Chapter 9. Young Children...--Infants...

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_ CHAPTER IX

SECTION I.--Of Gripes and Pains in the Bellies of Young Children.

This I mention first, as it is often the first and most common distemper which happens to little infants, after their birth; many children being so troubled therewith, that it causes them to cry day and night and at last die of it. The cause of it for the most part comes from the sudden change of nourishment, for having always received it from the umbilical vessel whilst in the mother's womb, they come on a sudden not only to change the manner of receiving it, but the nature and quality of what they received, as soon as they are born; for instead of purified blood only, which was conveyed to them by means of the umbilical vein, they are now obliged to be nourished by their mother's milk, which they suck with their mouths, and from which are engendered many excrements, causing gripes and pains; and not only because it is not so pure as the blood with which it was nourished in the womb, but because the stomach and the intestines cannot make a good digestion, being unaccustomed to it. It is sometimes caused also by a rough phlegm, and sometimes by worms; for physicians affirm that worms have been bred in children even in their mother's belly.

Cure. The remedy must be suited to the cause. If it proceed from the too sudden change of nourishment, the remedy must be to forbear giving the child suck for some days, lest the milk be mixed with phlegm, which is then in the stomach corrupt; and at first it must suck but little, until it is accustomed to digest it. If it be the excrements in the intestines, which by their long stay increase their pains, give them at the month a little oil of sweet almonds and syrup of roses; if it be worms, lay a cloth dipped in oil of wormwood mixed with ox-gall, upon the belly, or a small cataplasm, mixed with the powder of rue, wormwood, coloquintida, aloes, and the seeds of citron incorporated with ox-gall and the powder of lupines. Or give it oil of sweet almonds and syrup of roses; if it be worms, lay a cloth, dipped in oil of wormwood mixed with ox-gall, upon the belly, or a small cataplasm mixed with the powder of rue, wormwood, coloquintida, aloes, and the seeds of citron incorporated with ox-gall and the powder of lupines. Or give it oil of sweet almonds with sugar-candy, and a scruple of aniseed; it purgeth new-born babes from green cholera and stinking phlegm, and, if it be given with sugar-pap, it allays the griping pains of the belly. Also anoint the belly with oil of dill, or lay pelitory stamped with oil of camomile to the belly.

 

SECT. II.--Of Weakness In Newly-born Infants.

Weakness is an accident that many children bring into the world along with them, and is often occasioned by the labour of the mother; by the violence and length whereof they suffer so much, that they are born with great weakness, and many times it is difficult to know whether they are alive or dead, their body appearing so senseless, and their face so blue and livid, that they seem to be quite choked; and even after some hours, then-showing any signs of life is attended with weakness, that it looks like a return from death, and that they are still in a dying condition.

Cure. Lay the infant speedily in a warm blanket, and carry it to the fire, and then let the midwife take a little wine in her mouth and spout it into its mouth, repeating it often, if there be occasion. Let her apply linen dipped in urine to the breast and belly, and let the face be uncovered, that it may breathe the more freely; also, let the midwife keep its mouth a little open, cleanse the nostrils with small linen tents[11] dipt in white wine, that so it may receive the smell of it; and let her chafe every part of its body well with warm cloths, to bring back its blood and spirits, which being retired inwards through weakness, often puts him in danger of being choked. By the application of these means, the infant will gradually recover strength, and begin to stir its limbs by degrees, and at length to cry; and though it be but weakly at first, yet afterwards, as it breathes more freely, its cry will become more strong.

 

SECT. III.--Of the Fundament being closed up in a newly-born Infant.

Another defect that new-born infants are liable to is, to have their fundaments closed up, by which they can neither evacuate the new excrements engendered by the milk they suck, nor that which was amassed in their intestines before birth, which is certainly mortal without a speedy remedy. There have been some female children who have their fundaments quite closed, and yet have voided the excrements of the guts by an orifice which nature, to supply the defect, had made within the neck of the womb.

Cure. Here we must take notice, that the fundament is closed two ways; either by a single skin, through which one may discover some black and blue marks, proceeding from the excrements retained, which, if one touch with the finger, there is a softness felt within, and thereabout it ought to be pierced; or else it is quite stopped by a thick, fleshy substance, in such sort that there appears nothing without, by which its true situation may be known. When there is nothing but the single skin which makes the closure, the operation is very easy, and the children may do very well; for then an aperture or opening may be made with a small incision-knife, cross-ways, that it may the better receive a round form, and that the place may not afterwards grow together, taking care not to prejudice the sphincter or muscle of the rectum. The incision being thus made, the excrements will certainly have issue. But if, by reason of their long stay in the belly, they become so dry that the infant cannot void them, then let a clyster be given to moisten and bring them away; afterwards put a linen tent into the new-made fundament, which at first had best be anointed with honey of roses, and towards the end, with a drying, cicatrizing ointment, such as unguentum album or ponphilex, observing to cleanse the infant of its excrement, and dry it again as soon and as often as it evacuates them, that so the aperture may be prevented from turning into a malignant ulcer.

But if the fundament be stopped up in such a manner, that neither mark nor appearance of it can be seen or felt, then the operation is much more difficult, and, even when it is done, the danger is much greater that the infant will not survive it. Then, if it be a female, and it sends forth its excrements by the way I mentioned before, it is better not to meddle than, by endeavouring to remedy an inconvenience, run an extreme hazard of the infant's death. But when there is no vent for the excrements, without which death is unavoidable, then the operation is justifiable.

Operation. Let the operator, with a small incision-knife that hath but one edge, enter into the void place, and turning the back of it upwards, within half a finger's breadth of the child's rump, which is the place where he will certainly find the intestines, let him thrust it forward, that it may be open enough to give free vent to matter there contained, being especially careful of the sphincter; after which, let the wound be dressed according to the method directed.

 

SECT. IV.--Of the Thrush, or Ulcers In the Mouth of the Infant.

The thrush is a distemper that children are very subject to, and it arises from bad milk, or from foul humour in the stomach; for sometimes, though there be no ill humour in the milk itself, yet it may corrupt the child's stomach because of its weakness or some other indisposition; in which, acquiring an acrimony, instead of being well digested, there arise from it thrice biting vapours, which forming a thick viscosity, do thereby produce this distemper.

Cure. It is often difficult, as physicians tell us, because it is seated in hot and moist places, where the putrefaction is easily augmented; and because the remedies applied cannot lodge there, being soon washed with spittle. But if it arises from too hot quality in the nurse's milk, care must be taken to temper and cool, prescribing her cool diet, bleeding and purging her also, if there be occasion.

Take lentils, husked, powder them, and lay a little of them upon the child's gums. Or take bdellium flowers, half an ounce, and with oil of roses make a liniment. Also wash the child's mouth with barley and plantain-water, and honey of roses, mixing with them a little verjuice of lemons, as well to loosen and cleanse the vicious humours which cleave to the inside of the infant's mouth, as to cool those parts which are already over-heated. It may be done by means of a small fine rag, fastened to the end of a little stick, and dipped therein, wherewith the ulcers may be gently rubbed, being careful not to put the child in too much pain, lest an inflammation make the distemper worse. The child's body must also be kept open, that the humours being carried to the lower parts, the vapours may not ascend, as is usual for them to do when the body is costive, and the excrements too long retained.

If the ulcers appear malignant, let such remedies be used as do their work speedily, that the evil qualities that cause them, being thereby instantly corrected, their malignity may be prevented; and in this case, touch the ulcers with plantain water, sharpened with spirits of vitriol; for the remedy must be made sharp, according to the malignity of the distemper. It will be necessary to purge these ill humours out of the whole habit of the child, by giving half an ounce of succory and rhubarb.

 

SECT. V.--Of Pains in the Ears, Inflammation, Moisture, etc.

The brain in infants is very moist, and hath many excrements which nature cannot send out at the proper passages; they get often to the ears, and there cause pains, flux of blood, with inflammation and matter with pain; this in children is hard to be known as they have no other way to make it known but by constant crying; you will perceive them ready to feel their ears themselves, but will not let others touch them, if they can prevent; and sometimes you may discern the parts about the ears to be very red.

These pains, if let alone, are of dangerous consequences, because they may bring forth watchings and epilepsy; for the moisture breeds worms there, and fouls the spongy bones, and by degrees causes incurable deafness.

Cure. Allay the pain with all convenient speed, but have a care of using strong remedies. Therefore, only use warm milk about the ears, with the decoction of poppy tops, or oil of violets; to take away the moisture, use honey of roses, and let aqua mollis be dropped into the ears; or take virgin honey, half an ounce; red wines two ounces; alum, saffron, saltpetre, each a drachm, mix them at the fire; or drop in hemp seed oil with a little wine.

 

SECT. VI.--Of Redness and Inflammation of the Buttocks, Groin and the Thighs of a Young Child.

If there be no great care taken to change and wash the child's bed as soon as it is fouled with the excrements, and to keep the child very clean, the acrimony will be sure to cause redness, and beget a smarting in the buttocks, groin and thighs of the child, which, by reason of the pain, will afterwards be subject to inflammations, which follow the sooner, through the delicacy and tenderness of their skin, from which the outward skin of the body is in a short time separated and worn away.

Cure. First, keep the child cleanly, and secondly, take off the sharpness of its urine. As to keeping it cleanly, she must be a sorry nurse who needs to be taught how to do it; for if she lets it but have dry, warm and clean beds and cloths, as often and as soon as it has fouled and wet them, either by its urine or its excrements, it will be sufficient. And as to taking off the sharpness of the child's urine, that must be done by the nurse's taking a cool diet, that her milk may have the same quality; and, therefore, she ought to abstain from all things that may tend to heat it.

But besides these, cooling and drying remedies are requisite to be applied to the inflamed parts; therefore let the parts be bathed in plantain-water, with a fourth of lime water added to it, each time the child's excrements are wiped off; and if the pain be very great, let it only be fomented with lukewarm milk. The powder of a post to dry it, or a little mill-dust strewed upon the parts affected, may be proper enough, and is used by many women. Also, unguentum album, or diapompholigos, spread upon a small piece of leather in form of a plaster, will not be amiss.

But the chief thing must be, the nurse's taking great care to wrap the inflamed parts with fine rags when she opens the child, that these parts may not gather and be pained by rubbing together.

 

SECT. VII.--Of Vomiting in Young Children.

Vomiting in young children proceeds sometimes from too much milk, and sometimes from bad milk, and as often from a moist, loose stomach; for as dryness retains so looseness lets go. This is, for the most part, without danger in children; for they that vomit from their birth are the lustiest; for the stomach not being used to meat, and milk being taken too much, crudities are easily bred, or the milk is corrupted; and it is better to vomit these up than to keep them in; but if vomiting last long, it will cause an atrophy or consumption, for want of nourishment.

Cure. If this be from too much milk, that which is emitted is yellow and green, or otherwise ill-coloured and stinking; in this case, mend the milk, as has been shown before; cleanse the child with honey of roses, and strengthen its stomach with syrup of milk and quinces, made into an electuary. If the humours be hot and sharp, give the syrup of pomegranates, currants and coral, and apply to the belly the plaster of bread, the stomach cerate, or bread dipped in hot wine; or take oil of mastich, quinces, mint, wormwood, each half an ounce; of nutmegs by expression, half a drachm; chemical oil of mint, three drops. Coral hath an occult property to prevent vomiting, and is therefore hung about the neck.

 

SECT. VIII--Of Breeding Teeth in Young Children.

This is a very great and yet necessary evil in all children, having variety of symptoms joined with it. They begin to come forth, not all at once, but one after the other, about the sixth or seventh month; the fore-teeth coming first, then the eye-teeth, and last of all the grinders. The eye-teeth cause more pain to the child than any of the rest, because they have a deep root, and a small nerve which has communication with that which makes the eye move.

In the breeding of the teeth, first they feel an itching in their gums, then they are pierced as with a needle, and pricked by the sharp bones, whence proceed great pains, watching, inflammation of the gums, fever, looseness and convulsions, especially when they breed their eye-teeth.

The signs when children breed their eye-teeth are these:

1. It is known by the time, which is usually about the seventh month.

2. Their gums are swelled, and they feel a great heat there with an itching, which makes them put their fingers into their mouths to rub them; a moisture also distils from the gums into the mouth, because of the pain they feel there.

3. They hold the nipple faster than before.

4. The gums are white when the teeth begin to come, and the nurse, in giving them suck, finds the mouth hotter, and that they are much changed, crying every moment, and cannot sleep, or but very little at a time.

The fever that follows breeding of teeth comes from choleric humours, inflamed by watching, pain and heat. And the longer teeth are breeding, the more dangerous it is; so that many in the breeding of them, die of fevers and convulsions.

Cure. Two things are to be regarded:--one is, to preserve the child from the evil accidents that may happen to it by reason of the great pain; the other, to assist as much as may be, the cutting of the teeth, when they can hardly cut the gums themselves.

For the first of these, viz., the preventing of those accidents to the child, the nurse ought to take great care to keep a good diet, and to use all things that may cool and temper her milk, that so a fever may not follow the pain of the teeth. And to prevent the humour falling too much upon the inflamed gums, let the child's belly be always kept loose by gentle clysters, if he be bound; though oftentimes there is no need of them, because they are at those times usually troubled with a looseness; and yet, for all that, clysters may not be improper.

As to the other, which is to assist it cutting the teeth, that the nurse must do from time to time by mollifying and loosening them, and by rubbing them with her finger dipped in butter or honey; or let the child have a virgin-wax candle to chew upon; or anoint the gums with the mucilage of quince made with mallow-water, or with the brains of a hare; also foment the cheeks with the decoction of althoea, and camomile flowers and dill, or with the juice of mallows and fresh butter. If the gums are inflamed, add juice of nightshade and lettuce. I have already said, the nurse ought to take a temperate diet; I shall now only add, that barley-broth, water-gruel, raw eggs, prunes, lettuce and endive, are good for her; but let her avoid salt, sharp, biting and peppered meats, and wine.

 

SECT. IX.--Of the Flux of the Betty, or Looseness in Infants.

It is very common for infants to have the flux of the belly, or looseness, especially upon the least indisposition; nor is it to be wondered at, seeing their natural moistness contributes so much thereto; and even if it be extraordinarily violent, such are in a better state of health than those that are bound. The flux, if violent, proceeds from divers causes, as 1. From breeding of the teeth, and is then commonly attended with a fever in which the concoction is hindered, and the nourishment corrupted. 2. From watching. 3. From pain. 4. From stirring up of the humours by a fever. 5. When they suck or drink too much in a fever. Sometimes they have a flux without breeding of teeth, from inward cold in the guts or stomach that obstructs concoction. If it be from the teeth, it is easily known; for the signs of breeding in teeth will discover it. If it be from external cold, there are signs of other causes. If from a humour flowing from the head there are signs of a catarrh, and the excrements are frothy. If crude and raw humours are voided, and there be wind, belching, and phlegmatic excrements, or if they be yellow, green and stink, the flux is from a hot and sharp humour. It is best in breeding of teeth when the belly is loose, as I have said before; but if it be too violent, and you are afraid it may end in a consumption, it must be stopped; and if the excrements that are voided be black, and attended with a fever, it is very bad.

Cure. The remedy in this case, is principally in respect to the nurse, and the condition of the milk must be chiefly observed; the nurse must be cautioned that she eat no green fruit, nor things of hard concoction. If the child suck not, remove the flux with such purges as leave a cooling quality behind them, as syrup of honey or roses, or a clyster. Take the decoction of millium, myrobolans, of each two or three ounces, with an ounce or two of syrup of roses, and make a clyster. After cleansing, if it proceed from a hot cause, give syrup of dried roses, quinces, myrtles and a little sanguis draconis. Also anoint with oil of roses, myrtles, mastich, each two drachms; with oil of myrtles and wax make an ointment. Or take red roses and moulin, of each a handful; cypress roots two drachms; make a bag, boil it in red wine and apply it to the belly. Or use the plaster bread or stomach ointment. If the cause be cold, and the excrements white give syrup of mastich and quinces, with mint-water. Use outwardly, mint, mastich, cummin; or take rose seeds, an ounce, cummin, aniseed, each two drachms; with oil of mastich, wormwood and wax, make an ointment.

 

SECT. X.--Of the Epilepsy and Convulsions in Children.

This is a distemper that is often fatal to young children, and frequently proceeds from the brain, originating either from the parents, or from vapours, or bad humours that twitch the membranes of the brain; it is also sometimes caused by other distempers and by bad diet; likewise, the toothache, when the brain consents, causes it, and so does a sudden fright. As to the distemper itself, it is manifest and well enough known where it is; and as to the cause whence it comes, you may know by the signs of the disease, whether it comes from bad milk, or worms, or teeth; if these are all absent, it is certain that the brain is first affected; if it come with the small-pox or measles, it ceaseth when they come forth, if nature be strong enough.

Cure. For the remedy of this grievous, and often mortal distemper, give the following powder to prevent it, to a child as soon as it is born:--Take male peony roots, gathered in the decrease of the moon, a scruple; with leaf gold make a powder; or take peony roots, a drachm; peony seeds, mistletoe of the oak, elk's hoof, man's skull, amber, each a scruple; musk, two grains; make a powder. The best part of the cure is taking care of the nurse's diet, which must be regular, by all means. If it be from corrupt milk, provoke a vomit; to do which, hold down the tongue, and put a quill dipped in sweet almonds, down the throat. If it come from the worms, give such things as will kill the worms. If there be a fever, with respect to that also, give coral smaragad and elk's hoof. In the fit, give epileptic water, as lavender water, and rub with oil of amber, or hang a peony root, and elk's hoof smaragad, about the child's neck.

As to a convulsion, it is when the brain labours to cast out that which troubles it; the mariner is in the marrow of the back, and fountain of the nerves; it is a stubborn disease, and often kills.

Wash the body, when in the fit, with decoction of althoea, lily roots, peony and camomile flowerets, and anoint it with man's and goose's grease, oils of worms, orris, lilies, foxes, turpentine, mastich, storax and calamint. The sun flower is also very good, boiled in water, to wash the child.

 

FOOTNOTES:

[11] Tent (_surgical_). A bunch of some fibre such as sponge or horsehair introduced into an opening, natural or artificial, to keep it open, or increase its calibre.

[THE END]
Aristotle's Book: Experienced Midwife

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