vn s. I ^ VKl M A THE HEALTH OF CHILDREN. MY CHILDREN,” PART I. INCLUDES THE MANAGEMENT OF INFANCY; GENERAL DIRECTIONS ABOUT THE PRESERVATION OF HEALTH ; THE DISEASES OF CHILDREN; TREATMENT OF ACCIOENTS; ANO SHORT NOTICES OF SOME OF THE MOST USEFUL MEDICINES. d 0 ® d COMPILED FROM THE WORKS OF BIRCH, MOORE, WARING, GREEN, CHEVERS, CHAVASSE, WEST, NIGHTINGALE, AND OTHERS. FOURTH EDITION, 3,000 — TOTAL COPIES, 9,000. i/„ MADRAS THE CHRISTIAN LITERATURE SOCIETY FOR INDIA. S. P. -C. K. PRESS, VEPERT. 1895 . Price, 2 Annas. Post-fi-ee, 2^ Annas. V THE HEALTH OF CHILDREN. “ MY CHILDREN,” PART I. CONCLUDES THE MANAGEMENT OF INFANCY; CENERAL DIRECTIONS ABOUT THE PRESERVATION OF HEALTH; THE DISEASES OF CHILDREN; TREATMENT OF ACCIDENTS; AND SHORT NOTICES OF SOME OF THE MOST USEFUL MEDICINES. COMPILED FROM THE ^YORES OF BIECU, MOORE, WARIKO, GREEN, CHEYERS, CHAVASSE, WEST', NIGHTINGALE, AND OTHERS. - FOURTH EDITION, 3,000 — TOTAL COPIES 9,000, MADRAS: THE CHRISTIAN EITERATUEE SOCIETY lOK INDIA. S. r. C. K. PRESS, YEPEET.- 1895 PREFATORY NOTE- TO THE FIRST EDITION. — 00>*j0o — This little treatise is intended to assist parents in bringing up their children to be strong and healthy. The chief aim is to prevent sickness — not to cure it. Directions are given with regard to the treat- ment of the most common diseases among children. Except in the case of slight ailments, these are intend- ed only for persons living at out-stations, where no competent medical man is available. It is very foolish for parents to doctor their children where educated physicians are within reach. The compiler is chiefly indebted to the following valuable works, although several others have been consulted : Birch, Management and Medical Treatment of Children in India. Calcutta, Thacker, Spink & Co., Rs. 7. Moore, Family Medicine for India. London, Churchill. lOs. Waring, Bazaar Medicines, London, Churchill. 5s. Waring, Pharmacopcea of India. London, Allen. Qs. The first two treatises have special reference to Europeans, but they will yield useful hints to Indian parents. The first edition is largely tentative. Suggestions are invited from friends for the improvement of future issues. Cautions are especially needed agaitist injuri- ous Native practices. IV PREFATORY NOTE. The treatment of Childbirts is noticed in a small pamphlet, intended to precede this. Price, 1 Anna. The compiler would express his warm thanks to Professor Branfoot, of the Madras Medical College, to the Rev. Dr. Chester, of the American Madura Mission, and to Dr. S. Pulney Andy, f. l. s., m. r. e. s. Eng., for kindly looking over the proof-sheets, and for favouring him with some useful suggestions. Part II. treats of the Training op Children. Madras, September, 1887. J. Murdoch. CONTENTS INTRODUCTION. Page Infant Mortality ... ... ... ... 2 MANAGEMENT OF INFANCY. The .Mother ... ... ... 6 Feeding the Baby, etc. ... ... ... ... 8 Teething ... ... ... ... 15 Weaning ... ... ... ... ... 17 Infantile Ailments ... ... ... 18 MANAGEMENT OF OLDER CHILDREN. Preservation of Health, General Directions ... 22 Diseases of Children. Uses of Pain and Sickness ... ... ... 34 Disease in India ... ... ... 35 Germ Theory of Disease ... ... ... 36 Signs of Sickness ... ... ... 38 Care of the Sick ... ... ... ... 39 Fevers. Fevers generally ... ... ... ... 43 1. Simple Continued Fever ... ... 45 2. Intermittent Fever or Ague ... ... ... 46 Preservatives from Fever... ... 50 3. Remittent Fever ... ... ... ... 52 4. Typhoid or Enteric Fever ... 53 Eruptive Fevers. 1. Measles ... ... ... 54 2. Scarlet Fever or Scarlatina ... ... ... 55 3. Small-Pox ... ... ... 55 4. Chicken-Pox ... ... ... ... 57 Diseases of the Throat and Chest. Croup ... ... ... ... 57 Cold... ... ... ... ... ... 58 Cough ... ... ... ... 59 Bronchitis ... ... ... ... ... 59 Hooping Cough ... ... ... 60 VI CONTENTS. Diseases of the Bowels. Constipation ... Diarrlicea... Dysentery Cholera ... Worms ( Miscellaneous. Guinea Worm Itch ... Boils Headache Sunstroke Fainting Sore Eyes The Ear Toothache General Directions Bleeding ... Bruises Burns and Scalds ... Choking Dislocations Drowning Fractures Poisons Snake Bites, &c. Sprains Wounds ... • •• Accidents. Medicines and Preparations. Medical Weights and Measures ... Proportionate Doses Medicines Page . 61 , 61 . 63 . 63 . 70 72 72 73 76 75 76 77 78 79 79 79 80 80 81 81 81 82 82 83 84 84 85 86 86 Duty of Educated Men with regard to Sanitation ... 98 Spiritual Health ... ... ... 94 Prayer during Pestilence ... ... ... 94 Prayer for a Sick Child ... ... 95 Index ... ... ... 96 I THE HEALTH OF CHILDREN. — o-Oj^Oo— INTRODUCTION. Joy at the Birth of a Child. — It is one of the happiest days in married life when the husband and wife first receive the new names of father and mother. They ai’e drawn more closely together themselves; they have a new source of pleasure ; a new object to live for. The feelings of thoughtful parents are expressed in the following simple lines Another little wave Upon the sea of life ; Another soul to save, Amid its toil and strife. Two more little feet To walk the dnsty road ; To choose where two paths meet,— The narrow and the broad. Two more little hands To work for good or ill ; ' Two more little eyes, Another little will. Another heart to love. Receiving love again ; And so the baby came, A thing of joy and pain. 2 INTRODUCTION, Infant Mortality. — It is a sad fact that joy at the birth of an infant is sometimes soon followed by sorrow for its loss. About half the Muhammadan children born in Calcutta die within the first year, and the half of them within 15 days of birth. This is an extreme case ; but everywhere the deaths are far more numerous than they ought to be. Among Christians in Calcutta the mortality the first j’ear is about one in five. In England it is about one in eight. The deaths are much less numerous the second year, and after that they quickly diminish. Still, it is true that about one half who are born die under the age of five years. The life of an infant may be com- pared to the flame of a very small lamp, easily blown out. It gi’adually becomes stronger ; but at first especially, the greatest care is necessary. Imaginary Causes of Infant Mortality — Though Indian parents, as a rule, mourn greatly over the death of their children, many of them do not under- stand why they are taken away. Some ascribe it io fate ; it was fixed that they should then die. Hindus think that it is written on their heads. There is no such thing as fate. Sins in a former birth are one explanation of a short life in the present one ; but there is no proof that we ever existed before. Who remembers any thing of the kind ? The anger of demons is another reason which is given. Due offerings were not made to secure their favour. There are no such beings. A Persian pro- verb says, “ The proper devil of mankind is man.” It is from the ignorance and misconduct of ourselves or our fellow-men, that we cbiefly suffer. Muhammadans ascribe death to the will of God, and consider resignation their only duty. Without doubt it is God’s will tbat water should drown ; but it would be very wrong for a mother to throw her child into a tank, and say that the child died by the will of God. No more ought this to be said in many other cases. God, it is true, is the Lord of life and death. It is L INFANT M01?TAT.ITY. very right to feel our constant dependence upon Him, and to ask His blessing. Ou the other hand, it would be mockery for a mother to ask God to take care of her child while she was giving it poison. Real Causes of Infant Mortality — Under native rule, Rajputs sometimes destroyed their female infants as soon as they were born. A small piece of opium was sufficient. Numbers of children are as surely killed by their parents as those daughters of the Rajputs. The points of difference are that in the former case, the parents do not wish to murder their J children, and that they are slowly poisoned instead of being put to death at once. Kilt.ed by Ignorance must be the true verdict. Children are made to be healthy and live long, and if they sicken or die, it is almost always through bad management. Knowledge Needed . — Love is not enough on the part of parents. This they already possess. Know- ledge is also required. Suppose a mother gives poison to a child thinking it to be wholesome, it will kill it just as surely as if she knew its real nature. Most parents in this country are guided by ignorant old women who cannot even read. Hence the great ^ mortality. The following directions have been com- piled from books published by learned physicians, who have given their lives to the study of the diseases of children. By attention to them, children may be saved from much sickness, and many lives may be preserved. Only strong, healthy parents can be expected to have strong, healthy children, able to withstand the diseases of infancy. There are two customs among the Hindus which are very hurtful. Early marriages tend to produce feeble children. Intermarriage, con- fined to a few families, has the same effect. Apart . from the state of the parents, the chief causes of in- fant mortality are the following : — 1. Impure Air . — Air is what is most needed to sustain life. We can survive several days without food, but the strongest man will die in a few minutes 4 INTRODUCTION. without air. We not only need air, but the air must be pure. There are many kinds of poison in the world, but perhaps the poison which kills most people is had air. We are always breathing, but the air we give out differs much from the air we take in. It is dirtv, like water after washing out an unclean pot. It takes away poisonous matter which would cause sick- ness and death if left in the body. Most Hindus refuse to drink water from a vessel which another man has touched with his lips; but when they crowd together in close rooms, they drink in again and again the bad air and foul matter which come out of each other’s bodies. The frightful mortality among Muhammadan chil- dren in Calcutta has been mentioned. They die large- ly from lock-jaw within a few days from birth. This disease is almost unknown among European infants in the same city. Twice as many of the Muhammadan mothers die as among Christians. The women, at confinement, are shut up in small rooms which have all openings carefully closed ; a pan of charcoal is kept constantly burning ; while female relations and friends crowd around. Mother and child are poisoned by the foul air. When the chil- dren are older, and spend much of their time in the open air, the number of deaths becomes very much less. Fresh air is the breath of life. 2. Impure Water . — The greater part of our body consists of water. The water we drink passes into the blood, and thus goes to every part of the body. If the water is bad, our health must suffer. Pure water is as needful as pure air. Great carelessness is often shown about keeping tanks clean. People bathe in them, rinse their mouths and spit into them, wash their clothes and cooking pots in them, clean themselves in them after using the tank as a latrine ; cattle and swine lie in them. Yet water is taken from them for drinking and cooking. The’’ water in wells is often equally bad. Water infant mortality. 5 from above, in many cases, is allowed to run into them. Mud and the droppings of cattle thus find their way into the well. Fever is often caused by decaying matter in water. Impurities from privies are especially injurious. Some of the worst kinds of sickness are caused by drinking water containing putrid matter from the bowels of people. Drinking water should be bright and clear, and without either taste or smell. Parents for their own sakes and for their children, should endeavour to have pure water. f 3. Improper Food . — This is also a frequent cause of mortality. The stomachs of children are very deli- cate, and easily hurt. Grod has provided the most suitable food for them in the mother’s milk. Until they are about three years of age, they should not be allowed to taste strong, highly seasoned food. Parents often give their young children a share of what they are taking themselves, it may be hot curries, salt fish, or other articles equally indigestible. Unripe fruit is very injurious. Further remarks will be made on this subject under another head. 4. Want of Cleanliness . — Filth is the Mother op ^ Sickness. In one form or another, she is the true Mariamman, Mother of Death. Its hurtful effects in connection with air and water have already been noticed. The bodies and clothes of childi’en should be kept clean. Houses should be whitewashed twice a year. Plantain skins and other refuse should never be dropped near the house. Hollows where water gathers should be filled up. Houses should not be used as a stable for cattle or goats. All filth should be taken to a distance, and covered with dry earth. Notice carefully any bad smells. They generally come from rotting substances and bring sickness. ^ Follow up any bad smell in the house until you find out where it comes from. Look well to all drains and see that they are not choked by decaying matter. Clear them frequently with plenty of water. 6 MANAGEMENT OF INFANCY. In opposition to the foregoing causes of mortality, there should be 1. Pore Air. 2. Good Water. 3. Suitable Food. 4. Cleanliness. These are essential to have strong, healthy children, and such children are likely to grow up strong and healthy men and women. Need of Physicians. — The object of this little book is not to show parents how to treat diseases in their children and enable them to dispense with doctors. This would do more harm than good. The aim is rather to point out how health may be preserved, and “Prevention is better than cure.” Sometimes, how- ever, immediate action is necessary, as in convulsions, and a doctor may live at some distance. Parents may also reside at out-stations where there is no doctor available. Such are obliged to do the best they can themselves, and to them this little treatise may be of some help. Except, however, in the case of slight ail- ments, a physician, if possible, should be called in at the beginning. Disease may often be checked at the commencement, whereas, if allowed to go on, cure may be difficult or even impossible. Even in apparently slight ailments there may be danger. Some serious diseases begin with symptoms that are thought un- important. Directions in detail will now be given with regard to the health of children. MANAGEMENT OF INFANCY. Infancy is supposed to include the first two years ; Childhood from two to eight years of age. The Mother. In the little treatise on Childbirth the care necessary on the part of the expectant mother during pregnancy has been explained. It is equally needful after delivery. THE MOTHER. 7 I A healthy mother is required to uourish a healthy child. The requisites to health have already been men- tioned. The first thing is a sufl&cient supply of pure air. Many of the women of India suffer greatly from the want of this. Their rooms are often small, without windows, and in courts where the air cannot circulate freely. The case of what are called purda nasheen women is especially to be pitied. The Hindus proba- bly copied the practice from the Muhammadans. It l, may be necessary among the latter from their facility of divorce, but Hindus should revert to their ancient liberty. It is maintained at present only by foolish pride and false modesty. Impure air is the chief reason why so many Muhammadan women die in childbirth and from consumption ; and so long as this state of things continues, the same result must follow. While the room in which the mother lives should be well ventilated, it would be of great benefit both to herself and her infant to go out with it for some time every day into the open air, when the weather per- mitted. If she cannot go outside, at least let her take ^ the child into the courtyard. Pure water is another essential. The mother’s milk consists chiefly of water, and its quality will affect the infant for good or evil. The food of the mother should be nourishing, but not too rich. If it can be obtained, she should have plenty of good milk. Beer and wine should be avoided. Cleanliness about the house and compound is important. No rubbish should be left about. There should be no bad smells. Anything causing them should at once be removed. An idle life is not good for nursing women. Gentle exercise is useful. Household duties will furnish this 1 to some extent ; but, as already mentioned, a walk in the open air should be added, if practicable. Mothers should be kept free from care and anxiety and should be encouraged to be cheerful and happy. 8 MANAGEMENT OP INFANCY. The impressious they make on the child stre often life- long. Suckling a child after sudden fright or a fit of passion has been known to endanger its life. ~ Feeding the Baby. Nothing is more important in the bringing up of infants than the careful management of their food. Carelessness or errors in this respect cause a large proportion of their illnesses and deaths. Suckling by the Mother. — When the mother has had a little rest after the birth of the child, it should be put to her breast. Ignorant people consider the first milk bad and do not give it. On the contrary, the mother’s first milk both nourishes the child and clears its bowels. It is far better than any medicine : nothing else should be given. If the milk is delayed, a little cow’s milk, mixed with twice the quantity of warm water, may be given till it appears. The child should be placed to each breast in turn. It should not receive its nourishment lying flat. The upper part of the body should be raised. This helps the milk to flow down into its stomach, and the vomiting of milk is less frequent. A young infant may be pat to the breast every second hour during the day, and every third hour at night. The time between meals should be gradually lengthened. The interval allows the milk to digest. During the night the child does not need to be fed so often. After a time it should be .suckled only late at night and eai’ly in the morning, but not during the night. Let the mother keep to regular times, and the baby will get used to them. It is bad for mother and child to give the infant the breast simply because it cries. A baby’s cry does not always mean, “ I am hungry it may mean, “ 1 have had too much,” and then feeding it will only make it worse. A baby’.s cry may also mean, “ I am hot,” “I am cold,” “ Something hurts me.” Some mothers think that cramming with a great FEEDING THE BABY. 9 deal of food makes babies strong ; bat on the contrary it only weakens them. It causes indigestion, vomiting, wind, diarrhoea, and has killed thousands. As a rule, when the baby ceases to suck it should be removed from the breast. It shows that it has had enough. Sometimes, however, it may arise from wind. If the mother has not enough milk to nourish the child, some cow’s milk may also be given, especially at night. Every mother, unless in bad health, should nurse her child. This is good for herself as well as for the infant. It is health to both. Wet Nurse. — If the mother cannot suckle her child, a good wet nurse should be obtained if possible. As the milk changes to some extent, the child of the wet nurse should be about the same age as that of the child given to her. Care should be taken that she is in good health and has a sufficient supply of milk. Her skin should be free from eruptions, her tongue clean, and her bi’easts firm and plump, not hanging down loosely. The monthly courses should not have returned. The remarks about the health of the mother apply to the wet nurse. She is apt to be overfed and to lead too idle a life. Hand-fseding. — If neither of the foregoing is prac- ticable, this is the only course left. But the pro- portion of deaths among children reared in this way is far greater than among children who are suckled. Even a little human milk is a great advantage. One part of pure cow’s milk and two parts of warm water may be given the first month ; for the second and third months, equal parts of milk and water, during the fourth month two parts of milk and one of water. After the fourth month pure milk may be used. This may be too strong in some cases, and the proportion of water may be greater. If possible, the milk should be new and from one healthy cow. Bad water is sometimes mixed with 10 MANAGEMENT OF INFANCY. milk or it may have been drunk by the cow herself. Boiling' the milk is a safeguard. As soon as it boils, it should be taken off the fire. Glass feediug-bottles can be obtained in large towns. The simplest are the best. Those with tubes are to be avoided as it is difficult to clean them. The bottle should be emptied each time it is used and thoroughly cleaned. The nipple also should be taken off, washed well, and dried with a clean cloth. If they are the least dirty, they make the milk sour, and sour milk makes a baby troubled with wind, colic, and other bad things. Sucking from a bottle is better than feeding from a spoon. It brings into the mouth the saliva which mixes with the food, and makes it digest better. The child should be held in the same way as the mother would hold it when giving the breast. Milk alone should form the diet until the time arrives for giving other food, as described under Weaning.’’ Much of the mortality from hand-feeding arises from the use of arrowroot and other kinds of food which contain no proper nourishment. Children should never be allowed any solid food till they have cut their teeth. The infant should never get the empty bottle to suck to keep it quiet. It causes pain in the .stomach, wind, and diarrhoea. Cleanly Habits. Even a young child may be taught to acquire regular natural habits. An infant of three months old and upwards ought to be held out at least a dozen times during the 24 hours. A child often cries because it is wet and uncomfortable. Cleanly habits are pleasant both to the mother and infant. In course of time the child will give warning, and cry to be relieved. It should be wiped after each motion. When the child is a little older, a small chair, with a hole in it, may be used. SLtEPlNO. 11 Washing and Bathing. The skin is covered with innumerable very small drains, through which waste matter escapes which would be hurtful if kept within the body. Dirt chokes these little drains. To keep a baby’s skin in pex'fect health, it might to be washed all over at least once (and better twice) in the 24 hours. The water should be tepid or slightly warm. Cold water gives too great a shock, but hot water is also injurious. The hand can bear more heat than the other parts of the body. The warmth of the water is best tested by putting the elbow in it. The head should be wetted (but not dried) before putting the child in the bath. Then with a piece of soft cloth, well wetted, cleanse his whole body, parti- cularly his armpits and between his thighs. Next pour water over all his body, especially the back. This will be strengthening to the child. The skin must afterwards be well dried, with soft towels. Care should be taken not to hurt the tender skin by rubbing. The ears and the parts between the thighs should be well dried with a soft cloth. A cold wind is specially felt by a person bathing. It is particularly to be guarded against in the case of an infant. Draughts, at all times, are to be avoided. Sleeping. At first a baby sleeps nearly the whole day except when actually taking food. By degrees its waking hours increase, and it is then desirable to accustom it to sleep, as well as to eat, at regular times. It should be trained to take its longest sleeps at night. At the age of six months, it will require three sleeps in the day, but the earlier and later may gradually be short- ened. The mid-day sleep should be continued till the child is three years old. All plans of causing sleep are bad. The infant should not be hushed” to sleep by gentle move- 12 MANAGEMENT OF INFANCY. meuts and soft sounds. If a child is from tho first laid down to sleep without further attention, it will fall asleep just as readily and easily as with any amount of assistance. If, however, the habit is formed of walking about with it, &c., when this is not done the baby will cry and fret, perhaps losing half its sleep. It is safer and healthier for an infant to sleep on a little cot of its own than with its mother or nurse. It gets a better supply of pure air not having to breathe the bad air which comes from its mother or nurse. Its head should not be covered so that it cannot breathe freely. The mouth and nose should be quite free. Soothing syrups of all kinds should never he given to children to make them sleep. They contain opium. The child sleeps, but it is a dangerous kind of sleep, always hurtful, occasionally ending in death. Ayahs sometimes give opium to children that they may not give trouble; poor women who have to go out during the day, sometimes adopt the same plan, that their children may lie quiet till their return. But the practice is strongly to be condemned. The child should not be disturbed by noises when asleep ; it should be awaked gently and not suddenly. Its eyes should not be exposed to a sudden glare of light. Dress. The clothing should be light, warm, and soft. It should be sufficiently loose and short to permit the free play of the child’s limbs. Tightness of dress any- where is bad. It hinders free breathing and makes the child uncomfortable. The use of pins should bo avoided. Children bear cold less than grown-up people. Except in very hot weather, their bodies should be covered, with the exception of the head. Cotton is a good material next the skin. In cold weather, especially at night and during the rains, woollen clothing is desirable. VACCINATION. 13 The clothing at night should be different from that worn during the day. The clothing should always be kept clean, so that it never has a bad smell, nor shows spots of dirt. Pillows are often neglected in this respect. They should be covered, and the cases washed regularly. Vaccination. Small-pox is one of the most loathsome and fatal diseases. There is an Indian proverb that a mother can never say she has a son till he has had small-pox. It is wrongly attributed in the north to Sitala Mata and in the south to Mariamman, who are supposed to scatter in sport the seed of the disease. These dreaded goddesses have no existence. They neither cause nor cure small-pox. People need not be afraid of their anger, and offerings to them are worthless. The great safeguard against small-pox is vaccina- tion, discovered by an English doctor about a century ago. The word comes from the Latin vacca, a cow. The matter used was first got from a cow, and people are still sometimes vaccinated from cows. From want of care, ignorant persons think vaccina- tion useless. Sometimes the proper matter has not been employed, or the little boils have been broken. If rightly done, very few persons vaccinated take small-pox, and that generally in mild form. Four punctures in the skin are desirable, and for several days they should be protected from rubbing. Nothing whatever should be applied to them. There may be slight fever for a short time, but medicine ia seldom necessary. If the bowels are disordered, per- haps half a tea-spoonful of castor oil may be given on the fifth day. About the tenth day, the pocka burst, and the child is soon quite well again. Infants are best vaccinated before they are three months old. They do not suffer so much, and they cannot scratch the pocks, the chief thing to be 2 14 MANAGEMENT OE INFANCY. guarded against. Besides, it is an advantage to have vaccination over before teething begins. If a sore has been formed on the arm from the pock being scratched, keep it clean and apply a little ointment or butter. It will soon heal. Except when there is immediate danger from small- pox, children should be vaccinated only when they are in good health. Vaccination should be repeated after puberty. Thus almost perfect protection will be secured. Airing. A baby is like a plant — it cannot grow strong without plenty of out-door air and light. Besides having plenty of fresh air in the house, an infant should be taken out every day, when the weather permits, morning and evening. This may be done after it is a fortnight old, if properly clothed. It should be protected from the rays of the sun, and should not remain out after sunset. The ayah should not sit down and talk with her friends, for her motion in walking is exercise to the child. It should be changed from the one arm to the other every ten minutes. Exercise. Change of position and gentle movements are neces- sary for health. Sometimes the child should be laid down BO that it may move its limbs freely. A baby should not be constantly in its mother’s arms, for it only does it harm and gives the mother much needless trouble. Gentle dandling is pleasant and beneficial, but violent movements are to be avoided. A child should not be dragged or lifted by its arms; they may easily be put out of joint. Children should not be taught to walk. Their bones are soft, and if made to stand or walk too soon their legs become bent, and their back may be deformed. TBETHINQ. 15 The best way to teach a child to walk is to let it teach itself. It will first learn to crawl, a highly useful exercise. Next it will try to lift itself upon its feet by the help of a chair. Then it will try to stand alone, and to walk with the help of anything near it. After many trials it will at last, first fearfully, then proudly, walk alone. Children ought not to be still ; they should be allow- ed to shout and laugh as loudly as they can. This strengthens their lungs, and is a valuable exercise. Teething. A child is born toothless ; but it has hidden in the jaw the seeds of two sets of teeth. The first are small and drop out ; the second are larger and permanent. The first set consists of twenty. They are usually cut in pairs, those of the lower jaw generally pre- ceding the upper ones. The first appear about the sixth month and the last about the thirtieth month ; but the time varies greatly. Before the teeth come out, there is an increased flow of saliva, with swelling and heat of the gums. The child often thrusts its fingers or anything within its grasp into its mouth. Its thirst is increased, and it takes the breast more frequently though for shorter times than usual. It is fretful and restless ; a slight tendency to vomiting and looseness of bowels are not uncommon. When a child is cutting its teeth, it should be much in the open air and have plenty of exercise. It should not be overfed ; but it should be allowed to drink water as often as it pleases, a little at a time. There is nothing so good to cool the hotlittle mouth and gums. The bowels should not be confined ; but, on the other hand, continued diarrhoea is to be avoided. The mother should attend carefully to her own health and diet. No hard substance should be given to a child to bite while teething. It hardens the gums and some- times breaks the points of the teeth. A piece of India '16 MANAQfiMENT OF INFANTS. rubber is much better. But the child’s thumb is the most convenient and best gumstick. To suck it is a great relief to a child. The custom, however, should be broken i ff when no longer necessary. This may be done by smearing it with some bitter substance. Rubbing the gums gently with the linger affords some relief. When the gums are very red, hot, and swollen, they should be slightly cut by a doctor. It is not very painful. The infant that before was crying will often smile afterwards. In difficult teething the child should have plenty of fresh air. It should not have too much food, and only milk. Things are made worse by feeding it when it cries. Sponging the infant’s head with cold water, night and morning, will be of great benefit. The head should be kept cool. Convulsions sometimes take place during difficult teething. The muscles of the face twitch, the head and neck are drawn backward, the limbs are violently bent and stretched, the eyes stare and are rolled about. This may last for a few minutes, or, with intervals, for some hours. The child should at once be put in a bath as hot as the elbow can bear easily. The head should be covered with a piece of cloth, wet with cold water. Sprinkling cold water on the child’s face while in the bath is also useful. During convulsions the child is insensible and does not feel pain. When over, per- fect quiet should be observed, and sleep encouraged. Till sleep is procured, there is a liability to relapse. Some castor oil may afterwards be given. Eruptions, or breakings out, about the ears, face, and various parts of the body often appear during the first teething. In genei’al they should be let alone, being rather useful than otherwise, preventing more serious complaints. As already mentioned, plenty of fresh air is of great importance. About twice as many children die in towns during teething as in the country. WEANING. 17 Weaning. The time when a child should be weaned depends partly on the mother, partly on the child. If the mother’s health is delicate, the child may be weaned by the ninth month or even earlier. If, on the other hand, the mother is in good health and the child fee- ble, the nursing may be prolonged for a few months. It should not be effected while the child is suffering fi*om teething. The non-appearance of the teeth is also a sign of delay. But, as a general rule, it should take place not later than the twelfth month. After that the mother’s milk becomes poor in quality, and unfit to nourish the child. The child should not be weaned suddenly, but by degrees. It should gradually be accustomed to other food than its mother’s milk. When the child is seven months old it may get twice a day some good cow’s milk mixed with warm water. When the child gets older, less water may be put in the milk, and it may be thickened with some well boiled wheat flour. As already mentioned, arrowroot does not afford proper nourishment. It should not be used. Kanji may also be given at times. The mother should at first abstain from nursing the child at night, and after a time she need suckle her child only twice a day morning and evening. The demand for the milk being lessened, the supply will decrease in proportion. If the child refuse other food than that of the breast, let it get hungry, and it will yield. Suji, rice, and plain bread are all wholesome, but till a child is 18 months old milk should form a large proportion of its food. Sweetmeats, curry, highly spiced food, and unripe fruit are bad for young children. Many children die because their parents give them some of their own food. Diarrhoea and other troubles are the result. It would be just as wise to set infants to do grown-up people’s work as to give them grown-up people’s food. Tea and 18 INFANTILE AILMENTS. coffee are rot good for cWldreiij and any intoxicat- ing liquor is still worse. INFANTILE AILMENTS. Under this head only a few minor complaints will be noticed. Already some directions have been given. The diseases of children will be treated at greater length under another head. Medicines. — These should be given as seldom as possible. Nature herself chiefly effects a cure. If something gets into the eye, tears begin to flow to wash it away; if we eat anything unwholesome, it may be vomited or the bowels may try to get rid of it. Our great aim should be to remove the cause which hinders a cure. Of all medicines to move the bowels, castor oil is the safest ; but it should not be given if it can be avoided. Often a change of food will effect what is required without medicine. Few things are more weakening than dosing a child with medicine. Some of the medicines prescribed by ignorant Native doctors are dangerous ; many of them are useless. Diarrhoea — Looseness of bowels is one of the most common complaints of young children and the most fatal. If continued, the infant becomes weaker and weaker until at last it is taken away. It should receive careful attention. A child should have from three to six motions a day. The colour should be of an orange yellow, the consis- tency should be that of thick kanji, and there should be little smell. If the infant have double the latter number of motions ; if they are watery, slimy, green- ish or curdled ; hf they have a strong disagreeable smell ; if the child be sick, cross and restless ; it has diarrhoea. The causes of looseness of bowels are improper CONSTIPATION. 19 food, over-feeding, teething, cold, &c. It may also be occasioned by the bad health of the mother or by her eating unsuitable food. These causes ought to be re- medied, or medicine to the infant will be of little avail. A slight looseness for two or three days need not be interfered with. It is perhaps some indigestible food that is being worked off or an effort to lessen the irritation of the gums. If not soon relieved, half a tea-spoonful of castor oil may be given. A warm bandage round the belly is very useful, especially at night or when the weather is cold. If the child is at the breast, it ought, for a few days, to be kept entirely to it, and the mother should be most particular about her own diet. If the diarrhoea continue, medical aid should be sought. Constipation. — This is the opposite of diarrhoea. It is not so common nor so dangerous ; but, if continued, it is hurtful. The motions are fewer than usual, and sometimes consist of hard white lumps. In infants it is often caused by the milk of the mother, who should be careful about her food, and take more exercise. Or the child may have been given other food too soon or badly prepared. Regularity in relieving the bowels is a great safe- guard against constipation. Even infants, as already explained, may be trained to this. The use of aperient medicine should be avoided. If once begun, it is apt to be continued ; it loses its effect, and requires to be made stronger and stronger. Gently rubbing the belly is useful. Ayahs sometimes insert the pawn stalk up the anus of young children to relieve constipation. A better and safer plan is to cut a piece of white soap round and pointed, about the thickness of a lead pencil, and about two inches in length. This should be dipped in a little warm jinjili oil, and gently put up the bowel, allowing a little to I’emain in view. It must then be left alone. In a minute or two, it will be forced out and the bowels relieved. 20 INFANTILE AILMENTS. Griping and Wind — When an iufant screams and draws up its legs, and is free from fever, it is pro- bably griped. The stomach is usually full and hard — possibly there may be vomiting and a greenish motion or two may be passed. Flatulency, or wind, is caused by indigestion. The infant that is constantly at the breast will always suffer more or less in this way. Sufficient time is not allowed between meals, and the milk passes into the bowels undigested. Improper food has the same effect. The gases given out stretch the bowel and give pain. The great object should be to remove the cause — the bad quality of the milk, over-feeding, or other food than the mother’s milk. A tea-spoonful, or rather more, of dill water,* sweetened with a little sugar, will often give relief for a time. Rubbing some warm jinjili oil for quarter of an hour over the bowels is useful. A very simple remedy is to turn the child over on its belly that it may pi’ess against the mother’s lap. A warm bath sometimes gives immediate relief. If caused by some hurtful matter in the bowels, a little castor oil is the best remedy. Convulsions. — These have already been noticed under teething, one of the most common causes. They may also arise from improper food, indigestion, worms, flatulency, fright, or so forth. The treatment in most cases is the same. In fever convulsions, due to heat of the body, the child should be placed in cold water up to its neck and cold water poured on its head. This, however, requires caution, and ought to be done only by a physician. Further directions are given under fever. A purgative should generally follow convulsions, after some rest has been obtained. When the cause of convulsions has been ascertained, ■precautions should be taken during the remainder of childhood to prevent return. Vomiting. — This is very common in infants. It * See Appeudix on Medicines. Omum water has the Same effect, and is more readily procurable. MANAaEMENT OP OLDER CHILDREN. 21 usually means that they have taken too much milk, and throw out what is unnecessary. Continued attacks of vomiting are serious. The child becomes thin, feeble, and cross. Improper food and want of pure air are some of the chief causes. Attend carefully to the directions about food. G-ive it cold and in small quantities at a time. The belly should be gently rubbed with mustard oil. Rubbing oil over the whole body will give comfort, and en- courage sleep. Thrush. — This is caused by a small plant which appears as little white patches within the mouth. Unsuitable food is the chief cause. This should receive attention. After each meal the mouth should be washed out with a little wai-m water. Touch the white patches with a mixture of borax’^ and honey. It should be applied by means of the finger twice or thrice daily. Wasting. — Sometimes an infant does not thrive. It becomes thin ; it whines, suffers from griping, and perhaps from diarrhoea and vomiting. It is generally caused by something being wrong with the quantity or quality of the food. The infant should have fresh air at night, and be much in the open air during the day. If in town, a change to a healthy part of the country would be of great benefit. MANAGEMENT OF OLDER CHILDREN. The foregoing pages treat of the care of children during infancy. Directions will now be given about them when they are older. They will be arranged under two main heads — Preservation of Health and Treatment of Disease. * See Appendix on Medicines. 22 PRESERVATION OP HEALTH. PRESERVATION OF HEALTH. The proverb has already been quoted, “ Preven- tion is better than cure.” It ought to be kept con- tinually in mind. It will not be necessary to repeat explanations already given. New cautions required by a difference of age need only be mentioned. 1. Pore Air. This is the first essential. Its need has already been explained. It is not enough to have plenty of fresh air outside ; we must allow it to come within our bodies in suffi- cient quantities. A sponge or piece of cloth, held loosely, will take up a great deal of water. The more it is pressed, the less it holds. The air we breathe purifies our blood in the lungs, which are like a large sponge. The less the lungs are pressed, the more air they will take in, and the better the blood will be purified. Boys when reading, writing, or working in any way, should not be allowed to bend over, squeezing the lungs, and hindering the air from getting in. To keep the body upright, is much healthier. 2. Pure Water. This is the second essential to good health. The great neglect with regard to its provision has already been noticed. Get pure water if you can, and keep it pure. A little alum or the clearing nut will cause any particles of matter to fall to the bottom. Open earthen pots, with sand and charcoal, are often nsed as filters. The objection to them is that musquitoes lay their eggs in them. Closed filters are greatly preferable. But both are useless if the charcoal, &c. are not well cleaned from time to time. The great thing is to get pure water, and filters will not be needed. Filtering water does not destroy the poison which FOOD. 23 causes fever. For this purpose, it ought to be boiled for at least five minutes — better longer. Children, in general, are fond of drinking. They should be trained to be careful to use pure water. There is ah old Greek proverb, “ Water is best.'’ It quenches the thirst and does no harm. Parents should do all in their power to prevent their children acquiring a taste for intoxicating liquors. Abstinence from them on their own part will give most effect to their teaching. 3. Food. Why we Eat. — Our bodies are like burning lamps which will go out if not supplied with oil, or they may be compared to railway engines which will not move without fuel. Every word we speak, every step we take, wastes a little of our body. This goes on even while we are asleep, although not so quickly, for we are breathing and our hearts beat. It is our food which supplies this waste, and gives us strength to labour. A stone image does not need any food, because it does no work. Our food also warms us. It burns within our breast like a little fire, although it does not break out into a flame. If we do not eat, our bodies get colder and colder. A good meal, on the other hand, makes us feel warm. Children have usually good appetites, because they have to grow as well as work. Men and women have only to take in what they waste. What to Eat. — Some kinds of wood burn much better than others, yielding more heat. It is the same with food. Some kinds are much more nourishing than others, but a variety is best. We need food to make up for the waste, for strength, and for heat. Good food should contain all that the body requires. Milk supplies every want in the case of the young. When children grow up, they get other food. PKESERVATION OF UEALTH. 24 ■ Different kinds of grain form the chief food of man, Rice is one of the least nourishing. Wheat, the millets, and maize, are far superior. Men who live on them are stronger and can work harder than those who live on rice. Dholl, added in small quantity to rice, makes it more nourishing. Flesh and fish are both very strengthening. Oil gives heat, but not strength. People who live chiefly on rice, ghee, and sweetmeats get fat and unable to work hard. They become grey-headed in early manhood, and suffer from many diseases. In cold countries more heat-giving food is needed. But the body requires some fat for other purposes besides heat ; it is the excess which is hurtful. Fruit, properly ripe, is generally an excellent article of food. But if unripe or overripe it is hurtful. Children are often hungry, and are tempted to eat any fruit they see, although it may be sour and green. Parents should be watchful in this respect, as it will save their children from much sickness. Cooked food, kept too long, becomes unwholesome. This is sometimes the case with cold rice eaten in the morning. Decayed food of any kind should never be used, especially fish. Double care is necessary about food when cholera or dysentery prevails. What may do no barm at other times, may then cause sickness and death. Raw fruits and vegetables in large quantities, and all indigestible food, should be avoided. Spices, &c., in moderation, are useful. In excess, they injure the stomach. Betel-chewing, so common in this country, is filthy and hurtful. It is bad for the teeth ; it sometimes occasions cancer ; it wastes a great deal of time and money, and should be avoided. Smoking is especially hurtful to the young. Parents should not allow their children to acquire the habit. Badly cooked food is unwholesome. People are sometimes made ill through the poison of lead or copper iu cooking vessels. This should be kept dean, and FOOD. 25 care should be taken that they are tinned from time to time. Plain food is best for children, and indeed for any one. When the Queen Empress of India was a child, her breakfast was bread and milk, with a little fruit. When good milk can be obtained, it should be largely used, especially for young children. Rice and milk are excellent ; suji and milk are still more nourishing. Tea and coffee are not good for children. Sweetmeats and rich cake are much better avoided altogether. When children grow up, they must share in the food of their parents. How to Eat. — When a woman is boiling rice, she puts it all into the pot at once. If she kept throwing in rice now and then it would be badly cooked. It is the same with our food. We should eat only at fixed hours, and the stomach should have time to digest^one meal before another is taken. It is a bad habit to give food to children between meals. Food, especially if hard or tough, should be well chewed before it is swallowed. It is thus mixed with the saliva, which helps digestion, and makes the food more nourishing. Water should be taken only spar- ingly during meals. The saliva should moisten the food. Some food in the morning before going out strength- ens the body, and helps to keep off fever. A good warm meal should be taken if possible, about noon. Some children attend school at too great a distance to come home. In such a case they should have a hearty breakfast before leaving. It may be objected that it cannot be got ready in time ; but where there is a will, there is a way.’’ Clerks in public offices get a good meal before they leave, and parents should provide the same for their children. It is very hurtful to be obliged to work on an empty stomach. A badly- fed bullock cannot be expected to do as much as one that has plenty to eat. Children, with sufficient food, will get on better in their studies. Every school- boy should have some tiffin. Caste prejudices should 3 I'UBSJiKVATlOlS OF HEALTH. 2G not be allowed to interfere with this. A little food when the child comes home from school, is also desii’- able. A good meal should be taken in the evening about seven o’clock. After eating, the mouth should be washed and the teeth cleaned. This will help greatly to preserve the teeth and prevent toothache. 4. Light. Plants grown in the dark look white and sickly. They always try to get to the light. It is the same with human beings. Those who live in the dark are pale and feeble, liable to many diseases. Even their minds suffer. “ Truly the light is sweet, and a pleasant thing it is for the eyes to behold the sun.” If you wish to keep a bird in a cage from singing, cover the cage with a cloth. Birds sing only when they are happy, and the dark takes away their spirits. We also feel more cheerful in a bright day than when it is dark and gloomy. People getting better from sickness seem to drink in strength from the light. A dark house is always an unhealthy house. There is a saying, “ Where light cannot enter, the doctor must.” Sunlight helps to purify a house. It shows also when things are dirty, and reminds people to clean them. Light drives away snakes and vermin. But while light is good, exposure to the hot sun may cause illness. Children often get headaches from running out in the sun. People accustomed to work in the fields may get no harm, but others, when they go out in the heat of the day, should have the head well protected and an umbrella. 5. Deess. Clothiug should vary with the climate. In South India, the hot and cold seasons do not differ so much as in the North, Many people die in Bengal during BATHING. 27 the cold season, because their clothing is not suffi- ciently warm. The cold wind blows on them and they are attacked by fever. A flannel under-coat is a great protection. The two most tender parts of the body are the head and the bowels. Good turbans protect the head from the sun. Several folds of cloth round the belly, especially at night, are a great preservative against sickness. A flannel belt answers the same purpose. It has been called a life-preserver during a cholera epidemic. Special care is needed when the seasons change. TTot and cold days often follow each other. A chill is very apt to cause sickness. Weak children often suffer from the cold. Clothing worn during the day should be put off at nisrht and spread out. Sweat from the body will thus be allowed to dry. All clothinsr should be kept clean. This is essential to good health. Slovenliness in dress should not be allowed. Many crores of rupees are spent on gold and silver ornaments for children. Money which could be pro- fitably employed is thus rendered useless. The effect on the. children themselves is bad, tending to make them proud, and to dislike hard work. Many of them are also murdered every year on account of their ornaments. This bad custom should be given up. 6. Bathing. Bathing cleansesthe body, and coldbathingstrength- ens both body and mind. Brahmans bathe daily; some other castes but seldom. Part of the mental superioritv of the Brahmans has been attributed to this. A daily bath is of great benefit to all. Parents should teach their children the habit, and thev will foil ow it from pleasure, as well as find the value of it in their studies. Morning is, in general, the beat time. Pure water 28 PRESERVATION OF HEALTH. should be used. It is thought that guinea-worm finds its way into the body from bathing in dirty water. Pouring water on the head from chatties, or pots, is an excellent mode of bathing. The water gets cool in the pots, and the exertion of lifting and pouring them is beneficial. Swimming baths are also very good, but often they cannot be obtained. The body should, if possible, be cleaned with soap, and after it has been well washed, rubbed dry. with a rough towel. Plain soap is better than cheap scented soap. The rubbing is an important part, freshening the skin. Towels should be clean, or the benefit will be lost in a great measure. Cold water is best for the young and strong. It is not good to bathe in it soon after eating ; it hinders digestion. Nor should it be used when over-fatigued or when suffering from diarrhoea. Persons recovering from fever sometimes bring back the disease by bath- ing too soon in cold water. A cold wind blowing on the body when a person is bathing, may cause an attack of fever. It is a bad custom to walk home in the sun from a bath in wet clothes. If the body feels chilly after bathing in cold water although the skin has been well rubbed, it shows that water a little warm is better. But tepid water does not strengthen the brain, the organ of the mind, like cold water. Rubbing the skin well after a short bath at night before going to bed, promotes sleep. Warm baths are useful in certain cases, some of which will be mentioned hereafter. Bathing water should not be allowed to soak under a house. It gives rise to fever and rheumatism. Its drainage into wells should also be guarded against. 7. Exercise. A noted English writer says that “ the first requisite to success in life is to be a good animal” — or to be healthy, strong and active. One great difference FXSBCISi:. 29 between an Englishman and an Indian is, that the former generally walks or rides every day for health, while the latter, as a rule, sits at home, and does not go out unless he is obliged. The active habits of the English are one reason why nearly one-fourth of the earth’s population acknowledge their rule. If the Hindus wish to prosper like the English, let them, among other things, copy their love of exercise. Active exercise strengthens the muscles, purifies the blood, and drives waste matter out of the body. We can take more food after exercise, and digest it j better. Proper exercise makes us strong all over. Without it, people become inactive and the least effort is a burden ; they are miserable themselves, and useless to others. Children everywhere are fond of play. It is good for them. Their legs and arms become stronger by running, throwing the ball, and other games. Even shouting and laughing promote their health. Exercise outside is much better than within doors as the air is purer. While some boys neglect their lessons for their sports, others get too little exercise. In many Native * schools boys are kept in too long, and there is not a sufficient change of posture. Children should some- times stand as well as sit in school. The Indian Education Commission recommended “ that physical development be promoted by the en- couragement of native games, gymnastics, school drill, and other exercises suited to the circumstances of each class of school.” Exercise should not be taken when the stomach is empty, nor immediately after a full meal. A good game at cricket or ball about sunset is very useful. Girls require exercise just as much as boys, and |1 suffer much from the want of it. Skipping-rope and other active sports should be encouraged among them. Young men preparing for university examinations are the most apt to suffer from want of exercise. Some 30 [pRESKfiVATION OF HEALTH. of them think that all their time should be spent in study. This is a mistake. A carpenter is well employ- ed at times in sharpening his tools. The mind works through the brain. By exercise, the brain receives a larger supply of blood and is strengthened. It has happened that students who neglected exercise have become so ill, that they could not appear at the ex- aminations. Some have thus made themselves weak and sickly all their lives. It is a mistake, on the one side, for parents, to seek to keep their children always at study and nothing else ; and it is as great a mistake on the other hand to allow them to neglect their books as they please. 8. Sleep. It is during night that the waste of the body is chiefly made up. The brain gets rest, and alter a good sleep we rise in the morning like new beings. Children need more sleep than grown-up people. Directions have already been given about the sleep of infants. A boy or girl about 12 years of age requires about 9 hours' sleep. Some people need more sleep ; others less. Night is the best time to sleep. Parents should ]nake their elder children go to bed not later than ten o'clock and rise about daybreak. Early to bed and early to rise, Makes a man healthy, wealthy, and wise. A full meal should not be taken shoi’tly before going to bed. It is apt to make people sleep heavily and have bad dreams. The stomacb is hard at work, and the brain is disturbed. Sleeping on beds is better than sleeping on the ground. When the ground is dry and the country is not feverish, it may do no Ivnm. If the ground is damp, it sometimes occasions rheumatism, a sharp pain in the body, or other illne.'-s. The bad air which causes fever lies low, and even the small HOUSES. 31 height o£ a bed helps to keep it off. People who sleep on the ground are liable to be bitten by snakes that go about at night seeking for fooil. As already mentioned, pillows and be