Animals are born with instincts which need only circ.u.mstances to bring them out. Now a baby is not born with instincts of this character,--it has not even the instinct to help itself; it cannot find the b.r.e.a.s.t.s that were made for it; it is more helpless than the baby cat or dog or worm. Therefore a baby in whose brain the potential faculty of reason is slumbering must of necessity begin its career wholly dependent upon the supervision and love of its mother, until such time as it may be capable of reasoning for itself. Motherhood is therefore the supreme privilege of womanhood. It cannot be superseded, hence the fundamental factor in any system of race culture, or in any system of infant mortality, must tend to raise the quality and the intelligence of motherhood as a basic necessity. Motherhood at the present time, though the most important and sacred profession in the world, is almost exclusively carried on by unskilled labor. The maternal instinct is deeply rooted and universal; its absence must be regarded as an abnormality, or as a product of misdirected education. The requisites for the mothers of the future should be absolute physical health and love of children.

If nature endowed a baby with instincts there would be no need for reason or education. Education cannot teach a cat how to nurse or wash a kitten any better than it does,--its instinct is good enough. The mother of a human baby, however, is not born with the instinct which enables her to care for her baby equally as well as the cat cares for her kitten. She must be educated or taught to care for it. She can then care for it better than the cat cares for the kitten, and she can be taught to bake, to sew, to read; to play on the piano, which a cat cannot be taught. So while a baby may be the most helpless living thing at one stage of its career it has in it--in the faculty of reasoning--the ability to become the Lord of all the Earth and of all the animals therein. To limit the environment of a child by imposing instincts upon it, would be to limit its inherent freedom. To be obliged to obey a prescribed instinctive law would rob mankind of his creative or reasoning faculty, and that would be to lower him to the level of the brute creation. Reason is of no use if our acts are already determined for us. There are therefore good reasons why the human baby should be, at the moment of its birth, the most helpless living thing; and as a consequence it is imperative, if the eugenic ideal is worthy of attainment, that every baby should have the benefit of trained and efficient care and education.

THE DELICATE CHILD

There is a certain standard by which we measure the physical and mental development of children. This standard we regard as the evidence of normal development. Some children exceed these requirements; they are bigger and stronger at a given age than the average child at the same age. There are other children who cannot be called sick, but who are physically and mentally inferior to the average standard, whom we designate as "delicate." These children are not as big, or as strong, or as heavy, as other children of the same age. They are born with a reduced vitality, or through mismanagement in early infancy they have acquired a subnormal standard of development. Children born of parents who are not of standard vitality are predisposed to be delicate. If the parents are of average development, and the delicacy of the child is acquired by mismanagement, the proper dietetic and hygienic management will, as a rule, promptly result in a satisfactory restoration to normal health.

TREATMENT.--When a mother awakes to the knowledge that her child is delicate; when she understands that her child's vitality is not what it should be, and when she resolves to "do something" in the interest of her child, she is on the right road, and we hope to encourage her in the good intention. We would however tell her that her effort must be thorough, and that she must be patient and persevering. If she does not falter in well doing she will succeed beyond her expectation, and the satisfaction she will experience in noting the evidences of returning health and strength in the appearance and conduct of her child, should be ample recompense for the effort made and the time bestowed.

She must begin with a definite knowledge of just what she intends doing; she must know, however, what must be done and she must begin at the beginning and build from a sure foundation. It is therefore absolutely essential to ascertain if there is any actual disease underlying the reduced vitality which is responsible for the delicacy of the child; this necessitates a thorough examination by a competent physician. If you are a.s.sured there is no disease present, no tuberculosis, no syphilis, no malaria, and that debilitating conditions, such as adenoids, s.e.xual abnormalities, the results of self-abuse, skin disease, do not exist, then certain fixed rules can be laid down, and definite principles followed in the daily management.

WEIGHT, AS A STANDARD OF DEVELOPMENT.--It has been stated elsewhere in this book that one of the safest guides to follow, as to whether a child is thriving, is its weight. This can be relied upon as a general rule. A child should therefore be weighed regularly every week. If it is not gaining an average of four ounces weekly it is not thriving up to standard. When the average is below four ounces there is something wrong with the quality or quant.i.ty of the food.

HOW TO FEED THE DELICATE CHILD.--If the child is breast-fed and the weight standard, as evidenced by the weekly averages, is persistently below normal, we must find a subst.i.tute for the mother's milk. If the child is bottle-fed and it is demonstrated that it is impossible to maintain normal development on cow's milk, a wet-nurse should be obtained. After the child is weaned, or put upon a more liberal diet, milk should continue to be the chief article of diet. From the first to the third year a child should take one quart of milk daily in addition to the other food. There are some children, however, who seemingly cannot take milk without getting indigestion; they should be put on skimmed milk, to which may be added a small quant.i.ty of sugar to make up for the loss of fat. Mothers must be certain that too much milk is not given, or the desire for other necessary food will diminish.

After the first year it is a very good plan to give one teaspoonful of sc.r.a.ped beef daily. If this is well borne, two may be given and later three. It can be given immediately before the regular feeding of cereal and milk. From the twelfth to the sixteenth month eggs may be given: at first one-half, and later a whole egg mixed with bread crumbs. Various vegetables should also be given cooked in the form of a puree. If at any time the child should refuse the food, or act as if it had no appet.i.te, leave the milk out of the diet; this may then restore the appet.i.te and it will take the other food freely; the milk can be resumed later.

As the child grows older, the distaste for milk may grow, or he may be one of those children with whom milk really does not agree; in either event, do not hesitate to leave it out of the child's dietary. These children should be encouraged to eat plenty of good b.u.t.ter on their bread and crackers. b.u.t.ter will not only agree with them, but it will supply any fat deficiency in the general diet. The diet may now consist of milk (unless it disagrees), cereals cooked three hours, raw or rare meat, poultry, eggs, vegetables, purees, cooked and raw fruit, bread, crackers.

HOW TO BATHE THE DELICATE CHILD.--Regular daily baths are particularly of benefit to the delicate child, despite the prevailing fear that they may catch cold. The salt bath is advised and the time to take it is just before retiring. The room should be warm and the temperature of the water should be 90 F.: it should not last longer than five minutes, and the water should be cooled down to 70 F., before the child is removed from the bath. While the cold water is running in, the surface of the body should be briskly rubbed with the mother's hands and after removal the child should be dried with a fairly coa.r.s.e bath towel to ensure a good reaction. Very delicate children need not have the temperature of the water reduced; others may stand water of 80 F., but no lower. In the poorly nourished it is frequently advantageous to rub the body, after drying, with olive oil or goose oil. This aids nutrition and because of the ma.s.sage it aids circulation. In some older children a daily cold spinal douche seems to act particularly well. If the child does not promptly react from the effect of the cold water it is best to discontinue it.

AIRING THE DELICATE CHILD.--Delicate children should, above all things, be a.s.sured of the maximum amount of fresh air and sunlight. Many mothers entertain the idea that these children are disposed to take cold easily, if in the open air,--which is not the case. All children need an abundance of fresh air and the delicate need it particularly. The season of the year and the character of the weather will, of course, dictate just how much open-air exercise they may take.

If the weather is very cold and the air damp, or if there is a very cold high wind, it is best to remain indoors; otherwise the child should remain out for four or five hours. Indoor airing is obtained by dressing the child to go out-doors, putting him in his carriage, and leaving him before an open window in a room of good size with all the doors closed so as not to create a draught.

HABITS OF THE DELICATE CHILD.--The amount of sleep necessary for a delicate child is the same as for a normal child of the same age. The room should always be well aired, night and day, and should be devoted to the exclusive use of the child.

These children should never be allowed to sit on the floor. It is always a difficult matter to avoid this, but it must be religiously guarded against; otherwise a cold is the inevitable result.

A change of air is sometimes advisable and essential, especially during the hot, humid weather of July and August. Much better results will be obtained by sending these children to the mountains than to the seash.o.r.e.

Delicate children should always be clothed warmly, but not too warmly.

The feet and legs must always be kept comfortable. Moderate exercise, short of fatigue, is necessary. A midday nap after the noon meal should be taken every day. The child should be undressed and put to bed for two hours and left there, whether it sleeps or not. This applies to delicate children of all ages.

The education of delicate children should be postponed until the health is restored. They should, however, be made to obey and they should be taught good habits. When school work begins it should be made light and easy. They should not go to school before the eighth year, and then not unless physically fit. They should not play at rough games or with rough companions, though it is not wise to shield them too much. Their habits and peculiarities should be studied and every possible effort made to direct them kindly and wisely so that they may contribute to their own upbuilding.

A systematic observance of these suggestions will save many lives and will aid very considerably in producing stronger men and women. Infinite patience, tact and self-sacrifice is necessary, but the results in every case justify the measures adopted.

INDISCRIMINATE FEEDING: POOR APPEt.i.tE.--In considering many of the diseases of childhood the term "indiscriminate feeding" is used. An explanation of just what is meant by this will be of decided advantage.

There are two fundamental essentials in the successful feeding of infants and children: regularity and suitable food.

A child whose feeding intervals are not regular and whose food is unsuitable is a victim of indiscriminate feeding.

The lack of observance of the regularity rule always leads to loss of appet.i.te and indigestion.

Loss of appet.i.te is a serious condition in a growing child and may give infinite trouble. Indigestion in a growing child is unnecessary, unfortunate, and frequently is the one factor that spoils an entire life. It is unnecessary, because it means and is caused by neglect on the part of the mother; it is unfortunate, because it always paves the way for any serious ailment that is epidemic or "in the air"; and it is important, because it very frequently weakens the stomach and renders it unfit for normal digestion for a long period, if not for life.

If for some reason a child's appet.i.te becomes poor and it is not properly managed until the appet.i.te is restored to normal, indiscriminate feeding is always the result.

The reason for the poor appet.i.te may be because the child is kept indoors too long, or because it is being fed on unsuitable food, or is living in unsanitary surroundings, or many other reasons, sometimes trifling reasons, may cause it. When a child will not eat at meal time, the mother feels that it should eat sometime, so she encourages it to eat between meals, and because of a mistaken kindness she breaks the law of regularity,--a law that can never be broken without serious results following. A child in this condition becomes a disturber of the peace; the parents can do nothing with him; he insists on eating just what he likes and when he likes; and he chooses, as a rule, candy, cake, pastries, ice cream, tea, coffee. Indigestion follows, the child loses weight, is languid and listless and constipated.

When finally the physician is called in he finds it necessary to go back to first principles. He lays down the law in a definite, stern way, and the mother and the child must obey. Most parents know and admit they are doing wrong to give in to a whimsical child, and if they would only make up their minds to conquer when conquering is easy they would save themselves many heartaches, many regrets, and the child much suffering and much possible permanent injury as a consequence. Usually one parent is willing to be master but the other lacks the mental equipment to meet the issue, and argues, as he or she imagines, in favor of the child. The parent whose instinct is correct, whose judgment is true, whose interpretation of the situation is just, should not be dissuaded, or argued away from his or her duty. If it is the first real problem in your domestic experience in which a decided stand must be made, make it without fear and without hesitation, and carry it through to the bitter end. Results will justify and vindicate you.

The general treatment of these children will be found outlined in the following paragraph on Loss of Appet.i.te.

LOSS OF APPEt.i.tE.--If a child complains of not being hungry, and will not take enough food, and if this condition continues for some time, we must regard the matter as being abnormal and find the cause. This is necessary because a child must eat in order to maintain a certain standard of growth and vitality. These children are not sick; they are active and continue to play as usual and they sleep soundly, but they have no appet.i.te. One of the most frequent causes of this condition is too frequent feedings. Some children are naturally small eaters. They thrive and maintain a satisfactory weight; their system seems not to demand large quant.i.ties or even ordinary quant.i.ties of food. Parents observe this habit of little eating and begin to coax and bribe the child to eat more at meal time, and to eat between meals. In this way the child really overeats, the appet.i.te becomes capricious, and the stomach rebels. In a very short time the condition of "loss of appet.i.te"

is established as a consequence. Another cause is the drinking of too much milk, and yet another and very common cause is indiscriminate eating of candy, cakes crackers, and fruit between meals. Children who are fed at the table with adults eat things they should not eat, and spoil their digestive organs and loss of appet.i.te is the result. The Scotch custom of compelling children to eat at a separate table is an excellent one. They are not tempted to ask for things they cannot have.

Lack of fresh air and exercise frequently results in impaired appet.i.te.

TREATMENT.--The very first thing to do with these children is to stop any habit that may be responsible for the loss of appet.i.te. If the child has been eating between meals, stop it absolutely. If too much milk has been taken, stop milk entirely. If the child has not been getting enough fresh air, or if it has been sleeping in a badly ventilated room, or if baths have been too infrequent, rectify the fault. If eating at the family table and fed indiscriminately, change the programme; feed him before the family sits down to meals. Now regulate the time of feeding to suit the age of the child and adhere to strict regularity. It is a pernicious and absolutely wrong custom to force children to eat, or to coax them to eat when they do not want to eat. Loss of appet.i.te will never be cured by forced feeding, or by reducing the interval between feedings, or by giving the child stronger or more concentrated food under the mistaken idea that in this way the loss of appet.i.te can be "made up." The interval of feeding should rather be lengthened than otherwise in order to give the digestive organs an opportunity to regain the normal desire for food. Pay strict attention to the bowels. Be certain the child has a daily satisfactory movement and that he drinks frequently between meals.

If the child does not promptly respond to the proper hygienic and dietary treatment as outlined above there are two things that can be done:

1st: Send the child away. A change of scene and climate will sometimes work like a charm in these cases, and will, after a reasonable length of time, establish a permanently good appet.i.te.

2nd: If this is not possible, as sometimes it may not be with poor patients, then we can give the child suitable tonics.

OVEREATING.--The large majority of individuals eat too much. Most of us would enjoy better health, better spirits, and greater efficiency if we consumed from one-third to one-half less food than we habitually do.

Every living organism requires a certain amount of nourishment according to the work performed and to replenish wear and tear; when food is supplied in excess, the system cannot utilize it, but it is compelled to rid itself of the excess in some way. The work involved in this eliminating process is exceedingly detrimental to the various organs and to the individual. To overeat is to overwork, and to overwork a machine or an animal is not only poor economy but bad judgment. If the digestive apparatus is required to work overtime, it is a self-evident a.s.sumption that the various organs will not digest efficiently the food necessary for ordinary existence. If the necessary nourishment is not adequately digested, the general health will suffer as a consequence. If the general health is below standard the individual will not be competent to carry on the requirements of a normal, healthy life.

We must, however, give some thought to the effect which the excess of food exerts upon the human machine.

Nature provides and maintains a standard relationship between the capacity of the individual and his needs. A child has a digestive capacity to digest and a.s.similate a quant.i.ty of food sufficient for his growth and proper nourishment; an adult maintains the same standard according to his requirements. All the other organs are adjusted to harmonize with this scheme. If we overeat, the immediate result is to disorganize this relationship between the various organs; hence we have a mult.i.tude of effects which manifest themselves in various ways as a direct result of overeating. The combined general effect expresses itself in the form of what is regarded as poor health and a low standard of efficiency. When a larger quant.i.ty of food is taken into the stomach than it can properly digest within a reasonable time, two conditions immediately follow. The stomach itself is dilated and the food is not thoroughly digested. If the habit is persisted in, indigestion, and later chronic gastritis ensues. The direct symptoms of these conditions are given in detail in another part of this book. Very few individuals, however, appreciate the indirect consequences of overeating and of indiscriminate eating on the general health. It is impossible to tabulate in so many words the effect which this habit has on efficiency and temperament. We read and hear a great deal to-day about efficiency.

Now, an individual's efficiency is an expression of that individual's health standard or capacity. To be 100 per cent. efficient one must enjoy good health. It would be absurd to expect a high standard of efficiency from an individual with a low standard of health. Poor health means poor vitality. Vitality is the mark of the master. Without vitality one can never dominate. All the great achievements of the race have been consummated by those who conserved their vitality. No single factor contributes a larger percentage of inefficients and failures than overeating. The man or woman who, from habit or experience, has learned the lesson of right eating and living need not be lacking in efficiency, nor need they despair of the attainment of success.

SYMPTOMS OF OVEREATING.--Efficiency depends not only upon one's capacity to perform, but upon the character of the performance. The spirit must be willing to perform. The overeater is heavy, phlegmatic, indifferent, lacking in energy, tact and initiative. She is constantly subjecting her system to needless overwork; she is depressed, nervous, imaginative and she is not ambitious. She is a victim of self-poisoning, of constipation, indigestion, headaches, flatulency, neuralgia, vertigo, and melancholia. An overeater never enjoys good health, never is efficient, and cannot possibly be successful.

To enjoy good health one should know how to select food and how to combine and proportion it. It has been said that the American people are a race of dyspeptics, and it must be admitted that the a.s.sertion is more or less true. There are millions of people who suffer from indigestion in some degree, and it may justly be said that indigestion has its beginning in overeating, in some form. It may not be overeating in actual bulk, but it is overeating some article or articles that do not agree with the individual, and the fact that certain articles do not agree is unquestionably dependent upon the nervous temperament of the American people--and the temperament of a people is a product of the kind of existence the people subject themselves to. We are, therefore, unwittingly, victims of our environment.

Correct eating means simple eating--only a few things at a time. Food should be selected according to one's age and occupation, and according to the season of the year. To eat habitually large quant.i.ties and at the same time a large variety is suicide pure and simple. If one dared to make the experiment of cutting down one's diet one-half, it is absolutely certain the effect would be immediate benefit. The benefit would not only be manifest in the physical betterment, but the efficiency and general well-being would be greatly enhanced. It is not the kind of food that makes a dyspeptic, but the quant.i.ty. A well person need not consider whether a certain kind of food will or will not agree, providing she does not eat too freely of that food, or combine it with other food. The combination of which may in itself form too much of one kind at a time.

Some people imagine, for example, that oatmeal porridge does not agree with them. When the matter is inquired into, however, it is found that they habitually eat bread, eggs, and other articles, with coffee at the the same meal with the porridge. From this combination they experience distress and blame the porridge. If these would take a plate of oatmeal porridge with cream and salt, and some stewed fruit for breakfast they would not experience any trouble, and this would be an ample meal for the ordinary individual. It is not the porridge, but the unsuitable combination, that is at fault. The same may be said of milk. Many people state that they cannot take milk and they deprive themselves of one of the very best articles of diet because of this idea. There are very few people in the world who cannot take milk in some way. It is not the milk that is at fault; it is the combination of it with other less nutritious articles that is the cause of the distress. Even candy is responsible for thousands of cases of indigestion. Anyone may safely take a reasonable quant.i.ty of good candy, but if it is taken at a wrong time, or combined with other articles, it may readily produce indigestion.

Indiscriminate eating and overeating are prolific causes of rheumatism, kidney disease, heart disease, liver troubles, obesity, arteriosclerosis, and apoplexy. These diseases are notoriously on the increase and must be construed as a direct consequence of the tendency of the American people to overeat and to eat indiscriminately.

BRAN AS A FOOD.--In the chapter on constipation there may be found a formula for making bran m.u.f.fins. These m.u.f.fins are invaluable to children in health, and to the victim of indigestion or constipation, whether child or adult. One m.u.f.fin with each meal will solve the problem of constipation in growing children without the use of drugs or other aid. They will regulate the bowels of adults in many instances without resorting to drugs.

Raw fruit in season, or stewed fruit, or a baked apple, with a light boiled egg and one bran m.u.f.fin, is an ample and a nourishing breakfast for a child at school.

For lunch the same child should have a plate of thoroughly done vegetable soup, a bran m.u.f.fin, and more fruit. After school, a gla.s.s of milk with two or three Graham wafers may be given.

For dinner the child at school may have a mixed meal. This meal should not be later than six-thirty o'clock and the child should retire at eight-thirty at the latest. A bran m.u.f.fin should be taken with this meal unless the child's bowels are too loose.

Mothers should insist on their children eating these m.u.f.fins. If a child eats only what it likes it will not eat what is good for it. If the mother insists in the right way she will win; if she does not the child will win. If the child wins, the mother is the wrong kind of mother. I do not know of any other single article of diet that is of such value to growing children as these bran m.u.f.fins. Children who eat them regularly will have less sickness than other children; they will be strong, healthy and full of energy. The bran in itself is not responsible for this list of excellent acquirements, but the regular eating of the bran is. Most ailments of children are of gastro-intestinal origin; bran keeps the entire length of the gastro-intestinal tract sweet and clean; if the child eats a bran m.u.f.fin with each meal it will not have much desire or much room for any other form of bread or pastry. If white bread or pastry is abstained from the child will not have indigestion, or constipation, and hence it will not be constantly poisoning itself as most children do whose diet is not restricted and whose bowels are more or less constipated.

These m.u.f.fins should be made of the ordinary unsifted bran. If this is not procurable the sifted bran (Johnstone's) may be employed. This bran may be bought in any good grocery.