Abbildungen der Seite
PDF
EPUB

MEDICAL INTELLIGENCER.

JOHN G. COFFIN, M.D., EDITOR.

THE BEST PART OF THE MEDICAL ART, IS THE Art of AVOIDING PAIN.

VOL. 5.

TUESDAY, MAY 22, 1827.

From the London Literary Gazette.
MEDICAL ESSAYS.NO. III.

"First the infant, Mewling and puking in the nurse's arms." Shakspeare.

No. 1.

the orifice of the bottle should be guarded by a sponge enclosed in a piece of perforated washleather; so that the child shall obtain the tion of it which is fluid enough to food by suction, and only that porpass through the sponge shall be

In the conclusion of the former Essay, I endeavored to demonstrate the danger which attends taken into the stomach. The every attempt to rear an infant by any other means than the breast quantity of the food should be reby any other means than the breast gulated by the size and the milk. But, nevertheless, it must be admitted, that narrow means fants require more than a quarter strength of the child; but few inand many other causes concur, of a pint at a meal; and as the and always will occur, to render best kind of artificial food is less it necessary to hazard the expe- nutritive, from being less easily riment of dry nursing; and, when digested, than that which Nature such is unfortunately the case, it has prepared, the stated periods is of importance to know what de- of feeding should be at shorter inscription of food is best adapted tervals than when the infant is for early infancy. In selecting suckled. Asses' milk is regarded food for a young infant we should as an excellent substitute for the choose those substances which breast milk; but I am of opinion readily unite with water, so as to that it is more likely to disagree form a fluid diet, light, nutritious, with many children than the barand unfermentable. Perhaps no- leygruel and milk, which, on the thing is so suitable as barleygruel, whole, afford the best alternamixed with a small portion of tive.* cow's milk; or thin arrowroot mucilage, or grit gruel, thinned with milk, and slightly sweetened. Every description of bread food is injurious to very young children: it is too thick, even in the most pultaceous state to which it can be reduced, and being very susceptible of fermentation, it readily becomes sour in the stomach, and disorders the bowels of the child. Whatever kind of food is preferred, it should be given through the feeding bottle, and

2. Food of Children after Weaning.In entering on this part of our subject, we should first inquire what is the proper time for weaning an infant? Many circumstances concur to prevent any specific period in the age of the child from being fixed

* It is a curious fact, that the asses'milk sold in London, where the asses are while that of asses fed on a common, as fed on hay, seldom agrees with infants; seldom disagrees.

on for this process.* however, affords us something meal. The animal food should

Nature, form a part of the child's midday

like a guide in the protrusion of the teeth; for it is reasonable to suppose that the stomach must be prepared to digest solid food, when the instruments for masticating it are furnished to the mouth. When an infant is in health, therefore, it may be weaned as soon as the cutting teeth are protruded in both jaws; but still the food should be of a soluble quality, and continue to be so till the grinders are present. The food best adapted for a child, for some time after it is weaned, is that of a pultaceous kind, combined with cow's milk, and, once a day, with other light animal juices, such as beef tea or chicken tea, perfectly freed from fat. The common practice of giving puddings to children is, in some respects, objectionable, on account of the probability that the eggs with which they are made are not always newlaid; and, in general, also, the quantity of sugar which such combinations contain, disposes them to ferment and become acescent in the stomach; particularly if they be made with flour, or, as the term is, are batter puddings, the least wholesome which can be given to an infant. When the grinders are protruded, a portion of solid animal food should be given every other day for some time, and afterwards once a day; and well boiled vegetables may, now, also

"The Syrian women suckle their children two years; and some instances are recorded by Russell, in which the

former child was suckled at the same

breast with the newborn infant.-Nat. Hist. of Aleppo, vol. 1, p. 304. "In Af

rica, children are often suckled for three years."-Park's Travels, 4to. Appendix, p. 265.

be confined to poultry or mutton; all other kinds of animal food are improper; and nothing is so injurious to children as fat, or highly seasoned, or salted meats. Convulsions frequently occur among the children of the lower classes, from eating bacon and other strong and oily animal food; and in Iceland, more than twothirds of the children which are born are destroyed by ginkloffe, lockjaw, owing to their food consisting chiefly of Puffins and Fulmurs without any vegetable matter.* But, besides the quality of the food, great caution is requisite in regulating the quantity. Mothers are too fond of seeing their children fat. "O! what a fine fat fellow!" is a compliment which wins every mother's heart; and, consequently, every effort is made to deserve it. I cannot, however, avoid looking on all corpulent children with anxiety; as long as they continue in health, their plump and rounded figures are agreeable and flattering to the pride of a mother's eye; but when disease makes its attack, the gross and highly excitable state of the infant body affords fuel to the flame of disease, and, consequently, leads to a fatal issue; while, on the contrary, the more slender child, if moderately strong, struggles through disease, because the malady itself wants the aliment which furnishes its powers of destruction.

As children advance in age, and acquire all their teeth, and become capable of taking active exercise, less caution in diet is re

* See J. Mackenzie's Travels, 4to. Appendix, p. 413.

quisite; and the stomach should be accustomed to the stimulus of every description of plain food. Too much care in diet is as detrimental to health as improper food; for the stomach may be brought by custom to secrete a juice capable of dissolving one kind of aliment only, so that nutriment of every other nature necessarily becomes indigestible. Thus Spallanzani, an Italian philosopher, gradually brought the stomach of a sheep to accommodate itself to animal food, and that of a raven to receive and retain vegetable

matter.

Such are the rules which, in my opinion, ought to regulate the feeding of children. Though apparently trivial, they are of great importance, since much of every man's comfort, whatever be his station, must depend on the healthy state of his family. For, true it is, that "to be happy at home is the ultimate result of all ambition, the end to which every enterprise and labor tends, and of which every desire prompts the prosecution."*

Exercise proper for young Children.-Exercise is almost as necessary for the preservation of the infant as food; but great judgment is required in apportioning the quantity, in determining the kind of exercise, and in fixing the periods at which it should be

taken.

Though the circulation of the blood in every animal is carried on by the vital principle, and it would be continued while the animal lives, independent of any movement of the parts of the body, or locomotion of the whole body; yet, experience has demon

* Rambler.

strated, that muscular motion aids greatly the circulation, consequently promotes secretion and assimilation, and is, in fact, essential for maintaining health. In very young animals, however, and especially in those of the human race, the motion communicated to the body must be of the gentlest kind, continued for a few minutes only, and repeated at proper intervals. During the first month, indeed, of the life of an infant, nature requires that the greater part of every twentyfour hours be spent in sleep, and in replenishing the stomach; and consequently any movement which is given to the child should be effected when it awakes, a short time before it is suckled; for at this time the stomach is empty, and its function is at rest. Nurses, however, generally adopt the opposite plan. After taking the infant from the breast, instead of laying it softly down, and leaving it at rest till the stomach performs its office on the nutriment with which it has just been replenished, they set it up nearly erect, pat it on the back to expel the wind, and jog it on the knee, till the poor little creature becomes sick, and ejects nearly the whole of the meal which has been imparted to it. In consequence of this mismanagement, the infant again craves for the breast; but as there is yet no fresh supply, it whines and cries, and continues to do so, either till it be satisfied with some artificial food, or be lulled asleep by the influence of the cradle or of the swingcot, or by rolling it on the knee of the nurse. Nothing is so adverse to the nature of digestion as this plan. The digestive process never proceeds regularly unless the

animal be at rest; and this state should be preserved, if possible, till the whole of the food be converted into chyme, and be pushed forward into the intestines. It has been proved by experiment, that, if two dogs be fed in the same manner, on the same kind of food, and one of them has been permitted to sleep, whilst the other has been hunted; on dissection, the food in the stomach of the dog which has been asleep, is found to have been completely, or nearly wholly digested; while that in the stomach of the dog which was bunted, is scarcely changed from the state in which it was swallowed. But could no other circumstance be adduced to prove that this is an improper period of exercising the infant in the month, the necessity of using a cradle or a swing cot, or of rolling the infant on the knee of the nurse to lull it asleep, would be reason sufficient, The sleep procured by these methods is unnatural, and necessarily unwholesome. Whether it be the result of a partial pressure on the brain, from the blood being determined to this organ; or whether, as when the head of a chicken is placed under its wing, and the animal subjected to a rotatory movement, it empties the vessels of the head, by communicating a centrifugal motion to the fluids, and thereby causing a deficiency of the excitement which the brain requires, I shall not stop to inquire; it is, sufficient to know, that a child always sleeps more soundly when it is not accustomed to be rocked. An infant in good health, properly fed and managed well, will fall asleep the moment he is laid in bed, and will continue to sleep more serenely, and for a longer

period, than if he has been rocked; therefore, even on the score of saving trouble to the nurse, cradles, swing cots, and similar contrivances, ought to be rejected from every nursery.

As the infant advances in age, it reposes less, and needs more exercise; but still, if it be in good health, it generally sleeps immediately after taking the breast. While it is awake, however, it requires to be in constant motion; and declares, by the springs which it takes when the nurse ceases to dandle it, and the sounds of mirthful satisfaction which it utters whilst it is dandled, the gratification which movement affords to it; hence it is of great importance that a nurse be strong, active, and cheerful. When the mother cannot afford the means to procure the assistance of a hired nurse, and is too weak to do justice to her infant in this respect, friction with the hand along the spine, and over the limbs, three or four times a day, is the best substitute for exercise. Many nurses, both in carrying and in dandling infants, hold them on the bend of the arm, instead of placing them, as they should always do, on the palm of the hand. This method of carrying and dandling an infant on the bend of the arm, is less irksome to the nurse; but nothing can be more injurious to female infants; for, as their bones are in a soft and yielding state, it compresses the hips, contracting, and often occasioning deformity of that part of the trunk. of the body, which, from its being a bony basin, is named the pelvis, and entailing much suffering and misery on the future woman, in the event of her becoming a mother. Poverty, as I have al

ready remarked, often forces mothers to do many things connected with the rearing of their offspring which are injurious to health. A mother who is much engaged, and forced to work, ties her infant in to a chair, where it is forced to sit for hours; and being thus deprived of the exercise requisite in infancy, it grows up rickety and diseased, if it lives to attain to adult age. This is to be lamented, rather than blamed; but among the higher ranks also, children are made to suffer the irksomeness of sitting still-either to satisfy the indolence of the nursery maid, or in conformity with the wishes of some mothers, who imagine that they ought to instil habits of what they term propriety and gentility, even in the infancy of the future woman of fashion. But I shall have occasion to notice this folly at length, in my next essay, on the physical education of infants.

It is also of importance to pre vent nurses from tossing children too high whilst exercising them. The uneasy sensation which it induces is rendered obvious by the action of the infant, who clings to the arms of the nurse, and expresses terror both in its countenance and by its cries. Fits have been sometimes produced by tossing infants too high; and the rapidity, also, in descending through the air, when a child is thrown very high, excites a tendency of blood to the head, which may be productive of very serious consequences.

When a child has attained to the age of eight or nine months, he has generally acquired such vigor of limb as enables him to move himself in the recumbent posture; but few nurses are fond

of

of permitting infants to crawl, and rather seek to place them Great cauearly on their feet. tion, however, is necessary in attempting to anticipate nature in this operation; either the limbs become crooked, from bearing too early the weight of the body, or, what is worse, by premature exertion, and exhaustion strength, in maintaining the erect position, diseases are contracted which adhere to the individual throughout life. An infant, even when only a few months old, should frequently be laid on a soft carpet, or a mattress; at first, the freedom of stretching and exercising the limbs and arms, in kicking and sprawling, delights the child; then, by degrees, the power of rolling over and changing position is acquired; essays in crawling are next made; and gradually, as he acquires strength of limb, the infant raises himself by the foot of a chair, or some other upright body, and becomes conscious of the power of maintaining a perpendicular position. Still, however, the child does not walk; but pauses, and first, by repeated trials, ensures the power of balancing himself; takes a step, and timidly retracts it; till, day by day, gaining confidence, and feeling at length sufficiently strong, he makes the effort; and at once acquires the power of walking, which he ever afterwards retains. An infant, on the contrary, who is early made to step, whilst supported by the nurse under the arms, or upheld by backstrings, or by a gocart, is actually much longer in acquiring the power of walking alone; for, as he leans forwards on the prop, whatever it may be, the muscles of the back and of the loins, which

« ZurückWeiter »