The care of the child in health

Front matter

Chap........ Copyright No...

UNITED STATES OF AMERICA.

BY

Contents

CHAPTER PAGE

I. Introductory ....... 1

II. The Pregnant Woman ..... 23

Chapter I

It is not hard to imagine the glow of enthusiasm with which a young man begins his college life, enters a profession, or starts a business. All the traditions of his vocation, all the prospects of success, and the expectations of a useful development of his faculties combine to make a state of mind that becomes capable of surmounting obstacles, providing a rational outlet for natural energy, of giving a guiding point by which his various impulses are directed. His intellectual status and the usefulness of his future work may be measured not so much by their separate effects and acts as by the informing spirit which controls them. Such things have an inevitable sequence of action, on account of which the superior man,

B 1 the person of high mind and character, selects an admirable field of work, or such a field as is susceptible of being dignified by the exercise of thorough work and preparation, of thoughtful attention to details, of a large grasp of the inherent potentialities of the vocation, which marks it off from the sordid and petty affairs of ordinary, petty life. Great results are not obtained by a preternatural flash of wondrous inspiration. On the contrary, they rest upon unremitting toil, upon tireless industry, upon an endless struggle with adverse conditions, the conquering of which means a great step toward the final evolution of civilization.

This is the basis of genius, and a careful examination of the works of any great man will show how scrupulously he has met the demands of the situation. Leonardo da Vinci was willing to grind his own colors, and make his own paints in order to obtain the desired effects ; and in the wide range of activities in which he was proficient there was no detail too small or too burdensome to be carefully mastered. William Morris, who was great in both poetry and art, in order to produce works of beauty became a printer, a dyer, a weaver. There was no labor too commonplace, no outlay of time too great, no course of study and investigation too exhaustive, for his industry. Such men have achieved the great things of the world, and no one who is unwilling to recognize the truth of their methods is able to lead a really profitable life. Such a life cannot be passed in an atmosphere of carelessness, of disregard of duty, of a perpetual avoidance of burdens. Whatever truth there is in this view has a universal, not a particular, application; and men in every walk of life must recognize it in their work, or lacking this recognition must fail. Every citizen of the world has his share of work to do and problems to solve ; and the true judge of whether the doing and the solving are successful is not entirely the opinion of existing authority, but rather the ideal, based upon the most objective conception of the worker's intention, as well as his performance. A vigorous sense of responsibility is, after all has been said, at the root of a really profitable career. Expediency must have no part in it, and makeshift devices must necessarily end in some form of worthlessness. The inner spirit of a piece of work is as worthy of scrupulous attention as the outer form. The one stands for everlasting principle, while the other represents the adaptation of that principle to the exigencies of practical circumstances. And the perfect blending of these two factors rounds out a life-work as well as a character. It must be said that an appreciation of this truth is oftener found among men than among women. Such a statement is hard to make; it really hurts in the saying, especially if one has a normal respect for the many excellences of the womanly character. But an impartial observation of life necessarily leads one to this conclusion; and what one sees must be said.

There could not be a better demonstration of the unprejudiced truth of this idea than may be had from recognizing the methods which women employ in caring for their children. Such methods constitute a fair standard of comparison because they are the principal occupation of a majority of the really useful women in the world. Those women who are regarded as fortunate have as their vocation and life-work the bearing and the rearing of offspring. They grow up from girlhood with the hope and the belief that such work will be their future calling. Every other employment is frankly regarded as subsidiary, as a temporary means of gain or occupation, which is to be gladly and unhesitatingly relinquished when the great opportunity presents itself. This great opportunity usually seems so natural and inevitable that its demands are supposed to work themselves out in quite an irresponsible fashion, fully as irresponsible as the choice of a spouse commonly is. On the other hand, the necessities of competition demand a certain amount of preparation for obtaining even a low grade of commercial work, and, for a similar reason, a fair amount of effort is demanded to hold the position. Naturally enough, women recognize this fact, even if they have not thought about the matter very much ; but they go no farther than the barest demands of competition, because they recognize, and the world at large recognizes, that the ordinary commercial employments are for them scarcely more than a temporary means of gain or occupation. At the same time, the corollary of the proposition is that household and maternal duties are their permanent work, for which they are peculiarly designed and adapted, and in which they are expected, in the scheme of nature, to find their greatest gratification as well as usefulness.

A recent writer in a popular American magazine, in expressing the discontent of the women b THE CARE OF THE CHILD IN HEALTH

of to-day, cries out: "Give us labor! For countless ages, for thouands, millions it may be, we have labored. When man first wandered, the naked, newly erected savage, and hunted and fought, we wandered with him; each step of his was ours. Within our bodies we bore the race, on our shoulders we carried it; we sought the roots and the plants for its food; and when man's barbed arrow or hook brought the game, our hands dressed it. Side by side, the savage man and the savage woman, we wandered free together and labored free together. And we were contented." She then goes on to explain that as uncivilized conditions changed to civilized, the woman had less and less work to do, until to-day the race is in danger of degeneracy on account of her weakness, her lack of occupation, her unsatisfied condition of mind, and her increasing parasitism.

This cry for work is, in a certain way, astonishing, for the common belief has been that one of the main tendencies of the modern woman was away from the field of hard, manual labor, away from the personal performance of household duties which naturally constitute the quoted writer's "work." And this belief is very commonly held among various classes in society at large. It is often stated to be at the root of the increasing difficulty in supporting a household. At all events, we see that marriages are being contracted at a later age than formerly and with more difficulty ; that households are conducted on a more extravagant plan than was ever customary ; that less work is done by mistresses, and that the spread of luxury is ever increasing. It is claimed that children are no longer willing, in planning the externals of their prospective careers, to begin where their parents began, and to go through the same laborious course of financial evolution. On the contrary, they want to begin where their parents left off, evidently believing that a change in external circumstances and the details of social environment in the direction of simplicity was not to be endured, and meant a fall in public estimation.

An additional fact of interest is the change that has gradually been taking place in commercial life. There is a growing competition, there is an increasing development of business methods which requires more energy, more capital, more industry for the successful prosecution of a business enterprise than ever before. The successful business is falling more and more into the hands of groups of wealthy capitalists, or into those of one unusually active man who often represents a group or syndicate. As a result, many persons who formerly conducted individual enterprises must now be content to accept salaried positions whose pay is not great, either actually or prospectively. The most characteristic thing which one can say is that the plan of specialization is extending into every business and into the individual departments thereof; and that while there are a few places which are highly remunerative, the general salary does not tend to increase, the individual wage cannot be expected to grow larger. Thus, as the result of the centralization of responsibility as well as capital, a larger and larger proportion of the possible situations are subordinate. Such positions must from their nature require less of the qualities of the proprietor and more of the qualities of the employee. They must be administered by persons who have comparatively little personal connection with the intimate policy and welfare of the enterprise, who may be as useful to one firm as another, and who are ready to change from one to another according to the demands of a passing necessity or the whims of personal preference.

This has made the opportunity for thousands of women to participate in business life. They feel the constant impulse to increasing luxury, their needs are not so easily satisfied as formerly by the wage-earning head of the family, and during the interregnum between the period of their entire dependence and the equally distinct period when by marriage they believe that entire independence must come, they endeavor to piece out their possibilities of enjoying life, of gratifying their desire for petty luxury, and, possibly, for the present large necessities of life, by obtaining subordinate positions. They are able to accept less pay than the wage-earning head of the family, because their needs are less. And at the same time, on account of the divisions and subdivisions of specialized business, they are able to do the work almost as well, or fully as well as he does. Many of these positions — being subordinate, having comparatively little responsibilitjr, being merely functional — demand no more than a special, narrow preparation, for which the ordinary woman, whose needs are immediate and whose prospects are liable at any time to undergo a radical change, is almost as well fitted as her brother. He, on the other hand, knows that he must continue for the rest of his life to be a wage-earner; and his prospects, in all likelihood, will never change unless he, by his own power and resourcefulness, is able to bring the change about. When the woman comes to marry, as she naturally and inevitably hopes to do, she finds that her husband's income does not permit the same indulgences to which she has become accustomed. They are certainly not possible without the exercise of rigid economy, personal willingness to do many pieces of work in the household, intimate knowledge of all the details of household management, and a full experience of all the homely details that make for the family's prosperity or lack of prosperity. It is really rare that the woman tries in a systematic way to familiarize herself with and to perfect herself in all these details. Her cooking is done as it was learned, by haphazard, by rule of thumb, by the patchwork knowledge which comes from indiscriminate attempts and unregulated experience. She has no acquaintance with the physiology of nutrition, and is utterly unable to regulate her meals so that the maximum of strength is distributed at a minimum cost. She knows very little about fabrics, about dressmaking ; but she needs costly clothes or imitations of such clothes. She knows nothing about the care of her children, about the rules which will increase their measure of health, strength, and useful training; but she feels the necessity and the fitness of handing the care of these children over to nurses and teachers. She has, in short, lost the sympathy for a plain, modest, hard-working, homely life, without at the same time being capable of providing a more efficient plan of work than her grandmothers possessed.

In the wealthier classes the situation is as bad, or possibly worse. Girls are willing to contract marriage without much thought of their probable responsibilities, and wish even less preparation and training for their certain duties. I believe that there is no exaggeration in the statements about their wishing to begin their active life in circumstances which are equivalent to those obtained by their parents after a long period of effort. Of course there are exceptions, as there always are to any broad generalization. But the statement, as a rule, holds good. Manners of living are undoubtedly more extravagant than ever before, fashions of dress are more extravagant than ever before, the amount of personal work which is supposed to be done by the wife and mother is smaller than ever before. These customs are to be commonly found among the women of the more fortunately situated classes, and they necessitate larger numbers of servants, lessened attention on the part of the mistress, greater expense and wastefulness in the management of the house. And as the natural energy of these women must find some outlet, it shows itself in distortions from its normal manifestations, which have been called all manner of hard names by one part of the community and all manner of fine names by another. These fads do not call for great praise or great blame, any more than neurasthenia or indigestion should be praised or blamed. They should be regarded as the natural expressions of certain conditions of life ; and if these manifestations are unsatisfactory and burdensome, relief may be obtained by changing the conditions which produced them.

The inevitable result of these tendencies is a progressive increase in the burdens of the whole household. Difficulties are piled upon the man, and dissatisfaction becomes the lot of the woman. He suffers from care, worry, and the lack of opportunity to cultivate the finer and gentler parts of his nature. She becomes more artificial, more worldly, more self-seeking than she formerly was or than she ought to be. Each comes to have a separate world, which has few points of contact with that of the other. Concord gives way to discord, intimate affection to indifference; and, finally, the end of the matter is strife or unhappiness. Under such circumstances it is easy to understand the recent cry that marriage is a failure ; for nothing but failure can attend any enterprise which is not founded upon mutual understanding, common effort, and a common purpose. It makes very little difference whether the enterprise is in the way of commercial management or domestic management; the salient rules that govern the one may with equal justice be applied to the other. In both there is the strongest need to recognize fundamental requirements, to prepare for the efficient administration of them, and to undertake the working out of such requirements to their logical results which an elevated ideal demands.

The problem which the present time has to solve is the adaptation of its domestic conditions to the changed circumstances of commercial life. We must revert to the state where the women of a household had as active a share in its fortunes as men, where the women's responsible positions and occupations were as sharply defined as men's, where natural energy had as wholesome a method of expression in one as in the other. The woman of to-day is a more intelligent creature than her predecessor and ancestress of the eighteenth or seventeenth century. She has larger needs, a larger range of potentialities, and an enlarged outlook. These opportunities are fine things in their way, but they bear with them their commensurate share of responsibility. The woman of to-day has greater privileges than ever before; but also she must know that her duties should likewise be interpreted in a more developed and more strenuous manner. Instead of giving less of herself to her duties, she ought to give more ; she ought to bring to her work an increased zest, a more logical method, a greater efficiency than was formerly expected. There must be a distinct correspondence between what she expects to give and what she expects to get. The demands of the past, instead of being lessened, ought in all likelihood to be increased, for in no other way can the progress of the world be furthered. The spirit of the present time demands thoroughness of preparation, intensity, and devotion to principle in a greater degree than at any other period.

And women must participate in this movement to as great an extent as men. The well-meant efforts of many women to increase the family's income, and to obtain an outlet for their own activity by plunging into business enterprises cannot go to much further lengths without evil consequences. For the stability of the home and domestic institutions will inevitably be adversely affected. Women must, in the final analysis, be the ones who set the standard of the home ; and the ideals and practices which they represent are the patterns by which the household will be guided. The further inquiry about what means may be employed to remove the disabilities and the hardships of women in particular and families in general will be best answered by considering certain fundamental facts, and holding to certain elementary truths; and when these facts and truths have been ascertained, the next step consists in adapting the current conditions of life to them. We must recognize that domestic careers exist, and have their value in the scheme of existence, just as surely as commercial or professional careers. They are not the simple pursuits that the general public so commonly takes them to be, but, on the contrary, demand as thorough preparation and as intelligent study as any other work. The objects which they are intended to serve are among the worthiest and the most vital which can occupy human attention, for they include not only the comfort and the social progress of the family, but its very existence as well. In former times, when the opportunities which women possessed of going out into the world and mingling in its struggle, its successes, and failures, were very limited or did not exist, there was no choice for them but to stop at home and devote themselves to the occupations which the home provided. In those times they wove the cloth which clothed the family; they made the candles that illuminated the house; they preserved the fruits and the meats that were to last over the hard season of winter. The man had one work in the outer world, the woman had another in the inner.

As customs changed, as labor-saving inventions grew in number and complexity, the balance became disturbed, the unprotected position of men forced them to observe the changes and keep in consonance with them. The comparatively protected and isolated position of women allowed them to go on in much the same channels as before, and did not necessitate as prompt and entire a conformity to the new methods. As the result of inventions and new methods, wealth increased; but the demands of business and professional life became greater, and the standards set for success became higher. Men acquiesced with comparative readiness in the new demands and the new standards, and thus the business part of the world has gone on with no more than temporary disturbances and interruptions. There are many persons now living who well remember the hardships and industrial disorders that arose from the extensions of railroads into territory where the carrying trade had previously been done by sail-power, horsepower, or man-power. And the consequent changes occasioned local hardships, local upheavals, local dissatisfaction. But these were no more than temporary phases which in the course of a few years passed away, and were replaced by other and superior industrial conditions. The hardships gave way to ease, the upheavals to quiet, the dissatisfaction to content. The business life of these localities increased and flourished, for the business men saw the futility of stupid resistance, they recognized the demand for newer plans of work, they welcomed the prospect of greater outlays of specialized skill.

Let us ask in all fairness whether similar changes, and free acquiescence in their necessity, have come about in household management. And in making the inquiry I am not impelled by any manner of sex-feeling or sex-jealousy. For I recognize to the full the valuable parts of women's character, their possibilities of self-sacrifice, their generous willingness to respond to worthy appeals, and their fund of devotion to a worthy cause. At the same time, it is quite clear that they have not participated fully enough in the spirit of the age which calls for a clear-sighted view of the exigencies of everyday life. They, as well as men, know that a woman's work has always been and must always be connected with the home. The best exponents of the sex have never attempted to deny this, and at most have justified the taking up of business careers and the desertion of home life on the plea of paramount necessity. The whole excuse is that the man is not able to accomplish enough alone, is not able to make enough money to support the family on the scale that has become common ; and that therefore the girls and the women must leave their homes to help them. In the meanwhile much of the necessary work is done by various servants, who, in turn, want to help their families.

Another and more logical solution of the difficulty is possible. The woman must recognize and conform to the greater demands for specialized work. Since being a wife and mother is her best and natural profession, she must fit herself for its duties ; and she must clearly have in mind the greater needs and the more complicated duties which the present time demands. She need not weave cloth for clothes, she need not dip candles, she need not collect potash and fat for soap-making. But she has other work that requires a greater degree of study and preparation for its learning. She must know that these times require a keener intellect and a greater energy than any former period in the world's history, and she must fit herself to develop such qualities in her husband and children. These things cannot be learned after she has become a wife, for then, and before then, they must have been in active working. Long before she assumes these tremendously important duties, she ought to know how the greatest amount of nutrition is to be obtained from the

20 THE CAKE OF THE CHILD m HEALTH

smallest expenditure of time and money, what nutrition means, and how it may be obtained and conserved. She must know what work is to be done in a household, how and when it is to be done, as well as every advanced method by which one may augment the health, comfort, and pleasure of the family. She ought to know what health is and what sickness is, how one leads into the other, and the wonderful changes that can be accomplished with a knowledge of hygiene, and sanitation, and elementary biology. She must have information of her prospective duties as a mother, so that the birth of a child may be an occasion for rejoicing rather than a harbinger of extravagant outlay, largely increased household expenses, and domestic disorder. She must know what the child's growth entails, what demands will be made upon her store of information and ingenuity. She must, most of all, be prepared to take entire charge of her offspring, recognizing that this is the proper and natural outlet for her self-sacrifice, her willingness to respond to ideals, and her devotion to worthy causes. Moreover, she must constantly have the conviction that she is morally responsible for all these facts and conditions; that the burden of duty weighs upon her just as heavily as if she were working under a written contract. Indeed, she ought to feel the responsibility even more keenly than any form of mercantile agreement could make her realize. As matters now stand, the woman, as soon as she marries, is apt to feel that she is answerable to no one, and that there is no standard for her work except the one which she chooses to elect. But as surely as such a plan would work disaster in business affairs, just so certainly must it produce domestic irregularity, disorder, and failure.

The proper sphere for women is not to fight in the outer world for a miserable wage in dollars. Her potentialities are too fine for that, and in submitting herself to the consequent competition she is losing too much. She is much more able to save at home, to prevent countless occasions of waste, to raise the standard of healthfulness, of self-reliance, and usefulness in her husband and children, so that the burden of support is not too heavy for a man to bear. If she accomplish that, if she can acquire a good enough sense of proportion so that the foolish tendencies to artificial extravagances of methods and household manners are kept within bearable limits, she will do a great deal to end the competition between the sexes. Such competition is unnatural, unprofitable, not susceptible of a desirable outcome. The cry, "Give us labor! " is right; for no one can live without work, and enough work. But let us beware lest we look far off for this opportunity to expend our energies and develop our characters, while we are unmindful of the opportunities which lie immediately before us, so close, in fact, that we stumble over and tread upon them. The change must come, not from without the household, but from within it; not by the woman's entering into competition with her father, husband, and brother in sorts of work where she must necessarily occupy an undesirable position, but by increasing her value at home, by diminishing the amount of needless waste — in a word, by fitting herself for her vocation as carefully as she would if she wished to employ her male relatives in a commercial labor of value and responsibility. As much as home-content is better than home-discontent, as much as peace is better than discord, as much as real prosperity is better than artificial show, so much is the true training of women better than what is so commonly given. "Give us labor! " is a good enough cry; but "Let us do the labor that is within our hands ! " is a better.

Chapter II

The pregnant woman is the centre of the world's progress; she must regard herself as endowed with a great responsibility, whose pleasures are as sweet, and whose possibilities for good are as vast as those of any position in life. She should look upon herself not only as the giver of a living pledge to her husband, but also as the transmitter of humanity itself, of all its endeavors, hopes, and aspirations. Her function, while on the one hand private and domestic, is on the other a matter of worldnote, of the upbuilding of the race and the working out of every right-minded dream of the poet and philosopher. She must realize that in this matter, as in every other in human affairs, there is a necessity for exact preparation, for the discernment of elements of strength and weakness, and for the recognition of the methods which will increase the advantages and decrease the disadvantages of the situation.

The pregnant woman should recognize that one of the best preparations for the efficient future of her child is the efficient present care of herself. In this condition the welfare of both is so closely interwoven that a point of separation between them cannot reasonably be made. During this preparatory period the child is growing and developing, is laying the foundation for the future blossoming of mind and body, just as surely as in the later times when he requires meat and drink, shoes and caps, gowns and books. From the very moment of conception he begins to be a human being with definite needs; and carelessness of his welfare during his prenatal existence is fully as inexcusable as ignorant and stupid ordering of his affairs after birth. His various physical requirements and functions have as distinct an existence at one time as at the other. Instead of breathing through his lungs, he breathes through the maternal placenta ; instead of absorbing food from his stomach and intestines into his blood, he is nourished directly by the blood of his mother. If her blood is poorly oxygenated and nourished he feels the effect immediately and intimately. And in proportion to his extreme feebleness and immaturity he must necessarily be well or ill influenced. But the main fact that physiological activity exists is as true of one time as the other. Nothing can possibly be more important, from the standpoint of the collective welfare as well as that of the individual, than a discriminating knowledge of the relations of parent and child; in other words, of heredity. The general belief that descent acts in some blind and unchangeable manner is not only wrong, but also infinitely mischievous. While the oft-quoted aphorism that a child's training should begin two hundred years before his birth may be true enough, nevertheless a highly important fact which calls for an equal amount of consideration is that the immediate progenitors have a great part in the matter of a child's health and strength ; and that, most of all, the nourishment which the mother can and does give before his birth will have much to say in deciding what manner of person he may grow to be. And when one speaks of health and strength, the terms have so wide an application that they include the vitality of bone, muscle, and nerve tissue, of body and mind.