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It
is
highly important that a mother should possess such information as will
enable
her to detect disease at its first appearance, and thus insure for her
child
timely medical assistance. This knowledge it will not be difficult for
her to
obtain. She has only to bear in mind what are the indications which
constitute
health, and she will at once see that all deviations from it must
denote the
presence of disorder, if not of actual disease. With these changes she
must to
a certain extent make herself acquainted.
Signs
of health.
The
signs of health are to be found, first, in the healthy performance of
the
various functions of the body; the regular demands made for its supply,
neither
in excess or deficiency; and a similar regularity in its excretions
both in
quantity and appearance.
If
the
figure of the healthy infant is observed, something may be learnt from
this.
There will be perceived such an universal roundness in all parts of the
child's
body, that there is no such thing as an angle to be found in the whole
figure;
whether the limbs are bent or straight, every line forms a portion of a
circle.
The limbs will feel firm and solid, and unless they are bent, the
joints cannot
be discovered.
The
tongue, even in health, is always white, but it will be free from
sores, the
skin cool, the eye bright, the complexion clear, the head cool, and the
abdomen
not projecting too far, the breathing regular, and without effort.
When
awake, the infant will be cheerful and sprightly, and, loving to be
played
with, will often break out into its merry, happy, laugh; whilst, on the
other
hand, when asleep, it will appear calm, every feature composed, its
countenance
displaying an expression of happiness, and frequently, perhaps, lit up
with a
smile.
Just
in proportion as the above appearances are present and entire, health
may be
said to exist; and just in proportion to their partial or total absence
disease
will have usurped its place.
We
will,
however, for the sake of clearness examine the signs of disease as they
are
manifested separately by the countenance, the gestures, in sleep, in
the
stools, and by the breathing and cough.
Of
the
countenance.
In
health the countenance of a thild is expressive of serenity in mind and
body;
but if the child be unwell, this expression will be changed, and in a
manner
which, to a certain extent, will indicate what part of the system is at
fault.
The
brows will be contracted, if there is pain, and its seat is in the
head. This
is frequently the very first outward sign of any thing being wrong, and
will
occur at the very onset of disease; if therefore remarked at an early
period,
and proper remedies used, its notice may prevent one of the most
fearful of
infantile complaints "Water in the Head."
If
this sign is passed by unheeded, and the above disease be threatened,
soon the
eyes will become fixed and staring, the head hot, and moved uneasily
from side
to side upon the pillow, or lie heavily upon the nurse's arm, the child
will
start in its sleep, grinding its teeth, and awake alarmed and
screaming, its
face will be flushed, particularly the cheeks (as if rouged), its hands
hot,
but feet cold, its bowels obstinately costive, or its motions scanty,
dark-coloured, and foul.
If
the
lips are drawn apart, so as to show the teeth or gums, the seat of the
pain is
in the belly. This sign, however, will only be present during the
actual
existence of suffering; if, therefore, there be any doubt whether it
exist,
press upon the stomach, and watch the eifect on the expression of the
countenance.
If
the
pain arise simply from irritation of the bowels excited from
indigestion, it
will be temporary, and the sign will go and come just as the spasm may
occur,
and slight remedial measures will give relief.
If,
however, the disease be more serious, and inflammation ensue, this sign
will be
more constantly present, and soon the countenance will become pale, or
sallow
and sunken, the child will dread motion, and lie upon its back with the
knees
bent up to the belly, the tongue will be loaded, and in breathing,
while the
chest will be seen to heave with more than usual effort, the muscles of
the
belly will remain perfectly quiescent.
If
the
nostrils are drawn upwards and in quick motion, pain exists in the
chest. This
sign, however, will generally be the accompaniment of inflammation of
the
chest, in which case the countenance will be discoloured, the eyes more
or less
staring, and the breathing will be difficult and hurried; and if the
child's
mode of respiring be watched, the chest will be observed to be unmoved,
while
the belly quickly heaves with every inspiration.
Convulsions
are generally preceded by some changes in the countenance. The upper
lip will
be drawn up, and is occasionally bluish or livid. Then there may be
slight
squinting, or a singular rotation of the eye upon its own axis;
alternate
flushing or paleness of the face; and sudden animation followed by
languor.
These
signs will sometimes manifest themselves many hours, nay days, before
the
attack occurs; may be looked upon as premonitory; and if timely
noticed, and
suitable medical aid resorted to, the occurrence of a fit may be
altogether
prevented.
The
state of the eyes should always be attended to. In health they are
clear and
bright, but in disease they become dull, and give a heavy appearance to
the
countenance; though after long continued irritation they will assume a
degree
of quickness which is very remarkable, and a sort of pearly brightness
which is
better known from observation than it can be from description.
The
direction of the eyes, too, should be regarded, for from this we may
learn
something. When the infant is first brought to the light, both eyes are
scarcely ever directed to the same object: this occurs without any
tendency to
disease, and merely proves, that regarding one object with both eyes is
only an
acquired habit. But when the child has come to that age when the eyes
are by
habit directed to the same object, and afterwards it loses that power,
this
circumstance alone may be looked upon as a frequent prelude to disease
affecting the head.
Of
the
gestures.
The
gestures of a healthy child are all easy and natural; but in sickness
those
deviations occur, which alone will often denote the nature of the
disease.
Suppose
an infant to have acquired the power to support itself, to hold its
head erect;
let sickness come, its head will droop immediately, and this power will
be
lost, only to be regained with the return of health; and during the
interval
every posture and movement will be that of languor.
The
little one that has just taught itself to run alone from chair to
chair, having
two or three teeth pressing upon and irritating the gums, will for a
time be
completely taken off its feet, and perhaps lie languidly in its cot, or
on its
nurse's arm.
The
legs being drawn up to the belly, and accompanied by crying, are proofs
of
disorder and pain in the bowels. Press upon this part, and your
pressure will
increase the pain. Look to the secretions from the bowels themselves,
and by
their unhealthy character your suspicions, in reference to the seat of
the
disorder, are at once confirmed.
The
hands of a child in health are rarely carried above its mouth; but let
there be
any thing wrong about the head and pain present, and the little one's
hands
will be constantly raised to the head and face.
Sudden
starting when awake, as also during sleep, though it occur from
trifling
causes, should never be disregarded. It is frequently connected with
approaching disorder of the brain. It may forebode a convulsive fit,
and such
suspicion is confirmed, if you find the thumb of the child drawn in and
firmly
pressed upon the palm, with the fingers so compressed upon it, that the
hand
cannot be forced open without difficulty. The same condition will exist
in the
toes, but not to so great a degree; there may also be a puffy state of
the back
of the hands and feet, and both foot and wrist bent downwards.
There
are other and milder signs threatening convulsions and connected with
gesture,
which should be regarded: the head being drawn rigidly backwards, an
arm fixed
firmly to the side, or near to it, as also one of the legs drawn stifly
upwards. These signs, as also those enumerated above, are confirmed
beyond all
doubt, if there be present certain alterations in the usual habits of
the
child: if the sleep is disturbed, if there be frequent fits of crying,
great
peevishness of temper, the countenance alternately flushed and pale,
sudden
animation followed by as sudden a fit of languor, catchings of the
breath
followed by a long and deep inspiration, all so many premonitory
symptoms of an
approaching attack.
Of
the
sleep.
The
sleep of the infant in health is quiet, composed, and refreshing. In
very early
infancy, when not at the breast, it is for the most part asleep in its
cot; and
although as the months advance it sleeps less, yet when the hour for
repose arrives,
the child is no sooner laid down to rest, than it drops off into a
quiet,
peaceful slumber.
Not
so, if ill. Frequently it will be unwilling to be put into its cot at
all, and
the nurse will be obliged to take the infant in her arms; it will then
sleep
but for a short time, and in a restless and disturbed manner.
If
it
suffer pain, however slight, the countenance will indicate it; and, as
when
awake, so now, if there is any thing wrong about the head, the
contraction of
the eye-brow and grinding of the teeth will appear; if any thing wrong
about
the belly, the lips will be drawn apart, showing the teeth or gums, and
in both
instances there will be great restlessness and frequent startings.
Of
the
stools.
In
the
new-born infant the motions are dark coloured, very much like pitch
both in
consistence and appearance. The first milk, however, secreted in the
mother's
breast, acts as an aperient upon the infant's bowels, and thus in about
four-and-twenty hours it is cleansed away.
From
this time, and through the whole of infancy, the stools will be of a
lightish
yellow colour, the consistence of thin mustard, having little smell,
smooth in
appearance, and therefore free from lumps or white curded matter, and
passed
without pain or any considerable quantity of wind. And as long as the
child is
in health, it will have daily two or three, or even four, of these
evacuations.
But as it grows older, they will not be quite so frequent; they will
become
darker in colour, and more solid, though not so much so as in the
adult.
Any
deviation, then, from the above characters, is of course a sign of
something
wrong; and as a deranged condition of the bowels is frequently the
first
indication we have of coming disease, the nurse should daily be
directed to
watch the evacuations. Their appearance, colour, and the manner in
which
discharged, are the points principally to be looked to. If the stools
have a
very curdy appearance, or are too liquid, or green, or dark-coloured,
or smell
badly, they are unnatural. And in reference to the manner in which they
are
discharged, it should be borne in mind, that, in a healthy child, the
motion is
passed with but little wind, and as if squeezed out, but in disease, it
will be
thrown out with considerable force, which is a sign of great
irritation. The
number, too, of stools passed within the four-and- twenty hours it is
important
to note, so that if the child does not have its accustomed relief, (and
it must
not be forgotten that children, although in perfect health, differ as
to the
precise number,) Learn more about how to cure Infant Colic .
Of
the
breathing and cough
The
breathing of a child in health is formed of equal inspirations and
expirations,
and it breathes quietly, regularly, inaudibly, and without effort. But
let
inflammation of the air-tubes or lungs take place, and the inspiration
will
become in a few hours so quickened and hurried, and perhaps audible,
that the
attention has only to be directed to the circumstance to be at once
perceived.
Now
all changes which occur in the breathing from its healthy standard,
however
slight the shades of difference may be, it is most important should be
noticed
early. For many of the complaints in the chest, although very
formidable in
their character, if only seen early by the medical man, may be arrested
in
their progress; but otherwise, may be beyond the control of art. A
parent,
therefore, should make herself familiar with the breathing of her child
in
health, and she will readily mark any change which may arise.
Whenever
a child has the symptoms of a common cold, attended by hoarseness and a
rough
cough, always look upon it with suspicion, and never neglect seeking a
medical
opinion. Hoarseness does not usually attend a common cold in the child,
and these
symptoms may be premonitory of an attack of "croup;" a disease
excessively rapid in its progress, and which, from the importance of
the parts
affected, carrying on, as they do, a function indispensably necessary
to life,
requires the most prompt and decided treatment.
The
following observations of Dr. Cheyne are so strikingly illustrative,
and so
pertinent to my present purpose, that I cannot refrain inserting them:
"In
the approach of an attack of croup, which almost always takes place in
the
evening, probably of a day during which the child has been exposed to
the
weather, and often after catarrhal symptoms have existed for several
days, he
may be observed to be excited, in variable spirits, more ready than
usual to
laugh than to cry, a little flushed, occasionally coughing, the sound
of the
cough being rough, like that which attends the catarrhal stage of the
measles.
More generally, however, the patient has been for some time in bed and
asleep,
before the nature of the disease with which he is threatened is
apparent; then,
perhaps, without waking, he gives a very unusual cough, well known to
any one
who has witnessed an attack of the croup; it rings as if the child had
coughed
through a brazen trumpet; it is truly a tussis clangosa; it penetrates
the
walls and floor of the apartment, and startles the experienced mother,
'Oh! I
am afraid our child is taking the croup!' She runs to the nursery,
finds her
child sleeping softly, and hopes she may be mistaken. But remaining to
tend
him, before long the ringing cough, a single cough, is repeated again
and
again; the patient is roused, and then a new symptom is remarked; the
sound of
his voice is changed; puling, and as if the throat were swelled, it
corresponds
with the cough," etc.
How
important that a mother should be acquainted with the above signs of
one of the
most terrific complaints to which childhood is subject; for, if she
only send
for medical assistance during its first stage, the treatment will be
almost
invariably successful; whereas, if this "golden opportunity" is lost,
this disease will seldom yield to the influence of measures, however
wisely
chosen or perseveringly employed.
MOTHERS'
ROLE IN COMBATING DISEASES OF CHILDREN.
The
especial province of the mother is the prevention of disease, not its
cure.
When disease attacks the child, the mother has then a part to perform,
which it
is especially important during the epochs of infancy and childhood
should be
done well. I refer to those duties which constitute the maternal part
of the
management of disease.
Medical
treatment, for its successful issue, is greatly dependent upon a
careful,
pains-taking, and judicious maternal superintendence. No medical
treatment can
avail at any time, if directions be only partially carried out, or be
negligently attended to; and will most assuredly fail altogether, if
counteracted by the erroneous prejudices of ignorant attendants. But to
the
affections of infancy and childhood, this remark applies with great
force;
since, at this period, disease is generally so sudden in its assaults,
and
rapid in its progress, that unless the measures prescribed are rigidly
and
promptly administered, their exhibition is soon rendered altogether
fruitless.
The
amount of suffering, too, may be greatly lessened by the thoughtful and
discerning attentions of the mother. The wants and necessities of the
young
child must be anticipated; the fretfulness produced by disease, soothed
by kind
and affectionate persuasion; and the possibility of the sick and
sensitive
child being exposed to harsh and ungentle conduct, carefully provided
against.
Again,
not only is a firm and strict compliance with medical directions in the
administration of remedies, of regimen, and general measures,
necessary, but an
unbiased, faithful, and full report of symptoms to the physician, when
he
visits his little patient, is of the first importance. An ignorant
servant or
nurse, unless great caution be exercised by the medical attendant, may,
by an
unintentional but erroneous report of symptoms, produce a very wrong
impression
upon his mind, as to the actual state of the disease. His judgment may,
as a
consequence, be biased in a wrong direction, and the result prove
seriously
injurious to the welldoing of the patient. The medical man cannot sit
hour
after hour watching symptoms; hence the great importance of their being
faithfully reported. This can alone be done by the mother, or some
person
equally competent.
There
are other weighty considerations which might be adduced here, proving
how much
depends upon efficient maternal management in the time of sickness; but
they
will be severally dwelt upon, when the diseases with which they are
more
particularly connected are spoken of.
Note:
While every
care is taken to provide medically accurate and up to date information
in this web site, it is to be noted that this advice is not intended to
replace the advice of your physician. Before undertaking the advice
contained in this web site, you should consult a medical professional.
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