On the management and disorders of infancy and childhood : a treatise embracing the whole subject of maternal management from birth with hints to young mothers for the management of themselves, as well as their offspring

Front matter

22102238789

~x

Med

Preface

Every reflecting and experienced person will acknowledge that the subjects treated of in this volume are of the first importance to the welfare of society, — that young mothers are unavoidably ignorant of much that it is necessary for them to know, — and that they may easily obtain by reading such information on these points as they could scarcely obtain by asking. The author, therefore, hopes that by these sheets he is contributing towards the public good. Large as his publication on Domestic Medicine is, it has been impossible to compress into its pages the information, directions, and prescriptions here embodied ; and consequently he has been compelled to present them in a separate volume, which he designs to be supplementary and a companion to that larger work.

Since in the Domestic Medicine he has entered fully into the consideration of almost all diseases, the reader cannot expect that he should treat of them generally so much at length in this volume ;

a 3

VI

PREFACE.

but valuable additional matter, referring to the most common and dangerous complaints, is here supplied, which he hopes will be found veryuseful.

He has no design by this, or any other of his publications, to make people their own physicians,— to supersede the regular medical adviser ; but only to furnish such information as may be acted on with benefit in his absence, and as will materially assist parents and friends to carry out the medical instructions in the best manner. Of course in all severe attacks of disease, a professional man should be sent for without delay.

Woodcote End House, Epsom, June, 1865.

Introduction

Professional men averse to popular instruction on matters of health and disease — unreasonableness of this — Knowledge of diseases and their treatment useful and necessary to all parties — Errors in treatment of fever — Importance and vitality of the blood — Surprising changes in medical opinions and practice — Such changes and differences no reason for distrust of the profession — As great errors found among divines and lawyers — Medical aid not always at hand — Intelligence and information in the parent required to fulfil the medical instructions — The profession great benefactors of mankind 1 — 15

Chapter II. Conditions Op The Parents Affecting The Offspring

Delicate structure of an infant — No creature half so helpless as a child — Hereditary qualities exert visible influence on the constitution of children — Effects of intermarriage with near relations — Like produces like — Corporeal defects are propagated — Mental defects are propagated — Effects of the law of crossing in the Irish, South Americans, Maroons — Premature marriages — Early marriages desirable — Influence of habitual bad health of parents — Clever men often have stupid children. 16 — 57

Chapter III. Conditions In The Mother Affecting The Health Of

THE CHILD.

Important that the mother should guard against gloomy im pressions — ’Strong drinks injurious — Free exercise useful — Effects of longings — Effects of agitation in the mother — Hobbes’s timidity — Influence of food on the quality of the blood — The mother’s diet should be moderate and simple — Tight-laced corsets very injurious — Preparatory treatment of the breast — Dress to be accommodated to the new situation— Rules to prevent miscarriage and promote easy delivery 58—84

Chapter IV. Management Of The Infant Immediately After Birth

Reception of the infant — Washing and dressing — Precautions against cold— Best mode of washing — Precautions regarding the eyes, skin and temperature, &c. — Drying — Navel string — Dress of the child — Qualities required in infant clothing

Vlll

CONTENTS.

— Care required for delicate infants — Bleeding of the navel-string — Apply the infant to the breast within twelve hours — The head to be kept cool — Short and small nipples — — Irregular nursing a great evil — Purging off the Meconium 85 — 108

Chapter V. Hints For The Mother’s Management Of Herself During The Month

The mother must avoid sitting up early, &c. — She should cooperate with her professional attendant in all things — Diet during the month — Wine and spirits very hurtful- — Treatment of sore nipples— Wansbrough’s metallic shield excellent — Uncontrollable flow of milk — Treatment of milk abscess, the cold treatment generally the best — Management of the lying-in room. 109 — 123

Chapter VI. Management Of Infants As To Food Immediately

AFTER BIRTH.

The milk of the parent the best food for the infant — Suckling beneficial to the health of the mother — Dr. J. Clarke’s opinion— Regularity in nursing important — Intervals between suckling — Feeding infants with pap highly dangerous — Management of the infant when restless, if sleeping in its mother’s room — Recapitulation of Rules applicable to the mother and child during the month 124 — 141

Chapter VII. Of The Nursery

The nursery ought to be dry, airy, light and cheerful — Should have a southern aspect — Children should rise early and sleep in separate beds — The use of the cradle — A moderate uniform temperature desirable — Cooking in the nursery to be forbidden—Pure air a sedative and tonic of the highest importance— Proofs and illustrations — Perfectly dry soil of great importance. 142 — 163

Chapter VIII. Of The Employment Of A Wet-nurse

Principles to be observed in the selection of a nurse — Qualities required in a nurse — A good moral physiognomy a great recommendation — The nurse ought to resemble the mother in constitution, age, and time of delivery — Red-haired

women not fit for nurses — Moral qualities of a nurse of pre-eminent importance — They ought to be able to set a good example — Diet of wet-nurses — Too stimulating a diet diminishes the milk, with an illustration — Some professional

CONTENTS.

IX men prefer bringing up by hand to the employment of a wet-nurse — Nurses frequently give infants laudanum — Proofs and illustrations — Selfishness of nurses. 164 — 197

Chapter IX. Op Artificial Nursing And Weaning

When artificial nursing should be resorted to — The kind of food to be given — The food is to be accommodated to the age and strength of the child — Rearing by hand — Mode of feeding the infant — Feeding Bottle, an improved method — Nourishment proper in rearing by hand, intervals and quantity — Analysis of the milk of woman, the cow, &c. — Sometimes milk and the farinacea disagree with the child, then we give broths — Description of different kinds of farinaceous food — Time and manner of weaning — Precautions required — The food still to be very simple — Sometimes the infant will so pine after the breast that it must be restored, with an illustration — Pregnancy during suckling 198—255

Chapter X. Of Air, Exercise, Bathing, Clothing, And Sleep

The skin a highly organized structure — Numerous glands are disposed in its substance, destined to throw off both fluid and solid matter — An absorbing as well as a secreting surface— Respiration — Pure air equally necessary to children as good food — Exercise — Various kinds of exercise proper for young children — Valuable remarks of Dr. Moore — Adam Smith’s facts and opinions often as worthless as his philosophy— Bathing — Clothing, shoes and diapers — Neck and arms ought to be clothed — Sleep. 256 — 299

Chapter XI. Management Of Children During Teething

Names and positions of the teeth, and order of development — The milk teeth appear first — The teeth have nerves, blood-vessels, and absorbents — First symptoms of teething — Management required before and during teething most important— Pure air, and simplicity and spareness of diet essential — General treatment — Local treatment — Scarifying the gums of vast moment — Illustrations — Second dentition at seven or eight years of age 300—328

Chapter XII

MANAGEMENT FROM THE TIME OF WEANING TO THE END OF T&E FOURTH YEAR, AND ONWARDS TO PUBERTY.

Physical treatment during the first seven years very important — Principal organs on which health depends — Source of the

X

CONTENTS.

dangers children are exposed to after weaning — Errors in diet — Abuse of animal food and stimulants — Vegetables and ripe fruit excellent for children— Perfect mastication of immense importance — Brown bread the best — Unfermented bread condemned — Salt promotes the most universal and salutary changes in the body — Illustrations — Butter and thick milk useful — Ablutions — Exercise — Duty of schoolmistress to avoid the usual unnatural mode of physical education— Clothing — Pure air. 329 — 372

Chapter XIII. Of The Moral Training Of Children

The agency of mind upon matter immense — State of the moral feelings important in its bearings on the integrity of the animal functions — The lofty ambition of parents should be to foster tenderness of conscience and to rivet sound moral principles — The five primary lessons — Habitual, prompt, and absolute obedience from children to be insisted on — Popular writers on moral philosophy fail to fix their principles on right grounds, and enforce duties by right motives — Rational morality a pretended science — The great book upon morality is the Bible — Digging deep makes all the difference between wise and foolish builders — Dr. Abercrombie on the moral feelings an excellent book — Truth a cardinal virtue, with cautions and rules — Kindness carries a wonderful charm — Children to be taught it — Curiosity of children to be patiently and wisely satisfied— Teach them to respect the property of others, but do not innoculate them with high notions of the value of money — Children fond of stories — Parents and teachers should know their own faults and be willing that others should point them out to them — Fenelon’s conduct in training the young Duke of Burgundy a remarkable illustration of this — The necessity of help from heaven — Self-forgetfulness — Protect the simplicity of children — The importance of history and biography when self-applied — Howard’s illustrious deeds carried on in a large scale, and yet he was ever attentive to minor details in doing good — Value of old and wise savings — He that keepeth his mouth keepeth his life — Soft influences of the Infinite Spirit — Works of many historians infidel — How soon shall we begin to teach our children religion ? 373 — 428

CONTENTS.

XI

Part III. Of Diseases, Their Symptoms, Causes, And Treatment

Important General Rules

• . •

Symptoms of health and disease

Page

Page

Bums and Scalds

Inflammation of the Lungs

Chilblains

Jaundice

Mumps

Chicken Pox

Measles

Cholera

Nettle-Rash

Ophthalmia

Costiveness

Rheumatic Fever . .

Shingles

Spasmodic

Sore Throat

Diabetes

Spleen, Diseases of the . . .

Diarrhoea or Looseness . .

St. Vitus’s Dance ...

Thrash

. 531

malignant ..

Epilepsy

. 534

Tonsils, Enlarged ..

Eruptions on the Skin ..

. 536

Uvula, Enlarged

. 550

Vaccination

Water on the Head

Hoarseness

. 558

Worms

. 560

ERRATA.

The reader is requested to make the following corrections

Page 32. tenth line from top, apply the.

„ 20G. fourth line from bottom, for or read and.

„ 459, fifth line from top. for pound read pint.

CHAPTER I.

Introduction.

Knowledge of diseases and their treatment useful and necessary to all parties — Errors in treatment of fever — Surprising changes in medical opinions and practice— Such changes and differences no reason for distrust of the profession — As great errors found arqong divines and lawyers — Medical aid not always at hand — Intelligence and information in the parent required to fulfil the medical instructions — The profession great benefactors of mankind.

In our day the diffusion of useful knowledge among all classes is generally advocated by the best and most enlightened of the community. Publications of all kinds are, therefore, multiplied on all the branches of science, art, and literature. Is then practical medicine alone to be excluded ? And ought we, from a fear that it might be supposed to interfere with professional emolument, to refrain from enlightening to the utmost the minds of the clergy and heads of families particularly, with respect to the nature and treatment of disease ? Are the clergy and other benevolent

B

POPULAR MEDICAL INSTRUCTION persons to have no books to assist them, in attending to the neglected, and remembering the forgotten ? The members of our profession are as respectable and humane as those of any profession or business that can be named ; but we are none of us infallible ; and, independently of the many other advantages arising from publications like the present, we have always thought it a conclusive argument in their favour, that the hints given in them, as respects both the nature of particular disorders, and the power and application of efficient remedies, are capable of suggesting, and in numerous instances have actually suggested, to the patients or their medical friends, the correct line of treatment. These hints often lead to questions, put either by the sufferer, or by some member of. the family, to the attending physician, which have materially assisted him in forming a sound judgment, both as to the circumstances of the patient and the use of some particular remedy peculiarly adapted to the case under treatment, and which has even proved perfectly successful.

Great difficulties surround disease, with respect to an accurate knowledge both of its nature and treatment. Much obscurity envelops the functions of some of the most important organs in the body; and, consequently, the opinions of professional men on these subjects vary exceedingly. For instance, the most contradictory actions have

OF CONSEQUENCE.

been attributed to the bile. It has been said by some to promote digestion, and by others to impede digestion. “ Some say that it neutralizes free acid, thus lessening irritation ; others that it increases the peristaltic action of the bowels, thus increasing irritation. Some have said that it promotes the absorption of fatty substances ; and by others it has been said to have no action upon fats at all/’ *

Again, some assert that the fibrin, or solid part of the blood, is that part in the ascending scale of development, which stands next for appropriation into the living textures of the body, and which represents the ripeness, perfection, and nutriveness of the blood ; while other physicians assert the very contrary, that “ the fibrin of the blood is not to be regarded as its most organisable portion, but as an element resulting from the degeneration of the tissues , and destined to speedy elimination from the circulating current.” What an utterly irreconcilable difference of opinion is here !

And what has been, during the last fifty years, the ordinary state of professional views and practice in that active and deadly form of disease — Fever ? According to the far-famed theory of Cullen, the celebrated medical teacher in that most celebrated medical school Edinburgh, de-

* Dr. H. Bence Jones (Medical Times, July 5, 1851).

B 2

DIFFERENCE OF OPINION AS bility is tlie first link in the febrile chain ; — then the disease ought to begin just where it ends, for it is certain that debility is so far from being essential to the commencement of feverish action, that in the climate or yellow fever of the West Indies, the most ardent of all fevers, there is no debility in the first stage, but the weakness comes on exactly in proportion as the fever abates. Cullen asserts that the cold is the cause of the hot stage, but in warm climates the most unequivocal proofs to the contrary are exhibited; for in the endemic yellow fever of the West Indies there is seldom or ever the slightest chill in the commencement; generally the first feeling is a sudden flush of increased heat, followed by violent general excitement or fever. One party amongst professional men are quite sure that fever, in every case, is merely an inflammation of the mucous membrane of the stomach and intestines ; another party are equally positive that fever is neither more nor less than the effect of inflammation in the brain, or in other words, that fever and inflammation of the brain are one and the same ; while a third section, with the American physician Rush at their head, are assured that fever is produced by convulsions in all the arteries ! And what has. been the state of professional practice in fever ? The honest confession of an old practitioner, and an able one, according to the common views of men, is ( Westminster Review for 1829)

TO THE NATURE OP FEVER.

that “ although neither rank nor fortune, neither youth nor vigour, can shield from its influence, but the healthy and the young, the helpless and the old, the rich and the poor, may alike be its victims, yet we can derive no consolation from the belief that this terrible malady is either generally understood or scientifically treated.” This is the honest confession of a solidist of the present day, and such an unsatisfactory state of things is naturally to be expected so long as physicians continue to look for the cause of fever only in the solids, where it does not exist : for “ surely without a competent previous knowledge of the disease, no method of cure can be fixed at all ; and, in such a case, it must be acknowledged that the most able physicians are mere adventurers, and unfair ones too, in a matter of no less concern than the lives of their fellow creatures. If the patient has the good fortune to recover from his illness, and out of their hands, it is assuredly more owing to his own strength of nature, and happy temperament of body, than to their art or advice.”

“ I scorn,” says Warren, “ to speak this with the design of giving the least offence to any of the faculty, even in its inferior branches, but purely out of love to truth, and with a candour becoming an honest mind.”*

* Warren’s Treatise concerning the Malignant Fever in Barbadoes, p. 26.

CHANGES IN MEDICAL

Wlien the present author commenced practice, about forty years ago, nothing was heard of in pathology but irritation of the mucous membranes, and disorder of the digestive organs, as the chief causes of disease — as abnormal conditions exercising an immense and unlimited influence upon all the other functions and portions of the body, both solid and fluid. Almost, all medical practitioners were then solidists, looking alone for the origin of disease to the solid structures of the body, and thinking no more of the blood circulating through every part of it than of the water used in our external ablutions. This opinion has completely changed. A general rush has lately taken place in the opposite direction, and now the profession are travelling as fast as they can go towards the adoption of the ancient humoral 'pathology , considering that it is only in an altered state of the fluids, and particularly of the blood, that we can find the certain and efficient sources of disease. So that in the course of thirty years, our profession, from having been universally occupied in the study of the diseased action of the solids of the body as originating disease, has turned round to an almost equally universal conviction of blood poison being ordinarily the root of most human maladies ! We are thus rapidly again ascending to that point of humoral pathology which was maintained by our ancestors hundreds of years ago ! A few years since

OPINIONS AND PRACTICE.

organic changes of the solids were looked upon as the very foundation of all investigation into the nature of disease ; but now the subject of inquiry most interesting and of the highest consideration is the blood, in its various phases of development, integrity, and decay. Accordingly, that terrific disease, cholera , is no longer looked upon as originating in spasm of the gall ducts, and a stoppage of the bile, but is generally pronounced to be owing to poisoned blood. What would Mr. Abernethy say to this, could he rise from the dead ? His boasted faculty of seeing in all diseases nothing but derangement of the digestive functions, is proved a fallacy.

But a short time since, in the treatment of scrofulous inflammation of the hip, knee, ankle, or eyes, of enlarged glands of the neck, or mesentery, and of scrofulous sores, our sheet anchor was iodine in its different forms, in combination with steel and good diet. Now-a-days, however, all anti-strumous virtues seem to be centered in cod-liver oil. Undoubtedly the reputation of the oil is well merited, and it certainly does much good when other means at our command are not neglected; but formerly an equally favourable opinion was entertained with respect to the use of iodine; now it is, to a greater or less extent, generally abandoned.

This proves a very considerable change both in opinion and practice in an extensive class of

CHANGES IN MEDICAL diseases, as having taken place even in the space of fifteen years. Not only so, it .shows that the profession generally are liable to fluctuations of opinion, for which no stable and sufficient reasons can always be given. Seventy years ago, cod-liver oil was in great repute among some of the profession in this kingdom, but afterwards fell altogether into disuse. Lately it has regained and largely augmented its reputation; and the very same fluctuation has been witnessed in the reputation and use of other remedies.

Do not these considerations prove the benefit that may arise from, if not the necessity which exists for, sound popular treatises on the diseases both of adults and of children, such as those which we have ventured to place before the public eye? Our volumes are extensively read and employed by professional men themselves; but independently of the value that may be supposed to attach to them from this circumstance, we believe that the preceding facts prove that the situation and necessities of the public generally, both at home and abroad, demand them. They call aloud for the publication of volumes embodying a clear and ample description of the symptoms and causes of diseases, and the clearest and most exact detail of the various means applicable to their relief, or cure. Not with the view of making every person his own physician, but unquestionably with the view of enabling all persons

OPINIONS AND PRACTICE.

to judge a little of the nature of tlie diseases under which they, or their children, or the poor around them, suffer; and of the treatment, in its general principles, and distinct means or appliances, which the symptoms require. It is not true that the public are wholly incapable of forming any correct judgment with respect either to the nature or treatment of disease. They certainly are very liable to fall into mistakes with respect to these points; but so are we as professional men, although in a less degree. Being more frequently with the patient, the relations or friends are assisted thereby sometimes to notice an important symptom or symptoms which may have escaped, for the time, even the professional attendant; and how great the benefit may be that may arise to the patient if this is immediately pointed out to the physician in acute diseases, we need not labour to shew. The very same thing often takes place in the use of remedies, as I have recently remarked. The anxious thoughts of a parent or affectionate friend attending constantly on the invalid, prompt them to researches and reflections which, under our direction and assistance, lead them to institute inquiries of their medical adviser, or to throw out hints which elicit truth, by either leading him into new trains of thought, or calling up some fact or facts to his remembrance which had been for the time forgotten. Proud, unhappily, as we are by

b 3

CHANGES IN MEDICAL. OPINION nature, we are riot so proud but that we are ready to acknowledge tbat we have often ourselves been assisted in practice by bints derived from the patient himself, or his friends ; and we have known some of the ablest members of the profession, to a great extent, under the same obligations.

We scorn to adduce these instances of fundamental changes in professional opinion and practice as proofs of uncommon incapacity or ignorance, or as affording any ground for public distrust. Far from it. W e do no more than narrate what has taken place, from time to time, in all enlightened nations and ages of the world, up to the present moment. They are simply proofs of the universality of human error. Precisely the same manifestations of man’s proneness to err, his subjection to circumstances, his beclouded perceptions, his being led captive by the prevailing theory and fashion of the day, have been witnessed also in all other professions, not omitting those of divinity and law. The “ glorious uncertainty of the law” is proverbial; and in Divinity— the science of divine things; the science which unfolds the character of God, his laws and moral government, the duties of man, and the way of salvation; — the most sublime, the best, the most productive of all sciences, which teaches us the way to the blissful land —

“ Where glory sits on every face !

And friendship smiles in every eye 1” —

NO GROUND FOR DISTRUST.

what thick darkness and obstinate impenetrable error have from age to age, held possession of the minds of multitudes of its teachers, in all countries ! How common it is that the blind are leaders of the blind! How strong and manifold have been the bonds which for ages chained down and silenced all Christendom — the dogmatic authority of the Church, the notions of the schools, the influence of the hierarchy, ministers of religion making void the commandments of God by their traditions ! How often still do religious teachers, in all denominations, falsify the truth of Christ!* “ The prophets prophecy falsely, and the priests bear rule by their means, and my people love to have it so: and what will ye do in the end thereof?” — Jer. v. 31. If the professors of a divine science, — the physicians of the soul — having an infallible record to guide them, err so grievously, can it excite surprise that we, — the physicians of the body — who profess only a human art, should err? Verily, not only is man as prone to trouble as the sparks fly upwards, but he is as prone to error, and for the same reason. We are but of yesterday, and know almost nothing with clearness and certainty.

* Luther, the solitary monk who shook the world, resting on the Revelation from heaven, taught the heart-reviving doctrine, “ God ever pardons sin freely, and requires nothing from us in return, save that for the time to come we live according to righteousness.” The faculty of Theology in Paris replied, “ Heresy — let it be accursed.”

MEDICAL AID NOT

' It cannot with truth be asserted that parents require no knowledge of diseases, their symptoms, causes, and treatment, because medical aid is always at hand. Such aid is not always at hand ; and where it is, may not always be what can be depended on. Besides, intelligence and information in the parent, and especially the mother, are indispensable to enable her to fulfil the medical instructions in the best manner.

At this hour professional men are to be met with who regard cholera as originating in spasm of the gall ducts, and treat it with stimulants; others who think suppressed gout should, if possible, be brought out, and order a large dose of colchicum thrice a day, for weeks together, for that purpose,* when nothing can more certainly fix gout in the joints, and destroy the patient; others are readily to be found who, in severe infantile complaints, prescribe large doses of calomel, frequently repeated, until the child is killed by calomel and not by the disease ; others there are, who in every female complaint, use instruments of examination f as absolutely necessary, whereas the ablest of the profession deprecate such conduct as unnecessary and cruel. Some physicians positively declare that in insanity, little or no good results from medical

* See the author’s Modem Domestic Medicine, under Gout, p. 491, and at 279.

t See my volume on the Diseases of Females, Last Appendix.

ALWAYS AT HAND.

treatment; others, at least equally shrewd and skilful, pronounce this to be a sad and fatal doctrine, unhesitatingly assuring us that this terrible malady “ is as easily curable as any other form of bodily disease.”* The celebrated physician, Tissot, and other physicians of reputation in the last century, were in the habit of recommending that infants should not be permitted to suck the mother until twenty-four hours, or more, had elapsed from the time of birth, and that in the meantime the appetite of the infant should be satisfied with gruel, panada, milk and water, or some similar kind of food; and this injudicious and dangerous advice is given by some persons even at this day. From such contradictions, some — yes, even leavned and able physicians — have been led to believe that medicine seems doomed to follow an obscure, experimental, and conjectural course, f from which opinion, however, I dissent.

Mr. Carter, in his useful work on Hysteria, 07’ Hysterics, refers to twenty particular cases of hysteric affection that came under his notice, declaring that, in nineteen of them, that vile instrument the speculum was constantly used, and the neck of the womb cauterised for six months

* See Dr. Forbes Winslow’s Lecture No. 2, in Lancet of Oct. 9, 1852, p. 32.

f See the Preface to Dr. Knox’s very useful Manual of Human Anatomy.

HISTORY PULL OP PEOOFS together ! — at tlie end of which time the patients were in no degree whatever improved ; whilst the remaining patient (the twentieth), who had been in precisely the same condition, perfectly recovered, without the use either of instrument or of caustic. Without adverting to any other matters of general utility introduced into my volume on the Diseases of Females, I have abundant reason to hope that the remarks appended to that publication on the present enormous abuse of the speculum, in female complaints, have been, and will continue to be, of no small service.*