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The first one naturally leads to this most important therapeutic rule, that the head of the child should be uniformly kept exceedingly cool, in order to prevent any congestion or over-action in the vessels of the cerebrum.

From the very large quantity of blood sent to this organ, there must needs be a greater than usual tendency in early life to irritation and plethora within the head; more especially during the whole of that period when the early teeth are in a state of development and growth. Does not this consideration therefore at once suggest the utility of keeping the child's head exposed, and uncovered with warm caps, heavy bonnets, &c. and, in many cases, of wetting the scalp frequently with cold water, or any simple refrigerant lotion, while the rest of the body and more especially the feet are kept warm, with the view of diverting the course of the blood in another direction? Such a simple expedient as this, coupled with the use of an appropriate diet, of cooling laxatives, and of a leech or two occasionally to the temples if necessary, will often suffice to check the development of much future cerebral mischief, and enable the little sufferer to pass through the dangerous period of dentition with safety and comfort. And then what is the hygienic inference that we draw from the second position that we laid down; viz. the great tenderness and irritability of the skin and of the mucous passages? Is it not that the former should be duly protected against the inclemencies of a changeful climate, and that the latter-we allude more particularly to the bowels-should not be irritated with stimulating or indigestible ingesta? Hence we are led to perceive the necessary importance of sufficient clothing, and of constant attention to the proper diet of children; and yet we see these simple directions transgressed over and over again among all the classes of the community, and often, too, under the very eyes of medical men.

As we wish to call the attention of our readers to the very useful works of Dr. Bull and M. Donné, we shall take the present opportunity of making some remarks on the hygiene of infant life, blending the results of our own experience with the observations of these gentlemen.

It is a shrewd remark of M. Donné that the management of an infant's health should commence, if we may so speak, from before its birth. The future vigour of the offspring depends so much on the health of the parent during the period of her pregnancy, that medical men cannot too often or too seriously remind their patients of the great importance of attention to this circumstance.

Most mothers seem to be not at all aware of its truth; else they would surely act on many occasions very differently from what we observe them to do.

Without entering minutely into the question of the management of women during the period of their gestation, we may here allude to one particular only-but this is a very important one-which is far too much overlooked in the present day; and yet to the neglect of which may often be traced the feebleness and bad health of the child after birth-we mean the importance of their taking regular exercise in the open air every day, as long as circumstances will possibly allow. The injury that is often imperceptibly-on this very account, the more dangerous-done to the mother's constitution by remaining, as is too frequently done, whole days

and even weeks, if not months, within doors-perhaps in close confined rooms too-is immense. If spoken to on the subject, your patient will probably tell you that she feels very well, and that she is not sensible of any inconvenience to her health by the confinement. This may be all very true; she may not experience any ill effects at the time; but let her rest assured that nature's laws and nature's precepts cannot be disregarded without some future detriment ensuing either to herself or to her offspring. Does any plant or animal, we may ask, ever thrive as well under constant cover, as when exposed to the free air of heaven? certainly not; then why suppose that there can be any exception in the case of human beings. There is a simple, but very sound rule for our guidance on most points connected with the preservation of health, which deserves more attention than is usually given to it, and it is this: Whatever does no good, does harm." True maxim! applicable to the discipline alike of mind and body.


By much in-door confinement, as M. Donné very truly remarks, the mother's system is weakened and rendered irritable, a feverish restlessness is induced, her appetite decays or becomes irregular and capricious, and her general comfort is often seriously marred during the remainder of her pregnancy. She thus becomes far less favourably prepared to pass through the pains and anxieties of child-birth without injury; she is rendered more liable to many puerperal complaints; and, if there was no other inconvenience, she is much less fitted, than she might otherwise have been, to be a good nurse to her child. The health of the latter so intimately depends first upon its own actual condition when born, and secondly on the quality of the food provided for it, that it must be quite unnecessary to enter upon any argument to prove that, unless the mother be thoroughly healthy and prepared, as Nature designed, to supply a due supply of sound wholesome food, we cannot reasonably expect that her offspring can be vigorous and robust. As well might we look for pure fair water to spring from a brackish well, or a thriving shrub to shoot out from a dry sandy soil. The great secret therefore of rearing a child well is unquestionably, in the first place, to see that the mother's health is kept in a sound and wholesome condition, so that there may be a regular and sufficiently, but not an over, abundant supply of wholesome milk. Now Nature has been exceedingly benificent in her arrangements for this most important end, and it is only because we choose to deviate from them, and to act, so to speak, independently and often too at open variance with her wise appointments, that there are so many bad and incompetent nurses in the world. Is it not a matter of daily observation that a woman's health is seldom so uniformly good as during the whole period of her suckling? and do we not continually meet with cases where the usual course of complaints and diseases is obviously arrested by an All-merciful Providence for many months, in order that the helpless infant may be supplied with its natural food for a sufficient time to enable it to weather the subsequent trials of its orphaned life? We mention these circumstances to shew that Nature has done almost everything ready to our hands, and that, if we only did not wilfully thwart her most obvious intentions, we should seldom hear of the great difficulties, and often dangers too, that both mother and child are subject to during the period of suckling.

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Let us briefly consider some of these difficulties, and endeavour to find out whence they arise and how they may be most advantageously treated. The first that we allude to is the very common and ignorant practice of encouraging an excessive secretion of the milk, and the consequent suckling of the infant far more frequently than is necessary or wholesome. It is a very common opinion that a woman, while she is nursing, requires not only a very full diet of nourishing food, but also a good large allowance of some stimulating, usually fermented, liquor. The only result," says Dr. Bull very truly, "of this plan is, to cause an unnatural degree of fulness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to the secretion of the milk, instead of increasing it. The right plan of proceeding is plain enough; only let attention be paid to the ordinary laws of health, and the mother, if she have a sound constitution, will make a better nurse than by any foolish deviation founded on ignorance and caprice."

Most suckling women in this country would consider themselves halfstarved, if they were not allowed one or two pints of ale or porter per diem; and yet, might we not ask them how do their sisters thrive in other lands, where these Castalian beverages are unknown? Of this they may be assured that, if a sufficient quantity of light wholesome nourishment be taken at regular intervals, and due attention be paid to other hygienic rules, and especially to that of taking daily exercise in the open air, there will be no deficiency of milk, and the milk moreover will be of a better kind at the same time. How many a woman among the poorer classes in this country ruins her health by the common practice of forcing the secretion by drinking large quantities of beer of some sort or another! Now what is the usual effect of this practice? The appetite for solid food diminishes, the strength fails, the woman feels a sinking at the pit of the stomach, and a sense of dragging pain in the loins, and all the while the poor creature, attributing her every suffering to mere weakness, imagines that, if she only drinks more beer, she will be better. True it is, that her sufferings arise from weakness; but unfortunately she is pursuing the very plan to increase it. If she would abandon, for a time at least, the malt liquor, and live upon good wholesome meat and broth, and not over suckle her infant, we should see fewer instances of broken constitutions among the mothers, and of shrivelled decrepid and half-fed children at the breast.

Even among women in the higher and better educated classes of society, there is a vast deal of prevailing error, as to how they should manage their own diet, and regulate the suckling of their infants.

Many a young mother, on finding that for the first few weeks after confinement she has a great flow of milk, naturally supposes that she must be an excellent nurse, and that, if her baby does not thrive, it cannot possibly be from any fault on her part. The fault-if fault it can be calledarises from an affectionate over-desire to do all that she thinks benefit her child. She therefore encourages what is popularly called a frequent draft in the breast;' and nothing certainly does this so effectually as consuming large quantities of malt liquor. But it is right that she should know that the mere abundance of the milk for the first month or so is by no means a sure guarantee that it will continue so; or, if it

does, that the milk will necessarily be wholesome and nutritious. Most women-even those who afterwards may be obliged to give up suckling from the deficiency of the secretion-have a tolerably abundant supply for the first few weeks. Every thing, be it observed, at this time, has a tendency to promote it ;-the heated room, the warm clothing, drinking large quantities of fluid, want of exercise, &c. But then, as the woman begins to resume her former habits, and recurs to her ordinary diet and regime, the secretion of the milk often becomes much less abundant, while the wants of the child become greater; or, if the quantity remains sufficient, -probably in consequence of the nurse living chiefly on milk, liquor, and other fluids-the quality is perhaps poor, watery, and unnutritious. The practised eye will at once suspect this condition of the milk, partly from the looks of the mother, and in part from the general appearance and health of the child. If the former is pale and languid, if the white of the eyes be blueish, and the lips and tongue have lost their natural redness; if she complain of weakness in her back and limbs, and of a sense of faintness and sinking at the pit of the stomach-this last, we should say, is one of the most trustworthy of all the symptoms-especially after suckling, we may be pretty confident that the milk, however abundant, is watery and thin. A very common accompaniment of such symptoms in nurses is the existence, to a greater or less degree, of what is well known to them by the name of weakness; i. e. leucorrhoea.

When the milk is in this state, the child is observed not to thrive so well as might be expected, considering the frequency with which it takes the breast, and the abundant supply of the milk;* it is feverish, uncomfortable, and often crying; its bowels are very generally relaxed, and every now and then much purged; they are always more or less flatulent, and the infant is often teased with griping pains; the stools are seldom healthy; and the sleep is short and easily disturbed.

A much less frequent condition of the milk that we have to provide against is the reverse of all this-viz. the over-richness of a nurse's milk. This is very rarely the case with a mother suckling her own child; but every now and then we have occasion to observe its effects when young healthy nurses from the country are brought to town for the purpose of suckling the children of the higher classes. When the milk is too rich for an infant's stomach, it generally rejects more or less of it immediately after suckling; and, if it does not, it will be observed to be uncomfortable, and every now and then making an effort to retch for some time afterwards. As this condition however of the milk is certainly but of rare occurrence, we need say nothing more about it at present.

The practical inference from all that we have said is, that the diet of a nurse should not differ in any great respect from what she is ordinarily accustomed to, and should consist of fresh and easily-digested animal food

Indeed the appetite or craving of the infant for the breast is usually greater than usual; and for this very simple reason, that the milk, from being less substantial and nutritious than it ought to be, remains but a short time in the stomach, and passes without much change into the bowels. Here therefore is a simple sign-viz. the more frequent than usual desire of the infant for the breast -which may lead the nurse to suspect that her milk is defective in nutriment.

once or twice a day, with a due allowance of bread and vegetables, and a moderate quantity of sound well-fermented malt liquor. As long as the appetite and digestion continue healthy, there is no objection to this beverage; but if, after a time, these begin to fail, then-instead of increasing the quantity of the ale or porter drunk, in order to compensate for the deficiency in the amount of solid food taken-the use of it should be at once suspended for a few days, until the functions of the stomach be regulated and its energy restored.

The mother, indeed, will probably ask us, how is she to manage her baby; for, without her beer, she is sure that she will have no milk at all. This question leads us to the consideration of another one, of no trifling importance in the hygiene of infant life, to wit:

Ought a child to have any other food but the breast milk for the first five or six months?

Like every other question in medical practice, this one does not admit of an answer applicable to all instances, and proper under all circumThe following remarks however will, we trust, assist the reader to determine the right course to be pursued in each individual



When the nurse is uniformly healthy, and when the child evidently thrives on her milk, gaining gradually more and more plumpness and strength, we may feel assured that it does not require any other sort of food. But let it be remembered that this fortunate state of things is by no means of very frequent occurrence-more especially among the residents of large towns-and that every deviation from the state of perfect health on the part of the nurse, is necessarily attended with a certain amount of change in the secretion of the breasts.

Now there are a thousand little things which are apt to do this. For example, a slight indigestion, any derangement of the bowels, more than ordinary fatigue, a sudden fright, over-anxiety, the receipt of bad news, and even excessive joy-these and many other troubles to which suckling women are exposed, all tend to affect the qualities of the milk. It is astonishing how little an affair will be sometimes followed by an alteration in the condition of this secretion--manifested, indeed, not in the health of the mother, but in that of the infant. Every experienced medical man must have seen cases where griping and purging were induced in an infant, in the course of a few hours after the nurse had taken one glass of port wine; and where its very life has been brought into jeopardy from the anxiety of the mother-in consequence, perhaps, of the sickness of another of her children.

Among the lower classes, we feel quite assured that three-fourths of infantile diseases may be attributed to the unwholesome state of the milk, induced by the use of impure and drugged malt liquors.

There is one cause-not a very common one, indeed, but sufficiently so to deserve notice that is almost invariably accompanied with a derangement of the milk, and consequently of the infant's health-we allude to the occurrence of the periodical monthly indisposition in the nurse during the time of suckling. The intimate sympathy between the womb and the breasts is shewn by a variety of circumstances, but by none more obviously than No. LXXVII. G

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