The management of infancy, physiological and moral : intended chiefly for the use of parents

Front matter

I

■MM o IUUSRAEar °

Gift of

Chapter I

INFLUENCE OF THE CONSTITUTION OF PARENTS ON THE HEALTH OF THEIR CHILDREN.

Page

Influence of Hereditary Constitution upon the Offspring, . 1

Conditions in the Parents which affect the Health of the Child, 2

Manifestations of the Influence of Original Constitution, 4

Marriage of Persons too nearly allied in Consanguinity, . 9

Age at which Persons marry, ... 10

Influence of the State of the Parents on their Offspring, 12

Chapter II

INFLUENCE OF THE MOTHER'S MODE OF LIVING DURING PREGNANCY ON THE HEALTH OF HER CHILD.

State of Mind, Health, and Conduct of the Mother during

Pregnancy, .... .18

Influence of Mental Emotions — Longings, . 19

Circumstances which require attention during Pregnancy, . 26 Diet during Pregnancy, ... .27

Moderation and simplicity of Diet necessary, . . 31

Necessity of the Mother's resisting Morbid CravingB, 33

Arrangement of the Dress during Pregnancy, . . 34

Excellent effect of Exercise during Pregnancy, . 36

Beneficial influence of Tepid Bathing, . . 37

Management of the Breasts towards the end of Pregnancy, . 38

i2

XXX

CONTENTS.

Chapter III

GREAT MORTALITY IN INFANCY PRODUCED BY REMOVABLE CAUSES, AND INCREASED BY PARENTAL IGNORANCE.

Enormous Mortality within the first Five Years after Birth,

Extent of Infant Mortality estimated by Dr Farr,

Causes of Infant Mortality,

Value of Sanitary Measures in Improving the Health of

Towns, .

Decline of Infant Mortality during the past Century, Knowledge necessary to Mothers to prevent such Mortality,

51 52

Chapter IV. Infant Health Not Accidental, But Dependent On Fixed Laws

Infant Constitution described, . . 59 Disease and premature Death the result of the infringement of the natural Conditions of Health, . 60 Causes of Bad Health in Infants, . . 62 Religious aspects of Disease, ..... 63 Necessity for Physiological Knowledge, 64

Chapter V. On The Constitution Of The Infant At Birth

Causes which act directly on the Health of the Infant after

Birth, ....

Commencement of Respiration in Infants, High Nervous Sensibility of Infants, . Circulation of the Blood, and Supply of Animal Heat. Scanty Supply of Animal Heat in Infancy, . Little Power of resisting External Cold, Infants must be protected from Cold, . Commencement of Digestion by Infants, Nature of the Food of Infants, Organs of Excretion — Bowels, Kidneys, Skin, and Lungs.

CONTENTS. XXxi

Page

On Perspiration from the Skin, and Exhalation from the Lungs, 7 7

Noxious Influence of Animal Effluvia, . 78

Organic and Animal Functions of the Body, . 79

Characteristic Qualities of Man, . 81

Adaptation of the Organism to External Conditions, 82

Chapter VI. Management Of The Infant Immediately After Birth

Infant should be wrapt in soft, warm Flannel, 85

First "Washing of the Infant, ... 86

Great Care necessary to protect the Eyes, . 86

Temperature of the "Water, . . 87

How to dry the Infant, . 87

Application of Flannel Bandage, 87

Qualities required in the Dress of Infants, . 88

Great Utility of Flannel Clothing, . 89

Excessive Wrapping, and too hot Rooms, to be avoided, . 89

Proper Bed-Clothing during the Night, . 91

Chapter VII. On The Food Of The Infant

Appetite for Food, . . .93 Nature and Action of the Mother's first Milk, . 95 Intervals between Suckling, .... 97 Regular Periods ought to be observed from the earliest Infancy, .... . 97 Suckling during the Night, ... 99 Necessity of attending to the Diet of the Nurse, . 100 Milk of the Mother the best Food for the Infant, . . 101 The Mother the best Nurse, ... 103 Mode of Life of the Mother when Nursing, . 105 Best Supplementary Food for Infants, 107 Appearance of the First Teeth, . 108 Food of Infants before "Weaning, . 109 Best Time and Manner of Weaning, . . 110 Sources of Danger during Weaning, 113 Caution against the Abuse of Medicines, . 114

XXXll CONTENTS.

Chapter VIII. Cleanliness, Exercise, And Sleep, In Infancy

Page Secretion of Oily Matter from the surface, . .116 Daily Washing and Bathing of the Child, . 118 Temperature of the Water to be determined by a Thermometer, ..••■• 11"

Advantages of an Evening Tepid Bath, . 120 Cold Baths objectionable, . . 121 Exercise of the Infant, . 122 Exercise in the Open Air, 124 Precautions to be observed, . 125 How to lift young Children, ... .126 Curtailment of the Dress, so as to allow the Child to crawl

and exercise its Limbs, ... . 127

Premature attempts to Walk injurious, 128

Management of Sleep during Early Infancy, . 129

Length of Time for Sleep, . . .130

Regularity of Sleep to be cultivated, 131

Causes of Sleeplessness, . . 133

Chapter IX. Choice And P.egimen Of A Nurse

Qualities which ought to determine the Choice of a Nurse, 135

Causes disqualifying the Mother for Nursing, 137

Physician should decide on the Choice of a Nurse, . 141

Faults of Nurses, . . 143

Chapter X. Artificial Nursing

Danger and Difficulty of Rearing Children " by the Hand," 147

Most suitable Kind of Nourishment, . . . 148

Temperature at which the Food should be given, 149

Manner of giving the Food, . . . 149

Necessity for always using fresh Food, . 150

THE AUTHOR'S DEDICATION.

SIR JAMES CLARK, Bart., M.D., F.R.S.,

PHYSICIAN IN ORDINARY TO THE QUEEN, AND TO HIS ROYAL HIGHNESS PRINCE ALBERT.

My dear Sir James,

Two reasons, the one of a personal and the other of a professional nature, induce me to dedicate this treatise to you. I gladly embrace the opportunity which it affords me of publicly expressing my regard for you, as a friend whom I have long and intimately known, and whom, during years of constant and unreserved intercourse, I have ever found, even in the most trying circumstances, animated by the purest integrity, and the kindliest and most benevolent dispositions.

On professional grounds, too, there is perhaps no one to whom I could so appropriately dedicate a work intended to call attention to that comparatively unoccupied, but most important field of medical inquiry, which embraces the hygienic treatment of man, — as to you, who have already laboured in it with great ability and success. Tor many years, not only have you taken a. deep and active interest in the improvement of medical education, and in elevating the character, extending the scope, and increasing the usefulness of our profession ; but, acting on the same principles which I have endeavoured to enforce, you have, in your excellent works on Climate and Consumption, rendered no small service to science, by your instructive exposition of the manner in which fatal disease of the lungs so often, and so insidiously, originates in apparently trifling causes connected with disregard of the ordinary laws of health. You have further

THE AUTHOR'S DEDICATION.

shown, that when Medicine shall he cultivated in a more liberal and comprehensive spirit, and its principles be recognised as furnishing the only solid foundation for a proper system of physical, moral, and intellectual education, it will become one of its noblest uses, and, I may add, one of its greatest privileges, to be instrumental, not more in the prevention of disease and suffering, than in contributing to the general happiness and permanent advancement of the human race.

Even as regards the special subject of the present volume, you were the first, in your treatise on Consumption, to insist strongly on the necessity of adopting a proper system of management from the very commencement of infant existence, as the only effectual means of averting that general deterioration of health in which the fatal pulmonary disease has its origin, and of procuring for the individual that measure of health and vigour without which life and its varied duties become sources of suffering rather than of enjoyment. In your volume, accordingly, are to be found many instructive details on the hygienic management of both infancy and youth ; and it affords me no small gratification to know, that, while pursuing independently the same ends, we, unknown to each other in the outset, chose nearly the same paths, and arrived together at entirely consistent and not unfrequently identical results.

To you, therefore, on both public and private grounds, I have peculiar satisfaction in dedicating this work, as a mark of esteem and regard, of which, however intrinsically unimportant and inadequate it may be, I know few in every way so worthy as yourself.

Believe me to remain always,

My dear Sir James,

Yours very sincerely,

ANDREW COMBE.

Edinburgh, 10(A May 1840.

THE AUTHOR'S INTRODUCTION.

Many excellent treatises on the management of infancy already exist ; yet few of them are calculated to supply parents with the kind of information which, in their circumstances, is especially needed. Most of those hitherto published touch briefly upon the general management of early childhood, merely as preliminary to an exposition of its diseases ; and the perusal of them by non-professional persons frequently leads to dangerous tampering with the lives of the young. On this account, I cannot but consider them as improper guides for any except medical readers. Those again which, as intended for the use of mothers, are free from this objection, — even when abounding, as many of them do, in good sense and excellent practical advice, — lose much of their value and usefulness from presenting their rules and admonitions as so many abstract and individual opinions, and omitting to connect them with the physiological laws or principles on which they are based, and according to which the effects are produced.

Sensible of these imperfections as detracting from the usefulness, as guides for the non-professional reader, of many works in other respects of great merit, I had almost resolved, several years before the publication of the first edition of this book, to enter upon the preparation of a treatise on a more comprehensive plan, and which should, on the one hand, avoid all descriptions of disease, and, on the other, found its precepts, at every possible point, on well ascertained physiological principles. Under the apprehension, however, of being unable so to simplify the subject as to render it easily in-

b

XXvi THE AUTHOR'S INTRODUCTION.

telligible to the general reader, I refrained from putting together the materials which had accumulated in my hands ; till at length, encouraged by the very favourable reception of my other works on subjects somewhat analogous, and by the numerous testimonies I received of their practical utility, I set seriously to work, and completed the present volume. That it has, at least in some measure, supplied a want extensively felt, may fairly be inferred from the very favourable reception which it has met with both at home and abroad, and also from the spontaneous testimony of many parents and others in different ranks of life, speaking from experience of the deepened sense of the importance of their duties which its perusal had awakened in their minds, and of the comfort and assistance which they had derived from it in the management of the young entrusted to their care.

Bacon has not less profoundly than felicitously remarked, that " Man is but the servant and interpreter of nature, and is limited in act and understanding by the extent to which he has observed the order of nature : beyond this, neither his knowledge nor his power can extend." In accordance with the spirit of this aphorism, it has been my constant endeavour, in the present, as in all my other writings, to allow as little as possible to rest on mere human opinion, but to show a foundation for every rule, precept, and injunction, in the laws of the human constitution, and consequently in the will of the Creator. The obvious advantage of this mode of proceeding is, that, when we once succeed in discovering any truth, that truth will ever afterwards be regarded as an emanation of the Divine will, and the practical rules deducible from it claim our obedience with an authority which we cannot dispute. "Whereas, if we pass on from subject to subject, and precept to precept, disregarding the relations of facts to each other and to the laws of the constitution, we may add, it is true, much information to our store, but shall often be led to form a very erroneous estimate of its value, and be beset with difficulties in applying it with promptitude and decision to its proper vises, where, rightly directed, it would conduce to the happiest results.

To illustrate this proposition, we may compare a person who undertakes the management of the human constitution, whether in infancy

THE AUTHOR S INTRODUCTION. XXT11

or in maturity, without any reference to the principles under which it acts, to a traveller who, without a map or a guide, wanders over a new country in search of some particular place. By some lucky chance, he may stumble at once upon the locality he is in search of, or reach it at length by some very circuitous route. But the probability is, that, after wandering about in uncertainty, he will be forced to return, weary and disappointed with the fruitlessncss of his journey. He, on the contrary, who is guided by principle, may be likened to a traveller who, carrying with him a map in which the chief features of the country are accurately laid down, advances with comparative certainty towards his aim. If at any time, in consequence of omissions or slight inaccuracies, he chances to wander from the right course, the map itself soon warns him of the fact, and at the same time affords him the means of correcting the very error caused by its own imperfections.

It is, then, en the habitual application of principle to the inculcation and advancement of knowledge, more than on any novelty of detail, that the present volume rests its claim to attention. If I have been even partially successful in establishing the utility of principle in conducting inquiry, I shall not only have assisted in giving a more profitable direction to the labours of others in the same field, but have provided the best means for speedily detecting and rectifying errors inadvertently committed either by them or by myself.

In the following pages I have addressed myself chiefly to parents and to the younger and more inexperienced members of the medical profession ; but it is not to them alone that the subject ought to prove attractive. The study of infancy, considered even as an element in the history and philosophy of man, abounds in interest, and is fertile in truths of the highest practical value and importance. In this point of view, it can scarcely fail to arrest the attention of any thinking and intelligent mind which is once directed to it.

In taking leave of a subject which I cannot but feel to be one of vital interest to thousands yet unborn, I would respectfully offer one or two remarks on the spirit in which the following pages ought to be read. It has qflen happened to me to hear myself quoted as the xxviii THE author's introduction.

authority for modes of infant management not only unwarranted by, but in some instances actually opposed to, the principles I had expounded. On inquiry, it almost invariably appeared that, instead of the speakers being really familiar with the contents of the book which they professed to follow, or being in the habit of frequently referring to its pages for information when wanted, they fancied they had fulfilled their part by merely reading it once ; and on this as- Bumption they proceeded thenceforth to act on their own vague recollections of what it contained, as if these had been true and accurate transcripts of the book itself. But the subjects treated of embrace so many important facts and principles of action, which are comparatively new to the general reader, that it is only by their careful and repeated study, and, in time of need, turning again and again to the pages in which they are explained, that a, mother can become so familiar with them as to be able to apply them with ease and judgment to the many purposes for which they are adapted. Indeed, it is only by pursuing a sirnijar course that medical men themselves acquire that ready command of their knowledge which enables them at once to decide what ought to be done in any emergency ; and surely the interest of a mother in her own offspring ought to be as strong an incentive to her to qualify herself for her arduous task, as a love of science or a sense of duty is to the practitioner. To read a book like this merely as one reads a novel or a newspaper, can be of but little solid or permanent advantage ; and therefore, while I value highly the tribute of approval implied in endeavouring to act upon the principles I have unfolded, I feel indifferent to even the most eloquent and laboured eulogium, when it is not accompanied by those practical results which are the best guafentees of its sincerity. I am the more anxious to enforce this view, because many will, I believe, read the work with increased interest and advantage, after their attention has been thus directed to its true aim and character.

A. C.

Edinburgh, June 1847.

contents. xxxiii

Page Quantity of Food to be given at one time, 151

Change of Diet sometimea required, 152

Chapter XI. The Nursery, And Conditions Required In It

Situation and Qualities of a good Nursery, 155

Site of the Dwelling-House, . . . 157

Influence of the Soil on which it stands, 159

Proper Position of the Nursery, 160

Proper Ventilation of the Nursery, 161

Temperature to be preserved in the Nursery, 167

Chapter XII. Management Of The Infant During Teething

Changes in the Organism of the Infant, 170 The Temporary or Milk Teeth, . 172 The Permanent Teeth, . 1 72 The two Stages of Teething, . 173.

Management of the Infant during Teething, . 175 Use of the Tepid Bath, and Regulation of Diet, during Teething, . . . 177 Causes of Irritation to be avoided, 178 Medical Advice to be got when necessary, 178 The second Dentition, . 180 Importance of Preserving the Teeth, 181

Chapter XIII

MANAGEMENT OF THE CHILD FROM WEANING TO THE END OF THE SECOND YEAR.

Time to Wean a Child, . . 182

Great Mortality during the First and Second Years of Life, 183

Causes of Mortality during the Second Tear, . 183

Diseases mainly connected with the Digestive Organs, . 185

Errors in Diet at this period, . 185

Kind of Diet required, . 187

Regularity as to Time of Meals, . 189

XXXIV CONTENTS.

Tago

Regulation of the Quantity of Food, . 190

Some Variety in Food necessary, ■ 191

Cleanliness — Temperature of Bath, . • • - 19 -

Good Effects of Bathing, . . . 193

Dress Proper at this Stage of Infancy, . • 19S

Exercise and Pure Air indispensable, . 196

Premature Attempts at Walking to he forbidden, . 197

Best Time of Day for Exercise out of doors, . . 197

Infants should be well clothed when in the open air, 197

Due regulation of Sleep at this age, ... 198

Time for weaning from day-sleep, • 198

Children should not lie in bed after waking, . . .198

Each child should have a separate bed, . . 199

Bad practice of hushing Infants to sleep, . 199

Management of Infants during illness, . . . 201

Great injury done by ignorantly administering medicines, . 201 Erroneous notions of Mothers and Nurses as to the nature of

Folly of taking everybody's advice, and deceiving the Medical

Attendant, 203

Reasons for candour towards him, .... 205

Invalid Children should be placed in a quiet, well-aired room, 206 Mismanagement of Diet during illness, . . . 207 Bad effects of delaying too long to procure Medical Assistance, ....... 207

Rules to be attended to in sending for the Physician, 208

Impropriety of making him a bugbear in the Nursery, 208

Chapter XIV. Mental Constitution, And Principles Of Training In Infancy

Education should aim at the Development of a Sound Mind

in a Sound Body, . . . .211 Evils from Neglecting the Natural Conditions of Vigour of

Mental Constitution of Infants, . . 212

Education of the External Senses, . . 213

Cause of Short-sightedness, . . 217

Education of the Emotional and Intellectual Powers, 218

State of the Mind and Brain in Infancy, . . 218

CONTENTS. XXXV

Page Use of Phrenology in Education, .... 223 Each Faculty to be cultivated by applying to it its natural

Moral Training should be early begun, . . • 231

Necessity of Knowledge of the Nature and Objects of the

Mental Faculties, . . .232

Chapter XV. Moral Education In Infancy And Childhood

Moral Education begins soon after Birth, . . . 236

Opposite Errors of indulging every Wish, and of suppressing

all independent Action in Children, . . . 237 Danger of delaying Moral Education, . . 238 Errors in the Moral Management of Infancy and early Childhood, ....... 239

Lesson taught us by the Lower Animals in this respect, . 241 Cultivation of the Power of Self-action and Self-regulation

in Children, ...... 240

Chapter XVI. Further Remarks On The Moral Management Of Infancy And Childhood

Great Influence of Example on Children, . . . 247 The Passions and Moral Emotions not implanted by Intellectual Cultivation, ...... 249

Influence of the Mother, ... .252

Importance of well-conducted Infant Schools, . . 253

Necessity of training Teachers, .... 255

Religious Education of the Young, .... 257

Variety of Educational Influences, . . . 265

Every Mental Faculty should be exercised, . . . 267

Importance of Variety of Occupation, . . . 269

Progressive Development of the Mental Faculties, . . 271

Error of over-exciting the Nervous System of Children, . 273

Spoiling Children, ...... 274

Manner of avoiding this, ..... 275

Picture of a well-trained Child, .... 276

The Formation of Character takes place according to the

fixed laws of the Human Constitution, . . . 277

XX XVI CONTENTS.

Appendix

Page

A. Kesults of Marriages of Consanguinity, . 281

B. Diseases of Infancy, . . . 282

C. Composition of Milk and other Substances used for Food, 286

D. Indications afforded by Dentition, of the Constitutional

Development of the Child, .... 294

E. Medical Opinion on the Importance of Teaching Physio-

logy and the Laws of Health in Common Schools, 296

Index, _ 999

THE

MANAGEMENT OF INFANCY.