The Maternal Management Of Children, In Health And Disease Part 21

Sect. X.--WATER IN THE HEAD.

Water in the head is a formidable disease, and not unfrequent in its occurrence. It is often destructive to life, and the instances are numerous in which it has appeared again and again in the same family, carrying off one child after another, as they have successively arrived at the same age.

But notwithstanding its frequency and fearful character, a mother may do much to overcome a const.i.tutional predisposition to this disease, and thus prevent its appearance; as also she may a.s.sist greatly in promoting its cure, when it does occur. Hence it is most important that a mother should be acquainted with the measures of prevention; and also, when it does manifest itself, that clear and accurate information should be possessed, upon what may be said to const.i.tute the maternal management of the disorder.

ITS PREVENTION.--Whenever there is found to exist in a family a predisposition to this malady, one or more children having suffered from it, a mother must make up her mind, and in the strictest sense of the word, to be the guardian of the health of any child she may subsequently give birth to. And not only during the period of infancy, but during that of childhood also, must she continue the same careful and vigilant superintendence.

The infant must be brought up on the breast, and if the mother is not of a decidedly healthy and robust const.i.tution, she must obtain a wet-nurse possessing such qualifications. The breast-milk, and nothing beside, must form the nutriment of the child for at least nine months; and if the infant is delicate or strumous, it will be prudent to continue it even six months longer. When the period arrives for the subst.i.tution of artificial food, it must be carefully selected; it must be appropriate to the advancing age of the child; nutritious and unirritating. Good air and daily exercise, and the bath or sponging, are of much importance; in short, all those general measures which have a tendency to promote and maintain the tone and general health of the system, and thus induce a vigorous and healthy const.i.tution, and to which reference has been so fully made in the first chapter of this work, must be strictly regarded and followed out by the parent.

The condition of the digestive organs must be the mother's especial care. Costiveness must be guarded against; and if at any time the secretions from the bowels indicate the presence of derangement, the medical attendant must be applied to, that appropriate remedies may without delay be exhibited. Their disordered condition is frequently productive of head-disease. Again and again have I clearly traced the origin of the complaint, of which I am now writing, as more immediately resulting from disorder of the digestive apparatus. To a child thus predisposed to water in the head, the healthy state of these organs is not only of first consequence, but any deviation from health to be dreaded, to be immediately attended to, and guarded against in future; and, as there is a great liability to these attacks at the time of weaning, the above remarks especially apply to that period, when due attention must be particularly paid to the plan of diet adopted.

During teething the mother must be especially watchful, for it is at this time that the disease so commonly appears; the irritation produced by this process being a frequent exciting cause. Every thing, therefore, that will tend to allay excitement of the system, must be strictly enforced, as well as all causes avoided, which would produce derangement of the stomach and bowels. The head should be kept cool.

For this purpose it must be sponged night and morning throughout the whole period of teething; a horse-hair pillow used in the cot; and nothing but a light straw hat should be worn, except in winter, The diet should be moderate, and carefully regulated after leaving the breast, and the child should be as much as possible in the open air.

The mouth must be occasionally examined, and if the gums become hot or distended, they must be scarified or lanced, as may be advised. If the parent finds at any time an unusual heat about the head, the medical man must be at once consulted; or if there is watchfulness or indisposition to sleep at the proper periods, or frequent startings in the sleep, irritability of temper, and much crying, danger should be apprehended, and prompt and judicious means employed.

Eruptions about the head, or sores behind the ears, discharging more or less, will sometimes make their appearance just before the cutting of a tooth, and disappear after it is cut; or it will sometimes happen that, if not interfered with, they will continue throughout the whole period of dent.i.tion. Great caution should always be exercised in reference to these eruptions in all children; and when there is a predisposition to water in the head, it is dangerous to interfere with them at all, except they run to such an extent as to become very troublesome. The sudden healing of these cutaneous affections has again and again been followed by head-disease. They are unsightly in the eyes of a parent, but it must be recollected that they render the situation of such children much more safe; and when teething is completed they will generally disappear spontaneously; or, if they should not, they will readily do so by proper medical treatment. I have no doubt that many a child's life has been saved by the appearance and continuance of these eruptions; and so sensible are medical men of the benefit derived from them, that in individuals in whom they do not appear, and in whose family there exists a predisposition to the disease now under our consideration, an issue or seton, in the arm or neck, has sometimes been made, and had a remarkable influence in warding off this affection. Dr. Cheyne refers to the circ.u.mstance of ten children in one family having died of this disease; the eleventh, for whom this measure was employed, having been preserved.

Stimulants, throughout the whole period of infancy and childhood, and of every description, must be prohibited. Children nursed by drunken parents, and who have indulged in the use of spirituous liquors during suckling, are never healthy; are the frequent subjects of convulsions, and many of them die eventually of water in the head. The practice of administering spirits to the child itself; a habit unfortunately not very uncommon among the lower cla.s.ses; produces a similar result.

Narcotics may operate in a like manner: they derange the whole system when persevered in, particularly affecting the brain; promote disease; and sometimes give rise to the one in question. This remark should be borne in mind by the mother, as G.o.dfrey's Cordial and other preparations of opium are too often kept in the nursery, and secretly given by unprincipled nurses to quiet a restless and sick child.

All causes of mental excitement should be carefully avoided, and particularly the too early or excessive exercise of the intellectual faculties. If the child be endowed with a precocious intellect, the parent must restrain rather than encourage its exercise. Nothing is more likely to light up this disease in a const.i.tution predisposed to it, than a premature exertion of the brain itself.

MATERNAL MANAGEMENT OF THE DISEASE.--The early detection of this disease is of great importance. The chances that the medical treatment will terminate successfully much depend upon the early and prompt application of remedial means. The reason why these cases have so often terminated fatally has arisen from the physician being consulted when irremediable mischief had already taken place. It would be difficult, however, to point out the signs of its approach in all its forms (for this disease does not always commence in the same way, sometimes with fever, etc.), still it most frequently occurs preceded by certain striking and well-marked symptoms; and whenever the following are noticed by the parent apprehensive of mischief, she should at once send for her medical adviser:--watchfulness, or starting from sleep with a cry of alarm; prolonged screaming without any obvious cause; moaning and drowsiness; rolling the head from side to side on the nurse's arm, or thrusting it back against the pillow; knitting the brows and aversion from light, with heat of head, and constant carrying the little hand up to it; half closing the eyelids, and frequent vomiting.

The chief and princ.i.p.al point in the maternal management (for it includes every other) is promptly and faithfully to administer the remedies prescribed by the medical attendant. A vigilant maternal superintendence is more necessary in this than almost any other disease; and it is highly desirable, therefore, that the mother should have a day and night nurse--individuals upon whom she can depend. A careful notice of symptoms and changes in the patient, in the intervals of the medical man's visits, and a true and faithful report to him upon his return, are of essential importance. A sleepy nurse will neglect the application of the most important remedies, and necessarily give an unfaithful report of symptoms; hours the most valuable to the child's well-doing are thus lost, and the chances of saving its life worse than problematical.

The temperature of the room should be kept rather cool than warm, and the bed-clothes only sufficient to preserve the natural heat of the body. Strong light must be excluded. Great quiet should be observed.

Freedom from all excitement of the senses, and irritation of the temper, should be carefully avoided: this is particularly necessary where the child is naturally of a quick and sensitive disposition.

All the excretions must be put aside for the inspection of the physician, but not kept in the sick chamber, which must be well aired, and perfectly free from closeness. The regimen must be only such as is ordered, and any departure therefrom will be attended with mischievous consequences. During the early periods of the disease, all that is required are cooling diluents, given frequently, and in small quant.i.ties at a time; and upon approaching convalescence great carefulness must be paid to the amount of nourishment allowed, lest the disease be rekindled: strict compliance, therefore, to medical directions must be given.

A very useful and indeed powerful remedy prescribed in this disease, is sometimes rendered utterly useless from a want of a persevering and also proper mode of applying it, viz. cold applications to the head.

It is to be effected either by means of cloths kept constantly wet with cold water, or evaporating lotions; or by means of a bladder containing pounded ice mixed with water. If the two former are employed they require frequent renewal, or they become dry, hot, and more injurious than useful; and whichever is used, it must be kept in constant contact with the forehead, temples, and upper part of the head. Here is another error; they are seldom used large enough, and only partially cover these parts. With the further view of keeping the head cool, and preventing the acc.u.mulation of heat, a flat horse-hair pillow should be employed, and the head and shoulders somewhat raised.

Perseverance in the measures prescribed, even when the case appears beyond all hope, must ever be the rule of conduct. Recovery, even in the most advanced periods of the disease, in cases apparently desperate, occasionally takes place. There is great reason to fear that many a child has been lost from a want of proper energy and perseverance on the part of the attendants in the sick room. They fancy the case is hopeless, and, to use their own expression, "they will not torment the child with medicine or remedies any longer."

"Whilst there is life, there is hope," is a sentiment which may with great truth be applied to all the diseases of infancy and childhood.

Striking, indeed, are the recoveries which occasionally present themselves to the notice of medical men; and those individuals may with great justice be charged with unpardonable neglect who do not persevere in the employment of the remedies prescribed, even up to the last hours of the child's existence.

INDEX.

Ablution, or sponging, 125.

Abstinence, its good effect, in flatulence and griping in the infant, 50. 226.

Accidents and diseases which may occur to the infant at birth or soon after, 187.

Acids, injurious to the teeth, 159.

Air and exercise, in infancy, 83.

--, in childhood, 89.

--, its importance to the mother whilst a nurse, 33.

Animal food, in childhood, 55.

--, its injurious effects upon the young and delicate child, 58.

Aperient liniment, 107.

--, medicine, 97.

--, poultice, 104.

Artificial feeding; the causes rendering it necessary, 34.

Artificial food; the proper kind for the child before the sixth month, 35.

--; the mode of administering it, 39.

--; the quant.i.ty to be given at each meal, 42.

--; the frequency of giving it, 43.

--; the posture of the child when fed, 43.

--; the proper kind for the child after the sixth month, to the completion of first dent.i.tion, 44.

--; the kind most suitable under the different complaints to which infants are liable, 48.

Bath, the cold-water, plunge-bath, 118.

--, the shower, 123.

--, the warm, 128.

--, rules for the use of the warm bath, 131.

Bathing, sea, 120.

--, and cleanliness, during infancy, 72.

--, during childhood, 75.

Bleeding, from leech-bites, how controlled, 113.

--, from the navel string, 201.

--, navel, 203.

Blisters, mode of application, 114.

Bottle, nursing, 40.