THE HEALTH -CARE 
 
 OF THE 
 
 GROWING CHILD 
 
 LOUIS FISCHER, M.D. 
 
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THE HEALTH-CARE OF THE 
 GROWING CHILD 
 
A COMPANION VOLUME TO THIS 
 BY THE SAME AUTHOR 
 
 The Health-Care 
 of the Baby 
 
 A most useful Handbook for Mothers 
 and Nurses 
 
 Tells about feeding, teething, bathing, clothing, 
 accidents, skin diseases, bad habits, scarlet fever, 
 diphtheria, whooping cough, measles, croup, colic, 
 worms, and tonsilitis. 
 
 COMMENDATIONS 
 
 "Dr. Fischer's experience as a specialist in the 
 treatment of children's diseases gives the stamp of 
 authority to this handbook for mothers and nurses." 
 — Chronicle Telegraph, Pittsburg. 
 
 "Written so simply and plainly that it can be 
 readily understood by even the most inexperi- 
 enced." — Brooklyn Citizen. 
 
 "Such a book in the hands of a mother, especially a 
 young mother, is invaluable." — Baltimore Methodist. 
 
 "A very valuable addition to the household's 
 essentials." — The Citizen, Brooklyn. 
 
 12mo, Cloth. 75 cents, net; by mail, 82 cents 
 
 FUNK & WAGNALLS COMPANY, Publishers 
 NEW YORK and LONDON 
 
THE HEALTH-CARE OF 
 THE GROWING CHILD 
 
 HIS DIET—HYGIENE— TRAINI 
 DEVELOPMENT AND 
 PREVENT!*' F DISEASE 
 
 TAOflHT YHTJA3H JIO JAMflOM A 
 LOUIS iER, M.D. 
 
 AUTHOR OF "THE I; tB BABY, DING 
 
 IN HEALTH AND i iN " 
 
 FAN) 
 
 OF THE BABIES' WARDS lL - AND 
 
 THE WILLARr; 
 FORMEB TOR IN I SN 
 
 AT THE NEW YORK PO 
 
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 ,<j!i«noj nsllowi adi no aJoqa mtiw-drAwolte* srfj alotf 
 
 b3t83Sno5 bat nyflowg 3 ri*j 81 gfiimoJ adi nsawJad Uni^ned 
 
 baJBoo Bi fi9 ^, B o^aol 3 dT . 3 » S I BQ t) oa io sluvo 
 
A NORMAL OR HEALTHY THROAT 
 
 THE THROAT IN TONSILITIS 
 
 Note the yellowish-white spots on the swollen tonsils, 
 hanging between the tonsils is the swollen and congested 
 uvula or soft palate. The tongue appears coated. 
 
THE HEALTH-CARE OF 
 THE GROWING CHILD 
 
 HIS DIET— HYGIENE— TRAINING- 
 DEVELOPMENT AND 
 PREVENTION OF DISEASE 
 
 BY 
 
 LOUIS FISCHER, M.D. 
 
 AUTHOR OF "THE HEALTH-CAKE OF THE BABY," "INFANT FEEDING 
 IN HEALTH AND DISEASE," "a TEXT-BOOK ON DISEASES OF IN- 
 FANCY AND CHILDHOOD;" ATTENDING PHYSICIAN IN CHARGE 
 OF THE BABIES' WARDS OF SYDENHAM HOSPITAL, AND 
 TO THE WILLARD PARKER AND RIVERSIDE HOSPITALS; 
 FORMER INSTRUCTOR IN DISEASES OF CHILDREN 
 AT THE NEW YORK POST GRADUATE MEDICAL 
 SCHOOL AND HOSPITAL, ETC. 
 
 FUNK & WAGNALLS COMPANY 
 
 NEW YORK AND LONDON 
 
 1915 
 
TO 
 
 Copyright, 1915, by 
 
 FUNK & WAGNALLS COMPANY 
 
 (Printed in the United States of America) 
 
 Published* October, 1915 
 
 NOV 20 1915 
 
 )CI,A4 16497 
 
3Sebicateto 
 So tfie parents 
 
 of 
 "Utttle WW 
 
PREFACE 
 
 The main object of this book is to in- 
 struct and guide the intelligent mother 
 when remote from her physician, or to ad- 
 vise her sufficiently in case of emergency 
 until medical help is required and can be 
 procured. 
 
 Our methods of feeding, hygiene, gym- 
 nastics, development, school life, and home- 
 training are so vastly different from what 
 they were one decade ago that every mother 
 who wishes to keep up to date needs must 
 read. 
 
 So many conditions may be met with in 
 daily routine that the average mother is 
 likely to be bewildered and perplexed un- 
 less she has a guide near her. Every 
 mother should know the appearance of a 
 
 [vii] 
 
PKEFACE 
 
 healthy throat and of an inflamed throat. 
 She should know the symptoms of adenoids 
 and familiarize herself with rashes due to 
 inflammatory and also to non-inflammatory 
 conditions within the body. She should 
 know the normal temperature and recog- 
 nize fever by her thermometer. 
 
 Faulty position while sitting at home or 
 at school, if continued, may develop spinal 
 curvature or round shoulders. To obviate 
 this a series of exercises is provided which 
 show how this faulty development may be 
 corrected. The importance of correcting 
 this deformity early in life will be appre- 
 ciated, for if it be not checked, spinal ap- 
 paratus and plaster of Paris casts may 
 ultimately be required. 
 
 Headache is frequently due to eye-strain, 
 but there are many other causes of head- 
 ache in boys and girls. These are specified 
 in detail. 
 
 [ viii 1 
 
PEEFACE 
 
 Sex-hygiene is so described that every 
 mother can understand this delicate prob- 
 lem. What to avoid, and how to instruct 
 boys and girls to prevent habits which may 
 affect their future, and especially under- 
 mine their nervous system, are explained in 
 detail. 
 
 The communicable diseases, their dan- 
 gers, complications, and modern methods 
 of quarantine are considered and presented 
 from the modern viewpoint. Disinfection, 
 as formerly used, is now abandoned, and 
 modern sanitation and isolation have been 
 described with deference to modern views. 
 
 Many illustrations showing the value of 
 gymnastics, intended for the development 
 of the spine, the chest, the neck, the arms, 
 and the legs, have been added. Weak ankles 
 and defective walking are illustrated. 
 
 The adenoid expression so frequently 
 noted in school children has been depicted 
 
 [ix] 
 
PKEFACE 
 
 and described. This adenoid condition 
 should receive the close attention of every 
 mother. 
 
 The most important illustrations show 
 clearly how to recognize measles, chicken- 
 pox, and smallpox. The throat is the seat 
 of more trouble than any other part of the 
 human body. Studies of a normal throat 
 and of a diseased throat, showing yellow- 
 ish spots on the tonsils, have been in- 
 cluded. 
 
 Trachoma, which is regarded as one of 
 the most treacherous of eye-diseases, and 
 for which every medical inspector exam- 
 ines, is shown in such manner as to be 
 unmistakable. In addition, the tapeworm, 
 showing both segments and head, is in- 
 cluded. 
 
 Enlarged glands are sometimes an early 
 symptom of tuberculosis; this should be 
 well remembered. Ivy poison is a frequent 
 
 [*3 
 
PREFACE 
 
 source of irritation in school children, 
 hence every mother should know and be 
 able to teach her child the difference be- 
 tween poison-ivy and the harmless Vir- 
 ginia creeper. 
 
 Especial stress has been laid on the diet 
 best suited to the growing child. Special 
 diets, adapted to illness, have been given. 
 Whenever possible, advice that may serve 
 as first-aid to the injured has been given 
 freely, and so may be said to abound 
 throughout the book. 
 
 The Appendix will be found to contain 
 a series of diet formulas and instructions 
 on the application of poultices, the giving 
 of various baths and other treatments re- 
 quired in caring for the sick. 
 
 The author acknowledges with pleasure 
 the valued assistance and kindness ren- 
 dered to him by his publishers, who have 
 spared neither time nor expense to aid him 
 
 [xi] 
 
PREFACE 
 
 in the preparation of this book, which he 
 hopes may meet with the same cordial re- 
 ception as that accorded to its predecessor, 
 The Health-Care of the Baby. 
 
 Louis Fischer. 
 
 New York, 155 West 85th Street. 
 September, 1915. 
 
 [xii] 
 
CONTENTS 
 
 PART I 
 GENERAL HYGIENE AND DEVELOPMENT 
 
 CHAPTER PAGE 
 
 I. Channels of Elimination 3 
 
 II. Bathing 6 
 
 III. Ventilation 12 
 
 IV. Sleep 18 
 
 V. Exercise — Amusements 24 
 
 VI. Clothing — How to Haeden a Child .... 36 
 
 VII. School Hygiene — Summer Vacations ... 40 
 
 VIII. Characteristics and Peculiarities of 
 
 Children 47 
 
 IX. Nervous Children 55 
 
 X. Precocious Children 58 
 
 XL The Breath 60 
 
 XII. The Teeth 62 
 
 XIII. Hygiene of the Hair and Scalp 68 
 
 XIV. Growth in Height and Weight 74 
 
 XV. Puberty 75 
 
 XVI. Vaccination 84 
 
 XVII. Temperature — Fever 88 
 
 [ xiii ] 
 
CONTENTS 
 
 PART II 
 NUTRITION 
 
 CHAPTER PAGE 
 
 I. The Diet 97 
 
 Individual requirements — Milk — Quantity 
 required — Feeding intervals — Specimen 
 diets — Diet for a child from three to 
 six years old — Diet for a child with 
 weak digestion, from six to ten years 
 old — Diet for a child over ten years 
 of age — Diet for an underweight child 
 — Diet for a very fat child — Diet in 
 fever — Diet in diarrhea — Poor appetite 
 — Vomiting. 
 
 II. Disoeders Arising From Improper Nutri- 
 tion 118 
 
 The bowels — Constipation — Diarrhea — Colic 
 or cramps — Intestinal indigestion — Rick- 
 ets — Weak ankles — Scurvy. 
 
 PART III 
 
 CATARRHAL, COMMUNICABLE, AND SYS- 
 TEMIC DISEASES 
 
 I. Catarrhal Diseases 139 
 
 The throat — Adenoids — Tonsillitis — Rhi- 
 nitis, or cold in the head — Coughs. 
 
 II. Communicable Diseases 154 
 
 How contagious diseases are spread — 
 Table of communicable diseases — Influ- 
 [xiv] 
 
CONTENTS 
 
 CHAPTER PAGE 
 
 enza — Bronchitis — Bronchial asthma — 
 Pneumonia — Tuberculosis — Whooping- 
 cough — Mumps — Croup — True membra- 
 nous or diphtheritic croup — Diphtheria — 
 Chiekenpox — Measles — German measles 
 — Scarlet fever — Typhoid fever. 
 
 III. Systemic Diseases 209 
 
 Appendicitis — Malaria — Rheumatism. 
 
 PART IV 
 
 DISEASES OF THE SKIN AND NEKVOUS 
 SYSTEM 
 
 I. Diseases of the Skin 221 
 
 Rashes — Insect bites — Eczema — Erysipelas 
 Ringworm — Ivy-poison — Sunburn — 
 Frost-bite — Hives — Itch — Warts — 
 Head-lice— Dandruff. 
 
 II. Diseases or the Nervous System 238 
 
 Defects of speech — Chorea — Habit spasm 
 — Convulsions or spasms — Tuberculous 
 meningitis — Night-terrors — Paralysis 
 — Spinal curvature — Headache. 
 
 PART V 
 
 MISCELLANEOUS DISEASES AND AFFECTIONS 
 
 Miscellaneous Diseases and Affections 263 
 
 Operations in children — Hernia — Enlarged 
 glands — Fainting — Cold hands and feet — 
 
CONTENTS 
 
 PAGE 
 
 Hiccup — Foreign bodies in the ear — Ear- 
 ache — Pinkeye — Sties — Trachoma — 
 Fever-sores — Injuries — Burns — Splin- 
 ters — Sprains — Bleeding — Nosebleed 
 — Worms — Tapeworm — Bedwetting 
 — Retention of urine — Leucorrhea — Fis- 
 sure of the anus — Poisons and antidotes. 
 
 APPENDIX 
 Food recipes, 305 — Local remedies, 313 
 — Ointments and lotions, 325. 
 
 Index 329 
 
 [xvi] 
 
LIST OF ILLUSTRATIONS 
 
 Normal and Diseased Throats Frontispiece ' 
 
 Ventilating Window Box Page 16 
 
 Wand Exercises, I Facing 26 " 
 
 Wand Exercises, II Facing 30 ' 
 
 Pulley-weight Exercises, I Between 34 and 35^ 
 
 Pulley-weight Exercises, II Between 34 and 35 '- 
 
 Pulley-weight Exercises, III Facing 36 '^ 
 
 Hanging or Raising Exercise Page 34 
 
 Mat Exercises for Girls Facing 38 
 
 Small-pox Facing 84 " 
 
 Rickets Facing 132 x/ 
 
 Normal Walk. Abnormal Walk Page 134 
 
 A Group of Adenoid Faces Facing 142 V- 
 
 Chicken-pox Facing 194 ^ 
 
 Measles Facing 198 ^ 
 
 Poison Ivy-leaf. Virginia Creeper Facing 230 v 
 
 Ivy Poisoning Facing 230 v 
 
 Spinal Curvature Facing 256 v ' 
 
 Faulty Sitting Positions Between 258 and 259 V 
 
 Correct Sitting Positions Between 258 and 259 ^ 
 
 Enlarged Tuberculous Glands Facing 268 * 
 
 Trachoma Facing 280 
 
 Tapeworm Facing 288 
 
 [ xvii ] 
 
PART I 
 
 GENERAL HYGIENE AND 
 DEVELOPMENT 
 
 i 
 
 ; 
 
 [i] 
 
Chapter I 
 CHANNELS OF ELIMINATION 
 
 Theke are four channels through which 
 the body is cleansed of impurities. They 
 are: first, the skin; second, the bowels; 
 third, the kidneys; and fourth, the lungs. 
 
 The skin contains millions of pores The skin 
 through which the body throws off impuri- 
 ties, but these impurities will only be re- 
 moved if the skin is thoroughly cleansed; 
 therefore, bathing is imperative for the 
 healthy as well as for the sick child. 
 
 Unless one or two movements of the bow- The Bowels 
 els takes place daily, illness will result. 
 
 Nature demands that the waste products 
 of the system, including foul gases, be 
 passed through the body sewer. If this 
 sewer is clogged and obstructed the poison 
 
 [3] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 will remain in the system and give rise to 
 various disturbances. 
 The Kidneys Next in importance in elimination are the 
 kidneys. Every child should be reminded 
 to empty its bladder on awakening in the 
 morning as well as before retiring at night. 
 The bladder should be emptied at least three 
 to four times a day. Nature demands more 
 frequent relief if large quantities of liquids 
 are taken. A child should pass at least one 
 quart of urine in twenty-four hours. 
 
 With the urine is passed excessive poisons 
 thrown off by the blood and glands, through 
 the kidneys. If these poisons are retained 
 they can give rise to disease. 
 
 If the quantity of urine is scant and the 
 child passes but an ounce or two at a time 
 then ten drops of niter may be given in a 
 little water, every hour for three doses. If 
 the kidneys do not respond promptly it in- 
 dicates sluggishness or perhaps congestion 
 
 [4] 
 
CHANNELS OF ELIMINATION 
 
 of the kidneys, which must be supervised 
 by a physician. 
 
 When fresh air is taken into the lungs The Lungs 
 we give the body a lung tonic. The foul air 
 passed by each expiration rids the body of 
 poisons collected within the lungs. 
 
 [5] 
 
Chapter II 
 BATHING 
 
 The Tepid For the healthy child a daily tub bath 
 
 Tub Bath . - 
 
 should be given in the morning, at a tem- 
 perature of from 95 to 98 degrees. It is 
 more beneficial to gradually lower the tem- 
 perature of the bath two degrees daily un- 
 til from 80 to 85 degrees is reached. This 
 cooling of the water has a very toning ef- 
 fect on the nervous system, which is espe- 
 cially indicated in the nervous and restless 
 child. In many cases it is better, imme- 
 coid shower diately after the bath, to let a shower of 
 cold water run over the neck and shoulders 
 for a few minutes. This will not only con- 
 tract the pores and prevent the taking of 
 cold but it is one of the best tonics for the 
 nerve terminals. 
 
 [6] 
 
BATHING 
 
 Wlien a child is susceptible to colds and 
 coughs, and especially if the weather is cold 
 and damp and raw in winter, the tub bath 
 should be given in the evening rather than 
 in the morning. To such children the tub 
 bath should be given first, then the supper, 
 before retiring. 
 
 The reaction following a cold bath should Reaction 
 be a ruddy appearance of the skin and a gen- 
 eral glow, proving that the circulation has 
 returned to the surface with renewed vigor. 
 If however after the cold bath the skin 
 does not become pink and the fingers and 
 toes remain blue and cold it proves an in- 
 complete reaction. The effects of such cold 
 baths are harmful. 
 
 When after a cold bath children shiver 
 and complain of the cold and do not feel 
 braced up but are tired and languid, it 
 shows that to them cold baths are depress- 
 ing and harmful. We should not persist 
 
 [7] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Duration of 
 Bath 
 
 Warm Bath 
 
 with the cold baths, but instead give them 
 tepid or warm. 
 
 A cool or cold bath for a child of from 
 two to five years should never be given 
 longer than two minutes, to a child of from 
 five to ten years not longer than three 
 minutes. Frail, sensitive, and thin children 
 are susceptible to the influence of cold air 
 and water, hence we should watch the body 
 and note the color of the skin during the 
 bath. If blueness or extreme paleness takes 
 place, it shows that the bath should be 
 stopped and followed by a brisk rubbing 
 with a coarse bath towel. Exhaustion and 
 weakness will follow in an enfeebled child 
 if the bath is prolonged beyond the toler- 
 ance of the body. A bath properly given 
 stimulates, a bath prolonged, depresses. 
 
 A warm bath should never be prolonged 
 more than five to six minutes. The tem- 
 perature of the water should be from 100 
 
 [8] 
 
BATHING 
 
 to 103 degrees. After briskly rubbing the 
 skin dry, it is a good plan to rub with alco- 
 hol. This alcoholic sponging closes the 
 pores and prevents perspiration, which oth- 
 erwise might result in chilling the body. 
 
 Most children bathe too long in the surf. An ocean Bath 
 There is no objection to giving a child an 
 hour or several hours of activity and play 
 on the shore, but the bath itself should never 
 be prolonged more than ten to fifteen 
 minutes and should then be followed by 
 brisk rubbing. Friction after the bath to 
 restore circulation is as important as the 
 salt bath, and gives the reaction to the cir- 
 culation. 
 
 No child of fourteen or under should be too Frequent 
 
 Bathing 
 
 permitted to bathe more than once a day. 
 Too frequent bathing is harmful and low- 
 ers the vitality of the system. 
 
 The good effect of living at the seashore 
 is frequently counteracted by too much bath- 
 
 [9] 
 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Wading or 
 Paddling 
 
 Bath for 
 Sleeplessness 
 
 ing, which instead of toning the system de- 
 presses the nervous system. 
 
 Wading or paddling in the sea does no 
 harm if not carried to extreme, but it may 
 do great harm if the heat of the sun beats 
 upon the head while the feet and legs are 
 in an extremely cold temperature. Fre- 
 quently prolonged wading will result in in- 
 testinal catarrh and in a disturbance of the 
 nervous system. 
 
 The warm bath at a temperature of from 
 103 to 105 degrees, if used from three to 
 five minutes, with plenty of friction while 
 in the tub, will soothe the nervous system 
 and quiet the child. It promotes sleep. 
 
 When children are restless and their di- 
 gestion is not disturbed, especially if they 
 have been very active at school — then a 
 very warm bath will soothe the nerves and 
 quiet the brain, thus promoting sleep. 
 
 In order that the skin performs the func- 
 
 [10] 
 
BATHING 
 
 tion of eliminating waste material from the 
 body it is of the utmost importance that it 
 be kept in as perfect a condition of health 
 as possible. The circulation must be main- 
 tained by sufficient clothing, and the waste 
 products of the sweat glands constantly 
 thrown out through millions of glands in 
 the skin must be removed by frequent bath- 
 ing and friction. 
 
 [ii] 
 
Chapter III 
 
 VENTILATION 
 
 The blood contains oxygen, and the color- 
 ing matter of the blood depends on its sup- 
 ply of oxygen; hence, pure air is a neces- 
 sary factor in the nutrition of the body, and 
 especially necessary for the building of 
 healthy red blood corpuscles. 
 Dangers of If therefore a child is permitted to 
 
 Foul Air 
 
 breathe foul air or air robbed of its oxygen, 
 the result will be speedily shown by the 
 color of the skin. Such a child, instead of 
 having a healthy, ruddy color, has a pale, 
 sallow color, due to the lack of oxygen. 
 When it is remembered that an ordinary 
 gas-jet consumes as much oxygen as five 
 people, then we can understand why it is 
 imperative to open windows and admit pure 
 air if gas-jets have been burning. 
 
 [12] 
 
VENTILATION 
 
 There are other means of polluting air in 
 the house in addition to the burning of gas. 
 These are: gas given off from defective 
 stoves or furnaces, cellars that are damp, 
 house filth, exhalations from the body, and 
 decomposing vegetable matter. 
 
 What effect has breathing of foul air on 
 the child ! Such a child is usually very sus- 
 ceptible to colds and coughs. These are the 
 children that have a lowered vitality, and 
 the bodily resistance being reduced they 
 invite catarrh of the head and bronchial 
 tubes; they also are susceptible to pneu- 
 monia and tuberculosis. After a winter of 
 poor ventilation such children usually de- 
 velop adenoid vegetations and enlarged ton- 
 sils. They are restless by day, very sensi- 
 tive and nervous, and do not sleep well. As 
 a result of the loss of sleep, the appetite is 
 impaired. The bowels do not functionate 
 properly. Such children are underweight 
 
 [13] 
 
HEALTH-CAKE OF THE GEOWING CHILD 
 
 and show the evidences of malnutrition. 
 They are subnormal, and as a result of this 
 general weakness are more susceptible to 
 scarlet fever and diphtheria than they would 
 be in health. 
 
 Fresh food is to the stomach what fresh 
 air is to the lungs. Plants absorb oxygen 
 from the air and thrive. The same applies 
 to the lungs, which take in the oxygen and 
 oxygenate the blood, thus distributing 
 healthy blood corpuscles through the vital 
 organs of the body, also through the blood 
 vessels which enter the skin, nerves, and 
 the large organs of the body. The stom- 
 ach, the liver, and the intestines are the vital 
 organs of digestion, and if they carry thin 
 blood or blood that is not up to the stand- 
 ard in strength, they cannot perform their 
 proper functions and we find sluggish ac- 
 tions resulting therefrom. It is useless to 
 have a child out of doors all day playing in 
 
 [14] 
 
VENTILATION 
 
 and breathing fresh air, and then have him 
 cooped up at night in a stuffy bedroom with 
 windows and doors closed, and heavily 
 blanketed. "What is gained during the day 
 by an outdoor life is lost re-breathing foul 
 or impure air at night. Night air is purer value of 
 
 Night Air 
 
 than day air, and the windows should re- 
 main open, with full and free ventilation, 
 because the lungs give off poisoned air con- 
 tinuously. 
 
 I do not advocate placing children in 
 draughts, but they should be given the bene- 
 fit of plenty of fresh air with windows open, 
 as thereby they will sleep better. Every 
 mother or nurse knows that when an infant 
 is taken into the street, especially in winter, 
 it invariably goes to sleep, and the moment 
 such infant is brought back into the heated 
 house it awakens, is restless and dissatisfied 
 until it is again taken out-of-doors. 
 
 When draughts are feared, or the wind 
 
 [15] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 blows too strongly, a simple contrivance 
 consists in having a window-board inserted 
 
 =-=,-« 
 
 OUTSIDE VIEW. 
 
 T tt T t' il 'T T r T r 
 
 
 
 INSIDE VIEW. 
 
 Fig. 1. 
 DAYBROOK VENTILATOR WINDOW BOX. 
 
 These ventilators can be bought at department 
 stores. A fine bronze wire screen built into the venti- 
 lator prevents dust, snow, and insects from entering. 
 Sliding extensions make it adjustable to any window. 
 
 Ventilator Adjusted, inside view. Air is admitted 
 from the outside, and reflected at right angles, enter- 
 ing the room through the top of the ventilator, where 
 movable slides control the amount of air admitted. 
 
 after raising the window (Fig. 1). Such 
 window-boards allow the entrance of suf- 
 ficient air without causing a draught. 
 
 [16] 
 
VENTILATION 
 
 The value of sunlight for the growth of sunlight 
 plants is too well known to be dwelt upon. 
 Sunlight destroys bacteria. Disease germs 
 die when exposed to sunlight. The rays of 
 the sun in a room occupied by a typhoid, 
 diphtheria, or tuberculosis patient will de- 
 stroy more germs and in less time than the 
 commonly used disinfectants. It is a strong 
 argument in favor of opening windows, ad- 
 mitting sunshine, and giving the bedclo thing 
 as well as the room a sun bath. 
 
 In many sanitaria in this country and 
 abroad patients afflicted with tuberculosis 
 are exposed to the sun's rays. The only 
 covering on the body is a white sheet. This 
 is called "heliotherapy," and hardens the 
 skin; besides, the sun's rays penetrate into 
 the deeper parts of the lung and thereby 
 destroy the active germ life which causes 
 lung disease. 
 
 [17] 
 
Chapter IV 
 
 SLEEP 
 
 An active child walking or running about 
 needs rest. During sleep the body restores 
 its wasted energy. The nervous energy 
 causes great destruction of the nerve-tissue, 
 in which the brain, the muscles, and all the 
 vital organs of the child's machine partici- 
 pate. 
 
 Sleep is nature 's method of repair to the 
 vital organs. It is like an electric current 
 which recharges the batteries of the system 
 exhausted by the wear and tear incident to 
 an active life. 
 Amount of A weak, nervous, and frail child requires 
 
 Sleep Required 
 
 more rest, and a midday rest of one-half 
 hour after lunch. A strong and robust child 
 
 [18] 
 
SLEEP 
 
 may do without the midday rest. Children 
 under six years should rest at least eleven 
 to twelve hours. A growing child should 
 not be compared to an adult. A growing 
 child needs proportionately more sleep. A 
 child of from twelve to fifteen years re- 
 quires from nine to ten hours' sleep. At 
 this critical period we should insist on chil- 
 dren retiring between 8 and 9 P.M., and 
 rest, even if they do not sleep, until 6.30 in 
 the morning. 
 
 When children are deprived of sleep or 
 do not have a sound sleep their digestion 
 will be impaired, so that loss of appetite, 
 constipation, and indigestion may result. 
 Irritability and restlessness by day, dulness 
 in school, and backwardness in both physical 
 and mental development will result from 
 insufficient sleep. 
 
 From the loss of sleep and appetite the 
 body will lose weight. It is surprizing to 
 
 [19] 
 
HEALTH-CAEE OF THE GKOWING CHILD 
 
 note the bodily gain when sufficient sleep 
 is given a child. 
 to Promote To promote sleep the bedroom should be 
 
 Sleep r 
 
 cool and well ventilated; this will give a 
 continuous supply of fresh air. The cloth- 
 ing should be loose, to permit freedom of 
 respiration. The bedclothing should be 
 loose and light, and the child's arms and legs 
 free. Straight- jacket methods should be 
 discarded. 
 
 Sufficient food should be given at the eve- 
 ning meal, but the stomach should not be 
 overloaded. If too much food is given, in- 
 digestion, colic and cramps in the stomach 
 will interfere with sleep. 
 
 No child should go to bed at night with- 
 out having had a movement of the bowels 
 during the day. If constipation exists, na- 
 ture should be assisted by giving an injec- 
 tion of one pint of Castile soap water. (See 
 treatment of constipation.) 
 
 [20] 
 
SLEEP 
 
 Exciting stories which frighten the child 
 and frequently cause dreams should not be 
 told before retiring. Pleasant, quiet amuse- 
 ments and games will aid in promoting 
 sleep. 
 
 There are many conditions which disturb 
 sleep, causing insomnia, and if sleepless- 
 ness continues persistently a physician 
 should be consulted. 
 
 The eating of too much candy may cause 
 worms which will irritate the child. Indi- 
 gestion, colic, earache, toothache, adenoids, 
 or enlarged tonsils which prevent proper 
 breathing are frequent causes of restless 
 sleep. If a cough is present which disturbs 
 sleep then we should suspect whooping- 
 cough or adenoids. Masturbation in wake- 
 ful children should be suspected and 
 watched for; this applies to girls as well 
 as to boys. To safeguard the child where 
 such suspicion exists we should insist on 
 
 [21] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 having the child sleep with its hands out- 
 side of the blankets. 
 The Necessity Concerning the necessity for sleep, Dr. 
 
 for Sleep 
 
 Hammond in one of his articles on l ' Sleep ' ' 
 says: "So long as an individual is awake, 
 there is not a single second of his life dur- 
 ing which his brain is altogether inactive. 
 ... Its substance is consumed by every 
 thought, by every action of the will, by 
 every sound that is heard, by every object 
 that is seen, by every substance that is 
 touched, by every odor that is smelled, by 
 every painful or pleasurable sensation; and 
 so each instinct of our lives witnesses the 
 decay of some portion of its mass and the 
 formation of a new material to take its 
 place. . . . The necessity for sleep is due 
 to the fact that during our waking moments 
 the formation of the new substance does 
 not go on as rapidly as the decay of the 
 old. The state of comparative repose which 
 
 [22] 
 
SLEEP 
 
 attends upon this condition allows the bal- 
 ance to be restored, and hence the feeling 
 of freshness and rejuvenation we experi- 
 ence after a sound and healthy sleep/ ' 
 
 [23] 
 
Chapter V 
 
 EXERCISE— AMUSEMENTS 
 
 Every child requires exercise. A child 
 will run, and jump, and shout. The jump- 
 ing and shouting strengthens the lungs and 
 voice. It also develops the chest, stimulates 
 the appetite, and aids digestion. The run- 
 ning stimulates the circulation of the blood, 
 and from this active perspiration will result. 
 Perspiration is healthful; it is the means 
 of removing waste products through the 
 pores of the skin. The lungs also will throw 
 off exhalations by taking in a greater supply 
 of oxygen. This strengthens the blood and 
 renders the brain more active. 
 Lung Children on awaking should be taught 
 
 Gymnastics 
 
 to take deep breaths. They should inhale 
 and exhale very slowly. This form of lung 
 
 [24] 
 
EXEKCISE— AMUSEMENTS 
 
 exercise will strengthen the chest-walls 
 and if continued for weeks, months, and 
 years will prevent flat-chested and pigeon- 
 breasted conditions in the growing child. 
 Breathing should be through the nose, the 
 mouth remaining closed. If there is any 
 obstruction in the nose and throat such as 
 is caused by enlarged tonsils or adenoids, 
 the same should be removed. Thorough 
 oxygenation of the lungs is very necessary. 
 It is nature's method of giving fresh lung- 
 food. 
 
 All exercises and games such as ball- 
 playing, walking, running, bar-exercise, and 
 football have their advantages and should 
 be encouraged. For a poorly developed 
 chest nothing can equal rowing. This ex- 
 ercises not only the muscles of the arms 
 and chest and back but also strengthens the 
 lower limbs. 
 
 For girls the hoop, roller-skates, bean- 
 
 [25] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 bag, skipping-rope, tennis, and rowing are 
 among the games which may be permitted. 
 Swimming for both boys and girls is one of 
 the best exercises. 
 
 over Exercise No games or exercises should be permit- 
 ted during the menstrual period. Children 
 have a tendency to overtax their strength 
 by too much exercise. Serious results may 
 follow if the heart is overstrained, and it 
 is the duty of every mother or nurse to be 
 sure that the child's heart is able to stand 
 the amount of exercise taken. While lack 
 of exercise will render the muscles soft and 
 flabby, so will too much exercise overstrain 
 and cause, in some instances, irreparable 
 damage. 
 
 proper During the period of growth the bones 
 
 are soft and yield readily, and this is the 
 time when tight-fitting clothing will inter- 
 fere with the proper expansion of the 
 chest. Continued pressure on the chest by 
 
 [26] 
 
Fig. 2. Position. — Wand held in both hands and rest- 
 ing against the front of the thighs, palms turned 
 backward. 
 
 Fig. 3. Position. — Wand forward upward, swing, 
 arms straight and vertical. Wand downward, swing. 
 
 Fig. 4. Position. — Step-out, right. Swing wand to 
 right horizontal. Step-out, left. Swing wand to left 
 horizontal. Step-out, right. Swing wand to right 
 vertical. Step-out, left. Swing wand to left vertical. 
 
EALTJ 
 b« 
 
 Over Exercise be pemiit- 
 
 trual period. Children 
 
 overtax their strength 
 
 Serio mlts may 
 
 I it 
 
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 sure on i: 
 
EXEKCISE— AMUSEMENTS 
 
 faulty clothing may result in deformity such 
 as a flat chest. Most public schools and 
 kindergartens give callisthenics after a 
 short period of study and this is one of the 
 best means of restoring the circulation of 
 the blood after a period of brain activity. 
 During rainy weather exercise should be 
 given indoors. 
 
 The child should be encouraged to sleep 
 with the windows wide open. If after study- 
 ing or confinement in a room the child's 
 hands or feet are cold, the use of pulley- 
 weights or light dumb-bells, or a game of 
 handball for from five to ten minutes will 
 quickly restore the circulation of the blood. 
 
 Walking briskly is one of the best means 
 of aiding the circulation. In modern houses 
 the use of elevators has deprived children 
 of one of the best means of exercise for the 
 extremities, also for the heart, namely, 
 stair-climbing. 
 
 [27] 
 
HEALTH-CAEE OF THE GROWING CHILD 
 
 wand Exercise Exercise with a wand is practised in 
 many schools. When children do not attend 
 school this form of exercise can be carried 
 out at home. 
 
 The wand is usually of wood, from 24 to 
 30 inches in length and from one-half to 
 an inch in diameter. The ends should be 
 rounded. These sticks can be purchased 
 from dealers in gymnasium supplies or 
 from furniture manufacturers. As a sub- 
 stitute a walking cane or the handle of a 
 broom may be used. 
 
 This form of exercise, like dumb-bells, is 
 especially adapted for the development of 
 the arms. In order to properly distribute 
 the work, these exercises, in combination 
 with chest-, abdomen-, and leg-exercises, 
 distribute the movements. 
 
 The inserted illustrations give an idea 
 of the movements possible with the wand. 
 The exercises should be continued ten to 
 
 [28] 
 
EXERCISE— AMUSEMENTS 
 
 twenty minutes, but never to the point of 
 fatigue. Gymnastics, twice daily from five 
 to ten minutes, will aid in the development 
 of the bones and muscles of the body. A 
 graceful carriage will be acquired if the 
 muscles have tone. 
 
 The early use of gymnastic exercises will 
 prevent many of the deformities of the 
 chest and spine arising from flabby, unused 
 muscles. 
 
 Deep breathing — lung-expansion — is the 
 best means of oxygenating the lungs. By 
 this means we strengthen and prevent 
 disease-germs from taking hold. 
 
 PULLEY-WEIGHT OR CHEST- 
 WEIGHT EXERCISES 
 
 Pulley-weight exercises are adapted for 
 the home. They are especially useful for 
 indoor exercise during inclement weather. 
 
 These exercises should be given with one 
 
 [29] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 hand only, later after these simple move- 
 ments are mastered both hands can be used. 
 My preference however is for the use of 
 the gymnasium at school or otherwise under 
 the supervision of one competent to instruct 
 in the development of the muscles of the 
 body. 
 
 BEGINNER'S SERIES (WITH ONE HAND) 
 
 Right Side to Machine — I. Position — Broad 
 base (feet straight forward, the weight on the 
 outer borders), left hand on the hip, right, the 
 arm out. 
 
 1st Count — Swing right arm down, poise left. 
 (Fig. 8.) 
 
 2d Count — Bend right arm, elbow up, poise 
 right. (Fig. 9.) 
 
 Progression — (a) 1st Count — Swing right arm 
 down, bending trunk forward (trunk relaxed, 
 knees straight). (Fig. 10.) 
 
 2d Count — As in I, count 2. (Fig. 9.) 
 
 Progression — (6) Position — Feet together. 
 
 1st Count — Swing the right arm down, change 
 to left. (Fig. 11.) 
 
 2d Count — As in I, count 2. (Fig. 9.) 
 
 [30] 
 
/ 
 
 Fig. 5. Position.— Drop to left knee. Wand aimed 
 forward along left arm. ^ A 
 
 Position. — Drop to right knee. Wand aimed forward 
 along- right arm. s. 
 
 Fig. 6. Position.— Wand overhead, as in No. 2 
 
 arms, drop back of head. 
 to left. Step-out, right, 
 forward on chest. 
 
 Bend 
 
 Step-out, left. Bend body- 
 Bend body to right. Bring 
 
 Fig. 7. Position. — Retain position as in Fig. 5. Step- 
 out, right. Cross right arm over left. Step-out, left. 
 Cross left arm over right. 
 
GROT fLD 
 
 hand < 
 
 ool or 
 tbt competent to instruct 
 
 it of the muscles of the 
 
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 xed, 
 
 g 
 >n— Feet together, 
 right arm down, change 
 
 KM 
 
 
EXEKCISE— AMUSEMENTS 
 
 Facing Machine — II. Position — Left foot 
 forward, right hand on hip, left arm forward, 
 palm np. 
 
 1st Count — Swing left arm down, poise for- 
 ward. (Fig. 12.) (This forward poise is al- 
 ways taken with the chest high, the neck forced 
 back, and no hollow in the back.) 
 
 2d Count — Bend arm, elbow down and in, 
 poise forward. (Fig. 13.) 
 
 Progression — (a) 1st Count — As in II, 
 count 1. 
 
 2d Count — Swing arm out, shoulder high, 
 poise forward. (Fig. 15.) 
 
 Progression — (c) 1st Count — Swing left arm 
 down, bend trunk forward (bowing position). 
 (Fig. 14.) 
 
 2d Count — Bend arm forward, elbow out, 
 poise forward. 
 
 3d Count — Repeat 1st count. 
 
 4th Count — Swing left arm out, poise for- 
 ward. (Fig. 15.) 
 
 III. Position — Broad back, right hand on 
 hip, left arm forward. 
 
 1st Count — Swing left hand down to right 
 ankle, bend and twist trunk right. 
 
 2d Count — Swing left arm out, twist trunk 
 left (chest forward, weight over left foot). 
 
 [31] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 MAT EXERCISES FOR GIRLS 
 
 To strengthen the circulation of the blood 
 and give tone to the muscles, the following 
 series of exercises are advantageous. They 
 should be used in the morning, preferably 
 before breakfast. From five to ten min- 
 utes will suffice. A tub-bath or shower- 
 bath, followed by a brisk rubbing, after the 
 exercises will prepare any girl for her day's 
 work. These exercises should be omitted 
 during the menstrual period. 
 
 Figs. 16 and 17 
 
 Position — (1) On the back, the legs stretched 
 down. 
 
 Exercise — (1) Bend the knee up toward the 
 chest, then stretch the leg down to position and 
 relax it. 
 
 Take the movement six times with each leg. 
 
 (2) Bend the knee up as before. From this 
 bent-knee position stretch the leg up, making a 
 straight line to the tip of the toes. 
 
 (3) Bend the knee again. 
 
 (4) Stretch the leg back to position on the 
 floor. Do this six times with each leg. 
 
 [32] 
 
EXEECISE— AMUSEMENTS 
 
 Fig. 18 
 
 Position — (2) On the back, with legs 
 stretched down. 
 
 (1) Raise the arms straight in front of the 
 body and over the head until they touch the 
 floor. Reach up with the finger tips, stretching 
 comfortably. Then carry the arms back to the 
 sides again. Do this six times. 
 
 (2) Take the same exercise, drawing in a full 
 breath as the arms are raised and letting it out 
 as the arms are returned to the sides. 
 
 At another time, instead of carrying the arms 
 forward overhead, vary the foregoing exercise 
 by moving them sideways through half a circle 
 on the floor to the same position back of the 
 head, taking a deep breath as the arms move 
 toward the head, and letting it out as the arms 
 come back to the sides. 
 
 Fig. 19 
 
 Position — (3) On the back with knees drawn 
 up, the soles of the feet on the floor. 
 
 Exercise — From this position raise the hips 
 until there is a straight incline from the neck to 
 knees. Do not hold the position and relax thor- 
 oughly before repeating. Take this exercise 
 three to six times, limiting it to three times for 
 a few weeks. r33 . 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Fig. 20 
 
 For a child from five to twelve years old, 
 hanging on a bar and heaving or raising the body 
 
 from the floor six to eight times will strengthen 
 the muscles of the back and chest. It is val- 
 
 [34] 
 
a: 
 
 a 
 
 02 
 
 •l-H 
 
 o 
 M 
 
 -1-3 
 
 60 
 
 O 
 o 
 
 fee 
 
 
 £h 
 
EXEKCISE— AMUSEMENTS 
 
 liable to aid in the expansion and development 
 of the lungs, and will also aid in correcting 
 round shoulders. 
 
 The correction of deformities such as spinal 
 curvatures cannot be carried out in the home 
 but must be done under the supervision of a 
 physician or one skilled in physical culture. 
 
 [35] 
 
Chapter VI 
 
 CLOTHING— HOW TO HARDEN A 
 CHILD 
 
 It is surprizing to see how differently 
 mothers dress their children. A few facts 
 must be borne in mind before deciding this 
 important factor. The pulse of a child is 
 very much faster than that of an adult, 
 therefore the circulation of its blood in the 
 skin is more active. The surface of the 
 body of a healthy child is warmer than that 
 of an adult, because of the greater activity 
 of the healthy growing child. Too much 
 clothing, therefore, will cause an overheat- 
 ing of the skin, and perspiration followed 
 by chilliness results. 
 Effect of In addition to overheating the skin by 
 
 Excessive 
 
 ciothmg an excess j ve quantity of clothing, we render 
 
 [36] 
 
CD 
 
 M 
 
 H 
 
 bJD 
 
 £ 
 
 o 
 
 f-l 
 O 
 
 4^ 
 
 bJD 
 
 •rH 
 
 CD 
 CD 
 
CLOTHING— HOW TO HAKDEN A CHILD 
 
 the child more susceptible to catarrhal af- 
 fections. Many children have been brought 
 to me in midsummer wearing the thickest 
 of woolens. Such children are constant suf- 
 ferers of either catarrhal affections of the 
 respiratory passages or they suffer with 
 catarrh of the bowels. If an anxious mother 
 overheats the skin with heavy clothing by 
 day, she will be apt to overblanket the 
 child at night. A child so treated invari- 
 ably suffers with colds as well as restless 
 nights. 
 
 It is surprizing to see how much good can 
 be accomplished by resorting to a radical 
 change. Give a tepid or cool bath in the 
 morning, reduce the weight of the under- 
 clothing both winter and summer, give less 
 blanketing, and a cool room with fresh air 
 at night. Such a radical change will fre- 
 quently cause a restless and nervous child 
 to be transformed in a few weeks or months 
 
 [37] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Hardening 
 
 Open-air 
 
 Classes 
 
 into a healthier, stronger, and less irritable 
 child. 
 
 By hardening a child we render it less 
 susceptible to disease. Before resorting to 
 extreme measures of hardening we should 
 have the child examined by a physician. 
 Frail children or subnormal children re- 
 quire toning with iron, hypophosphates or 
 other tonics before attempting the hygienic 
 changes suggested. 
 
 The value of fresh air as a means of 
 bracing up anemic and pale children is so 
 well recognized in New York and elsewhere 
 in the United States that the public schools 
 have established open-air classes during the 
 winter term. In these classes, usually on 
 the roofs of school-buildings, the children 
 are dressed in warm clothing, many of them 
 wearing heavy sweaters and caps. In this 
 manner they receive instruction in the open 
 air. 
 
 [38] 
 
Mat Exercises 
 
CLOTHING— HOW TO HAKDEN A CHILD 
 
 For the frail child with a poor appetite, 
 for one having enlarged glands, for the 
 restless and nervous child, for the weak and 
 puny child, and for the one that inherits a 
 tuberculous tendency, the open-air classes 
 are indicated, and prove beneficial. The 
 child in the open air eats more, digests bet- 
 ter, and consequently assimilates his food, 
 thus enriching the blood, adding strength 
 to the body and offering resistance to dis- 
 ease. Such children do not sniffle and take 
 cold as easily as children brought up in 
 warmer surroundings. There are, however, 
 exceptions to this rule. 
 
 [39] 
 
Chapter VII 
 
 SCHOOL HYGIENE— SUMMER 
 VACATIONS 
 
 Theke are two places in a child's life 
 which play an important part in its mental 
 and physical development; they are the 
 home and the school. Many parents have 
 told me that their child is wilful, disobedi- 
 ent, and is only impressed by the teacher 
 at school. Thus parents frequently go to 
 school to secure the active cooperation of 
 the teacher, to impress the dangers of faulty 
 habits, to correct faults acquired by imita- 
 tion of other pupils, and to aid in procuring 
 home discipline. 
 
 Teachers frequently ask the mother to 
 assist in correcting little vices and habits 
 which apparently are unnoticed in the home. 
 
 [40] 
 
SCHOOL HYGIENE— SUMMER VACATIONS 
 
 It is wrong to expect the child to be a per- 
 fect specimen of childhood if the home train- 
 ing is lacking and if the mental, hygienic, 
 and moral training given at school is not 
 supplemented by the parents in the home. 
 
 What can we expect of a child who sees 
 discipline at school, good breeding, educa- 
 tion, refinement, and plenty of fresh air, 
 and then comes home to find a disorganized, 
 insanitary, and ill-ventilated home, just the 
 reverse of what the child saw at school. 
 After a few years the child will recognize 
 the difference and will antagonize its own 
 parents. 
 
 Modern hygiene has been so thoroughly 
 instilled into the minds of teachers in both 
 public and private schools that I venture to 
 say, with few exceptions, the ventilation 
 and sanitary environment is as good and 
 better in most schools than it is in the aver- 
 age home. 
 
 [41] 
 
Schools 
 
 HEALTH-CAKE OF THE GKOWING CHILD 
 
 I know of instances where mothers told 
 
 me they were glad to send their children 
 
 to school because they were not capable of 
 
 training them at home. 
 
 Dormitories In order to economize space, boarding- 
 
 and Boarding- 
 SChOOlS frequently use folding-beds. I have 
 
 known of one case of suffocation where the 
 
 bed suddenly closed itself on the sleeper. 
 
 Folding-beds are insanitary, as they sel- 
 dom receive the requisite amount of sun 
 and air. They are therefore hotbeds for 
 disease-germs. 
 
 Ventilation is of the utmost importance, 
 and a continuous supply of oxygen is as 
 necessary at night as by day, to secure 
 proper ventilation. 
 
 When children sleep in dormitories, we 
 should try to arrange for single rooms, if 
 possible. The supervision of boys and girls 
 at boarding-schools is a very important fac- 
 tor, and we should be very careful to know 
 
 [42] 
 
SCHOOL HYGIENE— SUMMEE VACATIONS 
 
 the character of the other scholars lest bad 
 habits are transmitted which may under- 
 mine the moral and physical welfare of our 
 child's future. 
 Every mother should train her child to Nature's 
 
 Demands 
 
 have the bowels move, if possible, each s2SS at 
 morning, or soon after a meal. By thus 
 training the bowels the habit of regularity 
 will soon be established. Many cases of 
 constipation owe their origin to poor train- 
 ing. On the other hand, the food may have 
 a distinct constipating effect, and then noth- 
 ing but a change in diet is necessary. 
 
 If the child feels a demand of nature, per- 
 mission should be given the child by the 
 teacher to answer this call. When such de- 
 sire of nature is repeatedly unanswered, a 
 tendency toward stool-stagnation is formed. 
 There is too much discipline enforced and 
 too little relaxing of rules, when necessary, 
 at school. I am constantly compelled to 
 
 [43] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 write letters to both principals and teachers 
 
 of schools, asking them to grant permission 
 
 to this or that child to satisfy the calls of 
 
 nature. 
 
 Summer Vacations 
 
 In deciding where to send a child for a 
 decided change of air we must consider 
 what portion of the human system requires 
 development. 
 
 A healthy boy or girl, well developed and 
 with fair appetite, may be sent either to the 
 seashore or the mountains. At both places 
 there is ample opportunity for exercise, 
 recreation, and change of scene. 
 
 If the child has been diligent at school, 
 camp-life would be an ideal change. Tent- 
 life in the mountains with a plentiful sup- 
 ply of balsam and pine trees, long walks 
 through the woods, rowing and swimming 
 in the lake is sufficient tonic for a hard 
 worked brain and nervous system. 
 
 [44] 
 
SCHOOL HYGIENE— SUMMEK VACATIONS 
 Children having a tendency to catarrh in catarrhal 
 
 ° Tendencies 
 
 the head, who suffer or have suffered with 
 adenoid vegetations and enlarged tonsils 
 will do best in the mountains. Mountain 
 air has a tendency to dry catarrhal secre- 
 tions, besides hardening the child suffi- 
 ciently to lessen susceptibility to colds. 
 
 Children suffering with winter colds, as 
 influenza, bronchitis, or pneumonia, require 
 toning-up of their air-passages for which 
 nothing is better than an altitude of from 
 1,000 to 2,000 feet. 
 
 Children suffering with stomach or bowel Dyspeptic 
 
 or Intestinal 
 
 affections, especially a tendency to loose Affectlons 
 bowels, will be strengthened by going to the 
 seashore. Cold bathing need not be indulged 
 in. Be sting on the beach will strengthen 
 the stomach and tone the bowels. Fre- 
 quently a change from the city to the sea- 
 shore, in a long-standing case of loose bow- 
 els, will terminate favorably in a few days. 
 
 [45] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Nervous and 
 Convalescent 
 Children 
 
 Anaemic 
 Children 
 
 Very nervous, sensitive children, and 
 those suffering with insomnia require rest. 
 They should have little or no excitement. 
 A quiet sojourn in the mountains is most 
 beneficial. The altitude should not be 
 higher than twelve hundred feet. 
 
 Convalescent children after long-stand- 
 ing illness require a quiet restful climate of 
 either the mountains or the farm. 
 
 Children with tendency to nose-bleed 
 should not be sent to high altitudes. 
 
 Anaemic children, especially girls around 
 the age of puberty, will do better in the 
 mountains, especially in a camp. Camp 
 routine will harden and develop them. I 
 have seen frail, nervous and sensitive chil- 
 dren transformed by a summer in camp. 
 They were able to continue out-dopr activi- 
 ties during the winter with marked benefit 
 in development; especially was this benefit 
 shown in the nervous system. 
 
 [46] 
 
Chapter VIII 
 
 CHARACTERISTICS AND PECULIARI- 
 TIES OF CHILDREN 
 
 Just as an adult craves quiet, rest, and 
 peaceful surroundings, so does a child de- 
 sire the very opposite — noise, running, 
 jumping, and perpetual motion. While this 
 may he looked upon hy some as a peculiarity 
 in childhood, it is a normal characteristic. 
 This important factor must be borne in mind 
 in selecting a nursemaid. If the nurse is 
 at all sensitive or nervous, and complains 
 of the child's overactivity, then she is not 
 a fit companion for the child. Children's 
 muscles are like rubber, and from the con- 
 stant use of these muscles they should sleep 
 very soundly, due to the exhaustion of the 
 daily exercise. 
 
 [47] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Fear Fear exists in all children, and can be 
 
 removed or greatly lessened by reasoning. 
 Find out what the child fears, and try to 
 eliminate such fear by proving the absurd- 
 ity of the same. 
 
 Children should not be frightened with 
 stories or pictures. I have known of many 
 cases where fright produced a nervous dis- 
 order. St. Vitus 's dance is a common re- 
 sult of a fright and very difficult to remedy 
 in a frail, sensitive child. 
 
 imitation Children are great students ; not only do 
 
 they watch every move and expression, but 
 they also possess the faculty of imitation 
 to a marked degree. They will mimic and 
 lisp and they will make grimaces of all 
 kinds, but they will also mimic facial 
 twitching, until the same remains as a per- 
 manent habit. 
 
 Many mothers will recall children who be- 
 gan to twitch the mouth or eye muscles be- 
 
 [48] 
 
PECULIAKITIES OF CHILDEEN 
 
 cause some other child at school did the 
 same. It looked cute ; later on this imita- 
 tion grew to be a habit which remained 
 many years. 
 
 The brain of a growing child possesses 
 quantity but lacks quality; it is an unde- 
 veloped organ. It is like a blank record of 
 a phonograph — sensitive; it receives and 
 gives off impressions. Curiosity is natural curiosity 
 to childhood. It is natural because it is the 
 child 's method of learning. It receives im- 
 pressions and sees things which its brain 
 cannot comprehend. 
 
 Instinct compels the child to ask why is 
 this and why is that. Childhood demands 
 an explanation of everything that it sees and 
 hears in the universe. It is the privilege of 
 children to be instructed and enlightened. 
 
 A crude brain can be developed provided Environment 
 the environment is intellectual. To associ- 
 ate a child with an ignorant nurse or with a 
 
 [49] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 woman lacking good breeding and education 
 is detrimental to the child. The seeds of 
 wisdom can only be sown into the fertile 
 brain of a child in an intellectual atmos- 
 phere. On the other hand, many years are 
 wasted, and we may have to undo the dam- 
 age done by an incompetent maid in whose 
 care the child had been placed. For this 
 reason we should be extremely careful in 
 selecting the companion for a child, lest we 
 do harm rather than good. The education 
 received in childhood is like a foundation 
 for a house : if it is well built, it remains ; 
 if poorly constructed, we shall have sooner 
 or later a tottering structure. 
 Rewards Eewards should be given much more fre- 
 
 quently than punishments. Children like 
 noise, and the more noise the better. It is 
 impossible to keep some children quiet. Re- 
 ward a child if he has been quiet for a cer- 
 tain time by permitting him to let off steam 
 
 [50] 
 
PECULIAKITIES OF CHILDREN 
 
 and become noisy and active. We should 
 not reward a child by giving him praise, 
 but there are times when a word of encour- 
 agement after a difficult task is in order. 
 Likewise, if a child acquire a bad habit, 
 and we notice a desire to correct such habit, 
 a word of encouragement is then in order. 
 
 The management of children will bring Punishment 
 out their good or their bad qualities. It 
 depends on the mother or nurse as to 
 whether the child obeys or disobeys. This 
 can readily be noticed at school. The same 
 class under the management of two teachers 
 behaves differently. With one teacher there 
 is obedience, order, and the children learn 
 a great deal, while another teacher cannot 
 enforce discipline, and will complain that 
 she has a very bad class ; therefore, the bad 
 and the good can be brought out, according 
 to the way children are managed. 
 
 Children need activity, and it is our duty 
 
 [51] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 to keep them interested and give them some- 
 thing to do, otherwise they will get into 
 mischief. 
 
 All children can not he punished alike. 
 Punishment must he meted out according 
 to their physical strength. A strong child 
 should be deprived of his most favorite 
 game. Most boys are passionately fond of 
 a game of ball. Forbidding this game for 
 a certain number of hours or days will, in 
 most cases, be all that is required. 
 
 A highly strung and nervous child can 
 best be punished by putting him to bed. 
 This serves the double purpose of resting 
 the nervous system in addition to correct- 
 ing some disobedience. 
 
 Always punish a child soon after the of- 
 fense, and explain to him why he is being 
 punished or corrected. After the punish- 
 ment is over, do not refer to the offense or 
 the punishment. 
 
 [52] 
 
PECULIAEITIES OF CHILDEEN 
 Corporal punishment should not be ad- corporal 
 
 Punishment 
 
 ministered to children. I invariably advise 
 every mother in selecting a nursemaid to 
 forbid bodily punishment. If a nursemaid 
 is given permission to slap or otherwise 
 punish a child in her care, while she may 
 exercise good judgment, she may also be 
 guilty of very poor judgment and apply 
 corporal punishment for offenses which may 
 be due to illness. I have known sensitive 
 children who were punished for refusing to 
 eat, when later it was discovered the child 
 had a sore throat or symptoms of tonsillitis, 
 which caused pain on swallowing. 
 
 Good judgment must prevail in deciding Despondency 
 whether or no the child's offense is really 
 serious enough to deserve corporal punish- 
 ment. If children are too severely punished 
 they become despondent, and in rare in- 
 stances have committed suicide. 
 
 There is a vast difference between wrong- 
 
 [53] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 doing and carelessness. For example : if a 
 child at the table accidentally breaks a plate, 
 we should not consider this a wilful wrong- 
 doing. In many instances it is better to let 
 the accident pass unnoticed. 
 
 Improper training due to the parents ' or 
 nurse 's fault is no reason why a child should 
 be punished. In most instances the fault 
 is not so much with the child as with the 
 mother or nurse. 
 
 To train a child to be patient, kind, and 
 gentle, be patient, kind, and gentle yourself. 
 
 A peculiarity of human nature is that 
 where there is but one child in the family, 
 it is usually a spoiled child. It seems that 
 nature intended mothers to have large 
 families, and thus divide the supervision 
 and attention, and bestow less devotion on 
 
 the one child. That there are exceptions 
 to this rule goes without saying. 
 
 [54] 
 
Chapter IX 
 
 NERVOUS CHILDREN 
 
 Suggestions for Their Development and 
 Training 
 
 Nekvous children dread examinations; 
 they also dread punishment; and it is this 
 dread or fear that will sometimes result in 
 extremes. The neurotic child requires mus- 
 cular training, athletics of all kinds, rowing, 
 and especially swimming. Swimming is 
 especially useful, as the cold water tones 
 the muscles and nerves while the exercise 
 strengthens and develops the same. This 
 physical development invariably balances 
 the highly strung neurotic child. If, how- 
 ever, we give to a nervous child additional 
 home lessons and constantly watch each 
 move and step with strict discipline, the 
 result will be that an occasional neurotic 
 
 [55] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 child unable to stand the mental strain will 
 suffer a mental breakdown. It is well to 
 remember this, because these unhappy re- 
 sults can be prevented if a stern parent will 
 realize that a child has certain rights which 
 should be respected and which need consid- 
 eration just as well as a careful parent 
 would supervise the diet. 
 
 Nervous children desire sympathy; they 
 complain frequently and make much out of 
 trivial symptoms. Sometimes it is difficult 
 to distinguish between major and minor ail- 
 ments. Such children, therefore, require 
 special training. Their lives should be filled 
 with thoughts foreign to the body, so that 
 they are kept busy. In this manner we con- 
 centrate the attention of the child on any- 
 thing but himself. While sympathy and 
 gentleness, rather than firmness, should be 
 the rule, it should be done with a spirit of 
 apparent indifference on the part of the 
 
 [56] 
 
NERVOUS CHILDREN 
 
 mother or nurse. If a child realizes that 
 one is anxious and sympathetic, it is but 
 natural for him to take advantage of the 
 situation. All children do this ; hence, know- 
 ing the peculiar make-up of a child, we 
 should restrain and repress our feelings, 
 and never shed tears or show other evidence 
 of sympathy in the presence of the child. 
 
 Children notice everything, they are keen 
 observers of details, but their viewpoint is 
 different. 
 
 A nervous child is a normal child in which 
 we have a sensitive, highly strung mechan- 
 ism requiring careful consideration. 
 
 The proper environment, therefore, for a 
 nervous child is one in which a quiet atmos- 
 phere exists. To surround a child with a 
 nervous, hysterical family and friends is 
 adding fuel to the flames. Such children 
 can not stand overtraining and exacting 
 discipline. 
 
 [57] 
 
Chapter X 
 PRECOCIOUS CHILDREN 
 
 Precocious children manifest their supe- 
 rior mental equipment very early in life. 
 Such children are keen observers of all de- 
 tails. They hear, see, and grasp quicker 
 than the average child. Because of this 
 higher mental adaptability they are fre- 
 quently pushed farther ahead than their 
 physical strength permits. 
 
 Teachers at school welcome such pupils, 
 because they are so bright. It is important 
 for the parents to recognize precocity, and 
 instead of urging such a child to do more 
 and more, we should be careful to restrain 
 and lessen the mental burden, lest a mental 
 breakdown occurs. 
 
 Athletics is the important medicine to 
 
 [58] 
 
PKECOCIOUS CHILDEEN 
 
 develop the muscles and to strengthen the 
 nerves. It equalizes the circulation of the 
 blood, especially where a tendency to con- 
 gestion of the brain exists. This conges- 
 tion of the brain is a normal result of pre- 
 cocity. Such children tire easily, complain 
 of headache, and show fatigue. At such 
 times all school-work and lessons must be 
 stopped. A radical change from the les- 
 sons consists in a game of ball or in playing 
 a musical instrument, or listening to music. 
 This will distract the mind, and relax the 
 nerve-tension, at the same time soothing 
 the highly strung child. 
 
 A tepid bath followed by a cold shower 
 is the best means of relieving an overworked 
 child. (For hygienic management read ar- 
 ticle on Nervous Children.) 
 
 [59] 
 
Chapter XI 
 THE BREATH 
 
 Foul odors are frequently noted from a 
 child 's month. They always have some sig- 
 nificance. We should, therefore, seek their 
 origin or cause. These odors may be due 
 to decaying teeth, they may also be caused 
 by an ulcerated tooth or an abscess in the 
 mouth or gum. 
 
 More often a bad breath is due to gaseous 
 fermentation arising from the stomach. In 
 indigestion and dyspeptic conditions foul 
 odors from the breath are noted. Chronic 
 swelling of the tonsils and adenoids will 
 give off catarrhal discharges, and these dis- 
 charges have a foul, putrid odor. We should 
 go slow, therefore, in ascribing a foul breath 
 to a coated tongue until all other causes 
 
 [60] 
 
THE BEEATH 
 
 have been eliminated. Sprew or thrush will 
 frequently be the cause of a foul breath. 
 
 A laxative, such as a teaspoonful of senna 
 leaves boiled in a teacupful of water and 
 strained, to which two tea spoonfuls of rasp- 
 berry sirup are added, may be given one- 
 half hour before breakfast, and repeated 
 one-half hour before retiring, to a child of 
 from five to ten years old. If the foul breath 
 is due to dyspeptic fermentation or catarrh, 
 this will quickly remedy it. 
 
 When belching and eructation of gas con- 
 tinue for many days, we must reduce starchy 
 foods, and stop cereals. Eelief is frequently 
 afforded by giving a tablet of Bulgarian 
 bacillus after each meal. If foul breath con- 
 tinues after the above remedies are tried, a 
 dentist should be consulted to see whether 
 or no the teeth are responsible. This will 
 be discussed in the following chapter. 
 
 [61] 
 
Chapter XII 
 THE TEETH 
 
 The teeth require thorough cleansing to 
 prevent decay. No particles of food should 
 be allowed to remain between the teeth. 
 Decaying food gives off acids which cause 
 the teeth to rot. The teeth require plenty 
 of exercise. The chewing of coarse food is 
 the best exercise for them. When coarse 
 food is properly chewed it not only strength- 
 ens the teeth, but massages the gums. The 
 teeth should be brushed with an alkaline 
 solution. Half a teaspoonful of bicarbonate 
 of soda in a tumblerful of lukewarm water 
 is best for this purpose. After brushing 
 the teeth with this solution the mouth should 
 be thoroughly rinsed with the same. 
 
 To keep the teeth in proper condition they 
 
 [62] 
 
THE TEETH 
 
 should be cleaned after each meal. The 
 brush should be scalded daily, to destroy 
 germs and cleanse the bristles. 
 
 Decayed teeth result in foul breath, in- Decayed Teeth 
 flammatory condition of the gums, and fre- 
 quently alveolar abscess. The constant 
 presence of pus back of the decayed tooth 
 gives rise to foul breath and enters the 
 system with the food during mastication. 
 From this pus-poison, headache, and fre- 
 quently anemia, result. 
 
 Decayed teeth, commonly known as ' i den- 
 tal caries," when present in the milk-teeth 
 (temporary teeth) can spread to the under- 
 lying permanent teeth. It is obvious, there- 
 fore, that caries affecting the temporary 
 teeth is a very serious matter and one that 
 should not be neglected by the mother. 
 
 Eecently the Board of Health and the 
 Department of Education in the City of 
 New York began an active crusade in the 
 
 [63] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 interest of a healthy mouth. The tooth- 
 brush drill, stimulated by the offer of a 
 prize for the child with the cleanest month 
 and teeth, is an effectual method of instill- 
 ing the necessity for a daily oral hygiene. 
 
 The gums, teeth, salivary glands, and ton- 
 sils are neighbors, and disease of one can 
 spread to the others. It is quite likely that 
 just as the glands below the jaw swell and 
 participate in active inflammation within 
 the mouth from the teeth, so, perhaps, do 
 disorders of the teeth and gums spread to 
 the tonsils, 
 irregular About the seventh year the milk teeth 
 
 loosen and fall out and give way to the 
 permanent teeth. The permanent teeth 
 should be carefully watched, and if they 
 appear irregularly the dentist should be 
 consulted. Teeth can easily be braced and 
 straightened if they appear irregularly. 
 Some teeth will grow sideways instead of 
 
 [64] 
 
 Teeth 
 
THE TEETH 
 
 in their regular, natural manner. To cor- 
 rect this the dentist should be consulted as 
 early as possible. In blood disorders such 
 as syphilis and tuberculosis the teeth show 
 the evidence of the same constitutional dis- 
 ease. As the blood, bones, and muscles re- 
 quire treatment, so will the teeth demand 
 medication to harden them. 
 
 Riggs's disease and pyorrhea alveolaris Riggs's Disease 
 
 and Pyorrhea 
 
 are diseases which require local attention 
 of a dentist. Pus-germs will burrow and 
 frequently form abscesses under the roots 
 of the teeth. 
 
 The milk-teeth should not be removed too Appearance of 
 
 the Permanent 
 
 early. When they become loose it is indica- Teeth 
 tive that they are being pushed by the per- 
 manent teeth which will soon replace them. 
 It should be remembered that the six-year 
 molars, often called the six-year-old teeth, 
 are the first of the permanent teeth to ap- 
 pear. Parents sometimes confuse these 
 
 [65] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 with milk-teeth and have them pulled. As 
 no other teeth will ever take their places, 
 spaces will be left in the jaws in after years 
 between the wisdom-teeth and the teeth 
 farther forward. This will either necessi- 
 tate bridge-work or will leave an ugly- 
 looking mouth. 
 
 No tooth should be extracted because it 
 is sensitive or aches. The advisability of 
 extraction is a matter for the dentist alone 
 to determine. 
 
 ERUPTION OF THE PERMANENT TEETH. 
 
 The first 4 molars 5th — 7th year. 
 
 The 4 inner incisors 8th year. 
 
 The 4 outer incisors 9th year. 
 
 The 4 anterior bicuspids 10th year. 
 
 The 4 canines 11th — 13th year. 
 
 The 4 posterior bicuspids 12th — 15th year. 
 
 The 4 second molars 13th — 16th year. 
 
 The last 4 molars (wisdom-teeth) 16th — 20th year. 
 
 The decay of the teeth, commonly known 
 as dental caries, is caused by the acid due 
 to fermentation or putrefaction of parti- 
 
 [66] 
 
THE TEETH 
 
 cles of food remaining between the teeth. 
 Brushing the teeth is only part of the nec- 
 essary hygiene. Such bits of food can best 
 be removed with dental floss. 
 
 Toothache signifies that a tooth is de- to Relieve 
 
 Toothache 
 
 cayed or decaying. The dentist may save 
 the tooth by filling it and preventing the 
 decay from spreading. To relieve a tooth- 
 ache apply oil of cloves on cotton into the 
 hole of the tooth. If oil of cloves is not 
 handy, use alcohol instead. If a tooth has 
 just been filled and gives pain, rinse the 
 mouth with salt water every fifteen minutes. 
 Add a teaspoonful of common salt to a tum- 
 blerful of warm water. 
 
 For the relief of pain caused by a gum- Gum-boa 
 boil, apply a warm raisin poultice, which is 
 made by splitting open raisins, removing 
 the seeds, adding a few drops of water, and 
 heating. Apply warm to the gum. A mus- 
 tard foot-bath should also be given. 
 
 [67] 
 
Chapter XIII 
 HYGIENE OF THE HAIR AND SCALP 
 
 The healthy scalp requires washing 
 every three or four weeks. In a large city 
 where dust and dirt ladened with germs can 
 set up an inflammation, weekly and some- 
 times daily washings will be demanded. Ac- 
 tive playing in the streets with consequent 
 perspiration will cause itching of the scalp. 
 By scratching the same when covered with 
 dust germs, head boils or scalp pustules 
 may result. 
 
 Not only is this frequent washing neces- 
 sary in the large cities but similar condi- 
 tions are found at the seashore where the 
 sand will give rise to irritation. After sea 
 bathing or lake bathing one is safer to thor- 
 
HYGIENE OF THE HAIK AND SCALP 
 
 oughly shampoo the scalp at least once a 
 week. 
 Either tar soap or liquid green soap washing 
 
 the Hair 
 
 should be used. Add enough hot water to 
 the soap to make a lather. This lather 
 should be thoroughly rubbed into the scalp 
 and allowed to remain there about five min- 
 utes until it has thoroughly penetrated the 
 same; during which time the head may be 
 covered or protected with a towel. Warm 
 water should then be poured or sprayed on 
 the scalp, and with brisk rubbing the lather 
 washed away. This lather can be gently 
 pressed downward through the hair, but no 
 rubbing of the hair is necessary. Many 
 quarts of water will be required to wash 
 away the lather. Soapy hair will never dry 
 or feel comfortable to the head. 
 
 Rub the scalp and hair thoroughly but 
 gently with hot soft towels until it is per- 
 fectly dry. The heat of the towels will help 
 
 [69] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 evaporate the moisture. One per cent, bo- 
 rated vaseline may be applied to the scalp 
 and the tips of the hair, if after such a 
 thorough shampooing it has become very 
 dry. 
 The Brush For children select a medium-hard brush 
 
 which has long bristles in the center and 
 shorter ones on the circumference. The 
 bristles should be arranged in bunches, not 
 too close together, the middle bristles of 
 each bunch being longer than the surround- 
 ing ones. The bristles arranged in this 
 manner will penetrate the hair and reach 
 down to the impurities which lie on the 
 scalp proper. It is the scalp which needs 
 the brushing more than the hair. 
 
 The brush should be firmly drawn 
 through the hair in such a way that there 
 is a feeling of pleasant warmth upon the 
 scalp, but not hard enough to cause a sen- 
 sation of soreness. 
 
 [70] 
 
HYGIENE OF THE HAIR AND SCALP 
 
 If the hair is left open and hanging a 
 soft even cut brush should be used to 
 smooth and polish the hair after it has been 
 brushed clean with the stiff brush. 
 
 A comb is used to separate the hair into The comb 
 strands. It should be a large comb with 
 long teeth set wide apart. The points 
 should be dull and the edges rounded, so 
 it will go through easily and not tear the 
 hair. 
 
 A fine-toothed comb should never be used 
 excepting to remove vermin. It should 
 never be employed to remove dandruff, for 
 it irritates the scalp and increases the 
 trouble. 
 
 Both comb and brush should receive a 
 weekly bath of ammonia and water, and a 
 daily tapping to remove the dust. 
 
 Airing the hair by keeping it uncovered 
 is supposed to add vigor to it and keep it 
 healthy, but the cause of good or poor hair 
 
 [71] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 are not dependent upon admission of air to 
 the hair, but upon the normal condition of 
 the stomach, the liver, the digestion, the 
 nerve centers, in fact upon the whole or- 
 ganism. 
 
 When children are compelled to remain 
 in bed during long periods of illness their 
 hair frequently becomes matted. At times 
 discharges from the scalp will glue the hair 
 together. While in many cases it will be 
 necessary to clip or cut the hair, in many 
 other cases the hair need not be sacrificed. 
 
 The scalp should first be thoroughly 
 washed as above described and after be- 
 ing thoroughly dried, a 1 per cent, borated 
 vaseline should be thoroughly rubbed into 
 each matted part. The mats should be 
 gently loosened as much as possible with 
 the fingers, after which they should be 
 brushed with a wire brush. This wire brush 
 consists of a number of bristle-shaped wires 
 
 [72] 
 
HYGIENE OF THE HAIK AND SCALP 
 
 set singly and far apart in a flexible rubber 
 backed hairbrush. Begin brushing at the 
 tips of the hair, gradually working upward 
 until the scalp is reached. It may require 
 days of patient treatment and brushing un- 
 til all the mats are disentangled. 
 
 [73] 
 
Chapter XIV 
 
 GROWTH IN HEIGHT AND WEIGHT 
 
 The following table exhibits the growth, 
 in height and weight, of boys and girls from 
 the third to the seventeenth year: 
 
 
 Boys. 
 
 Girls. 
 
 Age. 
 
 Height 
 in Inches. 
 
 Weight 
 in Pounds. 
 
 Height 
 in Inches. 
 
 Weight 
 in Pounds. 
 
 3 
 
 4 
 
 5 
 
 6 
 
 7 
 
 8 
 
 9 
 
 10 
 
 11 
 
 12 
 
 13 
 
 14 
 
 15 
 
 16 
 
 17 
 
 35 
 
 38 
 
 41 
 
 44 
 
 46 
 
 47 
 
 49| 
 
 52 
 
 53£ 
 
 55 
 
 57 
 
 59i 
 
 62£ 
 
 64£ 
 
 66£ 
 
 31 
 
 35 
 
 41 
 
 45 
 
 49£ 
 
 54£ 
 
 60 
 
 66 
 
 72£ 
 
 80 
 
 88 
 
 m 
 
 110 
 123 
 128 
 
 35 
 
 38 
 40£ 
 42| 
 44£ 
 
 m 
 
 48| 
 
 51 
 
 53 
 
 55J 
 
 57| 
 
 59| 
 
 61 
 
 61| 
 
 62£ 
 
 30 
 
 34 
 
 40 
 
 43£ 
 
 48 
 
 53 
 
 57£ 
 
 64 
 
 70 
 
 79 
 
 89 
 100J 
 108 
 113 
 119 
 
 [74] 
 
Chapter XV 
 PUBERTY 
 
 In girls between the age of eleven and 
 fifteen years the development of the breasts 
 and associated therewith the development 
 of the genital organs take place. As this 
 is the stepping-stone from childhood into 
 womanhood, a radical change takes place 
 both in the circulation of the blood and in 
 the nervous system. Very many symptoms 
 directly due to this change can be noted. It 
 is therefore an important point to prepare 
 each and every girl for the approaching de- 
 velopment and explain to her in plain lan- 
 guage the significance of menstruation. 
 
 If a mother feels herself incompetent Menstruation 
 to explain these details she should ask a 
 
 [75] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 trained nurse or her physician to impart 
 the necessary information. 
 
 In many schools sex-hygiene is being 
 taught. While this is better than no in- 
 struction, it is still better for the mother 
 to have the child's full confidence, and to 
 tell her just what nature intends to do, and 
 what it all means. Tell her the number of 
 days that she will menstruate and that it 
 will recur every month. This function 
 should be supervised and each girl taught 
 to note the date, every twenty-eight or 
 thirty days, for the recurrence of this 
 healthful flow. 
 
 Violent exercise, such as swimming, 
 horseback riding, golf, and tennis, should 
 be omitted during this period. Walking 
 moderately is beneficial. A sponge-bath 
 with lukewarm water will refresh the body. 
 Tub-bathing during the period and for 
 twenty-four hours following is prohibited. 
 
 [76] 
 
PUBEETY 
 
 The diet should be of the simplest charac- 
 ter. Iced foods and ice-cream should not 
 be permitted. Vinegar and strong acid 
 foods are prohibited. The body should be 
 well protected with clothing, and rest should 
 be enforced so that the young girl is not 
 overtaxed. The bowels should be super- 
 vised so that a daily movement takes place. 
 Several raw figs eaten before breakfast will 
 relieve constipation. This simple proce- cramps 
 dure of emptying the bowels will frequently 
 be all that is necessary to relieve the cramps 
 so frequently complained of, which is the 
 pressure of a full bowel on the distended 
 uterus. 
 
 During cold weather the feet should be 
 protected. We should not overtax the ner- 
 vous system with too much study. Lessons 
 can be postponed and extra home-work 
 should not be enforced. 
 
 Every boy approaching puberty requires 
 
 [77] 
 
HEALTH-CARE OF THE GROWING CHILD 
 Male Gemtai supervision and instruction. The boy can 
 
 Development 
 
 not be isolated from the company of boys, 
 and thus be will receive instruction in bad 
 habits which will be very hard to break. It 
 would appear more plausible, therefore, to 
 have the father or the uncle or the physi- 
 cian give such instruction as will impart the 
 knowledge of the development of the genital 
 organs, their uses, and their abuses. There 
 are many ways of approaching this subject 
 and making it instructive without picturing 
 horrors and frightening the frail, growing, 
 nervous boy because one wishes to keep him 
 sexually pure. 
 Masturbation Of all the bad habits one should try to 
 prevent the most important is masturbation. 
 We can instruct the boy in nature 's method 
 of development of the organs and their nat- 
 ural seminal emissions. These take place 
 voluntarily without masturbation or sexual 
 intercourse. These emissions take place 
 
 [78] 
 
PUBERTY 
 
 normally once every one or two months and 
 consist of a loss of an excess of seminal 
 fluid.* The frequency of their recurrence 
 usually depends on the amount of sexual 
 thought or stimulation. In some boys a 
 glass of wine or beer is sufficient to excite 
 or provoke an emission. In others, female 
 society will so excite the boy that he will 
 have an emission at night. 
 
 Such information should be imparted to 
 every boy, that he may know nature re- 
 sponds to various forms of excitement, be 
 they alcoholic or sexual, and that the occa- 
 sional loss of fluid at night is not harmful. 
 
 Do not allow boys to read trashy litera- 
 ture with which the country is flooded, and 
 which is sent out by fake medicine compa- 
 nies to impress and frighten the boy, for 
 business reasons. 
 
 *At times a glairy fluid resembling mucus follows 
 excitement, the loss of which is not detrimental to 
 the system. 
 
 [79] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 The habit of masturbation is dangerous 
 because of the ease with which the act is 
 performed, and because when once formed 
 the boy will be backward, languid, tired, 
 heavy, and nervous. Such boys have dark 
 rings under their eyes, and they appear 
 dull. The feet and hands show a cold, clam- 
 my perspiration, and they are neither sick 
 nor well. They lose ambition and do not 
 push ahead. They are the so-called dul- 
 lards. As a rule, if questioned they will 
 deny the habit, and it is only after they have 
 been told that the symptoms of such self- 
 abuse is stamped on their face that we can 
 compel them to admit the habit. 
 
 To treat this habit a cold shower or cold 
 bath or a spinal douche should be ordered. 
 Walking in the open air is excellent. The 
 quantity of meat should be reduced, and 
 milk, vegetables, and fruits given liberally. 
 Large quantities of water or lemonade 
 
 [80] 
 
PUBERTY 
 
 should be ordered, but neither wine nor al- 
 coholic beverages should be permitted. Tea 
 and coffee also should be prohibited. Cool- 
 ing and nutritious food, such as milk, butter- 
 milk, cocoa, and malted milk, may be per- 
 mitted. Spices and highly seasoned foods 
 should not be given. 
 
 Very warm clothing should not be worn 
 next the body. Cotton or linen should be 
 substituted for flannels. 
 
 My plan has been to give every boy the 
 benefit of the doubt and warn him besides 
 giving him the above outlined treatment. 
 If, however, we note after several weeks or 
 months that the boy has resumed his former 
 habits, then we can resort to sterner meas- 
 ures, and remind him that nervous break- 
 down, mental breakdown, and even insanity 
 can follow if he does not master the situa- 
 tion and control the habit. 
 
 It is important, as the boy reaches pu- 
 
 [81] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Advice to Boys berty, to warn him of the dangers that ex- 
 ist in life. Sexual intercourse with a dis- 
 eased girl may be the means of inoculating 
 him with syphilis, which will prove a very 
 costly lesson. The danger of being inocu- 
 lated with gonorrhea while a poison of a 
 lesser degree, can also prove costly. If the 
 discharges from a boy diseased with gonor- 
 rhea should accidentally be rubbed into an 
 eye, blindness may result therefrom. Such 
 apparently trivial conditions are important 
 enough for every parent to know, and to 
 impart such knowledge to a growing boy, 
 always having in mind that by so doing we 
 may prevent him from contracting such a 
 disease. 
 
 care of the The female child should be washed with 
 
 Genital Organs 
 
 soap and water. Unless there is a special 
 reason, and it is ordered by the physician, 
 no dusting powders nor salves should be 
 applied. Small deposits of dusting-powder 
 
 [82] 
 
PUEEKTY 
 
 combined with any possible discharge may- 
 adhere like glue and frequently be the cause 
 of inflammatory adhesions, which produce 
 an irritation and may later give rise to the 
 habit of masturbation. 
 
 In the male child not circumcised, the 
 foreskin should be pushed back over the 
 glans, and all accumulations removed with 
 soap and water while in the bath. Particles 
 of cheese-like deposit which do not readily 
 wash away may be removed with cotton and 
 warm oil. 
 
 No more or frequent handling of these 
 parts than is absolutely necessary should be 
 done because of the danger of starting the 
 habit of masturbation. Children who do 
 not have a tendency to discharges, but who 
 have a dry mucous membrane, may not re- 
 quire these genital baths more frequently 
 than once a month. 
 
 [83] 
 
Chapter XVI 
 VACCINATION 
 
 We vaccinate a child with virus taken 
 from a cow and induce a disease which pro- 
 tects the child against smallpox. Any one 
 familiar with the history of the ravages of 
 smallpox before the introduction of vaccina- 
 tion will remember the enormous mortality 
 which prevailed and the untold suffering 
 and pock-marks in those that recovered. 
 
 Vaccination properly performed consists 
 in cleansing the skin so that no germs or 
 filth can enter the wound and contaminate 
 the virus used. It is better to leave the 
 vaccination of a child to the physician. No 
 mother or nurse should undertake to vac- 
 cinate the child. There is no danger in 
 vaccination if properly done, on the con- 
 
 [84] 
 
Small-pox in an Unvaccinated Child. Vaccination with cow- 
 pox would have prevented the above (Shamberg). 
 
VACCINATION 
 
 trary, there is only the assurance of pro- 
 tection if an epidemic of smallpox should 
 arise. 
 
 During the active stage of the vaccination 
 the child should be isolated as well as pos- 
 sible from any one suffering from a conta- 
 gious disease. The germs of erysipelas and 
 diphtheria readily enter a fresh vaccination 
 so that if any one is ill in the same house, 
 it is better to postpone the vaccination un- 
 til after the patient recovers. 
 
 Five to seven days after inoculation, in- 
 flammation or redness around the inoculated 
 area will be noted. This is the natural 
 course of taking. If this redness spreads 
 and the skin is swollen and tense, the physi- 
 cian will usually prescribe a cooling moist 
 dressing of lead-water or a one per cent, 
 boric acid solution. The inflamed surface is 
 covered with several layers of gauze satu- 
 rated with one of these solutions until the 
 
 [85] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 inflammation subsides; this usually takes 
 two or three days. 
 
 One inoculation will protect a child about 
 five years. It is necessary, therefore, to 
 revaccinate every five or six years. 
 
 During the active stage of vaccination 
 the diet should be restricted to milk, cereals, 
 broth, vegetables, and fruit. No meat or 
 eggs should be given. Water should be 
 given liberally, also all fruit-juices. 
 
 The bowels should be watched and if con- 
 stipated raw figs with senna leaves should 
 be given before breakfast. Stewed peaches, 
 prunes, and apricots will aid in keeping the 
 bowels loose. A shield is unnecessary. A 
 piece of gauze or linen sufficiently large to 
 protect the wound from the clothing should 
 be placed over the vaccinated area and 
 changed every morning and evening. Do 
 not apply salves. If the linen or gauze ad- 
 heres to the wound, soak it loose with oil. 
 
 [86] 
 
VACCINATION 
 
 As a rule, the active stage persists sev- 
 eral weeks. Even though there has been a 
 temperature of 100 or 103 degrees, there 
 is no danger to be feared. A vaccinated 
 child should receive its daily bath and 
 should play and go to school as though noth- 
 ing had happened. It is only if active in- 
 flammation follows that we should keep the 
 child quiet at home, or if it has fever over 
 101 degrees. 
 
 [87] 
 
Chapter XVII 
 TEMPERATURE— FEVER 
 
 The normal temperature of the body, 
 taken in the month, is 98% degrees. If 
 taken in the rectum it varies between 99% 
 and 99% degrees. A temperature, therefore, 
 under 100 degrees in the rectum should be 
 regarded as normal. If it is higher it shows 
 some derangement of the system. 
 
 Active and excitable children always have 
 a slight rise in temperature. For example : 
 if a child plays vigorously it may develop 
 a temperature of 100% degrees in the rec- 
 tum, and after resting the body an hour 
 the temperature will go back to normal. A 
 child that is easy-going will usually have 
 a lower temperature than one with an ex- 
 
 [88] 
 
TEMPERATURE— FEVEK 
 
 citable temperament. Nervous children 
 have higher temperatures than the phleg- 
 matic type of child. 
 
 There is a slight difference between the 
 morning and the evening temperature. It 
 is usually about 99 degrees in the morning 
 and about 99% degrees in the evening. This 
 is a normal variation. No one can judge 
 temperature by feeling the surface of the 
 body with the hand. To be accurate we 
 must always employ a clinical thermometer. 
 
 In taking the temperature, shake the to Take 
 
 Temperature 
 
 thermometer so that the column of mercury 
 drops below 95 degrees. Apply vaseline 
 or oil to the end containing the mercury. 
 Place the child on the left side and insert 
 the thermometer one inch into the rectum. 
 Let it remain two to three minutes. The 
 end of the column of mercury indicates the 
 degree of temperature. The thermometer 
 should be washed with soap and cold water. 
 
 [89] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 The mercury remains registered in the tube 
 until it is again shaken down. 
 
 The value of the thermometer in recog- 
 nizing fever is well known. It is especially 
 valuable when the child is peevish or rest- 
 less. It is a serious mistake to discipline 
 a child for naughtiness if it is suffer- 
 ing from fever. To detect fever we must 
 use a thermometer. A healthy child will 
 have a normal temperature, a sick child 
 will have fever. When children breed dis- 
 ease, as for example before the eruption of 
 measles, scarlet fever, or diphtheria, they 
 are dissatisfied, sensitive, and will not eat. 
 To spank such a child or force it to eat a 
 full meal regardless of its tolerance for 
 the food is inviting trouble. If however 
 the temperature is taken, we can recognize 
 the presence or absence of illness. Thus 
 my advice is, use a thermometer if in doubt, 
 but do not use a thermometer daily or 
 
 [90] 
 
TEMPERATURE— FEVER 
 
 several times a day as a matter of rou- 
 tine. 
 
 Fever in an older child signifies more significance 
 
 of Fever 
 
 than it would in an infant. The body is 
 older, the system is stronger, and there is 
 usually more resistance to disease than in 
 infancy. Notwithstanding this there are 
 distinct diseases to which childhood is sus- 
 ceptible. Every mother therefore should 
 bear in mind that while fever may be caused 
 by a spoiled stomach or intestinal stagna- 
 tion of stool, the large majority of fever- 
 attacks are due to other causes. 
 
 Every mother should think of the possi- 
 bility of her child breeding a disease. A 
 slight cold in the head with fever may be 
 influenza or grippe, but it also may mean 
 the development of measles. In like man- 
 ner fever and vomiting with loss of appetite 
 may be due to indigestion or an overloaded 
 stomach, but it may also be due to the be- 
 
 [91] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 ginning of scarlet fever. Loss of appetite 
 — refusal to eat — may be due to a spoiled 
 stomach, but it is also well known that a 
 child will refuse to eat when it has a sore 
 throat and perhaps not enough ability to 
 locate the pain in the throat. 
 
 From what has been said it is safer to 
 keep a child in bed for several days if a 
 temperature of 101 degrees or higher exists, 
 until the temperature becomes normal. No 
 one would care to have a child walking 
 around in the street for the sake of "hard- 
 ening" it and suddenly find a day or two 
 later that the child was suffering with 
 measles or scarlet fever. Such risks may 
 prove costly and occasionally fatal. 
 Feeding At the beginning of fever put the child 
 
 During Fever 
 
 to bed and stop all solid food. Give milk, 
 soup, or broth. Orange-juice or lemonade 
 for thirst. Calomel, one-fourth grain, re- 
 peated every fifteen minutes until four 
 
 [92] 
 
TEMPEKATUKE— FEVER 
 
 doses are given, and then followed by a tea- 
 spoonful of rhubarb and soda mixture every 
 hour until three doses have been given. 
 Water should be given frequently. If at- 
 tention to the diet and the cleansing of the 
 stomach and bowels does not bring the fever 
 down within twenty-four hours, call a phy- 
 sician. 
 
 If a child is well in the morning and de- sudden Fever 
 velops a sudden rise in temperature of 103 
 or 104 degrees in the evening, we should 
 suspect stomach- or bowel- trouble. An 
 enema of soap-water will rapidly eliminate 
 stagnating or decomposed stool and there- 
 with reduce the temperature. 
 
 Sudden high temperatures are not as se- 
 rious as low, gradually increasing fever. A 
 temperature that starts with 100 degrees 
 and gradually rises one-half or one degree 
 more each day signifies a slowly developing 
 disease somewhere in the body. It may be 
 
 [93] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 an abscess, it may also be typhoid fever, 
 scarlet fever, or kidney-disease. Note if the 
 scanty urine urine is scanty ; if so we can eliminate poi- 
 sons through the kidneys by giving 15 drops 
 of sweet spirits of niter every hour until 
 five doses have been given. If the head is 
 very hot and the feet are cold, a mustard 
 foot-bath should be given, and cold cloths 
 applied to the forehead and around the 
 neck. Sponging the body with alcohol and 
 cold water will be found soothing and will 
 reduce the fever. 
 
 If a rash develops during the course of 
 fever, isolate the child until the physician 
 can see the case. 
 
 [94] 
 
PAET II 
 NUTRITION 
 
 [95] 
 
Chapter I 
 
 THE DIET 
 
 All children cannot he fed alike. As 
 every face is different, so is each and every 
 stomach a law unto itself. One child can 
 digest food that will render another dys- individual 
 
 Requirements 
 
 peptic. Then again, certain children re- 
 quire special articles of food that others 
 do not. A lean and constipated child re- 
 quires fat in the form of hutter or cream 
 or bacon, and a given quantity of starchy 
 food, such as potato. In this same type of 
 child fruit and fruit juices are demanded 
 to offset the usual tendency to stagnation 
 of the stool. Very fat children, and espe- 
 cially those having a tendency to loose 
 bowels, should receive less fruit, less hutter 
 and no cream, but should be given a large 
 
 [97] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 variety of vegetables, chiefly spinach, peas, 
 beans, lettuce and beets. 
 
 The feeding of children is most impor- 
 tant. By giving proper food at proper 
 intervals, growth and development take 
 place. Many diseases in childhood are due 
 to and caused by improper feeding. Every 
 mother should know about these diseases so 
 that she can guard against them. 
 Peculiarities Children have peculiarities, their likes 
 
 in Taste 
 
 and dislikes. One child will require sweet- 
 ened food, while another, equally healthy, 
 will crave salted foods. Some will refuse 
 an undisguised egg, but will eat eggs in 
 the form of a custard or flavored omelet. 
 A mild relish or sauce will frequently be 
 the means of cultivating a taste for meat, 
 when meat alone may be refused. I do not 
 advocate giving spices or condiments as a 
 rule, but there are times when children 
 will literally go on a hunger-strike, if some 
 
 [98] 
 
THE DIET 
 
 of their little whims are not gratified. 
 Children will seldom submit to force. 
 Many of them are so disgusted with forced 
 feeding methods that they will vomit after 
 partaking of a forced meal at which they 
 rebelled. This is especially true of the 
 nervous, sensitive, highly strung child. 
 
 Many mothers have a mistaken notion Miik 
 that children up to adolescence must take 
 at least a quart of milk a day, in addition 
 to their regular diet. This is Unnecessary 
 and frequently promotes dyspeptic condi- 
 tions by overtaxing the stomach after it 
 has partaken of a full meal. 
 
 It is impossible to state the quantity of Quantity 
 
 r ^ J Required 
 
 food a child of three, six, or nine years 
 requires, because the capacity of every 
 stomach varies and the digestion also 
 varies. One child can assimilate twice as 
 much meat as another. The same applies 
 to the total quantity of vegetables par- 
 
 [99] 
 
HEALTH-CAKE OF THE GEOWING CHILD 
 
 taken. There is no hard and fast rule that 
 can be applied to each and every child. 
 Feeding After the third year and until the sixth 
 
 Interval J 
 
 year the child should be given three meals 
 a day— at from 6.00 to 7.00 A.M., from 
 12.00 to 1.00 P.M., and from 5.30 to 6 P.M. 
 There is no objection to giving a glass of 
 milk or weak cocoa between meals if the 
 child asks for it. If, however, there is a 
 tendency to constipation, then one may 
 give a cup of malted milk or buttermilk 
 between meals. 
 
 The following diets can be used as a 
 guide: 
 
 For a Child Three to Six Years Old 
 
 Breakfast: 7.00 to 7.30 
 
 Orange, apple sauce, prunes, or figs. 
 
 Saucer of farina, cream of wheat, yellow corn- 
 meal, oatmeal, hominy, or wheatena. (All 
 cereals to be steamed in water at least two 
 hours. Served with cream and sugar.) 
 
 '[100] 
 
THE DIET 
 
 If appetite warrants it — a coddled egg and strip 
 
 of bacon. 
 Roll, toast, or corn muffin. If constipated, bran 
 
 muffin. 
 Cup of milk or cocoa. 
 
 Dinner: 12.00 to 1.00 
 
 Chicken, lamb, beef, or vegetable soup, expressed 
 steak-juice. 
 
 Calf 's foot or chicken jelly, raw scraped steak, 
 minced chicken, or fish. 
 
 Spinach, peas, beans, young carrots, beets, 
 asparagus, cauliflower, baked or creamed 
 potato. 
 
 Stewed apples, peaches, apricots, prunes, or 
 berries. Sponge cake, ladyfinger, or gela- 
 tine pudding. 
 
 Water. 
 
 Supper: 5.30 
 
 Two poached or scrambled eggs, ham or jelly 
 omelet. Custard, junket, corn-starch or 
 tapioca pudding. 
 
 Cream cheese. 
 
 Bread and butter. 
 
 Sliced banana with milk or raw fresh fruit. 
 
 Cup of milk, malted milk or cocoa. 
 
 [101] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 For a Child with Weak Digestion, from Six 
 to Ten Years Old 
 
 Many children of the neurotic type have a 
 peculiar palate. They crave a change of 
 diet and tire easily if the same flavor is con- 
 tinned. I have accordingly arranged a se- 
 ries of diets which can be varied from day 
 to day, so that the most capricious appetite 
 can be gratified. 
 
 Breakfast 
 
 Cream of wheat and cut figs, served with cream. 
 Soft-boiled egg. 
 Corn bread. 
 Cup of milk. 
 
 Or: 
 
 Wheatena cooked with dates, served with cream. 
 Wheat cakes and maple syrup. 
 Graham bread. 
 
 Malted milk (four teaspoonfuls Horlick's malted 
 milk to a teacup of hot water). 
 
 Or: 
 
 Oatmeal with cream. 
 Egg poached in bouillon. 
 
 [102] 
 
THE DIET 
 
 French roll. 
 Cup of cocoa. 
 
 Or: 
 Farina and seeded raisins with cream. 
 Broiled bacon or ham with creamed potato. 
 Whole wheat bread. 
 Cup of malted milk. 
 
 Or: 
 
 Baked apple with cream. 
 
 Hominy. 
 
 Corn bread. 
 
 Cup of milk. 
 
 Or: 
 
 Orange. 
 
 Scrambled eggs with minced tongue or ham. 
 
 Toast. 
 
 Cup of cocoa. 
 
 If constipated a saucer of Kellogg 's bran may 
 be given as a cereal, or two teaspoonfuls of 
 bran may be mixed with the cereal. 
 
 Lunch 
 
 Split pea soup. 
 Lamb chops. 
 Baked potato. 
 Ladyfingers and jam. 
 Water. 
 
 [103] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Or: 
 Noodle soup. 
 
 Fried halibut or fresh mackerel. 
 Spinach. 
 
 Baked apple with cream. 
 Wafers and water. 
 
 Or: 
 
 Cream of celery. 
 
 Broiled chicken, squab, or creamed chicken on 
 
 toast. 
 Asparagus. 
 
 Prune jelly with cream. 
 Water. 
 
 Or: 
 Beef and sago soup. 
 Bluefish or flounder. 
 Young carrots. 
 Apple sauce. 
 Wafers and water. 
 
 Or: 
 
 Cream of asparagus or vegetable soup. 
 Broiled sweetbread or stewed tripe. 
 Baked sweet potato. 
 Angel-cake. 
 
 Or: 
 Chicken and rice soup. 
 Roast beef, steak, codfish or smelts. 
 
 [104] 
 
THE DIET 
 
 Peas. 
 
 Celery. 
 
 Stewed peaches or apricots. 
 
 Wafers and water. 
 
 Supper 
 
 Glass of zoolak or buttermilk. 
 
 Cream cheese. 
 
 Toast. • 
 
 Apple or fresh fruit. 
 
 Or: 
 
 Ham omelet. 
 
 Toast. 
 
 Glass of milk. 
 
 Grapes. 
 
 Or: 
 Baked macaroni with cheese. 
 Fresh lettuce or celery with salt. 
 Cup of cocoa. 
 Imported Albert crackers. 
 
 Or: 
 
 Scrambled eggs. 
 
 Split banana baked in shell. 
 
 Saltines. 
 
 Glass of milk. 
 
 Or: 
 
 Rice pudding with almonds and raisins. 
 
 [105] 
 
HEALTH-CAKE OP THE GROWING CHILD 
 
 Cup of malted milk. 
 Bread with butter and jam. 
 Fresh fruit. 
 
 Or: 
 
 Apple or cherry custard. 
 Cream cheese. 
 Saltines. 
 Cup of cocoa. 
 
 Or: 
 
 Jelly omelet. 
 Swiss cheese. 
 Uneeda biscuit. 
 Cup of cocoa. 
 
 Or: 
 
 Cold breast of chicken. 
 Lettuce or celery with salt. 
 Sliced pineapple with cherries. 
 Glass of milk. 
 
 In feeding a child of from ten to sixteen 
 years, we should remember that the child is 
 still growing, and that his individual re- 
 quirements are vegetables, cereals, fruits, 
 eggs, fish, and meat. Instead of one egg, 
 two may be given at a meal. Wheat bread 
 
 [106] 
 
THE DIET 
 
 is very nutritious ; if, however, it has a ten- 
 dency to constipate, then bran or Graham 
 bread may be given. Corn bread baked in 
 the morning may be served in the evening. 
 
 Diet for a Child over Ten Years of Age 
 
 Morning 
 
 Raw fruit in season. 
 
 Wheatena, oatmeal, farina, cream of wheat, 
 corn-meal grape nuts, wheat flakes or shred- 
 ded wheat biscuit. 
 
 Ham or bacon and eggs. 
 
 Corn or bran muffins, wheat or Graham bread, 
 rolls. 
 
 Water, milk, or cocoa. 
 
 Noon 
 
 Chicken, beef and noodle, mutton, and all vege- soups 
 
 table soups. 
 Lamb chops, steak, roast beef, chicken, fish, raw Meats 
 
 chopped beef, lamb or beef stew. 
 Peas, beans, carrots, beets, potato, corn, cauli- vegetables 
 
 flower, or asparagus. 
 Celery, lettuce, tomato. 
 
 [107] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Dessert Berry pies, corn-starch, tapioca, custard, or 
 
 stewed fruits. 
 Wheat or Graham bread. 
 Water. 
 
 Evening 
 
 Scrambled eggs or omelet. 
 
 Cold chicken, lamb, or ham. 
 
 Swiss or cream cheese. 
 
 Custard or sponge-cake. 
 
 Bread, butter, and jam. 
 
 Fruit. 
 
 Water, milk, or buttermilk. 
 
 Diet for an Underweight Child 
 
 To increase a child's weight, certain in- 
 gredients of the food must be modified. 
 This will alter the general nutrition of the 
 body and give more weight. A word of cau- 
 tion is necessary. Do not force the change 
 from a light diet to a richer and more con- 
 centrated form of food too suddenly, as 
 thereby we may overtax the digestive func- 
 tion and induce dyspepsia, which may per- 
 manently weaken the stomach. 
 
 [108] 
 
THE DIET 
 
 To increase the weight of a child we must 
 increase the fat content of the food. A tea- 
 spoonful of cream added to a cup of milk 
 several times a day is indicated. If this 
 cream is well digested and causes no dis- 
 turbance we may add another teaspoonful 
 of cream and increase in four or five days 
 until three teaspoonfuls are added to each 
 cup. Butter should be given liberally. It 
 may be given on bread or potato. Sugar 
 may be given liberally on cereals and pud- 
 dings. If cereals such as farina, cream of 
 wheat, Pettij ohn, or wheat ena are well 
 borne they should be given at least once a 
 day. They should be served with cream or 
 butter, and sugar. 
 
 For the noon meal, puddings, such as 
 tapioca, arrowroot, or corn-starch, may be 
 given. Macaroni and home-made noodles 
 are very nutritious and increase weight. 
 Beets, carrots, potatoes, peas, beans, and 
 
 [109] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 lentils are vegetables that add greatly to 
 both nutrition and weight of the body. 
 Omelet, pancake, sponge-cake, rice pudding, 
 and custard, are desserts which are very 
 nutritious and increase the weight. 
 
 Olive oil may be given as a dressing on 
 lettuce. Cocoa, chocolate, nuts, bacon, and 
 eggs will aid nutrition. 
 
 Diet for a Very Fat Child 
 
 Reduction Before reducing the weight of a child we 
 
 should have the heart carefully examined. 
 In some cases it is important to have a 
 blood-examination made. This examina- 
 tion will determine the number of red blood- 
 cells, which is a good guide to go by during 
 the reduction-treatment, as thereby we can 
 learn whether or no the blood supply has 
 been weakened by the restricted diet. 
 
 If the reduction is accomplished too rap- 
 idly it will be at the expense of the general 
 
 [no] 
 
 Diet 
 
THE DIET 
 
 blood supply. A weak heart and collapse 
 may result therefrom. 
 
 The diet for children with a tendency to 
 fat formation should have the quantity of 
 liquids restricted, thus very small quanti- 
 ties of milk, soup, broth, or even water 
 should be given. Fat children should re- 
 ceive small quantities of meat and fish, but 
 large portions of vegetables and fruits 
 should form the bulk of their diet. 
 
 It is very important to assist the bowels 
 by giving a laxative that will carry off 
 fluids. One of the best laxatives for this 
 purpose is the lapactic pill. This may be 
 given before retiring at night and may be 
 repeated every evening until liquid stools 
 are produced daily. 
 
 Cereals, butter, and cream should be given 
 in very small quantities. Eggs, fish, lean 
 beef, ham, lamb, and veal in moderation. 
 
 Candies, cakes, and nuts are prohibited. 
 
 [in] 
 
HEALTH-CAEE OF THE GKOWING CHILD 
 Diet in Fever 
 
 When fever occurs all solid food should 
 be stopped. By fever is meant a tempera- 
 ture higher than 101 degrees. Eggs, meat, 
 vegetables, and cereals should be omitted. 
 Milk, gruel, broths, fruit juices, and in rare 
 instances junket, gelatine, toast, and bis- 
 cuit may be given. These diets are to be 
 given only until the physician can examine 
 the patient. 
 
 In many surgical conditions, where the 
 digestive tract is normal, and no fever ex- 
 ists, it may be possible to give a full diet of 
 meat, eggs, and vegetables to hasten repair 
 and aid in recovery. 
 
 Diet in Diarrhea 
 
 If ordinary looseness of the bowels exists 
 and there is but a slight rise in the tempera- 
 ture, give a good dose of castor-oil and stop 
 all milk. Give rice, steamed in water, mut- 
 
 [112] 
 
THE DIET 
 
 ton, lamb, or veal broth with rice or barley, 
 toast, corn-starch, or tapioca pudding, jun- 
 ket or cream cheese. No fruits should be 
 given. For thirst, weak tea or water may 
 be given. Albuminized tea, or tea contain- 
 ing the white of egg, may be given many 
 days in succession. An interval of at least 
 four hours is required between feedings. 
 
 Poor Appetite 
 
 Poor appetite may be due to a general 
 weakness of the stomach or a loss of tone. 
 It may also be due to a catarrhal condition. 
 When children suffer with nasal catarrh, 
 adenoids, or enlarged tonsils they will in- 
 directly disturb the stomach and thereby 
 cause a loss of appetite. Constipated chil- 
 dren usually suffer with loss of appetite. 
 When the stool stagnates in the bowel, we 
 must cleanse the intestines with a teaspoon- 
 ful of Epsom salts or Eochelle salts dis- 
 
 [113] 
 
HEALTH-CARE OF THE GEOWING CHILD 
 
 solved in sweetened water. This dose may- 
 be given two mornings in succession, then 
 omitted for three or four mornings. 
 
 One of the best drugs to kindle an appe- 
 tite is one or two drops of tincture of nux 
 vomica one-half hour before each meal for 
 one month. This dose is safe for a child of 
 any age. Large doses should not be given 
 without the direction of a physician. 
 
 Very nervous children, especially those 
 having strenuous work at school, will do best 
 by omitting school lessons, and being given 
 a complete rest for a day or two in bed. 
 
 Many other children will regain their ap- 
 petite by being given a change of air. A 
 change from the city to the country or sea- 
 shore or from the country to the city will 
 stimulate the appetite. 
 
 A cold sponge-bath or cold shower, fol- 
 lowed by a brisk rub, is one of the best 
 appetizers. 
 
 [114] 
 
THE DIET 
 
 A radical change in diet in which milk is 
 omitted can be tried for two days. Or, if 
 meat, eggs, and vegetables have formed the 
 bulk of the diet, let the stomach rest by giv- 
 ing a teacupful of milk, but nothing else, 
 three times a day. After three or four days 
 we can gradually return to the former diet. 
 
 Vomiting 
 
 Vomiting is not always a sign of disease. 
 If the stomach is very irritable, food may 
 provoke a spasm which results in vomiting. 
 In very nervous and sensitive children vom- 
 iting takes place easier than in the strong 
 and robust child. Vomiting is usually due 
 to a disordered stomach. It may also be 
 due to swollen tonsils or may be caused by 
 fright. As a rule, vomiting means the be- 
 ginning of a disease. When a child strikes 
 its head and has a concussion of the brain, 
 vomiting results. Continued vomiting, as- 
 
 [115] 
 
Vomit 
 
 HEALTH-CARE OF THE GROWING CHILD 
 
 sociated with fever, may mean the begin- 
 ning of scarlet fever or brain disease. 
 Nervous Habitual vomiting may be caused by a 
 
 growth in the stomach. It may also be due 
 to a nervous manifestation. The hysterical 
 and sensitive child, especially if it is forced 
 to eat food that it does not like, will throw 
 it up. This form of vomit depends on the 
 nervous mechanism of the child, and a case 
 of this kind requires judgment and treat- 
 ment of the whole nervous system rather 
 than that of the stomach. 
 
 Vomiting is sometimes caused by acido- 
 sis. In this condition there is headache, 
 fever and a sour breath resembling the odor 
 of vinegar. The urine contains diacetic acid 
 and acetone. These attacks may occur in 
 the best of families^ in children having ex- 
 cellent supervision. They are not caused 
 by imprudence in feeding. If meat or eggs 
 are the causative agents, stop them. Some 
 
 [116] 
 
THE DIET 
 
 children may require a milk or vegetable 
 diet for many months. If egg and meat 
 proteins act as irritants, they must be omit- 
 ted from the diet. Internally one-half tea- 
 spoonful or more of bicarbonate of soda 
 three or four times a day will stop the 
 attacks. 
 
 [117] 
 
Chapter II 
 
 DISORDERS ARISING FROM IM- 
 PROPER NUTRITION 
 
 The Bowels 
 supervision of It is better not to rely on the statement 
 
 the Bowels 
 
 of any child regarding the bowels. No child 
 up to the age of puberty is competent to 
 describe a stool as to size, color, consistency, 
 or quantity. The yellowish, pasty stool or 
 the yellowish-white stool of infancy is 
 changed to the brown, formed stool which 
 should be passed in long-formed, sausage- 
 like masses. Hard, round, and dry balls 
 signify the absence of secretions from the 
 liver, also the absence of intestinal glandu- 
 lar juices. These secretions are necessary 
 to soften as well as lubricate the stool, thus 
 keeping it in a semisolid consistency. 
 
 [118] 
 
IMPEOPEE NUTEITION 
 
 Many stools contain particles of undigest- 
 ed vegetables and meats. This indicates 
 lack of proper mastication. This has been 
 mentioned in the article on Intestinal Indi- 
 gestion. 
 
 When children eat too quickly and do not Proper 
 
 Mastication 
 
 take time to properly masticate their food, 
 they should be served with chopped or 
 minced meats, puree of peas, potatoes, etc. 
 Proper mastication can only be taught by' 
 constant and patient supervision. Some 
 children of the nervous and overactive type 
 do everything quickly, likewise they eat 
 quickly, hence one must expect frequent 
 dyspeptic attacks resulting therefrom. A 
 dyspeptic stomach means dyspeptic stools. 
 
 Constipation 
 
 The bowels must move at least once 
 in twenty-four hours, otherwise the child 
 is constipated. Health and development, 
 
 [119] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 which means growth, are dependent on the 
 digestive tract. 
 
 The absorption of food necessary to sus- 
 tain life takes place in the intestine, and 
 the balance or residue must be passed from 
 the body. If there is weakness of the in- 
 testinal muscles, or if there is an absence 
 of intestinal glandular activity, the stool, 
 instead of being soft, will be hard and dry, 
 and will stagnate in the bowel. This stag- 
 nation causes headache, besides a distention 
 of the abdomen, 
 causes Among the chief causes of constipation 
 
 are insufficient exercise and dietetic errors. 
 As a rule, mistakes in diet are responsible 
 for 75 per cent of all cases of constipation. 
 
 To provoke a regular movement of the 
 bowels we must have a regular system of 
 feeding. If a child has taken a meal, he 
 must be given sufficient time before par- 
 taking of the next meal to properly digest 
 
 [120] 
 
IMPEOPEK tfUTKITION 
 
 the previous meal. To overtax the stomach 
 and overwork the glands weakens them, and 
 consequently we overstrain the digestive 
 tract by giving it more work than it can 
 accomplish. Overeating and too frequent 
 feeding, therefore, are the two chief causes 
 of constipation. 
 
 Cakes, pies, puddings, pastries, and mac- 
 aroni may all be eaten in moderation. They 
 are nutritious, but if potatoes and large 
 quantities of starchy food and bread are 
 consumed, they must be aided by exercise 
 and water, otherwise constipation will re- 
 sult. Many children will not take fruit, 
 others eat too much candy, but such habits 
 may not be permitted without detrimental 
 result. Every child must eat vegetables, 
 for their nutritious as well as laxative ac- 
 tion. Kellogg's bran may be added to the 
 cereals, or a teaspoonful of malt extract 
 may be given with the food or after each 
 
 [121] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 meal. Graham or corn-bread, bran-muffin, 
 oatmeal with cream, and peach, apple, or 
 prune puree will all stimulate the action of 
 the bowel. 
 
 We should teach the child to use the toilet 
 chair at a certain time of the day, prefer- 
 ably after breakfast. By this means the 
 mind will aid in stimulating the bowel. 
 
 Diarrhea 
 
 When a child has more than three stools 
 a day, they usually assume a liquid char- 
 acter. This is termed diarrhea. 
 
 The stools may be yellow or green, or 
 they may contain traces of blood. As a rule, 
 diarrhea is caused by a derangement of the 
 stomach and bowels. 
 
 Among the most frequent causes is the 
 eating of unripe or overripe fruit, improp- 
 erly cooked, or partially decomposed foods, 
 such as milk or fish that has not been kept 
 
 [122] 
 
IMPEOPEE NUTEITION 
 
 on the ice, ice-cold water, or ice-cream when 
 the stomach is overheated. 
 
 Disease germs present in any article of 
 food will cause diarrhea. Water from a 
 creek or pond, if polluted with sewage, will 
 not only cause diarrhea, but may give rise 
 to bloody stools (dysentery). 
 
 From what has been said, we can see 
 that diarrhea is usually caused by the in- 
 troduction of disease germs in food which 
 set up an inflammatory process in the stom- 
 ach and intestine. This inflammation re- 
 sults in the discharge of loose, watery, or 
 mucous stools. There are other reasons 
 for diarrhea ; for example, by plunging the 
 feet in cold water and wading too long at 
 the seashore, many children suffer with 
 colic, and later on loose bowels. Many cases 
 of diarrhea are preceded by colic or cramps 
 in the abdomen. Besides the liquid stools, 
 there is also a great deal of flatulence. As 
 
 [123] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 a rule, exhaustion and prostration follow 
 loose bowels, and if the diarrhea continues 
 longer than one day, the child should be 
 kept quiet on the bed or couch, so that walk- 
 ing and all exercise is avoided. Especially 
 must the child be kept in bed if the tem- 
 perature is over 100 degrees. 
 
 In a neighborhood wherein typhoid fever 
 has occurred, we should call a physician at 
 the first sign of diarrhea, as typhoid fre- 
 quently begins in this manner. 
 
 Diarrhea is frequently brought on when 
 the bulk of the food has been liquid rather 
 than solid. If milk, soup, broth, tea, and 
 orange juice have been consumed during the 
 day, very little solid stool will be passed. 
 If, on the other hand, bread, cake, potatoes, 
 meat, and eggs were the chief articles of 
 food, then liquid stools should not be ex- 
 pected unless the food is of an irritating 
 character or has stagnated in the intestines, 
 
 [124] 
 
IMPEOPEE NUTEITION 
 
 producing decomposition with gaseous fer- 
 mentation resulting in explosive stools. 
 
 In every case of diarrhea, whole milk Treatment 
 should be stopped and skimmed milk given. 
 Such skimmed milk must be boiled before 
 using. Weak tea, rice steamed in water 
 and flavored with cinnamon, farina, tapio- 
 ca, and corn-starch pudding may be given. 
 Arrowroot pudding is valuable, and toast 
 made of stale bread may be given. Fresh 
 bread should not be permitted. Mutton 
 broth, thickened with rice or barley, is re- 
 quired. Fruit should not be given. Water 
 should be boiled and given sparingly. All 
 vegetables excepting carrots may be given 
 in moderation. 
 
 A tablespoonful of castor-oil should be soda 
 
 Injection 
 
 given at the first sign of diarrhea. Two 
 hours later the bowels should be washed 
 with one quart of warm water, to which 
 one heaping teaspoonful of bicarbonate of 
 
 [125] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 soda has been added. When giving this in- 
 jection the child should be placed on the 
 left side and the irrigation given with the 
 fountain- syringe held no higher than two 
 feet over the child's body. By this means 
 we avoid using too much pressure. 
 
 One tablespoonful of lime-water should 
 be added to each feeding of skimmed milk, 
 so that two or three tablespoonfuls of lime- 
 water may be given during the day. Give 
 one teaspoonful of chalk mixture, well 
 shaken, every hour for six doses, to a child 
 of from five to fifteen years. If the diar- 
 rhea does not improve after the above treat- 
 ment a physician should be called. 
 
 When a child has repeated attacks of 
 diarrhea during the year, a subnormal 
 condition exists, which can be improved by 
 toning up the system. A tonic of iron may 
 be required. 
 
 [126] 
 
IMPROPER NUTRITION 
 
 Colic or Cramps 
 
 Cramps in the stomach and bowels are 
 frequently caused by eating unripe fruit 
 or food which is iced. Very fatty food is 
 sometimes responsible for attacks of colic. 
 These attacks consist of pain and rumbling 
 in the abdomen due to gas. They are usu- 
 ally followed by loose bowels. The dis- 
 charges frequently contain mucus. The 
 temperature of the child should be taken 
 to see whether or not fever is present. At- 
 tacks of colic, if following a meal of unripe 
 fruit or too fatty food, require a tablespoon- 
 ful of castor-oil to cleanse the intestinal 
 tract. A pinch of calcined magnesia, in 
 water, after each meal will frequently pre- 
 vent recurring attacks. 
 
 Immediate relief can be afforded by the 
 application of a hot-water bag and by giv- 
 ing one-half teacupful of warm water to 
 
 which five drops of essence of peppermint 
 
 ■ [ 127 ] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 have been added. An injection of one-half 
 pint of warm camomile tea is soothing, and 
 will aid in the expulsion of gas and undi- 
 gested fecal matter. If an attack of colic 
 occurs and we are sure it is not caused by 
 an indiscretion of diet, a physician should 
 be called to determine the origin of the 
 same. 
 
 Intestinal Indigestion 
 
 In intestinal indigestion we find undi- 
 gested particles of food in the stool. There 
 is a loss of appetite. The child is languid, 
 complains of headache, and sometimes of 
 pain in the arms and legs. Overfed chil- 
 dren, and those suffering repeated attacks 
 of gastric and gastro-intestinal disorder, are 
 more likely to have intestinal indigestion. 
 As the food is not properly assimilated, the 
 child passes a large quantity of undigested 
 particles of food. This deprives the child 
 
 [128] 
 
IMPEOPEK NUTKITION 
 
 of strength and results in a lowering of 
 the vitality. 
 
 Long-continued attacks of intestinal in- 
 digestion produce loss of weight. The blood 
 being deprived of nutrition, shows anemia. 
 Thus, children suffering with intestinal in- 
 digestion are extremely pale. Their ears 
 are yellowish- white, and there is an absence 
 of the healthy ruddy color so natural to 
 child-life. 
 
 In addition to the feeding of improper cause 
 food, both quantity and quality, there is 
 usually bad hygiene at the bottom of the 
 trouble. 
 
 Children who are forced to study too hard 
 and are deprived of exercise and open-air 
 activities usually suffer with intestinal in- 
 digestion. Oxygen is demanded for the nu- 
 trition of the red-blood corpuscles, and if 
 foul air in classrooms or in bedrooms is 
 substituted for pure fresh air, the peptic 
 
 [129] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 glands and the intestinal glands being 
 robbed of their vitality, can not perform 
 their normal work, and as a result the food 
 is deprived of secretions which are neces- 
 sary for its digestion and assimilation. 
 Treatment To modify this condition the following 
 
 plan is suggested. If meat has been per- 
 mitted, it should be minced and then thor- 
 oughly masticated, so that saliva is incor- 
 porated with the food. Children frequently 
 bolt their food, and until this habit is 
 broken they should have all their vegetables 
 mashed. We can give puree of lima beans, 
 winter beans, peas, and potatoes, so that 
 large quantities of food do not enter the 
 stomach. Coddled eggs, junket, pot-cheese, 
 and custards may be permitted, whereas 
 pies, cakes, and iced foods should be pro- 
 hibited. Ice-cream and water-ice are espe- 
 cially harmful if given immediately after 
 a meal, as they interfere with digestion. 
 
 [130] 
 
IMPKOPEK NUTRITION 
 
 Medication especially intended for this 
 condition must be ordered for each indi- 
 vidual case by a physician. 
 
 Rickets 
 
 Rickets is a weakened or faulty condition 
 of the bones and teeth caused by improper 
 feeding or by poor assimilation of food. 
 Faulty hygiene, resulting from want of 
 fresh air, with closed windows at night, may 
 cause rickets. Bolters who eat quickly, do 
 not chew well, and digest badly, usually 
 develop rickets. Rickets may affect the 
 spine, the ribs, the arms, the legs, or the 
 bones of the skull, so that any part of the 
 body may show a structural weakness. 
 
 The teeth are brittle, chalky, and decay 
 easily. The muscles are flabby and lose 
 their tone. It is for this reason that we 
 usually have constipation present. Rachitic 
 children are usually backward in talking 
 
 [131] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 land backward in walking. The soft bones 
 yield on walking, thus causing bowlegs. 
 These children are very susceptible to dis- 
 eases. They have an especial tendency to 
 adenoids and enlarged tonsils. A rachitic 
 child should be hardened and protected, 
 because of a tendency to tuberculosis in 
 later life. 
 
 To harden a child, in addition to hygienic 
 measures previously described, necessitates 
 giving it food which is easily assimilated. 
 Food which will build the bones and 
 strengthen the muscles. Cereals, such as 
 oatmeal, cornmeal, wheatena, rice, and bar- 
 ley, are bone-builders. Yolk of egg should 
 be added to these cereals. Meat and vege- 
 tables may be given liberally. Vegetables 
 should be given twice a day. 
 
 To assimilate food properly, children 
 should be fed at regular intervals, with 
 nothing between meals. If practicable and 
 
 [132] 
 
IMPROPER NUTRITION" 
 
 possible, the child should be permitted to 
 sleep out of doors and hardened in this 
 manner. Do not give cathartics continu- 
 ously; they are weakening. Rely on diet, 
 principally, to modify constipation. 
 
 Weak Ankles 
 
 Weak ankles are caused by weakness in 
 the ligaments of the joints, or they may 
 be an association of rickets in which soft 
 bones and flabby muscles exist. Dyspeptic 
 manifestations during infancy and child- 
 hood lay the foundation for this condition. 
 
 Exercise and proper diet will build up 
 the ankles to a normal condition. Cereals, 
 eggs, meat, and vegetables should form the 
 principal part of the diet ; cakes, pies, and 
 puddings should be given but sparingly. 
 
 Children suffering with weak ankles 
 should not be deprived of exercise such 
 as roller-skating, ice-skating, or bicycle- 
 
 [133] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 riding. These exercises must, however, be 
 taken in moderation, and at the first sign 
 of fatigue or turning of the ankle, rest must 
 
 Fig. 21. 
 
 Fig. 22. 
 
 Fig. 23. 
 
 These illustrations, taken from Florence Bolton's 
 Exercises for Women, published by Funk & Wagnalls 
 Company, are well worth studying. 
 
 Fig. 21. — A common sight — the ankles bulging in- 
 ward under the weight of the body. 
 
 Fig. 22.— A front view of Fig. 21. "Toeing out" 
 has lengthened the inner line of the foot and allowed 
 the bodyweight to fall to that side, pressing down the 
 arch. 
 
 Fig. 23. — A normal springy step. Notice that the 
 weight falls on the outer side of the foot and that the 
 line of action is straightforward. 
 
 be enforced. The period between fatigue 
 will gradually lengthen until the child can 
 remain on skates or wheels an hour or 
 longer. 
 
 [134] 
 
IMPROPER NUTRITION 
 
 Crooked or run-down heels are not al- 
 ways a sign of weak ankles, but more fre- 
 quently result from the faulty use or posi- 
 tion of the feet in walking. 
 
 Scurvy 
 
 When children are deprived of fresh 
 meat, fresh vegetables, and fresh milk, and 
 fed on condensed milk and canned goods 
 for a very long time, scurvy may result. 
 
 The body requires a live factor which is 
 present in raw milk and which disappears 
 when the milk is boiled or preserved. 
 Scurvy shows itself by spongy gums with 
 tendency to bleed. The stools will be soft 
 and frequently contain streaks of mucus 
 and blood. There are tendencies to hemor- 
 rhage in various parts of the body, due to 
 frail blood-vessels. 
 
 There is no danger in giving an occa- 
 sional meal of canned or preserved food of 
 
 [135] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 standard quality, but if we deprive the child 
 of all fresh foods, such as raw milk, orange 
 juice, steak juice, and raw white of egg, 
 scurvy may result. 
 
 Cases of scurvy should always be placed 
 under the treatment of a physician, as ad- 
 vanced cases may have chronic symptoms 
 which would pass unobserved by the aver- 
 age mother. If properly treated, scurvy 
 will leave no after-effects. 
 
 [136] 
 
PART III 
 
 CATARRHAL, COMMUNICABLE, AND 
 SYSTEMIC DISEASES 
 
 [137] 
 
Chapter I 
 
 CATARRHAL DISEASES 
 
 The Throat 
 
 To examine the throat, we should take Normal 
 
 Appearance of 
 
 the child in a good light, near the window, the Throat 
 and depress the tongue with the handle of 
 a spoon. 
 
 Hanging over the root of the tongue is 
 the soft palate, and on either side of the 
 palate we have the tonsils. These, if swol- 
 len, are ragged, beanlike projections, pink- 
 ish in color. 
 
 The back of the throat, if healthy, pre- 
 sents a pinkish color; this can always be 
 distinguished from the bluish-red and dry 
 appearance of the throat during an inflam- 
 mation. 
 
 It is a good plan to inspect the throat 
 
 [139] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 of a healthy child frequently, so as to fa- 
 miliarize one's self with the appearance of 
 the same in health, and at the same time 
 teach the child not to fear the examination. 
 
 The throat is the source of more trouble 
 in the growing child than any other part 
 of the body, therefore it pays to carefully 
 inspect it many times in order to recognize 
 patches or swellings when they occur. 
 
 When a child refuses to eat, one of the 
 first things to do is to inspect the throat, 
 as all dust and disease germs are inhaled 
 through the mouth and nose. When chil- 
 dren are indisposed and appear languid, 
 the mother should inspect the throat. She 
 will be able to see the beginning of inflam- 
 mation in the throat, if present, and can 
 thereby locate the trouble very early. 
 
 Loss of appetite is in many cases believed 
 to be due to a spoiled stomach, when in 
 reality an inflammation in the throat is re- 
 
 [140] 
 
CATAEEHAL DISEASES 
 
 sponsible for the trouble. Frequently chil- 
 dren five to six years old, and sometimes 
 eight to ten years old, may complain of 
 headache, when the trouble really is in the 
 tonsil. This is important to know, because 
 fifty per cent of cases of fever in children 
 begin with a sore throat and loss of ap- 
 petite. 
 
 Adenoids 
 
 Adenoid vegetations are small wartlike 
 masses varying in size from one-quarter to 
 one inch in length. They are found at the 
 back of the nose and throat. Their growth 
 and enlargement depend on the presence 
 of catarrh. 
 
 Some children have a tendency to ade- 
 noid formation. This tendency is found in 
 the child with rickets, or with syphilis, and 
 in the glandular type of child. 
 
 In catarrhal families, where bronchitis, 
 tonsillitis, and frequent colds and coughs 
 
 [141] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 are found, most if not all children develop 
 adenoids. There are hundreds of children 
 with small adenoids that go through life 
 without any evidence of the same. But the 
 presence of adenoids may be suspected if 
 the child suffers with frequent attacks of 
 running nose, loss of appetite, and restless- 
 ness. 
 Mouth The most important symptoms are 
 
 Breathing 
 
 mouth-breathing, snoring, and occasionally 
 bed-wetting. If adenoids are permitted to 
 grow, they can block the back of the nose 
 so that they interfere with breathing ; there- 
 fore, an adenoid child uses its mouth in- 
 stead of its nose for respiration. Nature 
 gave us the nose through which to breathe, 
 but also to filter the dust from the air on 
 its way to the throat. Many disease germs 
 when inhaled through the nose are not as 
 dangerous as when they enter through the 
 mouth. 
 
 [142] 
 
CATAEEHAL DISEASES 
 
 Long-standing adenoids will produce a 
 deformity of the npper jaw and push the 
 jaw forward so that the upper teeth pro- 
 trude far beyond the lower teeth. 
 
 The nose has a peculiar pinched expres- 
 sion, and physicians speak of the facial ex- 
 pression as the "adenoid habitus.' ' That 
 there is extreme danger in the nonremoval 
 of adenoids can be seen by the fact that 
 the majority of sufferers from scarlet fever, 
 diphtheria, and recurring croup, are those 
 in which enlarged tonsils and adenoid vege- 
 tations are found. 
 
 We can safely say that the presence of 
 adenoids invites contagious diseases, be- 
 cause adenoids as well as tonsils will har- 
 bor disease germs, and give them a soil for 
 their propagation. 
 
 In addition to inviting disease, adenoids, Deafness 
 if obstructing the Eustachian tube in the 
 throat, can cause deafness. Such deafness 
 
 [143] 
 
 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 can fortunately be cured by the removal 
 of the adenoids. 
 
 Adenoid vegetations are usually the re- 
 sult of recurring colds in the head; they 
 are, however, occasionally found in the 
 newly born, so that pre-natal tendencies do 
 exist. 
 
 When adenoids exist in an otherwise 
 healthy throat they may not give rise to 
 any disturbing symptoms. When, on the 
 other hand, the child suffers with fever or 
 catarrh, then adenoids will swell, as they 
 frequently do in damp weather, and give 
 rise to symptoms. These symptoms are 
 nasal obstruction, caused by catarrhal dis- 
 charges, interference with breathing, and, 
 at night, snoring. 
 
 Adenoids Adenoid vegetations are frequently re- 
 
 cause Bar 
 
 Discharge sponsible for long-continued ear discharges. 
 When a running ear will not yield to the 
 routine methods of syringing and general 
 
 [144] 
 
CATARRHAL DISEASES 
 
 building up of the system, the cause may- 
 be looked for somewhere in the vault of the 
 pharynx. Very frequently the removal of 
 a small adenoid growth will aid in stopping 
 a discharging ear. 
 
 Many cases of restlessness at night are 
 due to the presence of adenoids. Many 
 children are dosed with useless worm medi- 
 cines when adenoids are the cause of the 
 grinding teeth and insomnia. 
 
 Every now and then a case of bed-wetting Bed-wettin g 
 will be seen that is due to a reflex disturb- 
 ance wherein adenoids are the cause. Pig- 
 eon-breasted children have this deformity 
 of the chest in many instances due to a 
 long-delayed operation. 
 
 The adenoids prevent the proper amount 
 of fresh air reaching the lungs, and by thus 
 interfering with the respirations, the de- 
 formity of the chest is gradually developed 
 until it remains permanent. 
 
 [145] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 From what has been said it will be seen 
 that the presence of adenoids in a growing 
 child is a great menace, the removal of the 
 same a great benefit. 
 
 In the public schools, teachers have long 
 since recognized the association between 
 mental backwardness and adenoids. The 
 dullest pupils in the classroom are usu- 
 ally sufferers from adenoids. These are 
 the reasons why the health department of 
 every large cosmopolitan city all over the 
 country, also educators, recognize the dan- 
 ger of adenoid vegetations among school- 
 children, and have urged parents for years 
 to have these growths removed. They in- 
 terfere with both the physical and mental 
 development of the child. 
 
 Tonsillitis 
 
 In this condition, when the throat is ex- 
 amined, yellowish or yellowish-white dots, 
 
 [146] 
 
CATARRHAL DISEASES 
 
 pin-point or larger in size, and looking like 
 droplets of cream, on one or both sides of 
 the throat, will be seen. (See frontispiece.) 
 There is always fever present. In the 
 beginning it may be only 102 degrees, but 
 later reach 103 or even 105 degrees. These 
 fever attacks are accompanied by a tired 
 feeling, with muscular pains and extreme 
 thirst. ' Some children are drowsy and do 
 not wish to be disturbed. The fever and the 
 poison from the tonsils disturb the internal 
 secretions, and constipation of a most ob- 
 stinate character frequently accompanies 
 the same. Headache and vomiting may also 
 be present. The examination of the throat 
 in addition to the spots above mentioned 
 shows redness, and the parts will be dry and 
 shiny. There is a sour odor to the breath. 
 The tongue will be correspondingly dry. 
 The physician should be called because of 
 the danger of complications. 
 
 [147] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Until the physician can he reached, one 
 pint of soapwater should he injected into 
 the howel. This will always reduce the tem- 
 perature, relieve the headache, and brighten 
 the child. 
 
 To quench thirst, reduce the temperature, 
 and stimulate the kidneys, a wineglassful 
 of citrate of magnesia should he given every 
 hour for six hours. 
 
 It is a good plan to investigate the origin 
 of every case of tonsillitis and find out at 
 school or among friends if the child has 
 been exposed to diphtheria. There are 
 many points of difference in the two dis- 
 eases which will be described in the chapter 
 on diphtheria. 
 
 Rhinitis, or Cold in the Head 
 
 catarrh Rhinitis means catarrh in the head with 
 
 running nose. Sneezing is usually present. 
 As a rule, when children have frequent re- 
 
 [148] 
 
CATAEEHAL DISEASES 
 
 curring colds in the head, we find the throat 
 to be the seat of the trouble. Adenoids 
 concealed somewhere in the back of the nose 
 will swell like a moistened sponge and give 
 off a continuous discharge of a yellowish 
 or yellowish- white color, or diseased tonsils 
 will carry millions of germs. The condi- 
 tion is found in children who are not in a 
 normal state of health. When the body is 
 weakened, the blood is thinner and the cir- 
 culation is poorer. The hands and feet, in- 
 stead of being warm, are cold. The slight- 
 est chilling of the surface of the skin by 
 changing to light clothing or thinner under- 
 wear is usually followed by a running nose, 
 or by sneezing, and symptoms commonly 
 called a cold in the head. 
 
 Active exercises followed by perspira- 
 tion, unless properly checked, will result in 
 a cold in the head. 
 
 Recurring colds can be improved, but not 
 
 [149] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 cured, by using sprays or inhalations, or 
 any of the rhinitis drugs, such as aspirin, 
 phenacetin, or salol. 
 
 To cure this catarrh permanently, we 
 must have the adenoids scraped away ; then 
 the discharge will stop. 
 
 A cold in the head, resembling rhinitis, 
 with sneezing and coughing, may be the 
 beginning of measles. It is safer to put 
 the child to bed for one day, or until the 
 nature of the cold is determined. Very fre- 
 quently an innocent-looking catarrh in the 
 head, with running nose, marks the begin- 
 ning of diphtheria of the nose. 
 Biood Test Syphilis, if the cause of rhinitis, can only 
 
 be determined by an examination of the 
 blood. If we are suspicious that catarrh is 
 inherited from either parent, then a Was- 
 sermann blood-test should be made — this 
 will determine positively whether or no the 
 child has a syphilitic catarrh. 
 
 [150] 
 
CATARRHAL DISEASES 
 
 Coughs 
 
 A cough means an irritation. Phlegm in 
 the back of the throat may cause a tickling 
 and irritation until expectoration clears the 
 same. Swollen tonsils or swollen adenoids 
 give off a discharge which causes a cough. 
 A cough due to adenoids or tonsils appears 
 when the child lies on its back; therefore, 
 a night cough is suggestive of the presence 
 of adenoids. Not all night coughs, however, 
 are caused by adenoids. In the beginning 
 of a whooping-cough, before the whoop ap- 
 pears, the child will cough mostly at night. 
 The cough will also be stronger at night. 
 The cough associated with whooping-cough, 
 as also the cough due to adenoids, is not 
 accompanied by fever. This point is im- 
 portant to remember, especially when an 
 irritating cough exists and continues for 
 many weeks. 
 
 The cough associated with influenza or the 
 
 [151] 
 
HEALTH-CARE OF THE GROWING CHILD 
 Due to cough associated with bronchitis is always 
 
 Pleurisy ° J 
 
 accompanied by fever. The fever may 
 reach 100 degrees in the morning and 102 
 degrees at night. A cough similar to a 
 bronchial cough, but usually accompanied 
 by pain on one or both sides of the chest, is 
 due to pleurisy. The little patient will in- 
 stinctively place his hand over the painful 
 spot on the side of the chest to relieve the 
 pain produced by coughing, and will always 
 lie on the affected side. In pleurisy there is 
 rarely any expectoration, but a great deal 
 of cough. The cough caused by a continued 
 bronchitis or pleurisy will, if prolonged, 
 cause a loss in weight. I shall refer to the 
 treatment of these coughs in the special 
 articles pertaining to diseases later on. 
 
 If the child has a cough and loses weight, 
 and if there is fever accompanying the same, 
 a physician should be called, so that the 
 nature of the cough can be established. 
 
 [152] 
 
CATARRHAL DISEASES 
 Tuberculosis frequently has a cough and Due to 
 
 x * ° Tuberculosis 
 
 a slight fever which resembles pleurisy, and 
 it would be very serious to neglect the 
 beginning of a tuberculosis, because the 
 chances of a cure are greater in the begin- 
 ning of every disease. My advice, there- 
 fore, is to consult a physician the moment 
 a cough is accompanied by fever, until the 
 true nature of the disease is established. 
 
 [153] 
 
Chapter II 
 COMMUNICABLE DISEASES 
 
 how conta- Diphthekia, measles, and scarlet fever — 
 
 gious Diseases 
 
 are spread m f ac ^ a n contagious diseases — are spread 
 by contact with discharges containing the 
 germs. 
 
 Convalescents who have living disease 
 
 germs in the throat or nasal discharges can 
 communicate the disease through these dis- 
 charges. Ear discharges and vaginal dis- 
 charges during the course of scarlet fever 
 assume malignancy, and frequently trans- 
 mit the disease thereby. 
 "Carrier" The most frequent means of dissemina- 
 
 tion of disease is through carriers. A ' ' car- 
 rier' ' is a person who has had an infectious 
 disease from which he is apparently cured, 
 but who still carries the disease germs capa- 
 
 [154] 
 
COMMUNICABLE DISEASES 
 
 ble of transmitting such disease to healthy 
 people. Many people may carry disease 
 germs in their nose and throat for months 
 after the active symptoms of the disease 
 have subsided. 
 
 To determine the existence of disease 
 germs after convalescence from scarlet 
 fever, and especially diphtheria, a culture 
 should be taken from the discharges of the 
 nose and throat. In suspected typhoid 
 fever a culture taken from the stool will 
 quickly determine the presence or absence 
 of such disease germs. 
 
 Another means of conveying the disease Direct 
 
 Contact 
 
 is by the fingers of a person nursing a pa- 
 tient. Unless the nurse is instructed in the 
 necessity of washing her fingers immedi- 
 ately after each handling of the patient, 
 she may be the means of carrying the dis- 
 ease to healthy persons. If we permit a 
 healthy child to drink from a glass or use 
 
 [155] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 a spoon immediately after a sick child has 
 used it, disease germs can be directly con- 
 veyed to the healthy child. This proves the 
 necessity for keeping all utensils separated, 
 and more especially the need of washing 
 them before they are used by others. Cloth- 
 ing should be thoroughly cleaned, under- 
 Disinfection wear should be boiled and washed, and when 
 thoroughly aired need not be feared. Dis- 
 ease germs die quickly when exposed to the 
 air. No one need fear contracting a con- 
 tagious disease by using clothing after the 
 same has been cleaned and aired. Chemi- 
 cal disinfection of clothing and bedding has 
 been abandoned. 
 
 Insects, such as flies, mosquitoes, and 
 Bugs, especially bedbugs, carry disease. 
 These insects come in direct contact by 
 crawling over the body, and so carry dis- 
 ease germs directly from person to person. 
 During illness all food should be carefully 
 
 [156] 
 
COMMUNICABLE DISEASES 
 
 covered to guard against insect contam- 
 ination. Windows and doors should be 
 screened to keep insects, and especially 
 flies, out of the house. 
 
 Affection bestowed by a kiss in the im- Kissing 
 mediate family is not harmful, nor is it 
 harmful providing we are sure that there 
 is no one ill with influenza, diphtheria, or 
 pneumonia, as these germs are found in 
 the saliva. 
 
 Indiscriminate kissing by the nursemaid 
 and by strangers is always risky, and must 
 be condemned. Our present knowledge of 
 the contagion of disease, and the ease with 
 which disease is communicated from mouth 
 to mouth, should render thoughtful parents 
 cautious in regard to kissing. 
 
 Syphilis can be conveyed by an innocent 
 kiss. We should prevent children, espe- 
 cially at school, from getting the habit 
 which some day may prove disastrous. 
 
 [157] 
 
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 [158] 
 
COMMUNICABLE DISEASES 
 
 Influenza 
 
 Influenza, commonly known as "grippe," 
 is a frequent disorder of childhood. There 
 are mild and severe types of influenza. It 
 is our most frequent form of winter cold, 
 and begins with a cold in the head, cough, 
 fever, and ache or pain in the limbs. 
 
 There is another form of influenza in Gastric Type 
 which we have fever, loss of appetite, and 
 either vomiting or diarrhea. This is the 
 so-called gastric type which affects the 
 stomach and bowels. 
 
 A third form of influenza affects the nerv- 
 ous system. There is fever and sometimes 
 delirium or intense headache. The influenza 
 bacillus causes either form of this disease. 
 It enters the nose and throat, gets into the 
 circulation, and produces the above-named 
 symptoms. 
 
 The most common type is the catarrhal catarrhal 
 
 Type 
 
 form, which has a tendency to spread from 
 
 [159] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 the nose and throat into the bronchial tubes, 
 setting up either a bronchitis, a pleurisy, 
 or a pneumonia. 
 
 An influenzal pneumonia is a long-drawn- 
 out affection in which the pneumonia does 
 not terminate by crisis in seven to nine days, 
 but lasts two to four weeks. Owing to the 
 length of time this disease lasts, there is 
 considerable loss of vitality and exhaustion 
 resulting therefrom. Another disagreeable 
 form of this catarrhal type is the spread of 
 the influenza bacillus into the ear-passages. 
 In some cases there will develop an ear 
 abscess, in other cases the influenza bacillus 
 penetrates the mastoid cells, behind the ear, 
 giving rise to mastoid inflammation. While 
 mastoid inflammation is not a fatal disease, 
 it should always be regarded as a serious 
 complication. 
 
 If a child contracts influenza from another 
 member of the family, and has fever (a tem- 
 
 [160] 
 
COMMUNICABLE DISEASES 
 
 perature of over 100 degrees), it should be 
 put to bed, given a mustard foot-bath and 
 a laxative. One grain cascara tablet, re- 
 peated in four hours if not effectual. After „ 
 the bowels are cleansed, one grain of salol 
 may be given three times a day. If the 
 fever does not subside within twenty-four 
 hours, call a physician. 
 
 Bronchitis 
 
 Bronchitis is a catarrhal affection of the 
 bronchial tubes, and begins with a cold in 
 the head. The air-tubes in the upper por- 
 tion of the lungs are very susceptible to 
 catarrhal inflammation. Catarrh germs 
 enter the nose and throat and set up an 
 inflammation which extends from the throat 
 downward to the bronchial tubes. There is 
 usually a slight rise in the temperature, the 
 fever will range between 100 degrees in the Fever 
 morning and 102 degrees in the evening. If 
 
 [161] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Neglected 
 Cases 
 
 Treatment 
 
 the bronchitis is associated with influenza 
 the duration may be several weeks. Bron- 
 chitis should not be neglected. Unless the 
 bodily strength is restored with the aid of 
 tonics, loss of weight may occur. In many 
 cases the tendency to ignore a bronchitis 
 and to trust to nature should be condemned. 
 
 Neglected cases of bronchitis lay the 
 foundation for repeated attacks, and result 
 in chronic bronchitis. Neglected cases are 
 also a favorable soil for the development 
 of tuberculosis, and this is really what we 
 must guard against. 
 
 Bronchitis is usually associated with 
 measles; it may also follow influenza. No 
 matter how mild the case, it is better to 
 have the lungs carefully examined by a phy- 
 sician and have a correct plan of treatment 
 outlined. 
 
 There is a vast difference in treating a 
 case of bronchitis in the city or in the coun- 
 
 [162] 
 
COMMUNICABLE DISEASES 
 
 try. Dust and dirt and changeable climate 
 are factors that provoke irritation and keep 
 up an active bronchial catarrh. It is there- 
 fore advisable to change from the city to 
 the country, preferably to a higher altitude. 
 An altitude of 1,000 to 1,500 feet, for sev- 
 eral weeks, will relieve the catarrhal inflam- 
 mation of a bronchitis, besides giving the 
 child a better appetite and aiding in the 
 digestion of food. 
 
 Sleep is an important factor, and the dis- 
 turbance of sleep caused by continued cough- 
 ing should be remedied. Antispasmodics, 
 such as belladonna, will soothe the mucous 
 membrane, dry the secretions, and thereby 
 promote sleep. It is self-understood that 
 all drugs must be ordered by a physician. 
 
 If a cough-mixture or an inhalation is or- 
 dered, and the child happens to fall asleep, 
 do not disturb it — wait until it awakens. 
 The habit of rousing a child out of a sound 
 
 [163] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 sleep is vicious and cannot be too strongly 
 condemned. Nature demands sleep to re- 
 pair waste, and it may be necessary to give 
 small doses of drugs to assist nature now 
 and then in promoting sleep. This applies 
 to sick children only. 
 
 Bronchial Asthma 
 
 Eecurring attacks of bronchitis, with 
 wheezing heard over the front and the back 
 of the chest, are known as bronchial asth- 
 ma. One of the reasons for this wheezing 
 and difficulty in breathing is due to a swell- 
 ing of the inside lining of the bronchial 
 tubes. This swelling renders the entrance 
 of air more difficult ; as a result there is an 
 wheezing imperfect oxygenation of the lungs. The 
 blood suffering from this loss of oxygen 
 is shown in a bluish color of the body, espe- 
 cially of the lips and finger-nails. There 
 is cough and difficulty in breathing, but lit- 
 
 [164] 
 
COMMUNICABLE DISEASES 
 
 tie or no expectoration. As a rule, there 
 is a slight fever, but rarely higher than 
 from 100 to 101 degrees. 
 
 These attacks of asthma usually owe 
 their origin to some albuminous food which 
 causes this disturbance, resulting in spas- 
 modic attacks of the bronchial tubes. 
 
 Some children will have recurring asth- 
 matic attacks after eating eggs. Other 
 children have a sensitive reaction to cere- 
 als. If once the reason for the attack has 
 been definitely determined, the recurrence 
 of the same can be avoided. 
 
 We do not look upon asthma as due to 
 a cold, although chilling the surface of the 
 body when overheated will render sensitive 
 children more liable to attacks. 
 
 For the relief of bronchial asthma, cup- 
 ping of the chest is beneficial. The bowels 
 should be kept loose. Kitchen odors and 
 tobacco smoke must be avoided. 
 
 [165] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Fresh air is of prime importance. The 
 windows must be open night and day, sum- 
 mer and winter. During the attacks, no 
 solid food should be given. Small doses 
 of calomel will relieve the congestion of the 
 liver and the lungs, and may be given in 
 doses of one-tenth grain every ten min- 
 utes for ten doses, after which a teaspoon- 
 ful of rhubarb and soda mixture may be 
 given every hour for three doses. 
 
 Pneumonia 
 Broncho- There are three kinds of pneumonia — 
 
 pneumonia 
 
 bronchopneumonia, lobar pneumonia, and 
 tuberculous pneumonia. 
 
 During the winter months, a cold in the 
 head or influenza may last several weeks. 
 The body loses strength, and there is a con- 
 tinued fever. If the child is not kept in bed 
 until the fever subsides, the influenza ba- 
 cillus or the pneumonia bacillus will extend 
 
 [166] 
 
COMMUNICABLE DISEASES 
 
 from the nose and throat to the bronchial 
 tubes, terminating in bronchopneumonia. 
 
 Bronchopneumonia usually follows mea- 
 sles, scarlet fever, or diphtheria. It is 
 therefore the form of pneumonia that asso- 
 ciates itself with an already weakened sys- 
 tem. There is consequently a certain ele- 
 ment of danger in this form of pneumonia. 
 
 The condition usually lasts several weeks, 
 but it may last months. It does not ter- 
 minate by a crisis, as does lobar pneumonia, 
 which will be described later. The tem- 
 perature may range between 100 and 101 
 degrees in the morning to 104 or even 105 
 degrees in the evening. There is cough of 
 a distressing character. There is very little 
 expectoration. The appetite is poor, the 
 bowels sluggish. The child perspires free- 
 ly. There is loss of weight, due to the 
 catarrh, the continuous fever, and lack of 
 assimilation of nutrition. 
 
 [167] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 In some cases the disease may extend 
 from one portion of the lung to another. 
 Not infrequently both lungs may be in- 
 volved, so that bronchopneumonia will be 
 found on both sides of the chest, and in the 
 upper as well as the lower lobes. 
 
 The outcome of a case of bronchopneu- 
 monia depends on the amount of lung in- 
 flamed. It also depends on whether or no 
 the child has rickets. The exhaustion due 
 to the prolonged fever demands not only 
 Alcoholic concentrated food, but also stimulation. 
 
 Stimulation 
 
 The heart must be strengthened during the 
 course of the disease. In many cases it is 
 imperative to add whisky to the milk and 
 egg to stimulate the circulation. Parents 
 should never object to the use of alcoholic 
 stimulation when ordered by a physician, 
 for thereby the life of the child may be 
 saved. 
 
 The treatment of this disease requires 
 
 [168] 
 
COMMUNICABLE DISEASES 
 
 the careful judgment of a physician, and 
 no mother or nurse should undertake the 
 responsibility of treating the child without 
 the supervision of a physician, 
 
 The danger-point in bronchopneumonia 
 consists in the weakness which may follow 
 continuous fever, and this is first shown by 
 the weakness of the heart action. The heart 
 therefore needs watching. Such cases oc- 
 casionally terminate in lung abscess, and 
 where rickets exist, bronchopneumonia may 
 terminate in tuberculosis. To prevent such 
 complication the physician must pilot the 
 case carefully from the beginning. 
 
 As to the open-air method of treatment, coidAir 
 
 Treatment 
 
 children of robust constitution can tolerate 
 cold air treatment. If, however, the circu- 
 lation is poor, extremities cold, fingers, toes, 
 and face bluish instead of pink, then warmth 
 will do more good than the open-air treat- 
 ment. Cold air exhilarates many children, 
 
 [169] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Lobar 
 Pneumonia 
 
 but it depresses those whose circulation is 
 poor, and especially children heretofore un- 
 accustomed to it. 
 
 Lobar pneumonia receives its name from 
 the fact that one portion or lobe of the lung 
 is inflamed. It usually is found associated 
 with influenza, or mid-winter bronchitis. 
 
 A sudden chill, followed by a very high 
 temperature, such as 103 to 105 degrees, 
 marks the beginning of an attack. Children 
 complain of pain on breathing, of a stitch 
 in the side. There is marked shortness of 
 breath, considerable cough, but rarely much 
 Expectoration expectoration. If there is any expectora- 
 tion, it is of a reddish or brownish color, 
 and is known as i ' prune- juice ' ' expectora- 
 tion. This form of expectoration is char- 
 acteristic of this type of pneumonia, and 
 usually lasts from four to seven days, rarely 
 longer. 
 
 Just as we have a sudden rise in temper- 
 
 [170] 
 
COMMUNICABLE DISEASES 
 
 ature at the beginning of this disease, so 
 do we have a characteristic drop from 105 
 degrees to normal, between the seventh and 
 ninth days of the illness. This is known 
 as the ' ' crisis. ' ' When this crisis occurs the crisis 
 child must be carefully protected against 
 exposure. We must not believe that, be- 
 cause the temperature is normal, all will go 
 well. The heart-action and the pulse are 
 better guides in estimating the true condi- 
 tion of the child. 
 
 Long after the physician has discontinued 
 treatment the mother or nurse should re- 
 member the severe strain to which the heart 
 has been subjected, and if possible the child 
 should be taken to the mountains or seashore 
 for a change of air which will strengthen 
 the lungs. 
 
 Exercise which tends to exhaustion must 
 not be permitted. 
 
 Lung gymnastics by deep inspiration and 
 
 [171] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Lung 
 Gymnastics 
 
 Tuberculous 
 Pneumonia 
 
 expiration should be ordered every morning 
 and evening. At least a dozen long breaths 
 should be taken, and this should be done 
 after thorough ventilation of the room. 
 This exercise will not only develop the lung 
 but will give the blood more oxygen. It is 
 therefore like giving a lung-tonic. 
 
 Tuberculous pneumonia is a form of 
 chronic inflammation in the lung in which 
 there is associated tuberculosis. Children 
 with pigeon-breast and flat chest, especially 
 those with enlarged glands possessing very 
 little vitality, are more liable to develop this 
 form of pneumonia than robust children of 
 good chest and lung development. 
 
 When whooping-cough is neglected, and 
 is a long-drawn out disease, we occasionally 
 have tuberculous pneumonia as a complica- 
 tion. When tuberculosis exists in a family 
 and there is carelessness with expectora- 
 tion, or kissing by a tuberculous father or 
 
 [172] 
 
COMMUNICABLE DISEASES 
 
 mother, or if milk from a diseased (tuber- 
 culous) cow is fed, the tuberculosis germ 
 can be carried into the body and thus set 
 up tuberculous pneumonia. 
 
 A child having tuberculous pneumonia 
 has no chance to recover in a crowded city. 
 It must be removed to the country for open- 
 air treatment. Many of these cases offer 
 little hope if the disease has progressed 
 many months, with continuous loss of 
 weight. Our only hope lies in giving such 
 a child tonic treatment, such as arsenic or 
 nux vomica to restore tone to the digestive 
 tract, in addition to an outdoor life. 
 
 Tuberculosis 
 
 Tuberculosis is a disease caused by the 
 tubercle-bacillus which enters the mouth or 
 nose by inhalation or by means of food. If 
 the food contains the tubercle-bacillus the 
 intestinal type of tuberculosis usually de- 
 
 [173] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 velops. In some cases the germs lodge in 
 the back of the throat and penetrate the 
 glands of the neck, causing glandular tuber- 
 culosis. 
 
 Milk and butter are frequently the vehi- 
 cles that convey tuberculosis-germs; this 
 applies to raw milk only. For this very 
 reason physicians have for years advised 
 the pasteurization or sterilization of milk, 
 because by this means disease-germs are 
 killed. When certified milk from inspected 
 cows is received we are dealing with safe 
 milk, and such milk only may be consumed 
 in its raw state. What has previously been 
 mentioned concerning the danger of ordi- 
 nary market-milk applies to milk of un- 
 known dairies. In such dairies if a milker 
 has tuberculosis he can convey, by cough- 
 ing, thousands of tuberculosis-germs to the 
 milk. Another danger is that of the cow 
 itself. The disease known as bovine tuber- 
 
 [174] 
 
COMMUNICABLE DISEASES 
 culosis is very common among cows, and if Bovine 
 
 Tuberculosis 
 
 the udder is diseased the milk is contami- 
 nated during the milking process. Ulcers 
 and discharges in and around the udder are 
 a source of danger to milk. 
 
 In a debilitated child, such as one that 
 is weakened from a prolonged attack of 
 whooping-cough, chronic bronchitis, pneu- 
 monia, or pleurisy, the danger of develop- 
 ing tuberculosis is readily understood. If 
 the body is weakened it becomes a suitable 
 soil for the development of the seed more 
 easily than if the body is strong and healthy. 
 
 Tuberculosis in childhood is curable pro- Giand 
 
 Tuberculosis 
 
 vided strict attention is given to modern 
 methods of treatment. The treatment of 
 gland-tuberculosis as well as the treatment 
 of bone-tuberculosis consists in the surgical 
 removal of the affected glands or bone. Do 
 not misunderstand me. All gland- or bone- 
 cases do not need surgical treatment. Many 
 
 [175] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Heliotherapy 
 
 Dietetic 
 Treatment 
 
 of these cases can, with excellent hygiene 
 and good food, be bnilt np so as to throw off 
 the disease and regain perfect health. The 
 most important part of the treatment con- 
 sists in giving the patient the benefit of 
 heliotherapy. This consists in living per- 
 manently at a slight altitude in the moun- 
 tains and having windows open night and 
 day, and exposing the body to the sun's 
 rays. If it is not feasible to remove the 
 child from its home to the mountains for 
 the above outlined treatment, the next best 
 thing is to take it to the seashore where the 
 same plan of outdoor life, sun-baths, and 
 in selected cases, sea-baths may be given. 
 
 Milk with yolk of egg y buttermilk, cheese, 
 vegetables, meat, and fruits should form the 
 bulk of the diet. Whereas an interval of 
 five hours between meals should be allowed, 
 a glass of milk, cocoa, or malted milk may 
 be permitted between meals. 
 
 [176] 
 
COMMUNICABLE DISEASES 
 
 Chronic bronchial coughs, especially if 
 the body loses weight, should be regarded 
 with suspicion. If fever is present in the 
 evening and the child perspires, the sputum 
 should be examined for the presence of the 
 tubercle-bacillus. Many diseases have symp- 
 toms similar to tuberculosis. In malarial Empyema 
 fever the symptoms resemble those of tuber- 
 culosis, but the blood-test can determine the 
 presence or absence of the malarial germ. 
 
 An abscess in the lung, so-called empy- 
 ema, gives symptoms similar to tuberculo- 
 sis. Because of the similarity of symptoms 
 in various diseases and the difficulty in iden- 
 tifying tuberculosis, when no expectoration 
 is present, we are compelled at times to 
 wait several weeks until a positive diagnosis 
 can be made. If expectoration is present, 
 the presence of the tubercle-bacillus in the 
 same will complete the diagnosis. 
 
 The diagnosis of brain-tuberculosis is 
 
 [177] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Brain- 
 Tuberculosis 
 
 Treatment 
 
 most easily made by drawing off a small 
 quantity of the spinal fluid and testing 
 the same for the presence of the tubercle- 
 bacillus. 
 
 Many years ago tuberculosis was re- 
 garded as a fatal disease, and every patient 
 who suffered with tuberculosis was re- 
 garded as doomed. Modern science has 
 recognized the necessity of taking all cases 
 of tuberculosis out of their bedrooms and 
 warm blankets and placing them in ham- 
 mocks or open-air shacks, or on balconies 
 and giving them a liberal supply of fresh 
 air and sunlight. The sun's rays are the 
 best disinfectants. This is recognized by 
 the various Health Departments who, in- 
 stead of using formalin and sulfur disin- 
 fection, now resort to fresh air and sunlight 
 to kill germs. Sirups, foul-smelling creo- 
 sote, and carbolic sprays to disinfect the 
 air-passages have been discarded as useless. 
 
 [178] 
 
COMMUNICABLE DISEASES 
 
 The treatment now consists in disinfecting 
 the lungs with continuous fresh air, placing 
 the patient in a sun-bath, keeping the skin, 
 bowels, and kidneys free, clean, and active, 
 aiding nature by restoring the lost vitality 
 with concentrated foods and following this 
 up with tonics such as arsenic, iron, cod- 
 liver-oil or butter and cream. 
 
 In order to develop the lungs, lung-gym- Lung 
 nasties, consisting of deep breathing to 
 exercise both inspiration and expiration 
 twice a day, five minutes each time, will 
 expand the collapsed portions of the lung, 
 bring fresh air into these darkened spaces, 
 and also aid in throwing of! accumulated 
 secretions. 
 
 We can easily combine some pleasure 
 with lung development in young children 
 by having them blow soap-bubbles or col- 
 ored liquid from one bottle into another by 
 means of tubes. This will expand the air- 
 
 [179] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 cells in the lungs. In older children a com- 
 bination of music with lung gymnastics can 
 be obtained by having the child take lessons 
 in cornet or flute playing. 
 
 Whooping-Cough 
 
 Whooping-cough usually develops in from 
 two to seven days after exposure. The first 
 symptoms are those of an ordinary cold, 
 with a cough. This lasts about ten days, 
 when the cough gets stronger until a pro- 
 nounced spasm appears. These spasms 
 consist of a number of short quick coughs, 
 then a long-drawn inspiration known as 
 "the whoop.' ' During these coughing 
 spasms the child will get very red, some- 
 times bluish-red in the face. The spasm 
 usually ends with a vomit. It will be no- 
 ticed that the cough is worse indoors and 
 is least troublesome out-of-doors. The 
 spasms are strongest at night. This is 
 
 [180] 
 
COMMUNICABLE DISEASES 
 
 usually so because the windows are shut. 
 Fresh air night and day is very necessary 
 for a cure. 
 
 The danger in whooping-cough consists 
 of exhaustion following lack of food as a 
 result of the constant vomiting. The ex- 
 haustion from the spasms of cough, espe- 
 cially at night, rob the system of vitality. 
 Loss of sleep due to the coughing parox- 
 ysms is another element of danger. Nose- 
 bleed is frequently provoked by a coughing 
 spasm. Eupture in the groin or of the 
 navel may be caused by the violent cough. 
 Neglected whooping-cough extending over 
 months may be the foundation for tubercu- 
 losis in later life. 
 
 It is better to know the dangers that 
 threaten the patient and guard against 
 them. No mother should undertake the 
 management of a case of whooping-cough 
 without consulting her physician. 
 
 [181] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 An old superstition is mentioned merely 
 to be condemned, namely: do not irritate 
 the child's respiratory tract by taking it 
 to a gas-house to inhale gas-fumes, 
 isolation The child should not be permitted at 
 
 school or at play with a healthy child until 
 the cough has entirely ceased. This may 
 be two months after the beginning of the 
 disease, or it may be four months. It is 
 better to safeguard a whole classroom 
 rather than expose it to the danger of con- 
 tracting whooping-cough. 
 
 The duration of the disease is from eight 
 to fourteen weeks. If the disease is neg- 
 lected the symptoms or the cough may 
 continue several months. 
 
 Relief can be afforded during the violent 
 coughing spasms by applying a tight muslin 
 or linen binder around the chest, just as a 
 mother applies an abdominal binder over 
 the abdomen of her infant. This binder 
 
 [182] 
 
COMMUNICABLE DISEASES 
 
 should be changed every morning and even- 
 ing. Relief can also be given by having the 
 physician apply a plaster support over the 
 ribs, just as is done in pleurisy. Strips of 
 ordinary adhesive plaster applied over the 
 ribs is best suited for this purpose. The 
 plaster is to be changed every week. Opi- 
 ates and drugs to cut short the spasms 
 should be used only under the direction of 
 a physician. Bitter almond water in two 
 drop doses may be given every three hours 
 to relieve the cough. 
 
 When once the spasms are lessened in 
 intensity and frequency, tonics such as iron, 
 olive-oil or codliver-oil will aid in restoring Diet 
 strength to the body. Milk with seltzer, 
 buttermilk, yolk of egg with lemon-juice, 
 malted milk, cocoa, or chocolate, ice-cream, 
 junket, custard, corn-starch, or tapioca pud- 
 ding and raw scraped steak are a few of the 
 foods to be given to strengthen the child 
 
 [183] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 during the active process of the cough and 
 when the same declines. 
 
 Mumps 
 
 Mumps consist of glandular swellings 
 below the ears, under the jaw. After expo- 
 sure mumps develops in one to three weeks. 
 
 There is pain on chewing or opening the 
 mouth and on swallowing. The tempera- 
 ture is rarely higher than 101 degrees. An 
 ice-bag, applied for four or five days, will 
 reduce the swelling and cut the disease 
 short provided there is no tonsil- or ear- 
 complication present. 
 
 The bowels should be kept loose. Liquid 
 food must be sipped. The child should re- 
 main in bed until all swelling has subsided. 
 In some instances too much rubbing of the 
 glands with massage or useless salves may 
 develop an inflammation terminating in an 
 abscess. 
 
 [184] 
 
COMMUNICABLE DISEASES 
 
 Croup 
 
 There are two kinds of croup, one called 
 false croup, the other true or diphtheritic 
 croup. 
 
 False croup comes on suddenly and usu- False croup 
 ally at night. The child awakens out of a 
 sound sleep with a barking, hoarse cough. 
 The breathing is usually very noisy when 
 the breath is being drawn in, and the child 
 appears to suffocate. As a rule the croupy 
 cough is so distressing that the children sit 
 up so that they can breathe easier. Perspi- 
 ration usually covers the face. The temper- 
 ature will rarely be higher than 101 degrees. 
 These cases occur in children who have 
 gone to school during the day and have 
 retired in apparent good health. The at- 
 tacks subside by day and may recur several 
 nights in succession. Such children may 
 be classed as of the catarrhal type, subject 
 to colds and coughs. Not infrequently they 
 
 [185] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 suffer with rickets, bronchitis, or wheezing, 
 and the frail condition renders them more 
 susceptible to croup. 
 Emetic Relief can be afforded by giving a tea- 
 
 spoonful of sirup of ipecac, repeated every 
 fifteen minutes if necessary, until vomiting 
 is produced. For a child under four years 
 of age give one-half the dose. If the accu- 
 mulation in the throat is thick and gummy, 
 let the child inhale steam from a tea-kettle 
 or croup-kettle containing one teaspoonful 
 of compound tincture of benzoin or spirits 
 of turpentine to a pint of water. If after 
 vomiting the child is not relieved, a warm, 
 moist, flaxseed poultice with camphorated 
 oil should be applied to the neck under the 
 chin. Unless the attack subsides promptly, 
 a physician should be called so that we may 
 be sure the child is suffering from a catar- 
 rhal or false croup and not from true mem- 
 branous or diphtheritic croup. 
 
 [186] 
 
COMMUNICABLE DISEASES 
 
 In all diseases affecting the air-passages 
 great relief will be afforded by opening tbe 
 windows and allowing plenty of fresh air. 
 Do not permit more than one person in the 
 room with a croupy patient. By poisoning 
 the air which occurs when several people 
 are in the room, we indirectly do harm to a 
 croupy sufferer. The patient should be 
 isolated. All children and adults should be 
 excluded from the room. 
 
 After the attack of false croup subsides 
 a tonic for the general system will restore 
 tone and may prevent future attacks. 
 
 True, Membranous, or Diphtheritic Croup 
 
 This form of croup is very serious. It 
 comes on gradually and the symptoms in- 
 crease from day to day. The fever rises 
 gradually. The glands of the neck become 
 swollen. The croupy cough increases in 
 severity from hour to hour. The breathing 
 
 [187] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 wheezing will be labored and noisy. Wheezing sounds 
 on inspiration can be heard in an adjoining 
 room. Such labored breathing will compel 
 the child to sit np and gasp for air. The 
 face will lose its pinkish color and become 
 bluish. The child looks distressed. The 
 cough is short and barking with no expec- 
 toration. The throat is filled with a thick 
 membranous mucus which is the cause of 
 the trouble. 
 
 On examination of the throat we will not 
 see yellowish- white spots or dots as we 
 see in diphtheria, because these spots are 
 so low in the throat that they can be seen 
 only with the aid of a laryngeal mirror. 
 
 Until a physician can be called, a tea- 
 spoonful of ipecac mixed with a teaspoon- 
 ful of glycerin may be given. In many 
 cases vomiting will occur, but it is not es- 
 sential to produce vomiting. If the croup 
 gets worse, relief can only be given by 
 
 [188] 
 
4 
 
 COMMUNICABLE DISEASES 
 
 inserting a tube through the mouth into Tube 
 the larynx. This process is called intuba- 
 tion. Some relief will be afforded by ap- 
 plying a warm flaxseed poultice, to which 
 camphorated oil or mustard is added, to 
 the neck. Isolate the child from all others. Antitoxin 
 Antitoxin should be injected as early as 
 possible. There is great danger of delay- 
 ing the injection of antitoxin in suspicious 
 cases. Even though a case of croup does 
 not prove to be real diphtheria, no harm 
 can be done by the injection of antitoxin. 
 
 As a rule, it takes from twelve to twenty- 
 four hours to determine whether or no a 
 case is diphtheria. The physician or nurse 
 can take a smear from a suspicious throat 
 and send it to a laboratory to have deter- 
 mined whether or no the Klebs-Loeffler ba- 
 cillus which causes diphtheria is present. 
 
 Antitoxin destroys the poison or toxin 
 given off by the diphtheria germs. To pre- 
 
 [189] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 vent complications such as paralysis or 
 kidney disease, or in fact any complicating 
 disease, antitoxin should be injected. The 
 earlier it is used the surer are we of avoid- 
 ing fatalities. It is too late to argue for 
 or against antitoxin after death has oc- 
 curred. 
 
 Diphtheria is robbed of its terrors by 
 using antitoxin as soon as we see symptoms 
 which point toward the beginning of diph- 
 theria. 
 
 Diphtheria 
 
 Diphtheria first appears as yellowish or 
 yellowish-gray spots or patches. They are 
 seen on one or both tonsils, behind the ton- 
 sils on the pharynx, or sometimes in the 
 nose. As a rule, the temperature rises, 
 and the glands below the jaw become swol- 
 len. There may be pain on swallowing. 
 The appetite is poor. Thirst becomes in- 
 
 [190] 
 
COMMUNICABLE DISEASES 
 
 tense. The bowels are sluggish, as a rule 
 constipated. 
 
 I have previously called attention to the 
 necessity of examining the throat of every 
 child that feels sick. We may be surprised 
 to find that a child with no appetite and 
 some fever will not complain of its throat, 
 but examination of the throat will reveal the 
 true nature of the trouble. Any spots visi- 
 ble in the throat demand medical attention. 
 While many cases of tonsillitis are mild, 
 we must not run the risk of neglecting a 
 true case of diphtheria. 
 
 The complication of the poisons given off 
 by the germs of diphtheria may cause pa- 
 ralysis or a weak heart. This can all be 
 prevented if an injection of antitoxin is 
 given as soon as the disease is detected, 
 thus preventing the poison of the germs 
 from doing serious damage. 
 
 Antitoxin is a specific serum which, when 
 
 [191] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Antitoxin 
 
 Isolation and 
 Disinfection 
 
 used early, in proper dosage, prevents com- 
 plications. There are two doses, one for 
 healing purposes and the other used as a 
 preventative of diphtheria, the so-called 
 immunizing dose. 
 
 When it is known that children have been 
 exposed to diphtheria they should be pro- 
 tected with an immunizing dose of antitoxin 
 rather than run the risk of having them 
 contract the disease. A child exposed to 
 diphtheria, if infected, usually shows the 
 first symptoms three to ten days after such 
 exposure. 
 
 A case of diphtheria should be isolated 
 from all other healthy members of the fam- 
 ily, and remain isolated until all symptoms 
 of the disease have subsided. A convales- 
 cent case should not be permitted to mingle 
 with other children until a culture taken 
 from the throat shows the absence of the 
 
 diphtheria bacillus. 
 
 [ 192 ] 
 
COMMUNICABLE DISEASES 
 
 Our views concerning disinfection have 
 changed considerably during the past few 
 years. It has recently been proven that 
 sunlight and fresh air will kill more germs 
 than strong disinfectants. Most of our 
 health departments have recognized the 
 uselessness of disinfecting with chemicals, 
 and have abandoned the same, using sun- 
 light, fresh air, and scrubbing with soap and 
 water. In New York we use no other disin- 
 fection after diphtheria and measles. 
 
 The Health Department requires that 
 each apartment in which a communicable 
 disease existed shall, on the termination 
 of the same, be thoroughly scrubbed and 
 freshly painted. If the rooms are papered, 
 the same should be scraped from the walls, 
 and fresh paper applied. 
 
 [193] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Chicken-Pox 
 
 The eruption consists of elevated pustules 
 filled with a yellowish serum. It is an in- 
 fectious disease, usually contracted by di- 
 
 The Eruption rect exposure. A child who has been ex- 
 posed usually contracts the disease within 
 two to three weeks after such exposure. 
 
 A rash of small pink papulae is first seen 
 on the face, scalp, or back, and quickly 
 spreads to the abdomen. These papulae soon 
 become elevated pustules filled with a yel- 
 lowish serum. The Germans call the dis- 
 ease "Wasser pocken," because they re- 
 semble water-blisters. In a few days these 
 pustules dry up and crusts form, which 
 drop off within a week or two. The erup- 
 tion appears in crops. While some of the 
 pustules are drying up, others are just be- 
 ginning to appear. 
 
 Fever As a rule, the temperature does not go 
 
 above 101 degrees. 
 
 [194] 
 

 CHICKEN-POX 
 
 For description see text. 
 
i 
 
 rr >F THE GROW 
 
 Chicken-Pox 
 
 Th on consists o I ted pustn 
 
 filled owish serum. It is an in- 
 
 . usually contracted by di- 
 The BrUF k child who has been ex- 
 
 tracts the o within 
 
 ks after su< osure. 
 
 mall pink papulae is first seen 
 scalp, or back, and quickly 
 abdomen. These papulae soon 
 
 xoJ.i«SJSte5 filled ™ ih a yel " 
 
 x-^^^feen^Piflans call the dis- 
 ■r pocken," because they re- 
 r-blisters. In a few days these 
 v up and crusts form, v 
 
 ek or 
 s in crops. While s« 
 drying up, other 
 pear. 
 Fever the temperatu go 
 
 

COMMUNICABLE DISEASES 
 
 Chicken-pox has no association with 
 smallpox, and will appear in either a vac- 
 cinated or unvaccinated child. It is the 
 mildest eruption in childhood, and need oc- 
 casion no alarm. Complications never oc- 
 cur. To guard against having the evidence 
 of pox later on, the child should be warned 
 against scratching the crusts. Alcohol, in 
 which a few grains of menthol have been 
 dissolved, stops the itching, if applied every 
 few hours. 
 
 No solid food should be permitted during 
 the first few days of the eruption. The 
 bowels should be kept loose with the aid 
 of a wineglassful of citrate of magnesia 
 twice a day. Cases of chicken-pox should isolation 
 be separated from healthy children for at 
 least two to three weeks, or until all crusts 
 have dried and fallen off. 
 
 [195] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Measles 
 
 Measles is most frequently found in chil- 
 dren between the third and seventh year. 
 It is very contagious. Measles poison 
 travels upward like smoke. As a rule, the 
 child on the fourth floor will contract the 
 disease from the child on the third floor. 
 The children on the lower floors, however, 
 usually escape. Congested apartments, 
 crowded houses, asylums, institutions, and 
 the steerage of ships breed measles. It 
 takes from seven to fourteen days for the 
 disease to develop after the child has 
 been exposed. Measles is most contagious 
 one or two days before, and about three 
 days after, the eruption appears on the 
 body. 
 
 The first symptoms of measles are a slight 
 fever, and symptoms resembling cold in the 
 head, with sneezing, coughing, and running 
 nose. The appetite will be poor and thirst 
 
 [196] 
 
COMMUNICABLE DISEASES 
 
 excessive. The eyes will be dull and the 
 child appears languid. 
 
 Generally on the fourth day the rash is The Rash 
 seen, first on the face which appears quite 
 swollen, then on the neck, from where it 
 spreads rapidly all over the body. The rash 
 is bright red and appears in blotches with 
 little crescent-shaped areas of white skin 
 between the blotches. The rash remains 
 at its .height about three days, when it be- 
 gins to fade. In some cases the skin peels Desquamation 
 off in fine flakes or scales. 
 
 Several days before the eruption appears 
 there will be restlessness and peevishness; 
 the child will be tired and desire rest. 
 
 The temperature before the eruption 
 ranges between 100 and 101 degrees in the 
 morning, reaching 102 degrees in the even- 
 ing. During the succeeding three or four 
 days the temperature may remain about Fever 
 the same, but will suddenly rise to about 
 
 [197] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 103 or 104 degrees. About the same time 
 a generalized eruption appears. Not infre- 
 quently the temperature reaches 105 de- 
 grees, twenty-four hours after the eruption 
 is at its height. This high temperature is 
 followed by a sudden drop of three or four 
 degrees, or to almost normal, forty-eight 
 hours after the eruption has fully appeared. 
 
 To be on the safe side, every child with 
 a cold in its head, with sneezing and cough- 
 ing, should be put to bed at least until the 
 fever subsides, unless the child has already 
 had measles, 
 complications Many cases of measles recover without 
 any complication, but there are many others 
 followed by sore eyes, a discharging ear, or 
 by pneumonia. Now and then the pus germs 
 which accompany measles will give rise not 
 only to ear abscess, but also to an abscess 
 in the chest-wall, called empyema. 
 
 One of the worst complications following 
 
 [198] 
 
MEASLES 
 
 For description see text. 
 
Complication* 
 
 HI 
 
 103 01 About t 
 
 a gen 
 
 que mature 1 
 
 g r » ours afte: 
 
 is high t ature is 
 
 a drop four 
 
 >st norm, 
 iiption has full 
 
 de, every child ^ 
 with sneezing and cough- 
 st until the 
 
 3.HJ2A3M 
 
 jx 9 t 99 . noi^&aiMd has already 
 
 measles recover without 
 but there are many others 
 es, a discharging ear, or 
 and then the pus g 
 
 les will givf 
 . but also to an al 
 lied empyema. 
 Oi rst complications following 
 
 [ i- 
 
'>■■■■■■■!■■ -■■■■'■■: .-.Vi' 
 
COMMUNICABLE DISEASES 
 
 measles is tuberculosis. A neglected bron- 
 chitis, followed by pneumonia, may extend 
 over a long period of fever and finally ter- 
 minate in tuberculosis. It is important, 
 therefore, to know that complications may isolation 
 follow an apparently innocent measles. My 
 advice is to keep the child isolated and in 
 bed from six to seven days in summer, and 
 in winter from seven to ten days, after the 
 eruption has appeared. The room should 
 be kept at an even temperature of from 
 70 to 72 degrees. Plenty of fresh air must 
 be admitted. The light must be subdued, 
 as the eyes usually are inflamed. The eyes 
 should be washed several times a day with 
 a boric acid solution. To stop itching the 
 body should be rubbed with vaseline. Spe- 
 cial rules for individual cases are required 
 if the child has fever or other complica- 
 tion. 
 
 [199] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 German Measles 
 
 This is a mild form of rash resembling 
 measles. After exposure the child will con- 
 tract the disease in from seven to twenty- 
 one days. Contrary to true measles, there 
 is an absence of sneezing, running nose, 
 and catarrhal symptoms such as bronchitis. 
 The temperature is not as high as in mea- 
 swoiien sles, rarely reaching 102 degrees. To dis- 
 
 Glands 
 
 tinguish German measles from true measles 
 we have glandular swellings behind the ear, 
 which are never present in true measles. 
 The eruption is usually a pale red and va- 
 TheRash ries in size from little spots the size of a 
 pinhead to those of a pea. Sometimes the 
 spots are isolated, again they will run to- 
 gether. The eruption fades after four or 
 five days and rarely has any complication 
 associated with it. It is better, however, 
 to keep the child in bed, protected, while 
 the eruption lasts. 
 
 [ 200 ] 
 
COMMUNICABLE DISEASES 
 
 Scarlet Fever 
 
 Scarlet fever is one of the most serious 
 diseases on account of the complications 
 which are liable to result. Vomiting is one 
 of the first symptoms. There is fever, loss 
 of appetite, and usually pain on swallowing. The Tongue 
 There is a nasal tone of voice, caused by the 
 tonsillar swelling. The tongue becomes 
 coated white, with little red dots resembling 
 a strawberry. A rash will be seen first on 
 the neck and chest. It is of a pin-point The Rash 
 character and has a bright scarlet color. 
 In severe cases the rash will so run together 
 that the skin resembles that of a boiled 
 lobster. The rash usually spreads over the 
 entire body and remains about from five to 
 seven days, after which the skin begins to 
 peel. On the palms of the hands, on the Desquamation 
 soles of the feet, on the ears, and between 
 the thighs peeling is very pronounced. 
 It will take from two to three weeks, 
 
 [201] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 sometimes, four weeks, for the body to 
 peel. 
 
 On looking into the throat we will notice 
 yellowish-white spots scattered over both 
 tonsils, and sometimes also below and be- 
 hind the soft palate. The glands below the 
 jaw are always swollen. The temperature 
 will range between 101 and 104 degrees 
 early in the disease. Such children are 
 irritable, and do not wish to be disturbed. 
 They are thirsty and drowsy. 
 
 We formerly believed that the disease 
 was spread by the germs or poison con- 
 tained in the peeled skin. We now know 
 this to be wrong, as the germs die when 
 exposed to sunlight. For this reason the 
 board of health in New York City has 
 stopped fumigation and disinfection of 
 houses wherein scarlet fever occurred, 
 isolation All cases of scarlet fever should be iso- 
 
 lated. Healthy children should be removed 
 
 [202] 
 
COMMUNICABLE DISEASES 
 
 and not permitted to come in contact with 
 the sick child, as the disease is spread by 
 contact. 
 
 If scarlet fever develops the child should 
 be put to bed and kept there at least five 
 weeks. This is not done to prevent the 
 spreading of the disease, but because it 
 takes several weeks for the poison to pass 
 through the body by way of the kidneys, 
 and also to restore the vitality of the heart. 
 
 For restlessness a warm sponge-bath may 
 be given under cover. A little alcohol may 
 be added to the water. The food must be 
 liquid during the first two weeks, such as 
 milk and broths. Later custards, puddings, 
 vegetables, and eggs may be added to the 
 diet. Water should be given liberally. The 
 bowels must move daily and the kidneys 
 kept active. The kidneys may remain weak 
 for several months or even several years 
 after an attack of scarlet fever. 
 
 [203] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Every mother should realize the impor- 
 tance of having the nrine examined at least 
 once a week, to guard against the develop- 
 ment of a chronic nephritis or inflammation 
 of the kidneys. The ears and the throat, 
 likewise, demand supervision. 
 
 The diet requires supervision. Many 
 children will be compelled to abstain from 
 meat and other protein foods, such as eggs, 
 until the kidneys become normal, which may 
 be months after the attack of scarlet fever 
 began. 
 
 After convalescence has been thoroughly 
 established, the child's throat should be 
 carefully inspected for the presence of ade- 
 noids or enlarged tonsils. If diseased ton- 
 sils or adenoids are present, they should 
 be removed, as they are likely to be the 
 source of another disease like diphtheria 
 which may prove fatal. 
 
 [204] 
 
COMMUNICABLE DISEASES 
 
 Typhoid Fever 
 
 This disease enters the body by means of 
 the typhoid bacillus. The bacillus is found 
 in water, in milk, and frequently in vege- 
 tables. Contaminated creeks and pools of 
 stagnant water may harbor the typhoid 
 bacillus. If a case of typhoid exists in a 
 household and the discharges from the bow- 
 els or the urine are not properly disinfected, 
 disease germs will remain alive and may be 
 transmitted to others. 
 
 The typhoid bacillus multiplies very rap- 
 idly, and if it finds its way into a substance 
 like milk, it can communicate the disease 
 to any one drinking such milk. Small epi- 
 demics have been reported in communities 
 without the source of the infection being 
 definitely known. These obscure epidemics carrier 
 are usually caused by typhoid convalescents 
 who carry typhoid germs in their throat 
 and in the discharges from their bodies. 
 
 [205] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 These carriers can communicate to every 
 one with whom they come in contact. It 
 is well, therefore, to inquire before accept- 
 ing a new cook or nursemaid as to her pre- 
 vious history of illness and see if she is 
 a carrier. 
 
 The most common symptoms of typhoid 
 are headache, fever, and loose, greenish 
 stools. Typhoid fever may run a mild 
 course, or it may run a severe course. It 
 may last two to three weeks or extend over 
 The three to six weeks. As a rule, there are 
 
 Eruption 
 
 small rose-colored spots visible on the ab- 
 domen and chest. These spots are few and 
 far apart. They are very small and re- 
 semble neither scarlet fever nor hives. 
 
 When a child is very languid and shows 
 a slight rise of temperature ranging be- 
 tween 100 and 102 degrees, with the above- 
 named symptoms, it should be put to bed 
 and watched. If the fever does not subside, 
 
 [206] 
 
COMMUNICABLE DISEASES 
 
 but rises from day to day, a blood-test 
 should be made. As a rule, the positive 
 diagnosis of typhoid fever can not be made 
 until the second week of the disease, when 
 we can get a positive Widal reaction in the 
 blood. The urine will show a Diazo reac- 
 tion which, combined with the other symp- 
 toms, strengthens the diagnosis of typhoid. 
 The spleen is usually swollen. If typhoid 
 fever exists in the vicinity, one would nat- 
 urally suspect this disease. 
 
 Typhoid may be latent and require a week 
 or ten days to develop properly. One is 
 therefore safest in keeping every child 
 having fever in bed until the nature of the 
 disease is established. 
 
 Typhoid is a milder disease in children 
 than in adults; hence, with good care and 
 strict attention to the diet, not permitting 
 the child to have food which is contraindi- 
 cated, the chances are far better than in 
 
 [207] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 adults. Children do not use alcohol, to- 
 bacco, or coffee; hence, the heart-action is 
 better and the system can undergo the 
 strain of an infection like typhoid and re- 
 adjust itself without complications more 
 easily than that of the adult. 
 
 As a safeguard against typhoid in an in- 
 fected district, all milk, water, and food of 
 all kinds should be boiled. Eaw vegetables 
 and raw fruits eaten indiscriminately may 
 have been the origin of the disease ; there- 
 fore, all vegetables and fruits should be 
 cooked. 
 Diet The diet should consist of lamb or chick- 
 
 en broth, split pea soup, boiled milk, butter- 
 milk, albuminized tea, and water. Later, 
 during convalescence, junket, custard, corn- 
 starch, tapioca, and fruit juices may be 
 given. 
 
 [208] 
 
Chapter III 
 
 SYSTEMIC DISEASES 
 Appendicitis 
 
 Appendicitis is not uncommon in children. 
 The attacks are different from those we 
 have in adults. It is important to recog- 
 nize the symptoms. Fever is associated with 
 all attacks. Some attacks begin with vom- 
 iting and diarrhea and distended abdomen. 
 Other attacks begin with pain, or cramps, 
 and vomiting. Some children will have re- 
 curring disturbances every month or two, 
 with pain, fever, and diarrhea or consti- 
 pation. We therefore have no distinct lo- 
 calized pains on the right side in the region 
 of the appendix, as is found in the adult. 
 
 On examination of the abdomen we will 
 usually detect a swollen or sensitive appen- 
 
 [209] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 dix. In nervous or unruly children, if we 
 are suspicious of appendicitis, it will be 
 necessary to give a few whiffs of laughing- 
 gas (nitrous oxide) or a few drops of chlo- 
 roform or ethyl chlorid to quiet the child 
 so that the abdomen can be carefully exam- 
 ined. In some cases it may be necessary to 
 take an X-ray picture of the abdomen, to 
 study the condition of the appendix. 
 
 Attacks of colitis simulate appendicitis. 
 If a child is constipated, retention of the 
 stool and gas will give rise to distention 
 and flatulence. An enema of soap and water 
 will relieve this condition. If, however, 
 we are dealing with appendicitis, then no 
 relief will follow the emptying of the bowel 
 by the injection. 
 Pain in Do not be frightened whenever the child 
 
 Abdomen 
 
 complains of a pain in the abdomen. In a 
 girl around the age of- development, or 
 between the eleventh and fifteenth years, 
 
 [210] 
 
SYSTEMIC DISEASES 
 
 remember that cramps in the abdomen will 
 appear for several months before actual 
 menstruation takes place. 
 
 Another reason for pains in the abdomen 
 is the passing of small uric acid crystals 
 through the kidneys, which will give rise 
 to colicky pains. These pains may also 
 appear on the right side in close proximity 
 to the appendix. Colitis is one of the most colitis 
 frequent causes of pain on the right side. 
 This pain may be caused by dietetic errors. 
 The eating of too much ice-cream or rich 
 cream-cakes, or chilling the body by pro- 
 longed bathing in the ocean, or by wading 
 in lake water, may give rise to abdominal 
 pains. 
 
 Neuralgia of the intestine may be caused 
 by the distention due to hard-formed and 
 impacted stools. Such stools are hard and 
 dry like marbles. From the pressure pain 
 results. 
 
 [211] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Tapeworms and round worms have been 
 described in their respective chapters. They 
 are frequently causes of abdominal pains. 
 From what has been said, one can see that 
 we should exercise caution in deciding that 
 the child has appendicitis simply because 
 pain exists in the abdomen. 
 
 Malaria 
 
 It is surprising to see how many children 
 are supposed to suffer with malaria, and 
 how few really have this disease. Malaria 
 is an infection that gets into the blood and 
 can be detected by the laboratory method 
 of examining the blood. When blood con- 
 tains Plasmodium, then malaria is present, 
 not otherwise. The common symptoms of 
 malaria in children are not the same as 
 those found in adults. The spleen is always 
 swollen in malaria. In children it is very 
 difficult to note a chill, although chills are 
 
 [212] 
 
SYSTEMIC DISEASES 
 
 frequently present. The fever is high, The Fever 
 reaching 104 or 105 degrees in the after- 
 noon of every second or third day. Chil- 
 dren complain of being tired, there is loss 
 of appetite and irritability. Perspiration 
 is usually noted. 
 
 We rarely see cases of malaria in large 
 cities, but when they do occur they are 
 very easily recognized by the examination 
 of the blood. Malaria in children is not a 
 fatal malady. It runs the same course as 
 in adults. There is loss in weight until the 
 fever subsides. Change of air and a diet 
 of concentrated foods — all dairy products, 
 fermented milk, etc. — must be supplemented 
 by giving quinin, and later on Fowler's 
 solution, during recuperation. 
 
 Very frequently tuberculosis gives symp- 
 toms which are identical with malaria. No 
 mother or nurse should rely on fever, per- 
 spiration, and loss of weight in forming 
 
 [213] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 a conclusion that the child has malaria, 
 unless the physician actually determines 
 this condition by a blood-test. 
 
 Growing-Pains 
 
 Frequently physicians are asked what can 
 be done for growing-pains. There is no 
 such thing as a growing-pain. The body 
 grows because of the physiological increase 
 normal in childhood. There is no pain 
 caused by the growth of the hair, the nails, 
 the teeth, or the joints. 
 
 When pains in the joints or muscles are 
 described, the throat should be examined. 
 As a rule, tonsillitis is a forerunner of 
 joint or muscle pains, which are usually due 
 to an inflammation of the membranes of the 
 joint itself. 
 
 Not infrequently physicians will note the 
 existence of heart disease, which, on ques- 
 tioning the family, can be traced back to 
 
 [214] 
 
SYSTEMIC DISEASES 
 
 a supposedly innocent attack of growing- 
 pains. 
 
 Therefore, if a child complains of pains 
 in the joints, take him to a physician rather 
 than run the risk of having chronic heart 
 disease due to neglected rheumatic inflam- 
 mation. 
 
 Pains in the thighs or in the leg may be 
 symptoms of tubercular hip- joint or knee- 
 joint disease, and these points should be 
 remembered before deciding that a pain 
 in the leg, sometimes due to neglected ton- 
 sillitis, can be due to growing. 
 
 Rheumatism 
 
 There are two kinds of rheumatism : mus- 
 cular rheumatism and joint rheumatism. 
 Muscular rheumatism usually follows ex- Muscular 
 
 Rheumatism 
 
 posure to a draught, as when riding in an 
 open car on a damp day. These pains may 
 be confined to any of the muscles of the 
 
 [215] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 body, the neck, the back, the arms, or the 
 legs. 
 
 The pains are noticeable only when the 
 affected muscles are used. Turning the 
 head or neck causes severe pain. Bending 
 forward or sideways in rheumatism of the 
 back, or when the arms and legs are ex- 
 tended as in walking or reaching out causes 
 pain which ceases when the extremities are 
 not used. 
 
 These rheumatic pains yield very easily 
 when massage is used. A warm poultice 
 is very soothing, and will frequently relieve 
 the stiffness and pain. Such children 
 should be kept in bed, as the warmth and 
 rest do much good. In guarding against 
 recurring attacks, warm underclothes should 
 be worn, and the body given a warm bath 
 before retiring, 
 joint or Joint rheumatism is frequently called 
 
 Inflammatory 
 
 Rheumatism inflammatory rheumatism. One or more 
 
 [216] 
 
SYSTEMIC DISEASES 
 
 joints will be painful, swollen, and tender 
 to the touch. There is usually fever, rang- 
 ing between 100 and 102 degrees. In many 
 cases throat trouble, such as tonsillitis, in- 
 fluenza, or grippe, will be a forerunner of 
 the rheumatic inflammation. It is there- 
 fore important to place every child having 
 a sore throat in bed for a few days rather 
 than try to fight nature by constant expo- 
 sure to the elements. Neglected colds, such 
 as prolonged tonsillitis, are frequently com- 
 plicated or followed by rheumatism. 
 
 A condition known as rheumatic tonsil- 
 litis is very common among children. When 
 rheumatism begins in childhood it should 
 be regarded with apprehension. The great 
 danger consists in the frequency of relapses. 
 Eecurring attacks of rheumatism mean a 
 spreading of the disease from joint to joint. 
 Not only may deformity of the joint and 
 stiffening follow, but more often a heart 
 
 [217] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 complication may associate itself which can 
 prove fatal. 
 Treatment If removed from the city and a physician 
 
 is not accessible, the first thing to do is to 
 place the child in bed. Stop all meat and 
 eggs. Give milk, buttermilk, and frnit 
 juices, such as lemonade or pineapple juice, 
 for thirst. 
 
 The bowels should be kept loose by giving 
 one-half teaspoonful of Eochelle salts in 
 sweetened water every morning, and re- 
 peating the dose every three hours until 
 effectual. 
 
 The joints should be protected with cot- 
 ton and oiled silk. If very painful, an ice- 
 bag may be applied. Many joints feel bet- 
 ter with warm applications, such as dry 
 bran. Often a tight, dry bandage is all 
 that is necessary. 
 
 [218] 
 
PART IV 
 
 DISEASES OF THE SKIN AND 
 NERVOUS SYSTEM 
 
 [219] 
 
Chapter I 
 
 DISEASES OF THE SKIN 
 
 Rashes 
 
 Thebe are dozens of rashes that may 
 appear on a child's skin. Some of them 
 are due to toxins from food taken into the 
 body. Some children will always have a 
 rash after eating oatmeal, shell-fish, straw- 
 berries, or eggs, which shows a sensitive 
 condition of the blood. (Read article on 
 hives.) 
 
 Whenever a rash is noticed, the tempera- 
 ture should be taken. If fever exists, a 
 physician should be called. 
 
 There are many obscure rashes in which 
 there may be little or no fever. The mother 
 should examine the throat to see if small 
 yellowish spots are present; if so, no time 
 
 [221] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 should be lost in calling a physician. Now 
 and then scarlet fever develops without 
 fever; this should be remembered. It is 
 safer to call a physician to pass on a rash 
 rather than neglect a rare type of eruption. 
 
 Insect-Bites 
 
 Mosquito bites or any insect sting causing 
 swelling and blotches can be relieved by 
 applying pure alcohol or spirits of cam- 
 phor. If the part swells from scratching, 
 apply lead water on gauze and cover with 
 oiled silk. If fever develops, send for a 
 physician. The great danger lies not in 
 the poison of the insect bite as much as in 
 the poison of the nails in scratching or 
 getting germs into the swelling. 
 
 A half teaspoonful of cream of tartar 
 added to a glass of lemonade, if given sev- 
 eral times a day, is cooling to the blood 
 when intense itching is present. 
 
 [222] 
 
DISEASES OF THE SKIN 
 
 Eczema 
 
 Eczema is an eruption of the skin which 
 appears as reddish or yellowish scales, moist 
 or dry, in round or irregular-shaped 
 blotches. It will be found in many chil- 
 dren on the cheeks, arms, legs, or any por- 
 tion of the body. A favorite place for ec- 
 zema is the scalp. There is an intense 
 itching of the parts affected, especially at 
 night. The itching is so intense that some 
 children scratch until the parts bleed. They 
 are peevish and irritable by day and rest- 
 less and sleepless at night. 
 
 As a rule, this condition is caused by 
 errors in diet. Overfeeding of sugar, espe- 
 cially too much candy and cake, and starchy 
 foods, such as potatoes, may cause eczema. 
 Large quantities of cereal, such as oatmeal 
 and rice, are predisposing factors. Hered- 
 ity plays an important part in eczema. As 
 a rule, a father or mother suffering with 
 
 [223] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 eczema will usually have children so af- 
 fected. Very fat children are prone to 
 eczema. In many instances starvation and 
 inanition due to the absence of fresh vege- 
 tables, and the feeding of canned vegetables 
 or canned condensed milk, may cause this 
 condition. Deficient ventilation, lack of 
 exercise, and unsanitary conditions, such 
 as insufficient bathing, may cause eczema. 
 
 Eczema may last for months and, if neg- 
 lected, may become chronic and last for 
 years. The first thing to do is to empty 
 the bowels with a mild laxative. A child 
 of from five to ten years may take one-half 
 teaspoonful of compound licorice powder 
 morning and evening for three days. This 
 will cleanse the bowels, cool the blood, and 
 relieve the itching and overheated skin. 
 
 The diet should be regulated by giving 
 milk; in no case is cream to be allowed. 
 Buttermilk, fruit, and all fresh vegetables 
 
 [224] 
 
DISEASES OF THE SKIN 
 
 may be given. Meat and eggs must not 
 be given. Cheese, fruit, bread, and a glass 
 of milk may be given in the evening. Large 
 quantities of water should be given to cool 
 the body and to flush the kidneys. 
 
 Water and soap should not be used on 
 the skin. If the scales and crusts adhere, 
 they may be loosened by soaking in an oat- 
 meal bath. Oatmeal water is made by soak- 
 ing for twenty minutes one pound of oat- 
 meal in two quarts of boiling water. 
 
 To relieve the itching an ointment, con- 
 sisting of one teaspoonful of oil of tar added 
 to and rubbed up with one ounce of zinc 
 ointment, can be applied after the scales 
 have been removed with the oatmeal bath. 
 The salve may be used two or three times 
 a day. Do not use soap and water to re- 
 move the salve, but continue to use salve 
 on top of salve. 
 
 If the eczema is confined to the scalp, a 
 
 [225] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 lather of tar soap can be thoroughly rubbed 
 in and the scalp shampooed until all the 
 scales are removed. After the scalp is 
 clean, rub in the tar and zinc oxid salve. 
 Eepeat the shampooing every third night, 
 but continue to use the salve morning and 
 evening during the three days in which you 
 do not shampoo the scalp. 
 
 Erysipelas 
 
 Erysipelas is an inflammatory affection 
 of the skin resulting from the introduction 
 of disease germs. These germs can be in- 
 troduced by scratching or by lacerating the 
 skin with a rusty nail or any unclean object. 
 An open wound, or boil, or abscess, if it is 
 not properly cleaned and bandaged, will fre- 
 quently be infected by the introduction of 
 erysipelas germs. We must exercise a great 
 deal of care in handling a wound, as there 
 is always danger of contamination. 
 
 [226] 
 
DISEASES OF THE SKIN 
 
 Any person dressing an open wound must 
 wash his hands with soap and water before 
 each dressing is changed. The finger-nails 
 must be thoroughly scrubbed, and all ac- 
 cumulated dirt underneath removed. 
 
 Erysipelas manifests itself as a reddish 
 glossy flush which usually extends several 
 inches around a wound. The temperature 
 varies between 101 and 104 degrees. The 
 skin feels hot and appears thick and swollen. 
 
 The infection spreads rapidly, and a flush 
 which began at the nostril can extend to the 
 cheeks, forehead, and scalp in a few days. 
 Herein lies the danger. No case of ery- 
 sipelas should be neglected, as the child's 
 life may be endangered. 
 
 Ringworm 
 
 Eingworm is a contagious disease caused 
 by the invasion of a fungus. Its favorite 
 location is on the scalp. It is not a worm 
 
 [227] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 as the name implies. It is not always in 
 ring-shape. It is recognized by patches 
 sometimes circular, sometimes oval, in 
 shape by scaly grayish-white marks, look- 
 ing as if they were covered with dust and 
 ashes. These marks are covered with 
 stumps of hair, which shows that hairs 
 have been broken off, this being the dis- 
 tinguishing mark of the disease. Although 
 curable, some forms of the disease take 
 years to eradicate. 
 
 It is usually transmitted by clothing such 
 as caps, towels, and pillow-cases containing 
 the spores. 
 Treatment The first step in the treatment is to have 
 
 the hair clipped short. After a thorough 
 cleansing of the scalp with tincture of green 
 soap, a thick coating of tincture of iodin 
 should be applied. Three days later an- 
 other washing of tincture of green soap 
 should be given, and later a coating of tinc- 
 
 [228] 
 
DISEASES OF THE SKIN 
 
 ture of iodin. If after several applications 
 of the above no improvement is seen, then 
 an application of a 5 per cent, chrysarobin- 
 ointment should be given morning and 
 evening until improvement is noted. If the 
 skin is sensitive and shows inflammation 
 after several applications, then two days 
 should elapse before the next application 
 is made. 
 
 In institutions, nurseries, and . schools, 
 children should be isolated while suffering 
 with ringworm. The danger in boys as well 
 as in girls consists in the baldness which 
 may be permanent after the ringworm dis- 
 appears. 
 
 Ivy-Poison 
 
 Ivy-poisoning manifests itself by an in- 
 tense inflammation of the skin, caused by 
 contact with the poison-ivy plant. Some 
 children are so susceptible to it that they 
 need only come moderately near it to have 
 
 [229] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 the rash come out. The rash usually comes 
 out within a few hours after exposure. The 
 skin becomes hot and red. There is intense 
 itching and swelling. Crusts form from 
 the dried discharges of the vesicles that 
 form on the inflamed surface. The swelling 
 sometimes becomes so intense that the eyes 
 can not be opened. 
 
 The intense itching and swelling can best 
 be relieved by a tub-bath containing sulfur, 
 the crude sulfuret of potassium, one-half 
 pound to a large tub of water, temperature 
 sulfur Bath 100 degrees for a full body bath. These 
 baths may be given morning and evening. 
 Until the sulfur can be obtained bicarbonate 
 of soda and water will relieve the itching. 
 
 Sunburn 
 
 After exposure to the sun, the burn may 
 be relieved by applying a mixture contain- 
 ing zinc-oxid three teaspoonfuls, lime-water 
 
 [230] 
 

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 gs.t"s| morning and evening. 
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DISEASES OF THE SKIN 
 
 three ounces, and rose-water three ounces. 
 Bathe the skin or saturate a piece of gauze 
 and apply every hour. Linen underwear 
 will cool the skin, so will silk. Kice-flour 
 or corn-starch used as a dusting-powder is 
 soothing. 
 
 Frost-Bite 
 
 Long exposure to cold frequently results 
 in frost-bite. The parts usually affected 
 are the fingers, toes, ears, or nose. If ex- 
 posed to cold too long the skin becomes 
 numb, white, and wrinkled. Upon coming 
 into a warm room the parts become red, 
 swollen, and itching. Sometimes blisters 
 form over the skin. 
 
 If a child has been overexposed to the 
 cold, it should be brought to a warm room 
 gradually. The hands or parts affected 
 should not be held near the heat, but should 
 be dipped in cold water and constantly 
 rubbed. This water can be gradually 
 
 [231] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 warmed until it reaches room-temperature. 
 The parts can later be bathed in camomile- 
 tea at a temperature of 90 degrees until 
 the skin is thoroughly macerated or shriv- 
 eled. Owing to the serious nature of 
 frost-bite the child should receive medical 
 attention if the above treatment is of no 
 avail. 
 
 Hives 
 An eruption of large red blotches with 
 whitish centers, resembling mosquito-bites, 
 is known as hives. They are found in 
 children whose blood is sensitive to certain 
 proteins. For example, some children will 
 have hives after eating oatmeal, others after 
 eggs, strawberries, lobster, or crab. Such 
 children usually have severe rashes follow- 
 ing an injection of antitoxin. If ill with 
 diphtheria it is important for the mother 
 to call the physician's attention to the sus- 
 ceptibility of her child. 
 
 [232] 
 
DISEASES OF THE SKIN 
 
 Milk of magnesia or citrate of magnesia 
 should be given as a laxative. Bhubarb 
 and soda may be given to cool the blood. 
 Locally, bicarbonate of soda and water will 
 allay the itching. 
 
 Itch 
 
 Itch usually appears between the fingers 
 and the toes in the form of a moist, scaly 
 eruption. It is caused by a fungus or germ 
 which gives rise to an intense irritation. 
 Scratching causes bleeding. The eruption 
 is frequently found on the face. It is usually 
 contracted from some other child. The 
 school and classroom where children play 
 together is the most usual source of spread. 
 Relief can be afforded by bathing the af- 
 fected parts with warm sulfur-water, ten 
 to fifteen minutes, then applying sulfur 
 ointment and a snug-fitting bandage to pre- 
 vent scratching. This condition will last 
 
 [233] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 many weeks, and persistence in the treat- 
 ment will be necessary to effect a cure. 
 
 Warts 
 
 These small growths may appear singly 
 or in bunches like cauliflower. They usually 
 appear on the moist surfaces of the body, 
 the rectum, the vagina, or in the armpit. 
 They appear on the hands, the feet, and 
 the neck. 
 
 A bit of absorbent cotton on the end of 
 a toothpick should be dipped into carbolic 
 acid and applied to the surface of the wart. 
 After three minutes apply in like manner, 
 on fresh cotton and toothpick, fuming nitric 
 acid. This second application will turn the 
 wart black. In order not to burn the sur- 
 rounding skin, cold cream or vaseline should 
 be applied around the root of the wart be- 
 fore applying the acids. This treatment 
 may be repeated every three days. 
 
 [234] 
 
DISEASES OF THE SKIN 
 
 Another successful method is to apply a 
 stick of nitrate of silver, or to have a physi- 
 cian cauterize the warts by first applying 
 ethyl chlorid and then using a galvano 
 cautery. 
 
 Head-Lice 
 
 In school, kindergarten, or where chil- 
 dren assemble head-lice may be contracted. 
 Especially does this vermin exist in con- 
 valescent children deprived of proper care. 
 In the chapter on swollen glands, I have 
 mentioned that swollen glands at the root 
 of the hair, at the back of the neck, fre- 
 quently owe their origin to head-lice. The 
 first symptom to appear is itching. 
 
 At hospitals and institutions we order 
 the hair cut short and the scalp saturated 
 with kerosene. The child wears a bathing- 
 cap during the night, and in the morning 
 the scalp is shampooed with soap and water. 
 Repeat if necessary every third night until 
 
 [235] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 the scalp is clean. This treatment destroys 
 the living parasite. Instead of the kerosene, 
 two ounces of larkspur with one ounce of 
 vinegar and one ounce of ether can be ap- 
 plied to the scalp after a thorough shampoo. 
 This can be repeated nightly until all lice 
 are destroyed. 
 
 The female lays eggs in vast numbers, 
 these eggs stick to the hair-shaft and are 
 recognized as tiny grayish-white bodies. 
 
 These " nits' 9 or eggs can not be removed 
 by brushing, no matter how persistently one 
 brushes, and this proves their identity, for 
 dandruff and crusts would easily be re- 
 moved by a hard brush. 
 Nits These nits can best be removed by satu- 
 
 rating the hair with strong vinegar or with 
 pure alcohol and using a fine-toothed comb, 
 being careful not to touch the scalp if it has 
 any sores or scratches. Olive-oil may be 
 applied to any sores on the scalp. 
 
 [236] 
 
 
DISEASES OF THE SKIN 
 
 Dandruff 
 
 Deficient lubrication by the oil-ducts 
 causes dryness of the scalp, and the skin 
 peels off in fine white particles. These par- 
 ticles destroy the hair-roots and should be 
 removed by washing. Poor circulation may 
 be aided by massage of the scalp. The 
 scalp should be washed with tar-soap, the 
 lather being rubbed into the scalp or hair- 
 roots, rinsed thoroughly with lukewarm 
 water, followed by cold water, and rubbed 
 dry. After the hair is dry, massage with 
 alcohol containing 1 to 1000 bichlorid of 
 mercury, then apply sufficient borated vase- 
 line to oil the scalp but not the hair itself. 
 Eepeat the washing and massage every 
 other night for two weeks; later once a 
 week will be sufficient. 
 
 [237] 
 
Chapter II 
 
 DISEASES OF THE NERVOUS SYSTEM 
 
 Defects of Speech 
 
 stammering Among the most important of the com- 
 
 mon nervous defects of childhood are 
 stammering, stuttering, and lalling. Stam- 
 mering is due to incoordination of the 
 muscles involved in articulation. Stutter- 
 ing results from repeated contractions of 
 the muscles concerned in forming some ini- 
 tial syllable. Lalling is baby-speech, in 
 which wrong consonants or vowels are em- 
 ployed and the pronunciation of the words 
 is slurred. Each of these defects is curable, 
 and we must therefore ascertain the prin- 
 ciples underlying their treatment. 
 
 The mechanism of speech is twofold — 
 vocalization and articulation. The former 
 
 [238] 
 
DISEASES OF THE NEEVOUS SYSTEM 
 
 which is produced by the vibrations set up 
 in a column of air passing over the vocal 
 cords depends on the movements of breath- 
 ing, on the vibrations of the vocal cords, 
 and on the resonating cavities in the head 
 and in the neck. By its help the five "physi- 
 ological" vowel sounds are produced, name- 
 ly, EE, A, AH, 0, and 00. Articulation 
 is produced by totally different means. The 
 current of air from the lungs is interrupted 
 or released by the muscular action of the 
 lips or of the tongue at one of three situ- 
 ations — the so-called "stop-positions." In 
 the first stop-position the lips are suddenly 
 parted or brought together so that one of 
 the following consonants is uttered — P, B, 
 W, M. The second stop-position is formed 
 by pressing the tongue against the hard 
 palate; the consonants that now result are 
 T, D, L, N, R (and SH). The third stop- 
 position is nearer the back of the mouth, 
 
 [239] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 and is used to form the consonants K, G 
 (girl), and Y. 
 
 In the majority of cases the nature of the 
 defect is essentially a want of harmony be- 
 tween the mechanisms of vocalization and of 
 articulation; the child is unable to pass 
 either smoothly or quickly from one to the 
 other. In almost all cases the difficulty lies 
 not in articulating, but in vocalizing, and 
 therefore our first step in treatment must 
 be to teach the child how vocalization differs 
 from articulation. We must then make him 
 give special attention to his vowel sounds, 
 and, in order to increase his command over 
 them, we should begin by teaching him to 
 take steady breaths and to control his ex- 
 pirations. When he has acquired this power, 
 he must be exercised in the different vocal 
 sounds. 
 
 The consonants are to be learned in three 
 groups, namely, the " voiceless" consonants, 
 
 [240] 
 
DISEASES OF THE KEKVOUS SYSTEM 
 
 P, F, Th (thin), S, Sh, T, and K, which are 
 without any vocal element; the " voiced' ' 
 consonants, B, W ', V, Th (thou), Z, Bh, D, 
 L, R, G, and Y; and the voiced nasal con- 
 sonants, M, N, and Ng. The important 
 point in learning this classification is that 
 the vocal element in the last two groups 
 should be given their full value. Thus, in 
 pronouncing the three words, brown, prim, 
 and mind, the child must give the full vocal 
 character to the initial consonants of the 
 first and last words, bur-own and um-ind; 
 but the second word, beginning with a voice- 
 less consonant, can be pronounced only as 
 pr-im. 
 
 When these consonants have been learned 
 by the aid of single words, the child should 
 begin to practise sentences. 
 
 In doing this his attention must be spe- 
 cially directed to vocalization. There is no 
 better way of enforcing this precaution than 
 
 [241] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 by making him intone in clerical fashion. 
 He will then be compelled to attend rather 
 to his voice than to his articulation. His 
 earliest sentences should be made up of 
 words whose initial consonants are all either 
 voiceless or voiced. In order to acquire 
 facility in the use of the various stop-posi- 
 tions, he should be given sentences to prac- 
 tise which contain the consonants produced 
 at the several positions; thus, for the sec- 
 ond position, a sentence such as "Not till 
 late did she return." 
 
 These are the simple lines on which stam- 
 mering is to be treated. Frequent practise 
 is essential, and the exercises are to be se- 
 lected according to the particular difficul- 
 ties of speech in each case. By testing the 
 child's vocalization and articulation as soon 
 as he comes under treatment, we shall have 
 no trouble in ascertaining wherein lies his 
 defective power. 
 
 [242] 
 
DISEASES OF THE KEKVOUS SYSTEM 
 
 In cases of lalling, the letters that can not Laiiing 
 be pronounced must be found out by making 
 the child repeat the vowels and the con- 
 sonants. Each of the latter must be tested 
 as an initial letter, as a terminal letter snd 
 as a middle letter (Forsyth). 
 
 Chorea 
 
 Chorea is frequently called St. Vitus 's 
 dance. It consists of involuntary twitchings 
 of the muscles of the face. It may also 
 affect the muscles of the arms or legs so that 
 walking is jerky, and any movement of the 
 arm is spasmodic in character. These 
 twitchings occur when the child is awake, 
 but never while asleep. 
 
 Eye-strain, due to overwork at school, 
 shock, fright, and fear, are among the causes 
 of this condition. 
 
 Frail, nervous children are more suscep- 
 tible than strong, hardened children. In 
 
 [243] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 rare instances astigmatism has been men- 
 tioned as a cause, although I have never 
 known it to be the cause. Many children 
 acquire this habit by imitation. They will 
 imitate other children who twitch until 
 Hawt-spasm it becomes a habit. This is called habit- 
 spasm. 
 
 If school or overwork is the cause, the 
 child should be sent to the country. Cold 
 showers or baths to tone the nervous sys- 
 tem are very important. Meat, coffee, and 
 too many eggs are stimulating, and should 
 be prohibited. Vegetables, fruits, cereals, 
 cheese, milk, and buttermilk should form 
 the bulk of the diet. The eyes must rest; 
 reading should be prohibited. Resting the 
 eyes with a smoked glass or placing the 
 child in a darkened room several hours a 
 day will soothe the nervous system. 
 
 [244] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 Convulsions or Spasms 
 
 Convulsions are frequently met with in 
 childhood. An overloaded stomach result- 
 ing in high fever will cause congestion of 
 the brain, and may result in convulsions. 
 Where an adult might have a headache, a 
 child may get a convulsion. 
 
 Sensitive, nervous, and frail children, 
 especially those who have frail bones, mus- 
 cles, and nerves, are susceptible to convul- 
 sions. 
 
 Convulsions occur suddenly. An appar- 
 ently healthy child will, without warning, 
 become rigid. The eyes will become fixed 
 and will stare, the jaws will stiffen, and 
 there may be frothing at the mouth. Breath- 
 ing will sometimes be suspended for a mo- 
 ment. Along with rigidity of the body the 
 muscles will twitch, especially the muscles 
 around the eyes and mouth. At times the 
 
 [245] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 color 'of the skin will be bluish, although the 
 skin will feel hot to the touch. 
 Treatment No time should be lost when a convulsion 
 
 occurs. The feet should be immersed at 
 once in very warm water, containing a ta- 
 blespoonful of mustard. If possible, a whole 
 bath containing several handf uls of mustard 
 should be given. This bath should be pro- 
 longed about two minutes. The body should 
 then be wrapped in a warm blanket, placed 
 on the bed, and cold cloths or an ice-bag 
 applied to the forehead and scalp. 
 
 As a rule, convulsions last from one to 
 five minutes, rarely longer. When the con- 
 vulsion ceases, and the child is relaxed, lose 
 no time in giving an enema of one pint of 
 soap-water, to relieve the bowels. 
 
 Remember, that during a convulsion the 
 jaws are rigid ; therefore, the child can not 
 swallow. One should not attempt to give 
 any medicine by the mouth, for there is 
 
 [246] 
 
DISEASES OF THE NERVOUS SYSTEM 
 
 danger of the same trickling into the lungs 
 instead of the stomach. 
 
 These instructions are to be followed un- Recurring 
 
 Convulsions 
 
 til a physician arrives. If a second convul- 
 sion occurs before the physician arrives, re- 
 peat the mustard bath, and again apply ice 
 to the forehead and scalp. 
 
 In prolonged convulsions it may be neces- 
 sary for the physician to use a few drops 
 of chloroform or ether by inhalation to con- 
 trol the spasm. This, however, must not 
 be attempted by the family without the 
 presence of a physician or a trained nurse, 
 as there is danger of asphyxia when proper 
 precautions are not taken. 
 
 Convulsions in children usually indicate 
 the beginning of a disease. Diseases like 
 pneumonia, typhoid fever, whooping-cough, 
 and meningitis may be ushered in with a 
 convulsion. This convulsion is the effect of 
 the poison (toxin) on the nerve centers. In 
 
 [247] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 pneumonia the pneumotoxin develops in the 
 blood, and this causes the convulsion. 
 
 When a child has a convulsion it should 
 be put to bed and kept there for observa- 
 tion. Sometimes a few days will pass be- 
 fore a disease appears. If the convulsion 
 is simply an explosion due to an overloaded 
 stomach, the child, after a brisk cathartic 
 and rest, will be normal in a few days. We 
 should always remember that if a child has 
 once had a convulsion he may have a recur- 
 rence of the same, 
 concussion If a child falls and strikes his head, a 
 
 convulsion may occur. This may be due 
 to a concussion or jar of the brain, but it 
 may also be due to meningitis or brain- 
 fever. Such cases are not necessarily fatal. 
 Children fall and strike their head many, 
 many times without doing any serious dam- 
 age. A good plan, however, is to have the 
 head carefully examined after any severe 
 
 [248] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 fall. If nosebleed, or earbleed, or bloodshot 
 eyes are noticed soon after an injury, or if 
 vomiting takes place, it shows that there 
 has been some disturbance, usually due to 
 the force of the concussion of the brain. 
 
 These cases may be serious, but are not 
 necessarily fatal. Children have enormous 
 vitality and can survive many injuries to 
 the brain and skull which would prove fatal 
 to adults. Nature repairs injuries to bones 
 very quickly. 
 
 Tuberculous Meningitis 
 
 Tuberculous meningitis usually occurs in 
 bottle-babies, in which milk contaminated 
 with the tubercle bacillus was fed during 
 infancy. Such children do not thrive; the 
 skull is large, the veins are very prominent 
 over the forehead and scalp, the nights are 
 restless with crying, and in spite of good 
 care the child does not seem to develop. 
 
 [249] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Such children will cry out in a sound sleep, 
 as though frightened, and stare at imagi- 
 nary objects. They are unhappy, dissatis- 
 fied, and always fretful. They perspire at 
 night. They cough without any evidence of 
 lung trouble. Frequently convulsions and 
 rigidity of the muscles are noted. When 
 convulsions convulsions recur it is due to an excess of 
 fluid in the brain, causing pressure within 
 the skull. To relieve the same the physician 
 must draw off some of the fluid by insert- 
 ing a needle into the spinal canal. By this 
 method one-half to one ounce of the spinal 
 fluid can be drawn off. By a laboratory 
 examination we can determine whether or 
 no the child is suffering with tuberculous 
 meningitis, or cerebro-spinal meningitis and 
 at the same time relieve the brain pressure. 
 There are many conditions in children 
 causing disturbed nights, restlessness, and 
 crying. A pain in the stomach or bowel 
 
 [250] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 due to overeating may cause colic and symp- 
 toms resembling meningitis. Children with 
 flabby muscles and soft bones suffering with 
 mild or severe rickets are easily disturbed 
 and peevish, and scream during sleep. 
 Thus we have irritation causing symptoms 
 which resemble meningitis. We should not 
 make the mistake, therefore, of believing 
 that every child that stares at imaginary 
 objects, or appears frightened, or has en- 
 larged veins over the scalp is suffering with 
 brain irritation or meningitis. A physician 
 must decide this important point. 
 
 Night-Terrors 
 
 Sometimes children will suddenly awake 
 from a sound sleep and shriek or scream. 
 Very heavy meals at night, with overloaded 
 bowels, will sometimes cause a disturbed 
 sleep. Besides irregularity of meals, worms, 
 and pain caused by kidney stones, an irri- 
 
 [251] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 tation due to an adherent or elongated pre- 
 puce, will disturb sleep. 
 
 Ghost stories and too rigid discipline will 
 excite mental impressions which will pro- 
 duce night-terrors. The cause of the fright- 
 ened scream must be sought by the one 
 in charge, and the same can then be reme- 
 died. 
 
 Very sensitive, nervous children are more 
 prone to these attacks than the strong, 
 healthy, and robust child. 
 
 When night-terrors exist, meat should be 
 stopped, likewise tea and coffee. If chil- 
 dren have been given beer, wine, or alco- 
 holic spirits, the cause of such fright-spells 
 is easily determined. 
 
 A laxative consisting of one-half tea- 
 spoonful of calcined magnesia should be 
 given every morning and the bowels washed 
 with a pint of soap-water in the evening. 
 
 Milk, fruit, vegetables, eggs, cereals, and 
 
 [252] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 fish should be allowed. Meat may be given 
 sparingly. 
 
 Paralysis 
 
 Paralysis of the arms or legs, or inability 
 to swallow, with regurgitation of food 
 through the nostril, is the form of paral- 
 ysis usually following diphtheria. Such 
 paralysis usually lasts several months, and 
 the child may recover completely. Now 
 and then a case may persist for a year, but 
 the paralysis, under appropriate treatment, 
 gradually lessens until the child recovers. 
 I have seen cases of permanent paralysis 
 of both legs following severe diphtheria, 
 but fortunately this is rarely the case. 
 
 Paralysis accompanying scarlet fever or 
 diphtheria comes on slowly and disappears 
 slowly. The cause of the same is the poison 
 or toxin from the disease germs which 
 paralyze the nerve centers. 
 
 After a fever in which symptoms of a 
 
 [253] 
 
HEALTH-CARE OF THE GROWING CHILD 
 infantile spoiled stomach are noted, paralysis may 
 
 Paralysis or 
 
 poliomyelitis suddenly appear. Many children will go 
 to school in the morning, have fever in the 
 afternoon and evening, and awake the fol- 
 lowing morning unable to walk. The fever 
 subsides quickly. The paralysis remains. 
 There is a gradual waste of flesh which is 
 very perceptible after a few weeks. The 
 arm or leg affected is cold to the touch, 
 and in contrast to the healthy extremity 
 shows marked changes. This form of paral- 
 ysis lasts throughout life. 
 
 Braces and supports have given the best 
 results. Plaster of Paris has been tried 
 with rest in bed and immobilization of the 
 parts, but the results are disappointing. 
 Massage, electricity, and a metallic brace 
 are about the only successful methods in 
 use to-day. If there is shortening of the 
 muscles, then muscle-grafting may be tried. 
 
 This form of paralysis requires very skil- 
 
 [254] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 ful treatment, and gymnastics must form 
 the most important part of muscle educa- 
 tion. 
 
 I always advise placing such a child un- 
 der the care of one skilled in medical gym- 
 nastics and muscle education, so that the 
 muscle strength can be gradually restored. 
 
 Spinal Curvature 
 
 Curvature of the spine is met with in 
 both sexes. As a rule, curvatures are caused 
 by weak muscles of the spine. We must 
 therefore expect curvature in those children 
 in whom exercise is neglected. 
 
 Faulty position assumed in sitting at 
 school or at home, or standing on one foot, 
 while not the direct cause of a curvature, 
 will aggravate and keep up a curvature that 
 might otherwise improve. 
 
 Spinal curvatures are usually associated 
 with bad chest development. Improper 
 
 [255] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 breathing and flat-chested children go to- 
 gether. One follows the other. An im- 
 proper development of the chest wall is 
 visible in the front ; so will a curvature of 
 the spine, as a rule, be associated with 
 faultily developed chests. 
 
 To cure a curvature medicines are use- 
 less. The treatment consists in the devel- 
 opment of the chest wall, and especially of 
 the spinal muscles, which can only be ac- 
 complished by gymnastics. Deep breathing 
 exercises, pulley weights, dumb-bells, row- 
 ing, and especially swimming, are samples 
 of exercises best adapted to develop both 
 sides of the chest and spine. 
 
 It is best, however, if a curvature exists, 
 to take the child to a specialist and have 
 him prescribe the exercises to be followed 
 in a gymnasium. The measurements of the 
 child should be taken, so that the progress 
 of development can be noted. Spinal curva- 
 
 [256] 
 
DISEASES OF THE NEKVOUS SYSTEM 
 
 tures can be cured unless we are dealing 
 with bone disease such as tuberculosis of 
 the spine. 
 
 Headache 
 
 When a child complains of headache, we 
 should suspect constipation or stagnation 
 of the intestinal contents. When poisons 
 from the bowels are absorbed into the body, 
 they give rise to violent headache. Such 
 putrefactive conditions will cause an auto- 
 intoxication. If, however, the bowels are 
 regular and there has been no imprudence 
 in eating, the temperature should be taken. 
 If there is any fever, the child should be 
 put to bed. Headache may mean constipa- 
 tion, but it may also mean the beginning of 
 an acute infection, like influenza, scarlet 
 fever, measles, diphtheria, or typhoid. It 
 also frequently precedes an ear abscess. 
 Eye-strain is a frequent cause of headaches 
 in schoolchildren. We should always ques- 
 
 [257] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 tion the child as to what portion of the head 
 aches, and note if it is over the eyes, and 
 Eye-Giasses if it follows reading or studying. If the 
 headache disappears when the child rests, 
 such headache may be caused by eye-strain. 
 Such children usually suffer with astigma- 
 tism. Their eyes should be examined by an 
 oculist, but not by an optician. The mus- 
 cles of accommodation in the eye are very 
 sensitive, hence only one skilled in testing 
 eyesight should undertake such a delicate 
 examination. 
 
 Every optician sells eye-glasses, and it is 
 to his advantage to enlarge his trade, but 
 the* delicate eyes of a child can be ruined 
 if improper lenses are fitted to them. 
 
 Some children require glasses for read- 
 ing only, others may require two sets of 
 glasses — one for distance-sight, the other 
 for reading and writing. 
 
 When girls between twelve and fifteen 
 
 [258] 
 
o 
 Cm 
 
 bo 
 a 
 
 m 
 
 +-> 
 o 
 
 o 
 O 
 
 OS 
 
 o 
 
 PL, 
 
 be 
 
 C 
 
 172 
 

DISEASES OE THE NEKVOUS SYSTEM 
 
 years complain of headache, one should bear 
 in mind that menstruation is frequently 
 preceded by headaches and also by nose- 
 bleed. Recurring headaches at intervals 
 of several weeks should always remind the 
 mother of the approaching menstrual flow, 
 if the girl has already begun to menstru- 
 ate. If there is a cessation of the flow and 
 an interval of two or three months has 
 passed since the last flow, headaches will 
 frequently occur. Such headaches are 
 caused by an overfilling of the blood-ves- 
 sels of the brain, and can best be relieved 
 by giving a hot mustard foot-bath. Nose- 
 bleed frequently occurs when menstruation 
 is delayed. 
 
 [259] 
 
PART V 
 
 MISCELLANEOUS DISEASES AND 
 AFFECTIONS 
 
 [261] 
 
OPERATIONS IN CHILDREN 
 
 Before deciding upon any surgical opera- 
 tion which necessitates the administration 
 of an anesthetic, there are a few points 
 which have an important bearing on the 
 outcome of any case. 
 
 We should be positive that the child is "Bleeder 1 
 not a " bleeder.' ' This can be easily ascer- 
 tained by the physician. A specimen of 
 blood can be sent to a laboratory to find out 
 in what length of time coagulation takes 
 place. By this means the physician learns 
 whether or no the child is a " bleeder. ' ' The 
 mother or nurse can also help to elucidate 
 this point by noting if bleeding of an un- 
 usual amount results after the extraction of 
 a tooth or after a pin-prick or slight cut. If 
 
 [263] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 when bleeding occurs it is stopped with dif- 
 ficulty, the child has a tendency to bleed, 
 and the same should be reported to the phy- 
 sician or surgeon. 
 
 The Kidneys An equally important point is to have 
 the urine examined so that we can learn 
 whether or no kidney-disease exists. If 
 albumin is found in the urine, the same 
 should be remembered, for it will have a 
 bearing on the choice of an anesthetic. 
 
 Bronchitis A tendency to bronchitis should be men- 
 
 tioned. If there is a tendency to bronchitis, 
 the use of ether as an anesthetic is contra- 
 indicated, as the ether will irritate the 
 bronchial tubes. 
 
 A weak heart or heart-disease requires 
 caution in using nitrous oxid or chloroform. 
 It is safer to have a physician present dur- 
 ing a nitrous oxid anesthesia, even though 
 only a tooth is extracted — if heart-disease 
 exists. 
 
 [264] 
 
HERNIA 
 
 HERNIA 
 
 A hernia is a loop or fold of intestine 
 which passes through the muscular struc- 
 ture of the abdomen. It is easily seen and 
 felt in the groin on either side as a round 
 or irregular mass which protrudes and gets 
 larger on coughing or pressing. 
 
 Girls as well as boys are easily ruptured 
 by active athletics. When children over- 
 strain they are liable to rupture. Many 
 children have a tendency to rupture because 
 of soft, flabby muscles. Children who have 
 suffered with rickets are easily ruptured. 
 Children whose muscles have been strained 
 by violent fits of coughing, as in whooping- 
 cough, are easily ruptured. 
 
 The rupture always comes down when the 
 child is on the toilet, especially if it strains 
 its bowels. Such rupture is called an in- 
 guinal hernia. Boys frequently have a large 
 
 [265] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 swelling or rupture which enters the sac 
 containing the testicles. It consists of a 
 fold of intestine forced through the inguinal 
 ring. 
 
 The treatment in these cases consists in 
 keeping the bowels so loose that the child 
 need not strain. Constipation is frequently 
 at the root of this trouble. A truss should 
 be fitted to the parts so as to support and 
 prevent the rupture from protruding. 
 
 Bread, cake, pies, pastries, and foods giv- 
 ing hard and formed stools must be avoided 
 during treatment. 
 
 A child having a rupture should be taken 
 to a physician so that the mother can learn 
 how to prevent the rupture from being 
 strangulated. 
 
 GLANDS 
 
 Lymphatic Glands are small, oval bodies about the 
 
 Glands 
 
 size of an almond. In health they give off 
 
 [266] 
 
GLANDS 
 
 secretions; for example, the saliva comes 
 from the salivary glands in the mouth. 
 During fever the mouth is dry, and the lips 
 are parched, hecause the glands do not per- 
 form their function. 
 
 Intestinal glands during fever do not 
 give off secretions, or only a very small 
 quantity; consequently we have constipa- 
 tion or dryness of the stool. 
 
 Glands are found in almost every part 
 of the body. We have bronchial glands, 
 stomach and intestinal glands, also throat-, 
 nose-, and mouth-glands. When inflamed Enlarged 
 
 Glands 
 
 they swell to two or three times their nor- 
 mal size. Swollen glands usually indicate 
 a nearby inflammation. When the glands 
 swell at the lower jaw or behind the ear 
 we should examine the mouth to see if the 
 child has an abscess at the root of a tooth 
 or on the gum. There may be a swelling 
 at the back of the throat, or the tonsil may 
 
 [267] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 be inflamed or have an abscess developing. 
 In many instances the swelling of the glands 
 will continue, and the gland itself break 
 down and result in an abscess. . 
 
 If there is an eczema on the scalp due to 
 head-lice, the glands in the back of the neck 
 near the roots of the hair will be swollen. 
 Inspectors of schoolchildren invariably ex- 
 amine the back of a child's head near the 
 neck in order io determine the hygiene of 
 the scalp. Glands will also swell in many 
 other diseases which will be described else- 
 where. 
 Tuberculous Tuberculosis frequently shows itself by 
 
 Glands * J J 
 
 an enlargement of the glands under the jaw 
 and neck. These glands enlarge and remain 
 swollen for months and years even though 
 diseased tonsils and adenoids are removed. 
 There is but one treatment for this condi- 
 tion and that is to remove them. When an 
 abscess forms in a tuberculous gland the 
 
 [268] 
 
Tuberculous Glands of the Neck, behind which diseased tonsils 
 and adenoids were found. 
 

GLANDS 
 
 pus should be evacuated as soon as possible. 
 I have already mentioned the absence of 
 fever in tuberculous glands in the article 
 on tuberculosis. The same treatment that 
 is given for other tuberculous conditions 
 (see chapter on tuberculosis) is indicated. 
 
 The body must be fortified with the aid 
 of concentrated food, such as milk, cheese, 
 eggs, fruits, and vegetables. Cakes, pies, 
 puddings, and candies should not be given, 
 or only in moderation. To assimilate the 
 food, fresh air and outdoor life are de- 
 manded. This will sharpen the appetite 
 and aid digestion. An outdoor life, with 
 porch-sleeping, soothes the nervous system 
 and promotes sleep. The constant supply 
 of oxygen taken into the lungs when awake 
 and during sleep strengthens the blood, 
 gives resistance to the body, and eventually 
 helps to cure the disease. 
 
 To throw off the poison from the skin and 
 
 [269] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 glands it is necessary to resort to daily 
 baths. A tepid bath followed by a cold 
 shower and brisk massage will stimulate 
 the circulation and help to restore good 
 health. Medicine alone will not cure tuber- 
 culosis. 
 
 FAINTING 
 
 Attacks of syncope are frequently seen 
 in children when riding in cars. The jar- 
 ring of the train will disturb the brain and 
 nervous system so that a faint or nausea 
 and vomiting may result. A sudden shock 
 or fright will sometimes cause a disturb- 
 ance of the circulation resulting in a faint. 
 Indigestion may cause a fainting-spell, 
 while at the same time there will be a cold 
 perspiration of the hands, feet, and fore- 
 head. There is danger unless the circula- 
 tion is quickly restored. 
 
 The child should be undressed and put 
 
 [270] 
 
FAINTING 
 
 to bed. Massage or rub the region of the 
 heart around the left nipple for a few mo- 
 ments. The feet should be immersed in hot 
 water. Care must be taken that the feet are 
 not scalded. Five to ten drops of whisky 
 or brandy or aromatic spirits of ammonia 
 should be given and repeated every five min- 
 utes until three doses have been taken. The 
 face should be sponged with alcohol and 
 water or with Florida water every few 
 minutes. 
 
 Even though the child craves drink avoid 
 giving large quantities of liquids. Thirst 
 should be quenched by giving small pieces 
 of cracked ice with or without brandy. 
 
 After the child is revived discontinue 
 foot-baths and let him rest. Hot coffee 
 with milk will assist in steadying the heart- 
 action and prevent the recurrence of such 
 fainting-spells. 
 
 If the abdomen is distended give an 
 
 [271] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 enema of one pint of soap-water. By reliev- 
 ing the bowels we remove the pressure on 
 the diaphragm which lies directly under the 
 heart. 
 
 No child should be permitted to walk for 
 at least one day after an attack. Rest is 
 demanded so that the heart shall not be 
 overstrained. 
 
 COLD HANDS AND FEET 
 
 Cold hands and feet are caused by an 
 insufficient supply of arterial blood to the 
 extremities. If circular garters are worn, 
 or if stockings, shoes, and gloves are worn 
 very tight, they will interfere with the cir- 
 culation of the blood to the extremities. 
 Insufficient exercise and anemia are also 
 reasons for this condition. 
 
 The treatment consists in briskly rubbing 
 the hands and feet with cold water, followed 
 by dry massage. Walking or jumping for 
 
 [272] 
 
HICCUP 
 
 several minutes will stimulate the circu- 
 lation. 
 
 If the child is anemic an iron tonic will 
 be necessary. "Warm drinks, such as milk, 
 broth, or gruel may be given every three 
 or four hours. 
 
 HICCUP 
 
 Hiccup is due to a spasm of the dia- 
 phragm. It is usually provoked by gas or 
 by something that has been swallowed 
 which irritated the lining of the stomach. 
 Cream and foods rich in fat frequently 
 cause hiccup. 
 
 A tight-fitting abdominal bandage will 
 frequently check the spasm. One-fourth tea- 
 spoonful of bicarbonate of soda in a teacup- 
 ful of warm water may be repeated every 
 half-hour until the spasm is controlled. 
 
 If the spasm persists in spite of this 
 treatment try firm pressure with the thumb 
 
 [273] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 s 
 
 over the stomach immediately under the 
 breast-bone. This firm pressure should be 
 continued for at least one minute. 
 
 FOREIGN BODIES IN THE EAR 
 
 Bugs, insects, beads, and other foreign 
 bodies will sometimes accidentally lodge in 
 the ear. Most objects can be dislodged by 
 dropping in the ear a few drops of warm 
 sweet- or olive-oil. If the foreign body can 
 not be dislodged by this means, place the 
 child in a sitting posture, and irrigate the 
 ear with one quart of warm water, using a 
 fountain-syringe and glass nozzle. The bag 
 should be hung no higher than two feet 
 above the child's head. 
 
 Do not probe the ear with a hairpin or 
 any sharp instrument, but take the child to 
 a physician if the foreign body is not easily 
 dislodged. 
 
 [274] 
 
EAEACHE 
 
 EARACHE 
 
 In the back of the throat on each side near 
 the tonsils is an opening leading into the 
 middle ear. This is called the Eustachian 
 tube. Pus-germs from the nose and throat 
 frequently enter and set up an inflammation 
 resulting in an abscess. We should always 
 bear in mind the danger of an extension of 
 the catarrhal inflammation from the back 
 of the nose and throat into the middle ear, 
 when children suffer with tonsillitis or ca- 
 tarrhal or influenzal fevers. 
 
 When cold in the head or catarrh in the 
 nose and throat persists a long time, or if 
 they constantly recur, it is better not to ex- 
 periment with home remedies but to have 
 the child carefully examined by a physician 
 to determine the origin of the trouble. In 
 nine cases out of ten adenoids will be re- 
 sponsible for the frequent colds. Shall we 
 let earache and ear-discharge continue and 
 
 [275] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 cause worry when a simple operation devoid 
 of danger can cure this trouble 1 ? 
 
 Violent blowing of the nose may result 
 in earache. A catarrh will frequently ex- 
 tend through the nose and throat and give 
 rise to earache. Earache without fever 
 need occasion no alarm. Earache is an 
 early symptom of measles. 
 
 Warm olive-oil may be dropped into the 
 ear, and the ear plugged with cotton. A 
 warm water-bag should be placed over the 
 ear. Gargling the throat with warm salt 
 water, one-half teaspoonful of salt to a 
 cup of warm water, every fifteen minutes is 
 beneficial. If the child is not relieved by 
 this simple means a careful examination of 
 the ear must be made by the physician to 
 determine the cause of the trouble. 
 
 A simple catarrh of the middle ear if 
 neglected may extend to the mastoid cells 
 causing inflammation which may prove fa- 
 
 [276] 
 
PINKEYE 
 
 tal. An early incision in the drum will fre- 
 quently prevent a mastoid inflammation. 
 
 PINKEYE 
 
 This infections disease is caused by a 
 germ. The blood-vessels of the eye swell. 
 Because of the number of engorged blood- 
 vessels the eye assumes a pink appearance, 
 hence the name pinkeye. The eyelids have 
 a discharge which will frequently glue them 
 together so that the eye can not be opened 
 after the night's rest. 
 
 Owing to the contagious nature of this isolation 
 disease the patient should be isolated and 
 all cloth or cotton coming in contact with 
 the eyes should be burned. Towels should 
 be boiled after being used, so that all germs 
 are destroyed. The eyes should be pro- 
 tected with smoked glasses or the child kept 
 in a darkened room. Eeading should be 
 prohibited. The heat and smarting in the 
 
 [277] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 eyeballs can best be relieved by the appli- 
 cation of gauze saturated with warm boracic 
 acid solution which should be changed every 
 five or ten minutes during the day. At 
 night borated vaseline applied to the eyelids 
 will prevent them from sticking together, 
 
 STIES 
 
 This is a very common infection and 
 occurs on the upper and lower eyelids. 
 The application of lukewarm lead- water on 
 gauze covered with oiled silk and bound on 
 with a handkerchief quickly relieves. The 
 dressings should be changed once or twice 
 every hour. If pus forms and the lid is 
 very much swollen, it may be necessary, in 
 rare instances, to sterilize a needle by hold- 
 ing it in an alcohol flame and open the head 
 of the pustule to let the pus out. 
 
 [278] 
 
EEVEK-SOKES 
 
 TRACHOMA 
 
 This is a highly contagions disease which 
 appears as a number of small elevations 
 nnder both eyelids. Children contract the 
 same in schools or wherever crowded to- 
 gether. 
 
 Medical inspectors in schools always 
 evert the eyelid to look for this infection. 
 
 The illustration shows the type of the 
 disease most common among schoolchil- 
 dren. Every mother can with care learn to 
 detect it. 
 
 Severe complications may follow if these 
 cases are neglected. The treatment is too 
 complicated for any mother to attempt. 
 
 FEVER-SORES 
 
 When the stomach is deranged or food 
 ferments and stagnates in the intestine we 
 will have fever. After the fever is over 
 blisters will be seen in the mouth or gums 
 
 [279] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 and especially around the lips. They are 
 the external manifestation of the poison 
 generated by the inflammation within the 
 body. These sores are frequently found 
 on the body as well as on the face. 
 
 One or two teaspoonfuls of rhubarb and 
 soda mixture can be given every three hours 
 for two days. A paste consisting of bicar- 
 bonate of soda and cold water is cooling and 
 reduces the swelling. It should be rubbed 
 into the sore twice a day. 
 
 Camphorated vaseline or camphorated ice 
 is soothing. Neither meat, eggs, nor cereals 
 should be given for three days. The diet 
 should consist of milk, fruit, and fresh vege- 
 tables. 
 
 INJURIES 
 
 Bruise or cut If a child falls the injury may result in 
 a black and blue mark known as a bruise. 
 If the skin is broken the wound should be 
 
 [280] 
 
Trachoma of both Lids. A serious eye- 
 trouble. Very contagious. 
 
INJUEIES 
 
 washed with absorbent cotton dipped in 
 boiled water. No ordinary house wool 
 should be used, nor should cotton be used 
 that has been exposed to dust or to the air. 
 Sealed package cotton must be used. If 
 there is bleeding, moisten the cotton with 
 peroxid, using one teaspoonful of peroxid 
 to one teaspoonful of boiled water. 
 If there is swelling or redness, which is swelling or 
 
 Inflammation 
 
 inflammation, apply gauze saturated with 
 diluted cold lead-water. In the absence of 
 lead-water, gauze may be saturated with 
 witch-hazel or with plain iced water. If 
 dirt or dust has entered the wound it should 
 be washed with a 1 to 5000 bichlorid solu- 
 tion. There is always danger of infection 
 from germs that enter the lacerated skin. 
 In this way erysipelas or tetanus germs may 
 produce fatal results. 
 
 If the wound is infected through im- 
 proper treatment and fever develops there 
 
 [281] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 is danger of blood-poisoning. Do not risk 
 a child's life by experimental antisepsis, 
 and, having given first aid to the injured, 
 call a physician. 
 
 Any person handling a wound, no matter 
 how slight, must see that the hands are 
 thoroughly scrubbed and the finger-nails 
 absolutely clean. 
 Bums Scalding the skin with hot water or steam 
 
 will produce blisters and redness of the 
 neighboring parts. If the burn is mild the 
 blisters should be opened with a clean nee- 
 dle, and the loosened skin removed with 
 sterilized cuticle-scissors. Apply linseed- 
 oil and lime-water in equal parts. If the 
 linseed-oil and lime-water are not at hand, 
 cold cream, corn-starch powder, flour, or 
 stearate of zinc may be thickly sprinkled 
 over the burn and covered with crossed 
 strips of oiled silk, over which gauze and a 
 bandage should be placed. The dressing is 
 
 [282] 
 
INJURIES 
 
 to be changed at least once a day, the same 
 treatment being carried out each time. 
 
 If a splinter becomes imbedded in a splinters 
 child's flesh it should be picked out with a 
 sharp needle. To sterilize the needle, pour 
 five or ten drops of alcohol in a saucer in 
 which the needle is placed, then set fire to 
 the alcohol. With this sterilized needle pick 
 out the splinter, beginning at the point of 
 entrance. Saturated boric acid solution 
 should then be applied overnight. 
 
 Children will often miscalculate distances Fan or s PI 
 and cause painful though not dangerous 
 wounds by a fall or misstep from a car, 
 curb, or any height, and especially in scaling 
 fences. 
 
 The treatment consists in having the child 
 rest as much as possible. Apply an ice-bag 
 during the day. At night saturate a piece 
 of gauze with tincture of arnica and apply 
 to the affected part. A tight-fitting ban- 
 
 [283] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 dage over the wet gauze will support the 
 affected parts and bring relief. 
 
 As a rule a sprain of this character will 
 last several days ; if however the pain con- 
 tinues it may be necessary to call a physi- 
 cian to determine the nature of the injury. 
 to stop If a child is cut and blood spurts like a iet 
 
 Bleeding r ° 
 
 an artery has been cut. If the blood oozes 
 and is bluish-red in color, a vein has been 
 severed. A clean linen handkerchief should 
 be tied around the part and a strip of clean 
 linen or sterile gauze of half a dozen thick- 
 nesses should be pressed over the wound. 
 Styptic cotton or styptic wool, if handy, 
 can be applied directly to the bleeding, 
 using a tight bandage or handkerchief to 
 hold it in place. 
 
 When arteries are cut it may be necessary 
 to tie them. In such a case call a physician. 
 
 [284] 
 
NOSEBLEED 
 
 NOSEBLEED 
 
 Violent exercise or injury to the nose will 
 sometimes cause nosebleed. Many children 
 will suddenly have a flushed cheek and asso- 
 ciated therewith nosebleed. There is a de- 
 cided difference between nosebleed of this 
 character and nosebleed resulting from a 
 swelling called a polypus in the nostril. Polypus 
 In the latter case a swelling exists, the nos- 
 tril is obstructed, and there is difficulty in 
 breathing. There will also be very fre- 
 quently recurring nosebleed. 
 
 To check nosebleed ice-cloths or a piece 
 of ice wrapped in cheese-cloth should be 
 held at the root of the nose between the 
 eyes. Firm pressure on the upper lip under 
 the nostrils for from ten to twenty seconds 
 will sometimes check the bleeding. 
 
 The child should be placed in an upright 
 position, and the feet immersed in hot 
 water. Styptic or plain absorbent cotton 
 
 [285] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 may be used to plug the nostril. Small bits 
 of cracked ice may be swallowed. No warm 
 food should be given. 
 
 If the attacks recur frequently, a physi- 
 cian should be called to determine the cause. 
 Constitutional treatment may be necessary. 
 It is very important to learn if the child is 
 a " bleeder.' ' This condition has been re- 
 ferred to in the article on Operations in 
 Children. 
 
 WORMS 
 
 Worms enter the body chiefly through 
 food. The most common form of worm is 
 the pinworm or threadworm. We also fre- 
 quently see the roundworm. Older children 
 are more subject to the tapeworm, 
 pinworm The pinworm is usually found in the stool 
 
 mixed with a catarrhal discharge from the 
 bowels. Children so affected are nervous, 
 restless, and have an itching around the 
 
 [286] 
 
WOKMS 
 
 anus. They are uneasy and do not sit long 
 in one place. 
 
 When there are very many worms, they 
 disturb the nervous system, so that fre- 
 quently their presence has been known to 
 cause convulsions. In little girls these 
 worms will frequently crawl from the rec- 
 tum into the vagina. Many cases of vulvitis 
 and vaginitis, consisting of an inflammation 
 of the external genitals, are thus caused by 
 worms. Their presence will cause itch- 
 ing which may ultimately lead to mastur- 
 bation. 
 
 These worms resemble spool-cotton and 
 can easily be removed by giving an enema 
 of a teaspoonful of salt to four ounces of 
 water twice a day. One grain of santonin 
 and one-fourth grain of calomel should be 
 given at bedtime for three successive nights, 
 and each morning two teaspoonfuls of rhu- 
 barb and soda mixture should be given. 
 
 [287] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 Compound licorice-powder may be substi- 
 tuted in one-half teaspoonful doses. 
 Roundworm This worm is reddish or reddish-yellow 
 and from five to ten inches long. It is 
 found in the smaller intestines in children 
 between the second and tenth years. Some 
 children may have five or six, others a 
 dozen or more. I have seen these worms 
 passed with the stool. Occasionally they 
 are vomited with the food. Frequently their 
 presence is not associated with any definite 
 symptom. They may cause restlessness and 
 itching of the anus, grinding of teeth, colic, 
 or diarrhea. The children have restless 
 nights and frequently complain of pain in 
 the stomach or abdomen. Such children are 
 not able to locate the exact spot where the 
 abdomen hurts. They will have a pain on 
 the left side one day and ou the right side 
 the next day. They are sensitive, dissatis- 
 fied, and hysterical. 
 
 [288] 
 
WOEMS 
 
 The eggs of these worms can be detected 
 in the stool, and as long as they are present 
 more worms should be suspected, even 
 though a dozen or more have been passed. 
 
 One of the best remedies is the oil of che- 
 nopodium, five drops on sugar, three times 
 a day for a child ten years old. Eepeat the 
 dose on the following day. On the third 
 day give a teaspoonful of compound lico- 
 rice-powder. If this is effectual repeat the 
 treatment three times, at intervals of ten 
 days. 
 
 Tapeworm enters the body by means of Tapeworm 
 food containing the larvae or eggs. The 
 eggs are found in pork, in beef, and in fish. 
 A worm develops in about three months. 
 When the terminal segments are mature 
 they separate and are discharged in the 
 stool. As each segment contains both male 
 and female organs, each one is capable of 
 regenerating a whole worm. For this rea- 
 
 [289] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 son the treatment of tapeworm will never 
 be successful until the head and every seg- 
 ment has been expelled. Tapeworms are 
 estimated to live from ten to twenty and 
 possibly thirty years. 
 
 The beef tapeworm is most frequently 
 found in children. It has four suckers, a 
 square head, and no hooks. Eaw beef may 
 contain the eggs of the worm. 
 
 The pork tapeworm is rarely found in 
 children. The head has four suckers sur- 
 rounding which there is a circle of about 
 twenty-six hooks. The length of the worm 
 varies from ten to fifty feet. 
 
 In older children we will notice colic, 
 restlessness, and foul breath. In spite of 
 an abnormally large appetite the body is 
 poorly nourished and sometimes wastes. 
 Many of these cases have been supposed to 
 suffer with tuberculosis. 
 
 The presence of the worm is easily de- 
 
 [290] 
 
WOEMS 
 
 tected by the large white segments of the 
 worm that can be seen in the stool. These 
 segments are white, flat objects resembling 
 a piece of tape. 
 
 The expulsion of the worm is difficult. 
 Even though the body may have been ex- 
 pelled, unless the head is dislodged and re- 
 moved the worm will grow and redevelop. 
 
 The treatment should be left in the hands 
 of a physician. It consists in dieting with 
 salt herring, onions, and garlic, which sick- 
 ens the worm. This diet is followed by a 
 large dose of felix mas. The dose, and fre- 
 quency of the same, and danger of giving 
 an overdose of this specific drug are too 
 important for the average mother to un- 
 dertake ; hence the physician should be con- 
 sulted. 
 
 In the South, and occasionally in the Hookworm 
 North, hookworm exists. The worm enters 
 the system through the soles of the feet and 
 
 [291] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 finally lodges in the intestinal tract. The 
 worms produce a profound anemia and pale- 
 ness of the skin. There is swelling of the 
 feet and ankles, and pufiiness of the face. 
 There is loss of weight. In the stool the 
 eggs of the hookworm can be found. If we 
 are living in the locality where hookworm 
 exists and the child shows the above named 
 symptoms, no time should be lost in placing 
 the child under the care of a competent phy- 
 sician. 
 
 BED-WETTING 
 
 This is a very common occurrence in 
 childhood. In some cases it is due to indif- 
 ference on the part of the child. In other 
 cases it is due to an irritation or weakness 
 of the bladder-muscles which do not retain 
 the urine but allow it to trickle away. Many 
 children wet by day as well as by night. 
 Local irritation, such as a tight foreskin, 
 
 [292] 
 
BED-WETTING 
 
 very acid urine, adenoids, or general weak- 
 ness of the bladder are the common causes 
 in boys as well as in girls. 
 
 If bed-wetting follows an attack of in- 
 fluenza or if it follows diphtheria, then 
 probably paralysis of the bladder-muscles 
 may be the reason for the same. 
 
 The treatment consists in giving small 
 quantities of liquids at supper. Cold spinal 
 douches should be given morning and even- 
 ing. The foot of the bed should be elevated. 
 Meat should be allowed only every other 
 day. Drugs such as strychnin must not be 
 given without the advice of a physician. 
 Toning up the muscles with electricity is 
 frequently serviceable. The urine requires 
 chemical examination, to see if too much 
 acid may not be the cause of the bed-wet- 
 ting. 
 
 [293] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 RETENTION OF URINE 
 
 The retention of urine is a serious matter. 
 The healthy child should pass about one 
 quart of urine in twenty-four hours, but 
 this quantity may vary with the amount of 
 liquids taken. When solid food is taken 
 there will be less urine passed than when 
 liquid food is taken. During fever and in 
 diseased conditions the kidneys sometimes 
 act sluggishly. 
 
 Fifteen drops of sweet spirits of niter 
 may be given in water and repeated three 
 times a day. If the kidneys do not respond 
 and the urine is still suppressed, a warm 
 hip-bath should be given for three minutes. 
 Dry cups may be applied over the region 
 of the kidneys once or twice a day. A warm 
 water-bag may be applied to the small of 
 the back or the abdomen. If the child does 
 not respond to this treatment a physician 
 should be called. 
 
 [294] 
 
LEUCORRHEA 
 
 LEUCORRHEA 
 
 A white milky discharge or a yellowish- 
 white discharge from the female genital 
 tract is known as leucorrhea. It may be the 
 result of a general systemic weakness. It 
 may also be due to threadworms crawling 
 from the rectum into the vagina. Scratch- 
 ing and rubbing so-called thigh-friction 
 will irritate and inflame the parts, giving 
 rise to leucorrhea. 
 
 After measles, diphtheria, influenza, and 
 especially scarlet fever, leucorrhea is fre- 
 quently noted. It may then be considered 
 as a complication resulting from the disease 
 with which the child suffered. Leucorrheal 
 discharges are occasionally carried from the 
 mother or nurse to the child by sleeping in 
 the same bed. 
 
 This condition should not be neglected, 
 and modesty should not prevent the mother 
 from taking the child to the family physi- 
 
 [295] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 cian for treatment. Now and then a child 
 may be infected by using a dirty toilet-seat 
 in a public school or hotel. 
 
 If the discharge persists in spite of mild 
 treatment a complete laboratory examina- 
 tion of the discharge should be made to 
 determine its nature and the treatment re- 
 quired. Sitz baths of two teaspoonfuls 
 alum and four gallons water are beneficial. 
 
 If in spite of local irrigations of alum- 
 water leucorrhea persists, tonics such as 
 iron or codliver-oil should be given. A 
 change of air from the city to the country 
 is desirable, preferably to the sea, for sea- 
 baths will prove beneficial. 
 
 Every mother should know that there is 
 great danger of infecting the eyes. She 
 should instruct the child to thoroughly wash 
 its fingers after going to the toilet. A light 
 pad should be worn, and changed several 
 times a day, and burned after using. 
 
 [296] 
 
FISSURE OF THE ANUS 
 
 The child should sleep alone. The dis- 
 charge may be communicated to others. 
 
 FISSURE OF THE ANUS 
 
 This is a painful condition of the rectum 
 that is occasionally met with in children. 
 They will complain of pain during stool. 
 Now and then the fissure will bleed during 
 a movement. 
 
 On separating the folds of the anus (out- 
 side rectum) one or more grooves of in- 
 flamed flesh will be seen. Into these fissures 
 particles of stool enter and cause irritation. 
 Hardened lumps of stool will frequently be 
 the cause of fissures while passing through 
 the anus. 
 
 The intense itching causes the child to 
 
 scratch by day as well as during the night. 
 
 If the fingers or finger-nails are not clean 
 
 an infection may take place giving rise to 
 
 an abscess. 
 
 ! 
 
 [297] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 The treatment consists in keeping the 
 parts clean, for which purpose a bath of 
 soap-water applied with absorbent cotton 
 after each movement of the bowels is re- 
 quired. Zinc-salve or cold cream should 
 then be applied. At times fissures of the 
 anus will bleed and require cauterizing with 
 nitrate of silver. 
 
 A bland diet, consisting of milk, cheese, 
 fruit, vegetables, and bread and butter, 
 should be given. Meat, fish, eggs, and cere- 
 als should be omitted from the diet until the 
 fissures have all healed. 
 
 POISONS AND ANTIDOTES 
 
 It is self-understood that no mother or 
 nurse should take the responsibility of 
 caring for a child that has been poisoned 
 or in which symptoms of poisoning are sus- 
 pected. Rapidity in eliminating the poison 
 may be the means of saving the child's life; 
 
 [298] 
 
POISONS AND ANTIDOTES 
 
 hence in every case of poisoning a physician 
 should be summoned. Certain symptoms 
 can always be noted by a physician which 
 may be overlooked by the layman. For in- 
 stance, the condition of the heart, the pulse, 
 the pupils, the extremities, whether or no 
 they are rigid, cold hands and feet, and con- 
 vulsions, all of these symptoms indicate the 
 condition of the system. 
 
 Until the physician arrives, no time 
 should be lost and the following suggestions 
 carried out : Accidents in which poison has Emetics 
 been swallowed usually call for the speedy 
 production of vomiting. Poisons act very 
 quickly unless they are neutralized or di- 
 luted. If possible a teaspoonful of ipecac 
 should be given and repeated every five 
 minutes until vomiting is produced. 
 
 If an acid has been swallowed olive-oil or 
 one teaspoonful of bicarbonate of soda in a 
 teacup of water should be given. 
 
 [299] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Warm or cold milk if given soon after 
 any poison has been swallowed will dilute 
 the same. 
 
 If an overdose of medicine such as pare- 
 goric or laudanum has been given, give 
 half a teacupful of black coffee as soon as 
 possible. 
 
 If a liniment or some patent medicine has 
 been given by mistake, give the child a half 
 cup of black coffee and fifteen minutes later 
 a teaspoonful of sirup of ipecac. 
 
 If carbolic acid or oxalic acid has been 
 swallowed give one or more wineglassfuls 
 of olive-oil. 
 
 If the child is drowsy from an overdose 
 of paregoric or a sleeping-mixture, give a 
 mustard foot-bath by using a tablespoonful 
 of mustard to a pail of warm water, bathing 
 the feet two minutes. Also give a cup of 
 coffee to which two teaspoonfuls of whisky 
 have been added. 
 
 [300] 
 
POISONS AND ANTIDOTES 
 
 A child that is drowsy should be sup- 
 ported under its arms and made to walk in 
 the open air in order to revive him. A cold 
 cloth to the head and sponging the face with 
 Cologne or Florida water, or the inhalation 
 of ammonia-vapor will help to revive the 
 child. 
 
 If in spite of this treatment the child 
 remains drowsy, an injection of a pint of 
 water containing one teaspoonful of table 
 salt should be injected into the rectum at a 
 temperature of 115 degrees. If possible a 
 high enema should be given, the soft rubber 
 tube being inserted six to eight inches. 
 
 [301] 
 
APPENDIX 
 
 [303] 
 
Appendix 
 
 FOOD RECIPES 
 
 Milk is frequently used as a drink by 
 school-children. If the milk is certified or 
 pasteurized it is safe, not otherwise. My 
 advice therefore is to give school-children a 
 bottle of pasteurized milk and keep it warm 
 in a thermos bottle until lunch hour. 
 
 If the source of the milk is unknown it is 
 safer to steam the milk twenty minutes or, 
 if the child is not constipated, the milk may 
 be brought to the boiling-point. 
 
 When milk has been steamed it should be 
 cooled rapidly and placed in a refrigerator 
 until it is used. If milk is exposed to the 
 air and not properly cooled in a refrigera- 
 tor it will easily be contaminated. 
 
 The danger in milk consists in the ease 
 with which tuberculosis, typhoid, or diph- 
 
 [305] 
 
Milk 
 
 HEALTH-CARE OF THE GROWING CHILD 
 
 theria germs can be conveyed by its use to 
 the healthy child. These germs multiply 
 and thrive in raw milk. They are destroyed 
 and lose their vitality when milk is boiled 
 or steamed, 
 peptonized Peptonizing powders are digestive agents 
 
 sold in glass tubes or in tablet form. They 
 are composed of pancreatin and bicarbonate 
 of soda. The contents of a peptonizing 
 tube or a tablet should be dissolved in a 
 tablespoonful of cold water, and a quart 
 of milk added. Place this milk containing 
 the powder in a pot of hot water at a tem- 
 perature of about 110 degrees, leaving it 
 there for ten minutes. The milk must then 
 be quickly brought to the boiling-point, 
 and placed in a pot of cold water, to pre- 
 vent further peptonization. Bringing the 
 milk rapidly to a boil will kill the digestive 
 ferment, thus avoiding a bitter taste. 
 For each large cup take a teaspoonful of 
 
 [306] 
 
FOOD EECIPES 
 
 cocoa and a teaspoonful of sugar ; mix to a cocoa 
 paste with a little boiling water or milk ; add 
 balance of milk, or milk and water, as rich- 
 ness is desired. Boil one minute, as boiling 
 improves the flavor. 
 
 Take the beaten yolk of one egg and add Yoik of E gg 
 
 Lemonade 
 
 to it the juice of one-half lemon. Let stand 
 five minutes, thus drawing off the raw taste 
 of the yolk of egg. Add one teaspoonful of 
 sugar and eight ounces of water. 
 
 Take the juice of one orange and one Aibumenized 
 
 Orangeade 
 
 ounce of water, and insert an egg-whisk. 
 When the orangeade is in full agitation 
 add slowly the white of egg. Continue the 
 whisking for one or two minutes. Add one- 
 quarter teaspoonful of sugar. 
 
 Heat six ounces of milk to a temperature E gg -No g 
 of 150 degrees, but do not allow it to boil. 
 When cold beat up a fresh egg in a tumbler 
 with some sugar, add a few drops of vanilla, 
 and fill up the tumbler with warm milk. 
 
 [307] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 chicken Broth Cut up a small chicken, put bones and all 
 with a sprig of parsley, salt, one tablespoon- 
 ful of rice, and a crust of bread, in a quart 
 of water, and boil for one hour, skimming 
 it from time to time. Strain through a 
 coarse colander. 
 
 Mutton soup Cut up fine two pounds of lean mutton, 
 without fat or skin. Add one tablespoonful 
 of barley, one quart of cold water, and a 
 teaspoonful of salt. Let it boil slowly for 
 two hours. If rice is used in place of barley, 
 soak the rice in water overnight. 
 
 Beef- juice Expressed beef -juice is obtained by 
 
 slightly broiling a piece of lean beef and 
 expressing the juice with a lemon-squeezer. 
 One pound of steak yields two or three 
 ounces of juice. This is flavored with salt 
 and served cold or warm. Do not heat to 
 coagulate the albumin. It is very nutri- 
 tious and well-taken. 
 
 junket Add one teaspoonful of liquid rennin or 
 
 [308] 
 
FOOD KECIPES 
 
 one junket tablet to one pint of milk. Mix 
 and heat until the steam rises. Pour into 
 cups and set aside to cool. Flavor with 
 vanilla or pineapple if desired. 
 
 Or to a bowl containing eight ounces of 
 cool milk add one teaspoonful of pepsencia 
 (Fairchild). Mix thoroughly. Place bowl 
 in pan of boiling hot water for two minutes. 
 Remove and let stand until jellied. 
 
 Beat one egg to a froth and sweeten with junket of 
 
 & ° Milk and Egg 
 
 two teaspoonfuls of white sugar. Add this 
 to one-half pint of warm milk ; then add one 
 teaspoonful of pepsencia (Fairchild) ; let 
 it stand until it is curdled. 
 
 Take one pint of milk and mix with it Arrow Root or 
 
 Corn-Starch 
 
 two tablespoonfuls of corn-starch ; flavor to v***™* 
 taste, then boil the whole eight minutes. 
 Allow it to cool in a mold. 
 
 Break one egg into a teacup and mix custard 
 thoroughly with one teaspoonful of sugar. 
 Add milk to nearly fill the cup, mix again, 
 
 [309] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 and tie over the cup a small piece of linen. 
 Place the cup in a shallow saucepan half 
 full of water and boil for ten minutes. 
 Rice pudding Boil a teacupful of rice, drain off the 
 water; add a tablespoonful of cold butter. 
 Mix with it a cupful of sugar, a quarter 
 teaspoonful each of nutmeg and cinnamon. 
 Beat up four eggs very light, whites and 
 yolks separately ; add them to the rice, and 
 gradually stir in a quart of sweet milk. 
 Butter a pudding-dish, turn in the mixture, 
 and bake one hour in a moderate oven. 
 
 Same as above recipe, sago being sub- 
 stituted for rice. 
 
 Take one pint of milk, two tablespoonfuls 
 of tapioca, two tablespoonfuls of sugar, one 
 saltspoonful of salt, and two eggs. 
 
 Wash the tapioca. Add enough water to 
 cover it and let it stand in a warm place 
 until the tapioca has absorbed the water. 
 Then add the milk and cook in a double 
 
 [310] 
 
 Sago Pudding 
 
 Tapioca 
 Pudding 
 
FOOD EECIPES 
 
 boiler, stirring often until the tapioca is 
 clear and transparent. Beat the yolks of 
 the egg. Add the sugar and salt and hot 
 milk. Cook until it thickens. Eemove from 
 the fire. Add the whites of the eggs, beaten 
 stiff. When cold add one teaspoonful of 
 vanilla. 
 
 Thoroughly clean two feet of a calf, cut cairs Foot 
 into pieces, and stew in two quarts of water 
 until reduced to one quart. When cold, take 
 off the fat and separate the jelly from the 
 sediment. Then put the jelly into a sauce- 
 pan with the whites of four eggs. Boil for 
 a quarter of an hour, cover it, and let it 
 stand for a short time. Strain while hot 
 through a bag into a mold. Flavor with 
 lemon. 
 
 Cut a young chicken into small pieces, put chicken jeiiy 
 in a saucepan with three pints of water. 
 Cook slowly, removing the grease from top 
 constantly. Allow it to cook about five 
 
 [311] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Coddled Egg 
 
 hours. Season with salt, pepper, celery, 
 and parsley. Strain. When cool remove 
 every bit of grease. Serve either hot or 
 cold. 
 
 Cover a fresh egg with boiling water and 
 let it stand five minutes. Pour off this 
 water j and again cover with boiling water, 
 and let stand five minutes. Eemove from 
 shell, add a pinch of salt, and serve. Pre- 
 pared in this manner the egg will be me- 
 dium soft, the yolk and white both being 
 of a jelly-like consistency, 
 poached Egg Drop eggs into hot, well-seasoned broth 
 or milk instead of into water. Be careful 
 that the yolks do not break. When heated 
 to a jelly-like consistency, remove and serve 
 on toast. Strain enough of the broth or 
 milk over them to moisten the toast. 
 
 All cereals should be steamed in salted 
 water, at least two hours, in a double boiler. 
 Serve with sugar and cream. 
 
 [312] 
 
 Cereals and 
 Gruels 
 
LOCAL KEMEDIES 
 
 If cereals are prepared in a fireless cooker 
 they may remain in the cooker overnight. 
 
 Scraped beef is prepared by scraping scraped Beef 
 with a dull silver knife a piece of raw lean 
 round steak. Season with salt and a little 
 pepper. Serve on toast or cracker. 
 
 If preferred the beef may be slightly 
 broiled or heated. 
 
 LOCAL REMEDIES 
 
 A sponge-bath is a simple general wash- sponge-Bath 
 ing of the body with sponge or wash-cloth 
 and warm water. The child should be un- 
 dressed completely and put between blan- 
 kets. The sponging must be performed 
 rapidly and under cover, one part at a time, 
 and drying it before going to another, fol- 
 lowing the order : face, arms, chest and ab- 
 domen, back, legs. 
 
 Cold sponging is sometimes ordered to cow sponge 
 reduce fever. A cotton blanket is used. 
 
 [313] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 One part of alcohol is added to two parts of 
 water, at room temperature. The sponge 
 is saturated and drawn lightly and slowly 
 over the parts. The bath may last from 
 fifteen to twenty minutes and may be re- 
 peated every hour if the fever is high. 
 
 In eruptive fevers no sponging should 
 be done until a physician has been con- 
 sulted. 
 Tub-Bath No tub-bath is given during illness unless 
 
 ordered by a physician. It is sometimes 
 ordered to bring out the rash of measles 
 or scarlet fever. 
 
 To allay nervous excitement and induce 
 sleep, the bath should be given at 100 
 degrees. The child may remain in the 
 bath for from five to ten minutes, be dried 
 quickly, and put to bed. 
 
 Cold tub-baths and hot tub-baths are 
 never given without a physician's order. 
 shower-Bath The shower-bath is an excellent nerve- 
 
 [314] 
 
LOCAL EEMEDIES 
 
 and muscle-stimulant and may be used fre- 
 quently, especially during the summer. 
 
 A cold shower-bath should not be given 
 unless ordered by a physician. 
 
 In cases of nephritis and to induce per- Bianket-Bath 
 
 or Hot Pack 
 
 spiration a blanket-bath or hot pack is some- 
 times ordered. The child is wrapped in 
 blankets wrung out in hot water, and cov- 
 ered with several dry blankets. The pack 
 is usually removed in one hour unless the 
 patient falls asleep. On removing the pack, 
 the body must be dried with a quick al- 
 cohol rub, being careful not to expose the 
 child. 
 
 A mustard-bath is a powerful stimulant Mustard-Bath 
 and is sometimes ordered when a child is 
 rapidly failing from any cause. 
 
 It is sometimes ordered to bring out a 
 rash in eruptive fevers. Mustard is added 
 in the proportion of one heaping teaspoon- 
 ful to one gallon of warm water. The child 
 
 [315] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 remains in the bath from two to three 
 minutes. 
 
 soda-Bath The soda-bath is given for hives and 
 
 similar skin affections. It is usually given 
 in the form of a sponge-bath, in the propor- 
 tion of one tablespoonful of bicarbonate of 
 soda to one gallon of water. 
 
 salt or Tonic The salt-bath when given as a tonic bath 
 
 Bath 
 
 should be tepid or cool and followed by a 
 brisk rubbing. One heaping tablespoonful 
 of salt is dissolved in one gallon of water. 
 
 suifur-Bath The sulfur-bath is given in rheumatism 
 
 and to allay itching in various skin-affec- 
 tions. Twenty grains of sulfid of potas- 
 sium should be dissolved in a gallon of water 
 at a temperature of 100 degrees. A wooden 
 tub should be used, as the sulfur tarnishes 
 metal. 
 
 Bran- and Bran- and oatmeal-baths are given to 
 
 Oatmeal-Baths 
 
 soothe an irritated skin. They are made by 
 tying one pound of bran or oatmeal in a 
 
 [316] 
 
LOCAL EEMEDIES 
 
 cheese-cloth bag, scalding it for ten minutes, 
 and squeezing out the milky fluid into a tub 
 of lukewarm water. The child remains in 
 the bath ten minutes. 
 
 Wet compresses are frequently ordered wet compress 
 to reduce inflammation, as in the cases of 
 sore throat. They consist of thick cloths 
 wet with water and applied to some part of 
 the body. 
 
 A warm compress is made by folding a warm or Hot 
 
 Compress 
 
 piece of flannel several times, placing it in 
 an open towel, dipping it into boiling water, 
 and wringing out thoroughly by twisting 
 the towel. After testing it against the 
 cheek, it is applied to the patient, covered 
 with a dry towel or piece of oiled silk. 
 
 A cold compress is sometimes ordered to coid compress 
 relieve a congested headache, for inflamma- 
 tion or for sprains. It is made of several 
 layers of linen dipped in cold water, wrung 
 out, and applied to the affected part. 
 
 [317] 
 
HEALTH-CARE OF THE GROWING CHILD 
 
 If an intense cold is desired, two parts 
 of ice-water and one part of alcohol are 
 used. The compresses are changed every 
 few minutes. 
 
 ice-Bag An ice-bag is sometimes used instead of 
 
 the iced cloths. The ice should be shaved 
 and packed in the ice-bag. If cracked ice 
 is used, a cup of hot water should be poured 
 over the ice to melt off the sharp edges. The 
 rubber ice-bag should never be filled more 
 than half. As much air as possible should 
 be expelled by twisting the top of the bag 
 before applying the screw-cap. 
 
 Dry Heat Dry heat is most conveniently applied by 
 
 means of hot-water bags. These rubber 
 bags may be bought of all sizes, from three 
 to four inches long, which are so useful in 
 earache or toothache, to the large ones 
 holding two to three quarts. 
 
 If one wishes to apply heat to the feet, 
 the bag may be filled with hot water. If the 
 
 [318] 
 
LOCAL KEMEDIES 
 
 bag is to be applied to the abdomen where 
 weight or pressure is to be avoided it should 
 be filled to one-half its capacity, and all the 
 air pressed out before putting in the stop- 
 per. Screw in the top very firmly, being 
 careful to have the rubber washer in place. 
 Evert the bag, to see if there is any leak. 
 Before applying the bag cover it with a 
 piece of flannel securely sewed in place, or 
 slip it into a flannel bag which can be se- 
 curely tied. These rubber bags must be 
 frequently tested or examined, as they 
 sometimes break and scald the patient. 
 
 In cases of backache there is nothing so 
 comforting as a hot- water bag. In headache 
 and many cases of toothache one of the 
 small bags, filled with ice-cold water and 
 applied to the cheek, the head, or the back 
 of the neck, will give great relief. 
 
 In an emergency, bags of salt, bricks, or 
 smoothing irons may be heated in the oven, 
 
 [319] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 wrapped in flannel, and applied as hot as 
 can be borne. 
 
 poultice A ponltice is a soothing remedy of a moist 
 
 mealy nature, applied to an inflammation. 
 It is intended to furnish heat, but should 
 always be tested against the cheek of the 
 nurse before being applied to the child. 
 
 Flaxseed- This is made of flaxseed-meal. The meal 
 
 Poultice 
 
 is first mixed with a little cold water and 
 then stirred into boiling water until it is 
 of the consistence of mush, after which it 
 should be removed from the fire. A layer of 
 this about an inch thick is spread on a piece 
 of cheese-cloth, the edges folded over and 
 secured. 
 Mustard- One part of mustard is mixed with four 
 
 Poultice x 
 
 or five parts of flaxseed- or wheat-flour. 
 Boiled water is added until it is reduced to 
 the consistence of mush. It is then spread 
 on cloth and applied directly to the skin. 
 If it burns too much a layer of linen can be 
 
 [320] 
 
LOCAL EEMEDIES 
 
 placed between. It should be kept on until 
 the skin is reddened but not long enough to 
 blister. 
 
 When a poultice of very light weight is Bran- or h op - 
 
 Poultice 
 
 desired, bran or hops is used. A bran-poul- 
 tice is made by sewing the bran in a muslin 
 or flannel bag, then heating the whole in the 
 oven or wringing it out of boiling water. 
 An oiled silk jacket is sometimes ordered oiied suk 
 
 Jacket 
 
 by the physician in cases of pneumonia. It 
 should be shaped like a child's sleeveless 
 shirt. A layer of cotton is placed between 
 a layer of cheese-cloth and one of oiled silk. 
 The edges are turned in and the three layers 
 basted together. The shoulder-seams or 
 straps may be sewed together or tied with 
 tapes. The front is closed by means of 
 tapes sewed on either side. The jacket is 
 worn with the layer of cheese-cloth next to 
 the skin. 
 
 To give a simple enema, ordinary suds simple Enema 
 
 [321] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Camomile- 
 Injection 
 
 High Enema 
 
 are made with Castile or glycerin soap and 
 warm water, temperature 100 degrees. A 
 fountain-syringe to which a nozzle is at- 
 tached should be used. Fill the bag with 
 the amount of suds ordered (usually one or 
 two pints) and anoint the nozzle with vase- 
 lin. Open the spring-clasp on the tube 
 and allow the air and cold water to escape. 
 Gently insert the nozzle into the rectum and 
 allow the water to flow in a slow, steady 
 stream. The bag should be held about two 
 feet above the child's body. The child 
 should be encouraged to retain the water 
 as long as possible. 
 
 A camomile-injection is given in the same 
 manner as a simple enema. Camomile tea 
 is used by steeping one tablespoonful of 
 camomile-flowers in a quart of boiling water. 
 
 When there is considerable constipation 
 the enema will be more successful if given 
 in the knee-chest position, that is with the 
 
 [322] 
 
LOCAL EEMEDIES 
 
 patient resting on the knees and chest in 
 bed, the head very low, and nsing a long 
 flexible rubber tube on the end of the sy- 
 ringe, so that the tube can be inserted six 
 or eight inches up into the bowels. This is 
 called a high enema. It can also be given 
 with the patient lying on the left side with 
 knees drawn up. 
 
 Adding olive-oil and glycerin to a suds- on-Enema 
 enema will prove effective if the simple ene- 
 ma is not sufficient. An ounce of each is 
 sufficient to add to a pint of water. 
 
 Sometimes the physician orders an oil- 
 enema to be given first and retained for an 
 hour, followed by a simple soapsuds-enema. 
 In that case four ounces of hot oil are in- 
 jected and allowed to work slowly through 
 the bowels before giving the simple enema. 
 
 In cases of acute diarrhea, starch-enema starch-Enema 
 is sometimes ordered. A starch-enema is 
 made by mixing a dessertspoonful of starch 
 
 [323] 
 
HEALTH-CAKE OF THE GKOWING CHILD 
 
 Stimulating 
 
 Enema 
 
 Nutritive 
 Enema 
 
 with cold water into a paste and adding 
 three ounces of boiling water. The water 
 is then injected and the child encouraged to 
 retain it as long as possible. 
 
 Stimulating enemas are given in case of 
 shock or collapse and should be very hot, as 
 they will be more easily retained. The 
 usual amount is one tablespoonful of whisky 
 or brandy to four ounces of very hot water. 
 Coffee is sometimes used instead of water, 
 or it may be given alone. The enema must 
 be given high to be retained. 
 
 When the stomach is much disturbed dur- 
 ing a severe illness so that food can not be 
 digested, or after some operations on the 
 mouth or throat, nutritive enemas are given 
 to nourish the system. Various formulae are 
 used; one of the best is: peptonized milk, 
 two ounces, one egg, and a pinch of salt. 
 Beef-juice may also be given according to 
 the physician's orders. When this is the 
 
 [ 324 ] 
 
 
OINTMENTS AND LOTIONS 
 
 only form of nourishment it must be given 
 every four or five hours. A simple soap- 
 suds enema is necessary onee a day to wash 
 out the lower bowel. 
 
 OINTMENTS AND LOTIONS 
 
 Good Mouth-Washes 
 To sweeten the mouth before breakfast: 
 
 Thymol lYi grains 
 
 Alcohol 2 ounces 
 
 Borax 15 grains 
 
 Distilled water to make 1 pint. 
 
 For pimples or soreness in the mouth : 
 
 Tincture of myrrh J/2 dram 
 
 Sodium bicarbonate Yl dram 
 
 Chlorate of potassium a pinch 
 
 Distilled water 6 ounces 
 
 Tooth-Powder 
 
 Powdered chalk 1 ounce 
 
 Oil of peppermint 1 drop 
 
 [S25] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Tooth-Paste 
 
 Powdered white Castile soap. 2]/£ ounces 
 
 Precipitated chalk 2J/g ounces 
 
 Powdered orris-root 24 ounce 
 
 Oil of peppermint J/& fluid dram 
 
 Add glycerin enough to make a paste. 
 
 Sunburn-Lotion 
 
 Glycerin 1 ounce 
 
 Spirits of camphor i/4 ounce 
 
 Boiled water 4 ounces 
 
 Rose-water 4 drops 
 
 Blackheads 
 
 Resorcin 60 grains 
 
 Zinc oxid 120 grains 
 
 Starch 120 grains 
 
 Petroleum 240 grains 
 
 Apply at night. 
 
 Pimples 
 
 Ichthyol 90 grains 
 
 Ether 2J/2 fluid drams 
 
 Alcohol 4 fluid drams 
 
 Dab on spots several times a day. 
 
 [ 326 ] 
 
OINTMENTS AND LOTIONS 
 
 Dusting Powder for Excessive Perspiration 
 
 Powdered calamine 2 drains 
 
 Florentine orris-root 1 ounce 
 
 Powdered starch 3 ounces 
 
 The parts should first be wiped with alcohol 
 before applying the powder. 
 
 Bath-Lotion for Tired Muscles 
 
 Spirits of ammonia 2 ounces 
 
 Spirits of camphor 2 ounces 
 
 Sea-salt V/2 cups 
 
 Alcohol 2 cups 
 
 Put all the ingredients together in a quart bot- 
 tle and fill it with hot water. Shake well before 
 using. 
 
 Perspiration and Fetor of the Feet 
 
 Orris-powder 1 ounce 
 
 Zinc-oxid 1 ounce 
 
 Talcum powder 6 ounces 
 
 For Dandruff 
 
 Resorcin ; 8 grains 
 
 Castor-oil 1 fluid ounce 
 
 Alcohol 3 fluid ounces 
 
 Peru balsam 5 grains 
 
 Rub in the scalp daily. 
 [ 327 ] 
 
HEALTH-CAKE OF THE GROWING CHILD 
 
 Dry Shampoo 
 
 Very fine white corn-meal .... 20 parts 
 
 Powdered orris-root 1 part 
 
 Sprinkle the powder through the hair. Mas- 
 sage the scalp, being sure to rub the powder 
 over it. Shake the powder through the long 
 hair, letting it stand for half an hour. Remove 
 all the meal from the hair by means of a long- 
 fibered brush. 
 
 Lotion for Freckles, No. 1 
 
 Compound tincture of benzoin 1 fluid dram 
 
 Glycerin Yl fluid dram 
 
 Rose-water 3 fluid ounces 
 
 Lotion for Freckles, No. 2 
 
 Borax 1 dram 
 
 Dilute acetic acid Yl fluid ounce 
 
 Rose-water Yl fluid ounce 
 
 Apply night and morning. 
 
 Alum Lotion 
 
 Alum 6 drams 
 
 Water 8 fluid ounces 
 
 Alcohol 8 fluid ounces 
 
 To be used as a wash in excessive perspiration 
 or if bed-sores are threatening. 
 
 [328] 
 
INDEX * 
 
 Abdomen, cramps in, 77, 
 123, 209, 212, 228 
 
 distended, 120 
 Abscess, following measles, 
 198 
 
 of anus, 297 
 
 of ear, 160 
 
 of gum, 60 
 
 of lung, 169, 177 
 Accidents. See Injuries 
 Acidosis causing vomit, 116 
 Adenoids, 13, 1^1 
 
 causing earache, 275 
 
 causing rhinitis, 149, 151 
 Air, fresh, 12, 38 
 
 in bronchial asthma, 166 
 
 in bronchopneumonia, 169 
 
 in tuberculosis, 176, 178 
 
 in whooping-cough, 181 
 
 impure, 13 
 
 night, 15 
 Albuminized orangeade, 307 
 Alcoholic sponge bath, 9, 94 
 Alcoholic stimulation, 168 
 Alum lotion, 328 
 Amusements, 24 
 Anemia, 38, 46 
 
 caused by intestinal indi- 
 gestion, 128 
 
 Anesthetics, 263 
 
 Antidotes for poisons, 298 
 
 Antitoxin, in diphtheria, 191 
 
 in diphtheritic croup, 189 
 
 rash, 232 
 Anus, fissure of, 297 
 
 itching of, 286 
 Appendicitis, 209 
 Appetite, loss of, 90, 113 
 
 loss of, due to adenoids, 
 142 
 
 loss of, due to sore throat, 
 140 
 
 loss of, in influenza, 159 
 
 loss of, in intestinal indi- 
 gestion, 128 
 
 to stimulate, 114 
 Arrowroot pudding, 309 
 Asthma, bronchial, 164 
 Athletics. See Exercise 
 
 for nervous children, 55, 
 58 
 
 B 
 
 Backache, 319 
 
 Bad habits, 51, 78 
 
 Bathing, 6 
 
 Baths, alcohol, 9, 313 
 
 blanket, 315 
 
 bran, 316 
 
 * Where more than one reference is given, the number in Italics (for 
 example 141) refers to the main article. 
 
 [329] 
 
INDEX 
 
 Baths, cold, 80, 244, 313 
 
 foot, 300 
 
 in eruptive fevers, 314, 
 315 
 
 mustard, 246, 315 
 
 oatmeal, 316 
 
 oatmeal, in eczema, 225 
 
 ocean, 9 
 
 salt, 316 
 
 shower, 314 
 
 shower, cold, 7 
 
 sponge, 313 
 
 sponge, during menstrua- 
 tion, 76 
 
 to induce perspiration, 315 
 
 to induce sleep, 10, 314 
 
 to reduce temperature, 313 
 
 to relieve nervousness, 55, 
 59, 244, 314 
 
 to stimulate appetite, 114 
 
 tonic, 316 . 
 
 tub, 6, 3U 
 
 warm, 8 
 
 warm, for sleeplessness, 10 
 Bed-bugs as disease carriers, 
 
 156 
 Bedsores, lotion for, 328 
 Bed-wetting caused by ade- 
 noids, 142, 145, 292 
 Beef-juice, 308 
 Beef, scraped, 313 
 Belching, 61 
 Bicycle riding, 133 
 Bites, insect, 222 
 Blackheads, lotion for, 326 
 Bladder, 4 
 
 weak, 292 
 Bleeder, 263 
 Bleeding, 263, 281, 284 
 
 from anus, 298 
 
 from nose, 285 
 
 in brain concussion, 249 
 
 Bleeding, in scurvy, 135 
 Blindness, from gonorrheal 
 infection, 82 
 
 from trachoma of eyelids, 
 279 
 Blisters, 282 
 
 in mouth, 279 
 
 lotion for, 325 
 
 water, 194 
 Blood, examination during 
 reduction diet, 110 
 
 poisoning, 281 
 
 test, for malaria, 212 
 
 test for syphilis, 150 
 Bones, in rickets, 131 
 Bowels, 118 
 
 function of, 3, 43, 122 
 
 loose, 45, 122 
 
 loose, in intestinal in- 
 digestion, 128 
 
 training of, 43, 122 
 Bowlegs, 131 
 Brain, concussion of, 248 
 Bran bath, 316 
 
 poultice, 321 
 Breasts, development of, 75 
 Breath, 60 
 
 in tonsillitis, 147 
 
 sour, 116 
 Breathing, correct, 25 
 
 difficult, 164 
 
 in croup, 185 
 
 in diphtheritic croup, 188 
 
 suspended, in convulsions, 
 245 
 Bronchial asthma, 164 
 Bronchitis, 152, 161 
 Bronchopneumonia, 166 
 Broths, 308 
 Bruises, 280 
 Brush, hair, 70 
 
 hair, wire, 72 
 
 [330] 
 
INDEX 
 
 Brush, tooth, 63 
 Burns, 282 
 from sun, 230 
 
 Calf's foot jelly, 307 
 Calomel, to reduce fever, 92 
 
 to relieve congested liver, 
 166 
 Camomile injections, 127, 
 
 318 
 Camp-life, 44, 1^6 
 Canned-foods, 135 
 Carbolic acid poisoning, 300 
 Carelessness, 54 
 Carrier of disease, 154, 205 
 Catarrh, 148 
 
 intestinal, 10, 37 
 
 of the head, 13, 37 
 
 of the head, causing ade- 
 noids, 141 
 
 of the head, causing loss 
 of appetite, 113 
 
 syphilitic, 150 
 Catarrhal influenza, 159 
 Cathartics. See Laxatives 
 Cereals, 312 
 Cerebrospinal meningitis, 
 
 250 
 Characteristics of childhood, 
 
 47 
 Chest, deformity of, 145 
 
 flat, 258 
 
 in pleurisy, 152 
 
 wheezing of, 164 
 Chest-weight exercise, 29 
 Chicken broth, 308 
 
 jelly, 311 
 
 pox, 194 
 Chills, in lobar pneumonia, 
 170 
 
 Chills, in malaria, 212 
 Chorea, 243 
 Circulation, 11 
 Clothing, 36 
 
 bed, 20 
 
 during exercise, 26 
 Coated tongue, 60 
 Cocoa, 307 
 Coddled egg, 312 
 Cold, applications of, 317 
 
 baths, 7 
 
 hands and feet, 27, 212 
 
 in the head, 91, 144, U8 
 
 in the head, a symptom of 
 influenza, 159 
 
 in the head, a symptom of 
 measles, 150, 196 
 
 prevention of, 6 
 
 shower, 6 
 
 taking, 13 
 Colic, 123, 121 
 Comb, 71 
 Compress, 317 
 Concussion of the brain, 248 
 
 causing vomiting, 115 
 Condiments, 98 
 Constipation, 43, 77, 86, 119 
 
 causing loss of appetite, 
 113 
 
 diet in, 97 
 Consumption. See Tubercu- 
 losis 
 Contagious diseases, 154 
 Convalescence, 46 
 Convulsions, 245 
 
 caused by worms, 287 
 
 in tuberculous meningitis, 
 250 
 Cooling lotions, 281, 325 
 Corn-starch pudding, 309 
 Corporal punishment, 53 
 Cough, 151 
 
 331] 
 
INDEX 
 
 Cough, a symptom of in- 
 fluenza, 159 
 
 a symptom of measles, 196 
 
 croupy, 185, 187 
 
 in bronchopneumonia, 167 
 
 whooping, 180 
 Cramps, 123, 121 
 
 during menstruation, 77 
 Crisis, in bronchopneumonia, 
 167 
 
 in lobarpneumonia, 171 
 Croup, 185 
 
 diphtheritic or true, 187 
 
 false, 185 
 Crusted eyelids, 277 
 Curiosity, 49 
 
 Curvature of spine, 35, 255 
 Custard, 309 
 Cuts, 280 
 
 D 
 
 Dandruff, 237 
 
 lotion for, 327 
 Deafness caused by adenoids, 
 
 143 
 Decayed teeth, 60, 63 
 Delirium, 159 
 Dentition, 64, 65 
 Despondency, 53 
 Desquamation, in measles, 
 197 
 
 in scarlet fever, 201 
 Development. See Puberty 
 Diarrhea, 122 
 
 diet in, 112 
 
 in influenza, 159 
 Diet, 97 
 
 causing eczema, 224 
 
 causing rickets, 131 
 
 during fever, 92 
 
 during menstruation, 77 
 
 Diet 
 
 for a child over ten years 
 of age, 107 
 
 for a child six to ten years 
 old, 102 
 
 for a child three to six 
 years old, 100 
 
 for a child with weak di- 
 gestion, 102 
 
 for a lean child, 97, 108 
 
 for an underweight child, 
 108 
 
 for a very fat child, 110 
 
 in constipation, 97, 121 
 
 in diarrhea, 112, 127 
 
 in eczema, 224 
 
 in fever, 112 
 
 in intestinal indigestion, 
 128 
 
 in rickets, 132 
 
 in scurvy, 135 
 
 in tuberculosis, 176 
 
 in typhoid, 208 
 
 in whooping-cough, 183 
 
 peculiarities of taste in, 
 98 
 
 reduction, 110 
 Diphtheria, 190 
 
 antitoxin in, 189, 191 
 
 disinfectant in, 17, 193 
 
 paralysis following, 253 
 Diphtheritic croup, 187 
 Discharging ear, 144, 154 
 
 nose, 142, 1^8 
 
 vagina, 154, 295 
 Discipline. See Punishment 
 
 of nervous children, 57 
 Disinfection, 156, 193 
 
 after scarlet fever, 202 
 Draughts, 15 
 Dreams, 21 
 Dry, heat, 318 
 
 [332] 
 
INDEX 
 
 Dry, shampoo, 328 
 Dysentery, 123 
 
 E 
 
 Ear abscess, 160 
 
 Earache, 275 
 
 Ears, bleeding from, 249 
 
 discharging, 144, 154, 198 
 
 foreign bodies in, 274 
 
 syringing of, 274 
 Eczema, 223 
 
 Education. See Scho 1 Hy- 
 giene 
 Egg, coddled, 312 
 
 poached, 312 
 
 yolk of, in lemonade, 307 
 Egg-nog, 307 
 
 Elimination, channels of, 3 
 Emetics, in croup, 186 
 
 in poisoning, 299 
 Emissions, seminal, 78 
 Empyema, 177 
 
 following measles, 198 
 Enema, 321 
 
 camomile, 128, 322 
 
 high, 322 
 
 nutritive, 324 
 
 oil, 323 
 
 salt water, 301 
 
 soap water, 321 
 
 soda, 125 
 
 starch, 323 
 
 stimulating, 301, 323 
 
 to relieve headache and re- 
 duce temperature, 148 
 Enlarged glands. See Glands 
 Environment, 49 
 
 for nervous children, 57 
 Eructations, 61 
 Eruption. See Rashes, also 
 Eczema 
 
 Eruption, in chicken-pox, 194 
 in typhoid fever, 206 
 
 Erysipelas, 226 
 
 Examination of throat, 139 
 
 Exercise, 24 
 
 during menstrual period, 
 
 26, 16 
 for the teeth, 62 
 for weak ankles, 133 
 hanging or heaving, 34 
 lack of, resulting in in- 
 testinal indigestion, 129 
 mat, 32 
 
 pulley-weight, 29 
 special, for girls, 32 
 wand, 28 
 
 Expectoration, in pneu- 
 monia, 170 
 in tuberculosis, 172 
 
 Eye-glasses, 258 
 smoked, 277 
 
 Eyelids, discharging, 277 
 in trachoma, 279 
 pustules on, 278 
 
 Eyes, blood-shot, 249, 277 
 care of, during measles, 
 
 199 
 dark rings under, 80 
 dull, in measles, 197 
 fixed or staring, in con- 
 vulsions, 245 
 fixed or staring, in men- 
 ingitis, 250 
 pink-eye, 277 
 
 sore, following measles, 
 198 
 
 F 
 
 Fainting, 270 
 
 Fall, 283 
 
 False croup, 185 
 
 [333] 
 
INDEX 
 
 Fear, 48 
 
 Feeding. See Diet 
 
 interval, 100 
 
 quantity required, 99 
 
 too much, causing sleep- 
 lessness, 20 
 Fever, 88 
 
 calomel treatment of, 92 
 
 diet in, 92, 112 
 
 in bronchitis, 161 
 
 in bronchopneumonia, 167 
 
 in influenza, 159 
 
 in lobarpneumonia, 171 
 
 in malaria, 213 
 
 in measles, 197 
 
 in rheumatism, 217 
 
 significance of, 91, J 
 
 sores, 279 
 
 sudden rise of, 93 
 Finger-nails, bluish, 164 
 Fissure of the anus, 297 
 Flaxseed poultice, 320 
 Flies as disease carriers, 156 
 Food recipes, 306 
 Foot-bath, mustard, 300 
 Foreign bodies in the ear, 
 
 274 
 Foreskin, tight, 292 
 
 hygiene of, 83 
 Foul breath, 60 
 Freckles, lotion for, 328 
 Fresh air, 12, 38 
 Fright, 48 
 
 causing vomiting, 115 
 Frost-bite, 231 
 
 G 
 
 Games, 25 
 
 Gas, in intestines, 3, 127 
 
 in stomach causing foul 
 breath, 60 
 
 laxative for, 61 
 
 Genital organs, care of, 82 
 development of, 75 
 male, 77 
 
 German measles, 200 
 
 Glands, 130, 266 
 
 enlarged, 172. See also 
 
 Mumps 
 in diphtheria, 190 
 in diphtheritic croup, 187 
 in German measles, 200 
 in scarlet fever, 202 
 tuberculosis of, 176, 268 
 
 Grinding of teeth, 145 
 
 Grippe. See Influenza 
 
 Growing pain, 214 
 
 Growth in height and 
 weight, 74 
 
 Gruels, 312 
 
 Gum-boil, 67 
 
 Gums, in scurvy, 135 
 
 Gymnastics, lung, 24, 172 
 
 Habit-spasm, 244 
 Habits, 48 
 
 bad, 49, 51, 78 
 Hair brush, 70 
 Hair, care of, 68 
 
 comb, 71 
 
 matted, 72 
 Handball, 27 
 Hands, cold, 27 
 Hanging or heaving, 34 
 Hardening a child, 38, 92, 
 
 132 
 Headache, 257, 315 
 
 caused by acidosis, 116 
 
 caused by constipation, 
 120 
 
 caused by decayed teeth, 
 63 
 
 [334] 
 
INDEX 
 
 Headache, caused by intes- 
 tinal indigestion, 128 
 
 caused by sore throat, 141 
 
 in influenza, 159 
 
 in tonsillitis, 147 
 
 to relieve, 148 
 Head, hot, 94 
 Head-lice, 235, 268 
 Heat, application of, 318 
 Height, 74 
 
 Heliotherapy, 17, 176 
 Hemorrhage. See Bleeding 
 Hernia, 265 
 Hiccup, 273 
 High enema, 322 
 Hip-joint disease, 215 
 Hives, 232 
 
 soda-bath for, 316 
 Hoarseness. See False Croup 
 Hookworm disease, 291 
 Hop poultice, 321 
 Hot pack, 315 
 Hot-water bottle, 318 
 
 to relieve cramps, 127 
 Hygiene, faulty, causing in- 
 testinal indigestion, 128 
 
 faulty, causing rickets, 
 131 
 
 of the hair and scalp, 68 
 
 of the mouth, 62 
 
 school, 40 
 
 sex, 76 
 
 Inflammation, 281 
 
 mastoid, 160 
 
 of joints and muscles, 216 
 Inhalation, steam, 181 
 Injections. See Enema 
 Injuries, 280 
 Inquisitiveness, 49 
 Insect-bites, 222 
 Insomnia, 10 
 
 bath to relieve, 314 
 
 caused by adenoids, 145 
 Intestinal, catarrh, 10 
 
 indigestion, 128 
 
 neuralgia, 211 
 Intubation in diphtheria, 
 
 189 
 Ipecac, syrup of, dosage, 186 
 Irrigation. See Enema 
 Irritability, 19 
 Isolation, in croup, 189 
 
 in diphtheria, 192 
 
 in measles, 199 
 
 in pinkeye, 277 
 
 in scarlet fever, 202 
 
 in whooping-cough, 182 
 Itch, 233 
 Itching, to allay, 195 
 
 in eczema, 223, 224 
 
 in measles, 199 
 
 of frost-bite, 231 
 
 of insect-bites, 222 
 
 of ivy-poison, 230 
 
 of the anus, 286, 297 
 
 Ice-bag, 318 
 Ice-cream, 130, 211 
 Imitation, power of, 48 
 Indigestion, intestinal, 128 
 caused by foul air, 14 
 Indoor-exercise, 29 
 Infantile paralysis, 254 
 
 Jacket, pneumonia, 321 
 Jaws, deformity of, caused 
 
 by adenoids, 143 
 stiffened, in convulsions, 
 
 245 
 Joint rheumatism, 216 
 
 [335] 
 
INDEX 
 
 Joints, pain in, 214 
 Junket, 308 
 
 K 
 
 Kidneys, function of, 4 
 in scarlet fever, 203 
 to stimulate, 94, 148 
 
 Kissing, 151, 172 
 
 Laxative, foods, 121 
 
 for foul breath, 61 
 
 for reduction, 111 
 
 in diarrhea, 112 
 
 in eczema, 224 
 
 in influenza, 161 
 
 to reduce fever, 92 
 Lemonade, cream of tartar, 
 222 
 
 nutritious, 307 
 Leucorrhea, 295 
 Lice, head, 235, 268 
 Lips, bluish, 164 
 Lobar pneumonia, 170 
 Local remedies, 313 
 Loose bowels. See Diarrhea 
 
 diet in, 97 
 Lotions, 325 
 
 Lung gymnastics, 24, 179 
 Lungs, function of, 5 
 
 M 
 
 Malaria, 212 
 
 Mastication, imperfect, 119, 
 
 130 
 Mastoid inflammation, 160, 
 
 276 
 Masturbation, 21, 78, 83, 287 
 
 Matted hair, 73 
 Meals. See Diet 
 Measles, 196 
 
 German, 200 
 Membranous croup, 187 
 Meningitis, tuberculous, 249 
 Menstruation, 75, 259 
 Mental breakdown, 56 
 Mid-day rest, 18 
 Milk, 99, 174, 305 
 
 peptonized, 306 
 
 teeth, 65 
 Mosquito, as disease carrier, 
 156 
 
 bites, 222 
 Mouth, blisters of, 279 
 
 hygiene of, 62 
 
 sore, 279 
 
 wash, 325 
 Mouth-breathing, 142 
 Movements. See Bowels 
 Mumps, 184 
 Muscles, in rickets, 131 
 
 pain in, 147, 214, 216 
 
 tired, lotion for, 327 
 Mustard foot-bath, 300, 315 
 
 poultice, 320 
 Mutton soup, 308 
 
 N 
 
 Nails, bluish, 164 
 Nature's demands while at 
 
 school, 43 
 Nephritis, 204 
 
 hot pack in, 315 
 Nervous children, 28, 46, 55 
 Nervous system, disturbance 
 of, 287 
 
 during puberty, 75 
 
 toning of, 6, 10 
 
 [336] 
 
INDEX 
 
 Nervous vomit, 115 
 Neuralgia of intestines, 211 
 Night, air, 15 
 
 cough, 151 
 
 terrors, 251 
 Niter, sweet spirits of, 94 
 Nose, pinched, in adenoids, 
 143 
 
 regurgitation of food 
 through, 253 
 
 running, 142, 11,8, 196 
 Nosebleed, 46, 259, 285 
 
 in brain concussion, 249 
 Nurse maid, 47, 49 
 Nutrition, 95 
 Nutritive enema, 324 
 
 O 
 
 Oatmeal bath, 316 
 
 in eczema, 225 
 Obedience, 40, 51 
 Ocean bath, 9 
 Oil, enema, 323 
 
 injections, 323 
 Oil-silk jacket, 321 
 Ointments, 325 
 One-child families, 54 
 Operations, 263 
 Orangeade, albuminized, 307 
 Out-door life, 38 
 
 in rickets, 132 
 
 in tuberculous pneumonia, 
 173 
 
 Pack, wet, 315 
 Pain, growing, 214 
 in abdomen, 210 
 in arms and legs, 216 
 
 Pain, in joints and muscles, 
 214, 216 
 
 in neck and back, 216 
 Pallor of skin, 12 
 Paralysis, 253 
 
 following diphtheria, 191 
 Paregoric poisoning, 300 
 Peculiarities of childhood, 47 
 Peptonized milk, 306 
 Perspiration, 2%, 36 
 
 dusting powder for, 327 
 
 lotion for, 328 
 Pertussis. See Whooping- 
 cough 
 Pigeon-breast, 145, 172 
 Pimples, lotion for, 326 
 Pinkeye, 277 
 Pleurisy, 152 
 Pneumonia, 166 
 
 influenzal, 160 
 
 jacket, 321 
 
 lobar, 170 
 
 tuberculous, 172 
 Poison-ivy, 229 
 Poisons and antidotes, 298 
 Poliomyelitis, 254 
 Polypus, 285 
 Poultices, 320 
 
 bran, 321 
 
 flaxseed, 320 
 
 hop, 321 
 
 mustard, 320 
 
 raisin, 68 
 Precocious children, 58 
 Prescriptions. See Oint- 
 ments and Lotions 
 Puberty, 46, 75 
 Puddings, 309 
 Pulley-weight exercise, 29 
 Punishments, 50 
 
 corporal, 53 
 Purgatives. See Laxatives 
 
 [337] 
 
INDEX 
 
 R 
 
 S 
 
 Raisin poultice, 68 
 Rash, 94 
 
 bringing out the, 314, 315 
 
 in chicken-pox, 194 
 
 in German measles, 200 
 
 in ivy-poisoning, 230 
 
 in measles, 197 
 
 in scarlet fever, 201 
 
 stomach, 221 
 Rashes, 221 
 
 food, 232 
 Raw beef, scraped, 313 
 Reduction diet, 110 
 Remedies for local use, 313, 
 
 325 
 Restlessness, 19, 37, 250 
 
 at night, 21 
 
 due to adenoids, 142 
 
 due to worms, 288 
 Retention of urine, 4 
 Rewards, 50 
 Rheumatism, 215 
 Rhinitis, 148 
 
 caused by adenoids, 149 
 Rice pudding, 310 
 Rickets, 131 
 
 causing weak ankles, 133 
 Riding, bicycle, 133 
 Riggs's disease, 65 
 Ringworm, 227 
 Roller-skates, 25 
 
 for developing weak an- 
 kles, 133 
 Round shoulders, 35 
 Roundworms, 288 
 Rowing, 26 
 Running ear, 144 
 
 nose, 142, U8 
 Rupture, 181. See also Her- 
 nia 
 
 [ 
 
 Sago pudding, 310 
 Salt bath, 316 
 Scald. See Burn 
 Scalp, to clean, 69 
 Scarlet fever, 201 
 School, 40 
 
 boarding, 42 
 
 exercise in, 28 
 
 hygiene, 40 
 
 open-air classes, 38 
 Scraped beef, 313 
 Sea-baths, 9 
 Sea, wading in, 10 
 Self-abuse, 80 
 Seminal emissions, 78 
 Sex-hygiene, 76 
 Shampoo of the scalp, 69 
 
 dry, 328 
 Sitz bath, 296 
 Skating, 26 
 Skin, 3, 11 
 
 diseases of, 221 
 
 effect of impure air on, 12 
 
 in erysipelas, 226 
 
 in intestinal indigestion, 
 128 
 
 in ivy-poisoning, 229 
 
 overheated, 36 
 
 pallor of, 12 
 
 peeling, in scarlet fever, 
 201 
 Skipping-rope, 26 
 Sleep, 18 
 
 medication during, 163 
 Sleeplessness, bath for, 10 
 Small-pox. Facing page 84 
 Sneezing, 148 
 Snoring, 142 
 Soda bath, 316 
 
 injections, 125 
 
 338] 
 
INDEX 
 
 Sore eyes, 277 
 
 Sore mouth, 279 
 
 Sore throat, 92, 217. See 
 
 also Tonsillitis 
 Soups, 308 
 
 Sour breath, 116, 147 
 Spasm, 245 
 
 habit, 244 
 
 in whooping-cough, 180 
 Speech defect, 238 
 Spices, 98 
 Spinal douche, 80 
 Spine, curvature of, 35, 255 
 Splinters, 283 
 
 Spoiled stomach, 40, 91. See 
 also Vomit, also Indi- 
 gestion 
 Sponge bath, 313 
 
 during menstruation, 76 
 Sports and games. See 
 
 Amusements 
 Sprains, 283 
 Stammering, 238 
 Standing or walking, cor- 
 rect, 134 
 Starch enema, 323 
 Staring in convulsions, 245 
 
 in meningitis, 250 
 Steam inhalation, 181 
 Sties, 278 
 
 Stimulating enema, 324 
 Stimulation, alcoholic, 168 
 Stomach, capacity, 99 
 
 disordered, 115 
 
 growth in, 115 
 
 rash, 221, 232 
 
 spoiled or overloaded, 91 
 Stools. See also Bowels 
 
 dry and hard, 211 
 
 explosive, 125 
 
 loose, 122 
 Stuttering, 238 
 
 [339 
 
 Sulfur bath, 316 
 Summer vacations, 44 
 Sunburn, 230 
 
 lotion for, 326 
 Sunlight, 17 
 
 as a disinfectant, 193, 202 
 
 in tuberculosis, 76 
 Swelling, 281 
 Swimming, 26 
 
 during menstruation, 76 
 Syphilis conveyed by kiss- 
 ing, 157 
 Syphilitic catarrh, 150 
 
 Tan. See Sunburn 
 Tapeworm, 289 
 Tapioca pudding, 310 
 Taste, peculiarities in, 98 
 Teeth, cleaning of, 62 
 
 grinding of, 145, 288 
 
 in rickets, 131 
 
 irregular, 64 
 
 permanent, 64, 65 
 
 protruding, 143 
 Temperature, 88. See also 
 Fever 
 
 how to take, 89 
 
 in typhoid fever, 206 
 
 of baths, 6 
 Tennis, 26 
 
 during menstruation, 76 
 Thermometer, clinical, 89 
 Thirst, in diphtheria, 191 
 
 in measles, 196 
 
 to quench, 148 
 Throat, 139. See also 
 Frontispiece 
 
 in diphtheria, 190 
 
 in scarlet fever, 202 
 
 ] 
 
INDEX 
 
 Throat, sore, 92, 217. See 
 
 also Tonsillitis 
 Thrush, 61 
 Tight foreskin, 292 
 Tongue, coated, 60 
 
 dry, 147 
 
 in scarlet fever, 201 
 Tonics, 38 
 
 after diarrhea, 126 
 
 nerve, 6 
 Tonsillitis, 146. See also 
 Frontispiece 
 
 rheumatic, 217 
 Tonsils, enlarged, 139. See 
 also Frontispiece 
 
 causing vomiting, 115 
 Toothache, 67, 319 
 
 powder, 325 
 Trachoma, 279 
 Tub baths, 6 
 
 during menstruation, 76 
 Tuberculosis, 173 
 
 cough in, 153 
 
 disinfectant in, 17 
 
 following bronchitis, 162 
 
 heliotherapy in, 17 
 Tuberculous meningitis, 249 
 Tuberculous pneumonia, 172 
 Twitching, 48, 21,3 
 Typhoid fever, 205 
 
 sunlight in, as a disin- 
 fectant, 17 
 
 U 
 
 Urine, 94 
 
 amount passed daily, 4, 
 
 294 
 examination of, before 
 
 operations, 264 
 incontinence of, 292 
 in scarlet fever, 202 
 
 Urine, in typhoid fever, 207 
 
 retention of, 294 
 
 scanty, 94 
 Urticaria. See Hives 
 
 V 
 
 Vacation, where to spend, 4 
 
 Vaccination, 84 
 
 Vaginitis, 287. See also 
 
 Leucorrhea 
 Veins, prominence of, on 
 
 scalp, 251 
 Ventilating window-box, 16 
 Ventilation, 12 
 Vermin, head, 235 
 Virginia creeper. See illus- 
 tration facing page 230 
 Vomiting, 91, 99, 115 
 
 in brain concussion, 249 
 
 influenza, 159 
 
 in scarlet fever, 201 
 
 in tonsillitis, 147 
 
 in whooping-cough, 180 
 
 W 
 
 Wading, 10, 211 
 Walking, correct, 134 
 
 jerky, 243 
 Wand exercise, 28 
 Warts, 234 
 Washing out the bowels. 
 
 See Enema 
 Wassermann blood test, 150 
 Water-ice, 130 
 Weight, 74 
 
 loss of, 19, 129, 152 
 Wetting the bed, 142, 145, 
 
 292 
 Wheezing, 164, 186, 188 
 
 [340] 
 
INDEX 
 
 Whooping-cough, 151, 180 Worms, causing abdominal 
 
 tuberculous pneumonia pain, 212 
 
 complicating, 172 hook, 291 
 
 Window-board, 16 tape, 289 
 
 Worms, 21, 286 Wounds. See Injuries 
 
 [341] 
 

ADVERTISEMENTS 
 
JUST THE BOOK FOR MOTHERS 
 
 THE 
 
 HEALTH-CARE 
 OF THE BABY 
 
 By LOUIS FISCHER, MD. 
 
 Author of "Infant Feeding in Health and Disease." "A Text-book 
 
 on Diseases of Infancy and Childhood." Attending Physician 
 
 to the IVillard Parker and Riverside Hospitals. New York, 
 
 Former Instructor in Diseases of Children at the New York 
 
 Post-Graduate Medical School and Hospital, etc. 
 
 Sixth Revised Edition. Price, Seventy-five Cents, Net 
 
INDISPENSABLE TO MOTHERS 
 
 A PHYSICIAN can not always be at hand to answer 
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