Advice to a Mother on the Management of Her Children Part 33

370. _What are the causes of consumption_?

The _predisposing_ causes of consumption are the tuberculous habit of body, hereditary predisposition, narrow or contracted chest, deformed spine, delicacy of const.i.tution, bad and scanty diet, or food containing but little nourishment, impure air, close in-door confinement in schools, in shops, and in factories, ill-ventilated apartments, dissipation, late hours, over-taxing with book-learning the growing brain, thus producing debility, want of proper out-door exercises and amus.e.m.e.nts, tight lacing; indeed, anything and everything, that either will debilitate the const.i.tution, or will interfere with, or will impede, the proper action of the lungs, will be the predisposing causes of this fearful and lamentable disease.

An ill, poor, and insufficient diet is the mother of many diseases, and especially of consumption: "Whatsoever was the father of a disease, an ill diet was the mother."

The most common _exciting_ causes of consumption are slighted colds, neglected inflammation of the chest, long continuance of influenza, sleeping in damp beds, allowing wet clothes to dry on the body, unhealthy employments--such as needle-grinding, pearl b.u.t.ton making etc.

371. _Supposing a youth to have spitting of blood, what precautions would you take to prevent it from ending in consumption_?

Let his health be the first consideration; throw books to the winds; if he be at school, take him away; if he be in trade, cancel his indentures; if he be in the town, send him to a sheltered healthy spot in the country, or to the south coast; as, for instance, either to St Leonards-on-Sea, to Torquay, or to the Isle of Wight.

I should be particular in his clothing, taking especial care to keep his chest and feet warm. If he did not already wear flannel waistcoats, let it be winter or summer, I should recommend him immediately to do so: if it be winter, I should advise him also to take to _flannel_ drawers. The feet must be carefully attended to; they ought to be kept both warm and dry, the slightest dampness of either shoes or stockings should cause them to be immediately changed. If a boy, he ought to wear double-breasted waistcoats; if a girl, high dresses.

The diet must be nutritious and generous; he should be encouraged to eat plentifully of beef and mutton. There is nothing better for breakfast, where it agree, than milk; indeed, it may be frequently made to agree by previously boiling it. Good home-brewed ale or sound porter ought, in moderation, to be taken. Wine and spirits must on no account be allowed. I caution parents in this particular, as many have an idea that wine, in such cases, is strengthening, and that _rum_ and milk is a good thing either to cure or to prevent a cough!

If it be summer, let him be much in the open air, avoiding the evening and the night air. If it be winter, he should, unless the weather be mild for the season, keep within doors. Particular attention ought to be paid to the point the wind is in, as he should not be allowed to go out if it is either in the north, in the east, or in the north-east; the latter is more especially dangerous. If it be spring, and the weather be favourable, or summer or autumn, change of air, more especially to the south-coast--to the Isle of Wight, for instance-- would be desirable; indeed, in a case of spitting of blood, I know of no remedy so likely to ward off that formidable, and, generally, intractable complaint--consumption--as change of air. The beginning of the autumn is, of course, the beat season for visiting the coast. It would be advisable, at the commencement of October, to send him either to Italy, to the south of France--to Mentone [Footnote: See _Winter and Spring on the Sh.o.r.es of the Mediterranean_, By J. Henry Bennet, M.D., London: Churchill.]--or to the mild parts of England--more especially either to Hastings, or to Torquay, or to the Isle of Wight--to winter. But remember, if he be actually in a _confirmed_ consumption, I would not on any account whatever let him leave his home; as then the comforts of home will far, very far, out-weigh any benefit of change of air.

372. _Suppose a youth to be much predisposed to a sore throat, what precautions ought he to take to ward off future attacks_?

He must use every morning thorough ablution of the body, beginning cautiously; that is to say, commencing with the neck one morning, then by degrees, morning after morning, sponging a larger surface, until the whole of the body be sponged. The chill at first must be taken off the water; gradually the temperature ought to be lowered until the water be quite cold, taking care to rub the body thoroughly dry with a coa.r.s.e towel--a Turkish rubber being the best for the purpose.

He ought to bathe his throat externally every night and morning with luke-warm salt and water, the temperature of which must be gradually reduced until at length no warm water be added. He should gargle his throat either with barm, vinegar, and sage tea, [Footnote: A wine-gla.s.sful of barm, a wine-gla.s.sful of vinegar, and the remainder sage tea, to make a half-pint bottle of gargle.] or with salt and water--two tea-spoonfuls of table salt dissolved in a tumbler of water. He ought to harden himself by taking plenty of exercise in the open air. He must, as much as possible, avoid either sitting or standing in a draught, if he be in one, he should face it. He ought to keep his feet warm and dry. He should take as little aperient medicine as possible, avoiding especially both calomel and blue pill. As he grows up to manhood he ought to allow his beard to grow, as such would be a natural covering for his throat. I have known great benefit to arise from this simple plan. The fashion is now to wear the beard, not to use the razor at all, and a sensible fashion I consider it to be. The finest respirator in the world is the beard. The beard is not only good for sore throats, but for weak chests. The wearing of the beard is a splendid innovation, it saves no end of trouble, is very beneficial to health, and is a great improvement "to the human face divine."

373. _Have you any remarks to make on the almost universal habit of boys and of very young men smoking_?

I am not now called upon to give an opinion of the effects of tobacco smoking on the middle-aged and on the aged. I am addressing a mother as to the desirability of her sons, when boys, being allowed to smoke.

I consider tobacco smoking one of the most injurious and deadly habits a boy or young man can indulge in. It contracts the chest and weakens the lungs, thus predisposing to consumption. It impairs the stomach, thus producing indigestion. It debilitates the brain and nervous system, thus inducing epileptic fits and nervous depression. It stunts the growth, and is one cause of the present race of pigmies. It makes the young lazy and disinclined for work. It is one of the greatest curses of the present day. The following cases prove, more than any argument can prove, the dangerous and deplorable effects of a boy smoking. I copy the first case from _Public Opinion_. "The _France_ mentions the following fact as a proof of the evil consequences of smoking for boys--'A pupil in one of the colleges, only twelve years of age, was some tune since seized with epileptic fits, which became worse and worse in spite of all the remedies employed. At last it was discovered that the lad had been for two years past secretly indulging in the weed. Effectual means were adopted to prevent his obtaining tobacco, and he soon recovered.'"

The other case occurred about fifteen years ago in my own practice. The patient was a youth of nineteen. He was an inveterate smoker. From being a bright intelligent lad, he was becoming idiotic, and epileptic fits were supervening. I painted to him, in vivid colours, the horrors of his case, and a.s.sured him that if he still persisted in his bad practices, he would soon become a drivelling idiot! I at length, after some trouble and contention, prevailed upon him to desist from smoking altogether. He rapidly lost all epileptic symptoms, his face soon resumed its wonted intelligence, and his mind a.s.serted its former power. He remains well to this day, and is now a married man with a family.

374. _What are the best methods to restrain a violent bleeding from the nose_?

Do not, unless it be violent, interfere with a bleeding from the nose. A bleeding from the nose is frequently an effort of Nature to relieve itself, and therefore, unless it be likely to weaken the patient, ought not to be restrained. If it be necessary to restrain the bleeding, press firmly, for a few minutes, the nose between the finger and the thumb; this alone will often stop the bleeding; if it should not, then try what bathing the nose and the forehead and the nape of the neck with water quite cold from the pump, will do. If that does not succeed, try the old-fashioned remedy of putting a cold large door-key down the back. If these plans fail, try the effects either of powdered alum or of powdered matico, used after the fashion of snuff--a pinch or two either of the one or of the other, or of both, should be sniffed up the bleeding nostril. If these should not answer the purpose, although they almost invariably will, apply a large lump of ice to the nape of the neck, and put a small piece of ice into the patient's mouth for him to suck.

If these methods do not succeed, plunge the hand and the fore-arm into cold water, keep them in for a few minutes, then take them out, and either hold, or let be held up, the arms and the hands high above the head: this plan has frequently succeeded when others have failed. Let the room he kept cool, throw open the windows, and do not have many in the room to crowd around the patient.

Doubtless Dr Richardson's local anaesthetic--the ether spray--playing for a few seconds to a minute _on_ the nose and _up_ the bleeding nostril, would act most beneficially in a severe case of this kind, and would, before resorting to the disagreeable operation of plugging the nose, deserve a trial. I respectfully submit this suggestion to my medical brethren. The ether--rectified ether--used for the spray ought to be perfectly pure, and of the specific gravity of 0.723.

If the above treatment does not soon succeed, send for a medical man, as more active means, such as plugging of the nostrils--_which, is not done unless in extreme cases_--might be necessary.

But before plugging of the nose is resorted to, it will be well to try the effects of a cold solution of alum:--

Take of--Powdered Alum, one drachm; Water, half a pint:

To make a Lotion.

A little of the lotion should be put into the palm of the hand and sniffed up the bleeding nostril; or, if that does not succeed, some of the lotion ought, by means of a syringe, to be syringed up the nose.

375. _In case of a young lady fainting, what had better be done_?

Lay her flat upon her back, taking care that the head be as low as, or lower than, the body; throw open the-windows, do not crowd around her, [Footnote: Shakspeare knew the great importance of not crowding around a patient who has fainted. He says--

"So play the foolish throngs with one that swoons; Come all to help him, and so stop the air By which he should revive."] unloosen her dress as quickly as possible; ascertain if she have been guilty of tight-lacing--for fainting is sometimes produced by that reprehensible practice. Apply smelling salts to her nostrils; if they be not at hand, burn a piece of rag under her nose; dash cold water upon her face; throw open the window; fan her; and do not, as is generally done, crowd round her, and thus prevent a free circulation of air. As soon as she can swallow, give her either a draught of _cold_ water or a gla.s.s of wine, or a tea-spoonful of sal-volatile in a wine-gla.s.sful of water.

_To prevent fainting for the future._--I would recommend early hours; country air and exercise; the stays, if worn at all, to be worn slack; attention to diet; avoidance of wine, beer, spirits, excitement, and fashionable amus.e.m.e.nts.

Sometimes the cause of a young lady fainting, is either a disordered stomach, or a constipated state of the bowels. If the fainting have been caused by _disordered stomach_, it may be necessary to stop the supplies, and give the stomach, for a day or two, but little to do; a fast will frequently prevent the necessity of giving medicine. Of course, if the stomach be _much_ disordered, it will be desirable to consult a medical man.

If your daughter's fainting have originated from a _costive state of the bowels_ (another frequent cause of fainting), I beg to refer you to a subsequent Conversation, in which I will give you a list of remedies for the prevention and the treatment of constipation.

A young lady's fainting occasionally arises from debility--from downright weakness of the const.i.tution; then the best remedies will be, change of air to the coast, good nourishing diet, and the following strengthening mixture:

Take of--Tincture of Perchloride of Iron, two drachms; Tincture of Calumba, six drachms; Distilled Water, seven ounces:

Two table-spoonfuls of this mixture to be taken three times a day.

Or for a change, the following:--

Take of--Wine of Iron, one ounce and a half Distilled Water, six ounces and a half

To make a Mixture. Two table spoonfuls to be taken three times a day.

Iron medicines ought always to be taken _after_ instead of _before_ a meal. The best times of the day for taking either of the above mixtures will be eleven o'clock, four o'clock, and seven o'clock.

376. _You had a great objection to a mother administering calomel either to an infant or to a child, have you the same objection to a boy or a girl taking it when he or she requires an aperient_?

Equally as great. It is my firm belief that the frequent use, or rather the abuse, of calomel and of other preparations of mercury, is often a source of liver disease and an exciter of scrofula. It is a medicine of great value in some diseases, when given by a _judicious_ medical man, but, at the same time, it is a drag of great danger when either given indiscriminately, or when too often prescribed. I will grant that in liver diseases it frequently gives temporary relief, but when a patient has once commenced the regular use of it, he cannot do without it, until, at length, the _functional_ ends in _organic_ disease of the liver. The use of calomel predisposes to cold, and thus frequently brings on either inflammation or consumption. Family aperient pills ought never to contain, in any form whatever, a particle of mercury.

377. _Will you give me a list of remedies for the prevention and for the cure of constipation_?

If you find it necessary to give your son or daughter an aperient, the mildest should be selected, for instance, an agreeable and effectual one, is an electuary composed of the following ingredients--

Take of--Beat Alexandria Senna, powdered, one ounce Best figs, two ounces, Best Raisins (stoned), two ounces,

All chopped very fine. The size of a nutmeg or two to be eaten, either early in the morning or at bedtime.

Or, one or two tea-spoonfuls of Compound Confection. of Senna (lenitive electuary) may occasionally, early in the morning, be taken. Or, for a change, a tea-spoonful of Henry's Magnesia, in half a tumblerful of warm water. If this should not be sufficiently active, a tea-spoonful of Epsom salts should be given with the magnesia. A Seidlitz Powder forms another safe and mild aperient, or one or two Compound Rhubarb Pills may be given at bed time. The following prescription for a pill, where an aperient is absolutely necessary, is a mild, gentle, and effective one for the purpose--

Take of--Extract of Socotrine Aloes, eight grains, Compound Extract of Colocynth, forty-eight grains, Hard Soap, twenty four grains, Treacle, a sufficient quant.i.ty

To make twenty four Pills. One or two to be taken at bedtime occasionally.

But, after all, the best opening medicines are--cold ablutions every morning of the whole body, attention to diet, variety of food, bran-bread, grapes, stewed prunes, French plums, Muscatel raisins, figs, fruit both cooked and raw--if it be ripe and sound, oatmeal porridge, lentil powder, in the form of Du Barry's Arabica Revalenta, vegetables of all kinds, especially spinach, exercise in the open air, early rising, daily visiting the water-closet at a certain hour--there is nothing keeps the bowels open so regularly and well as establishing the habit of visiting the water-closet at a certain hour every morning, and the other rules of health specified in these Conversations. If more attention were paid to these points, poor school boys and school girls would not be compelled to swallow such nauseous and disgusting messes as they usually do to their aversion and injury.

Should these plans not succeed (although in the majority of cases, with patience and perseverance, they will) I would advise an enema once or twice a week, either simply of warm water, or of one made of gruel, table-salt, and olive-oil, in the proportion of two table-spoonfuls of salt, two of oil, and a pint of warm gruel, which a boy may administer to himself, or a girl to herself, by means of a proper enema apparatus.

Hydropathy is oftentimes very serviceable in preventing and in curing costiveness; and as it will sometimes prevent the necessity of administering medicine, it is both a boon and a blessing. "Hydropathy also supplies us with various remedies for constipation. From the simple gla.s.s of cold water, taken early in the morning, to the various douches and sea-baths, a long list of useful appliances might be made out, among which we may mention the 'wet compresses' worn for three hours over the abdomen [bowels], with a gutta percha covering."