Part 41

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

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

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

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

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

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

This very important Consideration, on which I have treated pretty largely, in the Analysis, seems not to be attended to in Practice, as frequently as it ought. K.

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

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

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

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

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

General Directions, with Respect to Children.

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

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

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

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

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

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

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

I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion.

Sec. 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water.

Sec. 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty.

Sec. 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible.

If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed.

Sec. 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit.

I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person.

When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases.