Advice to young mothers on the physical education of children

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Preface

This book is really what it professes to be — the work of an old ivoman. In fact no other description of person would have been equal to the undertaking ; which, humble as it is, required a peculiar combination of circumstances to insure any prospect of success : and as those old women who have leisure to write, have not always opportunities of obtaining the experience of a nurse, or inclination to study the writings of medical men, the author has thought it expedient to attempt a work of real utility, for which, perhaps, few others possess the necessary qualifications.

Having suckled many children, she has had means of obtaining, from the first source, a species of knowledge which professional men can derive only from the information of women ; and by having read with attention most of the best books which have been written on the management of children, she has convinced herself that the subject has not been exhausted.

The object of this work is chiefly to instruct young mothers how to prevent, rather than to cure the diseases of children : for when maladies assume a dangerous form, and require medical treatment, the study of years is necessary to apply it with advantage. When, at some future time, the progress of science shall have simplified the art of healing, to the general advantage of mankind, the preventive part of medicine will probably be considered as the most important ; and in consequence, the number of maladies be diminished.

Long experience, and much observation, have induced the author of this work to believe, that a great number of the diseases which afflict the human race are effects of imprudence and neglect in the early part of life ; and that by constant and judicious attention to the physical education, during the first fifteen years, many of these diseases might be avoided. For this reason she is anxious to diffuse, amongst her own sex, a species of knowledge which may enable mothers to educate their children with better prospects ef health and happiness ; and perhaps occasion them to take a greater interest in the welfare of their offspring, !>y proving how much it depends OH their attention.

The disadvantages under which a medical man labors in his attendance on infant patients, are many, and may be ascribed to various causes ; but the greatest is the difficulty of obtaining accurate information from the sick, who arc incapable of describing their sensations, and when the principal lights arc to be received from some person totally ignorant of the science of medicine. This often renders the task of prescribing for the diseases of children a matter of great difficulty : ami the indiscretion of their attendants frequently counteracts the good effects of the most judicious advice.

Even where a physician, by being the father of a numerous offspring, may appear to have had the best means of studying those maladies incident to the early yean of man, it is impossible he should ever have such experience of the momentary changes to which the infant frame is liable, as may be acquired by an observing mother or an attentive nurse ; and which, were it combined with a moderate degree of scientific knowledge, would often prove the surest guide to the medical attendant. But it too frequently happens that, through the ignorance of those about them, the complaints of children are at first disregarded ; palliative remedies are neglected, and the professional man is not sought for until it is too late. In truth, no appearance of indisposition in a child should ever be thought trifling ; and though the greater number may not require the assistance of medicine, yet, in those that do, it should be resorted to without delay. It is to little purpose that a physician is consulted when the vital powers have been exhausted by the continuance of disease ; and still less when only a part of his advice is followed. Such is often the consequence of that sort of ignorance, which it is the object of this work to diminish.

When the best physicians are surrounded with difficulties in their treatment of the maladies to which infants are subject, it is not surprising that many child ren are lost through the want of a little more knowledge in the women who are constantly about them Various indispositions are brought on or increased by neglect ; and the timely application of simple remedies would often check the progress of maladies which become dangerous through inattention.

It sometimes happens that a long series of years spent in the service of children, may have given to an old nurse a degree of experience, which, if accompanied with discretion and modesty, would be of infinite value ; but, unfortunately, it is usually attended with the inconvenience of her fancying herself capable of prescribing medicines with the nature and force of which she is unacquainted, and which, if improperly administered, may occasion the most pernicious effects. The courage of ignorance is always great ; the mistakes resulting from it often fatal; and it frequently happens (both in regard to children and adults) that, in cases where the learned and judicious physician considers it prudent to delay his exertions, an ignorant apothecary or officious nurse, will throw in medicine upon medicine ; and, by disturbing the salutary efforts of nature, augment the disease, perhaps to the destruction of the patient.

The excessive ignorance of the generality of mankind respecting every thing which relates to medicine, is productive of many bad consequences ; one of which (and not the least) is the power it bestows on a tribe of ignorant pretenders, who infest the earth, to the great detriment of the sick: for few persons know how to distinguish between them and those men whi . d( dieating their time and talents to the researches of science, are enabled to relieve the infirmities of human nature. To choose a physician well, one should be half a physician one's self : butnstbisi, i \ ithmany, the best plan which the mother of a family can adopt i- to select a man whose education has been suitable to his profession ; whose habits of life are such as prove that be continues to acquire both pra tical and thco- . i knowledge; who is neither a bigot in old opinions, nor an enthusiast in new. A little attention in making the necessary inquiries, will suffice to ascertain the requisites here specified ; to which should be added (what is usually found in medical men of real m< rit,) those qualities which may serve to render him an agreeable companion : for the family physician sliould always be the family friend.

Though the design of this work has been merely to treat of physical education, a subject which has been much less discussed than moral, yet, the strict connexion between mind and body has render, d it impossible to enter fully into the former without touching on the latter : and it is hoped that what has been said of the moral part of education will not be considered as altogether useless .

The great influence which the conduct of a mother, during the time of pregnancy and nursing, is likely to have on the health of her offspring, has induced the author to prefix some introductory advice on those subjects ; which may possibly be advantageous to the inexperienced, and cannot appear misplaced in a work of this nature.

In these pages will probably be found many known truths and many old remarks : but let it be remembered that the task was undertaken wholly with a view to utility, and not to disseminate new opinions, or to display the learning of the author ; whose object, in fact, has been to write such a book as she would herself, at the age of twenty, have received as a valuable gift. Technical terms have been avoided as much as possible, and few medicines recommended ; for when many are .supposed to be necessary, the opinion of a professional man must be required.

The observations and advice contained in this work are chiefly the result of the author's own experience and when they are founded on the information of others, that information has been examined with the strictest attention. The book is the production of many years' study and reflection ; and the author cannot help flattering herself that it will be of some use to those for whom it is designed, — the anxious mother, the attentive governess, and the careful nurse.

Chap. III

PART THE FIRST. treatment of infants from their birth till after two months old, and the maladies to which they are liable during that period. Chap .1.

Manner in which a new-born infant should be washed and dressed— Wooden bathing vessel — Cushion stuffed with chopped straw — No pins in the

clothes — First shifts 51

Chap. II.

Cleanliness — Excoriations — Washing the mouth — Flannel — Night-dress — Caps — Time of washing — Of dressing .... 58

Chap. III.

Modes of Cleanliness — Of sleeping — Cradle — Care of sight, and of all the senses . . 63

Chap. IV

Rooms inhabited by infants — Manner of holding them — Of giving them fresh air ... 68 Chap. V.

Infants ought to have the mother's milk as soon as possible — Medicine seldom necessary — Want of appetite — Mucus in the stomach — Handling gently — How the head should be cleaned . 72 Chap. VI.

Internal pains — Crying — Costivcness — Strangury — Becoming thin — Distortions of face 78 Chap. VII.

Jaundice — Red gum — Hiccough — Looseness —

Gripes 82

Chap. VIII.

Cold in the head — Sore eyes — Coughs and Colds — Accidental sore mouth — Thrush . . 87 Chap. IX. ( Convulsions — their various causes, and the manner

of treating them !l *

Chaj>. -\.

Bringing up children without human milk

Chap. XI.

Hints respecting hired nurses .... 105

Chap. IV

Vomiting — Pain before the teeth appear — Hard substances unsuitable to the gums — Lancing the gums — Bleeding — Blistering . . . 121 Chap. V.

Advantages of air and exercise — Bowels to be kept open — How to treat spasmodic symptoms —

Eruptions 126

Chap. II

Pulse — Feverishness — Slight diarrhoea — Double teeth — Irregular growth .... 147 Chap. III.

The heads of children should be kept cool — Running at the nose not to be disregarded — Short hair — Bad habits — Dangerous tricks — Damp

shoes. 152

Chap. I

Food — Purification of water — Children should not be pressed to eat — Irregularity of appetite — Sweet things — Children naturally gluttons — Do not require food in inflammatory diseases . 286 Chap. II.

Clothing — Covering the bosom and arms — Ornaments injurious to health — Beauty to be acquired — Ligatures of all sorts bad . . 292 Chap. III.

Evacuations — Exercise — Amusements — Warmth

Change of air 298

Chap IV.

Heat of rooms — Crookedness — Round shoulders — Unwholesome postures — Sleep — Beds — Nocturnal terrors . . 306

Chap. V.

Painted toys — Independence — Praise — Wonderful children — Indolence — Deformed or discontented persons should not be about children 313 Chap. VI.

Sensibility — Jealousy — Punishments — Courage

— Peevishness 310

Chap. VII.

Praise — Forgiveness — Religion — Learning —

Accomplishments 328

Chap. VIII.

Physicians — Medicines — Treatment of children when ill — Conclusion .... 334 APPENDIX.

List of medicines, and some necessary directions 334

INTRODUCTION.

CHAPTER I.

ON PREGNANCY AND CHILDBIRTH.

A pregnant woman, who desires to produce an offspring, well constituted in body and mind, should pay the strictest attention to her own conduct, both physical and moral. She should carefully avoid any species of excess, and endeavor to keep her mind in the greatest tranquillity: she should contrive to have agreeable occupations, to enjoy the fresh air,%nd to take regular and moderate exercise; and she should, also, indulge the caprices of pregnancy, though not in too great a degree. A peculiar state of the stomach may enable it to digest a certain portion of apparently unwholesome food, but it is always imprudent, and sometimes dangerous, to yield entirely, even to what appears an instinct of nature, when nature deviates from the common track.

Food taken more frequently, and in smaller quantities than at other times, would (in many 1

18 OX PREGNANCY AND CHILDBIRTH.

cases) diminish that uneasiness of stomach which seems to belong to the first months of pregnancy, and which might often, be rendered scarcely perceptible by proper attention to the state of the bowels. Women of a costive habit of body, generally suffer more from what is called the breeding sickness, than those of a contrary constitution; and such should therefore have recourse to the aid of medicine; which, it is scarcely necessary to say, should be of the mildest sort. Bleeding is also sometimes requisite, and many women are taught to believe it so much so, that if they have had occasion for it in the first, the same necessity will occur in every succeeding pregnancy; but this is a false, and may often prove an injurious opinion. Were more judicious arrangements made respecting diet and exercise, it is probable that all these artificial aids might generally be dispensed with. If a pregnant woman eats a great quantity of animal food, drinks fermented liquors 111 abundance, and leads a sedentary life, her situation will naturally produce an extraordinary fulness of the blood-vessels, and incur the necessity of bleeding and other medical aid: but to one who eats moderately of meat, vegetables, fruit, Stc, drinks chiefly water, and takes exercise, (especially on foot) every day, for her amusement, such assistance will probably be unnecessary.

Loose and light clothing is, also, of the greatest importance to the well-being of both the mother and the child, and numerous instances are on record of the pernicious consequences of tight lacing during the time of pregnancy. And here I cannot help remarking, that this species of selftorture, frequently, (perhaps I might say always,) fails of the desired effect; for when nature has determined that a woman shall retain in part that increase of bulk occasioned by pregnancy, which it is the object of tight stays to prevent, nothing will protect her from it. Indeed, were I to judge from my own observation, I should say that this unnatural practice was likely to occasion the defect (if such it may be called) which it was intended to prevent, as all those women whom I have known to be most eager in taking this precaution, have been disappointed in their hopes; while others, who have never thought on the subject, but followed the simple dictates of nature, and consulted only their own convenience, remain perfectly free from the dreaded augmentation after having brought forth ten or twelve children.

In general, the whole business of labor is too much hurried. The slow and gradual operations of nature are not sufficiently respected: the females who are present, urge the sufferer to " help herself," and the unnecessary and useless efforts she is thus induced to make, only tend to debilitate her and her offspring. If women did but know something more of the animal economy, they would patiently submit to a little longer suffering, rather than run the risks attendant on making too great exertions, or receiving too much assistance. But in this, as in a thousand other instances, people run into fatal errors by allowing art to usurp the place of nature.

When a labor is tedious, the woman requires nourishment ; and this should be proportioned to that which she has been accustomed to take. One who is in the habit of drinking wine and fermented liquors may without danger apply to their aid during the time of labor: remembering, however, that the quantities should be less than she has been used to take at other times. But if a woman, who has always lived abstemiously, should be plied with heavy nourishment in this situation, the consequences might be extremely dangerous.

Another great source of evil, is the prejudice common amongst women, that they must be in great danger as long as the after-birth remains in the womb; and, for this reason, the expulsion is seldom left to nature, which in most cases would require no artificial aid to bring away either the child, or its appendages. The common expression, "is she tiiit'c yet?" to demand whether the after-birth has been expelled, clearly shows the vulgar opinion on this subject; i. e. that the woman is in danger of dying while it is retained. It is unnecessary to point out what must be the situation of a woman impressed with this idea, as long as this substance remains within her, which, if left to nature, it would often do for several hours without any injury, but the contrary. The instructed assistant, (whether male or female,) is well acquainted with the circumstances which render it necessary to extract the placenta by force; and, where there are not these indications, it is better to trust to nature. At all events, the ignorant should refrain from interfering with, or hurrying those who have studied their profession. But this is one of the many cases in which every gossip thinks she has a right to give her opinion and advice. Constitutions differ so much that there can be no general rule to judge by. To one woman it may be natural to expel the after-birth in five minutes, to another in five hours, after the birth of the child; and the premature extraction, even when not attended with danger, is usually followed by severe afterpains and unnecessary loss of blood.

Another injurious custom, which produces similar effects with the last mentioned, is that of changing all the clothes too soon after delivery. Matters should be so contrived, that the linen necessary to be removed immediately, may be taken away without raising up or disturbing the body of the woman; and any further changes of clothing should be deferred for several hours, until she may have taken nourishment and repose.

In urging the necessity of avoiding fatigue, I only repeat what is continually recommended by medical writers; but, as this book is intended for those who do not peruse their works, I think it requisite to enforce the greatest attention to this subject. No one should be with a woman in labor but the necessary assistants, unless she herself should express a particular desire to the contrary: her wish, of course, should be indulged; and, as it is not likely to extend to many persons, it cannot produce the bad consequences resulting from a number of unnecessary spectators. After the pains of labor are over, the utmost tranquillity is necessary; and care should be taken that the visits of relations and intimates, too soon after delivery, do not occasion some dangerous alteration. Many women have been thrown into the most perilous situations merely by tedious and fatiguing attentions of this sort; and I have myself known instances of some who have narrowly escaped with their lives. In general, silence, solitude and darkness, for the first eight-and-forty hours, are advantageous, if not absolutely necessary: and the mind of a woman, who has happily borne a promising child, is not liable to become melancholy for want of society.

It is natural for a healthy woman to feel an extraordinary desire for frequent nourishment during the first two or three days after delivery; but she should be very cautious as to the quality of her food for the first week, that she may escape, or more easily pass through that inflammatory state, commonly called the milk fever. I say nothing of the quantity, which is usually the more important consideration, because the quality, for the first few days, should be of a sort not likely to occasion an excess in eating; and after that time the desire for food is not so keen.

A woman of a good constitution, who suckles her child, will not require savory dishes or fermented liquors to give her an appetite, nor will she be likely to have occasion for medicine during the time of her confinement. It may however sometimes happen, that in consequence of remaining in bed, (and even the strongest women should be cautious not to leave it too soon, especially in cold weather,) some assistance to the bowels may be required during the first week or fortnight: and in this case it would be far better to employ a simple clyster,* which acts only on the parts that want it, than derange the stomach by having recourse to purgative medicines. When the work of digestion goes on well, why do any thing that may disturb it? And if the lower bowels, from being accidentally over-heated, do not perform their functions properly, why not apply the remedy to the part which requires it? A clyster relieves the overloaded bowels without offending the stomach, which is a part of the human body the most important, and which requires to be treated with the greatest respect.

What I have said in regard to the little necessity for medicine, refers only to the state of those women who follow the dictates of nature in administering to their offspring the food that Providence has destined for them. Those who are either so unfortunate as not to be able, or so unnatural as not to be willing to suckle their children,

* A form of syringe is now invented, with which persons are enabled to administer an injection to themselves, without assistance and with very little fatigue. This will, it is hoped, be a means of bringing into more general practice the use of a remedy which has hitherto been too much neglected in this country. Am. Ed.

must be treated as persons in a state of induced malady ; and accordingly have recourse to the aid of physicians and apothecaries.

I cannot leave this subject entirely without saying a few words on the unnecessary pain to which women in labor are frequently exposed, when they are obliged to lie for hours on one side, a thing sufficiently disagreeable at anytime, but particularly irksome when some pain produces a desire to vary the posture. I cannot think that accoucheurs would enforce this law, if their patients had courage to remonstrate: but as no one, who has not borne children, can be aware of the great difference between one position and another in this excrutiating state, it cannot be expected that professional men will make any change in established customs, unless induced by the representations of those whose sufferings they wish to alleviate.

The reasons assigned for this dreadful rule of making women lie on the left side during the time of delivery, are by no means unanswerable; and in other countries, where it does not exist, the accidents it is alleged to prevent, do not occur more frequently than in the British isles. It appears to me of great importance that all unnecessary inconveniences should be avoided, as productive of additional irritation, and therefore inclining to fever after the actual pains of childbirth are at an end ; and that the persons about a woman in labor should not consider the present moment alone, but always look to the consequences after delivery, especially when the mother is not destined to nourish her offspring according to the dictates of nature.

Chapter II. The Duties Of Nurses

It is much to be regretted that so little has been done with a view to qualifying persons to wait on the sick. The prescription of medicine and diet belongs to the physician; the administration of them is committed to the nurse; her qualifications therefore should be great, to be entrusted with such a charge, as on her, the life of the patient may depend. How few are qualified need not be told, especially at their commencement. It may therefore be useful in a work of this kind, to say something on the duties of the nurse to whose immediate care both the mother and the child are in a great degree consigned. There are, no doubt in every city, worthy persons, who by experience have rendered themselves capable of discharging their duty, and who are in every respect deserving of public confidence. Those are generally employed by the rich, while persons of another class, though requiring the same care and attention, are frequently under the necessity of entrusting themselves and children to the care of those by no means qualified for this office, and it is not to be expected that the young mother will always have an accurate knowledge of the treatment she ought to receive from her nurse ; therefore many are the dangers to which she is exposed from inexperience on the one hand, and officious ignorance on the other. That this may in some degree be prevented, I have ventured to present a concise statement of such things as ought to be understood by those whose office it is to nurse the sick. And it is much to be desired that heads of families would give their serious attention to this subject, not only because they will be forewarned of danger, but be enabled also to judge when their nurses have properly discharged their duty, and what remedies ought to be applied when it has been neglected.

Perhaps it is unnecessary to observe, that honesty and fidelity are essential qualities in a nurse. Perfect sobriety is likewise indispensable. The least approach to intemperance is a disgrace to every person, but unpardonable in those who are entrusted with the lives of others. Let nurses be aware of this shameful vice, never give way to the slightest excess, though at one time they may be exhilarated with joy, and at another depressed with care and fatigue; if they do, they will not only endanger the patient, but infallibly lose their own character, which once lost may never be regained, though their future maintenance may entirely depend on a good name. They should always be cheerful and respectful in their manners, and never incommode the patient with idle chit-chat, disagreeable subjects, or any thing that can occasion sudden surprise. They should never read the newspapers to the patient, lest they shock them by some paragraph or death in which they may be interested. These cautions will appear to be of the highest importance, when the feeble and excitable state of the mother is considered. An excessive and indiscreet loquacity, is sufficient to overbalance every good qualification in a nurse. They must learn to be very quick and expert in the execution of their office, yet without bustle or noise.

In preparing all kinds of aliments, it is necessary to be very cleanly, but especially in those designed for the sick. Nurses, therefore, must not only be cleanly in their persons, and in the materials which they use, but they must take care that the vessels in which thev are dressed, are either silver or iron, or if copper, very well tinned, and kept as perfectly clean as possible. They should see that all the cloths which are used be perfectly dry and soft.

If the nurse is present at the beginning of labor, it is her duty to arrange the bed, which she is often obliged to do as circumstances will permit. When a cot can conveniently be procured, it is sometimes preferred, as it can be gently drawn to the side of the bed, and the patient removed after delivery without undergoing any fatigue. This mot hod, therefore, may prove extremely useful in certain cases, but for general practice I recommend the following directions. The bed ought to be placed in such a situation that the room may be properly ventilated, without exposing the patient to a current of air, and if practicable it ought to be kept at a little distance from the wall. The bed curtains, if the season makes it necessary to have them, should be made of thin materials such as cotton or linen, and should never be drawn entirely round the bed; otherwise a free circulation of air will be prevented. A hair mattress should be placed on the feather-bed and over it a piece of oiled cloth, and above this a blanket ought to be spread. A sheet should then be laid on in the ordinary way, and another in the form of a roller across the bed, having the ends folded in at the sides. A coarse blanket folded within a sheet should be laid immediately beneath the patient, and should be removed after delivery. The upper sheet, blankets, and outer covering ought to be put on in the usual way, except that the edge of the cheet at that side of the bed to which the patient's back is to be placed, is to be pinned over the blankets and coverlet. The pillows should be so arranged that the practitioner can set behind the patient while she lies on her left side.

By adopting these directions, exposure to cold during labor will be avoided; and the patient may be left comfortable after delivery, without being much disturbed, while all the necessary assistance can be given without inconvenience.

The nurse should attend to the child, and be certain that it is safe and warm. In many cases it is a good practice to rub the body of the child over with olive oil or lard, and let it lay until the mother is made comfortable, when it may be wiped with a warm soft cloth and then washed in tepid water and a little castile soap; by this means the mucus with which it is generally covered, may be entirely and easily removed, and therefore will render more than one washing for that purpose unnecessary. The child's mouth should at the same time be washed with a little spring water.