Imatges de pàgina
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stitution to strumous disease in one or other of its forms, which will in all probability manifest itself at some future period, undoubtedly produced by the delicate state of the parent's health at the time of its suckling. A wet-nurse early resorted to will prevent this.

It will be naturally asked, for how long a period a mother ought to perform the office of a nurse. No specific time can be mentioned; and the only way in which the question can be met is this:-No woman, with advantage to her own health, can suckle her infant beyond twelve months; and at various periods, between the third and twelfth month, many women will be obliged partially or entirely to resign office.

Sect. 6. Weaning.

The time when weaning is to take place must ever depend upon a variety of circumstances, which will regulate this matter, independently of any general rule that can be laid down. The mother's health may, in one case, oblige her to resort to weaning before the sixth month, and, in another instance--the delicacy of the infant's health-to delay it beyond the twelfth. Nevertheless, as a general rule, both child and parent being in good health, weaning ought never to take place earlier than the ninth (the most usual date), and never be delayed beyond the twelfth month.

I should say further, that if child and parent are both in vigorous health, if the infant has cut several of its teeth, and been already accustomed to be partially fed, weaning ought to be gradually accomplished at the ninth month. On the other hand, if the child is feeble in constitution, the teeth late in appearing, and the

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mother is healthy and has a sufficient supply of good milk, especially if it be the winter season, it will be far better to prolong the nursing for a few months. such a case, the fact of the non-appearance of the teeth indicates an unfitness of the system for any other than the natural food from the maternal breast. It should never be effected while the child is suffering under the irritation of teething; it will derange the bowels, and perhaps induce convulsions. And again, if the infant is born of a consumptive parent, and a healthy and vigorous wet-nurse has been provided, weaning should most certainly be deferred beyond the usual time, carefully watching, however, that neither nurse nor child suffer from its continuance.

The mode in which it is to be effected must be gradual. From the sixth month most children are fed twice or oftener in the four-and-twenty hours; the infant is, in fact, therefore, from this time, in the progress of weaning; that is to say, its natural diet is partly changed for an artificial one, so that when the time for complete weaning arrives, it will be easily accomplished, without suffering to the mother or much denial to the child. It is, however, of the greatest importance to regulate the quantity and quality of the food at this time. If too much food is given (and this is the great danger), the stomach will be overloaded, the digestive powers impaired, and, if the child is not carried off suddenly by convulsions, its bowels will become obstinately disordered; it will fall away from not being nourished, and perhaps eventually become a sacrifice to the over-anxious desire of the parent and its friends to promote its welfare. The kind of food proper for this period, and the mode of administering it, are detailed in the section on Artificial Feeding,

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Much exercise in the open air (whenever there is no dampness of atmosphere) is highly necessary at this time; it tends to invigorate the system and to strengthen the digestive organs, and thus enables the latter to bear without injury the alteration in diet.

Sect. 7.-Drying up the Milk.

It may be necessary to dry up or 'backen the milk,' as it is popularly called, directly after delivery, from the delicate health of the mother; from local defect-the nipple, for instance, being too small or obliterated by the pressure of tight stays; and from the death of the infant, or some equally urgent

cause.

Now it is a very frequent practice to apply cold evaporating lotions to the breast for this purpose. It is true they may produce a rapid dispersion of the milk; but they ought never to be resorted to, as they frequently give rise to symptoms of an alarming and dangerous character. The best and safest local application consists in the following liniment :-Compound soap liniment, three ounces; laudanum, three drachms; camphor liniment, one drachm. Or, if this is found too irritating, compound soap liniment alone. Either of these liniments must be applied warm, and constantly, by means of a layer or two of linen or flannel, covered by a piece of oiled silk, and the breast gently rubbed for five or ten minutes, every four or five hours, with warm almond-oil.

Sometimes the skin is so thin and sensitive that even the compound soap liniment proves too stimulating, and covers the breast with an irritable eruption. In these cases bread-and water-poultices must be sub

stituted, but the warm almond-oil must also be used as directed in the former instances.

While the breasts remain only moderately hard, easy and but little distended with milk, they must not be emptied; for this would encourage further secretion, and they would soon fill again. If, however, they become very hard and painful, and give much uneasiness from their distension, they must be partially emptied, so as just to relieve the over-distensionnothing more; and this may be repeated as often as is absolutely necessary. A gentle saline aperient should be taken every morning, and, if necessary, at night, the object being to keep the bowels slightly relaxed. The diet must be very scanty, and only solid nourishment taken. If, however, the thirst is distressing, it must be allayed by frequently washing out the mouth with toast-and-water; and an orange or two, or a few ripe grapes, may be taken in the course of the day. Following up this plan, the distress arising from the extreme distention of the breasts, if present, will be removed, although several days will transpire before the milk is thoroughly dispersed, or the remedies can be discontinued, and a sensation, described by women as of a draught of milk' in the breasts, will sometimes be felt two or three times a day for weeks afterwards.

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In reference to drying up the milk at the time of weaning, from the circumstance of the child being partially fed for some time before it is completely weaned, the mother will experience little trouble in dispersing it. She must, however, not neglect to take opening medicine, not only to assist the foregoing object, but also to prevent that depression of spirits, lassitude, loss of appetite, and general derangement of health which

so frequently follow weaning when these medicines are omitted. If the breast should continue loaded, or indeed painfully distended, not only must the aperient be used to keep the bowels gently relaxed, but the diet must be diminished in quantity, and only solid nourishment taken. The breasts, too, if painfully distended, must be occasionally drawn, but only just sufficiently to relieve the distension; they must also be rubbed for five or ten minutes, every four or five hours, with the following liniment previously warmed :-Compound soap liniment, one ounce and a half; laudanum, three drachms.

Sect. 8.-Wet-nurse Suckling.

Choice of a Wet-nurse.-Ill health and many other circumstances may prevent a parent from suckling her child, and render a wet-nurse necessary. Now, although she will do wisely to leave the choice of one to her medical attendant, still, as some difficulty may attend this, and as the mother herself ought most certainly to be acquainted with the principal points to which his attention is directed in the selection of a good nurse, so it will be well to point out in what they

consist.

The first thing, then, to which a medical man looks, is the general health of the woman; next, the condition of her breast, the quality of her milk; its age, and her own; whether she is ever unwell while nursing; and, last of all, the condition and health of the child.

Is the Woman in good Health ?—Her general appearance ought to betoken a robust constitution, free from all suspicion of a strumous character or any hereditary taint of syphilis, consumption, cancer, and the

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