Part 39

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

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

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

Of the Meconium.

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

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

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

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

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

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

Of Acidities, or sharp Humours.

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

Or, for Want of it, the solutive Syrup of Roses. K.

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

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

The Magnesia is an excellent Substitute in Children, for these Oils Dr. Tissot so justly condemns here. K.

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

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

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

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

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

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

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

Of washing Children.

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

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

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

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