Modern milling methods, modern cookery, and modern methods of forced farming, have each contributed their share of rendering food inert and frequently deleterious. The miller has extracted the coa.r.s.e cellulose from the various flours in the effort to manufacture a product suitable to the super-civilized public demand. This cellulose is absolutely essential to gastric and intestinal digestion, and if children are deprived of it constipation and indigestion are the natural result.

Forced farming accomplishes the same effect--the fiber of the vegetable is deficient. Bran is rich in mineral salts, iron, protein, and phosphates, and gives to growing children the ingredients which ordinary food is deficient in. Bran prevents intestinal fermentation and children who eat it are free from intestinal gas and putrefaction. It harmonizes chemically with all other foods. Children should be made to take it every day as a matter of self-preservation and of duty.

HYSTERICAL CHILDREN.--Hysteria is not a disease of infancy or of young children. It is seen as a rule after the eight year. Male as well as female children may be the victims to an equal degree. It is much more frequently seen in the offspring of parents who are themselves nervous, or alcoholic, or who suffer from insanity, or have insanity in the family history. If these children in addition to the hereditary influence suffer from stomach or intestinal disease, or general poor health and are overworked at school, they are very apt to become hysterical.

They are capricious, indifferent, and excitable. Their disposition is irritable; they frequently exhibit fits of great excitability of temper and pa.s.sion. They cry or weep without cause. They often have hallucinations and while asleep have attacks resembling night terrors.

They complain of pains in the joints, and are frequently treated for disease that does not exist. Such condition as hysterical cough, spasm of the muscles of the face, mouth, eyes, and of the neck exist and are difficult to diagnose from real disease. These children complain of painful sensations and sensitive areas and exaggerate all symptoms unnecessarily.

The possibility of curing these patients is good, providing the treatment is faithfully carried out. It is less favorable when marked hereditary influences are strong.

TREATMENT.--In all children of distinctly nervous type and especially those of nervous parents, the first essential duty is to develop their muscular system. Try in every way to make healthy animals of them.

Attention and treatment should not be directed toward the nervous system. If the child is made strong by out-door life, good plain, digestible food, early hours, regular sleep in thoroughly aired rooms, regular bathing, and if the school work is conducted with moderation and judgment, the nerves and the nervous temperament will partic.i.p.ate in the healthy growth which will follow as a result. Tea and coffee should be forbidden. Exciting books and questionable entertainment as given in picture shows and theaters must not be allowed. If older members of the family, or parents, are excitable and nervous the children should be sent away to the country from them.

They should be put in charge of a person who will exercise firm control over them. It may be necessary to take these patients away from other children, and isolate them under proper control until they are able to control themselves. They should be interested in exercise that compels them to work; they should live and if convenient sleep out of doors; and they should take iron or cod liver oil, or any other indicated tonic. If they complain of pain they should receive cold-water douches, or the cold pack, or the shower bath; and they should be put to bed and treated firmly but kindly. Attention to the bowels is always essential, because these children are as a rule the victims of chronic constipation.

WHAT A MOTHER SHOULD KNOW ABOUT CATHARTICS AND HOW TO GIVE A CHILD A DOSE OF CASTOR OIL.--Broadly speaking there are three kinds of cathartics. I will, in a simple way, explain their action so that a mother may know which one to select under certain circ.u.mstances.

Frequently a mother is told by her physician to "keep the bowels of her child open." Few mothers know how to keep the bowels open, and as this is an important matter, every mother should know the reason why "any"

laxative or cathartic is not always suitable.

CASTOR OIL.--This is one of the oldest and one of the best cathartics we possess for children. It is a mechanical cathartic; it acts in exactly the same way as a street-cleaning machine. It cleans the street by sweeping or pushing everything before it.

CALOMEL--This is a chemical cathartic. It acts through the blood. When it is absorbed by the blood its chemical ingredients act on certain nerves as irritants. These nerves excite the liver and bowel to action and an evacuation is the result.

CITRATE OF MAGNESIA.--This is a saline laxative. It acts by drawing out of the bowel wall enough liquid from the blood to sweep the contents out. It may be likened to the street cleaner who flushes and cleans the street by means of a hose pipe attached to the water hydrant.

Under what condition should a mother use these remedies? Castor oil is ordinarily the best cathartic in childhood; it is not, however, always the best. Most ailments of children are of gastro-intestinal origin--they have either overeaten or they have eaten the wrong kind of food. The stomach and bowel are overloaded: they must be cleaned out. We want a mechanical cathartic, one that will push everything ahead of it, so we use castor oil. When a child needs a cleaning out, use castor oil.

By a "cleaning out" we mean, when we know he has eaten too much of a questionable variety of food, as pastries, cakes, fruit, ice cream, etc., as children do at parties; or when he has eaten unripe fruit, as green apples, etc.; or when for some reason he is constipated and complains of not feeling well, use castor oil.

If you decide to use castor oil, use enough. A large dose will act promptly and with less pain and with more certain results than a small dose.

It is always safe and it is always best to decide upon castor oil as the proper remedy, if the child has no fever. If he has a fever he will most likely vomit castor oil when another kind of cathartic would stay on the stomach.

Castor oil works more effectively, more thoroughly, and is less likely to be vomited if given on an empty stomach, so we give it two hours after eating and we give no food for two hours after it is taken.

Castor oil is distinctly of advantage in many chronic diseases of the intestines because of its healing properties. In chronic colitis, for example, when the child is suffering with malnutrition, irregular bowel action with an odor, and mucous or b.l.o.o.d.y stools, a combination of castor oil and salol, in emulsion, in small doses,--to which a small quant.i.ty of opium may be added or withheld according to the frequency of the movements,--with an occasional colon irrigation, is sometimes invaluable.

Mothers must remember that castor oil is not good in the treatment of constipation, because its after effect is to constipate, consequently we would not use it "to keep the bowels open,"--it is only of use to clean the bowel out thoroughly when that is indicated.

HOW TO GIVE A DOSE OF CASTOR OIL--The best way to give a child castor oil is as follows: Place the bottle containing the oil on its side on a piece of ice in the ice box; chill it thoroughly. Take a tablespoon and smear it with b.u.t.ter; pour the ice cold oil into the spoon; it will stick together like a piece of chewing gum and it will slide out of the b.u.t.tered spoon in one lump. In this way it will not spread over the mouth and teeth and throat, leaving a bad taste, but will go straight and surely into the stomach. The child cannot swallow some and retain enough in the mouth to sputter it all over itself and only get half a dose; it will not nauseate it, because it practically is tasteless if given cold, and the stomach will tolerate the cold oil much better than when given in the ordinary way.

A baby can be given oil in the same way, but in smaller doses. When the teaspoon is put into the mouth of a baby it should be immediately turned on its side so that it will keep the mouth open. If the nose is held closed and the mouth wide open for a few seconds the baby cannot spit the oil out--it must swallow, and if the oil sticks together as cold oil will, it gets the whole dose. It usually takes two persons to give a baby a dose of oil--one to open the mouth and give the medicine, the other to hold the nose and arms.

CALOMEL.--The general indication for calomel is fever. When a child develops a disease it immediately gets a temperature, and very frequently the fever is quite high because the slightest ailment gives a child fever. When fever begins, digestion practically stops, it is therefore imperative to clean the whole gastro-intestinal ca.n.a.l; otherwise the undigested material will putrefy and poison the entire system and render the disease more serious than it need be.

Now we select in such conditions calomel for two reasons:

First, because the presence of fever indicates that infection of the blood is taking place; this may come either from the intestinal ca.n.a.l itself, or from the germs of the disease with which the child is suffering. Since calomel acts chemically through the blood it is the cathartic indicated.

Second, because a cathartic like castor oil does not act through the blood and it would most likely be vomited by a fevered stomach.

Certain conditions indicate calomel; biliousness and jaundice, for example, because it has a specific action on the liver and if the liver is at fault calomel is the proper remedy.

Calomel is best given in small divided doses, 1-10 of a grain every half hour, for ten doses. It is best given combined with soda; every drug store carries tablets of calomel and soda for this reason.

Calomel should never be given in the treatment of constipation, nor should it be used indiscriminately by mothers, as much harm may result.

It has its specific use as indicated above, but it should never be used under any other circ.u.mstances.

CITRATE OF MAGNESIA.--This is a mild laxative. After the bowels have been thoroughly opened with castor oil or calomel, small doses of citrate of magnesia may be given for a few days, "to keep the bowels open." There is no danger or harm in its use if used for this purpose.

It must not be used, however, in the treatment of constipation of children for the simple reason that you cannot cure constipation by the use of drugs of any kind. Laxatives of this type have become a national curse. Adults, especially women, use them constantly. All these advertised saline laxative waters work by weakening the blood--when a dose is taken the chemicals in it draw through the bowel wall blood serum, and produce, because of the excess of this watery fluid, large, and frequently many, liquid movements.

If this practice is continued, as it often is every day, the quality of the blood will suffer seriously, and many individuals are the victims of neuralgic pains, headaches, nervousness, insomnia, anemia, and general broken health as a direct consequence of this pernicious habit.

Mothers will try to remember, therefore, that drugs and saline waters have no place in the treatment of constipation in children or themselves. Constipation must be treated by diet, exercise regular living and by the observance of hygienic and sanitary common-sense rules.

VACCINATION

TIME FOR VACCINATION.--The best time to vaccinate a child is during the first three months if he is healthy. The reason for selecting so early a period is because the const.i.tutional disturbances are much less at this time than in later childhood. It should not be done during active dent.i.tion. If the child is delicate if his nutrition is bad it should be deferred until a later time. Children suffering from eczema or from any skin disease or those syphilitic should not be vaccinated until it is compulsory, or until exposed to small-pox.

METHODS OF VACCINATING.--It is customary in America to vaccinate at one point rather than to make a number of inoculations as is the custom in some other countries. The leg or the arm is the usual location selected.

In infants the sore can be protected better on the leg; in children of the run-about age, the arm is the better location because it can be kept at rest easier.

Before vaccinating the skin should be rendered surgically clean; this can be done by washing with soap and water, drying and then rubbing with alcohol. The wound should be left uncovered for about twenty minutes to dry, it may then be covered with a bandage, or with a vaccine shield.

The part should not be washed for twenty-four hours.

THE SYMPTOMS OF SUCCESSFUL VACCINATION.--Nothing is noticed until the third or fourth day, when a red papule appears. In the course of the following day a vesicle appears; this vesicle enlarges until it reaches its full development on the ninth day. The size of the vesicle is about one-half inch in diameter; it is surrounded with a reddish inflammatory area for about two inches. The vesicle begins to dry and is shortly a dark crust which remains from one to three weeks and then falls off. It leaves a bluish scar which soon turns white and the part is roughened and honeycombed. During the period when the vaccination is at its height the child suffers from fever and irritability and loss of appet.i.te.

If vaccination does not "take" in an infant it should be done two or three times and if then unsuccessful it should be repeated every year until it takes. The fact that vaccination does not take does not imply that the child would not take small-pox but rather that the vaccine used is not suitable. There are some children, however, who seem to be immune to vaccination.

Sometimes the symptoms are more severe than those enumerated; this seems to depend upon the susceptibility of the child. The vesicle may be much larger and the area of inflammation much more dense and angry. The fever may be higher and may last longer; there may be a general rash and the degree of depression more profound. Vesicles may be produced on other parts of the body as a result of scratching. Mothers must always remember that vaccination is a surgical wound to begin with and that it is capable of infection in the same way as are other wounds, and that any result coming from such an infection is not due to the vaccine or to the process of vaccination, but to the infection. Many people get unjust ideas about vaccination from just such cases. If the mother is not cleanly or neglects the vaccinated area and permits it to become infected she must not and others should not decry vaccination as a consequence. Anyone who doubts the virtue of vaccination is condemning himself; he is simply ignorant of the acc.u.mulation of evidence in favor of it and a.s.sumes a position without any possible justification. The mortality of vaccination is stated by Voigt from statistics to be 35 in 2,275,000 cases. In fact, all the deaths are from causes which are preventable and no doubt the result of direct carelessness on the part of the operator or the mother.

TREATMENT.--The mother must understand in what way she may contribute to the successful termination of a case of vaccination. She should see that the part upon which the child is to be vaccinated is absolutely clean so far as she can make it with soap and water. She should see that the part is allowed to dry thoroughly after vaccination. She should not wash the part for at least twenty-four hours. If a vaccine shield is put on she should not disturb it. If the mother is prepared to do her part faithfully a vaccine shield is not necessary from a medical standpoint and in some cases it is objectionable. A simple, clean bandage is all that is necessary. It is very important that the child be kept from scratching the part; most of the troubles of vaccination come from this habit. It is desirable that the limb should be kept at rest during the stage when the process is at its height. If the vesicle discharges it is necessary that the area should be kept clean and dusted with boracic acid. If the wound becomes infected it must be treated by a physician.

The mother must not resort to home remedies in such cases unless she is prepared to take the consequences, which may be serious.

CHAPTER XXII

CONSTIPATION IN INFANTS AND CHILDREN

"It is a greater disgrace to be sick than to be in the penitentiary. When you are arrested it is because you have broken a man-made statute, but when you are ill, it is because you have disobeyed one of G.o.d's laws."

Constipation--Regularity of Bowel Function--The Function of the Stomach--Fermentation--Incomplete Constipation--Importance of a Clean Bowel--A Daily Movement of the Bowel Necessary--Constipation in Breast-Fed Infants--Treatment of Constipation in Breast-Fed Infants--Constipation in Bottle-Fed Infants--Treatment of Constipation in Bottle-Fed Infants--Constipation in Children Over Two Years of Age--Diet List for Constipation in Children--Bran m.u.f.fins in Constipation--Treatment of Obstinate Constipation--Oil Injections in Constipation.

CONSTIPATION. REGULARITY OF BOWEL FUNCTION

The most frequent cause of ill health and inefficiency in the human race is inattention to regulation of the bowel function. Good health depends upon many causes of which good blood is an absolutely necessary requisite. Good blood depends upon what feeds and sustains it. There are other contributing factors, such as the proper kind of exercise, the proper amount and quality of fresh air, the method of living, etc., but these are all food in a sense. The food we take in is acted upon by the various digestive juices until everything is extracted from it that contributes to the building up of the body. Whatever is left, whatever the body does not want, is immediately, or within a reasonable time, pa.s.sed out in the form of a movement of the bowels.