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Laa diagrammaa auivanta iliuatrant la mAthoda. ty errata Bd to nt ne pelure, ipon A I] 1 2 3 32X 1 2 3 4 5 6 A SUPBKIN \ THE \ C»RE OF CHILDREN BT ELISABETH ROBINSON SCOVIt SUPBIUNTBNOBlfT Of THE NbWPOKT HOSPITAL, AND OnB OF THB AsSOCIATS Editors or thb Ladibs' Homb Journal REVISED EDI"^N With a Copiom Index ^ PHILADELPHIA HENRY ALTEMUe CO. Copyrighted, bjr HENRY ALTEMbS 1804 BKNRT ALTBMtl] MANUFACTUKKB PHILADELrUIA INTRODUCTION". E^VERY mother desires that her children shall be strong and well. She does not always realize that the responsibility of making and keeping them so belongs in a large measure to her. She regulates their food, their clothing and, to a great extent, their surroundings ; it is on these that their health depends. Often, while earnestly desiring to do what is best for them, she fails from waqt of knowledge of what is best. It is well known, for example, that children can- not grow and develop properly without suitable, nutritious food. This is not always what is proper (3) iNTRODtTcrnoir for older persons, nor what a child would take from choice. It must be palatable enough to be relished, or it wil! not be eaten in sufficient quantities; it must contain the elements that arc necessary to build up muscles, nerves and bones, or the body suffers. If the mother does not know the kinds of food that will best serve these ends she is depriving her children of proper nourishment, although it may seem to her they have more than enough to eat. The care of children has never received as much attention as is being given to it at the present time. The wise mother will try to keep abreast of mc/dern thought in this matter and to take advan- tage of the experience of others for her children's good. A year or two i^ the writer, in her capacity as editor of the "Mother's Corner" of "The Ladies' Home Journal," received between twelve and thir- teen hundred letters asking for advice as to the care INTRODUCl. ON of infants. In re8(X)nse to these requests a pamphlet w&s written called *^ A Baby's Requirements." Tin's little book brought forth so many inquiries as to the care of children after babyhood that it was determined to expand it into a large** volume^ con- taining, beside the greater {)art of the original mat- ter, the information desired. An experience of many years in hospital work has given a familiarity with the details of nursing that it is hoped will render the chapters on the care in illness especially useful. Tt is then that the in- experienced mother most feels her helplessness and welcomes friendly aid. In man;' childish ailments the nursing equals in importance the medical treatment. Sometimes the knowledge of what ought to be done in the begin- ning is all-important and makes no slight difference in the result. An effort has been made in " The Care of Chil- dren" to answer in a plain and practical manner 6 INTRODUCTION the questions that are most likely to arise to puzzle those to whom this charge is entrusted^ whether in sickness or in health. ' If the book is a help to mothers— experienced or inexperienced — in their moments of jierplexity, its existence will be amply justified. CONTENTS INTRODUCTION Pood CHAPTER I NURSING Intervals of Nursing— Care of the Breasts— When the Milk Disagrees — When Nursing is Im- proper—Weaning ... w . • 17 CHAPTER n FEEDING Cream Food — Milk Sugar Water — Lime Water- Barley Food — Malted Food — Peptoniied Milk — Sterilized Milk — Condensed Milk — Amount of Food — ^Temperature of Food — Heating Food — Care of Nursing Bottle — Giving the Food— Water . . , . (7) 28 8 CONTENTB ( CHAPTER lU IN0RBA8INO THE FOOD Ottmeal Gruol— Farina Grael— Flour Ball— Rioe Water— Whey Food— Album iniied Food- Beef Juice — Cereab — Bread — Crackers— Eg£B — Junket — Baked Potato — Gelatine Cream— Maoaroni — Rice— Oranges — Baked Apple CHAPTER IV DUET Aim TWO YBAR8 OF AQB Meat — Cooking Meat — Beef Steak — Mutton Chops — Soup— Chicken— Bacon —Vegetables —Fruit— Stewed Fruit — Puddings — Bever- agee— Fruit Syrup 41 62 CHAPTER V • THE FOOD OF SCHOOL CHILDRBN The Purpose of Food — Fish — Breakfast — Lunoheon— Dinner— Supper— At Bedtime . 61 CHAPTER VI DIET IN ILLNESS Food in Constipation— Diarrhoea-Indigestion-^ Rickets— Colds— Eciema- Fever — Tubercu- losis 68 41 6S 61 OONTENTB 9 Clothing CHAPTER VII The Baby's Wardrobe— Bands-Shirts— Petti- ooats — Napkins— Pads—Night Slips— Dresses — Wrappers — Socks — Blankets — Cloak — Hood^Mittens ...... 81 CHAPTER Vin SHORT CLOTHES Shirts — Waists — ^Dresses — Creeping Skirts — Bibs —Cloaks— Bonnets-Stockings — Shoes . . 94 CHAPTER IX OLOTHINQ AFT ER BABYHOOD Boys' Frocks— Boys' First Suits— Little Girls' Dresses — Underclothing — Importance of Avoiding Pressure — Stockings— Shoes— Bed- room Slippers— Rubber Boots — Overshoes- Aprons — Wrappers — Nigh t Oowns — Out- door Garments— Hats 101 68 Beds and Bedding CHAPTER X THE BED Bassinets -» Cribs — Hammocks — Comforters 10 CONTENTS Blankefcs—Sheeis— Rubber Cloth Protectors — Pillows — Bed-clothes Fasteners — VentUa- tion — Necessity of Sleep— -Importance of Separate Beds 114 Th^ Baby's Toilet CHAPTER XI THE BABT'S basket Low Baskets — Standard Baskets — Hampei Contents of Basket — ^Receptacles for Clothing — ^The Carriage— Carriage Robes . 124 Baths CHAPTER XII The Bath Tub— Wash Cloths— Care of the Spcnge— Towels — ^Lap Pads — ^The First Bath — Sponge Batns — Cold Baths — Warm Baths —Salt Water Baths— Foot Baths— Sponge Baths in Bed— The Cold Pack— Bran Bath- Starch Bath — Open Air Bathing — ^Wading — Necessity for Care in Bathing. . , 131 CONTENTS 11 Care of the Teeth CHAPTER XIII When Teeth may be Expected — ^The Earliest Signs — Order of Appearance — Duration of Teething — ^Allaying the Discomfort — Teeth- ing Rings — Disorders Incident to Teething-^ ■ Diarrhoea — Convulsions — Rashes — The Sec- ond Teeth— Care of the Teeth — Grinding the Teeth— Tooth Ache ..... 143 Care of the Eyes CHAPTER XIV Ophthalmia of the New Born — Shading the Eyes — ^Testing the Eyes — Defects of Vision- Short Sight — Long Sight — Astigmatism — Squinting — Consequences of Eye Strain — Conjunctivitis — Studying at Night — Artificial Light — Styes — Foreign Bodies in the Eye Color Blindness . 152 Care of the Ears CHAPTER XV The Construction of the Ear — Prominent Ears— 12 CONTENTS Ear Caps—Flabby Ears^Keeping the Ears Clean — Wax — Protecting the Ears — ^Boxing the Ears — Ear Ache — Foreign Bodies in the Ear — Syringing the Ear — Diseases of the Ear 164 Care of the Hair CHAPTER XVI Brushing — Combing — Curling — Crimping — ^Tan- gles — Cutting — Bangs — Thir Hair — Harsh Hair — Splitting at the Ends — Dandruff — Washing the Hair — Parasites — Color of the Hair — Superfluous Hair 171 Care of the Nails CHAPTER XVII Baby' s Nails — Trimming -^ Cleansing — Oiling — Polishing — Developing the Lunela — Hang Nail — Ingrowing Nails — Splinters under the Nail — Biting the Nails — Sucking the Fingers . 180 Care of the Feet CHAPTER XVIII Resting on the Feet — Walking — Bathing the Feet —Protecting the Feet — Damn Feet — Exces- CONTENTS J 3 sive Perspiration — Corns — Chafed Heel- Chilblains . 186 Ailments CHAPTER XIX Simple Remedies — Feverishness — Colic — Crying — Constipation — Diarrhoea — Hiccough — Colds — ^Prevention of Colds — Cold in the Head — Cold on the Chest — Snoring — Sore Mouth — Cold Sores — Cracked Lips — Gum Boils — Sore Throat— StiflF Neck— Cough — Rashes— Ery- thema — Roseola — Urticaria — Eczema — Mos- quito Bites — Ring Worm — Itch — ^Worms — Bed Wetting — Night Terror — Sleepless- ness — Growing Pains — Boils — Chafing — Chapped Hands — Inflammation of the Breasts — Headache— Catarrh — The Medicine Box — How to Give Medicine. .... 192 Physical Deformities CHAPTER XX Bow Legs— Knock Knees— Flat Foot— Club Foot — Hip Disease — Curvature of Spine — Pigeon Breast — Hare Lip — Cleft Palate — Tongue Tie — Birth Marks — Extra Fingers — Protrusion of Navel — Rupture — Prolapse of Bowel — 14 CONTENTS vPiles — Enlarged Glands — Enlargement of Tonsils — Warts — ^Freckles — ^Tan — Sunburn — A Blue Baby 226 Diseases of Children CHAPTER XXI The Early Stage — Points in Nursing — Ventilation — Cooling the Sick Room — Furniture — Carpet — Screen — Bed — Changing Clothing — Nutri- tive Eneniata — Forced Feeding — Poultices — Fomentations — Pads — Preventing Infection — Disinfectants — Fumigation — Scarlet Fever — Measles — German Measles — Chicken Pox — Vaccination — Diphtheria — Croup — Whooping Cough — Mumps — ^Typhoid Fever — Pneu- monia — Bronchitis — Asthma — ^Rheumatism — Chorea — Rickets — Tuberculosis — Articles Useful in a Sick Room .... 244 Emergencies CHAPTER iXII Cuts — Cutting off a Fingei*— Bleeding — Bleeding from the Nose — From the Stomach — From the Lungs — Foreign Bodies in the Nose — In the Throat — Swallowing Foreign Bodies- Splinters — ^Bruises — Sprains— Stings — Bites CONTENTS 15, — Broken Bones — Dislocations — Burns — Frost Bites — Fainting — Fits — Convulsions- Poisoning — Drowning — Artificial Bespiration — ^The Emergency Box. . . . • 287 Physical Culture CHAPTER XXIII Necessity for Gymnastics — What the Mother Can Do — Standing — Breathing — Sitting — ^Walk- ing — Strengthening the Muscles — Stammer- ing 807 The Care of Qirls CHAPTER XXIV Menstruation — ^Rest — Cold — Bathing — Clothing- Coincident Symptoms — Delayed Menstrua- tion—Hysteria—School Work — Needle Work — House Work — Preparing Girls for Boarding School — A Daughter's Privileges . . . The Care of Boys CHAPTER XXV Youth — ^Preparing Boys for Boarding School — The Children's Companions — ^Reading — Home Training .•••«• 317 838 THE CARE OF CHILDREN FOOD CHAPTER I NURSING It is impossible fc * a child to grow and thrive unless it lias suitable food. Most of the disorder^ of young children, particularly of babies, arise from errors in diet. Either the kind of food or the quantity given is in fault. If a mother can nurse her child the problem of nourishing it is usually an easy one to solve. Sometimes, however, even the mother's milk does not agree with the baby, and then, unless she can alter it by dieting herself, a substitute must be found for it. The first fluid secreted by the breast is a thin liquid called colostrum. This acts as a cathartic and relieves the child of an accumulation of waste matter, the meconium. The colostrum is not very nutritious^ but it is all a (17) I 18 THE CARE OP CHILDREN that nature provides for the baby until it is about two days old, and she seldom makes mistakes. If for any reason the child cannot be nui'sed, it needs very little food until the third day. In nursing, the baby should be held comfortably on the mother's arm, the breast being pi'essed back a little with the finger that it may not obstruct the nostrils, as the child has to breathe through the nose. If the milk comes too quickly, it can be checked by gentle pressure with the fingers. The baby should nurse from either side alter- nately, having one at each nursing. If any preparation has been used on the nipple, it should be carefully washed before the baby takes it. After withdrawing it, bathe it again in warm water and gently wash out the child's mouth with a little swab, made of a piece of a fine handkerchief, dipped in cool water. If these precautions are neglected, the particles" of milk decompose and give nse to a fungoid growth called thrush, which may be fatal to a young baby. Should this happen through carelessness, put a pinch of borax in a couple of tablespoon fuls of water and wash the mouth with it frequently. When the coming of the milk is delayed, or the baby is an exceptionally vigorous child, it grows very hungry, and, not getting enough from the FOOD 19 breast to satisfy it, protests loudly against this con- dition of affairs. During the. first two days a few ' teaspoon fuls of warm water may be tried. If this does not meet the requirements, mix two teaspoon- fuls of cow's milk with four of boiled water and add a very little sugar of milk to sweeten it. The latter can be procured of any druggist. It is a powder and very inexpensive. INTERVALS OP NURSING This amount of food can be given not oftener than every four hours, putting the child to the breast once between each feeding. If the mother ia comfortable, the baby should try to nurse first about four hours "^.fter it is born, and then at the same interval for tlie firet two days. Aft,er that it should be nursed once in two hours during the day and six at night. A baby soon learns good habits if it is fairly dealt wit! J, and it is very important tli-t it should not be disturbed at night. No child wants food every time it cries. There are other causes for the discomfort that it can only express in one way. If it is fed too often the stomach cannot dispose of the quantity of food forced into it. If it does manage to digest it there are grumbles of discontent 20 THE CARE OF CIIII.DREN at tlie overwork, wliich the mother too often uiter- prets as a demand for more fo'xi. Fortunately babies vomit easily and so get rid of the surplus, but it is better not to overtax their limited capacity. Usually a baby requires to nurse about ten or fifteen minutes. When satisfied, it will leave oif of its own accord and drop asleep. Milk, which requires two hours to digest in the stomach of an adult, is disposed of by a baby*s digestive appamtus in ahout half the time. Thus feeding every two hours allows a sufficient interval of rest. ^ CARE OP THE BREASTS It is very important for the mother's future com- fort that the breasts should l)e properly attended to before the birth of the child. They enlarge, and are usually more or less sensitive. No pressure upon them should be permitted, a comfortably fitting waist being worn instead of corsets. Dissolve a little salt in brandy, or a pinch of alum in alcohol, and bathe the nipples with it every night for six weeks, pressing and pulling them gently at the same time. Dr. Starr recommends bathing them in warm water in the evening and anointing them with cocoa butter in the morning. Both processes have given good results. Probably a thin, delicate skin would FOOD 31 be more benefited by the first, and a thicker, tougher one by the last mentioned. If the nipple is retracted, or pushed inward, fill a ])int bottle with hot water, empty it quickly and place the mouth of the bottle over the nipple. As the air in it cools the nipple will be drawn out and can then be taken between the fingers and manip- ulated. When there has been no preparation, the first efforts of the baby to nurse may cause the skin of the nipple to crack and it becomes very sore, so much so, tliat nursing may have to be abandoned on this account alone. At the first suspicious symptom, white of egg should be i>ainted on the sensitive surface, making two or three applications and letting it dry. If this does not succeed, a pinch of powdered tannic acid can be stirred into glycerine and applied afler each nursing, being washed off with a solution of boracic acid before the child nurses again. A rubber nipple-shield should b« provided to cover that of the mother while the chi d is nursing. Glass shields are sold, which can he worn in the interval and make the part more comfortable. If the breast is hard, or contains lumps, it should be very geiiily but persistently rubbed fiom the base 22 THB CARE OF CHILDREN towards the nipple until it is mh. Neglect af ' this measure may result in an abscess. When for any cause the milk has to be dried up, the doctor will order a lotion ointment, or plaster, for the purpose. When the breasts feel heavy and uncomfortable, they should be sup{M)rted with a bandage sha[)ed like the letter Y. Tlie straigiit piece goes across the back, being made about twice as long as is needed. One side of the fork of the Y goes above the breasts, the other below them, and the points are pinned to the long piece. The extra length is brought over the nipples and can easily be turned back without disturbing the bandage when the child is to be nursed. Absorbent cotton can be put between the breasts and alK)ut them, under the bandage. To make it, take two strips of cotton tinec inches wide and a yard long. Fold qpe in the middle so the two ends come at an acute angle, and fasten it with safety-pins to the end of the straight strip. If it is not secure after it is in place, it can be fastened with straps over the shoulders. The mother should always have a light shawl, or other covering, thrown over the breast when the baby is nursing. FOOD 23 WHEN THE MILK DI8AOREE8 Sometimes the mother's milk i» insuffieietit in quantity, or not rich enough to satisfy the child. When this is the case it must be nursed once in four hours and fed between each nursing. The mother can drink milk, cocoa, albuminizcnl milk ; that is, the white of one egg to each half pint of milk, shaken in a self-scaling glass jar, or bottle, and gruel of oatmeal, Indian meal, or barley made with milk. Plenty of fluid increases the flow of milk. The breasts can be gently rubbed from the base to the nipple twice a day with warm campho- rated oil, and the child encouraged to nurse. The act of sucking stimulates the secretion of milk. As much nourishing food as possible should be taken, good soup, meat and fresh vegetables, as well as the cereals. This helps to improve the quality of the milk. When the baby does not digest its food properly it cries with pain after nursing, or throws up the milk curdled, or sour, and there are white curds of milk in the motions. It is restless and fretful, and the skin may be hotter than usual. Two teasix>onfuls of lime water given just before nursing will sometimes obviate the difficulty, and one or two may follow the meal. The doctor may li.ive to j>rescribe if the case is 7\ 24 THE CARE OP CHILDREN obstinate. Medicine should not be given without his prescription. Something in the mother's diet may not agree with the delicate stomach of the child. Acids are apt to affect it unpleasantly — as vinegar, or sour fruits, as strawberries, and oc(;asionally vegetables, as tomatoes. Only experience can show what mast be avoided. Articles that will not affect one baby may cause another much discomfort. The possibility of the ciiild being overfed should always be borne in mind. When the stomach feels hard and distended, or the milk is vomited soon after being swallowed, looking unchanged, the child should be kept at the breast a shorter time for the next meal. If a child is being properly nourished it will gain steadily in weight. It loses during the first three days, but after that gains about three-quarters of a pound or more during the first month. During the second month it should increase in weight from a quarter to half a pound each week : after that the gain is more slow, but should pro^iccss constantly until at six months old it gains about a pound a month. The increase is often more rapid, but this proportion shows that the baby is thriving. FOOD 25 WHEN NURSING IS IMPROPER It is the duty and ought to be the pleasure of every mother to nurse her own baby. All right- thinking women are anxious to do so in spite of the inconvenience to themselves. Yet there are cases in which this privilege must be denied. If the mother is afflicted with a constitutional disease, as scrofula or consumption, her milk will be injurious to the baby. Should there be a return of the menstrual flow nursing must be discontinued. Some women have not sufficient strength to nourish their children without injuring their own health, but no one should hastily decide that this is the case. If the milk manifestly disagrees with the baby its use cannot be continued. This is shown by the child losing flesh and becoming pale and puny. A well-nourished infant has firm flesh, slightly mottled, a good color in the lips, and bright, clear eyes. WEANING When the mother has been happy enough to be able to nurse her baby, she is apt to prolong the pleasure beyond due limits. No child should be nursed after it is a year old, and there are many reasons that may make it necessary to withdraw the natural nourishment much earlier. 26 THE CARE OF CHILDREN ! i One has been mentioned : its insufficiency to meet the demands of the child. Very oflien the supply of milk diminishes, the breasts do not fill, and it is evident there is not enough to satisfy the hungry ai)plicant. Sometimes the mothei'^s health suffers; she feels languid and miserable, grows thin, has constant headache and no appetite. She has pain between the shoulders and is always tired. The drain upon her vitality is too great and she cannot do justice to the child. When the weaning can be done gradually, there is usually little discomfort on either side. If the baby has a food it likes, alternately with the breast, for the first day or two, it will not rebel. It can be given more often each day, at the time the child has been accustomed to be nursed, until finally it is sub- stituted entirely, and the weaning is accomplished. The process is more painful, to the mother at least, when, for any cause, it has to be done sud- denly and there is an abundance of milk. The breasts should be comfortably supported with a bandage, and a handkerchief, wrung out of alcohol diluted with an equal quantity of water, laid on them and kept wet. Very little liquid should be drank and a gentle laxative taken : a heaping tea- FOOD 27 the spoonful of Epsom or Rochelle salts, citrate of magnesia, or a Seidlitz powder. Sometimes the breasts are rubbed with belladonna liniment, or painted with a mixture of belladonna and glycerine ; or a belladonna i)laster, cut round, with a hole in the middle for the nipple, is applied. When there is an unusual quantity of milk, it may have to be drawn with a breast-pump. This should be avoided if possible, as it tends to keep up the secretion instead of checking it. If a baby is thriving it is best not to wean it in summer, as a change of food may disagree with it and cause diarrhoea, which is to be dreaded in warm weather. Teething need not be an obstacle to weaning, un- less the child suffers very much and is made ill by the process, when it is unwise to add to its troubles by any experiment in new diet, unless the breast milk disagrees with it. '! CHAPTER II FEEDING When a baby cannot be nm*scd, life depends upon a food being found which it can digest. Cows' milk is the one most easily obtained and when properly prepared makes the best substitute. It contains less sugar of milk and fat than that of the humnn mother and these must be supplied — the fat by adding crc^am to it. It is slightly acid, instead of l)eing alkaline; this can boeorrec^ted by the addition of lime-water. There is more caseine, or the hard curd of which cheese is made, than in motliers* milk, and water must be added to reduce this. These points ai'c all covered in a recipe prepared by Dr. Meigs, called CREAM FOOD Cream, 2 tablespoonfuls. Milk, 1 tablespoonful. Lime wat<3r, 2 tublespoonfiils. Milk-sugar water, 3 tablespoonfukk (») POOD 29 One-quarter of this quaiititv (;an be given every two hours during tlie day and once or twice at night, if necessary, until the baby is a week old. After that the quantity must be incieased, one«half the amount prepared beiiig given at once, until at two months old the child takes ibe whole quantity. The proportion of milk is gradually increased and the water losscncd, the cream also being decreased, until when two months old the baby is taking: Milk, 3 tablespoon fuls. Cream, 1 tablcspuunful. Lime water, 1 tablespoon ful. Sugar water, 3 tablespoonfuls. After two months the lime water may be discon- tinued and the milk gradually increased, until at five months old the child has five tablesj^ooufuls of milk instead of three, the cream and sugar water remaining unchanged. When it is six months old the quantity of milk is doubled ; that is, increased every day until it has ten tablespoonfuls at each feeding. The milk used for a baby should be allowed to stand in a cool place for three hours after being received to allow the cream to rise. The upper half is then carefully dipped off with a saucer or ladle and the remainder set aside for other uses, The baby must have the best. THE CARE OF CHILDREN MILKH3UGAR WATER To make this, dissolve half an ounce of sugar of milk in half a pint of boiling water. It will not keep long after it is made. LIME WATER This is expensive if bqught and is easily prepared at home at the most trifling cost. Take a lump of lime as large as a good-sized plum — it weighs about an ounce. Put it in a bottle with one quart of cold water which has previously been boiled. Shake the bottle well until the lime is dissolved and let it stand for twelve hours before xising. Poui* it carefully into another bottle so as not to disturb the sediment. Water can only absorb a certain quantity of lime, about a quarter of a grain to a tablespoon ful, so there is no fear of its being too strong. BARLEY FOOD As cow's milk forms firmer curds in the stomach of a baby than its mother's milk would do;, it is sometimes impossible for this delicate organ to break them up and digest them. Barley seems to have the power of remedying this defect and barley food may be tried when the milk and lime water disagree with the baby. To make it, take two even tablespoonfuls of POOD 31 i'cd pearl barley. After washing it thoroughly put it in a double boiler, or saucepan, with one pint of boiling water and let it boil two hours. Ground barley need only be cooked half an hour. Use the barley water instead of the lime water and sugar water in the cream food, and sweeten with a tiny pinch of dry sugar of milk. MALTED FOOD Dr. H. D. Chapin and Dr. Arnold Eiloarfc, of New York, have been carrying out a series of ex- periments to ascertain a cheap and satisfactory method of preparing an easily digested food for babies. Their formula is given with the permis- sion of the former. Wheat flour, or barley meal, two ounces ; that is, two tablespoon fuls heaped as high as possible. Water, fifty-six ounces, or a quart and three- quarters. Extract of malt, a small teaspoonful. Mix the flour to a paste with a little water, grad- ually thin this with a scant quart of the water, put it into a double boiler and boil it ten minutes. Take out the inner vessel and add the rest of the w^ater cold, the malt extract being dissolved *n the last few tablespoonfuls. Let it stand fifteen min- utes. Put back the inner vessel in the double 32 THE CARE OP CHILDREN boiler, and heat again fifteen minutes. Strain through a wire-gauze strainer. Half the quantity may be made, using pints in- stead of quarts in measuring the water. This preparation is used instead of barley water, lime water or sugar water in diluting the milk. It should not, of course, be given without milk. In making the gruel, it must he stirred while cooking until it thickens, or it will not be smooth. The water in the outer part of the double bailer must boil all the time. The malted water enriches the milk and prevents •t from coagulating into the large, tough curds that are so objectionable in the baby^s stomach. PEPTONIZED MILK If the baby's digestion is seriously affected it may be necessary partially to digest the milk before giving it. This process is known as peptonizing it. Extract of pancreas can be obtained from the druggist, five grains of this and fifteen grains of baking soda are added to each pint of milk. Tablets of pancreatin and soda can also be used. After adding the peptonizing agent place the milk in water of a temperature of 115° Fahrenheit, or so hot that the hand can be dipped in the water only for a moment. Leave it there for twenty minutes POOD 33 es. Strain ? pints in- rley water, milk. It ilk. pred while )e smooth, ible boiler 1 prevents curds that ifected it Ik before >nizing it. from the jrains of ^e used, the milk eit, or so ater only minutes and then place it on the ice, or pour the milk into a clean saucepan and bring it to the boil, to stop the digestive process. If this is carried the least too far the milk will taste bitter. It is well to try it from time to time and if any change is detected to take it out of the hot water at once. Either Cream Food or Barley Food can be pep- tonized. This pre-digestion has undoubtedly saved the lives of many children who were unable to di- gest food for themselves. The use of peptonized food should only be contin- ued until the child gains strength, as it is not well to interfere with the natural process too long. STERILIZED MILK Milk is a frequent carrier of infection and in cities particularly it is very difficult to get it per- fectly pure. Sterilizing destroys any germs it may contain and renders it a safer food for the baby. It was once thought necessary to boil it, but it is now said that if the milk is heated to a temperature of 180° Fahrenheit and kept at this point for fifteen minutes, it will keep for twenty-four hours, and the flavor of the milk is not injured as by boiling. Water boils at 212°, so this is some distance below the boiling point 34 THE CARE OP CHILDREN Probably the easiest and most practical way for the mother to manage this imj)ortant business is to provide six or eight half-pint bottles, according to the number of times the child is fed in the twenty- four hours. Put the proper amount of food for one feeding in each bottle and use a tuft of cotton bat- ting as a stopper. Have a saucepan that the bottles can stand in conveniently. Invert a perforated tin pie plate in the bottom and put in enough water to come well above the milk in the bottles. Stand the bottles on it and when the water boils draw the saucepan to a cooler part of the stove. Cover the saucepan and let the bottles remain in the hot water one hour. Then put them in the ice box or stand them in cold water, or a coc\ place in winter. In sterilizing milk to use on a long journey re- peat the process three times, letting the milk cool between each. Patent sterilizers can be bought and are very convenient, but the home utensils answer every pur- pose. It is worth while- for the mother to take the trou- ble to be certain that her baby is having pure milk. Unless she draws it fron(i the cow herself, or is mire of the conditions under which it is drawn, it is wiiest to sterilize it u.. #0OD 39 It is said that if a wad of cotton batting is placed ill a funnel, the cold milk poured on it and allowed to filter slowly through into a pitcher, many impuri- ties are strained out of it. The fibres of the cotton have the power of arrelsting germs and the proportion is much smaller in the filtered milk. This experi- ment is woith trying when for any reason it is im- lK)ssible to sterilize the milk by heat. CONDENSED MILK Condensed milk, sold in tins, is not a suitable food for a baby. It contains a large quantity of sugar, which makes the child fat, but not enough material to build up the muscles and form firm flesh. It is laxative, and when there is constipation one meal daily may be given of it to secure the desired re- sult. It would not injure a child to be fed on it for two or three days, as in traveling, when it is difficult to procure fresh milk ; but its \iae should not be long continued. \ A baby's food must contain the elements necessary to build up the different parts of the body and fresh milk is the only one that combines all of these. One teaspoonful of condensed milk to one cup, or eight tablespoon fuls, of water is about the right pro- portion. If it is necessary to use it for any length of time, it is well to add one teaspoonful of cream. 36 THE CARE OF CHILDREN Always put a little salt in babies' food. AMOUNT OP FOOD A baby's stomach at the time of birth is said to hold about six teaspoonfuls, so that at first it needs very little food at a time. The capacity increases rapidly during the first and second months and not so fast fVom the third to the fifth. A child who has come into the world prema- turely may not be able to take more than a few drops of nourishment at a time, and these have to he administered with a medicine drojiper. There is no strength to suck and no power to assimilate a quantity of food. Many authorities maintain that the amount of a child^s food should be regulated by its weight rather than wholly by its age, a child of from six to eight pounds requiring after the first- weok about six tablespoonfuls at a feeding once in two hours from 6 A. M. to 8 P. M. and once during the night. The amount is gradually increased and the interval lengthened until a child weighing twenty pounds has sixteen tablespoonfuls every three hours during the day, and once at night if necessary. Children should have food as oflen as once in three hours during the day until they are four years old ; that is, a glass of milk, or some simple (]• POOD 37 nourishment, between breakfast and dinner and dinner and tea. The appetite varies even in babies, some infants requiring more food than others. It may be nec- (^ssary to feed a child every hour and a half if it wakes and is manifestly hungry, but the feeding should be delayed if possible. On the other hand some babies seem not to need food so oflen and will accept very contentedly a meal once in three hours. Each baby must be judged on its own merits ; it is only possible to lay down general principles for the treatment. Common sense must guide the ap- plication. TEMPERATURE OP POOD Too hot food is a fruitful source of trouble with young babies. It should never be more than " milk warm," about 99° Fahrenheit, as this is nearly the temperature of its natural food. HEATING POOD If the baby is fed once during the night it is convenient to warm the milk in the bottle before the mother goes to lied and wrap it in a blanket within easy reach. It will be about the right heat in four or five hours, when it is needed. If still too warm let it stand uncovered for a few moments. 38 THE CARE OP CHILDREN If it has been sterilized it will not be injured by waiting. In summer, or when the nursery is at a distance from the kitchen, it is convenient to have a small saucepan for warming the food. This can be (illcd with water to stand the bottle in and heated hi a few minutes. Tin chimneys with a mica slide in the side can be obtained that will fit a kerosene lamp, or little contrivances to put over a gas burner, either of which will support a saucepan. B THE NURSING BOTTLE Provide two plain round bottles, as they are the most easily kept clean, and half a dozen rubber tops ^without tubes. Graduated bottles with ounces or tablepoonfuls marked on the outside can be pur- chased and make it more easy to measure the exact quantity of food. Afl'ir using, empty any milk that may be left in it; rinse in cool water, then in scalding water and turn it up to dry. If particles of milk adhere to the bottle, use coarse salt, or raw potato cut in small pieces, to re- move them. If the bottle looks clouded, add a little ammonia to the water, rinsing the bottle thor- oughly in clear water. The rubber tops should be turned inside out and FOOD 39 scrubbed with a stiff brush kept for the purpose. Once in two or three days they should be boiled for ten minutes. The most delicate cleanliness is absolutely neces- sary in the care of the bottle and the top. The want of it will surely cause serious illness to the child. As soon as possible a baby should be taught to drink from a cup and the nursing bottle aban- doned. GIVING THE FOOD The mother must not grudge the time that is necessary to feed her baby. The child should be placed in a comfortable position in its crib and the mother sit by it and hold the bottle at such an angle that the top is kept filled with milk. If the bottle is laid on its side air is sucked in with the milk and a stomach-ache may be the re- sult. After a meal the baby should lie on its right side. The liver is disproportionately large in young children and if it presses on the stomach digestion is interfered with. When the child sleeps after eating, in about an hour it should be gently turned on the left side. It is not well for it to lie always in one position^ as in time this may cause deformity. 40 THE CARE OF CHILDREN WATER "Water 18 very necessary for children. They often cry from thirst instead of hunger. A young baby should have a teaspoonful several times a day and the quantity be increased as it grows older. The lack of sufficient water with tiie food is a frequent cause of constipation. If there is any reason to suspect its purity it siiotild be boiled. Tlie flat taste that boiling gives it can be removed by shaking it in a jar, or pitcher, so it can regain the oxygen, of which boiling de- prived it. CHAPTER III de- INCREASING THE FOOD After a food has been found that agrees with the baby it usually thrives well upon it ; the quan- tity being increased as the child grows older. When the first teeth are through, or it is about six or seven months old, it may begin to seem dissatisfied with milk alone and to demand an addition to its diet. What this is to be is an important question, and often several kinds of food have to be tried before the right one is chosen. A young baby cannot digest food containing a large amount of starch. Saliva is necessary to con- vert this into sugar, and there is no secretion of saliva in a baby's mouth before it is four months old. For some time starchy food must be given very sparingly. ArrowroM is out of the question because it is (41) 42 THE CARE OP CHILDREN chiefly comjiosed of starch. Barley gruel, which has already been spoken of, and oatmeal gruel, make a suitable addition. It must be borne in mind that the gruels are only added ; the chief reliance must still be placed on milk. OATMEAL GRUEL A delicate gruel can be made by rolling a cup of oatmeal on a cake board, or pounding it with a pestle. Put this in a dish and pour over it about a pint of water. Stir it up, and let the mixture settle for a minute. Pour off the milky fluid and repeat the process twice. Boil this water fo:' an hour, adding a little salt, and use it to dilute the milk in- stead of water. Gruel can be made from oatmeal by allowing one tablespoonful to each cup of boiling water, boiling one hour and straining through a wire strainer. FARINA GRUEL Farina is prepared from the most nutritious part of the wheat. Being already partially cooked, it does not require as long boiling as the other cereals. Take one tablespoonful of farina to two cups of boil- ing water, add salt, and cook for fifteen minutes. Use as directed for oatmeal gruel. FOOD 43 ing tes. FLOUR BALL This may be given to babies under four months old, as the long boiling converts the starch into dex- trine, a substance between starch and grape sugar, and digestible by young children. It is especially recommended in cases of diarrhoea, and mj be used instead of barley gruel as a fo^.. To make it, put a bowlful oi flour into a stout cloth, tie it up like a pudding, put it in a saucepan of boiling water, and boil it for ten or twelve hours. On removing, turn it out of the cloth and cut away the soft outside. When cool, grate the hard inside portion and use one teaspoonful at each feeding for a baby eight months old, increasing the amount for an older child. RICE WATER This is valuable as a food during diarrhoea, or when for any cause the use of milk has to be dis- continued for a time. Wash two tablespoonfuls of rice and put it in a quart of boiling, salted water. Let it cook for two hours, until the rice is nearly dissolved. Pour the liquid through a strainer, or a piece of thin muslin, and give it cool. WHEY FOOD Mix one teaspoonful of liquid rennet with one pint of milk. Set it in a warm place, but not where 44 THE CARE OF CHILDREN it will become more than milk-warm. When the curd forms, break it up with a spoon, beating it well, and strain off the whey. This can be given alone when milk cannot be digested, or with one- quarter part cream added to it. ALBUMINIZED FOOD Shake the white of an egg with half a pint of water in a self-sealing glass jar until they are thoroughly mixed. Add a few grains of salt. It may be given alone when milk cannot be taken, or with the addition of one-third milk or one-fourth cream. BEEF JUICE When the four front teeth are through, or after the child is nine months old, it may have once a day one or two tablespoon fuls of beef juice, not beef tea. This may be the juice that runs from rare roast beef when it is cut, or it may be specially prepared for the purpose. In this case cut half a pound of steak from the top of the round into pieces about one inch square. Place them in a glass jar or bottle, stand this in cold water over the fire. Let the water heat gradually until it is scalding hot, but not boiling, about 180° Fahr., and keep it at this temperature one hon^. Then pour off the juice and add a little salt for use. d FOOD 45 of are It or Mutton can be treated in the same way. The juice can be pressed from the rare meat with a lemon squeezer, the steak being first broiled for a minute, but it is a more troublesome process and not as much is obtained. This addition to the diet oflen relieves constipa- tion. It should be remembered that young children do not require a great variety in their food. A baby who is nursed by its mother has only her milk until it is at least ten months old. When the teeth are well developed, it is nature's indication that the little body is ready to digest and assimilate more solid food than milk. The wise mother gives it, but only one new article of diet at a time, and waits to see how that is disposed of be- fore introducing another novelty. After the child is a year old, the cereals, instead of being made into gruel, can be eaten as porridge with a little sugar. Hominy, cracked wheat and farinose may be added to the list, and, a little later, rice. All the cereals should be thoroughly cooked. BREAD Almost all children like bread and milk, and most babies make their first attempt at masticating solid food with a crust of bread. This is rather a 46 THE CARE OP CHILDREN dangerous plaything, as they are apt to bite off a piece which they cannot swallow with ease. Finely crumbled, or sofleued with warm milk, it is a very desirable form of food. Bread for babies, or young children, should be at least one day old. Chewing fresh bread converts it into a pasty mass which the saliva cannot })enetrate to digest the starch. It passes into the stomach, where it cannot be dealt with, and is a source of irritation there. Milk toast, made by pouring hot milk over thin slices of well-toasted bread^ is un- objectionable. CRACKERS Gluten, soda, oatmeal and Graham crackers can be given, at first soaked in milk and later alone. These are better than the square, sweet biscuit in which children usually delight. EGOS A properly cooked egg is easily digested by a child a year old, and one every day, or every other day, may be given. When an egg is plunged into boiling water and cooked for three or four minutes, the albuminous part, or white, is hardened into a tough, solid masF, difficult for the digestive powers of an adult to deal with. FOOD 47 Pour a pint of boiling water into a saucepan, put in the egg, leaving the vessel uncovered, and draw it to a cool part of the stove where the water will not boil again. In ten minutes the egg will be done, the white being like soft jelly instead of hard leather. The egg may be poached by breaking it carefully into a saucer and sliding it into a saucepan of boil- ing, salted water. Do not let the water boil after it is in, and cook it two minutes. a ler ind irt, is?, leal SCRAMBLED EGOS An egg may be beaten with two tablespoonfuls of milk and stirred in a hot frying-pan over a mod- erate fire, drawing it aside every few seconds so that the mass will not cook too quickly and be soft and light when done. If there is whey it has remained on the fire too long, and the hard curds should not he given to the child. Fried eggs are indigestible and must be pro- hibited. STIRRED EGG The yolk of an egg can l)e put m a cup and set in boiling water and stirred until it thickens. Add a little salt. JUNKET Junket is also called curds and rennet custard 48 THE CARE OP CHILDREN It 18 the albuminous or flesh-forming part of milk separated into a curd by the addition of rennet. Liquid rennet can be bought from the grocer or drug- gist, and is extracted from the inner lining of the stomach of the calf. Junket is much better for children of a year old, and upwards, than custard or puddings, and may be tried for babies who object to milk in a fluid form. To make it, take one pint of milk, warm it to 98° Fahr., or milk- warm, add one teaspoonful of rennet and one teaspoonful of sugar ; stir all together and let it stand in a warm place until it sets, or becomes semi-solid. Remove it to a cold place or the coag- ulation will go too far and whey will appear. ui thi h( stS hi lit! BAKED POTATO This is the only form in which potato should be given to a child under two years old. The potash salts, which are a valuable constituent of the potato, are lost when it is peeled and boiled; while the skin retains them during baking. It should be jierfectly cooked, dry and mealy, and be given with a little salt and a dessertspoonful of cream rather than butter. GELATINE CREAM Put one-quarter of a box of gelatine in a quarter FOOD 49 ) of milk >f rennet. • or drug- ig of the year old, and may n a fluid it to 98<» of rennet ither and becomes the coag- ould be B potash I potato, lile the iild be en with rather juarter of a cup of cold water ; let it soak for half an hour, then set the bowl on top of a boiling teakettle or in hot water and stir until the gelatine is dissolved. Pour it into a cold dish and when it begins to stiffen add one and a half cups of good milk, or half cream and half milk, a teaspoonful of sugar, a little cinnamon, lemon juice, or vanilla^ if desired. MACARONI Being made from wheat flour, either macaroni or vermicelli is excellent for children. It should be dropped into boiling milk, or half milk and half water, the heat lost by putting in the cold macaroni being restored by adding a little boiling water. If this is not done it will be pasty from soaking in the cooled water. Boil until tender, adding a little salt. RICE This is an excellent food for children and can be cooked in a variety of ways. When done, each grain should be distinct yet sofl. To boil it, put half a cup of well washed rice in one quart of boiling water, adding a little boiling water to keep up the heat and a good pinch of salt. It will cook in from fifteen to twenty minutes and must be removed while the water is perfectly clear. If the grains burst the starch gives the water a 50 THE CARE OF CHILDREN milky appearance. Drain the rice and return it to the saucepan to dry for a minute, stirring it lightly with a fork. To steam it in a double boiler, use one cup of boiling water to half a cup of rice that has been thoroughly washed. Add a little salt and cook for half an hour. Remove the cover and let the rice dry. Milk can be used instead of water or half of each. Chicken or beef broth can be substituted for the milk or water, for children requiring especially nourishing food. Stirred Rice. — Put half a teacupful of rice in one quart of milk, sweeten to taste and bake slowly until the milk is absorbed, stirring frequently. If the milk boils away pour in a little more from time to time. When done the pudding should be a soft creamy mass. , Eggs may be added to rice pudding and cin- namon, lemon, vanilla, rose water, or any flavoring desired. ORANGES The year-old baby may have the juice of half an orange and, as he grows older, the pulp scraped from its covering membrane and divested of the seeds. The orange juice should be given midway between the meals of milk as they sometimes dis- agree 'f brought into too close contact. a 1 V J u V u rooD 6t it it Orange juice given early in the morning is an excellent laxative. For this reason neither it nor apple should be given when there is a tendency to diarrhoea. BAKED APPLES The baby will enjoy the soft part of a baked apple when he has passed his first birthday. Very little sugar should be given with it. It is never well to begin the use of fruit in very warm weather. If the child has become accustomed to taking it, its use need not be discontinu* d unless _ it disagrees with him. Other fruit and vegetables should not be given until after the child is two years old. cm- CHAP1 ER IV DIET AFTEK TWO YEARS OF AQB MEAT It is stated that children from two to four years of age require about one-fourth as much food as a grown person at the act^ ^e, working age. There is a large amount of tissue to be built up and a proper supply of suitable .bod is very important. It is a mistaken idea that children require a quan- tity of meat, to strengthen them, as it is said. Nutritious food is that which gives to the body the different substances it needs to build up its various parts. Meat feeds the muscles but does not develop bone. The salts necessary for this purpose must be supplied by vegetables, including in this term cereals and fruits. Meat stimulates the nervous system and increases the activity of the brain, so that its use should be restricted in the case of nervous children. When taken in excess it is said to render the (62) POOD 53 disposition irritable and quarrelsome ; and that children in whose diet it predominates do not grow as tall as those fed on less stimulating fare. Until the full set of first teeth have come, which usually occurs between twenty months and two years and a half old, a child should not have meat, except in the form of meat juice, broth or soup. Afler that it can be given in small quantities once a day, never more oflen. Its place should be supplied by an abundance of milk. Bread, porridge of the various cereals, eggs, delicate vegetables, and fruit constituting the re- mainder of the diet. COOKING MEAT In giving meat to a child the cooking is a matter of prime importance. The albumen it contains can be hardened just as the white of an egg is by im- proper cooking. Children should be encouraged to like rare meat. If there is a distaste for it, this can sometimes be overcome by giving it a little less well done each day. As long as it looks red it is sufficiently mre for practical purposes. Roast beef, mutton, or chicken, are suitable for children. Veal, pork and salt meat, as ham, and the internal organs, liver, kidneys, sweetbreads, etc., must be avoided. 54 THE CARE OF CHILDREN Meat should be either roasted, or broiled, al- though boiled chicken and mutton are permissible. Frying, as it is usually done, renders meat unfit for human digestion. It should not be chosen as a means of cooking meat for children, but if it cannot be avoided, heat tiie frying-pan hot, put in a small piece of drip- ping, and, when it melts, the meat, turning the latter quickly from side to side. Use as little fat as is possible, and remove the meat the instant it is sufficiently done. \ BEEF STEAK Have a hot fire, place the steak on the gridiron and hold it close to the fire for a minute, turning it rapidly. The fierce heat coagulates the albumen near the surface, seals the pores of the meat and keeps in the juice. When the outside is seared, hold it farther from the fire until it is done. On removing, sprinkle it with salt. Steak should be cut about one inch thick. The top of the round is a juicy and well flavored part' of the beef, and steak cut from there is less expen- sive than the sirloin^ or choicer steaks, and more nutritious. MUTTON CHOPS These are cooked in the same way as beef steak. FOOD 55 They should be nicely trimmed and the iat re- moved before br&iiing. SOUPS When meat is to be made into soup it should be cut in pieces, the bones broken, and placed in cold water, which is gradually heated, to draw out the juices. In cooking meat, intended to be eaten, it should be plunged into boiling water to seal the pores and keep the juices in. CHICKEN Poultry is not more desirable for children than beef or mutton, although, being more delicate, it is sometimes considered so. Either the white or dark meat may be given, the former being preferable. It may be roasted, boiled or broiled. kk. BACON Fat is essential to the proper growth of the tis- sues of the nerves and brain, and is peculiarly important to children, as the brain enlarges rapidly during childhood. Next to butter and cream, bacon is one of the most palatable forms in which it can be given. It should not be over-cooked, as then 56 THE CARE OF CHILDREN too much of the fat is tried out. Sometimes bread soaked in bacon fat will be eaten with relish. Salt pork, well soaked, thoroughly boiled, cut in thin slices and eaten as a sandwich between thin slices of bread; makes a good substitute or alterna- tive, VEGETABLES After a child is two years old a vegetable of some kind beside potato may be given at the mid- day meal. Cabbage, raw cucumbers, and green corn are unsuitable, but any other well cooked vegetable is harmless in small quantities. Stewed celery, peas, beans, tender cauliflower^ baked or stewed tomato are all useful. FRUIT Any fresh, ripe, seasonable fruit may be given early in the day to a child who is well. The points to observe are to have it sound ; that is, without a suspicion of staleness, and not to give too much at once. Strawberries, raspberries, blackberries, pears, apples, peaches, oranges and grapes are all welcome. Fruit having a skin should be pared, and grapes should have the seeds removed, or the child should be taught not to swallow them. Bananas must be given with caution ; they dis- agree with many children. Try a slice one day POOD 67 and, if no ill effects follow, two the next, proceed* ing slowly until certain it can be well borne. le. )es lid STEWED FRUIT Stewed fruit can be given at supper and is much relished by moj^^t children. Apples, pears and peaches cooked in this way are a valuable addition to the diet list, and almost any of the fresh fruits can be similarly treated. In winter evaporated apples, apricots, nectarines, etc., are nearly as nice as the fresh fruit and bear little resemblance to the old-fashioned, leather-like dried preparations. They must be soaked over night before cooking and boiled until perfectly tender. Prunes with the stones removed are a favorite dish in many nurseries. The cravr.io' which children have for sweet things indicates a legitimate demand for sugar, which should be met by giving sweets at meals with other food, instead of allowing unlimited in- dulgence in candy between times. Bread and molasses, or syrup, or maple symp may be safely eaten when chocolate creams or caramels would cause a fit of indigestion. is- ay 58 THE CARE OF CHILDREN PUDDINGS No young child should taste pastry. Aflei seven years of age a little may be given occasionally if it is light, flaky and well baked. Its place can be filled with advantage by pud- dings of rice, tapioca, corn starch, baked Indian raeal, sago, baked and boiled custard, and all the varieties of blanc mange and creams that can be made with corn starch or gelatine, milk and eggs. Ice cream is beneficial to children if it is not given in too large quantity. Rich puddings should be avoided just as rich- made dishes are, because the simpler the food the stomach has to deal with the better. , BEVERAGES A child, until it is twelve years old, should drink little be«ide milk or water. Tea and coffee are stimulants and are better left untouched by a nervous race like oui*selves as long as possible. Milk can be diluted with hot water if necessary, and sweetened, when it is called " cambric tea." Children who do not care for milk can sometimes be induced to take it by adding a few drops of vanilla and a little sugar and calling it " ice cream milk,*' or by boiling part of the rind of a lemon in it with sugar. Sometimes merely heating it will POOD 59 overcome the distaste for cold milk and a pinch of salt may be added. Cocoa, cocoa nibs, or chocolate are good for children from the quantity of fat they con- tain. They should be made with half milk and half water. Ice water is injurious to the delicate stomach of a child. The water can be cooled by keeping it in a stoneware pitcher in the ice chest. When no ice is at hand, wrap the pitcher in a wet cloth and stand it in a draught, changing the cloth once or twice as it dries. The heat is removed by evaporation. A small quantity of home-made fruit syrup may be added to it as a treat. ' FRUIT SYRUP To make this, take two quarts of strawberries or raspberries and two pounds of sugar, put them in a jar standing in boiling water, and let them remain for an hour. This draws the juice out. Turn the con- tents of the jar into a wire sieve placed over a large bowl and let the juice drain off without press- ing the fruit. Have ready some self-sealing jars, scalded with boiling water, fill these with the juice, stand them in a saucepan of cold water over the fire and let them remain in it half an hour after the water boils ; screw on the tops and the syrup will keep like any other canned fruit until it is used. 60 THE CARE OP CHILDREN Children should be encouraged to take a suffi- cient quantity of fluid, as tlie want of it is very n])t to cause constipation. It is needless to say they should never touch alcohol in any form unless it is prescribed by a physician^ or is used in an emer- gency. fi- ll)! ey is CHAPTER V THE FOOD OF SCHOOL CHILDRBIT It has been well said that ''children in school are more or less like animals in captivity." They are existing under artificial conditions of cramped posi- tion, enfi)rced stillness of body and stimulation of mind, and too often deprived by bad ventilation of a fair share of the oxygen that is necessary to main- tain vitality. • Under these circumstances their diet becomes a matter of increased importance. When children live much in the open air, and are permitted to run about and exercise their bodies at- their own free will, their appetites may safely be trusted to demand the food that is required for their support. If we deprive them of these advantages we must see, at least, that they have nourishing, easily (61) 62 THE CARE OF CHILDREN assimilated food, prepared in such a |>alatable manner that they will be induced to eat it THE PURPOSE OF FOOD Food serves two great purposes : To build up flesh and bones, nerves and blood. To furnish heat and power to the body. The first end is accomplished by protein, a sub- stance found abundantly in lean meat, fish, eggs, milk, che(«e, and in some vegetables and meals, as i)eas, beans, oatmeal, wheat flour, rye and corn meal. k Heat and energy are furnished partly by fats, as cream, oil, butter, and the fat of meat ; and partly by starch, contained in potatoes, many of the cereals, rice, tapioca, etc., and by sugar. Children, from their ceaseless activity, require a large amount, proportionately, of the latter class of food. Fortunately, many articles of diet contain both classes of food materials, as wheat bread, Indian meal, oat meal, peas, beans, etc. It is not the most expensive food that is most nourishing, and the mother of moderate means may give her child all the substances necessary to develop his body as well as the millionaire. It only requiies a little knowledge, care and thought to do so. as iost lay lop li'es FOOD BREAKFAST It is very important that school children should lay a good foundation for the day's work in a substantial breakfast. This does not necessarily include meat. Indeed hot meat once a day is enough for children. Protein can be given them in a less concentrated form. The place of meat may be well supplied by fish. Many kinds are rich in nutritive properties. Fresh and salt cod fish, mackerel, blue fish, haddock, her- ring, shad, etc., are all useful. In a seaport town fish can be obtained in perfec- tion ; farther inland its freshness is sometimes doubtful and then it should of course be rejected. This objection does not apply to salt or pickled fish. Tiie meal should begin with a porridge of some cereal and milk followed by fish or bacon with bread or toast and butter, not hot rolls, and con- clude with fruit if it is obtain$ible. Fruit consists principally of agreeably flavored water, but as this is very necessary in the animal economy its value must not be underrated. The beverage should be cocoa, chocolate, hot or cold milk, diluted with water if preferred. LUNCHEON Children's luncheons require special thought. They should furnish about one-fourth o^ the food 64 THE CARE OF CHILDREN material consumed during the day and, being eaten at a time when the body is a little tired, should be particularly appetizing. Hot soup is desirable, but the practical difficulties in the way of providing a hot lunch are almost in- surmountable. When parents recognize the importance of insist- ing that the bodies as well as the minds of their children shall be developed at school, food will be provided there as one of the means to the end. Un- til then the mother must furnish the lunch basket. The basis of the meal, for so it should be consid- ered, and not merely as an unimportant morsel to be snatched by the way, must be sandwiches. These can be made of thin bread and butter, brown or white, spread with minced or finely cut meat, sliced cheese, boiled or scrambled egg, pre- served fruit, delicately shredded fish, sprinkled with salt, and sometimes a favorite vegetable, as celery or lettuce. Fresh fruit should be given whenever possible. A jelly tumbler with a tin top will hold a baked apple, stewed pear, prunes or any similar dainty. A suitable bottle should contain a glass of steril- ized milk, or cocoa. A few crackers, or plain cookies, can be added ; the aim being to have as much variety as possible. VOOD 66 The sandwiches should be wrapped in a napkin (those made from an old tablecloth do very well), and everything be as neat as possible. Nothing is small in the education of a child, and care in these trifling details will be well repaid by the taste for the re- finements of life that it helps to cultivate. DINNER A plate of hot soup should usher in the dinner. In every household where this save-all is unknown scraps are wasted every day that would be sufficient to furnish a bountiful supply for the whole family. Nothing comes amiss to the soup pot ; bread, cold vegetables, even fish, can be utilized, and their presence be unrecognized in the combination of flavors that renders the dish so acceptable. The soup should be followed by meat roasted, boiled, stewed, or broiled ; never fried, if it is possible to avoid it. Meat may be recookod in various simple ways, as minced and baked with alternate layers of tomato, or cut thin, warmed in gravy and served on toast, or cut in slices, covered with gravy and baked in a deep pan with a thick covering of mashed potato. A well made gravy is never greasy. Rich gravies and highly seasoned dishes, as currifl% should be avoided for children. «d THE CARE OF CHILDREN With the meat there should be potatoes and one other vegetable ; it matters little what so long as it is well cooked, neither over nor under done. Cabbage and turnips are rendered dark and strong-smelling by too long cooking. Cabbage may be made almost as delicate as cauliflower by removing it from the fire as soon as it is tender. Changing the water once during the boiling prevents the disagreeable, characteristic; odor during cooking. The meal may be concluded by a simple pud- ding, fruit, or ice cream. Pastry should be gi m very sparingly, but a perfectly healthy child may eat it occasionally with impunity, if it is good. Water is the only beverage that should be permitted at dinner. SUPPER There are two considerations that must be taken into account in preparing this repast. It is the last meal of the day and the chikFs digestion must not be overtaxed, or his sleep will be restless and un- comfortable. It is the last food he will have for twelve hours or more, and therefore must not be too slender in quantity or light in quality. Meat had better be avoided, particularly if it has been given at luncheon as well as at dinner. Eggs prepared in various ways are suitable, the cereals, if they are relished, bread and butter, milk toast, blanc mang^ FOOD cn jr custard, and fruit, fresh or stewed, preserves, honey or syrup. Milk, hot or cold, and water are still the only liquids permissible. AT BEDTIME. If a child plays hard and does not go to bed for two hours or more after supper, he may be hungry before he goes to sleep. In this case, it is wise to give a cracker and a glass of milk if they are de- sired. Sometimes, alas, under our pernicious system of education, which obliges lessons to be learned at home, he, or more probably she, may be exhausted by an hour of study in the evening, and the tired brain will not easily quiet down to sleep. If this outrage on nature cannot be stopped, the evil effect may be a little modified by a glass of warm milk, which, setting the digestive organs in action, will draw away the blood from the over-stimulated brain and render sleep possible. CHAPTER VI DIET IN ILLNESS Food plays a very important part in the treat- ment of disease, even more important than medi- cine. In serious cases it will be prescribed by the doctor in attendance, but there are many in which it is well for the mother to know what diet is most suitable for the time being. In slight ailments a change of food is sometimes all that is needed to effect a cure. FOOD IN CONSTIPATION This is one of the most frequent ills of childhood and one which can often be corrected by diet alone. It is frequently caused by an insufficiency of water ; not enough fluid is taken to flush the intes- tinal canal and help to carry off the waste matter. In these cases the child should have a glass of (OS) POOD 69 water early in the morning and several times dur- ing the day. It can be flavored with fruit syrup, or a little sugar added, if it is not readily taken alone. The water may be either hot or cold. Eggs, cheese and milk should be avoided for a time. These articles are thoroughly digested and absorbed by the system, leaving very little waste matter to be disposed of. This scanty remainder does not stimulate the intestines to action. Vegetables and cereals leave more residue behind them and so give a greater bulk for the intestines to act upon. Brown bread, oatmeal bread, or Graham bread, with butter and molasses, or syrup, oatmeal, or Indian meal porridge, stewed prunes, baked or stewed apples, any kind of fresh or stewed fruit, cream, soup, fresh meat, tomatoes and other vege- tables mav all be used to advantao^e. A fig soaked over night in a little water and given at breakfast l)efore other food is an effectual- remedy, the seeds acting as a stimulant. If a baby is constipated, try half a teaspoonful of beef juice in its food twice a day, increasing the quantity to half a tablespoonful if necessary. 70 THE CARE OP CHILDREN DIARRHCEA When a baby has diarrhoea, look to the food ; it is almost certainly in fault. Suspect the cleanliness of the nursing bottle, or the purity of the milk. Wash the one with redoubled care, sterilize the other, and boil any water used. If neither is guilty there may be some defect in tlie constituents of the food. Omit the cream for a day and in- crease the lime water. If this is ineffectual, stop giving the milk for a day and substitute rice water. Should the symptoms still continue, do not waste more time; send for the doctor. With older chil- dren diarrhoea often means tliat the digestive organs have been overtaxed with improper food or too great a quantity of it at once, and are trying to get rid of the offending substance. Except during the })revalence of cholera, when it should be attended to immediately, it may safely go unchecked for one day. The .diet should be light and unstimulating. Boiled milk may be given, grated flour ball, rice, tapioca, arrowroot, or sago, biscuit or crackers instead of bread, corn starch, barley gruel, junket, nnd, as the patient improves, boiled or baked custard. Water should be drunk sparingly; ice may be taken to quench thirst. POOD 71 ied be Avoid all the articles of food recommended for constipation. ARROWROOT GRUEL This is a useful food in diarrhoea, although, as it contains a large amount of starch, it is not suitable for very young babies. To malie it, mix a dessertspoonful of arrowroot to a smooth paste with cold water. Pour boiling water on it from the kettle, stirring until it thickens. The water mrst be boiling hard or it will remain liquid. Add a little salt and sugar if desired. If a spoon is lefl in it the thick gruel will become thin again.. INDIGESTION Indigestion in babies is usually caused by im- proper food, as when starchy and farinaceous sub- stances are used, which the baby cannot digest because it has no saliva to act upon them. Milk properly prei)ared with cream and lime water, or peptonized and given in the exact quantity required by the special baby in question, will usually effect a cure. In older children the food must still bear the blamci if tliere is indigestion. 72 THE CARE OF CHILDREN Some bad habits contribute to it. One of the worst of these is eating too fast, which works harm in two ways. The food stays in the month so short a time the saliva does not have a chance to convert the starch into sugar ; it is carried into the stomach, which nature has not fitted to deal with it in this condition, and there sets up an irritation and causes discomfort, as misplaced matter always does. When the food is hurried through the mouth it cannot be properly masticated, or ground by the teeth, and hard masses are sent to the stomach which it is beyond the power of ^hat organ to separate. It grumbles at having to do work that does not belong to it, and we resent the just remonstrance and call it pain and indigestion. Sometimes, of course, disease unfits the stomach to do its work, but this is not often the case, at least in the beginning, with children. Those who suffer from indigestion should eat a small quantity at a time and have meals more fre- quently than those in health. Toast soaked in beef or mutton juice, rare roast beef or mutton finely minced, the white meat of chicken, fresh f sh that can be boiled, like codfish or haddock, oysters, stale bread, plain puddings, rice, tapioca and oatmeal porridge with milk may be tried. FOOD 73 Avoid giving too great a variety at one time. One or two viands are enough at once. Fat meat; cheese, fresli bread, much butter or cream^ (wastry, nuts, and any meat that has been warmed over, should not be given. Potato should be mashed. When it is certain that any article of food disagrees with a child its use should be forbid- den. Only experience can decide which these are. There should be as little discussion about the food as possible before the child. POOD IN RICKETS As rickets is a disease resulting chiefly from an improper diet, the food is a matter of prime impor- tance. The first symptoms, which are described elsewhere, usually apj)ear when the child is about six months old. If the baby is being nursed he should be weaned, as the mother's milk is not nourishing him prop- erly, or the food from the breast should be supple- mented by alternate meals of malted milk, cream food, or barley food, or albumenized milk. A tablespoonful of beef juice should be given three times a day. Salt should never be forgotten in the food. The development of the bones being interfered with, material should be supplied to build them up and 74 THE CARE OF CHILDREN strengthen them. They are largely composed of the earthy salts, or phosphates, which are contained abiin- da'^tly in vegetables and t^raint;, particularly in wheat, Indian corn, peas and p \ ./x . Babies between six moii 'is ai - one year old may have bread, finely crumbled, and milk. Indian meal gruel, made with milk, cream and milk in abundance, diluted with lime water if necessary. After a year old the child may have well-cooked pea soup, white fish, if it can be obtained fresh, par- ticularly haddock, boiled and shredded, baked potato, corn meal, cracked wheat, oatmeal porridge, bread and butter, a plentiful supply of the latter, as fat is desirable, milk and cream. Dr. Emmet advises fat pork as a substitute for cod liver oil, which is often prescribed in these cases. Take a thick piece, free from lean, soak for thirty-six hours, changing the water frequently to get rid of the salt. Boil slowly, changing the water several times for eight hours. When cold it may be cut very thin and used in sandwiches, between thin slices of bread, sprinkled with salt; or rubbed to a paste and spread on the bread. Well-made soup is suitable, particularly pea or potato soup, good broth of any kind, and cheese as soon as the child can digest it. Fat bacon toasted over the coals mav l)e used and FOOD 76 any fresh meat cooked rare and finely minced before being given to the cliild. DIET IN COLDS When a child is chilly, fretful ai d feverish, hos some coryza, or discharge from the nose, and per- haps oppression on the chest, his diet should l< 5 carefully regulated. It is an old saying, evolved from the experience of our ancestors, " If you feed a cold you will have to starve a fever." Wlien there is disinclination for fowl the stomach should have complete rest for a few hours. Young mothers may remember for their comfort that starvation is a very slow process and that a well-fed child -may go without food for a day without suffer- ing from the fast, if water is given as required. When the appetite is languid in a child who has hitherto eaten well, Nature says decidedly," No more food at present, thank you. The digestive organs want a holiday." And we had better heed her in- dications. As the desire to eat returns, bread and milk, farina or hominy gruel, soup, or oyster broth, can be given. When there is great thirst, flaxseed tea, or barley water, either flavored with lemon, are grateful. Rice water with a little currant or raspberry jelly stirred in it may be more acceptable than plain water. 76 THE CARE OF CHILDREN Milk and water will sometimes be taken when milk alone would be rejected. DIET IN ECZEMA. Xliere are various affections of the skin, as roseola or heat rash, urticaria, known also as nettle rash or hives, and different forms of erythema, or heat Sjwts, which often alarm mothers. The skin of children is delicate and very sensitive, sympathizing with any disturbance of the system, particularly of the digestion. The diet, therefore, is a subject of importance in these cases, as very often some defect in it has produced the disorder. Meat should be discontinued until the affe(^tion has disappeared, sugar, or anything sweet, Ix'ing given sparingly, and oatmeal should not be used in any form. Milk should be chiefly relied upon ; boiled rice, gelatine, blanc mange, an egg occasionally and bi'ead, or crackers, being used to supplement it. FOOD IN FEVER. Tt may oe considered an invariable rule that if a child's temperature is 101°, taken with a clinical thonnometer which comes for the purpose, he should have only liquids until it falls to normal again, about 98i^ FOOD 77 Beef tea is a etiiudlant ratkcrthaii a food, and be- ing laxative in its effect is not used when diarrhoea is present. Milk fulfils every purpose and should l)e given in suitable quantities, according to tlie age of tlic child, every two hours. It may l)e dihited with lime water, Vichy, Apollinaris water, or Seltzer water, i)ep- tonized or sterilized, if necessary. If stimulant is ordered, it can be given in it, though not if the taste is disliked, as this wcaild dis- gust the child with his principal means of support. It can be flavored with a few drops of vanilla, rose water, essence of lemon, or cocoa added to it ; given iced or heated. The yolk, or the white, of an egg in the pro|ior- tion of one to each cup of milk, can be shaken with it, and by varying it in these different ways it will be l)etter borne. Koumiss. — This preparation of milk can some- times be retained when in other forms it disagrees with the child. It can be bought of the druggist; but is more cheaply made at home and with care success is easy. Dissolve the third of an yeast cake in a little warm water. Stir it into one quart of milk, as warm as when it comes from the cow. Add one ta- blespoonfui of sugar. Pour the mixture into lager^ T8 THE CARE OF CHILDREN boor bottles, filling tbcm about three-quarters full, and stand thcni in a warm place, about 68^ Fabr., for twelve hours, to rise like bread. If it is too hot the milk will curdle, instead of rising into a soil, foamy mass. The process of fermentation has been earriwl too far and the pjvparation is luifit for use. If not put into bottles with imtent stoppers it niurtt be kept tightly cork(>d. In any case it mnst be k(»pt on ice or in a very eool place, as the low tempemture cheeks further fermentation. It must b(» o|)ene(i carefully, as it flies. Koumiss resembles buttermilk in taste and this also is sometimes given when milk, containing the cream or fat, cannot Ikj borne. Matzoon is similar in its nature and can also be procured from a druggist. When the little patient begins to long for solid food, but cannot have it, the milk or beef juice can l)e stiffened with gelatine, which immediately re-dis- solves in tlie stomach, being a solid only in the mouth. Beef juice is more nutritious than beef tea. FOOD IN TUBERCm.OSIS. Children who have a tendency, inherited or other- wise, to consumption require special care in dieting. The object is to build up the tissues, particularly FOOD 79 those of the lunp^, and rondcr thorn unHuitahIc ftoll tor tiui growth of the gorin l)y.wliich the diHoaHO is (!onveyed. Fat is a very important elcnicMit in their food, and as nnu'li must l)e given as can Iw digested. Cream, butter, bacon and eggs, es|)eeially the yolk, are some of the forms in which it can usually be easily taken. Hrcad is sometimes liked soaked in bacon fat, or spread with marrow which has l)ecn broiled in the bone. Older children may have lettuce with may- onai.se dressing, and a taste for salad oil should l)e cultivated. Some (children will eat it on spinach or other green vegetables. Cocoa and chocolate contain fat and are useful ns a beverage. Plenty of milk should l)e given, fresh meat, and the cereals, as oatmeal, hominy, cracked wheat, farina, Indian meal, etc., may be made into porridge and eaten with cream. The child should not be allowed to eat when tired, which is another way of saying that no violent exercise, or ovf^'-exertion, should be jxjrmitted near the meal time. ) Too great a variety of food should not be given at once. Three or four articles are sufficient. If there is a distaste for solid food, more milk, uncooked eggs, white or yolk, preferably the lat- ter, can be given, and beef or mutton b**oth, or any 80 THE CARE OP CHILDREN good vegetable soup, particularly pea or beau soup. Artificial goat's milk is made by adding two tablespoon fu Is of beef suet, minced fine, to one pint of milk. This is brought to the boil and allowed to simmer for a short time, stirring constantly. If too much fat floats on the top, a little may be skimmed off. Salt is added, or a little celery salt, if the tast€ is liked, and the milk drunk when hot. i8A\ WO »int to too lied iste CLOTHING CHAPTER VII THE baby's wardrobe The young mother is often puzzled to know exactly what clothes will be needed by the new- comer and how they can best be provided. If a woman can sew neatly, has plenty of time, a little ingenuity, and is well enough to work with ease, it is a pleasure to her to make the dainty little garments herself. If the conditions are not favor- able, it is better to buy the outfit ready made than to employ a seamstress, as this makes it much more expensive. The looser a baby's garment! are the more com- fortable it will be. Modern patterns entirely dis- pense with the bands in which the tender body used to be tightly pinned, and the gain xo the baby, in comfort at least if nothing more, is V3ry great. It is sometimes difficult for an inexperienced per- « (W) / 82 THE CARE OP CHILDREN son to procure the right patterns. One for a plain slip, another for a Mother Hubbard diess with a yoke, and, if needed, a pattern for the little shirt, can easily be obtained from any large house dealing in cut-paper patterns. With these the whole outfit can be successfully fashioned. If materials cannot readily be procured in a small town or village, samples will be sent on application to any dry goods store in a city, and from these the choice can be made as easily and almost as satisfac- torily as if seated at the counter. The label on the patterns states the quantity of material required. There is one drawback to these models, the skirts are too long. Thirty inches from neck to hem is amply long for the outside dress, and the undergarments may be two or three inclies shorter. Allowance must be made for this in esti- mating the amount of material that will be needed. The wardrobe should consist of 3 Bauds, 2 Wrappers, 4 Shirts, Socks, 6 Petticoats, Blankets, 48 Napkins, . Cloak, 6 Night Slips, Hood. 8 Dresses, This supply will bo ample if the washing is done at home. If it has to be sent to u laundry, it is CLOTHING 83 better to add a dozen napkins, two night slips, four dresses, and two sliirts. Bands. — Tliese are only required for a week or two to keep the dressing in place. It is a great mis- take to think that the abdominal walls must be held immovable by a tight bandage. Nature has con- structed them to sup[)ort themselves. The band, as usually applied, increases the danger of rupture by pressing down the contents of the abdomen against the weak points, and so bringing about the very accident it was meant to guard against. As they are to be used so short a time, three strips of soft flannel, torn off and not finished in any way, are all that is necessary. The knitted bands preferred b) some mothers are difficult to keep in place, being apt to work up under the arms in an uncomfortable ritige. flhirt'i. — Many of the reformed systems of baby clothes dispense with the shirt, substituting for it a flannel slip with sleeves. The disadvantage is that if tlie long garment gets wet the baby must be un- dressed to have it removed. The short shirt is well out of harm's way. Those of ribbed cashmere, high neck, long sleeves and opening all the way down the front, are the best, even for the summer baby. They cost from forty-five to seventy-five cents each, and the better ■.TH-*?"-^ "'>*: 84 THE CARE OF CHILDREN quality wear very well. Silk and wool ones can be purchased, but of coui'se are more expensive, and have no si)ecial advantage except added daintiness. In putting on a shirt, it is wise to fasten it be- hind, as then the sleeves of all the garments can l)e fitted into one another and put on as one. Fasten it with a safety pin to the napkin in front to keep it from slipping up. The shii*ts can be made by the pattern from cot- ton and wool or silk and wool flannel, the seams being laid flat ana each side neatly cat-stitched in ])lace. Tliey can be bound with silk flannel bind- ing, which washes better tlian ribbon. Flannel containing cotton or silk shrinks less than that of all wool and so is prof r*»ble for an infant's garments. The cotton and \; k ; costs about thirty-five cents a yard, silk and wool from sixty- five cents to a dollar. At the latter price it is beautifully fine and pretty enough for a cloak or other outside garment. Shirts should be worn at night as well as in the day, one being kept for each service, unless a flan- VA:l night dress is used. Petticoats.- These are replaced in the modern outfit by sleeveless flannel slips, opening in the back, i^ed ; with large arm holes, which are button- holed witii rioft silk, cat-stitched or bound. In cut- m . , y-^ h CLOTHINO 85 ting them by a slip pattern make the arm holes larger and the neck lower than is indicated, finish- ing the latter to match the arm holes. The bottom should be finished with a plain two-inch hem. In another model tiie front and back are cut alike, the opening being on the shoulders. The shoulder seams are cut deeper to allow for lapping and fastened with tiny buttons and button holes. If the slip has to be removed during the day, the hand can be passed under the loose dress, the but- tons undone and the garment slipped off without removing the dress. If it is desired, one or two white slips can be made of Lonsdale cambric to wea • on state occa- sions, as the dress looks rather prettier over them. They are not needed ordinarily. Napkins. — The material tliat is variously known as Canton flannel, cotton flannel and swansdown, is a good one for napkins. It is soft and absorbent. The thinner quality, costing about seven cents a yard, is the best to use for this purpose. Squares are made the width of the material, about twenty- five inches, and hemmed on two sides. These can be folded twice at first. For a young baby napkins mav be made of sofl linen, as an old tablecloth. These should be thirty-five inches long by sevei> 86 THE CARE OP CHILDREN |i •> teen wide, being doubled to make the square before they are folded. Cotton and linen diaper, or birdseye, as it is also called, are used ; the latter is cold and does not ab- sorb the moisture well. Stockinet napkins can be procurea for this pur- pose at some of the larger dry goo(^ wtores. They are good, but more ex}x'nslve than those made of the other fabrics that have been mentioned. They must not be confounded with stockinet diapers, which have a coating of rubber on one side. India rubb r prevents the moisturi from evapo- rating and causes the wet cloth to act like a poul- tice to the tender skin. Waterproof napkins may save the baby\s clotliing from boconu'ug damp, but they are so injurious they should rot he tolerated by the careful mother. A square of thick flannel is an additional protec- tion and does no iiarm. One will be found very useful at nighf. Pcuh. — A j.ieco v>f soft old cotton or linen, folded to a square, may be piaced inside the napkin. If it is soiled it can be tolled up and burned, thus saving much disagreeable washing. If only wet, it can be sent to the laundry. Napki.M should not be used a second time with- out being washed. There is a solid deposit, invia- i ! CLOTHING 87 ible to the naked eye, wliich remains after the moisture has dried^ and is apt to chafe and irritate the skin. Night Slips. — These are best made perfectly plain, without a yoke, the fulness at the neck being gathered into a band. This may be edged with soft lace if desired and a few tucks added above the hem at the bottom. Lonsdale cambric, about sixteen cents a yard, is a good material to use for them. The baby will need no other dress during the first month, the one worn in the day being changed for another at night if necessary. As the flannel slip is worn also, nothing warmer is needed. Dresses. — The absurd fashion of encumbering a little baby with long skirts is happily becoming a thing of the past. The weight was a serious matter to a delicate child and an unnecessary burden to a strong one. Thirty inches from neck to hem is amply long and it is no disadvantage to have them an inch or two shorter, if the underslips are made ^o correspond. Nainsook muslin costing from fifl;y to seventy- five cents a yard is a very pretty material for them. Victoria lawu can be used and fine Lonsdale cam- bric is less expensive. There is a muslin with a fine 88 THE CARE OF CHILDREN cord or hair line, that makes serviceable garments, but checks and figures should be avoided. The dresses shoukl he made with yokes, or full in front and back, witli the fulness laid in fine tucks to the waist-line. The first requisite for a baby's dress is to be loose, so as to be easily slipped on or off. They may be trimmed with narrow lace or Ham- burg edging. Deep embroidery is not considered in good taste. A tiny vine embroidered by hand is ad- missible. Hem stitching is an a|)propriate decora- tion. Feather stitching l)etween clusters of tucks always looks well. A machine-made feather stitch- ing can be purchased, which saves many stitches. It can be put ov each side of narrow Hamburg inser- tion, or between clusters of tucks. Yokes can lie bought ready made and the skirts added. This is an easy way to make dresses, as the yokes are troublesome except to an expert needle- woman. If a specially handsome dress is required, it is l)est to get it ready for use. Wrappers. — There is nothing prettier in all the baby's outfit than the dainty little wrapjiers. They are useful to slip on early in the morning, or to put over the dress when the room is cooler than usual. CLOTHING 89 A cut paper pattern is easily obtained by writing to any firm that deals in patterns. They may be made witli a yoke and skirt fulled on, of course opening in front, or cut wide enough to tuck the front, or lay it in three plaits on each side with a box plait in the back. Silk and wool flannel, cashmere, opera flannel, Scotch flannel, outing cloth and Shaker flannel are all suitable materials, the latter two being very in- expensive. They may be feather-stitched, embroidered in a delicate pattern, or trimmed with lace, and tied with ribbon. There is room for the exercise of much taste and ingenuity in color and decora- tion. Socks. — There are strong arguments for and against covering the feet of little babies with socks. They are apt to become wet and so uncomfortable. But they can be changed when the napkin is and sometimes escape altogether. It is urged that if the baby is active they are kicked off, unleses tied too tiglitly for the good of the tiny foot. There is a happy medium of tightness by which they can be made tolerably secure and yet not impede the circulation. It is impoitant that the feet should be kept warm and, although this may be partially done by pinning together the ed^^ 90 THE CARE OF CHILDREN of the flannel slip, the socks are a great additional protection. Anyone who can knit or crocliet can make them out of white zephyr, or stouter ones from single • Germantown vvool,ornanK'nting them if desired with ])ink, blue, pale yellow, or crimson trimmings. Those who are not skilled in fancy work can pro- cure a pattern and cut them from stockinet or lialf-vvorn stocking-legs, feather-stitching the seams with embroidery silk in any color desired. The best parts of a discardt^l undershirt may be utilized for the purpose, if it is soft and compara- tively thick. Too many pairs cannot be provided ; at least a dozen are needed, for holes develop with marvelous rapidity when the little feet are constantly in motion. Blankets. — Kind friends are almost sure to pro-, vide one or two pretty, dainty ones of silk and wool, or fine all wool flannel, hem-stitched or em- broidered with flowers and leaves in satin stitch. These are delightful to possess for state occasions, but will not stand the wear and tear of everyday use. For ^this there is nothing better than blankets knitted from single Germantown wool. They should be, when finished, three-quarters of a yard wide and a yard long. CLOTH INQ 91 Thev are knittofl on riibl)or or bone needles a quarter of an inch in diameter. Set up 123 Htitehes and knit backwards and forwards in plain knitting, or any fancy stitcli preferred, until the desired length is attained. Stripes of pink, blue, or yellow are pretty knitted near the ends, but soon lose their color in washing. Rows of narrow rib- bon (^n 1)6 run in instead and taken out when the blanket is soiled. Those who prefer crocheting to knitting can use it. Plain blankets can l)e made of. cotton and wool flannel with a two-inch hem feather-stitched with washing silk. Blankets are only useful for the first month or two, while the baby is content to keep compara- tively still. Little jackets, which look so pretty and dainty when they are first made, soon lose their freshness. They are easily soiled and difficult to put on and take off*. When a cashmere shirl and flannel slip are used they are not needed for warmth. Cloaks. — There is a great diversity of opinion as to when a baby should first go out of doors. Much, of courae, depends upon the season of the year. What would be a perfectly safe proceeding at mid-summer would be a great risk in winter. 5^ v^^> IMAGE EVALUATION TEST TARGET (MT-3) 1.0 I.I LA 12^ 12.5 ^ ^ 12.2 2f BA ™^ us IM 2.0 I IL25 nig 1.4 Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 873-4503 92 THE CARE OP CHILDREN If the liouse is in a good sanitary condition and the room used as a nursery is well ventilated, there is no necessity for the baby being carried into the open air until it is six weeks or two months old. Nor need it be taken out at all in very cold weather. It is well to provide the cloak and hood before- hand, as the mother has plenty of cares to occupy her time and attention after the arrival of the baby. Nothing is as pretty as white for the first cloak. It may be made of cream cashmere or any soft all wool material, and trimmed with a fringe of ribbon loops, or stripes of riblwn, about four inches in length,* laid on the skirt and cape from the edge up- waixi, with feather stitching done in embroidery silk between. In winter it may be trimmed with narrow bands of white fur. The cloak should be lined with Canton flannel when warmth is necessary, and with cream-colored cambric or perv.9Le in summer. Cloaks can be pur- cnased ready made for little moi'e than it costs to I)uy the material, and, unless the mother is a skil- ful needlewoman, it is wisest to do this. Hoods. — Dainty little hoods may be bought at comparatively small expense. They are made of cashmere to match the cloak, or of soft cream or . white silk, or of embroidered muslin with a thin silk lining for the summer baby. djOTHIKG 93 inel )red )ur- to All have full frills of lace around the face and are tied with ribbon. If it is desii'ed to make the hood at home, a ))aper pattern can easily be obtained. The saving is not very great and the making is a difficult task to accomplish neatly. The winter l)aby must have its hands covered when it goes out, and it is a wise precaution when'* ever the weather is cool. Tiie dainiy mittens of white, pink, or blue &re as fascinating as the socks. Tiiey are easily made by a skilful knitter and cost about twenty-five cents a pair when purchased. ^ at of or Ihin CHAPTER Vm SHORT CLOTHES When a strong, active baby is between four and five months old, it is time to put it in sViort (clothes. Even moderately long skirts imjK^e its motions to some extent and should be discarded. Shirts. — The cashmere shirt is still worn, over that a flannel slip, with long sleeves in \^nter and short ones in summer. In very hot weather a cotton one may be substituted. These slips are cut princess shape, reaching nearly to the ankles, and are sloped In a little at the waist. If desired, a band can be stitched on at the waist line, buttons sewn on it and a cambric petticoat buttoned on. Napkins must be retained for some time to come. When they are left off little drawers may replace thorn, but this cannot be uutil the baby has learned good habits. (W) CLOTHING 95 that ome. )lace Irued Waists. — Some mothers orefer a waist buttoning behind, with buttons on the lower edge to which the skirt and drawers can be attached. These should be made double, of cotton, quite loose and not corded or stiffened in any way. In this case a flannel i3ettic<)at is used instead of the slip and the waist may be of flannel for tiie winter baby. Sometimes, until the child leaves off napkins and requires the waist to support drawers, two flannel slips are used, one with sleeves, the other without, and the shirt is dispensed with. Dresses. — Many mothers think it is most eco- nomical to shorten the long dresses. If they are likely to be needed again it is best to lay them aside for future use anu „iak€f new ones, perhaps of rather stouter material, at least for everyday wear. These should come to the ankles, just showing the feet. White i3 .jtill the prettiest color and at first the most suitable. When washing is an item to be considered, others may be substituted. For the summer baby, beside Lonsdale muslin, lawn, nainsook or any pretty muslin in stripe or small check ; cottons, cambrics, percales, etc., in delicate colors with fine lines, dots or tiny figures, can be used. The winter baby looks well in dresses of Shaker flannel, Scotch flannel^ in narrow stripes, plain ca^h- 06 THE CARE OP CHILDREN mere of any tint preferred, or other soft all wool material, plain or in a small pattern. Plaids or any striking effects should not be tolerated in a baby's dresses. White cashinei*e makes a useful best dress, as it looks well if carefully washed, and can be dyed when its freshness is gone beyond recall. Any fabric that will not wash is unsuited for a baby's dress. The short dresses look well made with square or pointed yokes, the little skirts being gathered on them. For older babies these yokes are sometimes trimmed with a deep frill extending over the shoul- dei-s, giving something the effect of a guimpe. The bottom of the skirl may have a cluster of narrow tucks above a wide hem. Creeping Skirts. — When a baby begins to creep it is impossible to keep the dress tidy and clean with- out some protection. This is best afforded by a creeping skirt. Dark cotton or gingham is a suit- able material to use, as it must be capable of being wasjied and not too heavy. It is made of two widths of cotton, perfectly straight, like a bag, only open at both ends, with a string case at each end. Broad elastics are run in these and the skirt put on over the dress, the other end being brought up lound the waist under the petticoats, enclosing them CLOTHING 97 like a bag. It can be slipped off in a moment, leaving the dress comparatively fresh. Bibs. — When teething liegins there is usually an extra secretion of saliva and it is difficult to keep the front of the dress dry. Bibs may be made of linen diaper lined with cotton flannel shrunk before using. They can be made of fine Lonsdale cambric or nainsook muslin, with a thin layer of wad- ding between it and the cotton lining and quilted in diamonds, or a pattern, either on the sewing machine or by hand. They cost much less to make than to buy. \ When there is so much moisture that the bib quickly becomes soaked with it, making the dress damp, it is a good plan to have a bib, cut the same shape, of white India rubber cloth to wear beneath it. The edges can be bound with silk binding if desired. This material makes a convenient feeding bib for older children, as it can be wiped with a damp cloth and does not require washing. White table oil cloth may be used for the same purpose and is less expensive. Qoaks. — The long white cloak is laid aside with the long dresses, and, although white is st'll pretty and suitable, colors may be used. Jersey, or eiderdown flannel is an excellent 7 98 TH£ CAKE OF CHILDREN i material for winter, being soft and warm. It can be lined with Canton flannel, matching it in color. White eiderdown is very pretty, trimmed with bands of beaver, either the real fur or the imita- tion plush, which closely resembles it. Red looks well with a narrow edging of black astrakan, and blue with white angora fringe, or the curled gray astmkan. The silky angora fringe can be ob- tained in different shades of steel and gray to match flannels of the same colors. For summer, any thick white washing material that is desired may be used ; new ones appear every year ; and it can be trimmed with narrow braid, edged with embroidery, or simply with rows of machine stitching. The fabrics mentioned for wrappers make excel- lent cloaks for a cool day. Bmineta, — These can be obtained in so many quaint and pretty shapes that the mother need never be at a loss for a covering for the baby's head. It must be soft ; nothing looks more forlorn than a stiff" hat, straw or felt, on a very young child. Dainty hoods may be made of the same material as the cloak and trimmed to match it, or they may be of silk, velvet, cashmere, or muslin, according to the season. There is ample opportunity for the exercise of individual taste. OLOTHINa 99 Stockings. — These sliould be long enough to cover the knees, and carefully chosen in regard to the size of the feet, that the toes may not be cramped. There is no reason why the foot should not be as symmetrical as the liand, the toes as little distorted as the fingers, h is only undue pressure that forces them out of shape, and corns are tho ef- fort Ihat nature makes to protect the tender tissue, which never was moaut to undergo such squeezing. Their foundation is too oflen laid in childhood. The stockings may be of any color that is pre- ferred. Black ones are much worn and look well with any shoes. They may be fastened to a button on the waist, or slip, with an elastic band, care being taken that it is not too tight. Shoes. — These may be made at home of cha- mois, felt or soft kid, sha^ied like a moc(%isin. They e > not wear very well, but, as shoes are an expensive item in the baby's wardrobe, they may repay the trouble of making. When a baby begins to use the feet for standing and prepares to make an attempt to walk, something firmer is needed that will give more support to the foot. It is then that the mother's trials in the matter of foot-gear commence. Diligent search must bo made for a shoe that Is broad enough in the sole not to cramp the foot 100 THE CARE OP CHILDREN and that makers a faint attempt to conform to the natural sha})c of it by, at least, liaving the sole flat and not rounded on the l)ottom. This i)eculi- arity prevents the weight from being thrown upon the toes, where a part of it belongs, and brings it on the heel, the toes being scarcely able to touch the ground. The inside line of the sole should be nearly straight, not to bend the joint of the great toe out of place. It is a pity that sandals ever went out of fashion, but, as they are gone, we can only try to supply their |)lace with shoes broad enough to give the toes free play. Much emphasis is often laid on having the shoe sufficiently long. While this is important, no excess in length, beyond the limit of comfort, will make up for deficiency in width. \ CHAPTER IX CLarHING AFTER BABYHOOD 2foya* Frocks. — Tliere is usually no distinction made between the dress of boys and girls until after they are two years old. It is a mistake to put I)oys into sailor suits too early; they do not look well in lliem before they are at least three years old. They are a saving of trouble, and, if the mother is overburdened, this is a great consideration. Until then, there are many pretty ways in which the little dresses can be made, which do not look too girlish to be suitable for boys. The simplest is a plain front with full back, the fulness held in place by two straps, coming from the side seams and crossing behind. This may have either a round collar or one cut in two squares in front and behind, and trimmed with braid or embroidery. (101) 102 THE CARE OF CHILDREN Another has the plaited kilt skirt and a hlouse fulling over it. The blouse may have jacket fronts, onioning over a full vest, the fronts being rounded or square, as desired. An eflfective pattern buttons diagonally from neck to hem in front, the skirt being full behind and having the fulness laid in two box plaits, the joining with the waist being concealed by straps coming from the side seams and buttoning in the back, J A very pretty suit has a box-plaited skirt and blouse with sailor collar, having long points in front that extend to the waist line. In one of the prettiest the waist has three box plaits in front and behind, the skirt being box- plaited also, finished with a ])lain belt, buttoned in front, and a little round collar. The front of the dress may hang straight, with three box plaits, the back being gathered on a plain waist with belt from the side scams, crossing behind. Boy8^ First Suits. — When a boy grows too largo for skirts, the next garment is a sailor suit, cousistin<^ of a blouse and knee breeches, or long trousers, as preferred. ) The material may be navy blue or gray flannel, light-weight tweed, or soft woolen fabric, velveteen, serge, either blue or white, and linen duck, blue denim, or any stout cotton material, for summer. CLOTHINQ 103 Boys enjoy the freedom of trousers and are always cliarmcd to assume them as a step towards the manliness they all aspire to. The suits should be supplied with pockets, and can usually be purchased almost as cheaply as they can be made. It is oflen ]H)ssible to get an extra pair of trousers and sometimes pieces for patching are sold with them. When the mother's inspiration fails her, she should send for a catalogue of children's fashions and glean ideas from that. The points to remember in dressing children are to have the clothing loose, the weight sup^/orted principally by the shoulders, and not to overload the dresses with trimming. Sim- plicity is not only the most sensible but is in the best taste. Littk Girla'' Dresses. — In little girls' dresses the Mis of the boys are replaced by sashes, coming from the side seams and tied behind. The waists are shorter than in boys', and very often an oveixlress is made to wear over a guimpe, or yoke and sleeves, of another material. Sometimes the fulness is simply shirred at the neck, or the skirt is gathered on a yoke, or there are two deep frills round the neck, the lower one ex- tending over the shoulders. The materials are much the same for both sexes, gingham, chambr6y, linen, or any pretty cotton 104 THE CARE OF CHILDREN goods, navy blue, or fancy flannel, soft all-wool fabrics ; and for little girls China or India silk, or light woolen materials, may be used. Children should not be dressed in such a way as to oblige them to think of their clothes. The play dresses should be strong, not to tear easily, and washable, so that a visit to the laundry will re- store their freshness. Close contact with mother earth i« essential to the health and well-being of all young, growing things, and the thouglit of danger to clothes should never have to stand in the way of it with Iwys and girls. Underdothinf/. — High-necked undershirts, vary- ing in weight from thick cashmere in winter to thinnest gauze in very hot weather, should be in- sisted upon. They need not be long sleeved in sum- mer. The chest must be protected, but the forearm is not a vital part. Drawers should be worn in cold weather, but are not essential for boys in warm. Some mothei*s prefer the union suits, shirts and drawers in one. Over the undergarment, boys, after they have put on knickerbockei*s, wear a cotton shirt, either white or of soft, twilled, colored ma- terial, and girls a waist. It cannot be too earnestly impressed upon the mind of the mother that girls should never wear tight-fitting waists, nor corsets. No woman ever CLOTHING 105 acknowledged that her corsets were tight, but no matter how loose they are, they interfere with the proper development of the growing girl, render her figure less pliant and gracMjful, and destroy the easy carriage that is such a charm. A comfortable waist with shoulder straps and buttons, on which the flannel petticoat, undei-skirt and drawers can be buttoned, does no harm and furnishes all the support that is necessary. If the muscles never have been weakened by the inaction that pressure maintains, they are abundantly able to support themselves and their owner too. The dresses may be of any shajie that is liked, provided there are no tight bands about the wai.st. If mothers only realized how important it is that the delicate organs should have free play, utterly untrammeled by pressure from without, and knew the disastrous consequences that must follow any infringement of nature's laws, they would be tlie very first to insist upon a rigid adherence to sensible methods of dress. STOCKINGS When economy is a necessity, a slight saving may be effected by purchasing stockings out of season, summer ones in the autumn and winter ones in the spring ; they are often sold at a reduction to prevent the necessity of packing them away. 106 THE CARE OF CHILDREN Black is, on the whole, the most satisfactory, al- though navy blue and dark brown look well for boys with suits of the same colors. Those purchased for boys should be stout, cotton or woolen, according to the time of year ; ribbed ones fit the leg better than plain. Knee pads are a great prot-ection when short trousers are worn. They are sha[)ed to fit over the knee and are ma ie of leather, or thick felt, being worn under the trousers. Some mothers line the heels of the new stockings with a piece of Canton flannel, cut to fit, to prevent their wearing so quickly. A pattern can be obtained for cutting over old stockings for a smaller foot. A part of the leg is utilized for the upper part of the foot and heel, a new sole being cut and sewed in. Stocking supporters hold the stockings firmly in place. Little girls may wear hose to match their dresses in color. Cotton or lisle thread in summer, cash- mere or woolen in winter. It is of the utmost im- portance to keep the feet warm. It is well to re- member, in purchasing stockings of an unusual shade, to buy cotton, or worsted, of the same with which to darn them. It is more economical to get cotton by the ball and wool in skeins, rather than a small quantity on cards. CLOTHING 107 Shjoes, — All that has been said on the importance of not cramping tlie baby's feet applies with added force to those of the growing boy and girl, who are constantly using theirs. The shoes should be comfortably long and wide, being careful that they fit well. Too much room is almost as bad as too little. Tiie heels must be low and flat, that the weight of the body may not be thrown too far forward in walking. High French heels should not be tolerated for lit- tle girls. No boy would endure them. It is a mistake to have too heavy shoes. They tire the feet unnecessarily. The soles should be stout enougli to protect from dampness. As the use of rubber overshoes is almost universal, they need not be so thick as to keep out water. It is good economy, when it is possible, to have two* pairs of shoes that can be worn alternately. Have them kept well brushed and clean. In buy- ing the patent dressing, try to procure one that con- tains glycerine, as this. helps to prevent the leatlier from cracking. A little vaseline, well rubbed in before an ordinary dressing is applied, serves the same purpose. Bedroom slippers must not be forgotten, as run- ning about in bare feet is a dangerous pastime. Thoy may be crocheted, or knitted, of German- 108 THE CARE OF CHILDREN town wool and liave lamb's wool soles. But red or black felt ones cost very little more and are far more durable. Pretty fancy leather ones can be purchased in red, blue or yellow, to match the wrapper. Long rubber boots are very desirable for wet weather. Lamb's wool soles can be slipped in them, rendering a shoe unnecessary. No rubber foot- covering should he worn for any length of time ; as in sitting in school. There is no escape for the moisture caused by the perspiration, and the feet soon become damp. Rubber overshoes are especially nowssary for girls, as wet feet are a distinct source of danger to them. It is said that when shoes are wet they should be freed from mud as much as possible, well rubbed with kerosene oil and ]>ut where they will dry slowly ; when partially dry, they should be rubl)ed with the oil again, and that this renders the leather soft and pliable. Aprons. — These useful garments have rather gone out of fashion at the present moment, but they are too convenient not to be restored to favor. High-necked, long-sleeved aprons of striped gingham, or blue and white cotton, are a great pro- lection to the child at play, and when soiled can be easily replaced. CLOTHING 109 A pretty white one that can be slipped on at a moment's notice makes a plain dress presentable. There are so many patterns for little girls, the mother has only to choose between them. White muslin, plain, checked, or strij^ed, or lawn trimmed with narrow lace, embroidery, or ruffles of the same, always look well and come from the laundry al- most as good as new. Black silk aprons, high-necked and with long sleeves, are fancied for school girls. They can be ornamented with feather stitching in black or color, and finished with rows of shirring or smocking around the neck. They serve to protect tlie dress, par- ticularly the sleeves, which are soon worn and soiled by rubbing on the desk. Wrappers, — These are useful for little children to be slipped on early in the morning, when they want to run about before being dressed. They can be made of Jersey or eiderdown flannel, for winter, or of Scotch flannel lined with cotton flannel. For suuimer, nothing is nicer than outing flannel, so called, though it does not contain a thread of wool. A girl always requires a wrapper, and it- may be made of any of the pretty, soft materials used for her mother's. Boys usually despise them, except in illness, until they are grown up and begin to ap- 110 THE CARE OP CHILDREN preciate the luxuries of bath robe and lounging jacket Nightgot. ^s. — This is an important i)art of the children's wardrobe, as they pass more than one- third of their lives in bed, and does not always re- ceive the attention it deserves. In wint'^r, for young children, they sliould be of white or gray flannel, made very long, extending at least half a yard below the feet. There may be a string case at the bottom, and the ctring, being loosely tied, converts the garment into a kind of bag, impossible tx) kick off and rendering exposure to cold an accident no longer to be feared. In the morning the superfluous length can be turned up and ti«d Jiround the waist or under the arms. Older children should wear night dresses of out- ing or Shaker flannel. If preferred, they may have an undei'shirt of the same weight as the one worn during the day, being sure that a different one is kept for the night, and always changed. A good substitute is an over-jacket of any light flannel; some children dislike the friction of any material thicker than cotton next to the skin. Except in the warmest weather, a single cotton garment is not sufficient protection at night. Deli- cate, nervous children, especially, require additional clothing, or else the nervous energy, so precious to CLOTHING 111 them, is t;:^pended in keeping the body warm, when proper covering would prevent the escape and waste of the heat already generated. Outdoor Gaimients. — A boy should be provided with two oveixx)ats — a thick ulster for winter, and one of lighter weight for the intermediate seasons. A rubber coat is useful when there is prolonged exposure to the rain, as in a long walk to school. No boy likes to play in one, particularly if those importart personages, "the other boys," do not wear them. Its place may be filled by a thick reefer. A girl needs a warm cloak for winter. If she lives in a cold climate, it should be supplemented by a jacket of chamois skin, lined with silk or al- paca, that it may slip on easily, and covered with flannel or any woolen material desired. If the cloak can be fur-trimmed, so much the better; it should have a high collar to protect the back of the neck. An ulster or long rubber-cloth garment is indis- {lensable for rainy days. Girls should have one or two blazers or light jackets for cool days in summer, as well as the thinner cloth ones that are necessary for spring and autumn. Hats, — It is always puzzling to the young 112 THE CARE OF CHILDREN 'mother to know what head-gear best befits the dig- nity of the buby boy after he has outgrown the silk or cashmere hood in which he looked so sweet at first. In summer he may have a linen sun hat for everyday wear, and a silk Tam o' Shanter or a soft cap with an hexagonal crown for best. These can be replaced in winter by a little velvet cap, trimmed vt^ith a fur band to match his coat. When he is two years old, he may be advanced to a sailor hat of straw or felt, or wear one of the quaint sha^ies, as the three-cornered Continental, that change with each successive year. Bonnets of silk, velvet or cashmere are still the prettiest for little girls. In cold weather. When it is warmer, they can be exchanged for the Nor- mandy muslin caps with high, peaked crown, that are so becoming to the dear little faces. The linen sun hats will be found very useful for them, too, as they can be washed without difficulty. Older children should be allowed some expres- sion of their own choice in clothes, particularly in the matter of head -covering. What se«ms a detail of perfect indifference to the mother may mean an agony of mortification to the sensitive boy or giil. In ^10 case is it more necessary for us to be able to put ourselves in another's placie than in dealing with the idiosyncrasies of children. CLOTHING 113 In selecting a hat for a girl, it is well to remem- ber that it must be worn with several dresses and should not look out of place with any one of them. To accomplish this, 't must l)e quiet in tone and not too conspicuous in shai)e. Ribbon or velvet, with perhaps one or two ostrich tips, is a more appropri- ate trimming than artificial flowers. The cruelty of wearing as an ornament the plu- mage of birds, which must he killed to obtain it, should be early impressed on the childish mind. The lesson will then never be forgotten. 8 BEDS AND BEDDINO CHAPTER X THE BED As babies ought to spend the greater part of their time in sleep, and older cliildren should ))ass at least ten hours out of the twenty-four in bed, the bed it- self becomes a matter of importance, Baminetft. — Yoiing mothers are always fascinated by ine pretty, wicker bassinets, muslin-trimmed and silk 'ined, that seem such cosy little nests for the tiny sleepers. They are very charming and, for those who can affoixl them, nothing can be prettier. This does not mean only afford the first cost, for that need not be excessive, but the tax on time and strength that renewing the dainty draperies involves. They begin to lose their freshness soon after the mother has assumed the sole charg3 of her new treasure, when every faculty is fully occupied with the necessary duties of each day. This slight additional demand seems like the proverbial last (U4) BEDS AND BEDDING 115 straw, and the mother is apt to wish she had chosen a couch with more durable decorations. If one is desired, it can be bought ready for use at any large establishment where babies' outfits are sold ; or, it may be bought without covering and finished at home. A large aval clothes-basket makes a good substitute. The bassinet is lined with glazed cambric, pink, blue, or yellow as preferred, covered with dotted, figured, or plain muslin, cither basted smoothly over it, or fulled on. Round the top of the basket there is a ruffle of silk or muslin to con- ceal the stitches that hold the lini* ; in place. India, China or surah silk can be used instead of muslin. The basket sometimes has a canopy or a curved rod to support curtains, which are tied back with ribbon. A stout framework may be provided to hold it and drajied to match the bassinet, or it may rest on a table, or two chairs. It has the advantage cf being easily carried from room to room. A pillow covered with a rubber case is the only bed required for the bassinet. A white pillow-case can be put on, or a little blanket folded over it. This, with a tiny pillow for the head, and a warm blanket or silk-wadded comforter completes the outfit. 116 THE CMIK OF CinLhUFV A large clothes-basket, or large, low box, makes a safe and convenient receptacle for a baby when he is able to sit alone. It can be padded with pil- lows and the little occupant will stay in it con- tenteilly for a long time with a few toys to amuse him. CRIRS A rattan or iron crib is the most sensible bed to purchase, for it can be used until the child has out- grown babyhood. Iron cribs painted white with brass finishings, look very well. They can be ob- tained fitted with rods for a canopy, which is always a pretty addition, besides protecting the head from draughts and the eyes from light. It can be made of rose-bud chintz, washing silk, India drapery, or any material that is liked. The crib is usually fitted with a woven wire mat- tress, which makes the best foundation for any bed, and over this a soft hair mattress. A folded blanket should be laid on this. Next, a square of rubber- cloth, or a pad, and over that the sheet. An upper sheet is not required, a sofl blanket and dainty white quilt, not too heavy, supplying its place. HAMMOCKS A hammock makes a convenient bed for a baby where space is a consideration. Very elaborate ones are manufactured of silk and with heavy silken BEDS AND BEDDING 117 IS fringe, l)nt the baby will sleep quite as comfortably in a small-sized, ordinary one. A crib blanket forms the bed, with the rublx»r protector over it. A pillow is not needed. Two bands should be provided to tie around the ham- mock, rendering it impossible for the occniiMint to fall out of it. It can be susjKinded from two stout hooks screwed into the wall. Comforters. — Babies need warmth without weight. For this reason, a down comforter makes a goixl covering in cool weather. It should frequently Ire hung out in the sun to air and, if the colors arc deli- cate, may be protected by a slip cover of any washa- ble material at night. A comforter of cheese cloth, wadded and tufted with zephyr of any color j>referred is not expensive and can be changed when soiled. Blankets. — Small ones can l)e purchased of a pro- per size for cribs. It is best to cut the pair in two and finish the cut ends by binding them with narrow ribbon, or buttonholing them with worsted match- ing the stripes in color. When soiled they should be sent to a professional cleaner as they never look as well after home washing. Cream eiderdown flannel may be used instead of blankets. It is pretty bound with ribbon, but this is not very durable. Sheets. — In hemming sheets, which the baby needs as he grows older^ it is well to remember that if 118 THE CARE OP CHILDREN there is a broad hem at each end the sheet can be reversed, and wears more evenly than if the same end were always placed at the top. Cotton is much better than linen for this purpose. Protectors. — Rubber cloth costs about seventy-five cents a yard for a narrow width ; if a cheaper material is required, white table oil cloth makes a good sub- stitute. It is not as durable as the rubber cloth, but is waterproof for a time. Path can be made of several thicknesses of nevvs- papcM', which answer the purpose very well, a fresli one lieing used when the old one becomes damp. They can be slipped into a cotton cover made for the purpose, which is easily washed. PILLOWS Pillows may be of down, feathers, or hair. A thin feather one is probably the best, giving softness without undue warmth. A tiny square one looks pretty at first, and two large hem-stitched pocket handkerchiefs, men's size, make a dainty pillow case. Children should be taught to sleep with the head low as it helps to make them straight. One thin pillow is all that is necessary. i b£ps and bedding 119 It is very important that a child should not be perniitUHl to draw the bed clothes over the face. The exhalations from the body are breathed into the lungs instead of the fresh, pure air, laden with oxygen, with which the sleeping room ought to be filled. BED-CLOTHES FASTEITERS Patent bed-clothes fastenei's can be purchased for a small sum, by which the upper coverings can lie fastened to the bedstead in such a way that the child cannot throw them off. Very large safety pins, such as are used for horse blankets, make a tolerable substitute. The clothes can be pinned to the mattress, but not drawn so tight as to interfere with the comfort of the sleeper. VENTILATION If the air that is breathed in too many bedrooms at night could be made visible with all its impuri- ties, the mother would resolve, with a shudder, that her child at least should never inhale such a pol- luted medium. Foul air is injurious to grown persons, but it is absolutely poisonous to the sensitive organization of a child. Air that has once been breathed is unfit to be taken into the lungs again. It is laden with waste matter and has lost its oxygen, the life-giving 1 m 120 THE CARE OF CHILDREN principle. If the outside air does not enter in a steady stream, tlie pure air sliut up in the room is exhausted in a very short time, and then nothing re- mains but the vitiated air to be rebreathed. Lighted lamps and gas burners consume a large amount of oxygen. Every one acknowledges this, yet not one in twenty provides for the regular admission of pure air into the room where the baby lies asleep. We cannot say " Open the window," and dispose of the problem in this easy fashion. It must be admitted at the outset that it is a difficult one, but mother-love can solve it, as it does so many others. The point is, how to keep the room filled witli pure airwitliout chilling the atmosphere and making a draught. In warm summer weather the windows can l)e thrown wide open and no one suffers. Even then a light screen should surround the baby's crib, and an extra covering be at hand to draw over him in the early morning. The temperature should not be allowed to fall be- low 60° Fahrenheit, and during the greater part of the year this means that some artificial heat must be maintained to counteract the coolness of the fresh air. When a house is heated by a furnace this is easily managed ; in other circumstances, a fire in the stove, BEDS AND BEDDING 121 or oil stove, must not be grudged. Gas stoves are very objectionable in bedrooms, as tbey consume a great quantity of oxygen and give off deleterious fumes. Having arranged to warm the fresh air, it must be admitted through a guarded window, not to create a draught. The simplest way is to lower the window from the top, or, if that sash does not let down, to open it at the bottom for about four inches and tack a strip of flannel over the opening. A light wooden frame, covered with flainiel, may be made to fit the opening and is easily put in and taken out. A stream of fresh air rushes in where the upper and under sashes are separated, and if the opening is at the top the warm, impure air finds its way out there. When a room smells close to anyone entering it from the outside air, it is not properly ventilated. Many persons have a horror of night air, but no one has a private receptacle whicli he can fill with fresh day air to last until the sun rises again. As the children, in common with everyone else, have to breathe night air at night, let it at least be pure. NECESSITY OF SI.EEP There is no one thing that is more conducive to a child's NvoU being than plenty of sleep. The want 122 THE CARE OF CHILDREN of it disturbs the delicate nervous system, upsets the digestioii and prevents proper physical developments It is cruel to waken a baby except for nourish- ment, and if it is sleeping very soundly it is better to wait for an hour beyond the appointed time, hoping that the waking will occur naturally. To take up a baby to exhibit it is an invasion of its rights that should not be tolerated for a moment. When the darling has ceased to be a novelty, and it is earnestly desired that it may sleep while the mother is busy, it will have lost the good habits it tried to practice until it was rudely disturbed, and will not be anxious to find them again. Sleep is a positive necessity to the growing boy and girl, and yet how hard it is to send them to bed. They need ten hours, from 9 p. m. to 7 A. M., until they are well grown, sixteen or seventeen, at least. Many girls are said to break down from over- study ,/ho could have gi'aduated without difficulty if they had had proper food and a sufficient amount of sleep. Children should not be wakened in the morning. If they are in bed in time to obtain the measure of sleep that nature requires it will not be necessary. They should be ready to spring up fresh and vig- orous, rested from the fatigue of yesterday, ready for whatever to-day may bring. BEDS AND BEDDING 123 It has often been remarked that little children are always ready to get np in the morning, while older ones are usually reluctant to do so. If the seniors had spent an equal number of hours in bed, or at least a sufficiently long time to become thoroughly rested, they too would be satisfied and not feel the need of more sleep, which makes them so unwilling to be disturbed. A child from one to three years old should have a nap in the morning and afternoon. These should be continued as long as the child can be jxjrsuaded to sleep in the day. The afternoon nap is especially important; the child gets tired and cross towards evening if it is missed. I IMPORTANCE OP SEPARATE BEDS Two children should not be allowed to sleep in the same bed ; one or other will surely suffer from the contact. It is a serious error to permit a child to sleep with an adult, particularly an elderly per- son. It is not fully understood why the association should be injurious, but it does affect the vitality of the child. THE BABYS TOILET CHAPTER .^I THE BABY'S BASKET lAiw Baskets. — A pretty basinet to hold the re(^uis- ites for the baby's toilet is indispensable and usually no little thought and care is expended upon it. A flat wicker one is used for the purpose, either round, square or oval in shape, about twenty-two inches long and with sides three or four inches high. This can be covered with glazed cambric of any color preferred. It is a French fancy to have blue for a boy and pink for a girl, but pale primrose yellow, delicate green, or crimson in winter, look equally well. Plain, figured, or dotted muslin is fulled over the cambric, with a deep ruffle of the same around the edge trimmed with narrow lace. A piece of cardboard is cut to fit the bottom of the basket and covered with cambric and muslin. Two small pin cushions and two little bags of the (124) THE BABY*8 TOILET 125 same materials are fastened to the sides^ ornamented with tiny bows of ribbon. Muslin decorations always grow limp in a short time and it is more sensible to choose a wicker bas- ket with an open edge through which ribbon of ihe proper width can be woven and ornamented here and there with bows. ,The bottom may be fitted with a sheet of cardboard covered with a thin layer of wadding sprinkled with sachet powder and over that India or Ciiina silk, either fulled a little and caught through the cardboard or put on plain. The pin cushions and bags may be of the same material, fastened to the sides of the basket with ribbon drawn through and tied on the outside. Chintz can be used instead of silk. Standard Baskets. — High baskets standing on a tri- pod i^re pretty. They can be treated in the same way anr' have a broad ribbon tied where the legs cross. Hampers — A wicker hamper will hold much more than the ordinary basket. One costs about five dollars and a half untrimmed. It has a tray to hold the arti- cles required for the toilet ; pockets and pin cushions may be fastened to it. It may be lined or not as preferred and covered with m\islin or silk. It looks very well with a broad ribbon crossing the cover diagonally, with a bow at each end, or 126 THE CARE OF CHILDREN arranged in two triangles crossing one another, with bows where they intersect. Wlien the wicker basket is not trimmed it is sometimes gikled or painted white, or red, with touches of gold, and varnished. This is a good device when the basket has done duty before and grown a little shabby in the service. If there is no cover it is well to make one of any pretty material that can be washed, to throw over it when not in use. THE CONTENTS The basket must contain a powder box and puff. The former may be of silver or any one of the pretty decorated ones that are perhaps even more suitable. The box is not nearly as important as the powder, which must be fine and soft. Any good toilet powder will answer; the cheaper ones sold under that name are to be suspected. Fine French chalk scented with a little powdered orris root is in- expensive and perfectly safe. It is well to have a little china, glass or porcelain box of vaseline. There must be a cake of Ivory soap in a celluloid or silver soap box. It is very important not to iise a cheap scented soap for the delicate skin of a THE baby's toilet 127 in- baby. There is no particular virtue in Castile soap, which has long been consecrated to this purpose. A little brush and tiny comb makes a pretty gift for a baby, but only the brush is needed at first. It must be very soft as the little head does not well bear being irritated with stiff bristles. A wide-mouthed bottle of powdered borax and one of precipitated fuller's earth should be in read- iness, but need not be in the basket. There should be a bunch of ab;sorbent cotton in one pocket and an old pocket handkerchief in the other. A jiair of blunt scissors, ai>d two or three yards of soft twine may be laid in the basket when it is to be used for the first time. One cushion must be filled with large, and the other with small safety pins, as a common pin should never be put into a baby's clothes. The garments that will be required for the first dressing may be laid in readiness in the basket. A band, a shirt, a flannel slip, one of the plain night- slips, a napkin, a pair of socks, and a Germantown wool blanket. I RECEPTACLES FOR CLOTHING A chiffonnier, or modern high bureau, with many shallow drawers, is a very convenient receptacle for the baby'^8 wardrobe. A delicate fragrance ought 1^8 THB CARE OF CHILDREN to linger about the dainty clothing, and violet always seems the most appropriate odor. Sachets can be laid amongst the little garments, or a stiff piece of paj)er, or thin card board, cut to fit exactly the bottom of the drawer, a split sheet of wadding tacked on it, thickly sprinkled with violet powder, covered with the other half of the sheet, and then with silk, or any material desired. The contents of the drawer will always be fragrant and not over- poweringly so. A trunk, or large wooden box, treated in the same way, neatly lined, the top being stutftnl, and the whole covered with chintz like an ottoman, is a substitute not to be despised, and makes a convenient receptacle for the napkins which often overflow a shallow drawer. THE CARRIAGE A young baby does not require a carriage, as it should be carried in the arms until at least two months old. The warmth and gentle motion, free from jolts and jars, are better for it than the uncer- tainties of a carriage, unless it is under experienced guidance. • In purchasing a carriage the money should be expended for good workmanship, smooth-running THE baby's toilet 129 be ling gear and stability of frame, rather than for a fine parasol, or handsome upholstering. The wicker ones are, on the whole, the most satisfactory, and those with a hood of the same material look well longer than those with shades of less durable material. \\'hen a parasol becomes shabby it can be re- covered at a moderate ex|)eiise. Lace covers can be bought wiiich conceal the ravages of time and^ as they can be washed, are easily made fresh when soiled. A nurpe maid never seems to remember that the parasol is adjustable, and is intended to shield the baby from the wind and protect the eyes from the sun. A touch will bring it into a position where it will be useful, but often during tiie whole time the baby is out it remains unchanged, sun and wind having it all their own way with the baby's face. A carriage should be rolled smoothly and care- fully lifled over curb stones. If mothers fully realized the risk of intrusting a baby in a carriage to an inexperienced, and sometimes untrustworthy nurse girl, they surely would hesitate to do it, A baby's bones are not easily broken but, being much softer than an adult's, they are easily bent. A bounce, a hard jolt, may do irretrievable mischief to lio THE CARE OF CHILDREN the tender spine ; a fall may render life a burden in all the years to oome. While the baby is young, it must lie flat in the carriage with a pillow as a bed. When old enough to sit up it should be carefully fastened in with one of the pat/cnt straps that render falling out almost impossible, unless the carriage is overturned. In this case the back must be comfortably supported with pillows. A carriage blanket may be crocheted, or knitted in one color. An eiderdown or Jersey flannel blanket looks well in cool wepther, or one of the ■ pretty silk striped rugs that can be bought for the purpose. In summer, pc/ngee silk makes a serviceable covering. Any pretty silk may be used with a cambric lining. Fine flanrel with a spray em- broidered on it looks well, but soils easily. Some of the stouter linen materials, bound with braid and with a monogram worked in the centre, are useful, as they can be washed. A blanket should be large enough to be well tucked in at foot and sides. CHAPTER XII THE BATH TUB A BASIN holds sufficient water for the baby's batli Juriug the first few weeks. Afler that, an oval tin tub makes a good bath tub. When water is precious or has to be carried a long distance, a tin hat bath is the most economical. It is shaped like a large round hat, the crown containing the water. When there is a bath-room the baby enjoys the large tub as Bcjon as he is old enough to appreciate it. A folding bath tub, made of heavy, flexible rub- ber cloth fastened to a frame, can be purchased for about five dollars. It is convenient where economy, of space is an object, as it can be folded up when not in use. China basins can be purchased with a division in the middle, one side for warm and the other foot ciai) 132 THE CARE OF CHILDREN cooler water, or one for plain and the other for scented water to finisli the bath, bnt thev are not of much practical use. They also come with wooden stands that hold the pitoher, soap-dish, etc., as welL WASH-CLOTHS These are much more satisfactory than sponges, and should be made of soft linen ; ])art of an old napkin answers very well. It is better to rav^el the edges into a fringe and overcast them than to hem them. For older children they may be knitted of white knitting cotton on large needles to make them loose and soft, or made of a square of Turkish towelling. CARE OF THE SPONGE It spoils a sponge to put soap on it. It should be rinsed in clear water, squeezed dry afler using, and hung in the sun when it is convenient, or where it will dry rapidly. It is said that when a sponge becomes slimy from long use, it may be restored by boiling it in water containing a few drops of ammonia, or a little washing soda. A sponge is a source of danger unless it is kept perfectly clean. It affords a good hiding-place for poisonous germs, and it is much safer to use a wash-cloth. BATHS 133 r for ot of Doden c, as oiiges, in old ^el the hem white 1 loose celling. lid be g, and it will jomes )oiling la, or a langer good much TOWELS It is difficult to get new towels that are soft enough for the baby's first bath. They are best made of the unworn parts of old table cloths. If they cannot be obtained, cotton or linen dia[)er washed several times until the stiffness is entirely gone, malies a tolerable substitute. Towelling can be purchased by the yard and hemmed at a cheaper rate than the finished towel can be bought. In purchasing these, it is better to avoid the fringed ones as the fringe is apt to wear off. They can be had either hemstitched or finished to imitate a hem with bands of color above it and these are very durable. Turkish towels make the best bath towels for older children and can be had in various degrees of roughness, either fringed, or by the yard. A separate towel should be kept for the face and hands. Towels should be changed frequently* It is not well for the children's sake to allow them to become too soiled. Each child should have his own towel. LAP PADS It is convenient to have a lap pad to hold a baby on when it is lifted from the tub. It should be about three-quarters of a yard long by half a yard wide. A bag is made of gray, or any pretty striped 134 THE CARE OP CHILDREN flannel, trimmed with a ruffle, if desired, into which the pad is slipped. This is»merely a piece of rubber cloth, cut to fit the bag and can be easily taken out to be dried and disinfected. The pad is also useful to put under the baby when it is laid on the bed for a few minutes, or to place on a visitor's lap for fear of accidents. It can have strings on one side to tie round the mother's waist to prevent it from slipping when in use. THE FIRST BATH A baby ought not to be plunged into water until it is at least a month old. It has been accustomed to a temperature of about 99°. We consider 80° hot for a room, nearly twenty degrees colder. No doubt, the exposure of washing is responsible for many of the bronchial affections, colds in the head, etc., that affect and sometimes prove fatal to little babies. The first bath should be given on the nurse's lap, the baby lying between the folds of a blanket. A small, soft, old one is the best for this purpose ; if one is not to be haer incisors should pierce the gum outside the old ones, the lower come inside their predecessors. Sometimes a year passes before the lateral, or side incisors, follow the middle ones. When the child is about ten the eight bi-cuspids, or two-pointed teeth, next the cuspids, come into view. About two years later the two lower cuspids make CARE OP THE TEETH 149 their appearance, follc^ved in from one to three years by the two upper ones. The second molai*s appear from the twelfth to the fourteenth year, the third molars, or wisdom teeth, at any time after the seventeentii year, making in all thirty-two, sixteen in each iaw. THE CARE OF THE TEETH Teeth are so important to the comfort and health that no care and pains that can \)e expended upon them is too great. Fi^equent cleansing and particu- larly passing a fine thread between those sufficiently separated to permit its passage to dislodge any mis- chief-making atom that may have found a place there, is the best preservative measure. Rinsing the mouth with a little lime water at night removes the traces of any acid that may have been there during the day. It is a mistaken idea that the first teeth need lit- tle or no attention. Until the child is old enough to attend to it himself, the mother should use a soft brush, at least twice a day, cleansing the teeth thor- oughly. The child should be taugnt to use the brush after each meal and to pass a thread of silk between the teeth at the same time to dislodge any particle of food or foreign matter that may be there. 150 THE CARE OF CHILDREN • This is of the greatest importance, as a compara- tively trifling obstruction, if left unr'sturbed, may cause a serious cavity. If the teeth are properly cleansed after eating, nothing that is taken into the mouth can injure them, because it is not allowed to remain in contact with them long enough to do harm. When medicine is given, iron and acids should \te taken through a glass tube. Tooth powders are not necessary to keep the teeth in good order. Pure soft water and a brush are all sufficient if they are used with the necessary fre- quency. Many dentifrices do more harm than good. A dentist should be consulted before even a first tooth is removed. If taken out too soon the jaw is permitted to contract and the tooth which comes to occupy the place is unduly crowded. If the teeth are not perfectly even and regular the child ought to be taken to a dentist. Defects can often be remedied if attended to in time which it is impossible to rectify after years of neglect. It is comparatively easy to straighten teeth and put them in their proper relative position while the child is young and it is wrong to permit a deform- ity to exist which might have been prevented if proper means had been used. CARE OP THE TEETH 151 ite ich GRINDING THE TEETH This is popularly supposed to be an unfailing, symptom of the presence of worms in the intestines. It is usually noticed in sleep, and is sometimes an indication of disease of the brain. Usually, how- ever, it proceeds from that fruitful source of the ills of childhood, a disordered digestion. It fre- quently occurs when there is diarrhoea and is gener- ally only temporary, disappearing when the cause is removed. If it persists the doctor should he con- sulted. TOOTHACHE This is a common affliction when the teeth decay. If there is a cavity, a drop of carbolic acid, creosote, or oil of cloves, put on cotton-wool and i>ressed into the hole, often gives ease. When no opening can be detected dissolve a tea- spoonful of powdered alum in sweet spirits of nitre and bathe the gum on each side of the tooth with the mixture. If there are shooting pains that cannot be tracked to any one tooth, neuralgia may be at the bottom of the mischief, and quinine, or some other tonic, be needed, with more stimulating and nutritious food. Very often extraction, or at least treatment by the dentist, is the only thing that will bring perma* nent relief. CARE OP THE EYES CHAPTER XIV \ THE EYES i A DEFECT in sight is such a grievous affliction in later life to a person burdened with it that the care of the eyes in children becomes a matter of the first importance. " It is interesting to the mother to know that the color of a baby's eyes is not fixed until after it is six weeks or two months old. They may change to a lighter or a darker shade. OPHTHALMIA OF THE NEW-BORN The slightest redne&s, or swelling, about the eyes of a young infant should receive immediate atten- tion. It is accompanied by a slight discharge whicli, if neglected, may cause loss of sight. This is so important that in France a nurse is obliged by law to report to a competent medical (162) c c 8 a e d o tl si n CJ n cl 1 CARE OP THE EYES 153 in ire rst le is Ere es 1- re IS il authority any affection of the eyes of a new-born child. The first symptoms may appear when the baby is two or three days old. Perfect cleanliness is the remedy, not allowing the discharge to accumulate on the cornea, or trans- parent covering of the eye. If tliis is permitted, an ulcer may form, penetrate the cornea, and produce blindness. The lower lid must be gently di-awn down at the outer corner, and tepid water put in with a dropper, or small syringe, thoroughly washing the whole surface. The doctor will probably order a slightly astringent wash. If the discharge adheres to the eyelids, they can be touched with vaseline, or a drop or two of pure oil. The eyes sometimes require washing as often as once in fifteen minutes, the frequency depending on the amount of the secretion. The nurse is respon- sible for the child's sight, and this thought should make her faithful to her duty. The disease is very infectious. The nurse must carefully guard her own eyes and those of the mother. Pieces of soft cotton should be used to cleanse and wipe the eyes, and immediately burned. The nurse must disinfect her hands after touching 154 THE CARE OF CHILDREN the eyes or she may convey the infection by means of her finger-tips. SHADING THE EYES A young baby's eyes sliould not be exposed to a strong light. Tliis does not mean that the sunliglit must be kept out of the room, but that the baby's eyes must be shaded from its direct rays. The canopy of the crib, or a screen, should protect them. It is equally injurious to let the gas, or any artificial light, shine directly on them. Older children should be taught to guard the eyes carefully, particularly when studying at night. A paper shade over the eyes is often a great relief. In climates where there is much snow, the sun shining on the dazzling white surface is very trying. Smoked or colored glasses should be worn if the strain causes stinging, or inflammation of the eyes. Wind is very injurious to weak eyes, and they should be protected from it by glasses. TESTING THE EYES Many persons never discover that their vision is not normal until some accidental occurrence reveals to them the fact that they do not see as >vell as their fellow-beings. Having always been accustomed to a limited Jt«!utt'*.> CARE OP THE EYES 155 range of sight, they do not realize that others have a wider field. Their own defect of vision, whatever it may be, is a part of their daily experience, and unless the difference between themselves and their more gifted companions is forced upon them they do not recognize it. Children are often unjustly blamed for being stupidy or inattentive, when the truth is they oainiot see clearly what they are required to under- stand. The mother should try to ascertain the amount of vision possessed by her child. She can find out which details of a picture he can see at various distances ; whetlier he can distinguish the faces of passers-by on the opposite side of the street, and before he goes to school what ability he has to read words and figures removed from him, as on a black- board. The eyes should be tested separately by covering first one and then the other. If there is any doubt as to the sight being perfectly normal they should be examined by a specialist. DEFECTS OF VISION The most common defects in vision are short sight, long sight, and astigmatism. Short Sight. — When a child seems to have diffi- 156 THE CARE OP CHILDREN culty in distinguishing objects at a distance, short sight should be suspected, and the eyes examined by an oculist. A child between eight and twelve yeai-s old should be able to read ordinary print with the book held at a distance of thirteen inches from the eye. ' Short sight can be corrected by proper glasses, and even very little children can wear them. Short sight may l)e produced where it does not exist naturally by overstraining the eyes, as in reading by a bad light. Long Sight. — The child is unable to use his eyes to see objects at a short distance without straining them. He cannot accommodate the sight easily to a short range and the eifort to do so often causes headache. The eyes feel strained and the letters look blurred. Pressure is sometimes made with the hand, as it gives a feeling of relief, or the eyes are often closed to rest them. If the defect is not remedied by proper glasses, it may produce a permanent squint. Astigmatism is caused by a defect in the curve of the cornea or front of the eyeball. While ob- jects can be seen, their outline is blurred and there is a certain indistinctness about everything. It can be entirely corrected by glasses, when it is the only defect in the eyes, and usually materially helped by them in any case. CARE OP THE EYES 157 it The eyes can l)e tested only by an oculist, as he has the proi>ei' ap[)aratus for doing so. When any defect is known or snspectes§ ^./' //I /A '^W 0% >> 7 Photographic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. MSSO (716) 873-4503 .v^V rW CARE OF THE FEIvT CHAPTER XVIII BESTING ON THE FEET The bones of children are very soft and easily bent. They contain a larger proportion of animal matter than the bones of grown ^)ersons, in which mineral substances predominate. This peculiarity renders the bones of infants especially liable to dis- tortion ; any undue weight or pressure upon them bends them out of shape. An active baby si. 01 .Id not be allowed to rest its weight on its feet for more than a few seconds at a time. This precaution is particularly necessary if the child is unusually large and heavy. After it is six months* old it will begin to feel its feet, resting partially upon them while supported by the mother's hands under its arms. Creeping is usually the next advance in locomo- tion, although some babies miss this stage altogether (180) CARE OP THE FEET 187 and struggle to their feet, standing alone by the time they are ten months old. It is a mistake to hold the baby too constantly in the arms. If put down on a rug or blanket on the floor it has a good opportunity to develop the po^vers of motion and also learns to amuse itself. WALKING Proper shoes are a great help in the first efforts to walk. As already mentioned, the soles bliL>uld be flat, not rounded, and, if the ankles are inclined to be weak, boots that support them for the time being are desirable. Weak ankles should be frequently bathed in salt and water and well rubbed several times a day. A healthy child shows a desire to pull himself up by some solid article of furniture when he is ready to walk ; usually at from ten to fifteen months old. He should not be forced in any way to anticipate this time by injudicious urging. If a child dees not walk when he is two years old there must be some physical disability which should be investigated. 10- ler BATHING The feet should be bathed in cool water every morning or evening, and well rubbed to bring about J88 THE CARE OP CHILDREN the reaction. This keeps the pores open and mate- rially lessens the tendency to take cold. PROTECTING THE FEET It cannot be too often repeated that the feet are two of the most vulnerable points in the body. Being at a distance from the heart the circulation is often interfered with and cold feet is the result. Warm stockings in cold weather, well-fitting but not too tight shoes, and overshoes for '^et days, are absolutely essential to health. DAMP FEET If the feet are wet the shoes and stockings should be removed as soon as possible and the feet rubbed with alcohol or spirits of camphor, dry foot-gear being put on, of course. Children should be instructed not to sit in school w^ith damp feet. If long rubber boots are worn, this accident cannot happen while the boots are whole, unless in the case of some boys to whom length' of leg only means a challenge to wade over the top of it. The feet are sometimes found cold and damp at night and should always be warmed and rubbed be*- fore the child goes to sleep. CARE OF THE FEET 189 are are EXCESSIVE PERSPIRATION This is a most annoying affection, as it is usually aocoinpanied by a disagreeable odor. Especial at- tention should be paid to cleanliness and the follow- ing liniment may be used : Tannic acid, two drams, or teaspoonfuls. Al- cohol, eight ounces, or sixteen tablespoon fuls. This preparation stains clothing. It may be applied twice a day. After it is dry uust the feet with finely powdered French chalk. Do not use a vegetable powder, as corn starch, for this is unfavorably affected by the heat and moisture. The stockings should be changed frequently. CORNS Corns are nature^s effort to protect the soft tissues of the foot by forming a callous to sustain the pres- sure. They are evidences of the faulty construction of shoes, and in some cases of the vanity that persists in wearing shoes too small for the foot. With children the shoe that has caused the mischief should be abandoned. If there is much tenderness a section of lemon can be bound over the sore spot at night. When the corn is between the toes a wad of cotton-wool gives great relief; if outside the toe a circle of felt with a 190 THE CARE OF CHILDREN hole in the middle 6sli\ be placed over it, and secured with sticking plaster. After soaking the foot in warm water the horny substance of the corn can be pared away, and if there is subsequent relief from pressure, it will probably be cured without farther trouble. A bunion is an enlargement and inflammation of the joint of a toe, usually of the great toe. It is not very common in children. Removal of pressure and painting the part with tincture of iodine will often be effectual if it is discovered early. Later, when there is much inflammation, and perhaps matter has formed, it should be seen by a physi- cian. CHAFED HEEL Children often suffer much from the heel having been rubbed by a badly-fitting shoe, or one that has a rough projection, where the seam is at the back of the uppers. A circular piece of rubber plaster, applied when the pain is first complained of, will give complete relief. If the skin is rubbed off, the place must be dressed with a little cold cream over night and the plaster applied over a fresh dressing in the morning. Ingrowing nails have already been mentioned. CARE OF THE FEET 191 CHILBLAINS Chilblains are painfully red inflamed spots on the toes, heels, and sometimes on the fingers, occasioned by exposure to cold. On their first appearance, they may be painted with iodine, or rubbed with an ointment of one part of ground mustard mixed with, three parts of lard. Camphorated oil sometimes gives relief. If neglected they may ulcerate and should then l)e dressed with balsam of Peru spread on linen and washed every day with a weak solution of carbolic acid. The following ointment is said to prevent the oc- currence of this condition : Oxide of Zinc, half an oance ; Glycerine, one and a half ounces ; Lanolin, one and a half ounces. It should be well rubbed in afler washing. lias 3k of will the over kssing AILMENTS CHAPTER XIX SIMPLE REMEDIES It cannot be too earnestly impressed upon the mother thut children need very little medicine, and that only the simplest remedies should be given them without the advice of a doctor. Many of their ailments a:ise from a disordered digestion. A gentle laxative will often carry off the offending substance, and a small dose of castor oil, citrate of magnesia, Rochelle salts, or spiced syrup of rhubarb may be ventured on with perfect safety. Compound liquori'ie powder is a safe laxa- tive. It owes its efficacy to the senna it contains. Half a teaspoonful may be given to a child of four years old at bed time, and the dose increased to a teaspoonful for older children. It is easily taken mixed with a little water, as the taste is not es])ecially disagreeable. (192) AILMENTS 193 More powerfu! remedies may do more harm than good when administered by the iiiexi)erienced. Attention to the diet, perfect cleanliness, good ventilation, and snfficient sleep are more valuable as curative measures than most of the drugs in the phtirmacopoeia. FEVERISHNESS A child's temperature rises very easily and an elevation does not mean as much as in an adult. A clinical thermometer is a useful instrument for the mother to have. The normal temperature is 98.4^ Fahr. If a child is flushed and hot at night, a warm l)ath should be given, and a saline laxative, as a teaspoonful of Rochelle salts, or more according to the and friction help to cut short an attack. The pain comes on with some babies at a certain time every day. When this is the case, the enemy can sometimes be circumvented by wrapping the baby in a blanket with a hot-water bag before the liour when the attack may be expected. Rubbing the bowels with the warm hand, be- ginning low down on the right side, bringing the iiand up, across the abdomen and down the left side, may give relief. The feet should be warmly wrapped in flannel and kept on a hot-water bag. A few teaspoon fuls of warm lime water may be given or two or three drops of essence of pepper- mint in hot water — not sweetened — as sugar tends to aggravate the fermentation. Plain warm water may be used. In severe cases an enema of warm water given with an infant's rectal syringe may bring relief. A hot bath can be tried when other means fail. 196 THE CARE OF CHILDREN CRYING Babies cry from other causes tlian colic and it in well to bear these in mind. They do occasionally have an opportunity to cry from hunger, as when a longer sleep than usual has lengthened the interval between two meals or when the last meal has fiom any cause been a small one. This cry is stilled after food, while that from colic is increased by feeding. A baby sometimes cries from thirst as well as hunger and one or two sjioonfuls of water may be a panaa'o. If the water is not passed at proper intervals, it causes discomfort. The legs are drawn up to lessen the pressure and the child frets and wails. Flannels wrung out of very hot water and laid over the lower part of the abdomen may relieve this condition. The heat and moisture cause relax- ation and the water escapes. When a rash is present the jwssibility of irritation from this source should be remembered. It can be bathed with a solution of baking soda in water. Unguarded pins are not put into the clothes of the modem baby and, as no tight bands confine it, these causes of tears are eliminated. A cry is the natural expression of discomfort from any cause. A baby does not shed tears until it is nearly three months old, as they are not se- creted before that time. Air.MRXTB 19: CONSTIPATION This is one of the most common ailments of oliildliood and may be relieved in a variety of ways. With older children attention to the diet is oflen ull that is necessary to give relief and this means lias already been touched upon. Massage/ or careful rubbing and kneading of the abdomen, either with warm oil or without^ will often produce a movement When the intestine is inactive, it can be induced to move by a suppository. The simplest for a young baby is a piece of white writing [)aper twisted into a cone about four inches long. The end is oiled and gently passed into ihe rectum for about an inch. A suppository can be made by scraping a piece of white soap to the thickness of a lead jiencil and in- serting about two inches. It is of course expelled with the movement. Molasses boiled to the consistency of candy and shaped into suppositories is very effectual. Prunes, covereil with water, boiled until they form a pulp and then strained, make an excellent laxa- tive. A teaspoonful of the water can be given every morning to a baby six months old, increasing the dose for older ones. 198 THE CARE OP CHILDREN Half a teaspoonfiil of flake manna can be added to the milk once a day and repeated, if necessary. It is unwise to give castor oil constantly, or any of the patent catliartic medicines, as they only give temporary relief and increase the difficulty ulti- mately. When it is necessary to effe(!t a movement in ob- stinate constipation, an enema of one ounce, or two tablespoonfuls, of warm oil can be given; or a larger quantity of warm soap suds. It is very important to establish regular habits. A baby can be held out at the same hour every morning and evening after it is a month old. Some children seldom soil a napkin after the first six we^ks. Older children should be required to make an ef- fort to have a movement every morning, but inef- fectual straining should not be permitted, as there is danger of the lower part of the bowel prolapsing, or coming down. The discharge should be soft, yet formed, except in babies under two years old. If it is in hard, round balls, it has been retained for some time and more fluid is needed and should lie given. There are children who do not seem to be able to have a movement oftener than every other day. If the AILMENTS 199 added ivy. ►r any y give f ulti- in ob- or two ; or a habits. r everv • Some irst six an ef- ut inef- here is sing, or except round d more lere are have a If the '> general health is good this is Dot a ground for anxiety. DIARRHCEA During the first few weeks of a baby's life there are usually three or four movements during the twenty-four hours. These gradually decrease in number until, when the child is two years old, eat- ing a variety of solid food, there is only one a day. While the diet is principally milk the motions will be yellow in color and soft in consistency. If white curds of milk appear in them the food is not being properly digested. It may be lessened in quantity for a time and a little more lime water /idded to it. When the movements are clay-colored the liver is torpid and the doctor should be consulted. If a child is taking iron or bismuth, the excre- tion will be very dark, almost black. Should there be a stricture of the bowel, the matter will be small in size, sometimes not larger than a pii^e stem. When the movements increase in frequency be- yond the normal limit and become greenish in color and watery in consistency, we say tlie child has diar- rhoea. This is an evidence of some disturl)ance of the intestinal tract, usually from indigestion. If it has been preceded by constipation, a dose of 200 THE CARE OF CHILDREN castor oil will probably give relief, removing the of- fending substance. To a young baby, three or four drops may be given every three hours for four or five doses, or until there has been a free evacuation. For a child six months old, a teaspoonful once will be sufficient. The dose can be increased to a tablespoonful for a child of six years. Children bear castor oil well. The food should always be attended to when diarrhoea is present. If the evacuations become white and watery, con- taining muoi^ and, perhaps, streaks of blood, with a constant straining and desire to have a movement the disease is known as dysentery. The inflamma- tion has extended to the large intestine. Diarrhoea should not be allowed to go on long unchecked. The physician should be consulted if home remedies are ineffectual. For older children rest in bed and restricted diet will often effect a cure. A flannel bandage should be worn during the day a^d nighty as warmth over the bowels is important. HICCOUGH Hiccough, or hiccup, is usually a symptom of little importance. It is caused by a spasmodic con- traction of the diaphragm, the muscle separating AILMENTS 201 the chest from the abdomen. It may arise from the presence of too much food, wind, or gas, in the stomach. Often diverting the child's mind is all that is necessary. A sudden, quick movement of a baby, or patting it on the back, telling an older child to hold his breath while he counts twenty slowly, is sometimes effectual. In obstinate cases, two drops of spirits of camphor on sugar may be given to a child of three years old, and increased to ten for one of fifteen. COLDS Prevention. — In northern climates a cold is one of the most common ills of childhood. There is a great difference in the susceptibility of children, some taking cold much more easily than others. It attacks special points, as the head or the chest, and when one is found to be vulnerable it must be specially guarded. Sponging with cool salt and water and aociistom- iug the child to live in a well ventilated room at not too high a temperature, helps^to insure immunity. If the chest is liable to be attacked it is well to rub it with warm oil, both back and front, at night, and keep a fold of cotton batting, or wadding, over it during the day. Cold in tlie Head. — A variety of cold in the head 202 THE CARE OF CHILDREN called snuffles, sometimes observed in a young baby, should always be reported to the doctor, as it may, indicate constitutional disease. When the nose is obstructed, rubbing it with vaseline or warm oil will sometimes give relief, carrying it inside with a camePs-hair brush. Older children may inhale cologne with a drop of am- monia water in it. Spirits of camphor may be used in the same way. Gently syringing the nostrils with warm salt and water is said to be an effectual remedy. A small glass syringe with a blunt nozzle is the l)est for the purpose. Hoarseness. — This is caused by inflammation of the larynx, the enlargement at the top of the wind- pipe that contains the vocal chords. A warm poul- tice or flannels wrung out of hot water are some- times useful. The throat should be covered with dry flannel the next day. Inhaling the steam from a pitcher of boiling water helps to relax the tension. Thirty drops of compound tincture of benzoin can be added to the water. A few drops of lemon juice given on sugar and repeated frequently is a pleasant remedy. Cold 071 the Chest — This is known to physicians as bronchitis, or inflammation of the bronchial tubes. The child is feverish, with some cough and a feeling of tightness in the chest and throat and |)erha|)s a AILMENTS 203 Is as nes. ing s a dull pain. The feet should be soaked in hot water with a little mustard added to it and a warm poul- tice applied to the chest. This must be changed every hour to keep up the heat. Wlien a poultice cannot be obtained, the chest can be rubbed with warm camphorated oil and covered with flannel. A warm drink — flaxseed tea flavored with lemon juice is good — can be given at bed time. If the cough is tight, ten to twenty drops of wine of ipe- cac can he given to a child two years old. It is especially important that children with deli- cate chests should wear flannel and have the feet protected with woolen stockings. When wool next the skin is unl)earably irritat- ing, as it undoubtedly is to some hyper-sensitive children, very thin cotton stockings can l)e w'orn underneath the others and gauze shirts and dmwers inside the woolen ones. There is no more efiectual measure for the pre- vention of colds than thoroughly protecting the ex- tremities, particularly the feet. Overshoes should be worn in wet walking and removed on entering the house. If the shoes are damp, the, evaporation as they dry carries off the heat from the feet, render- ing them cold and damp, and almost certainly brings on the symptoms of a cold. 204 THE CARE OF CHILDREN If a child's feet arc habitually cold, the cause should be sought for and removeci. Warmer foot H)vering8 must be provided and the circulation stimulated by brisk rubbing night and morning. SNORING Children as well as grown persons should keep the mouth shut and breathe through the nostrils. Snoring is a danger signal, showing that some- thing is wrong with the throat or the nasal pas- sages, presenting an impediment to proper breathing. The tonsils, or the little glands on each side of the throat a\ the back of the tongue, may be en- larged, partially filling up the passage from tlie tiiroat to the lose, preventing the free access of air in that way. If they are much inflamed, the child should be taken to a surgeon, who will apply some astringent application, or, if necessary, remove the offending glands — not a serious operation usually. Snoring may proceed from catarrh of the throat or nose. There may be a growth obstructing tlie nasal passage. Whatever the cause, it should be found and treated, as })ersistent breathing through the mouth impairs the capacity of the chest, injures the lungs and opens the way to many ills difficult, if not impossible, to cure in after years. AILMENTS 205 roat I the be ires ■It, SORE MOUTH Tkrvsh, — Young babies and even older children sometimes have tiny white patches in the mouth, which are really a fungoid growth like little toad- stools. They look like specks of milk. Sometimes they extend through the wliole digestive ti-act, causing the movements to become greenish, and upsetting the digestion. It is usually caused by want of cleanliness. Tiie nursing bottle, or nipple, may be neglected ; the mouth may not have been -swabbed faitiifully after food was given, or the diet may l)e improjier, causing disturbance in the stomach. Remove every exciting outside cause by exquisite cleanliness of bottle, nipple, and mouth. Use a saturated solution of boracic acid, instead of clear water, to swab the mouth, and if the patches appear at the anus, or opening of the bowel, sprinkle them with a powder made of equal parts of boracic acid, oxide of zinc, and French chalk. A saturated solution is made by dissolving in the water all the boracic acid it will take up, as is shown by some of the crystals remaining undissolved at the bottom of the bottle. Boracic acid can be obtained from the apothecary in small crystals and can be powdered. With older children, the little canker sores that 206 THE CARE OP CHILDREN sometimes come inside the mouth, at the jiinct/«>ii of the lips with the jaws, cau be cured by dusting them with powdered alum. COLD SORES Cold sores appearing at the corners of the lips outside can be touclied with spirits of camphor in the early stages, which will probably prevent their farther development. If it is too late for this treat- ment, vaseline, or cold crcam, is the best application. CRACKED LIFS When the lips are roughened and cracked, a mixture of four teaspoonfuls of glycerin and one of com)K)und tincture of benzoin is an excellent emollient to apply. GUM BOIU9 Gum boils show some inflammation at the root of a tooth and require the attention of a dentist. A tiny square of capsicum plaster over the offending part helps to relieve the conditio" for the time. SORE THROAT This may l)e a comparatively trifling ailment, or it may be the beginning of a disease that involves a struggle l^etween life and death. • A baby\s throat can be examined by holding it towards a window^ or a bright light,, tipping back AILMENTS 207 root List. the for )ack the head, pressing down the chin to open the mouth, and holding down the tongue with a flat tooth brush, or spoon lirndle. An older child, if amenable to reason, can be made to show the throat by telling it to open the mouth and say " ah." Some children find it impos- sible to hold down the tongue voluntarily, and then it must be depressed with a spoon handle. If a child is accustomed to do this occasionally when in health it. will not be so difficult to induce it to repeat the performance when it is really necessary. The throat is very sensitive in children, and responds quickly to any derangement of the system. Cold, impure air, or uay digestive disturbance, inflames the deliqate membrane that Viues it. In the sore throat resulting from cold the mucous membrane is congested, being a darker red than usual from the presence of an extra quantity of blood. A folded piece .f cotton wrung out of cohl water with a flannel band laid over it, renewed as it becomes dry, will oflen be all that is needed to give relief. A gentle laxative, as milk of magnesia, may be given if indigestion is suspected. ^* Sometimes there is slight tenderness on pressing the outside. The uvula, or pointed palate that hangs at tlie back of the mouth may be swelled, Mid there xnay be a little mucus, but no white 208 THE CARE OF CHILDREN spots, or patches. There may he a good deal of pain in swallowing, as the food presses on the in- flamed snrfaces, and only sofl things, or liquids, should Ik* given. There is another form of sore throat in which tlie tonsils princiimlly are affected. They can Ikj felt u little swelled and hard on the outside of the throat, and inside small spots, or patches, like little ulcers, white or yellow in color, apj>ear on them. These arc confined to the tonsils, mid do not extend to the uvula, or pointed part of the aoh palate, the roof of the mouth, or l)ackwards towards the throat. The s|)ots can he touched with a cameFs-hair brush dippo- pearance on the side of the abdomen just above the groin. The treatment is the same. The intestine must be returned by gentle manipulation and held in place by a proper truss. This caimot be applied too early. A rubber truss can be obtained, which is not injured by being wet. Great care is necesi^ry to keep the parts under- neath it in good condition. They must be wipt^l with a damp cloth, carefully dried and powdered each time the napkin is changed. 236 TIIR CARK OF riHLDREN The truss itself noods careful attention. It should be washed witli a weak solution of ('arlx)lic acid once a day and washed and dried every time it is taken off before replacing it. A truss often has to be worn for several years and should not be discarded until the child has been inspected by a physician. Rupture occurs in older children, particularly boys, from lifting a heavy weight, or straining themselves in some other way. As soon as it shows itself a truss should be provided and worn continu- ously. * A rupture is a comparatively simple matter as long as the intestine can l^e returned to the abdo- men and kept there. When it is above the navel a lM?lt like that for umbilical hernia can be worn, the pad being placed over the point of rupture. The danger lies in not being able to return the intestine to ti>e alxlomen. In this case the child may be put in a warm bath to relax the tension. After this, he may be placed on the back with the feet higher than the head and the mass gently pressed and manipulated in the hope of being able to slip it back through the opening. If this cannot be effected, the doctor should be sent for as the hernia may become strangulated ; that is, the folds of the intestine compressed so tightly that the circulation is cut olT. Obstinate vomit- PHYSICAL DEFORMITIES 237 ing and extreme depression follow and if not re- lieved the child dies. The possibility of this accident renders the proper care of rupture very ira])ortant. PROLAPSE OF THE BOWEL If a child strains too violently in the effort to have a movement the lower jpart of the rectum may come out beyond the anus, presenting an ai>i)ear- ance as of a soft, red tumor, very alarming to the mother if she does not know the cause of it. If it is slight, it can easily \ye returned by gently pressing it back with the finger covered with a little vaseline. When it is more severe a flannel wrung out of hot water can be applied to relax the parts before pressure is used. The accident sometimes happens after prolonged diarrhoea, or when there is constipation. The diet should be regulated and in the latter case a laxative or an enema be given before the next movement. PILES Piles, OP hemorrhoids, are not common in young children, although they do appear and older ones suffer from them. External piles are small swell- ings, or tumors, appearing around the opening of the bowel. They do not bleed but when inflamed 238 THE CARE OF CHILDREN are very painful. They should be sponged with very hot or cold water, whit-hever gives most relief. Rest in bed is beneficial and strict attention to regularity of the bowels, as they are often due to constipation. A flannel band worn over the ab- domen is also of use. Internal piles, situated farther up the passage, sometimes bleed, jmrticularly after a movement. When this is the case, a phvsician should be con- sulted. As much as a tablespoon ful of blood may be lost at one time, which has a depressing effect if it is often repeated. If internal piles descend afler a movement, the finger should be covered with vaseline and the piles gently pressed back again. An astringent ointment may be needed. ENLARGED GLANDS A system of glands called the lymphatic glands extends over the whole body. They are especially numerous in the neck, the groins and under the arms. Usually they cannot be felt, but when they are enlarged they are like a chain of beads to the touch. The enlargement may take place as the re- sult of an injury, or be due to some irritation, as in teething, catarrh, or acute disease, as scarlet fever. In children with a tendency to scrofula the glands PHYSICAL DEPORMTTIES 239 often break down, the swelling ending in the forma- tion of matter, or pus. The treatment in cases where the glands are en- larged is to remove or alleviate the source of irrita- tion, if possible, give nourishing food and, If neces- sary, cod-liver oil. Salt water sponge baths arc rec- ommended and special attention should be paid to having the child warmly clad. The glands can be painted with tincture of io- dine. Bathing wit i» hot water may give relief if they are painful. If there is heat and throbbing, pus is forming and a doctor should be consulted. When the abscess is lanced in time, the scar is smaller than if it were left to break of itself. ENLARGEMENT OP TONSTIJ3 Delicate children often suffer from an enlarge- ment of the tonsils, the almond-shaped glands on each side of the entrance to the throat. Snoring and starting or crying out in the sleep are sometimes due to this cause, as well as cough. On looking in the mouth these bodies are seen to he swelled, projecting towards each other, partially closing the passage behind them. Unless the child's health is much affected, little need be done, as the tonsils have a tendency to de- crease in size with increasing age. If they inter- 240 tHE <*^AllE OF CHILDREN fere with nursing, as in a >oung baby, or cause much discomfort, home treatment will be of little avail unless carried out under the direction of a physician. When matter forms in the tonsilg and they dis- charge, we have the condition known as quinsy. At this stage poultices are applied externally and every means adopted to hasten the suppuration. In aggravated cases it is necessary to remove the whole or a part of the gland. The directions as to food, baths and clothing in enlargement cf the other glands should be fol- lowed. It is especially necessary that farinaceous food, as oatmeal, Ln*ead, etc,, should be limited^ milk and meat beins: increased. WARTS Erasmus AVilson, one of the great authorities on diseases of the skin, says that Marts are causeHYSICAL DEFORMITIES 241 the Salicylic Acid, one dram, Lactic Acid, one dram. Flexible Collodion, two drams. Mix and apply with a camel's-hair brush twioe a day. FRECKLES Children with fair skin, particularly if the hair is red, freckle very easily. The face should be pro- tected as much as possible by a wide-brimmed hat. Persistent washing with buttermilk of the parts afifected will remove them. If this cannot be ob- tained, lactic acid diluted with one-half water mav be substituted. It is this acid that gives the buttermilk its virtue. TAN Tan is rather becoming than otherwise to most children. If it is desired to remove the brown coloring it can be done by covering the surface thickly with benzoated zinc ointment at night and washing it with soap and hot water in the morning. SUNBURN The smarting of sunburn is relieved by bathing with vinegar followed by a copious application of cold cream. A BLUE BABY The condition of cyanosis, as it i^ technically :(■ \ 242 THE CARE OF CHILDREN called, which causes a baby to look blue, arises from some affection of the heart. In severe cases the child lives only a short time, a few hours or days. Otherwise, with care, its life may be prolonged for years. Careful attention t^o diet, warmth and fresh air are especially necessary. The baby should be laid on the right side. When the breathing is oppressed, it must be sup- ported in a sitting position. If there is much dis- tress it can be placed in a warm salt-water bath and five or six drops of brandy given, the dose being repeated once or twice, until the doctor can see it. As the child grows older the diet must consist of milk, meat, bread, vegetables and farinaceous food, all rich or indigestible articles of diet being scrupu- lously avoided. Flannel must be worn next the skin and the feet protected with especial care. Warm water must always be used for bathing, and in very 'X)ld weather the child should stay in- doors. Cold is the enemy to be dreaded above all others. At the same time ventilatio!: of the sleeping room b most important. A child suffering in this way should not be feet PHYSICAL DEFORMITIES 243 air allowed to take violent exercise, nor over-exert him- self in any way. The studies must be regulated not to overtax the brain. The child is really an invalid, yet one who should be encouraged to make the mqst of his powers while being extremely careful not to exceed them. CHILDREN'S DISEASES CHAPTER XXI THE EARLY STAGES The watchful mother will be on the alert to de- tect the first symptom of illness in her child. Loss of appetite, languor and fretfulness should always arouse suspicion. An ailing child should not be allowed to sleep in the same room with those who are well and should as far as possible be separated from them until the nature of the illness is known. Some of the conta- gious diseases are infectious in the very early stages. Vomiting, not caused by indigestible food, diar- rhoea, a rapid rise of temperature, are all reasons for keeping the child in bed and on light diet, as milk diluted with lime water, a little bread or gruel, until farther symptoms have declared themselves. The throat should be looked at, the face, neck and body carefully examined for traces of a rash, and (244) DISEASES OF CHILDREN 245 any complaint of pain attended to and remembered for the doctor's information. If there is anything unusual about the discharges they sliould be saved in a covereber cloth, or table oil cloth, can be used as a foundation, being carefully sponged with disinfectant eacii time the pad is changed. Soiled napkins, pads, or vessels containing dis- charges should not be allowed to remain in any room where there are children, sick or well, for longer than it takes to remove them. Every mother should make this an invariable rule. PREVENTING INFECTION Isolation of the patient and nurse and thorough disinfection of everything that leaves the sick room will prevent the spread of infection. A room in the top story should be chosen if pos- sible and all communication with the rest of the house forbidden. Whatever is to be brought to the sick room should l)e left outside the door and everything to be taken away put in the same place. When the nurse leaves the room she should rub her hair thoroughly with a clean towel, kept outside the room, change her wrapper for a fresh one, wash her face and hands, and put on another pair of shoes. DISEASES OF CHILDREN 263 DISINFECTANTS Many disinfectants are recommended and, no doubt, are good. Any disease can be prevented from spreading by tlie use of carbolic acid for gen- eral purposes, sulphate of zinc and common salt for the clothing, and lime, or copperas, for the water closet. It is cheapest to buy the pure carbolic acid in crystals. Stand the bottle in hot water and the crystals become liquid ; mix one part to twenty of water for putting in the vessels in which the dis- charges are received and dilute this solution one- half for washing the hands, wiping the furniture, etc. The lotion recommended for chapped hands will keep the hands smooth and sofl while using the disinfectant. For the clothing, add a quarter of a pound of sulphate of zinc and half as much salt to a gallon of hot water. Soak the clothes in this and have them boiled in the laundry in water to which washing soda has been added. If this is not done, the clothes will have a disagreeable, greasy feeling after they are dried. A pail of water with as much copperas in it as it will dissolve should be poured down the closet each time it is used. If there is not a water closet a ' I • I I if, I I :'l T'l 254 THE CARE OF CHILDREN thick layer of lime should be put in the closet with a shovel instead. FUMIGATION At the close of the illness at least two pounds of sulphur should be burned in the room, the doors and windows being tightly closed. Furniture should be washed in carbolic acid, stuffed furniture and mattresses being first fumigated, then the covers burned and the upholstering re lOved. Walls and ceilings must be scrubbed, repapered, painted or lime- washed, as they may require. Every article that cannot be cleansed must be burned. The danger ib too great to justify running any avoidable risk. Sulphur candles can be obtained which are more convenient than the powdered sulphur. When this is used a crumpled newspaper should be put in an old coal-scuttle, or iron pan, and the sulphur sprinkled on it. The iron receptacle can be stood in a tub containing water to prevent any danger of fire. The newspaper is lighted and the room closed as quickly as possible. Moisture is very necessary to make the gas dis- engaged from the burning sulphur effective. The walls and floor should h' sprinkled with water and &}] surfaces that can be reached wetted. DISEASES OF CHILDREN 255 SCARLET FEVER Bym/ptoms, — Sore throat ; sometimes a rash may be seen on the tonsils and back of the throat before it api^ears on the skin. Vomiting is common. Rash, — Bright scarlet, in small points, does not feel raised to the touch, appears first on the upper part of the chest and about the lower part of the neck, extending to the arms. The tongue presents a peculiar appearance known as the " strawberry tongue." It is coated with a whitish fur through which pink points project. Progress. — There is usually high fever and thirst ; water may be given and weak lemonade. Towards the end of the first week the rash begins to fade and desquamation commences. The skin peels off, some- times in small particles, sometimes in large flakes. This process lasts for a week or ten days, and often much longer on the hands and feet. The fever should decline when peeling begins. Points to be Observed. — If the urine decreases in quantity disease of the kidneys may be feared. Earache, or discharge from the ear, should be re- [)orted to the doct/or, as the inflammation may have extended from the throat to the ear through the eu- stachian tube, or pjissage connecting them. Puffiness about the eyes must be watched for. Nursing, — Free ventilation is extremely impor- n ■ 1 :i ' I .0, 'i 'rv m ir: S56 THE CARE OP CHILDRElt tent, yet cold, or a sudden chill, may cause danger- ous complications. The room must not be colder than 65°. A sponge bath is given every day under a blanket ; sometimes more often if the temperature is high. During desquamation the body is anointed with carbolized vaseline or benzoinated lard, followed bv a sponge bath of warm water witli a little washing soda dissolved in it, to allay the irritation and disin- fect the particles of skin by means of which the con- tagion is conveyed to others. All clothing must be warmed before being put on. Liquid food is ordered and should be given every two hours. If pulse and temperature should fall suddenly, teaspoon ful doses of brand}' may be given every ten minutes for four or five doses until the doctor can be obtained, and heat applied. Pei'iod of Infection. — The patient may be disin- fected in six weeks from the beginning of the dis- ease, if the peeling has ceased. The entire person must be bathed and the hair thoroughly washed with a saturated solution of bo- racic acid, followed by a bath of warm water and soap. Clean clothing that has not been in the sick room must be put on. to DISEASES OP CHILDREN 257 Children between two and seven years of age are peculiarly liable to the disease. A child who has been exposed may develop it at any time from a few hours to twenty-one days. It is very infectious in certain cases. Others may come in close contact with it, yet escape unharmed. It is said not to be infectious until the tiiroat symptoms have appeared. A very malignant case may develop from expos- ure to a very light one. The virulence of the disease depends not so much on the germ which communicates it as on the soil into which the germ falls. Conditions may exist in one child which will cause a severe attack from the same poison that in another child would produce only mild symptoms of the malady. Too much care cannot be exercised in isolation and disinfection. The mattress used should always be burned. There should be the same watchfulness in a light case as in a severe one in the avoidance of cold. Dangerous complications may follow any impru- dence, even when the child does not seem very ill. Scarlatina is the Latin name of the disease and not a milder form. > Scarlet Rash is the same dread enemy and equally to be feared. IT I'/;; M ^58 THE CARE OF CHILDREN MEASLES Symptoms, — A cold in the head with discharge from the uose and inflamed eyes. Afler three days of languor and feverishness the rash appears on the fourth day in dots, feeling rough under the skin. It is first seen on the forehead, about the hair and on the cheek bones. Sometimes the blotches are half- moon-shaped, and are of a dark red color. There may be nausea, vomiting and a cough. Progress. — The disease should reach its height about the sixth day, remain stationary for two days and then the patient should begin to improve. At its height the rash covers the whole body and there may be high fever. Points to be Observed, — The points of danger are the eyes and chest. If the watery 'iischarge from the eyes is succeeded by matter or pus, the doctor should be informed. Should the cough increase, the breathing become difiicult, or pain in the chest be complained of, warm camphorated oil must be rubbed on and the chest covered with flannel until the physician comes. There is a fine, mealy desquamation, but not as marked as the peeling in scarlet fever. Nursing. — The room must be darkened on ac- count of the eyes. The child should not be per- mitted to use them even during convalescence. DISEASES OF CHILDRENT 259 While ventilation is very important, the room must be kept warm on account of the danger to the chest. About 68° is a good temperature. Isolation and thorough disinfection are necessary. Period of Infection. — Meu^les is infectious in the very early stages, as soon as the symptoms of cold appear, until the rash is gone, and the cough has ceased; usually about three weeks from its com- mencement. If a child exposed to it does not develop the dis- ease in between seven and twenty-one days after exposure it has probably escaped. It id said that babies under six months rarely take measles or scarlet fever. GERMAN MEASLES The mother may confound this rash with either measles or scarlet fever, and sometimes the charac- teristic scarlet fever tongue is present. It usually comes on very suddenly, the child awaking in the morning covered with rash, hav- ing been apparently quite well the night before. There may be a little sore throat, but the fever is ve^y slight, if there is any. The glands at the back of the neck are tender, and this point helps to decide in distinguishing the disease. Little treatment is needed. The child should be kept indoors and in bed if the throat is sore. A I \ I- m 1 I II 260 THE CARE OF CIIILPREN gentle laxative may Ije needed. The disappearance of the rash means an end of the trouble. CHICKEN POX ^ Symptoms. — The eruption of chicken pox usnally appears on the uj>per j)art of the back or chest first, though sometimes on the face. It begins as small red spots, which change to little vesicles, containing a watery fluid. On the second or third day they commence to dry up, a scab forming over them. If they are scratched they may leave white scars be- hind which never disappear. The child is feverish for a few days and should be kept in bed if this condition is marked. A tonic may be required if there is languor and want of ap- petite after the vesicles are healed. Period of Infection. — The disease can be com- municated until the scabs have all dropped off. Three weeks is the longest period they persist. Eighteen days after exposure the child may be con- sidered safe if it. has not developed. Disinfection is not necessarv, as it is such a mild disorder. VACCINATION The English law requires that babies shall !)€ vaccinated before they are three months old, unless a medical certificate can be obtained to certify that nld DISEASES OF CHILDREN 261 they are sufFering from sction they may filter into pure water con- -/irV>^.w f^. DISGABES OF CHILDREN 273 taminating it so that tliose who drink it may lake the disease. In one instance an epidemic is said to have originated from the use of milk which had been put into cans washed in water impregnated with the poisonous germs. It is important that tliose who are nursing a ease of typhoid fever should disinfect the hands before eating. PNEUMONIA Pneumonia, or inflammation ^ the lungs, is said to be one of the most common of the more severe diseases of childhood and most often occurs between four and seven years of age. Good authorities as- sert that it may be caused by foul air, as the escape of sewer gas into a house, as well as by cold. Symptoms. — It comes on suddenly with vomiting followed by very high fever and runs its course in five or six days, the child recovering rapidly, or the illness terminating fatally. The breathing is rapid, the nostrils dilating with each respiration and the pulse very quick. There is cough and a deep flush on one or both cheeks. The child refuses food but may take a little milk, milk and vichy, or milk with lime water. Not much nourishment is needed during the short time Uf ^1 ^ if l.ii ')( ,f :| - - -OrE 274 THE CARE OF CHILDREN 1 ; the fever lasts. It cannot be digested, and vhe child will not sink from exhaustion for want of it. The physician will order stimulant if it is required. Points to be Observed, — If there is reason to sus- pect that tiie plumbing is defective, the child should be removed from the house to a purer atmosphere. Ventilation is always im}X)rtant, the temperature being kept about 68^ It is important that it should not vary. When the fever is high, careful sponging with tepid water under a blanket is desirable. Frequent bathing of hands and fa(ie is soothing. A flannel jacket should be worn over the night dress as the child has to be supp^jrted with pillows in a half-sitting position to breathe comfortably. The ehesc is nif)bed with w ..-m oil and protected with flannel or cotton batting. BRONCHITIS A. cold on the chest is really a light attack of bruiiciiiitis. The bronchial tubes, which conduct air from the wl ml pipe to the lungs are iufiainod, the delicate Imiiig membrane being very susceptible in some persons. Living in heateil rooms and breath- ing; too wa'm dry air predisposes to it. Children find old persons are esiiecially liable to it, and it is more apt to bo fatal in them than in others. Expos- ure t^ ft cold wind with the uiiust Insufficiently pro- Diseases of children 276 tected may bring it on in a child. When it attacks the smaller branches of the tubes it is called capillary bronchitis, and this is an especially dangerous form. Symptoms, — Those of cold on the chest, with feverishness, hoarseness, more or less |)ain in the upper part of the chest and a slight cough. A child is usually especially languid and depressed. Young children almost always swallow the sputa ; if it can be seen it is at first watery then thick and sticky. Treatment. — The room must be kept at an even temperature of about 68°. Moisture can l)e intro- duced into the air by keeping a kettle boiling if there is a fire, or by a large sponge or cloth wrung out of water and allowed to dry over the register, or radiator, being re-wet as often as necessary. The throat may be steamed over a pitcher of boiling water with one teaspoonful of spirits of tur- pentine in it, or thirty drops of tincture of benzoin. A mustard paste can be applied over th< chest, or flaxseed poultices, changed every hour. After these applications are removed it may be rubbed with warm oil and covered with flannel. Hot lemonade, flaxseed tea, or any warm smmmiimip 276 THE CARE OF CHILDREN gliould not \ye allowed to sleep too long at one time for fear of the secretions accumulating in the tul)es, or collecting at the back of tl»c mouth, in such quantity that they cannot be disposed of. The disease may i)as.s into the chronic stage. The child always has :i slight cough in cold weather, and it may persist into the summer. It does not thrive and gain flesh as it should do. Sometimes removal to a milder climate will effect a cure. There is always danger of an acute attack develop- ing. Children in this condition should have spe- cial care as to clothing and food, and be kept in- doors in cold or damp weather. ASTHMA Asthma is a spasmodic contraction of the bron- chial tubes, causing at times great difficulty in breathing. There is sometimes an inherited ''pu- dency to the affection, one of the parents having been similarly afflicted. Sometimes it is caused by dust, or the odor from certain plants, or animals. It may follow bronchitis, whooping cough, or mea- sles, or be caused by anger, fright, indigestion, or constipation, and seems to be brought on by any cause that inflames the membrane lining the bron- chial tubes. Symptoms. — The child is often wakened from DISEASES OF CHILDREN 277 in roni sleep by the difficulty of breathing. The symp- toms are much the same as those of false croup. The distinction is said to be, that in croup there is a struggle to draw tlie breatii in, and in asthma to exhale, or breathe out. The paroxysm may last from half an hour to a much longer time. Treaiment. — This, during the paroxysm, is much the same as in croup. Inhalations of the steam from very hot water ; hot fomentations to the throat and ten to fifteen-drop doses of wine of ipecac, repeated four, or five times, until the child is a little nauseated. The object is to relax the parts and so relieve the spasm, and the condition of nausea is a very relaxing one. Children frequently outgrow the tendency. A change of climate is desirable. Gymnastic exercises that tend to develop and strengthen the chest are valuable. Warm clothing should be worn, the feet protected and exposure avoided. ^ The diet must be attended to and the last meal of the day be of light, easily-digested food. Toast or crackers should be substituted for bread, pota- toes prohibited and the cereals used in moderation, as starchy food has an unfavorable effect. Meat, fish and eggs may be used with care, not being given later in the day than the midday meal. Milk and good soup may be partaken of freely. is 27^ THE CARE OF CHILDREN RHEUMATISM Children may inherit this disease from rheumatic parents, or contract it from exposure to a cold draught, or from being chilled while perspiring after play. Symptoms. — There is a little tenderness or swell- ing of the joints of the wrists, knees, or ankles ; sometimes the back of the knee is painful, or there is stiff* neck. The temperature is apt to rise at night and there may be headache. As the heart is often involved, a physician should be consulted when rheumatism is suspected. Points to be Observed. — The child must wear a flannel night-dress and sleep between blankets. If the joints are painful, they can be wrapped in flannel, or cotton batting, kept in place with a light Imndage. They must be propped in an easy position with pillows. Food. — While the fever is high the diet is liquid ; as it falls, farinaceous food, eggs and broths are given, and flnally flsh and meat. Precautions. — A child with rheumatic tendency should be protected from cold by warm clothing, but not kept in a hot room. A tepid salt-water sponge bath, followed by vigorous friction, should be given every morning. If the child is accidentally DISEASES OF CHILDREN 279 fjver-heated, an extra wrap should be put on until he can be undressed, sponged and rubbed. The diet should be nourishing, avoiding too much meat. The bowels should not be allowed to be- come constipated, and plenty of sleep should be in- sisted upon. ^ -<*. V // ^ '^ ^■' 280 THE CARE OF CHILDREN active exercise should be forbidden, and only grad- ually resumed as there is a decided improvement. While in bed, the child may be amused with simple games and allowed to read amusing, unexcit- ing stories. Sponging with tepid water every day is valuable, if after the bath the child is wrapped in a blanket and persuaded to sleep. The food should be light and nourishing — milk, eggs and gruels, with a moderate quantity of digest- ible solid food. ^ If there is sleeplessness afler the hot milk and heat to the feet have been tried in vain, the doctor should be asked to prescribe. Children who suffer from St. Vitus^ Dance should never be subjected to the strain of a school examina- tion, nor any mental excitement that can be avoided. RICKETS Rickets is a disease of childhood, often beginning in early infancy. It affects the general nutrition, and especially the proper development of the bones, causing deformity. It proceeds from insufficient or improper food, which cannot be digested to nourish the body. Bad ventilation, or drainage, want of sunshine and damp houses, predispose to it. Too little milk and over-feeding with starchy DISEASES OF CHILDREN 281 of food, which a baby cannot digest thoroughly, is said to be a frequent cause of rickets. Fat alone is not an evidence of health. The muscles must be firm and the color good, the eyes bright, and the whole condition strong and vigorous to indicate that the child is well. If the baby is nursed too long the milk ceases to satisfy the demands of the system and rickets may ensue. Abundance of milk should be given after wean- ing, eggs occasionally, bread and oatmeal on account of the gluten they contain. Symptoms, — The first which the mother will ob- serve is profuse perspiration about the head and neck as the child lies asleep. He throws oflF the l)ed- clothes and seems unusually warm. Unless handled very gently he cries when he is moved or danced. The motions are more frequent than usual, large, sofl and offensive, with specks and cui*ds of undi- gested food. The fontanelle, or soft space on top of the head, which should be much smaller at the end of the first year and entirely closed before two years have passed, remains open. If the child can walk, the legs are bowed or twisted, the wrists are enlarged, the abdomen and chest are unduly prominent, and the spine is weak ! X If i 282 THE CARE OF CHILDREN and more or less curved. The teeth are late in coming. Treatment, — The food is the first consideration. Babies under a year old should have cream in addi- tion to the milk, raw eggs, and l)eef, or mutton broth. Older children must, besides these, be given meat, l)utter, and fresh fish, with bread, oatmeal, hominy, etc. Cod liver oil is often pi'escribcd as an effectual means of administering fat. The hygienic surroundings must be attended to. Sunlight, fresh air and good ventilation, particularly of the sleeping room, being very important. Salt water baths have a tonic effect. Warm clothing and protection to the feet are essential. When the child is old enough to walk he must not be permitted to do so, as permanent deformity of the legs may be caused by resting the weight on them. Splints are sometimes worn to prevent. this and keep the legs straight. The treatment recommended in bow legs is advantageous. Sometimes a surgical opei^tion is necessary to straighten the legs if the deformity is great. Rickets is not necessarily fatal unless some com- plications ensue. There is usually improvement as soon as the un- healthy conditions which caused it are changed. DISEASES OP CHILDREir 283 After the enx>rs in diet are corrected and the ventilation improved, attentiou shonld \ye given to the clothing. A flannel band should l)e worn, beside warm underclothing. This must be changed oflen on account of the excessive perspi- . ration. The bed must be changed and aired every day and scrupulous cleanliness carried out in every par- ticular. The child should be kept in the open air as much as iM)Ssible. If it is wheeled in a carriage a rubber hot-water l)ag should be placed at the feet, if the weather is at all cool. Rubbing the body, particularly alongr the spine, is beneficial, and cod-liver oil applied in this way is a very useful although a disagreeable remedy. There is hope that, as the child's condition and general nutrition improve, the deformities may les- sen^ if not entirely disappear. TUBERCIjLOSIS The children of consumptive i>arents do not necessarily inherit phthisis, or tuberculosis of the lungs. This disease is now said to be caused by a germ, or bacillus, which passes from the lungs of the infected person in the expectoration and so may communicate the malady to others. 284 THE CARE OF CHILDREN This germ can only be carried through the air when it is dry. The sputa of persons suifering from consumption should be received into a cup containing carbolic acid 1-40, and so thoroughly ^ disinfected before being emptied. Squares of cotton shouKl be carried for use in the street and burned as soon as possible after returning liome. It is wrong for these persons to expectorate where the air can dry up the moisture and set the germs free to do their deadly work. If they are breathed into the lungs of healthy persons they may do no harm, but if they come in contact with tissues predisposed to the disease, or affording a favorable soil for their growth, the mis- chief is done. The utmost care should be taken to keep the belongings of consumptive persons separate from those of others. Nothing that they use should be used by anyone else without thorough cleansing. They should not sleep with healthy persons. Kissing, or any close contact, should be discour- aged. Aft^r the death of a person from phthisis the room and its contents must be disinfected as in any other contagious disease. Upholstered furniture, as * couches or easy chairs, should be fumigated with special care and re-covered. DISEASES OF CHlfLDREN 285 Children^ with an hereditary tendency to con- sumption may be so built up and fortified against it by proper food and hygienic treatment, or by not being exposed to direct iufwtion, that they may escape it ahogether. Diet is a very imjjortant factor in their case, as has been mentioned elsewhere. Good ventilation is indispensable. Outdoor exer- cise in fine weather must be taken regulp'ly. The clothing must be warm, flannel worn and the feet protected. Whatever t^nds to depress vitality, as indigestion, over-study, late hours, excess of any kind, must be avoided as far as possible. Cod-liver oil is valuableas a good way of having fat taken. Having been elaborated in the liver of the fish it is more easily assimilated than many other forms of fat. Salt-water bachs are advisable for their tonic effect. The child's attention should not be directed towards himself nor should he be allowed to think that he is peculiarly liable to the disease. Gymnastic exercises to strengthen and expand the chest should be practised daily. Tuberculosis may manifest itself in other parts than the lungs. Sometimes the lymphatic glands in the neck are i I'll J. 286 THE CARE OF CHILDREN attacked and abscesses form, or a joint ^omes the seat of a strumous, or white, swelling. The brain niaj^ be affected, causing meningitis. If the intes- tines are attacked ulcers form and diarrhoea results, with grf,'at pain from colic. ARTICLES USEFUL IN A SICK ROOM Urinal, Bed pan, Bulb syringe. Glass s 'ringe, Gracu I . ' :\ med icine glass, Porceidin feeder, Bent glass feeding tube, Medicine dropper, Rubber hot-wator bag, Rubber ice bag. Rubber ring or cushion, Tv;o squares of rubber cloth. Rubber cloth pillow case. Granite ware basin, Calcutta cooler for ice, Shade for light, Saucepan, Alcohol lamp, or Stand to fit on gas. KMERGrENCIES CHAPTER XXII CUTS Thebe are amongst the most frequent accidents of childhood. A slight cut should be washed with cold water, covered with a small pad of cotton, bound up and left alone. It will usually heal with- out farther trouble, and the dressing should not l)e disturbed while it is comfortable. Undoing it pulls the e^iges apart an^ interferes with the healing process. If matter forms, or there is a disagreeable odor, the bandage must be taken off, the wound bathed with carbolized water 1-80 and a little carbolizcd vaseline spread on a bit of linen and laid over it. The washing and dressing should be repeated twice a day, or more oflen, if there is much discharge. When the sides of the wound are torn, the part should be very carefully washed with boiled water, ^237/ I' I 288 THE CARE OF CHILDREN and when perfectly clean carbolized vaseline applied on linen. In bandaging a cut finger use a strip of cotton one inch wide and about twelve inches long. Wind it neatly around the finger and split the end down about three inches ; pass one side behind the other and tie it in place. This makes a secure fastening not likely to slip. After the dressing is removed and the wound al- most healed a few narrow strips of adhesive plaster may be laid across it to keep the edges together. Often a slight cut bleeds profusely, particularly when it is on the head or face. A child comes in from play apparently streaming with blood and when it is washed off with cold water a very trifling injury is revealed. CUTTING OFF A FINGER If a child has the misfortune to have a finger cut off by a machine, as sometimes happens, the severed member should be picked up, washed in salt and water and put in place again, being fastened with strips of adhesive i)laster. A bandage should then be wound around it and left undisturbed until the wound heals. If there is a disagreeable odor, or any evidence of inflammation, as redness, heat, or EMERGENCIES 289 swelling, it must be unbound, waslied in carbolized water 1-40 and the dressing I'cplaced. Tliere is good hope tiiat the parts will unite, and at least the experiment ought always to be tried. cut lered and ^vith :hen the ,or or BLEEDING If a large blood vessel is cut there will be serious bleeding. If in an arm or leg it can be checked by tying a handkerchief tightly about the limb cSove the cut, or by putting a thick pad of cotton over the wound and bandaging it very tightly in place. The limb should be raised so that the blood will flow backward towards the heart. Sometimes a piece of ice wrapped in cotton and placed on the bleeding point will control the flow. If the palm is cut the hand can be closed on a piece of ice. Remember that cold and pressure will almost always stop bleeding and that a good deal of blood can be lost before the danger point is readied. BLEEDING FROM THE NOSE If the head is hot and the face congested, bleeding from the nose is sometimes a benefit. When it is profuse the child should sit with the head thrown back, a sponge or wet cloth being held to receive the blood, and something cold put at the back of the 19 m \r 290 THB CARE OF CHILDREN neck. Pressing the thumbs on each side the nose where it joins the lip will control it. If these means fail, gentle syringing with cold salt and water is usually effectual. BLEEDING FROM THE STOMACH Children sometimes swallow blood from the nose, or gums, and vomit it. It is dark and mixed with food. The symptom is seldom an alarming one. Pieces of ice may be sucked and the patient made to lie down. Blood in the motions is usually a dark, tarry- looking substance that would scarcely be recognized as such unless one were aware of its peculiar appear- ance. When it is bright red it often comes from piles. BLEEDING FROM THE LUNGS The blood is a bright color and frothy, with bub- bles of air through it, and is coughed up. Raise the head and shoulders with pillows, give bits of ice to suck and, if the pulse is very weak, a teaspoonful of brandy in very little water. Pour a teaspoonful of spirits of turpentine in a pitcher of boiling water and let the steam be in- bftled. There is seldom immediate danger. bub- in a in- EMFROENC'irS 291 I FC'RfiWX BODIES IX THE NOSE Yoin#g cbkldren are very apt to iK)ke buttons, beans, beads, and a variety of other small objects into the noso. Nothing may be said about it at the time and it^ presence remains undiscovered until inflammation sets in. When there is discharge from one side of the nose only this cause should l)e &us|)ectcd. Gently syringing the nose with warm salt and and water, or baking soda and water, will of\en dis> lodge the obstruction. The well nostril should be syringed first. Sometimes a few grains of i)ep|)er will cause a sneeze which will bring forth the intruder. If the object is in plain sight efforts may be made to draw it out with a bent hair pin, but poking may injure the delicate membrane and, if not im- mediately successful, it had better be left to a surgeon. FOREIGN BODIES IN THE THROAT These may be lodged in the wind-pipe or the food passage. A quick blow between the shoulder-blades, par- ticularly when the child tries to cough, may exjwl the body. The child may be seized by the feet, held up and shaken. The finger can be passed into the throat and an 292 CARK OF CHILDREN olTort he mane to draw out the obstruction, or, if it is ill the fo(Kl passage, to force it down. Sometimes the attempt to swallow the white of au egg will loosen the substance so it can be brought up or pushed down. The white should n«>t he beaten. I^ immediate relief is not obtained send for the nearest doctor, throw open the window to secure plenty of fresh air and begin artificial respiration. SWALLOWING FOREIGN BODIES The strong desire that little children have to rarry everything to their mouths frequently results in foreign sub?!tances being swallowed. A masterly inactivity is the best course to pur- sue. An object that can pass down the throat can nass through the intestine and probably will do so safely if it is not interfered with. Even pins may m:ke the journey without doing harm. Emetics a.id laxatives should not be given. Potato in any I'oi m, porridge of oatmeal, rye or wheat, or bread and milk, will form a soft coating around the intruder and conduct it away without injury. Close watch should be kept for it in the motions. It may not appear for two or three days. ii' j)ain is complained of and there is feverlshness or much disturbance, the doctor should be called. EMERGENCIES 293 SPLINTERS These should be removed with a sharp needle and usually need no farther treatment. If a part re- mains in the flesh matter will form and a snml'r poultice may be applied until it comes away, when the inflammation will subside and the spot can be dressed with carbolized vaseline until it heals. The mode of dealing with splinters under the nail has alrcJady been described. A fish-hook, crochet needle, or any similar in- strument with a barl)ed point, should be pushed through, that it may come out prAnt first, not di-awn back through the wound. ' 'III ions. BRUISES A flannel wrung out of very hot water laid on a bruise and frequently renewed helps to relieve the soreness. For bruises on the face ice is the best ap- plication. Brown paper wet in vinegar is a time- lionored remedy. Bathing the part in extract of witch hazel gives relief. After a general contusion, as a fall from a height, a warm bath is soothing. When the skin is broken the injury is treated as a wound, washed with carbolized water and dressed with carbolized vaseline. u )> I 294 THE GARE OF CHILDREN SPRAINS These painful accidents are most apt to occur at wrist, or elbow, knee, or ankle. The ligaments that hold the joints in place are stretched and some- times torn. It may take longer to recover from a sprain than it does for a bone to unite afler it is broken. Both the hot and cold treatment are recom- mended. The former is tlie most soothing for chil- dren. Immerse the joint in water as hot as can be borne, keeping up the temperature by adding fresh. Let it soak for an hour or more. Then wrap in warm flannel reinforced by hot-water bags. As soon as it can be borne gentle rubbing is use- ful. Some physiqians prescribe perfect rest for the injured part, otiiers active exercise, stopping short of fatigue. STINGS The part can be bathed in ammonia cr baking soda and water, and a cloth wet in the same bound over it. The sting of a bee can be extracted by pressing the barrel of a small key over it. A hand- ful of moist earth bound on the painful spot often gives ease. EMERGENCIES 295 BITES It is said that, contrary to the usual belief, the bites of the rattlesnake, the moccasin, the copi)er- head, and one or two other venomous snakes found in this country, are not generally fatal, although the sufferer is profoundly depressed. Children are more likely to be bitten by dogs, cats, or other pets. The wound should immediately be sucked. It is asserted that there is no danger to the person doing it if the skin of the mouth is un- broken and the saliva is not swallowed. The wound can be cauterized by heating a but- ton-hook, or any wire, white-hot and applying it to the surface. The hotter the iron the less the pain. The \vouiid can then be treated as a burn. If there is much depression, the child should have a little brandy and water. Tht animal ought to be kept in confinement, pro- vided with food and water and carefully watched. If it does not develop hydrophobia much needless anxiety will be spared. If it does, it is by no means certain that the chlid will do the same. Pasteur's method for the prevention of hydro- phobia by injecting the virus, properly prepared, lias warm advocates. There is an institute in New York where patients can be sent to undergo the treatment, as well as in Paris, where it originated. .if 'I 296 THE CARE OF CHILDREN BROKEN BONES The bones of children are so soft that they do not break very easily. When tl»e accident happens the fracture is often the kind called a green stick frac- ture. The bone is only partially broken, like a stick of green wood held together by some of the' fibres. The limb must be placed in as natural a position as possible and the child made comfortable until the doctor comes. It is not necessary that it should be set immediately ; delay does no harm. It should be carefully handled not to force the broken ends of the bone through tlie skin. When the collar-bone is broken the arm is laid across the chest with the hand touching the opposite shoulder and kept in place with a broad bandage or strips of adhesive plaster. It will take about four weeks to unite. With a broken rib a broad band- age is passed around the chest and pinned firmly in place. DISLOCATIONS In a dislocation the bone forming the joint is thrown out of the socket. Instead of being unnat- urally movable, as when it is broken, the bone is moved with difficulty, there is tenderness and pain. A dislocation should be put back, or reduced, as it EMERGENCIES 297 is technically called, as soon as possible. If there is much swelling and pain the jmrt can be covered with flannel wrung out of boiling water until the doctor arrives. M in BURNS Burns are of various degrees of severity, from reddening of the part to entire destruction of the tissue. Almost everyone knows that, as fire cannot burn without air, the most effectual way of putting it out is to wrap the sufferer in a thick woolen rug, blanket, shawl, or piece of carpet. If a child could be dipped under water it would, of course, extin- guish the flame ; but a little water does no good. The best remedies to have on hand for burns are baking soda and carlx)lizcd vaseline 1-30. For slight burns mix the soda to a paste with water and spread it thickly over the part, covering it with linen, or old cotton, secured in place by one or two turns of bandage. This can be kept wet by squeezing tepid water over it. When there are blisters they should be carefully pricked and the fluid absorbed with a piece of soft cotton. If the shreds of clothing adhere to the burn they should be soaked off with oil, or water, and not J I ■) i'jl '1 -■i 298 THE CARE OF CHILDREN pulled off. If the skin is gone, carbolized vaseline can be spread on linen and bound on the part until the doctor comes. In severe burns there is a profound shock to the system. The face is pale, the body cold, and the pulse weak. Put hot-water bags to the feet and over tlie heart, give brandy in teas}X)onful doses, and keep the head low. A child recovering from an injury of this kind requires careful watching and nourishing food. In burns caused by acids, water should not be ap- plied to the part ; it must be covered with dry bak- ing soda. If an alkali, as strong ammonia, lye, or quick lime, has done the mischief, US') an acid, as vinegar diluted, or lemon juice, to counteract it. SCALDS Children are apt to scald themselves by pulling over vessels containing boiling water. The injury should be treated like a burn. When the face is scalded painting it with glycerine sometimes gives relief. FROST BITES Frost bites affect the flesh like burns. The frozen part should be rubbed with snow or cold water, that it may thaw gradually, as a too sudden change EMERGENCIES 299 would destroy Its vitality. It should be rubbed persisteutly but gently until the circulation is re- stored. Slight cases, as children's usually are, re- quire no farther treatment. / FAINTING Young girls sometimes faint easily. The heart ceases to contract for an instant, cutting ofP the sup- fly of blood to the brain and unconsciousness fol- lows. Lay the person down with the head lower than the feet. Either let the head hang over the side of the couch, or raise the foot of it on a chair. This usually revives the patient without farther treatment. If not, the dress should be loosened, particularly tight bands about neck and waist. A few sharp taps may be given over the heart and the face sprinkled with cold water. If breathing ceases, artificial respiration must be begun. PITS These are very often epileptic and occur only in children suffering from epilepsy. The hands are clenched, the sufferer falls unconscious and there may be foam on the lips. Nothing can be done except to loosen the clothing and guard against the tongue being bitten by put i\ Hi H I 300 THE CARE OF CHILDREN ting a spoon, or tooth-brush handle, or a folded napkin, between the teeth. All that can be effected by treatment must be done under the physician's direction between the at- iai'ks, CONVULSIONS Any irritation of tlie system is very apt to pro- duce convulsions in a young child. Teething and indigestion often bring them on. The eyes roll, the hands are clenched and there is a general tremor of the whole body. Remove the clothing quickly and place the child in a hot bath, about 100° Fahr., with a cloth wrung out of cold water on the head. In about two minutes lift him out and roll him in a blanket with- out wiping him. Give an enema of warm water and, if the convul- sion is soon after a meal, a teaspoonful of wine of i|)ecac. Putting the finger down the throat will hasten the vomiting. Convulsions show an irritable condition of the nervous system and are not alarming unless they oc- cur frequently. The child should be kept quiet and the doctor consulted if they recur. POISONING Poison Ivy, — Children who roam in the woods EMERGENCIES 301 and fields sonetimes pick the poison ivy, poison oak, or sumach, which brings out an cruj)tion on the haads and face if it comes in contact with them. A saturated solution of baking sodu, or ammunia and \Vater, will relieve the itching; a cloth soaked in the liquid nan be laid over tiie part and kei)t wet. The things to l)e done^, and done quickly when a child has swallowed |)oi&on, are i To get it ont of the stomach ; To prevent wimt remains from doing more mis- chief; To counteract the bad effects if possible. The firet thing is to give an emetic One table- spoonful of salt in a glass of tepid water ; one des- sertspoonful of mustard, or one teaspoonful of pow- dered alum in the same. One teaspoonful of wine of i|)ecac, followed by lukewarm water. These can be repeated four oi five times. Ticklij-g the throat with the finger hastens the action. Some poisons pai-alyze the stomach so that it can- not respond to the emetic. If a piece of rubber tub- ing and a funnel can be procured the tubing can be puslied down the throat, keeping it well at tlie back, and water poui'ed in through the fimnel. Lowering the funnel below the level of the stomach outside, the water runs out. This can be repeated several times, washing it thoroughly. ' '? ■Sff ?(!' ^11 302 THE CARE OP CHILDREN Neutralizing the poison is accomplished by giving the pro])er antidote. It is well to administer a dose of castor oil after the dang*er is over to carry off any remnants of the poison that may have lodged in the intestine. After a poison that has burned the mouth and throat plenty of milk can be given, flour stirred in water, arrowroot or corn starch gruel. Opium. — Unfortunately, opium is the active ingredient of most of the soothing syrups that some mothers unhesitatingly give their children. Pare- goric contains it and laudanum is a strong prepara- tion of it. A baby under the influence of opium is unnatu- rally drowsy and sleepy, the breathing is slower than usual and the pupils of the eyes are very small. Nurses sometimes give it to save themselves trouble, and a mother who has to entrust her children to one should be on the watch for the symptoms. The baby should be roused and kept awake, if possible. Pour cold water on the head and chest, followed by hot water. An enema of coffee may be given, warm — not hot — and strong. If the breathing is feeble or stops, begin artificial respira- tion. Keep hot bags at the feet and heart and rub vigorously. There are some antidotes a doctor can EMEROENOIES 303 ib m use which it would not be sttfe for an unprofessional person to meddle with. Araenio, — Children sometimes get at fly poison, which generally contains arsenic. Give emetic quickly, followed by as much greasy water as can be swallowed. Tablespoon ful doses of oil, or oil and lime water, until five or six have been taken. White of egg, flour and water, or any soothing drink. Warmth, hot-water bugs, blankets, etc., and rubbing. Oxalic Add, used for cleaning brass, is some- times taken by children. Lime is the antidote, given stirred in water, followed by an emetic and later castor oil. Carbolic Acid. — In using carbolic acid in any quantity about a wound the urine should be watched and, if a dark greenish tinge appears in it, the dressing should be discontinued. If carbolic acid is swallowed by mistake, a table- spoonful of Epsom salts must be given stirnnl in water. This is followed by wine of ipe«4c, or mustard and water, as an emetic. White of egg beaten up in water soothes the ir- ritated membrane. If there is so much depression that stimulation is needed, apply heat to the feet and over the heart and give brandy in hot water. 804 THE CARE OF CHILDREN Phosphorus. — The tops of matches may be bitten off and swallowed. A child is said to have re- covered afler sucking three hundred. The best emetic is three grains, a very tiny pinch, of sulphate of copf)or, blue vitriol, dissolved in water ; given every five minutes until vomiting occurs. Salt or mustard can be used. Two teaspoonfuls of Epsom salts can be given as a laxative, but no oil nor fat, as that dissolves the phosphorus and makes it more easy for the stomach to absorb it. Children sometimes eat toadstools or poisonous berries, whose nature cannot be determined at the time. An emetic, followed by plenty of milk and later a dose of castor oil, is the best treatment. When the pulse is weak and the face pale, teaspoon- ful doses of brandy should be given. DROWNING Strip off the wet clothes and wrap in a blanket, if possible. Turn the child on the face over the knee, making pressure over the stomach to expel the water. Surround the body with hot-water bags, bottles filled with hot water, stove covers wrapped in flan- nel, or whatever is soonest to be had, taking care not to burn. Keep heat over the heart. Hav( feet un( Lay that tl)( artifioia Raise them u[ head, pii Brlnir til sure to e in tlie r mont. This c on the fa TJie p( To rei To ke( To j)rc Theef hours. This needed tions for 20 EMERGENCIES 305 Have 8oine one rub tlie hands, arms, legs and feet uiicoasingly. Lay the cliild on a Im^I, or table, on the back, see that the tongue is forward in the nioutli and begin artificial respiration. ARTIFICIAL RESPIRATION Raise the hands above the head ; that is, draw them lip until the wrists lie on each side of the head, pulling tiie arms slit^htly to expand the chest. Bring them down across the chest with a firm pres- sure to expel the air. JDo this slowly sixteen times in the minute, taking two seconds to each move- ment. This can be alternated by turning the child first on the fa(;e and then on the side at the same rate. The points are: To restore breathing ; To keep up the vital warmth ; To promote ^rcnlation. The efforts should not be abandoned for at least two hours. THE EMERGENCY BOX This should contain the dressings likely to be needed in an emergency and a few simple applica- tions for external use. Liniments and 'naedicines to 20 J 306 THE CARE OP CHILDREN be given internally never should be kept in the same place. The following will be found useful : An inch-wide roll of rubber adhesive plaster. A bunch of absorbent cotton. A yard of cheese-cloth that has been washed. Two rolls of bandage two inches wide and seven yards long, made out of an old sheet by sewing the strips together. Old cotton. Old linen, pieces of table cloth or napkins. Half a yard of thin rubber cloth. One dozen safety pins. A pair of scissors. A small pair of straight dressing forceps. Box of carbolized vaseline 1-30. Half a pint of extract of witch hazel. Half a pint of spirits of camphor. Two ounces of spirits of turpentine. Two ounces of camphorated oil. A quarter of a pound of boraeic acid. A quarter of a pound of baking soda. A quarter of a pound of mustaixi or box of \)ro- j)ared mustard leaves. Tv") ounces of good brandy. a 11 h a u s SI tl t< n the PHYSICAL CULTURE even [ the pr( CHAPTER XXIII NECESSITY FOa GYMNASTICS The ceaseless activity of young children develops their muscles sufficiently without the aid of sj>ecial exercises. The baby kicks, creeps, balances himself on his feet and finally walks, meanwhile keeping hands and arms in constant motion, grasping at and play- ing with every object within reach. As he grows older, the active games that every healthy child delights in call the muscles into action and promote their growth. It is when they are not used that they become weak and soft. When a child is cut off from play and forced to sit still for several hours every day, often in a con- strained, unnatural attitude, systematic exercise of the muscles becomes a necessity. We call the sys- tem of movements devised for this purpose gym- nastics. (307) I i I 308 THE CARE OP CHILDREN As we grow in wisdom, no doubt the culture of the body will receive a due share of attention in the schoolroom. The mind cannot be trained and ex- panded to its fullest capacity unless its companion is able to keep pace with its demands. This it can- not do when some of its parts are allowed to de- t-eriorate from want of use. In the education of the future comjietent teachers will be provided to train the body, developing the weak points in the physical frame of each child and strengthening the whole by judicious exercises adapted to its powers. Until that happy day arrives parents must do as much as possible for the physical development of their children, and what this is must depend a good deal upon the circumstances surrounding them. Children who live in the country lead an active outdoor lifCj running, jumping, often rowing, swim- ming and riding, sometimes engaging in work that calls many muscles into play. There is not such urgent need of gymnastics for these, although it is sometimes found that while the set of muscles most often used is well developed, others, which have not been employed so vigorously, are comparatively undersized. Children who have no play-ground but the street, PHYSICAL CULTURE 309 * or parks where they arc made to keep off the grass, and who do little or no manual labor, have not the opportunity to develop their muscles naturally. For them gymnastics arc a very necessary part of the school curriculum and in cities provision should be made for their needs. ive peet, WHAT THE MOTHER CAN DO The mother may do much at home if she can de- vote ten or fifteen minutes every day to the physi'al training of lier children. She must first teach her- self what she wishes to teach them, if she has had no special training. Blakie^s little book, " How to Get Strong," contains much valuable advice. Wat- son's "Manual of Calisthenics," although not as recent a work, has one point of advantage, music to which the different exercises can be executed. Without any special apparatus children can be trained to breathe, stand and walk properly. The muscles of the legs, arms, chest and back can be rounded out until the parts are shapely and firm. With very inexpensive apparatus, light dumb bells, and a pair of parallel bars, and perhaps a pair of pulley-weights, feats can be accomplished which will give keen pleasure to the ciiildren and be of lasting benefit to their rapidly growing bodies. No one exercise should be prolonged for more I % 310 THE CARE OP CHILDREN than two or three minutes and stopped in a shorter time if it fatigues. Pmctice will enable them to be carried on much longer without this result. The evening before bed time is a good oppor- tunity for these exercises if they are not begun too soon after tea. The clothing must be light and loose. Tight col- lars and bands, Injurious at any time, cannot be tol- erated now. Waist, knees, neck and arms must be free. If shoes are worn they must be light and well fitting, not in any way constraining the foot. STANDING We all know what a frank, fearless look it gives a child to have the head well thrown back and the chin properly poised. A few minutes practice each day standing in a correct attitude helps to render this carriage natuml. The heels should be placed together, the feet turned at right-angles to one another, the knees sti'aight, touching each other, the back straight, shouldei*s well thrown back, arms hanging eas' ly by the side, palms of the hands turned slightly forward, tlio neck straight, the chin drawn in, and the eyes a liule raised. BREATHING The importance of breathing through the nose has I PHYSICAL CULTURE 311 already been s|)oken of. Exercise In breathing properly is essential to develop the capacity of the lungs and especially so in children whose chests are weak, or who have an hereditary predisposition to consumption. Standing in a correct |)osition the mouth should be closed and a long breath taken through the nos- trils, exhaling the air slowly by the same channel. After this has been done several times the lungs can be filled through the nose and the air expelled through the mouth as forcibly as possible. Then the air can be inhaled through the nose, the breath held, the arms raised at right angles to the body, the hands placed on the chest and the chest quickly tapped as long as the breath can be held. Si)ecial care must be taken to see that the shoul- ders are held back, throwing the chest well forward, during these exercises. Also that the head is erect and the chin drawn in. I ;ht, by ird, >s a SITTING An authority on school hygiene has said that *' Movement is a child*s way of resting ; rest is a kind of work to be taught by degrees." Remem- bering this, we should not exj^ect little children to sit still for long at one time. They should be al- 312 THE CARE OF CHILDREN lowed frequent change of position and to rest by standing and marching about the school room, either to music or without. A child's chair should support the lower part of the back firmly and comfortably. This is more im- portant than that support should be provided for the shoulders, as much of the time they do not touch the back of tlie chair. In school, the desk should be so arranged that stooping is discouraged as much as possible. If the sight is normal it is easy, after a little practice, to read and write in a correct position with the chest expanded. The head can be bent instead of the shoulders being thrown forward and the back in- clined. The elbows should not rest on the desk as then the shoulders are raised from their proper position. WALKING In walking, the body should be held erect, the weight directed rather toward the toes and forward part of the foot. This gives a light springy step, which cannot be acquired if the heel is brought down firmly as the foot touches the ground. The knees must be kept back as much as possible and the bodv below the waist line thrown a little forward. Running is an excellent exercise for children ; PHYSICAL CULTURE 313 jn; races should be encouraged, taking care that they do not take cold afterwards from standing in draughts when they are perspiring and warm. STRENGTHENING THE MUSCLES Many exercises have been devised for strengthen- ing the different muscles of the body. By consult- ing any of tlie popular books on physical develop- ment, the mother will find a description of those best suited to the purpose. There is only room for a few simple ones in a work like this. Placing the feet together and rising on the toes while the mother counts one, two, or plays a bar of music, sinking on the heels and repeating the move- ments eight or ten times, or until fatigued, develops the calf of the leg. While rising on the toes the knees may be bent and straightened again before resting on the heels. Hopping on one foot is a good exercise ; the other mav occasionallv be bent backward and held in the hand. Standing firmly on the feet and bending the kuws, as if about to kneel, recovering the upright position, and repeating, is a good exercise for the muscles above the knees. Jiim|)ing with a skipping rope assists in develop- ing them, but this slu.uld not be overdone. 314 THE CARE OF CHILDREN Dancing also calls them into play and is valuable training for children. It gives them ease and self- confidence and, when well tauglit, helps to make them graceful. Standing erect with the knees straight, then bend- ing the body forward trying to touch the floor with the tips of the fingers, helps to strengthen the muscles about the waist. Also, placing the hands on the hips, bending the body first to one side then to the other as far as possible without lifting the feet fi'om the ground. Holding the head erect with chin well drawn in, placing the hands behind the neck, extending the arms slowly and bringing them down behind the back with the palms turned out, expands the chest. Bending the arms until the points of the fingers touch the shoulders and rapidly flexing and extend- ing them ; stretching the arms in front with the fists closed, bending them sharply towards the shoulders and letting them drop at the sides with some force, are good arm movements. Mr. Blakie says that simply opening and shut- ting the fingers rapidly improves the power of grasping firmly, if faithfully practised. In cases of curvature of the spine the surgeon will prescribe gymnastic exercises for remedying the PHYSICAL CULTURE 315 )n deformity, particularly if the patient is a young child. STAMMERINQ There are few defects more mortifying to the child and more annoying to the friends than stam- mering, or stuttering. Occasionally it arises from a malformation of the organs of speech. It may be caused by an aifection of the mouth, or throat, or some mental deficiency. Very often it proceeds from nervousness, or a temporary derangement of the health, or is acquired by imitating another child thus afflicted. It is more catching than measles. It does not usually manifest itself in children under four years old. Whispering and singing do not present the same difficulties as speaking, the child rarely stammering then. The utmost patience, gentleness and perseverance are necessary in training children with this defect. Very much can be accomplished by persistent pains- taking ; the efPcJt must be continuous and not aban- doned because there is little improvement for a long time. It is very important to enforce correct habits of breathing through the nose. The lungs should be filled before beginning to speak. 316 THE CARE OP CHILDREN Speaking slowly must be insisted upon and when there is a stammer, the child should stop and slowly and quietly repeat the difficult word, or letter. The sounds that he most often trips upon slionld be practised again and again, filling the lungs before eav\i attempt and re|)eating them deliberatt^ly until for once he can say them smootiily. The knowledge that he can do so gives him confidence in future trials. Standing erect and inhaling a long breath he can give different vowel sounds, as ah, ee, ih, oh, ooh, holding QSLch as long as possible. Then the vowels and consonants combined, in such words as ail, ebb, ice, old, up, etc. When the stammer comes, always stop the speaker and insist on his taking time to recover himself, fill his lungs and try again, instead of vainly trying to enunciate the word without stop- ping to breathe. Attention should be paid to the general health and the nervous system. Sleep and diet are factors in the treatment not to be neglected. THE CARE OF GIRLS. CHAPTER XXIV THE MENSTRUAL PERIOD Until a girl is ten years old her life may be much the same as her brother j'. She should be en- couraged to speml a good deal of time out of doors, to run, play active games, and take plenty of exer- cise. This contributes to her physical development and enables her to lay up a store of strength for the years to come. Tlie menstrual period comes much earlier to S'^me girls than to others. It is usually preceded by mental and bodily disturbances more or less well de- fined. In a strong, healthy girl these may be very slight. With more delicate ones there are nervous symptoms, often irritability and unreasonableness without apparent cause, and vague sensations of dis- comfort, hardly defined enough to be called pain, and yet disturbing and distressing. (317) 318 THE CARE OF CHILDREN Infinite |>atience and tenderness Is needed in deal- ing with these cases. Tlie child dues not mean to be naughty and Iier feelings are as much a problem to herself as they are to lier mother, who often does not recognize a physical cause for the ill humor siie finds it hard to condone. It is inexcusable that a girl should be allowed to approach this jKiriod without having its meaning ex- plained to her. Well instructed mothers do not leave their children to find out the great facts of life from ignorant companions, who strip them of their sacredness and make what God has ordained com- mon and unclean. If fathere and mothers were frank with their boys and girls, telling them modestly and truthfully the things that they ought to know and warning them against dangei*s into which they may fall frori ignorance, much sin, anguish of mind and suffer- ing of body would be saved. Why should not the questions that all children ask sooner or later, be candidly answered? They are conscious of no impropriety in asking them and there is none in answering thtm with the same fidelity to truth that we show in explaining any fact to them as far as they can understand it. Nothing so i-apidly and fatally destroys a child's confidence in his parents as to find that they have THE CARR OP GIRLS I! 319 deceived him, and girls arc fully an sensitive on this point as boys. The unthinking jest, or subterfuge, that stopped or satisfied the inquirer for the mo- ment, is looiced baci{ u))on, when fuller knowledge comes, with a resentment that parents would find it hard to understand unless they can remember viv- idly the experiences of their own childhood. REST This is one of the most important factors in the treatment of a girl, not only during the establish- ment of the menstrual function, but during all the years of school life until she is fully developed. For the first year the child should l)e kept quiet during these days, made to lie down for a few hours and not allowed to indulge in any violent exercise. Tennis, riding on horse-back, rowing, swimming, must always be given up for the time being. Ijong walks should not be taken, hard study pro- hibited and the girl trained to take care of herself at this time. Dancing is injurious; although an occasional indulgence in this pastime might not do harm, it should not be an habitual amusement under these circumstances. 4 s ^e COLD Cold is an enemy especially to be drea^^ and the 320 THE CARE OF CHILDREN feet are an extremely vulnerable point. With most girls it is a serious matter to get the feet wet. Should it happen, they must be well rubbed with spirits of camphor or alcohol, dried and kept in warm stockings. An extra wrap should be worn and every precau- tion taken against a chill, dr any exposure to draughts. If obliged to go out in damp weather, a cloak should be put on and the dress changed on coming ia if it is not perfectly dry. BATHING A plunge bath must never be taken while the flow continues. The feet should not be dipped into a basin of water, but washed with a cloth and thor- oughly rubbed until the blood circulates briskly through them. In taking a sponge bath the water should be warm and a part of the body washed and dried before proceeding farther, the parts that are not actually being washed being kept covered. The room must be comfortably warm. CLOTHING As already stated a girPs clothing must be loose, comfortable, and not too heavy. Grace, beauty and health all demand the absence of tight bands, or any constriction about the waist. THE CARE OP GIRU3 321 Sanitary towels can now be purchased to take the place of napkins. These are used once and then destroyed. They cost about sixty cents a dozen, and can be made more cheaply of cotton waste and cheese cloth. The latter must be washed to render it soil enough for use. An elastic girdle is the most comfortable, it can be about an inch wide, fast- ened with small button and button-hole. In cold weather it is an advantage to a delicate girl to wear a flannel binder. A straight strip rolls up unless kept in place by straps, but a pattern of a well-fitting one can be obtained from any establish- ment that deals in paper patterns. tse. ice COINCIDENT SYMPTOMS The breasts, enlarging at this time, sometimes become tender and a little painful. The dress should not be allowed to press upon them. The tenderness can be relieved by soaking a handker- chief in spirits of camphor and laying it across them. Backache should not manifest itself in a healthy girl. If it does, unless very severe, it does not require treatment. A mustr>rd paste, one part mustard to two of flour, left on until the skin is reddened, helps to relieve it. Sometimes severe abdominsl pain If (bit for a ai I 322 THE CARE OF CHILDRElif time during the early stage. A hot-water bag is comforting. If this does not relieve, poultices or hot fomentations may be tried. A teaspoonful of tincture of ginger in hot water is beneficial. Alco- hol and opium should never be given to a girl without a physician's prescription. If the pain is serious enough to seem to require these remedies a doctor ought to be consulted. DELAYED MENSTRUATION After the function is established the periods ought to recur about once in four weeks. With some perfectly healthy persons the interval is shorter. When the flow does not come at the expected time, a day or two of grace should be allowed, as cold, over- exertion, mental anxiety, or any over-strain, may delay its appearance. The feet can be soaked in hot water and a tumbler of hot lemonade taken at bed-time. A sitz bath, in which the girl sits in a tub of water with the feet outside and covered with a blanket, is efficacious. If the flow is long delayed, there may be bleed* ing from the nose, spitting blood, or, sometimes, vomiting it from the stomach. This is not spe- cially alarming, being nature^s compensation, or vicarious menstruation, as it is called. During the first year or two, the periods may THE CARE OF GIRLS 323 or intermit for two or three months at a time without serious consequences. There is often constipation, which should be relieved by liquorice powder, or any mild laxative. If a girl does not menstruate by the time she is fifteen a physician should be consulted. HYSTERIA Girls of a nervous temperament are apt to have a variety of symptoms at this time, which are in- cluded under this general term. Tliere may be fits of excessive laughter, or crying, a general want of self-control, shown in acts of wanton mischief, fits of unprovoked ill-temper and apparent attacks of fainting or convulsions. These can be distinguished from true faintness, or fits, by two symptoms. The girl never hurts herself, as by biting her tongue, or striking her head in falling, and the eyes are sensi- tive, which is not the case when a person is really unconscious. If an attempt is made to open the lids she resists, trying to keep them shut, and flinches if the eyeball is touched with the finger. This attempted deceit is a part of her mental and physical condition, for which she is not fully responsible. Medical treatment is necessary, tonics, nourishing food, baths, gentle exercise, sleep, and all hygienic measurto, to restore tone to the system. 324 THE CARE OF CHILDREN At the same time, her moral nature should be appealed to, and a desire to struggle against her weakness be awakened in her. Girls have a great longing for sympathy, and while this should he lovingly given, it must be directed to the causes that have brought about this condition of weakness, and not to the symptoms of it. She must be made to understand that self-control is a virtue, and that a girl who willfully gives way to foolish manifesta- tions loses the respect of right-thinking persons. During the attack, a judicious letting-alone is the most efficacious treatment. Often the mention of a disagreeable remedy, as assafoetida, or a do ache of cold water, will cut it short. Rest in a darkened room should be enforced afterwards. Contrary to the general belief, boys sometimes suffer from an hysterical condition, as well as girls, and even men have been known to be afflicted with it. SCHOOL WORK Girls seldom break down from over-study alone. If properly treated, the body is usually capable of meeting the demands upon it. When it is under- fed, stinted in sleep and expected to respond to calls in too many different directions at once, it rebels. Then we have pale faces, headache, backache, and nervous prostration^ with all its attendant ills. THE CARE OP GIRLS 325 lone, of [der- Icalls and The trouble lies, not in over-study, but in over- strain. Mothers must remember that girls cannot go to school and meet the claims of society at the same time. Late hours are absolutely incompatible with keeping the young, growing body in go., conui- ti(m. A s'jhool girl should not be allowed to go to parties in the evening, except possibly occasionally on Friday night. If she is permitted to go to the theatre, matinees should be chosen. A concert in the evening at rare intervals may be permissible. If a girl is restrained in these outside pleasures and made to live her life more slowly she is a gainer in the end. She gains in freshness what she loses in present gratification. She has not exhausted all forms of entertainment by the time she is eighteen, and when she is emancipated from the school room she brings to social functions a capacity for enjoy- ment that is in proportion to their novelty. If a girl wishes to go to college she wants to take there unimpaired health, steady nerves, and the power of close application. This she cannot do un- less her physical well being has been carefully at- tended to during the formative period of earlier youth. 326 THE CARE OP CHILDREN NEEDLE WORK A girl who cannot sew neatly and quickly misses an important accomplishment. The taste for it must be cultivated and tlie mother must not begin by making it unattractive to the little learner. The second occupation in Kindergarten work is a kind of coarse embroidery with coI')red worsted on card board pricked in diiferent patterns to permit the passage of the needle. This does for a beginning and may be followed by working with worsted on canvas. When the child has learned to handle the needle easily a smaller one can be substituted and the first lessons in over-hand- ing given. The seams should be short, the fabric pretty and the work made as fascinating as possible. Excellent paper patterns for dolls* clothes can be procured from the dealers in paper patterns. With these, cutting out the tiny garments can be made an interesting pastime. The proper way of placing the pattern on the material, the care necessary to ensure perfect accuracy, and many other useful lessons, can be taught by their means. ti As the girl grows older she should J'^arn to cut and fit her own dresses. There are several admira- ble systems oi' measurement which make the work THE CARE OF GIRLS 327 easier than it used to be when it was more empir- ical. If she has any taste for millinery, it should be cultivated and lessons taken in the art. In many large cities there are classes where instruction is given, and even in smaller places, there is usually some one who is able and willing to impaii; the necessary knowledge for a due consideration. A girl who can cut and make her own clothes, trim her own hats, and those of other people, if necessary, is independent. If reverses come she is prepared to meet them. Any girl can earn her own living who can do well what every one wants to have done. It is cruel to bring a girl up without giving her perfect command of some useful art which she can turn to account in time of need. Every mother should choose one for her daughter and see that she is perfected in it, whatever it may be. If she never requires to use it to gain her daily bread, it will still be a desirable accomplishment, and, in the changes that life brings, it may be the sheet anchor that saves her from destruction. Icut tra- )rk HOUSE WORK There is no better exercise for young girls than a moderate amount of. house work. It develops the ifi 328 THE CARE OF CHILDREN muscles, improves the circulation, and so the com- plexion ; and, if it roughens the hands, a little vase- line, or glycerine and rose water, with a pair of gloves worn at night, counteracts the ill effect. A knowledge of cooking is invaluable to a girl. How to purchase and prepare food so it may yield the largest amount of nutriment for the smallest ex- penditure of money, should be a part of her training. There are many good books on cookery which can be used to supplement the personal teaching. A mother should be ashamed to send her daugh- ter to be the house-mother in any man's home, if she 18 deficient in the housewifely arts in which it was her duty to instruct her. Home-making is the primary business of a wo- man's life, and she ought to understand the arts that lie at its foundation. She will find ample oppor- tunity to practise them, if it is only to make a home for herself in one room. Should her sphere be a wider one, she will have the satisfaction of filling it with ease and can com- mand efficient service, because she knows what she requires and can supplement deficiencies by proper instruction. Most people like to do what they can do well, and girls are no exception to the general rule. The mother must be patient with failures and not give ' THE CARE OF GIRLS 329 i too scanty a measure of praise when it is deserved. The efforts to render service that is sometimes more hindrance than help must be accepted and en- couraged. It is much easier to do things oneself than to teach others to do them, but training is the mother's mission and she must fulfil it faithfully in small things as well as great. Saturday morning is a good time to devote to the special lessons in housekeeping. If some triumph of cookery can appear at tlie festival dinner on Sun- day, the family approval will be a reward the young maker will remember all her Iffe. PREPARING GIRLS FOR BOARDING SCHOOL The question of whether or no to send a girl to boarding school is a vexed one. It seems a pity that she should ever have to be sent away from her parents. They are her natural guardians and no one can adequately fill their places. When a girl's home is in the country, where she cannot have suitable educational advantages without leaving it, sending her away seems to be a necessity, if it is impossible to employ a governess. Some- times the stimulus of companionship in study is necessary. When circumstances arise to render it desirable, the school should not be chosen because it is large, 330 THE CARE OF CHILDREN or fashionable, or cheap, but an earnest endeavor should be made to find one where the personal in- fluence of the principal may be counted upon as an element of good in the formation of the child's character. Many noble women have been at the head of these institutions whose uprightness and singleness of purpose, purity of mind and fidelity to duty, have left an impress ui)on their pupils' lives whose value it would he hard to over-estimate. Much depends upon the spirit in which the girl goes to meet her new opportunity. The mother may give wise and loving counsel that will greatly help her in the untried life, so different from the se- clusion of home. ' She should be especially cautioned in regard to her health and charged to go to those in author- ity if she is out of order, not to let constipation per- sist when a laxative would give relief, and to take the same care of herself that she has been accustomed to do at home. Some of the larger schools have a trained nurse in charge of the infirmary, to whom the girls may go at any time for advice and treat- ment for slight ailments. She will gain much more from the training if she goes in an obedient spirit, realizing that rules are not made at the caprice of the teiachers but for THE CARE OP OIBLS 331 the benefit of the girls, and that to break them for fun not only does not bring much enjoyment in the end, but is a distinct injury to herself. Tn choosing a school one should be selected where the pupils are well fed. Growing girls, especially wlien their brains are being taxed, need a varied and abundant diet. This point being satisfactorily settled, the mother should refrain from sending boxes of eatables. A little candy may be allowed now and then — if it is home-made so much the better — but a quantity of promiscuous sweets only dues harm. Many of the wisest principals will not permit them to be received. Tiie mother should insist that the home letters are to be free from surveillance and the girl should be encouraged to write freely. While being careful not to interfere between the pupil and the consti- tuted authority, many misunderstandings may be smoothed out by a little advice from the calmer judgment of the elder, and many questions settled by helping the child to bring them to the touch- stone of right or wrong. < The clothing that is necessary varies with the sea- son of the year and the length of the term. Four changes of underclothing are sufficient, as more can be supplied from the additional stock at home should they be needed. It is well to send six M 332 THE CARE OP CHILDREN pairs of stockings. A \mr of walking boots, two pairs of house sitoes, slippers and rubbers should be provided. A bottle of shoe dressing containing glycerine should 1)6 carried in the traveling bag. The con- •MH^uences of a breakage are too disastrous to trust it in the trunk. Extra shoe laces must not be forgotten. Two school dresses 6f some pretty, soft woolen material, a plain serge traveling dress, another rather more elaborate for Sunday, and a fine, light cashmere, challis, or India silk for evening wear or festival occasions, is an ample supply of dresses. A warm wrapper of Jersey or eiderdown flannel, a pretty dressing jacket of outing or opera flannel, and a pair of bed-room slippers should be included in the outfit. If tennis is played, a tennis suit will be required, and tennis shoes. Possibly a suit for gymnastic exercises as well. It is nice to have two or three cambric shirt waists for the first warm days in early summer. A girl loves fresh, dainty things and, while she should not be encumbered with a number of dresses for unnecessary display, she should have enough to keep her trim and comfortable. A thick jacket, or warm ulster, is necessary for THE CARE OF OTRT.S 333 the daily outing, and a pretty hat, felt in winter, and straw in siunmcr, not too elaborately trimmed. A second hat should be provided for state occasions. A girl should not be stinted in gloves. Three or four pairs are required, as she is obliged to wear thorn in the dally constitutional walk, and they soon grow shabby. A muff is a comfortable addi- tion in winter. A desk, well-furnished with pajier, envelopes, |)ens and postage stamps, tiie lataT in a little case with leaves of waxed paper, sliould be one of the parting gifts, if it is not already counted amongst the valued possessions. A lock and key are indis- pensable. A work-bag, with all the accessories for sewing ready at hand, must not be omitted. Besides the sewing implements there should be extra buttons of every kind used in the wardrobe, shoe and glove buttons, sewing cotton, mending silk, strong linen thread for sewing on boot buttons, beside the oixli- nary black and white spools. Tape and a bodkin are useful, and a box of patent button-fasteners enables a missing boot button to be replaced quickly. A shoe-bag for the closet door, two clothes-bags and a hanging-case for umbrella and sun-umbrella should be added. A napkin ring is always taken, and in some 334 THE CARE OP CHILDREN schools the pupils are i-equired to bring two silver forks, a teaspoon, dessertspoon and tablespoon. Too many belongings are burdensome, but the girl should have a standing frame for the home photographs, a toilet cushion, and a few pretty things to adorn her room. All her clothing should be plainly marked ; the underclothing with her full name. The umbrella may have a tag with the name sewn to one of the ribs inside, if she is not fortunate enough to have a silver plate engraved with her initials. A good-sized trunk must be provided to hold the equipment. It is well if thEX Beef juice, 44, 78 ** forced feeding, 24S, 249 tea a stimulant only, 77, 78 ** in diarrhoea, to avoid, 77 steak, cooking, 54 Belladonna, 27 beverages, 58 at meals, 63 — 67 Biith marks, 232, 233 Ijittrs, 295 mosquito, 211 Blankets, babe, 90, 91 Bleeding, 289, 290 from lungs in whooping- cough, 267 B'indness, color, 162, 163 Blisters, burns, 297 tlood and nerves, 62 vessels, cut, 289 Blue baby, 241, 242 Boarding school, boys', 338 — 341 school, girls', 329—335 Bnils, 218, 219 Bone and muscles, 52, 62, 73, 74 Bones, broken, 296. Bonnets, babe, 98 girls', 112, 113 Borax wash, 18 Bottles, nursing, 38, 39 Bowel, prolapse of. 237 rubbingThe, 195 B..\v legs, 226, 227, 281 Bo\s, care of, 338—348 Brain, meat increases activity of, 52 Bran baths, 140 Brandy, 20 Brrad, 45, 46, 53 and molasses, 57 Breasts, babe, inflammation of, 220 mother's^ 18 (( « « « « Breasts, mother's, bandages, 22, 26 " absorbent cotton,useor,22 " care of the, 20, 23 filling, when not, 26 hard, and lumpy, 21, 22 heavy, 22 nipple, 18 — 21 nipple.protecting the,22 pump, 27 " weaning, in, 27 " menstruation, in, 321 Breathing, 310, 311 through mouth, 170 Bronchial tubes, 202, 274— 276 Bronchitis, 274 — 276 Bruises, 293 Brushing, hair, 171, 174, 175 Bunions, 190 Burns, 297, 298 £urned, eyes, 162 CABBAGE, 66 ' * Canker sores, 205, 206 Carbolic acid, poison by, 303 Carriage, baby, 128 — 130 Caseine, 28 Castor oil, 198 dose of, 200, 224 Catarrh, 222, 223 of throat, 204 Cathartic medicines, 198 Catheter, rubber, 249 Cereals, 45, 53, 62, 63, 69, 74, 79 Chafed heel, 190 Chafing, 219 Chapped hands, 219, 220 Cheese, 28, 73 to avoid, when, 69 Chest, cold in, 201, 275 exercise to develop, 277 miEX 351 26 22 22 22 79 Chest, oppression on, 75 in pneumonia, 274 in whooping cough, 268 Chicken, cooking, 55 Chicken pox, 260 Chilblains, 191 Children's companions, 341 — 343 diseases. See under Diseases. home training, 346 — 348 Children, young, diet, errors in, 17 " diet, constipated, 69 '* disorders in, 17 " restless, fretful, 23, 75 " teething, 27 ** when properly nour- ished, 24 " weight and feeding, 24 Jhilly, child, when, 75 Chocolate, 57, 59, 63, 79 Cholera, 70 Chorea, 157, 279, 280 Cleft palate, 231, 232 Clothing, 8 1 — 113 Cloths, wash, bath, 132 Club foot, 228 Cocoa, 59, 63, 79 butter, lotion of, 20 Codliver oil, 74, 224 Cold, 201 and pressure to stop bleed- ing, 289 baths, 136, 137 exposure to, dangerous,* 274 feet, 188, 204 in head, 201, 202 in menstruation, 319, 320 in rheumatism, 278 to prevent, 20 1 sores, 206 Cold pack^ the, 139, 140 Collar-bone, broken, 296 College, girls going to, 325 Colic, 194, 195 Color blindness, 162," 163 Color of hair, 177,178 Colostrum, 17 Combing hair, 171 1 Comforters, crib, 117 Condensed milk, 35 Constipation, 160, 197, 379»323 and condensed milk, 35 in menstruation, 323 remedyfor,whenobatinate, 198 Convulsions, 300 in teething, 147 Cooking, knowledge of, 328 Cornea. See Eyes. Corns, 189, 190 Cow's milk, 19, 28, 34 sterilizing, 33—35 Coryza, 75 Croup, 265, 266 Culture of body, 307, 308 physical, 307 — 316 Curds, 23, 28, 30, 32, 47 Curling, hair, 171 Cuts, 287, 288 Cutting off finger, 288, 289 hair, 173 nails, 183 Curvature of spine, 229, 314, 315 Cyanosis, 241 — 243 DAMP houses, 280 Dampness, to avoid, 262 Dancing, 314 in menstruation, 319 Dandruff in hair, 176 Deformities, physical, 226 — 24J Delicate children, 217— 4ai 'M IKD£X Diarrhoea, 27, 70, 71, 199, 200 fruit, to avoid, in, 5 1 flour ball, recommended, 43 Diet, after two years old, 52 — 60 and hair, 176 errors in babe's, 17 for school children, 61 — 67 in colds, 75, 76 in constipation, 68, 69 in diarrhoea, 70 in eczema, 76 in fever, 77, 78 in illness, 68 — 80 in indigestion, 71 — 73 in rickets, 73 — 75 in rheumatism, 279 in tuberculosis, 78—80 Digestion and rest, 75 and skin diseases, 76 barley food, to help, 30 eggs and, 46, 47 food and feeding, 28 infant's, 19, 20, 23, 39 starchy food and, 41 Dinner, school children, 65, 66 Diphtheria, 208, 262 — 265 Discharges, the, 198 from ears, 170 from eyes, 152, 158 from nose, 75, 258 involuntary, 251, 252 in ailing child, 245 in diarrhoea, 199 in typhoid fever, 272 Diseases, children's, 244 — 286 Disinfectants, 253, 254 Disinfection, when necessary, 153, 257, 259, 268, 272, 273, 284 Disorders in young children, 17,23 incident to teething, 146—148 Distended stomach, infant ^, ^ Drainage, when bad, 280 Drawers, 104 Drowning, 304, 305 Drum, ear, 164 EARACHE, 167 Ears, 164 — 170 Eating too fast, 72 Eczema, 76, 211 Eggs,46, 47, 53 at meals, 64 — 67 fried, indigestible, 47 in constipation, to avoid, 69 Electrolysis and hair, 179 Emergencies, 287 — 306 Enemata, nutritive, 247 — 249 Enlarged glands, 238, 239 tonsils, 239, 240 Epilepsy, 299 Erythema, 76, 210 Eustachian tube, 164 Evacuations, 198 — 200 See under Ailments. Excitable children, 217 Exercise, 277, 285 in menstruation, 319 Expectoration in consumption,283 External piles, 237, 238 Extra fingers, 233 Extraction of teeth, 151 Eyes, 152—163 FAINTING, 299 Farina, 42 Farinose, 45 Fat, 28, 281 condensed milk makes, 35 Fats, and heat and energy, 6<' in food, 62, 79 H INDEX 353 Fatty foods, and hair, 176 Feeding, enema, 247 — 249 forced, 249, 250 Feet, 186—191 Fever, diet in, 76 — 78 diet, in pneumonia, 274 diet, in rheumatism, 278 diet in scarlet, 255 — 257 diet in typhoid, 270—273 temperature in, 76 Feverishness, 193, 194, 275 Figs, 69 Fish, 63, 64 Finger nails, 183 Fingers, sucking the, 185 extra, 233 Fits, 299, 300 Fixed pains, 218 Flabl)y ears, 165 Flat luot, 227, 228 Flaxseed poultice, 250, 251 tea, 75 Flesh and muscles, 35, 52, 62 Flour ball, 43 Flushed, and hot, child, 193 Fomentations, 25!, 265 Fontanelle, 281 Food, after two years old, 52 — 60 diet in illness, 68 — 80 feeding, babe, 28 — 40 - feeding,increasingthe,4i — 51 for sfchool children, 61 — 67 infant, nursing, 17 — 80 Foreign bodies in ears, 168, 169 lx)dies in eyes, 161, 162 bodies in nose, 291 bodies in throat, 291, 292 bodies, swallowing, 292 Freckles, 341 Fresh air in sick room, 346 33 Fresh milk, 35 Fretful children, 23, 75 Fried meat, avoid, 54, 65 Frost bites, 298, 299 Fruit, 53.56,57.64 stewed, 57 sy™P. 59. 60 Fruits and vegetables, 51 Fumigation, '54 — 264 Furniture, in sick room, 346 GARMENTS. See Clothing. long, 83 loose, for babe 81 outdoor. III short, 83 Gavage, 249, 250 Gelatine cream, 48, 49 Germs, and sterilizing, 33 diphtheria, in, 262 fever, in, 270 tuberculosis, in, 283, 284 Girls, care of, 317— 337 Glass nipple shields, 21 dresses, little, 103, 104 Glasses, eye, 154 Glands, enlarged, 238, 239 inflammation of, 269 Goat's milk, 80 Gowns, night, no Graham bread, 69 Gravies, 65 Gtinding the teeth, 151 Growing pains, 217, 218 Gruel, arrowroot, 71 barley, or malted, 33 farina, 42 oatmeal, 42 Gum boils, 206 Gymnastics, 277, 307 354 INDEX HAIR, 171— 179 Hammocks, 1 16, II8 I lampers, toilet, 125 — 127 Hands, chapped, 219, 220 liang nails, 182, 183 Hare lip, 230, 231 Hirsh hair, 175 Headache, 220 — 222 nursing mother's, 26 strained eyes, from, 157 Head, cold in, 201, 202, 258 soft spot, top of the, 281 Heat rash, 76, 210 Heel, chafed, 190 Hemorrhoids, 237, 238 Hernia, 234 — 237 Hiccough, 200, 201 Hip disease, 218, 228, 229 Hives, 76 Hoarseness, 202, 266, 275 I lome training, child's, 346 — 348 Hominy, 45 Hopping, 313 Hot drinks, in colic, 194 Hot-water bag, 194 Hours, late, 221 I {ousework, 327—329 I lysteria in girls, 323, 324 in boys, 324 ICE cream beneficial, 58 66 in diarrhoea, 70 in diphtheria, 264 in feverishness, 193 water injurious, 59 Illness, Brst symptoms of, 244, 245 In-ligestion, 71—73. i57 in colic, 194, 195 in diarrhoea, 199 in tuberculosis, 285 Infants, nursing. See Food. Infection, to prevent, 252 Infectious diseases, 153, 212, 257, 259, 260, 263, 268 Inflammation, 154, 158, 160, 183, 184,220,263,269,273 emollients useful in, 162 Ingrowing toe nails, 183, 184 Inguinal hernia, 235 Internal piles, 238 Intervals of nursing, 19, 23, 24 Intestines and hernia, 235 inactive, 197 ulcerated, 270 Isolating sick patient, 252, 257, 264 Itch, 212, 213 Ivy, poison by, 300, 301 JUICE, beef, 44, 73 ' beef, as food, before teeth, 53 mutton, 45 orange, 50, 51 Jumping, 313 Junket, 47, 48 KISSING, to avoid, 284 Knee pads, 106 Knock knees, 227 Koumiss, 77, 78 LAMENESS, 228 Lamps, 159, 160 Lap pad, bath, 133, 134 Larynx, 202 Late hours, 221, 285, 325 Laxatives, 26, 35, 5 1, 77, 192, 197, 223, 269 Legs, paralysis of, in teething, 146, 147 ■K 1 #< ■« INDEX 355 ■K Letluce, 79 Light, bad on eyes, 160 artificial, bad, 154, 159, 160 Limbs, broken, 296 dislocated, 296, 297 Lime water, 23, 28, 29 " babe, disagrees with, 30 " in diarrhoea, 70 Lip, cleft, and palate, 231, 232 hare, 230, 231 Lips, dry, in fever, 271 Liquids and constipation, 68 Liver, infant's, 39 Long sight, eyes', 156 Lunela, to develop, 182 Lungs and consumption, 285 and tuberculosis, 285 bleeding from the, 290 bleeding from the, in whoop- ing cough, 267 inflammation of 273, 274 Lymphatic glan'ds, 238, 239, 285, 286 MACARONI, 49 Malted food, 31, 32 " in rickets, 73 . Marks, birth, 232, 233 Mastication of food, 72 Massage, 197 Matches, poison by, 304 Matzoon, 78 Meals and indigestion, 72 Measles, 2lo, 258 — 260 Meat and brain, 52, 53 and skin diseases, 76 cooking, 53 diet, 52 for meals, 63 — 67 recommended, 53 Meat, to avoid, 53, 54, 65 warmed over, indigestible, 73 Meconium, 17 Medicine, box, 223 how to give, 224, 225 Medicines, cathartic, 198 Membranous croup, 265, 266 Meningitis, 286 Menstruation, 317 — 324 and baths, 142 Metastasis, 269 Milk, 63—67 cow's, 18 CQw's, cooling, 29 cow's, condensed, 35 cow's, filtered, 35 cow's, peptonizing, 32, 33 cow's, pure, 34, 35 cow's, sterilizing, 33, 35, 64 goat's, 80 in fevers, 77 in skin diseases, 76 in tuberculosis, 79 mother's, 17, 18 *♦ acids, to avoid, 23 and menstrual flow, 25 diet of, 17, 23 — 25 diminishing supply,26 flow.to increase the, 23 if delayed, 18 if disagrees, 23 " insuflicient, when, 23 «* to dry up, 22, 25 " vegetables, to avoid, 24 " weaning, when, 26 " withdraw,whento,25,26 sugar water, 28 sugar of, 19 to prepare, 29 to avoid, when, 69 « (I 366 INDEX Millinery, 337 Mittens, babe, 93 Molasses suppository, 197 Moles, 233 Morning, w&ter in the, 69 Mosquito bites, 211 Mother's milk. See Milk. Mouth, breathing through the, 170, 204 child's, 18 sore, 205 sore tonsils, 239, 240 Mumps, 269, 270 Muscles and bone, 52 to strengthen, 313—31$ Mutton juice, 45 chops, cooking, 54 NAILS. 180—185 Napkins, 65, 85, 86, 94, 135 rubber, 86 soiled, in sick room, 252 Nasal passages, 170, 204 Navel, protusion of, 234 Neck, stiff, 208, 209 Needlework, 326, 327 Nerves and blood, 62 and brain, 279 Nervousness, 315 Nervous children, 221 system, and meat, 52 system, and convulsions, 300 system, and nails, 184 temperament, and sleep, 216 temperament, and menstru- ation, 323, 324 Nettle rash, 76, 210 Night gowns, 1 10 slips, babe, 87 studying at, 159 Night terror, £16 Nipple, 18 — 23 for cleft palate, 233 shi«;l Is, 21 '» eaning, when, 27 Ntr , ok , ;ngfrom the, 290, 291 •eatnj.i^ through the, 315 aischarg ■ om, 75, 258 foreign bodies in, 291 stopped up, when, 167, 202 Nourishing food, 62, 158, 279 Nursmg. See Food. babe, 17, 18 bottles, 38, 39 bottles, proper care of, 39, 70 giving the food, 39 improper, when, 25 points in, 245, 247 too long, when, 281 Nutrition, 280 Nutritious food, 52, 63 Nutritive enemata, 247, 248 Nuts and colic, 194 OATMEAL gruel, 42 Occupations for girls, 327 Odor from feet, 189 Oiling nails, 182 Oils, how to give, 224, 225 Ointment, chilblains, 191 itch, 213 Open-air bathing, 141, 142 Opium, poison by, 302 Ophthalmia, 152 — 154 Oranges, 50, 51 Out-door garments, III Outline of nail, 1 81 Overfeeding, 24 and colic, 194, 195 Overstrain, girls', 325 U, 'f INDEX 357 291 5 02 f,7<» J Overstraining eyes, 156, 157, 221 Ov«rstudy, 122, 221, 279, 285, 324*325 girls', 324 Oxalic acid, poison by, 303 PADS, 251,252 babe, 86 crib, 118 lap, for hath, 133, 134 Pains, abdomtfn, 214 '* in menstruation, 321 fixed, 218 growing, 217, 218 knee, 218 Palate, cleft, 231, 232 Pancreas, 32 Pancreatin and soda, 32 Paralysis in teething, 146, 147 Parasites, hair, 177 skin, 213 Paregoric, 302 Pastry, 58, 66 Peptonized foods, 32, 33 beef juice, 248, 249 Perspiration, feet, 189 in rickets, 281 — 283 Petticoats, babe, 84, 85 Pigeon breast, 230 Phthisis, 284 Phosphorus, poison by, 304 Piles, 237, 238 Pills, how to give, 224, 225 " Pink-eye," 158 Plaster jacket, 230 Plunge bath, 142 Pneumonia, 273, 274 Poisoning, 300 — 304 Pork, 56, 74 Porridge, 45, 53, 63 Potatoes, 48, 66, 73 Poultices, ears, 168 eyes, 158 flaxseed, 250, 251 tonsils, 340 Powders, how to give, 224 tooth, 150 Powdering after bath, 135 Pox, chicken, 260 small, 262 Prolapse of bowel, 237 Protein, 62, 63 Protrusion of navel, 234 Prunes, 57, 197 Puddings, 58, 66 Purpose of food, 62 Pus, 239 Physical culture, 307 — 316 deformities. See Deformn TIES. RASHES, 76, 196, 209—211 in chicken pox, 260 in measles, 258 — 260 in scarlet fever, 255 in teething, 147 in typhoid fever, 270 Reading, children's, 343 — 346 Redness, eyes, 152 Regular and even teeth, 150 habits in children, 198 Rennet, 43, 47, 48 Respiration, artificial, 299, 305 Rest, in menstruation, 319 Resting on feet, 186 Restless children, 75 Rheumatism, 278, 279 Rice, 49, .50 water, 43 Rich gravies ai/d dishes, 58, 65 358 INDEX Rickets, 73—75, 227, 280—283 Ringlets, hair, 172 Ringworm, 212 Rope, skipping, 313 Roseola rash, 76, 210 Rubber nursing bottles, 38, 39 truss, 235 tube for enema, 247, 248 Rubbing abdomen, in constipa- tion, 197 bowels, 195 Running, 312, 313 Rupture, 83, 234—237 SALIVA, 41 Salt in food, 36, 52, 73 in meats, 53, 54, 56 in water baths, 137, 138 Salts, laxative, 27 Sanitary towels, 32 1 Santonin, 214, 215 Scabies, 213 Scalds, 298 Scalp diseases, 212 Scarlet fever, 255 — 257 Scarlatina, 257 Scarlet rash, 257 School children, food for, 61 — 67 boarding, boys', 338 — 341 boarding, girls', 329—335 work, 324, 325 Scrofula, 238 Second teeth, 147 — 149 Separate beds, importance of, 123 Sewer gas, dangerous, 262 Sick room,articles necessary in, 286 ** cooling the, 246 " fresh air, to admit, 245, 246 ** furniture of, 246, 247 Sick room, temperature of, 245 Sight, long, 156 short, I SS, 156 Shaving, hair, 179 Sheets, crib, 117, 118 Shields, nipple, 21 Shirts, babe, 83, 84, Shoes and corns, 189 and gymnastics, 310 and walking, 187 Sitting, 311 in school, 312 Skin diseases, 76, 240, 241 of fruits, 56 rashes, 76 Skirls, boys', 102 creeping, 96 Sleep, bedtime, 67 in bronchitis, 276 in rheumatism, 279 necessity for, 121, 123, 279 separate beds recommended, 123 to awaken from, 122 with ailing child, 244 with consumptives, 284 Sleeplessness, in Chorea, or Sl Vitus' Dance, 280 Slippers, 107 Sneezing, 222 Snoring, 204, 239 Socks, babe, 89, 90, 99 Soothing syrup, 302 Sore mouth, 205, 239, 240 throat, 206—208 " in diphtheria, 263 " in measles, 259, 260 " in scarlet fever, 25$ Soreness, nails, 183 Sores, bed, 271 INDEX 3S9 345 ,279 lenoed, or St 63 260 255 Sores, eanlcer, 205, 206 cold, 206 Soups, cooking, 55 at meals, 64--66 in consumption or tubercu- losis, 79, 80 in rickets, good, 74 Spasmodic croup, 265, 266 Spinach, 79 Spins, curvature of, 229, 314 Splints, 282 Splinters, 293 under nails, 184 Split ends, hair, 175 Sponge, care of the, 132 baths, 135, 136 ** in bed, 139 Sprains, 294 Squinting eyes, 157 Stammering, 315, 316 Standing, 310,311 Starch, 41, 42, 71 baths, 140, 141 Steel braces, 230 Sterilized milk, 33, 34, 64 Stewed fruits, 57 Stiff neck, 208, 209, Stimulants, 77 Stings, 294 Stomach-ache, in nursing, 39 Stomach and digestion, 72 bleeding from, 290 infant's, if distended, 24 rest in colds, 75 Straightening teeth, 150 Straining eyes, consequencesof,i57 Strangulated hernia, 236, 237 Strumous swelling, 286 Strengthening muscles, 313, 314 Study, at night, 159 St. Vitus* Dance, 279, 280 Styes, 160, 161 Sucking fingers, babe, 1 85 Sulphur ointment, for itch, 213 Sunburn, 241 Superfluous hair, 178, 179 Sunshine and air in rickets, 280 and air in teething, 147 Sugar, hejit and energy furnished by, 62 in condensed milk, 35 in water, 69 of milk, 19, 28 Supper, school child's, 66, 67 Suppositories, 197 Swallowing foreign bodies, 292 Sweets, craving for, 57 Swelling eyes, 152 Symptoms, first illness, 244, 245 Syringing ears, 169, 170 Syrup, and bread and fruits, 59 TABLETS, to give, 22$ Tan, 241 Tangled hair, 172 Tears, baby, 196 Teeth, 143— '5" extracting, 151 grinding the, 151 second, 147 — 149 to straighten) 150 Teething, 143—147 Temperature of food, 37 of sleeping room, 120 of sick room, 245 Terror, night, 216 Thirst, 75, 270 Throat, ailing child's, 244, 245,263 care of, in croup, 266 800 nfDEZ Throat, foreign bodies in, 391, 392 Thrush, 18, 305 Tight bandages, bad, 234 Tissue, to build up, 53 Toadstools, poison by, 304 Toast, 73 Toe nails, 181 — 183 Toilet, babe, 124 — 130 Tongue tie, 333 Tonsils, 304, 308, 263 enlargement of, 239, 240 Toothache, 151 powders, 150 Towels, iMiih, 133 sanitary, 321 Training, home, children's, 346 the body, 307, 308 what mothers can do, 309, 310 Truss, in hernia, 235, 236 Tuberculosis, 78 — 80, 283 — 286 Tumors, eyes, 160 Twisting, hair, 172 Twitching movements, 379, 280 Typhoid fever, 270—273 <* food to be given in, 272 ULCERS, eyes, 153 Ulcerated ear tube, 164 intestine, 270 Umbilical hernia, or rupture, 235 Underclothing, 104, 105 Urticaria, rash, 76, 210 VACCINATION. 260—363 Vegetables, 51, 53, 56, 69, 74, 79 cooking, 56 m nursing, to avoid, 34 Ventilation in diphtheria, 363 in measles, 259 in pneumonia, 374 in rickets, 380— 2S3 Ventilation In scarlet fever,355,356 in tuberculosis, 385 necessary in sickroom,345,246 " in sleeping room, 119 — 121 Vermicelli, 49 Vermifuges, in worms, 313 Vision, defective, 154 — 157 Vomiting 30, 34, 344, 349, 250, 267, 273 WAISTS, babe, 95 under, 105 Walking, 187, 312, 313 Warm baths, 137, 217 Warts, 240, 341 Water at dinner, 66 ice, injurious, 59 in diarrhoea, 70 in typhoid fever, 272 milk-sugar, 28, 29^ necessary, 40, 68, 69 passing, necessity for, 196 Wash-cloths, bath, 132 Washing eyes, 153 hair, 176, 177 Wax in ears, 166, 167 Weak ankles, 187 eyes, 154 Weaning infants, 25 — 27 ** in rickets, 73, 281 Wearing the hair, 174 Weights, lifting, bad, 236 Wetting bed, 215, 216 Whey food, 43, 44 White swelling, 286 Whooping cough, 209, 222, 266 Wind, and weak eyes, 154 in colic, 195 Worms, 213, 315 Wounds, to dress, 388 Wrappers, babe, 88, 89, 109 s ver,2S5,256 ^5 0111,245,246 n, 119 — 121 213 -157 , 249, 250, i 272 for, 196 s 27 ets, 73, 281 ^36 1 • « •. • 222, 266 154 1 i-. u 109 • • 4 • •