As to the first objection, that shoes cramp the feet too much, nearly its whole force turns upon the question whether they are made of proper materials or not. There is no need of making them of cow-hide, or any other thick leather. The soles are the most important part. These will defend the feet against pins, needles, and such other sharp substances as are usually found on the floor; and the upper part of the shoe, so long as the wearer remains in the nursery, may be made of the softest and most yielding material—even of cloth. Infants' shoes should always be made on two lasts, one for each foot.

The philosopher Locke held, that in order to harden the young, their shoes ought to be "so that they might leak and let in water, whenever they came near it." There may be and probably is, no harm in having a child wet his feet occasionally, provided he is soon supplied with dry stockings again; but it is hazardous for either children or adults to go too long in wet stockings, and especially to sit long in them, after they have been using much active exercise. I am in favor of good, substantial shoes and stockings for people of all ages and conditions, and at all seasons; and believe it entirely in accordance with sound economy and the laws of the human constitution.

SEC. 8. Pins.

The custom of using ten or a dozen pins in the dressing of children, ought by all means to be set aside. They not only often wound the skin, but they have occasionally been known to penetrate the body and the joints of the limbs. So many of these dreadful accidents occur, and where no accident happens, so much pain is occasionally given by their sharp points to the little sufferer, who cannot tell what the matter is, that it is quite time the practice were abolished.

Do you ask what can be substituted?—The following mode is adopted by Dr. Dewees in his own family, as mentioned in his work on the "Physical and Medical Treatment of Children," at page 86.

"The belly-band and the petticoat have strings; and not a single pin is used in their adjustment. The little shirt, which is always made much larger than the infant's body, is folded on the back and bosom, and these folds kept in their places by properly adjusting the body of the petticoat: so far not a pin is used. The diaper requires one, but this should be of a large size, and made to serve the double purpose of holding the folds of this article, as well as keeping the belly-band in its proper place; the latter having a small tag of double linen depending from its lower margin, by which it is secured to the diaper, by the same pin.

"Should an extraordinary display of best 'bib and tucker' be required upon any special occasion, a third pin may be admitted to ensure the well-sitting of the 'frock' waist in front;—this last pin, however, is applied externally; so that the risk of its getting into the child's body is very small, even if it should become displaced."

The writer from whom the last two paragraphs are taken, says be has seen needles substituted for pins; and relates a long story of a child whose life was well nigh destroyed in this manner. It underwent months of ill health, and many moments of excruciating agony, before the cause of its trouble was suspected. Sometimes its distress was so great that nothing but large doses of laudanum, sufficient to stupify it, could afford the least relief. At last a tumor was discovered by the attending physician, near one of the bones on which we sit, and a needle was extracted two inches long. The needle had been put in its clothes, and, by slipping into the folds of the skin, had insinuated itself, unperceived, into the child's body. It is pleasing to add, that, although the little sufferer had now been ill seven or eight months, and had endured almost everything but death,—fever, diarrhoea, and the most excruciating pain,—it soon recovered.

This shocking circumstance is enough, one would think, to deter every mother or nurse, who becomes acquainted with it, from using needles in infants' clothes. Happy would it be, if, in banishing needles, they would contrive to banish pins also, and adopt either the plan of Dr. Dewees, or one still more rational.

SEC. 9. Remaining Wet.

On the subject of changing the wet clothing of a child, there is a strange and monstrous error abroad; which is, that by suffering them to remain wet and cold, we harden the constitution. The filthiness of this practice is enough to condemn it, were there nothing else to be said against it.

It is insisted on by many, I know, that as water which is salt, when it is applied to the skin, and suffered to remain long, while it secures the point of hardening the child, prevents all possibility of its taking cold, it hence follows, that wet diapers are not injurious. But this is a mistake. Every time an infant is allowed to remain wet, we not only endanger its taking cold, but expose it to excoriations of the skin, if not to serious and dangerous inflammation. In short, if frequent changes are not made, whatever some mothers and nurses may think, they may rest assured, that the health of the child must sooner or later suffer as the consequence.

Nor is it enough to hang up a diaper by the fire, and, as soon as it is dry, apply it again. It should be clean, as well as dry. Let us not be told, that it is troublesome to wash so often. Everything is in a certain sense troublesome. Everything in this world, which is worth having, is the result of toil. Nothing but absolute poverty affords the shadow of an excuse for neglecting anything which will promote the health, or even the comfort of the tender infant.

Of the impropriety and danger of suffering wet clothes to dry upon us, I shall speak elsewhere; as well as of the evil of suffering children to remain dirty,—their skins or their clothing.

SEC. 10. Remarks on the Dress of Boys.

Whatever tends to disturb the growth of the body, or hinder the free exercise of the limbs, during the infancy and childhood of both sexes is injurious. And as every mother has the control of these things, I have thought it desirable to append to this chapter a few thoughts on the particular dress of each sex. I begin with that of boys.

"Nothing can be more injurious to health," says a foreign writer, "than the tight jacket, buttoned up to the throat, the well-fitted boots, and the stiff stock." And his remarks are nearly as applicable to this country as to England. The consequences of this preposterous method of dressing boys, are diminutive manhood, deformity of person, and a constitution either already imbued with disease, or highly susceptible of its impression.

No part of the modern dress of boys is more absurd, than the stiff stock, or thick cravat. It is not only injurious by pressing on the jugular veins, and preventing the blood from freely passing out of the head, but, by constantly pressing on the numerous and complex muscles of the neck, at this period of life, it prevents their development; because whatever hinders the action of the muscular parts, hinders their growth, and makes them even appear as if wasted.

It would be a great improvement, if this part of dress were wholly discarded; and when is there so appropriate a time for setting it aside, as before we began to use it; or rather while we are under the more immediate care of our mothers?

The use of jackets buttoned up to the throat, except in cold weather, is objectionable; but this is very fortunately going out of fashion.

Boots, if used at all, should fit well; to this there can be no possible objection. What the writer, whom I have quoted, referred to, was probably the tight boot, worn to prevent the foot from being large and unseemly; but producing, as tight boots inevitably do, an injurious effect upon the muscles, a constrained walk, and corns.

What can be more painful, than to see little boys—yes, little boys—boys neither fifteen, nor twenty, nor twenty-five, walk as if they were fettered and trussed up for the spit; unable to look down, or turn their heads, on account of a thick stock, or two or three cravats piled on the top of each other—and only capable of using their arms to dangle a cane, or carry an umbrella, as they hobble along, perhaps on a hot sun-shiny day in July or August?

But this evil, you who are mothers, have it very generally in your power to prevent, if you are only wise enough to secure that ascendancy over your children's minds which the Author of their nature designed. At the least, you can prevent it for a time—the most important period, too—by your own authority. This you will not need any urging to induce you to do, if you ever become thoroughly convinced of its pre-eminent folly.

SEC. 11. On the Dress of Girls.

The same general principles which should guide the young mother in regard to the dress of boys, are equally important and applicable in the management of girls. The whole dress should, as much as possible, hang loosely from the shoulders, without pressing on the body, or any part of it. This, I say, is the grand point to be aimed at; and this is the only great principle, whatever some mothers may think, which will lead to true beauty of person, and gracefulness of gesture.

There is, however, a slight difference to be made between the dress of girls and that of boys. The greater delicacy of the female frame requires that the surface of the body should be kept rather warmer, as well as better protected from the vicissitudes of the atmosphere.

But is this the fact? Is not the contrary true? While boys in the winter are clad in warm woollen vestments, covering every part of their trunk, many portions of the female frame, and especially many parts of their limbs, are left so much exposed, that in cold weather you scarcely find a girl abroad, who appears to be comfortable.

Nay, they are not only uncomfortable abroad, but at home; and if I were to present to mothers in detail, a tenth of the evils which their daughters suffer from not adopting a warmer method of clothing, I should probably be stared at by some, and laughed at by others. All this, too, without speaking of going out of warm concert rooms, theatres, ball rooms and lecture rooms, into the night air, or out of school rooms and churches, to walk home with measured and stiffened pace, lest the sin unpardonable of walking swiftly or RUNNING,—that active exercise which health requires, which youthful feeling prompts, and which duty ought to inspire,—should unwarily be committed.

The tremendous evils of confining the lungs have been adverted to at sufficient length. In reference to that general subject, I need only add, that if the chest be not duly exercised and expanded, the liver, the lungs, the stomach, digestion, absorption, circulation and perspiration, are all hindered. And even so far as the various internal organs of the body are active, they act at a great disadvantage. The blood which they "work up," is bad blood, and must be so, as long as the lungs do not have free play. Hence may and do arise all sorts of diseases; especially diseases of OBSTRUCTION; and such as are often very difficult of removal.

What can be a more pitiable sight than some modern girls going home from school or church in winter? Thinly clad, the blood is all driven from the surface upon the internal organs, and what remains is so loaded with carbon, which the lungs ought but cannot discharge, that her skin has a leaden hue; her teeth chatter; her very heart is chilled in her panting, frozen bosom; she cannot run, and if she could, she must not, for it would be vulgar! Every mother should shrink from the sight of such a picture.



CHAPTER V.

CLEANLINESS.

Physiology of the human skin. Of checking perspiration. Diseases thus produced. "Dirt" not "healthy." How the mistake originated. "Smell of the earth." Effect of uncleanliness on the morals. Filthiness produces bowel complaints. Changing dress for the sake of cleanliness.

No mother will ever pay that attention to cleanliness which its importance to health and happiness demands, till she perceives its necessity. And she will never perceive that necessity till she has studied attentively the machinery of the human frame—and especially its wonderful covering.

The skin is pierced with little openings or pores, so numerous that some have reckoned them at a million to every square inch. At all events, they are so small that the naked eye can neither distinguish nor count them; and so numerous, that we cannot pierce the skin with the finest needle without hitting one or more of them.

When we are in perfect health, and the skin clean, a gentle moisture or mist continually oozes through these pores. This process is called perspiration; and the moisture which thus escapes, the matter of perspiration.

Perspiration may be checked in two ways. 1. by filth on the skin; 2. by what is commonly called taking cold—for taking cold essentially consists in chilling the skin to such a degree as to stop, for some time, the escape of this moisture. Most persons have doubtless observed, that in the first stages of a cold, they frequently have a very dry skin. Whereas, when we are in health, the skin usually feels moist.

Our health is not only endangered, and a foundation laid for fevers, rheumatisms, and consumptions, by stopping the pores of the skin with dirt, or anything else, but there is also danger from another and a very different source.

The blood, in its circulation through the body, is constantly becoming impure; and as it thus comes back impure to the heart, is as constantly sent to the lungs, where it comes in close contact with the air which we breathe, and is purified. But this same purifying process which goes on in the lungs, goes on, too, if the skin is in a pure, free, healthy condition, all over the surface of the body. If it is not—if the skin cannot do this part of the work—an additional burden is thus laid on the lungs, which in this way soon become so overworked, that they cannot perform their own proportion of the labor. And whenever this happens, the health must soon suffer.

The strange belief, that "dirt is healthy," has much influence on the daily practice of thousands of those who are ignorant of the human structure, and the laws which govern and regulate the animal economy. It has probably originated in the well-known fact, that those children who are allowed to play in the dirt, are often as healthy—and even more healthy—than those who are confined to the nursery or the parlor.

Now, while it is admitted that this is a very common case, it is yet believed that the former class of children would be still more vigorous than they now are, if they were kept more cleanly, or were at least frequently washed. It is not the dirt which promotes their health, but their active exercise in the open air; the advantages of which are more than sufficient to compensate for the injury which they sustain from the dirt. That is to say, they retain, in spite of the dirt, better health than those who are denied the blessings of pure air and abundant exercise, and subjected to the opposite extreme of almost constant confinement.

There is something deceitful, after all, in the ruddy, blooming appearance of those children who are left by the busy parent to play in the road or field, without attention to cleanliness. If this were not so, how comes it to pass that they suffer much more, not only from chronic, but from acute diseases, than children whose parents are in better circumstances?

I am the more solicitous to combat a belief in the salutary tendency of an unclean skin, because I know it prevails to some extent; and because I know also, both from reason and from fact, that it is a gross error.

It is, however, true, that years sometimes intervene, before the evil consequences of dirtiness appear. The office of the vessels of the skin being interrupted, an increase of action is imposed on other parts, especially on those internal organs commonly called glands, which action is apt to settle into obstinate disease. Hence, at least when aided by other causes, often arise, in later life, after the source of the evil is forgotten, if it were ever suspected, rheumatism, scrofula, jaundice, and even consumption.

There is a strange notion abroad, that the smell of the earth is beneficial, especially to consumptive persons. I honestly believe, however, that it is more likely to create consumption than to cure it. Besides, in what does this smell consist? Do the silex, the alumine, and the other earths, with their compounds, emit any odor? Rarely, I believe, unless when mixed with vegetable matter. But no gases necessary to health are evolved during the decomposition of vegetable matter; on the contrary, it is well known that many of them tend to induce disease.

I am thoroughly persuaded that too much attention cannot be paid to cleanliness; and the demand for such attention is equally imperious in the case of those who cultivate the earth, or labor in it, or on stone, during the intervals of their useful avocations, as in the case of those individuals who follow other employments.

I must also protest against the doctrine, that the smell or taste of the earth, much less a coat of it spread over the surface, and closing up, for hours and days together, thousands and millions of those little pores with which the Author of this "wondrous frame" has pierced the skin, can have a salutary tendency.

The opinion has been even maintained, that uncleanly habits are not only unfavorable to health, but to morality. There can be no doubt that he who neglects his person and dress will be found lower in the scale of morals, other things being equal, than he who pays a due regard to cleanliness.

Some have supposed that a disposition to neglect personal cleanliness was indicative of genius. But this opinion is grossly erroneous, and has well nigh ruined many a young man.

I am far from recommending any degree of fastidiousness on this subject. Truth and correct practice usually lie between extremes. But I do and must insist, that the connection between cleanliness of body and purity of moral character, is much more close and direct than has usually been supposed.

But to return to the more immediate effects of cleanliness on health. There is one class of diseases in particular which, in an eminent degree, owe their origin to a neglect of cleanliness. I refer to the bowel complaints so common among children during summer and autumn. Except in case of teething, the use of unripe fruits, or the abuse of those which are in themselves excellent, it is probable that more than half of the bowel complaints of the young are either produced or greatly aggravated by a foul skin.

The importance of washing the whole body in water will be insisted on in the chapter on Bathing; it is therefore unnecessary to say anything farther on that subject in this place, except to observe that whether the washings of the body be partial or general, they should be thorough, so far as they are carried. There are thousands of children who, in pretending to wash their hands and face, will do little more than wet the inside of their hands, and the tips of their noses and ears unless great care is taken.

Few things are more important than suitable changes of dress. There are those, who, from principle, never wear the same under-garment but one day without washing, either in summer or winter; and there are others who, though they may wear an article without washing two or three successive days, take care to change their dress at night—never sleeping in a garment which they have worn during the day.

It is a very common objection to suggestions like these, that they will do very well for those who have wealth, but not for the poor;—that they have neither the time nor the means of attending to them. How can they change their clothes every day? we are asked. And how can they afford to have a separate dress for the night?

There must be retrenchment in some other matters, it is admitted. In order to find time for more washing, or money to pay others for the labor, the poor must deny themselves a few things which they now suppose, if they have ever thought at all on the subject, are conducive to their happiness—but which are in reality either useless or injurious. Something may be saved by a reasonable dress, as I have already shown. Other items of expense, which might be spared with great advantage to health and happiness, and applied to the purpose in question, will be mentioned in the chapter on Food and Drink.



CHAPTER VI.

ON BATHING.

Danger of savage practices. Rousseau. Cold water at birth. First washing of the child. Rules. Temperature. Bathing vessels. Unreasonable fears. Whims. Views of Dr. Dewees. Hardening. Rules for the cold bath. Securing a glow. Coming out of the bath. Local baths. Shower bath. Vapor bath. Sponging. Neglect of bathing. The Romans. Treatment of children compared with that of domestic animals.

Some of the hardy nations of antiquity, as well as a few savage tribes of modern times, have been accustomed to plunge their new-born infants into cold water. This is done for the two-fold purpose of washing and hardening them.

To all who reason but for a moment on this subject, the danger of such a practice must be obvious. So sudden a change from a temperature of nearly 100 of Fahrenheit to one quite low, perhaps scarcely 40, must and does have a powerful effect on the nervous system even of an adult; but how much more on that of a tender infant? We may form some idea of this, by the suddenness and violence of its cries, by the sudden contractions and relaxations of its limbs and body, and by its palpitating heart and difficult breathing.

Every one's experience may also remind him, that what produces at best a momentary pain to himself, cannot otherwise than be painful to the infant. In making a comparison between adults and infants, however, in this respect, we should remember that the lungs of the infant do not get into full and vigorous action until some time after birth; and that, on this account, the hold they have on life is so feeble, that any powerful shock, and especially that given by the cold bath, is ten times more dangerous to them than to adults, or even to infants themselves, after a few months have elapsed.

It is surprising to me that so sensible a writer as Rousseau generally is on education, should have encouraged this dangerous practice; and still more so that many fathers even now, blinded by theory, should persist in it, notwithstanding the pleadings of the mother or the nurse, and the plainest dictates of common sense and common prudence.[Footnote: Nothing is intended to be said here, which shall encourage unthinking nurses or mothers in setting themselves against measures which have been prescribed by higher authority,—I mean the physician. There are cases of this kind, where it requires all the resolution which a father, uninterrupted, can summon to his aid, to administer a dose or perform a task, on which he knows the existence of his child may be depending: but when the thoughtless entreaties of the mother or nurse are interposed, it makes his condition most distressing. Mothers, in such cases, ought to encourage rather than remonstrate. They who do not, are guilty of cruelty, and—perhaps—of infanticide.]

A child plunged into cold water at birth, by those whose theories carry them so far as to do it even in the coldest weather, has sometimes been twenty-four hours in recovering, notwithstanding the most active and judicious efforts to restore it. In other instances the results have been still more distressing. Dr. Dewees is persuaded that he has "known death itself to follow the use of cold water," in this way—I believe he means immediate death—and adds, with great confidence, that he has "repeatedly seen it require the lapse of several hours before reaction could establish itself; during which time the pale and sunken cheeks and livid lips declared the almost exhausted state" of the infant's excitability.[Footnote: "Dewees on children" p. 72.]

We need not hesitate to put very great confidence in the opinion here expressed; for besides being a close and just observer of human nature, Dr. D. has had the direction and management, in a greater or less degree, of several thousands of new-born infants.

Nothing, indeed, in the whole range of physical education, seems better proved, than that while some few infants, whose constitutions are naturally very strong, are invigorated by the practice in question, others, in the proportion of hundreds for one, who are less robust, are injured for life; some of them seriously.

Nor will spirits added to the water make any material difference. I am aware that there is a very general notion abroad, that the injurious effects of cold water, in its application both internally and externally, are greatly diminished by the addition of a little spirit; but it is not so. Does the addition of such a small quantity of spirit as is generally used in these cases, materially alter the temperature? Is it not the application of a cold liquid to a heated surface, still? Can we make anything else of it, either more or less?

I do not undertake to say, that the cold bath may not be so managed in the progress of infancy, as to make it beneficial, especially to strong constitutions. It is its indiscriminate application to all new-born children, without regard to strength of constitution, or any other circumstances, that I most strenuously oppose. Of its occasional use, under the eye of a physician, and by parents who will discriminate, I shall say more presently.

Our first duty on receiving a new inhabitant of the world is, to see that it is gently but thoroughly washed, in moderately warm soft water, with fine soap. Special attention should be paid to the folds of the joints, the neck, the arm pits, &c. For rubbing the body, in order to disengage anything which might obstruct the pores, or irritate or fret the skin, nothing can be preferable to a piece of soft sponge or flannel. Though the operation should be thorough, and also as rapid as the nature of circumstances will permit, all harshness should be avoided. When finished, the child should be wiped perfectly dry with soft flannel.

While the washing is performed, the temperature of the room should be but a few degrees lower than that of the water; and the child should not be exposed to currents of cold air. If the weather is severe, or if currents of air in the room cannot otherwise be avoided, the dressing, undressing, washing, &c., may be done near the fire. And I repeat the rule, it should always be done with as much rapidity as is compatible with safety.

Here will be seen one great advantage of simplicity in the form of dress. If the more rational suggestions of our chapter on that subject are attended to, it will greatly facilitate the process of washing, and the subsequent daily process of bathing, which I am about to recommend to my readers.

This washing process is also an introduction to bathing. For it should be repeated every day; but with less and less attention to the washing, and more and more reference to the bathing. How long the child should stay in the bath, must be left to experience. If he is quiet, fifteen minutes can never be too long; and I should not object to twenty. If otherwise, and you are obliged to remove him in five minutes, or even in three, still the bathing will be of too much service to be dispensed with.

Nothing should be mixed with the water, if the infant is healthy, except a little soap, as already mentioned. Some are fond of using salt; but it is by no means necessary, and may do harm.

The proper hour for bathing is the early part of the day, or about the middle of the forenoon. This season is selected, because the process, manage it as carefully as we may, is at first a little exhausting. As the child grows older, however, and not only becomes stronger, but appears to be actually refreshed and invigorated by the bath, it will be advisable to defer it to a later and later hour. By the time the babe is three months old, particularly in the warm season, the hour of bathing may be at sunset.

The degree of heat must be determined, in part, by observing its effect on the child; and in part by a thermometer. For this, and for other purposes, a thermometer, as I have already more than hinted, is indispensable in every nursery. Our own sensations are often at best a very unsafe guide. There is one rule which should always be observed—never to have the temperature of the bath below that of the air of the room. If the thermometer show the latter to be 70, the bath should be something like 80; perhaps with feeble children, rather more.

Great care ought always to be taken to proportion the air of the room and the water of the bath to each other. If, for example, the temperature of the room have been, for some time, unusually warm, that of the water must not be so low as if it had been otherwise. On the contrary, if the room have been, for a considerable time, rather cool, the bath may be made several degrees cooler than in other circumstances. But in no case and in no circumstances must a warm bath—intended as such, simply—be so warm or so cold, as to make the child uncomfortable; whether the temperature be 70, 80, or 90.

It is hardly necessary to add, that in bathing a young child, the vessel used for the purpose should be large enough to give free scope to all the motions of its extremities. Most children are delighted to play and scramble about in the water. I know, indeed, that the contrary sometimes happens; but when it does, it is usually—I do not say always—because the countenances of those who are around express fear or apprehension; for it is surprising how early these little beings learn to decipher our feelings by our very countenances.

Some of our readers may be surprised at the intimation that there are mothers and nurses who have fears or apprehensions in regard to the effects of the warm bath; but others—and it is for such that I write this paragraph—will fully understand me. I have been often surprised at the fact, but it is undoubted, that there is a strong prejudice against warm bathing, in many parts of the country. In endeavoring to trace the cause, I have usually found that it arose from having seen or heard of some child who died soon after its application. I have had many a parent remonstrate with me on the danger of the warm bath; and this, too, in circumstances when it appeared to me, that the child's existence depended, under God, on that very measure. Perhaps it is useless in such cases, however, to reason with parents on the subject. The medical practitioner must do his duty boldly and fearlessly, and risk the consequences.

But as I am writing, not for persons under immediate excitement, but for those that may be reasoned with, it is proper to say, that in medicine, the warm bath is so often used in extreme cases, and as a last resort, even when death has already grasped, or is about to fix his grasp on the sufferer, that it would be very strange if many persons did not die, just after bathing. But that the bathing itself ever produced this result, in one case in a thousand, there is not the slightest reason for believing. [Footnote: Let me not be understood as intimating that, the general neglect of bathing, of which I complain so loudly, is chiefly owing to this unreasonable prejudice, though this no doubt has its sway. On the contrary, I believe it is much oftener owing to ignorance, indolence, and parsimony.]

There are many more whims connected with bathing, as with almost everything else, which it were equally desirable to remove. Some nurses and mothers think that if the child's skin is wiped dry after bathing, it will impair, if not destroy, the good effects of the operation. Others still, shocking to relate, will even put it to bed in its wet clothes; this, too, from principle. Not unlike this, is the belief, very common among adults, that if we get our clothes wet—even our stockings—we must, by all means, suffer them to dry on us; a belief which, in its results, has sent thousands to a premature grave—and, what is still worse, made invalids, for life, of a still greater number.

I am aware, that in rejecting the indiscriminate cold bathing of infants, I am treading on ground which is rather unpopular, even with medical men; a large proportion of whom seem to believe that the practice may be useful. But I am not wholly alone. Dr. Dewees—of whose large experience I have already spoken—and some others, do not hesitate to avow similar sentiments.

The objections of Dr. Dewees to cold bathing are the following. 1. There often exists a predisposition to disease, which cold bathing is sure to rouse to action. Or if the disease have already begun to affect the system, the bath is sure to aggravate it. 2. Some children have such feeble constitutions that they are sure to be permanently weakened by it, rather than invigorated. 3. To those in whom there is the tendency of a large quantity of blood to the head, lungs, liver, &c., it is injurious. 4. In some, the shock produces a species of syncope, or catalepsy. 5. The reaction, as shown by the heat which follows the cold bath, is, in some cases, so great as to produce a degree of fever, and consequent debility. 6. It never answers the purposes of cleanliness—one great object of bathing—so well as the warm bath. 7. It is always unpleasant or painful to the child; especially at first. 8. It sometimes produces severe pain in the bowels.

This is a very formidable list of objections; and certainly deserves consideration. There is one statement made by Dr. D. in the progress of his remarks on this subject, in which I do not concur. He says—"The object of all bathing is to remove impurities arising from dust, perspiration, &c., from the surface; that the skin may not be obstructed in the performance of its proper offices."

But the object of cold bathing, with many, is to harden; consequently it is not true that cleanliness is the only object. If he means, even, that cleanliness is the only legitimate object of all bathing, I shall still be compelled to dissent.

If the cold bath could be used, always, by and with the direction of a skilful physician, I believe its occasional use might be rendered salutary. And although as it is now commonly used, I believe its effects are almost anything but salutary, I do not deny that if its use were cautiously and gradually begun, and judiciously conducted, it might be the means of making children who are already robust, still more hardy and healthy than before, and better able to resist those sudden changes of temperature so common in our climate, and so apt to produce cold, fever, and consumption.

Cold bathing, in the hands of those who are ignorant of the laws of the human frame—and such unfortunately and unaccountably most fathers and mothers are—I cannot help regarding as a highly dangerous weapon; and therefore it is, that in view of the whole subject, I cannot recommend its general and indiscriminate use.

If there are individuals, however, who are determined to employ it, in the case of their more vigorous children, and without the advice or direction of their family physician, I beg them to attend to the following rules or principles, expressed as briefly as possible.

In no ordinary case whatever, is the cold bath useful, unless it is succeeded by that degree of warmth on the surface of the body which is usually called a glow. This is a leading and important principle. The contrary, that is, the injurious effects of cold bathing—its immediate bad effects, I mean—are shown by the skin remaining pale and shrivelled after coming out of the bath, by its blue appearance, and by its coldness, as well as by a sunken state of the eyes, and much general languor.

To secure this point—I mean the GLOW—it is indispensably important to begin the use of cold water gradually; that is, to use it at first of so high a temperature as to produce only a slight sensation of cold, and to take special care that the skin be immediately wiped very dry, and the temperature of the room be quite as high as usual. Afterward the water may be cooled gradually, from week to week, though never more than a degree or two at once.

It will probably be unsafe to commence this practice of cold bathing—even in the case of the most robust children—until they are at least six months of age.

The appropriate season will be the middle of the forenoon, the hour when the system is usually the most vigorous, and at which we shall be most likely to secure a reaction. At first, twice or three times a week are as often as it will be safe to repeat it. Some writers recommend it twice a day; but once is enough, under any ordinary circumstances.

The method at first is, to give the infant a single plunge. Afterward, when he becomes older, and more inured to it, he may be plunged several times in succession.

On taking him out of the bath, the skin should be wiped perfectly dry, as in the case of the warm bath, and with the same or an increased degree of attention to other circumstances—the temperature of the room, the avoiding currents of air, &c. He should next be put in a soft, warm blanket, and be kept for some time in a state of gentle motion; and after a little time, should be dressed.

I have already mentioned the importance of avoiding the manifestation of fear, when we bathe a child; and the caution is particularly necessary in the administration of the cold bath. Some writers even recommend, that during the whole process of undressing, bathing, exercising, and dressing, singing should be employed. There is philosophy in this advice, and it is easily tried; but I cannot speak of it from experience.

There is one thing which may serve to calm our apprehensions—if we have any—of danger; which is, that though the child's lungs are feeble at first, from their not having been, like the heart, accustomed to previous action, yet when they get fairly into motion and action, and the child is a few months old, they are probably as strong, if not stronger, in proportion, than those of adults.

Bathing in cold water should never be performed immediately after a full meal. Neither is it desirable to go to the contrary extreme, and bathe when the stomach has been long empty; nor when the child's mental or bodily powers are more than usually exhausted by fatigue.

Although I have given these rules for those who are determined to use the cold bath with their children, yet, for fear I shall be misunderstood, I must be suffered to repeat, in this place, that, uninformed as people generally are in regard to physiology, I cannot advise even its moderate use. On the contrary, I would gladly dissuade from it, as most likely, in the way it would inevitably be used, to do more harm than good.

There is no sort of objection to what might be called local bathing with cold water. If the child's head is hot at any time, the temples, and indeed the whole upper part of the head, may be very properly wet with moderately cold water—taking care to avoid wetting the clothes. But avoid, by all means, the common but foolish practice of putting spirits in the water.

A tea-spoonful of cold water cannot be too early put into the mouth of the infant. The object is to cleanse or rinse the mouth; and the process may be aided by wiping it out with a piece of soft linen rag. If a part or all of the water should be swallowed, no harm will be done. This practice, commenced almost as soon as children are born, has saved many a sore mouth.

There are other forms of bathing besides those already mentioned; among which are the shower bath, the vapor bath, and the medicated bath. The shower bath—for which purpose the water is commonly used cold—is but poorly adapted to the wants of infants. The shock is much greater than the common cold bath, and more apt to frighten; and fear is unfavorable to reaction, or the production of a genial glow.

The vapor bath is much better; and probably has quite as good an effect as the common warm bath. The trouble and expense of procuring the necessary apparatus is somewhat greater, however, as a mere bathing tub costs but little, and can be made by every father who possesses common ingenuity. But whatever may be the expense, it is indispensable in every family; and whenever the pores of the skin are obstructed, a vapor bathing apparatus is equally desirable.

The medicated vapor bath is sometimes used; but I am not now treating of infants who are sick, but of those who are in a state of health.

The common warm bath is sometimes medicated by putting in salt. This, of course, renders the water more stimulating to the skin; but except when the perspiration is checked, or the skin peculiarly inactive from some other cause—in other words, unless we are sick—it is seldom expedient to use it.

There is one substitute for the bathing tub, in the case of the cold bath. I refer to the use of a wet cloth or sponge, applied rapidly to the whole surface of the body. When this is done, the skin should be wiped thoroughly dry immediately afterwards, as in the case of complete immersion.

The application of either a cloth or a sponge, filled with warm water, to the skin, in this manner, even if continued for several minutes together, is less efficacious than a continuous immersion. I repeat it—no family ought to be without conveniences for bathing in warm water daily. I speak now of every member of the family, young and old, as well as the infant; and I refer particularly to the summer season: though I do not think the practice ought to be wholly discontinued during the winter.

It will still be objected that this care of, and attention to the young, in reference to health—this provision for bathing daily, and care to see that it is performed—can never be afforded by the laboring portion of the community. But I shall as strenuously insist on the contrary; and trust I shall, in the sequel, produce reasons which will be satisfactory.

The great difficulty is, to convince parents that these things are vastly more productive of health and happiness to their children—more truly necessaries—than a great many things for which they now expend their time and money. There is, and always has been—except, perhaps, among the Jews, in the earliest periods of the history of that wonderful nation—a strange disposition to overlook the happiness of the young. It is not necessary to represent this dereliction as peculiar to modern times, for we find traces of the same thing thousands of years ago.

The Roman emperors—Dioclesian in particular—could make provision for bathing, to an extent which now astonishes us; but for whom? For whom, I repeat it, was incurred the enormous expense of fitting up and keeping in repair accommodations for bathing at once 18,000 people? For adults; and for adults alone. I do not say that children were not admitted, in any case; but I say they were not contemplated in these arrangements. Nothing was done—not a single thing—that would not have been done, had there been no child under ten years of age in the whole empire.

And what better than this do WE, now? We make provision for the happiness of the adult. The most indigent person will find time and money to spend for the gratification of his own senses, his pride, or his curiosity; but his children—they may be overlooked! Or, if he has an eye to the future happiness of his child, he conceives that he is promoting it in the best possible degree, by endeavoring to lay up a few dollars for his use, after his character is formed—at a period, as it too often happens, when money will do him little good, since it can neither purchase health, peace of mind, nor reputation.

Far be it from me to say, that the poor—ground into the dust as they are, by the force of circumstances operating with their own concurrence, to make them ignorant, vicious, or miserable—can do for their children all that is desirable. By no means. But they have it in their power to do much more than they are at present doing. They have it in their power, at least, to use the same good sense in the management of the human being that they do in that of a pig, a calf, or a colt, or even a young vegetable. No parent, let him be ever so poor, is found in the habit of neglecting either of these in proportion to its infancy, and of exerting himself only in proportion as it grows older. Common sense tells him that the contrary is the true course; that however poor he may be, he will be still poorer, if he do not take special pains with the young animal, to rear it and with the young vegetable, to give it the right direction, by keeping down the weeds, and pruning and watering it. And I say again, that however deserving of censure the wealthy of a Christian community may be in not directing the ignorant and vicious into the right path, and in not expending more of their wealth on those who are poor, in elevating their minds and their manners, and promoting their health, still the latter are inexcusable for their present neglect of their infant offspring, while they would not think of neglecting, on the same principle, the offspring of their domestic animals.



CHAPTER VII.

FOOD.

SEC. 1. General principles.—SEC. 2. Conduct of the mother.—SEC. 3. Nursing—rules in regard to it.—SEC. 4. Quantity of food. Errors. Over-feeding. Gluttony.—SEC. 5. How long should milk be the child's only food?—SEC. 6 Feeding before teething. Cow's milk. Sucking bottles. Cleanliness. Nurses.—SEC. 7. Treatment from teething to weaning.—SEC. 8. Process of weaning-rules in regard to it.—SEC. 9. First food to be used after weaning. Importance of good bread. Other kinds of food.—SEC. 10. Remarks on fruit.—SEC. 11. Evils and dangers of confectionary.—SEC. 12. Mischiefs of pastry.—SEC. 13. Crude and raw substances.

SEC. 1. General Principles.

The mother's milk, in suitable quantity, and under suitable regulations, is so obviously the appropriate food of an infant during the first months of its existence, that it seems almost unnecessary to repeat the fact. And yet the violations of this rule are so numerous and constant, as to require a few passing remarks.

There are some mothers who seem to have a perfect hatred of children; and if they can find any plausible apology for neglecting to nurse them, they will. Few, indeed, will publicly acknowledge a state of feeling so unnatural; but there are some even of such. On the latter, all argument would, I fear, be utterly lost. Of the former, there may, be hope.

They tell us—and they are often sustained by those around them—that it is very inconvenient to be so confined to a child that they cannot leave home for a little while. Can it be their duty—for in these days, when virtue and religion, and everything good, are so highly complimented, no people are more ready to talk of duty than they who have the least regard to it—can it be their duty, they ask, to exclude themselves from the pleasures and comforts of social life for half or two thirds of their most active and happy years? Ought they not to go abroad, at least occasionally? But if so, and their children have no other source of dependence, must they not suffer? Is it not better, therefore, that they should be early accustomed to other food, for a part of the time? Besides, they may be sick; and then the child must rely on others; and will it not be useful to accustom it early to do so?

Perhaps few mothers are conscious that this train of reasoning passes through their minds. But that something like it is often made the occasion of substituting food which is less proper, for that furnished by Divine Providence, there cannot be a doubt. And the mischief is, that she who has gone so far, will not scruple, ere long, to go farther. And, strange and unnatural as it may seem, that mothers should turn over their children to be nursed wholly by others, in order to get rid of the inconvenience of nursing them at their own bosoms, it is only carrying out to its fullest extent, and reducing to practice, the train of reasoning mentioned above.

Nor is it necessary that I should stop here to denounce a course of conduct so unchristian and savage. I know it is very common in some countries; and those American mothers who ape the other eastern fashions, or countenance their sons and daughters in doing it, will not be slow to imitate this also—especially as it is a very convenient fashion. And I question whether I shall succeed in reasoning them out of it. Habit, both of thought and action, is exceedingly powerful. I will, therefore, confine myself chiefly to those efforts at prevention, from which much more is to be hoped, in the present state of society, than from direct attempts at cure.

It will be soon enough to leave a child with another person, when the mother is actually sick, or unavoidably absent; or when some other adequate cause is known to exist. We are to be governed, in these and similar cases, by general rules, and not by exceptions. The general rule, in the present case, is, that mothers can nurse their own children; and, if they have the proper disposition, that they can do it uninterruptedly.

But those who are so ready to become counsellors on these occasions, will tell us, perhaps, that the child must be "fed to spare the mother." That is to say, nursing weakens the mother, and the child must be taken away, a part of the time, to save her strength.

Now it may safely be doubted whether the process of nursing, in itself considered, does weaken, at all. The Author of nature has made provision for the secretion (formation) of the milk, whether the child receives it or not. If it is not taken by the child, or drawn off in some other way, one of two things must follow;—either it must be taken up by what are called absorbent vessels, and carried into the circulation, and chiefly thrown out of the system as waste matter, or it will prove a source of irritation, if not of inflammation, to the organs themselves which secrete it. In both cases, the strength of the mother is quite as likely to be taxed, as if the child received the milk in the way that nature intended.

Besides, on this very principle, the plan of saving a mother's strength by requiring another to nurse for her, is but saying that we will weaken one person to save another. Or if we feed the child, to "spare its mother," what is this, in practice, but to say that the works of the Creator are very imperfect; and that he has thrown upon the mass of mankind a task to which they are not equal? For the mass of mankind are poor; and the poor, having neither the means nor the time to escape the duties in question, must submit to them, while their more wealthy neighbors escape.

But it is idle to defend customs so monstrous. They admit of no defence that has the slightest claim to solidity. The general rule then is, that mothers should nurse their own children.

SEC. 2. Conduct of the Mother.

Originally it was not my intention to give directions, in this volume, in regard to the food, drink, &c., of the mother while nursing; but repeated solicitations on this point, have led me to the conclusion that a few general principles may be very properly introduced.

The future health, and even the moral well-being of the child, depend much more on the proper management of the mother herself than is usually supposed. How, indeed, can it be other wise? How can the mother's blood be constantly irritated with improper food and drink, without rendering the milk so? And how can a child draw, daily and hourly, from this feverish fountain, without being affected, not only in his physical frame, but in his very temper and feelings?

It is not enough that we adopt the principles already insisted on by some of our wisest medical men, and even by one or two medical societies,[Footnote: Those of Connecticut and New Hampshire.] that children in this way often acquire a propensity for exciting drinks, that may end in their downright intemperance. What if it should not, in every case, proceed quite so far as to make the child a drunkard? If it but lays the foundation of a constitutional fondness for excitements, it tends to disease. Indeed that, in itself, is a disease; and one, too, which is destroying more persons every year than the cholera, or even the consumption. Consumption has at most only slain her tens of thousands [Footnote: About 40,000 a year, in the United States, as nearly as it can be estimated.] a year; but a fondness for exciting food and drink—innocent and harmless as it is often supposed to be, and therefore only the more dangerous a foe—does not fail to slay every year, directly or indirectly, its hundreds of thousands. At least this is my own opinion.

Why, where can you find the individual who is not a slave to this perpetual rage within—this perpetual cry, "Who will show us any" physical "good"? Who, in this land of abundance, will eat or drink plain things? Who will eat simple bread, meat, potatoes, rice, pudding, apples, &c. or drink simple water? A few instances may be found, of late, in which people confine themselves to simple water for drink; but they are rather rare. And no wonder. They must be rare so long as an unnatural thirst is kept up everywhere by the most exciting and most strange mixtures of food. Where, I again ask, is the person who will eat and relish plain bread, plain meat, plain puddings, &c.? Certainly not in the nursery. No young mother—scarcely one I mean—will, for a single meal, confine herself to a piece of bread, the sweetest and best food in the whole world, unless it is hot, or toasted, or soaked, or buttered. A natural, healthy appetite, is as rare a thing on our planet, almost, as an inhabitant of the sun or moon.

I have seen more than one mother made sick by using, while nursing, improper food and drink. I have known milk punch, taken by stealth—(because how could the mother, it was said, ever have a supply of food for her poor child without it!)—to kindle a fever that came very near burning up the mother and child both. And yet, if I have once or twice succeeded in convincing the mother that she was only suffering the natural punishment of her own transgressions, I have never, so far as I now recollect, succeeded in making her believe that her iniquities were visited upon her unoffending infant.

There is everywhere the most painful apathy on this most painful subject. We see little children of all ages, everywhere, the victims of debility, and pain, and suffering, and disease and death, and yet we very seldom seem to search for one moment for the causes of this premature destruction. In fact most parents—even many intelligent mothers—at once stare, if you attempt to inquire into the causes of their child's death, as if it was either a kind of sacrilege, or an impeachment of their own parental affection. Diseases, even at this day, with the sun of science blazing in meridian splendor, they seem to regard as the judgments of heaven; and to think of tracing out the causes of the early death of half our race, is, in their estimation, not only idle, but wicked.

Yet this is obviously one of the first steps, every, where, which philanthropy demands; to say nothing of the demands of christianity. It is the first step for the physician, the first step for the educator, the first step for the parent, and above all, the mother. Nay; more—we must not suppress so great and important a truth—it is the first step for the legislator and the minister. What sense is there in continuing, century after century, and age after age, to expend all our efforts in merely mending the diseased half of mankind, when those same efforts are amply sufficient, if early and properly applied, not only to continue the lives of the whole, but to make them whole beings, instead of passing through life mere fragments of humanity?

But I must not forget that this is merely a small manual, not intended for those who make it their profession to teach the laws of God and man, but simply for young mothers. For the sake of erring humanity, would that I could, but for one moment, divest myself of the idea, that in writing for the young mother I am not writing for legislators and ministers! Would that I could banish from my mind the deep conviction that the mother is everywhere far more the law-giver to her infant—far more the arbiter of the present and eternal destiny of her child—than he who is more commonly regarded as such.

Every mother owes it, not only to herself—for on this part she is not wholly forgetful—but to her offspring, to abstain, during the period of nursing at least, from all causes which tend to produce a feverish state of her fluids. Among these are every form of premature exertion, whether in sitting up, laboring, conversing, or even thinking. It is of very great importance that both the body and the mind should be kept quiet; and the more so, the better.

Among the particular causes of fever to the young mother, Dr. Dewees enumerates spirits, wine, and other fermented liquors, a room too much heated, closed curtains, confined air, too much exposure, and too much company; and during the early period of confinement, broths and animal food.

There is nothing which he insists on more strongly, than the importance of fresh air. Indeed, the practice of confining a nursing woman in a space scarcely six feet square, and excluding the air surrounding her by curtains and closed windows, and subjecting her to the necessity of breathing twenty times the air that has already been as often discharged, filled with poison, from her lungs, is not too strongly reprobated by Dr. Dewees, or anybody else. But I have spoken of these things in the chapter which treats on "The Nursery." I would only observe, on this point, that if I were asked what one thing is most indispensable to the health of the nursing woman, I would reply, Fresh air; and if asked what were the second and third most important things, I would still repeat—in imitation of the orator of old, in regard to another subject—Fresh air, Fresh air.

This important ingredient in human happiness, and especially in the happiness of the young mother and her tender infant, can usually be had within doors, if pains enough be taken. But if the weather is fine and in every respect favorable, a woman who is in tolerable health may venture abroad a little in about three weeks after her confinement, and sometimes even in two. Whether her exercise be without or within doors, however, she should be effectually protected against chills, and against the influence of currents of cold air.

It has been incidentally stated, that Dr. Dewees objects to the mother's use, during her early period of nursing, of broths and animal food. This is about as much as we could reasonably expect from one who belongs to a profession whose members are, almost without exception, enslaved to the practice of flesh-eating. But even this advice of his, if duly followed, would be a great advance upon the practice which generally prevails. There is so universal a belief among females that they demand, at this period of their existence, not only a larger quantity of food than usual, but also that which is more stimulating in its quality, as almost to forbid the hopes of making much impression upon their minds. Many young mothers seem to consider themselves as licensed, during a part of their lives, not only to eat immoderately, and even to gluttony, but also to swallow almost every species of vile trash which a vile world affords.

How long will it be, ere the mother can be induced to take as much pains to select the most appropriate and most healthy aliment for herself and her child, as she now does that which is demanded by a capricious appetite, without the smallest reference to fitness or digestibility! How long will it be ere the mother can be brought to believe and feel that, in every step she takes, she is forming the habitation of an immortal spirit—a spirit, too, whose character and destiny, both present and eternal, must depend, in no small degree, upon the character of the dwelling it occupies while passing through this stage of earthly existence! How long will it be, before mothers can be made to believe even these two simple truths, that the nourishment, which the human being actually receives, is not always in exact proportion to the quantity of nutritious food which he throws into his stomach, and that the diet is always best for both mother and child, which is least exciting.

The Charleston Board of Health, during the existence of cholera in that city in 1836, publicly announced that the "best food is the least exciting," and this great truth is just as true in all other places and circumstances on the globe as it was then in South Carolina. And though I am far from believing that health depends more on food and drink than on all other things put together, as many seem to suppose, yet I am entirely of opinion that he who should devote himself successfully to the work of applying this truth, in all its bearings, to the dietetic practice of all mankind, would do more for their reformation—yes, and their salvation too—than has yet been done by any merely human being, since the first day of the creation.

SEC. 3. Nursing—how often.

Many lay it down, as an invariable rule, that no system can be pursued with a child till it is six months old; and it must be admitted by all, that for several months after birth there are serious difficulties in the way of determining, with any degree of precision, how often a child should be nursed or fed. Still, there are a few rules of universal application; some of which are here presented.

1. A child should never be nursed, merely to quiet it; for if this be done, it will soon learn to cry, whenever it feels the slightest uneasiness, not only from hunger, but from other causes; merely to be gratified with nursing. Besides, if its cries should happen to be from illness, it is ten to one but the reception of anything into the stomach will do harm instead of good.

2. The stomach, like every other organ in the body which is muscular, must have time for rest; and this in the case of children as well as adults. But to nurse them too frequently is in opposition to this rule, and therefore of evil tendency.

3. For reasons which may be seen by the last rule, there should be regular seasons for nursing, and these should be adhered to, especially by night. When very young, once in three hours may not be too frequent; I believe that it is seldom proper to nurse a child more frequently than this. But whenever three hours becomes a suitable period by day, once in four hours will be often enough by night. I will not undertake to say at what precise age children should be nursed at intervals of three and four hours each; because some children are older, constitutionally, at three months, than others are at four.

There is one grand mistake, however, against which I must caution young mothers; which is, not to indulge the vain expectation that feeble infants will become robust, in proportion to their indulgence. On the contrary, it is the more necessary to be strict with feeble children, because they are feeble. To keep them hanging at the breast to invigorate them, is the very way to counteract our own intentions, and defeat our own purpose. Seasons of entire rest are even more important to their stomachs than to those of other persons.

4. But in order to secure intervals of rest, both to the strong and the feeble, we must avoid the pernicious habit of giving infants pap, and other delicacies, "between meals." Many a child's health is ruined by this practice. Nothing should be put into their stomachs for many months—if they are in health—but the mother's milk.

"This," says Dr. Dunglison, "is the sole food of the infant, and is consequently sufficiently nutrient to maintain life, and to minister to the growth, during the earliest periods of existence." [Footnote: Elements of Hygiene, page 271.] In another place, he says, "Milk is an appropriate nourishment at all ages, and is more so the nearer to birth."

SEC. 4. Quantity of Food.

"We all know," says Dr. Dewees, "how easily the stomach may be made to demand more food than is absolutely required; first, by the repetition of aliment, and secondly, by its variety;—therefore both of these causes must be avoided. The stomach, like every other part, can, and unfortunately does, acquire habits highly injurious to itself; and that of demanding an unnecessary quantity of aliment is not one of the least. It should, therefore, be constantly borne in mind, that it is not the quantity of food taken into the stomach, that is available to the proper purposes of the system; but the quantity which can be digested, and converted into nourishment fit to be applied to such purposes."

There is a great deal of truth in these remarks; and especially in the closing one, that not all which is taken into the stomach is digested. It is highly probable, that the least quantity which is usually given to an infant is more than sufficient for the purposes of digestion; and that nearly every child in the arms of its mother, is over-fed.

I know it has been said, by some physicians—and by those who are sensible men, in other respects, too—that the child's stomach is a pretty correct guide in regard to quantity. If we give it too much, say they, it will reject it;—as if that were an end of the matter.

But it is not so. It is by no means harmless to fill the child's stomach as full as is possible without overflowing. Such a process, though it should not create disease directly, would produce a gluttonous habit. The stomach, being muscular, may be increased in size by use, like all other muscular organs. The hands, the arms, the legs, the feet, the fleshy portions of the face, even, may be disproportionally enlarged by constant use. Thus a sailor, who uses his hands and arms much more than his legs and feet, has the former unusually large; one who is much accustomed to walking, has large feet; and in a tailor, who from childhood uses his lower limbs comparatively little, they are both small and slender. On the same principle, the stomach, by inordinate use, and by carrying unreasonable loads, may be made nearly twice as large as nature intended, and may demand twice as much food. And I have no doubt that the bulk of mankind, young and old, eat about twice as much as nature, unperverted, would require.

If the suggestions of our last section are duly attended to, one of the causes which lead the stomach to demand an unreasonable quantity of food will be avoided—I mean the too frequent "repetition of aliment." And if we never depart from the general rule, already laid down, not to give the infant anything but its mother's milk, we shall escape the evils incident to variety.

SEC. 5. How long should milk be the only food.

On this point, there is a great diversity of opinion. Perhaps the most approved role, of universal application, is, that the first change should be made in the child's diet, when the teeth begin to appear.

This period, it is well known, cannot be fixed to any particular age, but varies from the fifth to the twelfth month.

Some mothers, who have borne with me patiently to this place, will probably here object. "What child," they will ask, "would ever have any strength, brought up so?" Not only a little pap and gruel is, in their estimation, necessary, long before this period, but even many choice bits of meat.

Now I am very sure, that these choice bits—whatever they may be—given to a child before it has teeth, not only do no good, but actually do mischief. Indeed, that which does no good in the stomach must do harm, of course; since it is not only in the way, but acts like a foreign body there, producing more or less of irritation.

I ought to state, in this place, that many people—mothers among the rest—have very inadequate ideas of digestion. They appear to have no farther notion of the digestive process than that it consists in reducing to a pulp the substances which are swallowed; and hence, whatever is reduced to a pulp, they regard as being digested. Whereas nothing is better known to the anatomist and physiologist, than that this—the formation of chyme in the stomach—constitutes only a very small part of the digestive process. The chyme must pass into the duodenum and other portions of intestine beyond the stomach, and be retained there for some time, before it will form perfect chyle.

This is a more important part of the work of digestion than even the former. For, suppose the chyme to be perfect, though even this may be mere pulp, rather than chyme, and suppose it pass quietly along into the duodenum and other small intestines. All this process, thus far, may go on naturally enough, and yet the chyle may not be well formed, and the chymous mass may find its way out of the system without answering any of the purposes of nutrition. For no matter how well the food is dissolved in the stomach, if it do not become good and proper chyle, the blood which is formed will not be good and perfect blood; or, lastly, if it seem to make good blood, it may still be faulty, so that the particles which should be applied to build up or repair the system, are either not used, or if used, answer the purpose but imperfectly.

We hence see how little prepared a large proportion of the community, are, to judge of the digestibility or fitness of a substance for infants, by their own observation and experience merely; and how much more wisely they act, in contenting themselves with giving them—at least until they have teeth—such food only as the Author of nature seems to have assigned them; especially when thus course, is precisely that which is recommended or sanctioned by nearly every judicious physician, as well as by almost all our writers on health.

SEC. 6. On Feeding before Teething.

Having laid down the general rule, that until the appearance of teeth, the sole food of an infant should be the milk of its own mother, I proceed to speak of some of the more common exceptions to it.

EXCEPTION 1.—The first of these is when the supply furnished by the mother is scanty. There may be two causes of the scantiness of this supply; 1st, the want of suitable nourishment by the mother; and, 2dly, a feeble constitution, or bad health. In the former case, it should be her first object, as it undoubtedly will be that of her physician, to improve the quality of her diet; and in the latter, to restore her health, or at least invigorate her constitution.

In regard to the proper diet of a mother, as such, as well as the general management which her case requires, a volume might be written without exhausting the subject. But I have already said as much on this subject, in another place, as my limits will permit.

But we cannot wait for the mother's health to improve, and allow the infant to suffer, in the mean time, for a due supply of food. The appropriate question now is, How shall such a supply be furnished?

This should be done by means of an article resembling in its properties, as closely as possible, the mother's milk. For this purpose, we have only to mix with a suitable quantity of new cow's milk, one third of water, and sweeten it a little with loaf sugar. This is to be given to the child, at suitable intervals, and in proper quantities, by means of a common sucking bottle. It is, indeed, sometimes given with the spoon; but the bottle is better.

To the question, whether the child should be confined to this, till the period of weaning, Dr. Dewees answers, No. I am surprised at this; and my surprise is increased, when I find him, almost in the very next breath, urging with all his might, numerous reasons against the very common notion, that children in early life require a variety of food. He even insists on the importance of confining the child to a single article of food when it is practicable. Yet he has not given us so much as one reason why it is not practicable in the case before us; but has gone on to speak of barley water, gum arabic water, rice water, arrowroot, &c. I venture, therefore, to dissent from him, and to answer the foregoing question in the affirmative. When one good and substantial reason can be given for change, the decision will, however, be reconsidered.

I have already stated the general rule for preparing this substitute for the mother's milk. But there are several minor directions, which may be useful to those who are wholly without experience on the subject.

If possible, the milk used should not only be just taken from the cow, but should always be from the same cow; for it is well known, that the quality of milk often differs very materially, even among cows feeding in the same pasture, or from the same pile of hay; and the stomach becomes most easily reconciled to the mixture when it is uniform in its qualities. Great care should also be taken to see that the cow whose milk is used is young and healthy.

The mixture should not be prepared any faster than it is wanted, and should always be prepared in vessels perfectly clean and sweet, and given as soon as possible after it is prepared, to prevent any degree of fermentation. It is never so well to heat it by the fire. If taken from the cow just before it is used, and if the water to be added is warm enough, the temperature will hardly need to be raised any higher.

When it is impracticable, in all cases, to take milk for this purpose immediately from the cow, it should be kept, in winter, where it will not freeze; and in summer, where there will be no tendency to acidity.

Some mothers and nurses are addicted to the practice of passing the food through their own mouths, before they give it to the child—with a view, no doubt, to see that it is at a proper temperature. This practice is not only wholly unnecessary, but altogether disgusting, and even ridiculous. A thermometer would answer every purpose; and save even the trouble of another disgusting practice—that of blowing it with the breath.

The most proper season for giving the child this preparation, is immediately after it has been nursing. It is better for both mother and child, that the latter should nurse just as often as though the supply of food was adequate to his wants. And when his first supply is exhausted, then let him make up his meal from the sucking bottle. The great advantage of this plan is, that he will not be so likely in this way to be over-fed. If he is really needy, he will accept the bottle, even if he do not like it quite so well; if he refuse it, let him go without till he is hungry enough to receive it.

In regard to the water used in the preparation, only one thing needs to be said; which is, that it should be pure. If it is not, it should by all means be boiled. The sugar used should be of the very best kind; and the quantity not large; since if the preparation be too sweet, it readily becomes acid in the stomach.

There has been, and still is, a controversy going on among medical men, whether sugar is or is not hurtful to the young. "Who shall decide, when doctors disagree?" has often been asked. Without undertaking the task myself, I may perhaps be permitted to say, that I cannot see any reason why a substance so pure, and so highly nutritious as sugar—if given in very small quantity only—should prove injurious: though I do not regard the reasoning of Dr. Dewees as very conclusive on the subject, when, in reply to Dr. Cadogan, he has the following language—"If sugar be improper, why does it so largely enter into the composition of the early food of all animals? It is in vain that physicians declaim against this article, since it forms between seven and eight per cent of the mother's milk."—Now with me, the fact that milk and almost all other kinds of food are furnished with a measure of this substance, is the strongest reason I am acquainted with for making no additions. I believe, however, that they may sometimes be made, but not for these reasons.

EXCEPTION 2.—The second striking exception to the general rule that has been laid down, is when the mother is unable to nurse her own child from positive ill health, or when circumstances exist which render it obviously improper that she should do it. The following are some of the circumstances which render such a departure from nature indispensable.

1. When the mother is affected strongly with a hereditary disease, such as consumption or scrofula; or when her constitution is tainted, as it were, with venereal disease, or other permanent affections.

2. When nursing produces, uniformly, some very troublesome or dangerous disease in the mother; as cough, colic, &c.

3. There are a few instances in which the milk of the mother, owing to an unknown cause, has been found by experience to disagree with the child. In these circumstances, it is the unquestionable duty of the mother to resort wholly to feeding.

4. Sometimes the milk, at first abundant, fails suddenly, owing to some accidental or constitutional defect; and this failure becomes habitual. In all these circumstances, the proper resort is to a sucking bottle, or a hired nurse. I generally prefer the latter. The cases which seem to me to admit of the former, will be pointed out in the next section.

"When the bottle is used," says Dr. Dewees, "much care is requisite to preserve it sweet and free from all impurities, or the remains of the former food, by which the present may be rendered impure or sour; for which purpose a great deal of caution must be observed."

The business of feeding a child, whether by the bottle or the spoon, should never be hurried: the slower it is, the better. We should stop from time to time, during the process. Nor should the nourishment be given while lying down; it is much more pleasant, as well as more safe, to sit up.

A few thoughts more on the character and condition of the milk which we give to the young, will conclude the second division of this section.

Some are fond of boiling milk for infants; but to this I am decidedly opposed, so long as they are in health. Boiling takes away, or appears to take away, some of the best properties of the milk.

It is true that milk which is boiled does not turn sour so readily in hot weather; but it is quite unnecessary to boil milk in the common manner in order to present its changing, since such a result can be prevented by another process. You have only to put your milk in a kettle, cover it closely, and heat it quickly to the boiling point, and then remove and cool it as speedily as possible. This plan prevents the rising to the surface of that coat or pellicle which contains some of the most valuable properties of the milk.

I have already said that it was as necessary that the stomach should have rest as any other muscular organ. Some writers say that the infant should be kept perfectly quiet, at least half an hour, after each meal. This is certainly necessary with feeble children, but I question its necessity in the case of those who are strong and robust. I would not recommend, however, nor even tolerate, for one moment, the absurd practice of jolting, so common with a few ignorant nurses and, mothers, as if they could jolt down the food in the stomach with just as much safety as they can shake down the contents of a farmer's bag of produce. Such mothers as these should go and reside among the native tribes of Indians in Guiana, in South America, where they make it a point not only to stuff their children's stomachs as long as they will hold, but actually to shake it down.

Little less absurd than jolting is the custom of tossing a child high, in quick succession, which is practised not only after meals, but at other times. But on this point, I have treated elsewhere.

Some give the sucking bottle to children as a plaything. This is just about as wise a practice as that of giving them books as playthings. Both are done, usually, to save the time and trouble of those whose office it is to devote their time to the very purpose of managing and educating their offspring. The evil, however, of suffering the child to have the bottle when it pleases is, that he will thus be tasting food so often as to interfere with and disturb the process of digestion, to his great and lasting injury. For in this way, a part of the food will pass from the stomach into the bowels unchanged, or at least but imperfectly digested, where it is liable to become sour, and cause disease. It is not to be doubted that many diarrhoeas, as well as, other bowel affections, are produced in this way. Children that are always eating are seldom healthy; and we may hence see the reason.

In speaking of the importance of keeping the bottle, from which a child takes his food, perfectly clean and sweet, I ought to have extended the injunction much farther. There is a degree of slovenliness sometimes observable in those who manage children, both when they are sick and when they are in health, which even common sense cannot and ought not to tolerate. Every vessel which is used in preparing or administering anything for children, ought, after we have used it, to be immediately and effectually cleansed. How shocking is it to see dirty vessels standing in the nursery from hour to hour, becoming sour or impure! How much more so still, to see food in copper vessels, or in the red earthen ones, glazed with a poisonous oxyd! I speak now more particularly of vessels in which food is given; for with the administration of medicine, and nursing the sick, I do not intend in this volume to interfere.

EXCEPTION 3.—We come now to the consideration of those cases—for such it will not be doubted there are—where a hired nurse is to be preferred to feeding by the hand.

Before proceeding farther, however, it is important to say, that if a nurse could always be procured whose health, and temper, and habits were good, who had no infant of her own, and who would do as well for the infant, in every respect, as his own mother, it would be preferable to have no feeding by the hand at all.

But such nurses are very scarce. Their temper, or habits, or general health, will often be such as no genuine parent would desire, and such as they ought to be sorry to see engrafted, in any degree, on the child. For even admitting what is claimed by some, that the temper of the nurse does not affect the properties of the milk, and thus injure the child both physically and morally, still much injury may and inevitably will result from the influence of her constant presence and example.

Others have infants of their own, in which case either their own child or the adopted one will suffer; and in a majority of cases, it can scarcely be doubted which it will be. And I doubt the morality of requiring a nurse, in these cases, to give up her own child wholly. If one must be fed, why not our own, as well as that of another?

The only cases, then, which seem to me to justify the employment of a nurse, are where she possesses at least the qualifications above mentioned; and as these are rare, not many nurses, of course, would on this principle be employed. But when employed, it is highly desirable that the following rules should be observed:

1: The nurse should suckle the child at both breasts; otherwise he is liable to acquire a degree of crookedness in his form. There is another evil which sometimes results from the too common neglect of this rule, which is, that it endangers the deterioration of the quality of the milk.

2. The milk which is thus substituted for that of the mother, should be as nearly as possible of the same age as the child who is to receive it. It should be remembered, however, that the milk is not so good after the twelfth or thirteenth month, nor quite so good under the third.

3. When the parent or some trusty and confidential friend can, without the aid of interested spies and emissaries, have an eye to the general treatment, and especially to the moral management, it should be done; for even the best nurses may so differ in their principles, manners and habits from the parent, that the latter would deem it preferable to withdraw the child, and resort at once to feeding.

SEC. 7. From Teething to Weaning.

This period will, of course, be longer or shorter according as the teeth begin to appear earlier or later, and according to the time when it is thought proper to wean.

On few points, perhaps, has there existed a greater diversity of opinion than in regard to the age most proper for weaning. The limits of this work do not permit a thorough discussion of the question; and I shall therefore be very brief in my remarks on the subject.

Dr. Cullen, whose opinion on topics of this kind is certainly entitled to much respect, thought that less than seven, or more than eleven months of nursing was injurious. Yet in some countries, and even in some parts of our own, the period is extended by the mother, from choice, to two years. And although the milk is not so good after the thirteenth or fourteenth month, I have never either known or heard that any evil consequences followed from the practice.

Dr. Loudon, a recent writer, observes, that the period of nursing has a great influence over the numbers of mankind in various countries, as is evinced by numerous facts. He adduces proofs of this, position. Thus, he says, in China, where the population is excessive, and the inhuman practice of infanticide is common, they wean a child as soon as it can put its hand to its mouth. On the other hand, the Indians of North America do not wean their children until they are old and strong enough to run about: generally they are suckled for a period of more than two years.

He then enters into a physiological inquiry why it is that British mothers do not usually suckle their children longer than ten months. He seems—though he does not give us his precise opinion—to think that, in all ordinary cases, the period of nursing ought to be protracted to two or three years, and that perhaps it would be better still to extend it to four or five. His remarks are so excellent, and withal so curious, and their tendency so humane, that we venture to insert one or two of his paragraphs entire.

"Certain it is, that the milk does not diminish particularly at that time, (ten months,) so far as regards quantity; and from the health of children reared without spoon-meat beyond this time, it as certainly undergoes no change in its quality. Children are sometimes so old before weaning, as to be able to ask for the breast; and it has not been remarked that the health of mothers, thus suckling, was in any way worse than that of their neighbors. Altogether, then, it may be asserted, that a mother is likely to enjoy better health, and to be less liable to sickness and death during lactation, than during pregnancy.

"Many women believe, or affect to believe, that the weakness they labor under arises from some latent moral or physical cause; but this weakness is not attributed to lactation in the earlier months of suckling, because the mother then considers herself fulfilling a necessary duty, which her constitution, for so long, is well able to bear. So soon, however, as the period of lactation has passed over, as it is established by custom or fashion, she imagines she is exceeding the intentions of nature, and she forthwith concludes that the continuance of suckling is the cause of her uncomfortable sensations. This whim being entertained, the child is weaned, and too often becomes the victim of a most reprehensible delusion.

"Since nature has furnished the mother with milk for a longer period than custom demands, it is evident that some good purpose for the mother and child was intended in this arrangement. Had it been otherwise, the secretion of milk would stop at a definite time, in like manner as the period of gestation is definite. That a child, in comparison with the young of the lower animals, is so long unable to provide for itself, strongly tends to corroborate the proofs already advanced—that nature originally had in view a more protracted period for lactation than is now allowed.

"Some writers, following the laws of nature, as they interpreted them, fixed the period of weaning at fifteen months, when the infant has got its eight incisors and four canine teeth. There are well-authenticated instances of mothers having suckled their children for three, four, five, and even seven consecutive years; we ourselves have known cases of lactation being prolonged far three and for four years, with the happiest results."

It appears to me better, therefore, that the child should be nursed, in all ordinary cases, from twelve to fifteen months; and when there are no special objections, about two years. As the change, whenever it is made, and however gradual it may be, is an important one, in its effects on the stomach and bowels, it is better to wean a little earlier or a little later, than to do so just at the close of summer or beginning of autumn, at which season bowel complaints are most common, most severe, and most dangerous. It is sufficiently unfortunate that teething should commence just at this period; but when we add another cause of irregular action, which we can control, to one which we cannot, we act very unwisely.

I have already observed that we may begin to feed children when the teeth begin to appear. By this is not meant that we should do so while the system is under the irritation to which teething usually, or at least often, subjects it. But when this is over, and a few teeth have appeared, it is usually a proper time to commence our operations.

The first food given should be precisely of the kind which has been recommended for those children who are fed by the hand. The rules and restrictions by which we are to be guided, are the same, except in one point, which is, that in the case we are now considering, the child should be fed between nursing.

Let not parents be anxious about their healthy children under two years, who have a supply of good milk, either from the mother or from the cow. For those that are feeble, a physician may and ought to prescribe—not medicine, but appropriate food, drink, &c.

When the grinding teeth have cut through, if we have any doubts in regard to the nutritive qualities of the food we are giving, we may improve it by adding, instead of the one third of pure water, a similar quantity of gum arabic water, barley water, or rice water. Some use a little weak animal broth; but this is unnecessary, and I think, on the whole, injurious, except for purposes strictly medicinal.

This course is so simple, and so far removed from that which is generally adopted, that few mothers will probably be willing to pursue it with perseverance, especially when the teeth appear very late. Those who are, however, will be richly rewarded, in the end, in the advantages; which will accrue to the child's health, and the vigor it will ensure to his constitution.

SEC. 8. During the process of Weaning.

It has already been shown that, in weaning, some regard should be had to the season of the year; and that the end of summer and beginning of fall are of all periods the most unfavorable. The best time, on every account, is in the spring—in March, April, May, or June; and the next best is during the months of October and November. But December, January and February are better than July, August and September.

Weaning should never be sudden. We may safely and properly call upon those who are addicted to snuff or opium taking, tobacco chewing, rum drinking, and other habits which are purely artificial, to break off—to wean themselves—suddenly; since they can do so with considerable safety, and will seldom have the courage or the perseverance to do it otherwise. But with the child, in regard to his food, such a course will not be advisable. If we regard his future health or happiness, he must be weaned gradually.

The first proper step will be to give the child a little larger quantity of the cow's milk and gum arabic mixture, between nursings, at the same time increasing very gradually the intervals of nursing. When the intervals become six hours distant from each other, it will be best to add a little good bread to the milk with which it is fed, about two or three times a day. Arrowroot jelly, if he can be made to relish it, will be highly useful; but if not, some boiled rice, into which a little arrowroot has been sprinkled while boiling, may be added to his milk.

It may be worth the attempt to excite an aversion in the child to nursing his mother, so that be will refuse to nurse, if possible, of his own accord. This aversion may be excited by such an application of aloes, or some other offensive substance, as will cause him to withdraw himself from the breast as soon as he tastes it.

A serious mistake is often made, in connection with weaning, in giving the child not only too much food, but that which is too solid, or too rich. This mistake has undoubtedly grown out of the belief that his feeble condition requires it; whereas the truth is, that he neither needs food at this period, nor is capable of digesting it. For let us be as judicious in the process of weaning as we may, the tone of the child's stomach will be somewhat reduced, or in other words, its powers of digestion will be weakened by it; and to give it strong food, or overload it with that which is weaker, is not only unreasonable and unphilosophical, but cruel. And if there should be a tendency in the child's constitution to rickets, scrofula, consumption, and other wasting diseases, such a course would be likely to bring them on, and destroy life.

"When milk will agree," says Dr. Dewees, "there is no food so proper. It may be employed in any of its combinations, with good wheaten bread, rice, sago, &c., only remembering that when either of these articles is found to agree, it should be continued perseveringly, until it may become offensive. In this case, some new combination may be required." I do not see the necessity of continuing one kind of food till it offends. Besides, I do not believe that these simple articles of food are apt to become offensive to stomachs that have not already been spoiled. But whether a single dish should or should not come to be offensive, I greatly prefer an occasional change.

Buchan, in his Advice to Mothers, has recommended it to them to boil bread for their infants, in water. It should not, for this purpose—nor indeed for any other—be new; it is best at one or two days, old. It may be boiled in a small quantity of water, or what is still better, of milk; or it may be steamed till it becomes soft and light, almost like new bread, but without any of the objectionable properties of that which is wholly new. To bread, thus prepared, is to be added a suitable quantity of milk, fresh from the cow, and a little diluted with water, but not boiled.

But as there may be, here and there, at any age, a stomach with which milk, with bread, or rice, or sago, will not agree—though I think they must be very rare cases—we may be allowed to substitute for it a solution of "gum arabic, in the proportion of an ounce to a pint of water," to which may be added a little sugar; and if the child is old enough to observe the color, just milk enough to change the appearance. Another preparation for the same purpose consists of rennet whey, a little sweetened, and "disguised, if necessary, as just stated."

The health of the mother, too, during the period of weaning, often needs great attention. Let her avoid medicine, however, if possible. A due regard to food, drink, exercise, and rest of body and mind, &c., will usually be found more effective, as well as more permanently efficacious.

SEC. 9. Food subsequently to Weaning.

You will allow me to introduce in this place, some of the sentiments of Dr. Cadogan, an English physician, from a little work on the management of children. [Footnote: Though Dr. C.'s remarks will apply more closely to England in 1750, they are by no means inapplicable to the United States in 1837.] I do it with the more pleasure because, though he wrote almost a century ago, he urges the same general principles on which I have all along been insisting: hence it will be seen that mine are no new-fangled notions. His remarks refer to the young of every age, but chiefly to early infancy and childhood. It will be found necessary, in some instances, to abridge, but I shall endeavor not to misrepresent the Doctor's views.