is wonderful what change of air to the country will often do, in relieving a child who is painfully cutting his teeth. The number of deaths in London, from teething, is frightful; it is in the country comparatively trifling.

71. Should an infant be purged during teething or indeed, during any other time, do you approve of either absorbent or astringent medicines to restrain it?

Certainly not. I should look upon, the relaxation as an effort of nature to relieve itself. A child is never purged without a cause; that cause, in the generality of instances, is the presence of either some undigested food, or acidity, or depraved motions, that want a vent.

The better plan is, in such a case, to give a dose of aperient medicine, such as either castor oil, or magnesia and rhubarb; and thus work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so important and is often mistaken.--C. Locock.] If he be purged more than usual, attention should be paid to the diet--if it be absolutely necessary to give him artificial food while suckling--and care must be taken not to overload the stomach.

72. A child is subject to a slight cough during dentition--called by nurses "tooth-cough"--which a parent would not consider of sufficient importance to consult a doctor about: pray tell me, is there any objection to a mother giving her child a small quantity either of syrup of white poppies, or of paregoric, to ease it?

A cough is an effort of nature to bring up any secretion from the lining membrane of the lungs, or from the bronchial tubes, hence it ought not to be interfered with. I have known the administration of syrup of white poppies, or of paregoric, to stop the cough, and thereby to prevent the expulsion of the phlegm, and thus to produce either inflammation of the lungs, or bronchitis. Moreover, both paregoric and syrup of white poppies are, for a young child, dangerous medicines (unless administered by a judicious medical man), and ought never to be given by a mother.

In the month of April 1844, I was sent for, in great haste, to an infant, aged seventeen months, who was labouring under convulsions and extreme drowsiness, from the injudicious administration of paregoric, which had been given to him to ease a cough. By the prompt administration of an emetic he was saved.

73. A child, who is teething, is subject to a "breaking-out," more especially behind the ears--which is most disfiguring, and frequently very annoying what would you recommend?

I would apply no external application to cure it, as I should look upon it as an effort of the constitution to relieve itself, and should expect, if the "breaking-out" were repelled, that either convulsions, or bronchitis, or inflammation of the lungs, or water on the brain, would be the consequence. The only plan I should adopt would be, to be more careful in his diet, to give him less meat (if he be old enough to eat animal food), and to give him, once or twice a week, a few doses of mild aperient medicine, and, if the irritation from the "breaking-out" be great, to bathe it, occasionally, either with a little warm milk and water, or with rose water.

EXERCISE.

74. Do you recommend exercise in the open air for a baby? and if so, how soon after birth?

I am a great advocate for his having exercise in the open air. "The infant in arms makes known its desire for fresh air, by restlessness, it cries, for it cannot speak its wants, is taken abroad and is quiet."

The age at which he ought to commence taking exercise will, of course, depend upon the season and upon the weather. If it be summer, and the weather be fine, he should he carried in the open air, a week or a fortnight after birth, but if it be winter, he ought not on any account to be taken out under the month, and not even then, unless the weather be mild for the season, and it be the middle of the day. At the end of two months he should breathe the open air more frequently. And after the expiration of three months, he ought to be carried out every day, even if it be wet under foot, provided it be fine above, and the wind be neither in an easterly nor in a north-easterly direction. By doing so we shall make him strong and hearty, and give the skin that mottled appearance which is so characteristic of health. He must, of course, be well clothed.

I cannot help expressing my disapprobation of the practice of smothering up an infant's face with a handkerchief, with a veil or with any other covering, when he is taken out into the air. If his face be so muffled up, he may as well remain at home, as under such circumstances, it is impossible for him to receive any benefit from the invigorating effects of the fresh air.

75. Can you devise any method to induce a babe himself to take exercise?

He must be encouraged to use muscular exertion, and, for this purpose, he ought to be frequently laid either upon a rug, or carpet, or the floor. He will then stretch his limbs and kick about with perfect glee. It is a pretty sight, to see a little fellow kicking and sprawling on the floor. He crows with delight and thoroughly enjoys himself. It strengthens his back, it enables him to stretch his limbs, and to use his muscles, and is one of the best kinds of exercise a very young child can take. While going through his performances his diaper, if he wear one, should be unfastened, in order that he might go through his exercises untrammelled. By adopting the above plan, the babe quietly enjoys himself--his brain is not over excited by it; this is an important consideration, for both mothers and nurses are apt to rouse, and excite very young children to their manifest detriment. A babe requires rest, and not excitement. How wrong it is, then, for either a mother or a nurse to be exciting and rousing a new born babe. It is most injurious and weakening to his brain. In the early period of his existence his time ought to be almost entirely spent in sleeping and in sucking!

76. Do you approve of tossing an infant much about?

I have seen, a child tossed nearly to the ceiling! Can anything be more cruel or absurd! Violent tossing of a young babe ought never to be allowed, it only frightens him, and has been known to bring on convulsions. He should be gently moved up and down (not tossed), such exercises causes a proper circulation of the blood, promotes digestion, and soothes to sleep. He must always be kept quiet immediately after taking the breast, if he be tossed directly afterwards, it interferes with his digestion, and is likely to produce sickness.

SLEEP

77. Ought the infant's sleeping apartment to be kept warm?

The lying-in room is generally kept too warm, its heat being, in many instances, more that of an oven than of a room. Such a place is most unhealthy, and is fraught with danger both to the mother and the baby. We are not, of course, to run into an opposite extreme, but are to keep the chamber at a moderate and comfortable temperature. The door ought occasionally to be left ajar, in order the more effectually to change the air and thus to make it more pure and sweet.

A new born babe, then, ought to be kept comfortably warm, but not very warm. It is folly in the extreme to attempt to harden a very young child either by allowing him, in the winter time, to be in a bedroom without a fire, or by dipping him in cold water, or by keeping him with scant clothing on his bed. The temperature of a bedroom, in the winter time, should be, as nearly as possible, at 60 deg. Fahr. Although the room should be comfortably warm, it ought from time to time to be properly ventilated. An unventilated room soon becomes foul, and, therefore, unhealthy. How many in this world, both children and adults, are "poisoned with their own breaths!"

An infant should not be allowed to look at the glare either of a fire or of a lighted candle, as the glare tends to weaken the sight, and sometimes brings on an inflammation of the eyes. In speaking to, and in noticing a baby, you ought always to stand before, and not behind him, or it might make him squint.

78. Ought a babe to lie alone from the first?

Certainly not: at first--say, for the first few months--he requires the warmth of another person's body, especially in the winter; but care must be taken not to overlay him, as many infants, from carelessness in this particular, have lost their lives. After the first few months he had better lie alone, on a horse-hair mattress.

79. Do you approve of rocking an infant to sleep?

I do not. If the rules of health be observed, he will sleep both soundly and sweetly without rocking; if they be not, the rocking might cause him to fall into a feverish, disturbed slumber, but not into a refreshing, calm sleep. Besides, if you once take to that habit, he will not go to sleep without it.

80. Then don't you approve of a rocking-chair, and of rockers to the cradle?

Certainly not: a rocking-chair, or rockers to the cradle, may be useful to a lazy nurse or mother, and may induce a child to sleep, but that restlessly, when he does not need sleep, or when he is wet and uncomfortable, and requires "changing;" but will not cause him to have that sweet and gentle and exquisite slumber so characteristic of a baby who has no artificial appliances to make him sleep. No! rockers are perfectly unnecessary, and the sooner they are banished the nursery the better will it be for the infant community. I do not know a more wearisome and monotonous sound than the everlasting rockings to and fro in some nurseries, they are often accompanied by a dolorous lullaby from the nurse, which adds much to the misery and depressing influence of the performance.

81. While the infant is asleep, do you advise the head of the crib to be covered with a handkerchief, to shade his eyes from the light, and, if it be summer time, to keep off the flies?

If the head of the crib be covered, the babe cannot breathe freely, the air within the crib becomes contaminated, and thus the lungs cannot properly perform their functions. If his sleep is to be refreshing, he must breathe pure air. I do not even approve of a head to a crib. A child is frequently allowed to sleep on a bed with the curtains drawn completely close, as though it were dangerous for a breath of air to blow upon him [Footnote: I have somewhere read that if a cage containing a canary, be suspended at night within a bed where a person is sleeping, and the curtains be drawn closely around, that the bird will, in the morning, in all probability, be found dead!] This practice is most injurious. An infant must have the full benefit of the air of the room, indeed, the bed room door ought to be frequently left ajar, so that the air of the apartment may be changed, taking care, of course, not to expose him to a draught. If the flies, while he is asleep, annoy him, let a net veil be thrown over his face, as he can readily breathe through net, but not through a handkerchief.

82. Have you any suggestions to offer as to the way a babe should be dressed when he is put down to sleep?

Whenever he be put down to sleep, be more than usually particular that his dress be loose in every part, be careful that there be neither strings nor bands, to cramp him. Let him, then, during repose, be more than ordinarily free and unrestrained--

"If, whilst in cradled rest your infant sleeps. Your watchful eyes unceasing vigil keeps Lest cramping bonds his pliant limbs constrain, And cause defects that manhood may retain."

83. Is it a good sign for a young child to sleep much?

A babe who sleeps a great deal thrives much more than one who does not. I have known many children, who were born [Footnote: It may be interesting to a mother to know the average weight of new born infants. There is a paper on the subject in the Medical Circular (April 10, 1861) and which has been abridged in Braithwaite's Retrospect of Medicine (July and December 1861). The following are extracts--"Dr. E. von Siebold presents a table of the weights of 3000 infants (1586 male and 1414 female) weighed immediately after birth. From this table (for which we have not space) it results that by far the greater number of the children, 2215 weighed between 6 and 8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to 8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at 9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11 lbs. The author has never but once met with a child weighing 11 lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It is a remarkable fact, that until the weight of 7 lbs the female infants exceeded the males in number, the latter thenceforward predominating.

From these statements, and those of various other authors here quoted, the conclusion may be drawn that the normal weight of a mature new born infant is not less than six nor more than 8 lbs., the average weight being 6 1/2 or 7 lbs., the smaller number referring to female and the higher to male infants."] small and delicate, but who slept the greatest part of their time, become strong and healthy. On the other hand, I have known those who were born large and strong, yet who slept but little, become weak and unhealthy.

The common practice of a nurse allowing a baby to sleep upon her lap is a bad one, and ought never to be countenanced. He sleeps cooler, more comfortably, and soundly in his crib.

The younger an infant is the more he generally sleeps, so that during the early months he is seldom awake, and then only to take the breast.

84. How is it that much sleep causes a young child to thrive so well?

If there be pain in any part of the body, or if any of the functions be not properly performed, he sleeps but little. On the contrary, if there be exemption from pain, and if there be a due performance of all the functions, he sleeps a great deal, and thus the body becomes refreshed and invigorated.

85. As much sleep is of such advantage, if an infant sleep but little, would you advise composing medicine to be given to him?

Certainly not. The practice of giving composing medicine to a young child cannot he too strongly reprobated. If he does not sleep enough, the mother ought to ascertain if the bowels be in a proper state, whether they be sufficiently opened, that the motions be of a good colour--namely, a bright yellow, inclining to orange colour--and free from slime or from bad smell. An occasional dose of rhubarb and magnesia is frequently the best composing medicine he can take.

86. We often hear of coroner's inquests upon infants who have been found dead in bed--accidentally overlaid what is usually the cause?

Suffocation, produced either by ignorance, or by carelessness. From ignorance in mothers, in their not knowing the common laws of life, and the vital importance of free and unrestricted respiration, not only when babies are up and about, but when they are in bed and asleep. From carelessness, in their allowing young and thoughtless servants to have the charge of infants at night, more especially as young girls are usually heavy sleepers, and are thus too much overpowered with sleep to attend to their necessary duties.

A foolish mother sometimes goes to sleep while allowing her child to continue sucking. The unconscious babe, after a tune, looses the nipple, and buries his head in the bed-clothes. She awakes in the morning, finding, to her horror, a corpse by her side, with his nose flattened, and a frothy fluid, tinged with, blood, exuding from his lips. A mother ought, therefore, never to go to sleep until her child have finished sucking.

The following are a few rules to prevent an infant from being accidentally overlaid--(1.) Let your baby while asleep have plenty of room in the bed. (2.) Do not allow him to be too near to you; or if he he unavoidably near you (from the small size of the bed), let his face be turned to the opposite side. (3.) Let him lie fairly either on his side, or on his back. (4.) Be careful to ascertain that his mouth be not covered with the bed-clothes; and, (5.) Do not smother his face with clothes, as a plentiful supply of pure air is as necessary when he is awake, or even more so, than when he is asleep. (6.) Never let him lie low in the bed. (7.) Let there be no pillow near the one his head is resting on, lest he roll to it, and thus bury his head in it Remember, a young child has neither the strength nor the sense to get out of danger; and, if he unfortunately either turn on his face, or bury his head in a pillow that is near, the chances are that he will be suffocated, more especially as these accidents usually occur at night, when the mother, or the nurse, is fast asleep. (8.) Never intrust him at night to a young and thoughtless servant.

THE BLADDER AND THE BOWELS OF AN INFANT.

87. Have you any hints to offer respecting the bowels and the bladder of an infant during the first three months of his existence?

A mother ought daily to satisfy herself as to the state of the bladder and the bowels of her child. She herself should inspect the motions, and see that they are of a proper colour (bright-yellow, inclining to orange), and consistence (that of thick gruel), that they are neither slimy, nor curdled, nor green; if they should be either the one or the other, it is a proof that she herself has, in all probability, been imprudent in her diet, and that it will be necessary for the future that she be more careful both in what she eats and in what she drinks.

She ought, moreover, to satisfy herself that the urine does not smell strongly, that it does not stain the diapers, and that he makes a sufficient quantity.

A frequent cause of a child crying is, he is wet, and uncomfortable, and wants drying and changing, and the only way he has of informing his mother of the fact is by crying lustily, and thus telling her in most expressive language of her thoughtlessness and carelessness.

88. How soon may an infant dispense with diapers?

A babe of three months and upwards, ought to be held out, at least, a dozen times during the twenty-four hours; if such a plan were adopted, diapers might at the end of three months be dispensed with--a great desideratum-and he would be inducted into clean habits--a blessing to himself, and a comfort to all around, and a great saving of dresses and of furniture. "Teach your children to be clean. A dirty child is the mother's disgrace," [Footnote: Hints on Household Management, By Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS THE MOTHER'S DISGRACE.

AILMENTS, DISEASE, ETC.

89. A new born babe frequently has a collection of mucus in the air passages, causing him to wheeze: is it a dangerous symptom?

No, not if it occur immediately after birth; as soon as the bowels have been opened, it generally leaves him, or even before, if he give a good cry, which as soon as he is born he usually does. If there be any mucus either within or about the mouth, impeding breathing, it must with a soft handkerchief be removed.

90. Is it advisable, as soon as an infant is born, to give him medicine?

It is now proved that the giving of medicine to a babe immediately after birth is unnecessary, nay, that it is hurtful--that is, provided he be early put to the breast, as the mother's first milk is generally sufficient to open the bowels. Sir Charles Locock [Footnote: In a Letter to the Author.] makes the following sensible remarks on this subject:--"I used to limit any aperient to a new-born infant to those which had not the first milk, and who had wet nurses, whose milk was, of course, some weeks old, but for many years I have never allowed any aperient at all to any new born infant, and I am satisfied it is the safest and the wisest plan."

The advice of Sir Charles Locock--to give no aperient to a new-born infant--is most valuable, and ought to be strictly followed. By adopting his recommendation, much after misery might be averted. If a new born babe's bowels be costive, rather than give him an aperient, try the effect of a little moist sugar, dissolved in a little water, that is to say, dissolve half a tea-spoonful of pure unadulterated raw sugar in a tea-spoonful of warm water and administer it to him, if in four hours it should not operate, repeat the dose. Butter and raw sugar is a popular remedy, and is sometimes used by a nurse to open the bowels of a new born babe, and where there is costiveness, answers the purpose exceedingly well, and is far superior to castor oil. Try by all means to do, if possible, without a particle of opening medicine. If you once begin to give aperients, you will have frequently to repeat them. Opening physic leads to opening physic, until at length his stomach and bowels will become a physic shop! Let me, then, emphatically say, avoid, if possible, giving a new born babe a drop or a gram of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterwards. It is the first step, in this as in all other things, that is so important to take.

If a new-born babe have not for twelve hours made water, the medical man ought to be informed of it, in order that he may inquire into the matter, and apply the proper remedies. Be particular in attending to these directions, or evil consequences will inevitably ensue.

91. Some persons say, that new-born female infants have milk in their bosoms, and that it is necessary to squeeze them, and apply plasters to disperse the milk.

The idea of there being real milk in a baby's breast is doubtful, the squeezing of the bosom is barbarous, and the application of plasters is useless. "Without actually saying," says Sir Charles Locock, "there is milk secreted in the breasts of infants, there is undoubtedly not rarely considerable swelling of the breasts both in female and male infants, and on squeezing them a serous fluid oozes out. I agree with you that the nurses should never be allowed to squeeze them, but be ordered to leave them alone." [Footnote: Letter to the Author.]

92. Have the goodness to mention the SLIGHT ailments which are not of sufficient importance to demand the assistance of a medical man?

I deem it well to make the distinction between serious and slight ailments, I am addressing a mother. With regard to serious ailments, I do not think myself justified, except in certain urgent cases, in instructing a parent to deal with them. It might be well to make a mother acquainted with the symptoms, but not with the treatment, in order that she might lose no time in calling in medical aid. This I hope to have the pleasure of doing in future Conversations.

Serious diseases, with a few exceptions, and which I will indicate in subsequent Conversations, ought never to be treated by a parent, not even in the early stages, for it is in the early stages that the most good can generally be done. It is utterly impossible for any one who is not trained to the medical profession to understand a serious disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen in future Conversations that Sir CHARLES LOCOCK considers that a mother ought to be made acquainted with the treatment of some of the more serious diseases, where delay in obtaining immediate medical assistance might be death. I bow to his superior judgment, and have supplied the deficiency in subsequent Conversations.

The ailments and the diseases of infants, such as may, in the absence of the doctor, be treated by a parent, are the following:--Chafings, Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of the Nose, Sickness, Thrush. In all these complaints I will tell you--What to do, and--What NOT to do.

93. What are the causes and the treatment of Chafing?

The want of water: inattention and want of cleanliness are the usual causes of chafing.

What to do.--The chafed parts ought to be well and thoroughly sponged with tepid rain water--allowing the water from a well-filled sponge to stream over them,--and, afterwards, they should be thoroughly, but tenderly, dried with a soft towel, and then be dusted, either with finely-powdered starch, made of wheaten flour, or with Violet Powder, or with finely-powdered Native Carbonate of Zinc, or they should be bathed with finely-powdered Fuller's-earth and tepid water.

If, in a few days, the parts be not healed discontinue the above treatment, and use the following application:--Beat up well together the whites of two eggs, then add, drop by drop, two table-spoonfuls of brandy. When well mixed, put it into a bottle and cork it up. Before using it let the excoriated parts be gently bathed with luke-warm rain water, and, with a soft napkin, be tenderly dried; then, by means of a camel's hair brush, apply the above liniment, having first shaken the bottle. But bear in mind, after all that can be said and done, that there is nothing in these cases like water--there is nothing like keeping the parts clean, and the only way of thoroughly effecting this object is by putting him every morning INTO his tub.

What NOT to do.--Do not apply white lead, as it is a poison. Do not be afraid of using plenty of water, as cleanliness is one of the most important items of the treatment.

94. What are the causes of Convulsions of an infant?

Stuffing him, in the early months of his existence, with food, the mother having plenty of breast milk the while, the constant physicking of child by his own mother, teething, hooping-cough, when attacking a very young baby.

I never knew a case of convulsions occur--say for the first four months--(except in very young infants labouring under hooping-cough), where children lived on the breast-milk alone, and where they were not frequently quacked by their mothers.

For the treatment of the convulsions from teething, see page 46.

What to do in a case of convulsions which has been caused by feeding an infant either with too much or with artificial food. Give him, every ten minutes, a tea-spoonful of ipecacuanha wine, until free vomiting be excited then put him into a warm bath (see Warm Baths), and when he comes out of it administer to him a tea-spoonful of castor oil, and repeat it every four hours, until the bowels be well opened.

What NOT to do--Do not for at least a month after the fit, give him artificial food, but keep him entirely to the breast. Do not apply leeches to the head.

What to do in a case of convulsions from hooping cough--There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. Convulsions attending an attack of hooping-cough make it a serious complication, and requires the assiduous and skilful attention of a judicious medical man.

What NOT to do in such a case--Do not apply leeches, the babe requires additional strength, and not to be robbed of it, and do not attempt to treat the case yourself.

95. What are the best remedies for the Costiveness of an infant?

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

What to do.--If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan, may be brought into a regular state. Besides, it inducts an infant into clean habits, I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such encumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot of course, at an early age be dispensed with, unless a mother have great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having his bowels relieved and his bladder emptied every time he is either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little raw sugar and water, either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or two of water, or give him, out of your fingers, half a tea-spoonful of raw sugar to eat. I mean by raw sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for a while, opening medicine becomes a dire necessity, and then woe betide the poor unfortunate child. Or, give a third of a tea-spoonful of honey, early in the morning, occasionally. Or administer a warm water enema--a tablespoonful, or more, by means of a 2 oz. India Rubber Enema Bottle.

What NOT to do.--There are two preparations of mercury I wish to warn you against administering of your own accord, viz.--(1) Calomel, and a milder preparation called (2) Grey-powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it can be administered it being small in quantity, and nearly tasteless. Grey powder also, is, with many mothers, a favourite in the nursery. It is a medicine of immense power--either for good or for evil, in certain cases it is very valuable, but in others, and in the great majority, it is very detrimental. This practice, then, of a mother giving mercury, whether in the form either of calomel or of grey powder, cannot be too strongly reprobated, as the frequent administration either of the one or of the other weakens the body, predisposes it to cold, and frequently excites king's-evil--a disease too common in this country. Calomel and grey-powder, then, ought never to be administered unless ordered by a medical man.

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

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

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

For further information on this important subject see the 3d edition of Counsel to a Mother (being the companion volume of Advice to a Mother), on the great importance of desisting from irritating, from injuring, and from making still more costive, the obstinate bowels of a costive child,--by the administration of opening medicine,--however gentle and well-selected the aperients might be. Oh, that the above advice could be heard, and be acted upon, through the length and the breadth of the land, how much misery and mischief would then be averted!

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

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

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

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

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

What to do.--Notwithstanding these precautions, if the babe should still suffer, "One of the best and safest remedies for flatulence is Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce and a half of water" [Footnote: Sir Charles Locock, in a Letter to the Author Since Sir Charles did me the honour of sending me, for publication, the above prescription for flatulence, a new "British Pharmacopoeia" has been published in which the sal volatile is much increased in strength it is therefore necessary to lessen the sal volatile in the above prescription one half--that is to say, a tea spoonful of the solution of half a drachm to an ounce and a half of water.] Or, a little dill or aniseed may be added to the food--half a tea-spoonful of dill water Or, take twelve drops of oil of dill, and two lumps of sugar, rub them well in a mortar together, then add, drop by drop, three table-spoonfuls of spring water, let it be preserved in a bottle for use. A tea-spoonful of this, first shaking the vial, may be added to each quantity of food. Or, three tea-spoonfuls of bruised caraway-seeds may be boiled for ten minutes in a tea-cupful of water, and then strained. One or two tea-spoonfuls of the caraway tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may occasionally be given.

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

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

What NOT to do--"Godfrey's Cordial," "Infants' Preservative," and "Dalby's Carminative," are sometimes given in flatulence, but as most of these quack medicines contain, in one form or another, either opium or poppy, and as opium and poppy are both dangerous remedies for children, ALL quack medicines must be banished the nursery.

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

98. What are the symptoms, the causes, and the treatment of "Gripings" of an infant?

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

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

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

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

Make a Mixture, One or two tea-spoonfuls (according to the age of the child) to be taken every four boors, until relief be obtained--first shaking the bottle.) If it arise from a mother's imprudence in eating trash, or from her taking violent medicine, a warm bath, a warm bath, indeed, let the cause of "griping" be what it may, usually affords instant relief.

Another excellent remedy is the following--Soak a piece of new flannel, folded into two or three thicknesses, in warm water, wring it tolerably dry, and apply as hot as the child can comfortably bear it to the bowels, then wrap him in a warm, dry blanket, and keep him, for at least half an hour, enveloped in it. Under the above treatment, he will generally soon fall into a sweet sleep, and awake quite refreshed.

What NOT to do--Do not give opiates, astringents, chalk, or any quack medicine whatever.

If a child suffer from a mother's folly in her eating improper food, it will be cruel in the extreme for him a second time to be tormented from the same cause.

99. What occasions Hiccup, and what is its treatment?

Hiccup is of such a trifling nature as hardly to require interference. It may generally be traced to over feeding. Should it be severe, four or five grains of calcined magnesia, with a little syrup and aniseed water, and attention to feeding are all that will be necessary.

100. Will you describe the symptoms of Infantile Diarrhoea?

Infantile diarrhoea, or cholera infantum, is one of the most frequent and serious of infantile diseases, and carries off, during the year, more children than any other complaint whatever a knowledge of the symptoms, therefore, is quite necessary for a mother to know, in order that she may, at the proper tune, call in efficient medical aid.

It will be well, before describing the symptoms, to tell you how many motions a young infant ought to have a day, their colour, consistence, and smell. Well, then, he should have from three to six motions in the twenty four hours, the colour ought to be a bright yellow, inclining to orange, the consistence should be that of thick gruel; indeed, his motion, if healthy, ought to be somewhat of the colour (but a little more orange-tinted) and of the consistence of mustard made for the table; it should be nearly, if not quite, devoid of smell; it ought to have a faint and peculiar, but not a strong disagreeable odour. If it have a strong and disagreeable smell, the child is not well, and the case should be investigated, more especially if there be either curds or lumps in the motions; these latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint--that is to say, that he has six or eight motions during the twenty-four hours,--and that the stools are of a thinner consistence than what I have described,--provided, at the same time, that he be not griped, that he have no pain, and have not lost his desire for the breast:--What ought to be done?Nothing. A slight looseness of the bowels should never be interfered with,--it is often an effort of nature to relieve itself of some vitiated motion that wanted a vent--or to act as a diversion, by relieving the irritation of the gums. Even if he be not cutting his teeth, he may be "breeding" them--that is to say, the teeth may be forming in his gums, and may cause almost as much, irritation as though he were actually cutting them. Hence, you see the immense good a slight "looseness of the bowels" may cause. I think that I have now proved to you the danger of interfering in such a case, and that I have shown you, the folly and the mischief of at once giving astringents--such as Godfrey's Cordial, Dalby's Carminative, &c.--to relieve a slight relaxation.

A moderate "looseness of the bowels," then, is often a safety-valve, and you may, with as much propriety, close the safety-valve of a steam engine, as stop a moderate "looseness of the bowels!"

Now, if the infant, instead of having from three to six motions, should have more than double the latter number; if they be more watery; if they become slimy and green, or green in part and curdled; if they should have an unpleasant smell; if he be sick, cross, restless, fidgety, and poorly; if every time he have a motion he be griped and in pain, we should then say that he is labouring under Diarrhoea; then, it will be necessary to give a little medicine, which I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case becomes more serious; still, with proper care, relief can generally be quickly obtained. If the evacuations--instead of being stool--are merely blood and slime, and the child strain frequently and violently, endeavouring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of Dysentery. [Footnote: See Symptoms and Treatment of Dysentery.]

If there be a mixture of blood, slime, and stool from the bowels, the case would be called Dysenteric-diarrhoea. The latter case requires great skill and judgment on the part of a medical men, and great attention and implicit obedience from the mother and the nurse. I merely mention these diseases in order to warn you of their importance, and of the necessity of strictly attending to a doctor's orders.

101. What are the causes of Diarrhoea--"Looseness of the bowels?"

Improper food; overfeeding; teething; cold; the mother's milk from various causes disagreeing, namely, from her being out of health, from her eating unsuitable food, from her taking improper and drastic purgatives, or from her suckling her child when she is pregnant. Of course, if any of these causes are in operation, they ought, if possible, to be remedied, or medicine to the babe will be of little avail.

102. What is the treatment of Diarrhoea?

What to do.--If the case be slight, and has lasted two or three days (do not interfere by giving medicine at first), and if the cause, as it probably is, be some acidity or vitiated stool that wants a vent, and thus endeavours to obtain one by purging, the best treatment is, to assist nature by giving either a dose of castor oil, or a moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and magnesia mixture prescription, see page 71 (note).] and thus to work off the enemy. After the enemy has been worked off, either by the castor oil, or by the magnesia and rhubarb, the purging will, in all probability, cease; but if the relaxation still continue, that is to say, for three or four days--then, if medical advice cannot be procured, the following mixture should be given:--

Take of--Aromatic Powder of Chalk and Opium, ten grains; Oil of Dill, five drops; Simple Syrup, three drachms; Water, nine drachms;

Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half a tea-spoonful to be given to an infant of six months and under, and one tea-spoonful to a child above that age, every four hours--first shaking the bottle.

If the babe be at the breast, he ought, for a few days, to be kept entirely to it. The mother should be most particular in her own diet.

What NOT to do.--The mother must neither take greens, nor cabbage, nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of her babe continues, she had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought not, while the diarrhoea continues, to have any artificial food. He must neither be dosed with grey-powder (a favourite, but highly improper Remedy, in these cases), nor with any quack medicines, such as Dalby's Carminative or Godfrey's Cordial.

103. What are the symptoms of Dysentery?

Dysentery frequently arises from a neglected diarrhoea. It is more dangerous than diarrhoea, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skilful handling; hence the care and experience required in treating a case of dysentery.

Well, then, what are the symptoms? The infant, in all probability, has had an attack of diarrhoea--bowel complaint as it is called--for several days; he having had a dozen or two of motions, many of them slimy and frothy, like "frog-spawn," during the twenty-four hours. Suddenly the character of the motion changes,--from being principally stool, it becomes almost entirely blood and mucus; he is dreadfully griped, which causes him to strain violently, as though his inside would come away every time he has a motion,--screaming and twisting about, evidently being in the greatest pain, drawing his legs up to his belly and writhing in agony. Sickness and vomiting are always present, which still more robs him of his little remaining strength, and prevents the repair of his system. Now, look at his face! It is the very picture of distress. Suppose he has been a plump, healthy little fellow, you will see his face, in a few days, become old-looking, care-worn, haggard, and pinched. Day and night the enemy tracks him (unless proper remedies be administered); no sleep, or if he sleep, he is, every few minutes, roused. It is heart-rending to have to attend a bad case of dysentery in a child,--the writhing, the screaming, the frequent vomiting, the pitiful look, the rapid wasting and exhaustion, make it more distressing to witness than almost any other disease a doctor attends.

104. Can anything be done to relieve such a case?

Yes. A judicious medical man will do a great deal. But, suppose that yon are not able to procure one, I will tell you what to do and what NOT to do.

What to do.--If the child be at the breast, keep him to it, and let him have nothing else for dysentery is frequently caused by improper feeding. If your milk be not good, or it be scanty, instantly procure a healthy wet-nurse. Lose not a moment; for in dysentery, moments are precious. But, suppose that you have no milk, and that no wet-nurse can be procured: what then? Feed him entirely on cow's milk--the milk of one healthy cow; let the milk be unboiled, and be fresh from the cow. Give it in small quantities at a time, and frequently, so that it may be retained on the stomach. If a table-spoonful of the milk make him sick, give him a dessert-spoonful; if a dessert-spoonful cause sickness, let him only have a tea-spoonful at a time, and let it be repeated every quarter of an hour. But, remember, in such a case the breast milk--the breast milk alone--is incomparably superior to any other milk or to any other food whatever.

If he be a year old, and weaned, then feed him, as above recommended, on the cow's milk. If there be extreme exhaustion and debility, let fifteen drops of brandy be added to each table-spoonful of new milk, and let it be given every half hour.

Now with regard to medicine. I approach this part of the treatment with some degree of reluctance,--for dysentery is a case requiring opium--and opium I never like a mother of her own accord to administer. But suppose a medical man cannot be procured in time, the mother must then prescribe, or the child will die! What then is to be done? Sir Charles Locock considers "that, in severe dysentery, especially where there is sickness, there is no remedy equal to pure Calomel, in a full dose without opium." [Footnote: Communicated by Sir Charles Locock to the Author.] Therefore, at the very onset of the disease, let from three to five grains (according to the age of the patient) of Calomel, mixed with an equal quantity of powdered white sugar, be put dry on the tongue. In three hours after let the following mixture be administered:--

Take of--Compound Powder of Ipecacuanha, five grains; Ipecacuanha Wine, one drachm; Simple Syrup, three drachms; Cinnamon Water, nine drachms;

To make a Mixture, A tea-spoonful to be given every three or four hours, first well shaking the bottle.

Supposing he cannot retain the mixture--the stomach rejecting it as soon as swallowed--what then? Give the opium, mixed with small doses of mercury with chalk and sugar, in the form of powder, and put one of the powders dry on the tongue, every three hours:--

Take of--Powdered Opium, half a grain; Mercury with chalk, nine grains; Sugar of Milk, twenty-four grains;

Mix well in a mortar, and divide into twelve powders.

Now, suppose the dysentery has for several days persisted, and that, during that time, nothing but mucus and blood--that no real stool--has come from the bowels, then a combination of castor oil and opium [Footnote: My friend, the late Dr Baly, who had made dysentery his particular study, considered the combination of opium and castor oil very valuable in dysentery.] ought, instead of the medicine recommended above, to be given:--

Take of--Mucilage of Gum Acacia, three drachms; Simple Syrup, three drachms; Tincture of Opium, ten drops (not minims); Castor Oil, two drachms; Cinnamon water, four drachms:

Make a Mixture. A tea spoonful to be taken every four hours, first well shaking the bottle.

A warm bath, at the commencement of the disease, is very efficacious; but it must be given at the commencement. If he has had dysentery for a day or two, he will be too weak to have a warm bath; then, instead of the bath, try the following:--Wrap him in a blanket, which has been previously wrung out of hot water; over which envelope him in a dry blanket. Keep him in this hot, damp blanket for half an hour; then take him out, put on his nightgown and place him in bed, which has been, if it be winter time, previously warmed. The above "blanket treatment" will frequently give great relief, and will sometimes cause him to fall into a sweet sleep. A flannel bag, filled with hot powdered table salt, made hot in the oven, applied to the bowels, will afford much comfort.

What NOT to do.--Do not give aperients unless it be, as before advised, the castor oil guarded with the opium; do not stuff him with artificial food; do not fail to send for a judicious and an experienced medical man; for, remember, it requires a skilful doctor to treat a case of dysentery, more especially in a child.

105. What are the symptoms, the causes and the treatment of Nettle-rash?

Nettle-rash consists of several irregular, raised wheals, red at the base, and white on the summit, on different parts of the body; but it seldom attacks the face. It is not contagious, and it may occur at all ages and many times. It comes and goes, remaining only a short time in a place. It puts on very much the appearance of the child having been stung by nettles--hence its name. It produces great heat, itching, and irritation, sometimes to such a degree as to make him feverish, sick, and fretful. He is generally worse when he is warm in bed, or when the surface of his body is suddenly exposed to the air. Rubbing the skin, too, always aggravates the itching and the tingling, and brings out a fresh crop.

The cause of nettle-rash may commonly be traced to improper feeding; although, occasionally, it proceeds from teething.

What to do.--It is a complaint of no danger, and readily gives way to a mild aperient, and to attention to diet. There is nothing better to relieve the irritation of the skin than a warm bath. If it be a severe attack of nettle-rash, by all means call in a medical man.

What NOT to do.--Do not apply cold applications to his skin, and do not wash him (while the rash is out) in quite cold water. Do not allow him to be in a draught, but let him be in a well-ventilated room. If he be old enough to eat meat, keep it from him for a few days, and let him live on milk and farinaceous diet. Avoid strong purgatives, and calomel, and grey-powder.

106. What are the symptoms and the treatment of Red-gum?

Red-gum, tooth-rash, red-gown, is usually owing to irritation from teething; not always from the cutting but from the evolution--the "breeding," of the teeth. It is also sometimes owing to unhealthy stools irritating the bowels, and showing itself, by sympathy, on the skin. Red-gum consists of several small papulae, or pimples, about the size of pins' heads, and may be known from measles--the only disease for which it is at all likely to be mistaken--by its being unattended by symptoms of cold, such as sneezing, running, and redness of the eyes, &c., and by the patches not assuming a crescentic--half-moon shape; red-gum, in short, may readily he known by the child's health being unaffected, unless, indeed, there be a great crop of pimples; then there will be slight feverishness.

What to do.--Little need be done. If there be a good deal of irritation, a mild aperient should be given. The child ought to be kept moderately, but not very warm.

What NOT to do.--Draughts of air, or cold should be carefully avoided; as, by sending the eruption suddenly in, either convulsions or disordered bowels might be produced. Do not dose him with grey-powder.

107. How would you prevent "Stuffing of the nose" in a new-born babe?

Rubbing a little tallow on the bridge of the nose is the old-fashioned remedy, and answers the purpose. It ought to be applied every evening just before putting him to bed. If the "stuffing" be severe, dip a sponge in hot water, as hot as he can comfortably bear; ascertain that it be not too hot, by previously applying it to your own face, and then put it for a few minutes to the bridge of his nose. As soon as the hard mucus is within reach, it should be carefully removed.

108. Do you consider sickness injurious to an infant?

Many thriving babies are, after taking the breast, frequently sick; still we cannot look upon sickness otherwise than as an index of either a disordered or of an overloaded stomach. If the child be sick, and yet be thriving, it is a proof that he overloads his stomach. A mother, then, must not allow him to suck so much, at a time. She should, until he retain all he takes, lessen the quantity of milk. If he be sick and does not thrive, the mother should notice if the milk he throws up has a sour smell; if it have, she must first of all look to her own health; she ought to ascertain if her own stomach be out of order; for if such be the case, it is impossible for her to make good milk. She should observe whether in the morning her own tongue be furred and dry; whether she have a disagreeable taste in her mouth, or pains at her stomach, or heart-burn, or flatulence. If she have all, or any of these symptoms, the mystery is explained why he is sick and does not thrive. She ought then to seek advice, and a medical man will soon put her stomach into good order; and, by so doing, will, at the same time, benefit her child.

But if the mother be in the enjoyment of good health, she must then look to the babe himself, and ascertain if he be cutting his teeth; if the gums require lancing; if the secretions from the bowels be proper both in quantity and in quality; and, if he have had artificial food--it being absolutely necessary to give such food--whether it agree with him.

What to do.--In the first place, if the gums be red, hot, and swollen, let them be lanced; in the second, if the secretion from the bowels be either unhealthy or scanty, give him a dose of aperient medicine, such as caster oil, or the following:--Take two or three grains of powdered Turkey rhubarb, three grains of pure carbonate of magnesia, and one grain of aromatic powder--Mix. The powder to be taken at bed-time, mixed in a tea-spoonful of sugar and water, and which should, if necessary, be repeated the following night. In the third place, if the food he be taking does not agree with him, change it (vide answer to question 33). Give it in smaller quantities at a time, and not so frequently; or what will be better still, if it be possible, keep him, for a while, entirely to the breast.

What NOT to do.--Do not let him overload his stomach either with breast milk, or with artificial food. Let the mother avoid, until his sickness be relieved, greens, cabbage, and all other green vegetables.

109. What are the causes, the symptoms, the prevention, and the cure of Thrush?

The thrush is a frequent disease of an infant, and is often brought on either by stuffing or by giving him improper food. A child brought up entirely, for the first three or four months, on the breast, seldom suffers from this complaint. The thrush consists of several irregular, roundish, white specks on the lips, the tongue, the inside and the angles of the mouth, giving the parts affected the appearance of curds and whey having been smeared upon them. The mouth is hot and painful, and he is afraid to suck; the moment the nipple is put to his mouth he begins to cry. The thrush, sometimes, although but rarely, runs through the whole of the alimentary canal. It should be borne in mind that nearly every child, who is sucking, has his or her tongue white or "frosted," as it is sometimes called. The thrush may be mild or very severe.

Now with regard to what to do.--As the thrush is generally owing to improper and to artificial feeding, if the child be at the breast, keep him, for a time, entirely to it. Do not let him be always sucking, as that will not only fret his month, but will likewise irritate and make sore the mother's nipple.

If he be not at the breast, but has been weaned, then keep him for a few days entirely to a milk diet--to the milk of ONE cow--either boiled, if it be hot weather, to keep it sweet; or unboiled, in cool weather--fresh as it comes from the cow, mixed with warm water.

The best medicine is the old-fashioned one of Borax, a combination of powdered lump-sugar and borax being a good one for the purpose: the powdered lump-sugar increases the efficacy, and the cleansing properties of the borax; it tends, moreover, to make it more palatable.--

Take of--Borax, half a drachm; Lump Sugar, two scruples;

To be well mixed together, and made into twelve powders. One of the powders to be put dry on the tongue every four hours.

The best local remedy is Honey of Borax, which ought to be smeared frequently, by means of the finger, on the parts affected.

Thorough ventilation of the apartment must be observed; and great cleanliness of the vessels containing the milk should be insisted upon.

In a bad case of thrush, change of air to the country is most desirable; the effect is sometimes, in such cases, truly magical.

If the thrush be brought on either by too much or by improper food; in the first case of course, a mother must lessen the quantity; and, in the second, she should be more careful in her selection.

What NOT to do.--Do not use either a calf's teat or wash leather for the feeding-bottle; fortunately, since the invention of India-rubber teats, they are now nearly exploded; they were, in olden times, fruitful causes of thrush. Do not mind the trouble of ascertaining that the cooking-vessels connected with the baby's food are perfectly clean and sweet. Do not leave the purity and the goodness of the cow's milk (it being absolutely necessary to feed him on artificial food) to be judged either by the milk-man, or by the nurse, but taste and prove it yourself. Do not keep the milk in a warm place, but either in the dairy or in the cellar; and, if it be summer time, let the jug holding the milk be put in a crock containing lumps of ice. Do not use milk that has been milked longer than twelve hours, but if practicable, have it milked direct from the cow, and use it immediately--let it be really and truly fresh and genuine milk.

When the disease is severe, it may require more active treatment--such as a dose of calomel; which medicine must never be given unless it be either under the direction of a medical man, or unless it be in an extreme case,--such as dysentery; [Footnote: See the Treatment of Dysentery.] therefore, the mother had better seek advice.

In a severe case of thrush, where the complaint has been brought on by artificial feeding--the babe not having the advantage of the mother's milk--it is really surprising how rapidly a wet-nurse--if the case has not been too long deferred--will effect a cure, where all other means have been tried and have failed. The effect has been truly magical! In a severe case of thrush pure air and thorough ventilation are essential to recovery.

110. Is anything to be learned from the cry of an infant?

A babe can only express his wants and his necessities by a cry; he can only tell his aches and his pains by a cry; it is the only language of babyhood; it is the most ancient of all languages; it is the language known by our earliest progenitors; it is, if listened to aright, a very expressive language, although it is only but the language of a cry--

"Soft infancy, that nothing canst but cry."--Shakspeare.

There is, then, a language in the cry of an infant, which to a mother is the most interesting of all languages, and which a thoughtful medical man can well interpret. The cry of a child, to an experienced doctor, is, each and all, a distract sound, and is as expressive as the notes of the gamut. The cry of passion, for instance, is a furious cry; the cry of sleepiness is a drowsy cry; the cry of grief is a sobbing cry; the cry of an infant when roused from sleep is a shrill cry; the cry of hunger is very characteristic,--it is unaccompanied with tears, and is a wailing cry; the cry of teething is a fretful cry; the cry of pain tells to the practised ear the part of pain; the cry of ear-ache is short, sharp, piercing, and decisive, the head being moved about from side to side, and the little hand being often put up to the affected side of the head; the cry of bowel-ache is also expressive,--the cry is not so piercing as from ear-ache, and is an interrupted, straining cry, accompanied with a drawing-up of the legs to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the cry of inflammation of the lungs is more a moan than a cry; the cry of croup is hoarse, and rough, and ringing, and is so characteristic that it may truly be called "the croupy cry;" the cry of inflammation of the membranes of the brain is a piercing shriek--a danger signal--most painful to hear; the cry of a child recovering from a severe illness is a cross, and wayward, and tearful cry; he may truly be said to be in a quarrelsome mood; he bursts out, without rhyme or reason, into a passionate flood of tears--into "a tempest of tears:" tears are always, in a severe illness, to be looked upon as a good omen, as a

"The tears that heal and bless"--H. Bonar.

Tears, when a child is dangerously ill, are rarely, if ever, seen; a cry, at night, for light--a frequent cause of a babe crying--is a restless cry:--

"An infant--crying in the night; An infant crying for the light: And with no language hat a cry."--Tennyson.

111. If an infant be delicate, have you any objection to his having either veal or mutton broth, to strengthen him?

Broths seldom agree with a babe at the breast I have known them produce sickness, disorder the bowels, and create fever. I recommend you, therefore, not to make the attempt.

Although broth and beef-tea, when taken by the mouth, will seldom agree with an infant at the breast, yet, when used as an enema, and in small quantities, so that they may be retained, I have frequently found them to be of great benefit, they have in some instances appeared to have snatched delicate children from the brink of the grave.

112. My baby's ankles are very weak: what do you advise to strengthen them?

If his ankles be weak, let them every morning be bathed, after the completion of his morning's ablution, for fire minutes each time, with bay-salt and water, a small handful of bay-salt dissolved in a quart of rain water (with the chill of the water off in the winter, and of its proper temperature in the summer time); then let them be dried; after the drying, let the ankles he well rubbed with the following liniment:--

Take of--Oil of Rosemary, three drachms; Liniment of Camphor, thirteen drachms:

To make a Liniment

Do not let him be put on his feet early; but allow him to crawl, and sprawl, and kick about the floor, until his body and his ankles become strong.

Do not, on any account, without having competent advice on the subject, use iron instruments, or mechanical supports of any kind: the ankles are generally, by such artificial supports, made worse, in consequence of the pressure causing a further dwindling away and enfeebling of the ligaments of the ankles, already wasted and weakened.

Let him wear shoes with straps over the insteps to keep them on, and not boots: boots will only, by wasting the ligaments, increase the weakness of the ankles.

113. Sometimes there is a difficulty in restraining the bleeding of leech bites. What is the best method?

The difficulty in these cases generally arises from the improper method of performing it. For example--a mother endeavours to stop the haemorrhage by loading the part with rag; the more the bites discharge, the more rag she applies. At the same time, the child probably is in a room with a, large fire, with two or three candles, with the doors closed, and with perhaps a dozen people in the apartment, whom the mother has, in her fright, sent for. This practice is strongly reprehensible.

If the bleeding cannot be stopped,--in the first place, the fire most be extinguished, the door and windows should be thrown open, and the room ought to be cleared of persons, with the exception of one, or, at the most, two; and every rag should be removed. "Stopping of leech bites.--The simplest and most certain way, till the proper assistance is obtained, is the pressure of the finger, with nothing intervening. It cannot bleed through that." [Footnote: Sir Charles Locock, in a Letter to the Author.]

Many babies, by excessive loss of blood from leech bites, have lost their lives from a mother not knowing how to act, and also from the medical man either living at a distance, or not being at hand. Fortunately for the infantile community, leeches are now very seldom ordered by doctors.

114. Supposing a baby to be poorly, have you any advice to give to his mother as to her own management?

She must endeavour to calm her feelings or her milk will be disordered, and she will thus materially increase his illness. If he be labouring under any inflammatory disorder, she ought to refrain from the taking of beer, wine, and spirits, and from all stimulating food; otherwise, she will feed his disease.

Before concluding the first part of my subject--the Management of Infancy--let me again urge upon you the importance--the paramount importance--if you wish your babe to be strong and hearty,--of giving him as little opening physic as possible. The best physic for him is Nature's physic--fresh air, and exercise, and simplicity of living. A mother who is herself always drugging her child, can only do good to two persons--the doctor and the druggist!

If an infant from his birth be properly managed,--if he have an abundance of fresh air for his lungs,--if he have plenty of exercise for his muscles (by allowing him to kick and sprawl on the floor),--if he have a good swilling and sousing of water for his skin,--if, during the early months of his life, he have nothing but the mother's milk for his stomach,--he will require very little medicine--the less the better! He does not want his stomach to be made into a doctor's shop! The grand thing is not to take every opportunity of administering physic, but of using every means of with-holding it! And if physic be necessary, not to doctor him yourself, unless it be in extreme and urgent cases (which in preceding and succeeding Conversations I either have or will indicate), but to employ an experienced medical man. A babe who is always, without rhyme or reason, being physicked, is sure to be puny, delicate, and unhealthy, and is ready at any moment to drop into an untimely grave!

I will maintain that a healthy child never requires drugging with opening physic, and that costiveness is brought on by bad management. Aperient medicines to a healthy child are so much poison! Let me impress the above remarks on every mother's mind; for it is a subject of vital importance. Never, then, give a purgative to a healthy child; for, if he be properly managed, he will never require one. If you once begin to give aperients, you will find a difficulty discontinuing them. Finally, I will only say with Punch,--"Don't"

CONCLUDING REMARKS ON INFANCY.

115. In concluding the first part of our subject--Infancy--I beg to remark: there are four things essentially necessary to a babe's well-doing, namely, (1) plenty of water for his skin; (2) plenty of fresh genuine milk mixed with water for his stomach (of course, giving him ONLY his mother's milk during the first six, eight, or nine months of his existence); (3) plenty of pure air for his lungs; (4) plenty of sleep for his brain: these are the four grand essentials for an infant; without an abundance of one and all of them, perfect health is utterly impossible! Perfect health! the greatest earthly blessing, and more to be coveted than ought else beside! There is not a more charming sight in the universe than the beaming face of a perfectly healthy babe,--

"His are the joys of nature, his the smile, The cherub smile, of innocence and health."--Knox.