Chapter XXVII.Medical Directions concerning Children.Sect.377.The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem tohave been toomuch neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults.It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nayevery Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work.§ 378. Nearly all the Children who die before they are one Year, and even two Years, old, diewithConvulsions: People say they diedofthem, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, theMeconium; the Excrements contained in the Body of the Infant, at the Birth;Acidities, or sharp and sour Humours;the Cutting of the Teeth, and Worms. I shall treat briefly of each.Of the Meconium.§379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called theMeconium. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant.The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute thisMeconium, and promote the Discharge of it by Stool, and sometimes by vomiting.To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup85of Succory, which should bediluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds.Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada.Of Acidities, or sharp Humours.§ 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory86just mentioned.The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the PowderNº. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves.§ 381. It has been a Custom to load Children with Oil of Almonds,87as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increasesthe Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life.A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues.This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length oftenproves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult.Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels.§ 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving.Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines,&c.of Soap, or of Honey boiled up to a proper Consistence.But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life.§ 383. Before I proceed to the third Cause of the Diseases of Children, which is, theCutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them.Of washing Children.§ 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Childrenshould be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring.For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears,the back Part of the Head(carefully avoiding the88Fontanelle, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head.Weakly Infants89are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequentlyseen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation.They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake.After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it.The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often calledKernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health.§ 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances.§ 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kindsof Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers.Of the Cutting of the Teeth.§ 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging.2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because theStomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting.3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added.4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew.It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels.Of Worms.§ 388. TheMeconium, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference amongChildren too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few.They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even90gnawing them.§ 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of theBody meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams orDeliriums, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note90p.388.)§ 390. There are a great Multitude of Medicines against Worms. The91Grenetteor Worm-seed, which is one of the commonest, is a very good one. The PrescriptionNº. 62, is also a very successful one; and the PowderNº. 14is one of the best. Flower of Brimstone, the Juice ofNasturtium, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best.Nº. 63is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years.A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms,do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms.Of Convulsions.§ 391. I have already said,§ 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following.The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment.It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness andLoad at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep.The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge ofNº. 63, very generally remove such Convulsions.§ 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it.The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated.2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-treeFlowers, in giving it no otherNourishment for a Day or two, except Panada and other light Spoon-meat, without Milk.3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it.§ 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them.§ 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Causeproducing them, andwhich I have already pointed out in treating of each Cause.The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are oftenuseless, and still oftner prejudicial. Of this last Sort and Character are,1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,—other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them.2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an92Effort of Nature, in Order to effect aCrisis: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions.3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advisedto. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper,1, When the Convulsions still continue, after the original Cause of them is removed.2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and,3, When the Cause producing them is of such a Nature, as is apt to yield to the Force ofAnodynes; as when, for Instance, they have been the immediate Consequence of a Fright.§ 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easilyconvulsible, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the PowderNº. 14are serviceable in such Circumstances.General Directions, with Respect to Children.§ 396. I shall conclude this Chapter by such farther Advice, as may contribute to giveChildren a more vigorous Constitution andTemperament, and to preserve them from many Disorders.First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same.A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance,that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals.A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Considerationof this Abuse, and agree to put an End to it.Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs.To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible,or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious.I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion.§ 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water.§ 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty.§ 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible.If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed.§ 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit.I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person.When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases.
Chapter XXVII.Medical Directions concerning Children.Sect.377.The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem tohave been toomuch neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults.It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nayevery Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work.§ 378. Nearly all the Children who die before they are one Year, and even two Years, old, diewithConvulsions: People say they diedofthem, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, theMeconium; the Excrements contained in the Body of the Infant, at the Birth;Acidities, or sharp and sour Humours;the Cutting of the Teeth, and Worms. I shall treat briefly of each.Of the Meconium.§379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called theMeconium. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant.The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute thisMeconium, and promote the Discharge of it by Stool, and sometimes by vomiting.To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup85of Succory, which should bediluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds.Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada.Of Acidities, or sharp Humours.§ 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory86just mentioned.The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the PowderNº. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves.§ 381. It has been a Custom to load Children with Oil of Almonds,87as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increasesthe Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life.A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues.This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length oftenproves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult.Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels.§ 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving.Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines,&c.of Soap, or of Honey boiled up to a proper Consistence.But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life.§ 383. Before I proceed to the third Cause of the Diseases of Children, which is, theCutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them.Of washing Children.§ 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Childrenshould be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring.For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears,the back Part of the Head(carefully avoiding the88Fontanelle, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head.Weakly Infants89are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequentlyseen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation.They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake.After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it.The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often calledKernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health.§ 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances.§ 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kindsof Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers.Of the Cutting of the Teeth.§ 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging.2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because theStomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting.3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added.4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew.It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels.Of Worms.§ 388. TheMeconium, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference amongChildren too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few.They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even90gnawing them.§ 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of theBody meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams orDeliriums, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note90p.388.)§ 390. There are a great Multitude of Medicines against Worms. The91Grenetteor Worm-seed, which is one of the commonest, is a very good one. The PrescriptionNº. 62, is also a very successful one; and the PowderNº. 14is one of the best. Flower of Brimstone, the Juice ofNasturtium, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best.Nº. 63is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years.A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms,do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms.Of Convulsions.§ 391. I have already said,§ 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following.The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment.It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness andLoad at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep.The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge ofNº. 63, very generally remove such Convulsions.§ 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it.The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated.2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-treeFlowers, in giving it no otherNourishment for a Day or two, except Panada and other light Spoon-meat, without Milk.3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it.§ 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them.§ 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Causeproducing them, andwhich I have already pointed out in treating of each Cause.The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are oftenuseless, and still oftner prejudicial. Of this last Sort and Character are,1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,—other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them.2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an92Effort of Nature, in Order to effect aCrisis: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions.3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advisedto. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper,1, When the Convulsions still continue, after the original Cause of them is removed.2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and,3, When the Cause producing them is of such a Nature, as is apt to yield to the Force ofAnodynes; as when, for Instance, they have been the immediate Consequence of a Fright.§ 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easilyconvulsible, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the PowderNº. 14are serviceable in such Circumstances.General Directions, with Respect to Children.§ 396. I shall conclude this Chapter by such farther Advice, as may contribute to giveChildren a more vigorous Constitution andTemperament, and to preserve them from many Disorders.First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same.A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance,that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals.A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Considerationof this Abuse, and agree to put an End to it.Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs.To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible,or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious.I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion.§ 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water.§ 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty.§ 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible.If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed.§ 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit.I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person.When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases.
Medical Directions concerning Children.Sect.377.The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem tohave been toomuch neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults.It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nayevery Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work.§ 378. Nearly all the Children who die before they are one Year, and even two Years, old, diewithConvulsions: People say they diedofthem, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, theMeconium; the Excrements contained in the Body of the Infant, at the Birth;Acidities, or sharp and sour Humours;the Cutting of the Teeth, and Worms. I shall treat briefly of each.
Sect.377.
Sect.377.
The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem tohave been toomuch neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults.
It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nayevery Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work.
§ 378. Nearly all the Children who die before they are one Year, and even two Years, old, diewithConvulsions: People say they diedofthem, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, theMeconium; the Excrements contained in the Body of the Infant, at the Birth;Acidities, or sharp and sour Humours;the Cutting of the Teeth, and Worms. I shall treat briefly of each.
Of the Meconium.§379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called theMeconium. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant.The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute thisMeconium, and promote the Discharge of it by Stool, and sometimes by vomiting.To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup85of Succory, which should bediluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds.Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada.
§379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called theMeconium. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant.
The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute thisMeconium, and promote the Discharge of it by Stool, and sometimes by vomiting.
To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup85of Succory, which should bediluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds.
Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada.
Of Acidities, or sharp Humours.§ 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory86just mentioned.The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the PowderNº. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves.§ 381. It has been a Custom to load Children with Oil of Almonds,87as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increasesthe Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life.A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues.This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length oftenproves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult.Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels.§ 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving.Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines,&c.of Soap, or of Honey boiled up to a proper Consistence.But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life.§ 383. Before I proceed to the third Cause of the Diseases of Children, which is, theCutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them.
§ 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory86just mentioned.
The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the PowderNº. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves.
§ 381. It has been a Custom to load Children with Oil of Almonds,87as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increasesthe Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life.
A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues.
This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length oftenproves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult.
Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels.
§ 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving.
Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines,&c.of Soap, or of Honey boiled up to a proper Consistence.
But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life.
§ 383. Before I proceed to the third Cause of the Diseases of Children, which is, theCutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them.
Of washing Children.§ 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Childrenshould be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring.For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears,the back Part of the Head(carefully avoiding the88Fontanelle, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head.Weakly Infants89are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequentlyseen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation.They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake.After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it.The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often calledKernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health.§ 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances.§ 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kindsof Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers.
§ 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Childrenshould be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring.
For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears,the back Part of the Head(carefully avoiding the88Fontanelle, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head.
Weakly Infants89are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequentlyseen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation.
They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake.
After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it.
The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often calledKernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health.
§ 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances.
§ 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kindsof Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers.
Of the Cutting of the Teeth.§ 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging.2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because theStomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting.3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added.4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew.It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels.
§ 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging.
2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because theStomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting.
3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added.
4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew.
It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels.
Of Worms.§ 388. TheMeconium, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference amongChildren too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few.They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even90gnawing them.§ 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of theBody meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams orDeliriums, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note90p.388.)§ 390. There are a great Multitude of Medicines against Worms. The91Grenetteor Worm-seed, which is one of the commonest, is a very good one. The PrescriptionNº. 62, is also a very successful one; and the PowderNº. 14is one of the best. Flower of Brimstone, the Juice ofNasturtium, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best.Nº. 63is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years.A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms,do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms.
§ 388. TheMeconium, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference amongChildren too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few.
They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even90gnawing them.
§ 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of theBody meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams orDeliriums, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note90p.388.)
§ 390. There are a great Multitude of Medicines against Worms. The91Grenetteor Worm-seed, which is one of the commonest, is a very good one. The PrescriptionNº. 62, is also a very successful one; and the PowderNº. 14is one of the best. Flower of Brimstone, the Juice ofNasturtium, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best.Nº. 63is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years.
A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms,do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms.
Of Convulsions.§ 391. I have already said,§ 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following.The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment.It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness andLoad at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep.The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge ofNº. 63, very generally remove such Convulsions.§ 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it.The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated.2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-treeFlowers, in giving it no otherNourishment for a Day or two, except Panada and other light Spoon-meat, without Milk.3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it.§ 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them.§ 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Causeproducing them, andwhich I have already pointed out in treating of each Cause.The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are oftenuseless, and still oftner prejudicial. Of this last Sort and Character are,1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,—other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them.2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an92Effort of Nature, in Order to effect aCrisis: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions.3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advisedto. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper,1, When the Convulsions still continue, after the original Cause of them is removed.2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and,3, When the Cause producing them is of such a Nature, as is apt to yield to the Force ofAnodynes; as when, for Instance, they have been the immediate Consequence of a Fright.§ 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easilyconvulsible, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the PowderNº. 14are serviceable in such Circumstances.
§ 391. I have already said,§ 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following.
The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment.
It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness andLoad at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep.
The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge ofNº. 63, very generally remove such Convulsions.
§ 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it.
The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated.
2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-treeFlowers, in giving it no otherNourishment for a Day or two, except Panada and other light Spoon-meat, without Milk.
3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it.
§ 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them.
§ 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Causeproducing them, andwhich I have already pointed out in treating of each Cause.
The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are oftenuseless, and still oftner prejudicial. Of this last Sort and Character are,
1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,—other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them.
2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an92Effort of Nature, in Order to effect aCrisis: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions.
3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advisedto. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper,
1, When the Convulsions still continue, after the original Cause of them is removed.
2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and,
3, When the Cause producing them is of such a Nature, as is apt to yield to the Force ofAnodynes; as when, for Instance, they have been the immediate Consequence of a Fright.
§ 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easilyconvulsible, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the PowderNº. 14are serviceable in such Circumstances.
General Directions, with Respect to Children.§ 396. I shall conclude this Chapter by such farther Advice, as may contribute to giveChildren a more vigorous Constitution andTemperament, and to preserve them from many Disorders.First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same.A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance,that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals.A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Considerationof this Abuse, and agree to put an End to it.Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs.To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible,or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious.I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion.§ 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water.§ 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty.§ 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible.If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed.§ 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit.I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person.When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases.
§ 396. I shall conclude this Chapter by such farther Advice, as may contribute to giveChildren a more vigorous Constitution andTemperament, and to preserve them from many Disorders.
First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same.
A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance,that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals.
A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Considerationof this Abuse, and agree to put an End to it.
Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.
Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs.
To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible,or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious.
I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion.
§ 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water.
§ 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty.
§ 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible.
If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed.
§ 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit.
I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person.
When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases.