After five years of age the normal tonsils should begin to shrink, and at about the beginning of adolescence they should be no larger than a small lima bean, hidden almost completely out of sight behind the pillars of the throat. While healthy tonsils may serve some useful purpose even in the adult, it is almost universally conceded that the thoroughly bad and diseased tonsil is utterly useless to the body--only an open gateway for the entrance of infection.

BRONCHITIS

A very common disorder of early infancy and childhood is bronchitis--an inflammation of the bronchial tubes--accompanied by severe coughing. Its tendency to pa.s.s into pneumonia renders it a disease for skilled hands to treat--a disorder hardly safe for even the well-meaning mother to undertake to manage without medical advice and help. And since bronchitis is usually accompanied by alarming symptoms of high fever, weakened heart, embarra.s.sed breathing, mottled or blue skin, green stools, troublesome cough, disturbed sleep, "stopped up nose," and "choked up throat," it is of utmost importance not only to seek medical aid early, but also that the mother, herself, should have definite ideas concerning the proper manner of doing the following things in the line of treatment:

1. Making and applying a mustard paste.

2. The fashioning of an oil-silk jacket.

3. Improvising a steam tent.

4. Flushing out the colon, and a score of other things which the watchful doctor may want given any moment.

_Mustard Pastes_ are prepared by mixing one part of mustard and six parts of flour in warm water and applying to the chest between two pieces of thin muslin. It is left on just seven minutes and then talc.u.m powder is thickly sprinkled on the moist, reddened skin; this powder quickly absorbs all the moisture and leaves the skin in a good condition--ready for another paste in three hours if it is so ordered.

_The Oil-Silk Jacket_, or pneumonia jacket, consists of three layers--the inside of cheesecloth, an inner thin sheet of cotton wadding, and an outside layer of oil silk (procurable at any drug store). It should open on the shoulder and under the arm on the same side. It is worn constantly (change for fresh cheesecloth and cotton every day) during the inflammatory stage; it is removed only during the mustard pastes.

_A Steam Tent_ may be prepared by placing a sheet over the infant's crib and allowing steam to enter from a large paper funnel placed in the nose of a tea kettle of boiling water kept hot on a small stove of some sort.

The mattress and bedding are covered with rubber sheeting and the infant's clothes protected from moisture. The baby should remain in this steamy atmosphere ten minutes at a time.

Another method is to hold baby in arms near the large end of a big funnel placed in a tea kettle on the gas stove or range, and then have an a.s.sistant help hold a sheet tent over both the mother and babe. Or the baby carriage may be placed over a small tub of water into which are dropped several hot bricks. A sheet canopy spread over the carriage holds the steam in and baby reaps the benefits of the warm moisture.

_Colonic Flushing_ is necessary when green stools accompany bronchitis. A well-lubricated end of a large Davidson's syringe is inserted into the r.e.c.t.u.m, and with the hips of the baby brought to the edge of a basin (the heels held in the hands of the a.s.sistant), water is forced into the r.e.c.t.u.m. Not more than one ordinary cup of water should be introduced at any one time. After expulsion, another may be gently injected.

_The diet_ in bronchitis is always reduced so that no extra work will be thrown on the already overtaxed const.i.tution of the child.

_Absolute rest_ is necessary and perfect quiet should prevail. The humidity of the room should not be lower than 50 at any time, while the air should be moderately cool and fresh.

Numerous other details which may be necessary in the management of bronchitis will be directed by the physicians and nurses in charge of the case.

SPASMODIC CROUP

It is believed that children with enlarged tonsils and adenoids are much more subject to croup than others. Although very sudden in its onset and very alarming, spasmodic croup, fortunately, is seldom dangerous. A little child goes to bed in apparently normal condition and wakes up suddenly with a coa.r.s.e metallic cough, difficult breathing, and with a distressed expression on the face.

Alternate hot and cold compresses should be applied to the throat--first the hot cloths (wrung from very hot water) being applied over the throat, which should be covered with a single thickness of dry flannel. Then after three minutes of the hot cloths a very cold cloth is applied to the skin itself for one half minute; then more of the hot compress, followed again by the short cold, until five such changes have been made. A bronchitis tent should be quickly improvised so that the child can be "steamed."

Vomiting must be produced by kerosene (three or four drops on sugar), alum and mola.s.ses, or ipecac (ten drops every fifteen minutes). Some remedy must be administered continuously until free vomiting occurs. A good dose of castor oil should be given after the spasm. Suitable treatment should be administered through the day to prevent a recurrence of the attack the next night.

The general vital resistance should be raised by outdoor life, improved circulation, good food; adenoids if present, should be removed.

Medical advice should be sought in every case of severe croup, for membraneous croup usually is indicative of diphtheria, and the diagnosis is important, as on it hangs the determination of the administration of ant.i.toxin.

PNEUMONIA

Pneumonia is always a serious disease. It is accompanied by high fever, painful, very short cough, and rapid breathing with a moving in and out of the edges of the nose as well as the s.p.a.ces between the ribs. The possibilities of complications are always great--the dangers are many--so that the combined watchfulness of both the mother and a proficient trained nurse are required; not to mention the skill of the physician.

The steam tent, the mustard paste, the oil-silk jacket and the colonic flushing (described earlier in this chapter) may all be asked for by the physician in his untiring efforts to prevent dangerous complications during the course of the disease.

Plenty of moderately cool, fresh air (without drafts) is of great benefit. Never allow blue finger tips, or cold ear tips to exist; send at once for the doctor and administer a hot bath, or wrap in a sheet dipped in hot mustard water while awaiting his arrival. No mother should think of attempting to carry her baby through an attack of bronchitis or pneumonia without the best medical help available.

CHAPTER x.x.x

THE NERVOUS CHILD

While each child possesses an individuality all its own, nevertheless, there are certain general principles of psychologic conduct and family discipline which are more or less applicable to all children. The so-called nervous child, in addition to the usual methods of child culture, stands in need of special attention as concerns its early discipline and training. This chapter will, therefore, be devoted to special suggestions with regard to the management and training of those children who are by heredity predisposed to nervousness, over-excitability, and who possess but a minimum of self-control.

HEREDITARY NERVOUSNESS

The so-called nervous child--all things equal--is the child who is born into the world with an unbalanced or inefficiently controlled nervous system; and while it is all too true that the common nursery methods of "spoiling the child" are often equally to blame with heredity for the production of an erratic disposition and an uncontrolled temper, nevertheless, it is now generally recognized that the foundation of the difficulties of the nervous child reaches back into its immediate and remote ancestral heredity.

I no longer doubt but that many of these babies with a bad nervous heredity, who are born predisposed to Saint Vitus' dance, bad temper, chronic worry, neurasthenia, and hysteria could be spared much of their early troubles and later miseries by prompt and proper methods of early nursery discipline.

These nervous babies are born into the world with an abnormal lack of self-control. Their "inhibition control" over the natural and spontaneous tendency of the nervous system to manifest its inherent impulses and pa.s.sing whims is decidedly deficient. The child is unduly sensitive, whines, hollers, or flies into a violent rage when its will is crossed in the least degree. Such a child sometimes keeps its mother living in constant terror because, when its will is crossed in any particular, it will scream and hold its breath until it turns black in the face and sometimes actually goes into a convulsion.

In dealing with these unfortunate little ones, fathers and mothers, while they should be firm and persistent in their methods of correction, should also be kind and patient; fully recognizing that whatever undesirable traits the little ones manifest they have come by honestly--these naughty tendencies being the result either of heredity or spoiling, for both of which the parents stand responsible.

EARLY TRAINING

One of the very first things that a child, especially the nervous child, should learn is that crying and other angerful manifestations accomplish absolutely nothing. The greatest part of the successful training of the nervous child should take place before it is three and one-half years of age. It should early learn to lie quietly in its little bed and be entirely happy without receiving any attention or having any fuss made over it. It should not become the center of a circle of admiring and indulgent family friends and caretakers who will succeed in effectually destroying what little degree of self-control it may be fortunate enough to possess.

When the little one is discovered to be nervous, fretful, impatient, and easily irritated early in the morning, it should be left alone in its bed or in the nursery until it quiets down. If it has a good, healthy crying spell, leave it alone. Let it early get used to living with itself--teach the little fellow to get along with the world as it is--and you will do a great deal toward preventing a host of neurasthenic miseries and a flood of hysterical sorrows later on in life.

You must not expect to train the nervous child by the simple and easy methods which are successful in the case of a normal child; that is, you cannot repeat a simple discipline two or three times and have the child learn the lesson. In the case of the high-strung nervous child it requires "line upon line and precept upon precept;" for, whereas a normal child will respond to a certain discipline after it is repeated a half dozen times, the nervous child will require the persistent repet.i.tion of such a discipline from twenty-five to one hundred times before the lesson sinks into his consciousness sufficiently to enable him to gain control of his erratic and unbalanced nervous mechanism.

SPOILING THE CHILD

As bad as all spoiling methods are in child culture, they are decidedly disastrous--almost fatal--in the case of the nervous child; and yet it is these delicate, sensitive, cute little things that are the very ones who are most frequently the worst spoiled. Nervous children simply must not be played with all the time. They must be by themselves a great deal, at least this is true in their earlier years.

The nervous baby must early learn absolute respect for authority, so that what it lacks in its own nervous control may be partially made up for by parental suggestion and discipline. Of course, as suggested in a later chapter, the more ideal methods of suggestion, education, and persuasion should be employed in your efforts to secure obedience and promote self-control; but, when through either the deep-rooted incorrigibility of a child, or the inefficiency of the parent's efforts in the employment of suggestion--no matter what the cause of the failure of your ideal methods to control temper, stop crying, or otherwise put down the juvenile rebellion, whether the child has been spoiled on account of company, sickness or through your carelessness--when you cannot effectively and immediately enforce your will any other way, do not hesitate to punish; spank promptly and vigorously and spank repeatedly if necessary to accomplish your purpose. You must not fail in the case of the nervous child to accomplish exactly what you start out to do.

When the little fellow wakes up in the night and cries, see if he needs anything and administer to him. If you have previously tried the method of letting him "cry it out," which is usually entirely sufficient in the case of a normal child, and if such treatment does not seem to cure him, then speak to him firmly, give him to understand that he must stop crying, and if he does not, turn him over and administer a good spanking--and repeat if necessary to get results. In dealing with a nervous child we must follow the directions on the bottle of the old-fashioned liniment "rub in until relief is obtained."

No "spoiling practices" should be countenanced in the case of nervous children. They should be taught to sleep undisturbed in a room in the presence of usual noises. They should not be allowed to grow up with a sleeping-room always darkened by day and a light to sleep by at night.

They should be taught to sleep on without being disturbed even if someone does enter the room; they should be taught to sleep normally without having to quiet and hush the whole neighborhood.

PLAYMATES

The early play of nervous children should be carefully supervised and organized. Under no circ.u.mstance should they be allowed exclusively to play with children younger than themselves. They must not be allowed to dictate and control their playmates; it is far better that they should play at least a part of the time with older children who will force them to occupy subordinate roles in their affairs of play; in this way much may be accomplished toward preventing the development of a selfish, headstrong, and intolerant att.i.tude. When the nervous child is miffed or peeved at play and wants to quit because he cannot have his way, see to it that he quickly takes his place back in the ranks of his playfellows, and thus early teach him how to react to defeat and disappointment. The nervous child must not be allowed to grow up with a disposition that will in some later crisis cause him to "get mad and quit."