New Ifflrary of Useftd Knowledge. THE MOTHER'S Medical Adviser, THE DISEASES MANAGEMENT OF CHILDREN. With Recipes. CONTENTS. Infancy and Childhood.... 3 Diet of Children.......... 5 Nursing Infants........... & Cleanliness and Dress.. 13-16 .Studies of Youth.........22 Management of Diseases 25-33 Sore Eyes................34 Teething.................36 Vaccination...............40 Small Pox...:............4j2 2?; Chicken Fox and Measles 44 Tooth and Nettle Rash___47 Scarlet Fever.....___.».. 48 Other Diseases peculiar to Children..........52-55 Worms................... 56 , Hooping Cough........... 58 Croup, &c...............61 Epilepsy and Fits.......62-63 Advice to Mothers......63-64 By THOMAS WAKLEY, M.P. FIRST AMERICAN, FROM THE TENTH LONDON EDITION. NEW YORK: < WILSON AND COMPANY, 162 NASSAU STREET. 1844. Number One. .4+ ■n^c-rt -'-to- THE MOTHER'S MEDICAL ADVISER, ON THE DISEASES AND MANAGEMENT OP CHILDREN. WITH ORK'INAL RECIPES. BY THOMAS WAKLEY, M. P., SURGEON. FIRST AMERICAN, FROM THE TENTH IX5ND0N EDITION. NEW YORK: WILSON AND COMPANY, 162 NASSAU STREET. 1844. / w THE MOTHER'S MEDICAL ADVISER. INTRODUCTION. In offering this little manual to the perusal of mothers, it is the sincere wish of the author that it may be of ser- vice in correcting many abuses, not only in the man- agement, dress, diet, nursing, and education of chil- dren, but that, by following the directions herein con- tained, much disease, suffering, and distortion of figure, may be obviated or relieved. There is, perhaps, no field more interesting or impor- tant for inquiry and observation, than that which is pre- sented by an investigation of those maladies of early life unfolded to us by the infant economy. The periods of life treated of in this essay, are Infancy, Childhood, and Boyhood or Girlhood, with incidental observations relative to adults. Infancy may be subdivided into two periods. First, From birth to the commencement of the first dentition, or cutting of the teeth. Second, From the commencement to the completion of the first dentition. The second stage, or thai: of childhood, extends from J 4 the mother's medical adviser. the completion of the first to the completion of the second dentition. The third stage, or that of boy or girlhood, extends from the seventh or eighth year to the commencement of puberty. In each of these stages of life the individual is subject to distinct diseases, dependant very much upon the pe- culiar development and perfection of the various organs and senses of the body. To form the constitution of a child, to lead it in the paths of health and strength, it is necessary to commence our management of it from its earliest infancy ; for no reasonable person can doubt but by neglect and misman- agement at the commencement of life, the original soundness of a constitution may be destroyed, the evils of hereditary delicacy, if such exist, increased, and the seeds of future suffering and disease too deeply sown ever after to be eradicated. Neither need it be doubted that if, by care and judicious treatment, the happy or- ganization of the strong and vigorous may be preserved, health may be imparted to those whose sickly, feeble frames denote a deficiency of the vital energy, necessary to form a good constitution. Susceptible as children are of every impression, capable as their systems are of innumerable modifications, it is nearly at all times in our own power, by care and attention, to mould them to our mind, to educate the body, and to give to it that degree of physical perfection at which the standard of health and the requisites of beauty will be found. " Children, like lender osiers take the bow, And as they first are fashioned, so they grow." To those mothers whose minds are free from the tyranny of prejudice; who seek, with unceasing solici- tude, the welfare of their children ; whose joyous and delightful occupation it is to direct " the tender shoot," themselves; to guard the bud and blossom till the fruit is ripe ; who have the firmness to exert their own reason; DIET. 5 who prefer to adopt, as a guide in rearing their children, the instructions which experience sanctions, to arbitrary custom, or the capricious routine of the ill-informed and antiquated matron, these pages are addressed, in the confident hope of their being found useful. diet. It has been very justly remarked, that " almost every malady to which the human frame is liable, is, either by high-ways or by-ways, connected with the stomach/' Few indeed are the practitioners who would be bold enough to deny this assertion; and at no period of hu- man life is it more essentially necessary to pay attention to this important branch of our manual, than during in- fancy and childhood. It is a frequent practice, immediately after the birth of a child, and as soon as the washing and dressing are accomplished, to quiet its cries by administering gruel, or what is even more customary and still more perni- cious, for reasons hereafter to be explained—sugar and water. It should, however, be remembered, previous to administering food, that the child has but just emerged into its newly-acquired life, and that it requires a certain time to arrange its various organs; and, as none of the senses seem fully developed, or capable of undergoing any exertion, it can not be considered that the digestive organs are sufficiently settled to undertake so soon their respective labors. Instead, therefore, of feeding the child immediately after it is dressed, it should be placed in its cot, warmly wrapped in flannel, and there is little fear but that it will soon recruit its strength by sleep. This course of proceeding is clearly pointed out to us by all-wise Nature; for the secretion of milk in the breasts of the mother seldom takes place until some hours subsequent to the birth of the child. There is also another and most powerful reason why % 6 the mother's medical adviser. infants should not be stuffed with gruel and other fluids, which it is most important should be attended to :— During the growth of the child, in utero, a dark viscid matter is collected in the bowels, which it is necessary should be expelled previous to nourishment being con- veyed into the stomach. The fluid first secreted from the breasts of the mother is called colostrum ; it possesses peculiar purgative prop- erties, and is obviously intended to clear the intestinal canal of the meconium (the dark viscid matter), accumu- lated in it; its fluidity also renders it the most proper food for the stomach to digest. So long as the child seems satisfied, and sleeps after it has been at the breast, it is unnecessary to have recourse to any artificial feed- ing ; but if the secretion be so long in forming as to ren- der it requisite to give some other nourishment, it is advisable that it be a substance as nearly as possible sim- ilar in consistence to that pointed out as the natural food. About half an hour previous, however, to the adminis- tration of the artificial nourishment, some mild aperient medicine should be given in lieu of the colostrum: such, for instance, as a teaspoonful of castor oil. Where it is indispensable to feed an infant, a little new milk should be warmed, and added to about a third of water, in which a few caraway seeds have been boiled : it should be given in small quantities, and discontinued immedi- ately the mother has a sufficient supply of milk to sat- isfy the infant. It is curious to observe the link or connexion that continues to subsist between mother and child; for, as in the first instance, the milk is thin, so does it increase in quantity and consistence as the child advances in age and gains strength. It is obvious that this is all the nourishment requisite; and where there is no obstacle to oppose it, no other should be given for seven or eight months. At that period, should the child be healthy, it should be accustomed to a meal once in the, day, to pre- •# DIET. 7 pare its stomach for the change of diet which must ul- timately take place at the time of weaning, which should in no instance be delayed longer than the ninth month; as after that time it is probably injurious both to the mother and child. For this meal a little arrow-root is both simple and easy of digestion. Should this be found to agree with the stomach, it should be perse- vered in for a short time; then, as the digestive powers become strengthened, it may be changed by substituting a French roll, thoroughly boiled in water till it is re- duced to a pulpy consistence: it should be worked through a fine sieve, and to it should be added a little warm milk, sweetened with sugar. As flatulence is often produced by change of diet, it will be advisable to boil with the food a few caraway seeds, in a bag, which may tend to obviate it. Whatever the food may be, it should be always given through a bottle ; for, as the child is then obliged to take it by suction, he will not swallow more than suffi- cient ; and, what is of great consequence, the salivary glands will become stimulated, and the saliva will pass into the stomach with the food, which will materially assist the digestion. It is -usual for mothers, very frequently at the sug- gestion of nurses, to give cow's milk, besides other kinds of aliment, to infants, in addition to their own milk, with a view of making them plump and strong. This practice is, however, to be condemned, as it is eventually followed by an effect very different from what was in- tended. Instead of infants generally growing fat upon this plan, their digestive powers become weak ; they grow thin, pale, and delicate; vomiting, affections of the bowels, and convulsions ensue ; their bellies grow prom- inent; the skin is more or less covered with eruptions; they are restless, feverish, ultimately pine and fall away, and die, mere skeletons. Children brought up in this manner, and whose health is sinking under such a plan, 8 THE MOTHER'S MEDICAL ADVISER. seldom retain food long on their stomachs, and they are subject to an exhausting looseness, though the bowels are loaded with half digested aliment. To remedy this state, the most nutritious food is administered, and under an idea of thereby strengthening the stomach, it is ren- dered weaker and more irritable ; so that what was intended to restore the child, tends only to increase the evil. It will be evident from this but too true picture, that such a mode of rearing children is incompatible with a continuance of health, and that it will not only be ne- cessary nowto resort to medical means in order to subdue the affections of the stomach, bowels, and skin, but also to renounce this plan of domestic treatment, and to sub- stitute for it the simplest aliment, should any other than the mother's milk be necessary; taking care, at the same time, to administer that aliment at stated periods and in small quantities. To enable the digestive powers to recover their tone. and the infant thereby to regain its health, a child of three or four months old should not be put to the breast oftener than five or six times during the twenty-four hours. It is important also to interpose such an interval between the meals as to allow time for the food pre- viously administered to be digested. The most mild and bland foods, such as light sago, rice, tapioca, and arrowroot, &c, should form the nour- ishment for children from«the age of nine months to the end of the second year, when the first dentition will, in ordinary cases have been completed. The author has actually seen children of but twelve months old, and having but the four front teeth, biting and attempting to swallow pieces of meat; and upon addressing the mother on the impropriety of such a proceeding, the answer has generally been, "Oh, the little dear, he enjoys it so ; it keeps him quiet; he has got four teeth, and it can't hurt him." Little does the mother think NURSING. 9 what seeds of destruction and disease she is sowing in, perhaps, the child that might otherwise have proved her solace and even support in the decline of her life. Let it be distinctly understood, that children should never have meat of any kind given them to masticate, until they are provided with the proper instruments which Nature has most wisely ordained they shall be furnished with, when the assimilating and other organs are in a sufficiently advanced state to concoct and healthily carry on digestion ; and this time is about the seventh or eighth year, when the second dentition is completed. Their food in this latter period, viz., from the second to the seventh year, should consist, as before of light pud- dings, bread and milk, potatoes, nourishing broths, and occasionally a small quantity of grated meat; these will be found amply sufficient to satisfy and appease any child's appetite, and if administered at proper intervals, and in moderate quantities, the physician or surgeon will seldom have occasion to cross the threshold of its habitation. NURSING. Fortunate is that child who chances to have its mother for its nurse : it is indeed a mother's duty to be- come the nurse to her infant, for the health and happi- ness of both are mainly dependant on it. An infant has numerous little wants, and stands in need of many cares, which a mother's eye, and a mother's heart, alone can supply- There are, doubtless, many instances where a mother is compelled to renounce this, her first delight; where suckling, either from •extreme delicacy of constitution, from a failure of milk,'0^x>ther physical causes, is ren- dered entirely impracticable.*"- In such cases, it is indis- pensably necessary to hire a &et nurse. To bring up a child by hand is a task of great difficul- ty and risk, and should never be attempted when it is in 10 THE MOTHER'S MEDICAL ADVISER. the power of the parents to obtain a wet nurse. In large towns the risk is much greater than in the coun- try, where the opportunity of obtaining fresh milk is ready. Asses' milk is found to be the nearest in its properties to the human milk, and is therefore generally recommend- ed as the best substitute for it. The next best substitute is goat's milk; then that from the cow. These should be administered by means of the sucking-bottle, and un- diluted ; sugar should rarely be put into the milk with the idea of sweetening it, as it may turn acid on the stomach, and cause pains and griping. The greatest care and the most unremitting attention are necessary, and every mother ought to be seriously impressed with the necessity there is of attending per- sonally, not only to the administration, but as far as pos- sible to the preparation of the food for those children who should be dry nursed. If a wet nurse be hired, she should always undergo the inspection of a surgeon or physician. As a general guide in this respect, it may be mentioned that she ought to combine good health with good manners, an agreeable look, with a fine clear color. Her breath should be sweet, and perspiration free from smell; her gum3 firm and of a good color; teeth fine, white, and perfect; she should have an abundance of milk, should have been confined about the same time as the mother of the child to be suckled; her breasts should be of a moderate size, the veins plump, the nipple conical, brown, and well- proportioned, neither large nor small. Her milk should be white, inodorous, inclining to a sweet taste, neither watery nor thick, of a moderate consistence, separating into a curd over a slow fire. A strong nurse should be engaged for a vigorous child. The age of a wet nurse should be from twenty to thirty- five; she should be mild and sprightly, good tempered, and watchful; she should be interdicted from sleeping NURSING. 11 above eight or nine hours out of the twenty-four; for long sleep is ever prejudicial, and succeeded by heavi- ness, languor, and nervous debility. A wet nurse's food should be plain and simple, and her digestion good. Broths, plain roast and boiled meats, vegetables, rice, plain and suet puddings may all in turn be allowed. She may drink milk and water, barley-water, rice-water, gruel and toast-water, at pleas- ure. A pint of ale or porter will be an abundant supply of strong beverage for a wet nurse: should she dislike either of these beverages, and appear exhausted from the child's sucking, two glasses of wine, diluted with water would be desirable. She should take moderate exercise, but fatigue, like inactivity, is equally to be avoided. The positions in which infants and young children are frequently held during nursing, are a fruitful source of deformity and disease. Considering the pliability of the frame-work of the body of a child, which indeed is in a great measure composed of cartilage, we can not won- der that improper nursing should, for long-continued po- sitions and pressure upon any individual part, produce permanent deformities of limbs and other parts of the body, having as stated, for their basement, such yielding and soft materials. It is notorious that servants and nurses frequently produce indentations of the ribs, from their roughness and ignorance in handling and nursing infants. As children grow up, this deformity is occasioned by holding themselves in improper postures ; even when a child sits upon the knee of its nurse, or is supported in her arms, contraction of the chest will occur merely from constant leaning on one side. The carelessness of nursery-maids can not be too severely reprimanded. How frequently do we see them take hold of a child by the arm, near the shoulder, throw it up with one hand and catch it on the palm of the other, till they are wearied themselves, and the children 12 THE MOTHER^ MEDICAL ADVISER. frightened and hurt. By these practices a child is fre- quently seriously hurt, though the injury may escape notice at the time. If a child cries, it is shaken and scolded until it be- comes almost stupified, instead of the nurse taking the trouble to find out the cause of the child's pain. Many and many are the children who have fallen victims to such treatment, and prematurely sunk into the grave from the lingering and insidious progress of some com- plaint, which originated in a blow or an accident kept secret. Children should never be allowed to attempt to walk, until the ninth or tenth month. If a child is capable of rising up from the ground, and has acquired the habit of exercising its limbs, with freedom and activity, and feels itself secure in its motions, it will soon teach itse/f to walk; but it matters little whether this readiness is shown before or after the tenth month. The child should never be forced to walk, for by commencing be- fore it shows great signs of vigor, the hips, knees, and ankles, as well as the spine (all of which are at an early period, and in a weak child, too feeble to sustain the weight of the body, or prevent the child from falling to one side and becoming deformed,' especially by the pro- jection inward of the knee), become contorted and twisted in various ways, producing curved spines, con- tracted chests, deformed pelvis, and bandy legs. Children should not be taught to walk either by the assistance of a go-cart or leading-string, for the child seldom balances itself equally, but generally inclines its body to one particular side, or contracts the habit of placing one shoulder higher than its fellow. It will also be a much longer time learning to walk in consequence of resorting to this expedient. Dumb-bells and back-boards should be excluded from every nursery, and skipping-ropes should be freely used : of all toys, this latter is perhaps the most useful, it ex- CLEANLINESS. 13 pands the chest and affords at the same time an excel- lent amusement and exercise. When employed, every musele of the body is put in aetion, but the rope, when used, should always be tossed from before, backward. All sedentary occupations should be discouraged. Games in the open air, where violence is not used, should be promoted—such for instance as cricket, hock- ey, prisoners-bars, hoops, and, at a more advanced age, rowing in boats, when conducted with moderation; lor females from the age of fourteen, horse exercise will be found most beneficial. In hiring a general nurse, attention should be paid to . the mode- of address and speaking of the woman ; for Quintilian very justly remarks, "Before all things, let not the nurses have a faulty manner of speaking; them he will first hear, their words he will endeavor to imitate closely, let him not therefore be accustomed, not even while he is an infant, to a mode of speaking which must be unlearned." CLEANLINESS- There can hardly be but one opinion with respeet to the enforcement of a strict adherence to cleanliness; yet some nurses, who are generally guided by prejudice and superstition, would have you believe that frequent wash- ing and change of elothes are pernicious to the health „ of children, and if often renewed or repeated, weakens them, by imbibing those particles of perspiration which these nurses say are essential to their strength and growth. Different opinions have been given as to the tempera- ture of the water in which a newly-born infant should be washed. Cold water should never be used. Reason and experience teach us, that to plunge a newly-born infant into an element so diametrically opposite to that in which its previous existence has been passed, is ne- cessarily to expose it to dangers of the most serious 14 THE MOTHER'S MEDICAL ADVISEE. character. It is contrary to the general rules of nature ; for as time is required to perfect all things submitted to her laws, and as the uses of the senses and limbs are all gradually developed, so must it be with the means em- ployed to render an infant hardy. Let it be first accus- tomed to breathe the surrounding air, let its yet tender body be so far inured to its new life, as to have acquired some innate heat; then will it be time to use cold water in its ablutions. If on the other hand, the water should be too warm, its delicate skin may become irritated, and bad effects might be produced. Therefore the first ab- lution should be in water agreeably warm ; and when the infant is thoroughly cleaned, it should be well rubbed before the fire, to increase the circulation,-taking the greatest care to avoid exposure, which might produce cold, running at the nose, inflammation of the eyes, &c. If the child be healthy and the weather mild, after the first fortnight the warmth of the water may be gradually lessened, till at last cold water may be employed. Frequent bathing is not only conducive to cleanliness, but it imparts vigor to the muscles and nerves, and pro- motes alacrity and cheerfulness of mind. " Even from the body's purity, the mind Receives a secret sympathetic aid."—Thomson. It is proper to begin the practice of dipping in warm weather, and to c©ntinue it through every season after. The cold bath is not only a serviceable application to children in health, but to those that are sickly also, es- pecially the rickety ; it may be resorted to thrice a week; a sudden dip, twice repeated each time of using the bath, will be sufficient. The more delicate and weakly require the chill to be taken off the water, the first and second time of going into it. If the shock of a cold bath appears too powerful for the constitution, par- tial bathing with salt water, or spunging the body may be substituted, and is often highly useful. Sea-bathing CLEANLINESS. 15 agrees well with many constitutions, and is particularly beneficial where there is a tendency to scrofula. Immediately after bathing, the child should be wrap- ped in a blanket and well dried, and if it be disposed to sleep, allow it to do so ; if not, it may be dressed and permitted to run about. Cliildren should never bathe immediately after a meal. Weakly children using the cold bath, should wear flannel next to the skin. Al- though the warm bath is rarely employed except in dis- ease, yet both the cold and the warm bath are remedies against eruptions on the skin, by washing off those saline and acrid particles which are left upon it by per- spiration. Never wash a child with milk, with the view to heal a chafed part; milk will inflame, and cold water heal it. With respect to the necessity of a frequent change ot clothes, it will be treated of so fully in the article headed " Dress," that it need not be here referred to. The utility of observing cleanliness with children, should not be confined to their persons or their clothes ; for the cleanliness of the nurse and the nursery is highly essential to comfort and health. The nursery, or apartment in which children are brought up, should be one of the best, the largest, the loftiest, the cleanest, and best ventilated in the house; it should be thoroughly cleaned, at least once a day : the bed-clothes and curtains should v%o be frequently changed; indeed this latter article of furniture should perhaps be excluded from every nursery. Diseases are frequently engendered and kept up in a family from infected mattresses, beds, or blankets ; the former indeed are not in general so often cleaned, aired, and exchanged, as they should be. The fewer the articles of furniture, of whatever description they may be, in the nursery, the better. A nursery will often in appearance do credit to the nurse, while a closet, or a drawer will conceal many 16 THE MOTHER'S MEDICAL ADVISER. objectionable articles. The landing-places, or small rooms opening into nurseries, are occasionally the spots fixed upon for hoards of filth and dirt that ought many days previously to have been removed. Cool fresh air should be aljpwed to pass freely through a nursery several times in the day, and of course, if the currents of air from the windows and doors are strong, the children should not remain in the room; this mode of ventilating and regulating a nursery must not how- ever supersede the free and full influence of air out of doors. From the earliest age, children should be taken into the open air, as much as situation and circumstan- ces will permit, not only when they can walk, but while in arms, and even at the breast. DRESS. One of the most fruitful causes of deformities, dis- eased lungs, and many other affections incident to the human race, may be traced and attributed to the mode of dress adopted by parents and nurses toward their children. The state of infancy and childhood is impatient of restraint, through the restless activity incident to youth, which makes it delight to be in perpetual motion, and to see everything around it. See the happiness and de- light a child excesses, by its features, every time it is undressed and rubbed with a soft hand; observe the pleasure it experiences as soon as it is taken out of the fetters in which it is bound. It instantly ceases crying ; no sooner is it undressed, than it begins to smile, and to show signs of joy : even though it should be hungry now, it proves by its joy and its movements, that it wanted liberty still more than the breast. Bandage it up again, it becomes uneasy ; its countenance is sad, and its cries are renewed. It should be borne in mind, that the sole object of clothing a child is for warmth, DRESS. 17 and not for the purpose of giving it support, as is gen- erally supposed. Upon the first sight of a new-born infant, every one is struck with the idea of its weakness and helplessness: it is designed to be weak and tender in its infant state, as indeed is every other object around us. Take a survey of Nature, from the first opening leaves of the vernal flower, or the more delicate foliage of the sensitive plant, to the young lion, or the elephant; they are all in their several orders proportionally weak, and can not exist without some exterior support. But they stand in need of nothing but what nature has prepared for them. If seed be cast into a proper soil, it wants only the surrounding elements to ensure vigor and ma- turity. So, if the lender infant be born of healthy pa- rents, and at its full time, it is usually sufficiently strong; proper food and nursing are the elements whose foster- ing influence it requires: if it have these, it will need nothing more. It is true the new-born infant is very weak; but is it, therefore, to be tightly rolled, under the idea of support- ing it, and giving it strength ? A child is nothing more than a mass of tender vessels, through which a fluid is to pass, undisturbed, to be equally distributed through- out the body, and which are, therefore, surrounded by a soft medium, capable of yielding to the impetus of their contents. Hence we can not but conceive how injurious any great pressure must be to so delicate a frame. Nurses, indeed, appear to feel it a pwt of their duty to bind infants up with thick rollers, flannels, pilches, and wrappers, ail ingeniously tightened and fastened, with so many strings and pins, that you feel amazed at beholding how adroitly they succeed in placing the poor little child in so much misery and confinement. Should it be desirable to see the body of a child, it is not an easy matter, dressed in this mode, to obtain a sight of it. Before this can be accomplished, you have to wade through as much flannel and linen as, in point of weight, 18 THE MOTHER'S MEDICAL ADVISER. is equal to the weight of the child's body: and what is the consequence of wrapping the child in this prodi- gious quantity of clothes? Why, as it advances in growth, it continually makes efforts to disentangle itself from its prison. If it fails in this effort, it cries as long as it has strength to do so. From a repetition of this exertion, it at length experiences fatigue and exhaustion, and then it is ill. It is, in the next place, obvious that a child becomes tender from wearing so many clothes, and is ultimately so susceptible of cold, from this cause, that if, at the end of a few weeks, it be exposed to the air, it will eommonly be laid up with cough, fever, or a bowel complaint. The quantity of clothes, therefore, as usually put upon a young child, is to be reprobated, both on account of the inconvenience of the weight, and the retention of too much heat. The degree of tight- ness with which they are applied, also demands our at- tention. If a roller be wound tight round the body, or the clothes be tied tight, it is impossible for the bowels to perform their function, the circulation through them will be impeded, and obstruction the result. Rollers are often pressed so hard upon the stomach as to impede digestion, and excite vomiting and fits. So far from binding up children in this way, their dress should be light, loose, and cool. The limbs that are confined, are neither plump nor strong. If th^kgs, feet, and knees, be not left at lib- erty to be stretched, at all times, in their proper and 'natural direction, they will grow crooked, and the flesh will become flabby. The limbs that are not used, never can be strong. Nature demands the exercise of them. Good clothes, or such as are made well, and of proper materials, have the following properties, viz. :— 1. They neither hinder by their hardness, nor incom- mode by their weight and tightness, the free and easy motions of the joints. SJ. They keep the body in that degree of heat which DRESS. 19 is most agreeable, as well as most suitable, to the func- tions and actions of health. And, 3. They exert no noxious power themselves, nor are they rendered noxious by the excretions of the body or the atmosphere. Woollen is the only kind of clothing that should be worn nearest the skin, and that constantly, without ref- erence to the season or change of climate. The more obvious advantage to be derived from wearing always one kind of covering, may be easily understood from the following considerations : Uneasiness, itching, and pain, most commonly attend the change of one kind of cov- ering for another, even when there is no suspicion of dampness. A skin accustomed to the feel of fine linen, can not bear that of coarse. A skin accustomed to the feel of linen, can not bear, with equal pleasure, that of cotton ; and flannel, which seems in its effects most like the hairy covering of animals, is regarded with a degree of antipathy by those who have long accustomed their skin to linen or cotton. The practice of wrapping ourselves up in flannel at the approach of winter, changing it for calico at the ap- proach of spring and autumn, and wearing linen only during the summer, appears to be equally absurd and hurtful; there can be no doubt but that many have fallen martyrs to it, for it prevails equally among the strong and the weak, those of thirty and those^jpf sixty. Flannel is to be preferred to linen, because with the former, one may perspire without danger, and exercise" oneself without any unpleasant feeling; but who can do so when linen is in contact with the skin ? If one dances, or takes other active exercise, with flannel next to the skin, the perspiration is necessarily increased, the matter perspired is conveyed through the flannel to the atmosphere, and the skin remains dry, warm, and com- fortable. If, on the contrary, linen is next the skin, the perspiration is also necessarily increased, but the matter 20 THE MOTHER'S MEDICAL ADVISER. perspired is not conveyed through it to the atmosphere ; much of it being condensed into a fluid state, is retained in the linen, and kept in contact with the skin. Thus it appears how effectually a covering of wool can defend our bodies from sudden and excessive heat and cold, how exactly it co-operates with the powers of generating heat in living systems, and how constantly it preserves us in that temperature which is most pleasur- able, as well as most natural and beneficial. PARTICULAR ARTICLES OF DRESS. It is a good and wholesome maxim to keep the feet warm and the head cool. Caps should therefore never be worn, as they are injurious in various points of view. From their construction, they bind the external ears closer to the head than was ever intended. Mothers and nurses think nothing more unbecoming in an infant than prominent ears ; the absurdity of which is amply de- monstrated by reflection upon Nature's intention, and by observing the inconveniences which inevitably attend and follow any irrational attempt to supersede her operation. COLLARS, SCARFS, STOCKS, ETC. These, if too tight, are extremely dangerous, espe- cially in young children or aged persons ; they render swallowing diffwult, by pressing on the gullet and wind- . pipe, and frequently become the primary cause of in- flammation of the latter ; also by pressing upon the jugular veins, and so retarding the return of blood from the head to the heart, induce giddiness, stupor, and apoplexy. STAYS. As an article of dress, stays have been so long in use, that much expectation can not be entertained that any- DRESS. 21 thing which can now be said will have the effect of in- ducing any mother to forbid the use of them for her children, or that she will herself discard them. When manufactured so as perfectly to be adapted to the shape of the body, and to possess elasticity, in addition to being loosely laced, they certainly are of service in giv- ing support to the trunk ; but when, as is almost inva- riably the case, they are ill made and tightly laced, they produce the effect of distorting the chest, lessening the capacity for the lungs to act, and, by unequal pressure, preventing the natural action of the respiratory muscles. SLEEVES, BRACELETS, AND GARTERS, Are all in their respective situations, equally pernicious when too tight. Wasting of the limbs from pressure upon the blood vessels, varicose or swelled veins, drop- sies of the limbs, numbness and unsteadiness of the hands are produced. FROCKS, For children, should always be made so as to cover the chest and neck during the colder months. The rea- sons must be too obvious to every one to need explana- tion. STOCKINGS Should always be manufactured of woollen, for reasons already stated in our article on Dress, in page 17, rec- ommending the use of woollen next the skin. If cot- ton stockings be used, they should be changed at least once a day, or more, if much exercise be taken. Silk socks or stockings should never be worn, except over another and thicker pair. 22 THE MOTHER'S MEDICAL ADVISER. BOOTS AND SHOES, If made too tight, or of thick, hard leather, are highly to be reprobated ; their effects are obvious. They ren- der the bones of the feet immovable. Whoever looks at the foot of an infant, and remarks how beautifully the bones of the toes and foot are moved—whoever con- siders how savages, who never, wear shoes, climb up precipices—and how, even in this country, persons born without hands have made use of their feet in perform- ing many delicate operations, will wonder how ingeni- ously we take from ourselves what might be so extreme- ly useful, and what we can never again restore. The pernicious effects of tight coverings to the feet are bunions, corns, lameness, and the formation of ab- scesses in the groin, from irritation, besides very fre- quently dislocations of the various toes. Avoid walking in thin shoes, and if lightness is the object for so doing, a thin slip of cork, or even brown paper, placed inside the shoe or boot, will be found to be of considerable service. STUDIES OF YOUTH. Under this head we shall avail ourselves of an op- portunity of offering a few remarks upon a subject which may at first, perhaps, appear foreign to the pur- poses of the present work; but, in a medical point of view, the education of youth becomes a topic of very great importance, for it should be borne in mind that the mental faculties of youth are in a constant state of exercise, for they are every moment brought into con- tact with new objects, most of which have to become impinged on their memory. It is very natural that pa- rents, who are themselves gifted with highly endowed mental faculties, should wish their children likewise to shine ; and many parents indeed imagine that any child, STUDIES OF YOUTH. 23 by early and constant application, may be forced into a knowledge of the most abstruse and the deepest paths ot learning. True it is, that instances of many a preco- cious genius are on record, and they have attained a considerable age ; such, for example, as Wotton, who, when six years,old, was master of the Latin, Greek, and Hebrew languages; Cowley, Milton, and Pope, might also be said to "lisp in numbers;" but on the other hand, how many cliildren have fallen victims to their too constant application to studies: water in the head, diseases of the brain, and frequently idiotcy and insanity, several cases of which have come under the author's notice, the effects of over-exertion of the brain. At an early period of life, when the organ is already fully occupied with observation upon surrounding ex- ternal objects, it ought not to be surfeited and crammed with the dead and foreign languages. To what end is all this ? To gratify the pride of foolish parents, who wish their children to be thought prodigies! The mental faculties, in different constitutions, must and will display themselves earlier or later, according to some internal organization, as difficult to be observed as explained by human sagacity. A boy, during three or four years' continuance at school, will appear stupid, and will make little proficiency; keep him there an- other year, and perhaps his talents develop themselves on a sudden ; his emulation is strongly excited; he feels a pleasure in his progress, and soon outstrips those who went before him. On the other hand, he who is cried up as a prodigy of infant genius, sometimes becomes dull, contracts an aversion to learning, and at last ar- rives at no valuable attainment, examples of which are of every-day occurrence. Dr. Gregory says: "There is nothing to hinder a child from acquiring every useful branch of knowledge, and every elegant accomplishment suited to his age, without impairing his constitution; but then the greatest 24 THE MOTHER'S MEDICAL ADVISER. attention must be had to the powers of the body and the mind, that they neither be allowed to languish for want of exercise, nor be exerted beyond what they can bear." That which has just been observed must be consider- ed as referable solely to the acquirement of classical learning and other difficult branches of study. A child should early be taught its letters, and to read, and this may be so managed as to afford amusement rather than prove an irksome task, when application is continued but for short periods. It is most strongly recommended, unless under particular circumstances, that children should not be allowed to commence their classical studies until they shall at least have arrived at the age of ten or twelve years ; they will then comprehend the languages and necessary explanations much better than if they had commenced at an earlier period, and usually, by the time that three years shall have elapsed, will be quite as proficient and advanced as those who have com- menced even several years prior to them, and most probably will be in the enjoyment of much better health and clearer intellect. The Gracchi, we are told, were educated, not so much in the lap, as in the conversation of a mother. A sensible and good-tempered mother is, in every respect, best qualified to instruct a child, till he can read well enough to enter on the Latin grammar. " I have al- ways found," says Knox, "those boys the best readers, on their entrance on Latin, who had been prepared by maternal care. Boys thus instructed have seldom had vulgar tones, but have read with unusual ease and ele- gance. But even they who have been taught to read by the more illiterate, by nurses and by aged matrons, and have acquired disagreeable accents, have soon lost them again on receiving better instruction, and on hearing better examples." Corporal punishments should never be resorted to; DISEASE. 25 there are maDy ways of punishing infinitely preferable. Kindness in words and looks effect wonders in children, who are governed more by what they feel and see than by reason : Correct your little one by winning arts Of soft persuasion; but forbear to grieve His tender heart. DISEASE. While the energy of the vital system is uninjured, and its manifestations in the various organs are in due harmony throughout, and with the state of the,struc- tures with which it is associated, all the operations of the body are duly and steadily performed. This is the condition which may be termed health. But as soon as the energies of the vital principle become depressed, ex- cited, exhausted, or otherwise altered, either throughout the body, or in any of the systems or organs by which it is manifested, and when change from the natural con- dition is primarily produced in any of the structures with which it is associated, disease supervenes. This aberration from the natural condition of the vital ener- gies endowing the whole, or parts of the frame, or alter- ation of the textures which these energies actuate, is produced by causes acting sometimes singly, occasion- ally in combination, and frequently in succession. A knowledge of the causes inducing these changes are of the highest interest to the medical practitioner. The means of removing disorders, and of alleviating the suf- ferings which they occasion, when cure is beyond the reach of medical science, are the ends which the prac- titioner proposes to himself as the reward of his inves- tigations. It is not upon the textures or organs themselves that the causes of disease generally make their first impres- 26 THE MOTHER'S MEDICAL ADVISER. ■ion, but upon the vital endowment of an organ, disor- dering the functions which it performs under the do- minion of life ; and the functional disorder either leads on to further disease, or, indirectly, to a return to the healthy condition. Certain it is that some causes affect at once the organization of the part, such as many chemical, physical, and mechanical agents; but the ma- jority modifies the vital manifestations of the frame, either in one organ or structure, dr in several simulta- neously ; and by impeding or modifying, deranging or altogether changing these manifestations, thereby in- duces effects which become themselves causes of fur- ther disease, until life itself is terminated, or a healthy condition of function re-established. Causes of disease may be divided into predisposing and exciting. By these are meant such as are peculiar to individ- uals, and the circumstances in which they are placed, such as original conformation and hereditary predispo- sition, age, sex, temperaments, original and acquired, habit and constitution, trades, professions, and circum- stances of life, &c, and, secondly, into such as are not proper or peculiar to individuals, but which may affect various persons, and even numbers of persons, though perhaps but individually and occasionally, depending on the various external and internal agents and circum- stances, modifying the state of the functions, as pre- vious functional disorder and convalescence from dis- ease, and the pregnant and puerperal states. All extremes are conducive to disease, a few exam- ples of which may here with advantage be mentioned, for instance, extremes in dress. Too little clothing f.ivors the occurrence of pulmonary diseases, suppressed menstruation, disorders of the bowels, croup, and other diseases of the air-passages. On the other hand, too warm clothing is a source of disease, sometimes even of the Mine diseases which originate in exposure to cold, DISEASE. 27 and often renders the frame more susceptible of impres- sions of cold, especially of cold air taken into the lungs. The remarks now offered may be applied to overheated sitting and sleeping apartments, and to warm, soft beds and bed-clothing. These relax and weaken the frame, dispose to disorders of the kidneys, urinary and sexual organs, and render the system much more susceptible of injurious impressions from without. Among the most frequent predisposing causes to dis- ease, is intemperance in food and drink. Too much and too great a variety, particularly of animal food, highly- seasoned dishes and soups, rich sauces, the too liberal use of vinous, spirituous, or other exciting liquors, over-load, over-distend, and over-excite, the stomach, dispose it, the liver, and bowels, to inflammations and functional and organic disease, directly induce plethora, and when this state is produced inflammatory com- plaints in early life, and gout, apoplexy, paralysis, &c, at a more mature age, frequently follow. On the other hand, an unwholesome, poor, innutritious diet, or food of a fluid or watery consistence, predisposes to diseases of debility, by diminishing the powers of life, particu- larly in the digestive organs, and lessening the vital re- sistance to depressing causes. Typhoid or adynamic fevers, dysentery, cutaneous complaints, verminous dis- eases, tubercles, scrofula, scurvy, scorbutic dysentery, enlargements and affections of the joints, are common under such circumstances. Excessive secretions and evacuations, although in some instances diseases of themselves, frequently pre- dispose to further disease. The abuse of remedies which have an evacuant operation, excessive perspira- tion, too long suckling, &c, &c, weaken the powers of life, and expose them to the invasion of exciting causes. Indolence and too great exertion, both predispose to and occasion disease, while moderate exercise, especially in the open air, increases the energies of the frame. 28 THE MOTHER'S MEDICAL ADVISER. The want of sleep favors the invasion of fevers, in- flammations of the brain, and disordered manifestations of mind, while too much sleep predisposes to apoplexy, paralysis, softening of the brain, inflammation of the cerebrum or its coverings, and affections of the kidneys. On the other hand, early rising promotes both mental and corporeal energy. Indulgence of temper and passion not only predis- pose to disease, but also frequently directly excite it, particularly in nervous, irritable, and sanguine tempera- ments. Diseases of the heart, brain, liver, stomach, and bowels, often originate in these sources. Uncontrolled passions of every description occasion numerous func- tional and structural changes, seated chiefly in the vis- cera of the large cavities. Moderation in eating and drinking, in sleep, in the indulgence of those appetites, feelings, passions, and desires, which have been implant- ed in our natures by a wise Providence for our advan- tage, leads to gratification, social improvement and hap- piness, an equable state of the mind, with confidence in our powers, and the pleasant excitement accompanying a well-regulated course of application to business or study, are the best means of resisting the impressions of injurious agents. The attention of mothers should be particularly di- rected to the approaching symptoms, course, and treat- ment of those diseases most common to infants and children. Be assured that many of the slight ailments, and indeed the more serious ones, may be prevented by observing the precautions that have been previously suggested, more particularly to those of diet, dress, and nursing. There are also many of the trivial derange- ments of the system that may be cured by a mother's care, quite as efficaciously, if not more so, than by the family apothecary, who probably, with the view of sat- isfying a parent, would be induced to do much more than is necessary for the welfare of the child; implicit TONGUE-TIED—THRUSH. 29 bbedience must, however, be paid to our directions. In the more serious complaints, the aid of a surgeon or physician should be immediately sought; many indi- viduals are prevented from calling in either of these practitioners, from the fear of expense; but if they would reflect a little, they will find that the physician or surgeon pays but few visits, and has no object in drenching his little patients with bottle after bottle of needless medicine. TONGUE-TIED. This is a malformation, which in reality but very seldom occurs, but the practitioner is constantly having children brought to him for the purpose of dividing the bridle of the tongue, or that membrane that binds the tongue to the lower jaw. If a child can not suck, and there is no physical derangement of the mother's breast, it would be fair to infer that the child is tongue-tied, and in that case the mouth should be examined. It is an operation that should never be performed excepting under the above circumstances ; and several fatal termi- nations have occurred in consequence. At a more ad- vanced age, if the bridle is found so tight as to prevent distinct articulation, the operation may then be resort- ed to; but in the earlier part of life, and so long as the child can suck, it ought to be let alone. thrush. Of all diseases incident to children, perhaps this is the most frequent in its occurrence. There are two kinds, the one simple, the other malignant. The symp- toms that accompany the simple thrush are an eruption of little white curdy specks, with an inflamed base, dis- persed over the inner surface of the cheeks, lips, tongue, and the whole of the membrane lining the cavity of the mouth; the child's bowels are generally deranged; THE MOTHER'S MEDICAL ADVISER. there is acidity of the stomach, flatulence, and motions of a green color. As the disease usually depends on acidity of the stomach, half a teaspoonful of magnesia in a little caraway water, will generally, in the course of four-aml-twenty hours, cure the infant. The malignant thrush assumes a more dangerous appearance; the spots look black, there is an offensive discharge from the mouth, the gums and teeth are en- crusted with a black matter, the child's bowels are con- fined, and it suffers from fever, and the head also be- comes affected. In these cases it is proper to admin- ister, Of Blue Powder ... 2 grains. Powdered Rhubarb . 2 do. Mixed in a teaspoonful of gruel, and administered twice a-day, till the bowels are thoroughly cleaned out, at which time the disease will usually be on the mend ; as a local application, borax and honey may be used, and applied with the feather of a pen to the ulcerations. JAUNDICE, When occurring in children, is characterized by yellow- ness of the skin and eyes; the various secretions from the body tinge linen a yeljow color; the motions are of a light or clayish color, showing the absence of bile. An irritable stomach, constipation of the bowels, and a gradual emaciation of the body takes place. In this disease there is an obstruction of the bile through its proper ducts into the intestine, and it consequently be- comes diffused over the surface of the body, being se- creted by the blood-vessels in various parts of the sys- tem, instead of the liver. Our object must be to stim- ulate the liver, so that it may perform its proper func- tion. For this purpose, preparations of mercury should be used, and either calomel or blue powder should be administered; the latter for very young children is pre- COLIC. 31 ferable—two grains given twice a day, in a small quan- tity of jelly, and followed up by half a teaspoonful of castor oil, until the bowels act freely, and the motions assume their natural character. Should medicines of this nature not succeed, it is probable that the obstruc- tion is in consequence either of some mechanical cause or malformation of the viscus, in which cases the dis- ease will probably prove fatal. Children are frequently bom with a yellowish tinge upon the skin ; the whites of the eyes and the urine do not, however,' partake of this hue. The color usually quits the skin in about a week or ten days, without the interference of medical treatment. Children, it is usual- ly remarked, being affected at first with this yellow tinge, soon after birth, have a fairer and clearer complexion than those whose skin does not undergo this change. COLIC May depend upon acidity of the stomach, constipation of the bowels, improper aliment, or flatulency. When it depends upon the former, it may be detected by the acid odor of the child's breath and evacuations. Its cause will generally arise from improper nourishment, and not unfrequently the bad or poor quality of the breast-milk ; it also very frequently depends upon the quantity of sugar that is put into bottle food. When owing to constipation of the bowels, the stomach and belly will be swollen and hard, the skin usually dry, and the breath offensive. If dependant upon flatulency, the belly will be distended, but not hard, and by the ad- ministration of a couple of teaspoonfuls of dill-water, warmed, and rubbing the belly gently with the palm of the hand, the wind will in a short time be dispelled, and the child assume its natural ease. If arising from acid- ity, a teaspoonful of carbonate of magnesia should be given in a little water, but if owing to constipation of 32 THE MOTHER'S MEDICAL ADVISER. the bowels, or improper food, half a teaspoonful of magnesia, with four grains of rhubarb, or a teaspoonfhl of castor oil, administered, will usually effect the cuVe of the little sufferer. « The general symptoms attending this disease, are thj utterance of sudden screams, drawing up of the knees toward the belly, general restlessness and irritability, refusal of food, eructations, and vomiting of curdled milk. VOMITING, As previously stated, may be a symptom of acidity on the stomach; it may also depend upon dentition, in which case the gums should be lanced ; it may likewise be owing to unsteady nursing; if this latter be the cause, it needs only precaution and gentleness in hold- ing them after suckling. SWOLLEN BREASTS Are frequently perceived in children shortly after birth; it is caused by a milky fluid which is found in the rudi- mentary breast; the fluid is usually absorbed and taken into the system; but at other times inconvenience arises from the increase of this fluid, in which case inflam- mation of the surrounding parts takes place. When such occurs, nurses generally, and most improperly, endeavor to press out the fluid through the nipple, be- tween their fingers and thumb. It is almost needless to assure our readers of the impropriety of this practice, as it must materially tend to increase the inflammation. Warm water fomentations should be applied topically, after which the breasts should be covered with a bread- and-milk, or water poultice, and in a day or two both the inflammation and swelling will have subsided. RUrTtJRE. 33 RUPTURE. A rupture is the protrusion of a portion of the intes- tine from the belly, and will always be found to protrude from the weakest parts : thus, in the groins, where there are two natural openings previous to birth, and also at the navel, are frequently perceived swellings. These swellings are sometimes larger than at others, and occa- sionally disappear for a short time altogether. These protrusions are nothing more than portions of intestine forced from their natural cavities, and constitute what is called a hernia, or rupture. They are either found to exist at birth, or happen shortly afterward, in conse- quence of a strain, from violent crying, or natural weak- ness, and imperfection of the parts. If not attended to at an early period, they frequently become dangerous, and even occasionally prove fatal, by destroying the continuity of the intestinal canal, and consequently impeding their evacuation. In such a case as this, after the usual treatment has been pursued to return the bowel to its proper place, and without ef- fect, an operation has to be performed, the success of which must always be doubtful. When a child is ruptured, it must be kept in the re- cumbent posture as much as possible, and also prevent- ed from crying. Should it be taken with a fit of cry- ing or coughing, the hand should be placed against the openings, so as to prevent the descent or protrusion of the bowel, until a proper instrument can be made for the child, and applied. For ruptures at the navel no instrument is required; a small portion of cork, cut in a conical form, and fas- tened to the belly (the intestine having been first return- ed) by strips of adhesive plaster placed over it in a stel- late form, and the whole rendered still more secure by a few turns of a narrow flannel bandage round the body, will be quite sufficient to effect a cure of this species 3 34 THE mother's medical adviser. of rupture. The bowels should always be kept free by doses of castor oil. INFLAMMATION OF THE EYES. The eyes of new-born infants are very apt to become inflamed, during the first three or four days after birth. It usually arises from exposure to cold, as it more fre- quently takes place in the winter than summer, or it may have its origin from the rays of light too strongly infringing upon the retina or expanded nerve, forming the organ of sight. This inflammation is of little conse- quence, and generally upon the application of warm milk and water, subsides in the course of a day or two. There is however another kind of inflammation of the eye, which is more virulent in its character, and frequent- ly terminates by destroying the organ of sight altogether, it has received the name of PURULENT OPHTHALMIA. It generally occurs within a week or ten days after the birth of the child. It commences with pain and itching of the part, redness and swelling of the eyelids, increased secretion of the tears and intolerance of light. If the disease increases, the eye itself becomes affected, the in- flammation increases, purulent matter is discharged, the edges of the eyelids adhere together, and is slightly separated, matter of a light straw or green color, streaked with blood, escapes. If the disease proceeds still fur- ther, the humors in the globe of the eye increase in quantity, distending that organ until at last it bursts, or as more frequently happens, the structure of the eye undergoes such morbid changes as entirely to destroy vision, should the child survive. When the inflammation begins to lessen, the tumid state of the eyelids gradually subsides, the formation of matter is much less in quantity and thinner and lighter ERYSIPELAS. 35 in appearance, the eye is not so sensible to the stimulus of light, and the patient will be observed to open it a little. The period of its continuance is variable, but it will generally yield if the timely application of the proper remedies be had recourse to. It is almost needless to impress upon the reader that in such a disease as this no time should be lost in apply- ing to the medical practitioner for advice. It will, there- fore, only be necessary to enter very briefly upon the treatment that should be pursued. Two or three leeches should be first applied, the bowels should be attended to, and goulard lotion applied to the eyelids. In the more advanced stages, a repetition of leeches with a small blister applied to the temples should be had resort to; the eyelids should be gently opened, and goulard lotion squirted between them, and over all, a bread and water poultice, with a little camphorated water sprinkled on its surface, should be applied to the eyes. The causes of this disease are usually cold, deranged state of the bowels, foreign substances getting into the eye, or from contact of a diseased discharge, which the mother may be suffering from during the birth of the child. ERYSIPELAS. This formidable disease, which is fortunately of rare occurrence, happens mostly within the first month after birth; but curious as it may appear, many children have been born with the disease already far advanced. It seizes the most robust as well as delicate children, and in an instantaneous manner; the progress is rapid; the skin turns of a purplish hue; and soon becomes ex- ceedingly hard. The milder species of it often appears on the fingers and hands, or the feet and ankles, and sometimes upon or near the joints; forming matter in a very short time. The more violent kind is generally seated upon the belly, 36 THE MOTHER'S MEDICAL ADVISER. extending also down the thighs and legs; though it oc- casionally begins in the neck, and is equally fatal. It is always more dangerous when affecting and spreading to any parts of the body, than when confined to the limbs. The swelling is but moderate, but after becoming hard, the parts turn purple, livid, and very often mortify. The treatment at the commencement of the disease should be first of all to clear out the bowels, for which purpose two grains of blue powder with three of rhubarb should be administered every three hours until the bowels are thoroughly cleansed; warm fomentations of water should be applied to the inflamed parts, which should afterward be dabbed and not wiped dry, with a Boft towel, and then fine powder or flour besprinkled over the affected parts. When suppuration of the parts takes place, linen compresses, wrung out in camphorated spirit should be applied, but not poultices. The infant must be supported with a breast of good milk and small doses of decoction of bark, with aromatic confection, in which of course the practitioner will be guided by cir- cumstances. TEETHING, Or dentition, in the most favorable cases, is preceded by dribbling of saliva at the mouth, heat and fulness of the gums, occasional flushings, increased thirst, restlessness or fretfulness, and frequent endeavors to thrust things into the mouth, evidently to allay irritation or itching. These symptoms generally appear about the third or fourth month, and precede the appearance of the teeth, sometimes by several weeks; and occasionally subside, and reappear shortly before the tooth makes its way through the surface. The signs of disturbance are merely the necessary at- tendants on the formative processes going on in the gum. But, very commonly in children of deficient vital power, TEETHING. 37 and occasionally in those which are apparently robust, or of full habit from over-feeding, dentition is either de- layed or attended by more serious disorder, particularly while the eye-teeth are being protruded. In delicate children, particularly those living in crowd- ed towns, and low ill-ventilated localities, this process is both late and slow in taking place, and is often attended by signs of increased irritation, as redness or tumefac- tion of the gums; various cutaneous eruptions, greater fretfulness, sometimes sickness and feverishness toward night, with restlessness, fits of crying, and sudden start- ings from sleep. These may be the only ailments, which may subside either partially or altogether as soon as the tooth has passed the surface, and return shortly before others come in sight; but not unfrequently, par- ticularly in this class of patients, disorders of the bowels, diarrheal and dysenteric affections, slow remitting forms of fever, enlargement of the glands in the belly, obstinate and recurring coughs, tubercular diseases of the lungs or bowels, and marasmus, supervene more or less rapidly. In children who are of a plethoric rather than a ro- bust habit of body, the gums are often swollen and pain- ful, the face flushed, the head hot and painful; and all the symptoms of inflammation of the brain or its cover- ings supervene. In them the fever is generally high, and attended by great thirst, nausea, vomitings, constipa- tion, and occasionally by drowsiness or stupor, or by great irritability or restlessness, or by both states of dis- order alternately: sometimes by short broken slumbers, from which the child awakens in a state of alarm, or in a fit of crying; or by convulsions, diminished secretion of urine and other signs of cerebral affection; these are the usual symptoms and consequences of difficult teething. A natural or slightly difficult dentition may be con- verted into serious disease, by the not uncommon habit of giving the infant food whenever it cries from the 38 THE MOTHER'S MEDICAL ADVISER. irritation attending upon the process, and thereby over- loading and further disordering the digestive processes, which are already disordered by the febrile disturbance generally accompanying it; while determination of the circulation to the head is favored by the practice of cover- ing the head in-doors or when asleep, and by wearing thick felt-hats during mild or warm weather. The eruption of the second or permanent teeth may also be delayed or attended by sympathetic disorders, particularly in those persons, whose jaws are insufficient- ly developed, and when the wisdom and canine teeth are appearing. In delicate nervous, and irritable subjects, swelling of the neighboring glands, painful and some- times periodic affections of the ear or face, slight or re- curring ophthalmia, irregular convulsions, and even epi- lepsy, and Saint Vitus' dance, have, in some instances, been excited by this cause ; and have disappeared upon the eruption of the teeth, or the removal of the irritation. With respect to the treatment of children cutting their teeth, experience convinces us that no time should be lost in lancing the gums immediately that any urgent symptoms arise, or the child appears to be materially suffering from the irritation, otherwise it is best to let Nature take its course. A few French practitioners have recommended the surface of the gum to be. divided from time to time, by the point of the nail, a practice which possesses the advantage of not alarming the child, of being easily and readily performed, and of delaying the closing of the divided part. The propriety of allowing children to rub the gums with various substances has been questioned, but ex- perience justifies us in recommending it; and a ring formed of India-rubber is the best substance to employ, as the child does not stand the chance either of injuring its eyes as with a coral, or of widening its mouth as with an ivory ring. Substances pressed frequently between the gums, materially lessen the irritation and distressing HARE-LIP. 39 itching felt in them, and promote the flow of saliva, re- sults of no mean importance in preventing the superven- tion of sympathetic disturbance. Besides the above, various other means have been rec- ommended in order to subdue the local irritation; the chief of these are the preservation of a free and open Btate of the bowels and other secretions. The blue powder with rhubarb, as before directed, should be ad- ministered, and also two or three grains of James' powder at night-time, to promote perspiration. The warm bath may also be occasionally resorted to with great advantage. With respect to the sympathetic disorders, they should be subdued as soon as they appear, directions for the mode of treatment of these will be found under their re- spective titles. HARE-LIP. For the most part this is an original malformation from the time of birth, although in a few instances, it is the consequence of a wound. By a hare-lip is meant a division or fissure (always occurring in the upper lip un- less caused by accident) extending as high as the middle of the lip; in other instances it reaches to the nose, and even into one of the nostrils. In the latter circumstance, the nostril is very much expanded, and much wider than its fellow. Besides the fissure in the lip, there is fre- quently so large a cleft in the upper jaw and palate- bones, as to make the cavities of the mouth and nose, as it were, into one. This case is not only a great deformity, but is attended with a defect in the speech; and when the fissure extends along the palate, with an impediment to the power of sucking and swallowing. The malformation of the lip is cured by an opera- tion, by which the edges of the fissure are brought to- 40 THE MOTHER'S MEDICAL ADVISER. gether; the operation however should not be performed (unless under urgent circumstances) till the child has at- tained its second year, as infants when operated on are subject to convulsions. The defect in the palate may be remedied, when the patient has ceased to grow, by the mechanical contrivance of a gold or silver plate, man- ufactured so as to fit the pallatine fissure. VACCINATION. If a cow be inoculated with small-pox matter, it takes the disease, but by passing into the animal's system the disease becomes modified, and much milder in its char- acters than the original disease; consequently, if a child be inoculated with the matter taken from the cow, it, instead of receiving the disease in its more virulent form, receives it only in its modified state, under the name of cow-pox. Small-pox will occasionally occur after vaccination, but this is no proof that cow-pox is not modified small- pox, as we frequently find eruptive disease occurring more than once during life, and measles perhaps more than any other of the eruptive disorders. Small-pox itself will sometimes occur twice during a life, and has been frequently known to prove fatal the second time of its appearance. Vaccination may and should be repeated several times during life. It can not injure the system, and may prove beneficial; it gives no pain, and there is always an abundant supply of matter, and willing operators. The time at which vaccination should be performed is about the third month, care being taken, however, that the infant is not affected at the time with any other eruptive or skin disease. Previous to its being done, a mild purgative should be administered, and once or twice repealed during the progress of the occasioned disease. The effects produced by vaccination on the constitu- VACCINATION. 41 tion are generally very trifling. It is important, when practicable, to take lymph from the arm, and insert it immediately under the cuticle of the one inoculated, without drawing blood, and three or four punctures should be made in each arm. After the lymph, or mat- ter has been inserted, a very small red spot may be observed, appearing vesicular, when examined with a lens, on the second day; on the third, the spot will be incraased in size ; on the fourth, it will be still more ap- parent ; and on the fifth, or, at furthest, the sixth day, the vesicle will have become perfectly distinct, contain- ing a transparent fluid, which is capable of propagating the disease. On the seventh day, it is manifestly larger, from the increased secretion of lymph. On the eighth, a hard or inflamed areola, varying from one to two inch- es in diameter, will be observed to form round the vesi- cle; and about this time, it will not be uncommon to observe slight febrile action, which will sometimes con- tinue for two or three days, but this is not an invariable, nor a necessary concomitant. Hitherto, the vesicle has been depressed in the centre, with an uneven surface, but on the ninth or tenth day, it will appear more even, and sometimes the centre will be the most prominent part. The vesicle will assume a circular form, and be of an opaque, pearly color; the inflamed margin, or areola, will be at its height, and, after that period will begin to fade. A hard, round, brownish scab will then be formed by the concretion of the lymph, which will afterward have a blackish appearance, and if not acci- dentally picked off, will generally become detached in the course of a week or ten days, leaving a round in- dented scar. With respect to the place where the operation is per- formed, it matters little ; the arm is, however, usually chosen. If the patient be a boy, it does not matter what part of the arm is punctured, but if a girl, it should be done near the shoulder, so that hereafter the scar he 42 THE MOTHER'S MEDICAL ADVISER. hid by the arm of the sleeve. As fashions of dresses so frequently change, however, the punctures may be made on any other part of the body, as the thigh or back, where the scar is sure to be hidden from sight. Care should be taken that the frock sleeves do not press upon the pustules during their stage, otherwise they are apt to set up irritation and painful inflammation of the arm, to subdue which, goulard lotion, or a bread-and-water poultice, should be applied. The vesicles sometimes, without irritation from external causes, spontaneously inflame ; but this is usually owing to an ill-conditioned state of the bowels: a little rhubarb and magnesia will soon subdue this state of the arm. It is almost needless to add, that if small-pox be raging in the neighborhood, the infant, no matter how young, should be immediately vaccinated. SMALL-POX May occur at any age. Children are occasionally still born, one or two months previous to the proper time, and the surface of the body has been covered with small- pox pustules; it will be found, that, in such cases, the mother has either been where small-pox was prevalent, or has herself contracted the disease. Small-pox, like most other diseases, may be mild or malignant, or, as it is called, distinct, where the pustules are separate from each other, and confluent, where the pustules run the one into the other in clusters, and where the attendant fever is of a more virulent charac- ter. The former, or distinct small-pox, is the milder of the two; it is preceded by shivering, pains in the back, loins, and head; thirst, heat, nausea or vomiting, a quick pulse, and furred tongue. In some cases, however, these symptoms are but •lightly marked. At the end of the third, or beginning SMALL-FOX. 43 of the fourth day, from the first appearance of febrile symptoms, a number of little red spots or pimples, hav- ing a shot-like feel under the finger, appear on the lips, face, neck, and chest, slightly raised above the level of the skin, which extend successively to the other parts of the body. On the appearance of the eruption, the fe- ver usually abates; about the eighth day the suppura- tion in the vesicles will be completed, at which time, there is generally a difficulty in swallowing, the eyelids are closed, and there is an increase in the flow of saliva. From this time the eruption decreases, the pustules dry up, and fall off in crusts or scabs, leaving the skin of a brownish color, which disappears in a short time. If there be such days as critical days in fevers or eruptive diseases, the eleventh is assuredly the critical day in small-pox ; for if the disease terminates fatally, it is for the most part on that day. In the treatment of small-pox, it is strictly necessary to observe a due regard to The Bowels, The Diet, and Ventilation of the Apartment. Upon the approach of the suspected disease, a purga- tive should be administered, consisting of calomel and jalap or rhubarb, the dose varying according to the age of the child; and this should be repeated several times during the continuance of the disease. Great caution, however, must be exercised in exhibiting purgatives, lest they be too strong; for it must be borne in mind that there will be a great waste of the powers of the system during the progress of the disease, and much, therefore, depends upon the management of the child at the com- mencement of the disease. Should the eruption be tardy in making its appear- ance, the warm bath will be useful, or medicines that act upon the skin, such as James's powder. Should the 44 the mother's medical adviser. eruption, during its progress, go back, as it is called, recourse must be immediately had to sinapisms and blis- ters, leeches, and even, if necessary, the lancet. If the powers of the system fail, recourse must be had to bark, wine, and other tonics and stimulants. With respect to the diet, that should be of the lightest kind; indeed, the patient will show but little inclination to eat; light pud- dings, arrow-root, and slightly acidulated drinks should be taken. The room in which the patient is kept should be well ventilated ; there should be no bed-curtains, and but few bed-clothes ; the linen should be frequently changed, and the patient kept clean. Warm water should be used for washing—and let it be here understood, that whatever the disease a person may be suffering under, whether it be an eruptive disorder or not, no harm can accrue from moderate washing and cleanliness ; on the contrary, it will rather tend 1o the amelioration of the complaint, and certainly to the comfort of the patient. In confluent small-pox, the symptoms, before enume- rated, are all of an aggravated form, and require corres- ponding active treatment. chicken-pox. The term chicken-pox is familiarly applied to all those eruptive complaints in which, after a brief attack of fever, the skin is covered generally or partially, with vesicles, or imperfect pustules, which run through their stages of maturation and decline in three, four, or, at furthest, five days, the attending constitutional symptoms being slight, without any threatening of danger. Such disorders are very common, as occurring both to infants and even persons of mature age; it is very frequently mistaken for, or called, spurious small-pox. On the treatment of a disorder so mild in its nature, and so free from all sympathetic disturbance of the sys- MEASLES. 45 tern, it is necessary only to exhibit a mild aperient medicine (such as rhubarb and magnesia) during the progress of the eruption, and again toward the decline. MEASLES Commence by the patient complaining of heaviness and giddiness, swelling of the eyelids, great heat and red- ness in the eyes, which can pot bear the stimulus of light, and a discharge of tears of an acrid nature ; sneez- ing, accompanied by a running at the nose, and hoarse- ness. Febrile symptoms, with hoarse dry cough, make their appearance, with pain in the back, nausea, or vom- iting, slight soreness of the throat, sometimes accompa- nied with constipation, but not unfrequently with diar- rhoea, which latter symptom sometimes proves very obstinate. The pulse is quick, the tongue foul, and slight delirium is not uncommon. These are the most usual preludes to measles, though in different patients they will be found to vary in intensity. Three or four days, apd occasionally a week, may elapse from the ap- pearance of these symptoms, when small red spots, some- what resembling fleabites, will be observed, first on the forehead and face, then extending to the neck, chest, trunk, and extremities. As these papula? increase in size and number, they form into irregular clusters of a crimson color, and are generally smaller on the face than on any other part, though sometimes the contrary is the case. Upon drawing the finger over them, they will be found just to rise sensibly above the surface of the skin. The precursory symptoms are but little alleviated upon the appearance of the eruption, and in some in- stances are decidedly aggravated, particularly the head- ache, heaviness, cough, and febrile symptoms, but very generally the nausea and sickness are lessened. The difficulty of breathing, and other symptoms, remain with unabated violence. In some instances, bleeding at the 46 THE mother's medical adviser. nose, others, bilious vomiting, or profuse perspiration, will take place, which will frequently prove beneficial. About the third or fourth day after the appearance of the eruption, the redness on the face begins to lessen. The skin assumes a brownish color, and falls off in small mealy scales. In a few days the papula? on the rest of the body disappear in the same way. During this pro- cess of disorganization, the itching is very troublesome, but fomentations of tepid water relieve the irritation. During the disappearance of the eruption, the difficult breathing, cough, cold, opthalmia, and febrile irritation, sometimes increase. A retrocession of the measles should be guarded against, as in such cases delirium, difficulty of breath- ing, extreme debility, pains in the chest, a pallid or livid color of the pimples, an intermittent pulse, and convul- sions, in young children, may occur, and finally termi- nate in death. The treatment of this disease, both during and after its occurrence, requires the utmost attention, both from the practitioner and nurse ; for though the measles, as a cutaneous disease, is of trifling importance, yet the com- plications attending it, and the continued disposition to an inflammatory state of the lungs and other organs which it leaves behind, generally render the conse- quences of this disease of a much more formidable and dangerous nature than any other affections to which children are liable. At the commencement, and throughout the disease, meat and every kind of stimulating diet should be avoid- ed. The bowels should be cleared out with a dose of calomel and rhubarb, after which Seidlitz powders in small doses should be given every six hours, for the pur- pose of subduing febrile symptoms; and proving slight- ly aperient, they will also have the effect of lessening the nausea. The temperature of the room should be NETTLE rash. 47 warm, and flannel worn next the skin. In an ordinary attack of measles this is the only treatment necessary. Should the eruption be tardy in making its appear- ance, the warm bath is necessary; also mustard poul- tices to the feet, a blister to the chest, and a little spiced wine and water administered from time to time. Should symptoms of inflammation of the chest ap- pear, in addition to the warm bath and a blister, a few leeches should be applied ; it will also be serviceable to nauseate or produce vomiting by emetics; such as of Ipecacuanha, five grains; Tartarized antimony, one grain; mixed, and taken in two or three tablespoonfuls of tepid water, for a child of five or six years of age. Should diarrhoea take place toward the end of the disease, it should not be hastily checked, as it most probably is an endeavor of nature to get rid of some ir- ritative matter collected in the bowels; therefore it should rather be encouraged, and for this purpose the blue powder and rhubarb, in equal proportions, should be exhibited, and with caution. Calomel, while the bowels are in this state, should never be administered, as it would prove too irritating to the lining membrane of the bowels, that being already in an irritable state. Great caution must be exhibited in the after treat- ment of this disease. The child should not be too soon allowed to go out of doors; a light tonic should be given, strengthening broths taken, and a Burgundy pitch plaster applied to the chest. Flannel should also be worn nearest the body. NETTLE RASH, Is so called from its resemblance to the eruption pro- duced by the stinging of the nettle. It usually lasts 48 THE MOTHER'S MEDICAL ADVISER. from a week to ten days, if not checked, and is depend- ant upon acidity of the stomach or irritation from the teeth. The precursory symptoms are similar to those usually attendant upon other eruptive disorders, such as feverishness, nausea, sickness, loss of appetite, heavi- ness and drowsiness, and occasional irritability of tem- per. The treatment should consist in first administering an emetic of ipecacuanha, which should shortly be follow- ed up by small doses of carbonate of magnesia. The tepid bath usually increases the irritation, but a mild lotion, consisting of Vinegar, half an ounce; Spirits of wine, half an ounce ; Water, a pint, well mixed, and applied over the surface of water, allays the itching. tooth rash Usually occurs from the fourth to the sixth or seventh month during dentition; it affects the cheeks, neck, and ears, and depends in a great measure upon the irritation caused by the teeth, and also upon the state of the bowels. The treatment for this disease is to administer small and frequent doses of equal parts of blue powder and rhubarb, and to foment the eruptive parts with a lotion composed of Tincture of benzoin, ten drops; Water, four ounces, well shaken. SCARLET FEVER, Or, as it is usually termed, scarlatina, like measles, may affect the child either in a mild or severe form ; should the attack be mild, the symptoms will commence witfc SCARLET FEVER. 49 &light feverish action. The eruption appears on the second day, first about the neck and face, in the form of innumerable red points, which in twenty-four hours or less cover the whole body. Upon the limbs, but espe- cially about the fingers, there is a diffuse and continued efflorescence, but on the trunk of the body the rash is distributed in irregular patches. The color of the eruption is a bright scarlet, being always most distinct about the loins and bendings of the joints. The redness spreads over the surface of the mouth and fauces; the tongue is furred in the centre, while the edges and point are of a brilliant scarlet color, as also are numerous papillae seen above the furred cen- tre ; the pulse is quick, convulsions occasionally occur, and very generally when the eruption has attained its height, delirium takes place ; but less is to be appre- hended from this delirium than that occurring in any other disease. The eruption is most vivid toward even- ing ; the febrile symptoms are also "increased, and occa- sionally small papillae are observable on the chest and extremities. On the fourth day the disease may be considered at its height, for on the fifth the eruption begins to disap- pear, and by the close of the seventh, has entirely van- ished ; the skin then peels off scurfy scales, which pro- cess is usually terminated in about a week. These symptoms will usually constitute the milder form of scarlet fever; but to the more severe form may be added a greater sensation of lassitude and dejection, with headache, cold shiverings, alternating with flushes of heat, difficult deglutition, and painful sensation in the throat; should the patient be troubled with cough, the breathing may become difficult, and suffocation threat- ened if the child be young. The appearance of the eruption varies from the second to the fourth day, and is of a less deep color than in the milder form, with the exception of a few patches, which ultimately assume a 4 50 THE mother's medical adviser. darkened or purple hue; the eruption also occasionally recedes, either for a few hours, or even two or three days. The pulse is weak and frequent, varying from one hundred and thirty to fifty beats in a minute; the patient is irritable ; the heat of the skin great; the eyes heavy, inexpressive, and suffused with blood; the mouth, tongue, and teeth covered with a brown or blackish coat, and the breath highly offensive; the throat and fauces are frequently ulcerated; a discharge of acrid fluid escapes from the nose, excoriating and blistering the parts that it touches ; and lastly, the eruption lasts several days longer. treatment. As in all fevers, and in most diseases, the bowels must be first attended to, the usual purgative of calomel and rhubarb should be first administered. But if the symp- toms indicate an approach of the more malignant form of the disease, every precaution must be taken to keep up the patient's strength; and as it is certainly neces- sary that the bowels be cleared out, mild doses of castor oil should be given in lieu of the more powerful ca- thartic above mentioned. In the simple scarlet fever, little need be done but to attend to the due regulation of the patient's bowels. It should always be borne in mind that this disease produces a greater degree of debility than any other of the eruptive disorders, and consequently the treatment should always be conducted with caution. When signs of inflammation are present, cold or tepid sponging may be had recourse to, but bleeding should always be avoid- ed if possible. If there is a tendency to inflammation of any particular organ, as, for instance, the brain, v.hich may be conjectured from the suffused eyes, it will be necessary to apply a few leeches to the temples, but this should never be done except in the presence of SCARLET FEVER. 51 the practitioner, who will regulate the quantity of blood abstracted by the symptoms and constitution of the patient. Where the fever is attendant with sore throat, saline fever mixtures must be administered, and acidulated gargles freely used for the throat; one of the best gargles for the throat is as follows : Muriatic acid, one drachm; Lemon juice, half an ounce ; Water, eight ounces; a wine-glassful to be used every fourth hour; or Muriate of ammonia, two drachms; Pure water, eight ounces ; to be used as above. Where the patient is so young as not to be able to gargle, the external throat should frequently be sponged with vinegar and water, either tepid or cold. In the malignant form of the disease, every precau- tion must be taken from the earliest period to sustain the patient's strength, for which purpose tonics and cordials should be freely exhibited ; those most service- able will be found to be bark, with acids, port wine, opium, and draughts composed of camphor, serpentaria, and ether; also capsicum, taken internally and used as a gargle ; other stimulant gargles, as of port wine, or decoction of bark with tincture of myrrh, are of consid- erable use. The convalescence from this disease is always very tedious, and may sometimes be shortened by a judicious administration of bitters and cordials. At the same time it should be observed, that an excited and feverish state of the system frequently accompanies the process of desquamation, requiring the long-continued use of medicines that will encourage the action of the kidneys and bowels. 52 the mother's medical adviser. A.n attack of dropsy frequently succeeds the scarlet fever, most probably owing to the impaired state of the smaller blood-vessels. This affection may in general be easily overcome by medicines that will act upon the kidneys, and so carry off the fluid from the system, or to such remedies as will support and strengthen the pa- tient. For the former, a wine-glassful of broom tea, taken three times in the course of the day, will usually succeed, but if not, bark and aromatic confection must be had recourse to. The attendants, .and indeed the medical men them- selves who may have charge of these patients, can not be too careful how they hang over and about the pa- tient, although the disease itself is not usually liable to be contracted a second time, still the sore throat may, as the writer can attest. The patient, even sometime after he has been conva- lescent, should sleep by himself, as the power of infect- ing appears to remain long after the disease has ap- parently subsided, and certainly as long as any desqua- mation of the cuticle is going on. During the disease the apartment should be freely ventilated, and the fumes of hot vinegar allowed to im- pregnate the air; also the less furniture there is in the room the better. FEVERS. Children are seldom affected with fevers, excepting those which necessarily accompany other affections, such, for instance, as scarlet fever, and other eruptive disorders; also worms, mesenteric enlargements, denti- tion, diarrhoea, constipation, &c, &c, the symptoms of which will be described under their respective diseases. SHINGLES. A few days previous to this eruption, the patient complains of fever, nausea, headache, langour, thirst, and ITCH. 53 a feeling of heat and pricking in the skin. These symp- toms, however, vary very much, and are sometimes so trifling as not to indicate any constitutional disturbance whatever. The patient complains of an itching and tingling sensation half around the body : upon exam- ination, small clusters of vesicles, containing a clear liquor, appear in succession for three, four, or five days. These pustules shortly after fall off in the form of dark brown scabs, and the skin, although at first slightly in- flamed, soon assumes its healthy appearance. It seldom attacks children under ten years of age, and is most prevalent during warm weather. The treatment is very simple ; a dose of salts, or a little rhubarb and magne- sia, are the proper aperients to administer; and if the irritation should be great, the vesicles may be punctured, and their contents let out. ITCH. This most disagreeable disease usually assumes the form of small vesicles intermixed with pustules, but its aspects are very various and deceitful. It may at all times, however, be distinguished by the incessant and importunate itching which attends it, the constitution being perfectly unaffected. It appears occasionally on every part of the body, the face excepted. Its most usual seat is about the wrists, between the fingers, and at the flextures of the joints. The itch is highly conta- gious, and there is every reason to believe that it con- sists essentially in the presence of a minute insect* burrowing and breeding in the skin. Treatment.—There are few cases of genuine itch that will not yield to the steady employment of sulphur ointment. Five or six applications, assiduously made, are usually sufficient to effect a cure. The ointment should be rubbed well into the parts affected before a * Acarus scabiei. 54 the mother's medical adviser. fire, and the patient well washed with yellow soap and water previous to the application. While the child is suffering from the disease, it should of course sleep by itself, and between blankets. Any old clothes should be worn, as they must all be destroyed immediately the patient is freed from this noxious insect. The diet may be as usual. RING-WORM. Circular forms, composed of vesicular eruptions, with inflamed bases, usually occurring on the forehead, face, neck, and arms, and now and then extending to other parts of the body, may be frequently observed ; this, as is well known, constitutes the disease called ring- worm. If let alone, small scabs form, fall off, and are soon replaced by a second series. The constitution sel- dom suffers, except from the tingling and irritation, which, in young children, may produce febrile action. The treatment for this disease is very simple. A dose of salts may now and then be administered, and the rings rubbed over with lunar caustic—two applications will be found sufficient. This treatment never fails ; it gives much less trouble, is more agreeable to the pa- tient, and infinitely cleaner than the application of oint- ments and lotions. SCALD-HEAD Generally attacks children between the ages of three and six : the more advanced they are in age, the more tedi- ous will be the disease in its progress and cure. The disease may arise spontaneously in children of a full and flabby habit, who are badly fed, where cleanli- ness is not attended to, and where sufficient exercise is not taken ; also, it may be communicated by contagion, such as using the same caps, towels, combs, dec. SCALD-HEAD. 55 It usually occurs on the head, and commences by the color of the hair becoming lighter, dropping off, and decaying at their roots. It assumes the form of distinct irregular or circular patches, on which arise a number of small yellowish or straw-colored pustules ; on burst- ing, they discharge their contents, and form scabs, upon removing which, the part underneath appears red and shining, and very small papulae may be discovered, upon minute examination. The itching produced by this eomplaint is generally very great: the child from scratching the pustules, breaks them, and the conse- quent discharge tends to contaminate the surrounding parts; and in this way," from want of proper attention, the whole of the head may become encrusted with scabs. Treatment.—It is obviously difficult to lay down any plan of treatment for this disease upon which sole reliance can be placed. The treatment must depend, not only upon the general habit of the patient, but also upon the stage of the disease with which you com- mence. As general rules, the head must always be shaved, and well washed night and mcrtring. An oil-skin cap should be worn, and the bowels occasionally relieved by small doses of calomel and rhubarb. When taken in its earliest stages, it is not difficult to Overcome, and the application three times a day, with ft common paint-brush, of sulphate of copper, dissolved in brandy, will usually effect a cure. If the head be covered with scabs, if is necessary to apply a poultice, in order to remove the desiccated dis- charge; this being done, the surgeon will then see to what extent the disease has proceeded, and will conse- quently take his measures accordingly. In the more advanced stages, the application of tar ointment has been found most serviceable: other ointments are also recom- mended, being chiefly compounds of mercury, tobacco, 56 the mother's medical adviser. hellebore, sulphur, &c, &c. A slight diet should be strictly enforced. WORMS. Those children who are of a languid habit of body are usually the sufferers from this malady. The symptoms are a knawng uneasy feeling about the stomach, which is removed or diminished, by eating. The appetite is deranged and variable, often more than ordinarily voracious. The belly is hard and swelled. There is picking of the nose, hiccup, disturbed sleep, and grinding of the teeth. The countenance assumes a remarkable expression so well known to those who have the care of children. The nostrils are dilated, the eyes staring, the mouth is partially open and inclined to the sardonic smile, and the cheeks are blanched. The pulse is irregular, there is continued fever, the skin is scurfy, the tongue furred at the root, but bright red at the tip, and the extremities become emaciated. If the irritation be allowed to proceed, the delicate constitutions of children will soon fail, and symptoms marking an affection of the brain and nervous system, such as giddiness, dilated pupil, and epileptic fits, super- vene. There are five or more varieties of worms infesting the human intestinal canal, but it will be necessary here only to mention the three commonest varieties, as the other species are rarely met with. The first to be mentioned is the round worm, varying in length from twelve to fifteen inches, it is of a white color and chiefly infests the smaller intestines; they Bometimes ascend to the stomach and have even been taken out of the mouth. In general there exists but two, but occasionally as many as thirty or forty have been found. They are seldom met with in persons above fifteen years of age. The tape-worm is of very frequent occurrence both among children and adults; it is jointed, and varies in WORMS. 57 length from one to a hundred or more feet; it occupies the upper part of the intestines, and feeds upon the chyle or extracted nourishment of the food. The last to be spoken of are the thread-worms ; they are about half an inch in length, of a yellowish white color and very brisk. They are usually found in the rectum and lower intestines, and frequently fall out. The treatment for worms has usually been very em- pirical, for the only object sought has been the expul- sion of the worms by drastic medicines; whereas, if the cause be looked to, it will be found that the patient is troubled with these intruders, from weakness and the want of due energy of the bowels to expel them in the natural manner, so that by this means they increase not only in size, but also in number. See then the effect of a drastic purgative; it weakens the action of the stomach and intestines, and thus increases the disposi- tion to form the very nuisances which it is the object of the practitioner to displace. By what has been said it is not intended to be understood that all purgatives should not be used ; but it should be recollected that there is a medium in all things, and where you are backed by rea- son, you had better resort to what that points out than by using violent and mechanical means. There has collected in the intestines during the resi- dence of the worms, a great quantity of mucus, and which is most probably thrown out by the vessels of the lining membrane of the intestine as a defence against the encroaches of the worm, but which, in its turn in- terferes seriously'with the process of digestion, and pre- vents the due action of tonic remedies. Acting then upon this our first object will be to dislodge the mucus, which may easily be effected by one or two mild pur- gatives. If the round or tape-worm is suspected, a dose of calomel and rhubarb should be administered, as these medicines act upon the upper part of the alimentary canal, and it will of course be there that the mucus has 58 the mother's medical ADVISER. accumulated ; if it be the thread-worm, castor-oil will be the best medicine to be given. The mucus being cleared out, tonic medicines should be exhibited, such as bark, iron, or infusions of quassi, gentian, or columbo ; by this means the system will be strengthened, and the bowels restored to their natural action; and should it even now'be necessary, Nature may be aided by the ad- ministration of two or three drachms of oil of turpen- tine in milk. Having dislodged the enemy, the patient must not be neglected, otherwise all the old symptoms will recur. The diet of the patient is to be carefully regulated; digestion is to be promoted by the use of stimulants and bitters; a regular action of the bowels is to be kept up, and accumulation prevented by small doses of rhubarb in combination with the extract «of camomile. The general system is to be strengthened by daily exercise in the,open air, by the cold bath when the season per- mits, and partly, too, by the use of some preparation of steel. hooping-cough. Hooping-cough, chin-cough, or whooping-cough, is, for the most part, a disease of early life; few children indeed escape it; it is contagious, and appears to be communicated with great facility, but seldom occurs more than once in the course of life. The danger is not proportioned to the age of the pa- tient. A child of two or three months old will struggle through the complaint as well as another of two ot three years. When it attacks weakly or scrofulous children, or those laboring under some other disease, it generally proves severe, tedious, and consequently dan- gerous. When hooping-cough commences late in the spring, it \s commonly milder than when its approach is toward HOOPING-COUGH. 69 the beginning of winter, and is most fatal in cold and damp seasons and climates. The cough commences with the common symptoms of catarrh, accompanied with a more than ordinary dis- position to sleep, but those symptoms which denote general fever are seldom very strongly marked. About the third week the fever abates, the appetite returns, and the cough continues in paroxysms of extraordinary vio- lence. The child struggles for breath and appears in danger of suffocation, until relieved by the long and full inspiration known under the name of the back draught or hoop. The fit of coughing continues for several minutes, and is commonly terminated by expectoration of mucus, sometimes by vomiting, occasionally by bleeding at the nose, an epileptic paroxysm, or complete exhaustion. In mild cases the fits seldom occur more than three or four times a day. In severe ones they harass the patient every half hour; the least emotion of mind or exertion of body will bring them on. The child is often aware of the approach of the fit, and lays hold of any- thing near him for support. He finds relief by stoop- ing forward, and by support given to the head aiid back. When once the disease has assumed its regular form, the appetite is good, or rather the patient is never easy unless the stomach contains some kind of food, which relieves the fit of coughing, and generally terminates it by vomiting it up ; hence children as it were by natural instinct, crave for food immediately after a paroxysm of coughing. The tongue is usually clean and moist, and there is no difficulty of breathing in the intervals of the fit. The further progress and duration of hooping-cough are subject to great variety; it generally lasts from two to six or seven months. The disease, when terminating fatally, arises either from marasmus or low fever, with hectic, brought on by exhaustion, hydrocephalus, inflam- 60 THE MOTHER'S MEDICAL ADVISER. mation of the lungs, consumption, epilepsy, or con- vulsions. TREATMENT. An open state of the bowels is almost essential to the favorable progress of the disease. An occasional dose of rhubarb, combined with carbonate of potash or soda, will be of advantage, not only in mildly acting upon the bowels, but also in correcting acidity, which in this dis- ease is very apt to arise. Strong purgatives should never be given, for very fre- quently an attack of diarrhoea supervenes, which no power of medicine will arrest, and the child fall a victim to exhaustion. Emetics are of benefit, and may occasionally be ad- ministered, and, as in hooping-cough there is a natural tendency to vomit, the following mild emetic will be found serviceable : Powder of ipecacuanha, three grains; Prepared chalk, six grains; mix, and administer in warm water. When the disease has existed for a length of time, narcotics will be found useful, such as paregoric elixir, conium, &c, but always under the guidance of the medical attendant. We must, however, chiefly depend upon expectorants, and medicines which act upon the lining membrane of the lungs and the skin. Of the former, preparations of ipecacuanha, mucilages, antimony, &c, may be given; of the latter, a lotion composed of Tartarized antimony, two scruples; Tincture of blister fly, one ounce; Warm water, two ounces; or soap liniment rubbed over the chest and back twice a day, will produce excellent effects. CROUP—WATER IN THE HEAD. 61 Flannel should also be worn as the under garment, and a Burgundy pitch plaster kept upon the chest, both at the commencement and decline of the disease. If symptoms of inflammation of any particular organ arise, both topical and local bleeding must be resorted to, as also the use of blisters, warm bath, &c, accord- ing to the part affected. CROUP. Uusually occurs about the middle of the night, without any warning or initiatory symptoms; the child wakes with a cough, and the inspirations immediately following the cough are long, and attended with that crowing noise so peculiarly characteristic of the disease. It usually occurs during the prevalence of easterly winds; and if the child has been once attacked with the disease it is very liable to a return of it. Treatment.—Immediately the symptoms commence, the child should be placed in a warm bath, and an emetic administered. For farther treatment the practitioner must be con- sulted. WATER IN THE HEAD Generally affects those children who are constitutionally weak, whose dentition has been difficult, or who have suffered from prior diseases that leave the body weak and exhausted. The age at which the disease occurs is from two to fourteen, seldom earlier, and seldom later. As water in the head is a consequence of inflamma- tion, either of the brain or its coverings, every care must be taken to lessen and subdue that inflammation, there- fore leeches should be freely applied to the head, a blis- ter to the back of the neck, cold lotions to the head, and active purges occasionally administered. 62 THE MOTHER'S MEDICAL ADVISER. FITS. The fits to which children are liable are from epilepsy, dentition, overloading the stomach, water in the head, and a few other diseases. EPILEPSY. Usually occurs from tumors or abscesses seated in the brain, growths of bone pressing upon the brain, or the disturbance of function in some portion of the aliment- ary canal. The epileptic fit for the most part occurs suddenly. The patient falls to the ground, the body is violently convulsed, there is foaming at the mouth, the eyes are fixed and reverted, the pupils permanently contracted, the teeth gnash against each other, the tongue is thrust forward and bitten, the breathing is irregular and labo- rious, and complete insensibility prevails. The duration of the fit varies from a few minutes to hours. On its cessation the patient remains for some time motionless, insensible, and apparently in a profound sleep; when recovered he has no recollection of the circumstances of the fit. As general rules, the following advice may be taken: Keep the bowels gently open, the head cool, the feet warm, the mind easy, and never wear tight clothing. Immediately the fit occurs, the cravat or stays, and all strings, should be loosened, also the handle of a wooden spoon, or other instrument, placed between the teeth to prevent the tongue from being bitten. The temples may be bathed with vinegar during the fit, but the patient is much better left quiet; little resistance should be offered, as it only increases the struggle of the sufferer; and lastly, the diet, should be light, and a fire-guard al- ways before the fire in the room habited by the patient. FITS—SCROFULA—CONCLUSION. 63 FITS FROM DENTITION. These arise from excessive nervous irritation, and, consequently, the gums should be freely lanced. FITS FROM OVERLOADING THE STOMACH. These are of very frequent occurrence, and may gen- erally be attributed to the gross neglect and carelessness of nursery maids, who, while out, will frequently call upon their friends, and to prevent the children from tel- ling, will bribe them by cramming them with unripe fruit. Fits in the evening are generally the conse- quence of this improper food. The administration of an emetic will relieve the stomach and restore the child. Antimonial wine, administered until the child has thor- oughly emptied its stomach, is the best emetic for this purpose. SCROFULA. Perhaps, in the whole class of diseases, there are none more, or, indeed, so productive of the most loath- some, distressing, and melancholy disorders, as the va- rious forms of scrofula, which all demand the active treatment of the practitioner. CONCLUSION. In wishing all mothers adieu for the present, we heartily trust that the hints thrown out in this little vol- ume may prove useful in the delightful task of rearing their tender offspring. The medical portion is written, not so much for the mother herself to be the doctor to the child, as to give her sufficient hints to be of service in aiding the practitioner in his inquiries and treatment 64 THE MOTHER^ MEDICAL ADVISER. of his patient. Lastly, we strenuously recommend the lew following maxims to be attended to: Let attention be always paid to the regulation of the bowels. Let the clothes be always whole, if ever so homely, and woollen clothes be in contact with the skin. Never allow opium, in any form, to be administered to a child, except under the advice of the medical at- tendant. Never physic a child too much. Let every child have plenty of exercise in the open air. Let the diet be wholesome, and do not allow child- ren to stuff themselves till they can not eat more. And, lastly, never leave children entirely to the car? of nurses. THE END. A: A NEW AND SPLENDID SERIES COMIC NUESEEY TALES, DONE IN RHYME, AND BEAUTIFULLY EMBELLISHED WITH ENGRAVINGS, Wilson and Company, 162 Nassau street, New York, hare commenced the publication of a Series of popular Juvenile Tales; being new version!, in Rhyme, by the celebrated author of the " New Tale of a Tub." Thai first number contains, complete in ninety-six pages, JACK THE GIANT KILLER, EMBELLISHED WITH TWENTV ENGRAVINGS. No. II. contains, complete in sixty-four pages, a new and beautiful version of LITTLE RED RIDING HOOD, ILLUSTRATED WITH TWENTY-SIX ENORA VINOS. I No. III. contains a new version of the familiar story of BLUE BEARD, Which is given complete in sixty-four pages, and is embellished with TWENTY-FOUR ENGRAVINGS, No. IV. is a most magnificent tale, complete in sixty-four pages, entitled BEAUTY AND THE BEAST, EMBELLISHED WITH FIFTEEN FINE ENGRAVINGS. These works, although done up in rhyme as nursery tales, contain some fun, and fair hits at the times, for grown people. Each o&tfls embellished with all the original engravings of the London half-a-crown edition, by Vizetelly & Co., which have been imported by the publishers. Being issued in periodical form, they may be sent through the mails for common periodical postage. WILSON AND COMPANY. 162 Nassau street, New York.