Part 22

“Another cause of infantile indigestion, and which is too much overlooked through ignorance of its importance, is vitiation of the quality of the milk, caused by imprudence, neglect, or anxiety on the part of the mother. The extent to which this cause operates in inducing irritation and suffering in the child, is not generally understood; and, accordingly, it is not unusual for mothers to display as much indifference to health, regimen, and tranquillity of mind during nursing, as if the milky secretion, and all other bodily functions, were independent of every external and corporeal influence. Healthy, nourishing, and digestible milk can proceed only from a healthy and well-constituted parent; and it is against nature to expect that, if the mother impairs her health and digestion by improper diet, neglect of exercise, impure air, or unruly passions, she can, nevertheless, provide a wholesome and uncontaminated fluid, as if she were exemplary in her observance of all the laws of health.

“It is no new or uncertain doctrine, that the quality of the mother’s milk is affected by her own health and conduct, and that in its turn it directly affects the health of the nursling. Even medicines given to the parent act upon the child through the medium of the milk; and a sudden fit of anger, or other violent mental emotion, has not unfrequently been observed to change the quality of the fluid so much as to produce purging and gripes in the child. Care and anxiety, in like manner, exert a most pernicious influence, and not only diminish the quantity, but vitiate the quality of the milk.

“It is a common mistake to suppose that, because a woman is nursing, she ought, therefore, to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is to cause an unnatural degree of fullness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to, instead of increasing, the secretion of the milk. The health and usefulness of country nurses are often utterly ruined by their transplantation into the families of rich and luxurious employers. Accustomed at home to constant bodily exertion, exposure to the air, and a moderate supply of the plainest food, they live in the enjoyment of the best health, and constitute excellent nurses. But the moment they are transplanted from their proper sphere, their habits and mode of life undergo an unfavourable change. Having no longer any laborious duties to perform or any daily exposure to encounter, they become plethoric and indolent; and as they are at the same time too well fed, the digestive functions become impaired, the system speedily participates in the disorder, and the milk, which was at first bland, nourishing, and plentiful, now becomes heating and insufficient, and sometimes even stops altogether.”

Cocoa shells, made precisely like coffee, make a very pleasant and nutritious drink for nursing females.

Weaning.—“Diet for infants after weaning may be pure milk, two parts, water, one part; slightly sweetened. This,” says Combe, “makes the nearest approach to the nature of the mother’s milk, and, therefore, is more suitable than any preparation of milk and flour, or any other that can be given.” A child, as a general rule, one year old, ought to be gradually weaned, and the appearance of the teeth shows the propriety of giving food a little more substantial than milk. Bread a day old, mixed with milk and sweetened, may be given in connexion with nursing. Gruel, arrowroot, plain bread, Indian and rice puddings as they grow older, and subsequently bread and butter, thickened milk, hasty pudding or Indian, potatoes, and vegetables. Not a particle of flesh should ever be given. By the use of meat the system becomes excited, and diseases of irritation are apt to be produced, which impede nutrition, and lead ultimately to the production of scrofula and other organic changes in the glands and bowels, and not unfrequently also in the brain and lungs. In these instances the child generally eats heartily, but, nevertheless, continues thin, and is subject to frequent flushing and irregularity of the bowels, headache, and restlessness. His mind partakes of the general irritability of the system, and peevish impatience takes the place of the placid good humour natural to healthy childhood. In this state the ordinary diseases of infancy—measles, scarlet fever, and hooping-cough—are often attended with an unusual and dangerous degree of constitutional disturbance; and when inflammation takes place it is borne with difficulty, and the system does not easily rally; or the digestive organs become irritated, and the various secretions immediately connected with digestion are diminished, especially the biliary secretion. Constipation of the bowels soon follows; congestion of the hepatic and abdominal veins succeeds, and is followed by the train of consequences which have already been detailed. In reality the wonder comes to be, not that so many children die, but that so many survive their early mismanagement. A morbid condition of the system arises, extremely favourable to the production of scrofulous, consumptive, dyspeptic, and other diseases, under which, perhaps, the infant sinks; and yet, strange to state, parents will stuff their children with flesh and grease two or three times a day.

Says Combe, “One of the most pernicious habits in which children can be indulged is that of almost incessant eating. Many mothers encourage it from the facility with which, for a time, the offer of ‘something nice’ procures peace. Even from infancy the child ought to be gradually accustomed to eat only when hungry, and when food is really required. After two years of age an interval of four hours between meals, will rarely be more than enough; and to give biscuit, fruit, or bread, in the meantime, is just subtracting from the digestive power of the stomach. Like almost every organ of the body, the stomach requires a period of repose after the labour of digestion; and accordingly, in the healthy state, the sensation of appetite never returns till it has been for some time empty. To give food sooner, therefore, is analogous to making a weary traveller walk on without the refreshment of a halt.”

“When we reflect that the object of digestion is, to furnish materials for the growth of the body, and to supply the waste which the system is constantly undergoing, it must appear self-evident that, if the digestive powers be impaired by disease, by improper quantity or quality of food, or by any other cause, the result must necessarily be the formation of an imperfect chyle, and, consequently, of imperfect blood. The elements of the blood are derived from the chyle, and, if it be vitiated, the blood also must suffer: if the blood be diseased, so must necessarily be all the organs which it supplies; and if the body be thus debilitated, can any wonder be felt that it should no longer be able to resist the action of offending causes which full health alone can withstand?”

Clothing.—Infants and children are often injured by improper clothing. It is customary for some nurses to wrap them in such a quantity as to injure their health; moderation in this respect should be observed, due regard being paid to that which is sufficient to render them comfortable. Infants, when first born, have clothing enough almost to smother them.

Medicine.—Another very reprehensible custom is, to pour down some nauseous drug, such as paregoric, Godfrey’s cordial, or some other articles, every time the child begins to cry or is fretful, by which it becomes habituated to the use of opium, and makes it necessary to increase the dose in order to produce the same effect.

Another injurious practice is to give frequently worm lozenges (the basis of which is calomel or mercury) upon any attack of illness, under the impression that the disorder is occasioned by worms. By this imprudent course both the health and life of the child are endangered. Therefore those who wish to bring up their children in a healthy condition must avoid these evils, and be content to follow the simple path of nature and common sense.

Few things tend more to the destruction of children than drenching them with drugs. Medicine may be sometimes necessary for children; but that it injures them ten times for once it does them good, I will venture to assert. A nurse or mother, the moment her child seems to ail anything, runs immediately to the doctor or the apothecary, who throws in his powders, pills and potions, till the poor infant is poisoned; when the child might have been restored to perfect health by a change of diet, air, exercise, clothing, or some very easy and simple means.

Care must be taken to keep the bowels regular, which may be effected in most cases by the milk of the mother alone. Most of the complaints in children arise from flatulence or wind; to remove which give common catnip or fennel seed tea, let them drink it freely, and let the mother regulate her diet.

When children complain of pain in the stomach and bowels, it may be necessary sometimes to give a moderate dose of vegetable physic; senna and manna is very good; after the operation of physic let the diet be attended to. Green fruit must be avoided, and whatever is hard of digestion. The feet should be often bathed in warm water, the bowels must be fomented with bitter herbs, and it is also necessary to give the child sufficient exercise in the open air.

Bathing should never be neglected, as it contributes much to health. Many complaints of the skin and the system are caused by the neglect of this practice. Filth collects on the surface, obstructs perspiration, which retains morbid humors, and which are thrown upon some of the internal organs and create irritation. Is it not owing to this that infants fret and cry so much? Daily bathe with tepid water; this is also good for galling, chafing, excoriations, &c.

Pure Air and Exercise.—This is very necessary; impure and confined air with the want of exercise, causes disease; and hence children in cities are more pale, feeble, and sickly than those who live in the country and breathe pure air and play in the dirt. Confining children at home, in low, confined, dirty houses, cellars, and in school-rooms, is pernicious; also crowding too many in sleeping-rooms. When children are confined in small apartments, the air not only becomes unwholesome, but the heat relaxes their solids, renders them delicate, and disposes them to colds and many other disorders. Nor is the custom of wrapping them too close in cradles less pernicious. One would think that nurses were afraid lest children should suffer by breathing free air, as many of them actually cover the child’s face while asleep, and others wrap a covering over the whole cradle, by which means the child is forced to breathe the same air over and over all the time it sleeps. Children, therefore, must have as much exercise and air as possible, and should be employed in something useful and interesting.

Again; “The premature exertion of intellect to which the mind is stimulated at our schools, by the constant emulation and vanity, far from strengthening, tends to impair the health and tone of the brain, and of all the organs depending on it; and hence we rarely perceive the genius of the school manifesting in future years any of the superiority which attracted attention in early life.”

BARRENNESS.

Sterility proceeds from either a temporary or permanent incapability of conceiving or retaining the embryo, till it acquires a form. The causes producing this incapability, may consist in some malformation or deficiency of the womb, or its appendages, which cannot always be discovered during life, or in merely a weakness in the action of the womb. This last is by far the most frequent cause, and it is occasioned by local weakness of the womb, or general affections of the whole system; and is marked usually by an obstruction, deficiency, or redundancy of the menstrual evacuation, or by the complaint termed female weakness.

It may be considered as highly probable, that the absence of the capacity to be impregnated, will sometimes depend upon the imperfect condition of either the uterus itself or of the ovaries. If the former, it may consist in some derangement of the secreting surface of this organ; for, though there may be a regular discharge of a colored fluid, and this so nearly resembling the perfect secretion as to deceive the senses, it may yet want an essential condition or quality, and thus entail barrenness—hence, all women are not fruitful who may have a regular catamenial discharge; though, as far as can be determined by appearances, this discharge is every way healthy, and at the same time, the ovaries free from fault.

If it depend upon an imperfection of the ovaria, it may not, perhaps, admit of relief. The diseases of the ovaria may consist, 1st, in their imperfect development; 2dly, in derangement of structure; 3dly, in a want of a healthy organization of the ova themselves. Now, either of these conditions of the ovaria may be so complete as to altogether destroy their influence upon the secreting surface of the uterus; the catamenial discharge may, therefore, continue, with all due regularity, and yet the woman may be barren; and, hence, this discharge cannot be considered, rigidly, as a constant sign of fertility.

Yet it may be safely admitted, as a general rule, that women who menstruate regularly without pain, or the expulsion of coagula, or false membrane, are fecund; and that the reverse of these conditions is almost sure to be attended with sterility. It may also be observed, that we cannot attach much consequence to the quantity evacuated; for the woman who may evacuate double the quantity of another, is not for this reason more certainly prolific. I have known a number of instances of repeated impregnations, where, as far as could be ascertained, not more than two ounces were habitually evacuated; and this not occupying more than a day and a half, or two days, for its elimination: while, on the contrary, I have known women who were barren, discharge three or four times this quantity; and the fluid bear all the sensible marks of a healthy secretion. From this it would appear, that mere regularity in returns, the elimination of a proper quantity of fluid, and this fluid apparently of a healthy character, do not always declare the woman to be fecund. Yet, when the woman has never menstruated, or when this discharge has altogether ceased, agreeably to the ordinary arrangement of nature, or from disease, she either never becomes impregnated, or ceases to become so, if she ever have been.

We proceed on the principle of rectifying the constitution, where it is injured or weak, and of restoring the menstrual evacuation, to its due and healthy state. The means for effecting these purposes, must depend on the situation of the individual.

Causes.

There are chiefly two states of the constitution productive of those deviations in the action of the womb, which cause barrenness. The first is a state of fulness, and a disposition to obesity.

The person gradually becomes fat and inactive, the menstrual evacuation continues regular for some time; but at last diminishes, and becomes obstructed, or goes to the opposite extreme, and becomes frequent or profuse. The patient is either barren or subject to false conceptions. This state is to be rectified by spare or vegetable diet, total abstinence from malt liquor, regular and constant exercise, especially early in the mornings and on horseback, the prudent use of laxatives, and after some time the cold bath. These means will, if persisted in prudently, effect the desired changes; but if pushed to an undue degree, and especially if repeated purgatives, and much vinegar, or great abstinence be resorted to, the health may be completely ruined.

The second state is that of relaxation; the habit is spare, instead of corpulent; the mind lively, and, perhaps, even irritable; the menstrual evacuation either profuse, or it recurs too frequently, and at times clots and shreds are discharged.

This requires a different treatment: the diet, if not unusually nutritive, is at least not to be sparing, the exercise must not be carried the length of fatigue, the cold bath is useful, and strengthening medicines are required.

Such remedies as have been pointed out for the removal of irregularities of the menstrual evacuations, or of the fluor albus, must be employed when necessary.