1. Medicines Recommended for Children.
A CHEST containing the necessary homoeopathic medicines for the treatment of infantile disease should be always kept in readiness in every house in which there are children. The importance of this recommendation will be fully apparent when the peculiarities of the organism of the little patients are considered.
In consequence of the activity of the vital powers, and the quickness and force of the circulation, there is a remarkable susceptibility to inflammatory action in children, so that many of their disease rapidly run on to organic and incurable mischief.
The earliest recognition of an approaching illness, and the most prompt application of treatment, are therefore of the greatest importance. Neglect or delay may prove most disastrous to life, while a few doses of an appropriate remedy timely administered will often be alone sufficient to arrest the morbid process, or they will afford temporary relief till the arrival of a physician.
In the treatment of infants, perseverance and watchfulness are necessary. Patient attention should be given to the investigation of every ailment, and no case should ever be abandoned as altogether hopeless. It is well known that children often recover from the most severe disease, and, in the great majority of instances, especially if taken in time, the balance will quickly turn in the right direction.
The absence of nauseousness from homoeopathic medicines is an advantage which mothers can appreciate who have witnessed the natural and proper disgust of children to to draughts and pills. The agreeableness of the remedies is, however, only a minor advantage of the treatment.
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 Globules are now almost wholly superseded by Pilules; and Triturations are seldom used except in professional practice.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, pp.63 (210th thousand); and in the Vade Mecum of Modern Medicine and Surgery (115th thousand).
2. List of Remedies Recommended for Infants and Children
1. Acidum Hydrocyanicum Acid.-Hydrocy. 3x
2. Acidum Muriaticum Acid.-Mur. 3x
3. Acidum Phosphoricum Acid.-Phos 3x
4. Aconitum Napellus Aconite 3x
5. Agaricus Muscarius Agaricus 3x
6. Ailanthus Glandulosa Ailanth. 1
7. Ammonium Carbonicum Ammonium-Carb. 1
8. Antimonium Tartaricum Antim tart. 3x
9. Antimonium Crudum Ant.-Crud. 3x
10. Apis Mellifica Apis. 3x
11. Aralia Aral. 3x
12. Argentum Nitricum ArgentumNit. 4
13. Arnica Montana Arnica 3x
14. Arsenicum Album Arsenicum 3x
15. Arsenicum Iodidum ArsenicumIodium 3x
16. Aurum Metallicum AurumMet. 5
17. Baptisia Tinctoria Baptisia 1x
18. Belladonna Belladonna 3x
19. Bromium Bromium 1
20. Bryonia Alba Bryonia 3x
21. Calcarea Carbonica Calcarea carb. 5
22. Calcarea Phosphorata Calcarea-P. 3x
23. Cantharis Vesicatoria Cantharis 3x
24. Carbo Vegetabilis Carbo.V. 5
26. Chamomilla Matricaria Charm. 3
27. China Officinalis China 3x
28. Coffea Cruda Coffea 3x
29. Colocynthis Coloc. 3x
30. Croton Tiglium Crot.-T. 6
31. Cuprum Metallicum Cuprum-M. 5
32. Curare Curare 3
33. Drosera Rotundifolia Drosera 3x
34. Dulcamara Dulcamara 3x
35. Euphrasia Officinalis Euphrasia 1
36. Ferrum Iodidum FerrumI. 3x
37. Gelsemium Sempervirens Gelsemium 3x
38. Glonoine Gloninum 3x
39. Graphites Graphites 5
40. Guaiacum Guaia. 1
41. Hamamelis Virginica Hamamelis 1
42. Helleborus Niger Helleborus 3x
43. Hepar Sulphuris Calcareum Hepar sulph. 3x
44. Hyoscyamus Niger Helleborus 3x
45. Ignatia Amara Ignatia 3x
46. Iodium Iodium 3x
47. Ipecacuanha Ipecac. 3x
48. Iris Versicolor Iris 1
49. Kali Hydriodicum K.Hyd. 3x
50. Kreasotum Kreas. 3x
51. Lathyrus Satious Lath.S. 3
52. Mercurius Biniodatus Mercurius-Bin. 3x
53. Mercurius Iodatus Mercurius-Iodium 2x
54. Mercurius Corrosivus Mercurius-Cor. 3x
55. Mercurius Cyanatus Mercurius-Cyna. 6
56. Mercurius Solubilis Mercurius-Sol. 3x and 6x
57. Nux Vomica Nux.V. 3X
58. Opium Opi. 3x
59. Phosphorus Phosphorus 3
60. Plantago Plant 3
61. Podophyllum Peltatum Podoph. 1x
62. Pulsatilla Nigricans Pulsatilla 3x
63. Plumbum Aceticum Plumb.-Ac. 3
64. Rhus Toxicodendron Rhus. 3x
65. Rheum Rheum 1
66. Silicea Silicea 6
67. Spongia Tosta Spongia 3x
68. Stramonium Stramonium 3
69. Staphysagria Staphysagria 3x
70. Sulphur Sulph. 3
71. Veratrum Album Veratrum-A 3x
72. Veratrum Viride Veratrum-V. 3x
73. Zincum Zincum met. 5
Camphor (Rubini’s Tincture, or Camphor Pilules) should also be procured, but kept separate from the rest.
EXTERNAL REMEDIES.- The following remedies, in strong tinctures, will be found invaluable for the accidents to which children are liable:-
Arnica, Calendula, Cantharis, and Rhus Toxicodendron.
THE TWENTY-FOUR CHIEF REMEDIES.
In case it is inconvenient to procure a large chest containing all the above remedies, a smaller one filled with the following remedies should be kept in the house :-
1. Aconitum Napellus Aconite 3x
2. Arnica Montana Arnica 3x
3. Arsenicum Album Arsenicum 3x
4. Belladonna Belladonna 3x
5. Bryonia Bryonia 3x
6. Calcarea Carbonica Calcarea-P 5
7. Calcarea Phosphorata Calcarea-P 3x
8. Chamomilla Matricaria Chamomilla 3x
9. China Officinalis China 3x
10. Cina Anthelmintica Cin. 3x
11. Coffea Cruda Coffea 3x
12. Drosera Rotundifolia Drosera 3x
13. Gelsemium Sempervirens Gelsemium 3x
14. Hepar Sulphuris Calcareum Hepar-S 3x
15. Ipecacuanha Ipecac. 3x
16. Mercurius Solubilis Mercurius-Sol. 6
17. Nux Vomica Nux.-V. 3
18. Phosphorous Phosphorus 3
19. Pulsatilla Nigricans Pulsatilla 3x
20. Rhus Toxicodendron Rhus. 3x
21. Silicea Silicea 6
22. Spongia Tosta Spongia 3x
23. Sulphur Sulph. 3x
24. Veratrum Album Veratrum-V. 3x
If the forgoing remedies are kept in Pilules or Globules the attenuation of some of them must be slightly modified, according to the discretion of a qualified homoeopathic chemist.
3. Directions 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 an oblique manner, with the lip resting against the middle of the end of the cord (see Illustration), when the tincture will descend and drop from the lower edge of the cord; or a piece of solid glass, about 1/16 of an inch diameter, bent at a right angle, and introduced into the bottle, will so enable the most timid to drop the tinctures will exactness.
Water, in the portion of a dessert-spoonful to a drop, should then be poured upon the medicine. For infants who object to cold water, the spoon may be warmed by dipping it in hot water, and then the medicine added to about half a teaspoonful of water. The vessel should be scrupulously clean, and, if the mixture has to stand some time after being made, it should be covered over with a saucer or sheet of note paper. The spoon should be always wiped after being used, and put away in a clean place till again required. Fine glazed earthenware or glass spoons are the best for this purpose. If the medicine has to be kept several days, cold boiled water should be employed, but the mixture put into a new bottle, particular care being taken that the cork is new and sound. To protect the medicines from light and dust, and to distinguish them from other liquids graduated earthenware medicine-cups, with covers, specially made for this purpose, are the best, and may be procured of any homoeopathic chemist.
Drop conductors for the above purpose can be obtained of the Homoeopathic Chemists.
HOURS.- The most appropriate times for administering the medicines, and, if oftener prescribed, about an hour before or after a meal.
THE DOSE.- In determining the quantity and strength of doses, several circumstances require consideration, such as age, sex, habits, nature of the disease, organ involved, and susceptibility to the medicine. As before stated, the circulation of children is quicker than that of adults, and the nervous system more impressible; the dose has therefore to be regulated by these peculiarities.
With the above exceptions, and allowing for any peculiarity of constitution, the following general directions may be given as to the dose:-
One drop of Tincture or two Pilules. For young infants, one half or one third of the above quantities.
A Pilule, or one drop, is easily divided into two or more doses, by mixing it with two or more spoonfuls of water, and giving one spoonful for a dose.
REPETITION OF DOSES.- In this matter 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 Croup, Convulsions, etc., the remedies may be repeated every fifteen, twenty, or thirty minutes; in less urgent cases, every two, three of four hours. In chronic maladies the medicine may be administered every six, or twenty-four hours. In all cases when improvement takes place, the medicine should be taken less frequently, and gradually relinquished.
GENERAL DIRECTIONS FOR THE MANAGEMENT OF INFANTS
BEFORE commencing a description of the most common diseases of infants and children, we think it necessary to offer some general instructions on the management of early infancy, touching on points which may appear to be of only minor importance, but which have a most important bearing on the prevention of infantile disease and mortality.
4. The Newly-Born Infant.
As an illustration of helpless weakness, nothing can exceed that which an infant presents at birth. The little thing requires aid of every kind, and if abandoned it 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 (Secale57). If the child is healthy and strong, it will cry vigorously; for the transition from a condition of unconscious repose, in a bland fluid, at a temperature of 98oC Fahr., to the contact of rough cloths, and a comparatively cold temperature, cannot be agreeable. The act of crying helps to fill the lungs with air, and thus the functions of breathing and pulmonary 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, immediately washed, and as quickly as possible. Immediately, for the skin requires cleansing from the tenacious fluid which adheres to it at birth, in order that healthy transpiration may be established. A newborn 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 its skin become blue before it is placed by its mother’s side.
Before commencing the process of washing, the eyelids should be carefully wiped with a piece of moist soft linen, then the rest 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 unctuous matter be considerable or very adhesive, a little fresh lard rubbed upon the skin previously to the application of the soap and water will render its entire 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 around 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 apposition by a band, about four inches wide, passed gently around the child’s abdomen, and worn till the remnant of the cord comes away, which is usually within six days. All the linen thus used should be rendered surgically clean scorching before a fire. The raw surface left after separation must be protected with scorched linen until completely healed over some seven days later. If any signs of inflammation or suppuration show themselves, bathe with weak lysol (an eggspoonful to a pint of warm water) and give Hepar Sulph. internally.
The infant must never sleep in the mother;s bed, but in a cradle or cot by her side, and every care must be taken to keep it warm.
Milk in the Breasts the First Day.
It is affirmed by some nurses that until the third day after labour the breasts contain no milk, and that a substitute- gruel or some other farinaceous preparation – is necessary. In the great majority of cases, milk or a kind of milk sufficient for all the requirements of the infant, is present on the first day, and the only thing necessary to be done is to apply the child’s mouth to the nipple. Should there be no milk at the moment, the suction of the infant, which is the natural mammary stimulant, will hasten the secretion; while the suction promotes the necessary uterine contractions which are favourable to the mother and also lessens the chance of what is called “milk fever.” The infant should be put to the breast every four hours during the first day, and somewhat oftener on subsequent days until the milk comes freely. If the child cannot get enough and is unhappy in consequence, it should have sweetened water several times a day, best given after unsuccessful attempts upon the mother. No other food should be given. When the flow of milk has been fairly established, the child should be put to the breast every three hours, the breasts being used alternately. If during the first two or three days of life the infant’s temperature rises to over 101o and then there is no unhealthy appearance of the cord or other evidence of illness, the child is suffering from hunger and must be fed (see Section II).
Also see Ruptured Navel Chapter.
5. Still-born Infants.
Children are sometimes born apparently dead, and if means are not quickly adopted, this conditions may pass into one of real and permanent death. But so long as the heart continues to beat, even but feebly, there is a probability that well-directed efforts will be successful in exciting breathing.
CAUSES. Constitutional feebleness, so that the effort necessary to commence breathing cannot be made; obstructed circulation during labour by pressure or twisting of the navel-string; too long continued compression of the head; tenacious mucus in the mouth and throat, preventing the entrance of air, etc.
TREATMENT.- The navel-string should be at once divided. Obstructive mucus should be carefully wiped away from the mouth and throat, and the general surface exposed to cold air; an attempt should then be made to excite the function of breathing by blowing in the infant’s face, sprinkling cold water with some little force on the face or chest, or alternately cold and hot, and by giving several smart blows with the hand, or with the corner of a towel wetted with cold water, on the buttocks, back, and chest. The back and limbs should be well rubbed, while the face is freely exposed to the air.
The following is another capital method of exciting breathing;- Close the infant’s nostrils by the finger and thumb, press the windpipe gently backwards, and then blow into the mouth, so as to drive the air into the lungs; afterwards press the ribs together, so that the lungs may expel the air. The process should take place about fifteen times in one minute, and if preserved in, is most likely to be successful in a short time. Meanwhile the body should lie on a flat surface, and be well rubbed with warm flannels, and the head not suffered during these efforts to fall on the chest.
If these means are not successful, the infant should be plunged into a warm bath, 98o Fahr., or what is agreeable to the back of the hand. If the sudden plunge does not excite breathing, it will be no use keeping the infant in the bath beyond a minute or two, and Dr. Marshal Hall’s ready method may then be tried as follows:-
“Place the infant on its face; turn the body gently, but completely, on the side and a little beyond, and then on the face, alternately; repeating these measures deliberately, efficiently, and perseveringly, fifteen times in the minute only.”
A few physical facts with regard to the normal infant should be borne in mind. The anterior fontanelle on the head should close between eighteen months and two years. A depressed state of the fontanelle is an indication of a feeble state of health. A child should begin to hold up its head at three or four months, and to walk from twelve to eighteen months and three years, and the permanent set start at six years. Babies should be weighed regularly, as this is the most important test of progress. Dr. Hutchison has pointed out the multiples of seven to be noted in regard to the normal child’s weight : at birth 7 lbs, at four months 14 lbs., at twelve months 21 lbs., at six years 42 lbs., and at twelve years 84 lbs.
6. Washing and Bathing.
Cleanliness is of great importance to the healthy growth of children. An infant in health should have a tepid bath twice in twenty-four hours – morning and evening. The best method is to dip the baby into a bath of tepid water, 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 the bath, and then quickly and thoroughly dry with a fine warm towel. During warm weather, tepid bathing should not the continued beyond one or two months, after which it should gradually give place to cold. Feeble infants may required 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 atmospheric changes. But no child should have a cold bath oftener that once a day.
The care of the eyes is a subject of such enormous importance that we must notice it a little more particularly. The following is from The Prescribed, by Dr. John H. Clarke:- “Immediately after birth the nurse must wash the infant’s eyes with the greatest possible care, removing all traces of mucus. For this purpose a fine linen rag, dipped in clean water, may be used. Beginning at the outer corner, the eyelids are gently wiped from side to side, until all traces of mucus are removed, and the eyelids remain perfectly clean. Sponges must never be used. As soon as the child’s eyes are thus washed, cleaned, and dried, the nurse is to wash her own hands most carefully in water with which some carbolic acid, Condy’s fluid, or other disinfectant has been mixed. If in the first few days after birth signs of inflammation appear – redness, swelling, and sticking together of the lids – the greatest care must be taken.
If from any reason the doctor cannot be in attendance immediately, the nurse must herself clean the eyes in the following manner:- A perfectly clean and very soft piece of linen is moistened with tepid water; any excess of water is then squeezed out. The muco-purulent discharge between the eyelids is wiped off very gently – without scrubbing or scratching; special attention being paid to the inner corner of the eyelid where the mucus particularly accumulates. After repeatedly rinsing the linen in clean water, the ball of the eye is gently raised by means of the thumb placed on the eyelid immediately above the lashes, but without making any undue pressure.
The muco-purulent matter which escapes is removed with the rag as often as it appears. In the next place, the lower eyelid is drawn down with the forefinger, and also wiped with great care. If the eyelids stick together, they must be moistened with water until separation takes place without any effort. The water used in cleansing the eyes must be perfectly pure; no milk or soap is to be mixed with it. Medical Treatment.- Argent.-nit.3, 2h.; after well washing, a drop of a solution of Argentum-nit. (two grains to the ounce) to be introduced into the eye.”
It is hardly necessary to say that whenever there is serious danger, and however careful and experienced the nurse may be, the services of a medical man should be secured without loss of time.
7. The Warm Bath.
The temperature of the water for a hot bath should be about 98o to 100o, or what can be agreeably borne by the back of the hand, and for a warm bath, about 90o; the temperature should be full maintained, by additions of hot water carefully poured down the side of the bath till the child is taken out. The bath should be given in front of a good fire, and a warm blanket be in readiness to wrap the child in directly it leaves the bath.