Imagens das páginas
PDF
ePub

Eathing

Kurly

4.

Thous

[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]

are quite as necessary in young and delicate children (whose skin,
frequently soiled by the natural evacuations, is more liable than under
any other circumstances to become inflamed by contact with them)
as in those who are robust and vigorous, towards whom it does not seem
necessary to adopt these precautions. In all they have for their result
the development of the activity of the perspiratory functions of the skin,
of the constitution, and of the general strength of the individual.

border

Important questions have been raised on the subject of baths, in regard to their frequency and temperature.

In order to strengthen children, it was formerly thought very essential to wash and bathe them in cold water some days after birth, and to continue this plan until rather an advanced age. Hufeland was of this opinion; but he shows himself more scrupulous in the employment of these means, for he recommends waiting until the sixth week before they are put in force. Then, says he, the whole body should be washed every morning with tepid water, which is gradually made colder. This constitutes the best means of strengthening the nervous and cutaneous system, and of preserving children from nervous, catarrhal, and rheumatic affections. It is thus that they become inured to the injurious influences to which they are exposed in the course of their existence.

These ideas have gradually disappeared from the hygiene of children, for the application of them might be prejudicial to many, and especially to the most delicate. Whatever may be the weakness of these little beings, we wish to rear them, and this is accomplished by means of care and precaution. It would be seeking danger uselessly to bathe them too early in cold water, and we must be satisfied with washing the body with water slightly tepid, according to the season, and by means of a toilette sponge. This operation should be rather quickly performed, and immediately followed by gentle frictions on the skin with a fine linen cloth or flannel, so as to absorb the water and prevent the chilling of the body. In the day time, when the child requires changing, it should be again washed, and the linen removed as often as necessary.

Every time the child is washed, after having dried it, the body should be powdered, and especially the neighbourhood of the natural parts, with marechal powder, or by perfumed lycopodium powder. These substances protect the skin against the irritating action of urine and the excremental matters.

Some practitioners recommend the use of daily baths, but this is really carrying the practice of cleanliness too far. When the frequent washings of a child well attended to during the day are considered, the administration of a daily bath may be looked upon as superfluous. MAWe even regard this bath as injurious, for it fatigues and weakens the children rather than strengthens them. A bath of simple water, for twenty minutes, repeated every two days, and even once a week, may

[ocr errors]
[ocr errors][merged small][ocr errors]

Chap. VI.]

ON THE TOILETTE,

57 Once in

suffice. The temperature of the baths should be agreeable and moderate.

In summer they may be given nearly cold, but then they should be

very rapidly accomplished, and prolonged for some minutes only. They dug ir should be 86° Fah. in winter and 68° in summer. Bathing in a river

is only proper for children above the age of five years.

[ocr errors]

k hit.

in

[ocr errors]

The head requires as much, and probably even more care, than the body, for there still exists generally, and especially in persons of the poorer classes, ridiculous prejudices on the subject of the cleanliness of this part. A great number of mothers of families consider the brownish crusts on the head, vermin, and even the various eruptions of the scalp as necessary for the preservation of the health of their children. Many Shom will not have these abominations disturbed. Nevertheless, the parents must be prevailed upon to remove them, so as to avoid the diseases bet of the scalp, impetigo in particular, which invades the ears and the du clean eyes, and produces enlargement of the glands of the neck. the head in a state of cleanliness, it is sufficient to wash it at the same time as the body, with simple water of the same temperature.

To keep

CHAPTER VII.

OF THE INFLUENCE OF ANTECEDENT AND ACTUAL DISEASES
OF THE NURSE ON THE HEALTH OF CHILDREN.

[ocr errors]

I now approach one of the most debated, most difficult, and most important questions in medicine. Its importance will be well under-de stood by those who have made the treatment of children their study. In fact, as we have already seen, it is highly essential to ascertain the former state of the health of mothers and nurses at the time of would making choice of the person who should undertake the lactation of infants. It is not the less necessary to study the diseases of nurses, in order to ascertain their degree of influence over the health of children. In this manner we learn to distinguish the cases in which lactation, should be interrupted from those in which it should be allowed to her dis continue, and the circumstances which may authorize the change of nurse are scientifically determined.

[ocr errors]
[ocr errors]

This subject deserves the greatest attention. Physicians have but very rarely considered it in this manner. All those who, by the depth of their mind and by the extent of their experience, might have enlightened us on this point have not done so, or at least have not it published the results of their researches. The history of hereditary disorders is common enough, but as regards the influence of the diseases of the nurse, little mention is made of them by authors. Few persons have investigated this subject; and the only guide we have in our

labour consists of isolated allusions contained in treatises on midwifery, in researches on the milk, and in the foreign Latin dissertations of Platner, Baldini, Marianini, Wagner, &c. Here and there may also be found vague information on this subject; wonderful histories, always the same, vauntingly repeated by authors with the intention of demonstrating the influence of the moral affections of the nurse. The question is nowhere treated in a special manner, as we should desire to have it treated at the present day. Recently, however, a very conscientious author, M. Donné, has made great progress in this study. This physician, in his researches on the milk,* has described the alterations of this liquid, and has studied the influence which they may have over the health of the children. Further on, we shall refer to these observations, which deserve the greatest attention.

Division of the subject.-In order clearly to understand what follows, we must carefully separate-1st, that which relates to the influence of the antecedent affections of the mother on the health of the children, that is to say, all which relates to hereditary transmission from the mother; 2nd, that which relates to the influence of the actual diseases of the nurse.

In the first case the transmission is but an original vitiation, dating from the day of impregnation; in the second, on the contrary, the vitiation is accidental and takes place by means of lactation. Such are the chief circumstances which constitute the basis of an important division.

We shall then have successively to study-1st, the influence of antecedent diseases of the mother on the constitution of children, so as to corroborate this fact already well known, namely, the transmission of disease by generation; but we shall be brief on this subject. 2nd, we shall then treat of a more important question, relative to the influence of actual diseases of the nurse mother, or of the nurse herself on the nursling. In this place, the diseases of infancy acquired by lactation may be studied. Lastly, we shall conclude (and this will form the end of this chapter) by the recital of the considerations which necessitate the change of nurse.

1ST. INFLUENCE OF ANTECEDENT DISEASES OF THE MOTHER ON THE CONSTITUTION OF HER CHILD.

The facts which relate to hereditary transmission by the mother are in general well known and accepted by all medical men. We can merely refer to them here. They may be classified in the following

manner:

1st. Transmission of physical and moral characteristics, of the features, and of the qualities of the mind.

* Cours de Microscopie; Paris, 1844; pp. 347 et suiv.

2nd. Transmission of vices of organization and of deformities such as myopia, colour of the skin and the hair, the webbed form of some of the toes or fingers, increase in the number of the fingers in sexdigitarians, &c.

3rd. The transmission of the diseases of the pregnant women to the fœtus; small-pox, for example, a fact positively established, and which I have once observed; syphilis-but examples of this kind are rare; they are called connate diseases.

4th. The transmission of certain diseases, the development of which has taken place soon after birth; syphilis and scrofula in all their forms and in all their manifestations; nervous irritability, convulsions, &c. 5th. The transmission of the diseases which only appear at a much later period: gout, gravel, asthma, cancer, &c.

It is useless to insist any longer on these facts, which do not require further proof, and which, moreover, concern us but little at the present moment. It is well to consult them at the time of giving advice about a conjugal alliance, and in the course of the pregnancy, when it is required to know if the mother may undertake the suckling of her child.

Amongst these affections, there is one however-syphilis-which has not been so well studied as the others, and which is, perhaps, more difficult to recognize in children. It is the only one which I feel it necessary to investigate. I shall do it with so much the more advantage, as I can add to the small number of my observations the valuable information that one of my kind friends, Dr. A. Deville, late interne of the Lourcine Hospital, has been so kind as to furnish me. There is no fact better established, better authenticated, and more

[ocr errors]

frequent, than that of the transmission of syphilis by generation. Jack May it originate equally from the father and from the mother? The question is not yet decided, and it may not be for a long time as regards the father. In fact, women are often ignorant of the state of the health of their husband in this respect. They are unable to enlighten the physician who interrogates them. In the hospitals, the father is unknown, and he himself cannot be questioned. In town, we hesitate to put indiscreet questions, which might sometimes disturb domestic, peace. Consequently, everything seems opposed to the possibility of discovering the truth. It is sometimes accomplished, but with great difficulty, and then we run great chances of error, notwithstanding the precautions which have been taken. It is, doubtless, in consequence of these difficulties of observation, that many authors have very indiv incorrectly denied the transmission of syphilis originating from the father. This transmission is probable, and, indeed, quite as real as the transmission of a webbed finger, the colour of the hair, scrofula, &c. As to transmission by the mother, this is a common fact, and one

[ocr errors]

which is daily observed. It is not even rare to find positive examples of transmission of the disease by the mother alone, the father being quite healthy. M. Deville related to me the history of a lady with whose family he was acquainted, who, unfortunately, had chancres and mucous tubercles on the vulva. No general treatment had been pursued, and the local phenomena disappeared. Scarcely recovered, the patient, undoubtedly affected with latent syphilis, married and became pregnant; at the eighth month she was delivered of a dead child, covered with mucous tubercles; the father enjoyed excellent health, and had never had any syphilitic affection, this he affirmed with a frankness and sincerity against which M. Deville could raise no doubt. The woman who transmits syphilis to her child, may find herself, at the time of confinement, in three conditions: 1st, she presents secondary syphilitic symptoms; 2nd, she does not present them at the very moment, but she may have them at a later period; 3rd, she has had them previously.

1st. The mother is affected with secondary syphilis (indurated chancre, mucous tubercle, falling off of the hair, and crusts on the scalp, pains in the head and in the joints, papulæ or pustules, followed or not by ulcerations, &c.) at the time of confinement. These constitute the most decided cases, against which no doubt can be raised, and which the most superficial observation has enumerated from the most distant periods.

2nd. The mother will present at a later period the phenomena of constitutional syphilis; but she was already under the influence of syphilis, she had latent syphilis. Nothing is more common than this. A woman has contracted chancres; almost invariably, if constitutional syphilis results, the chancres becomes transformed in situ into mucous tubercles, or into indurated chancres, and all may stop there. But the patient is now affected with constitutional syphilis, although there may be nothing apparent on the exterior of the body, and if a proper treatment is not applied syphilitic symptoms, easily recognized, will afterwards develop themselves. If in the period which elapses between the time in which a patient has had an indurated chancre or a mucous tubercle and that in which she exhibits other syphilitic symptoms, pregnancy or delivery ensue, there is a probability that the child is infected. This observation has established.

3rd. The mother has had syphilitic symptoms either before pregnancy or before confinement. If a proper treatment has not been pursued, although these symptoms may have disappeared as local and apparent phenomena, the patient is not the less under the influence of constitutional syphilis, which may, at any time, betray itself by the manifestation of fresh syphilitic eruptions or of other external symptoms. It is in these cases especially that she can transmit it to the child.

« AnteriorContinuar »