THE COMMON DISEASES OF CHILDREN By E. H. RUDDOCK, M.D
I. Medicines for Children.
A SELECTION of Homoeopathic remedies in a case or chest is invaluable in every house in which there are children. The absence of nauseousness is an advantage which mothers can well understand who have witnessed the natural and proper disgust of children to draughts and pills. The agreeableness of our remedies is, however, only one advantage, for the diseases of children are most strikingly under their control.
In the treatment of infants, perseverance is necessary. Patient attention should be given to the investigation of every ailment, and no case should be abandoned as altogether hopeless. It is well known that children often recover from the most severe diseases, and in the great majority of instances, especially if taken in time, the balance will quickly turn in their favour.
Forms of Medicines.
The medicines used in Homoeopathic practice are prepared in different forms Globules, Pilules, Tinctures and Triturations. Globules are now almost wholly superseded by Pilules; and Triturations are seldom used except in professional practice. A description of the different forms may be found in The Stepping- stone to Homoeopathy and Health, which has now reached its fourteenth edition of 230,000 copies.
II. List of Remedies.
1. Aconitum Napellus
2. Arnica Montana
3. Arsenicum Album
6. Calcarea Carbonica
7. Calcarea Phosphorata
8. Chamomilla Matricaria
9. China Officinalis
11. Coffea Cruda
12. Drosera Rotundifolia
13. Gelsemium Sempervirens
14. Hepar Sulphuris Calcare
16. Mercurius Solubilis.
17. Nux Vomica
19. Pulsatilla Nigricans
20. Rhus Toxicodendron
22. Spongia Marina Tosta
24. Veratrum Album
ABBREVIATION in correspondence to above list 1. Aconite
7. Calcarea phos.
14. Hepar sulph.
17. Nux V.
ATTENUATION in correspondence to above list 1. 3x
If the foregoing remedies are kept in pilules or globules, the attenuation of some of them must be slightly modified, according to the discretion of a qualified chemist.
EXTERNAL REMEDIES: Arnica, Calendula, Cantharis, and Rhus should also be procured in strong tincture, and kept separate, being invaluable in cases of accident.
III. Direction respecting the Medicines.
Pilules or globules may be taken dry on the tongue, but it is better, when convenient, to dissolve them in pure soft water. If tinctures are used, a little practice is necessary to drop them with accuracy.
Before removing the cork, invert the bottle so as to wet the end of the cork. The required quantity should be dropped into the bottom of a glass by holding the bottle in a slanting manner, with the lip resting against the middle of the end of the cork (see illustration), when the tincture will descend and drop from the lower edge of the cork. The most timid may learn to drop the tinctures with exactness by introducing into the bottle a piece of solid glass, about 3/16 of an inch in diameter, bent at a right angle. 1 These Drop-conductors can be obtained of any Homoeopathic Chemists.
Water, in the proportion of a dessertspoonful to a drop, should be poured upon the medicine. For infants who object to cold water, the medicine may be added to about half a tea-spoonful of water, and the spoon previously warmed by dipping it in hot water. The vessel should be made scrupulously clean; and if it has to stand for sometime after being mixed, the medicine should be covered over, and the spoon wiped after measuring each dose. Fine glazed earthenware spoons are the best for this purpose. If the medicine has to be kept several days, it should be put into a new bottle, care being taken that the cork is new and sound, or into graduated earthenware medicine-cups, with covers, specially made for this purpose.
Generally, the best times for administering the medicines are on rising in the morning, at bedtime, and, if oftener prescribed, about an hour before a meal.
In determining the quantity and strength of doses, several circumstances require consideration, such as age, sex, habits, nature of the disease and the organ involved.
Allowing for any peculiarity of constitution, the following directions may be given as to the dose:
One drop of Tincture or two Pilules. For young infants, one half the above quantities.
A pilule, or one drop, is easily divided into two doses by mixing it with two spoonfuls of water, and giving one spoonful for a dose.
REPETITION OF DOSES
On this point we must be guided by the acute or chronic character of the malady, the urgency and danger of the symptoms, and the effects produced by the medicines. In violent and acute diseases, such as Fevers, Croup, Convulsions, etc., the dose may be repeated every fifteen, twenty, or thirty minutes; in less urgent cases, every two, three, or four hours. In chronic maladies the medicine may be administered every six, twelve, or twenty-four hours. In all cases when improvement takes place, the medicines should be taken less frequently, and gradually discontinued.
GENERAL DIRECTIONS FOR THE MANAGEMENT OF INFANTS
Before commencing a description of the most common diseases of children, we think it necessary to offer some general instructions on the management of early infancy, touching points which may appear to be of little importance, but which have a direct bearing on the prevention of infantile disease and mortality.
IV. The Newly-born Infant.
Nothing can exceed the helpless weakness which an infant presents at birth. It requires aid of every kind, and if neglected soon perishes.
If an infant be born before the doctor’s arrival, it should receive the attentions pointed out in the Section on “Labour” in the LADY’S MANUAL (sect. 52). If the child is healthy and strong, it will cry vigorously; for the change from a condition of unconscious repose, in a bland fluid, at a temperature of 98* Fahr., to the contact of rough clothes and a comparatively cold temperature, is certainly not agreeable. The act of crying helps to full the lungs with air, and thus the functions of breathing and lung-circulation become established.
The First Wash. As soon as breathing has fairly commenced, and the navel-string been tied, the infant should be enveloped in soft warmed flannel, and, everything being ready beforehand, it should be immediately washed and as quickly as possible. Immediately, for the skin requires cleansing from the sticky fluid which clings to it at birth, in order that its healthy action may be established. A new-born child is often allowed to remain a long time before it is washed, and even then it is not always washed quickly and skilfully, so that it shivers, and the skin becomes blue before it is placed by its mother’s side.
Before beginning to wash, the eyes should be carefully wiped with a piece of soft moist linen, then the remainder of the body should be cleansed by means of a fine sponge, with warm water and a little soap, and carefully dried with a soft warmed towel. If the sticky matter on the skin be considerable, a little fresh lard rubbed upon it previously to the application of the soap and water will render its removal an easy operation. As soon as the cleansing is completed, a little violet powder finely powdered scented starch may be dusted lightly on the surface, especially in the creases of the joints.
Dressing the Navel. This is to be done by folding a piece of soft linen into four or six thicknesses, about six inches by three, and cutting a hole through the centre for the remnant of the cord, winding round it a strip of soft linen: then one half of the folded linen should be doubled over the other half so that the portion of cord lies between the folds and directed upwards towards the chest; the whole is to be kept in opposition by a band, about four inches wide, passed gently round the child’s abdomen, and worn till the remnant of the cord comes away, which is usually about the sixth or seventh day. The separation of the cord may be hastened by the application of a small piece of scorched rag to the juncture of the cord and navel, until which great care should be exercised not to disturb it during washing.
Presenting the Infant to the Breast. As soon as the mother has some what recovered from the exhaustion of labour, the infant should be put to the breast. The disturbances common to the coming of the milk are often prevented or much diminished by applying the child to the breast early after delivery; it also tends to satisfy the cravings of the infant, and enables it better to grasp the nipple than when the breast is over-distended or hard with the milk; further, by favouring contraction of the womb of the mother, the probability of secondary haemorrhage, and also the chance of what is called “Milk fever,” will be much lessened.
Immediately after being dressed, the infant should be laid in its mother’s bosom, and not placed by itself in a cradle, where it is in danger of being too cold. For the first few days it should sleep in the bed with its mother, especially during cold weather; afterwards, in a cradle or cot.
Milk in the Breasts the First Day:
Some nurses say that until the third day after labour the breasts contain no milk, and that gruel or some other food is necessary. In the great majority of cases, sufficient milk for the infant is present on the first day, and the only thing necessary is to apply the child’s mouth to the nipple, which acts as the natural stimulus for hastening the supply. But if, after repeated attempts, in eight or nine hours, there be no breast- milk drawn, the only substitute required, till the supply be fairly established, is cow’s milk, diluted with warm water (two- thirds milk to one-third warm water), without the addition of sugar. The milk should not be boiled, nor should the water be too hot, lest the milk be rendered less digestible. The administration of any kind of farinaceous food, sugar, or butter to the new-born infant is not only unnecessary, but is likely to prove very hurtful.
V. Washing and Bathing.
Cleanliness is of great importance to the healthy growth of children. An infant in health should have a warm bath morning and evening. The best method is to dip the baby into the bath, while the head is supported by the hand and arm of the nurse, and then have the whole surface of the skin rapidly rubbed with a soft soaped sponge or piece of flannel; next again immerse the body in a bath, and then quickly and thoroughly dry with a fine warm towel.
Cold Water Bathing:
During warm weather, tepid bathing should not be continued beyond one or two months, after which it should gradually give place to cold. Feeble infants may require tepid bathing somewhat longer. For children born in the winter, the lukewarm bath may be continued till the return of warm weather, when the change to cold should be made. Except as above stated, warm bathing is to be emphatically condemned. The use of cold water, on the other hand, affords a great protection to children against excessive sensibility to changes of the weather.
Besides adapting it to the season, the clothing should be loose, soft, light, warm, arranged to fit without pins, and cover the legs, arms and neck. After the separation of the navel-string, belts, stays etc., are unnecessary.
When a baby is divested of its long-clothes, it is in danger of being insufficiently clad, the danger increasing when it can run alone and is more exposed to the weather. The practice of leaving those parts exposed which, when grown up, it is found necessary to clothe warmly, especially the lower limbs and abdomen, is a frequently cause of stunted growth, consumption, etc.
Warmth is of the first importance for children of all ages; especially for newly-born infants. Warm clothing should cover the whole body. The clothing, too, should be kept scrupulously clean, and all soiled and wet articles immediately changed. Caps are unnecessary; the aim should be rather to “keep the head cool and the feet warm.” In all cases, the night clothing should be looser and less warm than that worn in the day. It is also important that the dress should not impede the free movements of the limbs, or exert pressure on the digestive, breathing, or circulatory organs.
A Child should Sleep alone.
Except in earliest infancy, or in the case of infants born before the natural term, or constitutionally feeble, or during very cold weather, it is advisable that they should sleep alone, care being taken that they are warmly but not excessively covered. Boys and girls, however young, should, if possible, sleep separately.
Amount of Sleep.
During the first few months after its birth a healthy infant spends the chief part of its time in sleep. Even up to about the third year, a midday sleep is beneficial. During sleep the structures are repaired, and the formation of new tissues, for growth and development, takes place.
Just as in other matters pertaining to children, regularity is of great importance; and they should be put to bed at stated hours without the unnecessary and objectionable habit of rocking, or nursing them to sleep in the arms. Putting children to bed awake is one of the first steps in the formation of their future character. Neither should ordinary footsteps, speaking, or other sounds be avoided, the infant should be accustomed to sleep under such conditions.
Another important precaution is never to awaken children out of sleep. The length of the period of sleep may be safely left to nature, and if this be interrupted by waking, children feel uncomfortable and cross.
All the so-called soothing remedies syrups, cordials, spirits, or sleeping drops should be avoided, containing, as they do, to a greater or less extent, Opium, in some of its forms. These sleeping mixtures inflict an incalculable amount of mischief on health, and largely increase infantile mortality. No medicines to promote sleep should ever be given, except such as are prescribed in the Section on “Sleeplessness,” page 94.
Ventilation. Pure fresh air is of the utmost importance to children, especially during sleep. Their nurseries should be as large and airy as possible. A great advantage to health is secured by a separate night and day nursery; but where this is impracticable, the children should be not of the nursery a great deal, and every opportunity seized for promoting ventilation, by opening doors and windows at all suitable times. Lastly, their beds should not be remade until they have had sufficient time to air with the windows open. Bed-clothes require ventilation equally with a room.
VIII. Open-air Exercise.
Children require fresh air and sunlight, as much as plants and flowers; and as the latter are colourless and imperfect if excluded from direct sunshine, so children who live in places where light does not abundantly enter are pale and feeble. In fine weather, an infant over a month old should be taken out at least twice a day; the only precaution necessary being that it be sufficiently clothed in cold weather, and have its head protected from the sun in hot. A child should almost live out of doors during suitable weather. Plenty of exercise in the open air is necessary for the healthy development of the limbs and body generally. Games and exercises in the open air, or in large airy rooms, should form a part of the early education of children.
No point is of higher importance in the rearing of children than the proper management of their meals and meal-hours. Errors in feeling rank first among causes of disease and death among young children.
Breast Milk. Mother’s milk is the food provided by Nature for the infant, and as yields by healthy mothers is superior to all artificial substitutes; and suckling is the best method of feeding.
No Additions. When the mother enjoys good health, and has sufficient milk, an infant requires and should have no other food but breast-milk until from the sixth to the ninth month. Even during the first day or two, the first milk yielded by the breasts furnishes sufficient nourishment, and acts as a natural stimulant to the bowels, rendering any purgative positively unnecessary. The too common practice of giving butter-and-sugar, gruel, etc., to a new-born babe should be strictly forbidden as an act of cruelty.
When there is a deficient supply of mother’s milk some other means must be restored to, and the best substitute is the milk of the cow, to which must be added one-third or one-fourth of water. Where good cow milk cannot be obtained, condensed milk may occasionally be used, but this alone cannot be recommended as wholesome diet. Mothers will do well to study the Section, Diet in Infancy, in the Author’s Work, “Essentials of Diet, of Hints on Food in Health and Disease.” One of the prepared foods, Ridge’s, Brown and Polson’s or Neave’s should be given by means of a feeding bottle. Neave’s food is perhaps that which best suits most children, especially when weaning is about to commence, and for some time after. A good deal will depend upon the taste and constitution of the child, but the observant mother will readily detect that which agrees best with her child.
Feeding Bottles. No greater comfort has ever been invented for children, whether partially or entirely brought up by hand, than the modern feeding bottle with elastic tube, but great care is required in the use of it. Absolute cleanliness is of the utmost importance, as any neglect of this is likely to produce illness. As soon as the meal is over the tube should be removed from the mouth of the child; he should never be allowed to go to sleep while sucking it. The bottle and teat should be thoroughly washed after each meal, and the former when not in use always kept in a basin of cold water. It is well to have two bottles, so that one may be cleansed while the other is in use.
For the first five or six weeks the infant should be applied to the breast at regular intervals of two hours and a half during the day; but during the night (from 11 p.m. to 5 a.m.) he should, after the first two or three weeks, remain without food. It is important, too, that the infant should suck from each breast alternately. Regular habits of feeding may be soon acquired; and it is great mistake, and the cause of wind, colic, and other disorders, to give the infant the breast whenever he cries, or to let him be always sucking. When weaning is commenced seventh to the ninth month Neave’s Food is the best diet. It should be mixed, as directed, with good cow’s milk, and given at the temperature of mother’s milk. For detailed instructions on this point, the reader is referred to the chapter, ” Examples of dietary for healthy children, at different ages,” in the larger edition of this work.
Diet for a Nursing Mother. A nursing mother or wet-nurse does not require extra food, but care in its selection. To overload the stomach, or to eat indigestible articles, would lead to disorders, to the injury of the infant as well as herself. The meal-hours should be regular, and late meals avoided. The thirst to which nursing mothers are liable is best appeased by milk-and- water, barely-water, toast-and-water, or even pure water.
Regimen of Wet-Nurses. The habits and diet of a wet-nurse should as near as possible resemble those she had been previously accustomed to. A woman of active duties and moderate diet is certain to suffer in her health if she suddenly relapses into a life of indoor idleness, and has a too abundant supply of food, and, if unaccustomed to it, takes ale or stout. A wet-nurse taken from industrial habits should continue to perform at least light duties, and take plenty of regular open-air exercise.
Should a nursing mother again begin to suffer from headache, dim sight, dizziness, shortness of breath, palpitation, or night- sweats, it is evident that nursing weakness her, and she should commence to wean. If a wet-nurse suffer from similar symptoms the child should at once be taken from her.