THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES I -7-3 ./^X "si BRANCH, F CALIFORNIA, &RY, t .ES, CALIF. THE HEALTHY CHILD FROM TWO TO SEVEN THE MACMILLAN COMPANY NEW YORK BOSTON CHICAGO DALLAS ATLANTA SAN FRANCISCO MACMILLAN & CO., LIMITED LONDON BOMBAY CALCUTTA MELBOURNE THE MACMILLAN CO. OP CANADA. LTD. TORONTO THE HEALTHY CHILD FROM TWO TO SEVEN A Handbook for Parents, Nurses and Workers for Child Welfare Containing The Fundamental Principles of Nutrition and Physical Care, including Sections on Child Nature, Training and Education, and Safeguarding the Nervous System during the Preschool Years. BY FRANCIS HAMILTON MACCARTHY, M.D. Assistant Professor of Diseases of Children, Boston University 1922 All rights reserved PRINTED IN THE UNITED STATES OF AMERICA COPYRIGHT, 1922, BY THE MACMILLAN COMPANY. Set up and electrotyped. Published March, 1922 FERRIS PRINTING COMPANY NCW YORK (o "/* becomes increasingly clear that a better society must come through better children, and that the chief importance of soc^al > economic, and vital conditions lies in their influence on little chil- dren." From Editorial in "The Outlook," N. Y. PREFACE The gfeatest nations of the world are coming to realize that the greatness and power of any nation must always be dependent upon the in- tegrity of the home and the health of the child. A great war tests the strength and power of a nation to the utmost. Preparation for war is searching in its revelations of national strength or weakness. How has it come about that of the hundreds of thousands of young men appearing before the examining boards of army and navy, represent- ing the very flower of the youth of our country, a very large proportion were rejected because of physical and mental unsoundness? Careful investigation has shown that more than half the defects causing rejection were pre- ventable, and that nearly all these defects had their inception during the years of early child- hood. The Children's Year Campaign inaugurated by the Children's Bureau also demonstrated the fact that a very large proportion of the nation's children suffer from malnutrition, underweight and physical handicaps. As one makes daily rounds in the children's wards of a large hospital, the impression be- comes more and more firmly fixed that much of the illness and suffering and deformity of the viii PREFACE little folks might have been prevented by proper care during the first years of life. Out of the turmoil of international strife has again come the revelation that as a people we are lacking in the conservation of our most priceless resource, of life in its beginnings, of the health and well-being of the nation's children. Are the children of today to be the defective men and women of tomorrow? Have we not here a mighty challenge to unite in the great task of developing a stronger and more robust childhood? /To work for children is, from many points of view, the most important and most interesting of all tasks. Constant companionship with chil- dren, studying and endeavoring- to understand the child nature, and treating them when ill, is a rare privilege. The present book has grown out of such companionship and work extending over many years. It deals with the care and nurture of children during the foundation years, before school life begins. Whatever else the recent chaos of war may have taught, certainly one great lesson which stands out clearly and distinctly is that a better order of things must come through higher ideals of parenthood, and from stronger and better children. That this book may have some useful part in the great crusade now being carried on to build up a stronger race of men and women, is the fervent hope of the writer. CONTENTS Page CHAPTER I. INTRODUCTION 1 CHAPTER II. THE HOME AND SURROUND- INGS. The city child handicapped 9 Sunshine and Fresh Air in the Home 9 Ventilation in the Home 10 Heating the House various methods Health First 12 The Children's Room 13 CHAPTER III. FOOD FOR BODY-BUILDING. The under nourished child 19 Many children under weight 19 Under nourished child always below par 19 Table of Weights and Heights of Children 20 Facts about weight and height 21 The father's part 22 Training children in fundamentals of right living.... 22 Causes of under-weight in children 25 Food for Growing Children 27 Milk the most perfect food for children 27 Care of Milk , 29 Cereals 30 Eggs 31 Breads, crackers and cakes , 31 Butter, cream and other fats 32 Broths and soups 33 Meat and Fish .. 33 Meat stews .., . 34 x CONTENTS Page Vegetables; cooking of 35 Fruits 37 Desserts and Sweets 38 Feeding During the .Second Year 39 Diet-list for Healthy child during the Thirteenth and Fourteenth months 41 Schedule for feeding healthy children from Fif- teenth to Eighteenth Months Inclusive 42 Schedule for Children from Nineteenth to Twenty- fourth Month Inclusive 43 Dietary for Children from Third to Sixth Year Inclusive 45 When Children have Indigestion 48 Acute Indigestion 48 Chronic Indigestion and the right kind of food 49 CHAPTER IV. SLEEP AND REST. Sleep a fundamental necessity 55 Number of hours sleep required at different ages 56 Daily nap discontinued too soon 56 Time for daily nap 57 Sleep during the school years 58 Conditions favorable to healthy sleep 59 Bedtime stories 59 Bed and bedroom 60 Sleeping out doors and sleeping bags 61 Causes of disturbed sleep 62 CHAPTER V. PLAY AND GROWTH. Play a fundamental need in the life of the child 67 Importance of play not generally appreciated 67 Difference between the adult's conception of play and that of the child , .. 68 CONTENTS xi Page Play activities of children 68 Children are explorers and creators 69 Small tasks for children 70 Parents and children comrades 70 Play materials and occupations for children 71 The Sand-box, the making and equipping of 72 Making houses and keeping house .73 A tool-box and its contents 75 Little girls and the out door life 76 Cold weather sports 76 Teaching children to swim 77 Gardening, garden tools for children 78 Companionship of other children needed 79 The City Child; materials and tools for play 79 Indoor play materials and occupations 80 The Constructive Instinct and Building Blocks 83 CHAPTER VI. CHILD-NATURE; TRAINING AND EDUCATION. Parent Teachers 87 Parents have the greatest teaching opportunity 87 Early years afford the richest soil 89 Characteristics of the child nature 90 Natural independence 90 Changeableness 93 Slowness of Perception 94 Individual temperament 94 Obedience and Self-control 95 Children learn much by imitation of others 98 Instant obedience not always possible 100 Uselessness of argument 101 Overuse of the word "Don't" ., ...102 xii CONTENTS Page Punishment, common mistakes in training 103 Methods of Correction 106 Children need suitable occupation 108 Teach the joy of work well done 109 Truthfulness 109 Education : They learn by observation and imita- tion Ill Companionship with parents in Outdoor World 113 Instruction concerning Origin of Life 113 Answer questions simply and frankly 114 Instruction concerning personal cleanliness 117 CHAPTER VII. STEADY NERVES AND HEALTHY MIND. Disorders of nerves and mind on the increase 121 Many nerve disorders begin during childhood 121 Need of preventive work in the home 121 Heredity and environment considered 122 Importance of suitable home and wise training.. ..122 Instability of child's nervous system 122 Factors of vital importance 123 Girls as well as boys need outdoor sports 125 Mental and physical hardening 126 Must learn not to be over-sensitive 126 Self-mastery to be learned early 127 Cheerfulness and good-nature contagious 128 Dark moods and irritability unhealthy 129 Learn to laugh at small hurts and difficulties 130 Children should have no fear of darkness 131 Teach them to have faith instead of fear 132 Over-stimulation and precociousness dangerous 132 Importance of suitable play activities 134 CONTENTS xiii Page Children need each other 134 Children reflect the life about them 135 CHAPTER VIII. CARE OF THE CHILD'S BODY. Care of the skin 141 Bathing 142 Bathing to prevent taking cold 144 Soaps and powders 145 Care of the genital organs 147 Care of the hair 147 Care of the eyes 148 Care of the ears 150 Care of the nose and throat 151 Care of the mouth and teeth 153 Irregular teeth and causes of 154 Food and the teeth 156 Keeping the teeth clean , 158 The Child's Feet, prevention of deformities 160 CHAPTER IX. COMMON DISEASES AND DIS- ORDERS OF CHILDHOOD. A new point of view in regard to "Children's Di- seases" 167 Many children crippled by the contagious diseases.. 167 Measles and German Measles 169 Whooping cough 170 Chicken pox 171 Mumps, scarlet fever 172 Diphtheria 173 xiv CONTENTS Page PREVENTION OF CONTAGIOUS DISEASES ....175 A community conscience needed 177 The Schick test and safe-guarding child against Diphtheria , 178 Vaccination 178 The Care of the Sick Child 180 COMMON DISORDERS OF CHILDHOOD 181 Constipation and its prevention 181 "Worms" Causes and Prevention 183 Bed wetting; causes and prevention 184 Convulsions 186 Earache 188 Croup - 189 Colds and Prevention 190 Adenoid Growths 192 Enlarged tonsils ., , 194 Thumb and Finger Sucking 194 Nail-biting and self-abuse 196 CHAPTER X. COMMON EMERGENCIES OF CHILDHOOD. Burns of different kinds; first aid 201 Wounds of various kinds; first aid 203 Bleeding from nose 208 Foreign bodies in nostrils and ear 209 Injuries to the eye 210 Swallowing of foreign bodies 213 Drowning accidents: First Aid 214 Prevention of drowning accidents 216 Accidents from poisoning, household precautions.. ..217 First aid treatment 218 Common poisons, List of, Treatment 219 THE HEALTHY CHILD FROM TWO TO SEVEN THE CHILD FROM TWO TO SEVEN CHAPTER I INTRODUCTION Children are so utterly helpless and dependent during the first year of life that the importance of good care at this time is quite generally ap- preciated, but after the first year, and during the five or six years previous to entering school, many children show a lack of the right sort of training and good care, so essential for the de- velopment of healthy childhood. It is safe to say that the chief cause of the defects of constitution discovered by govern- ment physicians while examining men for enlist- ment in the army, was a lack of oversight and good care during the years of early childhood. Teachers, principals of schools and school physi- cians testify that many children when they first come to school have pale faces, thin bodies and heavy eyes, showing the lack of proper food, in- sufficient sleep, and the appearance of being too closely housed. There is no doubt that mothers and fathers sacrifice much for their children, and because of the little folks in their own home, feel tenderly toward all children. It is not lack of parental affection. It is rather parental preoccupation 1 2 THE CHILD FROM TWO TO SEVEN with other matters, and with very many parents, the ever pressing struggle to keep family ex- penses within family income. As parents, however, we must ever keep in mind one vitally important fact, that all the time while we are so very busy with the prob- lems of living, the children are growing and de- veloping just the same; they are receiving im- pressions of the everyday life about them; they are being shaped or moulded according to the care and training they receive. There is no standing still with childhood; chil- dren will grow even under most unfavorable conditions and surroundings, but it will be a stunted growth, something like a plant shut away from fresh air and sunshine. ^Whatever qualities children inherit from par- ents may be modified by their surroundings either to their advantage or disadvantage, j For perfect development of body and mind certain fundamental conditions are essential. It is every child's birthright_to have pure air, nourishing food, sleep and rest, plenty of room for play, and careful guidance during these pre-school years. Just as the plant needs proper soil, water and sunshine if it is to bloom and bear fruit, so the human plant must have sunshine, fresh air and good food in order to reach its full development. The fathers and mothers are the arbiters of the child's destiny; upon them depend whether the child is to be strong and sturdy, and face INTRODUCTION 3 the world with full equipment of body and mind, or whether it is to be a weakling, always at a disadvantage when the tasks and tests of school and after life come, because of lack of early training and wise care. Here then are four or five years full of splen- did possibilities for the building of strong, ro- bust bodies. It is a period of freedom from care and responsibility. It should be a time of prepa- ration for the more exacting and confining duties of school and adult life. Now, if ever, is the time for life in God's out of doors, plenty of wholesome food, careful training, and long nights of refreshing sleep. Later care and training can never take the place of painstaking, constructive building during the pre-school years. As parents we must not only adore our chil- dren; we must love them wisely. It is not so important that little daughter shall be pretty as it is that she shall have rosy cheeks, clear eyes, good blood, bone and muscle; if she has these last the first will come as a matter of course, for there is no more beautiful sight than a child whose every feature and action betokens perfect health of body and mind. The parent's part is to provide healthy en- vironment, carefully chosen food, and wise train- ing] LeTTt no longer be said that there is too much haphazard bringing up of children. Let our efforts no longer be without definite plan- 4 THE CHILD FROM TWO TO SEVEN ning and direction; let us shape and plan our course. The ground is good. No soil is so pro- ductive; no culture so fascinating; no work so great; no task so worthy of the best effort and talent of men and women as that of having a part in the upbringing of sturdy children, and leading them along upland and sunny ways. THE HOME AND SURROUNDINGS "Everyone in his own house, and God in all of them." Cervantes. "In the homes of America are born the children of America, and from them go out into American life American men and women. They go out with the stamp of these homes upon them, and only as these homes are -what they should be, will .the children be what they should be." J. G. Holland. CHAPTER II THE HOME AND SURROUNDINGS Where shall the home be established, in the country where there is space and outlook, or in the city with its crowded brick apartment houses and walled in, narrow, paved streets? The city is no place to found a real home. To be sure there are a few parks and open spaces, but in most cities the parks which really have space and breadth of view are some miles away from where the average family finds it convenient to live. It is possible to make a fairly comfortable stopping place in a city apartment, and a baby may thrive fairly well for the first year or two of life, but a child old enough to be on its feet needs more freedom than such living conditions permit, and should spend a large part of the time out of doors. A large city is no place for real living. Rents are so high that only large incomes can com- mand an apartment or house worthy to be called a home. The parents themselves cannot keep well and feel vigorous in a city apartment unless the family income is sufficiently generous to pay a large rent for an apartment in the more open, 7 8 THE CHILD FROM TWO TO SEVEN cleaner streets near an open space or park. A mother and baby obliged to live in a small city apartment cannot live a free, natural, healthy life, and must inevitably suffer for lack of out of door air and sunshine, for even sunshine is expensive in the city, apartments on the sunny side of buildings bringing much higher rents. Now when city children find their feet and commence to look about, life is indeed a shut-in sort of existence. Apartment houses are not built with little folks in mind. Indeed, many owners openly advertise the fact that no children will be allowed on the premises. There are no yards, even porches are exceptional, no place to run about, no green grass, no fields, no flowers, no birds. In the summer, hot brick walls shut in the hot stone-paved streets which are the only playgrounds, the child's life being varied some- what by an occasional trip to the park or sea- shore in crowded cars. It is worse in the winter. Any cold day in winter little white faces may be seen pressed sorrowfully against the window-panes, gazing wistfully out upon the city streets. They are the little folks between two and six. Their fath- ers are at work, and their mothers busy with the baby, or they may also be at work to help pay the high rent. The windows are apt to be closed and locked to prevent the children from falling out and the cold from coming in, for many apart- ments have but little heat. THE HOME AND SURROUNDINGS 9 Many such children play very little; they be- come thin, pale, dull, listless and undeveloped; they are all too silent and sober for little people. Pneumonia and tuberculosis find them ready victims. Do parents want their children to live under such conditions? Children living in the city are handicapped right at the beginning of life, and should not be allowed needlessly to suffer such hindrance in their development. Better by far to live out of the city where a house with a yard is available, and where pure air and sunshine are abundant. The house may be small and lack some of the comforts and modern conveniences, but if the water is pure, and the children can spend much of the time out of doors, they will be much better off than they would be living in the city. The water-supply should be carefully investigated in regard to contamination, and careful consideration should be given the sani- tary arrangements. SUNSHINE AND FRESH AIR IN THE HOME Sunshine and fresh air are absolutely neces- sary for life and growth. The air in our homes is constantly being deprived of its life-giving qualities by the breathing of those present, by gases from the fires, from kerosene and gas light, by dust and smoke, and particularly to- bacco smoke. To sweep out these impurities and 10 THE CHILD FROM TWO TO SEVEN purify the air, fresh air and sunshine should have constant and free access to the living rooms. It is desirable if possible that the house should face the South or Southeast in order that the rooms may be flooded with sunshine. Windows and outside doors must be depended upon as the chief means of ventilation in the average home. Good ventilation means that the air in the house should be kept in gentle motion, even though imperceptible, that it should be warmed or cooled to the right temperature, and have the proper degree of humidity and freshness. The air in many living rooms is kept too warm and dry. The lining membrane of nose and throat becomes too dry, and the body susceptible to cold. A dry heat and closed windows are constant sources of nose and throat disorders. The temperature in a living room should not be over 68 or 70. Every living room in the house should be com- pletely flushed with pure out-of-door air at least once every twenty-four hours. The best way to ventilate a room is to open windows on oppo- site sides, thus producing a current of air. If there is considerable wind it will speedily fill every part of the house with clean fresh air, but on a still day it will take longer. To prevent the cold air from chilling the floor a window board may be placed in the opening when the lower sash is raised a few inches, thus permitting the cool air to enter the room be- THE HOME AND SURROUNDINGS 11 tween the two sashes, while the heated air passes out through a slight opening at the top of the window. In colder parts of the country it is difficult to keep the house completely warm and at the same time keep the air fresh. During the day the rooms may be aired when not in use. Such rooms must be warmed before allowing the children to use them. Bedrooms may be thor- oughly aired during the day even on the coldest days, and the playroom or sitting room may be aired while the children are outdoors or taking their nap. At night the bedroom window should be opened at least an inch or two even in the cold- est weather. A good way to ventilate a bed- room is to cover an ordinary window-screen with one or two thicknesses of cheese-cloth, and in- sert in the open window. This will afford pro- tection against a too sudden inrush of cold air. Sleeping bags are also useful, and a folding screen can be used to protect the children from drafts. If well covered the children will sleep better and wake in the morning with bright eyes and keen appetites. Children are much less likely to contract colds in rooms through which a gentle current of air is constantly passing than in still air and closed- up, over-heated rooms. But children need to get out of doors as well as to breathe fresh air in the home. Even in cold or stormy weather 12 THE CHILD FROM TWO TO SEVEN when they cannot enjoy outdoor life, a sheltered but sunny porch will make it possible for the children to spend many happy hours in the open air, while in the milder months they should live out of doors as much as possible. HEATING THE HOUSE The ideal system of heating is one that will keep the house sufficiently warm to permit hav- ing the windows slightly open much of the time. In apartment houses where families do not have control of the heat, a constant even temperature is unusual; rooms are often overheated, and fre- quently have no heat at all for two or three hours during the day. A system that requires tightly closed windows in order to keep occu* pants of living rooms warm is certainly unsatis- factory. Houses in the United States are usually heated by indirect radiation, that is, by hot water, steam or hot air; or by direct radiation from stoves or open fire places. Steam or hot water heated houses are apt to be overheated, and the air in the rooms too dry. Shallow pans of water placed on registers, radiators or stoves will help to keep the air moist. Oil or gas heaters are objectionable in that they consume much larger quantities of oxygen, but may be useful when no other means of heat- ing is available, or when quick heat is needed, but are suitable for temporary use only. Care should THE HOME AND SURROUNDINGS 13 be taken to guard children against accident if such stoves are used. An open fire place is a most useful addition to any heating system. It is an excellent ventilator, and for the cool days of fall and late spring when it is not cold enough to start the furnace, an open fire removes the chill and gives just the right amount of warmth. In front of the open fire should be placed a stong wire screen to protect the children against accident. But the fact that the open fire provides warmth and ventilation is not all that can be said in its favor. Given a home-like living room in which is a good-sized fire-place, what wonderful possibilities it holds for family gatherings in front of its friendly light and warmth! What a jolly place it is for the telling of bedtime stories, for popping corn, and family counsel! What more beautiful sight than the faces of little children eagerly listening to a story told in front of the open fire, its cheerful blaze lighting up the childish faces and reflected in bright eyes, as they look away into childhood's land of make believe. The memory of such happy hours remains with children always, and because of such happy times, home and parents become increasingly precious with the passing years. THE CHILDREN'S ROOM It is desirable that some provision should be 14 THE CHILD FROM TWO TO SEVEN made in the home for the little people, a place of their own, at least a corner of the living room, for playthings and books. In some homes the children's sleeping room is arranged for use partly as a playroom; in other homes a room is set aside especially as a playroom. There are still other homes where no provi- sion is made for wholesome play. It is mani- festly a great misfortune for little folks to be compelled to live through childhood surrounded with furnishings entirely for the use of grown- ups, with no place for dolls, doll-houses, scrap- books, balls, and all the various and sundry treasures which go to make up the small boy's and little girl's world. Certainly the task of keeping the living room tidy and the care of the children would be much more simple if some definite planning were done to provide suitable places for childhood belongings. Chil- dren learn while they play, and the more intel- ligent the planning for daily living and playing, the better the children will be. A sunny playroom with simple inexpensive furnishings becomes a blessed place for the children. The rooms should contain only neces- sary furniture of simplest design, easy to keep clean, and not too expensive. Bare painted or hardwood floor with an inexpensive, cheer- ful colored rug is preferable to carpeted floor, and walls painted some quiet but cheerful color which can be washed, are preferable to papered walls. THE HOME AND SURROUNDINGS 15 Plain curtains without ruffles or lace arc better than those which are fancy or expensive. Windows should be screened to keep out flies. Chairs, tables, bookcases, shelves and beds should be low and not too large. Strong, low, plain tables, and low pine chairs serve the pur- pose, and shelves and drawers for playthings will encourage the habit of keeping things in place. Such an equipment in a bright, sunny room having plenty of fresh air, and warmed to 68 F. in winter can be provided at small expense, and parents will have cause to rejoice in seeing their children happy and contented. FOOD FOR BODY BUILDING "Health and good estate of body are above all gold." Ecclesas- ticus. "Our chief ambition is for the nurture of our children," Josephus. "The errors of parents the gods turn to the undoing of their children." Euripedes. CHAPTER III FOOD FOR BODY BUILDING From the very beginning of life the child who is to be strong and robust must have sufficient and suitable food. Many children are eight to ten pounds underweight; indeed, it is safe to say that one child out of every three or four is underweight. Children who are underweight are apt to be pale, have flabby muscles, and an irritable dis- position. Quite frequently they are punished for being irritable and peevish when in reality they are suffering from lack of proper nutrition. Such children cannot be expected to be cheerful and contented; they are below par; they are not well. Their resistance to disease is low, and later when they enter school they are apt to contract the contagious diseases. Children who are several pounds underweight are often retarded in their development, and backward in their studies. Weight is such an important index of a child's nutrition, it seems best to insert at this place the following table of weights and heights, in order that parents may have some standard for guidance in judging the condition of their children. 19 20 THE CHILD FROM TWO TO SEVEN TABLE OF WEIGHTS AND HEIGHTS OF HEALTHY CHILDREN" Boys Girls Weight Height Age Weight Height pounds inches pounds inches 7y 2 20^ Birth 7% 20^ 16/ 2Sy 2 6 months 15/ 25 21/ 29 12 21 28 24/ 30^ 18 24 30 27y 2 32^ 2 years 27 32^ 32 36 3 * " 31 35% 36 38^ 4 " 35 38 41 4\y 2 5 " 39^ 41% 45 44 6 " 43% 43^2 49M 46 7 " 47y? 45% jy 48% . & " -Jl? 48 49% 9 " 57 49^ 65/ 52 10 " 63y 2 51^ 72 54 11 " 69y 2 53^ 79 55*/2 12 " 81 57 88 58 " 13 " 91 58^ 99 60/ 14 " 100 60 110 62% 15 " 108 6iy> 123 65 16 " 113' 6f% In using the table it is to be remembered that the figures represent average weights and heights of several thousand public school chil- a. The figures for the first five years are weights without clothes, and are derived from Dr. Emmett Holt's book "Diseases of Infancy and Childhood". The figures for height and weight of children from five to sixteen years are based on observations made by Bowditch upon several thousand school children of Boston; these weights include ordinary clothing. FOOD FOR BODY BUILDING 21 dren living- under all sorts of conditions in a large city. There are many children from five to sixteen years of age having proper food and wise care, who weigh from one to four or five pounds more than these figures indicate. In- crease in weight and height varies a great deal in different children, depending upon heredity, conditions surrounding the mother before the child is born, and the care and kind of food the child receives after birth and throughout child- hood. Lack of carefully chosen, body-building food during these foundation years will surely result in a weakened constitution, and be a handicap to children during the school years and later adult life. It is highly important, then, that parents should know something about food values in relation to body-building, and that they should carefully consider what foods are suitable for children at different ages. Parental love is deep and abiding, but not always wise in its expression. Love for chil- dren fulfils its highest office in earnest endeavor to do only what is best for them, in order that they may grow and thrive, and develop into healthy, robust children. Nor should these matters be entirely turned over to the mother. Much has been said and written about mother love, and the importance of good mothering, and this is as it should be, for who can measure the tremendous impor- 22 THE CHILD FROM TWO TO SEVEN tance of the mother's care and influence, but something should also be said in regard to the importance of thoughtful and intelligent father- hood. The job of being a good father is worthy the best thought and study of every man. So it would seem to be important that the father as well as the mother should know some- thing about what is proper food for his chil- dren. Many fathers do know. Mistakes are not usually made because of not knowing what is right or from lack of affection, but from preoccupation with other matters, and the feel- ing that the care and training of children is the mother's work. No greater mistake can be. made. It is a man's job as well as a wo- man's, and if the father does not attend to his part of it, the children will later on in life show that lack of broad training which marks the well bred child. TRAINING CHILDREN IN FUNDAMENTALS There- are certain fundamental principles in regardto the feeding of children which deserve careful consideration. First, it is not so im- portant what children like or dislike in the way of food/ as it is that the food is suitable for the age and digestive powers, that it is nourish- ing, well cooked and given at regular times. Children have not the same powers of diges- tion as adults any more than they have the same ability to think and judge as adults. They FOOD FOR BODY BUILDING 23 cannot eat everything on the table; children know nothing about the body-building qualities of food; they are guided solely by their desires, which are capricious and changeable; their judgment is undeveloped, and they are unable to choose wisely. Therefore, parents should know the value of different foods, and should choose for the children foods which will build blood, bone and muscle. Children should not be asked what they want to eat. The best way is to place before them with6ut comment simple, nourishing food at regular times, keeping des- sert or fruit out of sight until the plate is cleaned of hearty food. Second, children cannot be expected to be hungry at mealtimes if they have been indulged in sweets, soda, ice-cream, fruit and other food between meals. A very common mistake when children refuse to eat their regular food is to urge them to eat, or to tempt them with spe- cially prepared food which they are unable to digest. This is bad practice, as children will acquire a taste for such dainties, and lose appe- tite for simple, wholesome food. Nor should anything be given between meals except water when the regular food is refused at mealtime. Healthy children who have plenty of sleep and outdoor air, and are not allowed to eat between meals, are usually sufficiently hungry to eat any wholesome food placed be- fore them. If such food is refused it is best 24 THE CHILD FROM TWO TO SEVEN not to give anything until the next meal, when the healthy appetite will assert itself. It is vitally important that children should learn from earliest childhood to eat whatever is placed before them of the staple, wholesome foods. Children will not only be more robust and sturdy, but both they and their parents will be saved much future trouble and humiliation. Acute and chronic indigestion with conse- quent loss of weight and weakness, are almost certain to follow faulty feeding. The best way is to give only the regular diet suitable for the age. If the child is not allowed to taste food improper for its age, it will not learn to ask for it. It is also essential and part of a child's train- ing, that it should eat only at regular meal- times. Food of any kind, or fruit and candy given between meals becomes a burden to the stomach, destroys the appetite, causes serious indigestion and loss of weight. The stomach needs the time between meals to digest the food and rest before the next meal. Children are apt to spend pennies for cakes, doughnuts, candies and pickles; these are eaten between meals and destroy the appetite for nourishing food offered at the regular meals. Just how long children will appear well under these conditions will depend upon the care they receive in other respects, but sooner or later digestion becomes impaired, children have bad dreams, lose much sleep, and become thin and FOOD FOR BODY BUILDING 25 pale. It is such children who develop the un- healthy condition of the bowels favoring the production of intestinal parasites or worms, suffer from weakness of the bladder, and be- cause of their run down condition, become sus- ceptible to colds and the contagious diseases. When children commence to have meals at the table with parents, some training in proper habits of eating will be necessary. Children do not naturally chew their food thoroughly, and unless taught otherwise, are apt to form the habit of bolting half chewed food with milk or water. A very common cause of underweight in children is that they frequently hurry away from the table to play or to school without taking time to eat properly or to eat enough. This is especially true in regard to little girls who frequently refuse to eat any breakfast. Such habits are very apt to continue into the school years with the result that children suffer from underweight, nervous irritability and weakness. Their progress in school is also re- tarded. During these early years when so much en- ergy is expended in constant physical activity and rapid growth, children should not be al- lowed to go to school or leave the table for play without eating their breakfast any more than a man should start his day's work on an empty, stomach. 26 THE CHILD FROM TWO TO SEVEN The first thing to do then is to be sure that all rules of right living are being followed. There should be no eating between meals; this means no fruit, candy, bread, milk nothing should be allowed between meals except plenty of water. On the other hand, if the condition is reversed, and the child is hungry and eats well at every meal and wants a glass of milk about 3.00 or 4.00 P. M., there can be no objec- tion to such addition to the diet. Children must have plenty of fresh air; lack- ing this, both in and out of doors, is a very common cause of lack of appetite. They must also have plenty of sleep; from twelve to four- teen hours at night and an hour or two during the day is about right. If such rules are carefully followed most healthy children will be ready for each of the three meals. If in addition to careful regula- tion of habits, a few words of explanation is given at some suitable moment as to why breakfast should be eaten before starting for play or school, the meal will frequently be eaten without protest. With some such training as here outlined children will learn what is wholesome and nutritious, and will gradually develop a liking for simple, substantial food which will remain with them all their lives. On the other hand, unless some gentle firmness is brought to bear in these matters, children are apt to acquire FOOD FOR BODY BUILDING 27, likes and dislikes in regard to food, and irregu- lar habits of living which will not only become a source of much annoyance, but will also result in under nourished and weak bodies later in life. f It must, also be remembered that this early~~home training in the fundamentals of right living is the foundation of the child's edu- cation, and no amount of later training can make up for any lack of it during these early yearsN FOOD FOR GROWING CHILDREN It has been proven that human beings thrive best on a mixed diet of animal and vegetable foods because from such a diet is obtained the materials needed by the body for growth and repair. A carefully chosen diet is one which supplies all these materials in right proportion in order that the growing child will lack none of the essential food substances. Before giving diet lists and schedules for feeding children at differ- ent ages during the pre-school period, it will be well to consider some of the most important foods for growing children. MILK First and foremost must be mentioned milk. No food can take the place of milk in the feeding of children. When parents commence 28 THE CHILD FROM TWO TO SEVEN to dilute milk with cocoa, tea and coffee they are depriving the children of the best body- building food, and feeding them chaff. To be sure, cocoa is a valuable food, and is not to be compared with tea and coffee, which have no food value, and should under no circum- stances be given to children, but cocoa can never take the place of milk as a body-builder. Milk is the most perfect food for children. No one food contains to such a degree all the elements needed for the growing body. Every child needs a pint and a half to a quart of pure, clean milk every day in the year. A greater part of this is usually given a glassful at meals or served with cereals. Milk is often classed with water, tea or coffee as a beverage by those who do not understand its food value. This is a serious mistake, and one which frequently causes trouble; milk is often used as a beverage between meals and causes indigestion and constipation. Usually it should be given only at mealtimes, the one exception being when a glass of milk is given once between breakfast and dinner or dinner and supper, when the child is really hungry. Some children especially fond of milk will drink a whole glass of milk at once at the beginning of the meal and then refuse to take sufficient other food. It is best for them to take it a sip at a time, or near the end of the meal. FOOD FOR BODY BUILDING 29 Cow's milk should not only be pure, but the fresher it is, and the less handling it has con- sistent with cleanliness and keeping 1 it, the better. Fresh, clean, raw or unheated milk is an ideal food for children, but if there is the slightest doubt about its freshness and cleanli- ness, it should be pasteurized. In the large cities where the milk has been transported long dis- tances, ordinary raw milk is unsafe. It is pos- sible, however, to buy safe, unheated milk, and whenever it is available it should be given to children. When safe raw milk is not obtainable pas- teurized milk should be used. Milk is pasteur- ized when heated to 155 F. for thirty minutes. This process destroys 99 per cent of the bac- teria or germs in milk, and delays its souring. Milk thus heated is not sterile, and will not keep unless quickly chilled and kept chilled until used; it should be used within 36 hours after pasteurization. Goat's milk is excellent for children when obtainable. If good raw or pasteurized milk cannot be obtained, fresh evaporated or dried milk may be used, but such milks do not con- tain the growth promoting elements as do fresh cow's milk, and other foods like fresh eggs, animal broths, green vegetables, and fresh fruit like the orange, must be added to the diet, in order that children shall not suffer from lack of proper nourishment. 30 THE CHILD FROM TWO TO SEVEN CEREALS Cereals are useful foods for children if prop- erly cooked and not used in excess, or to the exclusion of other necessary food. The dry or ready to serve cereals are not as valuable as those cooked at home. Because a child is fond of cereal it should not constitute the whole meal. The coarse cereals are to be preferred for children who are constipated. Oatmeal when thoroughly cooked is the best, but it is well to have two or three kinds on hand for variety. Cereals should be served with very little sugar. If too much sugar is used children are apt to eat too much, and too little of other needed food. Cereals should be well salted, and not over a small teaspoon of sugar served with a saucer of cereal. Cereals are very frequently insufficiently cooked; they should be cooked much longer than is usually stated on the packages. Most of the grains, such as oatmeal, rice, cornmeal, hominy and wheaten grits, require at least three hours cooking in a double boiler. Wheat- ina, cream of wheat and farina should be cooked at least one hour. The fireless cooker provides an excellent means of cooking cereals, especially oatmeal, hominy and rice, which require long cooking. Cooked in this way the grains retain more of their flavor and are softer. FOOD FOR BODY BUILDING 31 EGGS Eggs are especially valuable as a food for children. They must be fresh and only slightly cooked. They are best served soft boiled, poached or coddled, though they may be scram- bled with milk for older children if not over- cooked. Fried eggs should not be given to children. Eggs seldom cause indigestion or biliousness if cooked in the ways here men- tioned, and there are very few children who cannot eat them. Certainly parents should consider most carefully before depriving chil- dren of such a nutritious food. Children often acquire food dislikes from observation of other people; they learn by imi- tation; if they do not hear anybody mention a dislike for eggs or milk, or any other whole- some food, they will usually eat whatever is placed before them without question. BREAD, CRACKERS AND CAKES Well baked bread and thoroughly cooked cereals with milk should make up a large part of the diet of children. As children are apt to swallow bread without much chewing, bread two to three days old is to be preferred to that just from the oven. Cut thin and dried crisp in the oven, children will learn to chew it, and when soaked in milk is less apt to cause indigestion than new bread. Unsweetened zweiback is also useful. 32 THE CHILD FROM TWO TO SEVEN It is a mistake to give children white flour bread only. Oatmeal, graham, whole wheat and cornmeal flours may be used in varying quantities to make delicious breads which not only offer some variety in the diet, but also assist in regulating the bowels, and provide the body with certain needed material. Oatmeal and graham crackers are useful in feeding children, but should be given only at mealtimes. Buckwheat and other griddle-cakes, hot breads or fresh sweet cakes should not be given to children until they reach the age of eight or nine years. Spongecake two days old and plain cookies may be given at the evening meal occasionally. BUTTER, CREAM AND OTHER FATS Butter, or milk fat, and cream, which is rich in milk fat and other nutritious substances of milk, are both valuable foods. There is at least two and one-half tablespoonfuls of fat in a quart of good milk. If a healthy child is given a quart of milk per day, has butter on bread, and a small portion of meat or an egg once a day, this is sufficient fat and in whole- some form. Therefore, it is not best to give other fatty foods such as pastry, doughnuts or rich cakes, fried meats and vegetables, for in these the fat is not in suitable form for chil- dren. It is best not to give butter to children during the first two years, but commencing with the FOOD FOR BODY BUILDING 33 third year it may be used in small amount until children become accustomed to its use. Cream should be used with some care, espe- cially with young children. An ounce of thin cream may be used on cereal, but good milk serves as well, except occasionally when a child is constipated, a small amount may be useful. It should be remembered, however, that too much fat may cause constipation, as shown by dry and putty-colored stools. BROTHS AND SOUPS Beef or chicken broth may be given to young children. Most plain broths are allowable, and are made more nutritious by thickening with rice and barley. Vegetable purees of spinach, potato or celery made with milk are useful after three years of age, and those containing peas and beans are valuable additions to the diet after five years. It is best to withhold tomato soup until chil- dren are older. MEAT AND FISH Children of two years and over need some meat, at least every other day, and the days when no meat is given an egg should be given instead. If for any reason meat is omitted from the child's diet, special care must be taken to provide some other protein food to take its place, preferably an extra amount of milk or eggs. 34 THE CHILD FROM TWO TO SEVEN The best meats for young children are beef- steak, lamb chop, roast lamb, roast beef, chick- en, and certain fish, such as sole, shad, bass and butter fish. When children reach the age of five or six years, a small quantity of breakfast bacon may be allowed. Broiling and roasting are the best methods of preparing tender meats for children. The tougher cuts of meats should be stewed or pre- pared in a fireless cooker, or first chopped and then broiled. Most meats should be rare, and either scraped, chopped or ground fine, as chil- dren will not chew food thoroughly. Fried or cold meats require much chewing, and should not be given to children. Every effort should be made, however, to teach children to chew their food. A tablespoonful of any one of these meats may be given once a day, or every other day, at the mid-day meal. MEAT STEWS Stews made from meats and vegetables offer a large variety of appetizing dishes, and have the advantage of being economical as well as nourishing. The lower priced cuts may be used provided they are made tender by long, slow cooking. Potatoes and carrots may be cut in small pieces and added to stews, and rice, barley, macaroni, and crusts of stale bread or toast may be used for variety. FOOD FOR BODY BUILDING 35 MEATS NOT ALLOWED Ham, pork, sausage, kidney, liver, game and all dried or salt meats; also mackerel and halibut are best withheld until children are ten years of age. Thickened, rich gravies are not digested easily, and only* a very small' quantity should be given children. The fresh, red beef juice, however, from a roast is nutritious and bene- ficial; several teaspoonfuls of this may be added to the meat and potato on a child's plate. VEGETABLES if Vegetables are an important but often a neglected part of a child's diet. They supply iron, lime and other mineral matter having blood enriching and bone building qualities. They should be served at least once a day as they tend to prevent constipation. To accus- tom the child to unfamiliar vegetables they may be used for flavoring broths and stews. White potatoes are used every day, but should not be given in excess. Some children like potatoes so well that they eat a whole plateful, and leave other needed food. Potatoes should be thoroughly cooked by baking or boiling. Of the green vegetables the best are spinach, asparagus tips, peas, string beans, young lima beans well mashed, stewed carrots, young beets, celery and squash. Baked sweet potato, cauli- 36 THE CHILD FROM TWO TO SEVEN flour and boiled onions may be given in mod- erate amount after the sixth year. The young and tender parts of lettuce and celery are allow- able; they should be slightly salted and the celery cut into fine bits. A satisfactory way of serving these is in sandwiches, the bread and vegetable being chewed together. All vegetables, whether served raw or cooked, should be washed with much care, potatoes, carrots and parsnips being scrubbed with a brush. Greens should be washed leaf by leaf in running water whenever possible. COOKING VEGETABLES Most vegetables should be either steamed, baked, boiled or stewed. Green vegetables should be cooked until tender. Spinach needs to be cooked twenty to thirty minutes, prefer- ably steamed, as it loses much less of its valu- able qualities than when boiled. It is almost impossible to cook vegetables too much for children. Simple methods of preparing vegetables are preferable to the more complicated frying or scalloping. For the smallest children vegetables like greens should be finely chopped, and if the skins of green peas or lima beans are found to disagree, they can be put through a sieve. When first given to children the amount of vegetable should not be over two tablespoon-^ fuls. n . FOOD FOR BODY BUILDING 37 Radishes, onions, cucumbers or tomatoes should not be given to children, and corn, old beets, cabbage or egg plant should not be al- lowed until the child has passed the ninth year. Vegetables in salads are more difficult to digest, and are best withheld from young children. FRUITS Fruits are an exceedingly valuable part of the child's diet. They are particularly useful for their laxative qualities; they also supply mild acids and mineral elements required by the body. It is important that fruits should be selected and used with some care, especially in cities. Up to five years of age usually only the juices of fresh fruits and the pulp of cooked fruits should be used. The juice from sweet oranges is best, but the juice from fresh grape- fruit, peaches, strawberries and raspberries, may also be used, care being taken to strain away all seeds. Of the cooked fruits stewed or baked apples, prunes, peaches and apricots are the best. After the fifth year the soft pulp of the orange or grapefruit may be given at mealtime, and by the seventh year a small amount of apple or banana may be given with the meal. No fruits should be allowed between meals. Special care should be taken in the selection of fruit for children during hot weather, and I ;.} ii' The coming of a little child into the world is the greatest of all mysteries, and the most awe-inspiring of miracles. What is to be the destiny of the young spirit, mysterious and new, which thus makes its advent into the home? Here are infinite possibilities for good or for evil, and the parents are the arbiters of the child's future welfare. No governess, no tutor, no school, can foster and nurture the child spirit so understandingly and sympathetically as the parents. These early years, the foundation years, may well be spent in the home and out of doors, under the guidance of the mother and father. To them is given the greatest and most sacred of all teaching opportunities. As parents we must acknowledge that we have learned all too slowly that our children 87 88 THE CHILD FROM TWO TO SEVEN cannot be robust and sturdy unless we give them all the benefits of proper food, plenty of sleep, and outdoor air. We have much more to learn about the nature of the child, the mean- ing of various child activities, and how best to direct these activities in order to develop all that is good and true and beautiful in our children. Love for our children is planted deep in our natures. We can hardly love them too much if we love them wisely, and if underneath this love is a solid foundation of common sense. This instinctive love which so takes possession of our lives is Nature's way of assuring care and protection to little children. Although it may help us to be patient in trying situations, it may, on the other hand, make us over-in- dulgent and lax in matters of training. Par- ental love is not all-sufficient. The sacred office of parent means more than to be mere pro- viders of physical necessities; it is a teaching office having boundless possibilities; we make or mar the men or women of the future. To make the most of our children, and thus do our part in the building of men and wo- men, it is for us to add to our equipment as parents a knowledge of child nature, and the meaning of child activities. It is a subject ab- sorbingly interesting and intensely illuminating; it leads to a better understanding of the child's point of view, and makes clear many perplexing problems which are constantly arising in the TRAINING AND EDUCATION 89 training of children. It is safe to say that such study would tend to prevent many misunder- standings between parents and children. If there is any one fundamental principle in child training that is more important than any other, it is that such training should commence in infancy. Good or bad habits are being formed during the first twelve months of a child's life, and it is as easy to learn good habits as it is to acquire bad ones. To super- vise the daily living of the young infant in such a way that only good habits may be formed becomes the parent's task. Some definite or- derly plan in the daily care of the young infant is not only essential to healthy development of body and mind, but lays the foundations for later training. The child who has been trained from birth to have food, sleep, and outings at regular times has already learned something of the habit of regularity. As children grow older their ac- tivities increase, hereditary traits appear, and to the simple routine of infancy is added the necessity of providing space and opportunity for their developing energies and interests. The constant care of a healthy growing child is by no means a small matter, and if there are two or three in the family, some attention will need to be given to the matter of conserving the mother's strength. Constant, excessive fatigue on the part of the mother must in- 90 THE CHILD FROM TWO TO SEVEN evitably bring disaster to the family. Her's is the greatest of all tasks; to it she must bring abundant stores of strength. Overstrain must be prevented by suitable food, plenty of sleep, some variety of scene and recreation. The mother needs to get out of doors as well as the children, and she will benefit largely if she will share their outings as often as possible. Brief rest periods of complete relaxation on a couch once or twice during the forenoon and a longer rest in the afternoon, will do much to prevent over-fatigue, and to maintain a cheer- ful, hopeful outlook on life. CHARACTERISTICS OF THE CHILD NATURE As children come up out of infancy and be- come conscious of themselves and of other people, we are met at the outset by certain inborn traits. If we will but recognize and endeavor to undertsand these natural charac- teristics we shall find the task of guiding our children much more simple, for they lie back of, and to a large degree control, the conduct of all children. First, there is the native independence with which every healthy young American is en- dowed; then, the changeableness so common to all children; next, is slowness of perception; and finally, there must be considered the matter of individual temperament, which influences and gives color to all other characteristics. TRAINING AND EDUCATION 91 Confronted with some difficulty children im- mediately resist the obstacle which thwarts their purpose. In their play we like to see them persist until they overcome obstacles which prevent the carrying out of their constructive ideas, but when they come up against us as the obstacle, we are often-times indignant, and apt to object to such resistance. At such times it will help us if we will re- member that we are dealing with an untrained mind; the reasoning powers are developed but little; the child is controlled by impulse, and desire is the primitive instinct. Judgment is only attained by experience, and little children are lacking in experience. Children do not understand why we object to certain actions. They have yet to learn the full meaning of parental authority. Their natural instinct is to overcome a difficulty, and their native independence leads them to blaze their own trail; hence, we need not be surprised if at times they refuse to be guided by our experience and direction. It will not be strange, and parents need not be disheartened if at times active, high-spirited children, full of eager curiosity, have sudden, violent attacks of temper. Such outbursts are especially liable to occur unless children are provided with some outlet for their super- abundant energy. They need plenty of room and materials for suitable occupation and play. 92 THE CHILD FROM TWO TO SEVEN The high spirits and curiosity are valuable in- born qualities if diverted into proper channels. Children are frequently described by parents as rebellious, sullen, ugly, stubborn, and even stupid. We must look back of the fits of temper and rebellion, and endeavor to find the reason why the child is thus expressing him- self. Very often there is a legitimate cause for the upset. The child may have eaten im- proper food, and the ugly fit of temper may be the result of indigestion; or unusual excite- ment the day before, such as a party or enter- tainment, may be the cause of tired nerves and consequent irritability. It is frequently our inability to understand children that brings about circumstances which demand discipline. Children cannot be quite natural when conscious that they are under continuous observation, however friendly such supervision may be. They need opportunity for self-expression. This does not mean that they are to be allowed to do as they please at all times, but that while occupied with play or work, it is best not to hedge them about with unnecessary restrictions. Whatever may be the cause of irritability or loss of temper, it is of the utmost importance that as parents we maintain our own poise, and with gentle firmness and patience, endeavor to understand the child nature. To guide the chil- dren with sympathy and understanding is our TRAINING AND EDUCATION 93 high privilege, giving them the benefit of our experience and judgment, but always allowing the child nature ample freedom of expression, in order that it may grow and blossom and un- fold itself naturally and without hindrance. CHANGEABLENESS One of the most apparent characteristics of the child nature is the element of changeable- ness. Who has not been impressed and even amused by the constant changes which occur in children from day to day? Their progress in development is marked by many phases, mental and physical. They assume various gro- tesque expressions and attitudes without neces- sarily being in any sense abnormal. Such man- nerisms are but the temporary expression of an unstable and undeveloped mind and body, and very frequently disappear while parents are considering the best course to pursue. It is also true that much of this grotesque activity of children represents an effort to imi- tate the odd sights and sounds in the everyday world about them. Whatever attention we give to these oddities should be unobtrusive, and they are seldom to be regarded as real faults. Nor do they demand stern measures which would rather tend to give them undue importance, and to make them worse. Our best course will be to ignore them as much as 94 THE CHILD FROM TWO TO SEVEN possible, and provide suitable materials for wholesome play activities. SLOWNESS OF PERCEPTION Another characteristic of the child nature is what might be called slowness of perception. That this is natural to an untrained mind would seem to be apparent to all, yet, oftentimes fathers and mothers forget this fact, and ex- pect the child mind to comprehend at once, and demand instant obedience. It is not strange that sometimes the young child instinctively prefers to do that with which it is already familiar, or acts slowly in doing something new and unfamiliar. It is something of the same quality inherent in us all the instinctive desire to understand before we attempt to do. If we are patient and reasonable in our de- mands, and extend to our children the same courtesy which we ask for ourselves, we shall have much less cause for discipline. INDIVIDUAL TEMPERAMENT In all our relations with children it should be borne in mind that no two children are alike in temperament, and therefore, cannot be guid- ed in the same way. It is essential that we study the temperament of each child, and adapt our methods to his special need. It should fur- ther be considered that it is difficult to estimate just how much the moods and actions of chil- TRAINING AND EDUCATION 95 dren are dependent upon inherited tendencies. For this reason we should be ever patient in dealing with our children, always keeping in mind that such tendencies can to a large ex- tent be overcome by proper environment and wise training. OBEDIENCE AND SELF-CONTROL The natural inclination of the undeveloped child nature is to do that which is most attrac- tive at the present moment. Left alone out of doors with a vista of green fields dotted with daisies and buttercups to attract, a child is apt to wander out of sight and hearing; in the house a box of matches may arouse curiosity and investigation, leading to serious disaster; and at the dinner-table, if meat, vegetables, and dessert are placed near at hand, the child is very apt to eat the dessert first, and leave the hearty food. The eager young investigator is constantly on the alert to test and feel of objects in the world about him. Without guidance injury may come to body and soul ; he must learn how far he may safely stray from the home door: what may or may not be handled; and how to conduct himself at table. Patiently and persist- ently he must be taught the difference between right and wrong, and wholesome respect for wise leadership. Thus does the child come to 96 THE CHILD FROM TWO TO SEVEN arn the great lessons of obedience and self- control. The child who is allowed to grow up with- out such training, who has not been taught to respect the rights of others nor the meaning of authority, who is allowed to eat all sorts of unsuitable food at all sorts of hours, and to have his own way because he makes so much disturbance, is an exceedingly disagreeable ob- ject, and a reproach to his parents. Further- more, not having learned self-control, self-de- nial, and respect for authority, such a child is bound to be at a disadvantage later in life for lack of that poise and stability of character, which mark the well rounded man or woman. Although the task of guiding our children may at times seem beset with difficulty because of their inborn desire to make and follow their own way, we should have on the other hand as valuable aids, their affection, their respect and confidence. If they love, admire and trust us, they will the more readily follow our lead- ership. Unless repelled, they give us their love in full measure; we have but to hold it fast; we cannot hold their love and respect by mere gifts and free indulgence. Our aim should be to show them by simple explanation and illustra- tion the difference between right and wrong, and why an- act is wrong; to give them our sympathetic understanding, not indulgence; to TRAINING AND EDUCATION 97 share their interests, and to allow them to share our interests as far as may be. The old ideas of repression and suppression in the training of children are passing away. We want our children to be able to respect us, and to come to us for counsel; we want them to come to us feeling that we are their best friends, not because of any compulsion or fear. May they ever find us ready and sympathetic, and always worthy of their confidence. Having their love, respect and confidence we can do much for them, but there are also other factors which will help us in obtaining obed- ience. Children naturally like praise, which is only another word for appreciation, and we all like to have our efforts appreciated. They also like to do things the right way, and to see them come out right. They are readily interested and pleased; everything is new to them, and they are inexperienced and uncritical. If we are patient, and watch for the opportune mo- ment, we can very often lead them to a bet- ter understanding, and compliance with our wishes. As parents we must not expect too much of our little folks. The world about them is so full of objects and sounds to which they must become accustomed, and which they must learn to comprehend, that we must always be patient with them. They need time for perception and adjustment. 98 THE CHILD FROM TWO TO SEVEN It is well to remember, too, that we ourselves are much like the children, only larger and somewhat more experienced. With all our mature judgment and experience, we are con- tinually making blunders. We also like to have our own way, and are subject to changes of mood and disposition. In our relations with older people we recognize our own imperfec- tions, and endeavor to be at our best, but we are too apt to consider ourselves apart from the little folks, and forget that we owe them even greater courtesy and consideration be- cause of their inexperience. Thus do we need to recognize our own frailties and hold our- selves well in hand if we are to make the most of our children. Living with them day by day, we unconsciously shape and mold their char- acters by our own actions and words. They are watching us all the time, and learn more by imitation than by admonition. They have a right to expect much from us. If they are to learn self-control, respect for authority, and consideration for the rights of other people, it is essential that they should at all times see these qualities exemplified in the lives of those about them. The more we can teach by ex- ample, the less occasion will there be for com- mand or punishment. As children grow out of infancy and awake to a consciousness of self, they commence to express themselves in acts and words which TRAINING AND EDUCATION 99 constitute behavior. To these acts and words we older people apply certain names. If the child acts contrary to our instructions we call it disobedience; or if he misrepresents some- thing we call it untruthfulness. Children are not born obedient or truthful; nor are they born disobedient or untruthful; but they are born with certain possibilities and tendencies. Some children seem to have an inborn sense of right; they need guidance in order to become adjusted to the world about them, but they have little difficulty in learning to obey, to be polite, and to tell the truth. Gentle manners seem natural to them, and the other good qualities seem to follow easily. There are other children unfortunately who have just the opposite tendencies, who are han- dicapped at the very beginning of life, and who are always in trouble. We may feel, however, that the great majority of children fall in neith- er of these classes, but are just healthy, natural little folk in the making, with unlimited pos- sibilities for good, their standards of behavior yet to be formed. Training in obedience and self-control must of necessity be gradual; the power to reason and understand is undeveloped, and naturally there will be lapses into disobedience and mis- behavior of different sorts. We cannot, how- ever, be too careful about judging our children to be disobedient or untruthful. There is a 100 THE CHILD FROM TWO TO SEVEN difference between willful disobedience and dis- obedience which results from lack of percep- tion or lack of understanding. In the beginning of their experience children frequently do things which seem disobedient to parents, and misuse words, simply because they have not learned the full significance of certain acts, or the correct meaning of words. It is our part to appreciate their difficulties in adjusting themselves to the world, and by ex- planation and interpretation, to simplify this adjustment as much as may be. It is seldom wise to exact instant obedience to new or unfamiliar demands; to do so is to invite disobedience or deceitfulness. Except in ordinary, familiar matters, time must be al- lowed for comprehension and adjustment. Children differ markedly in perception; some minds are slow, some very quick, but we must not expect instant comprehension. On the other hand, certain occasions may arise when prompt obedience is necessary in order to protect the child from mental or phys- ical injury, to protect the rights of other people, and to develop the will power and judgment of the child. Sooner or later our children must learn that they will frequently be obliged to give up their own way; hence, the habit of cheerful obed- ience should be acquired during these early years, in order that they may learn to yield TRAINING AND EDUCATION 101 gracefully and courteously when occasion re- quires. With the exception of certain emer- gencies, when to wait would bring disaster, there is usually time before obedience is ex- pected for a few quiet words of explanation to make clear to the childish comprehension the reason for prompt obedience. This is only treating our children as we would wish to be treated ourselves. Adults are seldom if ever expected to change their plan of action without knowing the reasons therefor, and are apt to object even when obliged to change for good reason. There are people, however, who think that children should obey cheerfully without question. Some care should be taken to choose the most suitable time to explain matters, or to appeal to a child's reason. Obviously this should not be attempted during moments of rebellion when ill-temper is rife. It is when calmness and good-nature is restored that we should try by simple explanation to make clear to the child the reasons why one way is better than an- other. Frequently an apt illustration or a time- ly story will open the way for more complete understanding. It is best not to argue with a child. Argu- ment is useless as a means of enlightening the way of a little child, and more often leads to misunderstanding between parent and child. Oftentimes, after a few kindly words of ex- 102 THE CHILD FROM TWO TO SEVEN planation as to why we disapprove, silence will serve our purpose better than words, and if we quietly leave the child alone, he will frequently find his own mistake, and later show us that he understands. OVERUSE OF THE WORD "DON'T" Probably most parents of young children will admit that they overuse the word "Don't", and that they often use the word unnecessarily. Its use becomes such a habit that we forget there are other words which will bring about obed- ience even more quickly and more willingly. If every small misadventure is punctuated with the word "Don't", the day will become a con- stant series of "Don'ts", for it is inevitable that there will be many such minor mistakes during childhood. Children hear the word so frequent- ly that they give little heed to it, and learn little of the real meaning of obedience. As parents, then, we may well practice a certain amount of judicious letting alone, and ignore some of the more unimportant deviations from what we might consider absolutely correct. In our efforts to steer our little folks into the right path, if we would more often say "Keep to the right," "Lift up your feet" in- stead of so frequently using the word "Don't", obedience would come more readily and cheer- fully. TRAINING AND EDUCATION 103 AS TO THE USE OF BRIBES AND REWARDS One of the most serious mistakes made in the training of children is to bribe or reward in order to secure obedience. Once commenced, the demands of children are apt to become more and more insistent, and they become like so many little tyrants. Our purpose should be to appeal to only what is best in our children, to show them the right way, and expect them to do right because it is right. To do other- wise, is to appeal to the lower side of their nature, and must inevitably weaken their moral sense. The more we can take children into our confidence, and make clear and luminous the way of right and truth, the less need will there be for bribes and rewards. PUNISHMENT The more we can appeal to the child's reason, the less occasion will there be for punishment. Eventually children must learn to govern the body by the will, and normal, healthy children prefer to control their own actions. It should be our purpose to lead rather than force, to influence the child's mind rather than the body. It is well to make clear and definite to the child's understanding the meaning of punish- ment, and that wrong-doing is usually followed by unpleasant results. Children may be told 104 THE CHILD FROM TWO TO SEVEN that touching a hot surface or fire will burn and cause pain; or that if they stray from the home yard they may become lost, be without food, the protection of home, and the care of parents. Wrong-doing frequently brings its own punishment, and the lesson is thus suffi- ciently impressed upon the child's mind without further discipline, although we can often re- enforce the lesson by simple explanation. Parents will differ as to methods of punish- ment used, but there is common ground upon which all can stand. It should be used only with the one purpose in mind of helping the child to remember not to repeat a misdeed. If there is any other effective way to accom- plish this purpose, punishment should be avoid- ed. It should be used thoughtfully, only after careful consideration, and never when the par- ent is angry. A common mistake is to threaten some form of punishment and not carry it out. Such threats, often made on the impulse of the mo- ment, are frequently not consummated because in the press of other duties the parent forgets; or when the moment for actual punishment arrives the parent may feel that the threatened penalty is too severe, and relents. Children soon learn that the threats are never carried out, ignore them, and are very apt to lose that wholesome respect for parents, upon which real affection is founded. TRAINING AND EDUCATION 105 It is best not to threaten children with cer- tain penalties. Aside from the fact that the busy parent may forget to carry them out, chil- dren may consider that the pleasure is worth the cost of disobedience. We should make the fact perfectly clear that discomfort or depriva- tion will surely follow misbehavior or disobed- ience, but we should not make it possible for children to anticipate or weigh the possibilities of the exact kind of punishment. Nor should we put off an expected punish- ment until the following day. This is cruelty, especially to sensitive children. A new day is a glorious opportunity for joyous living and work well done. Let us not mar it by un- pleasant reminders of the doleful mishaps of yesterday. Loud or harsh tones arouse rebellion or anger in strong, independent children, and frighten and sear the spirit of sensitive children. In either case such treatment is not only useless, so far as helping children to do better is con- cerned, but very often does irremediable harm. Lack of control or loss of temper on the part of parents can but result in humiliation and defeat. A parent who is a despot in the household is not a pleasant or gracious influence in a home. His children may obey, but it is that sullen, rebellious obedience which is an out- growth of fear. Obedience is desirable, but 106 THE CHILD FROM TWO TO SEVEN children cannot be spanked or whipped or scold- ed into doing right. Such punishment is fre- quently used in moments of annoyance or anger; indeed, it is safe to say that if parents stopped to think there would be very little corporal punishment. Children cannot be expected to reason or think very deeply, but parents surely must be thoughtful and reasonable and hold themselves well in hand, if they are to teach their children obedience and self-control. Impetuous, ill-con- sidered treatment of children will never accom- plish the only legitimate purpose of all dis- cipline, namely, to make children realize some- thing of genuine regret for wrong action, and to inspire them with a fervent desire for im- provement. There are many parents whose children show excellent training, who have seldom if ever used strap or stick; there is a constant endeavor to make the home a place where a spirit of all for each and each for all abides; where there is an atmosphere of good cheer and wholesome enjoyment; and where high standards of con- duct for parents as well as children prevail. METHODS OF CORRECTION There are so many excellent methods of cor- recting misconduct that the use of harsher methods is usually unnecessary. For miscon- duct at the table, depriving the child of dessert may prove effective, or having the child sit at TRAINING AND EDUCATION 107 a small table alone for the remainder of the meal, will often teach better manners. For cross or saucy language, washing out the mouth with soap and water has helped some children to be more careful how they talk. Leaving the child alone in a room gives opportunity for reflection. Crying, screeching and kicking cease very quickly when there is nobody to notice; tense nerves relax, the body becomes quiet, and very often sleep will follow. On awaking the child usually greets us with sunny good nature, and seeks to make amends. One of the best ways to bring about a. better state of mind is to take it for granted that the child is not well, and put him to bed in a quiet room, alone and without play material of any kind. Inasmuch as many attacks of ill- temper are the result of tired nerves, sleep often comes quickly, and the child awakes re- freshed and happy. Most children dislike to go to bed, and the lesson is seldom forgotten. Sending children to bed earlier than usual after supper will frequently teach them to re- member not to repeat wrong-doing. Although we may limit supper to crackers and milk, it is not good practice to send children to bed with- out food of some sort. Nor should we allow them to go to sleep without the usual kindly explanation and "Good-night". Many excellent methods of training and dis- cipline are used by as many different parents. 108 THE CHILD FROM TWO TO SEVEN No matter how good the method it will not serve with all children, nor will it always serve with the same child. We must study our little folks, and treat each one individually. CHILDREN NEED PLENTY TO DO Idleness and mischief go hand in hand. The surest preventative of mischief is to provide plenty of occupation and play material suitable for the age. All normal children must be fully occupied with work for hand, eye and mind, for unless activities of the right kind are pro- vided, they will inevitably seek for and find the sort that brings disaster. As parents we need to remember that what we are apt to term "Mischief" is really the re- sult of a perfectly normal instinct on the part of children to look for something to do. We must also keep pace with the child's mind, which develops with exceeding rapidity. Nor- mal children rapidly outgrow their occupations as well as their 'clothes. As the mind develops, and they feel the force of new powers and ex- periences, they must be provided for anew. They are not to be treated the same way a month or two hence as they are today. They are advancing and must have new interests and tasks to help them develop creative power and judgment. Children w r ho are without occupa- tion, and who are wandering aimlessly about asking for something to do, have simply out- TRAINING AND EDUCATION 109 grown the occupations provided for them, or have not been taught the joy of creating new things. It is for parents to provide suitable material for constructive occupation, and to give them some insight into the use of material and tools for working out their own ideas. TEACH THE JOY OF WORK WELL DONE In all these play activities there is abundant opportunity to teach children the joy of work well done, and in the performance of their small duties about the house, it is well from the be- ginning to start them with a strong purpose to do well whatever they have to do. The world has no use for slipshod work; men and women are expected to do their work thor- oughly and completely; otherwise they fail, and fall behind in the race. Children are naturally heedless, but they also have an inborn desire for perfection. If then, we can teach them to be prompt and accurate, and to strive for perfection, even though they may often come short of the mark, we shall be giving them an ideal which will ultimately make them better citizens, and help them to serve mankind with greater power and effi- ciency. TRUTHFULNESS As our children gain steadily in habits of thoroughness and accuracy, they will naturally learn the importance and value of truth in 110 THE CHILD FROM TWO TO SEVEN thought and speech. To cultivate in our chil- dren the power to use simple, correct English in low, yet distinct and pleasing tones, is to add immeasurably to their charm of manner; but it also does more than this; children who learn to think and speak simply and accurately are not so apt to exaggerate or misrepresent the facts. Normal, healthy children growing up in a home atmosphere where there is at all times a high regard for the sacredness of truth, are usually truthful. They are quick to detect any evasion or misrepresentation of facts; hence, their questions should be answered with frank- ness and sincerity. There is always some way of representing the truth which is suitable for children, and if we are to have their full con- fidence and trust, we must make the truth stand out as clearly and distinctly as possible. The more accurate their ideas, the more clearly they can see their way. In this as in other matters pertaining to child culture, we need to remember that we are dealing with an untrained mind. Some- times children do not know they are telling an untruth. There are many words the mean- ing of which is not clear in their minds, and they may be telling the truth in so far as they understand words and facts. It is also true that children are not always clear in their dis- tinctions; they may confuse thought and real- TRAINING AND EDUCATION 111 ity; they speak as they think and believe, and the spoken idea becomes to them reality. Thus it is evident that we should give the little folks the benefit of the doubt, and be slow to show any lack of belief. In our search for the truth we need to exercise patience, gentle- ness and tact. Children have been frightened into telling an untruth by sharp questioning, impatience or indignation. Our aim should be to lead our children to a correct understanding of the difference between fact and fancy, and to show them that we are always ready to help them find the truth. EDUCATION The most valuable and important part of a child's education is acquired unconsciously at home and in the great out of doors, while the young mind is still free and unconfused by the multiplicity of school subjects. These first years of life afford the richest soil and the parent's greatest opportunity for building strong and deep the foundations of character. Children acquire knowledge not so much by precept or teaching as by observation and imi- tation; they copy the sights and sounds of the family life about them, and thus learn to ex- press themselves in words and actions. Throughout childhood they unconsciously imi- tate the language and manners of the older people with whom they come in contact. 112 THE CHILD FROM TWO TO SEVEN Taking these facts into consideration we can see where our responsibilities lead us. In so far as the children themselves are concerned, the nobler attributes of character are as easily ac- quired as the coarser and meaner qualities. If from birth children hear only language which is correct and pleasing, and are with people who are cheerful, kindly and thoughtful for the welfare of others, they invariably reflect these qualities in their own characters. On the other hand, children* who are obliged to live in a home where there is constant fault-finding, scolding and strife, are bound sooner or later to show such qualities in their behavior. When we see older children and men and women who have personal charm and gracious- ness of manner, we are too much inclined to regard this graciousness of manner as a rare and precious gift, but it is probably more fre- quently the result of careful training by thoughtful parents during the first six or eight years of life, in the two great qualities upon which personal charm depends, namely, un- selfishness, and thoughtfulness for the pleasure and comfort of others. Little children are discoverers and explorers setting out on the most wonderful of journeys in a world full of strange people and marvelous countries. They are in the morning of life; everything is new and fresh and mysterious. Fortunate indeed are we who have the privi- TRAINING AND EDUCATION 113 lege of faring forth as the companions of our children; of seeing with their eyes the glories of the fields, the flowers, the trees, and the marvels of the starry heavens; of listening with them to the songs of the birds, the joyous notes of all insect life; the sighing of the wind in the tree-tops, and the breaking of the surf on the sandy shore. As older comrades let us answer their eager questioning with an understanding sympathy which shall always bring them to our side in time of need. It is for us to explain and in- terpret to our children as best we may the meaning of all the sights and sounds of the great world. Simple as their questions may appear to our mature minds, we should meet them with patience and sincerity. Often the questions may not be so simple, and we may find ourselves surprised that some particular point had not occurred to us before. We shall learn as well as the children, and in their blessed companionship we shall see new radi- ance and loveliness in the beautiful things of earth. INSTRUCTION CONCERNING THE ORIGIN OF LIFE Many children ask questions concerning the origin of life before they reach the age of seven years. It is perfectly natural and normal that they should be curious in regard to the advent of the young stranger in home or neighborhood 114 THE CHILD FROM TWO TO SEVEN They are interested in everything that lives and changes and grows. As soon as children are old enough to won- der and ask questions, they are old enough to be told the more elemental truths in regard to sex and reproduction, and the parents should be the first teachers. Too often parents avoid this important duty, and when children ask the first question either silence them at once, or change the subject. Children are quick to de- tect evasion or deception, and soon learn that their parents do not wish to talk about these matters. Parents should not deceive themselves. Chil- dren must mingle with other children more and more as school life begins, and few children reach the age of ten without acquiring some sort of knowledge concerning the subject, how- ever crude it may be. It is much to be pre- ferred that they should be told the truth in clean language by parents who love them, than that their ideas should be corrupted by the coarse exaggeration and vulgarity of chance acquaintances. When children are repulsed by those nearest to them, and learn to hide their thoughts from their parents, there is built up between children and parents a dangerous reserve, and as they approach the critical years of adolescence, there will be lacking that complete confidence be- tween parents and children so sorely needed at this time. TRAINING AND EDUCATION 115 Children should be taught from the earliest years to bring all questions to mother and father, and should be made to feel that they will always be sure of a sympathetic hearing. Answers to questions should be so frank and straight-forward that not the slightest doubt will remain in the child's mind as to the par- ent's sincerity. We cannot keep our children innocent by keeping them ignorant. The best way to avoid morbid curiosity is to satisfy nor- mal curiosity. In talking with children it is best to present only the normal aspect of the subject. First impressions are always the strongest and deep- est; therefore, we should see to it that the earliest impressions are correct and of a high order. From the very first children should be made to feel the sacredness of parenthood. They will naturally think of it in this way if their ideas of sex and parenthood are not dis- torted by fanciful stories or evasive replies to questions. Let us teach our children that this great function is intimately related to the mental, moral and physical welfare of the race. The whole subject needs to be divested of the cloak of secretiveness and prudery; bring it out into the light of day, and thus dignify and ennoble it with the transparency of truth and whole- someness. 116 THE CHILD FROM TWO TO SEVEN When the child asks the first question con- cerning the new baby, the parent should give the real truth. We need not be experts to satisfy the normal curiosity of a little child. The simple truths given with frankness and sincerity in plain, simple language, are more easily comprehended by the child. It is best to give only one or two facts at one time, and children will probably ask about some of the fundamental truths several times before they fully understand. The answering of a question may take the form of a quiet talk, and should be unhurried and undisturbed, for we are build- ing foundations, and lasting impressions are be- ing made. In simple words, then, we may tell the chil- dren that the baby comes from the mother, that while it is little the mother keeps it in a warm, safe place right under her own heart. At first the baby is very little, so small that it must stay a long time where it is warm and safe. All this time while the baby is growing strong enough to live outside, the mother and father are thinking about it. The mother is making little clothes for it, and the father is working hard so that he can buy everything needed to make the mother and baby com- fortable. The father watches over the mother very carefully, for he does not want her to work too hard. When the baby has grown strong enough it leaves its warm nest, and the TRAINING AND EDUCATION 117 mother and father are glad to have the little one in their arms and care for it. It is entirely natural, and need not surprise parents, if children ask how the baby comes out, or how it is born, and why the doctor comes. It is much better for the parent to answer than for the information to be given by strangers, who may distort the facts, or be careless as to choice of words. No details con- cerning birth should be given, but the simple fact stated that there is a passageway which enlarges sufficiently to allow the baby to come out, and the doctor comes to see that the baby is born safely, and to tell the parents how to care for the little one. Just how much information should be given to children will depend upon their age, environ- ment and development. We must be guided by their questions, answering them frankly and simply as they occur. Certain children may never ask any questions; such children should be observed closely in order to circumvent any outside influences in this respect. During these first years when they are most easily guided into a clean and wholesome view of physical life, it is desirable to impress upon their minds the importance of personal clean- liness. The time of bathing and dressing offers an opportunity to mention to children that the sex organs should not be touched except to wash them, adding if necessary that any hand- 118 THE CHILD FROM TWO TO SEVEN ling of the parts interferes with good health and growth. Brevity is desirable in speaking about such matters, avoiding undue emphasis or any words which might arouse curiosity. We should also make it plain from the be- ginning that well-bred children never talk about these matters with other people, but only with their own father and mother, who can tell them more about what they want to know, and who will always be glad to answer questions; also, that it is better to ask about these matters when mother and father are alone, rather than in the presence of other people. As children grow older and enter school life, parents will need to observe closely in order to prevent the acquisition of spurious or un- wholesome knowledge. A little unobtrusive questioning occasionally will show whether they have been talking with people outside the home. The parent should correct any false im- pressions, and be sure that the children under- stand and know the truth. If the subject is approached with some care and thoughtfulness, it can be presented to 'chil- dren in an entirely wholesome manner, and- they may be impressed with the sacredness of home and family life, as well as by the love and de- votion of the mother and father, STEADY NERVES AND HEALTHY MIND "A sound mind in a sound body; if the former be the glory of the latter, the latter is indispensable to the former." Edwards. "To look up and not down; To look fortvard and not back; To look out and not in, and to lend a hand." Edward Everett Hale. CHAPTER VII STEADY NERVES AND HEALTHY MIND A group of merry children, sunny tempered, cheery and wholesome, robust of body, and healthy in mind, is a heartening sight, and makes the whole community a blithesome place in which to live. Fortunately for the world in general, there are many such children. On the other hand, there are far too many children of the other kind; little folks w r ho are thin and pale, silent and unsmiling, irritable or sullen; and others who are precocious and old beyond their years, and this is a sad and disheartening state of affairs. The first picture is the most beautiful sight in the world; the latter is the saddest. The fact is becoming more and more apparent that disorders of the nerves and mind are on the increase. Many of these disorders have their beginnings during the early years of child- hood, and we are rapidly coming to feel that there must be a large and important work done in the home during the first years of life to pre- vent the inception of these disorders. Conditions and happenings which seem trivial and unimportant very often form the basis of the nerve disorders of adult life. Most chil- dren are on certain occasions restless or peev- 122 THE CHILD FROM TWO TO SEVEN ish, and all children are more or less self-con- scious and timid, but when such symptoms become more constant and pronounced, we must scrutinize carefully our ways of living and home conditions for possible sources of irritation which may be causing nervous strain. There will always be a difference of opinion as to whether a child's heredity or environment has most to do with its future life and condi- tion. Perhaps we are too ready to ascribe cer- tain unpleasant traits to inheritance. We may be sure 'that both nature and nurture are of great importance. To what extent the child nature is influenced by the characteristics of parents and grandparents is impossible to esti- mate. We may assure ourselves that the stronger and nobler qualities are inherited as well as the weaker. Very many thoughtful people feel that with most children, coming from good average racial stocks, suitable sur- roundings and careful training will offset many undesirable inherited characteristics. Parents may well bear in mind the fact that during these early years the child's brain and nervous system are in an undeveloped, unstable condition, and should be carefully^ guarded against over stimulation; such care should com- mence in early infancy, and continue through- out childhood. During the first year of life children should simply sleep, eat and grow. They will usually NERVES AND MIND 123 sleep eighteen and often twenty hours out of the twenty-four during the first six months, and sixteen to eighteen hours of the day during the second six months of life. Aside from providing proper food at regular intervals, plenty of fresh air, and keeping them clean and dry, parents may well follow a policy of judi- cious letting alone, allowing the dawning in- telligence to unfold itself. No toys or other means of amusement are needed during the first half year, and even during the latter half, it is best to allow chil- dren to amuse themselves most of the time. Only a few very simple toys are needed. Young children become irritable and do not sleep well if constantly subjected to the excitement of play. Playing with infants at bedtime is a common cause of sleeplessness. Especially in- jurious is the practice of tossing them and catching them in the arms, or other violent exercise. Such amusement is bound to result in loss of sleep, indigestion and nervous irri- tability. After the first year, and all through the foundation years, the same careful planning of the child's life must be continued if we would have children with rosy cheeks, clear eyes, steady nerves and sunny dispositions. Factors of the most vital importance are a well bal- anced diet, abundance of sleep, plenty of fresh air, carefully supervised play activities and out- 124 THE CHILD FROM TWO TO SEVEN door exercise with other children. These are fundamental necessities in the healthy develop- ment of all children. Lacking any one of these fundamentals must ultimately prove detrimen- tal to the child's mental and moral well-being. One factor which stands out more and more clearly as a cause of stunting of body and mind is lack of proper food during these early years. The matter of nutrition and the train- ing of children in regard to the fundamentals of careful living has been so thoroughly con- sidered in Chapter III, that it is mentioned here only for re-emphasis. Probably the most common cause of poor nutrition, and the most serious mistake made by parents is allowing children to choose their own food. Obviously, little children know nothing about food values; they are not capable of choosing a well balanced, body-building diet. Parents should choose foods which are known to be nutritious. No greater blessing can be conferred upon children than to accustom them to eat and digest plain, wholesome food. Children who are permitted to acquire a dislike for wholesome foods, suf- fer from poor nutrition, loss of sleep, and are very apt to develop disorders of the nerves later in life. A sound mind is dependent upon a sound body. Children who lack healthy outdoor play and muscular exercise, are often timid and lack self-reliance and courage. Those who are NERVES AND MIND 125 trained to like healthy exercise out of doors acquire much more than muscular strength and skill in outdoor sports. A strong, erect body and good, rich blood gives a sense of well-being and power, of self-reliance and hardihood. Girls and boys alike need outdoor sports. They need to dig, to climb, to run, and to play ball. Our girls must be fearless and self- reliant as well as our boys. Some judicious hardening of the body is desirable. This does not mean to go without stockings in cold weather; nor does it mean that we should have our children take plunges into cold water; such practices are fully as harmful as too much coddling. It is well to accustom their bodies to cool air, cool baths, and to exercise out of doors in cold as well as warm weather. Protected by rubber coats and rubber boots they can enjoy themselves out of doors on rainy days. Too closely housed, and over-sensitive to slight changes of temperature, children are bound to suffer sooner or later. On the other hand, if each morning they are given a quick rubbing with cool water over the face, chest and back, and a good rub-down with the towel until the skin is glowing, and if they learn to go out of doors every day, rain or shine, cold or warm, the skin and nervous system quickly become inured to all sorts of weather, and the children benefit not only in strong, healthy bodies, but 126 THE CHILD FROM TWO TO SEVEN in a robustness of character and in a steadiness of nerve, which will help them to overcome obstacles, and to endure hardship without com- plaint. There is also what might be called a strength- ening of the spirit as well as hardening of the body. Sooner or later children must meet with more or less discomfort, pain and disappoint- ment. Becoming accustomed to cool baths, walking, playing and exercising in all kinds of weather, will teach children to bear pain, and to ignore discomforts. Children who have not learned in childhood to bear pain with fortitude, or to adjust them- selves without complaint to the unpleasant ex- periences and disagreeable sensations which are part of everyday living, will find it increasingly difficult to adapt themselves to the people with whom they must associate, and to the condi- tions which surround them. As a result they live too much within themselves, and it becomes more and more difficult to mingle and talk with other people, which is so essential to whole- some living. It is such children who are sub- ject to nervous and mental breakdown later in life. Children are naturally capricious in their likes and dislikes; they are very apt to complain about certain smells and tastes, and may be over-sensitive to certain noises and bright lights. To indulge such over-sensitiveness is a NERVES AND MIND 127 serious injustice to children, for it increases as the years go on. Parents may endure it, but as children enter school and come in contact with other people, they will find themselves at a disadvantage, and unable to adjust themselves to other children and conditions. They are left more and more to themselves, become more and more sensitive, morose and even peculiar. There is little doubt that many nervous break- downs of adult life might be prevented by judi- cious training during the early years. If we can train children to a wholesome toleration of the ordinary discomforts and disagreeable sensations which are bound to come to them in life, they will meet the more acute hardships with greater courage, and the task of teaching them self-control under trying situations will be made much easier. Children should begin to learn self-control during infancy. A good start will have been made if they are trained in regularity as re- gards feeding and sleeping. If they learn that by crying or by an outburst of temper, they can obtain what they want, then surely, they will have made a sorry beginning toward at- taining self-mastery. The parent who gives children whatever they desire in order to quiet them is paving the way for serious trouble later on. If instead of such indulgence children are told that they must first control themselves, and then in a polite 128 THE CHILD FROM TWO TO SEVEN manner make their request, they will soon learn that they can attain their desire only by controlling themselves, and not by emotional outbursts. While such training is easy if com- menced early, it becomes very difficult if left until later in life. Children should also learn to bear disappoint- ment. Life is full of disappointments as it is also full of successes and surprises. If disap- pointment is treated as something to be avoided it will be much harder to bear when it does come. It is much better to teach chil- dren to meet it as an interesting experience, and to turn defeat into victory by accomplish- ing something new and useful. As children grow older, and become more and more aware of themselves as individuals and conscious of what is going on around them, they will, as a matter of course, be exposed to more or less daily friction. Criticism or blam- ing other people in the presence of children is very apt to make them over critical and in- tolerant in their attitude toward others. Just as cheerfulness and good-nature are con- tagious, so unfortunately, are moroseness, un- charitableness, and ill-will. The latter are un- healthy attitudes of mind, and must inevitably have disastrous effect upon a child's disposition and nervous system. It should be possible to eliminate a large part of the discord in family life. Children should be taught both by ex- NERVES AND MIND 129 ample and counsel to master irritability, and to cultivate a charitable and tolerant attitude toward other people. Parents should endeavor to prevent the har- boring of a grudge, or the continuance of dis- agreeable moods for any length of time. Pout- ing, sulking, or dark looks of any kind, show that children are bearing malice for some rea- son. Such moods have a blighting influence on a child's mind, and if they become habitual, are apt to develop into more serious mental states later in life. Dark moods, however, are usually of short duration if parents endeavor to understand their children, and look for and correct the cause of irritability. Unhealthy moods seldom survive very long in an atmosphere of good cheer, and if chil- dren are provided with suitable occupation. A child may seem dull, stupid or sullen simply be- cause objects which interest some children have no interest for him, but some day the child may be found completely absorbed in some occu- pation unthought of by the parents, but in- tensely interesting to him. Thus, unexpectedly, may be revealed to us the child's natural in- clination to one of the useful arts or sciences, and that the reason for the apparent dullness and moroseness, was lack of suitable occupa- tion. To follow up this clew to the child's nature, and to provide resources for the de- velopment of such inherent possibilities, is part 130 THE CHILD FROM TWO TO SEVEN of the parent's task. Our efforts will often be rewarded by seeing an apparently dull, sulking child become wide-awake, smiling and agree- able. Another mental attitude which needs to be carefully watched is the abnormal craving of some children for sympathy. It is best for them to learn to bear small hurts and dis- appointments without too much help from par- ents. Teach them to laugh at small hurts and difficulties; they will be much happier as the years bring larger difficulties, for having had such training in hardihood and self-reliance. It is a serious mistake to foster too great dependence on the mother. This does not pre- clude the respect and devotion which is every mother's due, but it is an injustice to children to encourage them to be so dependent that they lack backbone and self-reliance. As soon as possible they should be taught to wash and dress themselves, to comb their own hair, to clean their teeth, and to put away their own clothes and playthings. For the same reason it is best for children to sleep alone in a separate room from the parents. There are too many frail, nervous children who have been brought up from in- fancy to depend upon the mother; who are afraid to go to bed alone; who fear the dark- ness of night, and who demand that they be rocked and sung to sleep. Such treatment is NERVES AND MIND 131 mistaken kindness, for children become over- sensitive, timid, and fearful. As they grow older and meet other boys and girls, they are handicapped in sports and occupation because they lack courage and initiative. From earliest infancy children should be taught to sleep alone without rocking and with- out a light in the room. Excessive timidity or fear should have no place in the minds of little children. Both states may easily develop into serious nervous disorders. No toy, game or story should carry any suggestion of fear, and children should be taught that mice, worms and toads are harmless, and learn to look upon them with interest rather than fear. All stories which have any suggestion of fear, such as ghost stories, or tales about goblins, ogres, the bogey-man, witches, bears or wolves, should be excluded. A child's imagination may magnify seemingly harmless tales into dreams of frightful monsters. On the other hand, there are many stories about the stars and the won- ders of the heavens, the birds, and trees of wood and field, which have only suggestions of the beauty and glory of the wonderful world in which we live. Children should be taught to welcome the night as soothing and friendly, and that dark- ness is given us to rest the eyes and for sleep; that outside the stars are gleaming in the heavens, and that there is One who never 132 THE CHILD FROM TWO TO SEVEN sleeps, but watches over and cares for little children. The storm, the thunder and lightning, should be explained to little children. If they are taught in early childhood something of the meaning of the great forces of Nature, and if they see those around them calm and fearless, they also will learn to be fearless. Such times would seem to be opportunities given to par- ents to impress upon the child mind the pres- ence in the universe of a Higher Power, and to implant the beginnings of faith. Certainly no greater protection against unrest, fear, and anxiety of spirit, can be given to children than a sense of dependence upon a Supreme Being. One of the most common causes of a troubled mind is vacillation. While some children are impetuous by nature, and need to learn to be more deliberate in deciding matters, many others have a tendency to indecision. A very useful lesson for them to learn, and one which will stand them in good stead in years to come, is the power of making a quick decision and holding to it. Another cause of overstimulation of the nerv- ous system is the practice of allowing children to have experiences which properly belong to older people. Precociousness in children is not to be desired. It is a well known fact that unusually clever children often have weak and stunted bodies; the mind has been developed at NERVES AND MIND 133 the expense of the physical powers. Extensive travel, the visiting of museums and picture gal- leries, except those especially planned for chil- dren; the theatre, the opera, the most of the moving picture entertainments, are wholly un- suited to the immaturity and simplicity of the child. To allow children to attend such entertain- ments is to force and stimulate the child nature, thus robbing it of its greatest charm, namely, that simplicity and artlessness which is so at- tractive and appealing in little children. More- over, by introducing them to such entertain- ments during the early years we deprive them of the pleasure which should be theirs later on, when they are capable of appreciating some of the real masterpieces in art, music, and the drama; the attractiveness and freshness of novelty is gone. Of all the good and wholesome pleasures of life, which make for healthy nerves and normal minds, the joy and satisfaction derived from suitable occupation 'and work well done, must be regarded as one of the most important. Children who are idle, who lack occupation, are not happy and contented, and become irritable and morose. The importance of providing proper occupa- tion for children has been considered in detail in Chapter V. While we should guard our children against excessive fatigue of body and 134 THE CHILD FROM TWO TO SEVEN mind, it is highly essential to their best de- velopment and good health, that they be sup- plied with materials and occupation for hands and mind suitable for their age. If the children can live in the country, and have all the benefits of ample space and coun- try air, much will be gained toward building sound minds in sound bodies. The present in- clination of our people to crowd into the large cities is a dangerous tendency, and must in- evitably tend to weaken the mental, moral and physical welfare of the race. The city is a sterile waste for most children. Mental and physical development is stunted for lack of opportunity for wholesome, outdoor play. The country, on the other hand, affords boundless opportunity for healthy occupation and play in forest, field and garden. Parents of city children will need to make special effort to provide healthy surroundings, and to open up some possibilities for suitable play with other children. Public spirited men and wo- men especially interested in the welfare of children have established museums for chil- dren in a few of our large cities, but the pros- pects for healthy play for city children is ex- tremely limited. Children need to live and play with other children. They need to play vigorously and even aggressively, taking the knocks and dis- appointments without malice, and learning from NERVES AND MIND 135 this give and take to be tolerant and good- natured toward others. If instead of such com- radeship a child is too much by itself, there comes a time when he cannot seem to get on good terms with other children; he becomes absorbed in his own fancies, resents interfer- ence, is over-sensitive to knocks and disappoint- ments, and resents and broods over them. Such a child is more likely than others to develop mental disorder. In all our efforts to give our children a healthy outlook on life, we must always re- member that they are easily influenced by the words and actions of those with whom they are associated. If they hear much complaining about ills and aches of different sorts, and of being "nervous", they are very apt to reflect such complaints in their own lives. It is a serious mistake to talk about nervousness or any diseased condition in their presence. They are impressionable and self-conscious, and it is best to direct their attention away from them- selves, and from thoughts of unhealthy states, to wholesome play and more cheerful subjects. If children seem nervous, irritable and more restless than children should be, talking about such states of mind and body in their hearing will not improve matters, but rather make them worse. Many times it is not the children who are too restless or nervous, but the parents may be over tired, and the natural vivacity of 136 THE CHILD FROM TWO TO SEVEN childhood seems to the mature mind almost superabundant. As parents we need to look upon this exuberant energy with tolerance and patience; to remember that nearly all robust children are the same; that probably we were the same when we were children, and that it is our part to provide suitable occupation in order that their natural buoyancy may find expres- sion in a normal way. An atmosphere of sorrow, regret or fear is depressing and damaging to the impressionable child nature. On the other hand, an atmos- phere of cheery helpfulness, of joyful expecta- tion concerning the possibilities of each new day, and of resolute faith and courage, is heart- ening and rejuvenating. To cultivate in our children a love for genu- ine goodness wherever seen; a love for truth, for humanity, and for Nature in all her vari- ous moods, cannot help but enrich the char- acter, and strengthen the will. To live bravely and wholesomely they- must also learn to meet each day as it comes, and to make the most of it; to look upon each morning as the begin- ning of a new day to make better than the day before; to forget the grudges of yester- day; to never look back, but always forward; "to look up and not down; to look out and not in," and always to lend a hand. Such are some of the more essential factors to be considered in our efforts to safeguard the NERVES AND MIND 137 child's nervous system. As we endeavor to put them into practice we may hope that not only are we leading our own children into healthy ways of thinking and living, but we are also doing our fair share in the work of lessening the present deplorable condition of nerve weakness, and of fostering higher stand- ards of health in the Nation. CARE OF THE CHILD'S BODY "He who has health has hope, and he who has hope has every- thing." Arabian Proverb. "The first wealth is health. Sickness is poor spirited, and cannot serve any one; it must husband its resources to live. But health a fullness answers its own ends, and has to spare, runs over, and inundates the neighborhoods and creeks of other men's necessities." Emerson. CHAPTER VIII CARE OF THE CHILD'S BODY For the child-nature to be at its best the temple within which it dwells must be kept in order. To build into a child's character high standards of personal cleanliness is one of the most valuable services parents can render. CARE OF THE SKIN The importance of the role of the skin in maintaining bodily health deserves some care- ful consideration. It is not merely a protective covering for the body. It is an organ of sen- sation, and the great heat regulator of the body. Its millions of sweat-glands pour out the pers- piration, which in hot weather cools the body by evaporation, while in cold weather they con- tract, thus conserving the body heat. The skin must also be regarded as an organ of excretion vitally essential to the body health, a large amount of waste material being thrown off by the sweat glands. Upon a healthy con- dition of the skin depends to a large degree the activity of the circulation ; thus, the importance of keeping the skin clean and active becomes apparent. 141 142 THE CHILD FROM TWO TO SEVEN BATHING Regular bathing cleanses the skin, opens the pores of the sweat-glands, stimulates the cir- culation of the blood, and refreshes the nerves. All sorts of bath-tubs are used for young children, depending upon conditions, and wheth- er the house is fitted with modern plumbing, but whatever the living conditions may be, it is always possible to have some sort of baths. Elaborate fittings are unnecessary. An ordi- nary wash-tub with soap, water and towels con- stitute the really necessary equipment, and these are available everywhere. When a bath- tub in a modern bath-room is available, there is no reason why children two years and up- ward should not be bathed in the large tub if the bath-room can be kept sufficiently warm in winter. Such a bath-tub is large enough for some splashing and real fun, so that children anticipate and enjoy the bath. Some mothers, however, prefer the small tub, especially during the second and third years of the child's life. Of the small tubs probably the best is the oval enamelware tub, thirty- two to thirty-six inches in length. This can be placed inside the large bath-tub, or on a board laid across the top of the large set tub, but most children will enjoy the bath in a large tub. The room in which children are to be bathed should be warmed to about 72 to 75 F. CARE OF THE CHILD'S BODY 143 In bathing the child the head and neck are first washed and dried, then arms and chest, after which the child stands in the warm water, the remainder of the body is washed, and the bath is finished by pouring a pitcher of luke- warm water over the entire body. This should be followed by a brisk but thorough drying with the bath-towel until the body is aglow. The warm water bath, at 95 to 98 F. is given with soap, for the purpose of cleansing the skin. It opens the pores of the skin and relaxes the muscles and nerves. The best time for such a bath is before going to bed, as it soothes the nerves, tends to make the child sleepy, and there is less possibility of taking cold at this time. Twice a week is as often as the warm bath should be given, and it should not be prolonged beyond ten or fifteen minutes. THE DAILY BATH For the daily bath the temperature of the water should be tepid, or about 90 F. The best time for this bath is on rising in the morning, and it should be given quickly. After using the luke-warm water and soap, cool water at about 85 F. may be used to rinse off the soap, close the pores and stimulate the skin. This bath should not last over five minutes, and should be followed by brisk drying with towel, which should produce a good reaction. During later childhood, the temperature of the 144 THE CHILD FROM TWO TO SEVEN water for the morning bath may gradually be reduced to 75 to 80 F. A bath thermometer is an inexpensive convenience for the bath- room. At no time of life is it wise to have a bath soon after a meal. One of the best means of preventing children taking cold is to gradually accustom them to the cold douche, by splashing cool water over neck, chest and arms as they stand with feet in warm water. During the splashing cr show- er, if the child is taught to rub and slap the body with the hands, the tonic effect of the bath will be increased, and reaction will be better. When there is a shower attachment in the bath-room children easily become accus- tomed to the morning cool shower, enjoy it greatly, and are much benefited thereby. The room should be comfortably warm, the bath brief, not over a minute long, and followed by brisk friction with the towel, until the body is dry and glowing. Most robust children show good reaction to such a bath, and learn to like the glow and tingle of it, but any child who invariably shiv- ers after the brisk rub-down, and who shows poor reaction, as evidenced by bluish lips and finger-tips, or if a child seems weak and languid after the cold bath, it is not suitable for such a child and should be discontinued. The tepid bath is more suitable for such children, fol- lowed by friction of the entire body with a CARE OF THE CHILD'S BODY 145 moderately coarse towel. Rapid rubbing of the body with a towel wrung out of salt water, followed by friction with a dry towel, may well take the place of the cold bath with such chil- dren, and. gives the warmth and glow without the shock. Children will also enjoy having a bath-towel of their own, and helping in the after-bath rub- down. Parental supervision will be necessary to see that it is done thoroughly, but if chil- dren are taught to dry themselves front and back, they will derive some healthful exercise and considerable pleasure from it. Some children are frequently kept awake at night by cold feet. For this condition a brisk rubbing of the feet every night, after dipping them in cold water in which is dissolved a hand- ful of coarse salt, will be beneficial. SOAPS AND POWDERS Soap should be pure and not too strong. Highly perfumed and fancy soaps are apt to be irritating to the skin. Soap should lather freely, and after using it should be entirely removed by rinsing. Irritation and chafing of the skin is most frequently caused by lack of thorough rinsing and drying. Powder should be pure, unscented, and used sparingly from a sprinkle-top container to pre- vent chafing where surfaces of the skin come together, such as about the neck, arm-pits, 146 THE CHILD FROM TWO TO SEVEN groins and buttocks. Even in such places it is better to remove the excess by a bit of ab- sorbant cotton. Ointments clog the pores of the skin, and are unnecessary when the skin is healthy. The less creams and ointments used the better, un- less clearly indicated by some abnormal condi- tion of the body, and should be prescribed by a physician. A soft, loosely woven wash-rag and a bath- towel should be provided for each child, and children should be taught to hang them up to dry after using. Old soft turkish toweling, or old knitted underwear may be cut in suitable sizes, and used for wash-rags. KEEPING THE HANDS CLEAN Most children are heedless about proper cleansing of the hands. There is no doubt that disease germs are carried to the nose and mouth by the hands. To prevent the carrying of disease in this way, children should be taught the importance of washing the hands after visiting the toilet, after using the handkerchief, and before eating or handling food of any kind. In order that this important duty may be more easily carried out by young children, basins, towels, soap and water should be easy of access. It may be necessary to provide a box or stool upon which little folks may stand CARE OF THE CHILD'S BODY 147 when washing, in order to reach the basin com- fortably without wetting the clothes. CARE OF THE GENITAL ORGANS Some attention should be given to the genital organs at the daily bath. The parts of a fe- male child may be easily cleansed with bits of absorbant cotton dipped in warm boric acid solution, two teaspoonfuls of powder to the pint of water. After cleansing, the parts should be thoroughly dried and kept dry with plain unscented dusting powder. When there is a discharge present, the boric acid solution should be used twice daily. If the discharge is per- sistent, medical advice should be sought. The genital organs of the male child also need some care. During infancy and early childhood the foreskin should be pushed com- pletely back two or three times weekly, and the parts gently cleansed with absorbant cotton dipped in water, and dried with plain, boric-acid dusting powder, not leaving any excess powder, after which the foreskin should be drawn for- ward again. When the foreskin is so long and tight that is cannot be pushed back without force, cir- cumcision is advisable. CARE OF THE HAIR The scalp needs to be cleansed as well as the skin or other parts of the body. While the 148 THE CHILD FROM TWO TO SEVEN child has short hair it should be washed as often as once a week, and sometimes two sham- poos weekly may be necessary. The scalp is so much more easily kept clean when the hair is short that little girls may with advantage and comfort wear it that way until twelve years of age. Any pure soap not too strong which makes a good lather, will serve to cleanse the scalp. After rubbing the lather thoroughly into all parts of the scalp, the soap should be removed by several rinsings, the first rinsing just com- fortably warm, each rinsing being cooler until the last is cold. Care must be taken to rub the scalp and hair completely dry. In warm weather when nearly dry the hair may hang loose, and dry completely in the sun, avoiding too lengthy ex- posure to hot sunlight. Brushes and combs need frequent and thorough washing, drying in open air and sunshine if possible, CARE OF THE EYES The care of the child's eyes should com- mence at birth and continue throughout child- hood. Many eye troubles may be prevented by careful attention during the first years of life. A child showing any tendency to cross-eye or other abnormalities, should be placed under the care of a physician who makes a special study of the eye. Normal eyesight is such a priceless CARE OF THE CHILD'S BODY 149 possession that we should make every effort to see that our children have it. The eyes have a great deal to do with the health and normal development of children. When a child is apparently slow or dull in school-work the eyes should receive careful consideration, for the child may be suffering from near-sightedness or far-sightedness. It has happened quite frequently that when such disorders are corrected by proper glasses, chil- dren show marked improvement not only in school-work, but in general health. Some special supervision is necessary in or- der to prevent children from injuring their eyes. If it is noticed that a child persistently holds a book or whatever is in hand, nearer than fourteen inches, we may suspect some eye- trouble, and should consult a physician. Unless watched carefully and cautioned, chil- dren may read without sufficient light, by an unsteady or poorly adjusted light, or read too long at a time. They should not read at a table so low as to require stooping, and if the table is highly polished, some covering of dull- faced, dark-colored material which does not re- flect the light, should be provided. To prevent over-strain of the children's eyes while they are reading or studying, they should be taught to raise the eyes frequently and look out of the windows, or into a distant corner of the room, thus resting the muscles of the 150 THE CHILD FROM TWO TO SEVEN eyes whch have been busy with close applica- tion. It is also wise to teach them when out of doors, to look away over stretches of field, woodland or water, in order that the eyes may be trained to accommodate over consider- able distance. When children are obliged to face a glare of light like that reflected from bright light on water, or from snow, slightly colored glasses should be provided. Amber colored lenses are the best. The eyes are frequently weak and easily over- strained after illness, especially after measles or scarlet-fever, and should be carefully guard- ed against using too soon, or for too long at a time. The habit of rubbing the eyes is somewhat common in children. It is injurious in that it produces irritation, and infection may thus be carried to the eyes. Cleansing with a simple eye-wash tends to prevent styes and crusts on the lids, allay irritation, and possibly avert more serious inflammation. A very good eye- wash may be made by dissolving half a tea- spoonful of boric-acid powder in half a pint of water. Bits of absorbant cotton may be dipped in this solution, using a fresh piece for each eye. CARE OF THE EARS Healthy ears require little care beyond keep- ing the outer portion clean. Articles should CARE OF THE CHILD'S BODY 151 not be introduced into the ear. Nature usually takes care of superfluous wax. Some people, however, are troubled by excessive accumula- tions, which fill up the canal and even press against the ear-drum, causing a feeling of full- ness, and temporary deafness in the affected ear. As the wax is often hardened and ad- herent to the sides of the canal, unskillful at- tempts to remove it may do harm; the best plan is to consult a physician. Discharging ears, swelling or pain in the ears, or signs of deafness are symptoms which demand medical attention. Many children are deaf because of neglected colds and ear dis- charges. Such troubles are fairly easy to cure at the beginning, but if allowed to go without treatment, become chronic, more difficult to cure, and frequently result in partial or com- plete deafness. Many school children who seem dull, are really suffering from impairment of hearing, which prevents their going forward in school work. CARE OF THE NOSE AND THROAT Most of the diseases of childhood are due to infection by germs, and it is now quite gen- erally believed that these germs enter the body principally by way of the nose, throat and mouth. Therefore, the importance of teaching children to keep these parts thoroughly clean cannot be too strongly emphasized. 152 THE CHILD FROM TWO TO SEVEN By spending oniy a little time and attention during these early years teaching our children how to wash and clean the nose, throat and teeth, we will establish habits of cleanliness which will always remain with them, and which may be the means of preventing many colds, contagious diseases, and decay of the teeth. Children learn easily as part of the morning bath, to flush out the lower portion of the nostrils, and to blow out any accumulations which have collected during the night. The best way to cleanse the nostrils is to close one nostril with the forefinger, and gently blow out the other; then flush out with water. Too much force in blowing the nose is injurious; it should be done gently. Children should also be cautioned not to snuff water up into the nostrils; simply splashing the water with the hands in and out of the lower portion of the nostrils is cleansing, refreshing, and will do no harm. The various nasal douches and sprays should not be used without the advice of a competent physician. Sometimes the nostrils become clogged; first have the child gently blow out each nostril as described above; then, using a medicine drop- per, introduce two drops of benzoinol into each nostril. This will tend to soften the accumula- tions, and help to insure a good night's sleep. An excellent health habit for the child to acquire is to rinse out the throat and mouth CARE OF THE CHILD'S BODY 153 at bedtime and on rising in the morning 1 , using warm water for the purpose. This will help to protect against the common diseases of child- hood, and it will be much easier to treat the throat should treatment become necessary. CARE OF THE MOUTH AND TEETH Of all the various measures tending to build up healthy children and to keep them healthy, one of the most important is the care of the mouth and teeth. Good health depends to a very large degree upon a healthy mouth and sound teeth. Broken down teeth in an unclean mouth is a constant menace to a child's health. It should be considered that the mouth is the gateway to the body. The teeth are to cut and grind the food which goes to build up the body. Well-chewed food is more easily digested and more readily used by the body than food swal- lowed with but little chewing. This cutting and grinding is important ; without it the food is not thoroughly mixed with the saliva, an extra burden is thrown upon the other diges- tive organs, and the food is not properly di- gested. When the first teeth decay they ache just as severely as the permanent teeth, and become painful to chew upon. Heat, cold, sweets and acids cause pain, and food lodging between broken-down teeth causes pressure, which is exceedingly uncomfortable. The child avoids chewing and eats only the softest foods. The 154 THE CHILD FROM TWO TO SEVEN body is not fully nourished by such foods, and the child must inevitably lack in strength and development as the years go on. Thus, it is easily appreciated how decayed teeth during the foundation years, interfere with the child's growth. Not only does the condition of decaying teeth and an unhealthy mouth effect physical growth, but it also influences to a marked degree the nerves and mind of the child. If the teeth are a source of constant irritation, a child certainly cannot pay strict attention to school-work. If there is indigestion and lowered vitality from diseased teeth, the nature and disposition of the child must suffer. It must also be remembered that many forms of disease germs, including those of pneumonia and diphtheria, lodge in cavities and irregular- ities of the teeth, and many diseases of children commence from germs developed in the mouth. When decay of the first teeth reaches an ad- vanced stage they frequently ulcerate, an ab- scess develops and pus forms. The pus may be swallowed or absorbed directly into the circulation, with the inevitable result of low- ered vitality, and increased susceptibility to disease. IRREGULAR TEETH Why do children have irregular teeth? Can parents do anything to prevent the teeth com- ing in crooked? It may be said positively that if a mother lacks a nutritious, well-balanced CARE OF THE CHILD'S BODY 155 diet during the time before her child is born and while nursing the child, the child's teeth may be late in appearing, of poor quality, and of irregular growth. Also, faulty habits of eat- ing in young children will surely influence the quality and growth of the teeth. Young children may also acquire certain habits which influence the growth of the teeth. During the first years of life the bones are soft, yielding, and easily molded or bent. Conse- quently, the common habit of sucking the thumb or pacifier frequently results in distor- tion of the bones of the jaw, and an unsightly displacement of the teeth. Mouth breathing is one of the most frequent causes of irregular teeth. It often starts with a common cold, or because of adenoids, or en- larged tonsils. Another very common cause of irregular teeth is decay resulting in loss of a tooth. It is important to keep intact the complete set of first teeth because of the support they give each other. The loss of one tooth deprives the other teeth of support; they get out of their true position, and crowd the permanent teeth as they appear, thus also causing irregularity of the permanent teeth. AN OUNCE OF PREVENTION WORTH A POUND OF CURE By the end of the second year the first teeth, numbering twenty, are usually present, and 156 THE CHILD FROM TWO TO SEVEN they should be kept in sound, healthy condition. The first teeth are frequently neglected because they are not considered of sufficient importance to warrant much care. This is a serious mis- take. The old adage, "An ounce of prevention is worth a pound of cure," was never more aptly used than when applied to the care of the teeth. When parents come to realize how essential such care is to the child's present and future welfare, much suffering and disease will be prevented. To influence favorably the quality and growth of a child's teeth the mother must have good care and nourishing food before the child is born, and during the nursing period. The mother's milk is essential to the best develop- ment of the child, and everything possible should be done in order that the mother should have a good supply of milk. FOOD AND THE TEETH In Chapter III, "Food for Body-Building," the importance of a well-chosen diet of mixed foods for children, has already been amply empha- sized. The young child must be furnished with all the materials of growth in order to have sound teeth. It is not wise to give children too much soft food to the exclusion of that which requires chewing in order to swallow. Children are too apt to swallow food without, chewing. A diet which includes a large amount CARE OF THE CHILD'S BODY 157 of sweets hastens decay of the teeth; the more sugar, the greater the decay. The constant exercise of vigorous chewing is essential to the proper growth and development of the jaws and teeth. Food which requires chewing before it can be swallowed, such as crusts, toast, and hard crackers, should form part of the child's daily diet, and as the child grows older, raw apple, pineapple, celery, and boiled, roasted and broiled meat, should form part of the diet. Patiently and persistently we must teach children to chew their food so thoroughly that they can swallow it comfort- ably without drinking. It may be necessary to keep milk or water out of sight until the food is eaten. It is important to keep the first teeth in good condition so that when the second or per- manent set begin to come through they will not come in contact with broken-down, diseased roots and germ-laden cavities. The second teeth will be less apt to decay if, when they first make their appearance, the mouth is healthy and free from conditions which tend to produce disease, THE SECOND OR PERMANENT TEETH The permanent teeth begin to appear at about the sixth year, about a year before the first teeth begin to fall out. The first of the per- manent set to make their appearance are the 158 THE CHILD FROM TWO TO SEVEN six-year molars. These are probably the most valuable teeth in the mouth, and unfortunately, are the ones most often neglected. They come in just behind the last molar of the temporary set, and are very frequently mistaken for the first teeth because they come so early, and without pushing out or disturbing any of the first set. The six-year molars are usually large, fine teeth, and with proper care should last a life- time. Upon them falls the brunt of most of the hard chewing, and they are very largely concerned in maintaining regular alignment of the other teeth. It will be seen, therefore, that the preservation of these teeth is a matter of supreme importance to the health of the child. KEEPING THE TEETH CLEAN Without parental supervision children will not care for their teeth. They should be taught how to use the tooth-brush by the time they are three years of age, but parental influence will be necessary throughout the entire period of childhood, for very few children will do it thoroughly. Children should be trained to clean the teeth at least after the morning and evening meals and at bedtime. It is surprising how little time is consumed in this healthful practice. Three cleanings need not take over five minutes of the day. When the habit of brushing the teeth CARE OF THE CHILD'S BODY 159 is thoroughly established it is no longer irk- some. Good habits formed in early childhood are seldom discontinued. Especially important is the cleansing at bedtime, fermentation in the mouth proceeding more rapidly during the night. The brush should be narrow, not too large, and the bristles of medium stiffness. Before a new brush is used the parent should see that it is thoroughly flushed out with boiling hot water. Any of the simple tooth preparations may be used; the best for the teeth is the one which induces the child to clean them fre- quently. There is little difference in the pre- servative power of the various powders and pastes. In cleaning the teeth it is best to brush from the gums toward the teeth rather than across, or with a rotary motion. After the brushing the mouth should always be thoroughly rinsed with warm water, the brush rinsed in hot water, and laid aside to dry. The task should be made as pleasant as possible, and a cheerful word of commendation frequently given when it is well done. In addition to establishing the habit of clean- ing the teeth, it is of the utmost importance that the growing child should be taken to the dentist frequently. Beginning at the age of three years, the teeth should be carefully ex- amined at least every four months for decay 160 THE CHILD FROM TWO TO SEVEN in cavities, which should be filled without delay. With some such care as here outlined chil- dren will reach adult life with sound teeth, and will be saved many hours of suffering, as well as humiliation from unsightly teeth. They will also rise UD and gall their parents blessed. THE CHILD'S FEET Of late years considerable attention has been given to the care of children's feet. This may be due to the fact that during the late war thousands of young men were rendered unfit for active service by the condition known as flat-foot; .or, it may be because of the increas- ingly large number of children appearing at out-patient departments of. hospitals for treat- ment of weak and deformed feet. Much of this suffering and deformity may be prevented by proper care of the feet during the first eight years of a child's life. The choice of a properly fitting shoe is of the greatest im- portance, since most of the trouble comes from the bones of the foot being thrown out of balance by continued pressure of badly fitting shoes. The shoes, therefore, should be selected with some care to fit the natural shape of the foot. The soles should have straight inside lines, and on the outside should follow the natural outline of the foot, allowing plenty of room for the toes. The shoe should be suffi- ciently long to allow plenty of room for the CARE OF THE CHILD'S BODY 161 great toe, pressure on this part often causing deformity. The soles and uppers should be sufficiently flexible to permit free movement of the joints in walking. Heels should be low and broad. Fortunately for the future welfare of girls, the high heel is gradually being discarded, and we see more and more of the low-heeled shoe. It is per- fectly possible to manufacture a low-heeled shoe along attractive lines, and there are some such shoes sold in the stores. The high-heeled shoe runs over at the heels and loses its shape more quickly, thus necessitating the purchase of new shoes. It is the mother who controls the mar- kets of the world. If mothers will persistently talk about and ask for an attractively built low- heeled shoe for their little girls and big girls, the shoe will be forth-coming. One fact is established beyond doubt, namely, that the high-heeled shoe throws the bones of the foot out of their normal relation with each other, destroys the natural equilibrium of the body, makes healthy walking impossible, and tends to bring about serious trouble later in life. Care should be taken not to lace or button the shoes so tight that pressure marks show on the feet. PREVENTION OF FLAT-FOOT Flat-foot is rather common during childhood. Flat-footed children turn the toes outward, and 162 THE CHILD FROM TWO TO SEVEN walk somewhat stiffly. The upper part of the shoe turns inward over the heel and instep. Such children tire easily, have pain in the feet, legs, and back, and do not like to walk far. To prevent flat-foot children should be taught to walk with toes pointing straight forward. In this position one steps squarely upon the foot, distributing the weight of the body equally. It is toeing out which tends to throw the weight on the inner side of the foot, that causes flat- foot. While toeing in is not graceful, and dis- turbs somewhat the natural balance of the body, it does not weaken the structures of the foot, or cause flat-foot. Properly fitted shoes will do much to pre- vent this condition, and it is important to keep the shoes in good repair. Shoes which have lost their shape, and are run down at the heel, do not give proper support, and allow the body weight to fall too much on one side. Even stockings which do not fit properly may do harm. If too tight they compress the toes and interfere with the circulation. A stocking which is too short will cause the toes to curl under, and for this reason it is wise to buy stockings half a size too large. Wearing the same pair of shoes every day continuously tires the feet, and wears out the shoes rapidly. Alternating shoes relieves the strain, rests the feet, and saves the shoes. Bathing the feet frequently and rubbing with CARE OF THE CHILD'S BODY 163 a towel until they are warm and glowing", is particularly beneficial. The stockings also should be changed frequently. Certain exercises are also beneficial, such as running and jumping rope, if not carried to excess. The muscles of the feet are also strengthened by an exercise especially adapted for weak feet; with the feet exactly parallel and pointing straight forward, the child rises slowly on the toes, and as slowly returns to the heels. * While home care and early training can do much in the way of prevention, abnormalities of the feet and legs frequently demand special mechanical appliances. Conditions like club- foot and knock-knee, and sometimes the "pigeon-toe" position and flat-foot, require the special skill of the orthopedic physician. All such abnormal conditions should have skilled attention before the bones become hardened, since at this time corrective work can be done much more easily, and at less expense than in later childhood. COMMON DISEASES AND DISORDERS OF CHILDHOOD "He who has health is rich and does not know it." Italian Proverb. "Health is the greatest of all possessions, and it is a maxim with me that a hale cobbler is a better man than a sick king." Rirlfprstaff Bickerstaff. CHAPTER IX COMMON DISEASES AND DISORDERS OF CHILDHOOD THE CONTAGIOUS DISEASES The present day witnesses a new point of view in regard to the diseases of children. It is not so many years ago that parents help- lessly accepted the so-called "Children's Dis- eases" as a necessary evil, incident to the period of childhood. There has even been a tendency to consider rather lightly such diseases, no spe- cial effort being made to avoid exposure, par- ents taking it for granted that children must have them sometime. We are coming to believe at the present time that these diseases should be prevented by care- ful hygiene in the home and school. The fact cannot be too strongly emphasized that such diseases not only weaken and retard the growth of children for the time being, but very often leave them crippled by a damaged heart, weak lungs, or impaired kidneys. Too many people regard measles as a disease of trifling importance, yet, it must be consid- ered as one of the most serious diseases of childhood. Not only does it leave many chil- 167 168 THE CHILD FROM TWO TO SEVEN dren in such a weakened condition that they have pneumonia, but the bronchial tubes and lungs are so weakened by the persistent bron- chitis following measles, that many children develop tuberculosis of the lungs, and some- times of the hip or spine, with their attendant deformities. Disease of the middle ear is a common complication of measles, and is fre- quently followed by a chronic discharge from the ear and partial deafness. Whooping-cough is by no means insignificant in its effect upon the health of children. The racking attacks of coughing extending over some weeks, so lowers the natural resistance of the body, that tuberculosis is apt to show itself later on. Even chicken-pox, the least serious of the most common contagious diseases, has been known to seriously impair the health of cer- tain children, sometimes leaving broken down glands and ugly scars. The ravages of diphtheria before the use of antitoxin will long be remembered; many thou- sands of little children died each year, and thousands of others were left with weakened bodies and crippled hearts. It is still regarded as one of the most destructive of the con- tagious diseases. Scarlet fever is also to be considered one of the most serious diseases of childhood. It has been known to leave serious after-effects, such DISEASES AND DISORDERS 169 as diseased kidneys, defective vision, and im- paired hearing. Thus it is evident that if children are not to be handicapped in life, every effort must be made to keep them away from places where contagious disease is known to exist. Parents cannot be too careful in this respect. Not only must we think of the welfare of our own chil- dren, but of other children as well, and if we have a child who has measles, whooping-cough, or any infectious disease, it becomes our duty to keep other children away until the quar- antine is lifted by the family physician. To prevent the spread of these diseases it is neces- sary to keep a sick child by itself until it is known not to have contagious disease. MEASLES Measles commences much like a cold in the head, with sneezing, discharge from the nose, eyes sensitive and watery, some fever, and later, a dry cough. The rash appears first on the face and neck as small red spots which come together into blotches. The face looks swollen, and the rash soon spreads over the entire body. Sometimes children are only slightly ill, the rash appearing very light. They should be kept by themselves until all doubts as to the identity of the disease is removed. The disease is exceedingly contagious from the time the sneezing and cold symptoms appear, 170 THE CHILD FROM TWO TO SEVEN before the appearance of the rash, and is car- ried from one child having the disease to an- other. Second attacks are not common. Chil- dren ill with measles should be kept away from other children for two weeks following disap- pearance of the rash. Even if another child is said to have had measles it should not be allowed to visit the sick child, since the disease known as German measles is easily confused with measles, and neither disease protects against the other. GERMAN MEASLES This also is very contagious, occurring most often during the winter season, the first sym- toms appearing from the ninth to the eighteenth day after exposure. The symptoms are fre- quently very light, the disease seldom being as severe as measles. The rash looks like the measles rash, but disappears more quickly. After an attack children should be carefully guarded against taking cold, and should not mingle with other children for a week follow- ing the disappearance of the rash. WHOOPING-COUGH Whooping-cough is one of the common and most contagious diseases of childhood, occurring most frequently during the first five years of life, and is even rather common during the second six months of life. Some children have DISEASES AND DISORDERS 171 it mildly while others have severe attacks, de- pending partly upon their condition at the time. The first symptoms appear usually from seven to fourteen days after exposure, coming on like a cold in the head, with an irritable cough, which is usually worse as night approaches. When the attacks of coughing become worse and more frequent rather than better, and there is a ten- dency to vomit and gag, the parents should think of whooping-cough. When the sharp cough is repeated several times during an at- tack, ending with the drawing in of the breath, causing the peculiar crowing sound so charac- teristic of the disease, and accompanied by much stringy mucus, and possibly vomiting, there can be no doubt of the presence of whooping-cough. The disease is serious because of the inces- sant exhausting cough, so severe that vomiting frequently occurs, thus interfering with the child's nutrition, and also because of the long duration, the disease lasting from six to eight weeks. A child having whooping-cough should be kept away from other children for at least six weeks, and better, until the attacks of coughing disappear. CHICKEN-POX This common disease of childhood is very contagious, and one attack usually protects against a second. Red pimples first appear on the neck, then the chest, abdomen and face. 172 THE CHILD FROM TWO TO SEVEN The pimples soon change into small blisters, which dry up, and frequently pimples, vesicles and dried-up vesicles may be seen at the same time. There is some itching, sometimes fever. The child should not mingle with other chil- dren until all scabs disappear. MUMPS This occurs as a swelling just below, and extending rapidly upward, on the cheek in front of the ear. It is sore to touch, and eating and even talking is sometimes painful. Swelling may also occur on the other side of the face, the entire attack extending over a week or ten days. One attack usually protects against an- other, and to prevent other children contracting the disease, they should be kept away from the sick child for a week after the disappearance of the swelling. SCARLET-FEVER "Scarletina," "scarlet rash," and "scarlet- fever" are one and the same disease. It comes on suddenly, usually in from three to seven days after exposure, with vomiting, fever and sore throat, the rash appearing within twenty- four hours as an intense, bright red blush upon neck and chest, and spreading rapidly over the body. Although markedly contagious, it is not so much so as measles or whooping-cough. Some DISEASES AND DISORDERS 173 children have the disease very lightly, having but little fever, with only slight congestion of the throat, and almost no rash. The very mild- ness of the attack may prove a serious danger to the child having it, and to the community, in that medical advice may not be sought, the disease remain unrecognized, and other children exposed. It should be remembered that the mildest symptoms may be followed by the most serious after-effects, and that from the child having a mild attack, another child may con- tract the disease, have the severest form, and be crippled for life by serious after-effects. Thus, it is highly essential that the mildest cases be kept away from other children, and that they have the same careful supervision as the severest cases. Of late years the belief has been gaining ground that scarlet-fever is carried by dis- charges from nose, throat and ear, and also by the scales when contaminated by such dis- charges. A child who has had scarlet-fever should not be allowed to mingle with other children for at least a month after all symp- toms have disappeared, including not only peel- ing, but any discharge from the ear. DIPHTHERIA This is still a very common disease, is highly contagious and infectious, and shows itself as 174 THE CHILD FROM TWO TO SEVEN early as the second day, or as late as six to twelve days after exposure. While young in- fants do have the disease, it is more frequently seen in children from two to six years of age. Older children, however, also have the disease, and all children and young people should be protected from contagion. Unlike the other contagious diseases, one attack does not pro- tect from a second. The first symptom which may attract the mother's attention is pain when swallowing, and soreness and swelling of the glands under the jaw. Usually there is feverishness, loss of appetite, and the throat is inflamed, showing greyish white patches on tonsils and uvula. There are some cases in which the throat shows little or no inflammation, but a bloody dis- charge from the nose may be noticed with difficult breathing, while others may first show trouble in the larynx, having hoarseness, short- ly followed by difficult or noisy breathing and a croupy cough. A child who has had diphtheria should not mingle with other children for two weeks after the throat is clean in mild attacks, and this should be extended to four weeks if the attack has been severe. Because of the tendency of this disease to weaken the heart, special care should be taken to follow the physician's ad- vice in regard to keeping the child in bed for sometime after the throat symptoms disappear. DISEASES AND DISORDERS 175 PREVENTION OF CONTAGIOUS DISEASES From the foregoing facts it must be evident that the welfare of the sick child, and of other children as well, makes it imperative that the correct identity of the disease be determined at once, in order that the right treatment may be commenced immediately, and proper meas- ures taken to prevent the spread of the disease. At the very first signs of illness, therefore, it is good judgment to put the child to bed in a simply furnished room by itself, call a physi- cian, and keep other children away. The germs of these diseases are present in the mouth, throat and nose of the sick child, and are spread about by coughing, talking and sneezing. Thus, it is apparent that children may easily pass the germs from one to another. Children should be taught to cover trie mouth when coughing or sneezing, and to keep away from other children who are frequently cough- ing and sneezing. Children are very apt to suck their fingers, pick the nose, and bite the nails. In playing games they take hold of each other's hands, and thus contagious diseases are transmitted from one child to another. They should be taught to keep the hands clean, the nails cut fairly short, and to keep the hands away from mouth and nose. Children must also learn not to exchange candy or fruit with other children, not to put 176 THE CHILD FROM TWO TO SEVEN into the mouth pencils, whistles or horns which have been used by other children, and never to use another's handkerchief. Parents are realizing as never before the importance of teaching children to clean their teeth, but it is surprising what a large num- ber of school children neglect this simple but essential health measure. Children should be given a good tooth-brush and paste and taught as early as possible to clean the teeth, and to flush out the mouth and throat twice daily. A condition of health and vigor is the best protection against disease, while on the other hand there are certain disorders which tend to produce weakness, and increase susceptibility to disease, such as chronic indigestion, catarrh of the nasal passages, and loss of sleep, all of which may be prevented by not allowing chil- dren to eat between meals, by giving them sim- ple, nourishing food at regular times, and in- sisting upon long nights of sleep. Chronic catarrhal conditions of the nose should receive careful treatment. Outdoor air and sunshine are powerful fac- tors in the prevention of disease. Children who have plenty of fresh air out of doors and in the house, sleep better, and resist disease much better than children who are too closely housed. The temperature of living rooms should not be over 70 F., and a constant supply of fresh air should be maintained. Sleeping rooms need DISEASES AND DISORDERS 177 a thorough airing each day, and should be open freely to the night air, which is usually purer than that of the day. The importance of sun- light as a destroyer of disease germs is quite generally recognized, and it is desirable that all rooms at some time during the day be open to its health-giving influence. So many thousands of child lives are de- stroyed annually by the contagious diseases, that city, state and national health departments are expending much time and money in a united effort to prevent the spread of these diseases. Much has been accomplished by the improve- ment of school conditions, and a step in the right direction is the appointment of school physicians and nurses. Schools are better ven- tilated, have improved sanitary arrangements, more sunshine and fresh air. There is more painstaking effort to detect contagious disease early, and to prevent infection spreading from child to child. Very little progress in this direction, how- ever, can be accomplished, and the work of prevention will be seriously handicapped unless physicians, nurses and teachers are supported by the earnest co-operation of parents. If the contagious diseases are to be stamped out, there must be a community conscience. Each mother and father in the community must not only take every precaution against the spread of disease among the members of their own fam- 178 THE CHILD FROM TWO TO SEVEN ily, but do everything possible to prevent the spread of infection to other families. Not un- til this responsibility is accepted by all parents shall we witness the conquest of the diseases which are destroying so many thousands of lives of little children each year. THE SCHICK TEST AND SAFEGUARDING THE CHILD AGAINST DIPHTHERIA There has of late years been perfected what is known as the Schick Test, by which it is possible to detect to what extent any child is susceptible to diphtheria. To children thus proved to be sus- ceptible is administered toxin-antitoxin, which renders them immune to the disease. The method is simple, absolutely harmless, and is being used in the public schools. Parents have but to lend their earnest cooperation to health and school officers, and many children will be safe- guarded against this most crippling and destruc- tive foe of little children. VACCINATION As a preventive measure against the dread disease smallpox, vaccination has long since passed the experimental stage. The ravages of the disease before the days of vaccination, and its rarity now that the practice is so uni- versal, is indicative of its protective power. Vaccination is best done when the child is DISEASES AND DISORDERS 179 about six months of age, although if smallpox is epidemic, or if there is any possibility of exposure to the disease, it may be done as early as three or four months. On the other hand, it may be postponed in a very delicate child who is not apt to be exposed to smallpox, or in a child having skin disease. The best place for vaccination is the part which is easiest to protect and keep at rest. In young infants who are not creeping or walk- ing, the leg offers the best location, while in older children usually the arm is to be pre- ferred. If older children are vaccinated on the leg, they should be kept off their feet while vaccination is active. WHEN VACCINATION IS SUCCESSFUL If successful, in two or three days after vac- cination, a red pimple appears, which increases in size until in a few days it becomes'a vesicle containing watery fluid, later becoming yellow- ish, and surrounded by a red ring. During the active stage there is some swelling and redness, and there may be some soreness, restlessness and feverishness. The swelling and redness gradually decrease until about the twelfth day, when the vesicle begins to dry up and at the end of fourteen days a scab forms, which comes off in about three weeks, leaving a small scar. If unsuc- cessful the vaccination should be repeated in 180 THE CHILD FROM TWO TO SEVEN two or three weeks. If it is successful, a child should be revaccinated sometime before puber- ty, but if at any time there is some possibility of exposure to smallpox, vaccination should be repeated. THE CARE OF THE SICK CHILD If a child has been trained from infancy to habits of regularity in feeding and sleeping, the task of caring for it when ill is much easier. Children should be taught to show the throat, to wash out the throat, to take liquid medicine from a teaspoon, and to take tablets or cap- sules. They should also be taught to regard the family physician as a good friend, and to anticipate his visit, as one of the pleasant events of the day. Under no consideration should children be frightened into obedience by threats of what the doctor will do on his arrival. Such threats absolutely prevent the pleasant relationship which should exist be- tween the little folks and the physician, and make his task of helping the children very difficult. With some tact and patience most children may be taught to wash out the throat and take pills at four or five years, and to show the throat at two or three years. The secret of success lies in not frightening them in the be- ginning, and all these matters should form part of a child's early education. DISEASES AND DISORDERS 181 Serious illness may frequently be prevented by giving careful attention to the first signs of illness. At the first appearance of acute indi- gestion, accompanied by diarrhoea or vomiting, fever and pain, or an oncoming cold with run- ning nose, sneezing and feverishness, the child should be put to bed in a quiet, shaded room, and a physician called. Such symptoms may mean only a slight up- set, or on the other hand, may mark the be- ginning of one of the contagious diseases. This latter possibility should always be kept in mind, and all children and other visitors excluded, pending the arrival of the physician. Until he arrives no food should be given other than a small quantity of some simple gruel. Cool, boiled water may be given frequently, and a simple bath may be given before the child is put in bed, COMMON DISORDERS OF CHILDHOOD CONSTIPATION AND ITS PREVENTION This very common disorder should be pre- vented by careful attention to regularity and proper diet. No health habit is more important than a regular, daily action of the bowels. The first essential is that the bowels should act at the same time every day. Such training should commence in infancy, and be continued through- out childhood. 182 THE CHILD FROM TWO TO SEVEN The principal causes of constipation are ir- regular meals, improper food, eating between meals, lack of variety in the diet, and neglect- ing the time for regular action of the bowels. Medicine alone will not cure constipation. It can be accomplished only by careful training. The best time is in the morning after break- fast, and parents will need to see that children take time to attend to this important health habit. School children should arise sufficiently early to have ample time to attend to this after breakfast before leaving the house. Unless some attention is given to the matter, in the hurry incident to getting to school, this impor- tant duty is neglected, and irregularity results in chronic constipation. Next to establishing regularity is the matter of providing a well-balanced diet, insisting upon regular meals, and not allowing children to eat between meals. Some variety in foods should be planned for breakfasts, as described in Chap- ter III. The coarse cereals, such as oatmeal or pettyjohn are preferable to cream of wheat or rice, and graham or whole wheat bread in- stead of white bread. Green vegetables, such as spinach, green peas, string beans, carrots, asparagus and celery, are especially valuable, and only a limited amount of potato and rice. Meat once daily is suffi- cient. Milk should be given only at the two light meals. Fruits are valuable, and should DISEASES AND DISORDERS 183 be used freely. Fruit juices given in water on rising are useful. Stewed prunes, dates and figs, apple sauce and baked apples, stewed peaches, and raw scraped apples are all excel- lent for constipation, and should be given once or twice daily at meals. Two or three tea- spoonfuls of honey used as a sauce with bread, and given daily, may prove beneficial. Children often need to be taught to drink water. A glass on rising in the morning and two glasses twice daily between meals is a minimum amount for the day. When it becomes necessary to move the bowels at once, an injection of half to one pint of soapy water, using a bulb syringe or foun- tain syringe, is a simple but effective method. A tablespoonful of sweet oil used as an injec- tion is also useful. A small suppository of Cas- tile soap is easily made, and will serve the same purpose. It is not best to use any of these methods constantly. Constipation which persists in spite of careful training and well- regulated diet, demands the attention of a physician. "WORMS" A common disorder in children is a condition of the bowels which favors the development of worms. The small thread or "seat-worms", re- sembling bits of grey thread less than half an inch long, are the most common variety, and 184 THE CHILD FROM TWO TO SEVEN locate in the lower bowel, often in large num- bers. They cause few symptoms in some children, but in many children they cause itching at the anus, picking of the nose, bad breath, coated tongue, loss of appetite, grinding of the teeth, restless sleep and bad dreams. Faulty food habits, such as eating irregularly and between meals, too much sweet food and candy, and too rapid eating, all tend to bring about the unhealthy condition of the bowels favoring the growth of these pests. Correc- tion of such habits will do much to eradicate this condition. In addition, children should be taught to eat slowly, to chew food thoroughly, and not to bolt their food. One of the most important preventive meas- ures is to see that children's hands are kept clean. The finger-nails should be watched with special care, and kept short and clean, as chil- dren are very apt to put their fingers in the mouth, and thus reinfect themselves. Warm salt solution injected into the bowel every other night for a few weeks, may help to clear the bowels of the worms, but to get rid of them entirely, the help of a physician is necessary. BED-WETTING Most children will go through the night with- out wetting the bed at two or three years of age, if taken up late in the evening. Certain DISEASES AND DISORDERS 185 children learn before this age, while some do not acquire control until four, five or even six years of age. Older children wet the bed occa- sionally, but wetting the bed every night after three years of age is not normal. This troublesome condition is often the re- sult of faulty habits, such as eating an excess of sweets, too rich and highly seasoned foods, and eating between meals. Sometimes it is due to general debility, or to some trouble of the genital organs. Punishment is seldom helpful, and may make the condition worse, especially corporal punish- ment. Everything possible should be done to build up the child's general health. Correction of faulty habits of eating often produces sur- prisingly good results. Simple, nutritious food at regular times only, and allowing nothing be- tween meals except water, will prove beneficial. Children should be encouraged to drink plenty of water between meals up to 4.00 P. M., but none later, the supper being made up mostly of solid or semi-solid food. They should be taken up regularly at about 10.00 P. M. Scolding, ridicule or whipping are worse than useless. Children are sensitive, and often ex- tremely self-conscious in regard to the condi- tion. It is so often due to a run-down state of health due to faulty living, that parents need to be careful how they treat children hav- ing this trouble. 186 THE CHILD FROM TWO TO SEVEN Nothing will help very much until the child's general condition is improved. Sometimes by using much tact and gentleness it is possible to appeal to a child's pride, but it should not be done in the presence of other children. Tact and gentleness will sometimes win, but harsher methods are apt to make a child sullen and stubborn. Various methods have been successful with different children. When the bed is dry in the morning, a child may be allowed to play with a special doll, a set of dishes, or box of tools kept for the purpose. Being deprived of the special pleasure on account of a wet bed, will sometimes impress the child's mind, and stimu- late the will-power to new effort. It is important to bear in mind, however, the possibility of some irritation or weakness of the genital organs, and if the condition does not improve, the child should be taken to a physician for examination and treatment. CONVULSIONS It is always best to send for a physician at once, but until he arrives some home care should be given. Wrap the child's body in large bath-towels or small blanket dipped in luke- warm mustard water, using two heaping table- spoonfuls of mustard powder to about three pints of water. At the same time place the feet in warm mustard water, and cold cloths DISEASES AND DISORDERS or cloths in which ice is wrapped, on the head, keeping the child as quiet as possible. It is well to have plenty of hot water and a tub at hand, in case a warm bath becomes neces- sary. A hot bath may be necessary if the convul- sions have continued until the face is very pale, the lips and nails blue, feet and hands cold, and pulse weak. When the child is in this condition the hot bath will help by bringing the blood to the surface, and giving relief to the lungs, heart and brain. The temperature of the bath should not be over 104 R, and small quantities of hot water should be added to keep the water warm. The water should be tested by a bath thermometer, but if this is not con- venient, the water may be tested by thrusting the bared arm up to the elbow into the water. Without such care, in times of emergency, chil- dren have been put into water so hot as to pro- duce serious burns. The water should be just comfortably warm, and the bath may be made more useful by adding three tablespoo'nfuls of mustard powder. The cold cloths should be kept on the head while the child is in the bath, which should not be prolonged beyond eight to ten minutes, when the child should be wrapped in a warm towel or blanket without drying. The most common cause of convulsions is indigestion due usually to improper food, and 188 THE CHILD FROM TWO TO SEVEN for this reason it is often desirable to clean out the bowel by an injection of warm soap- suds. EARACHE The pain due to earache is nearly always severe and continuous, and the child frequently cries loudly and persistently, occasionally more sharply with an extra acute twinge of pain, cringes if the ear is touched, and sometimes keeps the hand placed over the ear. It is not advisable to put oil or medicines in the ear. Irrigation of the ear with boric acid solution comfortably warm will often give re- lief, using a bit less than half a teaspoonful of boric acid powder to two tablespoonfuls of water. The warm solution may be poured slowly into the ear with a spoon. When there is a discharge from the ear such irrigation should not be used without medical advice. After the warm solution, dry heat may be applied if necessary. This may be accomplished by binding over the ear with a bandage or handkerchief, a small cloth bag filled with hot salt or bran. A small butter-dish heated in hot water and covered with cloth may serve the same purpose. A small hot-water bag may be held to the ear, or the child may rest the aching ear on the bag, being careful in all these procedures not to burn the ear. If the pain persists, or a discharge appears, it is best DISEASES AND DISORDERS 189 to consult a physician, as serious inflammation and deafness have been known to occur. CROUP An attack of ordinary, spasmodic croup, the form most frequently seen, seems alarming, but is seldom dangerous. An attack is usually ushered in with hoarseness during the after- noon, followed later in the day by the char- acteristic sharp, barking, croupy cough. In a mild attack, in addition to the peculiar cough, there is hoarseness and somewhat labored breathing. In the more severe attacks the hoarseness is more pronounced, and the breath- ing becomes difficult and noisy. The attacks are not usually long, but the croupy cough and oppressed breathing may continue for an hour or two, when the child goes to sleep, usually resting well until morn- ing. The dangerous form of croup, called mem- braneous croup, is diphtheria of the larynx, and differs from the common spasmodic croup, in that it comes on gradually, and the symp- toms continue throughout the day. TO RELIEVE SPASMODIC CROUP The room should be warm, and cloths soaked in hot water applied over the throat. The warm air should be kept moist by steam from boil- ing water in a croup kettle if convenient, or 190 THE CHILD FROM TWO TO SEVEN an ordinary tea-kettle. This will be still more effective if the child is placed under a tent, arranged by throwing a sheet over an open umbrella, leaving an opening at the side for the entrance of the steam. If the symptoms become alarming, ten drops of the syrup of ipecac may be given every fif- teen minutes until vomiting occurs, but if at any time breathing becomes loud and difficult, a physician should be summoned at once. COLDS Children are made susceptible to colds by keeping them too closely housed in overheated, poorly ventilated rooms, by improper feeding, and too much or too little clothing. Certain children inherit a tendency to nasal and bron- chial disorders. Enlarged adenoids and tonsils also increase the liability to colds. It is always to be remembered that colds are caused by germs and are contagious; therefore, children should be kept away from persons having colds, or who are sneezing and coughing. A cold often runs through an entire family for lack of precautions to protect those not having a cold. A cold should not be regarded as a very slight indisposition to which little atten- tion need be given. It is very often the start- ing point of serious illness. DISEASES AND DISORDERS 191 PREVENTION OF COLDS Everything possible should be done to pre- vent children taking cold. Children having a chronic nasal discharge, and who habitually keep the mouth open, should be examined for enlarged adenoids and tonsils, and if present they should be removed. The diet is very often at fault. Too much starchy food, cereals, potatoes, sugar and sweets, are apt to cause indigestion and lack of resistance. Children who .are very susceptible to colds are benefited by taking cod-liver oil through- out the entire winter. The pure cod-liver oil is preferable, commencing with half to one teaspoonful with meals, and increasing up to two to four teaspoonfuls, as children become accustomed to it. Many children are clothed too heavily. Med- ium weight underwear of wool and cotton mix- ture should be worn, and only light weight outer clothing worn in the house. When out of doors a child should not be so bundled up as to perspire freely when playing. Living and sleeping rooms should be well ventilated, and the more sunny they are the better. A living-room temperature of 68 F. is better than one of 70 R, and the air should be changed completely every day. This sub- ject has been so thoroughly considered in Chap- ter II (Sunshine and Fresh Air in the Home) 192 THE CHILD FROM TWO TO SEVEN that it is mentioned here simply for re- emphasis. A morning rubbing of the face and chest with cold water, followed with a brisk rub with a coarse towel until the skin glows, is an excellent preventive of colds. The bath should not be extended over a minute, and should be followed by a good reaction. A warm soap and water bath given at bedtime twice a week, tends to keep the skin active, and prevents colds. Right at the onset of an acute cold with sneezing and running nose, the wisest course is to put the child to bed in a sunny room by itself, and keep other children away. Even if the symptoms are very slight, children can be made happy in bed with picture-books, dolls, and other toys. Such care will stop the prog- ress of the cold much more quickly, and pre- vent other members of the family from con- tracting the cold. Unless the symptoms yield quickly to such care, it is best to seek medical aid, for neglected colds are apt to become serious bronchial conditions. ADENOID GROWTHS Back of the nose in the upper part of the throat, is situated a glandular mass known as "Adenoids". It is a normal growth, and only when it becomes enlarged or diseased does it require removal. DISEASES AND DISORDERS 193 Overgrowth of adenoids causes mouth-breath- ing, and during sleep children snore and toss restlessly about the bed. Children having dis- eased adenoids are constantly having colds, chronic nasal discharge, and swelling of the glands of the neck; their speech is apt to be thick and nasal in tone. They are also subject to earache, and sometimes serious inflammation and abscess of the ears, often resulting in chronic discharge and deafness. In the course of time the condition may result in deformity of the upper jaw and mouth. Headaches, sleep- lessness, and various nervous symptoms accom- pany adenoids, and diseases such as measles, whooping-cough, pneumonia, scarlet fever, and diphtheria, are worse in children who have en- larged adenoids. The necessity for careful examination by a physician and the removal of the overgrowth, is apparent. The operation is simple in skillful hands, and not to be considered as dangerous. Just when to have it done depends upon the urgency of the symptoms. Usually it is better to postpone the operation until the child is over two years of age, as there is less possi- bility of recurrence than when it is done in early infancy. Children recover quickly after the operation and show improvement at once. The breathing becomes easy, and sleep is more restful and quiet. Children who have been thin, pale and 194 THE CHILD FROM TWO TO SEVEN listless improve in color, become brighter, and the weight increases. ENLARGED TONSILS Overgrowth of adenoids is very often accom- panied by enlarged tonsils, and are frequently removed at the same operation. Swollen and repeatedly inflamed tonsils are very apt to lead to serious illness, such as inflammation of the joints, and disease of the heart. Chronically enlarged tonsils should be brought to the at- tention of the physician, who will decide the question of removal. THUMB AND FINGER SUCKING The habit of sucking usually commences in infancy, and unless interfered with may con- tinue until children are six to eight years of age. Children suck the thumb, the fingers, the corner of a blanket, and are frequently given rubber nipples and rings to suck. Some parents may question whether the habit is really harmful, but when it is considered that children handle toys, books, different pieces of furniture, play on the floor, and that people frequently take a child's hand in greet- ing, it is evident that the carrying of disease germs to the mouth and throat by sucking the fingers, is not only possible, but must be con- sidered wholly probable. The delicate mucous membrane of the mouth DISEASES AND DISORDERS 195 is undoubtedly often injured by the habit, re- sulting in inflammation and infection of the mouth. It is a habit which can never be of use to any child. Viewed from any standpoint it is distinctly unwholesome and unhealthy, and every effort should be made to prevent the formation of the habit, or to break it if al- ready commenced. By every means possible, from earliest in- fancy, children should be trained to keep the hands away from the mouth. They should not be allowed to suck any article in order to keep them quiet. The question of the child's food should be carefully considered, remembering that a hungry child will suck the whole hand if it can get it into the mouth, and cries for some minutes before feeding time. Applying to the hands medicine having a dis- agreeable taste is seldom effective. The wear- ing of small bags or mittens without thumbs will break the habit in some children, but other means are necessary in most cases. Some mothers have prevented sucking by putting on the child a belt having small bone rings attached on each side, and wristlets hav- ing similar rings; the rings on the wristlets are then attached by tape to the rings on each side of the belt. This permits freedom of arm move- ments, but prevents the child reaching the mouth with the hand. The belt and wristlets may be made from strips of unbleached cotton 1% THE CHILD FROM TWO TO SEVEN cloth about one and a half inches wide. This contrivance has also been used to prevent scratching of the face when children have eczema. Much may be accomplished by persistently removing the child's hand from the mouth, and diverting the attention elsewhere. As children reach the age of two years suggestion may be effective, but during sleep fastening the arms to the sides as described above may be neces- sary. NAIL-BITING This habit is most frequently seen in chil- dren over three years of age, and unless stopped in the beginning is apt to extend into adult life. It is seen especially in children whose general health is not good, and is often a sign of an irritable condition of the nerves. Every effort should be made to break up this habit at the beginning. It not only injures the nails, and mars the shape of the ends of the fingers, but is one way of carrying disease germs to the mouth and throat. Every means should be used to build up the general health by wholesome food, an abundance of sleep, and outdoor life. MASTURBATION (SELF-ABUSE) The most injurious of all bad habits, this habit should be broken up as soon as discov- DISEASES AND DISORDERS 197 cred. It is practiced by rubbing the genital organs with the hands, the clothing, against the bed, or by rubbing the thighs together. Other children sit upon the floor, and with thighs tightly crossed, rock forward and backward. The habit is more common in older children, but has been observed as early as one year, and in both sexes. Fortunately there are many children who escape this pernicious habit altogether. Much depends upon early training and good care. An excessively long tight foreskin which does not allow of pushing back for thorough cleans- ing, should receive medical attention; other- wise, the collection of secretions underneath will produce irritation. Infants should be watched, and if necessary the hands mechanically restrained. Punish- ment is of little use with older children, and makes matters worse. This close observation should be unobtrusive, and is especially neces- sary when children are first going to sleep, and on waking in the morning. As soon as children can talk and can under- stand, they should be instructed at the daily bath not to touch the parts except to keep them clean. The most important means of prevention are, to watch children closely, to keep their trust and confidence, and from earliest childhood to teach self-control by every possible means. COMMON EMERGENCIES OF CHILDHOOD "Good health and good sense are two of life's greatest blessings" Publius Syrus. CHAPTER X COMMON EMERGENCIES OF CHILDHOOD Children are naturally carefree and unthink- ing of any possibility of mishap in their play. Forgetful of words of caution they enter whole- heartedly into all sorts of play activities, and so it is not strange that they meet with some upsets, tumbles, and other accidents of various kinds and degree. For the reason that some of these mishaps may demand first aid care, it is desirable that parents should know some- thing of the best methods of meeting the most common emergencies of home and playground. BURNS One of the most common accidents which befall children is burning while playing with matches or fireworks, or from scalding with hot water. By far the most common burn is that received while playing with matches. To chronicle all the serious and often fatal acci- dents occurring to children in this way would fill many newspaper columns. Such accidents are reported in the papers almost daily. Matches should be kept high out of reach of 201 202 THE CHILD FROM TWO TO SEVEN all children, and it is best not to leave young children alone in a room where there is fire. Fortunately parents are coming to realize the possibilities of danger in the use of fireworks, and while there are still many serious and fatal injuries occurring every year, the number has decreased during the last few years. If chil- dren are permitted to play with fireworks, it should be only under the direct supervision of parents. THE CARE OF BURNS If the child's clothes are on fire, beginning at the neck, wrap the child quickly in whatever heavy, woolen material is handy, such as a rug, carpet, a woolen blanket or overcoat, at the same time placing the child low on the floor, in order that the flames will not rise to the face and head. If ready at hand, dash a bucket of water over the flames. Do not run about with the child, or allow the child to run about; under such circumstances the flames spread more rapidly. To prevent pain air must be kept from the burns, and the clothes should not be allowed to rub against the burned skin. An excellent solution for burns is made by dissolving a heaping teaspoonful of baking soda in a glass of water. In this solution soft linen or cheese cloth is soaked and applied to the burn. When the pain subsides boric-acid ointment may be applied. EMERGENCIES OF CHILDHOOD 203 When the burns are more extensive and severe, the child should be put to bed and kept quiet until the physician arrives. Instead of pulling off the clothing it should be cut away piece by piece. Only small places should be exposed, and linen cloths soaked in the solution applied. When air reaches large areas it is very painful. It is best to leave dressings for the physician unless he is long delayed. After applying the soda solution by pieces of linen, the parts may be still further protected from the air by wrapping in raw cotton and ban- daging loosely. Usually in severe burns there is considerable prostration. Keep the child quiet in a dark- ened room and apply hot water bottles wrapped in towels or flannel, about the legs and feet, and if there is much weakness, give a few swallows of strong, hot coffee. BURNS FROM ACIDS AND ALKALIES Burns caused by acids should be washed quickly with water or baking soda solution. Those caused by alkalies or lye should be washed with a solution of vinegar and water. Either kind of burn may then be wrapped in soft linen or cheese cloth soaked in boric-acid solution. WOUNDS If the wound is deep or extensive, or if the bleeding does not stop easily, it should have 204 THE CHILD FROM TWO TO SEVEN surgical attention at once. If the wound is slight, apply a few drops of the tincture of iodine, then cleanse with boiled water, or one of the simple boric-acid solutions. A solution may be prepared by dissolving a half teaspoon- ful of boric-acid powder in a cup of clean, boiled water. It will do no harm to allow the wound to bleed a moment; the blood will wash away any bits of dirt present, and if the wound is a slight, clean cut, further cleansing may be unnecessary, other than to wipe clean all about the wound. Then, using a bit of clean absorb- ant cotton soaked in the boric-acid solution, slight pressure on the wound will usually stop the bleeding. A small compress of clean linen or gauze soaked in the solution is then bound on the wound, using a small gauze bandage if handy. If there is no pain or inflammation, this first dressing may be left on for two or three days unless it becomes much soiled. If the wound is on a finger, a finger-cot will help to keep the dressing clean. Should the wound become painful and swollen a physician should be consulted. LARGE OR DEEP WOUNDS When the wound is large or deep, emergency care until the physician arrives demands that the child be kept quiet, the wound as clean and free from contamination as possible, and that bleeding be controlled. EMERGENCIES OF CHILDHOOD 205 The wound should be freed from the cloth- ing, if necessary cutting the clothing away, and the wound exposed to the air. If it is a clean-cut wound, and everything about the wound is clean, it is best to let it alone until the physician arrives. Bleeding may be con- trolled by steady pressure maintained on ad- jacent blood vessels, or just above the wound. A compress of clean linen or gauze soaked in boric-acid solution or other mild antiseptic, should then be placed over the wound, main- taining pressure to stop bleeding if necessary. It is unwise to handle such a wound more than absolutely necessary until the hands can be properly cleansed with warm water, soap and brush. All articles used for the dressing should be boiled before using. If sterile gauze is not available, linen, cotton or cheese-cloth used in dressing the wound, should be boiled in clean water before using. If cleansing is necessary it should be done thoroughly, using bits of absorbant cotton or gauze soaked in an antiseptic solution. The sterile dressing may then be applied and bandaged firmly. TEARS OR LACERATED WOUNDS Such wounds are very apt to leave scars, and unless very slight, medical care is advisable. They are also more liable to be contaminated by dirt than clean-cut wounds, and need careful 206 THE CHILD FROM TWO TO SEVEN cleansing in warm boiled water and antiseptic solution. In cleansing, use several bits of ab- sorbant cotton squeezed out in antiseptic solu- tion. First wipe away all dirt around the wound, then with clean bits of cotton cleanse the wound thoroughly. The ragged edges should be brought together, covered with a sterile compress, and bandaged. If the wound keeps clean and free from pain or swelling, it may be left until healing is complete, or changed if much soiled. PUNCTURED WOUNDS Punctured wounds are made by tacks, nails, fish-hooks, splinters, needles or pins. If a piece of a fish-hook or needle becomes imbedded in the flesh, or if the wound is deep from a nail, surgical help is advisable. A fish-hook which is in the flesh beyond the barb should never be pulled or torn out, but carefully cut out. If a needle is imbedded in the flesh, care should be taken not to break it in trying to pull it out, and it should be examined carefully after re- moval to see if it is intact. After removing the object the wound should be squeezed in warm water, in order that the blood may wash out any remaining dirt. A sterile compress may then be applied and bandaged. Should pain and swelling ensue, medical advice should be sought without delay. EMERGENCIES OF CHILDHOOD 207 BROKEN BONES AND DISLOCATIONS A broken bone or bone out of place is very painful, and usually there is a deformity. The limb should be placed in as comfortable a posi- tion as possible until a physician can give it the care needed. The child should be moved with the utmost gentleness, and the broken limb supported continually, as the slightest move- ment causes severe pain, and the jagged ends of the broken bone tear the flesh. If a child must be carried some distance, something in the way of support should be provided. The limb may be bandaged with handkerchiefs to a piece of board or paste- board, a piece of branch from a tree, or the broken leg may be bandaged to the sound one, or the arm to the side. At home a broken limb may be supported by two pillows, one on each side. DOG-BITES Fortunately most of the bites are very slight, often mere abrasions of the skin, and seldom cause serious trouble if properly cleansed, and covered with a suitable dressing. Children are seldom bitten by a dog in their own family. It is more often by some other dog which dislikes to be petted by children. Little folks should be taught to keep away from dogs outside of the family, and that even with 208 THE CHILD FROM TWO TO SEVEN their own dear home friend, it is best not to disturb him while eating, or maul him too much on hot summer days. Few dogs really become rabid unless horribly thirsty, starved or abused. If a child is bitten by a dog which is thought to be rabid, it is best not to kill the dog immediately unless in self- defence, but to keep it in confinement until the matter can be passed upon by experts. If it is found not to be rabid, much relief will be experienced by all concerned. The bite of any animal should be squeezed out thoroughly under warm water, and thor- oughly cleansed with an antiseptic solution. A compress soaked in the solution should then be applied, and a physician called. BLEEDING FROM THE NOSE Nosebleed is such a common complaint during childhood that we are apt to regard it as of little importance. It is true that bleeding from the nose is seldom a serious matter, yet, it is also true that frequent nosebleed may be a symptom of some abnormal condition of the nose, or disease of the body, needing attention. When they occur very frequently, therefore, the child should be taken to a physician for thorough examination. The most common reason for nosebleed is that a crust has been picked away, leaving a bleeding point on the septum in one of the EMERGENCIES OF CHILDHOOD 209 nostrils. Usually it is easy to determine from which nostril the blood is coming, when firm and steady pressure maintained for a short time on the affected side will stop the bleeding. Steady pressure maintained on the upper lip at the outer edge of each nostril, or at the root of the nose, will usually stop bleeding. Such means failing to stop it, a piece of absorbent cotton rolled into a cone and soaked in ice-cold water, or a bit of ice thus rolled in cotton, and gently inserted into the nostril, over which steady pressure is maintained outside, will fre- quently serve to stop bleeding. The plug of cotton should protrude from the nostril to per- mit of easy removal, and the child must not blow the nose. At the same time, if the bleed- ing continues, the feet may be placed in a mus- tard foot-bath, thus diverting the blood from the head. Usually such home methods will prove effec- tive, but if bleeding continues, the nostrils may need special treatment by a physician. Chil- dren should be taught to keep the fingers away from the nostrils. Constant picking produces a chronic unhealthy condition, and is apt to carry infection to the nose. FOREIGN BODY IN THE NOSTRIL Children sometimes put a small object such as a pea or bean into a nostril and forget it. 210 THE CHILD FROM TWO TO SEVEN After a time chronic inflammation and discharge calls attention to it. If the object is not too far in, or too firmly held by the swollen mem- brane, it may sometimes be expelled by having the child blow its nose, while the empty nostril is closed by pressing firmly with the finger, or by causing the child to sneeze by tickling the nostril. Unless such simple means are effective, it is best to consult a physician, since injury may be caused by unskilled attempts to remove the object. FOREIGN BODIES IN THE EAR Children occasionally put such objects as beads, peas or beans into the ear. Unless the object can be grasped easily and removed, it is best to leave its removal until such time as a physician can be consulted. Such an object does little harm unless it causes pain or distress, and unskilled attempts to remove it may push it farther into the canal, where it may produce irritation by pressing against the ear-drum. Sometimes it happens that an insect crawls into the canal of the ear, and causes much dis- comfort. Four or five drops of sweet or castor- oil should be introduced into the canal, followed about half an hour later by syringing with warm water. INJURIES TO THE EYE When a bit of soot or dirt gets into the eye, the tendency is to rub it which makes matters EMERGENCIES OF CHILDHOOD 211 i worse by causing irritation. The tears will fre- quently wash away the object, unless the par- ticle adheres to the surface under the upper lid. Sometimes by gently lifting the upper lid away from the eye and downward over the lower lid, then letting go, the lower lashes will act as a brush, and sweep away the particle. Should this not prove successful the surface of the eyeball and under portion of the eyelids must be examined. It is a simple procedure to pull down the lower lid, and look for a speck on its inner surface, or on the surface of the eyeball and the corners of the eye. If the par- ticle is seen it may be removed with the corner of a handkerchief, a bit of cotton twisted about a match, or a moistened camel's hair brush. If the speck is not found and irritation per- sists, the inner surface of the upper lid must be exposed to view. To accomplish this the eyelid should be gently dried but not rubbed. The child is told to look down, the edge of the lid and lashes are seized with the thumb and forefinger of the right hand, and the lid is drawn first forward and downward away from the eyeball, then upward over the thumb or forefinger of the left hand; the particle may then be removed with the corner of a handker- chief. It may be necessary to try several times. It often happens that no particle is found, and yet, the eye still feels irritated and as though something remained on the surface. 212 THE CHILD FROM TWO TO SEVEN This may be from the irritation produced by the particle, and by efforts to remove it. The eye is so sensitive that the irritation may re- main for a few hours even after the particle has been removed. Bathing the eye gently with boric-acid solution by allowing the solution to trickle from a bit of cotton from the outer to the inner corner of the eye, will give consid- erable relief. LIME OR ACIDS IN THE EYE Although not very common, it occasionally happens that lime or acid enters the eye and causes much pain. A physician should be con- sulted as soon as possible, but until he arrives, to relieve the pain when lime is in the eye, a solution made by adding a teaspoonful of vine- gar or lemon juice to a glass of water, may be allowed to flow freely into and over the eye. When an acid is in the eye, a solution of baking-soda, a tablespoonful to a glass of warm water, may be used in the same way. After the lime or acid is removed by the solution as described, a teaspoonful of sweet oil may be instilled into the eye, and is very soothing. WOUNDS OF THE EYE For wounds of the eye cold compresses should be applied, and the child kept quiet on a couch in a dark room until the physician arrives. When the eyes are burned, sweet oil or vase- EMERGENCIES OF CHILDHOOD 213 line should be applied, and the eyes covered with a clean, soft handkerchief until the arrival of the physician. SWALLOWING OF FOREIGN BODIES This can often be prevented by watching little children, and when they put some object in the mouth, removing it at once. With some care it is possible to teach children not to put articles in the mouth. If the object has lodged in the upper part of the throat where it can be seen and felt, a cautious attempt may be made to remove it with the fingers. If it is not seen in the throat it has probably passed on into the stomach. If some object fails to pass along and causes chok- ing, the child should be held by the feet with head downward, and slapped upon the back. If this fails to dislodge it a physician should be summoned at once. It is well to be sure that an object has really been swallowed. Careful search about the child's clothes, in the crib, or wherever it has been playing, will often reveal the article sup- posed to have been swallowed, and thus prevent needless anxiety. The child may be allowed to chew and swal- low plenty of potato and bread, but under no circumstances should a cathartic or an emetic be given. If an object has been swallowed the 214 THE CHILD FROM TWO TO SEVEN cathartic is liable to hurry it so rapidly through the bowel as to cause injury; otherwise, it be- comes covered with fecal matter and passes harmlessly through the intestine. A foreign body usually passes from the bowel in three to four days, but occasionally it may take a week or ten days. DROWNING ACCIDENTS Prompt action is sometimes necessary to save the life of a person who has been rendered un- conscious by drowning, or to prevent severe illness due to exposure and cold. Every effort should be made to restore consciousness even though the chances appear to be hopeless. The clothes should be loosened about the neck, and the child turned upon the face with the body raised higher than the head, in order that the water may run out of the mouth and throat. At the same time the mouth should be gently wiped out with a handkerchief, and the tongue pulled forward to allow free breathing. The nostrils also should be freed of mucus as much as possible. ARTIFICIAL RESPIRATION The child is turned on the back with shoul- ders raised by placing under them a folded coat or pillow, the head falling backward. To prevent the tongue from falling back in the throat and impeding respiration, it should be EMERGENCIES OF CHILDHOOD 215 wrapped in cloth and held well forward. Now grasp the arms near the elbows, and swing them outward and upward away from the body until they meet above the head. This movement raises the ribs and expands the chest, and al- lows the air to enter the lungs. The arms are kept above the head for a moment, pulling upon them strongly; they are then brought down to the sides and pressed forcibly against the lower chest walls, which expels the air from the lungs. This is an effort to imitate normal ins- piration and expiration, and should be repeated slowly and steadily from sixteen to eighteen times a minute. With different people taking turns, it should be kept up two or three hours, until it is certain that the heart as well as the pulse has ceased beating. Life has been re- stored when all efforts seemed hopeless. While artificial respiration is being carried out, somebody should remove the clothing, rub the body thoroughly dry, and wrap the child in warm blankets, applying extra warmth by whatever means are available, such as hot- water bottles, or by stones heated in fires built nearby. To prevent burning the child the hot- water bottle or stone should be wrapped in newspapers or clothing. In the summer at the seashore, hot sand would supply needed heat. The limbs should be rubbed from hands and feet toward the heart, and when breathing be- gins artificial respiration should keep pace 216 THE CHILD FROM TWO TO SEVEN with it, evenly and steadily, in order to help and not to hinder it. Stimulants and hot drinks in small quantities should be given as soon as the child can swallow. Unless compelled by cold weather, it is best not to move the child from the place until recovery is well established. On arriving home the child should be given a warm bath, a good rubbing, wrapped in warm blan- kets, and given a hot drink, in order to avoid illness from exposure. Many drowning accidents might be prevented by keeping boys and girls off rivers and ponds until the ice is declared safe. The custom existing in some of the larger cities of not per- mitting skating on ice until tested and declared safe by city or town officers, has much to com- mend it. Such supervision of rivers and ponds would be the means of an annual saving of many precious lives. The slogan "All children should learn to swim" has been heard quite generally over the country of late years; consequently, less chil- dren are drowned when bathing and boating, but the necessity of every child learning this useful art must still be emphasized. It would seem wise for children not to go boating or canoeing unless accompanied by an older person who can swim. If children are not allowed in boats or canoes until they are good swimmers, there will be less loss of child life by drowning. EMERGENCIES OF CHILDHOOD 217 POISONING HOUSEHOLD PRECAUTIONS In this as in other accidents, it is often found that much suffering and possible loss of life might have been prevented by a little care and foresight. This is especially so in regard to the use and disposal of dangerous drugs, for poison most often occurs from the giving of some drug out of the wrong bottle, because of a misplaced or improperly labelled bottle, or from the fact that poisonous substances or liquids have been left within easy reach of the investigating, curious child. After an illness all drugs and medicines should be destroyed. Popular tonics and medi- cines should be kept where children cannot reach them, and soothing syrups should not be given to children. Few real poisons are needed in any home. The few which are kept should be in special bottles, such as the dark blue bottle having the word "Poison" indelibly printed on the side, as well as the name of the poison printed plainly in black letters on white background. They should be kept in an entirely separate closet. The ordinary harmless house- hold remedies should also be kept out of reach and in a place especially assigned for the pur- pose. Both closets should be kept locked, and the key kept in some convenient place, but out of reach of childish hands. By following some 218 THE CHILD FROM TWO TO SEVEN such plan as this, an article can be found quick- ly when needed, and possibility of accident be- comes very remote. FIRST AID TREATMENT The first thing to do when a child has taken poison is to send for a physician. In order that he may bring the needed antidote, he should be informed if possible as to the nature of the poison. If there is doubt as to the kind of poison taken, an emetic should be given to empty the stomach. If vomiting has already commenced it should be encouraged by giving an abundance of lukewarm water. To start vomiting a teaspoonful of mustard or common salt dissolved in a glass of lukewarm water is often effective, or a teaspoonful of syrup of ipecac may be given at fifteen minute Intervals for two or three doses. Tickling the back of the throat will often lead to vomiting. As soon as vomiting begins the patient should swallow large quantities of tepid water, in order to dilute the poison and wash out the stomach. After emptying the stomach soothing drinks, such as the whites of raw eggs in water, milk, barley-water, or flour and water, should be given, and the bowels emptied by an enema of soapsuds as soon as possible. If the child becomes weak and cold, it should be wrapped in warm blankets in bed, warmth EMERGENCIES OF CHILDHOOD 219 applied to the body, and stimulants given. Brandy or whiskey may be given in small quan- tities as follows: For a child of one year, a teaspoonful is diluted with three teaspoonfuls of hot water, and half of this mixture is given, followed in five minutes by the other half. To a child of two years or over, a teaspoonful may be given in three teaspoonfuls of hot water. Us - e cold water if hot water is not quickly available. If breathing is very feeble or stops, artificial respiration as carried out in drowning accidents, should be practiced. COMMON POISONS AND TREATMENT I. For these poisons an emetic is given first. POISON SYMPTOMS TREATMENT Unknown Emetics ; Stimulants; Soothing liquids. Alcohol: Brandy, Whiskey, etc. Dizziness, unsteady on feet, face flushed, skin cold, pulse weak; patient may be unconscious. Emetic; hot cofifee; aro- matic spirits ammonia. Cold douche to face and chest. Keep awake but do not 220 THE CHILD FROM TWO TO SEVEN POISON SYMPTOMS TREATMENT exhaust by forcing to walk. As recovers, wrap warmly in blankets in bed. Arsenic: Severe pain Present in in stomach, rat poisons, purging^ vermin cramps in destroyers, legs, vomit- Paris green, ing, cold Fowler's sweat, solution prostration. in its various forms : Drowsiness, becoming unconscious; Emetics; drink much luke- warm water; magnesia in large quantity; baking-soda, or water of ammonia. Follow with whites of raw eggs, milk or sweet oil. Castor oil to open bowels. Soap and water enema. Warmth and rubbing. Emetics; diffi- cult to produce EMERGENCIES OF CHILDHOOD 221 POISON Laudanum, paragoric; certain syrups and cough mixtures SYMPTOMS pulse first strong, then weak. Breathing deep and slow, becom- ing more and more slow and shallow. Pupils of eyes very small, face flushed, then bluish. TREATMENT vomiting, but should persist. Strong coffee. Keep awake by speaking to patient loudly, but do not tire out by walking. Stimulants; artificial respiration. Phosphorus: In match- heads, rat poisons, and vermin destroyers. Severe pain in stomach, vomiting, bloody diarrhoea, skin dark, nose-bleed, possibly convulsions. Emetic, follow with epsom salts, table- spoonful in glass of water; or magnesia. Milk; no oils of any kind. Stimulants and warmth. Lead: Lead paint, White lead Metallic taste, throat dry, and great Heaping table- spoonful epsom salts in glass 222 THE CHILD FROM TWO TO SEVEN POISON Sugar of lead. SYMPTOMS thirst. Colic in abdomen, cold sweat, cramps in legs. Legs are sometimes paralyzed, and may be convulsions. TREATMENT of water, Stimulants, soothing liquids. Ptomaine: Poisoning by decayed meat, fish, dirty milk, ice-cream decayed vegetables. Nausea, vomiting, diarrhoea, cold sweat; pulse weak. Severe colic and cramps; prostration extreme ; skin rashes common. Purgative, epsom salts or castor oil. Teaspoonful powdered charcoal, and repeat. II. Poisons Emetics not given first. POISON Mercury: Corrosive sublimate, Antiseptic tablets. SYMPTOMS Corrosive sublimate very irritating. When taken, TREATMENT First give white of egg or whole egg well beaten. Flour and water. EMERGENCIES OF CHILDHOOD 223 POISON SYMPTOMS turns mouth, lips and tongue white. Mouth swol- len, tongue shrivelled; metallic taste. Pain in abdo- men, vomiting mucus and blood. Bloody diarrhoea, cold, wet skin, prostration, convulsions. TREATMENT Then give emetics; follow with soothing liquids and stimulants. Iodine: Metallic taste, Marked prostration, severe pain in stomach and abdomen. Violent vomiting and purging. Large amounts starch or flour mixed with water; then give emetics; follow with milk, raw whites of eggs. Warmth to body and extremities. 224 THE CHILD FROM TWO TO SEVEN POISON Nitrate of Silver: Lunar Caustic. SYMPTOMS Pain in mouth and stomach. Mouth ap- pears white, then black. Vomit white, then black. TREATMENT Teaspoonful table-salt dissolved in glass of water. Milk; then give an emetic. Follow with soothing liquids and stimulants. III. Poisons for which an emetic should never be given. POISON The Strong Corrosive Acids: 1. Acetic 2. Hydro- chloric 3 Nitric 4. Sulphuric (Vitriol) SYMPTOMS Severe burn- ing pain in mouth, throat, and stomach. Acid destroys membrane and skin. Vomiting and diarrhoea. Suffocation from swelling of throat. Prostration. TREATMENT Magnesia or chalk in water, often, and large amounts. Baking soda, lime, whiting, even tooth- powder may be used as alkali to neutralize acid. Follow with soothing liquids, milk, raw eggs, olive or sweet oil. EMERGENCIES OF CHILDHOOD 225 POISON SYMPTOMS TREATMENT Stimulants. If acid has en- tered the nos- trils, inhale fumes of ammonia. Oxalic Acid: (Salts of lemon or sorrel) Similar to corrosive acids named above, but not so much burning" of lips, etc. Magnesia, chalk and water, or lime- water to neutralize acid. Follow with two table- spoonfuls castor oil, and stimulants. Carbolic Acid: Creosote Powerful corrosive poison. Great pain and vomiting. In severe cases, patient unconscious. Characteristic odor of acid. Wash out mouth with lime-water, pure alcohol or Two table- spoonfuls of epsom salts in half glass water. Raw eggs, castor 226 THE CHILD FROM TWO TO SEVEN POISON Strong Caustic Alkalies: Ammonia, Quick lime or lye, Caustic Potash, Caustic Soda. GAS: Illuminating or coal gas. SYMPTOMS Turns burned membrane white if acid is pure, black if impure. Severe burn- ing pain in mouth, throat and stomach. Vomiting and purging. Alkali destructive to tissues of mouth. Severe pros- tration, and suffocation due to swell- ing of throat. TREATMENT or sweet oil. Stimulants; keep warm. To neutralize the alkali, vinegar, lemon juice, orange juice. Tartaric or citric acid in an abundance of water. Soothing liquids; stimulants. If unable to swallow, inhale vinegar from handkerchief. Depend mostly on artificial respiration as in drowning. Ammonia to nostrils. INDEX A Page Accidents 201 Acids, treatment of burns from 203 Adenoid growths 192 Air, fresh air in the home.... 9 Alkalies, treatment of burns from .203 Amusements 123, 132, 133 Antidotes for Poisons 217 to 226 Apartment houses as homes 7, 8, 9, 12 Appetite, lack of 23, 24 Arches, weak, prevention of 160, 161 B Bacon, when to give to chil- dren 34 Bag, sleeping, how to make 61, 62 Barley gruel, use of, how to prepare 40, 41 Baths and Bathing, 142, 143, 144, 145 conveniences for 142 daily 143, 144 prevention of colds 144 shower 144 soap for 145 warm 143 Bed and sleeping room 59, 60, 61 Bedtime stories, choice of 59, 60 Bedwetting, Causes and Pre- vention 184, 185, 186 Beef juice, as part of child's diet 41, 42 Page scraped, for young chil- dren 34 Bleeding from nose 208 from wounds 204, 205 Blocks, Building, how to make set of -...83, 84 Body-building, food for 19 Body, care of 141-163 Bones broken 207 Boric acid solution 150 Bottle, weaning from 41 Bowels, care of the 181, 182, 183 Breads 31, 32 Breakfast foods, cereals 30 Broths and soups 33 Bumps and Bruises, care of 201 Burns, care of, first aid 201, 202, 203 Butter for children 32, 33 c Cake 32 Candy and sweets 38 Care of Child's body 141 Ears 150 Eyes -.148 genitals 147 hair 147 mouth 153 nails, biting the 195 nose and throat 151, 152 skin 141 teeth, 153, 154, 155, 156, 157, 158, 159 Carrots 35 227 228 INDEX Page Cereals 30 dry, ready to serve 30 cooking of 30 Changeableness in children.... 93 Chickenpox 171 Child, the city 8 nature, characteristics of 90, 91, 92, 93, 94 sick, care of 179, 180 undernourished, under- weight 19, 21, 25 Childhood, common emergen- cies of 201, 221-226 Children, feading of 19 diseases and disorders of.. 167 play activities of 67 training of 87 Circumcision 147 City Child, Materials and tools for play 79 Clay modeling 81 Cold baths 144, 145 Colds, causes of 189, 190 prevention of 191 Cold weather sports 76 Common foods arranged in tables 41 Common diseases of child- hood 167 Common accidents of child- hood 201 Common poisons and their antidotes -.219 Constipation 181 causes and prevention 181 changes in food will help 182 fruits and vegetables in.. ..182 Page measures for relief 183 Contagious diseases 167 care of children having.. ..180 prevention and control of 175 Convulsions, first aid in 186 Correction, methods of..... 106 Cough, whooping 170 Country life, advantages of 9, 70, 76, 78 Crayons, watercolors and pencils 81 Cream in diet for children.... 32 Cross-eye 148 Croup, spasmodic, relief of 188, 189 Daily nap, importance of.... 58 time for 57 during school years 58 Dark moods unwholesome.... 129 Deafness, a cause of back- wardness in school 151 Defective teeth, results of 153, 154, 155, 156 Deficient nourishment, re- sults of 21, 24, 25, 27 Deformities, of feet from ill- fitting shoes 160 of jaw as result of thumb- sucking 155 of teeth 154, 155 Delicate children, bathing of 144 care of 125, 126 feeding of 24, 25 sleep of 58, 59 INDEX 229 Page Dentistry, importance of 159 Desserts allowable for chil- dren 38 Development, conditions ne- cessary for 2 Diet for growing children.. 27 must be carefully chosen.... 27 and the teeth 156, 157 regulating the 22, 23 lists for feeding children 40-49 (See also FOOD) Digestion impaired by defec- tive teeth 153, 154 Diphtheria 173, 174 making children immune to 178 Schick Test and preven- tion of 178 Discharging ears 151, 173 Discipline 106, 107 in the prevention of nerve disorders 126 Disease, prevention of 167, 168, 169, 175, 180 Disease germs, how they get into the body 154 how they spread 175 Diseases, common, of chil- dren 167-175 new point of view 167 prevention of 175, 176, 178 Disorders, common, of chil- dren 181-197 nerve and mind, preven- tion of 121-137 Dog-bites, first aid 207, 208 Page Dressings for wounds 203, 204, 205 Drinking water, importance of 45 Drowning accidents, first aid 214, 215, 216 E Earache 187, 188 Ears, care of 150, 151 discharging 151 foreign bodies in 210 Eating between meals, results of 23, 24, 25, 50, 51 Education 87, 111, 112 and discipline 104-111 by companionship with parents 112, 113 imitation and observation 111, 112 early years, importance of 87, 89, 111 in the home 87, 109, 110 study of child nature.. ..90-95 training for steady nerves and healthy mind ....121-137 Eggs 31 Emergencies, common 201 Emetics, in spasmodic croup 189 in poisoning accidents 218 English, importance of teach- ing correct 110 Enlarged tonsils 193 Entertainments for children, injury to nerves from public 132-133 Epidemics, prevent spread of . ....175-178 230 INDEX Page Equipment for play and oc- cupation 67-84 Evaporated milk 29 Example, power of, in edu- cation Ill, 112 Exercise 71 for girls 76 outdoor, 76, 77, 78, 125 Exercises for weak feet and flat-foot 163 Eye, acids in the, first aid 212 foreign bodies in the 211, 212 lime in the 212 wounds of the 212 Eyes care of 148, 149, 150 Eyestrain, prevention of 149 Facts about weight and height 19, 20, 21 Faith, teach, instead of fear 132 Family life, high ideals of 111, 112, 113 Fat in whole milk 32 proper kinds for children 32, 33 Father, influence of in fam- ily life 21, 22 Feet, care of 160-163 prevention of deformities of 162, 163 Filling the teeth 159 Finger-nails, biting of 195 Finger-sucking 193, 194, 195 Fire-place, desirability of in the home . .. 13 Page Fireworks, danger to chil- dren from 202 First aid in acidents 201 Fish 34 Fish-hook, care of wounds from 206 Flat foot, correction of 161, 162, 163 Food, adapted to age of child.... 22 cultivation of liking for wholesome 24 for growing children 27 Foods, body-building 19 cereal 30 description of 27-39 groups of 31-38 lists of, for children dur- ing second year 39-44 from third to seventh year 45-48 Foreign bodies in the ear....210 in the eye 211, 212 in the nose 209 swallowing of 213 Fractures 207 Fresh air, importance of.. ..9, 10 in living and play-rooms 10, 11 in sleeping rooms 11, 61 Fruits 37, 38 cooked 37 in diet for children 37 when they should be avoid- ed 38 Fundamental principles in feeding children 22 INDEX 231 Page Furniture for the playroom 14, 15 G Gardening for children 78 Gargling of throat 179 German measles 170 Girls, outdoor life for 76, 78, 125 should not go without breakfast 25 Growth and development, conditions necessary for normal 2 H Habits, bad 193, 195, 196 good, of cleanliness.... 117, 141, 159 obedience and self-control 95-100 regularity of bowel move- ments 181-183 of proper eating 22-27 Hair, care of 147, 148 short 148 Hands, keeping clean 146 Hardening of body 126 Healthy, keeping the chil- dren 141 Heating the home 12, 13 Heights and weights of chil- dren 19, 20, 21 Hemorrhage from nose 208 from wounds 204, 205 Heredity, influence of 122 Home, choosing the 7, 8, 9 sunshine and fresh air in the .. . 9 Page training 9, 87, 137 Household precautions against poisoning 217 Hygiene and care of the body 141-163 I Ideals of cleanliness ....117, 141 of Education and Training 87, 88, 111, 112 Illness, prevention of 180 signs of 180 Imagination in children 131, 132 Imitation in early education 111 Individual temperament 94 Indigestion, acute 48, 49 chronic 49, 50 due to improper habits of eating 50 Indoor play .... 80 blocks for 83, 84 equipment for 81, 82 (See also chapter "Play and Growth" 67) Infection, prevention of 175-178 Infectious colds 189, 190, 191 diseases 167-178 Inherited characteristics 122 Injections 182, 183 for worms 184 Instinctive desire for some- thing to do 108 Instruction concerning per- sonal cleanliness 117 reproduction 113-118 Irregular teeth, causes and prevention of 154, 155 Iron in food, 232 INDEX Page in fruits ....._. 35 in vegetables . 37 Isolation in contagious di- seases 175 of sick child 169, 180 L Leg, broken, first aid 207 Light, good, for reading 149 List of foods, for children during second year 39-44 from third to seventh year 45-48 of poisons and antidotes 217-226 M Malnutrition 19, 21, 25 Mannerisms, transient of children 93 Manners Ill, 112 acquired by imitation 112 table 23, 25 Mastery, self- learned early 96, 127, 128 Masturbation 196 Matches, danger of, to chil- dren 201, 202 Materials, play 67-84 for Indoor 80-84 Outdoor 71, 72, 78 Meals, number of 39, 42, 45 regular times for 40-46 Measles 169, 170 German 170 Meats, best for children 34 cooking of 34 stews . ..21 Page substitutes 33 Mental hygiene of childhood 121, 137 Methods of punishment 106, 107 of ventilation 10, 11 Milk 27 amount required per day... .28 body-building qualities of 28, 29 goat's 29 invaluable as food for chil- dren 28 is a food, not a beverage.. 28 pasteurized . 29 substitutes for 29 unheated or raw 29 Mind, charateristics'of child's 90-95 development of Ill, 112 early training of Ill hygiene of the 121-137 Mineral elements in food 35, 37 Mischief, in children 108, 109 to prevent 108 Modeling materials 81 Moisture of air in heated rooms 12 Molars, first, importance of 158 Moods, dark, in children.. ..129 causes of 129 prevention of 129 Mother, care of 89, 90 Mouth breathing 192 Mouth, care of 153, 194, 195 Moving pictures, influence of, on children 133 Mumps 172 INDEX 233 Page Muscular development from play 125 N Nails, biting the 195 Nap, daily 57, 58 Nasal douche, caution about use of 152 Nature, child, characteristics of 90-94 Needle-wound 206 Nerves, disorders of, on the increase 121 preventive work in the home 121-128 Nervous system, care of the childs 121-137 instability of child's 122 Nose, care of 151, 152 Nose-bleed 208 Nostrils, clogged 152 foreign body in 209 O Obedience and self-con- trol 95-102 Occupation, children need 68, 108, 138 Oil and gas heaters, tempo- rary use only 12 Oil for clogged nose 152 Origin of life, instruction concerning 113-118 Outdoor play 71, 77, 78 apparatus for 71, 72, 78 clothing for 76, 125 girls need 76, 125 regardless of cold or rain ., ....125 Page (See also Play and Growth, 67) Outdoors, sleeping 61, 62 Oversensitive, teaching chil- dren not to be 135 P Parenthood, new ideals of 4, 87, 112 Parents, as companions of their children 113 as teachers 87, 88 relation of, to children 88, 89, 130 Pasteurized milk 29 Pastry, use of, in diet for children 38 Perception, slowness of, in children 94 Play, a fundamental need of the child 67-69, 84 a factor in education and growth 67-69 adult's conception of 68 child's conception of 68 indoor, material for 80-84 outdoor 76-78, 125 room 13, 14 with other children, neces- sary 79 Playmates, children need 79, 134, 135 Playthings, for indoor play 80-84 for outdoor play 76-78 made at home 71, 72, 82 Poisoning 217-226 first aid . ....218 234 INDEX Page household precautions against 217 Praise, use of, in training of children 97 Precociousness, not desir- able 132 Punishment 103-109 methods of 106, 107 Questions of children 110, 113-118 about reproduction and sex 113-118 answer simply and truth- fully 113-118 R Rain, outdoor play in 125 Reason, appeal to child's, ....103 Recreation and rest for the mother 89-90 Regularity in life of child 26, 27 of bowels 181-183 of meals 41,, 48 of sleep 55-58 Religious training, begin- nings of 131, 132 Reproduction and sex, instruc- tion concerning 113-118 Respiration, artificial, in drowning 214-215 Responsibility of parents 87, 88, 21, 22, 112, 113 Rest, importance of, for children 55 for the mother 89, 90 Page Restlessness of children 67, 135, 136 often due to lack of oc- cupation 108 Reverence, teaching of 132 Room, children's 13-15 S Sand-box, directions for mak- ing 72 playthings for 72, 73 Scalds and burns, first aid 202, 203 Scarlet fever 172, 173 Schedules for feeding chil- dren 41-47 Scolding, useless ....104, 105, 112 Second year, feeding dur- ing 39-45 lists of foods for 41-44 schedules for meals during 41-44 Self-control, early lessons in 96, 127, 128 Service to others, teaching....70 Sex, instruction concerning 113-118 Shoes, proper fitting of 160-162 Sick child, care of 179, 180 Sight, protection of 148-150 Simplicity, desirable in child's life 64, 132, 133 Skin, care of 141 Sleep, child's need of 55, 56 conditions favorable to sound 59, 61 disturbed, causes of 62, 63 during first two years 56, 57 INDEX 235 Page from third to seventh year 57, 58 Sleeping bag 61, 62 Sleeping outdoors 61 Small tasks for children .... 70 Soaps, for the bath 145 Soups and stews 34 Spasms (see convulsions) first aid 186 Spasmodic croup 188, 189 Sports, outdoor 71, 77, 78 Sterilized milk 29 Stories for children 59, 131 Sunshine in living rooms....9, 10 Sweets 38 Swimming, teaching children 77 T Tables and lists : diet during second year 39-44 from third to seventh year 45-48 weights and heights of chil- dren 19-21 Tasks, small, for children 70 Teachers, Parent- 87, 88 Teeth, care of 153-159 cleaning the 158 food and the 156 irregular 154-155 second or permanent 157 Temper, causes of 91, 92 outbreaks of 91, 92 what to do ....92, 107, 127, 128 Temperament, individual, of child 94 Tendencies, inherited 122 Third to 7th yr., diet from 45-48 Page Throat, care of -...152, 176 Thumb-sucking, to break ha- bit of 193-195 Thunder and Lightning, teach children not to fear 132 Tonsils, enlarged 193 Tool-box for children, con- tents Of; 75 Tools, garden, for children 78 Toys 80-84 Training (See also Education) early 87, 89, 111 home 87, 109, 110 Truthfulness 109, 110, 111 U Undernourished children .... 19 Underweight, causes of 19, 20, 21 V Vaccination 178, 179 Vegetables, for children 35 cooking of 36 Voice, cultivation of low, pleasant 110 W Water, children need 45 Water-colors for children 81 Weight and height, Table of 19 facts about, of children 20, 21 Wetting of bed, causes and prevention 184-186 Whooping cough 170 Worms, causes and preven- tion 183, 184 Wounds 203-207 First aid for various 203-207, 212 UNIVERSITY OF CALIFORNIA LIBRARY Los Angeles This book is DUE on the last date stamped below. Form L9-75m-7,'61(C1437s4)444 A 001 378 496 2 ( RJ 41 M12 , S ^V OF CALIFORNIA, , CALIF.