Kitabı oku: «The Young Mother: Management of Children in Regard to Health», sayfa 2

CHAPTER II.
TEMPERATURE

General principle—"Keep cool." Our own sensations not always to be trusted. Thermometer. Why infants require more external heat than adults. Means of warmth. Air heated in other apartments. Clothes taking fire. Stove—railing around it. Excess of heat—its dangers.

There is one general principle, on this subject, which is alike applicable to all persons and circumstances. It is, to keep a little too cool, rather than in the slightest degree too warm. In other words, the lowest temperature which is compatible with comfort, is, in all cases, best adapted to health; and a slight degree of coldness, provided it amount not to a chill, and is not long continued, is more safe than the smallest unnecessary degree of warmth.

But the application of this rule to those over whom we have control, is not without its difficulties. Our own sensations are so variable, independently of external and obvious causes, that we cannot at all times judge for others, especially for infants. The absolute and real state of temperature in a room can only be ascertained by the aid of a thermometer; and no nursery should ever be without one. It should be placed, however, in such a situation as to indicate the real temperature of the atmosphere, and not where it will give a false result.

No mother should forget that the infant, at birth, has not the power of generating heat, internally, to the extent which it possesses afterward. The lungs have as yet but a feeble, inefficient action. The purification of the blood, through their agency, is not only incomplete, but the heat evolved is as yet inconsiderable. In the absence of internal heat, then, there is an increased demand externally. If 60° be deemed suitable for most other persons, the new-born infant may, for a few days, require 65° or even 70°.

Much may and should be done in preserving the child in a proper temperature by means of its clothing. On this point I shall speak at length, in another part of this work. My present purpose is simply to treat of the temperature of the nursery.

The best way of warming a nursery—or indeed any other room, where MERE warmth is demanded—is by means of air heated in other apartments, and admitted through openings in the floor or fire-place. The air is not only thus made more pure, but every possibility of accidents, such as having the clothes take fire, is precluded. This last consideration is one of very great importance, and I hope will not be much longer overlooked in infantile education.

Next to that, in point of usefulness and safety, is a stove, placed near or IN the fire-place, and defended by an iron railing. Most people prefer an open stove; and on some accounts it is indeed preferable, especially where it is desirable to burn coal. Still I think that the direct rays of the heat, and the glare of light from open stoves and fire-places, particularly for the young, form a very serious objection to their use.

One of the strongest objections to open stoves and fire-places in the nursery is, the increased exposure to accidents. I know it is said that this evil may be avoided by laying aside the use of cotton, and wearing nothing but worsted or flannel. This is indeed true; but I do not like the idea of being compelled to dress children in flannel or worsted, at all times when the least particle of fire is demanded; for this would be to wear this stimulating kind of clothing, in our climate, the greater part of the year.

Besides, I write for many mothers who are compelled to use cotton, on account of the expense of flannel. And if the stove be a close one, and well defended by a railing, cotton will seldom expose to danger. Still, as has been already said, the introduction of heated air from another apartment, whenever it can possibly be afforded, is incomparably better than either stoves or fire-places.

Dr. Dewees is fully persuaded that the excessive heat of nurseries has occasioned a great mortality among very young children. "In the first place," he says, "it over-stimulates them; and in the second, it renders them so susceptible of cold, that any draught of cold air endangers their lives. They are in a constant perspiration, which is frequently checked by an exposure to even an atmosphere of moderate temperature." If this is but to repeat what has been already said, the importance of the subject seems to be a sufficient apology.

CHAPTER III.
VENTILATION

General ignorance of the constitution of the atmosphere. The subject briefly explained. Oxygen gas. Nitrogen. Carbonic acid. Fires, candles, and breathing dependent on oxygen. Danger from carbonic acid. How it destroys people. Impurity of the air by means of lamps and candles. Other sources of impurity. Experiment of putting the candle under the bed-clothes. Covering the heads of infants while sleeping—its dangers. Proportions of oxygen and nitrogen in pure and impure air. No wonder children become sickly. Particular means of ventilating rooms. Caution in regard to lamps. Washing, ironing, cooking, &c., in a nursery. Their evil tendency. Fumigation—camphor, vinegar.

Few people take sufficient pains to preserve the air in any of their apartments pure; for few know what the constitution of our atmosphere is, and in how many ways and with what ease it is rendered impure.

It is not my purpose to go into a learned, scientific account in this place, or even in this work, of the constitution of the atmosphere. A few plain statements are all that are indispensable. The atmosphere which we breathe is composed of two different airs or gases. One of these is called oxygen,¹ and the other nitrogen. There is another gas usually found with these two, in smaller quantity, called carbonic acid gas; but whether it is necessary, in a very small quantity, to health, chemists, I believe, are not agreed. One thing, however, is certain—that if any portion of it is healthful, it must be very little—not more, certainly, than one-fiftieth or one-hundredth of the whole mass.

It is by means of the oxygen it contains, that air sustains life and combustion. Were it not for this, neither fires nor candles would burn, and no animal could breathe a single moment. Breathing consumes this oxygen of the air very rapidly. When the oxygen is present in about a certain proportion, combustion and respiration go on well, but when its natural proportion is diminished, the fire does not burn so well, neither does the candle; and no one can breathe so freely.

Not only are breathing and combustion impeded or disturbed by the diminution of oxygen in the atmosphere, but just in proportion as oxygen is diminished by these two processes, or either of them, carbonic acid is formed, which is not only bad for combustion, but much worse for health. If any considerable quantity of it is inhaled, it appears to be an absolute poison to the human system; and if in very large quantity, will often cause immediate death.

It is this gas, accumulated in large quantities, that destroys so many people in close rooms, where there is no chimney, nor any other place for the bad air to escape. But it not only kills people outright—it partly kills, that is, it poisons, more or less, hundreds of thousands.

In a nursery there is the mother and child, and perhaps the nurse, to render the air impure by breathing, the fire and the lamp or candle to contribute to the same result, besides several other causes not yet mentioned. One of these is nearly related to the former. I allude to the fact that our skins, by perspiration and by other means, are a source of much impurity to the atmosphere; a fact which will be more fully explained and illustrated in the chapter on Bathing and Cleanliness. It is only necessary to say, in this place, that it is not the matter of perspiration alone which, issuing from the skin, renders the air impure; there are other exhalations more or less constantly going off from every living body, especially from the lungs; and carbonic acid gas is even formed all over the surface of the skin, as well as by means of the lungs.

One needs no better proof that carbonic acid is formed on the surface of the body, than the fact that after the body has been closely covered all night, if you introduce a candle under the bed-clothes into this confined air, it will be quickly extinguished, because there is too much carbonic acid gas there, and too little oxygen.

We may hence see at once the evil of covering the heads of infants when they lie down—a very common practice. The air, when pure, contains a little more than 20 parts of oxygen, and a little less than 80 of nitrogen. Breathing this air, as I have already shown, consumes the oxygen, which is so necessary to life and health, and leaves in its place an increase of nitrogen and carbonic acid gas, which are not necessary to health, and the latter of which is even positively injurious. But when the oxygen, instead of forming 20 or more parts in 100 of the atmosphere of the nursery, is reduced to 15 or 18 parts only, and the carbonic acid gas is increased from 1 or 2 parts in 100, to 5, 6, 8 or 10—when to this is added the other noxious exhalations from the body, and from the lamp or candle, fire-place, feather bed, stagnant fluids in the room, &c., &c.—is it any wonder that children, in the end, become sickly? What else could be expected but that the seeds of disease, thus early sown, should in due time spring up, and produce their appropriate fruits?

It is sometimes said that fire in a room purifies it. It undoubtedly does so, to a certain extent, if fresh air be often admitted; but not otherwise.

I have classed feather beds among the common causes of impurity. Dr. Dewees also condemns them, most decidedly; and gives substantial reasons for "driving them out of the nursery."

In speaking of the structure of the room used for a nursery, I have adverted to the importance of having a large or double room, with sliding doors between, in order that the occupants may go into one of them, while the other is being ventilated. But whatever may be the structure of the room, the circumstances of the occupants, or the state of the weather, every nursery ought to be most thoroughly ventilated, once a day, at least; and when the weather is tolerable, twice a day. If there is but one apartment, and fear is entertained of the dampness of the fresh air introduced, or of currents, and if the mother and babe cannot retire, there is a last resort, which is for them to get into bed, and cover themselves a short time with the clothing. For though I have prohibited the covering of the face with the bed-clothes for any considerable length of time together, yet to do so for some fifteen or twenty minutes is an evil of far less magnitude than to suffer an apartment to remain without being ventilated, for twenty-four hours together—a very common occurrence.

When a lamp is kept burning in a nursery during the night, it should always be placed at the door of the stove, or in the chimney place, that its smoke, and the bad airs or gases which are formed, may escape. But it is better, in general, to avoid burning lamps or candles during the night. By means of common matches, a light may be produced, when necessary, almost instantly; especially if you have a spirit lamp in the nursery, or what is still better, one of spirit gas—that is, a mixture of alcohol and turpentine.

It is highly desirable that all washing, ironing, and cooking should be avoided in the nursery. They load the air with noxious effluvia or vapor, or with particles of dust; none of which ought ever to enter the delicate lungs of an infant.

Fumigations with camphor, vinegar, and other similar substances, have long been in reputation as a means of purifying the air in sick-rooms and nurseries; but they are of very little consequence. Fresh air, if it can be had, is always better.

CHAPTER IV.
THE CHILD'S DRESS

General principles. SEC. 1. Swathing the body—its numerous evils.—SEC. 2. Form of the dress. Fashion. Tight lacing—its dangers. Structure and motion of the chest. Diseases from tight lacing.—SEC. 3. Material of dress. Flannel—its uses. Cleanliness. Cotton—silk—linen.—SEC. 4. Quantity of dress. Power of habit. Anecdote. Begin right. Change. Dampness.—SEC. 5. Caps—their evils. Going bare-headed.—SEC. 6. Hats and bonnets.—SEC. 7. Covering for the feet. Stockings. Garters. Shoes—thick soles.—SEC. 8. Pins—their danger. Shocking anecdote.—SEC. 9. Remaining wet.—SEC. 10. Dress of boys. Tight jackets. Stocks and cravats. Boots.—SEC. 11. Dress of girls—should be loose. Temperature. Exposure to the night air.

Dress serves three important purposes:—1. To cover us; 2. To defend us against cold; 3. To defend our bodies and limbs from injury. There is one more purpose of dress; in case of deformity, it seems to improve the appearance.

In all our arrangements in regard to dress, whether of children or of adults, we should ever keep in mind the above principles. The form, fashion, material, application, and quantity of all clothing, especially for infants, ought to be regulated by these three or four rules.

The subject of this chapter is one of so much importance, and embraces such a variety of items, that it will be more convenient, both to the reader and myself, to consider it under several minor heads.

SEC. 1. Swathing the Body

Buffon, in his "Natural History," says that in France, an infant has hardly enjoyed the liberty of moving and stretching its limbs, before it is put into confinement. "It is swathed," says he, "its head is fixed, its legs are stretched out at full length, and its arms placed straight down by the side of its body. In this manner it is bound tight with cloths and bandages, so that it cannot stir a limb; indeed it is fortunate that the poor thing is not muffled up so as to be unable to breathe."

All swathing, except with a single bandage around the abdomen, is decidedly unreasonable, injurious and cruel. I do not pretend that the remarks of M. Buffon are fully applicable to the condition of infants in the United States. The good sense of the community nowhere permits us to transform a beautiful babe quite into an Egyptian mummy. Still there are many considerable errors on the subject of infantile dress, which, in the progress of my remarks, I shall find it necessary to expose.

The use of a simple band cannot be objected to. It affords a general support to the abdomen, and a particular one to the umbilicus. The last point is one of great importance, where there is any tendency to a rupture at this part of the body—a tendency which very often exists in feeble children. And without some support of this kind, crying, coughing, sneezing, and straining in any way, might greatly aggravate the evil, if not produce serious consequences.

But, in order to afford a support to the abdomen in the best manner, it is by no means necessary that the bandage should be drawn very tight. Two thirds of the nurses in this country greatly err in this respect, and suppose that the more tightly a bandage is drawn, the better. It should be firm, but yet gently yielding; and therefore a piece of flannel cut "bias," as it is termed, or, obliquely with respect to the threads of which it is composed, is the most appropriate material.

If the attention of the mother were necessary nowhere else, it would be indispensable in the application of this article. If she do not take special pains to prevent it, the erring though well meaning nurse may so compress the body with the bandage as to produce pain and uneasiness, and sometimes severe colic. Nay, worse evils than even this have been known to arise. When a child sneezes, or coughs, or cries, the abdomen should naturally yield gently; but if it is so confined that it cannot yield where the band is applied, it will yield in an unnatural proportion below, to the great danger of producing a species of rupture, no less troublesome than the one which such tight swathing is designed to prevent.

But besides the bandage already mentioned, no other restraint of the body and limbs of a child is at all admissible. The Creator has kindly ordained that the human body and limbs, and especially its muscles, or moving powers, shall be developed by exercise. Confine an arm or a leg, even in a child of ten years of age, and the limb will not increase either in strength or size as it otherwise would, because its muscles are not exercised; and the fact is still more obvious in infancy.

There is a still deeper evil. On all the limbs are fixed two sets of muscles; one to extend, the other to draw up or bend the limb. If you keep a limb extended for a considerable time, you weaken the one set of muscles; if you keep it bent, you weaken the other. This weakness may become so great that the limb will be rendered useless. There are cases on record—well authenticated—where children, by being obliged to sit in one place on a hard floor, have been made cripples for life. Hundreds of others are injured, though they may not become absolutely crippled.

I repeat it, therefore, their dress should be so free and loose that they may use their little limbs, their neck and their bodies, as much as they please; and in every desired direction. The practices of confining their arms while they lie down, for fear they should scratch themselves with their nails, and of pinning the clothes round their feet, are therefore highly reprehensible. Better that they should even occasionally scratch themselves with their nails, than that they should be made the victims of injurious restraint. Who would think of tying up or muffling the young lamb or kid? And even the young plant—what think you would be the effect, if its leaves and branches could not move gently with the soft breezes? Would the fluids circulate, and health be promoted: or would they stagnate, and a morbid, sickly and dwarfish state be the consequence?

Those whose object is to make infancy, as well as any other period of existence, a season of happiness, will not fail to find an additional motive for giving the little stranger entire freedom in the land whither he has so recently arrived, especially when he seems to enjoy it so much. Who can be so hardened as to confine him, unless compelled by the most pressing necessity?

SEC. 2. Form of the Dress

On this subject a writer in the London Literary Gazette of some eight or ten years ago, lays down the following general directions, to which, in cold weather, there can be but one possible objection, which is, they are not alamode, and are not, therefore, likely to be followed.

"All that a child requires, so far as regards clothing, in the first month of its existence, is a simple covering for the trunk and extremities of the body, made of a material soft and agreeable to the skin, and which can retain, in an equable degree, the animal temperature. These qualities are to be found in perfection in fine flannel; and I recommend that the only clothing, for the first month or six weeks, be a square piece of flannel, large enough to involve fully and overlap the whole of the babe, with the exception of the head, which should be left totally uncovered. This wrapper should be fixed by a button near the breast, and left so loose as to permit the arms and legs to be freely stretched, and moved in every direction. It should be succeeded by a loose flannel gown with sleeves, which should be worn till the end of the second month; after which it may be changed to the common clothing used by children of this age."

The advantages of such a dress are, that the movements of the infant will be, as we have already seen, free and unrestrained, and we shall escape the misery of hearing the screams which now so frequently accompany the dressing and undressing of almost every child. No chafings from friction, moreover, can occur; and as the insensible perspiration is in this way promoted over the whole surface of the body, the sympathy between the stomach and skin is happily maintained. A healthy sympathy of this kind, duly kept up, does much towards preserving the stomach in a good state, and the skin from eruptions and sores.

But as I apprehend that christianity is not yet very deeply rooted in the minds and hearts of parents, I have already expressed my doubts whether they are prepared to receive and profit by advice at once rational and physiological. Still I cannot help hoping that I shall succeed in persuading mothers to have every part of a child's dress perfectly loose, except the band already referred to; and that should be but moderately tight.

Common humanity ought to teach us better than to put the body of a helpless infant into a vise, and press it to death, as the first mark of our attention. Who has not been struck with a strange inconsistency in the conduct of mothers and nurses, who, while they are so exceedingly tender towards the infant in some points as to injure it by their kindness, are yet almost insensible to its cries of distress while dressing it? So far, indeed, are they from feeling emotions of pity, that they often make light of its cries, regarding them as signs of health and vigor.

There can be no doubt, I confess, that the first cries of an infant, if strong, both indicate and promote a healthy state of the lungs, to a certain extent; but there will always be unavoidable occasions enough for crying to promote health, even after we have done all we can in the way of avoiding pain. They who only draw the child's dress the tighter, the more it cries, are guilty of a crime of little less enormity than murder.

"Think," says Dr. Buchan, "of the immense number of children that die of convulsions soon after birth; and be assured that these (its cries) are much oftener owing to galling pressure, or some external injury, than to any inward cause." This same writer adds, that he has known a child which was "seized with convulsion fits" soon after being "swaddled," immediately relieved by taking off the rollers and bandages; and he says that a loose dress prevented the return of the disease.

I think it is obvious that the utmost extent to which we ought to go, in yielding to the fashion, as it regards form, is to use three pieces of clothing—the shirt, the petticoat and the frock; all of which must be as loose as possible; and before the infant begins to crawl about much, the latter should be long, for the salve of covering the feet and legs. At four or five years of age, loose trowsers, with boys, may be substituted for the petticoat; but it is a question whether something like the frock might not, with every individual, be usefully retained through life.

I wish it were unnecessary, in a book like this, to join in the general complaint against tight lacing any part of the body, but especially the chest. But as this work of torture is sometimes begun almost from the cradle, and as prevention is better than cure, the hope of preventing that for which no cure appears yet to have been found, leads me to make a few remarks on the subject.

As it has long been my opinion that one reason why mothers continue to overlook the subject is, that they do not understand the structure and motion of the chest, I have attempted the following explanation and illustration.

I have already said, that if we bandage tightly, for a considerable time, any part of the human frame, it is apt to become weaker. The more a portion of the frame which is furnished with muscles, those curious instruments of motion, is used, provided it is not over-exerted, the more vigorous it is. Bind up an arm, or a hand, or a foot, and keep it bound for twelve hours of the day for many years, and think you it will be as strong as it otherwise would have been? Facts prove the contrary. The Chinese swathe the feet of their infant females; and they are not only small, but weak.

I have said their feet are smaller for being bandaged. So is a hand or an arm. Action—healthy, constant action—is indispensable to the perfect development of the body and limbs. Why it is so, is another thing. But so it is; and it is a principle or law of the great Creator which cannot be evaded. More than this; if you bind some parts of the body tightly, so as to compress them as much as you can without producing actual pain, you will find that the part not only ceases to grow, but actually dwindles away. I have seen this tried again and again. Even the solid parts perish under pressure. When a person first wears a false head of hair, the clasp which rests upon the head, at the upper part of the forehead, being new and elastic, and pressing rather closely, will, in a few months, often make quite an indentation in the cranium or bone of the head.

Now is it probable—nay, is it possible—that the lungs, especially those of young persons, can expand and come to their full and natural size under pressure, even though the pressure should be slight? Must they not be weakened? And if the pressure be strong, as it sometimes is, must they not dwindle away?

We know, too, from the nature and structure of the lungs themselves, that tight lacing must injure them. Many mothers have very imperfect notions of what physicians mean, when they say that corsets impede the circulation, by preventing the full and undisturbed action of the lungs. They get no higher ideas of the motion of the chest, than what is connected with bending the body forward and backward, from right to left, &c. They know that, if dressed too tightly, this motion is not so free as it otherwise would be; but if they are not so closely laced as to prevent that free bending of the body of which I have been speaking, they think there can be no danger; or at least, none of consequence.

Now it happens that this sort of motion is not that to which physicians refer, when they complain of corsets. Strictly speaking, this bending of the whole body is performed by the muscles of the back, and not those of the chest. The latter have very little to do with it. It is true, that even this motion ought not to be hindered; but if it is, the evil is one of little comparative magnitude.

Every time we breathe naturally, all the ribs, together with the breast bone, have motion. The ribs rise, and spread a little outward, especially towards the fore part. The breast bone not only rises, but swings forward a little, like a pendulum. But the moment the chest is swathed or bandaged, this motion must be hindered; and the more, in proportion to the tightness.

On this point, those persons make a sad mistake, who say that "a busk not too wide nor too rigid seems to correspond to the supporting spine, and to assist, rather than impede the efforts of nature, to keep the body erect."

Can we seriously compare the offices of the spine with those of the ribs, and suppose that because the former is fixed like a post, at the back part of the lungs, therefore an artificial post in front would be useful? Why, we might just as well argue in favor of hanging weights to a door, or a clog to a pendulum, in order to make it swing backwards and forwards more easily. We might almost as well say that the elbow ought to be made firm, to correspond with the shoulders, and thus become advocates for letting the stays or bandages enclose the arm above the elbow, and fasten it firmly to the side. Indeed, the consequences in the latter case, aside from a little inconvenience, would not be half so destructive to health as in the former. The ribs, where they join to the back bone, form hinges; and hinges are made for motion. But if you fasten them to a post in front, of what value are the hinges?

If mothers ask, of what use this motion of the lungs is, it is only necessary to refer them to the chapter on Ventilation, in which I trust the subject is made intelligible, and a satisfactory answer afforded.

But I might appeal to facts. Let us look at females around us generally. Do their countenances indicate that they enjoy as good health as they did when dress was worn more loosely? Have they not oftener a leaden hue, as if the blood in them was darker? Are they not oftener short-breathed than formerly? As they advance in life, have they not more chronic diseases? Are not their chests smaller and weaker? And as the doctrine that if one member suffers, all the other members suffer with it, is not less true in physiology than in morals, do we not find other organs besides the lungs weakened? Surgeons and physicians, who, like faithful sentinels, have watched at their post half a century, tell us, moreover, that if these foolish and injurious practices to which I refer are tolerated two centuries longer, every female will be deformed, and the whole race greatly degenerated, physically and morally.

Those with whom no arguments will avail, are recommended to read the following remarks from the first volume of the Library of Health, p. 119:

"It is related, on the authority of Macgill, that in Tunis, after a girl is engaged, or betrothed, she is then fattened. For this purpose, she is cooped up in a small room, and shackles of gold and silver are placed upon her ancles and wrists, as a piece of dress. If she is to be married to a man who has discharged, despatched, or lost a former wife, the shackles which the former wife wore are put on the new bride's limbs, and she is fed till they are filled up to a proper thickness. The food used for this custom worthy of the barbarians is called drough, which is of an extraordinary fattening quality, and also famous for rendering the milk of the nurse rich and abundant. With this and their national dish, cuscasoo, the bride is literally crammed, and many actually die under the spoon."

We laugh at all this, and well we may; but there are customs not very far from home, no less ridiculous.

"There is a country four or five thousand miles westward of Tunis, where the females, to a very great extent, are emaciated for marriage, instead being fattened. This process is begun, in part, by shackles—not of gold and silver, perhaps, but of wood—but instead of being put on loosely, and causing the body or limbs to fill them, they are made to compress the body in the outset; and as the size of the latter diminishes, the shackles are contracted or tightened. As with the eastern, so with the western females, many of them die under the process; though a far greater number die at a remote period, as the consequence of it."