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JOHN G. COFFIN, M.D., EDITOR.
THE BEST PART OF THE MEDICAL ART, IS THE ART OF AVOIDING PAIN.
TUESDAY, JUNE 5, 1827.
From the London Literary Gazette. that the moral management of MEDICAL ESSAYS.-NO. IV. children should commence; for
_“ First the infant, the disposition being unformed, it Mewling and puking in the nurse's arms." is of vital importance to secure
the primary step in its formation; “ The straits of infancy, in which mul- and to impress at first the most titudes had perished, some by the weak.
desirable characters on the yet ness and fragility of their vessels, and more by the folly, perverseness, or negli- yielding and ductile mass.
In atgence, of those who undertook to steer tempting this, we are to regard them."-The Rambler.
both the personal welfare and the Having, in the foregoing Es- social connexions of the adult insays, pointed out those circum- dividual—to regulate personal stances connected with the cloth- feelings—to promote generous ing, diet, and exercise of infants, impulses—to lay the foundations · which are requisite for the pre- of truth, and, consequently, of servation of health, it remains to happiness: and it is undeniable, inquire what influence moral man- that the education necessary to agement is calculated to exert on effect these objects may be comthe physical powers of the body menced even within the period at this early period of life? which properly comprehends the
In tracing the dawnings of in- infantine age, by proper attention tellect in the human animal, it is to the formation of proper habitsapparent, that the whole opera- to the indulgence of some desires, tions of the infant, during the first and the repression of others and month of its existence, are alto- by the judicious developement of gether automatic. The nervous mind. system is susceptible of the sti 1. Formation of proper habits in mulus of heat and light, of odor- childhood.-If a child be suckled, ous and of sapid bodies; but, as dressed, and undressed, and eveyet, nothing that indicates mind ry other little operation connectis conspicuous ; and it is not till ed with its situation, be performafter this period, that the facul- ed at stated times, habits will be ties of the soul gradually unfold fixed, and the infant will be not themselves; and the actions of only rendered comfortable by the the child demonstrate a conscious regular performance of these ofness of volition, of the existence fices, but will acquire the power of external objects, and a power of waiting patiently, and without of selection and of rejection, with suffering uneasiness, till the reother anticipations of reason. It currence of the customary periis at this stage of life, therefore, ods. The quietude produced hy
so regular a system is highly fa- moderated by regulating the vorable to health, and the founda- wants and methodizing the díurtion of a placid and equable tem- nal habits of the infant. A moper is thus commenced. In in- ther who suckles her child every fancy, every cause of irritation is hour, or as often as it cries, withconnected with corporeal feelings; out attention to regularity while and when, by attending to the me- she is at home, and then leaves thod which I recommend, the it for several hours, when busiwants of the child are regulated ness or amusement calls her so as to recur only at stated times, abroad, cannot be astonished to and are supplied exactly at the find the infant exhausted with periods of their recurrence- crying--the only means by which causes of irritation are anticipat- it can express its wants—when ed, and the temper is preserved she returns ; nor is it surprising; in such a state of equanimity as that the temporary fever induced to leave the animal functions by this state of irritation, the unimpaired, for promoting the overcharged state of stomach growth and strength of the body. which must result in the habit of On the contrary, if a mother or a the infant from a full supply on nurse be irregular in the perform- an eager demand for food, and ance of the various duties con- the state of the nutriment itself nected with the nourishment and from the overcharged and heated the comfort of the infant, constant condition of the organ which supcauses of irritation must necessa- plies it-should be followed by rily arise ; every burst of fretful. disease and a long train of the ness and of passion—by hurrying most serious evils. The formathe passage of the blood through tion, therefore, of regular habits the brain, the glandular system, in infancy, is of great importance, and particularly through the liver so far as the physical energies and --will change the characters of the temper of the child are conthe secretions separated from the cerned ; and it is not less imporlastmentioned organ; and as a tant to the comfort and convecertain state of these juices is nience of the mother. How litrequisite for carrying on the pro- tle trouble attends the care of cesses of digestion and assimila- the infant who takes rest, and is tion, whatever tends to deprave exercised, and cleaned, and sucthem must diminish the growth kled, at stated hours, compared and vigor of the body, and favor with that of one whom caprice the production of disease. Many and circumstances only control! mothers endeavor to throw the The mother, in the first instance, blame of the evils produced by is unrestrained in following any their own mismanagement and ir- object of business or amusement regularities, on Nature ; and re- which may engage her attention fer the peevishness and irascible out of her nursery, because she tempers of their infants to connat- knows the precise periods when ural disposition : but, though it her presence there shall be remust be admitted that some indi- quired; whereas in the second, viduals are born with a greater sus- she must be constantly with her ceptibility of nervous impression child, and either be its slave or than others, yet even this may be become indifferent to its clamors
-à disposition fortunately of misery, when they cannot be great rarity; for, whatever may gratified. As infants are altogebe the failings of the sex, no mo- ther creatures of habit, moral ther can hear the cry of her in- management commenced at a suffant without endeavoring to sootheficiently early period, may be exit ; and where can it find consola- ercised, without altering natural tion but on that bosom which is character-if there be such a the fountain of its nourishment, state--and occasion the child to and the cradle of all its little escape much sorrow and many cares ? On the other hand, if dangers which arise to physical she ventures to leave her nurse- health from temper and mental ry, she must do so with the cer- irritation. Thus, as I have altainty of her infant's suffering, ready stated, if a habit of reguand consequently, with an anxiety larity be induced in the earliest which poisons the current of eve- stage of life, the exercise of pary enjoyment.
tience becomes almost natural to 2. Limits to which indulgence to the infant ; and in the same manthe inclinations of a child may
desire be not comextended.-In examining this point, plied with, however painful to the nature of these Essays re- the infant may be the first disapquires that I preface my remarks pointment, the result will be most by declaring, that it is the physi- satisfactory, in setting aside many cal influence only of this branch an anxious moment to the parent, of moral management on the and many a punishment to the health and bodily energies of the child. In“ infancy, as in riper child that comes under my consi- age, the gratification of every dederation. It is not an uncommon sire only tends to create new remark, that life is so replete wants; and with these arises a with misery, that we ought not morbid sensitiveness, which rento cloud its morning by lessening ders many circumstances of the the pleasures which attend on the most trifling description sources steps of infancy; that the whims of real misery. This is particuand caprices of the child should larly the case in children who are be indulged to the full ; and that yet unable to express their feelrestraints and punishments are in- ings and wishes in language ; for compatible with this period of life. in them the disappointment is freIt must, indeed, be admitted, that quently productive of paroxysms it would be cruelty to check the of irascibility and passion, which exuberance of enjoyment, which cause a determination of blood to is the natural lot of this age; the head, that may terminate in when, like the spring in the natu- apoplexy, or produce inflammaral year, all is promise, and ver- tion of the membranes of the dure, and flowers, and sunshine : brain, and its sequent, water in but, at the same time, it is neces- the head. The liveliest and most sary to draw the distinction be- intellectual children are those tween those indulgences which most liable to fall into such pasecure real and substantial enjoy- roxysms : and therefore it is the ment, and those which form and duty of every parent to repress foster artificial desires, and only selfish desires in their progenycontribute to the production of to accustom children from a very
early period of life to see every- grown into habits that restraints thing without thinking it requisite must be imposed; and for preventthat they should possess it or ing the repetition of evils which share it--and to feel satisfied, may lead to vice or future infathat what is not offered to them my, that punishments are to be they ought not to covet. Chil- inflicted. * Overindulgence is ru. dren are naturally generous; self- inous; but in avoiding it we need ishness is solely the offspring of not pass into the opposite exoverindulgence; and with the treme: gratification of selfishness the temper becomes irritable, and Dum vitant stulti vitia, in contraria cur , the nervous system suffers a degree of derangement, which being To prevent the necessity of eicommunicated to the lungs, the ther, is the great object of moral stomach, and to the great secret management; and the first step ing organs of the body--the func- towards this, is to convince pations of respiration, digestion, and rents that it is unnecessary to be assimilation, are disturbed, and constantly administering to the disease necessarily follows. A gratification of the senses of chil. child who is overindulged, there- cren. Curiosity, which is unfore, lives in a state either of doubtedly the great inlet of knownervous excitement-which from ledge to the mind, should be enits effect on the brain may sooner couraged; but when a child is or later produce hypochondriasis, permitted to handle the objects and terminate in insanity, where around him, the permission must there is a predisposition to this be granted in such a manner as to disease, or he exists in a condi- make him sensible that it is a fation of febrile irritability—which, vor conferred on him, and not a by interfering with the healthy matter of right. Indeed, to check functions of the other parts of the inordinate desires, and to teach animal economy, may induce or a child habitual obedience and ganic diseases that defy the influ- regularity in all bis little transacence of medicine, and either ter- tions; to leave him in a degree to minate in death, or render life a own resources, without the mere state of protracted suffering. constant aid of toys for his amuse.
But, it may be asked, in what ment, and to teach him that pammanner, as children under a cer- pering the appetite with sweettain age are incapable of being in- meats is not a real gratification, fluenced by reasoning, is any plan constitute the most certain plan of moral management to be begun by which his mental character and carried on, without producing, can be formed, and his physical by constant restraints and punish- powers perfected, and by which ments, a degree of mental'irrita- his animal frame can be maintaintion similar to that which is like. ed in that state which is denomi. ly to result from 'overindulgence? nated health. But if such a haI reply, that, where a proper sys- bit of obedience and tractabletem is pursued from the begin- hess be of importance in health, ning, neither restraints nor punish- it is doubly iinportant in disease . ments will be requisite; it is only for reforming errors already
To manage a passionate and irri- and display traces of the mind table child, when he is laboring gradually unfolding itself. If the under disease, or to exercise au- mother or the nurse be lively, thority over one who has been this process is rapidly advanced, accustomed to be coaxed into the and intellect often beams more performance of every duty, and decidedly in the eyes and on the been taught only to think of him- countenances of some children self, is a most distressing task, only six months old, than on those which either a nurse or a parent of others thrice this age. Someis ill fitted to encounter. If me- thing, it must be admitted, is to dicine be requisite, and cannot be be attributed to original conforgiven except by force, the strug- mation and to greater perfection gles and the paroxysms of rage in- of organization; and I might even to which the effort to administer allow something to that undefinait throws the child, often produce ble endowment of soul which is a state as dangerous as the disease supposed to constitute what is itself, if not more so: on the other termed genius,-a possession hand, if the temper be consulted, which all men covet, though none and the remedies be neglected have determined in what it confrom the difficulty of giving them, sists : but I must contend, that how poignant must be the feelings character is more the production of a parent to behold an infant of circumstances than a natural sinking the victim of disease, who endowment ; and at this early pemight have been saved, had his riod, the developement of mind disposition been early trained to is intimately connected with the more pliability, and to a habit of vivacity of the nurse, and her obedience! This may be regarded power of awakening and keeping as an imaginary case ; but the alive the attention of the infant. writer of these Essays has wit. The strong propensity of infants nessed more than one instance of to imitation, also, has a considera child's dying of disease, which able influence ; it is, therefore, might have been averted, but for of much importance that the nurse the unmanageable temper of the be a sensible person, and free infant and the weakness of the from habits, the transference of parents ; so true is the remark in which to the infant would be inour motto, that if many children jurious. Thus, grimaces and conperish from natural debility of tortions of countenance are rapidframe, more are lost “ by the ly caught up by the child; and so folly, perverseness, and negli- much do its eyes dwell on the gence" of those to whose care features of the nurse, that its own they are entrusted.
features, even, in some degree 3. Developement of mind.-As I assume the characters of hers; have already stated, children are and it is not unfrequent to peralmost automatic beings in the ceive a greater resemblance, at first month or six weeks of their least in the expression of the existence after birth. When this moveable features, between the period is passed, they begin to no- child and its daily attendant, than tice the objects around them, be- between it and the parents. come more capable of distinguish- Hence the propriety of selecting ing between different impressions, welleducated, .agreeable, and