A 584072

ARTES
1837
SCIENTIA
LIBRARY
VERITAS
OF THE
UNIVERSITY OF MICHIGAN
E PLURIBUS UNUM
TURBUR
SQUAERIS PENINSULAM AMOENAM
CIRCUMSPICE
HOMOEOPATHIC
LIBRARY
46.18.9
T5-6
A GUIDE
FOR
MOTHERS AND NURSES
IN THE
MANAGEMENT OF YOUNG CHILDREN ;
WITH REFERENCE TO HEREDITARY, OR FAMILY DISEASES;
AND ADVICE TO THE PREGNANT, AND LYING-IN FEMALE.
Compiled, in part, from the best English and American Writers.
BY CALEB TICKNOR, A.M., M.D.
Late Prof. of Hygiene in the University of the City of New-York:
Author of" the Philosophy of Living ;" (No. 77, Harper's Family Library ;)
"An Exposition of Quackery and Imposture in Medicine," &c. &c.
NEW-YORK:
TAYLOR & DODD,
LATE JOHN S. TAYLOR.
1839.
H618.9
T56
Entered according to the Act of Congress, in the year 1839, by
TAYLOR & DODD,
in the Clerk's Office of the District Court of the United States, for
the Southern District of New-York.
G. F. HOPKINS, 2 ANN-STREET.
Lyst
Dedication.
TO MY COUNTRYWOMEN,
WHO HAVE THE HAPPINESS TO BE MOTHERS,
These Pages are Enscribed,
WITH THE HOPE THAT THEY MAY BE INSTRUMENTAL
IN DIMINISHING THE SUFFERINGS,
AND PRESERVING THE LIVES
OF THEIR OFFSPRING.
171277
TO THE READER.
-
THE chief reasons which induced me to perpare
this work, are the general ignorance of the per-
sons, for whom it is designed, in relation to the sub-
jects of which it treats, the great interest with
which I always regard children,—and my sym-
pathy for their sufferings, in consequence of the
mismanagement of those whose duty and happi-
ness it is to provide for their necessities and
comforts.
With the desire of doing the greatest good, I have
availed myself of the observations and labors of
many of the most eminent men who have written
on the management of children; and have inter-
spersed such remarks of my own as my limited
opportunities have enabled me to make. The
excellent work of Professors Maunsell and Evanson
of Dublin has been laid under contribution, and
that part of it which treats of the management of
children, has been divested of its technicalities,
somewhat altered, and appropriated to my own
use.
1*
iv
TO THE READER.
Whenever I have found any thing to answer
my purpose in the works of Sir James Clark,
Prof. Dewees, Prof. Eberle, Esquirol, and others,
I have not hesitated to use it.
The plan of managing children with reference
to their hereditary predisposition to disease, I do
not recollect ever to have seen more than glanced
at in any work on the subject; it is the true plan
upon which to rear children, it is the only one
upon which they can be reared. This view of
the subject is novel to most persons, and I doubt
not will be peculiarly so to most of my readers;
and my only regret is that I have not been able to
extend my remarks, and treat the subject as ably
and fully as it deserves.
Of one thing, however, I am confident, and
may be allowed to express my conviction of its
truth, that is, that if all the precepts contained
in the following pages are honestly carried into
practice, much sickness and suffering in this world,
from the cradle to the grave, will be prevented.
NEW-YORK, July, 1839.
C. T.
Page Missing
in Original
Volume




Page Missing
in Original
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CONTENTS.
CHAPTER I.
OF THE CONDUCT OF MOTHERS DURING PREGNANCY.
SEC. I.
Diet during Pregnancy, - Popular Error, -Dan-
ger of Abortion, · Acid Stomach, Costive-
ness, Heart-burn, -Flatulency, &c.
SEC. II. Nausea and Vomiting, -Morning Sickness,
Pains, Cramps, - Numbness, &c.
SEC. III. Bleeding for Pains in the Head, Giddiness, &c.,
PAGE
-
13
20
not always necessary,
SEC. IV.
Stimulating Drinks,
other Remedies,
21
22
SEC. VI.
SEC. V. Longings, -Indulgence of the Appetite,
Dress and Exercise,-Tight Lacing, &c.
23
24
SEC. VII.
The Passions, - Anger, Jealousy, — Grief, -
&c.
26
SEC. VIII. The Effect of the Mother's Imagination upon
the Fetus,
SEC. IX. Attention to the Breast and Nipples,
Summary of Advice to the Pregnant Female,
CHAPTER II.
27
29
30
RULES TO BE OBSERVED BY THE MOTHER DURING CONFINEMENT.
SEC. I. Bandaging, Diet, -Sitting up, &c.
SEC. II. The Breast, Nipples, &c.
34
36
•
viii.
CONTENTS.
CHAPTER III.
PECULIARITIES OF THE INFANT STRUCTURE AND CONSTITUTION.
PAGE
SEC. I. General Considerations,
37
SEC. II. Digestive Organs,
SEC. III. Organs of Respiration,
their difference from those of
Adults, &c.
-
42
changes that occur,-
SEC. IV.
SEC. V.
Activity of Respiration, Circulation, &c.
Organs of Circulation, -Lungs, Heart, &c.
System of Brain and Spinal Marrow,- Difference
between the Brain of an Infant and Man,-
Seeing, Hearing, Taste, Speech,
47
49
Touch, &c.
-
51
SEC. VI.
SEC. VII.
-
58
- Secre-
Apparatus for Walking, - Bones, -- Muscles,
Growth,- Digestion, — Respiration,
tion,
OPEN MA
Perceptive Faculties brought into Ac-
tion, -- Growth of Organs of the Senses, Intel-
lect, &c.-Growth of Organs of Voluntary
Motion, Growth of Skeleton, — Growth of
Brain, Head varies in Shape,- Mental Fac-
ulties not developed at once, - Different de-
grees of Talent in Children, Smartest Boy
not always the smartest Man, &c. &c.
-
CHAPTER IV.
MANAGEMENT AND PHYSICAL EDUCATION OF CHILDREN.
SEC. I. Management immediately after Birth,
SEC. II. Washing,
·
SEC. III.
Dress,
Wearing Caps,
SEC. IV. Medicine Immediately after Birth,
60
-
78
81
8888
82
86
CONTENTS.
ix
PAGE
SEC. V. Food immediately after Birth,
SEC. VI. Food in the First Period,
-
89
91
SEC. VII.
Wet Nursing, Milk, Difference between
Cows' Milk and Human Milk,
Cows' Milk
not good for Children,
-
96
SEC. VIII.
SEC. IX.
Choice of a Nurse,
Artificial Feeding
102
104
Additional remarks on the Food of Infants, -
how the quality of the Milk is altered, -- Nurs-
ing is good for the Mother, - Feeding Gin, Es-
sences, Paregoric, &c., Infants are made
Drunkards, Cramming Infants, -- Ginger-
bread containing Jalap,
Stewed Prunes, 108
J
SEC. X.
Weaning,
*
118
SEC. XI.
Food in the Second Period, - Regular hours for
Feeding,
SEC. XII. Cleanliness, -- Washing, -- Evacuations, &c.
SEC. XIII. Clothing,
SEC. XIV. Sleep,
Cradles,
Early Rising,
Child's Bed,
·
119
126
-
130
135
1
I
-
137
139
1
140
The Nursery,
SEC. XV. Exercise,
Walking, - Running, — Playing,
Exposure to Air, --Hardening, &c.
141
-
143
-
144
148
SEC. XVI. Medicine,
SEC. XVII. Light,-its Influence upon Plants and Ani-
mals,
SEC. XVIII. Air,
SEC. XIX. Temperature,
159
160
161
X.
CONTENTS.
CHAPTER V.
MENTAL AND MORAL EDUCATION.
PAGE
Memory of Young Children should not be burdened, -- Per-
ceptive Faculties cultivated, -- Moral Faculties
cultivated, --Music should be taught, &c.
CHAPTER VI.
Age when Teeth appear,
TEETHING.
Number of Teeth, -- Cutting the
163
Gums, -- Fits from Teething, --Eruptions, &c. 184
CHAPTER VII.
its Causes,
190
Cholera Infantum or Summer Complaint,
confined to Cities,
CHAPTER VIII.
The Responsibilities and Duties of a Nurse,
CHAPTER IX.
HEREDITARY DISEASES.
General Law of Transmission, Curious in its Operations,
- Why the Children of Distinguished Men do
not inherit their Parents' Talents,
that are hereditary,
193
Diseases
200
SEC. I. Consumption, and Scrofula in all its Forms, — Num-
ber of Deaths from Consumption, --New-York,
--London, -- Opinion of Sir James Clark,
Preventives, — Suckling, -Bathing, — Air,
Exercise, — Diet, -Clothing,- Education,
not sent to School early, - Young Ladies'
Boarding Schools injurious to Health,— Pre-
ventive Measures,
207
CONTENTS.
xi.
CHAPTER X.
APOPLEXY AND OTHER AFFECTIONS OF THE BRAIN.
Number of Deaths from these Diseases, in proportion to other
Diseases,― Causes, - Preventives,
CHAPTER XI.
INSANITY.
PAGE
220
Management,
Preventives, &c.
-
227
CHAPTER XII.
DYSPEPSIA, HYPOCHONDRIA, AND OTHER AFFECTIONS OF THE
DIGESTIVE ORGANS.
Affections of the Stomach, acquired by bad Management,
Unhealthy Mothers should not nurse their Chil-
dren,- Proper Course,
CHAPTER XIII.
230
GOUT AND RHEUMATISM.
How they are to be Prevented,
235
CHAPTER XIV.
Marriage,
238
A GUIDE FOR MOTHERS AND NURSES, &c.
CHAPTER I.
OF THE CONDUCT OF MOTHERS DURING PREG-
NANCY.
THE well-being of the fetus is so immediately de-
pendent upon whatever affects the maternal sys-
tem, that the moment conception has taken place,
there are new, most important, and sacred duties
to be performed by the female.
Pregnancy is not a disease, but a natural health-
ful state; and yet it is such an unusual state, and
gives rise to such powerful and pervading sym-
pathies, that we have a combination of circum-
stances peculiarly calculated to increase the lia-
bility to disease from the influence of irritating
and exciting causes.
2
14
A GUIDE FOR MOTHERS AND NURSES.
SECTION I. Diet during Pregnancy. The pecu-
liar tendency to febrile irritation, and general pleth-
ora, attendant upon pregnancy, the sensibility of the
stomach, and its sympathies with the uterus, often
causing morbid appetite, nausea, and vomitings,
render it indispensable that some attention should
be paid to diet.
It is a popular opinion, — though an erroneous
one that women during gestation require more
food, and that of a more stimulating character,
than at other times. The foundation of this erro-
neous notion is in the idea that the fetus requires
the additional amount of food which the mother
craves. But there is little reason to believe that
the slow growth of the child requires three times
the quantity, which is often taken, that is neces-
sary to support the mother when not carrying the
child within her.
When there is a strong morbid appetite, it is
indispensable to exercise a great deal of firmness
and good sense, to withstand its importunities;
keeping, at the same time, a steady eye upon the
evil consequences of indulgence. A woman in
this interesting situation need not be compelled to
adopt a system of abstinence, or rigid diet; but
she ought by all means to pursue a course not at-
A GUIDE FOR MOTHERS AND NURSES.
15
tended with risk—the happy medium. Let her
diet be plain, of a mixed character, consisting of
tender meat, if she has been accustomed to it, fa-
rinaceous articles, and a moderate proportion of
vegetables, if they have formerly agreed with the
stomach, and ripe fruits. All kinds of pastry and
sweet-meats should, in general, be avoided, as
they are productive of acidity; the diseases in-
duced by improper diet are, disordered digestion,
nausea and vomiting, diarrhæa, and that most
distressing complaint, heart-burn; and, what is
still worse, flooding and miscarriage. I could
enumerate instances of all these, were it necessa-
ry, that have occurred frequently in my own prac-
tice; and they are daily occurring in the practice
of almost every physician.
Where the health has been previously good, and
still continues so, pregnant women may eat and
drink as they do at other times; but where there is
any tendency to bowel complaint, nausea, or head-
aches, the utmost caution is requisite. It is not
to a single abortion only that the danger is confined,
where there is a tendency to this misfortune, or
where it has once occurred. When there has
been one miscarriage, the chances are much in-
creased that there will be a second; and when
16
A GUIDE FOR MOTHERS AND NURSES.
there has been a second, the chances are much
more increased that there will be a third, and so
on, till the most ardent hopes are blasted, and she
who would be a mother, is doomed to live child-
less —from her own indiscretion. I have attend-
ed a lady, during the last ten months, in four mis-
carriages; and she had two or three previously.
These were not the result of imprudences in diet,
but they show the liability to a recurrence of this
misfortune.
It must be remembered that an abortion is
quite as injurious to the health, and impairs the
constitution quite as much, as a natural labour at
the full time.
Let moderation and simplicity regulate the diet
in ordinary cases.
When the health is delicate, and the digestive
organs feeble, more care is necessary in selecting
proper articles of diet; the most tender, lean
meats, of any kind most agreeable, broths, and
farinaceous articles, without vegetables, should
constitute the whole bill of fare, with, perhaps, in
their season, now and then, the ripest fruits.
Acid Stomach. When there is a tendency to
acidity of stomach, all substances containing sac-
charine matter should be avoided. Even the tea
A GUIDE FOR MOTHERS AND NURSES.
17
and coffee, and all other food and drink should be
prepared without sugar. Sugar is the ingredient
which runs into fermentation, by which process,
the acid is formed; and when this fermentation
does take place, digestion is impeded or wholly
arrested; then there are pains in the stomach,
cholic, nausea and vomiting, cold perspiration,
headache, and a sense of impending dissolution.
The most distressing state is often almost instantly
relieved by a half a teaspoonful of super carbon-
ate of soda, in half a tumbler of water, or a lit-
tle less of salæratus, or pearlash. If the bowels
are costive, a teaspoonful of calcined magnesia
may be taken to correct the acidity; but at no
other time, unless recommended by the family
physician.
Costiveness. The bowels are sometimes so cos-
tive that their contents accumulate, and produce
colics, vomiting, headache, &c., and not unfre-
quently pains, resembling the throes of labour.
This ought, by all means, to be remedied. And
as this is often the result of too inactive a life,
more exercise should be taken. When it is caused
by improper diet, a change in that respect should
be made; and when it is a habit of long standing,
an attempt should be made to break it up by all
2*
18
A GUIDE FOR MOTHERS AND NURSES,
the means that can be brought to bear upon it.
The first is diet; and, when there is nothing to
forbid, that should consist, to a considerable de-
gree, of ripe fruits and vegetables, when they can
be procured, stewed prunes, figs, bread made of
unbolted flour, corn bread, Indian mush and mo-
lasses. But it is often the case that none of these
things are admissible; we must then have recourse
to other means. When acidity is present, mag-
nesia may be used: or, when this is absent, the
bowels may be relieved with an injection, if it is
not particularly disagreeable. Castor oil, rhubarb,
senna, and manna, &c. may also be employed, but
nothing farther should be ventured upon without
medical advice.
One thing ought, by no means, to be omitted by
those who are troubled with constipation; and
that is, to give nature a chance to perform her
office, by paying their devotions at the temple of
Cloacina every morning, whether they experience
an urgent call to do so or not. They will soon
find themselves amply compensated for this small
trouble. Attention to this particular is more im-
portant towards the end of pregnancy; confined
and loaded bowels then encroach upon the proper
domains of the uterus, and the latter may be pro-
A GUIDE FOR MOTHERS AND NURSES.
19
voked to expel its contents too soon, or at least to
create a false alarm.
If the bowels are not freely relieved spontane-
ously about the time labour commences, they
should always be moved, at that time, by an in-
jection.
If the more common injection of water and mo-
lasses is not sufficiently active, it may be render-
ed quite efficacious by adding to a pint of warm
water a tablespoonful of salt, and a gill of vinegar.
This quantity will not unfrequently act as an ener-
getic purge.
Heart-burn, Flatulency, &c. When heart-
burn is the result of acidity, it may be corrected,
temporarily, by neutralizing the acid, as has been
directed. But, unfortunately for the comfort of
those most immediately concerned, this is not al-
ways the case; and then, as it is caused by the
morbid state of the stomach, I have found minute
doses of calomel and opium to be the best reme-
dy; but this is for the physician to direct. Flat-
ulency, being only a symptom of deranged diges-
tion, is best corrected by striking at the root of the
evil, and keeping the digestion good by commit-
ting no improprieties in diet. A little soda, dis-
solved in water, as for an acid stomach, with a
20 A GUIDE FOR MOTHERS AND NURSES..
few drops of essence of peppermint, or any other
essence, is a good temporary remedy.
SECTION II. Nausea and Vomiting. These are
very constant attendants upon pregnancy; and
when they are not the result of improper food or
drink, they are caused by the sympathy of the
stomach with the uterus.
Many articles have been used as a preventive
of these distressing symptoms; but, I am sorry
to say, too often without effect. When the
source of these evils can be traced to improper
diet, they may be corrected by observing what has
previously been said; but when sympathy with
the uterus is the cause, time and patience are the
best remedies.
Morning Sickness and vomiting is more likely
to occur, as every one knows, in the early period
of pregnancy; and very often disappears entirely
by the third month. Creosote has been recently
recommended for this complaint. Put four or
five drops into half a tumbler of water, and take
a swallow or two every half hour, or hour. When
the sickness is distressing, I would recommend
lying flat upon the back, appplying a cloth mois-
tened with hot brandy and spirits of camphor, to
the pit of the stomach, and taking the creosote
A GUIDE FOR MOTHERS AND NURSES.
21
in water, or a few drops of spirits of camphor.
A teaspoonful of paregoric, or ten or twelve
drops of tincture of hops will occasionally allay
the complaint.
Pains in various parts, Cramps, Numbness, &c.
There are often pains in the back, hips, side, &c.,
and cramps in the limbs; and they are often the
result of costiveness-for which a remedy has
already been recommended. But they are fre-
quently caused by pressure of the enlarged ute-
rus upon the surrounding parts. As the uterus
rises in the body, the pains change their location,
or diminish, or disappear. The parts accommo-
date themselves to the new condition of things,
lose their sensibility to the new impressions, and
there is consequently a greater degree of com-
fort; but this is not always the case; and then,
although it is cold comfort, "what can't be cured,
must be endured."
SECTION III. Bleeding, for Pains in the Head,
Giddiness, &c. It is a very popular notion, that
every pregnant woman must be bled once or more
during every pregnancy, be her state of health
what it may. There are some, no doubt, who
require it; but it is impossible to give any general
rule by which to be governed in this particular,
22
A GUIDE FOR MOTHERS AND NURSES.
except, that, if there be giddiness and pain which
are not removed by a proper regulation of the
bowels, or if they exist when the digestive organs
are in a good state, it is important to seek medical
advice. There is often observed a pain in the
head when the feet are cold; and then the best
remedy is a foot-bath, with two table-spoonfuls of
Cayenne pepper in it, often enough to keep the
feet warm. Mustard flour may be used inabout
the same quantity; or, in the country, where Cay-
enne pepper is not to be had, what would make the
same quantity, of the common red pepper.
When there is tendency to flooding, the bath
may be omitted, and the feet and limbs may be
rubbed with a strong infusion of pepper, or mus-
tard plasters may be applied to the soles of the
feet. Bleeding is by no means always necessary
in pregnancy; and those who are about to be-
come mothers should not insist upon being bled,
contrary to the advice of their physician, and
he ought not to yield his own judgement to grat-
ify a whim.
SECTION IV. Stimulating Drinks. There is of-
a strong desire to take stimulating drinks during
gestation, which, if indulged, is likely to form
a habit of intemperance. The annoying sensations
A GUIDE FOR MOTHERS AND NURSES.
23
created by pregnancy, are, for the time, allayed
by stimulants, such as porter, ale, wine, brandy,
&c.;
but when their stimulant effect has subsi-
ded, a repetition of the same remedy is required
more than at first. So that there is great danger
in commencing; this morbid desire for unusual
stimulants may be conquered by a strenuous ef
fort of the will, if it is met at the outset, and not
allowed to obtain the mastery by indulgence.
SECTION V. Longings. The sensibilities, and
sympathies of the stomach, undergo such derange-
ment, that disgust is created for those articles
which were once most agreeable, while there is
any irresistible craving for those which were before
highly disagreeable or offensive. This is most
likely to occur in delicate, nervous females. The
question is, how far is it proper to indulge these
longings when they are not for articles that are
positively indigestible. I have no hesitation in say-
ing that when the longing is really urgent, the risk
of danger from indulging it is much less than it
would be from disappointment; provided the cra-
ving is not for any thing absolutely disgusting or
injurious. It is a fact, though a remarkable one,
that, in many cases where the stomach craves
really unwholesome articles, they may be taken
24
A GUIDE FOR MOTHERS AND NURSES.
with impunity. This is well understood by most
people; and it is generally believed that ill conse-
quences never result. But this is a great mis-
take, for I have seen the worst effects from this
unusual indulgence; and it must not be forgotten,
that when craving for unwholesome articles is to be
gratified it must be done with the greatest cau-
tion, and in moderation. When there is an appe-
tite for charcoal, clay, and other articles of this
character, the case is one that requires the advice
of the medical attendant.
SECTION VI. Dress and Exercise. Nothing is
of more importance during gestation, than dress.
The practice of wearing tightly laced corsets is
so decidedly injurious, at any time, that it would
seem no hard matter to induce one, about to be-
come a mother, to abandon their use, at least tem-
porarily. But who has not seen ladies in the
sixth or seventh month of pregnancy, so tightly
laced for the sake of attending a ball or party, as
to give no evidence, by her size, of her situation?
The duties of a mother commence when she be-
comes pregnant; and we should suppose that
one would sooner listen to the dictates of humani-
ty, and discharge her responsibilities by consult-
ing the welfare of the "fruit of her womb," than
A GUIDE FOR MOTHERS AND NURSES.
25
obey the caprice of fashion. Tight lacing impedes
the circulation of the blood, prevents the expan-
sion of the body necessary to give room to its
increased and increasing contents, and, conse-
quently, is likely to produce disordered digestion,
abortion, flooding, premature labour. Besides,,
the child, even if born at the full time, may be
delicate and feeble from not having been properly
nourished, and may continue feeble during its
whole life. Professor Eberle says, that since the
re-introduction of corsets, uterine diseases are
more frequent than formerly—that in his expe-
rience, leucorrhea (whites), and prolapsus uteri,
(falling of the womb,) are more frequent among
unmarried females than they were when corsets
were less generally worn.
Allowing the feet to be habitually cold, by hav-
ing the lower extremities too thinly clad, predis-
poses to headaches, convulsions, apoplexy, flooding,
and abortion.
Let the clothing be adapted to the season of
the year, and let it, at all times, be such as to
give the greatest possible comfort.
All advice in regard to exercise may be com-
prised in few words. Every kind of exercise or
occupation that fatigues, or excites the circulation,
3
26 A GUIDE FOR MOTHERS AND NURSES.
should be avoided; so, also, long walks, lifting,
ascending stairs, particularly in a hurry, dancing,
riding on horseback, or in a carriage over a rough
road: care must be taken not to run into the
opposite extreme of being too inactive. If the
custom has been to take considerable exercise
before pregnancy, let it be continued afterwards;
only let it be in moderation-such as riding in
an easy carriage, walking moderately, and the like.
Young married females, pregnant for the first
time, or those who have once miscarried, must be
doubly careful to observe the precepts here laid
down; and those who have once been unfortunate,
should keep very quiet for three or four weeks,
about the period of their pregnancy when the
abortion occurred.
SECTION VII. The Passions-Anger, Jealousy,
Grief, &c. In pregnancy, a state of mental
tranquillity is indispensable. Anger, jealousy,
terror, grief, disappointment, in short, any of the
exciting or depressing passions, may produce all
the ill effects before-mentioned; such as flooding,
abortion, convulsions, and the like.
It is of great importance, then, that the great-
est effort which good sense and moral feeling
dictate, should be steadfastly persevered in by
A GUIDE FOR MOTHERS AND NURSES.
27
pregnant females, to keep down these injurious
and degrading sentiments, and irregularities of
temper, when the causes which tend to excite
them cannot be entirely avoided.
SECTION VIII. The Effect of the Mother's
Imagination upon the Fetus. It may be expected
that I should make some remarks upon this ques-
tion, which is, and always will be, involved in
mystery. It is, however, rather singular that wo-
men universally believe that a strong impression
upon the mother's mind may communicate itself
to the fetus, producing marks, deformities, &c.
while a majority of medical men ridicule the idea
as a great absurdity. It must be confessed that
some strange coincidences do now and then occur,
which are no more satisfactorily accounted for by
the doctors than by the women. It is generally
thought that the admission of this power, even if it
be true would be injurious by confirming pregnant
women in this faith, and putting them upon the
lookout for frightful objects; thus making them
anticipate unhappiness which they are never to
realize. But their minds are already made up
on this point; and their faith cannot be shaken
by any argument that has ever heen used. On
the contrary, it seems to me that if they should
28
A GUIDE FOR MOTHERS AND NURSES.
be confirmed in their belief, the result would be, to
keep them from exposure to the causes likely to
produce any unhappy effect. Here we must
leave this subject, with a warning to females, that
if they believe in the power of their imagination
to mark their children, they must sedulously avoid
all causes likely to affect their imagination; and if
they happen to have been surprised by an unex-
pected sight, not to allow their minds to dwell
upon it, but strive to eradicate the impression
made, and substitute another in its place; for the
power ought to act both ways; so that if it can
mark it ought also to unmark. All shows, theat-
rical representations, and excitements on religious
subjects should be avoided. There is a frequent
tendency to despondency during pregnancy, and
to anticipate the most serious results. I have
often known women to prepare their grave clothes
previous to their confinement, and firmly believe
their death to be inevitable. It cannot be denied
that giving birth to a child is attended with anxiety,
and more or less peril; and it is well always to
contemplate the end of life, and to be prepared
for it. But the despondency of which I speak,
increases the danger; and it is therefore neces-
sary that an effort be made to maintain as much
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29
cheerfulness as possible, and to derive encourage-
ment from the consideration that few, compara-
tively, very few, die in parturition.
SECTION IX. Attention to the Breast and
Nipples. Much of the comfort of a lying-in-
woman depends upon the ease with which the
child obtains its nourishment from the maternal
formation. To this end a well developed and
sound nipple is necessary.
The chest has been frequently so compressed by
a tight dress that the nipple has not been allowed
a chance to develope itself; so that when the
breast has become distended with milk, it can be
drawn out only with the greatest difficulty, and
frequently an abscess, or broken breast, follows.
Attention for a few weeks previous to confinement
will, in a great measure, remedy this difficulty.
The breast should be daily drawn by some per-
son, or when this is impracticable, by a pup, and
an effort made to elongate the nipple with the
fingers and this must be persevered in till the
object is accomplished. A suction pump, or a
common tobacco pipe, may also be used for this
purpose. The nipple is itself a delicate organ,
and when well developed it too often becomes
cracked, raw, and sore; so that what would oth-
3*
30 A GUIDE FOR MOTHERS AND NURSES.
erwise give the greatest pleasure, causes the most.
exquisite anguish. This could mostly be prevented
by proper management during the last few weeks
of gestation, and gradually accustoming the nipple
to the office it will soon be called upon to per-
form. Washing the nipples in warm water, draw-
ing by the mouth daily, and exposure of the nip-
ples to the atmosphere a few hours daily, will be
the most likely means of preventing soreness.
Exposure to the atmosphere gives the nipple a
firmness that nothing else can. Dr. Ebale recom-
mends a wash to be made of two drachms of tinc-
ture of myrrh, two ounces of water, and a drachm
of laudanum; the nipple to be first washed with
warm water, rubbed gently with a soft flannel a
few minutes, after being dried, and then the wash
applied.
If these hints should be carried into practice
four weeks previous to confinement, I believe we
should hear but little complaint of sore nipples
when nursing.
Summary of Advice to the Pregnant Female.
The following summary I have condensed from
Professor Dewees's large work on the diseases of
children :
1. She must avoid all unnecessary, and especially
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31
violent exercise, or exertion; such as too fast
walking, running, dancing, &c.
2. To avoid all situations which may subject.
her to unpleasant sights or seeming dangers.
3. To shun overheated rooms, and stimulating
liquors of every kind.
4. To avoid all substances that have a tendency
to produce a costive state of the bowels, or those
which give rise to indigestion, as late suppers, &c.
5. To take no substances, or drug that shall
give too frequent and too severe motion of the
bowels, or such as too severely constipate them,
as chalk, opium, &c., and especially not to disre-
gard the calls of nature, when they would be suc-
cessfully exerted.
6. To remove from her chest, waist, and abdo-
men, every restraint; lest undue pressure should
be made upon them.
7. To avoid all substances that may have a
tendency to increase the irritability of the system;
as strong tea and coffee, opium, &c. the too long
indulgence in bed, &c.
8. To shun all severe study, nightwatching, &c.
9. To avoid unnecessary bloodletting.
10. To have recourse to the operation when
32
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pain, headache, sense of fulness, giddiness, the
loss of, or imperfect, sight, declare the necessity
of it; but when these are present, to have med-
ical advice.
11. The indulgence of all inordinate appetites.
12. She must not be afraid that her child will
be marked because certain longings have not been
indulged.
13. She must not be apprehensive of evil con-
sequences to her child because she has been dis-
appointed or frightened.
14. To guard against any sudden gust of
passion.
15. To solicit as much as possible tranquillity
and equanimity.
16. Let her turn a deaf ear to all tales of dis-
aster, or horror, which purport to have happened
to a pregnant woman, for, from an investigation,
they will nearly all prove to be false.
17. Let her procure the best aid for the period
of her necessities that circumstances will permit.
18. Let her not indulge in gloomy forebodings,
nor unreasonable fears for the event; nor forget
how rarely death happens during, or even after, a
well conducted labour.
19. Let her recollect that the safety of labour
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33
does not depend upon the celerity with which it
is performed.
20. Let her be passive and obedient, having no
opinion of her own that may clash with that of
her medical attendant.
21. Let her not, as she values her life, indulge
in any gust of passion, lest it provoke incurable
convulsions.
CHAPTER II.
RULES TO BE OBSERVED BY THE MOTHER DURING
CONFINEMENT.
SECTION I. Although it comes strictly within
the province of the attending physician to pre-
scribe the course to be pursued by a lying-in-
woman, yet, a few words may not be deemed
unimportant, or obtrusive.
What I consider of the greatest moment of any
one thing, is the proper application of the bandage
immediately after delivery. This is left, by some,
for the nurse to adjust, but it should be done by
the physician, and strict charge should be given
to the mother and nurse to pay particular atten-
tion and keep it pinned as tightly as it can be borne
with comfort, and as low down as possible, to
make pressure directly over the womb. The ab-
domen must be supported in this manner, after
being so long distended and so suddenly deprived
of its contents. I have never known a case of
flooding to occur when the bandage has been
properly applied. Every woman who expects to
become a mother should supply herself with two
THE MOTHER DURING CONFINEMENT.
35
at least, of this necessary article. A variety
of bandages have been recommended, but I be-
lieve there is nothing better than good firm muslin,
cut to resemble a corset, so as to fit the body;
it may then be made with eyelet-holes and tied
with strong tape, or pinned, to suit the fancy.
The diet should be as simple and unirritating as
possible, consisting chiefly of gruel, weak tea, cocoa,
and the like, for the first few days; and, at the
same time, the mother should be careful not to
use what little strength she has in sitting up in
the bed, or in exerting herself in any way. The
best rule is, not even to move without considera-
ble assistance. The room should be kept quiet
and comfortable, as to temperature, both in sum-
mer and winter, well aired, and the bed should
not, as is generally the case, be enclosed with
curtains.
Too much care cannot be taken till after the
period has passed for the milk fever; and even
then, for two weeks, no company, unless it be a
very intimate friend, or near relation, should be
admitted.
Sitting up too soon, or walking about the room,
is one of the greatest mistakes that a lying-in-
woman can commit. I attended a woman who
36 A GUIDE FOR MOTHERS AND NURSES.
felt so uncommonly well on the eighth day that she
would walk about her room; an attack of inflam-
mation of the womb supervened, from which she
was three months recovering. "Milk leg," as it
is called, is caused by too early exercise; so is
child-bed fever, convulsions, &c. ; the last I have
seen after having talkative companions during the
first few days.
SECTION II. The Breast, Nipples, &c. The
child should be applied to the breast as soon as
the mother feels able to permit it; but this should
not be repeated frequently, till the milk makes its
appearance. When the milk flows freely, the
breasts should be kept well drawn, if the child
does not do it, either by the mouth of one able to
perform this office, by a pup, or by a pump, or
breast-pipe. Inflammation and “broken breasts,”
may be prevented by attention to this particular.
When the nipples are sore and tender, I have
known the oil of eggs very serviceable: this is an
old remedy, but a good one. The oil is obtained
by boiling the eggs hard, roasting the yolks over
a slow fire in a vessel, till they feel oily, and then
putting them in a linen or cotton cloth, the oil may
be expressed. The same remedies may be ap-
plied to the nipples after confinement as before ;
to the observations on which the reader is referred.
CHAPTER III.
PECULIARITIES OF THE INFANT STRUCTURE AND
CONSTITUTION.
SECTION I. General Considerations. In consid-
ering the peculiarities of the infant structure and
constitution, as well as in the observations which we
propose to make upon the diseases of children, we
shall regard the period of childhood as consisting
of two epochs - the first commmencing at birth,
and continuing until the twelfth month; the se-
cond commencing at the termination of the first
year, and continuing until the eighth.
This division, which has been generally adopt-
ed, possesses the merit of being nearly in accor-
dance with one definitely marked out by nature
herself. About the tenth or twelfth month, the
child, by its acquisition of teeth, becomes fitted
for the use of other nourishment than the mo-
ther's milk; and the stomach and bowels re-
ceive, not merely with impunity, but with ad-
vantage, kinds of food, which, during the earlier
months, would have been productive of serious
4
38
A GUIDE FOR MOTHERS AND NURSES.
derangements of the digestive functions; at
the same time, very obvious external changes
have their commencement, and indicate marked
alterations, both bodily and mental.* During the
first period, also, the child is subject to some pe-
culiar diseases and dangers, to which the atten-
tion of the physician requires to be specially
directed, and the diminished liability to which,
upon the commencement of the second epoch,
appears materially to increase the chances of
existence.
Beyond the eighth year, we would not employ
the term, child-though applied by some until
the age of puberty: but before then, the peculiari-
ties characteristic of childhood have been merg-
ing into the attributes of adult age; while the
influence of sex begins to be discernible, and the
individual may thenceforward be designated boy
or girl.
The infant, at birth, is endowed with the same
organs as the adult; but so different, for the most
part, in structure, developement, or even situation,
as to constitute essential characters which distin-
* "At this time," says Wendt, "the hitherto projecting fore-
head becomes flattened, the countenance receives expression, the
eyes intelligence, the limbs firmness."
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39
guish childhood, and without a knowledge of
which, neither the management nor diseases of
children can be correctly understood.
Infancy may be emphatically termed the period
of growth. We find the infant, at birth, fully
provided with the organs of nutritive or organic
life - those which are essential for the suste-
nance and nutrition of the individual; while the
organs of animal life or relation,- those which
connect man with the external world, and make
him on their completion, the superior being that he
is, are as yet but imperfect in developement or
structure, and herein is to be found the basis of
that great difference observable between the in-
fant and the adult. In the former, we have the
organs of nutritive life alone, fully developed, and
actively employed; but in the latter, we have
both classes of organs, relative as well as nutri-
tive, brought to completion and in full activity,
constituting the period of maturity or perfect
growth.
To speak in general terms, we may say, that
the anatomical structures in the infant differ from
those in the adult, by their greater softness or
want of consistency; being surcharged with fluids,
and many of them as yet unfitted for the full dis-
40
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charge of their appropriate functions; while in
advanced life, on the contrary, the quantity of
fluids diminishes, and the structures become con-
densed, so that the organs, instead of being too
soft, have become too rigid, as we find them to be
in old age. In the infant, the capillary system,
in particular, predominates; absorption and de-
position are active, and the processes of growth
most vigorous; secretion is abundant, and evacua-
tion frequent; the nervous sensibility being acute,
and the membranes remarkable for their quantity
of blood-vessels; all of which phenomena depend
not merely on the abundance of blood present,
and the activity of its circulation, but on the pre-
ponderance of the arteries over the veins.
Before proceeding to a particular review of the
several organs, and the properties by which they
are characterized in childhood, it may be well to
take a glance at the general appearance of the
newly born infant.
The length of the body varies from about one
foot and a half to less than two feet. Baude-
locque states sixteen inches and twenty-two (or
at most twenty-three) inches, as the extreme
limits. The average weight is from about six to
seven pounds and a half; more has been assigned,
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41
but is not common: six pounds is by far the most
common weight, according to Camus's Tables.
The skin is thin, tender, and of a reddish hue;
but covered at birth with a whitish unctuous mat-
ter, called vernix caseosa.
There is some hair
upon the scalp, and the nails reach to the ends of
the fingers: the joints are commonly flexed, the
limbs round, and the body plump.
The relative dimensions of various parts differ
materially from those observed in after life. The
lower limbs are less developed than the upper;
the median point, that lying midway between
the two extremes of the body,- being found at
the navel, or a line or two below it. The pelvis
in the infant is small and contracted, being less
developed in proportion than the chest, which
is flattened at the sides, but prominent in front;
while the abdomen and head present dimensions,
not only very large in comparison with the other
cavities, but also as compared with their own di-
mensions in after life.
The newly born infant possesses little power
of motion; none of independent support. Sen-
sation and perception are dull or absent. Its
cries and movements may be looked on as invol-
untary its search for food as instinctive. One
4*
42
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third of its time is chiefly occupied in taking
nourishment, the remainder is passed in sleep.
Peculiarities not less striking or important, ar-
rest our attention, on turning to the consideration
of the internal organs; and these we shall briefly
notice in succession, commencing with those of
organic life, as being first called into action :
and of these the digestive organs naturally claim
precedence, and will be found in a high state of
developement.
SECTION II. Digestive Organs. The mouth of
the infant is fully formed, and in some respects par-
ticularly adapted to the performance of its proper
office of suction, as we see in the disposition of
the palate and lips and the obliquity of the pos-
terior nostrils; yet appearing to be imperfect
from the want of teeth, which, however, can
hardly be said to be wanting-only absent: as
they already exist within the gum, in due time
to make their appearance, and mark a new era,
when the child becomes fitted for a different ali-
ment, from that hitherto provided by nature for
its sustenance.
The mucous membrane lining the whole tract
of the intestinal tube, is thick and has a velvet-like
appearance; being more sensitive and more filled
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43
with blood-vessels, than in after periods of life ;
softer in texture, and more bedewed with mucous,
which is abundant, but thin; becoming viscid
however, and much increased in quantity, on the
occurrence of any irritation.
The sensibility of the mucous membrane is
adapted to the mild and unirritating fluid provi-
ded by nature as the suitable nourishment for the
infant; any other substance proves irritating in a
greater or less degree, and is therefore to be
avoided.
The stomach and upper portion of intestines
are fully formed, their mucous membrane being
thick, villous or velvet-like, and of a rosy tint.
But the position of the stomach in the infant, dif-
fers from that in the adult, in hanging almost
perpendicularly, so as to extend from the epigas-
tric to the umbilical region: instead of being pla-
ced in the tranverse position, which it occupies
in after life.
The omentum, which is attached always to the
great curvature of the stomach, will, in conse-
quence, be found in the infant, more towards the
left than the right side.
The small intestines in the infant are a third
longer in proportion to the length of the whole
44 A GUIDE FOR MOTHERS AND NURSES.
intestinal tract, than in the adult; and the large
intestines are longer in proportion to the small,
but their calibre is relatively less.
The salivary glands and the pancreas are very
large, and seem particularly active.
Digestion is rapid and incessant; the child fre-
quently requiring food, which, if permitted, will
be often taken to repletion; so as to be ejected
without effort from the overloaded stomach,
which is not capable of containing more than a
few ounces of fluid at a time.
The gall bladder, though small at birth, soon
enlarges; and is found to contain bile, bitter in
taste, and green in colour; but bile, in the infant,
is less viscid and less charged with the principles
peculiar to this fluid, than at a more advanced
age when concretions are liable to form.
The liver undergoes a remarkable alteration
in function and form after birth. The mode of
circulation is changed; the left lobe diminishes,
some of the blood-vessels are obliterated; while
others are developed, and the secretion of bile
becomes the peculiar function.
The substance of the liver becomes darker as
life advances; and the size of the organ dimin-
ishes relatively in volume, receding towards the
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45
ribs, within which it is situated in the adult; but
in the infant, it extends to the middle region of
the abdomen; and instances are recorded, where
the proportions of the liver remained through life
as in the fetus.
The spleen presents little peculiarity that we
are as yet able to notice; too little is known of its
functions to enable us to appreciate any changes
that may occur; but we have observed that it is
subject to disease at a very early period. The
spleen may be felt in the infant below the false
ribs, chiefly in the middle region; not in the left
hypochondrium, as in the adult, in whom indeed
the spleen can hardly be discovered by the touch,
unless when in a diseased state.
The bowels at birth, are found to contain a
dark coloured, inodorous, insipid substance, which
is called meconium, and appears to result from
accumulation of intestinal secretion, for which
passage had not before been provided. This is,
however, soon expelled, and its place occupied by
the residue of the food, which from the nature
of the infant's aliment, we might conjecture
would be but little characterized by the proper-
ties of fecal matter. Accordingly, we find the
contents of the bowels in infants much less fecu-
46
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lent than they afterwards become; being thin,
charged with mucus, and of a yellowish colour;
possessing little fetor, but abundant and frequently
expelled, the infant passing a stool three or four
times each day.
In a similar manner, we find the other excre-
tions less odorous, more watery, and not so largely
charged with their peculiar principles, saline or
otherwise, as in the adult; but they are quickly
expelled, though not very abundantly secreted.
The perspiration is less saline and odorous, but
more watery, though not copious. The urine dif-
fers in like manner from that of the adult, and it
is retained a much shorter time, being like the
feces, often expelled.
This does not depend merely on the constant sup-
ply of food, or less relative capacity of the contain-
ing organ; but is connected with the peculiar sen-
sibility of the lining membranes and irritability of
the muscular coats of these organs; which, like
the other involuntary muscles, are more irritable
in the infant than they are subsequently found
to be. In their tissue, they are softer and of a
paler hue, nor has command over their actions been
yet acquired.
This latter character, in particular, attaches to
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47
the urinary bladder in the child, and occasionally
continues to give annoyance for some time, by
leading to frequent wetting of the dress or bed-
clothes. The bladder, in the infant, is more
elongated in shape, and situated higher up, than
that of the adult; but is less capacious in propor-
tion, while the ducts leading from the kidneys to
the bladder are particularly large. But it is
upon its difference of anatomical structure, as
regards the position of the urethra, or canal
through which the urine flows from the bladder,
more than perhaps other circumstances, that this
difficulty of retaining the urine depends; for the
pouch or fundus of the bladder does not exist in
the fetus, the neck or urethral opening being
then most dependent; and this state of parts still
obtains to a certain degree in the young subject ;
probably in some more than others.
The kidneys undergo remarkable alteration;
but the relation which these changes bear to the
functions of the organ, is not very obvious.
SECTION III. Organs of Respiration. Having
considered the digestive organs, or those which
generate the materials for the blood, we shall
now notice the respiratory organs, or those by
which the blood is regenerated, and fitted again for
the purposes of the circulation.
་
48
A GUIDE FOR MOTHERS AND NURSES.
In no organs do more important changes occur,
at birth, than in the lungs; in nothing does the
infant more remarkably differ from the fetus, than
in being a respiratory animal. The lungs, which
before birth had been condensed, of a brownish
red hue, very full of blood-vessels and not as
yet inflated with air, now suddenly augment in
size, becoming, after respiration, of a rosy colour,
soft and vesicular in structure, and crackling to
the touch.
The respiratory process is carried on with ra-
pidity and force, consonant with the general activity
observable throughout the system; and in partic-
ular, with the constant demand for fresh supplies of
blood. The inspirations are frequent, counting
from 35 to 40 in the minute, or nearly double
those of the healthy man; while the sound emit-
ted on the passage of the air, is so peculiar, from
its force and clearness, as to obtain the distin-
guishing appellation of puerile or child-like respi-
ration.
Notwithstanding this activity in the process of
respiration, it would appear that less oxygen is
consumed in the infant than the adult, and that
the power of generating heat (a process closely
related to respiration,) is also less.
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49
SECTION IV. Organs of Circulation. The blood,
having undergone the requisite changes in the lungs,
is conveyed again to the heart, thence to be sent
throughout the system. From the moment the
act of respiration is performed, the circulation
undergoes a total change; and the heart is altered
accordingly, becoming complete in its functions,
but still retaining some remarkable peculiarities
in the infant. Its volume is proportionably large;
but the relative capacity of its cavities differs from
what is afterwards observed, those of the left side
preponderating decidedly at first; the balance,
however, is gradually altered, until we find, in the
adult, the cavities of the right side of the heart
nearly three times the size of those of the left.
The thickness of the walls or sides of these
cavities, however, changes inversely with their
capacity; for, from being nearly equal, the sides
of the left ventricle become almost four times as
thick as those of the right.
The sides of the heart are softer and paler than
in after life, when the relative bulk is less, but
the texture firmer, and colour deeper; this organ
being then called upon to propel its contents with
greater force, as they have to traverse a longer
space. In the infant, the large volume but feebler
5
50
A GUIDE FOR MOTHERS AND NURSES.
power of the heart fits it for the propulsion of a
larger quantity of blood, but through a less dis-
tance; while the peculiar irritability of this, as
well as the other hollow muscles, during infantile
life, ensures more active contractility, and so,
more rapid action, suited to the constant demand
for fresh supply. Accordingly, we often find the
pulse in the infant, like the respiration, nearly
double in frequency that of the adult, varying from
120 to 140 beats in a minute.
The part of the nervous system more immedi-
ately connected with the class of organs which
we have just been considering, should naturally
be in a high state of developement, to allow of
the fulness of function which we have seen these
organs to possess; and accordingly, we find the
ganglions, or system of the sympathetic nerve,
very perfectly formed at birth; while the brain
and its nervous connections, on the contrary, are
very imperfectly formed, though largely developed,
--more especially the brain itself.
We now come to the consideration of the sec-
ond class of organs,—those of animal life, or re-
lation to external objects; and here we shall find
remarkable changes manifested in the advance of
organs from a state of essential imperfection, to
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51
one of completeness-this advance in organiza-
tion, and successive devolopement of function,
constituting the most interesting eras of infantile
life, looked forward to with eagerness, and re-
membered with pleasure, as the periods of dawn-
ing intelligence, and independent muscular exer-
tion
when the infant first begins to take notice,
to walk alone, and to speak.
SECTION V. System of the Brain and Spinal
Marrow. The brain, though large in volume, is
very imperfect in structure in the infant, being so
soft as to be almost fluid, the quantity of watery
matter preponderating much over the solid; it is of
a reddish hue, but with the outer portion less
deeply coloured than in adult age, and the convo-
lutions less deeply marked.
The brain is altogether inadequate to perform,
on first entrance into life, those exalted functions
which afterwards render it so important an organ,
and so characteristic of the superiority of man ;
and accordingly, we find the newly born child
incapable of thought, and apparently devoid of
perception.
The precise changes which the brain undergoes,
in its progress towards perfection of structure,
are not accurately determined; but those appear
52
A GUIDE FOR MOTHERS AND NURSES.
*
to be as important which regard alterations in the
quality, as in the quantity of the cerebral sub-
stance. The increase in size is not perhaps so
remarkable as that in the density of the organ;
which, according to Wenzel, does not attain its
greatest weight until the seventh year,-the size
and weight of the brain at that time being said
to differ little from what they are at mature age,
when the power of function is so far superior.
Such is the opinion generally entertained on
this subject; but which is not strictly accordant
to fact. The fact is, the brain does continue to
increase in size until manhood; and the relative
size of its different parts constantly varies during
several of the first years of life; but it is not
perhaps, until about the seventh year that all its
parts are fully formed.
The brain of the newly born infant seldom ex-
ceeds ten ounces in weight; that of the adult avera-
ges about three pounds and a half, often something
* The presence of phosphorus constitutes an essential ingredi-
ent in the chemical composition of the brain, (as proved by re-
searches,) and the quantity of this substance present in the brain
of the child, is much less than in that of the adult, and again di-
minishes in advanced life. The brain of an idiot is found to be
remarkably deficient in this ingredient.
A GUIDE FOR MOTHERS AND NURSES.
53
less; but in some individuals, the brain has ex-
ceeded four pounds, or even four pounds and a
half in weight.
In advanced life, again, the brain diminishes
somewhat in relative, as well as general, size, and
it has been ascertained, according to Desmoulin's
and Cauzevielh,' that it diminishes in specific
gravity, from one-twentieth to one-fifteenth. It
grows rigid in its quality, becomes again unequal
to the due performance of its functions, as it had
before been in infancy, though from an opposite
cause, and second childishness is said to take
place.
The cerebellum, or lesser brain, situated in the
posterior part of the head, is, at birth, somewhat
more advanced in organization than the brain ;
but it is about the period of puberty that the rela-
tion between the cerebrum, or brain, situated in
the anterior, or front and upper part of the head,
and cerebellum, undergoes the most remarkable
change, the latter becoming considerably aug-
mented in relative size, being then nearly twice as
large, in proportion, as it had been at birth.
The spinal marrow is largely developed, like
the brain in the infant, but appears to be more
matured in structure, and farther advanced in the
performance of its functions.
5*
54
A GUIDE FOR MOTHERS AND NURSES.
The general sensibility is acute, and the nervous
susceptibility in the infant remarkable; so that all
impressions are violently felt, and sympathetic
affections are presented in a very aggravated form,
and are very prone to occur, constituting a pecu-
liar feature in the infant constitution, which may
be emphatically said to be nervous.
The large
endowment of nervous matter, and its peculiar
susceptibility of impression from the softness of
its texture, appear to confer this quality, which is
never to be lost sight of in the treatment of in-
fantile disease a remark as old as the time of
Boerhaave, but which is nevertheless too frequently
forgotten.
As the infant grows older, the brain becomes
capable of perceiving impressions made through
the senses. Signs of intelligence begin to be
manifested the infant takes notice, and becomes
sensible of the qualities of bodies, recognising
them and exhibiting symptoms of gratification or
annoyance. The nerves of sensation, however,
though freely developed, are as yet but imperfect
in their functions, and inadequate to the convey-
ance of their appropriate impressions; while we
find that the apparatus by which the external
sources of these sensations are supplied, is more
A GUIDE FOR MOTHERS AND NURSES.
55
3
or less imperfect, and destined to undergo much
alteration.
To notice particular senses, we shall commence
with vision, which does not appear to exist in the
newly-born babe, though the eye is fully devel-
oped and it has been ascertained, that perfect
images are formed on the retina. Vividly illumi-
nated objects seem soon to attract notice; but
the eye follows, or is fixed on them, at first, in an
apparently passive manner, little dependent on
the will. Light is at all times agreeable to the
infant, which seems naturally to dislike darkness;
but a very bright light is injurious, as well as an-
noying, to the eye.
The sense of hearing is as little exercised as
that of sight, in the first instance. It is doubtful
if the young infant can hear at all; at least for
some time it does so but very imperfectly; and
that this must be the case is manifest, from the
deficiency of structure in the external ear, which
is, as yet, ill calculated to collect or receive vibra-
tions of sound.
Taste early exists, and provision is made for its
exercise in the full developement of the mouth;
but probably perception of flavours is enjoyed to
a less extent than we might at first suppose. The
56 A GUIDE FOR MOTHERS AND NURSES.
apparatus connected with the sense of smell, is
much less fully formed; and although this sense
be manifested early, there is little probability that
delicacy of perception is early enjoyed by it.
The absence of speech, or of the capability of
uttering articulate sounds, is a deficiency charac-
teristic of infancy, but not to be accounted for by
mere anatomical examination of the organs of
voice, though these certainly are but imperfectly
developed. This condition of parts, combined
with an immature muscular endowment, suffi-
ciently accounts for the shrill, feeble tone, and
wailing cry, peculiar to the infant; but the acqui-
sition of the power of speech is connected with
the advance of intellect, rather than alteration of
mechanical structure, in this part of the apparatus
of voice. The gradual alteration going on in the
larynx, or upper portion of the windpipe, does
not become very evident until the period of pu-
berty, when all the organs concerned in articula-
tion, become elongated and enlarged, and a change
in the tone of voice is consequently occasioned.
In the male this assumes the deep and grave
sound, which characterises the full-toned voice of
manhood; while in the female little change takes
place in the larynx; and the acute tones still re-
A GUIDE FOR MOTIERS NND NURSES.
57
main characteristic of the female voice, which
always more or less resembles that of childhood.
The mechanism on which depends the power of
articulating intelligible sounds, is more connected
with the increased growth and power of the mus-
cles of the mouth and pharynx, which, even before
intellect begins to dawn, become, by a happy
provision, early developed, being necessary both
for sucking and swallowing. The infant begins
to articulate at from half a year to a year old;
and usually speaks plainly, or so as to be under-
stood by a stranger, at from two to three years
of age.
The general sense of touch, or perception of
contact, makes us conscious of the presence of
external bodies; and to a certain extent, is exer-
cised by the whole cutaneous surface, though not
in like degree. In the young infant, however, the
skin does not seem well disposed for the active
exercise of this power, the papillæ being less de-
veloped, and its structure more gelatinous than
in after life. The sense of touch, strictly so call-
ed, or that perception by contact, in virtue of
which we not only recognise the presence, but
certain of the qualities of bodies, exists only in
some organs almost solely in the hands
is but little developed in the infant.
and
58
A GUIDE FOR MOTHERS AND NURSES.
Whether the skin be less sensitive or not, the
muscular endowment necessary for the exercise
of this sense is but very imperfect, the use of
the fingers for this purpose being yet unknown,
or the attemps to employ them sufficiently awk-
ward.
The assistance of muscles is necessary for the
exercise of all the special senses; and the imper-
fection of the muscular apparatus is a principal
cause of the deficiences of these senses in the in-
fant.
SECTION VI. Apparatus for Walking. These
organs are but little developed in the child, in either
of their chief component parts, bone or muscle.
The bony system, in particular, is imperfectly
and unequally developed, varying according to
the purposes of its different parts. The bones ne-
cessary to contain and protect important organs,
as the bones of the head or chest, are much more
advanced in ossification than those destined mere-
ly for muscular support, or walking, -- which are
but imperfectly ossified, or exist as yet only in the
form of cartilage. The bones in general are
*
*“The most striking fact of this kind," to use the words of
Dr. Symonds, in his able article "Age," Cyclopædia of Anatomy
and Physiology, "is presented in the spinal column. The circu-
A GUIDE FOR MOTHERS AND NURSES.
59
characterised by their smallness of size, redness
of colour, and softness of texture, being very vas-
cular, and the earthy part not only much less in
proportion than in the adult bone, but even the
animal portion being less firm, in consequence of
the larger proportion of gelatine. The bones in
the infant, then, are little calculated, from their
formation or structure, for the support of the body
in the erect posture, or the endurance of strong
muscular exertion; nor are the muscles themselves
better prepared for such efforts.
We have already noticed the characters of the
muscular tissues of organic life, or the involuntary
muscles in the infant. Similar characters of
structure belong to the voluntary muscles. They
are pale in colour, and easily torn, being soft in
consistence, and slender in shape, the bellies of
the muscles not being yet formed. They contain
less fibrine than in after life, and have their fibres
lar portions of the spine, which form the canal of the spinal mar-
row, are found strongly ossified at birth: but the bodies of these
bones, which are to be used hereafter in supporting the weight
of the head and trunk, are very slightly expanded, and all but
devoid of carthy particles; while the projections to which the
muscles employed in the flexion and extension of the column
afterwards contract attachments, are either only shaped in carti-
lage, or may be said to have no existence.
60
A GUIDE FOR MOTHERS AND NURSES.
but loosely united. Similarly imperfect are the
tendons and ligaments, or muscular appendages.
In the child, the irritability of the muscles, or ten-
dency to contract, is more easily excited, but less
easily sustained than in after life. Hence the
motions of the child are quick or sudden, and
frequent, but fail in capability of effecting pow-
erful action, or sustaining continued exertion.
The first efforts of the infant at voluntary move-
ments are thus necessarily imperfect. It begins
to attempt walking at about twelve months of
agc, and has generally acquired the power of
walking alone between the first and second year.
But many are the mischances which such efforts
entail; foreseeing which, nature has providently
furnished a shield of defence in the yielding and
elastic fatty matter, in which the body of the child
is so liberally encased.
SECTION VII. Growth. We have already desig-
nated infancy as the period of growth; and this
character, which continues during childhood, is
sufficiently manifested by the progressive and rapid
advance made in the body at large, and its several
organs in detail. The progress of this advance.
is uniform; so that the successive developements
of different parts observe stated periods, and a
well-known order.
A GUIDE FOR MOTHERS AND NURSES.
61
In this progress we are most attracted by the
advance made in the organs of animal life; but
the changes which take place in the organic func-
tions are not less remarkable, though less noticed;
consisting principally of a decrease in activity, if
not power, and occurring out of sight, so as to be
little exposed to observation.
As the infant grows older, digestion ceases to
be so active, and the digestive tube so sensitive.
Food is less frequently required; and the kind of
food may be more varied, a more stimulating va-
riety being borne and necessary. The secretions
begin more to resemble those of adult life, and
the evacuations require less frequently to be void-
ed, being no longer passed independently of the
will. The involuntary muscles generally acquire
more tone, grow firmer in structure, and deeper
in colour, losing their puerile irritability.
Respiration becomes slower, and the pulsations
of the heart less frequent, the respiration grad-
ually parting with the attributes of puerility, and
the pulse diminishing in rapidity.
The activity of secretion becomes abated, and
the membranes are not so vascular or sensitive.
Less mucus is secreted naturally, or poured out
on the occurrence of irritation. The capillary
6
62
A GUIDE FOR MOTHERS AND NURSES.
vessels are no longer so abundant, nor do the
arteries preponderate so much over the veins.
As the child advances in age, the activity of
the sympathetic system of nerves is less manifest-
ed, while that of the brain and spinal marrow
comes more into play; and the body, gradually
losing the characters of infancy, begins to assume
the attributes of adult age.
In these various stages of advance, we are par-
ticularly struck by the progress made in the pow-
ers of sensation, perception, and voluntary mo-
tion, or in the organs of animal life. Sensation
awakens, and the senses successively and rapidly
expand. Perception is manifested, and reflection
in due time succeeds. Thus endowed, the child
is competent to voluntary efforts; and muscular
power is proportionably developed, and brought
into action. The several senses improve as they
are exercised, and mutually aid each other by
corroborating or correcting the impressions re-
ceived by each.
Our perceptive faculties are thus brought first
into action, and we obtain a knowledge of the
existence and properties of external objects. Me-
mory, "the store-house of the understanding,"
becomes furnished, and the intellect is supplied
A GUIDE FOR MOTHERS AND NURSES. 63
with the materials of knowledge and business for
thought.
The progress of growth in the organs devoted
to the exercise of the senses, the intellect, and
voluntary motion, is remarkable and characteris-
tic, but unequal in advance, and tardy in com-
pletion. The perfecting of these organs, finishes
the process of growth; and is not fully completed
until the period of maturity, or near to the meri-
dian of life. Perfect developement of the bones
and muscles, connected with the apparatus of the
organs of sense, is necessary for the full exercise
of the several senses, and is not finally completed
until long after the period of childhood; nor are
the powers of sensation brought to perfection be-
fore then. The acuteness of the early impres-
sions is probably great, whether in consequence
of their novelty, or the sensibility of the nerves;
and such impressions seem to be recollected as
peculiarly pleasurable. But it is only by practised
experience that the perfection of sensation can be
attained, as is remarkably exemplified in the sense
of touch.
The advance in the organs of voluntary mo-
tion, — the knitting of the frame, and develope-
ment of the muscular power, constitute the
!
64 A GUIDE FOR MOTHERS AND NURSES.
most noted feature of growth; and the comple-
tion of these organs, the most characteristic attri-
bute of manhood.
The form of the skeleton, and its several parts,
alter much; and the chemical constitution of the
bony system, also, undergoes change. The rela-
tive developement of the pelvis across the hips
and lower limbs, comes to bear a better propor-
tion to that of the chest and the rest of the body.
The form of the spine assumes more of the alter-
nate curvatures of full growth. The shafts of the
bones become firmer, and more closely united
to their heads, and the processes shoot out; while
the quantity of calcareous matter gradually in-
creases, until the completion of bony growth,
when the frame-work of the muscular system is
brought to perfection.
The muscles do not remain stationary while
the bones advance. Their colour deepens, and
the fibres become well-defined and firm, being
developed so as to form the belly or central ful-
ness: more fibrine enters into their composition.
The sheaths and tendinous appendages, have be-
come necessary, and are added. Muscular exer-
tion now comes into busy operation, but continues
to be characterized by activity rather than power.
A GUIDE FOR MOTHERS AND NURSES.
65
The child has a constant tendency to muscular
movement, and loves exercise; but the power is
soon expended, and rest is required, well-con-
certed, or long-sustained, muscular exertion being
beyond its capability. This is an important moral
as well as physical check, the corporeal power
being limited, and full strength not acquired, until
the controlling influence of a matured intellect has
been provided.
This brings us to consider the progress of
growth in another portion of the nervous system;
particularly the brain, the organ of thought and
feeling, and that in which remarkable changes
take place.
As the body elongates, the spinal marrow of
course becomes enlarged, until it bears to the
brain a greater proportion in size than it did at
birth; but having been more forward in structure
from the first, its advance in this respect is less
remarkable.
The brain grows, and the head enlarges re-
markably, within the first year after birth — par-
ticularly, during the first few months. The im-
perfect state of ossification in the bones of the
skull at this period, admits readily of the rapid
enlargement of the skull and its contents; this
6*
66 A GUIDE FOR MOTHERS AND NURSES.
being one of the uses of the fontanelles or open-
ings, in addition to the facility with which they
can afford in delivery, by allowing the bones to
overlap each other, and so diminishing the bulk
of the head. Six of these deficiencies in ossifica-
tion are found at birth, the spaces being covered
by membrane; nor have the sutures or seams yet
begun to form. The principal of these openings
is called the bregma, and is situated at the top of
the head, between the front and side bones; an-
other is found behind, between the hindmost and
side bone; and of the remaining two, (each of
which is double, thus constituting six in all,) one
is found in the temple at each side, the other be-
hind each ear. The presence of these fontanelles
(particularly that on the top of the head,) is a
source of uneasiness to the ignorant, imparting to
the hand an uncomfortable sensation, as if the
brain were devoid of protection; and improper,
and often injurious attempts are accordingly made
to remove them, by compressing the head, for the
purpose of bringing the bones together. But so
far from being a cause for alarm, these openings
are a source of advantage. The effects of blows
or falls on the head, (to which the infant is so lia-
ble,) are thus mitigated, the shock being inter-
A GUIDE FOR MOTHERS AND NURSES. 67
cepted before it has affected the brain; while, in
cases of disease, the danger from effusion is les
sened by the possibility of quick expansion thus
permitted, and which diminishes the effects of
compression. The full or sunk state of the breg-
ma, is an important point in disease. These open-
ings gradually close by a natural process, and will
be found completely united by the fifth year,
when the sutures are well marked and formed.
Occasionally, the fontanelles are later in closing,
the process of ossification being slow or imper-
fect; and this is a just cause for uneasiness, hav-
ing its source usually in a general delicacy of
constitution, often connected with a scrofulous
taint.
The brain not only increases much in size in
the child, but also alters sensibly in structure, ad-
vancing towards more complete organization; and
this is remarkable, at the time when signs of in-
telligence begin to be displayed. From about the
period when the first teeth appear, this advance
in structure is striking, that in size having been be-
fore more remarkable. The brain now becomes
firmer, more consistent, and less vascular; the
difference between the two portions is more pro-
nounced; the former is less red, the latter deeper
68 A GUIDE FOR MOTHERS AND NURSES.
coloured; the convolutions are better marked, and
so the surface more extended. The advance in
quantity and quality continues manifest to the age
of seven years, or about the period of second
dentition, which appears to be on many accounts
remarkable.
The brain has now assumed considerable vo-
lume, and its structure apparently resembles that
of adult life; but after this period, advance in
structure, and increase of size, may still be ob-
served, though not so remarkably.
The character begins now to be defined, and
some indications of the mental endowments of the
future man are afforded; the features form, and
the physiognomy begins to exhibit traces of a
marked disposition. But in regarding the coun-
tenance, we must take into account the develope-
ment of the bones and muscles connected with
the head and face, which occurs about this age;
yet, the general enlargement of the head is not so
much connected with the expansion of the skull
and its integuments as some insist. When the
circumference of the head, taken above the orb-
its, does not exceed thirteen inches in the adult,
idiocy always attends, according to Gall: and
Dr. Voisin found, on careful examination, that
A GUIDE FOR MOTHERS AND NURSES. 69
idiocy was complete when this measurement va-
ried from eleven to thirteen inches; while that
from the root of the nose over the head, to the
most prominent point in the posterior part of the
head, measured only between eight and nine
inches. In the full-sized head, the former mea-
surement averages two and twenty inches, the
latter fourteen. A very small head is usually ac-
companied by feebleness of character; but the
head may be large, and the person dull, or even
idiotic, the deficiency existing in the structure,
or quality, not in the size of the brain.
The advance of growth in the brain, does not
seem to proceed equally, either as to size or
structure, in all parts. Vimont notices, that the
increase of size, during the first months, is most
remarkable in the parts situated at the base of the
skull, and occupying the anterior and inferior re-
gions of the frontal bone; while, of the cerebral
convolutions, those soonest acquiring firmness of
structure, are placed in the lateral and middle
parts of the base. All know that the cerebellum
does not acquire its full developement until about
the period of puberty.
The head varies with the progress of growth
not only in size, but shape, the different regions
70 A GUIDE FOR MOTHERS AND NURSES.
of the brain being found to bear a different rela-
tive proportion at different ages, particularly
during youth; while at all periods there exists a
certain degree of individual peculiarity.
Not less remarkably do we observe a certain
order or relation in the successive developement of
the several moral and intellectual powers; which
is, doubtless, dependent upon this relative advance
in size or structure in different parts of the brain,
though not generally confessed to be directly con-
nected therewith, observations for determining
this point having been but partially made, and the
importance of the subject not yet duly apprecia-
ted. However this may be, it is certain, that the
disposition and intellect are gradually unfolded ;
and that attempts to force the one or the other
before its appointed time and proper progression,
are sure to be attended with injurious, if not
dangerous consequences. The reason is obvious
and physioligical; because, what is called the cul-
tivation of the mind, is in truth but the exercise of
the brain; and this, like every other organ, if
overtasked, will be worn out or destroyed.
In noticing the developement of the intellectual
powers, we see that the child observes before he
that the perceptive faculties come into
reasons
A GUIDE FOR MOTHERS AND NURSES.
71
play before the reflective. The child early ob-
serves and recollects things, and the qualities and
relations of things; and is inquisitive about
events. He constantly asks what this or that is.
But the senses advance still more rapidly than
the perceptive faculties, and are thus prepared to
furnish these faculties with knowledge of the va-
rious properties of matter. The differences to be
observed, however, in the power of appreciating
these qualities of bodies depend on differences in
the constitution of the perceptive faculties — not
of the senses. The eye may see well, and clearly
perceive the differences in size and form, and yet
not be able to distinguish differences in colours ;
the ear that hears best, is not that which best ap-
preciates those variations in sound that constitute
melody.
·
The various degrees of talent exhibited by some
children more than others, depend much on the
different degrees with which they are endowed
with those faculties that take cognizance of the
physical properties of things. In these quali-
ties and relations of bodies, we have the foun-
dation of the physical and natural sciences: and
for these sciences, (especially the latter,) mental
capacity exists at a much earlier age than seems
commonly supposed,
72 A GUIDE FOR MOTHERS AND NURSES.
The gift of language as a mental power, is that
which earliest attracts attention, and is first culti-
vated. Hence, facility in this respect, with a
quick observation, are taken as indications of great
intellectual capacity. But the reflective faculties
must be in full operation to constitute a really
good understanding; and these are always the
latest to be developed, and often not very liberally
bestowed. It is indeed, upon a due balance be-
tween the reasoning and perceptive faculties, that
the superiority of the intellect will depend.
Where the latter preponderate, they early show
themselves, and give a quickness of apprehension,
which in the child is often taken for superior talent.
But the smartest boy does not necessarily
make the cleverest man; there must be a full
endowment of the reflective faculties, to give
depth of thought, or soundness of understanding.
When these faculties early preponderate, how-
ever, the child may be slow in apprehension,
and will probably be esteemed dull; but when
the period for their exercise arrives, powers will
be exhibited which had not been anticipated.
Peculiarities of disposition, moreover, affect these
results as much as differences in talent, though
seldom, if at all, taken into the account. The
child often exhibits (from the earliest age) a mark-
A GUIDE FOR MOTHERS AND NURSES.
73
ed disposition, as it occasionally does some pecu-
liar talent. Almost from the moment of birth,
some infants are observed to be peevish, pas-
sionate, or obstinate; while others are gentle and
affectionate, or timid. A determined infant may
be seen to rule a weak parent, and even exer-
cise an influence over a whole family. A very
gentle child may never acquire sufficient force of
character to make his way in the world, no mat-
ter how intellectual he may be.
The higher sentiments, generally speaking, are
the more slowly developed; and superior moral
powers, as the sense of justice and religion, are
among the latest to come into operation, requiring
some assistance from the understanding for their
direction and support.
No doubt can exist that the child is endowed
with certain powers, moral and intellectual, vary-
ing in different individuals, and constituting natu-
ral differences of character; but this militates not
against the necessity for education or training, and
the vast influence exercised thereby; on the con-
trary, it serves as a guide and a limitation,
pointing out what requires to be cultivated, and
what to be repressed; and shows us what is pos-
sible to be done.
7
74
A GUIDE FOR MOTHERS AND NURSES.
How important, then, to acquire a knowledge
of the primitive faculties of man, and the laws by
which they are regulated in their natural devel-
opement, or influenced by artificial training. Nor
is the necessity for such knowledge confined to
the system more immediately connected with
mental manifestation. The same holds good res-
pecting all the other systems in the body; for
without due attention to cach, we shall not be
able to do justice to any, or secure for the whole
its best advantages during the period of develope-
ment or growth.
With regard to the general growth of the body,
and the advance in height, weight and strength,
differences arise from age and sex; and these
have been accurately investigated by M. Quetelet.
According to him, the average weight of the
male infant at birth, is about half a pound more
than that of the female, and the length about
an inch more; and the annual growth of the
female infant is less than that of the male, but
her developement is more early completed. Im-
mediately after birth, the weight of the infant is
found to diminish; nor does it begin sensibly to
increase until after the first week.
The growth of the stature is most rapid during
A GUIDE FOR MOTHERS AND NURSES.
75
the first year, when it amounts to nearly eight
inches; it is less rapid as the child approaches the
fourth or fifth year, appearing to diminish in direct
ratio to the age; up to that time the growth in the
second year being only half that of the first; in
the third year, only one third; but afterwards it
increases with a tolerably regular progression.
-
A remarkable difference is often to be obser-
ved in the degree of developement, or proportional
growth of one organ or system of organs more
than another. In some children the head is very
large, and great liveliness and intelligence are
early displayed, the system of nerves consisting
of the brain and spinal marrow and their appen-
dages, being that which preponderates; and this
lays the foundation for a particular temperament,
which according to the rational view of M. Tho-
mas, would, in this instance, be the nervous tem-
perament.
In other children, great muscular power is
early displayed, the chest is large, the body well
nourished, and the complexion florid. This con-
stitutes the thoracic, or as it is most commonly
called, the sanguineous temperament-the circu-
latory system predominating. The child is strong
and active, but not particularly intelligent.
776
A GUIDE FOR MOTHERS AND NURSES.
When the abdomen is very large, and the cir-
culation languid,—the child being pale, indolent,
and dull, with a large appetite, but little activity
of mind or body, the abdominal organs prepon-
derate, and the temperament is abdominal or
lymphatic.
Other varieties of temperament exist; and in
some individuals no temperament is strongly
marked; or more than one are mixed together.
But attention to the subject is important, as mo-
difying our plan of management both in health
and disease.
These varieties of constitution may be born with
the child, and looked on as hereditary: but they
will be much influenced by the manner in which
the individual is managed; according as one sys-
tem of organs, or another, is exercised or neglect-
ed. The great principle that should guide us is,
to afford to all and each its proper or appropriate
share of exercise or occupation, so as to strengthen
the weak or ill-developed organs; while we re-
press those that are disproportionately developed,
or over active, by consigning them to quiescence.
To be enabled to do this, however, we must study
the subject as physiologists.
Thus have we, in a brief and summary man-
A GUIDE FOR MOTHERS AND NURSES.
117
ner sketched those peculiarities of infancy, a know-
ledge of which, must serve as our guide in under-
standing aright the management of children in
health or disease. This object we have kept ex-
clusively in view, and resisted the temptation of
pursuing any of these subjects, however interest-
ing, further than the object proposed would war-
rant.
We have seen the infant presented to us, in
the first instance, as a mere vegetative being,
with the organs of nutritive life preponderating in
developement and activity.
As growth proceeds, however, the little being
asserts its claim to a higher order of existence.
The organs of organic life diminish relatively in
importance, while those of animal life advance,
and ultimately preponderate the infant becomes
a rational being.
To promote this preponderance, and ensure
the sound mind in a sound body, is the great end
proposed in the rearing and management of chil-
dren. Theprinciples by which we are to be gui-
ded in our attempts to attain this object, have
been already pointed out; and the manner in
which these principles are to be carried into
effect, will constitute a chief part of the ensuing
chapter.
7*
CHAPTER IV.
MANAGEMENT AND PHYSICAL EDUCATION OF
CHILDREN.
In the consideration of the subject of this chap-
ter, we shall adopt the division, already made,
into the two epochs of infancy and childhood;
and shall, therefore, first proceed to consider the
management of the infant directly after its birth.
SECTION I. Management immediately after birth.
Let us suppose, then, a healthy child to be placed
in our hands immediately after birth; the duty
of the accoucheur having been duly performed,
any mucus or other matter likely to obstruct its
breathing has been removed from its mouth, and
the cord has been tied and divided at the distance
of three or four inches from its navel. The
young being will be observed to cry stoutly, and
to move its limbs in such a manner as forcibly to
convey to us the impression that it is suffering
pain, which we can readily account for, when we
recollect the sudden transition of temperature it
has experienced, from about 98°, the heat of the
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79
mother's body, to that of the atmosphere, which,
at the highest, will seldom exceed 70°. The pro-
duction of pain, however, is but a necessary con-
sequence of the access of air to the surface of
the body; which in itself is highly beneficial, its
vivifying influence being, as we learn from the in-
genious researches of Dr. Edwards,* calculated
powerfully to counteract the greater or less de-
gree of insensibility induced during birth. The
pain, also, by exciting the infant to cry, contrib-
utes materially to the perfect expansion of the
lungs by air; the non-effecting of which, is not
unfrequently attended with fatal results. Although
such are the good effects of exposure to cold; it
should however be but momentary, as its con-
tinuance would be, certainly, productive of the
worst consequences to the well-being, and even
existence of the child.
"Instinct," says Dr. Edwards, "leads mothers
to keep their infants warm, though philosophers,
by more or less specious reasoning, have, at
different times, and in different countries, induced
them to abandon this guide, by persuading them
that external cold would fortify the constitutions
* Dr. Edwards on the Influence of Physical Agents on Life.
Translated by Doctors Hodgkin and Fisher.
80
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of their children, as it does those of adults."
To this distinguished physiologist we
are in-
debted for the observations, that the heat of
mature infants at birth, is from 3° to 5° less
than that of adults-varying between 93° and
95°; that the heat of premature infants is still
less; and that the power of producing heat being
in all young animals at its minimum at birth, they
have not the same capability of resisting a dimi-
nution of their temperature, from exposure to cold,
aş adults. From Dr. E.'s discoveries, we are in-
deed fully warranted in concluding that the phi-
losophers of whom he speaks, are in the wrong:
and that nature has, with her usual wisdom, con-
ferred a proper instinct upon mothers, in teaching
them to keep their offspring warm. It is for us,
therefore, immediately upon taking charge of the
newly-born child, to have it warmly wrapped up
in flannel, and to take care that, in cold weather,
it should be dressed in the neighbourhood of a
comfortable fire, and that during the operation, it
shall not be unnecessarily exposed to cold.*
* The views of Dr. Edwards have been practically confirmed
by some observations of Dr. Milne Edwards, and Dr. Villermé.
It is the custom in France to convey infants, within a few hours
of their birth, to the office of the mayor of the eommune, in order
that their birth may be registered; and Drs. E. and V. discovered
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81
SECTION II. Washing. When we examine more
carefully the body of the infant, we shall find that it
is more or less covered with a white, greasy, or
curd-like substance. This is denominated the
vernix caseosa, and appears to be provided for
the purpose of defending the tender skin from the
-injurious effects of the warm, watery fluid in
which it floats while in its mother's womb. After
birth, however, this coating has no useful purpose
to serve, and would be injurious, by intercepting
the vivifying influence of the air of which we
have already spoken.* It is, therefore, advisable
to remove it; and, accordingly, the first act of
the nurse is, to wash the new-born child. The
washing should be performed with warm water,
and a fine sponge. Particular care should be
taken to remove all extraneous matters from the
eyes, and from the folds of the skin, in the arm-
that the proportion of deaths, within a very limited period after
birth, compared with the total births, was much greater in winter
than in summer,
in the northern and colder, than in the south-
ern and warmer, and in parishes where the inhabitants were
scattered over a large surface of ground, than in others, where
they were more closely congregated round the mayor.
* If any authority were wanting for the removal of the vernix
caseosa, we have it in the practice, which obtains universally among
animals, of licking their offspring immediately after birth.
82
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་
pits, &c.; but no force likely to hurt the surface
should be employed and we have not found
soap to be required, although it is recommended
by many writers. In this country, Great Britain,
where whiskey is in universal use, the nurses
generally employ a little of it for washing the
child's head, under the idea that it prevents the
taking of cold. This practice is certainly not a
necessary one in ordinary cases; but at the same
time, it does not appear to be attended with any
injurious consequences: and when we can say so
much for any popular custom, it is as well to let
people have their way, and direct our attention
the more closely to the prevention of what may
be really prejudicial.
SECTION III. Dress. The washing having been
accomplished with as little delay as possible, and
the surface carefully dried with a soft napkin, the
next business of the nurse is, to dress her charge.
This process is commenced by an arrangement
for the protection of the remnant of the navel
string. The cut surface of this should be carefully
examined, lest, as frequently happens, secondary
bleeding should take place, in consequence of the
loosening of the ligature, -dependent on the
oozing out of the gelatinous fluid, which makes up
A GUIDE FOR MOTHERS AND NURSES.
83
the bulk of the cord. If such an occurrence has
taken place, a fresh ligature must be applied firm-
ly, and its ends cut off close to the knot. The
cord is then to be drawn through a circular hole,
cut in a piece of old linen, about four or five inches
in diameter, which is to be gently folded round it.
In the preparation of this envelope, the nurses
are particularly anxious to have it extremely dry
and warm. It is always held carefully to the
fire, and sometimes even scorched, before they
will permit its application--a prejudice which is
certainly harmless, and probably but one indica-
tion of the general instinct which teaches them
that a new-born infant requires its heat to be
carefully husbanded.* The cord thus enveloped,
is to be placed flat upon the child's abdomen, and
secured there by a band of thin flannel, five or
six inches broad, and long enough to go twice
round the body. The chief use of this band ap-
pears to be, to support the navel string and its
* As a curious instance of this dread of abstracting heat from
the child, we often find the peasants of Great Britain carefully
warming the scissors, before using it for the division of the cord.
It is easy, and no doubt appears scientific, to ridicule popular
customs and superstitions; but would it not be more discreet and
philosophical, to endeavour to discover their origin from some in-
stinct to which they may generally be traced ?
84 A GUIDE FOR MOTHERS AND NURSES.
covering; and we cannot think that it is required,
as Dr. Dewees* supposes, as a support to the ab-
domen: it never should be applied so as to make
any pressure upon that cavity; and on that account,
it is well to have it made of the thinnest flannel,
cut diagonally or bias, so as that it may be perfectly
elastic. In fastening it, pins are usually employ-
ed; but the fewer of these used in dressing an
infant, the better; and it would be well, if we
could have strings substituted for them in every
possible case. The further dressing of the body
of the child, is very much a matter of fashion,
with which the physician has little to do further
than to see that the clothing is sufficiently warm,
and not calculated to place any restrictions upon
the movements of the limbs. The arrangement
of the head-dress must be conducted upon princi-
ples similar to those which guide us with respect
to the other clothing: the head is to be protected
from the cold air by a moderately thick muslin
cap, but so as that it shall suffer no compression,
and not be placed in a constrained position. Over
all, a thin flannel shawl is to be wrapped in such
a way as neither to impede the free access of air
to the mouth, nor to hamper the extremities so as
* On Physical and Medical Treatment of Children.
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85
to prevent their spontaneous movements. The
infant is then to be placed in a cradle or bed, so
situated, as that it shall not be exposed to draughts
of cold air; and that while it is not absolutely in
the dark, still its eyes may be protected from a
strong light, which, as yet, they are unable to en-
dure thus placed, it will usually fall asleep, and
remain so for several hours, until awakened by
the calls of hunger.
:
[The propriety of wearing a cap must depend
very much upon the season of the year. In this
climate where the winters are cold and rather
long, caps are necessary for young children; but
in the summers, when the heat is great and of
long continuance, caps are productive of much
evil after the first two or three weeks, unless
made of thin material. By the uneasiness and
nestling of the child the strings act as ligatures,
obstructing the return of blood from the head
through the larger vessels in the neck; besides,
the heat of the head is increased, thus incurring
much the danger of all head affections in those
thus predisposed.
It is only in the cold season, and two or three
weeks in summer in new-born infants, that caps
are admissible; and healthy children in cold
8
86 A GUIDE FOR MOTHERS AND NURSES.
i
weather, after the first few weeks, are better
without them. Covering the head with a blanket
is an error that nurses almost universally commit;
and it is one of the most serious that they can
well be guilty of. They think that the child has
never had air to breathe, and seem to think that
he never requires it. But they should remember
that he is now a breathing animal, and that the
child, although small, requires just as free access
to air, and just as pure air as a nurse herself does.
A nurse, or mother, can judge for herself how
important pure air is to the child, by covering
his own head and mouth, and excluding the air
with a blanket; she would soon experience a
sense of suffocation, and throw the covering from
her face. It must also be remembered that in-
fants possess great irritability, being seriously
affected by small causes; and a slight privation
of air, therefore, is sufficient to do them material
injury; and I have no doubt that fits, and death
indirectly, are occasioned by depriving the child
of free access to air.]
SECTION IV. Medicine immediately after birth.
During foetal existence, the various organs de-
signed for the performance of digestion, produce
a greater or less quantity of their peculiar secre-
A GUIDE FOR MOTHERS AND NURSES.
87
tions; and, as there is no exit provided for these,
they accumulate in the intestines of the child,
constituting the dark green, or brownish, pitch-
like substance denominated meconium. By many
persons, even at the present day, this meconium
is supposed to exert a most baneful influence
upon the health of the child; and it is believed
that no time should be lost in effecting its speedy
removal. Accordingly, very few children in this
country, are fortunate enough to escape being
dosed with castor oil, immediately upon their
arrival in the world; and many are obliged to
undergo the additional peril of having a quantity
of calomel forced down their throats.
Neither of these practices, however, is constantly
necessary, and the last is positively injurious: the
delicate mucous membrane of the child's intestines,
only fitted for the reception of the mildest nutri-
ment, is always injured by the operation of a medi-
cine so active and so irritating as calomel. To the
milder action of castor oil, the same objection does
not apply; and where the abdomen of the child is
full, and no evacuation takes place for five or six
hours after birth, it will usually be found advan-
tageous to administer half a drachm of oil, provi-
ded we can procure it fresh, and free from ranci-
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dity.
We are, however, decidedly of opinion,
that it is better and more natural to allow an in-
fant to sleep quietly for five or six hours after
birth; and not before that period to disturb it, or
irritate its stomach, by the administration of any
thing whatsoever. Those who advise the imme-
diate employment of purgatives, assert that such
practice is consistent with the plans of nature,*
inasmuch as they suppose the milk first secreted
by the mother (or colostrum, as it is termed,) to
possess a purgative property. The argument is
obviously a contradictory one; for, if nature her-
self provides a purgative, why should we seek to
supersede her efforts by artificial means? The
fact, however, of the first milk being purgative, is
not proved, and is altogether denied by some.
It is probable that it possesses no distinct purga-
tive quality, but excites the intestines merely by
mechanical distention, and so in effect produces
expulsion of the meconium, as other food is found
to do in cases in which the secretion of milk is not
established, for two or three days after labour.
[A small quantity of molasses and water is fre-
quently employed, in this country, to evacuate the
meconium; and when this is insufficient, I have
* Dewees.
A GUIDE FOR MOTHERS AND NURSES. 89
used a tea-spoonful of the best salad oil, which is
very unirritating, and very certain in its operation.]
SECTION V. Food. So much for medicine, im-
mediately after birth; and upon the same princi-
ple, viz., that sleep is what the infant most re-
quires, we do not think it necessary to give any
food for some hours. Should the mother be able
to supply the natural nutriment at the end of eight
or ten hours, or even earlier, as is often the case,
we think the infant should be then applied to the
breast; and that it is highly desirable to avoid giv-
ing, in the interim, any other food whatsoever.
Should the secretion of milk not be perfectly es-
tablished for two or three days, as sometimes hap-
pens, the child will be cross and evince signs of
hunger, and we shall then generally find it neces-
sary to give a small quantity of thin gruel, with a
little milk. Even in these cases Professor Jörg
recommends, that nothing should be given but a
few tea spoonsful of lukewarm water; and we
happen to know that such is his practice, without
any bad results, in the lying-in Hospital of Leipzig.
Notwithstanding this, however, should it not be
practicable to have the child suckled within ten
or twelve hours after birth, we think it advisable
*8
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to give, every five or six hours, a few tea spoonsful
of such food as has been mentioned above, but to
desist immediately upon a nurse being procured,
or the mother becoming herself capable of supply-
ing sufficient nourishment.
[It is sometimes the case that infants decline
taking the breast for a day or two, the mother and
nurse become alarmed lest the child will never
nurse; but I have never known an instance when
it did not, sooner or later, nurse with as much
avidity as other children. This however, requires
some management. The first thing, is not to feed
it, at least for the first thirty-six hours, except
something to open its bowels. The next plan to
be adopted, is to make a sugar teat, to resemble
the nipple in shape and size, as nearly as possible,
of fine linen, or cambric; and this should be kept
in the child's mouth, by the nurse, several hours in
the day.]
Having premised thus much respecting the at-
tentions required by the infant immediately upon
its entrance into the world, we shall now proceed
to consider its further management with regard to
food, cleanliness, clothing, sleep, exercise, medi-
cine, and the action upon it of physical agents, as
light, air, and temperature.
A GUIDE FOR MOTHERS ANd nurseS.
91
SECTION VI. Food in the first period. It is un-
necessary to go at any length into the question of
the propriety of mothers nursing their own chil-
dren; the weight of the moral and physical con-
siderations which leave no choice as to the propri-
ety of obeying the dictates of nature, being now
universally acknowledged. Women are not, at
least at the present time, in this country, the
unnatural deserters of their offspring that system-
atic writers would lead us to suppose; and we
think most experienced physicians will join us in
declaring, that our duty less frequently is, to urge
maternal nursing, than to explain, and even en-
force in individual instances, the exceptions where-
by nature herself does sometimes render it impos-
sible or inexpedient to comply with her general
law. We are, in fact, oftener obliged to save an
infant from destruction, and a delicate mother
from injury, by forbidding ineffectual attempts at
nursing on the part of the latter, than we are call-
ed upon to remind a stout and healthy parent of
the urgency of the natural claims upon her. We
shall therefore assume, as a general rule, that all
mothers should nurse their own children, and
merely indicate those cases in which it becomes
necessary to substitute another mode of rearing
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the child. Women who labour under any mortal
or weakening disease, as phthisis, hemorrhages,
epilepsy, &c., are obviously disqualified for the
office of nurses; some, who are in other respects
healthy, have breasts incapable of secreting a suf-
ficient supply of milk, and this may be temporarily
the case with one child (especially the first) while
upon other occasions the same individuals make
excellent nurses; in other instances the breast
may perform its functions well, but the nipple may
be naturally so small, or may be so completely
obliterated by the pressure of tight stays, as not
to admit of its being laid hold of by the child.
These are actual, physical hinderances to nursing.
Again, women may, and in the higher classes fre-
quently do, possess such extremely sensitive and
excitable temperaments as will render it impru-
dent for them to suckle their own children.
Frightened and excited by every accidental
change in the infant's countenance, and inordin-
ately moved by the common agitations of life,
such persons are kept by their own tenderness,
and over-anxious desire to do their duty well, in a
state of continued fever, which materially inter-
feres with the formation of milk, both as to quan-
tity and quality. Women, also, who become mo-
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93
thers for the first time, at a late period of life,
have seldom the flexibility of disposition, or the
physical aptitude for secretion of milk, required
to constitute a good nurse. Another disqualifica-
tion for nursing we must notice, although we hope
and believe that it is rarely observable among our
countrywomen: if women of fashion are not con-
tented to give up their engagements in society
in favour of their domestic duties, it is better for
them not to undertake the latter "In this mat-
ter," says Wendt, "it is better to do nothing, than
only half."
We have already stated, that the child should
be put to the breast as soon as the latter contains
any thing for it to extract; this generally happens
when the mother's system has been relieved, by
sleep and ten or twelve hours' rest, from the fever
which is always more or less attendant upon la-
bour. Unless there has been some secretion of
milk, it is better not to apply the child as it be-
comes disappointed by continued ineffectual at-
tempts at obtaining nourishment, and there may
subsequently be some difficulty in getting it to en-
gage seriously in the business of sucking. As
*
* We have heard the propriety of the advice given above, call-
ed into question. Practical men will, however, have no difficulty
94 A GUIDE FOR MOTHERS AND NURSES.
soon, however, as it has fairly commenced, it will
require no other food; and if the mother be a
good nurse, she should be able to support her in-
fant independently of any other nutriment, during
at least two-thirds of the period of infancy, that
is to say, until the seventh or eighth month.
About that time the teeth usually begin to appear,
and to indicate that the digestive system is assum-
ing a capability of doing more work than it was
adequate to at first; and, accordingly, we should
then take the hint from nature, and begin gradu-
ally to train and exercise its powers. The suck-
ling of the infant, which during the first months
should be performed at regular intervals of about
four hours, should now be repeated not more than
three or four times during the day and night; and
twice during the same period some artificial food
should be given. This at first may consist of soft
bread, steeped in hot water, with the addition of a
little sugar and fresh cow's milk; subsequently
some light broth, free from fat and vegetable mat-
in understanding the advantage of preventing the disappointment
to the child, and the injury to the nipple itself, sometimes occa-
sioned by protracted drawing at an absolutely empty breast: this is
the utmost extent of delay which we wished to recommend, and
to this recommendation we must still adhere.
A GUIDE FOR MOTHERS AND NURSES.
95
ters, may be given once during the day. With
respect to the mode of feeding at this period, the
spoon will be the best vehicle, as it is an object to
give food somewhat more solid than could be
drawn through the sucking bottle. The child,
however, should not be placed horizontally on its
back, and gorged until it is filled to the throat, as
is often done; but its head should be kept eleva-
ted, and its actions be carefully attended to, so
that we may know, and at once stop, the moment
it appears to be satisfied.
During the first five or six months, the infant
must be suckled during the night as well as day,
but this should be done at regular intervals of
four hours; and if it sleeps with the mother or
nurse, the nipple should not be allowed to remain
in its mouth, as it is not our object to keep the
stomach constantly full, but to give it time, when
filled, to digest its contents. A child nursed as
we have recommended, will be found to awaken,
with a good deal of regularity, at the proper peri-
ods for its meals. During the process of weaning,
the intervals between the times of sucking at night,
may be at first gradually lengthened: but in order
to insure unbroken rest at a subsequent period,
both to the attendants and the child itself, it is
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very desirable not to accustom it to receive any
artificial nourishment during the hours proper for
sleep.
SECTION VII. Wet Nursing. We have been
hitherto supposing the mother to be a perfect
nurse, and the relative supply and demand to be
well adjusted between her and her infant; but
these are not exactly the cases which we always
meet with in practice. We shall frequently have
a demand greater than the supply, long before the
seventh or eighth month; and in such instances,
we shall be obliged to give food at an earlier pe-
riod, and will often find it to agree well, if its
kind and administration be regulated upon the
rules just laid down. The great maxim to be ob-
served is, not to let the infant want nourishment
which will agree with it. If this can be furnished
by the mother alone, so much the better; if the
deficiency can be supplied by artificial food, with-
out the infant suffering, there will be no necessity
for making any further change: but if neither of
these conditions obtain, we must have recourse to
a strange nurse.
As we have stated it to be desirable, that as
much as possible of infant's nourishment should be
derived from the nurse, it of course becomes an
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97
object to render our source of supply as available
as may be; and we are, therefore, legitimately
called upon to consider how this may be done
most efficiently. The grand secret is, in a word,
to keep the nurse in good health; if we succeed
in this, we render the milk, both as to quantity
and quality, as good as it can be produced by the
individual. Now, how is this to be done? Is it
by overloading the stomach with a mass of indi-
gestible food and drinks, and keeping the system.
under a continued fever of digestion? or, is it not
rather by allowing the person to live, as much as
possible, in the manner customary with her, sup-
posing that to be one which has hitherto preserv-
ed her in good health,— permitting her to eat her
usual meals, which she will probably do with in-
creased appetite, and not inculcating upon her
the necessity of taking drinks more stimulating, or
in larger quantities (relatively with her probably
increased consumption of food,) than she has been
in the habit of using? With hired nurses, it is es-
pecially necessary to act upon the principle just
laid down; for these persons, coming from the
scanty table of their own homes, are apt to indulge
their appetites from mere novelty, if, as is usually
the case, their employers show any disposition
9.
98
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towards a stall-feeding system. Nurses should
not be kept upon any one description of food ex-
clusively, but should have, as is natural, a whole-
some, mixed, animal and vegetable diet, with or
without wine, according as they have been accus-
tomed to live; but we may, perhaps, allow them
with advantage somewhat of an extra, though never
an unreasonable quantity of malt drink, providing
always that it be found to agree with their diges-
tive system.
Irritability of temper, and indulgence in passion,
interfere with the secretion of milk, to such an ex-
tent, that a child has been known to be attacked
with convulsions immediately after being suckled
by a nurse, while suffering under the effects of a fit
of anger. A knowledge of this circumstance influ-
ences many persons to indulge nurses in the most
extravagant whims, lest their temper should be
crossed, and the child thereby injured. Irritable
persons are unquestionably unfitted to nurse or
manage children; but we apprehend, that over-
indulgence is not the way to improve temper: and
as we fear that the most learned diatribe from us,
would have little efficacy in supplying a good dis-
position where Providence has not created it, we
shall not pursue this subject farther.
A GUIDE FOR MOTHERS AND NURSES.
99
[Milk. This is the only aliment which nature
has kindly provided for the sustenance of the
young of the human family, as well as for a large
proportion of all inferior animals. Milk is said
by some to be partly a vegetable and partly an
animal production, or vegeto-animal; while others,
again, whose mental optics must be peculiarly
constructed, can see in it nothing but of a purely
vegetable nature. In herbivorous animals, and in
woman, when she partakes of no animal food, the
milk, as well as the whole body, is, doubtless, of
vegetable origin. The blood is significantly termed
the pabulum vitæ, the food of life; and from it
all parts of the body derive their sustenance and
growth. From the blood are formed bone, mus-
cle, nerve, tendon, horns, hair, nails, skin, the
various secretions, as tears, saliva, mucus, milk,
&c., and yet, because the blood of a cow, or
sheep, is formed from vegetable aliment, no one
thinks of calling the one or the other of these
animals a vegetable production. The question is
asked, if the food is vegetable, how can the milk
be an animal production? Like many other ques-
tions, this may be best answered by putting another.
If the food is purely vegetable, how happens it
that the flesh of an animal is not purely vegetable
100
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also? Speculation and fancy can do but little in
settling the question, how, in the process of diges-
tion, vegetable matter becomes animalized. Cer-
tainly, no one would claim that milk, drawn from
a carnivorous animal, one that never tasted a
vegetable, was any other than an animal pro-
duction.
Milk differs greatly in the different animals-
that of each species being provided solely for the
sustenance of its own young. Cows' differs from
human milk in containing a greater proportion of
cheese and cream, and less of serum, or the watery
part. "The milk of a woman who suckles, living
upon vegeto-animal food, never becomes acid, or
coagulates spontaneously, although exposed for
many weeks to the heat of a furnace. But it
evaporates gradually in an open vessel, and the
last drop continues thin, sweet, and bland. The
milk of a sucking woman who lives upon vegeta-
ble food only, like cows' milk, easily and of its
own accord becomes acid; and is acted upon by
all coagulating substance, like the milk of animals.
Children affected with pain in the bowels, arising
from acids, are often cured by giving the nurse
animal food."*
* Hooper's Medical Dictionary.
A GUIDE FOR MOTHERS AND NURSES. 101
The advocates of an exclusively vegetable diet
may, perhaps, receive a severe check in their
enthusiasm, by learning that animal food is ab-
solutely necessary; and an important precept
may be deduced for parents from the foregoing
consideration, to wit: to substitute no other for
the mother's milk, when that can be obtained.
Because nature has ordained that infants, and
the young of all mammiferous animals, shall de-
rive their sustenance from the mother's breast, it
is, therefore, concluded that milk is the most
proper diet for man in all ages. But in coming
to this conclusion, it seems to be forgotten that
nature has decreed that each species of animal
shall live on the milk of its own kind. In accord-
ance with this law, we see that the stomach of an
infant cannot digest cows' milk, on account of its
becoming acid, and we find also that nursing moth-
ers are compelled to live on a mixed diet, to prevent
their milk becoming like that of a cow. Thus, it
is evident, from incontrovertible facts, that there
is a glaring impropriety in substituting the food
for one animal, which nature has designed for
another. The impossibility of doing this with
impunity is manifest in mature life; there being
many who find it almost impossible to subsist on
a milk diet.
9*
102 A GUIDE FOR MOTHERS AND NURSES.
The first process of digesting milk, is its sepa-
ration into two parts, solid and fluid, or curd and
whey—of which the latter is in the greatest pro-
portion; and as the experiments of Dr. Beaumont
prove that fluids are more difficult of digestion than
solids, we have one reason why milk is particu-
larly apt to disagree with those whose stomachs
are deranged, and for whom it is often injudiciously
recommended.-T.]
SECTION VIII. Choice of a Nurse. When cir-
cumstances prevent a parent from suckling her
own child, it is important that we should have
some principle to guide us in our selection of a
strange nurse. Medical men are constantly asked
for an opinion upon this subject, and we shall
therefore offer a few rules, which may be useful
in enabling us to form one. The great thing we
have to look to is, to ascertain that both woman
and child are in good health; and of this we must
endeavour to judge from the following signs:
The woman's general appearance and form should
be observed; and they ought to be such as beto-
ken a sound constitution. Her skin should be
free from eruptions; her tongue clean, and indica-
ting a healthy digestion; her gums and teeth
sound and perfect; the breasts should be firm, and
A GUIDE FOR MOTHERS AND NURSES. 103
well formed, not too large, or flabby,—and
with perfect, well-developed nipples. We should
see that the milk flows from them freely, upon
slight pressure; and we should allow a little of it
to remain in a glass, in order that we may judge
of its quality.* It should be thin, and of a bluish-
white colour; sweet to the taste; and when
allowed to stand, should throw up a considerable
quantity of cream. A nurse should not be old;
but it is better that she should have had one or
two children before, as she will then be likely to
have more milk, and may also be supposed to
have acquired experience in the management of
infants. The more recently the nurse's own con-
finement has taken place, provided she has recov-
ered from its effects, the better, as we may count
upon her services so much the more permanently.
It is, however, not generally a serious objection
should two or three months have elapsed since
* Nurses who have not a good supply of milk will, occasionally,
be found to adopt a practice commonly employed with milch cows
when brought to market, and called by the cattle dealers stocking :
that is, they allow the milk to accumulate in their breasts for seve-
ral hours before presenting themselves for examination, so as to
cause the examiner to believe that they are very abundantly pro-
vided. Young practitioners and mothers should be especially on
their guard against this deception.
104
A GUIDE FOR MOTHERS AND NURSES.
that event. Having examined the mother, we
must next turn to the child, which should be well
nourished, clean, and free from eruptions, espe-
cially on the head and buttocks. We should,
also, carefully examine its mouth, to ascertain
that it is free from sores or aphthæ. If both wo-
man and child bear such an examination as we
have mentioned, we may with tolerable security,
pronounce the former as likely to prove a good
nurse.*
SECTION IX. Artificial Feeding. What we
have already stated as to the management of an
infant's food, negatives altogether the question of
the propriety of ever choosing to rear a child en-
*The following is the beau ideal of a good nurse, according
to Wendt. Some of its Germanisms may amuse. "Youth, full-
ness of health, plenty of milk, and a good build of breasts and
nipples a rather phlegmatic temperament, a quiet disposition,
and no inclination to sensuality or dissolute habits, —a white, deli-
cate skin, traversed by blue veins, and covered with freckles,
fair or reddish hair, large blue eyes, sound teeth, a fresh breath, a
clean skin, no disagreeable odour, no unnatural discharges, a
bluish-white, rather thin, than thick and tenacious milk, which
dropped upon the thumb-nail, flows off rather quickly, it should
have no smell, and a mildly sweet taste, along with these, large
and firm nipples, a cleanly person, and a harmless temper, form
the ideal of a good nurse.”
A GUIDE FOR MOTHERS NND NURSES. 105
tirely by artificial feeding. Certain cases occur,
however, in which we have no alternative. Pecu-
liar circumstances may preclude the possibility of
procuring a nurse; or an infant, whose mother is
incapable of nourishing it, may be the subject of
some contagious disease, to contamination from
which, we cannot, in common honesty, permit a
stranger to be exposed. The necessity of resort-
ing occasionally to artificial feeding, obliges us,
therefore, to consider how we can render it least
injurious, for such is really the question; although,
we do not mean to deny, that in certain instances,
extremely healthy children have been reared in
this way. These are, notwithstanding, but excep-
tions; for a very extended experience, in differ-
ent countries, have proved that spoon-feeding is
generally unsuccessful. The kind of artificial
food proper to be employed, forms the subject of
our first inquiry; and, as a general rule, we may
say, that it should be as like the natural nutriment
as possible. This rule, however, is easier laid
down, than acted upon; "for nature," says Dr.
Prout, "will not permit the chemist to officiate as
her journeyman, even in the most trifling degree.”*
* Gulstonian Lecture. 1831.
106 A GUIDE FOR MOTHERS AND NURSES.
In the present state of our knowledge, then, it is
vain to attempt any preparation, upon chemical
principles, of a food resembling human milk. It
will be better to be satisfied with employing the
food of some other young animal, and modifying
it, so as to make its sensible properties as nearly
similar as we can to the milk in question. For
this purpose, good cows' milk is usually the most
convenient; and as it is thicker and whiter, and
not so sweet as human milk, we may add to two
parts of it, one of very thin barley water, and suf-
ficient white sugar to make the necessary increase
in sweetness. Asses' milk approaches more near-
ly, in sensible properties, to what we require; but
it is richer, and requires to be diluted with about a
third part of water. So modified, it may be used,
if the cow's milk disagrees, or if it can be conven-
iently procured. As the child becomes a little
older, thin bread pap, made as we have already
directed,* may be advantageously employed; and
it will also be advisable to give, occasionally,
some light beef or chicken tea. In managing
spoon-feeding, all our ingenuity will frequently be
required for varying the kinds of food; as one
* P. 37.
A GUIDE FOR MOTHERS AND NURSES. 107
which agrees well with the infant at first, may,
after a little time, derange the bowels,-producing
acidity, gripes, and purging, or perhaps costive-
ness. Thus, prepared barley, dressed with water
and unboiled milk, will sometimes purge, -an ef-
fect which may be obviated by having the milk
boiled. In other cases, we must have recourse to
the use of arrow root, for a short time, for the pur-
pose of restraining the bowels, and again recur to
the barley when costiveness has been produced.
A great matter is accomplished, if we can pre-
vent the production of acid fermentation in the
stomach and bowels; and, on this account, we
must be most particular in requiring every article
of food to be freshly prepared before use, and in
enforcing the strictest attention to cleanliness with
respect to every vessel employed. Every kind
of food should be used tepid, or lukewarm.
Our second inquiry relates to the mode of ad-
ministering artificial food. This may be accom-
plished either with the spoon or sucking bottle.*
The former has the advantage of leaving less op-
*These bottles have a narrow neck, about the size of the nip-
ple, with a small orifice, covered with a teat of washed shammy
leather, through which the infant sucks the food. They can be
had at any druggist's, ready for use.
108 A GUIDE FOR MOTHERS AND NURSES.
portunity for uncleanliness, as a spoon is easily
washed, and its condition at once perceptible;
while the bottle may appear clean, and yet con-
tain a leaven of acidity, which will do material in-
jury. On the other hand, the bottle has the ad-
vantage of giving out the food in a mode some-
what analogous to that employed by nature; the
child has some trouble in procuring what it wants,
and will therefore not be likely to take too much;
the action of sucking must also be practised,
whereby a degree of pressure is made upon the
child's salivary glands, and the necessary secre-
tion from those organs, in all probability usefully
promoted. In the earlier periods, we think, the
bottle possesses, on these points, decided advan-
tages; but while using it, too much precaution
cannot be taken against uncleanliness. No food
should ever be allowed to remain in it after the
infant has been fed; and there should be always
two in the nursery, in order that one may be ex-
posed to the air, and dried, while the other is in
use.*
Additional Food of Infants. We have already
* Dr. Zwierlein of Brückenau, has written a book to prove that
goats are the best and cheapest wet nurses. We fear it would
be difficult to introduce the practice into this country.
A GUIDE FOR MOTHERS AND NURSES. 109
to this part of our subject, in showing that milk is
the food that nature has provided for the young
of all mammiferous animals; but with the import-
ance of this truth, nurses and mothers are not suf-
ficiently impressed. And here let me urge upon
those whose happiness it is to be mothers, in all
circumstances when it is not absolutely improper,
the expediency at least, if not the necessity, of
permitting their own offspring to draw their nour-
ishment from that pure fountain which God has
ordained. There is a holy pleasure in affording
sustenance to a helpless, innocent being, brought
into the world by the perils of life, and by the most
exquisite pains that human nature can endure,
which none but a mother can ever experience.
When a mother can nurse her own infant, cold, in-
deed, must be her affection, when she can, with the
utmost indifference, turn him over to the careless at-
tention of a hireling nurse. Ought a parent, who
can thus coldly expel from her bosom her tender
offspring, to complain if in her old age she is re-
paid with the like affection? To follow the dic-
tates of nature is always safe and prudent, but to
disregard her precepts, even in seemingly unim-
portant matters, is dangerous and unwise; and
therefore, when she has appointed a guardian and
•
· 10
110 A GUIDE FOR MOTHERS AND NURSES.
protectress for an infant, we may rest assured that
no one can, in all respects, supply her place.
If, then, it becomes necessary that a child draw
its sustenance from some other breast than its mo-
ther's, let a perfectly healthy nurse be obtained;
and above all, let her be of an amiable temper,
good character, and of regular habits. The breast
milk differs at different times, so that it may be
improper for the child.
1st. As has been before mentioned in respect to
food a purely vegetable diet rendering the milk
unhealthy, and causing pain and griping in the
child's bowels, which is often relieved by using
a diet composed in part of animal food.
2d. In respect to time of digestion. Towards the
twelfth hour after eating, the milk becomes thick
and yellowish, and is spit out by the child; hence
the meals should be taken regularly, that a healthy
secretion of this nutritious fluid may be preserved.
The
3d. In respect to the age of the milk.
milk that is first drawn is serous or watery; and
from this period it becomes thicker, so that after a
twelvemonth it is rejected by the child's stomach
on account of its thickness; hence nature indicates
a change of food, and the proper time for wean-
ing.
A GUIDE FOR MOTHERS AND NURSES. 111
4th. In respect to food and medicines. It is, no
doubt, generally known, that in some of the West-
ern States a disease occasionally prevails, with
great fatality, called the milk-sickness, which is
caused by eating the milk of cows that have fed
on poisonous herbs. The milk of nurses is affect-
ed in the same manner; so that if a nurse eat
onions, or any thing having an unpleasant odour,
or possessing any noxious properties, the milk is
impregnated with it, and rendered disagreeable
and unwholesome. If a nurse indulge in intoxica-
ting drinks, the child is intoxicated also; if she
use beer or wine in moderation, the child becomes
ill; or if she take purgative medicine, the child is
also purged.
5th. The influence of the mind upon the body
is well exemplified in the case of nursing women;
the milk always becoming deranged and being
rendered unfit for nutrition when the mind is any
way disturbed. There are frequent instances of
infants being seized with convulsions after sucking
an enraged nurse; and cases are not wanting
where they have been destroyed by violent inflam-
mations from the same cause. An infant of a
year old, while he sucked milk from an enraged
mother, on a sudden was seized with a fatal bleed-
112 A GUIDE FOR MOTHERS AND NURSES.
ing, and died; and infants at the breast in a short
time pine away if the nurse be affected with griev-
ous care.
6th. Disease of the body, as well as affections.
of the mind, derange the secretion of milk, and
render it unwholesome or unfit for nourishment.*
Infants should be allowed no other food than
that which nature has provided; and this should
be offered them as soon as practicable after they
enter this state of existence. The first drawn milk
is precisely what they need to prepare their deli-
cate digestive organs for that of a different cha-
racter which is soon to be formed. They should
generally, if possible, take little or no other food
than the breast milk, till, by their teeth, they give
evidence that nature has prepared them to receive
other and more solid aliment. It is a great error
in the management of children which leads a
nurse or a fond mother, from some mistaken views,
to be forcing down panada, arrowroot, and sundry
other preparations; this is frequently done with
the fallacious idea that something, or almost any
thing, is better than the mother's milk. I have
little hesitation in saying, in the most decided
* Hooper's Medical Dictionary.
A GUIDE FOR MOTHERS AND NURSES. 113
Į
terms, that most, if not all articles usually given
to children during the first few months after birth,
are unequivocally improper and injurious.
Lactation, or nursing, defends a woman from
many diseases incident to those who do not give
suck; such as induration, abscess of the breast,
and other painful and dangerous affections which
it is needless to mention; so uniformly and wisely
has nature ordained that punishment shall succeed
the infringement of her laws.
The practice of feeding young children, on the
appearance of any slight derangement in their
health, with teas and other stimulating drinks, as
punch, gin, essences, and the like, cannot be too
severely reprobated. This custom, once univer-
sal, is happily getting into disuse, but occasionally,
and quite too often, there is to be found a nurse
or mother of the old school, who yet believes that
intoxicating doses are necessary and omnipotent
in all affections of childhood. Not long since I
met with an old-fashioned mother, who wondered
that her baby grew so very slowly and looked so
puny, for she fed him gin sling two or three times.
every day. Regarding the use of ardent spirit in
adults, the world has of late been greatly enlight-
:
10*
114 A GUIDE FOR MOTHERS AND NURSES.
ened; and if the strength and vigour of manhood
cannot resist their deleterious influence, as has
been fully demonstrated, what must be their effect
when given to children? Besides proving ruinous
to health by undermining the constitution and lay-
ing the foundation for future disease, thousands
who have filled the drunkard's grave may thank
the ill-directed kindness of their parents for a taste
for strong drink, acquired in infancy, which in af-
ter life has irresistibly hurried them on their
downward course to wretchedness and death.
Observation leaves no room to doubt that many
children, by being frequently dosed with alcoholic
liquors, by the overweening fondness of weak mo-
thers and nurses, are beguiled into a love for intox-
icating liquors, which gains strength in the pro-
gressive stages of life. But further on this point.
There can, in a philosophic mind, be no doubt that
the child of an intemperate mother acquires a love
for rum during the period of nursing; with the
life-giving fountain is mingled the stream of death,
which, if it do not early destroy life, creates a
taste that is not easily forgotten. This is not the
case in the intemperate alone; many pious, good
women have hitherto believed it impossible to
A GUIDE FOR MOTHERS AND NURSES.
115
nurse a child without the daily use of milk punch;
and the same cause must, in the moderate drinker,
produce proportionally the same effect that it does.
in the intemperate.
Another, perhaps more universal practice, is the
frequent dosing with paregoric. This is done,
not altogether on account of ill health, but merely
to suit the convenience or whim of a careless
nurse, and still more careless and culpable mother.
They may have company, or they wish to call on
a friend to spend an hour or two, or occupy their
time in some other way, and forthwith the baby
is held, and paregoric is administered in sufficient
quantity to put the little chap at rest. The prop-
erty which paregoric, Godfrey's cordial, and all
medicines of this class, have of quieting the child,
depends upon the opium they contain; with the
effect of which drug in adults all are acquainted,
and a similar, or worse effect is produced in in-
fants and young children. Their digestive organs
are deranged, and being thus early disordered,
they with difficulty resume their healthy and vig-
orous tone of action. But the operation of opiates
upon the body is no more to be dreaded than it
is upon the mind, which is rendered compar-
116 A GUIDE FOR MOTHERS AND NURSES.
atively feeble and inert, a state from which it is
doubtful whether it ever entirely recovers. When
a child recovers from a state of stupid intoxica-
tion, into which he has been thrown by a dose of
paregoric, his delicate stomach is perhaps cram-
med with food, the opiate dose is again repeated,
and again the "baby" is plunged into a state of
stupidity.
Another error in the management of children
consists in overloading their stomachs with food
when they are in good health; and those who
have the care of them are particularly apt to err
in this respect. If the baby is uneasy or cries, he
is put to the breast; and if that is not sufficient to
make him quiet, he is fed with a spoon with more
substantial fare and he continues to cry from
being over-distended with food. It is astonishing,
often, to see a nurse ply the little fellow with
nourishment; the more she can force down, the
better she appears to be suited; the stomach re-
jects it by vomiting, and then she continues to re-
peat her kindness.
Infants are not unfrequently tormented with
thirst, which their nurses seldom gratify; their
crying is supposed to result from hunger, and they
:
A GUIDE FOR MOTHERS AND NURSES. 117
are therefore applied to the breast. But this does
not satisfy, and they again commence their unap-
peasable cries, and are again put to the breast with
no better success. Dr. Dewees says, that he has
often seen infants, when seeming to suffer exquisite
agony, rendered perfectly quiet and easy by a
draught of cool water.
There is no single article used as a child's diet,
that disagrees, in so many instances, as cows' milk,
or what is sold as such. In my own practice
at least, I do not find more than one-third of
the children whose digestive organs can bear it.
It is often very difficult to prescribe proper food for
children between the ages of one and two years.
Some are habitually costive, others have an oppo-
site state of the bowels. When the former pre-
vails, Indian mush and molasses, bread made of
unbolted flour, or mush made of the same mate-
rial, will answer well with just unboiled milk
enough to make it palatable. Plain cake, or gin-
gerbread, containing jalap, and a piece of this con-
taining five or six grains of jalap, once or twice a
day, is a convenient mode of administering medi-
cine, when the diet is not sufficient. Stewed
prunes may also be used. When the bowels are
118
A GUIDE FOR MOTHERS AND NURSES.
too relaxed, a diet consisting of rice, common
stale bread, or crackers, with a moderate quantity
of boiled milk, if this latter article agrees.-T.]
SECTION X. Weaning. The time of wean-
ing, we have already intimated, should be that in-
dicated by nature, (that is to say, between the sev-
enth and twelfth months in ordinary cases,) when,
by providing the child with teeth, she furnishes it
with the means of obtaining nourishment from
substances of a somewhat solid form. The
mode of weaning may be easily deduced from the
rules which we have laid down for the feeding of
the infant. If it has been gradually accustomed
to a diminished supply of maternal, and an in-
crease of artificial food, weaning will be an easy
process, and a great deal of suffering will be spar-
ed both to parent and offspring. No violent
change should be made; and by proceeding grad-
ually, the child will come to prefer artificial food
contemporaneously with the failure of the mater-
nal supply. This is what the term weaning im-
ports, and this is the mode in which it should be
accomplished.
[Very much must depend in our variable climate,
where we are subject to great extremes of tem-
A GUIDE FOR MOTHERS AND NURSES.
119
perature, when the important business of weaning
is undertaken. If there are no circumstances
that render weaning necessary, it should by no
means be undertaken in the heat of summer; for
when the child can have a good supply of breast
milk from a healthy nurse, the change to artificial
feeding, would be placing it in jeopardy. If the
mother's milk should not be good at such a season,
and the child in perfect health, it had better be
kept so by procuring a wet nurse till the heat of
the season has subsided, and the danger from sum-
mer complaint passed by.-T.]
SECTION XI. Food in the second period. For
some time after weaning, the child's food should
consist of those materials which we have men-
tioned as proper during the latter months of suck-
ling. Regularity in the times of feeding, is prob-
ably of nearly as much importance as the quality
of the food itself. No definite rules, however, can
be laid down, as to particular hours, as much must
be dependent upon the habits of the child, and of
its guardians, as to sleep, &c. ; but the general
principles should, under all circumstances, be ob-
served, of permitting no variation, from day to
day, in the time for the different meals, and of
120
A GUIDE FOR MOTHERS AND NURSES.
not breaking in upon these by giving food at ir-
regular periods; while, at the same time, protrac-
ted fastings must not be allowed. During the
day-time, about four hours is quite sufficiont inter-
val between any two meals; this will give time
enough, in children, for the stomach, and upper
portion of the small intestines, to perform their
offices in the process of digestion, and allow the
former an opportunity of recovering energy after
the discharge of its function. It is better not to
allow a child to acquire a habit of being fed dur-
ing the night, as uninterrupted sleep is what they
then require most; to ensure which, it is necessary
that the stomach should be in a state of compara-
tive rest. Perhaps, the best mode in which we
can illustrate our ideas with respect to the plan
upon which a child should be fed, will be, to des-
cribe specifically a day's feeding of a healthy
child, - premising that we do not mean to enforce
a literal observance of certain hours, &c. specified,
but merely to give an example of the working of
the principles we have laid down.
A healthy child, of two or three years old, com-
monly awakes, hungry and thirsty, at five or six
o'clock in the morning; sometimes even earlier.
Immediately after awaking, a little bread and
A GUIDE FOR MOTHERS AND NURSES. 121
sweet milk should be given to it, or (when the
child is too young to eat bread,) a little bread pap.
The latter should be warm; but in the former
case, the bread may be eaten from the hand, and
the milk allowed to be drunk cold, as it is as well,
at this meal, to furnish no inducement for eating,
beyond that of hunger. After eating, the child
will generally sleep again for an hour or two; and
about nine o'clock, it should get its second meal,
of bread softened in hot water, which latter is to
be drained off, and fresh milk, and a little sugar,
added to the bread. Between one and two, the
child may have dinner, consisting, at the younger
ages, of beef, mutton, or chicken broth, (deprived
of all fat,) and bread. When a sufficient number
of teeth are developed to admit of chewing being
performed, a little animal food, as chicken, roast
or boiled mutton, or beef, not too much dressed,
should be allowed, with a potato or bread, and
some fresh, well-dressed vegetable, as turnips or
cauliflower. After dinner, some drink will be re-
quisite; and a healthy child requires, or indeed
wishes for, nothing but water. Between six and
seven o'clock, the child may have its last meal, of
bread steeped in water, &c., as at nine o'clock in
the morning. A healthy child, who has been in
11
122 A GUIDE FOR MOTHERS AND NURSES.
the open air, during the greater part of the day,
will be ready for bed shortly after this last men-
tioned supply, and will require nothing more until
morning. Similar regimen and hours may be
adopted throughout the whole period of childhood;
only, as the fourth or fifth year approaches, giving,
for breakfast and supper, bread and milk, without
water, and either warm or cold, according to the
weather, or the child's inclination. The supply of
food, upon first waking in the morning, may also
be gradually discontinued, and breakfast given
somewhat earlier.
The foregoing, we conceive, may fairly be of
fered as a model of a suitable diet for childhood;
but, as Dr. Barlow very judiciously observes, “No
exclusive system can be right, nor can any pre-
cise rule of diet be possibly laid down, as this re-
quires to be adapted, in every case, to the partic-
ular constitution concerned." With the stomach
of one child, for example, so much milk as we
have recommended may disagree, and produce
acidity, and it may be advisable to substitute for
it tea or cocoa; with another, a meat dinner
every day may produce plethora, and it may be
necessary to alternate with rice, or some other
vegetable substance.
A GUIDE FOR MOTHERS AND NURSES. 123
The constitution of the child, its habits of expo-
sure to the air, and its residence in a city or the
country, must be taken into account; and some-
thing must also be allowed for the customs of the
community in which it is being brought up. A ju-
dicious parent or physician will recollect all these
matters; and while, as we hope, they will be able
to derive something like a foundation of principles
from our recommendations, they will yet recog-
nise the expediency of occasional modifications in
matters of detail. It is of great importance, that
no pre-conceived system or theory, with respect
to diet, should be assumed and adhered to with
unreflecting obstinacy, as is but too often the case.
Thus one class of persons, arguing that the
growth of a child requires an active nutrition,
adopt the theory that an excess either in the quan-
tity or quality of nutritious matter cannot be com-
mitted; and then, by cramming and overloading
the stomach, impair the digestive powers, so as to
prevent the food from being converted into nutri-
ment, and thus produce the defect in supply of
new material which it is their object to avoid.
Others, observing a healthy remnant of potato-
fed children in an Irish cabin, and hearing that
the Hindoos live and thrive upon rice, instantly
124 A GUIDE FOR MOTHERS AND NURSES.
infer that scanty vegetable food is the true pana-
cea for health and longevity; and accordingly,
condemn their offspring or patients to the mise-
ries and perils of an insufficient, non-animal diet.
Most unfounded prejudices are also taken up from
ex-parte observations as to the wholesomeness
or unwholesomeness of individual articles of
food. Fruits, for instance, are under a general
interdict from the dietary of children; and the
consequence is, that the school-boy, impelled by
his instinct* on the one hand, and restrained by
the so-called science of his managers on the other,
devours, in secret, the unripe, ill-cultivated, and
pernicious trash of the fruit stall, instead of being
permitted a moderate use of the wholesome, cool-
ing, and anti-septic produce of the garden. Much
learned trifling has also escaped from writers with
respect to the propriety and necessity of "living
naturally, and on such food as is presented to us
by nature:" and we are often told that children
should be fed upon bread and milk alone; because
* We have the authority of Dr. Paris for the fact, "that artisans
and labourers, in the confined manufactories of large towns, suf-
fer prodigiously in their health, whenever a failure occurs in the
crops of common fruits. This fact was remarkably striking in
the years 1804 and 1805.”—Art. Dietetics, in Cyc. Prac. Med.
1
A GUIDE FOR MOTHERS AND NURSES. 125
the former is prepared by the simplest cookery,
and the latter in what they call the laboratory of
nature. Dr. Fordyce, however, has met the ques-
tion, and settled it at once, by declaring that "man
has no natural food." Let those who may be
startled by this proposition call to their recollec-
tion the difference between the milk afforded by
a cow kept alive upon the weeds and scanty veg-
etation of neglected waste, and one fed upon the
riches of a pasture which has experienced the
transforming power of cultivation; let them recol-
lect that the wheat, of which their so-called na-
tural diet is composed, is itself the result of a long
course of cultivation, and a full employment of all
the resources of the complicated art of agricul-
"The potato," says Dr. Paris, among ma-
ny other examples" the potato, whose intro-
duction has added so many millions to our popula-
tion, derives its origin from a small and bitter
root which grows wild in Chili, and at Monte
Video."
ture.
The science of Dietetics is, in truth, an uncer-
tain one; any facts that we know respecting it,
being liable to be influenced by many varying
conditions, all of which should be taken into the
consideration of every individual case; and after
11*
126 A GUIDE FOR MOTHERS AND NURSES.
all, no theory should be permitted the slightest
weight in a particular instance in which it may
be contradicted by experience. If an article of
food, in favour of whose wholesomeness we have
universal testimony, should disagree with a cer-
tain individual, its use with that person must not
be insisted upon.
SECTION XII. Cleanliness. The importance
of the excretion from the skin is universally ac-
knowledged, and is sufficiently proved by the
amount of the daily perspiration, which was esti-
mated by Lavoisier and Seguin at an average of
1lb. 14oz. in the adult. The necessity of remov-
ing from the body of the child any obstructions to
this discharge which might be offered by the ad-
hesion of extraneous matters, must be sufficiently
obvious. The beneficial action of the physical
agents upon the system (of which we shall again
speak,) as these agents must act through the me-
dium of the skin, leads us to infer a similar neces-
sity. The accumulation of dirt upon the surface
will also be observed to produce very distressing
excoriations, and even permanent cutaneous dis-
eases, which, when once established, are often
with difficulty removed. With these considera-
tions in view, we therefore feel authorized to
A GUIDE FOR MOTHERS AND NURSES. 127
advance the dogma, that too much attention can-
not be paid to the subject of cleanliness, during
both periods of childhood.
The infant's body, we have already stated, re-
quires to be carefully washed immediately after
birth; and the same operation should be performed
daily, until the child becomes old enough to attend
to its own comforts. Washing should at first be
performed with warm water and a fine sponge,
taking care, in the early periods, that no exposure
be permitted long enough to produce an impres-
sion of cold. As the infant grows stronger, and
when the weather is warm, we may gradually
lessen the temperature of the water, until at length
it may be used nearly quite cold. It is better,
however, for the reasons assigned in p. 29, to be
in no hurry about employing a perfectly cold
bath; and under any circumstances, we would
not recommend water to be used without allowing
it to remain during the night in the nursery, and
so acquire a slight increase of temperature. It is
not necessary to use soap, except with parts of
the body (as the hands and arms,) which are par-
ticularly exposed to the reception of dirt, and
with these only occasionally. Brown soap is
better than white, as being less likely to cause
128 A GUIDE FOR MOTHERS AND NURSES.
cracking of the skin, which is often a source of
much annoyance to the child. In all cases, great
care should be taken to dry the surface well with
a soft napkin, especially where there are folds of
skin, as between the thighs, on the front of the
neck, arm-pits, &c. A neglect of this precaution
will be sure to occasion excoriation, and often
troublesome sores; to make matters more secure,
we shall do well in fat children, after carefully
drying, to dust over the skin in such situations
with some fine dry powder, as hair-powder, or
starch finely powdered, and contained in a muslin
bag. This will absorb the secretions from the
When the infant is
surface, and prevent friction.
being washed, during the first few days of its life,
attention must be paid to the condition of the
navel string. In ordinary cases, this dries up and
falls off between the sixth and tenth days, ulcera-
tion taking place at the navel. A small healthy
sore remains for a few days longer, which will
heal up without any interference, except the daily
application of a piece of dry old linen. The linen
in which we have at first enveloped the navel
string, commonly adheres firmly to it; and if it
remains dry, we need not disturb it, but merely
raise it gently, so as to have the abdomen under-
neath carefully washed and dried.
A GUIDE FOR MOTHERS AND NURSES. 129
The frequency of the discharges from the bow-
els and bladder of an infant, requires us to enforce
especial care in changing the napkin placed for
the reception of those matters, otherwise the skin
will be injured, and disagreeable excoriations pro-
duced. We are to recollect, that, in the natural
state, these evacuations are regularly periodical;
and an observant nurse will soon discover the
periods when they are about to take place, and
not only anticipate them, but teach the child at
a very early age to give intelligible warning of
its necessities; the complaint is often made to us
of a child's being dirty, but it may be relied upon
that the fault is almost always with the nurse.
Indeed, we have no doubt that an orderly educa-
tion of these functions, commenced in the earliest
infancy, will be the means of establishing a regu-
larity of the bowels which will continue through-
out the whole of life,--and the more tenaciously,
as in such training we are not altering or improv-
ing nature, but merely working in unison with
her tendency to periodicity. As the child advan-
ces, we must continue an unabated attention
to cleanliness; the hair must be carefully combed
and brushed; and the ears, eyes, and all other
openings of passages from the interior of the
130 A GUIDE FOR MOTHERS AND NURSES.
body, must be kept perfectly clean, as well as the
skin itself. By adopting such a line of conduct,
we may count upon certainly preventing most of
the eruptions upon the scalp or skin which have
not been directly communicated by contagion,
and of materially diminishing any tendency that
may exist to scrofula, marasmus, or rickets.
Mere washing would, of course, have little ef
fect if scrupulous exactness was not observed in
making frequent changes of the child's clothes:
an infant and young child should have a complete
change of dress every day; and the linen of elder
children should be changed very frequently, so
often as never to allow the accumulation of the
slightest quantity of dirt.
SECTION XIII. Clothing. We have already
dwelt at sufficient length, upon the principles
which should guide us in the clothing of an infant
immediately after birth. They are simply to pre-
serve a sufficient quantity of heat, and to do so
without setting any restrictions upon the free
movements of all parts of the child's body and
limbs, or irritating its tender skin. Although the
discoveries of Dr. Edwards, to which we have
referred at the commencement of this chapter,
lead directly to the establishment of the first prin-
A GUIDE FOR MOTHERS AND NURSES. 131
ciple now laid down, yet the subject is one of
such great importance, and so much mystified by
the phantasies of systematic writers, that we shall
make no apology for the following long quotation.
"It (mortality from cold) is not confined to chil-
dren whom the misery of their parents cannot
guard from the rigour of the weather, but it ope-
rates to a great extent, without being either per-
ceived or suspected, in families enjoying affluence,
and in which it is believed that the necessary
precautions are taken; because cold being rela-
tive, it is difficult from our own feelings to judge
of its effects on others, and because it does not
always manifest itself by determinate and uniform
sensations. They do not feel the cold, but they
have an uneasiness or an indisposition which arises.
from it; their constitution becomes deteriorated
by passing through the alternations of health and
disease, and they sink under the action of an un-
known cause. It is the more likely to be unknown,
because the injurious effects of cold do not always
manifest themselves during or immediately after
its application. The changes are at first insensi-
ble; they increase by the repetition of the impres-
sion, or by its long duration; and the constitution
is altered without the effect of being suspected."
132 A GUIDE FOR MOTHERS AND NURSES.
We wish we could, as a commentary upon the
foregoing passages, adequately depict one of those
miserable victims of parental vanity, whose ap-
pearance in our streets will sometimes, upon a
March or November day, strike cold into our
hearts. The cap and feathers set upon, not cov-
ering, the child's head, and probably of a colour
and richness contrasting mournfully with the blue
ears, sharpened nose, and shrunken cheeks, in
which cold has assumed the features of starvation,
(the short kilt and Highland hose, exposing be-
tween them cracked and quivering knees,) alto-
gether require for their description more graphic
power than we presume to lay claim to. We
hope, however, that we have said enough to call
attention to the absurdity of the "hardening” sys-
tem, as it is called, and to show that a clothing
regulated so as to obviate the rigours of our cli-
mate, is both demanded by our sensations and
sanctioned by our knowledge.
The material of clothing is not, we conceive,
of very great consequence. We are rather in-
clined to discourage the use of flannel next the
skin in children; it is liable to injure the tender
and irritable surface, and it is more likely than
linen to permit the concealed accumulation of
A GUIDE FOR MOTHERS AND NURSES. 133
dirt. Upon these accounts, and as children need
not be exposed to wet, we think flannel next the
skin had better be avoided. The feet should be
protected in winter by warm stockings, and suffi-
ciently strong shoes; and when the weather is
particularly cold, woollen gaiters should be drawn
over the legs when the child is about to be expos-
ed to the air. It has latterly been a good deal
the fashion to allow children, when a little ad-
vanced, to sleep without night-caps; and this, we
think, may be permitted without injury, as the
non-confinement of the hair certainly promotes its
growth, and in this instance we may safely leave
nature to herself.
In every article of dress the principle should be
carefully followed, of placing no constraint upon
the motions of any part. For the boy, tight-
waisted trowsers or braces, and for the girl, stays
of all kinds, must be forbidden during the whole
period of childhood. The injuries that may be
committed upon the organs in the chest and abdo-
men, by the latter article, are well known to be
of the most serious nature; the chest may be
completely altered in shape by a continued pres-
sure, and the lungs diminished in their capacity,
while at the same time the stomach and liver are
Dor M
12
134 A GUIDE FOR MOTHERS AND NURSES.
driven from their natural position, and made to
press upon the other organs of the abdomen.
Derangements of the functions of respiration, cir-
culation, and digestion, follow as natural conse-
quences, and but too often lead to an early grave,
or, what is perhaps worse, a life of prolonged
delicacy and ill health. After all these risks, the
object held in view in the use of stays is not at-
tainable by their means. By active and contin-
ued compression upon the lower part of the chest,
its shape may no doubt be altered, the ribs may
be brought together, so as to form a narrower
circle, and a shape be produced which, however
it may be fancied to constitute the ideal of beauty,
yet bears no resemblance to the human form,
either as it comes from the hands of nature, or
exists in the conception of the artist. The only
way which we can assist in the production of a
really fine figure, is to remove all restrictions, and
secure, as far as possible, so free an action of the
muscles as will lead to their perfect developement.
By such a course, also, we shall best promote the
acquisition of a good carriage, which is infinitely
more likely to be the result of a perfect balance
of the muscles, than of any mechanical support
whatsoever.
A GUIDE FOR MOTHERS AND NURSES. 135
If the principle of avoiding constraint be held
in view in the management of a child's feet, much
suffering would be spared in after life. Corns
and tumours upon the toes are almost always the
results of tight or ill-fitting shoes; and therefore
it is highly desirable that we should have these
articles so constructed as to protect the foot
equally, and not injure it by any undue pressure
upon particular parts.
SECTION XIV. Sleep. For several weeks after
birth, the infant is disposed to sleep continuously,
only awaking when pressed by the demands of
hunger, and it should certainly be our object not
to disturb its repose. As its sense becomes more
capable of bearing external impressions, and prob-
ably as its brain begins to elaborate these latter
into ideas, the waking intervals become gradually
longer, and after some time, the chief portion of
sleep is taken during the night. Throughout the
whole period of childhood, however, more sleep
is required than in adult age; and up to the third
or fourth year, the child will be disposed, and
ought to be allowed to sleep for an hour or two
during the day.
In regulating the periods for sleep, as in other
matters, we should not forget the periodical plan
136 A GUIDE FOR MOTHERS AND NURSES.
almost universally adopted by nature; and by a
little training, or rather by permitting that plan
to operate undisturbedly, the nurse will be saved
many a sleepless night. Matters should be ar-
ranged in the nursery, so as to have no obstacle
opposed to the child's sleeping, about the middle
of the day, an hour or two before its time of din-
ner; it will thus be again sufficiently tired in the
evening to ensure its sleeping soundly from seven
or eight o'clock, until the following morning. On
the other hand, if we defer its mid-day rest, and
keep it awake until later, by amusing it, its night's
sleep will not commence so early, and (the child
being less fatigued,) it will probably be interrupted
before morning.
A question is often put to a physician — should
the child sleep with its mother, or nurse? For a
month or two after birth, it is unquestionably
desirable that it should; for the infant, we have
seen, possessing a low temperature, and but a
small power of generating heat, requires to be
kept warm by contact with another being. In
support of this conclusion, we may allude to the
care which is taken by birds and other warm-
blooded animals, to preserve heat in their young
offspring by the almost continual application of
A GUIDE FOR MOTHERS AND NURSES.
137
their own bodies. In our care for the infant,
however, we must not forget the mother; and as
her health would be likely to suffer from the anx-
iety and disturbance occasioned by being obliged
to attend to a child during the night, we need not
prolong unnecessarily the period of its sleeping
with her. At the expiration of a month or six
weeks, especially when the weather is warm, the
infant, if healthy, will, with due precautions, be
able to maintain its own heat, and we may then
allow it to sleep in a cradle or bed by itself. A
sufficiency of bed-clothes should be employed, and
the temperature of the room during the first few
months, should not be allowed to fall below 60°
F. While we are anxious to keep it warm, we
must be equally careful to permit a free access of
air to its mouth, which should also be strictly
attended to while it sleeps with the mother or
nurse.
Cradles. There has been at all times a con-
siderable expenditure of words, and much learned
trifling with regard to the question of the salubrity
or insalubrity of cradles. It appears to us that
their employment is a matter that may very safely
be left to the fancy or convenience of the parents.
A cradle makes a clean, airy, and, from the facility
12*
138 A GUIDE FOR MOTHERS AND NURSES.
of moving it about, a convenient bed, and as such,
has advantages over more ponderous pieces of
furniture. As to the injury likely to be inflicted
upon the brain, by rocking, we have not the
shadow of a proof of such a species of motion
being ever injurious to the brain of either in-
fants or adults; if it were so, how would the
sensorium of the infant escape the effects of the
thousand shocks to which it is exposed, and that
too in an inverted position before birth; or among
adults, what sort of brains would the veteran sailor
possess? Throughout all our views respecting
the management of children, we wish to avoid
speculating or dogmatizing in the absence of any
basis of facts, and to lean to popular opinions,
whose antiquity we are not ashamed to confess,
is in our minds primâ facie evidence of their hav-
ing originated in accurate observation, rather than
to affect a pretension to science by abusing upon
a theory, practises which possess the sanction of
long and general use. We cannot, therefore,
agree that "rocking must be utterly disallowed,"
or that the reason for its disallowance, viz: "Sleep
here ensues, because the motion promotes a con-
gestive state of the vessels of the brain, inducing
A GUIDE FOR MOTHERS AND NURSES. 139
a degree of vertigo"*— is anything more than a
very shadowy hypothesis.
During the whole of the second period, a child
should decidedly sleep alone in a bed without any
hangings which might impede the free access of
air, and in a room as larget as can conveniently
be procured; not cold, or admitting draughts of
wind, but possessing the means of a free ventila-
tion. As few persons as possible should be allowed
to sleep in the nursery, and in winter a fire is an
essential requisite, both for the preservation of a
sufficient temperature, which should be permitted
to fall as little below 60° F. as possible; and also
for the promotion of a free circulation of air.
Early Rising. With respect to early rising,
we are ready to admit to the fullest extent, the
Cyc. Pract. Med. art. Physical Education.
† According to Dr. Edwards's views, the advantages of large
rooms are not merely owing to the great purity of the air, but he
also thinks that the slight agitation of the atmosphere, caused by
the space being extended, produces such a feeling of well-being,
that the chest dilates in consequence, and admits a larger propor-
tion of air. The agreeable sensation which is experienced on
breathing in the country is, he says, principally due to that cause.
Henke refers short sightedness to the narrow circle of vision ren-
dered customary in confined nurseries. Adolphe Henke Hand-
buch der Kinderkrankheiten. Fkt. a. m. 1813.
140 A GUIDE FOR MOTHERS AND NURSES.
great advantages, physical and moral, of the habit,
but still we must protest against a child being,
under any circumstances, curtailed of the due
proportion of sleep. The way to bring about
early rising safely and usually, is to train the child
to habits of retiring early to bed, and then to en-
courage it to rise immediately upon its spontane-
ous awaking, but by no means to force it from
its bed before the latter occurrence. No definite
rules can or ought to be laid down as to the num-
ber of hours' sleep to be allowed: one child may
require more or less than another; and our only
safe guide will be to train it to go to bed shortly
after its last meal in the evening, and then to
permit it to sleep without disturbance until it
awakes of its own accord upon the following
morning.
Child's Bed. The composition of the infant's
or child's bed, is a matter of some moment; it
should be firm and elastic, and of such material
as can readily be dried, or altogether changed,
when wet. To answer these ends, a small tick,
stuffed with straw, forms the best bed for the
infant and young child; the straw should be fre-
quently changed, and the tick as often washed
and well exposed to the air. For a more advanced
A GUIDE FOR MOTHERS AND NURSES. 141
child, a hair mattrass answers all purposes. It
should be exposed daily to a draught of air; and
in summer, placed for an hour or two in the sun-
shine, when that is practicable.
[The Nursery. Agreeably to my ideas of
pure
air, a nursery ought to be spacious and airy, and
on the second or third floor. If the room is small,
as is too often the case, the air is apt to be con-
fined, contaminated with perspiration, and load-
ed with a variety of effluvia. A fire in winter
makes it too warm, and if a door or window is
opened to air the room it then is made too cold;
thus subjecting its inmates in the twenty-four hours.
to too great a fluctuation of temperature.
Two rooms, the one opening into the other,
are preferable to one room; and if both are large,
so much the better, both for ventilation and ex-
ercise, when the weather will not permit of going
out of doors. If there are two rooms there will
be an advantage in having a pure air in the sleep-
ing room, and also of having pure air in the
morning in the play room. There is some differ-
ence of opinion as to the best method of warm-
ing a nursery; some recommending stoves, others
preferring an open fire. The inconveniences of a
stove, are, in my opinion, so great as to entirely
142 A GUIDE FOR MOTHERS AND NURSES.
exclude it from nurseries. In a small room it
makes too much heat, it rarifies and dries the
air, and if any substance is thrown upon it, it fills
the air with an unpleasant odour. On the whole,
I should prefer an open fire, so protected with an
immovable screen, as to prevent the possibility
of accidents, from falling into it, or from the
clothes taking fire.
Should a fire be continued in the nursery at
night? I have no hesitation in saying, that during
the first four years the nursery should be kept at
about 60 degrees of temperature at night as well
as in the day; for children are apt to throw off
the bed-clothes and lie almost naked. Even if
they sleep in a dress with sleeves and legs to it,
it is or ought to be less warm than their dress in
the day time: besides, the system is more suscep-
tible to the influence of cold when asleep than
when awake. In houses furnished with hall stoves,
and where the fire is kept up at night, the nursery
would be sufficiently warmed. The general rule
should be to keep the nursery at about the tem-
perature above-specified, i. e. 60 degrees Fahren-
heit. The windows of nurseries should be fur-
nished with bars across to prevent children falling
out, an accident that is not uncommon. The floor
A GUIDE FOR MOTHERS AND NURSES. 143
should be covered with a carpet to obviate the
effects of falls which are constantly taking place;
and which, when seemingly of no importance,
often prove fatal. The carpet should be fre-
quently cleaned. No cooking should be done in
a nursery; no plants should be kept in it; no su-
perfluous furniture; but it should be well provi-
ded with contrivances to amuse its little inmates,
and, if they are of sufficient age, to impart at the
same time instruction.-T.]
SECTION XV. Exercise. From the very ear-
liest periods of infancy, some degree of muscular
motion is necessary for the well-being of the child;
and as Dr. Barlow judiciously observes, "it is
advisable to suffer them to exercise their limbs
freely, by laying them frequently on a bed, sofa,
or carpet, and allowing them to roll and kick at
their good pleasure." This, and being carried
about in the nurse's arms, is all the exercise a
mere infant requires.* It may be well to advert
to a hazard notice by Dr. Barlow, as likely to
* Nurses are in the habit of rubbing the infant's body gently
with their hand, during the time of dressing. This friction ap-
pears to be agreeable to the child, and is probably useful, by stim-
ulating the surface, and promoting the cutaneous circulation. It
may be considered as a species of exercise.
144 A GUIDE FOR MOTHERS AND NURSES.
attend the practice of tossing, jumping, as it is
termed: it is the danger of the child's chest being
compressed by the hand of the person holding it,
being placed with the thumb and fingers on each
side of the breast-bone. That some impression is
likely to be made in this way upon the chest of a
young infant, appears to us extremely probable,
and we should therefore caution the nurse against
allowing it to be so grasped. The act of hoisting,
itself, appears to be always attended with pleas-
ure to a healthy child; probably in consequence
of that sense of well-being we have already noticed
as being produced by agitation of the atmosphere;
and if no risk of a fall be run, it need not be inter-
dicted.
Walking. With respect to the period of the
child's walking, we conceive that it should be left
entirely to nature. Spontaneous efforts will never
be made to an extent likely to produce injury ;
but go-carts, &c., should be banished from the
nursery, as by such contrivances, the child will be
supported, and induced prematurely to walk, be-
fore its limbs have acquired sufficient firmness to
enable them to support the weight of the body.
By these attempts at anticipating the child's
strength, its legs may be made crooked, or a still
A GUIDE FOR MOTHERS AND NURSES. 145
worse effect may be produced in female children
by causing distortion of the bones of the pelvis,
the evil consequences of which may be first dis-
covered when the child herself is about to become
a mother: such results, however, are scarcely to be
dreaded when the commencement of walking is a
voluntary act.
In early childhood, the taking of exercise may
in like manner be left altogether to nature; all
we have to do is to provide opportunity, by allow-
ing the free and unrestrained use of a garden or
field in fine weather, or of a large nursery at other
times. The active and restless spirits of the child
will then prompt it to do all that is required for
its health, and its own sense of fatigue will be the
best monitor as to the proper duration of its exer-
tions.
When the child grows into the boy or girl, more
consideration becomes due to the management of
its muscular system, as the necessity for the dedi-
cation of definite portions of time to mental edu-
cation then first arises. It then becomes an object
to economize the hours of exercise, and for this
purpose the gymnasium and dancing-school are
sought by parents, and recommended by physicians.
The latter is generally considered rather as a
13
146 A GUIDE FOR MOTHERS AND NURSES.
place for acquiring an accomplishment than for
exercise; but under a judicious master, who avoids
constrained positions and restrictive machinery,
it may do excellent service, by giving vent to the
buoyant spirits of youth, and exercising almost all
the muscles. The gymnasium has certainly been
an improvement in modern education, but it too
has its evils and hazards. In it also a skilful
teacher is required, whose knowledge of muscular
anatomy will enable him to contrive means of
generally exercising the frame, and whose judge-
ment will constantly interfere to prevent the
youth from being carried on by spirit and emula-
tion to an overtaxing of his own powers. When
practised to too great an extent, gymnastic exer-
cises certainly stop the growth,* by directing all
the energy of the individual towards a develope-
ment of the muscular system; if improperly direc-
ted, they may also occasion ruptures and inju-
statement.
* Any person who recollects the stunted stature of a boy, ser-
vant in a gymnasium in this city, will admit the truth of the above
We are happy in being able to corroborate our some-
what heterodox notions respecting the abuse of gymnastic exer-
cises by the authority of Dr. James Johnson. He also, very cor-
rectly, points out their tendency to call into activity discases of
the heart and great vessels in young individuals previously predis-
posed to those affections. Vide Economy of Health. Lond. 1837.
A GUIDE FOR MOTHERS AND NURSES. 147
ries to the joints; but under a skilful teacher,
such abuses may be certainly and safely prevent-
ed. Neither gymnastics nor dancing ought, how-
ever, to supersede the daily play in the green
fields, and both parents and children are fortunate,
when not called upon by circumstances to sacri-
fice this, the most healthful and most invigorating
of exercises.
Our plan, restricting our observations to the
management of childhood, does not warrant us in
considering at any greater length the exercises of
youth, a full view of the merits, &c. of the dif
ferent kinds of which, belong more to the prov-
ince of the physiologist, than of the child's physi-
cian. With respect to the quantity of exercise to
be permitted to the child, we can give no rules
more definite than to allow the dictates of nature
to be followed as to fatigue, and to adopt the
views already put forward as to sleep and food;
by carefully attending to these latter, regular in-
terruptions to play, or continuance in the open air
will, of course, be provided.
It is much to be desired that public gardens should be estab-
lished in our large towns, to which the inhabitants of all classes,
and their children, could have access. They should be planted
with shrubs and trees, so as to afford moderate shelter, and be
provided with a large shed, in which refuge might be taken from
148 A GUIDE FOR MOTHERS AND NURSES.
the vicissitudes of our variable climate. Most large continental
towns have a provision of the kind, as well as numerous private
gardens, to which the poorest can resort at no greater expense
than the price of a cup of coffee. We know that it will he objected
that in our country such places would become scenes of drunken-
ness and riot; but we are sanguine enough to hope that the op-
portunity of enjoying temperate amusements in the presence of
their fellow-citizens of a better rank, would be appreciated by
our artisans, and, ultimately tend to restrain their ferocity, and
elevate them in their own opinions. The lower classes of these
countries are too much thrown upon the one brutal indulgence of
drinking; and it is an absurdity to suppose that the strictest reve-
nue laws will have any effect, except to aggravate the evil. Make
spirits dearer, and the labourer will certainly diminish his allow-
ance of food and clothing to procure the only means within his
reach of relieving his mind from the pressure of toil and want.
Give him an opportunity of being amused when his labour is
ended, with music, and of enjoying the pleasure of a public gar-
den in the presence of his superiors, and we hope (perhaps too
sanguinely,) that he would be gradually led to lessen his allow-
ance of spirits, in order to enable him to procure dress sufficiently
decent to admit of his partaking in those amusements without a
sense of degradation.
Exposure to the air. The importance of attend-
ing to the habitual exposure of children to the
air, is not duly estimated. At no period of life
does any cause produce such permanent ill effects,
as in the feeble and susceptible age of children.
The bad effects of want of pure air and exercise,
are seen in children confined to manufactories,
A GUIDE FOR MOTHERS AND NURSES. 149
and in those inhabiting a dense and badly venti-
lated part of a large city. Contrast these with
children of the country and we shall see a won-
derful difference, -the first will be pale, thin,
and weak, the others, rosy-cheeked, plump, robust,
and full of activity.
"Infants," says Dr. Eberle, "ought to be early
exposed to the open air. The practice of confin-
ing them, for the first five or six weeks, to the close
and heated air of nurseries, has a direct tendency
to impair the energies of the system, and to im-
pede its healthful developement. The daily en-
joyment of fresh air, contributes greatly to the
health and sprightliness of infants, and is one of the
most efficient preventives against that delicate and
sickly condition which is so frequently witnessed
in those who are almost constantly confined and
pampered in nurseries."
"Pale countenances, weak eyes, general relax-
ation of the body, an accumulation of all the in-
conveniences and sufferings of childhood,-at
length consumption, and early dissolution of life:
all these are the natural and frequent consequen-
ces of such confinement. On the contrary, there
is no method by which children may be more
effectually preserved against such unfortunate
13*
150 A GUIDE FOR MOTHERS AND NURSES.
events, than by permitting them to inhale a fresh
and uncontaminated air. Pure air, is indeed most
grateful to the feelings of children. After having
been carried out but a few times, they evince even
at a very early age, a strong desire to return to
the open air. While yet in the arms of the nurse
they anxiously point to the door, and make efforts
to approach and open it. When they can scarcely
crawl, they instinctively advance towards that
part of the room from which they have a prospect
of escaping. Hence, in the bosom of nature, they
experience the greatest comfort, and their tears
can be stopped in no other way than by taking
them out of doors into the free air.” (Struve.)
[In the warm season of the year, infants two or
three weeks old, may be carried into the open air
for an hour, once or twice daily. In damp and
cold weather they should be carried from the nur-
sery into an adjoining room that is more open;
avoiding currents of air and exposure to win-
dows, &c.
Children should be gradually exposed to the
external atmosphere; and I believe it is better in
this climate, that children born in the winter and
spring, should not be carried out until the com-
mencement of summer; but when once the child
A GUIDE FOR MOTHERS AND NURSES. 151
1
is accustomed to being carried out, the practice
ought by no means to be discontinued, even in the
winter, provided the child is well, unless in the
coldest or most stormy weather. I have recom-
mended children born of delicate parents, to be
carried out daily, and have had the satisfaction of
seeing them rejoicing in health and strength, and in
cold weather their enjoyment seemed to be not
the least diminished. Gradual exposure to the
common causes that produce illness, is the real
philosophical system, of "hardening."
hardening." Children
must be able to bear exposure to the air at differ-
ent seasons with impunity, or remain forever with-
in doors; and after being shut up for four or five
months, if for any reason they do venture out in a
cool day, they invariably suffer in their health.
I have known tender mothers, more fond than
wise, keep their children within doors from fall
till spring, with a very few exceptions, not to aver-
age once a week: such children have been sick
more than others who had scarcely the necessaries
of life; for the least breath of air, in passing
through a cold hall, playing for a few minutes in
a cold room, standing by a window, and the like,
and always on going out, no matter how pleasant
the weather, in the cold season, they are sure to
152 A GUIDE FOR MOTHERS AND NURSES.
be attacked with some affection of the chest or
throat.
Let the child then be carried out daily, com-
mencing in the summer; but let exposures of this
kind be, even then, gradual, in young children.
First let it be carried into a well-aired and large
chamber, for a little time, during a week or so-
then let him be carried in the open air for a few
minutes, and so on increasing till several hours
are spent under the clear canopy of Heaven. Ast
the autumn approaches and the weather becomes
cool, let the clothing be increased in quantity, so
that the surface of the body shall never be chilled;
and let the practice of going out be forever con-
tinued daily, unless in very cold or wet weather.
Ordinary winter weather should not keep a
healthy child in the house.
-
The country is decidedly the place for children
in warm weather; there they enjoy an oppor-
tunity of play and frolic that is not to be had in
large cities. But even in cities, we have now and
then a grass plat, and open space where children
can be indulged. They should be carefully
watched when old enough to run about and play,
and not be allowed to sit upon the damp or cold
grass, or lie upon the ground, in the shade, or in
A GUIDE FOR MOTHERS AND NURSES.
153
a warm sun, or sit any where after severe play,
till the perspiration is checked. I have known
three little girls in one family to be attacked with
croup the same night after playing on the Battery
of an afternoon, and riding up town in an omni-
bus, with a current of air upon their necks,
through the open windows of the omnibus. Just
in proportion as we accustom the body to be kept
warm within doors, are we sure to suffer when
exposed to the weather out of doors.
There should be little if any difference in the
exercise of boys and girls, during the few first
years of their lives; they should be allowed to
run and play, roll the hoop, play ball, and engage
in all the sports of youth, that their health and
strength will allow. Mothers need have little
fear that their daughters will not be genteel, if al-
lowed to play out of doors when young. First
give them health and let the body have strength,
and the fond parent will be amply repaid in the
increased activity, sprightliness, buoyancy, and vig-
our of mind. A pale delicate girl may interest us
inasmuch as she will excite our commiseration;
we may feel the same desire to protect and cher-
ish her, that we would a drooping flower; but
such are not the ones who most engage the affec-
154 A GUIDE FOR MOTHERS AND NURSES.
tions, and enlist the admiration,
who are most
likely to be sought for as wives, and who can best
discharge the duties of a mother. — T.]
SECTION XVI. Medicine. There is no sub-
ject connected with the management of children,
in which such fatal errors have prevailed, as in
the treatment of their bowels; and unfortunately,
the influence of certain medical theories has, of
late years, tended rather to the increase than di-
minution of those mistakes. The importance
which has, in many respects, very justly, been at-
tached to the condition of the digestive system in
disease, has attracted much attention to its state
in health; but, unhappily, the great majority of
persons fall into the grievous fallacy of supposing
that what is useful as a remedy, must also be use-
ful as a preventive; and as the multitude has,
in the case of the system in question, but one idea
cognate with either remedy or preventive, viz.,
the idea of purging, the propriety of adopting a
regular system of purgation with healthy children,
has been admitted almost without question.
There cannot, however, be a more dangerous ab-
surdity than such a system; and in proof of our
opinion, we shall ask a single question, and bring
forward one fact. What is the mode of action
A GUIDE FOR MOTHERS AND NURSES.
155
and effect of every aperient drug in the pharma-
copoeia? Is it not irritation, direct or indirect, of
the intestinal mucous membrane, in a greater or
less degree; and does it not produce, as a neces-
sary effect, in every instance, a larger or smaller
quantity of increased secretion? So much for
our question. We presume that no person, but a
devoted disciple of St. John Long, will maintain
that irritation producing increase of secretion, can
ever be necessary in the healthy body. With res-
pect to our fact- let any person with regular, or
moderately regular bowels, take an aperient, and
he will certainly find that after its immediate ef-
fects have passed away, a state of costiveness will
remain. The tendency of nature to periodical
movements, has been interrupted by the produc-
tion of evacuations at irregular periods, and she
requires some time to enable her to recur to the
simplicity of her original design.
We wish it to be distinctly understood, that
what we are now advancing has no reference to
the use of purgatives in disease, but solely to their
abuse during health; and we are the more partic-
ular in endeavouring to convey our own views
upon the subject, because we know that the im-
propriety of a needless resort to medicines of this
156 A GUIDE FOR MOTHERS AND NURSES.
kind, is not sufficiently thought of by medical men.
We have, indeed, too often had occasion to la-
ment over the display of drugs upon the mantel-
piece of even a medical man's nursery, not to feel
special interest in this matter. The least judicious
would surely grieve, did he see an ointment of
cantharides rubbed to a healthy skin with no other
apparent intention than that it might be followed
by a healing salve; yet, what less absurd is por-
tended by the accumulation, in such a situation as
we have alluded to, of packets of aperient draughts,
bundles of restraining powders, and bottles of car-
minative mixture all designed for the same un-
lucky children. This is no imaginary description,
we have but too often seen its original; yet, bet-
ter and more merciful would it be, towards many
of the victims, to destroy them in the birth, than,
by such a course, to provide for them the endur-
ing miseries of an irritable mucous membrane.
The bowels of a healthy infant, after the meco-
nium has passed away, should be opened from
two to four times in the twenty-four hours. The
discharge should be fluid, of a lightish yellow co-
lour, free from any fetid or acid smell, and desti-
tute of lumps, or white curdy matter: it should
pass without pain, or any considerable quantity of
A GUIDE FOR MOTHERS AND NURSES,
157
wind. As long as these conditions exist, there is no
occasion for medicine; should they be materially
deviated from, a state of disease must be present,
and will be indicated by other symptoms, the nature
and treatment of which shall be considered in the
proper place. The infant may, however, labour un-
der a degree of costiveness which can scarcely be
called disease, and yet requires medical interfer-
ence. Having less than two stools, for example,
in the twenty-four hours, calls for an aperient;
and so also does a lumpy, or partially solid, condi-
tion of the discharge. The medicine, in such ca-
ses, should be of the mildest nature. For an in-
fant, from half a drachm to a drachm of fresh
castor oil, will generally answer every purpose;
or a dessert-spoonful of a mixture formed of a
couple of drachms of manna dissolved in an ounce
of fennel or carraway water, may be given, and
repeated every hour until the bowels are opened.
These are probably the only safe nursery medi-
cines. Calomel, which is but too commonly the
first article in the list, should be banished from it
altogether, and never given for the mere removal
of, what we may perhaps call, healthy costiveness.
Its use seldom fails to produce motions of a green
colour, mixed with gelatinous mucus; thereby
14
158
A GUIDE FOR MOTHERS AND NURSES.
showing that it is likely to do much more than
what we want, when our object is merely to emp-
ty the bowels of their contents. A piece of mo-
lasses candy, two or three inches long, and the
size of a common tobacco pipe stem, will, almost
always, produce an evacuation of the bowels, and
may
be used for children of any age from one day
to fifteen months. It is much better than soap,
which is often used for the same purpose.
During childhood, the bowels should be regularly
freed once or twice a day, (some difference ex-
isting in individuals as to the precise number of
their periodical motions.) The discharge should
be rather of a darker yellow than in the infant
and more solid, but less so than in the adult; it
should have a feculent smell, and be free from
mucus or lumps of indigested matter.
When a
healthy child has been treated upon the principles
which we have indicated, under the heads of
food, exercise, and cleanliness, it will seldom
require any purgative medicine; but occasionally,
from some error of diet, or other accidental cir-
cumstance, costiveness will occur, and we must
then be prepared to recommend a mild aperient.
A couple of drachms of castor oil will usually an-
swer very well.
A GUIDE FOR MOTHERS AND NURSES. 159
SECTION XVII. Light. The influence of this
physical agent in the vegetable kingdom, is known
to every one who has observed the bleached ap-
pearance of a plant growing in the dark, or has
noticed the efforts made by flowers placed near a
window, to turn towards the light, even though
they may not be led to grow in that direction by
the direct influence of the solar rays. Dr. Ed-
wards has made some ingenious experiments to
show the influence of light upon the developement
of animals; in the course of which, he found that
those which naturally change their form, as tad-
poles, were prevented from doing so by the with-
drawal of light. In man it is not easy to obtain
any information as to the specific effect of light
unaided by air and temperature; but from the
facts just alluded to, we are warranted in infer-
ring analogically that light must materially influ-
ence developement of form. The infant, there-
fore, as soon as its eyes lose their extreme sensi-
bility, should be freely exposed to light. The nur-
sery should never be darkened during the day;
and at night, it is better that the shutters should
be left unclosed, and no window curtains used.
Too much care cannot be taken in regard to the
exclusion of light; for I believe that the admis-
160 A GUIDE FOR MOTHERS AND NURSES.
sion of an ordinary degree of light, is quite suffi-
cient to produce, in a new born infant, inflamma-
tion of the eyes; at any rate, such a result has,
more than once, come within my observation.
SECTION XVIII. Air. We hope that the stress
which we have laid upon the propriety of keep-
ing up a due degree of warmth in the nursery, will
not be interpreted as warranting any measure
likely to interfere with a free access of air. Both
objects are perfectly compatible. The purity of
the air in which the child resides and sleeps should
be secured, by providing means for ventilation, in
a sufficient number of windows, and a chimney,
which latter is absolutely essential to the estab-
lishment of a current of air; and also by restrict-
ing the number of individuals residing in the apart-
ment within the narrowest limits. It has been
already stated, that a certain agitation in the at-
mosphere is healthful; and, therefore, the nursery
should be as large as possible, in order to favour
motion of the air contained within it. But our
attentions with regard to air, should not be con-
fined to the nursery; the vivifying influence which
it has been shown to produce upon the system,
by contact with the surface of the body, furnishes
us with a reason for the advantages, shown by
A GUIDE FOR MOTHERS AND NURSES. 161
experience, to be derivable from an exposure of
the child to the open air as freely as possible, con-
sistently with an observance of the principles al-
ready inculcated under other heads. It is this
vivifying influence which renders the play in the
open fields so much more useful than the most
carefully directed exercise of the gymnasium.
SECTION XIX. Temperature. We have alrea-
dy incidentally said so much upon this subject,
that any thing farther would be merely repetition.
We may, however, take the opportunity of con-
troverting a very common fallacy, viz., that expo-
sure to heat renders the body more susceptible of
the ill effects of cold. Dr. Edwards found, that
“in exposing animals to successive applications of
cold, their temperature will fall the more slowly,
the longer they shall have been subjected to the
influence of warmth. Hence, that those who
are liable to frequent exposure to severe cold, are
rendered more capable of supporting it, by sub-
jecting themselves, in the intervals, to a high
temperature." We find, in point of fact, that the
Russians, and other northern nations, preserve, by
means of stoves, and double doors and windows,
a very high temperature in their dwellings during
winter, and yet leave them with impunity to pur-
14*
162 A GUIDE FOR MOTHERS AND NURSES.
sue their occupations in the open air.* This
should make us hesitate in denying access to a
fire to a cold and shivering child, under the idea
that we should render him, by the prohibition,
hardier, and less likely in future to suffer from
cold.
[NOTE. It must not be inferred from the above,
that the longer a child is shut up in a hot room,
the better will he be enabled to bear the cold.
The author means that he may live in a high tem-
perature within doors, but should be frequently
in the open air. -T.]
* The common winter temperature of houses in St. Petersburgh,
is 64° F.; while, out of doors, it is frequently so low as 20°.— Dr.
Granville's Travels.
CHAPTER V.
MENTAL AND MORAL EDUCATION.
THE Connection between mental and moral edu-
cation, and the physical management of children,
is so close, and the action and reaction of the one
upon the other so constant and influential, that an
essay upon the latter would be incomplete, indeed,
almost useless, without some notice of the former
subject. In turning our attention, however, to
this most important of human concerns, we feel
considerable embarrassment, both from the diffi-
culties incidental to the subject, and from the nar-
rowness of the limits within which the nature of
our present plan obliges us to confine ourselves in
our observations; at the utmost we can deal but
in generalities, and even with those only in the
briefest manner.
r
In the foregoing chapter, we commenced our
consideration of physical education, by supposing
an infant to be placed in our hands immediately
upon its entrance into the world we then found
164 A GUIDE FOR MOTHERS AND NURSES.
་
it naked and helpless, in fact a mere vegetative
being, with its organs of nutritive life fitted, and
ready to act, but altogether dependent upon the
care of others for such a supply of material for
those organs to work upon as was absolutely ne-
cessary to preserve its existence. We endeav-
oured to investigate the nature of its various
wants, and to point out the principles which
should guide us in administering to and supplying
them. We are now in a precisely similar position
with regard to the moral and intellectual system
of the young being it is placed in our hands
fresh from nature, we are called upon to make a
like investigation into the wants of the system in
question, and to consider in like manner the princi-
ples upon which we can most safely and prudently
obviate them.
The progressive developement of the various
intellectual powers in the child has been already
alluded to in the first chapter, and to this we must
look for our only natural guide in all attempts at
the education of those powers. The infant at
birth, we have seen, possesses little capability of
perception; some of its senses are still imperfect,
and all are, for want of training, unfitted to con-
vey correct information to the mind; the memory
A GUIDE FOR MOTHERS AND NURSES. 165
is as yet unfurnished with facts; and the whole
system is, as it were, a machine ready for work,
but from which the moving power is still withheld.
Soon, however, the process of learning commen-
ces, the senses first receive a knowledge of the
agents which act specifically upon them; the eye
becomes acquainted with light, and afterwards no-
tices objects which are presented to it; the ear is
affected in like manner with regard to sound, &c.
Subsequently the infant learns to compare the
impressions made upon the different senses, and to
derive inferences from this comparison; a famil-
iar example will best illustrate this dawning of
intelligence. Thus, the mother's nipple is soon
recognised by the sense of sight, and probably the
first item of knowledge laid up in the memory is
the fact that it is the source from whence nour-
ishment is to be derived; but it is at a later period.
that the information conveyed by the eye is cor-
rected by the touch, so far as to enable the mouth
or hands to be directed with certainty towards
the object in question. After a short period, the
power of perceiving external objects is so far ed-
ucated, and the memory so well stored with facts,
the result of observations, that the infant can de-
termine the differences between persons, and be-
166 A GUIDE FOR MOTHERS AND NURSES.
comes capable of recognising its mother or nurse.
All this is really mental education, and that too of
the most important kind; for what a small pro-
portion does the learning of the schools bear to
the knowledge of external agents, and of our own
powers and relations, which we must acquire dur-
ing the period of childhood, and without which
we should be incapable of supporting our own ex-
istence. What countless observations must be
made before we ascertain our ability to speak or
walk, and what a wondrous mass of facts must
be learned before we understand in the most gen-
eral way the difference between animate and in-
animate bodies; between the firm and resisting
land, and the yielding and unstable water.
We cannot, however, materially aid in the com-
munication of such knowledge; the demands of
the senses for their proper excitements will force
it upon the young being; and we refer to it, here,
only to show that the young child who is permit-
ted to use its eyes and ears, is always busily em-
ployed in learning, and that the hours of play are
not to be considered as periods of intellectual
idleness. At what time the business of formally
instructing the intellect, should be commenced,
becomes an interesting question, and one upon
A GUIDE FOR MOTHERS AND NURSES. 167
which much difference of opinion exists; if we
begin too early, we shall certainly injure the
health; and if we delay too long, we shall often
experience much difficulty is restraining the hab-
its of bodily activity, (which in such cases will
generally be acquired,) within limits favourable to
the necessary exertion of the mental powers. In
this, as in most other matters, we shall probably
find our best guide, if we carefully observe the
plans of nature. She seldom fails to implant in
the child a most restless and prying curiosity,
which is in reality the appetite for knowledge, and
should never be denied its gratification. Books
and pictures never fail to attract the attention of
very young children; and allowing them to apply
it, at their own pleasure, to these, and espe-
cially to the latter, is precisely doing for the mind
what we do for the body when we place it in the
garden or field—it is giving it an opportunity of
taking wholesome exercise, which it will cease
from doing upon the first approach of fatigue. In
the one case the child will, itself, learn to walk
and run with firmness; and as its muscles and
bones become stronger, it will usually desire to
acquire the more artificial exercises of riding and
swimming. In the other case, an acquaintance
168
A GUIDE FOR MOTHERS AND NURSES.
will be imperceptibly attained with the forms of
letters, and of animals and other external objects;
and the uses of the one being gradually learned,
and a curiosity respecting the others being excited,
a growing desire for information will lead the
child to devote more and more time to its acquire-
ment, until at length we shall find it no difficult
matter to include among our periodical arrange-
ments, a daily allotment of a short portion for the
purposes of instruction. The precise age for
adopting this latter arrangement cannot be exact-
ly defined it must differ a little, according to the
strength of the child, but we conceive it should not
be before the sixth year. The time to be allotted
for instruction is also a matter of moment; it
should never be long enough to produce fatigue,
and we think should not exceed two hours daily
during any part of the period of childhood.
When considering in the last chapter the sub-
ject of physical education, we avoided entering in-
to a detailed examination of the various exercises
suited to the developement of the muscular system
in youth, considering such a detail as lying rather
within the province of the general physiologist
than of the child's physician. In like manner we
now conceive that a special consideration of the
A GUIDE FOR MOTHERS AND NURSES. 169
subjects of mental education would be entrenching
upon the domain of the moral philosopher; the
objects, however, of this process, and the mode of
effecting them, may fairly engage a small share of
our attention, from their intimate connection with
the bodily health of the child. In the first place,
then, we cannot but think that a grand mistake is
very generally made with respect to the proper
object of education, which is commonly supposed
to be the storing of the memory with a quantity
of verbal knowledge, with a mere crowd of words,
to the exclusion of the ideas which those words
ought to convey. Thus very young children are
mechanically taught lengthy rhymes, or verbose
catechisms of geography and history, and their
repetition of these by rote is looked upon and ex-
hibited by their parents as a pregnant proof of
their precocious understanding. All the time,
however, the child comprehends nothing of what
it has been repeating, and its memory, which, it
must be recollected, has abundant employment
during the first years of childhood, in storing up
the facts derived from impressions upon the sen-
ses; has been not wholesomely exercised, but in-
juriously fatigued by the exertion. We were
much struck with the monstrous absurdity of this
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170 A GUIDE FOR MOTHERS AND NURSES,
wordy instruction, upon observing its effects in
some of the parochial schools of this country,
(Great Britain.) Many of these institutions are
under the patronage of a society whose inspectors
annually visit them, and examine the pupils. The
examination chiefly consists in ascertaining how
much of the Scripture can be repeated by rote;
and the rule is, that unless a certain number of
children be produced, each capable of reciting at
least four chapters of the new testament, no re-
muneration is to be given to the master. The
result of this system, as we have repeatedly found
from personal investigation, is, that while so much
as an entire epistle will, in some instances be cor-
rectly repeated, the sense of a single paragraph
will often not be comprehended by the child. In
the course of a very extended visitation of these
schools, we have been repeatedly told by the mas-
ters that their own time, and that of the pupils,
was so completely occupied with the committing
of mere words to memory, that it became utterly
impossible to pay any attention to their meaning.
Now, if we reflect for a moment upon the exer-
cise to which the memory of the young child is
subjected in laying up a knowledge of its rela-
tions to the things and persons which surround it,
A GUIDE FOR MOTHERS AND NURSES. 171
and of its duties with regard to this and to a future
world, we would surely pause before tasking it
with the remembrance of words of which it is un-
able to comprehend the value.
The acquisition of verbal knowledge, or indeed
of almost any knowledge which can be conveyed
by words, we do not look upon as the legitimate
object of early education. The effort should ra-
ther be made to instruct the mind in the perform-
ance of its functions; and in the mode of doing
this, due regard must be had to the order in
which the mental powers are developed. The
perceptive faculties, for example, being the ear-
liest in play, the instructer's object should at first
be to impress upon the child a knowledge of the
properties and relations of matter in its various
forms; and in doing this, he should, as far as pos-
sible, train the mind to habits of correct observa-
tion. Materials for thought will in this way be
stored for future use, and at the same time an or-
derly and accurate habit of observing will be im-
pressed upon the mind. As the reasoning pow-
ers begin to be developed, these, too, should be
trained into their proper action. Comparisons
should be instituted between things which have
been already the subjects of observation. Gene-
172 A GUIDE FOR MOTHERS AND NURSES.
ral laws may be explained, and the child may be
encouraged to investigate the causes of various
natural operations which it has previously observ-
ed. All this, however, must be done gradually,
and with caution. The mind of the child, like its
body, is incapable of great or long continued ex-
ertion, and to subject it to such before its powers
are developed, would be to urge it into prema-
ture decay. "We must not," to borrow the
words of an ingenious writer, "attempt to force
their intellectual growth, must not feed them with
meat, until they have teeth to masticate it. There
is a great deal which they ought to learn, can
learn, and must learn, before they can or ought to
understand it."*
So much for intellectual education: it must not
be forgotten that our consideration of it has been
restricted to the first eight years of life, and dur-
ing that period it should scarcely, in our opinion,
be made a matter of formal business, but the
foundation of it should rather be laid by such
playful exercise of the faculties as we have sketch-
ed. A more important subject, however, is what
*"The Doctor," generally (we believe,) attributed to the pen
of Southey.
A GUIDE FOR MOTHERS AND NURSES. 173
we have designated as moral education. This
commences at the earliest period of infancy, and
we almost believe is finished, for good or for evil,
before the individual passes the epoch of child-
hood. In moral qualities, the child is, indeed, fa-
ther to the man; and the education of these re-
quires the most anxious attention, even during the
earliest periods of infancy. No one who is famil-
iar with the habits of infants can avoid observing,
that from the moment of birth they display obvi-
ous marks of being endowed with active passions
and affections, and that, too, in very varying pro-
portions in different individuals. Anger is per-
haps the first which is displayed to our notice,
but shame and jealousy soon make their appear-
ance, and also some of a more amiable character,
as compassion and brotherly affection. Now, we
must recollect that these, and all the other ele-
ments of our moral constitution, are originally
implanted in us, and designed for good. "It is
very true," says Dr. Chalmers,* "that the anger,
and the shame, and the emulation, and the paren-
tal affection, and the compassion, and the love of
reputation, and the sense of property, and the
*
Bridgewater Treatise, vol. i. p. 106.
15*
174 A GUIDE FOR MOTHERS AND NURSES.
conscience or moral sense, are so many forces of
mechanism, which, if not thus furnished, and that
too within certain proportions, would run into a
disorder that might have proved destructive both
of the individual and of the species." We shall
give an example of our meaning, and again in the
words of the pious and eloquent writer just quo-
ted. "The more patent view of anger is, that it
is an instrument of defence against the aggres-
sions of violence or injustice, and by which they
are kept in check from desolating, as they other-
wise would, the face of society."*
In this way
the passion of anger, (which we take merely as an
example,) is not to be considered as in itself evil,
which is too often the view taken by superficial
observers, but it is to be looked upon as a neces-
sary constituent of our moral system, without
which we should be unable to feel a suitable ab-
horrence of sin or of injustice: it is only the im-
proper direction of anger, or its indulgence un-
restrained by the other elements of our moral
constitution which is productive of evil. In like
manner, all the passions and affections are design-
ed for good; and we conceive, therefore, that our
* Op. Citat. p. 203.
A GUIDE FOR MOTHERS AND NURSES. 175
object in morally educating a child should be, not
to obliterate those forces of his moral mechanism,
but to guide them into a system of harmonious
operation with each other. Now, how is this most
likely to be accomplished? Is it not by cultiva-
ting those affections which are obviously good, and
by their influence regulating the violence of oth-
ers, whose unrestrained indulgence would certainly
lead to evil? Thus, the anger even of a very
young infant will be best restrained, not by a dis-
play of anger upon the part of its parent, but by a
steady exhibition of parental affection, and by
showing it a practical example of calmness. Cau-
ses likely to excite irritability should also be care-
fully removed from the infant, as a habit of indul-
gence in anger will readily be acquired before the
counteracting affections can be correspondingly
excited.
As the child advances in age, new passions and
affections call daily for our notice; and as its
mental education simultaneously progresses, and
it is constantly acquiring an increased knowledge
of external objects, we are furnished by this pro-
gress and knowledge with additional and power-
ful instruments for influencing its moral nature.
He displays but a small acquaintance with the
176 A GUIDE FOR MOTHERS AND NURSES.
human heart, who hopes by an apothegm to ex-
tinguish the passion of jealousy, or to repress the
cravings of ambition by a dry statement of the
unquestionable truth that all is vanity. But still
the natural feeling of emulation, which is the
commencement of jealousy, can be restrained
within just and wholesome limits, by calling into
play the family affection, and the compassion,
which are equally original elements of the moral
constitution; and the love of reputation may be
prevented from growing into a dangerous ambi-
tion, by encouraging, along with the affections
just mentioned, a developement of the conscience
or moral sense, and of the sense of property, both
of which we conceive to be inherent in our nature.*
The child may in this way be practically shown,
that while a generous rivalry in its sports and
lessons is not forbidden, still that benevolence and
natural affection for its brothers and playmates
teach it to stop short, in every instance, of carry-
ing this so far as to wound the persons or feelings
of others; and, again, that while it may be law-
fully anxious to obtain credit and praise from its
teachers, still that its sense of property forbid it
to seek for either by making an unpermitted use
* See Chalmers in Bridgewater Treatise, passim.
A GUIDE FOR MOTHERS AND NURSES. 177
of the labour of others, and its conscience peremp-
torily interdicts any advantage which might be
attained by the assertion of an untruth. In this
way we avoid overtaxing nature ; -we do not
vainly denounce, or attempt to obliterate, forces
which are as much part of our moral frame as
hunger is of our physical ;-we do not tell the
hungry man he shall not eat, because gluttony is
a vice, but we furnish him with a guide as to the
quantity and quality of food which is wholesome
and necessary. Above all the restraining princi-
ples (if one may be preferred to another,) we
would be inclined to endeavour with most care
to bring into activity the sense of property, and
conscience or the moral sense, as Dr. Chalmers
terms it. Upon these the well-being of society
mainly depends: if not encouraged in early child-
hood, they are of all others the most likely to re-
main dormant; but if once well-developed in the
child, they require a long course of vice for their
overthrow. The progress of mental knowledge
may be brought into useful operation in our work
by directing the growing faculties of the child to
such portions of the general plan of nature as
may be within its comprehension. Admiration
for the skill of Providence may, at a very early
178 A GUIDE FOR MOTHERS AND NURSES.
age, be excited by calling attention to the more
obvious adaptations of means to ends in the forms
of animals, in the benefits conferred by the mode
of distribution of water over the earth, &c. &c. ;
and a perception of beauty can be called up in a
very young mind, by the colours and fragrance of
flowers, and the influence of music.* From all
these the watchful parent can derive practical
lessons of humility and love, which would be
sought in vain in the maxims of a dry morality.
* We were sorry to observe that Dr. James Johnson in his able
and justly popular work upon the "Economy of Health," has, in
his desire to prevent the abuse of music, been led away from a fair
appreciation of its use as an agent in moral education. We would
heartily join with him in discountenancing the system which
leads to a perilling of the health of our young ladies for the pur-
pose of converting them into opera singers; but this is altogether
different from the wholesome use of music as the proper language
of the milder, and the tamer of the fiercer qualities of our nature,
as the gentlest, and yet most enduring of our social bonds. How
tenderly must the recollections of the family circle be directed to
an absent son, or brother, when his loss to the domestic concert ist
nightly experienced, and how much more joyously is his return.
welcomed when his voice is once more heard at home! So far,
perhaps, the advantages of music are generally appreciated, but
its suitableness as an agent for the moral education of the poor
is, we regret to say, totally overlooked in this country, and yet
the education which the poor man chiefly requires is to have his
fierceness tamed, and his gentler affections called into play — to
A GUIDE FOR MOTHERS AND NURSES. 179
To work out in practice the principles which we
have attempted to lay down, we are well aware,
would require qualifications, on the part of the
parent or teacher, of no ordinary kind; but the
nearer we can approach to them, the more likely
be bound to his fellow-man by partaking in a common source of
enjoyment rather than to be divided from him by that jealousy
which must exist between the poor and the rich, whenever the in-
tellects of the former are educated without simultaneous instruc-
tion of their moral nature. The poor man also, as well as the
rich, requires recreation after labour, a fact which appears to be
totally forgotten by our philanthropists, who, while they enjoy the
indulgences of their comfortable homes, can see no excuse for the
intemperance of the hard-worked labourer, or artisan: whiskey,
however, is merely resorted to as the only attainable means of re-
lieving the exhaustion of protracted toil, and the first effectual
temperance institution will be the placing within reach of the poor,
some tranquilizing and social amusement. Those who have mix-
ed in the society of the lower class of beer-houses and gardens, in
the North of Germany, will not deny that music may be made to
answer this end.
Many will admit the justice of the foregoing views, but will
ask how are they to be attained? We answer— - let those who
have the direction of the great experiments of education, at pre-
sent in progress, abandon polemical controversies, and seek for
guidance by examining the merits and demerits of systems which
have been tried in other countries. If they inquire into the state
of the Prussian and Saxon schools, and their enviable results in
the happy condition of the people of those nations, they will, or
180 A GUIDE FOR MOTHERS AND NURSES.
are we to produce the sound mind, which we feel
confident is fully as certain of producing, as of
inhabiting, the sound body.
Our limits forbid us to enter at greater length
into this most interesting subject; but one word
we must add, to prevent misconception. We
have not yet spoken of religious instruction as a
part of moral education, because we have been
considering the management of the moral facul-
ties as they exist in the natural man; we are
deeply convinced, however, of its necessity
and importance; and we are firmly of opinion,
that in no way can we promote the interests of
an individual, both as regards himself and his re-
lations with society, so effectually, as by encourag-
ing in him early habits of religious observances;
in no way can we so surely call forth and strengthen
his best affections as by early setting before his
view the living truths of revelation.
we are much mistaken, change their course. They will probably
be content with training the minds of the children to work without
burthening those who are to live by manual labour, with much
intellectual knowledge; they will especially try to regulate the
moral nature of their pupils, and they will, we hope, make music
as it is in Saxony and Prussia, a part of the system of every
school.
A GUIDE FOR MOTHERS AND NURSES. 181
As general conclusions from the views we have
put forward, we would say, that during childhood
(i. e. until the eighth year,) education should have
for its main object the cultivation of the moral
qualities; and that, during the greater portion of
the same period, the intellect will be pretty fully
occupied in obtaining such most necessary infor-
mation as can be acquired by the use of the senses
without much formal assistance, and therefore
that schooling, properly so called, should not be
commenced, at the very earliest, before the ter-
mination of the sixth year. Until then, the con-
finement of a school is injurious to the bodily
health, and not required for the mental improve-
ment of the child. In coming to these conclusions,
we may appear to undervalue those useful inven-
tions of late years, — infant schools. We con-
ceive, however, that they have a specific purpose,
and that, when well regulated, they effect that
purpose usefully, viz.: to take charge of the child-
ren of the poor in large cities, when their parents
are engaged in their daily labour, and unable to
attend to their wants. In this view, their value
is inestimable; but still they are but the substitution
of a less for a greater evil; all the ties of social
affection, of well-regulated obedience, and of mu-
16
•182 A GUIDE FOR MOTHERS AND NURSES.
tual co-operation, which constitute the bonds of
society, are learned by the infant in the domestic
circle, and can be learned nowhere else; and if
we can leave it in the care of an intelligent moth-
er, and in the society of its brothers and sisters,
we should not send it to an infant school, where
it is governed by and associated with strangers,
with none of whom it is likely to have natural
sympathies. What the child may be expected to
gain specifically in these schools, beyond mere
protection, can only be regularity of habits, which
certainly is of great importance, but not so great
as to countervail the advantages of a well-regulated
domestic circle. For the reasons we have ad-
vanced, we conceive that infant schools, though
most serviceable in large cities for the poor, are
totally unfitted for children of more opulent parents.
With the latter the system might be characterized,
as Dr. Chalmers has done another artificial sys-
tem, as a taking to pieces of the actual frame-
work of society, and reconstructing it in a new
way or on new principles, which is altogether
fruitless of good, and often fruitful of sorest evil,
both to the happiness and virtue of the common-
wealth."
66
A GUIDE FOR MOTHERS AND NURSES. 183
Since writing the above, we have had the pleasure of reading
an interesting little treatise on Infant Education, published in
Chambers' Educational Course. Edinburgh, 1836. At the same
time that we are most gratified to find that the principles which
we have attempted to lay down for early education, are those
sanctioned by the experience of Mr. Wilderspin and others, still
we cannot change our opinion with respect to the class of society
for which the infant school is really adapted; and we must be ex-
cused for preferring the family circle, as a place of education for
the very young, in all cases in which it can be made use of without
important sacrifices. We do not agree that the element of num-
bers, as Messrs. Chambers assert, is indispensable for exercising
the social virtues of the child, particularly of the female child; but
we acutely feel, that a tenderness, not less than parental, is re-
quired to keep unceasingly awake the sense of responsibility which
ought to be felt by the infant's instructer: and we conceive that
this responsibility is intended, by a wise Providence, not merely
for the child's advantage, but also for a strong and wholesome
check upon the morality of the parent, which it would not be
beneficial to society to weaken by division, in any case, admitting
of its being left whole and undivided.
CHAPTER VI.
TEETHING.
THE period of dentition, or teething, is one
fraught with no little anxiety to the mother, and
with no less of danger and suffering to the child.
The teeth first make their appearance about the
sixth or seventh month; it may be sometimes ear-
lier, but is often much later; and the process is
completed, generally, within eighteen months.
The number of the first set, or milk teeth, is
twenty. They generally make their appearance in
pairs, those in the lower jaw coming first. They
are, four incisors, or single teeth, in each jaw; two
canine, or eye teeth, as they are called, in the upper
jaw, and stomach teeth in the lower jaw; four mo
lars, or double teeth. In the second set, there are
four grinders, or double teeth, in each jaw, addi-
tional, and two wisdom teeth; making, when the
set of teeth is completed, thirty-two of the whole.
"This process is a natural one, and does not
necessarily lead to diseased action; but such is
A GUIDE FOR MOTHERS AND NURSES. 185
liable to occur in consequence of the irritability of
the infant constitution, which is, at this time, par-
ticularly remarkable, as well as the proneness to
sympathetic disturbance. Some irritation must
attend the passage of the tooth through the gum ;
and this is caused both by the pressure of the
crown of the tooth against the parts above, and
of the root on the dental nerves below. Hence
arises pain; and to this we are to attribute, as a
chief cause, the morbid sympathies that accom-
pany dentition. The degree to which these may
amount, however, depends more upon the state
of the infant at the time, than the extent of local
irritation caused by the tooth; for we see what
little suffering attends cutting the large double teeth,
compared with the small ones which preceded
them, at a time when the susceptibility of the infant
constitution was at its height."
The symptoms that attend teething, are well
known to every mother. They are, increased
flow of saliva, thirst, gums more or less swollen,
hard, hot, and tender to the touch. The child is
fretful, — peevish,— has sudden fits of crying, —
starts in its sleep, screams as if frightened by
some dreadful dream, has a disturbed sleep,-
No doubt many of these
flushed cheeks, &c.
16*
186 A GUIDE FOR MOTHERS AND NURSES.
symptoms are the result of pain in the head from
nervous sympathy. The bowels are sometimes
obstinately costive, not being evacuated for sev-
eral days, without assistance; frequently diar-
rhoea attends, or is alternated with constipation.
The most obstinate, and most frequently, fatal
cases of disease with which I ever met, in chil-
dren, have occurred during teething. Children
are sick at this period of their lives, independently
of dentition; so that it is wrong, as is often the
case, to attribute all diseases, at this time, to teeth-
ing, and to wait for the child to get well without
having recourse to medical aid. A few days'
neglect in such cases, may seal the fate of a lovely
child, and prove the source of years of subse-
quent and unavailing regret and self-reproach to
the parents.
"Convulsions," "fits," "spasms," as they are
commonly called, are the frequent attendants up-
on teething. "The convulsive movements are
often confined to mere twitchings, or spasmodic
motions of the face, eyes, and arms; and, in such
cases, are not as dangerous as is commonly
thought. In no case, however, are they to be
neglected; for great danger attends them when
they become general, violent, and frequent.
A GUIDE FOR MOTHERS AND NURSES. 187
Death may take place suddenly, as if by apoplexy;
or an incurable paralysis (palsy) be the result, as
we have more than once witnessed.
It must be remembered that these spasms,
however slight, even when they affect only the
hands and fingers, are indicative of more or less
affection of the brain, or spinal marrow; and that
when they have once occurred, they are likely,
though not certain, to be repeated. Frequently,
there is sufficient warning of their approach given
to prevent an attack; and when we are apprized
by the restless nights, grinding of the teeth in
sleep, starting up suddenly in sleep, flushed face,
and costive bowels, that danger is threatening,
there should be no delay in calling in medical ad-
vice: or, when there should be present any other
disease, bowel complaint, vomiting, or the like, it
is much the safest to consult the family physician.
Whatever disease does occur, during the period
of teething, is almost certain to be aggravated;
and whoever waits for the unaided operations of
nature in these cases, may live to most bitterly
lament his delay.
I would not, willingly, add one particle to the
anxiety that some mothers feel at such times; but
all are not alike in knowing, and consequently,
188 A GUIDE FOR MOTHERS AND NURSES.
-
feeling, the danger: to such I now address
myself, hoping that timely caution may not prove
unavailing.
I frequently meet with objections to scarifying
the gums, when that operation is indispensable,
“because it makes the gum harder, and the tooth is
then longer in coming through." This is altogeth-
er an erroneous notion. A cicatrix or scar,
will always give way sooner than the uncut gum.
The reason for this popular error is this: teeth,
occasionally, require to have the gum cut several
times; and, because the tooth advances slowly, it
is believed that it is retarded by the hardened
gum.
Diseases of the skin occur frequently, during
dentition; and it is curious to observe, that an
eruption of a peculiar character, and appearance,
will show itself with the cutting of almost every
tooth. These eruptions are to be treated with
the greatest caution; or, in other words, no appli-
cation should be made except by medical advice.
They are the result of a salutary effort of nature
to maintain the internal and vital organs, in a state
of health.
It is as much impracticable, as it would be out.
of place, for me to prescribe the medical treat-
A GUIDE FOR MOTHERS AND NURSES. 189
ment to be pursued through the whole course of
dentition; my object being rather to make known
the existence of danger, and to point out the man-
ner and time to avoid it.
1
CHAPTER VII.
CHOLERA INFANTUM, OR SUMMER COMPLAINT.
THIS is a disease which annually destroys many
children, in large towns, and crowded cities; and
is confined to children from two months to two
years old, though a majority are in the period of
their first teething.
Professor Eberle says, that, during a practice of
twelve years, in the country, he saw but two ca-
ses of this disease. He considers "there are
three causes whose concomitant influence is con-
cerned in the production of this variety of cholera ;
namely, high atmospheric temperature, the con-
taminated air of crowded cities, and the irritation
produced by teething."
There is, in my opinion, another, and quite as
efficient a cause, operating to produce this disease,
so much dreaded by mothers in this city, and one
which the Professor has not mentioned; and it is
to point out this cause, that my remarks on this
disease are introduced.
It has been before shown how, by various cau-
A GUIDE FOR MOTHERS AND NURSES. 191
ses, the milk of a mother, or nurse, can be ren-
dered unfit for nourishing a child, that when it
becomes thus altered in quality, it is capable of
producing the worst effects in the innocent nurs-
ling. Now the "high temperature" and contam-
inated air of "crowded cities," are operating as
well upon the already exhausted, and delicate mo-
ther, as upon her child. The system becomes
enfeebled by increased perspiration; the sleep is
broken at night; the appetite is impaired, and di-
gestion is imperfect. Added to these causes, there
is, almost always, an indulgence, to a greater or less
degree, in fruits and vegetables. In the hot sea-
son, there is always less appetite for farinaceous
and animal food, than in the other seasons; the
system then demanding a more succulent and
cooling diet. But, an indulgence in such diet, we
see affecting adults unfavourably, often, when it
does not pass the bounds of moderation. The
character and quality of the milk, we have also
seen to depend upon the material of which it is
made; so that all the above causes are brought
to bear directly, or indirectly, upon the infant's
food, to make it unwholesome; which, with the
superadded cause of irritation from teething, ren-
der it not at all surprising, that cholera infantum
should be a frequent, and often fatal, disease.
192 A GUIDE FOR MOTHERS AND NURSES.
This view of the subject explains to us why this
disease is of more rare occurrence in the country
than in the city. Mothers in the country have,
in the first place, more strength of constitution,
and a better stock of health, than mothers in
crowded cities, and are, hence, less affected by
the ordinary causes of disease; and are less expo-
sed to the causes which we have mentioned as
affecting mothers who reside in cities. The fruits
and vegetables which are eaten in the country,
are of a better quality than those procured from
our markets; if not of better quality, they are at
least fresher and less likely to do injury. So that,
on the whole, the child that is nursed in the coun-
try, stands many more chances of escape from the
"summer complaint," than one nursed in a large
city.
I believe this to be a more efficient cause of the
disease in question, than all others; and if it is
admitted to be so by those more intimately con-
cerned, the remedy, or rather the preventive,
which is quite obvious, will immediately suggest
itself. I believe this cause has been too generally
overlooked by medical men; and there is no
doubt, that, if it had been duly estimated, and
A GUIDE FOR MOTHERS AND NURSES. 193
measures adopted accordingly, many, who have.
fallen victims to this oversight, might have been
preserved.
The proper course, under this view of the sub-
ject, to be pursued by one rearing a child at the
breast, who does not uniformly enjoy good health,
in the city, is, when circumstances will permit, to
seek a healthful location in the country, during
the heat of summer. Too great attention cannot
be paid to diet; and if fruit and vegetables do
not perfectly agree, or if symptoms of illness show
themselves in the child, the diet of the nurse should
be confined to animal food, and farinaceous articles.
If the health of the mother continues delicate, — if
her appetite is capricious, and digestion not well
performed, a healthy wet nurse should be procur-
ed; or when this is impracticable, the child should
be weaned. It is better that it should take its
chance on a variety of artificial food, than be con-
fined to a single article, which is most assuredly a
principal cause of its sickness, and which may be
fatal in its consequences. The limits of this work
will not allow me to dwell longer on this topic;
but it is hoped the hints here thrown out may not
be without their value to an affectionate mother,
ever ready to sacrifice her own comfort to the
good of her offspring.
17
CHAPTER VIII.
THE RESPONSIBILITIES AND DUTIES OF A NURSE.
THERE are few persons in any occupation, whose
duties are more arduous, or whose responsibil-
ities are greater, for the same length of time,
than those of a nurse who devotes her whole en-
ergies to administering to the comforts of a lying-
in woman. To her, in a great measure, are en-
trusted the life, and subsequent health, of a mother
and child, and the happiness of those depending
upon them. The greater the value then of the
trust committed to her charge, the more impor-
tant it is that it is faithfully and wisely executed.
The physician may do his duty; he may do all
that is within his power, by giving advice to the
patient, and instruction to the nurse; he may en-
join their compliance by the force of argument,
and the persuasion of eloquence; and yet, when
his back is turned, if the nurse chooses to be a
little obstinate, a departure from his precepts in a
A GUIDE FOR MOTHERS AND NURSES.
195
small particular may cost the patient her life.
The directions of a physician must be given some-
times in short-hand; other patients are requiring
his immediate attendance, and he has not the time
to give a series of reasons for everything he may
recommend; and, consequently, a self-sufficient
nurse, who cannot, of course, see and appreciate
his reasons, takes it upon herself to call in ques-
tion the wisdom of his counsel; and as such nur-
ses always have some real or fancied case to quote,
to support them in their rebellion, the patient is
too often persuaded to follow the leading of a
blind guide. When the nurse gives advice coun-
ter to that of the physician, the patient, or her
husband, ought to remember that one or the other
must be wrong; and that the advice of both cannot
be followed without injury. The duty of the patient
then becomes manifest; either she must dismiss
her physician, or nurse, or exact a compliance, on
the part of one, with the advice of the other.
What practitioner has not had his injunctions
disregarded in respect to diet, to sitting up, to
walking, &c.? And who has not seen the worst
consequences ensue from such indiscretion? There
is now and then discovered a longing almost on
the part of a nurse; and I am sorry to say, it
196 A GUIDE FOR MOTHERS AND NURSES.
is met with also in the patient to cheat the doc-
tor to disregard his injunctions; and then, if
sickness follows, to conceal the fraud, or equivo-
cate when questioned in relation thereto. If no
evil follows, it is considered a great achievement-
quite a Waterloo affair-and is boasted of with an
air of triumph. Success in these attempts at de-
ception embolden the perpetrators to a repetition of
their audacity; so that, sooner or latter, some one
confiding in the integrity of her nurse, falls a
victim to these rash and conceited experimen-
ters. Where one escapes with impunity, another
may suffer death.
At the time these pages were being prepared
for the press, the writer had a patient who suffered
severely from convulsions during labour, who was
subsequently in a precarious state, and whose life
was considered in jeopardy. She had several
relapses from her own imprudence; but, at length,
promised the most implicit obedience to my advice.
Her situation was such that the greatest danger
attended her sitting up; and therefore, to make
her feel and understand the importance of keeping
her bed, I told her on no condition to rise from
it, even if the house should be on fire; to wait till
the last minute, and see if assistance could not be
A GUIDE FOR MOTHERS AND NURSES. 197
procured to carry her; these injunctions were
repeated again and again; and at the same time,
it was made imperative upon the nurse to give
her only some simple gruel, or something of a like
character. On my next visit, the patient was
thought to have been dying just previous to my
arrival, and a messenger had been despatched for
me in the greatest haste. On inquiring, it was
ascertained that on the evening before, the nurse
had urged the patient to rise while her bed could be
made, but she was unable to sit, and was hurried
back to her bed; from that time she was much worse;
and although the nurse was expecting her to die
at almost every moment, she was in the very act
of preparing a friccazeed chicken, which she in-
tended to force her to eat, to strengthen her. It
may be readily supposed how much longer the
nurse continued her services.
There are many times when patients are sud-
denly taken worse, so that a nurse is called upon
to do something with the hope of affording relief;
they ought, therefore, to make themselves ac-
quainted with the accidents most likely to happen,
and the common remedies most suitable to be ap-
plied on such occasions. If they omit to do this,
they neglect an important duty; but when they
17*
198
A GUIDE FOR MOTHERS AND NURSES.
act according to the best of their information, even
if they fail to do the good they aim at, the will
should be taken for the deed.
The fault of nurses, next in importance to dis-
regarding the physician's advice, is annoying, and
alarming the patient with tales of suffering and
distress. A perfect silence on such matters should
be observed. No good can possibly come of re-
tailing stories of this kind. But if the patient
herself even voluntarily alludes to them, it should
be the nurse's duty to lead her mind to some more
agreeable subject; and if the patient's mind dwells
upon a case of suffering analogous to their own,
when the danger was greater than her's, the nurse
should encourage her with one of an opposite
character, and counteract by her own influence
the evil that the patient may bring upon herself.
There is a fault too prevalent among nurses,
and of which I have often heard complaint; and
that is, too great a propensity to talk. Lying-in-
women are not usually fond of much talking; and
it is generally not good for them. Nurses talk
with the best intention; they do it to amuse their
patients; not once suspecting that their conversa-
tion may be an annoyance, instead of a pleasure.
The patients themselves, for fear of doing violence
A GUIDE FOR MOTHERS AND NURSES. 199
to the kindest feelings, will not express dissatisfac-
tion; but they do sometimes make grievous com-
plaints to their physician. Nurses ought to study
the disposition and temper of their patients; and
when they can amuse by an anecdote, or encourage
by the narration of cases, they ought, by all means,
to do so. A cheerful countenance, pleasant tone of
voice, and kind manner, and readiness to render
any service, and a proper degree of watchful
anxiety, both for the mother and child, will en-
dear a nurse to mothers, and will ensure their
being held in grateful remembrance for ever after.
One thing a nurse must never forget, that is, to
be neat in her personal appearance; and scrupu-
lously so in whatever she does for her patient,
particularly in preparing all her articles of food
and drink.
CHAPTER IX.
HEREDITARY DISEASES.
Ir is a general law of nature, that like shall pro-
duce like that the progeny shall resemble the
parents. This law prevails, not only in the ani-
mal, but throughout the vegetable kingdom. By
virtue of this law, many of our most valuable ani-
mals have been brought from a wild and fierce
state into one of docility and domestication, and
from a small and stinted, to a much increased size;
many of our most beautiful plants and flowering
shrubs, our most delicious viands, and most valu-
able vegetables and grains, have been brought to
their present state of perfection, from being com-
paratively unsightly and valueless herbs.
If like produces like, how happens it, it may
be asked, that the product is so unlike the original?
All the animals, plants, and vegetables, that are so
seemingly unlike their originals, yet retain all their
distinctive specific features; they are the same in
A GUIDE FOR MOTHERS AND NURSES. 201
reality, but by continued improvement brought
to greater perfection.
There are, however, what are called freaks of
nature, sports of nature, &c.; they are deviations
from her uniform course,-exceptions to the gene-
ral law. They are seen in both the vegetable
and animal kingdom; and when the species is
propagated from them they may, and generally do,
produce their like; and hence the curious and
multitudinous varieties of some of the flowering
shrubs, and domesticated animals. Acquired or
accidental peculiarities in the human species are
transmitted by the same law; which is curious
in its operations. For instance, an acquired pe-
culiarity may be regularly transmitted to all the
male members of a family, or to all the females,
or to one-half of the children of either sex, or
to one or two only of a large family. They also
disappear in one or two generations to reappear
in a subsequent one. Thus, I am acquainted
with a gentleman whose mother had two thumbs
on one hand none of her children had the ad-
ditional thumb, but a son of the gentleman, one
of the third generation, has the supernumerary
member.
The question is often asked with reference to
202 A GUIDE FOR MOTHERS AND NURSES.
hereditary peculiarities, why is it, if there is such
a thing as transmission of resemblances from pa-
rents to offspring, that the children of distinguish-
ed men are often not above mediocrity for talent.
This question is of easy solution, and by this very
law of transmission. It must be remembered that
both parents are concerned in this matter; and
that the progeny may resemble either, or both;
or it may resemble one in the mental capacity,
and the other in personal appearance; or its men-
tal capacities may be an average of both parents.
Now it so happens that very distinguished men
do not often have wives equal to themselves in
intellect; consequently, the children, by the laws
of transmission, are as likely to resemble the moth-
er as the father.
This plan of transmission holds true in regard
to diseases; peculiarities of temperament, consti-
tution, or predisposition, being transmitted from
parent to child; so that it has become familiar to
all to hear mention made of "family diseases," or
66
family complaints." It is not often that the
disease itself is transmitted—the child is not often
born diseased, but inherits those peculiarities
which constitute a susceptibility to the disease of
its ancestors, which may be developed by the ap-
A GUIDE FOR MOTHERS AND NURSES. 203
plication of slight causes. The heriditary predis-
position may, indeed, develope the disease without
any other additional cause, if preventive meas-
ures are not taken. When there are no coun-
teracting influences used, we see whole families
one after another, afflicted with the same disease;
and when that is mortal in its nature, one after
another at about the same age, is swept away.
Many of "the ills that flesh is heir to" may be
considered hereditary, or pervading particular fam-
ilies; and in fact, I believe that most of the dis-
eases incident to humanity are propagated by trans-
mission. Popular opinion confirms this; for noth-
ing is more common than to hear people speak of
the necessity of a doctor's understanding their con-
stitution. So far their notions are correct, or at
least they are founded in truth; but they err
when they suppose that a physician, to whom they
are strangers, may not soon so well acquaint him-
self with their peculiarities as to do them no injury
by his prescriptions. It is the business of a phy-
sician to make himself acquainted with individual
peculiarities.
The diseases that may be considered as most
peculiarly hereditary are scrofula, one form of
which is consumption, apoplexy, palsy, convulsions,
various affections of the head, epilepsy, hysteria,
204 A GUIDE FOR MOTHERS AND NURSES.
affections of the chest, such as consumption, inflam-
mations, &c. gout, rheumatism, cutaneous diseases,
such as what is commonly called salt rheum, &c.
In fact, an attentive observer will discover a simi-
larity, if not a striking resemblance, in the diseases
of a numerous family, and more particularly if the
same temperament is strongly marked. To illus-
trate this, I may remark, that I knew a family of
seven daughters, five of whom died under similar
circumstances soon after giving birth to their first
children.
Insanity is a disease that is also hereditary
and there are numerous instances of several mem-
bers of a family, at about the same period of life,
becoming insane.
Of what practical value is it to make known
these unpleasant truths, it may be asked, to those
who are likely to inherit some of these diseases?
Till the existence of an evil is fully known, it will
certainly not be remedied; and when once known,
an inquiry into its causes is instituted, and the
best means sought for to effect a remedy. A timid
person need not, necessarily, be overcome with
alarm on being warned of imminent danger, es-
pecially if, at the same time, a way of escape is
pointed out. Other causes, besides transmission,
A GUIDE FOR MOTHERS AND NURSES. 205
may contribute to the developement of hereditary
or family diseases. Among these may be reck-
oned, as the chief, the same circumstances in
which the different members of a family are
placed, and the same influences to which they are
subjected. Thus, they may all be accustomed to
the same way of living, use the same diet, follow
the same occupation, be exposed to the same
climatorial influences, &c. For instance, a man
is predisposed to apoplexy; his profession is one
that engages the intellect and passions more
or less, and instead of avoiding the causes which
excite the disease, he is constantly exposed to
their operation. He dines heartily, indulges in
wine, perhaps only to a moderate extent, keeps
late hours, and eats late suppers. His sons, if he
have any, and such cases are very common, are
quite likely to follow the example of their father
he dies of apoplexy, and they, without knowing it
is in their own power to shun his fate, fall victims
to the same disease.
By the same law, by which diseases are trans-
mitted, they are also increased, though not in the
ratio of the increase of population. The spread
of family predisposition is counteracted by im-
proved medical science, by intermarriages, and
18
206 A GUIDE FOR MOTHERS AND NURSES.
by other causes, but still they do increase: for the
children of diseased parents, other things being
equal, have the same power of transmitting their
predisposition to the next generation, that their
parents had of communicating theirs to them.
When the predisposition to disease exists by in-
heritance, the developement of the disease may
be prevented, frequently, and, unless the predispo-
sition is very strong, in a majority of instances:
but, to do this, we must commence our preventive
course with the infant.
All the preceding advice with regard to moth-
ers, as well as to the management of children, has
been given with particular reference to the pre-
vention of hereditary diseases generally; and with
no further arguments to enforce these precepts, if
they were literally followed, one half the deaths,
from hereditary predisposition, would be prevent-
ed. But, as cach disease requires some particular
Hygienic precept, inasmuch as some are excited
by different causes, we will notice some of the
principal complaints that are considered heredita-
ry, and point out the best method to prevent their
developement, and to eradicate the predisposition;
and we will begin with one which numbers more
victims than any other which afflicts the human
family.
A GUIDE FOR MOTHERS AND NURSES. 207
SECTION I. Consumption, and Scrofula in all
its forms. This, as every body knows, is a dis-
ease of the lungs, and is generally considered as
certainly fatal. But for the comfort of those con-
cerned, I may here state, on the authority of the
best writers on this disease, that it has been often
arrested in its first stage, and never after re-ap-
peared; and that sometimes, when patients have
been, to appearance, on the verge of the grave,
the disease has been cured. It prevails, to a
great extent, causing about one-fifth of all the
deaths in this city, including foreigners; and de-
stroying one in nine of the white natives of the
United States, who die in New-York.
The whole number of deaths reported, from
consumption, from 1805 to 1836 inclusive, is 24,883
(twenty-four thousand, eight hundred and eighty-
three.) If the lives of one half of these had been
prolonged, perhaps for years, how incalculable
would have been the blessing; and how great a
benefactor would he be, who would disseminate the
precepts by which such a boon could be acquired.
By a published report of all the interments in
this city, from the year 1805 to the present time,
it appears, that from 1805 to 1815, there was one
death from consumption to every 183 inhabitants:
208 A GUIDE FOR MOTHERS AND NURSES.
from 1815 to 1825, the ratio was one to 189; and
from 1825 to 1835, it was one to 178. It is im-
possible to get at any accurate result, so as to de-
termine the increase of the disease with precision,
so that we rest satisfied with a bare approximation
to the truth.
Sir James Clark, of Great Britain, physician to
the Queen, states, in his invaluable work on con-
sumption, that in London, the deaths from con-
sumption increased, from 1700 to 1750, from four
to six in every 1000 of the population; since which
time, it seems to have remained stationary, although
he does not place implicit reliance upon the re-
ported bills of mortality.
Notwithstanding the boasted healthfulness of
the climate of London, Dr. Clark states that the
number of deaths from consumption, amount to
one-third of the whole mortality; while the deaths
from the same disease in this city, are about one-fifth
of the whole mortality. "Although we are not
acquainted with any direct means of correcting
the constitutional predisposition to consumption,
there can be no doubt, that in many instances we
have the power of effecting it indirectly.
CC
By placing the predisposed child in the most
favourable circumstances, as regards those agents
A GUIDE FOR MOTHERS AND NURSES. 209
which exert a constant influence on the health'
such as food, air, exercise, &c.— by removing
functional derangements as they occur, and espe-
cially by maintaining the digestive organs, in a
state of integrity, we may improve the constitu-
tion, so as to enable it to overcome the hereditary
predisposition. By the judicious application of
these means, I am persuaded that the lives of a
large proportion of children, born with the predis-
position, might be saved; and it is not, perhaps,
beyond the truth to say, that, under the present
system of management, five-sixths perish." — (Sir
James Clark on Consumption.)
What is true of consumption, is true of all he-
reditary diseases; and I believe it is not too much
to say, that, with proper precaution, the lives of
"five-sixths" of those who die from hereditary
predisposition, might be preserved.
Suckling. Mothers of a strongly marked scro-
fulous constitution, or, to speak more plainly, those
of a consumptive family, unless the health at the
time, be perfectly good, should on no account
nurse their own children. As much as it is their
duty, at other times, to supply their children with
nourishment from the maternal fountain, in the same
degree is it now incumbent on them to forego this
18*
210 A GUIDE FOR MOTHERS AND NURSES.
happiness. A young, healthy nurse should be pro-
vided, and she should be selected agreeably to
advice given in a former part of this work.
The child should take no other nutriment than
the breast milk, during the first six or eight months ;
and after that, if he is rather delicate, pale, and
what is called feeble, plain animal broth may be
allowed once or twice a day. After the double
teeth have made their appearance, he may have
a reasonable quantity of tender meats, fruits, and
vegetables.
If, on the contrary, the child is ruddy, rather
robust, strong, and healthy, animal food should be
withheld, and a farinaceous diet, only, permitted.
Bathing, Air, Exercise, &c. All the precepts
before laid down, in regard to these particulars,
ought to be most rigidly adhered to. The causes
that excite this disease being exposure to cold and
wet, and atmospheric vicissitudes generally, it
follows, of course, that to prevent their effects,
they must be wholly avoided, or the system ren-
dered insensible to their influence. A location
enjoying a climate of uniform temperature, would,
therefore, be most suitable for the rearing of chil-
dren, predisposed to consumption: but, as this is
out of the question in most cases, the next thing
A GUIDE FOR MOTHERS AND NURSES.
211
is to so accustom the system to climatorial changes,
so that ordinary exposure shall not affect it. Let
the child, then, the first summer after its birth, be-
gin to be accustomed to the use of the cool bath,
or cool sponging, gradually diminishing the tem-
perature, till it is brought a little lower than that
of the atmosphere in warm weather, and employ-
ing it a few degrees above freezing in the winter.
Friction with a soft flannel, for a few minutes,
ought always to follow the use of the bath; the
body should be then well protected with clothing,
and exercise taken in the open air. Too much
clothing may be employed as well as too little;
and the quantity must be regulated by common.
sense.
This system of bathing need not alarm a tender
mother to whom such a proposal is novel, and there-
fore shocking; for she may rest assured, that quite
young children, even long before they begin to
talk, become fond of it, and manifest great de-
light when they see preparations making to give
them their usual bath. This plan is not designed
to be temporary, or confined to the period of
youth; but should be persevered in during the
whole life. The proper place for the residence
of children of this predisposition is, during the
212 A GUIDE FOR MOTHERS AND NURSES.
warm season of the year, in a dry, airy situation
in the country. There they should be allowed to
run in the open air, to engage in all the sports and
exercises of youth, except, perhaps, running vio-
lently, or any thing that may produce absolute fa-
tigue and exhaustion.
The diet during childhood, must be regulated
according to the individual. When the child is
pale and delicate, provided the digestive organs
are strong enough, the diet should consist, in part,
of meat; but when there is a glow of health upon
the cheek, with strength and activity, for both
these states are seen in this predisposition,
diet should be of a less stimulating character;
being made to consist of milk, if it agrees with the
stomach, and farinaceous articles.
the
In children, and young persons, predisposed to
consumption, who have an active circulation, indi-
cated by red cheeks and lips, there is a strong
tendency to inflammatory affections, and frequent,
though they may be slight, fevers, from trifling
causes. And as their diet should be less exciting,
so ought also their plays and exercises to be of a
moderate character. Passive exercise, such as
riding on horseback, is more proper for these than
for those less excitable.
A GUIDE FOR MOTHERS AND NURSES. 213
The clothing of young persons, predisposed to
consumption, should consist of flannel next the
skin, in the cold season; it should be put on early
in the fall, and worn till late in the spring.
The advice here given is applicable to girls as
well as boys.
Education. The less that children, under eight
years of age, predisposed to consumption, or any
form of scrofula, see of the inside of a schoolroom
the better. This, to some, may seem strange;
but it is no more strange than true; and whoever
disbelieves the doctrine and persists in treating
their children like hot-house plants, forcing their
intellect at the expense of the body, may prepare
themselves to follow their children to an early
grave, and in after life, may suffer from self-
reproach for having been the cause of their un-
timely death.
It is a well known fact, that children predis-
posed to consumption, generally manifest a preco-
city of intellect; in other words, they are uncom-
monly bright, good scholars, and the pride of
their parents and teachers. It is never once
thought that this may be the result of a state of
the systern bordering upon disease, and that a
little forcing the intellect may develope the malady
214 A GUIDE FOR MOTHERS AND NURSES.
which will destroy life. These bright children
are sure to be put forward; their ambition is
stimulated at the sacrifice of health. A contrary
course should be pursued; the health of the body
should be cultivated; vigour should be given to
that in proportion to the powers of the mind, and
the danger will then be diminished. Intelligent
boys of this kind are selected by their doating
parents to study a profession, when they, of all
their children, are the least able to endure the
fatigue, and tax upon their bodily health, to which
a student's life subjects them. Instead, therefore,
of being put early to study, they ought rather to
engage in some agricultural pursuit suitable to their
age and strength, till they shall have acquired
sufficient stamina to bear the unhealthful effects
of confinement to study. Here we have a reason
why so many young men break down in the midst
of their studies, and so many more soon after
they enter upon the practice of their professions.
This subject is one that might be much enlarged
upon; but this is not the proper place for it.
Let the rule be, with regard to the education of
children, that the physical and mental education
keep pace with each other-laying it down as a
fixed principle, that study shall not be commenced
till the health shall have become good; that due
A GUIDE FOR MOTHERS AND NURSES. 215
attention shall be paid to exercise, &c., and that,
whenever the health begins to fail, confinement to
a schoolroom shall be discontinued till the health
shall have been re-established.
The present boarding-school system of educa-
ting girls is open to the most serious objections;
the greatest of which are the too long confinement
and too little exercise.
To gratify a whim of fashion, or some other
whim equally ridiculous, it is the custom, at what
are called the genteel boarding-schools, to keep
the young misses at their studies from nine in the
morning till three in the afternoon, with an inter-
mission of from fifteen minutes to half an hour.
During this intermission, exercise is taken to little
purpose; for the schools, generally, have not play-
grounds sufficiently airy and extensive. A young
lady's education comprises a smattering of so many
subjects, and is condensed into so small a com-
pass of time, that nearly all the hours out of school
must be spent in hard study, and those studies
are forced upon them without regard to natural
taste, or capacity for acquirement.
The seats at young ladies' boarding-schools,
upon which they are confined so many hours in a
day, are without backs; and thus the muscles,
whose office it is to keep the body erect, have a
216 A GUIDE FOR MOTHERS AND NURSES.
greater task imposed upon them than they can,
for so long a time, perform; and curvature of the
spine is the consequence, at first, and consump-
tion, or some other form of scrofula, afterwards.
Let there be an intermission of two hours instead
of fifteen minutes, and let the girls be compelled
to take the exercise proper to give them health
and vigour.
Dr. Clark recommends that a warm bath should
form an appendage to every young ladies' boarding-
school; and in addition to the bath I would urge
the importance of having a gymnasium suitable
for the age and sex of the scholars.
—
The same writer speaks much in favour of ex-
ercising the respiratory organs by deep inspira-
tions. The chest should be unencumbered with
a tight dress, and young ladies of a delicate con-
stitution, or predisposed to consumption, should
never wear a tight dress ;* the arms are then to
be thrown gently back and a succession of deep
inspirations taken. This should be repeated sev-
eral times daily, but not to such an extent as to
cause pain.
Har-
* I may take the liberty of referring the reader to No. 77,
per's Family Library, to the article on tight lacing, where the author
shows that tight lacing neither contributes to the improvement of
the form, nor to the benefit of health, but invariably injures both.
A GUIDE FOR MOTHERS AND NURSES. 217
Reading aloud in a full, but not too much an
elevated tone of voice, should constitute a daily
exercise of the lungs.
Singing, or playing on a wind instrument, I
believe in general to be too great a tax upon or-
gans strongly predisposed to consumption, and
ought therefore to be avoided.
Riding on horseback is an invaluable exercise
for young persons of both sexes. It should form
a part of their education; it developes the mus-
cles about the back and chest, gives tone and ac-
tivity to the digestive organs, and vigor to the
whole system.
Fencing is also useful for boys and young men,
and should form a part of their education.
There is what is called the club exercise, which
Dr. Clark thinks of more service to both sexes
than almost anything else.
It is so called from the circumstance of two long
pieces of wood; or clubs, being the weights em-
ployed, they must, of course, vary in length and
size according to the strength and size of the
son who is to use them.
per-
The exercise consists in standing in an erect
position, and swinging the clubs in various direc-
tions about the head, across the shoulders, behind
19
218 A GUIDE FOR MOTHERS AND NURSES.
and before, &c. giving action to all the muscles
that are used in moving the upper extremities. I
have had no experience in this kind of exercise,
but Dr. Clark thinks it superior to the dumb bells,
because the action is not as violent, but more
gentle and steady. The practice is borrowed
from the Persians and Hindoos, who, from their
being much accustomed to it, have the muscles of
the upper part of the body largely developed with
a proportional increase of strength.
This would be a good exercise for the young
of both sexes, and particularly for students, and
all who suffer from want of exercise. Every
family, therefore, might be supplied with one
or more pairs of clubs. Battledore and the
graces are excellent exercises for young ladies.
The chances for long life must depend much
upon the choice of a profession. From what has
been already said, an inference will readily be
drawn that all professions are to be avoided which
will expose one to the causes which develope
the disease. Among these may be reckoned a
sedentary occupation, without a good deal of
active exercise in the open air, public speaking,
&c. Of all occupations best suited to one predis-
posed to consumption, or scrofula in any form,
A GUIDE FOR MOTHERS AND NURSES. 219
some branch of agriculture must stand foremost.
This is an interesting and fruitful subject; and
I am sensible that I have by no means done it
justice; the preceding remarks being of a very
brief character, and only thrown out as hints to
put parents and others on their guard, to call their
attention to the subject that they may consult their
medical advisers before it is too late to profit by
their counsels.
CHAPTER X.
APOPLEXY, AND OTHER AFFECTIONS OF THE HEAD.
THOUGH not, perhaps, strictly professional, yet in
accordance with the designed brevity of this work,
I shall comprise, under this head, all or nearly all,
the affections of the brain, and some of those of
the nervous system. These are all hereditary, to
a greater or less extent; a fact of which any one
may be assured, if he will call to mind the differ-
ent members of a family, who have been carried
off, or afflicted by any of the diseases mentioned
below.
The deaths in this city, from the year 1805,
when reports of interments were first made, to
1836, have been as follows:
Inflammation of the Brain, whole number, 1676
Dropsy of the Brain,
Apoplexy,
Palsy,
Convulsions,
4986
2075
1057
9343
19,137
These are in proportion to the whole number of
A GUIDE FOR MOTHERS AND NURSES. 221
deaths from all diseases, rejecting casualties, sui-
cides, and still-births :-
Inflammation of the Brain,
Dropsy of the Brain,
Apoplexy,
Palsy,
Convulsions,
. 1 to 72
1 to 24
1 to 58
1 to 114
1 to 13
Here is an immense amount of loss of human
life, which might have been prolonged, had the in-
fluence of hereditary diseases been fully under-
stood, as well as the causes which bring them into
action, and the means of counteracting their fatal
tendency.
The deaths reported, from convulsions, do not
all, and, perhaps, but a small part, occur in those
systems predisposed to apoplexy; nor are con-
vulsions in reality, much akin, in their nature, to
apoplexy; for they, are mostly the closing symp-
toms of a variety of diseases which are reported
as convulsions.
It is said by writers, that a large head and
short neck, constitute the predisposition to apo-
oplexy, and head affections. This is probably so.
far true, as that one of this conformation, other
circumstances being equal, is more likely to be
affected with some complaint of the head than one
19*
222 A GUIDE FOR MOTHERS AND NURSES.
of a different make; but it does not follow that
one with a small head may not have apoplexy, or
that one with a large head must have this disease.
Some families predisposed to apoplexy, have not
large heads; but in them the sanguine and ner-
vous temperaments predominate.
It is a fact, well known to those who observe
closely, that there are diseases of a certain class,
pervading whole families, which are less depend-
ent upon hereditary predisposition, than upon the
conduct of the parties themselves. This is par-
ticularly the case with the class of diseases now
under consideration.
It is seldom that apoplexy occurs among the
middle class of people, who are not addicted to the
use of alcoholic or fermented drinks; but it is seen
most frequently in the student, the statesman, and
those who lead rather inactive lives, and are what
are called free livers. Any occupation that se-
verely taxes the mental faculties, tends to induce
some disease of the brain; and the danger of this
organ becoming diseased is increased by good liv-
ing, and a life of indolence. Persons fond of high
living may expect their children to follow their
example, if they do not even go beyond; and ac-
cordingly the infant is soon taught to relish high
A GUIDE FOR MOTHERS AND NURSES. 223
seasoned food, to sip his wine, and, in fact, be a
youthful epicure. The keen appetite of youth,
always ready to gratify itself, upon plain food, if
nothing better is equally attainable, is hardly satis-
fied with the delicacies of a professional cook,
while there is room in the stomach to make any
further deposites. Need we be surprised when
we are suddenly called to a child, pampered in
this way, just dying of convulsions? Is it any
wonder that children have inflammation of the
brain, dropsy of the brain, epilepsy, and apoplexy,
in after life, if they attain the age of manhood?
To one who understands these things, it seems lit-
tle short of ridiculous, when a coroner's jury, after
holding an inquest upon a man who has suddenly
died of apoplexy, from excesses in eating and drink-
ing, brings in a verdict of "death by visitation of
God." To me such a verdict seems little short of
blasphemy. God has ordained laws by which his
creatures are all governed: to the infringement
of every one of his laws, there is a penalty annex-
ed: some pain or punishment must follow every
transgression. The punishment for gormandizing
and debauchery is disease; and that disease may
be apoplexy, terminating in death; - death by
God's visitation, just as much as any thing else that
happens in the natural course of cause and effect.
224
A GUIDE FOR MOTHERS AND NURSES.
The time to commence our measures with ref-
erence to the prevention of head affections, in
a child, is when that child is born; or when that
child is first conceived in its mother's womb. We
have seen the importance of a pregnant female
maintaining her health, in as good a state as pos-
sible; and, therefore, if she has previously allow-
ed herself in the indulgence of high living, she
must set about an immediate and thorough ref-
ormation.
The child's diet, when he is allowed any thing
more than breast milk, should be plain, and nutri-
tious, such as has been previously recommended
for infants of this age generally. When he is
more advanced, and of an age to sit at table with
his parents, the best thing is to give him nothing
but plain food; or if that is impracticable at home,
he had better be boarded with a farmer in the
country.
By plain living I mean a mixed diet; and for
children from three years old, and upwards, this
should consist of tender, lean meat, not overcook-
ed, with no seasoning but salt, and no gravy but
the juice of the meat: good vegetables, fruits in
their season, with a large proportion of farina-
ceous articles, as rice, bread, &c.
A GUIDE FOR MOTHERS AND NURSES. 225
Pastry, which includes all kinds of pies, pud-
dings, cakes and sweetmeats, should form no part
of a child's diet, particularly, if it is predisposed
to any affection of the head.
Children who are predisposed to head affec-
tions, ought never to wear caps, unless it be for a
few weeks after birth in the winter; and care
should be taken that no article of dress should be
worn tight about the neck.
As it is the organ of the mind which is the seat
of the diseases under consideration, our chief at-
tention ought to be directed to it. We must,
therefore, look at the method to be pursued in the
cultivation of the mind. Any thing that calls the
brain into action, such as thought, study, the pas-
sions, &c., causes an unusual flow of blood into
it; and if the quantity, or the force of the circula-
tion, be too great, the vessels are over distended,
or suddenly ruptured, constituting a fit of apo-
plexy. If the flow of blood is less, there is only
pain in the head, with more or less confusion of
ideas, which will subside, if the brain is allowed
to repose.
Common sense teaches us what effect too much
exercise, or fatigue of a young brain, predisposed
to disease, must produce. No one need be told
226 A GUIDE FOR MOTHERS AND NURSES.
that the developement of the disease will be an
almost certain result.
When it is suspected that affections of the head
constitute the family predisposition, children ought
not to be sent to school, till six years of age; and
then no hard task should be given them,-nothing
should be done to excite their ambition, unless
marked dullness is evinced; and long confinement
in a close room should be always avoided.
A young man with marked hereditary predis-
position to head affection, one, or both of
whose parents, may have died of apoplexy,-
would, were he to consult his health simply, never
engage in severe study, nor follow any profession
that would require extraordinary, or prolonged
mental exertions.
CHAPTER XI.
INSANITY.
INSANITY, in all its forms and degrees, is now, by
all sound physiologists, believed to consist in some
diseases of the brain, or, in other words, mental
alienation is a symptom, or evidence, of diseased
brain. There is no predisposition to disease more
clearly hereditary than insanity.
Children born previous to the appearance of
the disease in their parents, are generally not lia-
ble to an attack; but those born after the parents
have become afflicted are frequently attacked at
about the same age that the disease was mani-
fested in the parents.
Esquirol, a French physician, who has probably
seen more of this disease than any man, says that
mothers are more likely to transmit this disease
to their offspring than fathers; and, consequently,
pregnant women should be particularly careful
about allowing their minds to be affected by any
of the exciting or depressing passions.
228 A GUIDE FOR MOTHERS AND NURSES.
In this city the proportion of deaths from in-
sanity from 1805 to 1836, to deaths from all other
diseases, is 1 to 329.
The records of insane hospitals show that this
disease is hereditary in greater proportion in the
better classes of society. "In the Salpetriére
at Paris, the hospital for paupers, of 321 female
lunatics only 105 were ascertained to belong to
families where the disease already existed; while,
out of 264 of the higher classes, 150 or more than
one-half, were in this predicament. The experi-
ence of Dr. Burrows is still more decisive, as he
assures us that he clearly ascertained the existence
of a hereditary predisposition in six-sevenths of
all his patients in private practice." (Dr. Combe
on Mental Derangement.)
Insanity being the result of disease of the brain,
all the preventive measures recommended in the
preceding chapter are applicable to insanity.
If the children thus predisposed are daughters,
they ought, if possible, to avoid the circumstances
which excited the disease in their mothers; their
education and management should be directed
with reference to this end, and all pains taken to
invigorate the nervous system, and preserve tran-
quillity of mind by exercise in the open air,—coun-
try residence a part of the year,- travelling, &c.
A GUIDE FOR MOTHERS AND NURSES. 229
If a son inherits the predisposition of his father,
the same care should be taken in regard to cir-
cumstances, whether it be occupation, exclusive
attention to business, and the like; and if it be
the occupation which developed the disease, the
son ought to pursue another of a different charac-
ter, that different mental faculties may be called
into action.
20
CHAPTER XII.
DYSPEPSIA, HYPOCHONDRIA, AND OTHER AFFECTIONS
OF THE DIGESTIVE ORGANS.
DISEASES of the digestive organs may be consid-
ered as hereditary to some extent; and to a very
great degree they are strictly family complaints.
This predisposition I believe is less likely to be
transmitted from parents to children than some
others; but, to compensate for this, diseases of
the digestive organs are more likely to be acquired
by each individual than most of the others of
which we have already spoken.
I have more than once alluded to the influence
of the mother during pregnancy upon the child
which she is to bear; and if she is a confirmed.
dyspeptic, her child will probably be delicate, and
feeble, and partake more or less of its mother's com-
plaint. Dyspepsia is unlike other, or most other,
diseases in one important particular; and that is,
the causes which generate the disease in the pa-
A GUIDE FOR MOTHERS AND NURSES. 231
rent, in most cases, operate upon the child after
birth. I allude now to an improper course of
living; for it is a notorious fact that most dyspep-
tics are made so by their own imprudence, and
that, in this particular, their children are trained
up to follow in their footsteps.
Suppose, then, that a child is born of a dyspep-
tic mother, and that it is not predisposed to its
parent's disease any more than to be delicate like
most children born of unhealthy parents. The
milk of a dyspeptic woman, I have no hesitation
in saying, is never healthy, and never suitable to
nourish and sustain a feeble infant. Milk is the
product of digestion; and how can the product be
healthy when the process is unhealthy? A child
may live and thrive upon improper or unwhole-
some food; if it does, it may be considered an
exception to a general rule-an escape rather
than a result to be expected. At any rate, I find
in my own practice, that most dyspeptics cannot
nurse their own children; and that, frequently, I
have saved the lives of infants who have been daily
dwindling away, by providing a healthy stranger
nurse instead of the mother. It is truly wonderful
to see the effect of this change; weeks may be
spent in fruitless attempts to control a bowel
232 A GUIDE FOR MOTHERS AND NURSES.
complaint, or in a variety of expedients to make
the child thrive; but after a few days, sometimes
not more than two or three, more will be accom-
plished after the child has been put to the breast
of a healthy nurse, than has been done in as many
weeks, when nursing its mother.
The course to be pursued, then, with the chil-
dren of dyspeptic mothers who do not thrive well,
is to try, if there is no immediate danger, to sub-
stitute artificial feeding with a bottle or spoon,
not however letting them forget how to suck; and
if a favourable change is not soon wrought, to
procure a healthy wet nurse.
During childhood, regard must be paid to the
diet; for the digestive organs, more than any other,
are liable to be affected by improprieties in this
respect; so much so, that probably in nine-tenths
of the cases where they are diseased, the cause is
to be found in errors which might have been
avoided.
A plain, nutritious diet, and no other, should be
allowed the children who may inherit a predispo-
sition to this class of diseases, or who may be in
danger of having them thrust upon them by inju-
dicious parents.
Particular attention ought to be paid to regular
A GUIDE FOR MOTHERS AND NURSES. 233
hours of eating, and on no account should lunch-
eons be permitted, or the idea encouraged of eat-
ing little and often. This is the greatest error that
can be fallen into. A little food destroys a keen
appetite, as any one can easily satisfy himself by
experience; and when the habit becomes estab-
lished of indulging the appetite as soon as any is
felt, there is, in the aggregate, but little food taken;
digestion is not well performed, and consequently
the health is not perfect, and the system lacks
vigour and energy.
Again I must repeat, that affections of the di-
gestive organs become family complaints, not so
much by hereditary transmission, as by being ac-
quired or generated, from youth through the whole
of life; and hence, parents must look to their own
living; and, inasmuch as they cannot expect to
keep two tables, one for themselves and one for
their children, they must effect a reformation in
themselves. And here lies the difficulty. They
either do not, or their appetite will not let them,
see that their high-seasoned food, their made dishes,
their rich pastries, sweetmeats, and other articles
that pamper the appetite, cause their sick head-
aches, heartburn, bad taste in the mouth, or distress
at the stomach. Even if they are told of the
20*
234 A GUIDE FOR MOTHERS AND NURSES.
cause of all their troubles, they will not believe
the truth. "Why," they say, "a little of this can't
hurt, and a little of that can't hurt, and a little of
the other can't hurt; we have always eaten these
things!" Yes, and they have always been unwell;
and have never been prevailed upon to live as
they ought, long enough to recover from the effects
of years of imprudence.
The most comprehensive, as well as most gen-
erally applicable advice that I can give to dyspep-
tics, who are made so by too free living, is, to eat
but three times a day, and try how cheaply they can
live.
Hypochondria, the Vapours, the Blues, &c. may be
regarded only as indicative of deranged digestion,
or disease of the digestive organs, and not by any
means, as specific diseases, and therefore not re-
quiring any special notice in this place, as they
are incidental only to adults, and the application
of this work is limited in its design to the manage-
ment of children.
CHAPTER XIII.
GOUT AND RHEUMATISM.
THESE diseases resemble each other so strongly,
in their prominent features, that some have regard-
ed them, if not identical, at least as belonging to
the same family. At any rate, their features are
so much alike, that, in practice, it is not always
easy to say, with certainty, which is gout, and
which rheumatism. In one particular, however,
and which is most essential to our present purpose,
there is little difference; and that is in being as
decidedly hereditary as any two diseases in the
class of human maladies. This fact does not pre-
clude the existence of another, to wit: that they
may both be generated anew, by the application,
in sufficient force, of the legitimate causes. When
gout is hereditary, it does not often show itself till
about the period of manhood. Rheumatism is
developed at any time of childhood. The most
efficient, if not the only original, cause of gout, is
high living, when not hereditary: the same cause
236 A GUIDE FOR MOTHERS AND NURSES.
may also predispose the system to rheumatism,
or excite it where the predisposition already ex-
ists; but then this disease occurs, as frequently as
elsewhere, where the living could have had no
agency in its production.
Of these two diseases, rheumatism is more fre-
quently fatal; the proportion of deaths in this city,
from 1805 to 1836, being as one to 619 of the
whole number of deaths, from all diseases; while
the proportion from gout, was one to 1828.
Prevention of a disease, implies avoiding the
causes which excite or predispose to it; and to do
this we must know what these causes are. High,
or good living, I have already said, is the most
general cause of gout, and therefore, a contrary
course should be its preventive. I have, there-
fore, only to repeat the same advice to parents,
subject to gout, in regard to the diet of their chil-
dren, that I have already given under the head of
apoplexy, dyspepsia, &c.; so that, if the children
subsequently suffer from gout, they may give their
parents credit for half the twinges they experi-
ence. Rheumatism is more a disease of climato-
rial influence, and atmospherical vicissitude. This
is evinced by its greater prevalence in winter and
spring; and by its more frequent occurrence in
A GUIDE FOR MOTHERS AND NURSES. 237
latitudes where the temperature is subject to great
changes. The remedial measures must, therefore,
be different from those applicable to gout; and we
must endeavour to render the system, as much as
may be, proof against the causes which induce
this disease. This may be best done, provided
the precepts that I have all along endeavoured to
inculcate, in regard to diet, &c., have been fol-
lowed, by bathing the feet and limbs, or the whole
body, after the first few months, in cold water,
and applying, afterwards, a moderate degree of
friction.
Flannel should be worn next the skin during
the cool season, till warm weather, and the sys-
tem invigorated by active exercise in the open air.
The practice of cold bathing, to be of any
avail, should be persevered in; and the most hap-
py results may be then anticipated. In persons sub-
ject to rheumatism for years, I have known the
disease diminished, two-thirds, by a few months'
application of the cold bath to the feet and lower
limbs. But when it is commenced late in life, it
must be employed, at first, with caution.
CHAPTER XIV.
MARRIAGE.
THOUGH marriage, strictly speaking, does not
come under the head of "management of young
children,” yet, our Hygienic principles in regard to
the prevention of hereditary diseases, would not
be fully expressed, nor clearly understood, if this
subject were passed over in silence. It is an in-
variable law, in the doctrine of causation, that the
effect shall be in direct proportion to its cause.
Let us keep this law in view, and look at its bear-
ings and effects, when brought into operation by
matrimony. It is well known that it is the cus-
tom, in many countries, much less in ours than in
others, for different branches of the same family
to form matrimonial alliances, from generation to
generation. It is even the case in our own land,
to some extent; but when not confined to fami-
lies, marriages, almost necessarily, to considera-
ble extent, take place between those of the same
class, or station in society.
A GUIDE FOR MOTHERS AND NURSES. 239
The effect of continued intermarriage between
members of the same family, is such, that very of-
ten, whole families become extinct, in the second
or third generation; or, if the race is perpetuated,
those who survive are feeble, both in intellect and
body. The same is the result, though in a less
degree, from intermarriages between different
families of the wealthy class. Here, there is a
similarity in the habits of living, generally all tend-
ing to create some peculiar predisposition, which,
sooner or later, is manifested.
When both parents are predisposed to disease
of any kind, it is almost a miracle, if the children
of such a parentage, escape inheriting it; for the
cause, in this case, is doubled, and the effect must
be looked for with certainty. Therefore it is,
when the predisposition is not, in a measure, de-
stroyed by intermarriage with a healthy person,
that we see all hereditary diseases upon the in-
crease, their characters more strongly marked in
families, and their fatal effects more frequently
occurring.
On the contrary, if a different course were pur-
sued, — if those who inherit predisposition to dis-
ease, were to contract matrimonial alliances with
the healthy and robust, the third generation in-
240 A GUIDE FOR MOTHERS AND NURSES.
stead of becoming extinct, would have recovered
the original health and vigour of their family.
What then is to be done? what rule or princi-
ple is to govern in forming matrimonial connec-
tions ?
These questions are more easily put, than prac-
tically and satisfactorily answered. Philosophy,
or a knowledge of the laws of hereditary diseases,
may indicate a proper course; but the finger of
philosophy will not be sufficient to direct the aim
of the blind god Cupid: it is his delight to disregard
the monitions of wisdom, and to scatter his ar-
rows where it suits his wayward fancy. But
there is another love than this: there is a love, so
called, into which many are drawn by chains of
gold. There is a love of money, which is the ba-
sis of as many marriages as any other kind of
love; and these marriages are sought where fam-
ily disease is most likely to exist,
wealthy.
among the
Shall a parent dictate to his children, whom
they shall marry? A parent shall instruct his
children in regard to hereditary diseases, and, if
they inherit any tendency to disease, it ought to
be a part of his duty to make them fully under-
stand the general principles of its transmission.
A GUIDE FOR MOTHERS AND NURSES. 241
This he owes to his children, and to those who
might be induced to become their partners; oth-
erwise their marriage would be a deception, and
years of misery might be entailed upon the un-
suspecting. How many fathers, with the seeds.
of fatal disease about them when they marry,
leave a widow with a family of little children,
with slender means of support? Is this right,
without, at least, warning both parties that such
a result may occur?
Parents do interfere with the matrimonial af-
fairs of their children, where money is concerned;
and I know of no reason why they may not equally
interfere, when their health is concerned. I would
ask for no further interference than this; and I
would advise wealthy parents to look more to the
health and character of those who may become
members of their family, than to the amount of
their income, or their prospects from rich rela-
tions.
There is a duty we owe to posterity, and I can
see no justice in inflicting certain disease upon
our children, to gratify what is not always the holy
and pure passion of love. Let every one con-
cerned be his own judge, how far self sacrifice
21
242 A GUIDE FOR MOTHERS AND NURSES.
ought to be made, rather than incur the risk of
entailing disease upon a succeeding race.
If marriages do take place between parties
where one or both are predisposed to disease, ev-
ery reasonable precaution and care ought to be
taken to eradicate the inherent taint, or prevent
its developement in them and their offspring.
APPENDIX.
MORTALITY OF INFANTS IN THE FIRST YEAR OF
THEIR EXISTENCE. BY PROFESSOR RAU OF
BERN.
*26 in 100 of the deaths in Russia, are of children
under one year old.
"Rh. Prussia, and
Westphalia.
"France.
21“ “
(6
(C
66
21 “
66
(C
66
29 "
66
(C
(6
(6
22 “
CC
(C
23 “
18 "
(C
66
"C
22"
(6
22"
66
66
66
66
(6
66
Department of the
Seine.
" Sweden.
"Courland.
"Paris.
"Amsterdam.
Philadelphia.
Of the whole number of children born, there
die before the expiration of the first year: —
*23 in 100 in Paris.
20 "
(C
" Sweden.
33 "
66
"the Province of Kasan, (in Russia.)
*Rejecting fractions.
244
APPENDIX.
21 in 100 in Russia (in the level country.)
25
CC
66
32 (6
(
31
16
17
(6
66
"Berlin.
"London.
"St. Petersburgh.
"Prussia.
"Courland.
(British and Foreign Med. Review for April.)
THE END.
S. C.

DEC 10 1907
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